TBRG TruBridge Inc

---

---

---

---

---

---

---

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (the “SEC”) and include all adjustments that, in the opinion of management, are necessary for a fair presentation of the results of the periods presented. All such adjustments are considered of a normal recurring nature. Quarterly results of operations are not necessarily indicative of annual results.

Certain footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) have been condensed or omitted. The condensed consolidated balance sheet as of December 31, 2023 was derived from the audited consolidated balance sheet at that date. These unaudited condensed consolidated financial statements should be read in conjunction with the audited financial statements of TruBridge, Inc. (“TruBridge” or the “Company”) for the year ended December 31, 2023 and the notes thereto contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023.

In May 2024, the Company realigned its reporting structure due to certain organizational changes. As a result, the Company changed from three reportable segments of (i) Revenue Cycle Management (“RCM”), (ii) Electronic Health Records (“EHR”), and (iii) Patient Engagement to two reportable segments of (i) RCM and (ii) EHR. The Patient Engagement segment results have been transitioned into the EHR segment. This change is intended to improve connectivity and alignment between the two business units to better serve our clients and more accurately reflect how the Company’s management views and operates the business. All prior segment information has been recast to reflect the Company's new segment structure and current period presentation. Refer to Note 17 - Segment Reporting for more information.

During the third quarter of 2023, we changed the presentation of certain costs previously recorded within the expense captions of "Product development" and "General and administrative" to better comply with the disclosure requirements of Staff Accounting Bulletin Topic 11.B. Miscellaneous Disclosure: Depreciation and Depletion Excluded from Cost of Sales. These changes are summarized as follows:

•Amortization expense associated with capitalized software development costs, previously recorded within the expense caption of "Product development," has been combined with amounts previously recorded within the expense caption "Amortization of acquisition-related intangibles" and reflected in a newly-presented expense caption of "Amortization."

•Depreciation expense previously recorded within the expense caption of "General and administrative" has been reclassified within the newly-presented expense caption of "Depreciation."

•The expense caption previously labeled as "Costs of sales" has been renamed "Costs of revenue (exclusive of amortization and depreciation)," with the previously reported reference to "Gross profit" removed from the current presentation.

---

The following table provides the amounts reclassified for the three and six months ended June 30, 2023.

			Three Months Ended June 30, 2023
(in thousands)			As previously reported						Re-classifications						As reclassified												As currently reported
Costs of revenue (exclusive of amortization and depreciation)
RCM			$	27,119					$	—					$	27,119											$	27,119
EHR			17,014						—						17,014												17,014
Other expenses
Product development			10,595						(1,826)						8,769												8,769
Sales and marketing			8,132						—						8,132												8,132
General and administrative			19,654						(597)						19,057												19,057
Amortization of acquisition-related intangibles			4,014						(4,014)						—												—
Amortization			—						5,840						5,840												5,840
Depreciation			—						597						597												597

			Six Months Ended June 30, 2023
(in thousands)			As previously reported						Re-classifications						As reclassified						As currently reported
Costs of revenue (exclusive of amortization and depreciation)
RCM			$	54,302					$	—					$	54,302					$	54,302
EHR			34,008						—						34,008						34,008
Other expenses
Product development			20,434						(3,313)						17,121						17,121
Sales and marketing			15,089						—						15,089						15,089
General and administrative			34,604						(1,094)						33,510						33,510
Amortization of acquisition-related intangibles			8,029						(8,029)						—						—
Amortization			—						11,341						11,341						11,341
Depreciation			—						1,095						1,095						1,095

Principles of Consolidation

The condensed consolidated financial statements of TruBridge include the accounts of the Company and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated.

New Accounting Standards Adopted in 2024

There were no new accounting standards required to be adopted in 2024 that would have a material impact on our consolidated financial statements.

New Accounting Standards Yet to be Adopted

In November 2023, the FASB issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures” (“ASU 2023-07”), which is intended to improve reportable segment disclosure requirements, primarily through additional and more detailed information about a reportable segment's expenses. The guidance is

---

Our contracts with customers can include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately versus together may require significant judgment. Our contracts are generally distinct and accounted for as separate performance obligations. Revenue is recognized upon transfer of control of promised products or services to clients in an amount that reflects the consideration we expect to receive in exchange for those products and services. The Company employs the 5-step revenue recognition model under ASC 606, Revenue from Contracts with Customers, to: (1) identify the contract with the client, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when (or as) the entity satisfies a performance obligation.

Revenue is recognized net of shipping charges and any taxes collected from clients, which are subsequently remitted to governmental authorities.

•Revenue Cycle Management

Our revenue cycle management (“RCM”) business unit provides an array of business processing services (“BPS'’) consisting of accounts receivable management, private pay services, insurance services, medical coding, electronic billing, statement processing, payroll processing, and contract management. Fees are recognized over the period of the client contractual relationship as the services are performed based on the stand-alone selling price (“SSP”), net of discounts. SSP for BPS services is determined based on observable stand-alone selling prices. Fees for many of these services are invoiced, and revenue recognized accordingly, based on the volume of transactions or a percentage of client accounts receivable collections. Payment is due monthly for BPS with certain amounts varying based on utilization and/or volumes.

Our RCM business unit also provides professional IT services. Revenue from professional IT services is recognized as the services are performed based on SSP, which is determined by observable stand-alone selling prices. Payment is due monthly as services are performed.

Lastly, our RCM business unit also provides certain software solutions and related support under Software as a Service (“SaaS”) arrangements and time-based software licenses. Revenue from SaaS arrangements is recognized in a manner consistent with SaaS arrangements for electronic health records (“EHR”) software, as discussed below. Revenue from time-based software licenses is recognized upon delivery to the client (“point in time”) and revenue from non-license components (i.e., support) is recognized ratably over the respective contract term (“over time”). SSP for time-based licenses is determined using the residual approach, while the non-license component is based on cost plus reasonable margin.

•Electronic Health Records

The Company enters into contractual obligations to sell perpetual software licenses, installation, conversion, and related training services, software application support, hardware, and hardware maintenance services to acute care community hospitals. The Company also enters into contractual obligations to sell time-based software licenses, implementation and customization professional services, and software application support services to a variety of healthcare organizations, including hospital systems, health ministries, and government and non-profit organizations.

•Non-recurring Revenues

•Perpetual software licenses and installation, conversion, and related training services are not considered separate and distinct performance obligations due to the proprietary nature of our software and are, therefore, accounted for as a single performance obligation on a module-by-module basis. Revenue is recognized as each module's implementation is completed based on the module's SSP, net of discounts. We determine each module's SSP using the residual method. Fees for licenses and

---

installation, conversion, and related training services are typically due in three installments: (1) at placement of order, (2) upon installation of software and commencement of training, and (3) upon satisfactory completion of monthly accounting cycle or end-of-month operation by application and as applicable for each application. Often, short-term and/or long-term financing arrangements are provided for software implementations; refer to Note 11 - Financing Receivables for further information. EHR implementations include a system warranty that terminates thirty days from the software go-live date, the date which the client begins using the system in a live environment.

•Hardware revenue is recognized separately from software licenses at the point in time it is delivered to the client. The SSP of hardware is cost plus a reasonable margin and revenue is recognized on a gross basis. Payment is generally due upon delivery of the hardware to the client. Standard manufacturer warranties apply to hardware.

•Perpetual software licenses are sold only to one re-seller client and are considered a separate and distinct performance obligation. Revenue is recognized at the point in time perpetual licenses are delivered to the client, which occurs at the time of sale. The SSP of perpetual licenses is directly observable. Payment is generally due upon delivery of licenses.

•Implementation and customization services are considered a separate and distinct performance obligation. Revenue is recognized over time based on SSP, which is generally directly observable. Payment for professional services is typically due in two installments: (1) upon signature of the agreement and (2) upon customer acceptance of the delivered services.

•Recurring Revenues

•Software application support and hardware maintenance services sold with software licenses and hardware are separate and distinct performance obligations. Revenue for support and maintenance services is recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three to five years. Payment is due monthly for support and maintenance services provided.

•Subscriptions to third-party content revenue is recognized as a separate performance obligation ratably over the subscription term based on SSP, which is cost plus a reasonable margin, and revenue is recognized on a gross basis. Payment is due monthly for subscriptions to third party content.

•SaaS arrangements for EHR software and related conversion and training services are considered a single performance obligation. Revenue is recognized on a monthly basis as the SaaS service is provided to the client over the contract term. Payment is due monthly for SaaS services provided.

