0001564590-21-029784 | 10-Q | XBRL Viewer | Aveanna Healthcare Holdings INC

Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Apr. 03, 2021	May 25, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Apr. 03, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	--01-01
Entity Registrant Name	Aveanna Healthcare Holdings Inc.
Entity Central Index Key	0001832332
Entity Current Reporting Status	No
Entity Interactive Data Current	Yes
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Filer Category	Non-accelerated Filer
Entity Common Stock, Shares Outstanding		184,164,184
Entity File Number	001-40362
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	81-4717209
Entity Address, Address Line One	400 Interstate North Parkway SE
Entity Address, City or Town	Atlanta
Entity Address, State or Province	GA
Entity Address, Postal Zip Code	30339
City Area Code	770
Local Phone Number	441-1580
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	AVAH
Security Exchange Name	NASDAQ
Document Quarterly Report	true
Document Transition Report	false

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Apr. 03, 2021	Jan. 02, 2021
Current assets:
Cash and cash equivalents	$ 67,105	$ 137,345
Patient accounts receivable	195,720	172,887
Receivables under insured programs	8,388	7,992
Prepaid expenses	12,609	11,080
Other current assets	9,394	11,340
Total current assets	293,216	340,644
Property and equipment, net	32,168	32,650
Operating lease right of use assets	45,231	46,217
Goodwill	1,317,340	1,316,385
Intangible assets, net	72,266	73,572
Receivables under insured programs	25,184	23,990
Deferred income taxes	2,931	2,931
Other long-term assets	9,426	7,627
Total assets	1,797,762	1,844,016
Current liabilities:
Accounts payable and other accrued liabilities	41,906	56,668
Accrued payroll and employee benefits	49,239	56,834
Accrued interest	2,476	2,398
Notes payable	1,814	2,872
Current portion of insurance reserves - insured programs	8,388	7,992
Current portion of insurance reserves	13,186	12,294
Current portion of long-term obligations	9,910	9,910
Current portion of operating lease liabilities	11,312	11,884
Current portion of deferred payroll taxes	24,824	24,824
Government stimulus liabilities		29,444
Other current liabilities	44,430	45,293
Total current liabilities	207,485	260,413
Long-term obligations, less current portion	1,163,059	1,163,490
Long-term insurance reserves - insured programs	25,184	23,990
Long-term insurance reserves	32,910	30,336
Operating lease liabilities, less current portion	39,260	40,246
Deferred payroll taxes, less current portion	24,824	24,824
Deferred income taxes	3,285	2,591
Other long-term liabilities	28,076	30,957
Total liabilities	1,524,083	1,576,847
Commitments and contingencies (Note 10)
Deferred restricted stock units	2,135	2,135
Stockholders’ equity:
Preferred stock, no par value, 5,000,000 shares authorized; none issued or outstanding
Common stock, $0.01 par value, 1,000,000,000 shares authorized;141,928,184 issued and outstanding, respectively	1,419	1,419
Additional paid-in capital	721,959	721,247
Accumulated deficit	(451,834)	(457,632)
Total stockholders’ equity	271,544	265,034
Total liabilities, deferred restricted stock units, and stockholders’ equity	$ 1,797,762	$ 1,844,016

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Apr. 03, 2021	Jan. 02, 2021
Statement Of Financial Position [Abstract]
Preferred stock, no par value
Preferred stock, authorized	5,000,000	5,000,000
Preferred stock, issued	0	0
Preferred stock,outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, authorized	1,000,000,000	1,000,000,000
Common stock, Issued	141,928,184	141,928,184
Common stock, outstanding	141,928,184	141,928,184

CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($)	3 Months Ended
	Apr. 03, 2021	Mar. 28, 2020
Income Statement [Abstract]
Revenue	$ 417,160,000	$ 355,223,000
Cost of revenue, excluding depreciation and amortization	285,477,000	247,682,000
Branch and regional administrative expenses	69,372,000	59,694,000
Corporate expenses	27,399,000	25,797,000
Depreciation and amortization	4,848,000	4,183,000
Acquisition-related costs	1,768,000	0
Operating income	28,296,000	17,867,000
Interest income	77,000	46,000
Interest expense	(22,425,000)	(21,063,000)
Gain on debt extinguishment		127,000
Other income	159,000	41,791,000
Income before income taxes	6,107,000	38,768,000
Income tax expense	(309,000)	(1,131,000)
Net income	$ 5,798,000	$ 37,637,000
Income per share:
Net income per share, basic	$ 0.04	$ 0.27
Weighted average shares of common stock outstanding, basic	142,122,934	137,468,875
Net income per share, diluted	$ 0.04	$ 0.27
Weighted average shares of common stock outstanding, diluted	146,266,014	140,330,909

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Deficit
Beginning Balance at Dec. 28, 2019	$ 270,192	$ 1,368	$ 669,406	$ (400,582)
Beginning Balance (shares) at Dec. 28, 2019		136,803,189
Issuance of common stock	50,000	$ 51	49,949
Issuance of common stock (shares)		5,124,995
Non-cash compensation	318		318
Net income	37,637			37,637
Ending Balance at Mar. 28, 2020	358,147	$ 1,419	719,673	(362,945)
Ending Balance (in shares) at Mar. 28, 2020		141,928,184
Beginning Balance at Jan. 02, 2021	265,034	$ 1,419	721,247	(457,632)
Beginning Balance (shares) at Jan. 02, 2021		141,928,184
Non-cash compensation	712		712
Net income	5,798			5,798
Ending Balance at Apr. 03, 2021	$ 271,544	$ 1,419	$ 721,959	$ (451,834)
Ending Balance (in shares) at Apr. 03, 2021		141,928,184

- Definition

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

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+ Details

- Definition

Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.

+ References + Details

CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Apr. 03, 2021	Mar. 28, 2020
Cash Flows From Operating Activities:
Net income	$ 5,798	$ 37,637
Adjustments to reconcile net income to net cash (used in) provided by operating activities:
Depreciation and amortization	4,848	4,183
Amortization of deferred debt issuance costs	2,140	1,744
Amortization and impairment of operating lease right of use assets	3,550	3,123
Non-cash compensation	712	318
(Gain) loss on disposal of licenses, property and equipment	(4)	48
Fair value adjustment on interest rate derivatives	(2,820)	6,422
Gain on debt extinguishment		(127)
Deferred income taxes	694	573
Changes in operating assets and liabilities, net of impact of acquisitions:
Patient accounts receivable	(22,852)	(1,168)
Prepaid expenses	(1,684)	1,760
Other current and long-term assets	1,957	2,748
Accounts payable and other accrued liabilities	(15,841)	(10,187)
Accrued payroll and employee benefits	(7,595)	(1,881)
Accrued interest	78	1,826
Insurance reserves	3,466	684
Operating lease liabilities	(4,126)	(3,317)
Deferred payroll taxes		885
Other current and long-term liabilities	(1,232)	(1,218)
Net cash (used in) provided by operating activities	(32,911)	44,053
Cash Flows From Investing Activities:
Acquisitions of businesses, net of cash acquired	(500)
Purchases of property and equipment	(2,665)	(6,327)
Net cash used in investing activities	(3,165)	(6,327)
Cash Flows From Financing Activities:
Proceeds from issuance of common stock		50,000
Proceeds from revolving credit facility		14,000
Repayments on revolving credit facility		(45,500)
Principal payments on term loans and notes payable	(3,535)	(2,677)
Payment of government stimulus funds	(29,444)
Principal payments of financing lease obligations	(203)	(153)
Payment of debt issuance costs	(196)	(689)
Payment of deferred offering costs	(786)
Net cash (used in) provided by financing activities	(34,164)	14,981
Net (decrease) increase in cash and cash equivalents	(70,240)	52,707
Cash and cash equivalents at beginning of period	137,345	3,327
Cash and cash equivalents at end of period	67,105	56,034
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest	20,207	17,493
Acquisition of property and equipment on accrual	2,520	$ 4,003
Deferred offering costs included in accounts payable and other accrued liabilities	1,874
Cash paid for income taxes, net of refunds received	$ (202)

Description of Business

3 Months Ended

Apr. 03, 2021

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Description of Business

1.	DESCRIPTION OF BUSINESS

Aveanna Healthcare Holdings Inc. (together with its consolidated subsidiaries, referred to herein as the “Company”) is headquartered in Atlanta, Georgia and has operations in 30 states with concentrations in Texas, Pennsylvania, and California, providing a broad range of pediatric and adult healthcare services including nursing, rehabilitation services, occupational nursing in schools, therapy services, day treatment centers for medically fragile and chronically ill children and adults, as well as delivery of enteral nutrition and other products to patients. The Company also provides case management services in order to assist families and patients by coordinating the provision of services between insurers or other payers, physicians, hospitals, and other healthcare providers. In addition, the Company provides respite healthcare services, which are temporary care provider services provided in relief of the patient’s normal caregiver. The Company’s services are designed to provide a high quality, lower cost alternative to prolonged hospitalization.

Summary of Significant Accounting Policies

3 Months Ended

Apr. 03, 2021

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2.	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Principles of Consolidation

The accompanying interim unaudited consolidated financial statements include the accounts of Aveanna Healthcare Holdings Inc. and its wholly owned subsidiaries. All intercompany accounts and transactions have been eliminated in the accompanying interim unaudited consolidated financial statements, and business combinations accounted for as purchases have been included in the accompanying interim unaudited consolidated financial statements from their respective dates of acquisition.

