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Exit and Realignment Costs
9 Months Ended
Sep. 30, 2022
Restructuring and Related Activities [Abstract]  
Exit and Realignment Costs Exit and Realignment Costs
We periodically incur exit and realignment and other charges associated with optimizing our operations which includes the consolidation of certain distribution and outsourced logistics centers, administrative offices and warehouses, our client engagement center and IT restructuring charges. These charges also include costs associated with our strategic organizational realignment which include leadership reorganization costs, certain professional fees, costs to streamline administrative functions and processes and divestiture related costs.
Exit and realignment charges by segment for the three and nine months ended September 30, 2022 and 2021 were as follows:
Three Months Ended
 September 30,
Nine Months Ended
September 30,
2022202120222021
Products & Healthcare Services$1,983 $5,091 $4,396 $18,933 
Patient Direct 1,289 483 2,034 
Total exit and realignment charges$1,983 $6,380 $4,879 $20,967 
The following table summarizes the activity related to exit and realignment cost accruals through September 30, 2022 and 2021:
Total
Accrued exit and realignment costs, December 31, 2021$8,306 
Provision for exit and realignment activities:
Severance811 
Other871 
Cash payments(6,903)
Accrued exit and realignment costs, March 31, 20223,085
Provision for exit and realignment activities:
Severance246 
Other968 
Cash payments(3,477)
Accrued exit and realignment costs, June 30, 2022822
Provision for exit and realignment activities:
Other1,251 
Cash payments(1,693)
Accrued exit and realignment costs, September 30, 2022$380 
Accrued exit and realignment costs, December 31, 2020$3,146 
Provision for exit and realignment activities:
Information system restructuring costs1,029 
Lease obligations347 
Other781 
Cash payments(2,915)
Accrued exit and realignment costs, March 31, 20212,388
Provision for exit and realignment activities:
Information system restructuring costs1,611 
Lease obligations(126)
Other989 
Cash payments(2,302)
Accrued exit and realignment costs, June 30, 20212,560
Provision for exit and realignment activities:
Information system restructuring costs1,506 
Lease obligations107 
Other3,142 
Cash payments(4,199)
Accrued exit and realignment costs, September 30, 2021$3,116 
In addition to the exit and realignment accruals in the preceding table, we also incurred $0.7 million of costs that were expensed as incurred for the three and nine months ended September 30, 2022, which related to an increase in reserves associated with certain retained assets of Fusion5. We incurred $1.6 million and $11.6 million of costs that were expensed as incurred for the three and nine months ended September 30, 2021, which primarily includes $1.5 million and $9.6 million of wind-down costs related to Fusion5 for the three and nine months ended September 30, 2021.
Acquisition-related charges within acquisition-related and exit and realignment charges presented in our consolidated statements of operations were $6.9 million and $45.2 million for the three and nine months ended September 30, 2022, which consisted primarily of costs related to the Apria Acquisition. There were no acquisition-related charges included within acquisition-related and exit and realignment charges presented in our consolidated statements of operations for the three and nine months ended September 30, 2021. We do not expect material additional costs in 2022 for activities that were initiated through September 30, 2022.