•Term-based software licenses are considered a separate and distinct performance obligation. Revenue is recognized based on SSP, which is directly observable, at the point in time the term-based licenses are delivered to the client or upon annual renewal. Payment is generally due upon delivery of licenses or upon annual renewal.

•Software application support services sold with software licenses are separate and distinct performance obligations. The related revenues are recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three to five years. Payment is generally due for the full amount of annual support fees at the beginning of an annual license term.

Refer to Note 17 - Segment Reporting for further information, including revenue by client base (acute care or post-acute care) bifurcated by recurring and non-recurring revenue.

Deferred Revenue

Deferred revenue represents amounts invoiced to clients for which the services under contract have not been completed and revenue has not been recognized, including annual renewals of certain software subscriptions and customer deposits for implementations to be performed at a later date. Revenue is recognized ratably over the life of the software subscriptions as services are provided and at the point-in-time when implementations have been completed.

---

The following table details deferred revenue for the six months ended June 30, 2024 and 2023, included in the condensed consolidated balance sheets:

(In thousands)			Six Months Ended June 30, 2024						Six Months Ended June 30, 2023
Beginning balance			$	8,677					$	11,590
Deferred revenue recorded			8,230						10,623
Less deferred revenue recognized as revenue			(7,065)						(12,328)
Ending balance			$	9,842					$	9,885

The deferred revenue recorded during the six months ended June 30, 2024 and 2023 is comprised primarily of the annual renewals of certain software subscriptions billed during the first quarter of each year and deposits collected for future EHR installations. The deferred revenue recognized as revenue during the six months ended June 30, 2024 and 2023 is comprised primarily of the periodic recognition of annual renewals that were deferred until earned and deposits for future EHR installations that were earned during the period.

Costs to Obtain and Fulfill a Contract with a Customer

Costs to obtain a contract include the commission costs related to SaaS and RCM arrangements, which are capitalized and amortized ratably over the expected life of the customer contract. As a practical expedient, we generally recognize the incremental costs of obtaining a contract as an expense when incurred if the amortization period of the asset would have been one year or less. Costs to obtain a contract are expensed within the caption “Expenses - Sales and marketing” in the accompanying condensed consolidated statements of operations.

Contract fulfillment costs related to the implementation of SaaS arrangements are capitalized and amortized ratably over the expected life of the customer contract. Costs to fulfill contracts consist of the payroll costs for the implementation of SaaS arrangements, including time for training, conversions, and installation that is necessary for the software to be utilized. Contract fulfillment costs are expensed within the caption “Costs of revenue (exclusive of amortization and depreciation) - EHR” in the accompanying condensed consolidated statements of operations.

Costs to obtain and fulfill contracts related to SaaS and RCM arrangements are included within the “Prepaid expenses and other current assets” and "Other assets, net of current portion" line items on our condensed consolidated balance sheets. The following table details the costs to obtain and fulfill contracts with customers for the six months ended June 30, 2024 and 2023:

(In thousands)			Six Months Ended June 30, 2024						Six Months Ended June 30, 2023
Beginning balance			$	13,115					$	11,577
Costs to obtain and fulfill contracts capitalized			3,430						3,690
Less costs to obtain and fulfill contracts recognized as expense			(3,649)						(2,691)
Ending balance			$	12,896					$	12,576

Remaining Performance Obligations

Disclosures regarding remaining performance obligations are not considered material as the overwhelming majority of the Company's remaining performance obligations either (a) are related to contracts with an expected duration of one year or less, or (b) exhibit revenue recognition in the amount to which the Company has the right to invoice.

Sale of American HealthTech, Inc.

On January 16, 2024, we entered into a Stock Purchase Agreement (the “Purchase Agreement”), by and among the Company, American HealthTech, Inc. a Mississippi corporation (“AHT”), and Healthland Inc., a Minnesota corporation and an indirect, wholly-owned subsidiary of the Company (“Healthland” and, together with the Company, the “Seller Parties”) and PointClickCare Technologies USA Corp., a Delaware corporation (“Buyer”). The Transaction (hereinafter defined) also closed on January 16, 2024. Under the Purchase Agreement, Buyer purchased from Healthland all of the issued and outstanding capital stock of AHT (the “Transaction”), with AHT becoming a wholly-owned subsidiary of Buyer. Prior to this transaction, results for AHT were reported within our EHR operating segment.

---

The Purchase Agreement provides for an aggregate purchase price (the “Purchase Price”) of $25 million (the “Base Cash Consideration”), subject to adjustments based on working capital, cash, indebtedness and transaction expenses of AHT. Additionally, pursuant to the Purchase Agreement, a total of approximately $3.75 million was withheld from the Base Cash Consideration at the closing and deposited by Buyer into various escrow accounts with an escrow agent, including $2.5 million as a general indemnity escrow and $1 million as a special indemnity escrow. Based upon the adjustments and the various escrow holdbacks, Buyer paid a net amount of approximately $21.41 million to Healthland at the closing. The Purchase Price was subject to a post-closing true-up. In connection with the closing of the Transaction, Buyer has provided offers of employment to certain key employees of the Company that primarily supported AHT’s business.

The Purchase Agreement contains customary representations, warranties and covenants. The representations and warranties made by the Seller Parties to Buyer cover a broad range of items related to, among other things, the business and financial condition of AHT. Subject to certain exceptions and limitations, the Seller Parties have agreed to indemnify Buyer for certain breaches of representations, warranties and covenants and certain other enumerated items. Such limitations on the Seller Parties’ indemnification obligations are subject to various exceptions for certain fundamental representations, tax representations, special representations, and fraud. Subject to certain exceptions and limitations, Buyer has likewise agreed to indemnify the Seller Parties for certain breaches of representations, warranties and covenants and certain other enumerated items.

As part of the divestiture, as of January 16, 2024 we entered into a transition services agreement (“TSA”) with Buyer to assist them in the transition of certain functions, including, but not limited to, information technology, finance and accounting, for 18 months in accordance with the terms of this agreement. Aside from these customary transition services, there is no continuing involvement after the disposal. The Company has $0.6 million in receivables from Buyer for the TSA services reflected under the caption “Accounts receivable” in the condensed consolidated balance sheet.

The Company finalized the accounting for the sale during the three months ended March 31, 2024 and has recorded a $1.25 million gain on sale, which is reflected under the caption “Other income” in the condensed consolidated statement of operations.

The accompanying condensed consolidated balance sheet as of December 31, 2023 includes amounts related to this Transaction under the captions "Assets of held for sale disposal group" and "Liabilities of held for sale disposal group," the details of which are as follows as of December 31, 2023:

(In thousands)
Assets of held for sale disposal group
Accounts receivable, net			$	3,087
Financing receivables, net			37
Prepaid expenses			34
Software costs, net			3,386
Intangibles, net			11,739
Goodwill			7,694
Total			$	25,977
Liabilities of held for sale disposal group
Accounts payable			$	178
Other accrued liabilities			576
Deferred tax liability			223
Total			$	977

---

The following table presents the pretax loss for AHT that is included in our condensed consolidated statement of operations for the three and six months ended June 30, 2024 and 2023:

			Three Months Ended June 30,												Six Months Ended June 30,
(In thousands)			2024						2023						2024						2023
Pretax loss			$	—					$	(505)					$	(241)					$	(376)

Acquisition of Viewgol, LLC

On October 16, 2023, the Company acquired all of the assets and liabilities of Viewgol, LLC (“Viewgol”), a Delaware limited liability company, pursuant to a Securities Purchase Agreement dated October 16, 2023. Based in Frisco, Texas, Viewgol is a provider of ambulatory RCM analytics and complementary outsourcing services with an extensive offshore presence we intend to leverage and grow to accommodate the growing demand for RCM services by our pre-existing acute care customers.

Consideration for the acquisition included cash (net of cash of the acquired entity) of $37.4 million (inclusive of seller's transaction expenses). Also included in the acquisition consideration were contingent earnout payments of (i) up to $21.5 million based on the Viewgol business achieving earnings before interest, taxes, depreciation, and amortization (“EBITDA”) of $6.0 million or more during fiscal year 2024 (the “EBITDA Earnout Amount”), and (ii) up to $10.0 million based on the number of productive agents the Viewgol business hires in India in fiscal year 2024 (the “Offshore Earnout Amount”); provided, however, that none of the Offshore Earnout Amounts may be earned if the EBITDA Earnout Amount’s minimum EBITDA threshold of $6.0 million is not achieved during fiscal 2024. During 2023, we incurred approximately $4.7 million of pre-tax acquisition expenses in our condensed consolidated statements of operations.