Basis of Presentation

The accompanying consolidated financial statements are unaudited and have been prepared by the Company in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information and in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”). Accordingly, these interim unaudited consolidated financial statements do not include all the information and disclosures required by U.S. GAAP for complete financial statements. In the opinion of management, these interim unaudited consolidated financial statements reflect all adjustments, consisting of normal recurring adjustments, necessary to present fairly the Company’s financial position as of April 3, 2021 and the results of operations for the three-month periods ended April 3, 2021 and March 28, 2020, respectively. The results reported in these interim unaudited consolidated financial statements should not be regarded as indicative of results that may be expected for any other period or the entire year. These interim unaudited consolidated financial statements and related notes should be read in conjunction with the audited consolidated financial statements and related notes for the year ended January 2, 2021 included in the Company’s prospectus dated April 28, 2021 (the “Prospectus”), which is deemed to be part of the Company’s Registration Statement on Form S-1 (File No. 333-254981) filed with the SEC.

Our fiscal year ends on the Saturday that is closest to December 31 of a given year, resulting in either a 52 or 53-week fiscal year. The accompanying interim unaudited consolidated balance sheets reflect the accounts of the Company as of April 3, 2021 and January 2, 2021. For the three-month periods ended April 3, 2021 and March 28, 2020, the accompanying interim unaudited consolidated statements of operations, stockholders’ equity and cash flows reflect the accounts of the Company from January 3, 2021 through April 3, 2021 and December 29, 2019 through March 28, 2020, respectively.

Use of Estimates

The Company’s accounting and reporting policies conform with U.S. GAAP. In preparing the consolidated financial statements, the Company is required to make estimates and assumptions that impact the amounts reported in these consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates.

Deferred Offering Costs

The Company has deferred offering costs, consisting of legal, accounting, filing and other fees and costs directly attributable to the Company’s initial public offering. The deferred offering costs will be offset against the proceeds received upon the closing of the initial public offering. As of April 3, 2021 and January 2, 2021, capitalized deferred offering costs totaled $4.8 million and $2.9 million, respectively, and were included in other long-term assets on the accompanying consolidated balance sheets. See Note 15 – Subsequent Events for additional information regarding the completion of the Company’s initial public offering and its effects.

Recently Adopted Accounting Pronouncements

In December 2019, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes, which simplifies the accounting for income taxes by removing certain exceptions to the general principles in Topic 740 and improves consistent application by clarifying and amending existing guidance. This ASU is effective for annual fiscal years beginning after December 15, 2020, and interim periods therein. The Company adopted this standard effective January 3, 2021, and the adoption of this standard did not materially affect the Company’s consolidated financial statements.

Recently Issued Accounting Pronouncements

In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional expedients and exceptions for applying U.S. GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The amendments in this ASU apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2022. An entity may adopt this ASU as of any date from the beginning of an interim period that includes or is subsequent to March 12, 2020. The Company is currently evaluating the impact of adopting this standard.

In January 2021, the FASB issued ASU 2021-01, Reference Rate Reform (Topic 848): Scope, to clarify that certain optional expedients and exceptions in Topic 848 for contract modifications and hedge accounting apply to derivatives that are affected by the discounting transition. This ASU is effective immediately and should be adopted in conjunction with ASU 2020-04. The Company is currently evaluating the impact of adopting this standard.

Revenue

3 Months Ended

Apr. 03, 2021

Revenue From Contract With Customer [Abstract]

Revenue

REVENUE

Revenue is primarily derived from pediatric healthcare services provided to patients, including private duty nursing, therapy services, and adult home health and hospice services (“patient revenue”) and from the delivery of enteral nutrition and other products to patients (“product revenue”). The services provided by the Company have no fixed duration and can be terminated by the patient or the facility at any time, and therefore, each treatment is its own stand-alone contract. Incremental costs of obtaining a contract are expensed as incurred due to the short-term nature of the contracts.

Services ordered by a healthcare provider in an episode of care are not separately identifiable and therefore have been combined into a single performance obligation for each contract. The Company recognizes revenue as its performance obligations are completed. For patient revenue, the performance obligation is satisfied over time as the customer simultaneously receives and consumes the benefits of the healthcare services provided. For product revenue, the performance obligation is satisfied at the point in time upon delivery to the patient. The Company recognizes patient revenue equally over the number of treatments provided in a single episode of care. Typically, patients and third-party payers are billed within several days of the service being performed, and payments are due based on contract terms.

The Company disaggregates revenue from contracts with customers by reportable segment and by payer within each of the Company’s lines of business. The Company uses a portfolio approach to group contracts with similar characteristics and analyze historical cash collection trends.

The Company’s lines of business are generally classified into the following categories: private duty services; home health and hospice; and medical solutions.

Private Duty Services (“PDS”). The PDS business includes a broad range of pediatric and adult healthcare services including private duty skilled nursing, unskilled services, which include employer of record support services (“EOR”) and personal care services, pediatric therapy services, rehabilitation services, and nursing services in schools and pediatric day healthcare centers.

Home Health & Hospice (“HHH”). The HHH business provides home health, hospice, and personal care services to predominately elderly patients.

Medical Solutions (“MS”). The MS business includes the delivery of enteral nutrition and other products to patients.

Other Revenue. The Company provides financial management services in order to assist families and patients by coordinating the reimbursement of authorized medical expenses between certain state-contracted non-profit programs and families and patients. Other revenue represents the monthly fee earned by the Company for providing these services.

For the PDS, HHH, and MS businesses, the Company receives payments from the following sources for services rendered: (i) state governments under their respective Medicaid programs (“Medicaid”); (ii) Managed Care providers of state government Medicaid programs (“Medicaid MCO”); (iii) commercial insurers; (iv) other government programs including Medicare and Tricare (“Medicare”); and (v) individual patients. As the period between the time of service and time of payment is typically one year or less, the Company elected the practical expedient under ASC 606-10-32-18 and did not adjust for the effects of a significant financing component.

The Company determines the transaction price based on established billing rates reduced by contractual adjustments and discounts provided to third-party payers and implicit price concessions. Contractual adjustments and discounts are based on contractual agreements, discount policies and historical experience. For the PDS, HHH, and MS businesses, implicit price concessions are based on historical collection experience. As of April 3, 2021 and January 2, 2021, estimated explicit and implicit price concessions of $56.3 million and $55.4 million, respectively, were recorded as reductions to our patient accounts receivable balances to enable us to record our revenue and patient accounts receivable at the estimated amounts we expected to collect. For the PDS, HHH, and MS businesses, most contracts contain variable consideration. However, it is unlikely a significant reversal of revenue will occur when the uncertainty is resolved, and therefore, the Company has included the variable consideration in the estimated transaction price. Subsequent changes resulting from a patient’s ability to pay are recorded as bad debt expense which is included as a component of operating expenses in the consolidated statements of operations. The Company did not record any bad debt expense for the three-month periods ended April 3, 2021 and March 28, 2020, respectively.

The Company derives a significant portion of its revenue from Medicaid, Medicaid MCO, and other government payers that receive discounts from established billing rates. The regulations and various managed care contracts under which these discounts must be estimated are complex and subject to interpretation. Management estimates the transaction price on a payer-specific basis given its interpretation of the applicable regulations or contract terms. Updated regulations and contract negotiations occur frequently, necessitating regular review and assessment of the estimation process by management; however, there were no material revenue adjustments recognized from performance obligations satisfied or partially satisfied in previous periods for the three-month periods ended April 3, 2021 and March 28, 2020, respectively.

The following table presents revenue by payer type and as a percentage of revenue for the three-month periods ended April 3, 2021 and March 28, 2020, respectively (in thousands):

	For the Three-Month Periods Ended
	April 3, 2021					March 28, 2020
	Revenue		Percentage			Revenue		Percentage
Medicaid MCO	$	232,884		55.8	%	$	209,873		59.1	%
Medicaid		103,497		24.8	%		94,960		26.7	%
Commercial		47,003		11.3	%		41,235		11.6	%
Medicare		32,016		7.7	%		8,552		2.4	%
Self-pay		1,760		0.4	%		603		0.2	%
Total revenue	$	417,160		100.0	%	$	355,223		100.0	%

- 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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Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI http://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Acquisitions

3 Months Ended

Apr. 03, 2021

Business Combinations [Abstract]

Acquisitions

4.	ACQUISITIONS

Acquisitions During the Three-Month Period Ended April 3, 2021

On March 31, 2021, the Company acquired certain assets of Loma Linda University Medical Center (“Loma Linda”). Loma Linda specializes in providing pediatric, private duty, and home care services in California. Total consideration for the transaction was $0.5 million, which was paid in cash at closing. The total consideration was recorded directly to goodwill on the accompanying consolidated balance sheet. The entire amount of goodwill is deductible for tax purposes.

During the three-month period ended April 3, 2021, the Company incurred $1.8 million in transaction costs, including $0.1 million related to the Loma Linda transaction, as well as $1.7 million related to the subsequent acquisition discussed in Note 15 – Subsequent Events. These costs are included in acquisition-related costs in the accompanying consolidated statement of operations. The Company did not incur any acquisition-related costs during the three-month period ended March 28, 2020.

Pro forma financial information related to the Loma Linda acquisition has not been provided as it is not material to the Company’s consolidated results of operations. The results of operations of the Loma Linda acquisition are included in the Company’s consolidated results of operations from the date of acquisition and were not significant for the three-month period ended April 3, 2021.

