0000950170-25-062263 | 10-Q | XBRL Viewer | Brightspring Health Services INC

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Discontinued Operations - Summary of the Significant Non-cash Items and Purchases of Property and Equipment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Cash flows from discontinued operations operating activities [Abstract]
Share-based compensation	$ 15,681	$ 24,848
Community Living Business \| Discontinued Operations
Cash flows from discontinued operations operating activities [Abstract]
Depreciation and amortization	1,329	9,686
Share-based compensation	3,207	1,262
Impairment of long-lived assets		1,437
Cash flows from discontinued operations investing activities [Abstract]
Purchases of property and equipment	$ 3,044	$ 2,607

Fair Value

3 Months Ended

Mar. 31, 2025

Fair Value Disclosures [Abstract]

Fair Value

12. Fair Value

Assets and liabilities measured at fair value are based on one or more of the following three valuation techniques:

Market approach: Prices and other relevant information generated by market transactions involving identical or comparable assets or liabilities.

Cost approach: Amount that would be required to replace the service capacity of an asset (replacement cost).

Income approach: Techniques to convert future amounts to a single present amount based upon market expectations (including present value techniques, option-pricing and excess earnings models).

Assets and Liabilities Measured at Fair Value on a Recurring Basis

The financial assets or liabilities recorded at fair value on a recurring basis are set forth in the table below (in thousands):


	March 31, 2025		December 31, 2024		Valuation Technique
Assets:
Interest rate swaps (Level 2)	$	6,330	$	10,633	A
Total assets	$	6,330	$	10,633

Liabilities:
Contingent consideration (Level 3)	$	10,084	$	8,386	C
Total liabilities	$	10,084	$	8,386

The fair values of our interest rate swaps are based upon Level 2 inputs, which include valuation models. The key inputs for the valuation models are quoted market prices, interest rates, forward yield curves, and credit risk adjustments that are necessary to reflect the probability of default by the counterparty or us. For disclosures about the fair value measurements of our derivative instruments, refer to Note 6.

The contingent consideration represents future earn-outs and a post-closing equity adjustment feature, both associated with acquisitions, which are recognized as a component of the purchase price at the estimated fair value on the acquisition date. These liabilities are classified as accrued expenses and long-term liabilities in our accompanying unaudited condensed consolidated balance sheets.

The fair values of the liabilities associated with future earn outs were derived using the income approach with unobservable inputs, including future earnings forecasts and present value assumptions, and there was little or no market data (Level 3). The Company will re-assess the fair values on each reporting period thereafter until settlement.

The fair value of the liability associated with post-closing equity adjustment feature related to the Haven Hospice acquisition was derived with unobservable inputs using a Monte Carlo simulation, where the common stock price of the Company was evolved using a Geometric Brownian Motion of a period from the valuation date to the end of the fourth anniversary of closing. Estimated equity volatility was based on historical volatility, implied volatility, and peer group volatility over various periods. The Company will re-assess the fair value at each reporting period with changes in value being recorded through the statement of operations. The ultimate settlement of the liability will be through either issuance of additional equity shares and/or additional cash paid in case of net realized losses on sales; or reduction of the outstanding balance of the seller note, in the case of net aggregate realized gain on sales up to the amounts previously paid.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Earnings Per Share ("EPS") - Summary of Shares Excluded from Computation of Diluted Net Income (Loss) Per Share (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares excluded from computation of diluted net loss per share	1,422	24,202
Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares excluded from computation of diluted net loss per share	1,422	15,583
RSUs
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares excluded from computation of diluted net loss per share	0	4,037
TEUs
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares excluded from computation of diluted net loss per share	0	4,582

Acquisitions

3 Months Ended

Mar. 31, 2025

Business Combinations [Abstract]

Acquisitions

4. Acquisitions

2025 Acquisition

During the three months ended March 31, 2025, we completed an acquisition within the Provider Services segment on January 1, 2025. We entered into the transaction in order to expand our services and geographic offerings. Aggregate consideration for the acquisition was approximately $6.8 million. No cash was acquired as a part of this transaction. The operating results of the acquisition are included in our unaudited condensed consolidated financial statements from the date of the acquisition.

The following table summarizes the consideration paid (in thousands) for the 2025 acquisition, and the estimated fair value of the assets acquired and the liabilities assumed at the acquisition date, which are adjusted for immaterial measurement-period adjustments through March 31, 2025.


Goodwill	$	6,400
Intangible asset		400
Accrued expenses		46
Aggregate purchase price	$	6,754

The Company is in the process of reviewing the fair value of the assets acquired and liabilities assumed. We have estimated the fair value of the acquired intangible asset based upon the values assigned in prior acquisitions that were deemed comparable in nature. Based on the Company’s preliminary valuations, the total estimated consideration has been allocated to assets acquired and liabilities assumed as of the acquisition date.

The intangible asset consists of a $0.4 million covenants not to compete and has an estimated useful life of 5.0 years. We expect all of the goodwill will be deductible for tax purposes. The Company believes the resulting amount of goodwill reflects its expectation of synergistic benefits of the acquisition.

The above acquisition contributed approximately $0.8 million in revenue and $0.3 million in operating income during the three months ended March 31, 2025. Pro forma financial data for the 2025 acquisition has not been included as the results of the operations are not material to our unaudited condensed consolidated financial statements.

During the three months ended March 31, 2025, the Company incurred approximately $0.1 million in transaction costs related to the acquisition completed in 2025. These costs are included in selling, general, and administrative expenses in our unaudited condensed consolidated statements of operations.

2024 Acquisitions

During the year ended December 31, 2024, we completed eight acquisitions within the Pharmacy Solutions and Provider Services segments. We entered these transactions in order to expand our services and geographic offerings. Aggregate consideration net of cash acquired for these acquisitions was approximately $110.6 million. The operating results of these acquisitions are included in our unaudited condensed consolidated financial statements from the respective dates of the acquisition.

Haven Hospice

The following table summarizes the consideration paid (in thousands) for the September 1, 2024 acquisition of North Central Florida Hospice, Inc. (“Haven Hospice”) and the fair value of the assets acquired and the liabilities assumed at the acquisition date, which are adjusted for immaterial measurement-period adjustments through March 31, 2025. Haven Hospice provides hospice and palliative care services in the state of Florida. Its results are consolidated within the Provider Services segment.


Inventories	$	45
Property and equipment		495
Goodwill		45,114
Intangible assets		19,860
Operating lease right-of-use assets		7,157
Trade accounts payable		764
Current portion of obligations under operating leases		2,235
Obligations under operating leases, net of current portion		4,922
Aggregate purchase price	$	64,750

Consideration for the Haven Hospice acquisition included a $15.0 million cash payment, $15.0 million seller note payable in 2028, and $30.0 million of the Company's common stock equal to 2,471,251 shares. The number of shares was calculated by dividing $30.0 million by a price per share equal to the average of the volume weighted average trading price of the Company's common stock on each of the fifteen consecutive trading days ending on and including the trading day that is three trading days prior to the closing date, as required by the asset purchase agreement. The sellers are restricted from trading during a 180-day lock-up period from closing with agreed-upon sale volume limitations for four years thereafter. The asset purchase agreement also includes a post-closing adjustment feature to the extent any losses are incurred by the sellers in the sale of their common stock for four years following closing with a final equity adjustment feature. See Note 12.

The intangible assets consist of $14.8 million in indefinite-lived licenses and $5.1 million of trade name. The fair value of acquired licenses and trade name were based upon a third-party valuation. The trade name has an estimated useful life of 10.0 years. We expect all of the goodwill will be deductible for tax purposes. The Company believes the resulting amount of goodwill reflects its expectation of synergistic benefits of the acquisition.

Haven Hospice contributed $15.9 million in revenue and $1.2 million of operating income during the three months ended March 31, 2025. The Haven Hospice acquisition was not completed until the third fiscal quarter of 2024, as such it did not contribute any revenue or operating income during the three months ended March 31, 2024. Pro forma financial data for the Haven Hospice acquisition has not been included as the results of the operations are not material to our unaudited condensed consolidated financial statements.

Others

The following table summarizes the consideration paid (in thousands) for 2024 acquisitions, excluding Haven Hospice, and the estimated fair value of the assets acquired and the liabilities assumed at the acquisition dates, which are adjusted for immaterial measurement-period adjustments through March 31, 2025. Consideration for acquisitions by the Pharmacy Solutions and Provider Services segments was $27.0 million and $18.9 million, respectively.


Accounts receivable	$	3,749
Inventories		1,234
Prepaid expenses and other current assets		174
Property and equipment		398
Goodwill		17,814
Intangible assets		31,233
Operating lease right-of-use assets		364
Other assets		1,438
Trade accounts payable		650
Accrued expenses		7,750
Current portion of obligations under operating leases		56
Current portion of obligations under financing leases		53
Obligations under operating leases, net of current portion		308
Obligations under financing leases, net of current portion		8
Deferred income taxes, net		1,686
Aggregate purchase price, net of cash acquired	$	45,893

The Company is in the process of reviewing the fair value of the assets acquired and liabilities assumed. We have estimated the fair value of acquired customer relationships, licenses, trade names, and covenants not to compete based upon third-party valuations and/or the values assigned in prior acquisitions that were deemed comparable in nature. Based on the Company’s preliminary valuations, the total estimated consideration has been allocated to assets acquired and liabilities assumed as of the acquisition dates.

The estimated intangible assets consist primarily of $22.3 million in customer relationships, $5.7 million in definite-lived licenses, $2.1 million in indefinite-lived licenses, $0.6 million in covenants not to compete, and $0.5 million in trade names. Definite-lived intangible assets have an estimated weighted average useful life of 14.9 years. We expect $12.0 million of the goodwill will be deductible for tax purposes. The Company believes the resulting amount of goodwill reflects its expectation of synergistic benefits of the acquisitions.

The above acquisitions contributed approximately $19.1 million in revenue and $1.3 million in operating income during the three months ended March 31, 2025, compared to $0.8 million in revenue and $0.1 million in operating income during the three months ended March 31, 2024. Pro forma financial data for the 2024 acquisitions has not been included as the results of the operations are not material to our unaudited condensed consolidated financial statements.

Measurement period adjustments for all aforementioned acquisitions completed in 2024 recorded in the three months ended March 31, 2025 were not material to the unaudited condensed consolidated financial statements. The Company expects to finalize the purchase price allocation for the 2024 acquisitions prior to the one-year anniversary date of each acquisition.

During the three months ended March 31, 2024, the Company incurred approximately $0.6 million in transaction costs related to 2024 acquisitions that were completed in subsequent quarters of 2024. These costs are included in selling, general, and administrative expenses in our unaudited condensed consolidated statements of operations.

The Company also agreed to purchase the remaining 30% noncontrolling interest in Gateway Pediatric Therapy, LLC during the first fiscal quarter of 2024 and the remaining 45% noncontrolling interest in Harvest Grove LTC, LLC during the third fiscal quarter of 2024. These transactions did not meet the definition of a business combination in accordance with ASC 805, Business Combinations.

Commitments and Contingencies	3 Months Ended
Mar. 31, 2025
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	13. Commitments and Contingencies Legal Proceedings On March 4, 2011, Relator Marc Silver, on behalf of the U.S. Government and various state governments, filed a complaint in the United States District Court for the District of New Jersey (“the District Court”) against PharMerica, seeking relief, with respect to alleged violations of the federal False Claims Act and state false claims acts. The U.S. Government and state governments declined to intervene in the case. The District Court issued an order dismissing the case in full in 2016. In 2018, however, the Third Circuit Court of Appeals issued an order reinstating the case. In June 2023, the District Court issued an order setting a trial date of December 4, 2023. In November 2023, the District Court denied our motion for summary judgment and the Company subsequently agreed to settle the matter without admitting liability. On May 29, 2024, the parties entered into a final settlement agreement, which was approved by both the United States Department of Justice and the District Court. The total financial impact of the settlement was $120.0 million; $110.0 million of which was paid during the year ended December 31, 2024, with the remaining $10.0 million in accrued expenses in the unaudited condensed consolidated balance sheet as of March 31, 2025, which was paid in April 2025. The District Court entered an order dismissing the Silver action in its entirety, with prejudice, on July 3, 2024. The Company is also party to various legal and/or administrative proceedings arising out of the operation of our programs and arising in the ordinary course of business. We record accruals for such contingencies to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. We do not believe the ultimate liability, if any, for outstanding proceedings or claims, individually or in the aggregate, in excess of amounts already provided, will have a material adverse effect on our consolidated financial condition, results of operations, or cash flows. It is reasonably possible that an adverse determination might have an impact on a particular period. While we believe our provision for legal contingencies is adequate, the outcome of legal proceedings is difficult to predict, and we may settle legal claims or be subject to judgments for amounts that exceed our estimates.

Commitments and Contingencies

3 Months Ended

Mar. 31, 2025

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

13. Commitments and Contingencies

Legal Proceedings

On March 4, 2011, Relator Marc Silver, on behalf of the U.S. Government and various state governments, filed a complaint in the United States District Court for the District of New Jersey (“the District Court”) against PharMerica, seeking relief, with respect to alleged violations of the federal False Claims Act and state false claims acts. The U.S. Government and state governments declined to intervene in the case. The District Court issued an order dismissing the case in full in 2016. In 2018, however, the Third Circuit Court of Appeals issued an order reinstating the case. In June 2023, the District Court issued an order setting a trial date of December 4, 2023. In November 2023, the District Court denied our motion for summary judgment and the Company subsequently agreed to settle the matter without admitting liability. On May 29, 2024, the parties entered into a final settlement agreement, which was approved by both the United States Department of Justice and the District Court.

The total financial impact of the settlement was $120.0 million; $110.0 million of which was paid during the year ended December 31, 2024, with the remaining $10.0 million in accrued expenses in the unaudited condensed consolidated balance sheet as of March 31, 2025, which was paid in April 2025. The District Court entered an order dismissing the Silver action in its entirety, with prejudice, on July 3, 2024.