Our acquisition of Viewgol was treated as a purchase in accordance with ASC 805, Business Combinations, which requires allocation of the purchase price to the estimated fair values of assets and liabilities acquired in the transaction. Our allocation of the purchase price was based on management's judgment after evaluating several factors, including a valuation assessment.

The preliminary estimated fair values of assets acquired and liabilities assumed as of December 31, 2023, and as updated through June 30, 2024, are as follows:

(In thousands)			Purchase Price Allocation as of December 31, 2023			Purchase Price Allocation as of June 30, 2024
Acquired cash			$	1,449		$	1,449
Accounts receivable			2,233			2,233
Prepaid expenses			132			132
Property and equipment			1,112			1,112
Intangible assets			17,720			17,720
Goodwill			17,263			17,927
Accounts payable and accrued liabilities			(711)			(711)
Contingent consideration			(1,044)			(1,044)
Net assets acquired			$	38,154		$	38,818

In April 2024, the Company paid an additional $0.7 million for working capital adjustments which is reflected under the caption “Goodwill” in the condensed consolidated balance sheet.

The intangible assets in the table above are being amortized on a straight-line basis over their estimated useful lives. The amortization is included under the caption “Amortization of acquisition-related intangibles” in our condensed consolidated statements of operations.

---

The fair value measurements of tangible and intangible assets and liabilities (including those related to contingent consideration) were based on significant inputs not observable in the market and thus represent Level 3 measurements within the fair value measurement hierarchy (see Note 16 - Fair Value). Level 3 inputs included, among others, discount rates that we estimated would be used by a market participant in valuing these assets and liabilities, projections of revenues and cash flows, client attrition rates and market comparables.

Our condensed consolidated statement of operations for the six months ended June 30, 2024 includes revenue of $9.9 million and net income of $3.7 million attributed to the Viewgol acquisition.

Property and equipment, net was comprised of the following at June 30, 2024 and December 31, 2023:

(In thousands)			June 30, 2024						December 31, 2023
Land			$	2,848					$	2,848
Buildings and improvements			8,487						8,481
Computer equipment			10,363						10,104
Leasehold improvements			631						631
Office furniture and fixtures			626						586
Automobiles			18						18
Property and equipment, gross			22,973						22,668
Less: accumulated depreciation			(14,494)						(13,694)
Property and equipment, net			$	8,479					$	8,974

Software development costs are accounted for in accordance with ASC 350-40, Internal-Use Software. We capitalize incurred labor costs for software development from the time the preliminary project phase is completed until the software is available for general release. Research and development costs and other computer software maintenance costs related to software development are expensed as incurred. We amortize capitalized software value on a straight-line basis over that estimated useful life of five years. If the actual useful life of the asset is determined to be shorter than our estimated useful life, we will amortize the remaining book value over the remaining actual useful life, or the asset may be deemed to be impaired and, accordingly, a write-down of the value of the asset may be recorded as a charge to earnings. Amortization begins when the related software features are placed in service. In the normal course of business, we occasionally abandon software development projects due to various reasons. During the three months ended June 30, 2024 we recognized $2.9 million of accelerated amortization with respect to a change in estimated useful life of an abandoned software development project.

Software development costs, net was comprised of the following at June 30, 2024 and December 31, 2023:

(In thousands)			June 30, 2024						December 31, 2023
Software development costs			$	60,673					$	51,349
Less: accumulated amortization			(20,932)						(12,210)
Software development costs, net			$	39,741					$	39,139

---

Other accrued liabilities was comprised of the following at June 30, 2024 and December 31, 2023:

(In thousands)			June 30, 2024						December 31, 2023
Salaries and benefits			$	6,219					$	5,194
Severance			2,781						5,806
Commissions			945						1,185
Contingent consideration			1,044						1,044
Operating lease liabilities, current portion			1,349						1,804
Other			5,143						4,859
Other accrued liabilities			$	17,481					$	19,892

The Company presents basic and diluted earnings per share (“EPS”) data for its common stock. Basic EPS is calculated by dividing the net income attributable to stockholders of the Company by the weighted average number of shares of common stock outstanding during the period. Diluted EPS is determined by adjusting the net income attributable to stockholders of the Company and the weighted average number of shares of common stock outstanding during the period for the effects of all dilutive potential common shares, including awards under stock-based compensation arrangements.

The Company's unvested restricted stock awards (see Note 10 - Stock-Based Compensation and Equity) are considered participating securities under ASC 260, Earnings Per Share, because they entitle holders to non-forfeitable rights to dividends until the awards vest or are forfeited. When a company has a security that qualifies as a “participating security,” the Codification requires the use of the two-class method when computing basic EPS. The two-class method is an earnings allocation formula that determines EPS for each class of common stock and participating security according to dividends declared (or accumulated) and participation rights in undistributed earnings. In determining the amount of net income to allocate to common stockholders, income is allocated to both common stock and participating securities based on their respective weighted average shares outstanding for the period, with net income attributable to common stockholders ultimately equaling net income less net income attributable to participating securities. Diluted EPS for the Company's common stock is computed using the more dilutive of the two-class method or the treasury stock method.

The following is a calculation of the basic and diluted EPS for the Company's common stock, including a reconciliation between net income and net income attributable to common stockholders:

			Three Months Ended June 30,												Six Months Ended June 30,
(In thousands, except per share data)			2024						2023						2024						2023
Net income (loss)			$	(5,049)					$	(2,837)					$	(7,565)					$	247
Less: Net (income) loss attributable to participating securities			216						64						263						(5)
Net income (loss) attributable to common stockholders			$	(4,833)					$	(2,773)					$	(7,302)					$	242
Weighted average shares outstanding used in basic per common share computations			14,313						14,200						14,273						14,168
Add: Dilutive potential common shares			—						—						—						—
Weighted average shares outstanding used in diluted per common share computations			14,313						14,200						14,273						14,168
Basic EPS			$	(0.34)					$	(0.20)					$	(0.51)					$	0.02
Diluted EPS			$	(0.34)					$	(0.20)					$	(0.51)					$	0.02

---

During 2022, 2023, and 2024, performance share awards were granted to certain executive officers and key employees of the Company that will result in the issuance of common stock if the predefined performance criteria are met. The awards provide for an aggregate target of 512,103 shares, of which none have been included in the calculation of diluted EPS for the three and six months ended June 30, 2024 because the related threshold award performance levels have not been achieved as of June 30, 2024. See Note 10 - Stock-Based Compensation and Equity for more information.

The Company determines the tax provision for interim periods using an estimate of our annual effective tax rate ("ETR"), adjusted for discrete items, if any, that are taken into account in the relevant period. Each quarter we update our estimate of the annual ETR, and if our estimated tax rate changes, we make a cumulative adjustment. If a reliable estimate of the annual ETR cannot be made, the actual ETR for the year to date may be the best estimate of the annual ETR.

For the three months ended June 30, 2024, our effective tax rate decreased to 29.6% from 36.8% in the same period in 2023. This reduction was primarily driven by a decrease in the impact of state deferred taxes and the research and development (R&D) tax credit generated during the current quarter compared to the prior-year quarter.

Similarly, our effective tax rate for the six months ended June 30, 2024 decreased to 32.9% from 141.2% for the six months ended June 30, 2023. This improvement was largely due to the R&D tax credit, which provided an incremental benefit of 21.0% compared to the first six months of 2023. The significantly higher effective tax rate in the prior year was primarily driven by a disproportionate impact of tax credits and non-conforming state deferred taxes relative to the pretax loss.

Stock-based compensation expense is measured at the grant date based on the fair value of the award, and is recognized as an expense over the employees’ or non-employee directors’ requisite service period.

The following table details total stock-based compensation expense for the three and six months ended June 30, 2024 and 2023, included in the condensed consolidated statements of operations:

			Three Months Ended June 30,												Six Months Ended June 30,
(In thousands)			2024						2023						2024						2023
Costs of revenue (exclusive of amortization and depreciation)			$	230					$	140					$	266					$	320
Other expenses			1,271						(263)						2,034						804
Pre-tax stock-based compensation expense			1,501						(123)						2,300						1,124
Less: income tax effect			(315)						27						(483)						(247)
Net stock-based compensation expense			$	1,186					$	(96)					$	1,817					$	877

The Company's stock-based compensation awards are in the form of restricted stock and performance share awards granted pursuant to the Company's Amended and Restated 2019 Incentive Plan (the "Plan"). As of June 30, 2024, there was $10.9 million of unrecognized compensation expense related to unvested and unearned, as applicable, stock-based compensation arrangements granted under the Plan, which is expected to be recognized over a weighted-average period of 2.1 years.