Long-Term Obligations and Notes Payable

3 Months Ended

Apr. 03, 2021

Debt Disclosure [Abstract]

Long-Term Obligations and Notes Payable

5.	LONG-TERM OBLIGATIONS AND NOTES PAYABLE

Long-term obligations and notes payable consisted of the following as of April 3, 2021 and January 2, 2021, respectively (dollar amounts in thousands):

Instrument	Stated Maturity Date	Contractual Interest Rate (1)	Interest Rate as of April 3, 2021	April 3, 2021			January 2, 2021
Term loan - First Lien Term Loan	03/2024	L + 4.25%	5.25%	$	561,600		$	563,061
Term loan - First Lien Term Loan Amendment	03/2024	L + 5.5%	6.50%		216,580			217,133
Term loan - First Lien Term Loan Fourth Amendment	03/2024	L + 6.25%	7.25%		184,075			184,538
Subordinated term loan - Second Lien Term Loan	03/2025	L + 8.0%	9.00%		240,000			240,000
Revolving Credit Facility	03/2023	L + 4.25%	5.25%		-			-
Notes payable - finance agreements	09/2021	2.07%	2.07%		1,814			2,872
Total principal amount of long-term obligations and notes payable					1,204,069			1,207,604
Less: unamortized debt issuance costs					(29,286	)		(31,332	)
Total amount of long-term obligations and notes payable, net of unamortized debt issuance costs					1,174,783			1,176,272
Less: current portion of long-term obligations and notes payable					(11,724	)		(12,782	)
Total amount of long-term obligations and notes payable, net of unamortized debt issuance costs, less current portion				$	1,163,059		$	1,163,490
⁽¹⁾ L = Greater of 1.00% or one-month LIBOR

On March 11, 2021, the Company amended its revolving credit facility to increase the maximum availability to $200.0 million, subject to the occurrence of an initial public offering. The amendment also extended the maturity date to March 2023; provided that upon the occurrence of an initial public offering, the maturity date will become the date that is five years after the completion of such initial public offering, or May 2026; provided further that if the Company does not refinance its term loans by December 2023, the maturity date will become December 2023. See Note 15 – Subsequent Events for additional information regarding the completion of the Company’s initial public offering and its effects on the Company’s long-term obligations.

In conjunction with entering into a settlement agreement related to an acquisition, the Company amended its first lien credit agreement on March 19, 2020, and April 1, 2020. These amendments allowed the Company to retain certain legal settlement payments it received during the three-month period ended March 28, 2020 and also increased the letter of credit commitment limit under the revolving credit facility to $30.0 million.

The Company has a LIBOR floor of 1.0% under its credit facilities. Beginning on March 18, 2020 and continuing for the remainder of the first fiscal quarter of 2020, as well as continuing through the three-month period ended April 3, 2021, the LIBOR benchmark rates decreased below 1.0%. Accordingly, the LIBOR floor rate of 1.0% became operative under the Company’s credit facility agreements and remained in effect at April 3, 2021.

Debt issuance costs related to the term loans are recorded as a direct deduction from the carrying amount of the debt. The balance for debt issuance costs related to the term loans as of April 3, 2021 and January 2, 2021 was $29.3 million and $31.3 million, respectively. Debt issuance costs related to the revolving credit facility are recorded within other long-term assets. The balance for debt issuance costs related to the revolving credit facility as of April 3, 2021 and January 2, 2021 was $0.4 million and $0.5 million, respectively. The Company recognized $2.1 million and $1.7 million of interest expense related to the amortization of debt issuance costs during the three-month periods ended April 3, 2021 and March 28, 2020, respectively.

Issued letters of credit as of April 3, 2021 and January 2, 2021 were $19.8 million, respectively. There were no swingline loans outstanding as of April 3, 2021 and January 2, 2021, respectively. Borrowing capacity under the revolving credit facility was $55.2 million as of April 3, 2021 and January 2, 2021, respectively.

The Company was in compliance with all financial covenants and restrictions at April 3, 2021 and January 2, 2021.

Fair Value Measurements

3 Months Ended

Apr. 03, 2021

Fair Value Disclosures [Abstract]

Fair Value Measurements

6.	FAIR VALUE MEASUREMENTS

The carrying amounts of cash and cash equivalents, patient accounts receivable, accounts payable, accrued expenses and other current liabilities approximate their fair values due to the short-term maturities of the instruments.

The Company’s other liabilities measured at fair value are as follows (amounts in thousands):

	Fair Value Measurements at April 3, 2021
	Level 1		Level 2		Level 3		Total
Liabilities:
Interest rate swap agreements	$	-	$	25,804	$	-	$	25,804
	$	-	$	25,804	$	-	$	25,804

	Fair Value Measurements at January 2, 2021
	Level 1		Level 2		Level 3		Total
Liabilities:
Interest rate swap agreements	$	-	$	28,624	$	-	$	28,624
	$	-	$	28,624	$	-	$	28,624

The fair values of the interest rate swap agreements are based on the estimated net proceeds or costs to settle the transactions as of the respective balance sheet dates. The valuations are based on commercially reasonable industry and market practices for valuing similar financial instruments. See Note 7 – Derivative Financial Instruments for further details on the Company’s interest rate swap arrangements.

- 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 + Details

Derivative Financial Instruments

3 Months Ended

Apr. 03, 2021

Derivative Instruments And Hedging Activities Disclosure [Abstract]

Derivative Financial Instruments

7.	DERIVATIVE FINANCIAL INSTRUMENTS

The Company’s earnings and cash flows are subject to fluctuations due to changes in interest rates, and the Company seeks to mitigate a portion of this risk by entering into derivative contracts. The derivatives the Company currently uses are interest rate swaps. The Company recognizes derivatives as either assets or liabilities at fair value on the accompanying consolidated balance sheets and does not designate the derivatives as hedging instruments. Changes in the fair value of derivatives are therefore recorded in earnings throughout the term of the respective derivative.

In October 2018, the Company entered into two interest rate swap agreements to limit its exposure to interest rate risk on its variable rate debt. At April 3, 2021 and January 2, 2021, the aggregate notional amount of the interest rate swaps was $520.0 million, respectively. The fair value of the interest rate swaps at April 3, 2021 and January 2, 2021 was $25.8 million and $28.6 million, respectively, and is included in other long-term liabilities on the accompanying consolidated balance sheets. The agreements expire on October 31, 2023. The Company does not apply hedge accounting to these agreements and records all mark-to-market adjustments directly to other income on the accompanying consolidated statements of operations. The effects of the interest rate swaps are recognized through cash flows from operating activities on the accompanying consolidated statements of cash flows.

The following gains (losses) from these derivatives not designated as hedging instruments were recognized in the Company’s consolidated statements of operations for the three-month periods ended April 3, 2021 and March 28, 2020, respectively (amounts in thousands):

	Statement of Operations	For the Three-Month Periods Ended
	Classification	April 3, 2021		March 28, 2020
Interest rate swap agreements	Other income	$	2,820	$	(6,422	)

The Company does not utilize financial instruments for trading or other speculative purposes.

Income Taxes

3 Months Ended

Apr. 03, 2021

Income Tax Disclosure [Abstract]

Income Taxes

8.	INCOME TAXES

The Company’s provision for income taxes is recorded on an interim basis based upon the Company’s estimate of the annual effective income tax rate for the full year applied to “ordinary” income or loss, adjusted each quarter for discrete items.

The Company recorded income tax expense of $0.3 million and $1.1 million for the three-month periods ended April 3, 2021 and March 28, 2020, respectively. The Company’s effective tax rate was 4.8% and 2.9% for the three-month periods ended April 3, 2021 and March 28, 2020, respectively. The effective tax rates for the three-month periods ended April 3, 2021 and March 28, 2020 differ from the statutory rate of 21% primarily due to a release of a valuation allowance recorded for certain deferred tax assets reflected in the consolidated financial statements and separate state and local income taxes on taxable subsidiaries. The valuation allowance release is due to pre-tax book income recorded in the quarter.

For the three-month period ended April 3, 2021, there were no material changes to the Company’s uncertain tax positions. There has been no change to the Company’s policy that recognizes potential interest and penalties related to uncertain tax positions within the Company’s operations in income tax expense.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References + Details

Stockholders' Equity and Stock-Based Compensation

3 Months Ended

Apr. 03, 2021

Shareholders Equity And Share Based Compensation [Abstract]

Stockholders' Equity and Stock-Based Compensation

9.	STOCKHOLDERS’ EQUITY AND STOCK-BASED COMPENSATION

On March 19, 2020, the Company issued 5,124,995 shares of common stock as a result of equity contributions totaling $50.0 million. This transaction caused no significant changes in the Company’s ownership structure. The proceeds were used to fund strategic growth initiatives and provide additional liquidity for business operations.

See Note 15 – Subsequent Events for additional information regarding the completion of the Company’s initial public offering and its effects on stockholders’ equity and stock-based compensation.

Commitments and Contingencies

3 Months Ended

Apr. 03, 2021

Commitments And Contingencies Disclosure [Abstract]

Commitments and Contingencies

10.	COMMITMENTS AND CONTINGENCIES

Insurance Reserves

As is typical in the healthcare industry, the Company is subject to claims that its services have resulted in patient injury or other adverse effects.

The accrued insurance reserves included in the accompanying consolidated balance sheets include estimates of the ultimate costs, in the event the Company was unable to receive funds from claims made under commercial insurance policies, for claims that have been reported but not paid and claims that have been incurred but not reported at the balance sheet dates. Although substantially all reported claims are paid directly by the Company’s commercial insurance carriers, the Company is ultimately responsible for payment of these claims in the event its insurance carriers become insolvent or otherwise do not honor the contractual obligations under the malpractice policies. The Company is required under U.S. GAAP to recognize these estimated liabilities in its consolidated financial statements on a gross basis; with a corresponding receivable from the insurance carriers reflecting the contractual indemnity provided by the carriers under the related malpractice policies.

The Company maintains primary commercial insurance coverage on a claim basis for professional malpractice claims with a $500,000 per claim deductible and $6.0 million per claim and annual aggregate limits. Moreover, the Company maintains excess insurance coverage for professional malpractice claims. In addition, the Company maintains workers’ compensation insurance with a $500,000 per claim deductible and statutory limits. The Company reimburses insurance carriers for deductible losses under these policies. The Company’s insurance carriers require collateral to secure the Company’s obligation to reimburse insurance

carriers for these deductible payments. Collateral as of April 3, 2021 and January 2, 2021 was comprised of $18.8 million of issued letters of credit, $2.9 million in cash collateral, and $2.3 million in surety bonds, respectively.