The Company is also party to various legal and/or administrative proceedings arising out of the operation of our programs and arising in the ordinary course of business. We record accruals for such contingencies to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. We do not believe the ultimate liability, if any, for outstanding proceedings or claims, individually or in the aggregate, in excess of amounts already provided, will have a material adverse effect on our consolidated financial condition, results of operations, or cash flows. It is reasonably possible that an adverse determination might have an impact on a particular period. While we believe our provision for legal contingencies is adequate, the outcome of legal proceedings is difficult to predict, and we may settle legal claims or be subject to judgments for amounts that exceed our estimates.

Debt and Derivatives - Schedule of Interest Rate Swap with Notional Value (Details) - USD ($)
$ in Millions

3 Months Ended

Mar. 31, 2025

Dec. 31, 2024

Derivative [Line Items]

Derivative, notional amount

$ 2,000

Existing contracts | Credit Suisse

Derivative [Line Items]

Derivative, description of terms

3-year period ending September 30, 2025

Derivative, inception date

Sep. 30, 2022

Derivative, maturity term

3 years

Derivative, maturity date

Sep. 30, 2025

Derivative, notional amount

$ 500

500

Fixed rate

3.4165%

Existing contracts | Morgan Stanley

Derivative [Line Items]

Derivative, description of terms

3-year period ending September 30, 2025

Derivative, inception date

Sep. 30, 2022

Derivative, maturity term

3 years

Derivative, maturity date

Sep. 30, 2025

Derivative, notional amount

$ 1,050

1,050

Fixed rate

3.42%

Existing contracts | Credit Agricole Corporate and Investment Bank

Derivative [Line Items]

Derivative, description of terms

3-year period ending September 30, 2025

Derivative, inception date

Sep. 30, 2022

Derivative, maturity term

3 years

Derivative, maturity date

Sep. 30, 2025

Derivative, notional amount

$ 450

Fixed rate

3.5241%

Forward Starting Contracts

Derivative [Line Items]

Derivative, notional amount

^[1]

$ 1,000

Forward Starting Contracts | Credit Agricole Corporate and Investment Bank

Derivative [Line Items]

Derivative, description of terms

1-year period ending September 30, 2026

Derivative, inception date

Mar. 17, 2025

Derivative, maturity term

1 year

Derivative, maturity date

Sep. 30, 2026

Derivative, notional amount

$ 500

Fixed rate

3.725%

Forward Starting Contracts | Mizuho Capital Markets

Derivative [Line Items]

Derivative, description of terms

1-year period ending September 30, 2026

Derivative, inception date

Mar. 28, 2025

Derivative, maturity term

1 year

Derivative, maturity date

Sep. 30, 2026

Derivative, notional amount

$ 500

Fixed rate

3.611%

[1]

During the first fiscal quarter of 2025, we enter into two forward starting interest rate swap agreements, each with a $500 million notional amount, to hedge the cash flow risk of variability in interest payment on our variable rate borrowings. The effective date of the forward starting interest rate swap agreements is September 30, 2025. As of March 31, 2025, these contracts meet the criteria of a cash flow hedge.

Earnings Per Share ("EPS") - Additional Information (Details) - $ / shares	Mar. 31, 2025	Mar. 31, 2024
Maximum
Earnings per Share [Line Items]
Average applicable market value	$ 15.28
Maximum \| TEUs
Earnings per Share [Line Items]
Average applicable market value		$ 13
Minimum
Earnings per Share [Line Items]
Average applicable market value	13
Minimum \| TEUs
Earnings per Share [Line Items]
Average applicable market value	$ 15.28

Fair Value (Tables)

3 Months Ended

Mar. 31, 2025

Fair Value Disclosures [Abstract]

Summary of Financial Assets or Liabilities Recorded at Fair value on Recurring Basis

The financial assets or liabilities recorded at fair value on a recurring basis are set forth in the table below (in thousands):


	March 31, 2025		December 31, 2024		Valuation Technique
Assets:
Interest rate swaps (Level 2)	$	6,330	$	10,633	A
Total assets	$	6,330	$	10,633

Liabilities:
Contingent consideration (Level 3)	$	10,084	$	8,386	C
Total liabilities	$	10,084	$	8,386

Common Stock, Preferred Stock, and Share-Based Compensation - Additional Information (Details) $ / shares in Units, $ in Millions		3 Months Ended
	Jan. 24, 2024	Mar. 31, 2025 USD ($) $ / shares shares	Dec. 31, 2024 $ / shares shares	Jan. 25, 2024 shares	Dec. 31, 2023 shares
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock split ratio	15.7027
Stock split description		15.7027-for-one
Common Stock, par value \| $ / shares		$ 0.01	$ 0.01
Preferred Stock , par value \| $ / shares		$ 0.01	$ 0.01
Common Stock, shares authorized \| shares		1,500,000,000	1,500,000,000	8,750,000	137,398,625
Preferred Stock, shares authorized \| shares		250,000,000	250,000,000
Incremental share-based compensation expense recognized		$ 1.4
2024 Equity Incentive Plan
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Recognizing of costs related to new equity awards granted		8.1
2017 Stock Plan
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Unrecognized share-based compensation expense		$ 15.0

Revenue - Additional Information (Details)	3 Months Ended
Revenue - Additional Information (Details)	Mar. 31, 2025 Customer
Customer Concentration Risk \| Revenue
Product Information [Line Items]
Number of customer whose revenue was 10% or more of consolidated revenue	0

Discontinued Operations (Tables)

3 Months Ended

Mar. 31, 2025

Discontinued Operations and Disposal Groups [Abstract]

Summary of the Financial Results, Aggregate Carrying Amounts of Assets and Liabilities Held for Sale and Significant Non-cash Items and Purchases of Property and Equipment

The following table presents the financial results of the Community Living business (in thousands):


	For the Three Months Ended
	March 31,
	2025		2024
Services revenue	$	299,106	$	290,872
Cost of services		204,183		213,972
Gross profit		94,923		76,900
Selling, general, and administrative expenses		60,744		53,498
Operating income of discontinued operations		34,179		23,402
Interest expense, net		7,907		10,550
Income of discontinued operations before incomes taxes		26,272		12,852
Income tax expense of discontinued operations		6,478		3,210
Income from discontinued operations, net of income taxes	$	19,794	$	9,642

The following table presents the aggregate carrying amounts of assets and liabilities held for sale for the Community Living business in the unaudited condensed consolidated balance sheets (in thousands):


	March 31, 2025		December 31, 2024
Assets
Current assets:
Cash and cash equivalents	$	305	$	299
Accounts receivable, net of allowance for credit losses		124,737		125,872
Inventories		3,631		4,007
Prepaid expenses and other current assets		3,276		1,269
Total current assets held for sale		131,949		131,447
Property and equipment, net of accumulated depreciation of $110,728 and $110,417 at March 31, 2025 and December 31, 2024, respectively		72,839		69,715
Goodwill		307,640		307,640
Intangible assets, net of accumulated amortization		216,331		216,258
Operating lease right-of-use assets, net		101,651		88,717
Deferred income taxes, net		287		287
Other assets		5,486		5,343
Total assets held for sale	$	836,183	$	819,407
Liabilities
Current liabilities:
Trade accounts payable	$	17,629	$	17,366
Accrued expenses		59,235		60,791
Current portion of obligations under operating leases		32,863		30,755
Current portion of obligations under financing leases		8,419		8,651
Total current liabilities held for sale		118,146		117,563
Obligations under operating leases, net of current portion		60,389		58,147
Obligations under financing leases, net of current portion		17,160		18,461
Long-term liabilities		553		569
Total liabilities held for sale	$	196,248	$	194,740

The following table presents the significant non-cash items and purchases of property and equipment for the discontinued operations that are included in the accompanying unaudited condensed consolidated statements of cash flows (in thousands):


	For the Three Months Ended
	March 31,
	2025		2024
Cash flows from discontinued operations operating activities:
Depreciation and amortization	$	1,329	$	9,686
Share-based compensation		3,207		1,262
Impairment of long-lived assets		—		1,437

Cash flows from discontinued operations investing activities:
Purchases of property and equipment		3,044		2,607

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section 50
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-SubTopic 10
-Topic 360
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Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
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-SubTopic 20
-Name Accounting Standards Codification
-Section 45
-Paragraph 11
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-URI https://asc.fasb.org/1943274/2147483475/205-20-45-11

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 205
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-Name Accounting Standards Codification
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Reference 11: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 360
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-Name Accounting Standards Codification
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Reference 12: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 13: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 205
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-URI https://asc.fasb.org/1943274/2147483499/205-20-50-3

+ Details

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Mar. 31, 2025
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Detail of Certain Balance Sheet Accounts - Schedule of Long-Term Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Disclosure Text Block Supplement [Abstract]
Workers compensation insurance reserves	$ 24,280	$ 25,360
General and professional liability insurance reserves	22,319	21,182
Automobile insurance reserves	10,546	9,034
Contingent consideration	4,750	5,250
Employee incentives	3,493	3,993
Interest rate swaps	818	0
Deferred gain	462	195
Other	5,917	6,176
Total long-term liabilities	$ 72,585	$ 71,190

Revenue - Schedule of Revenue by Payor Type (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Disaggregation of Revenue [Line Items]
Revenue	$ 2,878,129	$ 2,285,766
Commercial Insurance
Disaggregation of Revenue [Line Items]
Revenue	715,900	545,500
Medicaid
Disaggregation of Revenue [Line Items]
Revenue	323,300	270,000
Medicare A
Disaggregation of Revenue [Line Items]
Revenue	262,800	234,700
Medicare B
Disaggregation of Revenue [Line Items]
Revenue	21,000	23,800
Medicare C
Disaggregation of Revenue [Line Items]
Revenue	520,300	357,100
Medicare D
Disaggregation of Revenue [Line Items]
Revenue	910,900	756,300
Private and Other
Disaggregation of Revenue [Line Items]
Revenue	123,900	98,400
Pharmacy Solutions
Disaggregation of Revenue [Line Items]
Revenue	2,532,200	1,977,000
Pharmacy Solutions \| Commercial Insurance
Disaggregation of Revenue [Line Items]
Revenue	674,500	504,400
Pharmacy Solutions \| Medicaid
Disaggregation of Revenue [Line Items]
Revenue	238,200	187,300
Pharmacy Solutions \| Medicare A
Disaggregation of Revenue [Line Items]
Revenue	140,400	129,400
Pharmacy Solutions \| Medicare B
Disaggregation of Revenue [Line Items]
Revenue	19,500	16,900
Pharmacy Solutions \| Medicare C
Disaggregation of Revenue [Line Items]
Revenue	487,700	336,900
Pharmacy Solutions \| Medicare D
Disaggregation of Revenue [Line Items]
Revenue	910,900	756,300
Pharmacy Solutions \| Private and Other
Disaggregation of Revenue [Line Items]
Revenue	61,000	45,800
Provider Services
Disaggregation of Revenue [Line Items]
Revenue	345,900	308,800
Provider Services \| Commercial Insurance
Disaggregation of Revenue [Line Items]
Revenue	41,400	41,100
Provider Services \| Medicaid
Disaggregation of Revenue [Line Items]
Revenue	85,100	82,700
Provider Services \| Medicare A
Disaggregation of Revenue [Line Items]
Revenue	122,400	105,300
Provider Services \| Medicare B
Disaggregation of Revenue [Line Items]
Revenue	1,500	6,900
Provider Services \| Medicare C
Disaggregation of Revenue [Line Items]
Revenue	32,600	20,200
Provider Services \| Private and Other
Disaggregation of Revenue [Line Items]
Revenue	$ 62,900	$ 52,600
Product Concentration Risk \| Revenue
Disaggregation of Revenue [Line Items]
% of Revenue	100.00%	100.00%
Product Concentration Risk \| Revenue \| Commercial Insurance
Disaggregation of Revenue [Line Items]
% of Revenue	24.80%	23.90%
Product Concentration Risk \| Revenue \| Medicaid
Disaggregation of Revenue [Line Items]
% of Revenue	11.30%	11.80%
Product Concentration Risk \| Revenue \| Medicare A
Disaggregation of Revenue [Line Items]
% of Revenue	9.20%	10.30%
Product Concentration Risk \| Revenue \| Medicare B
Disaggregation of Revenue [Line Items]
% of Revenue	0.80%	1.00%
Product Concentration Risk \| Revenue \| Medicare C
Disaggregation of Revenue [Line Items]
% of Revenue	18.00%	15.60%
Product Concentration Risk \| Revenue \| Medicare D
Disaggregation of Revenue [Line Items]
% of Revenue	31.60%	33.10%
Product Concentration Risk \| Revenue \| Private and Other
Disaggregation of Revenue [Line Items]
% of Revenue	4.30%	4.30%
Product Concentration Risk \| Revenue \| Pharmacy Solutions
Disaggregation of Revenue [Line Items]
% of Revenue	88.00%	86.50%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Commercial Insurance
Disaggregation of Revenue [Line Items]
% of Revenue	23.40%	22.10%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicaid
Disaggregation of Revenue [Line Items]
% of Revenue	8.30%	8.20%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicare A
Disaggregation of Revenue [Line Items]
% of Revenue	4.90%	5.70%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicare B
Disaggregation of Revenue [Line Items]
% of Revenue	0.70%	0.70%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicare C
Disaggregation of Revenue [Line Items]
% of Revenue	16.90%	14.70%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Medicare D
Disaggregation of Revenue [Line Items]
% of Revenue	31.60%	33.10%
Product Concentration Risk \| Revenue \| Pharmacy Solutions \| Private and Other
Disaggregation of Revenue [Line Items]
% of Revenue	2.20%	2.00%
Product Concentration Risk \| Revenue \| Provider Services
Disaggregation of Revenue [Line Items]
% of Revenue	12.00%	13.50%
Product Concentration Risk \| Revenue \| Provider Services \| Commercial Insurance
Disaggregation of Revenue [Line Items]
% of Revenue	1.40%	1.80%
Product Concentration Risk \| Revenue \| Provider Services \| Medicaid
Disaggregation of Revenue [Line Items]
% of Revenue	3.00%	3.60%
Product Concentration Risk \| Revenue \| Provider Services \| Medicare A
Disaggregation of Revenue [Line Items]
% of Revenue	4.30%	4.60%
Product Concentration Risk \| Revenue \| Provider Services \| Medicare B
Disaggregation of Revenue [Line Items]
% of Revenue	0.10%	0.30%
Product Concentration Risk \| Revenue \| Provider Services \| Medicare C
Disaggregation of Revenue [Line Items]
% of Revenue	1.10%	0.90%
Product Concentration Risk \| Revenue \| Provider Services \| Private and Other
Disaggregation of Revenue [Line Items]
% of Revenue	2.10%	2.30%