Restricted Stock

The Company grants restricted stock to executive officers, certain key employees and non-employee directors under the Plan with the fair value of the awards representing the fair value of the common stock on the date the restricted stock is granted. During the vesting period, recipients of restricted stock are entitled to dividends and possess voting rights. Shares of restricted stock generally vest in equal annual installments over the applicable vesting period, which ranges from one to three years. The Company records expenses for these grants on a straight-line basis over the applicable vesting periods.

---

A summary of restricted stock activity under the Plan during the six months ended June 30, 2024 and 2023 is as follows:

			Six Months Ended June 30, 2024												Six Months Ended June 30, 2023
			Shares						Weighted-Average Grant Date Fair Value Per Share						Shares						Weighted-Average Grant Date Fair Value Per Share
Unvested restricted stock outstanding at beginning of period			343,315						$	29.08					281,161						$	32.24
Granted			495,003						10.03						186,822						29.23
Vested			(151,642)						30.95						(139,760)						31.33
Forfeited			(54,603)						12.84						—						—
Unvested restricted stock outstanding at end of period			632,073						$	14.57					328,223						$	30.92

Performance Share Awards

The Company grants performance share awards to executive officers and certain key employees under the Plan, with the number of shares of common stock earned and issuable under each award determined at the end of a three-year performance period, based on the Company's achievement of performance goals predetermined by the Compensation Committee of the Board of Directors at the time of grant. These performance share awards include a modifier to the total number of shares earned based on the Company's total shareholder return (“TSR”) compared to a small-cap stock market index. If certain levels of the performance objective are met, the award results in the issuance of shares of common stock corresponding to such level. Performance share awards that result in the issuance of shares of common stock are not subject to time-based vesting at the conclusion of the three-year performance period.

In the event that the Company's financial performance meets the predetermined targets for the performance objectives of the performance share awards, the Company will issue each award recipient the number of shares of common stock equal to the target award specified in the individual's underlying performance share award agreement. In the event the financial results of the Company exceed the predetermined targets, additional shares up to the maximum award may be issued. In the event the financial results of the Company fall below the predetermined targets, a reduced number of shares may be issued. If the financial results of the Company fall below the threshold performance levels, no shares may be issued. The total number of shares issued for the performance share award may be increased, decreased, or unchanged based on the TSR modifier described above.

The recipients of performance share awards do not receive dividends or possess voting rights during the performance period and, accordingly, the fair value of the performance share awards is the quoted market value of TruBridge’s common stock on the grant date less the present value of the expected dividends not received during the relevant period. The TSR modifier applicable to the performance share awards is considered a market condition and therefore is reflected in the grant date fair value of the award. A Monte Carlo simulation has been used to account for this market condition in the grant date fair value of the award.

Expense related to performance share awards is recognized using ratable straight-line amortization over the three-year performance period. In the event the Company determines it is no longer probable that the minimum performance level will be achieved, all previously recognized compensation expense related to the applicable awards is reversed in the period such a determination is made.

---

A summary of performance share award activity under the Plan during the six months ended June 30, 2024 and 2023 is as follows, based on the target award amounts set forth in the performance share award agreements:

			Six Months Ended June 30, 2024												Six Months Ended June 30, 2023
			Shares						Weighted-Average Grant Date Fair Value Per Share						Shares						Weighted-Average Grant Date Fair Value Per Share
Performance share awards outstanding at beginning of period			273,791						$	33.17					252,375						$	31.84
Granted			323,461						10.03						122,071						31.21
Forfeited or unearned			(85,149)						37.98						(96,069)						26.96
Performance share awards outstanding at end of period			512,103						$	18.60					278,377						$	33.25

Stock Repurchases

On September 4, 2020, our Board of Directors approved a stock repurchase program under which we were authorized to repurchase up to $30.0 million of our common stock through September 3, 2022. On July 27, 2022, the Board of Directors extended the expiration date of the stock repurchase program to September 4, 2024. We repurchased 49,789 shares during the six months ended June 30, 2023, and there were no additional shares repurchased during the six months ended June 30, 2024. The approximate dollar value of shares that may yet be repurchased under the stock repurchase program was $16.5 million as of June 30, 2024. Any future stock repurchase transactions may be made through open market purchases, privately-negotiated transactions, or otherwise in compliance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended. Any repurchase activity will depend on many factors, such as the availability of shares of our common stock, general market conditions, the trading price of our common stock, alternative uses for capital, the Company’s financial performance, compliance with the terms of our Amended and Restated Credit Agreement and other factors. Concurrent with the authorization of this stock repurchase program in September 2020, the Board of Directors opted to indefinitely suspend all quarterly dividends.

In addition to shares repurchased under the approved stock repurchase program, we purchased 42,979 and 37,989 shares as of June 30, 2024 and 2023, respectively, to fund required tax withholdings. Shares withheld to cover required tax withholdings related to the vesting of restricted stock do not reduce our total share repurchase authority.

Common Stock Rights Agreement

On March 26, 2024, the Company’s board of directors declared a dividend of one right (a “Right”) for each of the Company’s issued and outstanding shares of common stock. The dividend was paid to the stockholders of record at the close of business on April 4, 2024. The complete description and terms of the Rights are set forth in the Rights Agreement, dated as of March 26, 2024, by and between the Company and ComputerShare Trust Company, N.A. as rights agent, as amended by the Amendment to the Rights Agreement dated as of April 22, 2024 (as amended, the “Rights Agreement”).

Each Right initially entitles the registered holder, subject to the terms of the Rights Agreement, to purchase from the Company one half of a share of common stock, at an exercise price of $28.00 for each one half of a share of common stock (equivalent to $56.00 for each whole share of common stock), subject to certain adjustments. The Rights currently are not exercisable and will only become exercisable upon the occurrence of certain events as described in the Rights Agreement. The Rights will expire prior to the earliest of (i) the close of business on March 25, 2025, or such later date as may be established by the Board prior to the expiration of the Rights; (ii) the time at which the Rights are redeemed pursuant to the Rights Agreement; (iii) the time at which the Rights are exchanged pursuant to the Rights Agreement; and (iv) upon the occurrence of certain transactions (the earliest of (i), (ii), (iii) and (iv) is referred to as the “Expiration Date”).

The Company analyzed the terms governing the Rights under ASC 480 - Distinguishing Liabilities from Equity and concluded that the Rights are a freestanding financial instrument that qualifies for liability classification. Specifically, the provisions within the Rights Agreement provide for scenarios outside of the Company’s control that may require the Company to settle a portion of the Rights in cash, rather than in shares of common stock.

---

The Rights are only exercisable upon the occurrence of certain events, which have not occurred as of the end of the reporting period, and the Company does not consider it likely that these events will occur in the future. As it is not considered likely that these events will occur, the Company considers the likelihood of exercise to be remote and has not ascribed value to the Rights as of June 30, 2024. The Company will continue to monitor the likelihood of exercise in future reporting periods.

Short-Term Payment Plans

The Company provides fixed monthly payment arrangements ("short-term payment plans") over terms ranging from three to twelve months for certain add-on software installations. As a practical expedient, we do not adjust the amount of consideration recognized as revenue for the financing component as unearned income when we expect payment within one year or less. These receivables, included in the current portion of financing receivables, were comprised of the following at June 30, 2024 and December 31, 2023:

(In thousands)			June 30, 2024						December 31, 2023
Short-term payment plans, gross			$	1,119					$	788
Less: allowance for losses			(56)						(39)
Short-term payment plans, net			$	1,063					$	749

Long-Term Financing Arrangements

Additionally, the Company provides financing for purchases of its information and patient care solutions to certain healthcare providers under long-term financing arrangements expiring in various years through 2030. Under long-term financing arrangements, the transaction price is adjusted by a discount rate that reflects market conditions that would be used for a separate financing transaction between the Company and licensee at contract inception, and takes into account the credit characteristics of the licensee and market interest rates as of the date of the agreement. As such, the amount of fixed fee revenue recognized at the beginning of the license term will be reduced by the calculated financing component. As payments are received from the licensee, the Company recognizes a portion of the financing component as interest income, reported as other income in the condensed consolidated statements of operations. These receivables typically have terms from two to seven years.