As of April 3, 2021, insurance reserves totaling $79.7 million were included on the consolidated balance sheets, representing $41.2 million and $38.5 million of reserves for professional malpractice claims and workers’ compensation claims, respectively. At January 2, 2021, insurance reserves totaling $74.6 million were included on the consolidated balance sheets, representing $38.5 million and $36.1 million of reserves for professional malpractice claims and workers’ compensation claims, respectively.

Litigation and Other Current Liabilities

On December 16, 2016, Aveanna Healthcare LLC (f/k/a BCPE Eagle Buyer LLC) entered into a stock purchase agreement with Epic/Freedom, LLC, Epic Acquisition, Inc., and FHH Holdings, Inc. for Aveanna Healthcare LLC to acquire Epic Acquisition, Inc. and FHH Holdings, Inc. (the “Acquisition”). The Acquisition closed on March 16, 2017. On February 19, 2020, the Company entered into a settlement agreement for a legal claim totaling $50.0 million related to the Acquisition. The settlement proceeds were included in other income in the accompanying consolidated statement of operations for the three-month period ended March 28, 2020.

On December 24, 2018, Aveanna Healthcare LLC (“Aveanna”) entered into a Stock Purchase Agreement (the “Agreement”) to acquire a pediatric home health company (the “Seller”). The agreement contained a provision whereby a $75.0 million transaction termination fee (the “Break-up Fee”) could be payable to the Seller under certain circumstances. On December 20, 2019, Aveanna terminated the Agreement, and the Seller demanded payment of the Break-up Fee. The Company believes the Agreement was terminated for cause and therefore no payment of the Break-up Fee is due to the Seller. The Seller has disputed this assertion. While the Company believes that litigation over this matter is unlikely at the present time, it is possible that the Company and the Seller may in the future pursue claims and counterclaims related to the termination of the Agreement and payment of the Break-up Fee. At this time, the Company is unable to predict the possible loss or range of loss, if any, associated with the resolution of any such litigation, or any potential related effect on the Company or its business or operations.

The Company is currently a party to various routine litigation incidental to the business. While management currently believes that the ultimate outcome of such proceedings, individually and in the aggregate, will not have a material adverse effect on the Company’s financial position or overall trends in results of operations, litigation is subject to inherent uncertainties. Management has established provisions within other current liabilities in the accompanying consolidated balance sheets, which in the opinion of management represents the best estimate of exposure and adequately provides for such losses that may occur from asserted claims related to the provision of professional services and which may not be covered by the Company’s insurance policies. Management believes that any additional unfavorable provisions would not be material to the Company’s results of operations or financial position; however, if an unfavorable ruling on any asserted or unasserted claim were to occur, there exists the possibility of a material adverse impact on the Company’s net earnings or financial position. The estimate of the potential impact from legal proceedings on the Company’s financial position or overall results of operations could change in the future.

Healthcare Regulatory Matters

On October 30, 2019 the Company received a grand jury subpoena (“Subpoena”) issued by the U.S. Department of Justice, Antitrust Division (the “Antitrust Division”) requiring the production of documents and information pertaining to nurse wages and hiring activities in two of its local markets. The Company is fully cooperating with the Antitrust Division with respect to this investigation and management believes this matter is unlikely to materially impact the Company’s business, results of operations or financial condition. However, based on the information currently available to the Company, management cannot predict the timing or outcome of this investigation or predict the possible loss or range of loss, if any, associated with the resolution of this litigation.

Laws and regulations governing the government payer programs are complex and subject to interpretation. Compliance with such laws and regulations can be subject to future governmental review and interpretation as well as significant regulatory action. From time to time, governmental regulatory agencies conduct inquiries and audits of the Company’s practices. It is the Company’s practice to cooperate fully with such inquiries. In addition to laws and regulations governing the Medicaid, Medicaid Managed Care, and Tricare programs, there are a number of federal and state laws and regulations governing matters such as the corporate practice of medicine, fee splitting arrangements, anti-kickback statues, physician self-referral laws, false or fraudulent claims filing and patient privacy requirements. Failure to comply with any such laws or regulations could have an adverse impact on the Company’s operations and financial results. The Company believes that it is in material compliance with all applicable laws and regulations and is not aware of any pending or threatened investigations involving allegations of wrongdoing.

Covid 19

3 Months Ended

Apr. 03, 2021

Covid19 C A R E S Act [Abstract]

Covid 19

11.

COVID-19

In March 2020, the World Health Organization declared COVID-19 a pandemic. The COVID-19 outbreak has adversely impacted economic activity and conditions worldwide, including workforces, liquidity, capital markets, consumer behavior, supply chains and macroeconomic conditions. After the declaration of a national emergency in the United States on March 13, 2020, in compliance with stay-at-home and physical distancing orders and other restrictions on movement and economic activity intended to reduce the spread of COVID-19, the Company altered numerous clinical, operational, and business processes. While each of the states deemed healthcare services an essential business, allowing the Company to continue to deliver healthcare services to patients, the effects of the pandemic have been wide-reaching.

In response to COVID-19, the U.S. Government enacted the CARES Act on March 27, 2020. The following portions of the CARES Act have impacted the Company:

Provider Relief Fund (“PRF”): Beginning in April 2020, funds were distributed to health care providers who provide or provided diagnoses, testing or care for individuals with possible or actual cases of COVID-19. During fiscal year 2020, the Company received PRF payments totaling $25.1 million, which were included in government stimulus liabilities on the accompanying consolidated balance sheet as of January 2, 2021. On March 5, 2021, the Company repaid these PRF payments in full.

State Sponsored Relief Funds: In fiscal year 2020, the Company received $4.8 million of stimulus funds from the Commonwealth of Pennsylvania Department of Human Services (“Pennsylvania DHS”). Such funds were not applied for or requested. The Company did not receive stimulus funds from any individual state other than Pennsylvania. The Company recognized $0.5 million of income related to these funds in fiscal year 2020, with the remaining $4.3 million included in government stimulus liabilities on the accompanying consolidated balance sheet as of January 2, 2021. On February 4, 2021, the Company repaid the remaining $4.3 million of direct stimulus funds to Pennsylvania DHS.

Deferred payment of the employer portion of social security taxes: The Company was permitted to defer payments of the employer portion of social security taxes in fiscal year 2020, which are payable in 50% increments, with the first 50% due by December 31, 2021, and the second 50% due by December 31, 2022. The Company did not defer any payroll taxes after December 31, 2020. As of April 3, 2021, the Company had deferred payment of $49.6 million of social security taxes in total, which is reflected in the current portion of deferred payroll taxes and in the deferred payroll taxes, less current portion liabilities on the accompanying consolidated balance sheet. The Company did not commence deferrals until April 1, 2020; therefore the Company did not defer any payroll taxes during the three-month period ended March 28, 2020.

Temporary reimbursement rate increases from various state Medicaid and Medicaid Managed Care Programs: Shortly after the onset of the COVID-19 pandemic in March 2020, numerous state Medicaid programs began to issue temporary rate increases and similarly directed Medicaid Managed Care programs within those states to likewise adjust rates. These temporary rate increases are paid to the Company via normal claim processing by the respective payers. Over the remainder of fiscal year 2020 and continuing into fiscal year 2021, while some states discontinued the temporary rate increases, most states issued continuations of the temporary rate increases with many state legislatures communicating support for either making such increases permanent or otherwise increasing PDS reimbursement rates.

Medicare Advances: Certain of the home health and hospice companies the Company has acquired received advance payments from the Centers for Medicare & Medicaid Services (“CMS”) in April 2020, pursuant to the expansion of the Accelerated Payments Program provided for in the CARES Act. Advances received by the Company as of April 3, 2021 totaled $4.3 million. These advances become payable beginning one year from the date on which the accelerated advance was issued. The repayments occur via offsets by Medicare to current payments otherwise due from Medicare at a rate of 25% for the first eleven months. After the eleven months end, payments will be recouped at a rate of 50% for another six months, after which any remaining balance will become due.

Temporary Suspension of Medicare Sequestration: The Budget Control Act of 2011 requires a mandatory, across the board reduction in federal spending, called a sequestration. Medicare fee-for-service claims with dates of service or dates of discharge on or after April 1, 2013 incur a 2.0% reduction in Medicare payments. All Medicare rate payments and settlements are subject to this mandatory reduction, which will continue to remain in place through at least 2023, unless Congress takes further action. In response to COVID-19, the CARES Act temporarily suspended the automatic 2.0% reduction of Medicare claim reimbursements for the period from May 1, 2020 through December 31, 2021.

Related Party Transactions

3 Months Ended

Apr. 03, 2021

Related Party Transactions

12.	RELATED PARTY TRANSACTIONS

The Company had entered into an advisory services agreement with affiliates of certain stockholders of the Company (the “Management Agreement”). Under this agreement, the managers provide general and strategic advisory services and are paid a quarterly management fee plus out of pocket expenses. The Company incurred management fees and expenses totaling $0.9 million and $0.8 million during the three-month periods ended April 3, 2021 and March 28, 2020, respectively, which are included in corporate expenses in the accompanying consolidated statements of operations. The Company did not owe any amounts in connection with the Management Agreement as of April 3, 2021. Amounts owed by the Company in connection with the Management Agreement totaled $1.6 million as of January 2, 2021 and were included in accounts payable and other accrued liabilities on the consolidated balance sheet. See Note 15 – Subsequent Events for additional information regarding the completion of the Company’s initial public offering and the resulting termination of the Management Agreement.