Earnings Per Share ("EPS") (Tables)

3 Months Ended

Mar. 31, 2025

Earnings Per Share [Abstract]

Summary of Basic and Diluted Net Income (Loss) Per Share

The following table sets forth the computation of basic and diluted net income (loss) per share attributable to common shareholders (in thousands, except per share amounts):


	For the Three Months Ended
	March 31,
	2025			2024
Numerator:
Net income (loss) from continuing operations	$	9,216		$	(56,027	)
Less: Net loss attributable to noncontrolling interests		(532	)		(635	)
Net income (loss) from continuing operations attributable to common shareholders		9,748			(55,392	)
Net income from discontinued operations		19,794			9,642
Net income (loss) attributable to common shareholders	$	29,542		$	(45,750	)

Denominator:
Weighted-average shares outstanding - basic		201,005			175,531

Effect of dilutive securities:
Stock options		8,055			—
RSUs		5,867			—
TEUs		—			—
Weighted-average shares outstanding - diluted		214,927			175,531

Basic income (loss) per share attributable to common shareholders:
Continuing operations	$	0.05		$	(0.31	)
Discontinued operations	$	0.10		$	0.05
Net income (loss)	$	0.15		$	(0.26	)

Diluted income (loss) per share attributable to common shareholders:
Continuing operations	$	0.05		$	(0.31	)
Discontinued operations	$	0.09		$	0.05
Net income (loss)	$	0.14		$	(0.26	)

Summary of Shares Excluded from Computation of Diluted Net Income (Loss) Per Share

The following potentially common share equivalents were excluded from the computation of diluted net income (loss) per share because their effect would have been anti-dilutive for the periods presented (in thousands):


	For the Three Months Ended
	March 31,
	2025		2024
Stock options		1,422		15,583
RSUs		—		4,037
TEUs		—		4,582
Total		1,422		24,202

Detail of Certain Balance Sheet Accounts - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Disclosure Text Block Supplement [Abstract]
Wages and payroll taxes	$ 113,490	$ 98,245
Checks in excess of cash balance	36,680	27,643
Workers compensation insurance reserves	24,672	19,966
Compensated absences	24,639	24,360
Health insurance reserves	18,383	14,934
Legal settlements and professional fees	12,569	13,982
Deferred revenue	8,730	10,196
General and professional liability insurance reserves	6,669	8,328
Contingent consideration	5,334	3,136
Automobile insurance reserves	3,303	21,353
Interest	1,838	8,779
Taxes other than income taxes	1,551	1,985
Recoupment fees	177	536
Other	44,555	42,303
Total accrued expenses	$ 302,590	$ 295,746

Income Taxes (Tables)

3 Months Ended

Mar. 31, 2025

Income Tax Disclosure [Abstract]

Schedule of Reconciliation of Effective Tax Rate

A reconciliation of the Company’s effective tax rate is as follows:


	For the Three Months Ended
	March 31,
	2025			2024
Estimated annual effective tax rate before discrete items		25.7	%		37.9	%
Discrete items recognized		(28.4	)%		(5.8	)%
Effective tax rate recognized in the statements of operations		(2.7	)%		32.1	%

Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2025	Apr. 30, 2025
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Central Index Key	0001865782
Document Fiscal Period Focus	Q1
Document Period End Date	Mar. 31, 2025
Document Fiscal Year Focus	2025
Document Quarterly Report	true
Document Transition Report	false
Entity File Number	001-41938
Entity Registrant Name	BrightSpring Health Services, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	82-2956404
Entity Address, Address Line One	805 N. Whittington Parkway
Entity Address, City or Town	Louisville
Entity Address, State or Province	KY
Entity Address, Postal Zip Code	40222
City Area Code	502
Local Phone Number	394-2100
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding (in shares)		174,245,248
Common Stock
Document Information [Line Items]
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	BTSG
Security Exchange Name	NASDAQ
6.75% Tangible Equity Unit [Member]
Document Information [Line Items]
Title of 12(b) Security	6.75% Tangible Equity Units
Trading Symbol	BTSGU
Security Exchange Name	NASDAQ

Significant Accounting Policies - Additional Information (Details)
$ / shares in Units, $ in Thousands

1 Months Ended

3 Months Ended

Jan. 31, 2024

USD ($)

Unit

$ / shares

$ / Unit

Mar. 31, 2024

USD ($)

Summary Of Significant Accounting Policy [Line Items]

Tangible equity units issued | Unit

8,000,000

Tangible equity units, stated price per unit | $ / Unit

Net proceeds from tangible equity units issuance

$ 389,000

Net proceeds from offering

$ 656,485

Common Stock

Summary Of Significant Accounting Policy [Line Items]

Shares issued | shares

^[1]

53,333,334

Net proceeds from offering

$ 656,500

Common Stock | Initial Public Offering

Summary Of Significant Accounting Policy [Line Items]

Shares issued | shares

53,333,334

Common stock price per share | $ / shares

$ 13

[1]	Issuance of common stock on initial public offering is presented net of underwriting discounts and commissions, and offering-related expenses of $36.8 million.

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Operating activities:
Net income (loss)	$ 29,010	$ (46,385)
Adjustments to reconcile net income (loss) to cash provided by (used in) operating activities:
Depreciation and amortization	42,161	48,922
Impairment of long-lived assets	3,411	1,769
Change in fair value of contingent consideration, net	1,698
Provision for credit losses	8,101	6,622
Amortization of deferred debt issuance costs	2,749	4,447
Share-based compensation	15,681	24,848
Deferred income taxes, net	4,031	(31,732)
Loss on extinguishment of debt		12,726
(Gain) loss on disposition of fixed assets	(287)	122
Other	161	(312)
Change in operating assets and liabilities, net of acquisitions and dispositions:
Accounts receivable	(79,449)	(115,576)
Prepaid expenses and other current assets	23,973	8,916
Inventories	103,300	30,485
Trade accounts payable	(53,871)	21,605
Accrued expenses	8,643	(43,430)
Other assets and liabilities	(7,714)	(1,886)
Net cash provided by (used in) operating activities	101,598	(78,859)
Investing activities:
Purchases of property and equipment	(17,632)	(21,816)
Acquisitions of businesses	(6,754)	(9,394)
Other	195	272
Net cash used in investing activities	(24,191)	(30,938)
Financing activities:
Long-term debt borrowings		2,566,000
Long-term debt repayments	(11,792)	(3,359,353)
Proceeds from issuance of common stock on initial public offering, net		656,485
Proceeds from issuance of tangible equity units, net		389,000
Repayments of the Revolving Credit Facility, net	(63,300)	(50,700)
Payment of debt issuance costs		(42,963)
Repurchase of shares of common stock		(325)
Proceeds from shares issued under share-based compensation plan	345
Taxes paid related to net share settlement of equity awards	(2,763)
Purchase of redeemable noncontrolling interest	(5,100)	(300)
Payment of financing lease obligations	(3,408)	(3,081)
Net cash (used in) provided by financing activities	(86,018)	154,763
Net (decrease) increase in cash and cash equivalents	(8,611)	44,966
Cash and cash equivalents at beginning of year	61,253	13,071
Cash and cash equivalents at beginning of period	52,642	58,037
Cash and cash equivalents included in assets held for sale at end of period	305	2,494
Cash and cash equivalents included in continuing operations at end of period	52,337	55,543
Supplemental disclosures of cash flow information:
Interest, net	53,799	60,282
Income taxes, net of refunds	245	11,186
Supplemental schedule of non-cash investing and financing activities:
Financing lease obligations	3,408	3,004
Repurchases of common stock in accounts payable		325
Purchases of property and equipment in accounts payable	$ 10,416	937
Consideration for purchase of redeemable noncontrolling interest in accounts payable		$ 5,100

Acquisitions - Additional Information (Details)		3 Months Ended		12 Months Ended
Acquisitions - Additional Information (Details)	Sep. 01, 2024 USD ($) shares	Mar. 31, 2025 USD ($) Acquisitions	Mar. 31, 2024 USD ($)	Dec. 31, 2024 USD ($) Acquisitions
Pharmacy Solutions
Business Acquisition [Line Items]
Consideration transferred to asset acquired		$ 27,000,000
Provider Services
Business Acquisition [Line Items]
Consideration transferred to asset acquired		18,900,000
Haven Hospice, Inc.
Business Acquisition [Line Items]
Consideration transferred to asset acquired	$ 64,750,000
Cash payment	15,000,000
Business combination seller note payable	$ 15,000,000
Shares issued for payment of acquisition, shares \| shares	2,471,251
Shares issued for payment of acquisition	$ 30,000,000
Share value calculated	$ 30,000,000
Sellers restriction trading lock up period	180 days
Proforma revenue		15,900,000
Proforma operating income		1,200,000
Haven Hospice, Inc. \| Indefinite-lived Licenses
Business Acquisition [Line Items]
Estimated intangible assets	$ 14,800,000
Haven Hospice, Inc. \| Trade Names
Business Acquisition [Line Items]
Estimated intangible assets	$ 5,100,000
Definite-lived intangible assets estimated weighted average useful life	10 years
2024 Acquisitions
Business Acquisition [Line Items]
Consideration transferred to asset acquired				$ 110,600,000
2024 Acquisitions \| Pharmacy Solutions and Provider Services
Business Acquisition [Line Items]
Number of businesses acquired \| Acquisitions				8
2025 Acquisition
Business Acquisition [Line Items]
Consideration transferred to asset acquired		6,754,000
Estimated intangible assets		$ 400,000
Definite-lived intangible assets estimated weighted average useful life		5 years
Cash acquired from acquisition		$ 0
Proforma revenue		800,000
Proforma operating income		300,000
Transaction costs		$ 100,000
2025 Acquisition \| Provider Services
Business Acquisition [Line Items]
Number of businesses acquired \| Acquisitions		1
Pharmacy Solutions and Provider Services Segments
Business Acquisition [Line Items]
Consideration transferred to asset acquired				$ 45,893,000
Definite-lived intangible assets estimated weighted average useful life				14 years 10 months 24 days
Proforma revenue		$ 19,100,000	$ 800,000
Proforma operating income		$ 1,300,000	100,000
Estimated goodwill deductible for tax				$ 12,000,000
Transaction costs			$ 600,000
Pharmacy Solutions and Provider Services Segments \| Indefinite-lived Licenses
Business Acquisition [Line Items]
Estimated intangible assets				2,100,000
Pharmacy Solutions and Provider Services Segments \| Definite-lived Licenses
Business Acquisition [Line Items]
Estimated intangible assets				5,700,000
Pharmacy Solutions and Provider Services Segments \| Customer Relationships
Business Acquisition [Line Items]
Estimated intangible assets				22,300,000
Pharmacy Solutions and Provider Services Segments \| Trade Names
Business Acquisition [Line Items]
Estimated intangible assets				500,000
Pharmacy Solutions and Provider Services Segments \| Covenants Not to Compete
Business Acquisition [Line Items]
Estimated intangible assets				$ 600,000

Income Taxes - Schedule of Reconciliation of Effective Tax Rate (Details)	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Income Tax Disclosure [Abstract]
Discrete items recognized	(28.40%)	(5.80%)
Effective tax rate recognized in the statements of operations	(2.70%)	32.10%

Detail of Certain Balance Sheet Accounts - Schedule of Other Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Disclosure Text Block Supplement [Abstract]
Notes receivable	$ 10,112	$ 8,577
Insurance recoveries	7,385	7,564
Cloud computing	6,526	7,362
Deposits	5,689	6,733
Deferred debt issuance costs	2,293	2,470
Equity method investments	650	670
Other assets	5,624	5,752
Total other assets	$ 38,279	$ 39,128

- Definition

This item represents the carrying amount on the entity's balance sheet of its investment in common stock of an equity method investee. This is not an indicator of the fair value of the investment, rather it is the initial cost adjusted for the entity's share of earnings and losses of the investee, adjusted for any distributions (dividends) and other than temporary impairment (OTTI) losses recognized.

+ References + Details

Goodwill and Intangible Assets (Tables)

3 Months Ended

Mar. 31, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Summary of Changes to Goodwill, by Reportable Segment

A summary of changes to goodwill, by reportable segment, is as follows (in thousands):


	Goodwill
	Pharmacy Solutions		Provider Services			Total
Goodwill at January 1, 2025*	$	841,052	$	1,522,832		$	2,363,884
Goodwill added through acquisitions		—		6,400			6,400
Measurement period adjustments		—		(279	)		(279	)
Foreign currency adjustments		—		19			19
Goodwill at March 31, 2025*	$	841,052	$	1,528,972		$	2,370,024

* For the periods presented, the carrying amount of goodwill is presented net of accumulated impairment losses of $40.9 million.