The components of these receivables were as follows at June 30, 2024 and December 31, 2023:

(In thousands)			June 30, 2024						December 31, 2023
Long-term financing arrangements, gross			$	4,284					$	5,212
Less: allowance for expected credit losses			(332)						(377)
Less: unearned income			(271)						(361)
Long-term financing arrangements, net			$	3,681					$	4,474

Future minimum payments to be received subsequent to June 30, 2024 are as follows:

(In thousands)
Years Ending December 31,
2024			$	1,671
2025			2,195
2026			276
2027			69
2028			62
Thereafter			11
Total minimum payments to be received			4,284
Less: allowance for expected credit losses			(332)
Less: unearned income			(271)
Receivables, net			$	3,681

---

Credit Quality of Financing Receivables and Allowance for Expected Credit Losses

The following table is a roll-forward of the allowance for expected credit losses for the six months ended June 30, 2024 and year ended December 31, 2023:

(In thousands)			Balance at Beginning of Period						Provision						Charge-offs						Recoveries						Sale of AHT						Balance at End of Period
June 30, 2024			$	416					$	(26)					$	—					$	—					$	(2)					$	388
December 31, 2023			$	549					$	(133)					$	—					$	—					$	—					$	416

The Company’s financing receivables are comprised of a single portfolio segment, as the balances are all derived from short-term payment plan arrangements and long-term financing arrangements within our target market of community hospitals. The Company evaluates the credit quality of its financing receivables based on a combination of factors, including, but not limited to, customer collection experience, current and future economic conditions, the customer’s financial condition, and known risk characteristics impacting the respective customer base of community hospitals, the most notable of which relate to enacted and potential changes in Medicare and Medicaid reimbursement rates as community hospitals typically generate a significant portion of their revenues and related cash flows from beneficiaries of these programs. In addition to specific account identification, the Company utilizes historical collection experience to establish the allowance for expected credit losses. Financing receivables are written off only after the Company has exhausted all collection efforts.

Customer payments are considered past due if a scheduled payment is not received within contractually agreed upon terms. To facilitate customer collection and credit monitoring efforts, financing receivable amounts are invoiced and reclassified to trade accounts receivable when they become due, with all invoiced amounts placed on nonaccrual status. As a result, all past due amounts related to the Company’s financing receivables are included in trade accounts receivable in the accompanying condensed consolidated balance sheets. The following is an analysis of the age of financing receivables amounts (excluding short-term payment plans) that have been reclassified to trade accounts receivable and were past due as of June 30, 2024 and December 31, 2023:

(In thousands)			1 to 90 Days Past Due						91 to 180 Days Past Due						181 + Days Past Due						Total Past Due
June 30, 2024			$	594					$	235					$	518					$	1,347
December 31, 2023			$	857					$	231					$	323					$	1,411

From time to time, the Company may agree to alternative payment terms outside of the terms of the original financing receivable agreement due to customer difficulties in achieving the original terms. In general, such alternative payment arrangements do not result in a re-aging of the related receivables. Rather, payments pursuant to any alternative payment arrangements are applied to the already outstanding invoices beginning with the oldest outstanding invoices as the payments are received.

Because amounts are reclassified to trade accounts receivable when they become due, there are no past due amounts included within financing receivables, current portion, net or financing receivables, net of current portion in the accompanying condensed consolidated balance sheets.

---

The Company utilizes an aging of trade accounts receivable as the primary credit quality indicator for its financing receivables, which is facilitated by the reclassification of customer payment amounts to trade accounts receivable when they become due. The table below categorizes customer financing receivable balances (excluding short-term payment plans) based on the age of the oldest payment outstanding that has been reclassified to trade accounts receivable:

(In thousands)			June 30, 2024						December 31, 2023
Stratification of uninvoiced client financing receivables based on aging of related trade accounts receivable:
Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due			$	2,347					$	1,068
Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due			579						1,720
Uninvoiced client financing receivables related to trade accounts receivable that are 181 + Days Past Due			975						965
Total uninvoiced client financing receivables balances of clients with a trade accounts receivable			$	3,901					$	3,753
Total uninvoiced client financing receivables of clients with no related trade accounts receivable			112						1,098
Total financing receivables with contractual maturities of one year or less			1,119						788
Less: allowance for expected credit losses			(388)						(416)
Total financing receivables			$	4,744					$	5,223

The following tables summarize the gross carrying amounts, accumulated amortization and accumulated impairment of identifiable intangible assets with definite lives by major class as of June 30, 2024 and December 31, 2023:

			June 30, 2024
(In thousands)			Customer Relationships						Trademark						Developed Technology						Non-Compete Agreements						Total
Gross carrying amount, beginning of period			$	116,470					$	7,720					$	31,900					$	1,620					$	157,710
Accumulated amortization			(45,441)						(5,378)						(20,905)						(684)						(72,408)
Accumulated impairment			—						(2,342)						—						—						(2,342)
Net intangible assets as of June 30, 2024			$	71,029					$	—					$	10,995					$	936					$	82,960
Weighted average remaining years of useful life			8.0						0.0						8.2						3.0						8.1

			December 31, 2023
(In thousands)			Customer Relationships						Trademark						Developed Technology						Non-Compete Agreements						Total
Gross carrying amount, beginning of period			$	132,170					$	12,320					$	40,800					$	1,400					$	186,690
Intangible assets acquired			16,100						—						1,400						220						17,720
Accumulated amortization			(63,686)						(6,974)						(29,934)						(522)						(101,116)
Accumulated impairment			—						(2,342)																		(2,342)
Held for sale			(8,735)						(3,004)																		(11,739)
Net intangible assets as of December 31, 2023			$	75,849					$	—					$	12,266					$	1,098					$	89,213

---

During the fourth quarter of 2023, the Company committed to the Company-wide rebranding and legal entity consolidation initiative that culminated in the change of the Company’s corporate name to “TruBridge, Inc.” on March 4, 2024. As a result of this initiative, it was expected that certain of the Company’s brand names and related trademarks would cease to be used, resulting in total trademark impairment recorded during the year ended December 31, 2023 of $2.3 million. Of the total trademark impairment charge, $1.0 million is derived from our RCM segment, $1.2 million is derived from our EHR segment, and $0.1 million is derived from our former Patient Engagement segment.

The following table represents the remaining amortization of definite-lived intangible assets as of June 30, 2024:

(In thousands)
For the year ended December 31,
2024			$	6,253
2025			12,190
2026			11,517
2027			10,497
2028			10,203
Thereafter			32,300
Total			$	82,960

The following table sets forth the change in the carrying value of our goodwill balances by reportable segment for the six months ended June 30, 2024:

(In thousands)			RCM			EHR			Total
Gross value at December 31, 2023			$	79,084		$	136,432		$	215,516
Accumulated impairment			—			(35,913)			(35,913)
Held for sale			—			(7,694)			(7,694)
Carrying value at December 31, 2023			79,084			92,825			171,909
Purchase price adjustment (Viewgol)			664			—			664
Gross value at June 30, 2024			79,748			128,738			208,486
Accumulated impairment			—			(35,913)			(35,913)
Carrying value as of June 30, 2024			$	79,748		$	92,825		$	172,573

Goodwill is evaluated for impairment annually on October 1, or more frequently if indicators of impairment are present or changes in circumstances suggest that impairment may exist.

During the first quarter of 2024, our share price experienced a sustained decline resulting in a decrease in our market capitalization. This decline in share price was identified as a triggering event requiring a quantitative assessment for goodwill impairment in all of our reporting segments.

We assessed goodwill in each of our reporting segments for impairment as of March 31, 2024, by using a combination of the income and market valuation approaches. Under the income approach, we used a discounted cash flow model, which utilizes present values of cash flows to estimate fair value. Our forecasted cash flows reflected conditions as of March 31, 2024, and reflected management’s anticipated business outlook for each reporting unit, which requires the use of estimates. The market approach applied selected trading multiples of companies comparable to the respective reporting units to the Company’s financial measures. Trading multiples selected for each reporting unit varied from the low end of the range of guideline public companies up to the median depending on the specific characteristics of each reporting unit. The income approach was given significantly more weight in determining the fair values. The approaches, which qualify as Level 3 within the fair value hierarchy, incorporate a number of market participant assumptions including, but not limited to, future cash flows, growth rates, and discount rates. The assumptions about future cash flows and growth rates are based on the Company’s forecasts and long-term plans. Discount rate assumptions are based on an assessment of the inherent risk of the respective reporting units. These quantitative evaluations of the fair values of each of our reporting units resulted in no impairment as of March 31, 2024. Given that the fair values of the reporting units are based on management’s best estimates, if actual results should differ from those estimates, impairment charges may be required in future periods.