One of the Company’s stockholders has an ownership interest in a revenue cycle vendor used by the Company for eligibility and clearinghouse billing services. Fees for such services totaled $0.1 million during each of the three-month periods ended April 3, 2021 and March 28, 2020, respectively, and are included in corporate expenses in the accompanying consolidated statements of operations. The Company did not owe any amounts in connection with the expenses described above as of April 3, 2021 and January 2, 2021, respectively.

As of April 3, 2021, one of the Company’s stockholders owned 5.7% of the Company’s first lien term loan.

Segment Information

3 Months Ended

Apr. 03, 2021

Segment Reporting [Abstract]

Segment Information

13.	SEGMENT INFORMATION

The Company’s operating segments have been identified based upon how management has organized the business by services provided to customers and how the chief operating decision maker (“CODM”) manages the business and allocates resources, consistent with the criteria in ASC 280, Segment Reporting. The Company has three operating segments and three reportable segments, Private Duty Services, Home Health & Hospice, and Medical Solutions. The PDS segment predominantly includes private duty skilled nursing services, unskilled and personal care services, and pediatric therapy services. The HHH segment provides home health and hospice services to predominately elderly patients. Through the MS segment, the Company provides enteral nutrition and other products to adults and children, delivered on a periodic or as-needed basis.

The CODM evaluates performance using gross margin (and gross margin percentage). Gross margin includes revenue less all costs of revenue, excluding depreciation and amortization, but excludes branch and regional administrative expenses, corporate expenses and other non-field expenses. The CODM does not evaluate a measure of assets when assessing performance.

Results shown for the three-month periods ended April 3, 2021 and March 28, 2020 are not necessarily those which would be achieved if each segment was an unaffiliated business enterprise. There are no intersegment transactions.

The following tables summarize the Company’s segment information for the three-month periods ended April 3, 2021 and March 28, 2020, respectively (amounts in thousands):

	For the Three-Month Period Ended April 3, 2021
	PDS			HHH			MS			Total
Revenue	$	350,827		$	31,518		$	34,815		$	417,160
Cost of revenue, excluding depreciation and amortization		248,997			17,329			19,151			285,477
Gross margin	$	101,830		$	14,189		$	15,664		$	131,683
Gross margin percentage		29.0	%		45.0	%		45.0	%		31.6	%

	For the Three-Month Period Ended March 28, 2020
	PDS			HHH			MS			Total
Revenue	$	320,513		$	4,477		$	30,233		$	355,223
Cost of revenue, excluding depreciation and amortization		227,963			2,803			16,916			247,682
Gross margin	$	92,550		$	1,674		$	13,317		$	107,541
Gross margin percentage		28.9	%		37.4	%		44.0	%		30.3	%

	For the Three-Month Periods Ended
Segment Reconciliation:	April 3, 2021			March 28, 2020
Total segment gross margin	$	131,683		$	107,541
Branch and regional administrative expenses		69,372			59,694
Corporate expenses		27,399			25,797
Depreciation and amortization		4,848			4,183
Acquisition-related costs		1,768			-
Operating income		28,296			17,867
Interest income		77			46
Interest expense		(22,425	)		(21,063	)
Loss on debt extinguishment		-			127
Other income		159			41,791
Income before income taxes	$	6,107		$	38,768

- 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/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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+ Details

Net Income Per Share

3 Months Ended

Apr. 03, 2021

Earnings Per Share [Abstract]

Net Income Per Share

14.	NET INCOME PER SHARE

Basic net income per share is calculated by dividing net income by the weighted average number of shares of common stock outstanding for the period. Diluted net income per share is calculated by dividing net income by the diluted weighted average number of shares of common stock outstanding for the period. For purposes of this calculation, outstanding stock options are considered potential dilutive shares of common stock. The following is a computation of basic and diluted net income per share (dollar amounts in thousands, except per share amounts):

	For the Three-Month Periods Ended
	April 3, 2021		March 28, 2020
Numerator:
Net income	$	5,798	$	37,637
Denominator:
Weighted average shares of common stock outstanding ⁽¹⁾, basic		142,122,934		137,468,875
Net income per share, basic	$	0.04	$	0.27

Weighted average shares of common stock outstanding ⁽¹⁾, diluted		146,266,014		140,330,909
Net income per share, diluted	$	0.04	$	0.27
Dilutive securities outstanding not included in the computation of diluted net income per share as their effect is antidilutive:
Stock options		7,479,384		6,015,548

(1)

The calculation of weighted average shares of common stock outstanding includes all vested deferred restricted stock units.

Subsequent Events

3 Months Ended

Apr. 03, 2021

Subsequent Events [Abstract]

Subsequent Events

15.	SUBSEQUENT EVENTS

Acquisition

On April 16, 2021, the Company acquired 100% of the issued and outstanding membership interests of Doctor’s Choice Holdings, LLC (“Doctor’s Choice”) for a purchase price of $115.0 million, subject to customary adjustments. Doctor’s Choice provides home health services in Florida. As part of funding the Doctor’s Choice acquisition, on the date of acquisition, the Company borrowed incremental amounts under the existing Second Lien Term Loan of $67.0 million, including debt issuance costs of $1.7 million. The entire portion of the proceeds, as well as cash on hand, were used to pay cash consideration at closing and costs and expenses incurred by the Company in connection with the transaction of $2.4 million.

Change in capital structure

On April 19, 2021, the Company’s Board of Directors and its stockholders approved, and the Company filed, amendments to the Company’s certificate of incorporation, including the Company’s Second Amended and Restated Certificate of Incorporation, which (i) eliminated Class B common stock, resulting in one class of shares of common stock authorized, issued and outstanding, (ii) effected a one-to-20.5 forward stock split and (iii) authorized 1,000,000,000 shares of common stock and 5,000,000 shares of preferred stock. The par value of each share of common stock and preferred stock was not adjusted in connection with the aforementioned forward stock split.

All share and per share information for prior periods, including options to purchase shares of common stock, deferred restricted stock units, option exercise prices, weighted average fair value of options granted, shares of common stock and additional paid-in capital accounts on the consolidated balance sheets and consolidated statements of stockholders’ equity, including the notes to the consolidated financial statements, have been retroactively adjusted, where applicable, to reflect the stock split and the increase in authorized shares.

Stock Incentive Plan

On April 19, 2021, the Company’s Board of Directors adopted the Company’s Amended and Restated 2017 Stock Incentive Plan (the “Amended Plan”). The Amended Plan (i) provides for the issuance of common stock, as opposed to the Class B common stock previously issuable under the plan, to align with the Company’s Amended and Restated Certificate of Incorporation and (ii) modified the vesting terms of the existing issued performance-vesting options to now vest upon the achievement of volume weighted average price per share hurdles for any ninety consecutive days commencing on or after the nine-month anniversary of the initial public offering.

The issuance of shares of common stock rather than Class B common stock resulted in a modification of the Company’s time-vesting options for accounting purposes; however, the incremental fair value was not material. The amendment of the vesting terms for the performance-vesting options has not yet resulted in a modification for accounting purposes as the Company’s Board of Directors has not specified the volume weighted average price per share.

Initial Public Offering and Use of Proceeds

On May 3, 2021, the Company completed its initial public offering and received proceeds, net of underwriters’ discounts and commissions, of $432.4 million in exchange for the issuance of 38,236,000 shares of the Company’s common stock. On May 3, 2021, the Company paid an aggregate principal amount of $307.0 million to repay in full all outstanding obligations under the second lien credit agreement, including the incremental amount borrowed in connection with financing the acquisition of Doctor’s Choice, thereby terminating the second lien credit agreement. In addition, on May 4, 2021, the Company repaid $100.0 million in principal amount of its outstanding indebtedness under the first lien credit agreement.

On May 4, 2021, following completion of the initial public offering and satisfaction of the other applicable conditions precedent, the maximum availability of the Company’s revolving credit facility increased from $75.0 million to $200.0 million. In connection with this increase in capacity, the Company incurred debt issuance costs of $1.3 million, which the Company capitalized and included in other long-term assets during the second fiscal quarter of 2021.

Upon completion of the initial public offering, the Management Agreement was terminated. Additionally, the managers agreed to waive the fee due to them from the Company upon the successful completion of an initial public offering.

The Company granted the underwriters an overallotment option to purchase up to an additional 5,735,400 shares of common stock from the Company at the offering price of $12.00 per share, less the underwriting discounts and commissions, within 30 days from the date of the Prospectus, dated April 28, 2021. On May 21, 2021, the underwriters exercised their overallotment option to acquire an additional 4,000,000 shares of the Company’s common stock. This transaction was completed on May 25, 2021 and resulted in additional proceeds to the Company of $45.2 million, after deducting underwriting costs of $2.8 million.