Schedule of Intangible Assets

Intangible assets are as follows (in thousands):


	March 31, 2025						December 31, 2024
	Gross		Accumulated Amortization		Net Carrying Value		Gross		Accumulated Amortization		Net Carrying Value		Life (Years)
Customer relationships	$	540,935	$	349,417	$	191,518	$	542,137	$	335,647	$	206,490	5-20
Trade names		332,977		146,113		186,864		332,977		140,020		192,957	2-20
Licenses		62,801		16,837		45,964		68,425		17,528		50,897	10-20
Doctor/payor network		5,650		4,426		1,224		12,730		10,965		1,765	5-8
Covenants not to compete		7,890		4,996		2,894		8,790		5,886		2,904	2-7
Other intangible assets		10,940		6,753		4,187		10,940		6,362		4,578	5-7
Total definite-lived assets	$	961,193	$	528,542	$	432,651	$	975,999	$	516,408	$	459,591
Licenses		135,633		—		135,633		135,633		—		135,633	Indefinite
Total intangible assets	$	1,096,826	$	528,542	$	568,284	$	1,111,632	$	516,408	$	595,224

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 24
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482548/350-20-55-24

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
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-Subparagraph (h)
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+ Details

Segment Information - Schedule of Segment Reporting Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Reconciliation of income or loss:
Segment depreciation and amortization	$ 42,161	$ 48,922
Expenses not allocated at segment level:
Income (loss) from continuing operations, net of income taxes	9,216	(56,027)
Operating Segments
Reconciliation of income or loss:
Total Segment EBITDA	166,806	134,929
Segment depreciation and amortization	34,277	32,992
Material Reconciling Items
Expenses not allocated at segment level:
Selling, general, and administrative expenses	75,235	111,028
Depreciation and amortization	6,555	6,244
Loss on extinguishment of debt		12,726
Interest expense, net	41,763	54,470
Income tax benefit	$ (240)	$ (26,504)

Segment Information (Tables)

3 Months Ended

Mar. 31, 2025

Segment Reporting [Abstract]

Schedule of Segment Reporting Information

The following tables set forth information about the Company’s reportable segments, along with the items necessary to reconcile the segment information to the totals reported in the Company’s unaudited condensed consolidated statements of operations as follows (in thousands):


	For the Three Months Ended March 31, 2025
	Pharmacy Solutions		Provider Services		Total Segments
Products revenue	$	2,532,171	$	—	$	2,532,171
Services revenue		—		345,958		345,958
Cost of drugs		2,147,576		—		2,147,576
Cost of services		—		211,545		211,545
Other direct costs (1)		180,639		—		180,639
Segment selling, general, and administrative expenses (2)		115,738		90,102		205,840
Segment depreciation and amortization expense (3)		27,508		6,769		34,277
Segment EBITDA	$	115,726	$	51,080	$	166,806


	For the Three Months Ended March 31, 2024
	Pharmacy Solutions		Provider Services		Total Segments
Products revenue	$	1,977,035	$	—	$	1,977,035
Services revenue		—		308,731		308,731
Cost of drugs		1,657,759		—		1,657,759
Cost of services		—		186,175		186,175
Other direct costs (1)		149,341		—		149,341
Segment selling, general, and administrative expenses (2)		109,010		81,544		190,554
Segment depreciation and amortization expense (3)		27,249		5,743		32,992
Segment EBITDA	$	88,174	$	46,755	$	134,929

(1)

Other direct costs primarily includes direct labor costs, delivery costs, insurance, and depreciation and amortization expense that relates to revenue-generating assets.

(2)

Segment selling, general, and administrative expense includes direct labor costs, depreciation and amortization, insurance, rent, lease, supplies, professional services, maintenance, repairs, utilities, and communications expense.

(3)

Total segment depreciation and amortization expense is presented in other direct costs, costs of services, and segment general and administrative expenses, based on the associated asset.


	For the Three Months Ended
	March 31,
	2025			2024
Reconciliation of income or loss:
Total Segment EBITDA	$	166,806		$	134,929
Segment depreciation and amortization		34,277			32,992
Expenses not allocated at segment level:
Selling, general, and administrative expenses		75,235			111,028
Depreciation and amortization		6,555			6,244
Loss on extinguishment of debt		—			12,726
Interest expense, net		41,763			54,470
Income tax benefit		(240	)		(26,504	)
Net income (loss) from continuing operations	$	9,216		$	(56,027	)

Discontinued Operations - Summary of the Financial Results of the Community Living Business (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income from discontinued operations, net of income taxes	$ 19,794	$ 9,642
Community Living Business \| Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Services revenue	299,106	290,872
Cost of services	204,183	213,972
Gross profit	94,923	76,900
Selling, general, and administrative expenses	60,744	53,498
Operating income of discontinued operations	34,179	23,402
Interest expense, net	7,907	10,550
Income of discontinued operations before incomes taxes	26,272	12,852
Income tax expense of discontinued operations	6,478	3,210
Income from discontinued operations, net of income taxes	$ 19,794	$ 9,642

Debt and Derivatives (Tables)

3 Months Ended

Mar. 31, 2025

Debt Disclosure [Abstract]

Schedule of Total Outstanding Debt

The table below summarizes the total outstanding debt of the Company (in thousands):


	March 31, 2025					December 31, 2024
	Rate			$		Rate			$
First Lien Incremental Term Loan Tranche B-5 - payable to lenders at SOFR plus applicable margin		6.82	%	$	2,540,404		6.86	%	$	2,546,787
Revolving Credit Loans - payable to lenders at SOFR plus applicable margin		7.32	%		—		7.61	%		—
Swingline/Base Rate - payable to lenders at ABR plus applicable margin		9.50	%		—		9.75	%		63,300
Amortizing Notes (1)					48,399					53,804
Notes payable and other					19,424					19,428
Total debt					2,608,227					2,683,319
Less: debt issuance costs, net					70,163					72,736
Total debt, net of debt issuance costs					2,538,064					2,610,583
Less: current portion of long-term debt					48,725					48,725
Total long-term debt, net of current portion				$	2,489,339				$	2,561,858

(1)

See Note 7 for discussion of Amortizing Notes.

Schedule of Interest Rate Swap with Notional Value


		Notional Amount as of
Financial Institution	Date entered into	March 31, 2025			December 31, 2024			Effective Dates	Fixed Rates
Credit Suisse	September 30, 2022	$	500	million	$	500	million	3-year period ending September 30, 2025		3.4165	%
Morgan Stanley	September 30, 2022		1,050	million		1,050	million	3-year period ending September 30, 2025		3.4200	%
Credit Agricole Corporate and Investment Bank	September 30, 2022		450	million		450	million	3-year period ending September 30, 2025		3.5241	%
Existing contracts		$	2,000	million	$	2,000	million

Credit Agricole Corporate and Investment Bank	March 17, 2025	$	500	million	$	—		1-year period ending September 30, 2026		3.7250	%
Mizuho Capital Markets	March 28, 2025		500	million		—		1-year period ending September 30, 2026		3.6110	%
Forward starting contracts (1)		$	1,000	million	$	—

(1)

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

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+ Details

- Definition

Tabular disclosure of pertinent information about a derivative or group of derivatives on a disaggregated basis, such as for individual instruments, or small groups of similar instruments. May include a combination of the type of instrument, risks being hedged, notional amount, hedge designation, related hedged item, inception date, maturity date, or other relevant item.

+ References + Details

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Statement of Financial Position [Abstract]
Property and equipment, net of accumulated depreciation	$ 355,623	$ 339,892
Common Stock, par value	$ 0.01	$ 0.01
Common Stock, shares authorized	1,500,000,000	1,500,000,000
Common Stock, Shares, Issued	175,183,434	174,245,990
Common Stock, shares outstanding	175,183,434	174,245,990
Preferred Stock , par value	$ 0.01	$ 0.01
Preferred Stock, shares authorized	250,000,000	250,000,000
Preferred Stock, shares issued	0	0
Preferred Stock, shares outstanding	0	0

Debt and Derivatives - Schedule of Interest Rate Swap with Notional Value (Parenthetical) (Details) - USD ($)
$ in Millions

3 Months Ended

Mar. 31, 2025

Dec. 31, 2024

Derivative [Line Items]

Total notional value

$ 2,000

Forward Starting Interest Rate Swap Agreements

Derivative [Line Items]

Total notional value

^[1]

1,000

Forward Starting Interest Rate Swap Agreements | Cash Flow Hedge

Derivative [Line Items]

Total notional value

$ 500

Derivative, maturity date

Sep. 30, 2025

[1]

- Definition

Date derivative contract ends, in YYYY-MM-DD format.

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Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Significant Accounting Policies

3 Months Ended

Mar. 31, 2025

Accounting Policies [Abstract]

Significant Accounting Policies

1. Significant Accounting Policies

Description of Business

BrightSpring Health Services, Inc. and its subsidiaries (“BrightSpring”, the “Company”, “we,” “us,” or “our”) is a leading home and community-based healthcare services platform, focused on delivering complementary pharmacy and provider services to complex patients. Our platform delivers clinical services and pharmacy solutions across Medicare, Medicaid, and commercially-insured populations.

On December 7, 2017, affiliates of Kohlberg Kravis Roberts & Co. L.P. (“KKR”) and Walgreens Boots Alliance, Inc. (“WBA”) purchased PharMerica Corporation (“PharMerica”) and on March 5, 2019, expanded with the acquisition of BrightSpring Health Holdings Corp. The surviving entity was renamed BrightSpring Health Services, Inc.

BrightSpring Health Services, Inc. completed its initial public offering (“IPO”) of 53,333,334 shares of its common stock at a price of $13.00 per share and its concurrent offering of 8,000,000 6.75% tangible equity units (“TEUs”) with a stated amount of $50.00 per unit in January 2024 (collectively, “the IPO Offerings”). The net proceeds from the IPO Offerings amounted to $656.5 million and $389.0 million for the common stock and TEUs, respectively, after deducting underwriting discounts and commissions, and offering-related expenses.

On January 17, 2025, the Company entered into a purchase agreement to divest its community living services, home and community based waiver programs, and intermediate care facilities (the “Community Living business”). The transaction is subject to customary closing conditions and certain other antitrust laws and is expected to close in 2025.

Principles of Consolidation

The accompanying unaudited condensed consolidated financial statements include the accounts of BrightSpring Health Services, Inc. and its subsidiaries. The Company consolidates its majority-owned and controlled entities, including variable interest entities (“VIEs”) for which the Company is the primary beneficiary. All intercompany balances and transactions have been eliminated.

We record a noncontrolling interest for the allocable portion of income or loss and comprehensive income or loss to which the noncontrolling interest holders are entitled based upon their ownership share of the affiliate. The Company determined noncontrolling interests for certain of these VIEs to be redeemable noncontrolling interests, which are presented in the unaudited condensed consolidated balance sheets as redeemable noncontrolling interests.

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations, and our cash flows in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial reporting. Our results of operations for the interim periods presented are not necessarily indicative of the results of our operations for the entire year.

As a result of the Company's plan to divest the Community Living business discussed in Note 2, the Community Living business met the criteria to be reported as discontinued operations. Therefore, the Company has reported the historical results of the Community Living business, including the results of operations, cash flows, and related assets and liabilities, as discontinued operations for all periods presented herein. Unless otherwise noted, all activities and amounts reported in the accompanying notes to the unaudited condensed consolidated financial statements relate to the continuing operations of the Company and exclude activities and amounts related to the Community Living business.

This report should be read in conjunction with our consolidated financial statements and related notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2024, which include information and disclosures not included herein. Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented, as allowed by the rules and regulations of the Securities and Exchange Commission.

Use of Estimates

The preparation of consolidated financial statements in conformity with U.S. GAAP requires us to make estimates and assumptions that affect the reported amounts and related disclosures. We rely on historical experience and on various other assumptions that we believe to be reasonable under the circumstances to make judgments about the carrying values of assets and liabilities that are not

readily apparent from other sources. Significant estimates are involved in the valuation of accounts receivable, inventory, long-lived assets, intangible assets, derivatives, contingent consideration, taxes, insurance reserves, share-based compensation, and goodwill. Actual amounts may differ from these estimates.

Recently Adopted Accounting Standards

There were no new accounting standards adopted during the three months ended March 31, 2025.

Recently Issued Accounting Standards

In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This ASU requires the following disclosures on an annual basis:

•

A tabular rate reconciliation using both percentages and amounts, broken out into specific categories with certain reconciling items at or above 5% of the statutory tax further broken out by nature and/or jurisdiction;

•

Qualitative disclosure of the nature and effect of significant reconciling items by specific categories and individual jurisdictions; and

•

Income taxes paid (net of refunds received), broken out between federal, state/local and foreign, and amounts paid to an individual jurisdiction when 5% or more of the total income taxes paid.

The amendments in this ASU are effective for annual periods beginning after December 15, 2024, with early adoption permitted, and should be applied on a prospective basis. This ASU will have no impact on the Company’s consolidated financial condition or results of operations. The Company is currently evaluating the impact to the income tax disclosures.

In November 2024, the FASB issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses, which was further clarified in January 2025 through the issuance of ASU 2025-01. These ASUs require new financial statement disclosures to provide disaggregated information for certain types of expenses, including purchases of inventory, employee compensation, depreciation, and amortization in commonly presented expense captions such as cost of goods and services and selling, general and administrative expenses. The amendments in these ASUs are effective for annual periods beginning after December 15, 2026, with early adoption permitted. The adoption of this guidance will have no impact on the Company's consolidated financial condition or results of operations. The Company is currently evaluating the impact to the related disclosures.