---

Our share price continued to experience sustained decline during the first half of the second quarter of 2024. This decline in share price was identified as a triggering event requiring a quantitative assessment for goodwill impairment in all of our reporting segments.

On May 14, 2024, the Company announced a reorganization of its operating and reporting segment structure. This restructuring resulted in another triggering event requiring a quantitative assessment for goodwill impairment in our reporting units immediately pre- and post- reorganization as of that date. We utilized the same goodwill valuation approach as described above. These quantitative evaluations of the fair values of the goodwill in each of our reporting units resulted in no impairment.

Long-term debt was comprised of the following at June 30, 2024 and December 31, 2023:

(In thousands)			June 30, 2024						December 31, 2023
Term loan facility			$	58,125					$	63,875
Revolving credit facility			123,416						135,723
Debt obligations			181,541						199,598
Less: unamortized debt issuance costs			(1,503)						(1,187)
Debt obligation, net			180,038						198,411
Less: current portion			(3,074)						(3,141)
Long-term debt			$	176,964					$	195,270

As of June 30, 2024, the carrying value of debt approximated the fair value due to the variable interest rate, which reflected the market rate.

Credit Agreement

In conjunction with our acquisition of Healthland Holding Inc. in January 2016, we entered into a syndicated credit agreement with Regions Bank ("Regions") serving as administrative agent, which provided for a $125 million term loan facility and a $50 million revolving credit facility. On June 16, 2020, we entered into an Amended and Restated Credit Agreement that increased the aggregate principal amount of our credit facilities to $185 million, including a $75 million term loan facility and a $110 million revolving credit facility. On May 2, 2022, we entered into a First Amendment (the "First Amendment") to the Amended and Restated Credit Agreement that increased the aggregate principal amount of our credit facilities to $230 million, which includes a $70 million term loan facility and a $160 million revolving credit facility. There are no limitations on borrowing under the revolving credit facility other than that as of a date of borrowing there cannot be an ongoing event of default and there cannot be an event of default that would result from a new credit extension. In addition, the interest rate provisions of the First Amendment reflect the transition from the London Interbank Offered Rate ("LIBOR") to the Secured Overnight Financing Rate ("SOFR") as the new benchmark interest rate for each loan.

Each of our credit facilities continues to bear interest at a rate per annum equal to an applicable margin plus, at our option, either (1) the Adjusted SOFR rate for the relevant interest period, subject to a floor of 0.50%, (2) an alternate base rate determined by reference to the greater of (a) the prime lending rate of Regions, (b) the federal funds rate for the relevant interest period plus one half of one percent per annum and (c) the one month SOFR rate, subject to the aforementioned floor, plus one percent per annum, or (3) a combination of (1) and (2). The applicable margin for SOFR loans and the letter of credit fee ranges from 1.8% to 3.0%. The applicable margin for base rate loans ranges from 0.8% to 2.0%, in each case based on the Company's consolidated net leverage ratio.

Principal payments with respect to the term loan facility are due on the last day of each fiscal quarter beginning June 30, 2022, with quarterly principal payments of approximately $0.9 million through March 31, 2027, with maturity on May 2, 2027 or such earlier date as the obligations under the Amended and Restated Credit Agreement, as amended by the First Amendment, become due and payable pursuant to the terms of such agreement. Any principal outstanding under the revolving credit facility is due and payable on the maturity date.

---

Anticipated annual future maturities of the term loan facility and revolving credit facility are as follows as of June 30, 2024:

(In thousands)
2024			$	1,750
2025			3,500
2026			3,500
2027			172,791
			$	181,541

Our credit facilities are secured pursuant to the Amended and Restated Credit Agreement, dated as of June 16, 2020, among the parties identified as obligors therein and Regions, as collateral agent, on a first priority basis by a security interest in substantially all of the tangible and intangible assets (subject to certain exceptions) of the Company and certain subsidiaries of the Company, as guarantors (collectively, the “Subsidiary Guarantors”), including certain registered intellectual property and the capital stock of certain of the Company’s direct and indirect subsidiaries. Our obligations under the Amended and Restated Credit Agreement are also guaranteed by the Subsidiary Guarantors.

The First Amendment provides incremental facility capacity of $75 million, subject to certain conditions. The Amended and Restated Credit Agreement, as amended by the First Amendment, includes a number of restrictive covenants that, among other things and in each case subject to certain exceptions and baskets, impose operating and financial restrictions on the Company and the Subsidiary Guarantors, including the ability to incur additional debt; incur liens and encumbrances; make certain restricted payments, including paying dividends on the Company's equity securities or payments to redeem, repurchase, or retire the Company's equity securities (which are subject to our compliance, on a pro forma basis to give effect to the restricted payment, with the fixed charge coverage ratio and consolidated net leverage ratio described below); enter into certain restrictive agreements; make investments, loans and acquisitions; merge or consolidate with any other person; dispose of assets; enter into sale and leaseback transactions; engage in transactions with affiliates; and materially alter the business we conduct. The First Amendment requires the Company to maintain a minimum fixed charge coverage ratio of 1.25:1.00 throughout the duration of such agreement. Under the First Amendment, the Company is required to comply with a maximum consolidated net leverage ratio of 3.50:1.00. Further, under the First Amendment, in connection with any acquisition by the Company exceeding $25 million, the Company may elect to increase the maximum permitted consolidated net leverage ratio for the fiscal quarter in which the acquisition occurs and each of the following three fiscal quarters by 0.50:1.00 above the otherwise permitted maximum. If the consolidated net leverage ratio is less than 2.50:1.00, there is no limit on the incremental facility. The Amended and Restated Credit Agreement also contains customary representations and warranties, affirmative covenants and events of default. On March 10, 2023, the calculation of the fixed charge coverage ratio was amended pursuant to the Second Amendment to the Amended and Restated Credit Agreement in order to specifically exclude from the definition of fixed charges the Company's share repurchases conducted during the third and fourth quarters of 2022.

As of September 30, 2023, we were not in compliance with the fixed charge coverage ratio required by the Amended and Restated Credit Agreement. On November 8, 2023, the Company and the Subsidiary Guarantors entered into a Waiver with Regions Bank, as administrative agent, and various other lenders, which provided for a one-time waiver of this failure as an event of default. As of December 31, 2023, the Company was similarly not in compliance with the fixed charge coverage ratio required by the Amended and Restated Credit Agreement, and a one-time waiver was provided in conjunction with the Fourth Amendment to the Amended and Restated Credit Agreement (described below). Any failure by us to comply with this or another covenant in the future may result in an event of default. There can be no assurance that we will be able to continue to comply with this covenant or obtain amendments or waivers to avoid future covenant violations, or that such amendments or waivers will be available on commercially acceptable terms.

The First Amendment removed the requirement that the Company mandatorily prepay the credit facilities with excess cash flow generated during the prior fiscal year. The Company is permitted to voluntarily prepay the credit facilities at any time without penalty, subject to customary “breakage” costs with respect to prepayments of SOFR rate loans made on a day other than the last day of any applicable interest period.

---

Credit Facility - Third Amendment

On January 16, 2024, the Company entered into a Third Amendment (the “Third Amendment”) to the Amended and Restated Credit Agreement, dated as of June 16, 2020, by and among the Company; the Subsidiary Guarantors; Regions Bank, as administrative agent and collateral agent; and various other lenders from time to time. Capitalized terms used but not defined herein shall have the meanings ascribed to them in the Credit Agreement.

The Third Amendment modified the term “Consolidated EBITDA” to provide that the following amounts will be added back to Consolidated Net Income: (i) the reasonably expected value of all earn-out consideration in connection with any Permitted Acquisition, provided that the aggregate amount of fees and out-of-pocket expenses incurred in connection with anticipated Permitted Acquisitions which are not consummated during any period of four fiscal quarters ending on or after the Closing Date will not exceed the greater of $7 million and 10% of Consolidated EBITDA; (ii) any fees, costs or expenses related to the implementation of cost savings, operating expense reductions and synergies related to Permitted Acquisitions, restructurings and other initiatives; and (iii) costs and expenses related to the previously disclosed U.S. Securities and Exchange Commission investigation that occurred during the fiscal year ended December 31, 2023, in an aggregate amount not to exceed $1.25 million. Additionally, the Third Amendment (y) removed from the maximum aggregate amount of fees and expenses that can be added back to Consolidated Net Income any losses resulting from any Asset Sales or Involuntary Disposition and (z) increased the maximum amount of fees and expenses that can be added back to Consolidated Net Income related to savings initiatives, Equity Transactions, the incurrence of Indebtedness and amendments to the Credit Documents from 10% to 15% of Consolidated EBITDA (determined prior to giving effect to such adjustments).