Summary of Significant Accounting Policies (Policies)	3 Months Ended
Summary of Significant Accounting Policies (Policies)	Apr. 03, 2021
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation The accompanying interim unaudited consolidated financial statements include the accounts of Aveanna Healthcare Holdings Inc. and its wholly owned subsidiaries. All intercompany accounts and transactions have been eliminated in the accompanying interim unaudited consolidated financial statements, and business combinations accounted for as purchases have been included in the accompanying interim unaudited consolidated financial statements from their respective dates of acquisition.
Basis of Presentation	Basis of Presentation The accompanying consolidated financial statements are unaudited and have been prepared by the Company in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information and in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”). Accordingly, these interim unaudited consolidated financial statements do not include all the information and disclosures required by U.S. GAAP for complete financial statements. In the opinion of management, these interim unaudited consolidated financial statements reflect all adjustments, consisting of normal recurring adjustments, necessary to present fairly the Company’s financial position as of April 3, 2021 and the results of operations for the three-month periods ended April 3, 2021 and March 28, 2020, respectively. The results reported in these interim unaudited consolidated financial statements should not be regarded as indicative of results that may be expected for any other period or the entire year. These interim unaudited consolidated financial statements and related notes should be read in conjunction with the audited consolidated financial statements and related notes for the year ended January 2, 2021 included in the Company’s prospectus dated April 28, 2021 (the “Prospectus”), which is deemed to be part of the Company’s Registration Statement on Form S-1 (File No. 333-254981) filed with the SEC. Our fiscal year ends on the Saturday that is closest to December 31 of a given year, resulting in either a 52 or 53-week fiscal year. The accompanying interim unaudited consolidated balance sheets reflect the accounts of the Company as of April 3, 2021 and January 2, 2021. For the three-month periods ended April 3, 2021 and March 28, 2020, the accompanying interim unaudited consolidated statements of operations, stockholders’ equity and cash flows reflect the accounts of the Company from January 3, 2021 through April 3, 2021 and December 29, 2019 through March 28, 2020, respectively.
Use of Estimates	Use of Estimates The Company’s accounting and reporting policies conform with U.S. GAAP. In preparing the consolidated financial statements, the Company is required to make estimates and assumptions that impact the amounts reported in these consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates.
Deferred Offering Costs	Deferred Offering Costs The Company has deferred offering costs, consisting of legal, accounting, filing and other fees and costs directly attributable to the Company’s initial public offering. The deferred offering costs will be offset against the proceeds received upon the closing of the initial public offering. As of April 3, 2021 and January 2, 2021, capitalized deferred offering costs totaled $4.8 million and $2.9 million, respectively, and were included in other long-term assets on the accompanying consolidated balance sheets. See Note 15 – Subsequent Events for additional information regarding the completion of the Company’s initial public offering and its effects.
Recently Adopted and Issued Accounting Pronouncements	Recently Adopted Accounting Pronouncements In December 2019, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes, which simplifies the accounting for income taxes by removing certain exceptions to the general principles in Topic 740 and improves consistent application by clarifying and amending existing guidance. This ASU is effective for annual fiscal years beginning after December 15, 2020, and interim periods therein. The Company adopted this standard effective January 3, 2021, and the adoption of this standard did not materially affect the Company’s consolidated financial statements. Recently Issued Accounting Pronouncements In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional expedients and exceptions for applying U.S. GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The amendments in this ASU apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2022. An entity may adopt this ASU as of any date from the beginning of an interim period that includes or is subsequent to March 12, 2020. The Company is currently evaluating the impact of adopting this standard. In January 2021, the FASB issued ASU 2021-01, Reference Rate Reform (Topic 848): Scope, to clarify that certain optional expedients and exceptions in Topic 848 for contract modifications and hedge accounting apply to derivatives that are affected by the discounting transition. This ASU is effective immediately and should be adopted in conjunction with ASU 2020-04. The Company is currently evaluating the impact of adopting this standard.

Revenue (Tables)

3 Months Ended

Apr. 03, 2021

Revenue From Contract With Customer [Abstract]

Schedule of Revenue by Payer Type and Percentage of Patient and Product Revenue

The following table presents revenue by payer type and as a percentage of revenue for the three-month periods ended April 3, 2021 and March 28, 2020, respectively (in thousands):

	For the Three-Month Periods Ended
	April 3, 2021					March 28, 2020
	Revenue		Percentage			Revenue		Percentage
Medicaid MCO	$	232,884		55.8	%	$	209,873		59.1	%
Medicaid		103,497		24.8	%		94,960		26.7	%
Commercial		47,003		11.3	%		41,235		11.6	%
Medicare		32,016		7.7	%		8,552		2.4	%
Self-pay		1,760		0.4	%		603		0.2	%
Total revenue	$	417,160		100.0	%	$	355,223		100.0	%

Long-Term Obligations and Notes Payable (Tables)

3 Months Ended

Apr. 03, 2021

Debt Disclosure [Abstract]

Schedule of Long-Term Obligations and Notes Payable

Long-term obligations and notes payable consisted of the following as of April 3, 2021 and January 2, 2021, respectively (dollar amounts in thousands):

Instrument	Stated Maturity Date	Contractual Interest Rate (1)	Interest Rate as of April 3, 2021	April 3, 2021			January 2, 2021
Term loan - First Lien Term Loan	03/2024	L + 4.25%	5.25%	$	561,600		$	563,061
Term loan - First Lien Term Loan Amendment	03/2024	L + 5.5%	6.50%		216,580			217,133
Term loan - First Lien Term Loan Fourth Amendment	03/2024	L + 6.25%	7.25%		184,075			184,538
Subordinated term loan - Second Lien Term Loan	03/2025	L + 8.0%	9.00%		240,000			240,000
Revolving Credit Facility	03/2023	L + 4.25%	5.25%		-			-
Notes payable - finance agreements	09/2021	2.07%	2.07%		1,814			2,872
Total principal amount of long-term obligations and notes payable					1,204,069			1,207,604
Less: unamortized debt issuance costs					(29,286	)		(31,332	)
Total amount of long-term obligations and notes payable, net of unamortized debt issuance costs					1,174,783			1,176,272
Less: current portion of long-term obligations and notes payable					(11,724	)		(12,782	)
Total amount of long-term obligations and notes payable, net of unamortized debt issuance costs, less current portion				$	1,163,059		$	1,163,490
⁽¹⁾ L = Greater of 1.00% or one-month LIBOR

- 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

Fair Value Measurements (Tables)

3 Months Ended

Apr. 03, 2021

Fair Value Disclosures [Abstract]

Summary of Other Liabilities Measured at Fair Value

The Company’s other liabilities measured at fair value are as follows (amounts in thousands):

	Fair Value Measurements at April 3, 2021
	Level 1		Level 2		Level 3		Total
Liabilities:
Interest rate swap agreements	$	-	$	25,804	$	-	$	25,804
	$	-	$	25,804	$	-	$	25,804

	Fair Value Measurements at January 2, 2021
	Level 1		Level 2		Level 3		Total
Liabilities:
Interest rate swap agreements	$	-	$	28,624	$	-	$	28,624
	$	-	$	28,624	$	-	$	28,624

Derivative Financial Instruments (Tables)

3 Months Ended

Apr. 03, 2021

Derivative Instruments And Hedging Activities Disclosure [Abstract]

Schedule of Gains (Losses) from Derivatives

	Statement of Operations	For the Three-Month Periods Ended
	Classification	April 3, 2021		March 28, 2020
Interest rate swap agreements	Other income	$	2,820	$	(6,422	)

Segment Information (Tables)

3 Months Ended

Apr. 03, 2021

Segment Reporting [Abstract]

Summary of Segment Information

The following tables summarize the Company’s segment information for the three-month periods ended April 3, 2021 and March 28, 2020, respectively (amounts in thousands):

	For the Three-Month Period Ended April 3, 2021
	PDS			HHH			MS			Total
Revenue	$	350,827		$	31,518		$	34,815		$	417,160
Cost of revenue, excluding depreciation and amortization		248,997			17,329			19,151			285,477
Gross margin	$	101,830		$	14,189		$	15,664		$	131,683
Gross margin percentage		29.0	%		45.0	%		45.0	%		31.6	%

	For the Three-Month Period Ended March 28, 2020
	PDS			HHH			MS			Total
Revenue	$	320,513		$	4,477		$	30,233		$	355,223
Cost of revenue, excluding depreciation and amortization		227,963			2,803			16,916			247,682
Gross margin	$	92,550		$	1,674		$	13,317		$	107,541
Gross margin percentage		28.9	%		37.4	%		44.0	%		30.3	%

	For the Three-Month Periods Ended
Segment Reconciliation:	April 3, 2021			March 28, 2020
Total segment gross margin	$	131,683		$	107,541
Branch and regional administrative expenses		69,372			59,694
Corporate expenses		27,399			25,797
Depreciation and amortization		4,848			4,183
Acquisition-related costs		1,768			-
Operating income		28,296			17,867
Interest income		77			46
Interest expense		(22,425	)		(21,063	)
Loss on debt extinguishment		-			127
Other income		159			41,791
Income before income taxes	$	6,107		$	38,768

Net Income Per Share (Tables)

3 Months Ended

Apr. 03, 2021

Earnings Per Share [Abstract]

Summary of Computation of Basic and Diluted Net Income Per Share

The following is a computation of basic and diluted net income per share (dollar amounts in thousands, except per share amounts):

	For the Three-Month Periods Ended
	April 3, 2021		March 28, 2020
Numerator:
Net income	$	5,798	$	37,637
Denominator:
Weighted average shares of common stock outstanding ⁽¹⁾, basic		142,122,934		137,468,875
Net income per share, basic	$	0.04	$	0.27

Weighted average shares of common stock outstanding ⁽¹⁾, diluted		146,266,014		140,330,909
Net income per share, diluted	$	0.04	$	0.27
Dilutive securities outstanding not included in the computation of diluted net income per share as their effect is antidilutive:
Stock options		7,479,384		6,015,548

(1)

The calculation of weighted average shares of common stock outstanding includes all vested deferred restricted stock units.

Description of Business - Additional Information (Details)	Apr. 03, 2021 State
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Number of states in which entity operates	30

Summary of Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Millions	Apr. 03, 2021	Jan. 02, 2021
Summary Of Significant Accounting Policies [Line Items]
Capitalized deferred offering costs	$ 4.8	$ 2.9
ASU 2019-12
Summary Of Significant Accounting Policies [Line Items]
Change in accounting principle, accounting standards update, adopted [true false]	true
Change in accounting principle, accounting standards update, adoption date	Jan. 03, 2021
Change in accounting principle, accounting standards update, immaterial effect [true false]	true

- Definition

Indicates (true false) whether accounting standards update was adopted.