Acquisitions - Schedule of Consideration Paid for Acquisitions and Estimated Fair Value of Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands		3 Months Ended	12 Months Ended
	Sep. 01, 2024	Mar. 31, 2025	Dec. 31, 2024
Business Acquisition [Line Items]
Goodwill		$ 2,370,024	$ 2,363,884
Haven Hospice, Inc.
Business Acquisition [Line Items]
Inventories	$ 45
Property and equipment	495
Goodwill	45,114
Intangible asset	19,860
Operating lease right-of-use assets	7,157
Trade accounts payable	764
Current portion of obligations under operating leases	2,235
Obligations under operating leases, net of current portion	4,922
Aggregate purchase price	$ 64,750
2025 Acquisition
Business Acquisition [Line Items]
Goodwill		6,400
Intangible asset		400
Accrued expenses		46
Aggregate purchase price		$ 6,754
Pharmacy Solutions and Provider Services Segments
Business Acquisition [Line Items]
Accounts receivable			3,749
Inventories			1,234
Prepaid expenses and other current assets			174
Property and equipment			398
Goodwill			17,814
Intangible asset			31,233
Operating lease right-of-use assets			364
Other assets			1,438
Trade accounts payable			650
Accrued expenses			7,750
Current portion of obligations under operating leases			56
Current portion of obligations under financing leases			53
Obligations under operating leases, net of current portion			308
Obligations under financing leases, net of current portion			8
Deferred income taxes, net			1,686
Aggregate purchase price			$ 45,893

Debt and Derivatives - Additional Information (Details) - USD ($)				3 Months Ended		12 Months Ended
	Dec. 11, 2024	Feb. 21, 2024	Mar. 05, 2019	Mar. 31, 2025	Mar. 31, 2024	Dec. 31, 2024	Dec. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Repayment of borrowings				$ 11,792,000	$ 3,359,353,000
Loss on extinguishment of debt					12,726,000
Total notional value				2,000,000,000		$ 2,000,000,000
Fair value of interest rate swaps				6,300,000		10,600,000
Interest received				4,400,000	9,600,000
Pre-tax gains				7,200,000
Revolving Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maturity date		Jun. 30, 2028
Line of credit facility, maximum borrowing capacity				475,000,000
Borrowings outstanding				$ 475,000,000		63,300,000
Line of credit facility, remaining borrowing capacity						411,700,000
Revolving Credit Facility \| SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)		3.25%		3.00%
Letter of Credit
Debt Instrument [Line Items]
Borrowings outstanding				$ 0		0
LC Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity				65,000,000
Line of credit facility, remaining borrowing capacity				3,200,000		3,200,000
Letter of credit outstanding amount				61,800,000		$ 61,800,000
First Lien Credit Agreement
Debt Instrument [Line Items]
Line of credit facility, agreement date			Mar. 05, 2019
Repayment of borrowings		$ 343,300,000
Line of credit facility, maturity date		Feb. 21, 2031
First Lien Credit Agreement \| Tranche B-1 Term Loan
Debt Instrument [Line Items]
Principal amount			$ 1,650,000,000
Delayed draw			150,000,000
Line of credit facility, borrowing capacity			$ 1,800,000,000
First Lien Credit Agreement \| Tranche B-2 Term Loan
Debt Instrument [Line Items]
Principal amount								$ 550,000,000
First Lien Credit Agreement \| Tranche B-3 Term Loan
Debt Instrument [Line Items]
Principal amount							$ 675,000,000
First Lien Credit Agreement \| Tranche B-4 Term Loan
Debt Instrument [Line Items]
Principal amount		$ 2,566,000,000
First Lien Credit Agreement \| Tranche B- 5 Term Loan
Debt Instrument [Line Items]
Principal amount	$ 2,553,200,000
Principal at issuance (as a percent)	0.25%
First Lien Credit Agreement \| Tranche B- 5 Term Loan \| SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)	2.50%
First Lien Credit Agreement \| Tranche B- 5 Term Loan \| ABR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)	1.50%
Swingline Loans \| Revolving Credit Facility
Debt Instrument [Line Items]
Aggregate amount of outstanding				$ 50,000,000
Swingline Loans \| Revolving Credit Facility \| ABR
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)				2.00%		2.25%
LC Sublimit \| Revolving Credit Facility
Debt Instrument [Line Items]
Aggregate amount of outstanding				$ 82,500,000
Second Lien Credit Agreement
Debt Instrument [Line Items]
Principal amount				$ 450,000,000
Loss on extinguishment of debt					$ 12,700,000

Related Party Transactions

3 Months Ended

Mar. 31, 2025

Related Party Transactions

14. Related Party Transactions

The Company was party to a Monitoring Agreement with KKR and WBA, which required payment of an aggregate advisory fee equivalent to 1% of consolidated earnings before interest, taxes, depreciation, and amortization (“EBITDA”), payable in quarterly installments in arrears at the end of each quarter. The Monitoring Agreement terminated upon the completion of the IPO Offerings in January 2024.

Prior to the termination of the Monitoring Agreement, the Company recognized $0.7 million in monitoring and advisory fees during the first fiscal quarter of 2024 as a component of selling, general, and administrative expenses in our accompanying unaudited condensed consolidated statements of operations.

As a result of the termination of the Monitoring Agreement and in accordance with the agreement, the Company paid $22.7 million in termination fees to KKR and WBA in the fourth fiscal quarter of 2024. The termination fees were recognized in the first fiscal quarter of 2024 as selling, general, and administrative expense in our unaudited condensed consolidated statement of operations.

KKR Capital Markets LLC (“KCM”), a wholly owned subsidiary of KKR, acted as an underwriter in the IPO Offerings during the first fiscal quarter of 2024 and received $7.4 million in underwriting discounts and commission. In connection with debt refinancing in 2024, the Company paid underwriter, arranger, and transaction fees to KCM of $1.9 million. These fees are included within selling, general, and administrative expenses in our unaudited condensed consolidated statement of operations for the three months ended March 31, 2024. There were no similar fees paid to KCM during the three months ended March 31, 2025.

KKR has ownership interests in a broad range of portfolio companies, and we may enter into commercial transactions for goods or services in the ordinary course of business with these companies. We do not believe such transactions are material to our business.

The Company had an agreement with WBA and/or certain of its affiliates under which the Company purchased significant volume of inventory, including a Joinder Agreement to the Pharmaceutical Purchase and Distribution Agreement (the “WBAD Membership Agreement”) between WBA and AmerisourceBergen Drug Corporation (“ABDC”). The WBAD Membership Agreement was terminated in the first fiscal quarter of 2025, and we entered into a separate agreement with ABDC on February 1, 2025.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Name Accounting Standards Codification
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-Paragraph 2
-Subparagraph (e)
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 1
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

+ Details

Fair Value - Summary of Financial Assets or Liabilities Recorded at Fair value on Recurring Basis (Details) - Fair Value Measurement Recurring - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Market Approach
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets	$ 6,330	$ 10,633
Income Approach
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial liabilities	10,084	8,386
Level 2 \| Market Approach \| Interest Rate Swaps
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets	6,330	10,633
Level 3 \| Income Approach \| Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial liabilities	$ 10,084	$ 8,386

Condensed Consolidated Statements of Comprehensive Income (Loss) - USD ($)
$ in Thousands

3 Months Ended

Mar. 31, 2025

Mar. 31, 2024

Statement of Comprehensive Income [Abstract]

Net income (loss)

$ 29,010

$ (46,385)

Other comprehensive (loss) income, net of tax:

Foreign currency translation adjustments

(38)

(146)

Cash flow hedges:

Net change in fair value, net of tax

108

17,959

^[1]

Amounts reclassified to earnings, net of tax

(3,357)

(7,242)

^[2]

Total other comprehensive (loss) income, net of tax

(3,287)

10,571

Total comprehensive income (loss)

25,723

(35,814)

Comprehensive loss attributable to redeemable noncontrolling interests

(407)

(483)

Comprehensive loss attributable to noncontrolling interest

(125)

(152)

Comprehensive income (loss) attributable to BrightSpring Health Services, Inc. and subsidiaries

$ 26,255

$ (35,179)

[1]	The income tax effects of the net change in fair value were $(33) and $(5,815) for the three months ended March 31, 2025 and 2024, respectively.
[2]	The income tax effects of amounts reclassified to earnings were $1,087 and $2,345 for the three months ended March 31, 2025 and 2024, respectively.

Discontinued Operations - Summary of the Aggregate Carrying Amounts of Assets and Liabilities Held for Sale (Parenthetical) (Details) - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Community Living Business \| Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Accumulated depreciation	$ 110,728	$ 110,417

Subsequent Events

3 Months Ended

Mar. 31, 2025

Subsequent Events [Abstract]

Subsequent Events

16. Subsequent Event

On April 30, 2025, the Company entered into a purchase agreement with Amedisys, Inc., UnitedHealth Group Incorporated and certain of their respective subsidiaries, to purchase certain Amedisys home health and hospice care centers and certain UnitedHealth Group care centers.

Income Taxes - Additional Information (Details) $ in Millions	3 Months Ended
	Mar. 31, 2025 USD ($)
Income Tax Disclosure [Abstract]
Income tax rate	$ 2.4

Tangible Equity Units - Additional Information (Details) - USD ($)	1 Months Ended	3 Months Ended
	Jan. 31, 2024	Mar. 31, 2025	Mar. 31, 2024
Minimum
Class of Stock [Line Items]
Mandatory conversion to common stock		26,200,000
Average applicable market value		$ 13
Maximum
Class of Stock [Line Items]
Mandatory conversion to common stock		30,800,000
Average applicable market value		$ 15.28
Senior Amortizing Note
Class of Stock [Line Items]
Maturity date	Feb. 01, 2027
Amortizing Notes
Class of Stock [Line Items]
Maturity date	Feb. 01, 2027
TEU installment payments		$ 6.7
Purchase Contracts
Class of Stock [Line Items]
Units converted at holder's option		0	0
TEUs
Class of Stock [Line Items]
Tangible equity unit	8,000,000
TEUs \| Minimum
Class of Stock [Line Items]
Average applicable market value		$ 15.28
TEUs \| Maximum
Class of Stock [Line Items]
Average applicable market value			$ 13

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Mar. 31, 2025	Mar. 31, 2024
Pay vs Performance Disclosure
Net Income (Loss)	$ 29,542	$ (45,750)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
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-Name Accounting Standards Codification
-Section 50
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-URI https://asc.fasb.org/1943274/2147483443/250-10-50-6

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Redeemable Noncontrolling Interests - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Redeemable Noncontrolling Interest [Line Items]
Purchase of remaining noncontrolling interest paid	$ 5,100	$ 300

Revenue (Tables)

3 Months Ended

Mar. 31, 2025

Revenue from Contract with Customer [Abstract]

Schedule of Revenue by Payor Type

The following tables set forth revenue by payor type (in millions):


	Pharmacy Solutions
		For the Three Months Ended March 31,
		2025					2024
		Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance		$	674.5		23.4	%	$	504.4		22.1	%
Medicaid			238.2		8.3	%		187.3		8.2	%
Medicare A			140.4		4.9	%		129.4		5.7	%
Medicare B			19.5		0.7	%		16.9		0.7	%
Medicare C			487.7		16.9	%		336.9		14.7	%
Medicare D			910.9		31.6	%		756.3		33.1	%
Private & other			61.0		2.2	%		45.8		2.0	%
		$	2,532.2		88.0	%	$	1,977.0		86.5	%


	Provider Services
		For the Three Months Ended March 31,
		2025					2024
		Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance		$	41.4		1.4	%	$	41.1		1.8	%
Medicaid			85.1		3.0	%		82.7		3.6	%
Medicare A			122.4		4.3	%		105.3		4.6	%
Medicare B			1.5		0.1	%		6.9		0.3	%
Medicare C			32.6		1.1	%		20.2		0.9	%
Private & other			62.9		2.1	%		52.6		2.3	%
		$	345.9		12.0	%	$	308.8		13.5	%


	Consolidated
		For the Three Months Ended March 31,
		2025					2024
		Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance		$	715.9		24.8	%	$	545.5		23.9	%
Medicaid			323.3		11.3	%		270.0		11.8	%
Medicare A			262.8		9.2	%		234.7		10.3	%
Medicare B			21.0		0.8	%		23.8		1.0	%
Medicare C			520.3		18.0	%		357.1		15.6	%
Medicare D			910.9		31.6	%		756.3		33.1	%
Private & other			123.9		4.3	%		98.4		4.3	%
		$	2,878.1		100.0	%	$	2,285.8		100.0	%

Significant Accounting Policies (Policies)	3 Months Ended
Significant Accounting Policies (Policies)	Mar. 31, 2025
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation The accompanying unaudited condensed consolidated financial statements include the accounts of BrightSpring Health Services, Inc. and its subsidiaries. The Company consolidates its majority-owned and controlled entities, including variable interest entities (“VIEs”) for which the Company is the primary beneficiary. All intercompany balances and transactions have been eliminated. We record a noncontrolling interest for the allocable portion of income or loss and comprehensive income or loss to which the noncontrolling interest holders are entitled based upon their ownership share of the affiliate. The Company determined noncontrolling interests for certain of these VIEs to be redeemable noncontrolling interests, which are presented in the unaudited condensed consolidated balance sheets as redeemable noncontrolling interests.
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations, and our cash flows in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial reporting. Our results of operations for the interim periods presented are not necessarily indicative of the results of our operations for the entire year. As a result of the Company's plan to divest the Community Living business discussed in Note 2, the Community Living business met the criteria to be reported as discontinued operations. Therefore, the Company has reported the historical results of the Community Living business, including the results of operations, cash flows, and related assets and liabilities, as discontinued operations for all periods presented herein. Unless otherwise noted, all activities and amounts reported in the accompanying notes to the unaudited condensed consolidated financial statements relate to the continuing operations of the Company and exclude activities and amounts related to the Community Living business. This report should be read in conjunction with our consolidated financial statements and related notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2024, which include information and disclosures not included herein. Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented, as allowed by the rules and regulations of the Securities and Exchange Commission.
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires us to make estimates and assumptions that affect the reported amounts and related disclosures. We rely on historical experience and on various other assumptions that we believe to be reasonable under the circumstances to make judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Significant estimates are involved in the valuation of accounts receivable, inventory, long-lived assets, intangible assets, derivatives, contingent consideration, taxes, insurance reserves, share-based compensation, and goodwill. Actual amounts may differ from these estimates.
Recently Adopted and Issued Accounting Standards	Recently Adopted Accounting Standards There were no new accounting standards adopted during the three months ended March 31, 2025. Recently Issued Accounting Standards In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This ASU requires the following disclosures on an annual basis: • A tabular rate reconciliation using both percentages and amounts, broken out into specific categories with certain reconciling items at or above 5% of the statutory tax further broken out by nature and/or jurisdiction; • Qualitative disclosure of the nature and effect of significant reconciling items by specific categories and individual jurisdictions; and • Income taxes paid (net of refunds received), broken out between federal, state/local and foreign, and amounts paid to an individual jurisdiction when 5% or more of the total income taxes paid. The amendments in this ASU are effective for annual periods beginning after December 15, 2024, with early adoption permitted, and should be applied on a prospective basis. This ASU will have no impact on the Company’s consolidated financial condition or results of operations. The Company is currently evaluating the impact to the income tax disclosures. In November 2024, the FASB issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses, which was further clarified in January 2025 through the issuance of ASU 2025-01. These ASUs require new financial statement disclosures to provide disaggregated information for certain types of expenses, including purchases of inventory, employee compensation, depreciation, and amortization in commonly presented expense captions such as cost of goods and services and selling, general and administrative expenses. The amendments in these ASUs are effective for annual periods beginning after December 15, 2026, with early adoption permitted. The adoption of this guidance will have no impact on the Company's consolidated financial condition or results of operations. The Company is currently evaluating the impact to the related disclosures.