Credit Facility - Fourth Amendment

On February 29, 2024, the Company entered into a Fourth Amendment (the “Fourth Amendment”) to the Credit Agreement, by and among the Company; the Subsidiary Guarantors; the Administrative Agent; and various other lenders. Capitalized terms used but not defined herein shall have the meanings ascribed to them in the Credit Agreement.

The Fourth Amendment modified the term “Consolidated EBITDA” to provide that the additional following amounts will be added back to Consolidated Net Income: (i) costs and expenses related to the voluntary early retirement program during the fiscal year ending December 31, 2023; and (ii) fees, costs and expenses in categories identified to the Administrative Agent to the extent incurred during the fiscal year ending December 31, 2024, in an aggregate amount not to exceed $7.25 million. Additionally, the modified definition of “Consolidated EBITDA” limits the amount of pro forma “run rate” cost savings, operating expense reductions and synergies (collectively, “Savings”) related to the Viewgol acquisition that can be added back to Consolidated Net Income to an aggregate amount not to exceed $6.6 million; however, Savings related to the Viewgol acquisition are not subject to the cap of 15% of Consolidated EBITDA that otherwise applies to Savings related to Permitted Acquisitions, restructurings or cost savings initiatives.

The Company leases office space in various locations in Alabama, Pennsylvania, Maryland, Mississippi, and Washington. These leases have terms expiring from 2024 through 2029 but do contain optional extension terms. Leases with an initial term of 12 months or less are not recorded on the balance sheet; we recognize lease expense for these leases on a straight-line basis over the lease term.

On April 30, 2023, the company terminated its lease agreement for approximately 12,500 square feet of office space in Plymouth, Minnesota. Pursuant to a Termination of Lease Agreement dated April 18, 2023, the Company paid $1.1 million to the landlord as consideration for the early termination. In connection with the lease termination, the Company derecognized the assets and liabilities associated with the operating lease and recorded a $0.1 million loss on the disposal of leasehold improvement.

---

Supplemental balance sheet information related to operating leases was as follows:

(In thousands)			June 30, 2024						December 31, 2023
Operating lease assets:
Operating lease assets			$	3,861					$	5,192
Operating lease liabilities:
Other accrued liabilities			1,349						1,804
Operating lease liabilities, net of current portion			2,512						3,074
Total operating lease liabilities			$	3,861					$	4,878
Weighted average remaining lease term in years			3.8						4
Weighted average discount rate			4.1%						4.2%

Because our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at the lease commencement date in determining the present value of lease payments. We used the incremental borrowing rate on January 1, 2019, for operating leases that commenced prior to that date.

The future minimum lease payments payable under these operating leases subsequent to June 30, 2024 are as follows:

(In thousands)
2024			$	825
2025			1,008
2026			962
2027			678
2028			462
Thereafter			231
Total lease payments			4,166
Less imputed interest			(305)
Total			$	3,861

Total lease expense for the six months ended June 30, 2024 and 2023 was $0.6 million and $1.1 million, respectively.

Total cash paid for amounts included in the measurement of lease liabilities within operating cash flows from operating leases for the six months ended June 30, 2024 and 2023 was $0.6 million and $1.1 million, respectively.

FASB Codification topic, Fair Value Measurements and Disclosures, establishes a framework for measuring fair value and expands financial statement disclosures about fair value measurements. Fair value is the price that would be received to sell an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. The Codification does not require any new fair value measurements, but rather applies to all other accounting pronouncements that require or permit fair value measurements. The Codification requires that assets and liabilities carried at fair value be classified and disclosed in one of the following three categories:

Level 1: Quoted market prices in active markets for identical assets or liabilities.

Level 2: Observable market-based inputs or unobservable inputs that are corroborated by market data.

Level 3: Unobservable inputs that are not corroborated by market data.

---

At June 30, 2024, we measured the fair value of contingent consideration that represents the potential earnout incentive for Viewgol’s former equity holders. We estimated the fair value of this contingent consideration based on the probability of Viewgol meeting EBITDA targets (subject to certain pro-forma adjustments).

The following table summarizes the carrying amount and fair value of the contingent consideration at June 30, 2024:

									Fair Value at June 30, 2024 Using
(In thousands)			Carrying Amount at June 30, 2024						Quoted Price in Active Markets for Identical Assets (Level 1)						Significant Other Observable Inputs (Level 2)						Significant Unobservable Inputs (Level 3)
Description
Contingent consideration			$	1,044					$	—					$	—					$	1,044
Total			$	1,044					$	—					$	—					$	1,044

The following table summarizes the carrying amount and fair value of the contingent consideration at December 31, 2023:

									Fair Value at December 31, 2023 Using
(In thousands)			Carrying Amount at December 31, 2023						Quoted Price in Active Markets for Identical Assets (Level 1)						Significant Other Observable Inputs (Level 2)						Significant Unobservable Inputs (Level 3)
Description
Contingent consideration			$	1,044					$	—					$	—					$	1,044
Total			$	1,044					$	—					$	—					$	1,044

Our chief operating decision makers ("CODM") previously identified the following three operating and reportable segments: RCM, EHR, and Patient Engagement. In May 2024, the Company made a number of changes to its organizational structure and management system to better align the Company's operating model with its strategic initiatives. As a result, the Company changed from three operating and reportable segments of (i) RCM, (ii) EHR and (iii) Patient Engagement to two operating and reportable segments of (i) EHR and (ii) RCM. These two segments are distinct business units with unique market dynamics and opportunities. They represent the components of the Company for which separate financial information is available and is utilized on a regular basis by the CODM in assessing segment performance and in allocating the Company's resources. The Patient Engagement segment results were transitioned into the EHR segment for all periods presented.

Management evaluates the performance of the segments based on revenues and adjusted EBITDA. Management believes adjusted EBITDA is a useful measure to assess the performance and liquidity of the Company as it provides meaningful operating results by excluding the effects of expenses that are not reflective of its operating business performance. Our CODM group is comprised of the Chief Executive Officer, Chief Operating Officer, and Chief Financial Officer. Accounting policies for each of the reportable segments are the same as those used on a consolidated basis.

Adjusted EBITDA consists of GAAP net income (loss) as reported and adjusts for (i) depreciation expense; (ii) amortization of software development costs; (iii) amortization of acquisition-related intangibles; (iv) stock-based compensation; (v) severance; (vi) other non-recurring charges; (vii) interest expense and other, net; and (viii) the provision (benefit) for income taxes. There are no intersegment revenues to be eliminated in computing segment revenue.

The CODM do not evaluate operating segments nor make decisions regarding operating segments based on assets. Consequently, we do not disclose total assets by reportable segment.

---

The following table presents a summary of the revenues and adjusted EBITDA of our two operating segments for the three and six months ended June 30, 2024 and 2023:

			Three Months Ended June 30,												Six Months Ended June 30,
(In thousands)			2024						2023						2024						2023
Revenues by segment:
RCM			$	54,108					$	47,760					$	107,146					$	96,391
EHR
Recurring revenue
Acute EHR			26,666						30,013						54,160						59,353
Post-acute EHR			—						3,729						582						7,636
Total recurring EHR revenue			26,666						33,742						54,742						66,989
Non-recurring revenue
Acute EHR			3,956						2,775						6,008						6,750
Post-acute EHR			—						345						81						725
Total non-recurring EHR revenue			3,956						3,120						6,089						7,475
Total EHR revenue			$	30,622					$	36,862					$	60,831					$	74,464
Total revenues			$	84,730					$	84,622					$	167,977					$	170,855
Adjusted EBITDA by segment:
RCM			$	7,804					$	5,682					$	14,202					13,580
EHR			4,770						5,545						7,826						12,289
Total adjusted EBITDA			$	12,574					$	11,227					$	22,028					$	25,869

The following table reconciles net income to adjusted EBITDA:

			Three Months Ended June 30,												Six Months Ended June 30,
(In thousands)			2024						2023						2024						2023
Net income (loss), as reported			$	(5,049)					$	(2,837)					(7,565)						247
Deferred revenue and other purchase accounting adjustments			—						—						—						—
Depreciation expense			400						597						800						1,095
Amortization of software development costs			5,980						1,826						8,722						3,312
Amortization of acquisition-related intangibles			3,126						4,014						6,253						8,029
Stock-based compensation			1,501						(123)						2,300						1,124
Severance and other non-recurring charges			4,586						6,819						8,430						7,920
Interest expense			4,151						2,586						8,051						4,988
Gain on sale of AHT			—						—						(1,250)						—
Provision (benefit) for income taxes			(2,121)						(1,655)						(3,713)						(846)
Total adjusted EBITDA			$	12,574					$	11,227					$	22,028					$	25,869

Certain of the items excluded or adjusted to arrive at adjusted EBITDA are described below:

•Amortization of acquisition-related intangibles - Acquisition-related amortization expense is a non-cash expense arising primarily from the acquisition of intangibles in connection with acquisitions or investments. We exclude acquisition-related amortization expense from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of new acquisitions and full amortization of previously acquired intangible assets.