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- Definition

Date accounting standards update was adopted, in CCYY-MM-DD format.

+ References

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

Revenue - Additional Information (Detail) - USD ($)	3 Months Ended
Revenue - Additional Information (Detail) - USD ($)	Apr. 03, 2021	Mar. 28, 2020	Jan. 02, 2021
Revenue Disclosure [Line Items]
Estimated price concession	$ 56,300,000		$ 55,400,000
Bad debt expense	$ 0	$ 0
Maximum
Revenue Disclosure [Line Items]
Revenue, performance obligation, expected timing of satisfaction, period	1 year

Revenue - Schedule of Revenue by Payer Type and Percentage of Revenue (Detail) - USD ($) $ in Thousands	3 Months Ended
	Apr. 03, 2021	Mar. 28, 2020
Disaggregation Of Revenue [Line Items]
Total revenue	$ 417,160	$ 355,223
Revenue from Contract with Customer, Product and Service Benchmark
Disaggregation Of Revenue [Line Items]
Percentage of total revenue	100.00%	100.00%
Medicaid MCO
Disaggregation Of Revenue [Line Items]
Total revenue	$ 232,884	$ 209,873
Medicaid MCO \| Customer Concentration Risk \| Revenue from Contract with Customer, Product and Service Benchmark
Disaggregation Of Revenue [Line Items]
Percentage of total revenue	55.80%	59.10%
Medicaid
Disaggregation Of Revenue [Line Items]
Total revenue	$ 103,497	$ 94,960
Medicaid \| Customer Concentration Risk \| Revenue from Contract with Customer, Product and Service Benchmark
Disaggregation Of Revenue [Line Items]
Percentage of total revenue	24.80%	26.70%
Commercial
Disaggregation Of Revenue [Line Items]
Total revenue	$ 47,003	$ 41,235
Commercial \| Customer Concentration Risk \| Revenue from Contract with Customer, Product and Service Benchmark
Disaggregation Of Revenue [Line Items]
Percentage of total revenue	11.30%	11.60%
Medicare
Disaggregation Of Revenue [Line Items]
Total revenue	$ 32,016	$ 8,552
Medicare \| Customer Concentration Risk \| Revenue from Contract with Customer, Product and Service Benchmark
Disaggregation Of Revenue [Line Items]
Percentage of total revenue	7.70%	2.40%
Self-pay
Disaggregation Of Revenue [Line Items]
Total revenue	$ 1,760	$ 603
Self-pay \| Customer Concentration Risk \| Revenue from Contract with Customer, Product and Service Benchmark
Disaggregation Of Revenue [Line Items]
Percentage of total revenue	0.40%	0.20%

Acquisitions - Additional Information (Details) - USD ($)		3 Months Ended
	Mar. 31, 2021	Apr. 03, 2021	Mar. 28, 2020
Business Acquisition [Line Items]
Acquisition, transaction costs		$ 1,800,000
Acquisition-related costs		1,768,000	$ 0
Loma Linda University Medical Center
Business Acquisition [Line Items]
Total consideration for transaction	$ 500,000
Acquisition, transaction costs		100,000
Doctor’s Choice Holdings, LLC
Business Acquisition [Line Items]
Acquisition, transaction costs		$ 1,700,000

Long-Term Obligations and Notes Payable - Schedule of Long-Term Obligations and Notes Payable (Details) - USD ($) $ in Thousands	3 Months Ended
	Apr. 03, 2021	Jan. 02, 2021
Debt Instrument [Line Items]
Total principal amount of long-term obligations and notes payable	$ 1,204,069	$ 1,207,604
Less: unamortized debt issuance costs	(29,286)	(31,332)
Total amount of long-term obligations and notes payable, net of unamortized debt issuance costs	1,174,783	1,176,272
Less: current portion of long-term obligations and notes payable	(11,724)	(12,782)
Total amount of long-term obligations and notes payable, net of unamortized debt issuance costs, less current portion	1,163,059	1,163,490
Term loan - First Lien Term Loan
Debt Instrument [Line Items]
Total principal amount of long-term obligations and notes payable	$ 561,600	563,061
Stated Maturity Date	2024-03
Contractual Interest Rate	L + 4.25%
Interest Rate	5.25%
Term loan - First Lien Term Loan \| LIBOR
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	4.25%
Term loan - First Lien Term Loan Amendment
Debt Instrument [Line Items]
Total principal amount of long-term obligations and notes payable	$ 216,580	217,133
Stated Maturity Date	2024-03
Contractual Interest Rate	L + 5.5%
Interest Rate	6.50%
Term loan - First Lien Term Loan Amendment \| LIBOR
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	5.50%
Term loan - First Lien Term Loan Fourth Amendment
Debt Instrument [Line Items]
Total principal amount of long-term obligations and notes payable	$ 184,075	184,538
Stated Maturity Date	2024-03
Contractual Interest Rate	L + 6.25%
Interest Rate	7.25%
Term loan - First Lien Term Loan Fourth Amendment \| LIBOR
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	6.25%
Subordinated Term Loan \| Second Lien Term Loan
Debt Instrument [Line Items]
Total principal amount of long-term obligations and notes payable	$ 240,000	240,000
Stated Maturity Date	2025-03
Contractual Interest Rate	L + 8.0%
Interest Rate	9.00%
Subordinated Term Loan \| Second Lien Term Loan \| LIBOR
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	8.00%
Notes Payable - Finance Agreements
Debt Instrument [Line Items]
Total principal amount of long-term obligations and notes payable	$ 1,814	2,872
Stated Maturity Date	2021-09
Contractual Interest Rate	2.07%
Interest Rate	2.07%
Revolving Credit Facility
Debt Instrument [Line Items]
Less: unamortized debt issuance costs	$ (400)	$ (500)
Stated Maturity Date	2023-03
Contractual Interest Rate	L + 4.25%
Interest Rate	5.25%

Long-Term Obligations and Notes Payable - Schedule of Long-Term Obligations and Notes Payable (Parenthetical) (Details)	3 Months Ended
	Apr. 03, 2021
Debt Disclosure [Abstract]
Debt instrument, description of contractual interest rate	L = Greater of 1.00% or one-month LIBOR

Long-Term Obligations and Notes Payable - Additional Information (Details) - USD ($)		3 Months Ended
	Mar. 11, 2021	Apr. 03, 2021	Mar. 28, 2020	Jan. 02, 2021
Debt Instrument [Line Items]
Debt instrument, interest rate, basis spread terms		L = Greater of 1.00% or one-month LIBOR
Debt issuance costs		$ 29,286,000		$ 31,332,000
Interest expense related to amortization of debt issuance costs		2,100,000	$ 1,700,000
Swingline loans		$ 0		0
Revolving Credit Facility
Debt Instrument [Line Items]
Debt instrument due date, month and year		2023-03
Debt issuance costs		$ 400,000		500,000
Borrowing capacity of revolving line of credit		$ 55,200,000		55,200,000
Credit Facilities \| LIBOR
Debt Instrument [Line Items]
Debt instrument, interest rate, basis spread terms		The Company has a LIBOR floor of 1.0% under its credit facilities. Beginning on March 18, 2020 and continuing for the remainder of the first fiscal quarter of 2020, as well as continuing through the three-month period ended April 3, 2021, the LIBOR benchmark rates decreased below 1.0%. Accordingly, the LIBOR floor rate of 1.0% became operative under the Company’s credit facility agreements and remained in effect at April 3, 2021
LIBOR floor rate		1.00%
Letter of Credit
Debt Instrument [Line Items]
Issued letter of credit		$ 19,800,000		19,800,000
Amended Revolving Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 200,000,000.0
Debt instrument due date, month and year	2023-03
Debt instrument, maturity date, description		The amendment also extended the maturity date to March 2023; provided that upon the occurrence of an initial public offering, the maturity date will become the date that is five years after the completion of such initial public offering, or May 2026; provided further that if the Company does not refinance its term loans by December 2023, the maturity date will become December 2023.
Amended First Lien Credit Agreement \| Revolving Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity			$ 30,000,000.0
Term Loan
Debt Instrument [Line Items]
Debt issuance costs		$ 29,300,000		$ 31,300,000

Fair Value Measurements - Summary of Other Liabilities Measured at Fair Value (Details) - USD ($) $ in Thousands	Apr. 03, 2021	Jan. 02, 2021
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Liabilities	$ 25,804	$ 28,624
Level 2
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Liabilities	25,804	28,624
Interest Rate Swap Agreements
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Liabilities	25,804	28,624
Interest Rate Swap Agreements \| Level 2
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Liabilities	$ 25,804	$ 28,624

Derivative Financial Instruments - Additional Information (Details) - Interest Rate Swap Agreement	3 Months Ended
	Apr. 03, 2021 USD ($)	Jan. 02, 2021 USD ($)	Oct. 31, 2018 Swap
Derivative [Line Items]
Number of interest rate swap agreement \| Swap			2
Aggregate notional amount	$ 520,000,000.0	$ 520,000,000.0
Derivative expiration date	Oct. 31, 2023
Other Long-Term Liabilities
Derivative [Line Items]
Fair value of interest rate swaps	$ 25,800,000	$ 28,600,000

Derivative Financial Instruments - Schedule of Gains (Losses) from Derivatives (Details) - USD ($) $ in Thousands	3 Months Ended
	Apr. 03, 2021	Mar. 28, 2020
Derivative Instruments Gain Loss [Line Items]
Derivative gain (loss)	$ 2,820	$ (6,422)
Interest Rate Swap Agreements \| Not Designated as Hedging Instruments
Derivative Instruments Gain Loss [Line Items]
Derivative gain (loss)	$ 2,820	$ (6,422)