Earnings Per Share ("EPS") - Summary of Basic and Diluted Net Income (Loss) Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Numerator
Net income (loss) from continuing operations	$ 9,216	$ (56,027)
Less: Net loss attributable to noncontrolling interests	(532)	(635)
Net income (loss) from continuing operations attributable to common shareholders	9,748	(55,392)
Net income from discontinued operation	19,794	9,642
Net income (loss) attributable to common shareholders	$ 29,542	$ (45,750)
Denominator
Weighted-average shares outstanding - basic	201,005	175,531
Weighted-average shares outstanding - diluted	214,927	175,531
Basic income (loss) per share attributable to common shareholders:
Continuing operations	$ 0.05	$ (0.31)
Discontinued operations	0.1	0.05
Net income (loss)	0.15	(0.26)
Diluted income (loss) per share attributable to common shareholders:
Continuing operations	0.05	(0.31)
Discontinued operations	0.09	0.05
Net income (loss)	$ 0.14	$ (0.26)
Stock Options
Denominator
Weighted-average shares outstanding - diluted	8,055	0
RSUs
Denominator
Weighted-average shares outstanding - diluted	5,867	0
TEUs
Denominator
Weighted-average shares outstanding - diluted	0	0

Discontinued Operations

3 Months Ended

Mar. 31, 2025

Discontinued Operations and Disposal Groups [Abstract]

Discontinued Operations

2. Discontinued Operations

On January 17, 2025, BrightSpring entered into a definitive agreement to sell its Community Living business to National Mentor Holdings, Inc. (the “Purchaser”), for $835.0 million in cash upon closing, subject to certain post-closing adjustments. We entered into the transaction in order to streamline our service offerings and further focus on the senior and specialty populations. The transaction is currently expected to close in 2025, subject to receipt of customary regulatory approvals and satisfaction of other closing conditions.

The Company has determined the divestiture of the Community Living business represents a strategic shift that will have a major effect on its business and has concluded the criteria for classification as discontinued operations were met during the first fiscal quarter of 2025. Accordingly, the Community Living business is reported as discontinued operations in accordance with Accounting Standards Codification (“ASC”) 205-20, Discontinued Operations. The related assets and liabilities of the Community Living business are classified as assets and liabilities held for sale in the accompanying unaudited condensed consolidated balance sheet as of March 31, 2025 and the results of operations from the Community Living business are classified as discontinued operations in the unaudited condensed consolidated statements of operations. Applicable amounts in prior years have been recast to conform to this discontinued operations presentation. The Community Living business was historically presented as a part of the Provider Services reportable segment.

In accordance with ASC 205-20, Allocation of Interest to Discontinued Operations, the Company elected to allocate interest expense to discontinued operations for the Company’s debt that is not directly attributed to the Community Living business. Interest expense was allocated based on a ratio of net assets held for sale to the sum of consolidated net assets and consolidated debt. In addition, upon closing of the divestiture, we will enter into a transition services agreement with the Purchaser to support the Purchaser's post-closing operations of the Community Living business by providing the Purchaser with certain transition services in exchange for service fees

in the form of both fixed-price and pass through costs. Transition services provided primarily include finance and accounting, human resources, IT, facilities management, and compliance.

The financial results of the Community Living business are presented as income from discontinued operations on our unaudited condensed consolidated statements of operations through March 31, 2025. The following table presents the financial results of the Community Living business (in thousands):


	For the Three Months Ended
	March 31,
	2025		2024
Services revenue	$	299,106	$	290,872
Cost of services		204,183		213,972
Gross profit		94,923		76,900
Selling, general, and administrative expenses		60,744		53,498
Operating income of discontinued operations		34,179		23,402
Interest expense, net		7,907		10,550
Income of discontinued operations before incomes taxes		26,272		12,852
Income tax expense of discontinued operations		6,478		3,210
Income from discontinued operations, net of income taxes	$	19,794	$	9,642


	March 31, 2025		December 31, 2024
Assets
Current assets:
Cash and cash equivalents	$	305	$	299
Accounts receivable, net of allowance for credit losses		124,737		125,872
Inventories		3,631		4,007
Prepaid expenses and other current assets		3,276		1,269
Total current assets held for sale		131,949		131,447
Property and equipment, net of accumulated depreciation of $110,728 and $110,417 at March 31, 2025 and December 31, 2024, respectively		72,839		69,715
Goodwill		307,640		307,640
Intangible assets, net of accumulated amortization		216,331		216,258
Operating lease right-of-use assets, net		101,651		88,717
Deferred income taxes, net		287		287
Other assets		5,486		5,343
Total assets held for sale	$	836,183	$	819,407
Liabilities
Current liabilities:
Trade accounts payable	$	17,629	$	17,366
Accrued expenses		59,235		60,791
Current portion of obligations under operating leases		32,863		30,755
Current portion of obligations under financing leases		8,419		8,651
Total current liabilities held for sale		118,146		117,563
Obligations under operating leases, net of current portion		60,389		58,147
Obligations under financing leases, net of current portion		17,160		18,461
Long-term liabilities		553		569
Total liabilities held for sale	$	196,248	$	194,740


	For the Three Months Ended
	March 31,
	2025		2024
Cash flows from discontinued operations operating activities:
Depreciation and amortization	$	1,329	$	9,686
Share-based compensation		3,207		1,262
Impairment of long-lived assets		—		1,437

Cash flows from discontinued operations investing activities:
Purchases of property and equipment		3,044		2,607

Discontinued Operations - Summary of the Aggregate Carrying Amounts of Assets and Liabilities Held for Sale (Details) - Community Living Business - Discontinued Operations - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Current assets:
Cash and cash equivalents	$ 305	$ 299
Accounts receivable, net of allowance for credit losses	124,737	125,872
Inventories	3,631	4,007
Prepaid expenses and other current assets	3,276	1,269
Total current assets held for sale	131,949	131,447
Property and equipment, net of accumulated depreciation of $110,728 and $110,417 at March 31, 2025 and December 31, 2024, respectively	72,839	69,715
Goodwill	307,640	307,640
Intangible assets, net of accumulated amortization	216,331	216,258
Operating lease right-of-use assets, net	101,651	88,717
Deferred income taxes, net	287	287
Other assets	5,486	5,343
Total assets held for sale	836,183	819,407
Current liabilities:
Trade accounts payable	17,629	17,366
Accrued expenses	59,235	60,791
Current portion of obligations under operating leases	32,863	30,755
Current portion of obligations under financing leases	8,419	8,651
Total current liabilities held for sale	118,146	117,563
Obligations under operating leases, net of current portion	60,389	58,147
Obligations under financing leases, net of current portion	17,160	18,461
Long-term liabilities	553	569
Total liabilities held for sale	$ 196,248	$ 194,740

Debt and Derivatives - Schedule of Total Outstanding Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Debt Instrument [Line Items]
Total debt	$ 2,608,227	$ 2,683,319
Less: debt issuance costs, net	70,163	72,736
Total debt, net of debt issuance costs	2,538,064	2,610,583
Less: current portion of long-term debt	48,725	48,725
Total long-term debt, net of current portion	$ 2,489,339	$ 2,561,858
First Lien Incremental Term Loan Tranche B-5 - Payable to Lenders at SOFR plus Applicable Margin
Debt Instrument [Line Items]
Rate	6.82%	6.86%
Total debt	$ 2,540,404	$ 2,546,787
Revolving Credit Loans - Payable to Lenders at SOFR plus Applicable Margin
Debt Instrument [Line Items]
Rate	7.32%	7.61%
Swingline Loans and Base Rate Loans - Payable to Lenders at ABR Plus Applicable Margin
Debt Instrument [Line Items]
Rate	9.50%	9.75%
Total debt		$ 63,300
Amortizing Notes
Debt Instrument [Line Items]
Total debt	$ 48,399	53,804
Notes Payable and Other
Debt Instrument [Line Items]
Total debt	$ 19,424	$ 19,428

Condensed Consolidated Statements of Comprehensive Income (Loss) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Statement of Comprehensive Income [Abstract]
Income tax effects of net change in fair value	$ (33)	$ (5,815)
Income tax effects of amounts reclassified to earnings	$ 1,087	$ 2,345

Detail of Certain Balance Sheet Accounts

3 Months Ended

Mar. 31, 2025

Disclosure Text Block Supplement [Abstract]

Detail of Certain Balance Sheet Accounts

9. Detail of Certain Balance Sheet Accounts

Prepaid expenses and other current assets consist of the following (in thousands):


	March 31, 2025		December 31, 2024
Rebate receivable	$	39,116	$	49,538
Non-trade receivables		30,038		45,428
Inventory returns receivable		11,676		11,245
Income tax receivable		10,886		13,468
Prepaid insurance		10,785		13,892
Interest rate swaps		7,148		10,633
Prepaid maintenance		5,274		3,644
Other prepaid expenses and current assets		16,104		13,462
Total prepaid expenses and other current assets	$	131,027	$	161,310

Other assets consist of the following (in thousands):


	March 31, 2025		December 31, 2024
Notes receivable	$	10,112	$	8,577
Insurance recoveries		7,385		7,564
Cloud computing		6,526		7,362
Deposits		5,689		6,733
Deferred debt issuance costs		2,293		2,470
Equity method investments		650		670
Other assets		5,624		5,752
Total other assets	$	38,279	$	39,128

Accrued expenses consist of the following (in thousands):


	March 31, 2025		December 31, 2024
Wages and payroll taxes	$	113,490	$	98,245
Checks in excess of cash balance		36,680		27,643
Workers compensation insurance reserves		24,672		19,966
Compensated absences		24,639		24,360
Health insurance reserves		18,383		14,934
Legal settlements and professional fees		12,569		13,982
Deferred revenue		8,730		10,196
General and professional liability insurance reserves		6,669		8,328
Contingent consideration		5,334		3,136
Automobile insurance reserves		3,303		21,353
Interest		1,838		8,779
Taxes other than income taxes		1,551		1,985
Recoupment fees		177		536
Other		44,555		42,303
Total accrued expenses	$	302,590	$	295,746

Long-term liabilities consist of the following (in thousands):


	March 31, 2025		December 31, 2024
Workers compensation insurance reserves	$	24,280	$	25,360
General and professional liability insurance reserves		22,319		21,182
Automobile insurance reserves		10,546		9,034
Contingent consideration		4,750		5,250
Employee incentives		3,493		3,993
Interest rate swaps		818		—
Deferred gain		462		195
Other		5,917		6,176
Total long-term liabilities	$	72,585	$	71,190

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Current assets:
Cash and cash equivalents	$ 52,337	$ 60,954
Accounts receivable, net of allowance for credit losses	975,264	902,782
Inventories	533,637	636,561
Prepaid expenses and other current assets	131,027	161,310
Total current assets	2,528,448	1,893,054
Property and equipment, net of accumulated depreciation of $355,623 and $339,892 at March 31, 2025 and December 31, 2024, respectively	177,228	180,570
Goodwill	2,370,024	2,363,884
Intangible assets, net of accumulated amortization	568,284	595,224
Operating lease right-of-use assets, net	162,371	161,032
Deferred income taxes, net	2,311	5,288
Other assets	38,279	39,128
Total assets	5,846,945	5,926,140
Current liabilities:
Trade accounts payable	868,080	923,926
Accrued expenses	302,590	295,746
Current portion of obligations under operating leases	38,687	38,910
Current portion of obligations under financing leases	3,287	3,463
Current portion of long-term debt	48,725	48,725
Total current liabilities	1,457,617	1,428,333
Obligations under operating leases, net of current portion	130,360	129,467
Obligations under financing leases, net of current portion	6,477	6,530
Long-term debt, net of current portion	2,489,339	2,561,858
Long-term liabilities	72,585	71,190
Total liabilities	4,156,378	4,274,555
Redeemable noncontrolling interest	3,323	3,730
Shareholders' equity:
Common stock, $0.01 par value, 1,500,000,000 shares authorized, 175,183,434 and 174,245,990 shares issued and outstanding at March 31, 2025 and December 31, 2024, respectively	1,752	1,742
Preferred stock, $0.01 par value, 250,000,000 authorized, no shares issued and outstanding at March 31, 2025 and December 31, 2024
Additional paid-in capital	1,880,099	1,866,850
Accumulated deficit	(192,613)	(222,155)
Accumulated other comprehensive (loss) income	(1,869)	1,418
Total shareholders' equity	1,687,369	1,647,855
Noncontrolling interest	(125)
Total equity	1,687,244	1,647,855
Total liabilities, redeemable noncontrolling interest, and equity	5,846,945	5,926,140
Discontinued operation held for sale
Current assets:
Current assets held for sale	836,183	131,447
Non-current assets held for sale		687,960
Current liabilities:
Current liabilities held for sale	$ 196,248	117,563
Non-current liabilities held for sale		$ 77,177

Detail of Certain Balance Sheet Accounts (Tables)

3 Months Ended

Mar. 31, 2025

Disclosure Text Block Supplement [Abstract]

Schedule of Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consist of the following (in thousands):


	March 31, 2025		December 31, 2024
Rebate receivable	$	39,116	$	49,538
Non-trade receivables		30,038		45,428
Inventory returns receivable		11,676		11,245
Income tax receivable		10,886		13,468
Prepaid insurance		10,785		13,892
Interest rate swaps		7,148		10,633
Prepaid maintenance		5,274		3,644
Other prepaid expenses and current assets		16,104		13,462
Total prepaid expenses and other current assets	$	131,027	$	161,310

Schedule of Other Assets

Other assets consist of the following (in thousands):


	March 31, 2025		December 31, 2024
Notes receivable	$	10,112	$	8,577
Insurance recoveries		7,385		7,564
Cloud computing		6,526		7,362
Deposits		5,689		6,733
Deferred debt issuance costs		2,293		2,470
Equity method investments		650		670
Other assets		5,624		5,752
Total other assets	$	38,279	$	39,128

Schedule of Accrued Expenses

Accrued expenses consist of the following (in thousands):


	March 31, 2025		December 31, 2024
Wages and payroll taxes	$	113,490	$	98,245
Checks in excess of cash balance		36,680		27,643
Workers compensation insurance reserves		24,672		19,966
Compensated absences		24,639		24,360
Health insurance reserves		18,383		14,934
Legal settlements and professional fees		12,569		13,982
Deferred revenue		8,730		10,196
General and professional liability insurance reserves		6,669		8,328
Contingent consideration		5,334		3,136
Automobile insurance reserves		3,303		21,353
Interest		1,838		8,779
Taxes other than income taxes		1,551		1,985
Recoupment fees		177		536
Other		44,555		42,303
Total accrued expenses	$	302,590	$	295,746

Segment Information - Additional Information (Details)	3 Months Ended
Segment Information - Additional Information (Details)	Mar. 31, 2025
Segment Reporting [Abstract]
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration]	srt:ChiefExecutiveOfficerMember
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description	Segment EBITDA is used as the key profitability measure when we set our annual operating plan for each segment, is the metric with which our CODM assesses segment results, and is a key component of our annual variable compensation plans. Segment EBITDA is commonly used as an analytical indicator within the health care industry and is utilized in the evaluation of segment operating performance as it is a profit measure that is generally within the control of the operating segments.

Goodwill and Intangible Assets - Summary of Changes to Goodwill (Parenthetical) (Details) $ in Millions	Mar. 31, 2025 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Net of accumulated impairment losses	$ 40.9

Condensed Consolidated Statements of Shareholders' Equity - USD ($)

Total

Common Stock

Additional Paid-In Capital

Accumulated Deficit

Accumulated Other Comprehensive Income (Loss)

Noncontrolling Interest

Balance at Dec. 31, 2023

$ 585,410,000

$ 1,179,000

$ 771,336,000

$ (200,319,000)

$ 12,544,000

$ 670,000

Balance, shares at Dec. 31, 2023

117,857,055

Net income (loss)

(45,902,000)

(45,750,000)

(152,000)

Other comprehensive income (loss), net of tax

10,571,000

Share-based compensation

24,848,000

Derecognition of redeemable noncontrolling interest

14,981,000

Issuance of common stock on initial public offering, net

^[1]

656,485,000

$ 533

655,952,000

Issuance of common stock on initial public offering, net, shares

^[1]

53,333,334

Proceeds from stock purchase contract issued under tangible equity units, net

^[2]

321,611,000

Balance at Mar. 31, 2024

1,568,004,000

$ 1,712,000

1,788,728,000

(246,069,000)

23,115,000

518,000

Balance, shares at Mar. 31, 2024

171,190,389

Balance at Dec. 31, 2024

1,647,855,000

$ 1,742,000

1,866,850,000

(222,155,000)

1,418,000

Balance, shares at Dec. 31, 2024

174,245,990

Net income (loss)

^[3]

29,417,000

29,542,000

(125,000)

Other comprehensive income (loss), net of tax

(3,287,000)

Share-based compensation

15,681,000

Exercise of stock options

345,000

Exercise of stock options, shares

36,253

Issuance of common stock for settlement of RSUs, shares

1,052,536

Issuance of common stock for settlement of RSUs

$ 11,000

(11,000)

Tax effect of net share settlement of equity awards, shares

(151,345)

Tax effect of net share settlement of equity awards

(2,767,000)

$ (1,000)

(2,766,000)

Balance at Mar. 31, 2025

$ 1,687,244,000

$ 1,752,000

$ 1,880,099,000

$ (192,613,000)

$ (1,869,000)

$ (125,000)

Balance, shares at Mar. 31, 2025

175,183,434

[1]	Issuance of common stock on initial public offering is presented net of underwriting discounts and commissions, and offering-related expenses of $36.8 million.
[2]	Proceeds from stock purchase contract issued under tangible equity units is presented net of underwriting discounts and commissions of $9.1 million.
[3]	Net loss to the Company for the three months ended March 31, 2025 and 2024 excludes $(407) and $(483), respectively, allocable to the redeemable noncontrolling interests for our joint venture arrangements.

Goodwill and Intangible Assets - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 23.4	$ 23.7

Discontinued Operations - Additional Information (Details) $ in Millions	Jan. 17, 2025 USD ($)
Community Living Business \| Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash receivable for the disposal including discontinued operation.	$ 835.0

Acquisitions (Tables)

3 Months Ended

Mar. 31, 2025

Haven Hospice, Inc.

Business Acquisition [Line Items]

Schedule of Consideration Paid for Acquisitions and Estimated Fair Value of Assets Acquired and Liabilities Assumed


Inventories	$	45
Property and equipment		495
Goodwill		45,114
Intangible assets		19,860
Operating lease right-of-use assets		7,157
Trade accounts payable		764
Current portion of obligations under operating leases		2,235
Obligations under operating leases, net of current portion		4,922
Aggregate purchase price	$	64,750

2024 Acquisitions

Business Acquisition [Line Items]

Schedule of Consideration Paid for Acquisitions and Estimated Fair Value of Assets Acquired and Liabilities Assumed


Accounts receivable	$	3,749
Inventories		1,234
Prepaid expenses and other current assets		174
Property and equipment		398
Goodwill		17,814
Intangible assets		31,233
Operating lease right-of-use assets		364
Other assets		1,438
Trade accounts payable		650
Accrued expenses		7,750
Current portion of obligations under operating leases		56
Current portion of obligations under financing leases		53
Obligations under operating leases, net of current portion		308
Obligations under financing leases, net of current portion		8
Deferred income taxes, net		1,686
Aggregate purchase price, net of cash acquired	$	45,893

2025 Acquisition

Business Acquisition [Line Items]

Schedule of Consideration Paid for Acquisitions and Estimated Fair Value of Assets Acquired and Liabilities Assumed


Goodwill	$	6,400
Intangible asset		400
Accrued expenses		46
Aggregate purchase price	$	6,754

Income Taxes

3 Months Ended

Mar. 31, 2025

Income Tax Disclosure [Abstract]

Income Taxes

8. Income Taxes

The provision for income taxes is attributable to U.S federal, state, and foreign income taxes. The Company’s effective tax rate used for interim periods is based on an estimated annual effective tax rate and includes the tax effect of items required to be recorded discretely in the interim periods in which those items occur.

A reconciliation of the Company’s effective tax rate is as follows:


	For the Three Months Ended
	March 31,
	2025			2024
Estimated annual effective tax rate before discrete items		25.7	%		37.9	%
Discrete items recognized		(28.4	)%		(5.8	)%
Effective tax rate recognized in the statements of operations		(2.7	)%		32.1	%

During the three months ended March 31, 2025, the Company’s effective tax rate was lower than the U.S. federal income tax rate, primarily as a result of including $2.4 million in tax benefits resulting from the recognition of excess tax benefits from share-based compensation.

During the three months ended March 31, 2024, the Company’s effective tax rate was higher than the U.S. federal income tax rate, primarily as a result of limitations on the deductibility of certain executive compensation that now apply to the Company after the IPO Offerings, which were completed in January 2024. The discrete tax expense for the three months ended March 31, 2024 primarily relates to additional legal settlement accruals recorded in the period, which are not expected to be deductible for tax purposes.

- Definition

The entire disclosure for income tax.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 12
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-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12

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+ Details

Goodwill and Intangible Assets

3 Months Ended

Mar. 31, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

5. Goodwill and Intangible Assets

A summary of changes to goodwill, by reportable segment, is as follows (in thousands):


	Goodwill
	Pharmacy Solutions		Provider Services			Total
Goodwill at January 1, 2025*	$	841,052	$	1,522,832		$	2,363,884
Goodwill added through acquisitions		—		6,400			6,400
Measurement period adjustments		—		(279	)		(279	)
Foreign currency adjustments		—		19			19
Goodwill at March 31, 2025*	$	841,052	$	1,528,972		$	2,370,024

* For the periods presented, the carrying amount of goodwill is presented net of accumulated impairment losses of $40.9 million.

Intangible assets are as follows (in thousands):


	March 31, 2025						December 31, 2024
	Gross		Accumulated Amortization		Net Carrying Value		Gross		Accumulated Amortization		Net Carrying Value		Life (Years)
Customer relationships	$	540,935	$	349,417	$	191,518	$	542,137	$	335,647	$	206,490	5-20
Trade names		332,977		146,113		186,864		332,977		140,020		192,957	2-20
Licenses		62,801		16,837		45,964		68,425		17,528		50,897	10-20
Doctor/payor network		5,650		4,426		1,224		12,730		10,965		1,765	5-8
Covenants not to compete		7,890		4,996		2,894		8,790		5,886		2,904	2-7
Other intangible assets		10,940		6,753		4,187		10,940		6,362		4,578	5-7
Total definite-lived assets	$	961,193	$	528,542	$	432,651	$	975,999	$	516,408	$	459,591
Licenses		135,633		—		135,633		135,633		—		135,633	Indefinite
Total intangible assets	$	1,096,826	$	528,542	$	568,284	$	1,111,632	$	516,408	$	595,224

Amortization expense for the three months ended March 31, 2025 and 2024 was $23.4 million and $23.7 million, respectively.

Condensed Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Total revenues	$ 2,878,129	$ 2,285,766
Cost of goods	2,328,215	1,807,100
Cost of services	211,545	186,175
Gross profit	338,369	292,491
Selling, general, and administrative expenses	287,630	307,826
Operating income (loss)	50,739	(15,335)
Loss on extinguishment of debt		12,726
Interest expense, net	41,763	54,470
Income (loss) from continuing operations before income taxes	8,976	(82,531)
Income tax benefit	(240)	(26,504)
Income (loss) from continuing operations, net of income taxes	9,216	(56,027)
Income from discontinued operations, net of income taxes	19,794	9,642
Net income (loss)	29,010	(46,385)
Net loss attributable to noncontrolling interests included in continuing operations	(532)	(635)
Net loss attributable to BrightSpring Health Services, Inc. and subsidiaries	$ 29,542	$ (45,750)
Basic income (loss) per share attributable to common shareholders:
Continuing operations	$ 0.05	$ (0.31)
Discontinued operations	0.1	0.05
Net income (loss)	0.15	(0.26)
Diluted income (loss) per share attributable to common shareholders:
Continuing operations	0.05	(0.31)
Discontinued operations	0.09	0.05
Net income (loss)	$ 0.14	$ (0.26)
Weighted average shares outstanding:
Basic	201,005	175,531
Diluted	214,927	175,531
Products
Total revenues	$ 2,532,171	$ 1,977,035
Services
Total revenues	$ 345,958	$ 308,731

Goodwill and Intangible Assets - Summary of Changes to Goodwill, by Reportable Segment (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2025 USD ($)
Goodwill [Line Items]
Goodwill, Beginning balance	$ 2,363,884
Goodwill added through acquisitions	6,400
Measurement period adjustments	(279)
Foreign currency adjustments	19
Goodwill, Ending balance	2,370,024
Pharmacy Solutions
Goodwill [Line Items]
Goodwill, Beginning balance	841,052
Goodwill added through acquisitions	0
Measurement period adjustments	0
Foreign currency adjustments	0
Goodwill, Ending balance	841,052
Provider Services
Goodwill [Line Items]
Goodwill, Beginning balance	1,522,832
Goodwill added through acquisitions	6,400
Measurement period adjustments	(279)
Foreign currency adjustments	19
Goodwill, Ending balance	$ 1,528,972

- Definition

Amount, after accumulated impairment loss, of asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

+ References

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- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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+ Details

Related Party Transactions - Additional Information (Details) - USD ($)	3 Months Ended			12 Months Ended
	Mar. 31, 2025	Dec. 31, 2024	Mar. 31, 2024	Dec. 31, 2024
KKR Capital Markets, LLC
Related Party Transaction [Line Items]
Fees paid to arranger	$ 0
Underwriting discounts and commissions paid			$ 7,400,000
Underwriter, arranger and transaction fees paid				$ 1,900,000
Monitoring Agreement \| KKR and WBA
Related Party Transaction [Line Items]
Termination fees paid		$ 22,700,000
Selling, General, and Administrative Expenses \| Monitoring Agreement \| KKR and WBA
Related Party Transaction [Line Items]
Recognized monitoring and advisory fees			$ 700,000

Tangible Equity Units - Schedule of Proceeds from Issuance Allocated to Equity and Debt Based on Relative Fair Value of each TEU (Details) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2024 USD ($) $ / shares
Class of Stock [Line Items]
Debt Component, Less: issuance costs	$ 42,963
TEUs
Class of Stock [Line Items]
Equity Component, Fair value per unit \| $ / shares	$ 41.3382
Equity Component, Gross proceeds	$ 330,706
Equity Component, Less : issuance costs	9,095
Equity Component, Net proceeds	321,611
Debt Component, Gross proceeds	69,294
Debt Component, Less: issuance costs	1,905
Debt Component, Net proceeds	67,389
Total, Gross proceeds	400,000
Total, Issuance costs	11,000
Total, Net proceeds	$ 389,000