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Apr. 03, 2021	Mar. 28, 2020
Income Tax Disclosure [Abstract]
Income tax expense	$ 309	$ 1,131
Effective tax rate	4.80%	2.90%
Statutory tax rate	21.00%	21.00%

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

Stockholders' Equity and Stock-Based Compensation - Additional Information (Details) - USD ($) $ in Thousands		3 Months Ended
	Mar. 19, 2020	Mar. 28, 2020
Schedule Of Shareholders Equity And Share Based Compensation [Line Items]
Stock issued, equity contributions	$ 50,000	$ 50,000
Common Stock
Schedule Of Shareholders Equity And Share Based Compensation [Line Items]
Stock issued, shares	5,124,995	5,124,995
Stock issued, equity contributions		$ 51

Commitments and Contingencies - Additional Information (Details) - USD ($)		3 Months Ended
	Feb. 19, 2020	Apr. 03, 2021	Jan. 02, 2021	Dec. 20, 2019	Dec. 24, 2018
Loss Contingencies [Line Items]
Insurance, per claims deductible		$ 500,000
Professional malpractice claims, per claim and annual aggregate limits		6,000,000.0
Insurance reserves		79,700,000	$ 74,600,000
Settlement agreement, legal claim	$ 50,000,000.0
Provision for transaction termination fee					$ 75,000,000.0
Break-up fee due to Seller				$ 0
Professional Malpractice Claims
Loss Contingencies [Line Items]
Insurance reserves		41,200,000	38,500,000
Surety Bonds
Loss Contingencies [Line Items]
Collaterals		2,300,000	2,300,000
Cash Collateral
Loss Contingencies [Line Items]
Collaterals		2,900,000	2,900,000
Letters of Credit
Loss Contingencies [Line Items]
Collaterals		18,800,000	18,800,000
Workers Compensation Insurance
Loss Contingencies [Line Items]
Insurance, per claims deductible		500,000
Insurance reserves		$ 38,500,000	$ 36,100,000

Covid 19 - Additional Information (Detail) - USD ($)	3 Months Ended	12 Months Ended	20 Months Ended
Covid 19 - Additional Information (Detail) - USD ($)	Apr. 03, 2021	Jan. 02, 2021	Dec. 31, 2021	Dec. 31, 2022	Feb. 04, 2021	Apr. 01, 2013
Covid 19 CARES Act [Line Items]
Provider relief fund payments received CARES Act		$ 25,100,000
Incremental percentage of deferred payment of employer portion of social security taxes	50.00%
Deferred social security tax CARES Act	$ 49,600,000
Medicare
Covid 19 CARES Act [Line Items]
Advance received for expansion of accelerated payments program in CARES Act	$ 4,300,000
Percentage of repayments due for first eleven months	25.00%
Percentage of payments recouped rate for another six months	50.00%
Percentage of reduction in payments						2.00%
Scenario Forecast
Covid 19 CARES Act [Line Items]
Percentage of social security tax due CARES Act			50.00%	50.00%
Scenario Forecast \| Medicare
Covid 19 CARES Act [Line Items]
Percentage of reduction of claim reimbursements			2.00%
Pennsylvania DHS
Covid 19 CARES Act [Line Items]
Stimulus funds received CARES Act		4,800,000
Stimulus funds recognized as income CARES Act		500,000
Stimulus funds included in government stimulus liabilities CARES Act		4,300,000
Direct stimulus fund repaid CARES Act					$ 4,300,000
Other Than Pennsylvania
Covid 19 CARES Act [Line Items]
Stimulus funds received CARES Act		$ 0

Related Party Transactions - Additional Information (Details) - USD ($)	3 Months Ended
	Apr. 03, 2021	Mar. 28, 2020	Jan. 02, 2021
Related Party Transaction [Line Items]
Management fees and expenses	$ 900,000	$ 800,000
Amounts owed in connection with advisory services agreements	0		$ 1,600,000
Fees for revenue cycle vendor eligibility and clearing house billing services	100,000	$ 100,000
Amount owed to revenue cycle vendor	$ 0		$ 0
First Lien Term Loan
Related Party Transaction [Line Items]
Shareholders ownership percentage	5.70%

Segment Information - Additional Information (Details)	3 Months Ended
Segment Information - Additional Information (Details)	Apr. 03, 2021 Segment
Segment Reporting [Abstract]
Number of operating segments	3
Number of reportable segments	3

Segment Information - Summary of Segment Information (Details) - USD ($)	3 Months Ended
	Apr. 03, 2021	Mar. 28, 2020
Segment Reporting Information [Line Items]
Revenue	$ 417,160,000	$ 355,223,000
Cost of revenue, excluding depreciation and amortization	285,477,000	247,682,000
Gross margin	$ 131,683,000	$ 107,541,000
Gross margin percentage	31.60%	30.30%
Segment Reconciliation:
Total segment gross margin	$ 131,683,000	$ 107,541,000
Branch and regional administrative expenses	69,372,000	59,694,000
Corporate expenses	27,399,000	25,797,000
Depreciation and amortization	4,848,000	4,183,000
Acquisition-related costs	1,768,000	0
Operating income	28,296,000	17,867,000
Interest income	77,000	46,000
Interest expense	(22,425,000)	(21,063,000)
Gain on debt extinguishment		127,000
Other income	159,000	41,791,000
Income before income taxes	6,107,000	38,768,000
PDS
Segment Reporting Information [Line Items]
Revenue	350,827,000	320,513,000
Cost of revenue, excluding depreciation and amortization	248,997,000	227,963,000
Gross margin	$ 101,830,000	$ 92,550,000
Gross margin percentage	29.00%	28.90%
Segment Reconciliation:
Total segment gross margin	$ 101,830,000	$ 92,550,000
HHH
Segment Reporting Information [Line Items]
Revenue	31,518,000	4,477,000
Cost of revenue, excluding depreciation and amortization	17,329,000	2,803,000
Gross margin	$ 14,189,000	$ 1,674,000
Gross margin percentage	45.00%	37.40%
Segment Reconciliation:
Total segment gross margin	$ 14,189,000	$ 1,674,000
MS
Segment Reporting Information [Line Items]
Revenue	34,815,000	30,233,000
Cost of revenue, excluding depreciation and amortization	19,151,000	16,916,000
Gross margin	$ 15,664,000	$ 13,317,000
Gross margin percentage	45.00%	44.00%
Segment Reconciliation:
Total segment gross margin	$ 15,664,000	$ 13,317,000

Net Income Per Share - Summary of Computation of Basic and Diluted Net Income Per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Apr. 03, 2021	Mar. 28, 2020
Numerator:
Net income	$ 5,798	$ 37,637
Denominator:
Weighted average shares of common stock outstanding, basic	142,122,934	137,468,875
Net income per share, basic	$ 0.04	$ 0.27
Weighted average shares of common stock outstanding, diluted	146,266,014	140,330,909
Net income per share, diluted	$ 0.04	$ 0.27
Stock Options
Denominator:
Dilutive securities outstanding not included in the computation of diluted net income per share as their effect is antidilutive	7,479,384	6,015,548

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22583-107794

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
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-Publisher FASB
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-Name Accounting Standards Codification
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The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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+ Details

- Definition

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

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+ Details

Subsequent Events - Additional Information (Details) $ / shares in Units, $ in Thousands								3 Months Ended
	May 25, 2021 USD ($)	May 21, 2021 shares	May 04, 2021 USD ($)	May 03, 2021 USD ($) shares	Apr. 28, 2021 $ / shares shares	Apr. 19, 2021 shares	Apr. 16, 2021 USD ($)	Mar. 28, 2020 USD ($)	Apr. 03, 2021 shares	Jan. 02, 2021 shares
Subsequent Event [Line Items]
Common stock, authorized \| shares									1,000,000,000	1,000,000,000
Preferred stock, authorized \| shares									5,000,000	5,000,000
Received proceeds, net of underwriters discounts and commissions								$ 50,000
Subsequent Event
Subsequent Event [Line Items]
Stockholders' equity, forward stock split description						effected a one-to-20.5 forward stock split
Stockholders' equity, forward stock split						20.5
Common stock, authorized \| shares						1,000,000,000
Preferred stock, authorized \| shares						5,000,000
Subsequent Event \| Revolving Credit Facility
Subsequent Event [Line Items]
Line of credit facility, maximum borrowing capacity			$ 200,000	$ 75,000
Debt issuance costs			1,300
Subsequent Event \| Initial Public Offering
Subsequent Event [Line Items]
Received proceeds, net of underwriters discounts and commissions				$ 432,400
Issuance of common stock (shares) \| shares				38,236,000
Subsequent Event \| Initial Public Offering \| Second Lien Term Loan
Subsequent Event [Line Items]
Repayment of subordinated debt				$ 307,000
Subsequent Event \| Initial Public Offering \| Term loan - First Lien Term Loan
Subsequent Event [Line Items]
Repayment of debt			$ 100,000
Subsequent Event \| Underwriters Overallotment Option
Subsequent Event [Line Items]
Received proceeds, net of underwriters discounts and commissions	$ 45,200
Issuance of common stock (shares) \| shares		4,000,000
Debt issuance costs	$ 2,800
Shares granted to underwriters right to purchase additional shares \| shares					5,735,400
Stock, offering price per share \| $ / shares					$ 12.00
Doctor’s Choice Holdings, LLC \| Subsequent Event
Subsequent Event [Line Items]
Business acquisition, issued and outstanding membership interests percentage acquired							100.00%
Business acquisition, purchase price							$ 115,000
Business acquisition, amount borrowed under existing Second Lien Term Loan							67,000
Business acquisition, debt issuance costs							1,700
Business acquisition, transaction costs							$ 2,400