Detail of Certain Balance Sheet Accounts - Schedule of Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Disclosure Text Block Supplement [Abstract]
Rebate receivable	$ 39,116	$ 49,538
Non-trade receivables	30,038	45,428
Inventory returns receivable	11,676	11,245
Income tax receivable	10,886	13,468
Prepaid insurance	10,785	13,892
Interest rate swaps	7,148	10,633
Prepaid maintenance	5,274	3,644
Other prepaid expenses and current assets	16,104	13,462
Total prepaid expenses and other current assets	$ 131,027	$ 161,310

Tangible Equity Units - Schedule of Number of Common Stock Issued Based on 20 Day Volume Weighted-Average Price of Common Stock (Details)	3 Months Ended
	Mar. 31, 2025 USD ($) $ / shares shares
Maximum
VWAP of BTSG Common Stock	$ 15.28
Common Stock Issued \| shares	30,800,000
Minimum
VWAP of BTSG Common Stock	$ 13
Common Stock Issued \| shares	26,200,000
Greater than $15.28
Common Stock Issued \| shares	3.2733
Greater than $15.28 \| Minimum
VWAP of BTSG Common Stock	$ 15.28
Equal to or less than $15.28 but greater than or equal to $13.00
Amount to determine Common Stock Issuance \| $	$ 50
Equal to or less than $15.28 but greater than or equal to $13.00 \| Maximum
VWAP of BTSG Common Stock	$ 15.28
Equal to or less than $15.28 but greater than or equal to $13.00 \| Minimum
VWAP of BTSG Common Stock	$ 13
Less than $13.00
Common Stock Issued \| shares	3.8461
Less than $13.00 \| Maximum
VWAP of BTSG Common Stock	$ 13

Commitments and Contingencies - Additional Information (Details) $ in Millions	3 Months Ended
	Mar. 31, 2025 USD ($)
Loss Contingencies [Line Items]
Estimated settlement amount	$ 120.0
Long-term Liabilities
Loss Contingencies [Line Items]
Estimated settlement amount	10.0
Long-term Liabilities Current
Loss Contingencies [Line Items]
Paid settlement amount	$ 110.0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Condensed Consolidated Statements of Shareholders' Equity (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Net of underwriting discounts and commissions	$ 9,100
Net loss excluding allocable redeemable noncontrolling interests	(407)	$ (483)
Initial Public Offering
Net of underwriting discounts and commissions	$ 36,800

Segment Information

3 Months Ended

Mar. 31, 2025

Segment Reporting [Abstract]

Segment Information

15. Segment Information

The Company's Chief Operating Decision Maker (“CODM”) is its Chief Executive Officer, who evaluates the performance of our segments and allocates resources based on segment EBITDA. Segment EBITDA is used as the key profitability measure when we set our annual operating plan for each segment, is the metric with which our CODM assesses segment results, and is a key component of our annual variable compensation plans. Segment EBITDA is commonly used as an analytical indicator within the health care industry

and is utilized in the evaluation of segment operating performance as it is a profit measure that is generally within the control of the operating segments.

For all segments, the CODM uses segment EBITDA in the annual budgeting and monthly forecasting process. The CODM considers actual-to budget and actual-to current forecast variances for segment EBITDA on a monthly basis for evaluating performance of each segment and making decisions about allocating capital and other resources to each segment.

Segment amounts exclude certain expenses not specifically identifiable to the segments for functions performed in a centralized manner, which include accounting, finance, human resources, legal, information technology, corporate office support, and overall corporate management. Segment assets and capital expenditures are not provided to the Company’s CODM and, therefore, are not disclosed.


	For the Three Months Ended March 31, 2025
	Pharmacy Solutions		Provider Services		Total Segments
Products revenue	$	2,532,171	$	—	$	2,532,171
Services revenue		—		345,958		345,958
Cost of drugs		2,147,576		—		2,147,576
Cost of services		—		211,545		211,545
Other direct costs (1)		180,639		—		180,639
Segment selling, general, and administrative expenses (2)		115,738		90,102		205,840
Segment depreciation and amortization expense (3)		27,508		6,769		34,277
Segment EBITDA	$	115,726	$	51,080	$	166,806


	For the Three Months Ended March 31, 2024
	Pharmacy Solutions		Provider Services		Total Segments
Products revenue	$	1,977,035	$	—	$	1,977,035
Services revenue		—		308,731		308,731
Cost of drugs		1,657,759		—		1,657,759
Cost of services		—		186,175		186,175
Other direct costs (1)		149,341		—		149,341
Segment selling, general, and administrative expenses (2)		109,010		81,544		190,554
Segment depreciation and amortization expense (3)		27,249		5,743		32,992
Segment EBITDA	$	88,174	$	46,755	$	134,929

(1)

Other direct costs primarily includes direct labor costs, delivery costs, insurance, and depreciation and amortization expense that relates to revenue-generating assets.

(2)

(3)

Total segment depreciation and amortization expense is presented in other direct costs, costs of services, and segment general and administrative expenses, based on the associated asset.


	For the Three Months Ended
	March 31,
	2025			2024
Reconciliation of income or loss:
Total Segment EBITDA	$	166,806		$	134,929
Segment depreciation and amortization		34,277			32,992
Expenses not allocated at segment level:
Selling, general, and administrative expenses		75,235			111,028
Depreciation and amortization		6,555			6,244
Loss on extinguishment of debt		—			12,726
Interest expense, net		41,763			54,470
Income tax benefit		(240	)		(26,504	)
Net income (loss) from continuing operations	$	9,216		$	(56,027	)

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 280
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+ Details

Revenue

3 Months Ended

Mar. 31, 2025

Revenue from Contract with Customer [Abstract]

Revenue

3. Revenue

The Company is substantially dependent on revenues received under contracts with federal, state, and local government agencies. Operating funding sources are generally earned from Medicaid, Medicare, commercial insurance reimbursement, and from private and other payors. There is no single customer whose revenue was 10% or more of our consolidated revenue during the periods presented. The following tables set forth revenue by payor type (in millions):


	Pharmacy Solutions
		For the Three Months Ended March 31,
		2025					2024
		Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance		$	674.5		23.4	%	$	504.4		22.1	%
Medicaid			238.2		8.3	%		187.3		8.2	%
Medicare A			140.4		4.9	%		129.4		5.7	%
Medicare B			19.5		0.7	%		16.9		0.7	%
Medicare C			487.7		16.9	%		336.9		14.7	%
Medicare D			910.9		31.6	%		756.3		33.1	%
Private & other			61.0		2.2	%		45.8		2.0	%
		$	2,532.2		88.0	%	$	1,977.0		86.5	%


	Provider Services
		For the Three Months Ended March 31,
		2025					2024
		Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance		$	41.4		1.4	%	$	41.1		1.8	%
Medicaid			85.1		3.0	%		82.7		3.6	%
Medicare A			122.4		4.3	%		105.3		4.6	%
Medicare B			1.5		0.1	%		6.9		0.3	%
Medicare C			32.6		1.1	%		20.2		0.9	%
Private & other			62.9		2.1	%		52.6		2.3	%
		$	345.9		12.0	%	$	308.8		13.5	%


	Consolidated
		For the Three Months Ended March 31,
		2025					2024
		Revenue		% of Revenue			Revenue		% of Revenue
Commercial insurance		$	715.9		24.8	%	$	545.5		23.9	%
Medicaid			323.3		11.3	%		270.0		11.8	%
Medicare A			262.8		9.2	%		234.7		10.3	%
Medicare B			21.0		0.8	%		23.8		1.0	%
Medicare C			520.3		18.0	%		357.1		15.6	%
Medicare D			910.9		31.6	%		756.3		33.1	%
Private & other			123.9		4.3	%		98.4		4.3	%
		$	2,878.1		100.0	%	$	2,285.8		100.0	%

Refer to Note 15 for the disaggregation of revenue by reportable segment.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

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-URI https://asc.fasb.org/606/tableOfContent

+ Details

Earnings Per Share ("EPS")

3 Months Ended

Mar. 31, 2025

Earnings Per Share [Abstract]

Earnings Per Share ("EPS")

10. Earnings Per Share (“EPS”)

Basic net income (loss) per share excludes dilution and is reported separately for continuing operations and discontinued operations. Basic net income (loss) per share of common stock for continuing operations and discontinued operations is calculated by dividing net income (loss) from continuing operations and discontinued operations attributable to common shareholders by the weighted average number of shares outstanding for the reporting period, respectively. Diluted net income (loss) per share of common stock is computed by giving effect to all potential weighted average dilutive common stock. In periods of net loss, no potentially dilutive common shares are included in the diluted shares outstanding as the effect is anti-dilutive.

The number of additional shares of common stock related to restricted stock units (“RSUs”) and stock option awards is calculated using the treasury stock method, if dilutive.

For the three months ended March 31, 2025 and 2024, the TEUs were assumed to be outstanding at the minimum settlement amount for weighted-average shares for basic EPS. For the three months ended March 31, 2025, the Company's average applicable market value was greater than $15.28, resulting in no dilutive impact to EPS for TEUs. For the three months ended March 31, 2024, the Company's average applicable market value was less than $13.00. Thus, the TEUs were assumed to be settled at a conversion factor based on the maximum settlement amount of 3.8461 shares per Purchase Contract, if dilutive. See Note 7 for further discussion of TEUs.

The following table sets forth the computation of basic and diluted net income (loss) per share attributable to common shareholders (in thousands, except per share amounts):


	For the Three Months Ended
	March 31,
	2025			2024
Numerator:
Net income (loss) from continuing operations	$	9,216		$	(56,027	)
Less: Net loss attributable to noncontrolling interests		(532	)		(635	)
Net income (loss) from continuing operations attributable to common shareholders		9,748			(55,392	)
Net income from discontinued operations		19,794			9,642
Net income (loss) attributable to common shareholders	$	29,542		$	(45,750	)

Denominator:
Weighted-average shares outstanding - basic		201,005			175,531

Effect of dilutive securities:
Stock options		8,055			—
RSUs		5,867			—
TEUs		—			—
Weighted-average shares outstanding - diluted		214,927			175,531

Basic income (loss) per share attributable to common shareholders:
Continuing operations	$	0.05		$	(0.31	)
Discontinued operations	$	0.10		$	0.05
Net income (loss)	$	0.15		$	(0.26	)

Diluted income (loss) per share attributable to common shareholders:
Continuing operations	$	0.05		$	(0.31	)
Discontinued operations	$	0.09		$	0.05
Net income (loss)	$	0.14		$	(0.26	)


	For the Three Months Ended
	March 31,
	2025		2024
Stock options		1,422		15,583
RSUs		—		4,037
TEUs		—		4,582
Total		1,422		24,202

Segment Information - Schedule of Reportable Segments Reconcile of Segment Information (Details) - Operating Segments - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Segment Reporting Information [Line Items]
Cost of drugs	$ 2,147,576	$ 1,657,759
Cost of services	211,545	186,175
Other direct costs	180,639	149,341
Segment selling, general, and administrative expenses	205,840	190,554
Segment depreciation and amortization expense	34,277	32,992
Segment EBITDA	166,806	134,929
Products
Segment Reporting Information [Line Items]
Revenues	2,532,171	1,977,035
Services
Segment Reporting Information [Line Items]
Revenues	345,958	308,731
Pharmacy Solutions
Segment Reporting Information [Line Items]
Cost of drugs	2,147,576	1,657,759
Other direct costs	180,639	149,341
Segment selling, general, and administrative expenses	115,738	109,010
Segment depreciation and amortization expense	27,508	27,249
Segment EBITDA	115,726	88,174
Pharmacy Solutions \| Products
Segment Reporting Information [Line Items]
Revenues	2,532,171	1,977,035
Provider Services
Segment Reporting Information [Line Items]
Cost of services	211,545	186,175
Segment selling, general, and administrative expenses	90,102	81,544
Segment depreciation and amortization expense	6,769	5,743
Segment EBITDA	51,080	46,755
Provider Services \| Services
Segment Reporting Information [Line Items]
Revenues	$ 345,958	$ 308,731

Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2025	Dec. 31, 2024
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 961,193	$ 975,999
Definite-lived assets, Accumulated Amortization	528,542	516,408
Total intangible assets, Net Carrying Value	432,651	459,591
Total intangible assets, Gross	1,096,826	1,111,632
Intangible assets, net of accumulated amortization	568,284	595,224
Licenses
Schedule Of Intangible Assets [Line Items]
Indefinite-lived assets	135,633	135,633
Customer Relationships
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	540,935	542,137
Definite-lived assets, Accumulated Amortization	349,417	335,647
Total intangible assets, Net Carrying Value	$ 191,518	206,490
Customer Relationships \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	5 years
Customer Relationships \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	20 years
Trade Names
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 332,977	332,977
Definite-lived assets, Accumulated Amortization	146,113	140,020
Total intangible assets, Net Carrying Value	$ 186,864	192,957
Trade Names \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	2 years
Trade Names \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	20 years
Licenses
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 62,801	68,425
Definite-lived assets, Accumulated Amortization	16,837	17,528
Total intangible assets, Net Carrying Value	$ 45,964	50,897
Licenses \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	10 years
Licenses \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	20 years
Doctor/Payor Network
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 5,650	12,730
Definite-lived assets, Accumulated Amortization	4,426	10,965
Total intangible assets, Net Carrying Value	$ 1,224	1,765
Doctor/Payor Network \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	5 years
Doctor/Payor Network \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	8 years
Covenants Not to Complete
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 7,890	8,790
Definite-lived assets, Accumulated Amortization	4,996	5,886
Total intangible assets, Net Carrying Value	$ 2,894	2,904
Covenants Not to Complete \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	2 years
Covenants Not to Complete \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	7 years
Other Intangible Assets [Member]
Schedule Of Intangible Assets [Line Items]
Definite-lived assets, Gross	$ 10,940	10,940
Definite-lived assets, Accumulated Amortization	6,753	6,362
Total intangible assets, Net Carrying Value	$ 4,187	$ 4,578
Other Intangible Assets [Member] \| Minimum
Schedule Of Intangible Assets [Line Items]
Life (years)	5 years
Other Intangible Assets [Member] \| Maximum
Schedule Of Intangible Assets [Line Items]
Life (years)	7 years