---

•Stock-based compensation - Stock-based compensation expense is a non-cash expense arising from the grant of stock-based awards. We exclude stock-based compensation expense from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of the timing and valuation of grants of new stock-based awards, including grants in connection with acquisitions.

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

---

v3.24.2.u1

COVER - shares	6 Months Ended
	Jun. 30, 2024	Aug. 07, 2024
Document Information [Line Items]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2024
Document Transition Report	false
Entity File Number	000-49796
Entity Registrant Name	TRUBRIDGE, INC
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	74-3032373
Entity Address, Address Line One	54 St. Emanuel Street
Entity Address, City or Town	Mobile
Entity Address, State or Province	AL
Entity Address, Postal Zip Code	36602
City Area Code	251
Local Phone Number	639-8100
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		14,960,311
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q2
Amendment Flag	false
Central Index Key	0001169445
Current Fiscal Year End Date	--12-31
Common Stock, par value $.001 per share
Document Information [Line Items]
Title of 12(b) Security	Common Stock, par value $.001 per share
Trading Symbol	TBRG
Security Exchange Name	NASDAQ
Common Stock Purchase Rights
Document Information [Line Items]
Title of 12(b) Security	Common Stock Purchase Rights
No Trading Symbol Flag	true
Security Exchange Name	NASDAQ

v3.24.2.u1

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 7,709	$ 3,848
Accounts receivable (net of allowance for expected credit losses of $3,315 and $3,631, respectively)	59,603	59,723
Financing receivables, current portion, net (net of allowance for expected credit losses of $332 and $319, respectively)	4,137	3,997
Inventories	793	475
Prepaid income taxes	2,307	1,628
Prepaid expenses and other current assets	17,034	15,807
Assets of held for sale disposal group	0	25,977
Total current assets	91,583	111,455
Property and equipment, net	8,479	8,974
Software development costs, net	39,741	39,139
Operating lease assets	3,861	5,192
Financing receivables, net of current portion (net of allowance for expected credit losses of $56 and $97, respectively)	607	1,226
Other assets, net of current portion	8,337	7,314
Intangible assets, net	82,960	89,213
Goodwill	172,573	171,909
Deferred tax assets	4,146	0
Total assets	412,287	434,422
Current liabilities:
Accounts payable	15,854	10,133
Current portion of long-term debt	3,074	3,141
Deferred revenue	9,842	8,677
Accrued vacation	5,458	5,410
Other accrued liabilities	17,481	19,892
Liabilities of held for sale disposal group	0	977
Total current liabilities	51,709	48,230
Long-term debt, net of current portion	176,964	195,270
Operating lease liabilities, net of current portion	2,512	3,074
Deferred tax liabilities	0	1,230
Total liabilities	231,185	247,804
Stockholders’ equity:
Common stock, $0.001 par value; 30,000 shares authorized; 15,561 and 15,121 shares issued, respectively	15	15
Additional paid-in capital	197,846	195,546
Accumulated other comprehensive gain	108	0
Retained earnings	567	8,132
Treasury stock, 615 shares and 572 shares, respectively	(17,434)	(17,075)
Total stockholders’ equity	181,102	186,618
Total liabilities and stockholders’ equity	$ 412,287	$ 434,422

v3.24.2.u1

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Accounts receivable, net of allowance for doubtful accounts	$ 3,315	$ 3,631
Financing receivable, allowance for credit loss, current	332	319
Financing receivable, allowance for credit loss, noncurrent	$ 56	$ 97
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	30,000,000	30,000,000
Common stock, shares issued (in shares)	15,561,000	15,121,000
Treasury stock (in shares)	615,000	572,000

v3.24.2.u1

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenues
Total revenues	$ 84,730	$ 84,622	$ 167,977	$ 170,855
Costs of revenue (exclusive of amortization and depreciation)
Total costs of revenue (exclusive of amortization and depreciation)	43,342	44,133	85,103	88,310
Product development	8,207	8,769	18,894	17,121
Sales and marketing	7,815	8,132	14,408	15,089
General and administrative	18,878	19,057	38,274	33,510
Amortization	9,107	5,840	14,975	11,341
Depreciation	400	597	800	1,095
Total expenses	87,749	86,528	172,454	166,466
Operating income (loss)	(3,019)	(1,906)	(4,477)	4,389
Other income (expense):
Other income	91	78	1,514	346
Interest expense	(4,242)	(2,664)	(8,315)	(5,334)
Total other expense	(4,151)	(2,586)	(6,801)	(4,988)
Loss before taxes	(7,170)	(4,492)	(11,278)	(599)
Income tax benefit	(2,121)	(1,655)	(3,713)	(846)
Net income (loss)	$ (5,049)	$ (2,837)	$ (7,565)	$ 247
Net income (loss) per common share—basic (in dollars per share)	$ (0.34)	$ (0.20)	$ (0.51)	$ 0.02
Net income (loss) per common share—diluted (in dollars per share)	$ (0.34)	$ (0.20)	$ (0.51)	$ 0.02
Weighted average shares outstanding used in per common share computations:
Basic (in shares)	14,313	14,200	14,273	14,168
Diluted (in shares)	14,313	14,200	14,273	14,168
RCM
Revenues
Total revenues	$ 54,108	$ 47,760	$ 107,146	$ 96,391
Costs of revenue (exclusive of amortization and depreciation)
Total costs of revenue (exclusive of amortization and depreciation)	30,269	27,119	59,866	54,302
EHR
Revenues
Total revenues	30,622	36,862	60,831	74,464
Costs of revenue (exclusive of amortization and depreciation)
Total costs of revenue (exclusive of amortization and depreciation)	$ 13,073	$ 17,014	$ 25,237	$ 34,008

v3.24.2.u1

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ (5,049)	$ (2,837)	$ (7,565)	$ 247
Other comprehensive income (loss):
Foreign currency translation adjustment	(5)	0	108	0
Comprehensive income (loss)	$ (5,054)	$ (2,837)	$ (7,457)	$ 247

v3.24.2.u1

CONDENSED CONSOLIDATED STATEMENT OF STOCKHOLDERS’ EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Additional Paid-in-Capital	Accumulated Other Comprehensive (Loss) Income	Retained Earnings	Treasury Stock
Beginning balance (in shares) at Dec. 31, 2022		14,913
Beginning balance at Dec. 31, 2022	$ 231,711	$ 15	$ 192,275	$ 0	$ 53,921	$ (14,500)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net Income (Loss)	247				247
Foreign currency translation adjustment	0
Issuance of restricted stock (in shares)		186
Stock-based compensation	1,124		1,124
Treasury stock acquired	(2,532)					(2,532)
Ending balance (in shares) at Jun. 30, 2023		15,099
Ending balance at Jun. 30, 2023	230,550	$ 15	193,399	0	54,168	(17,032)
Beginning balance (in shares) at Mar. 31, 2023		15,099
Beginning balance at Mar. 31, 2023	233,558	$ 15	193,522	0	57,005	(16,984)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net Income (Loss)	(2,837)				(2,837)
Foreign currency translation adjustment	0
Stock-based compensation	(123)		(123)
Treasury stock acquired	(48)					(48)
Ending balance (in shares) at Jun. 30, 2023		15,099
Ending balance at Jun. 30, 2023	230,550	$ 15	193,399	0	54,168	(17,032)
Beginning balance (in shares) at Dec. 31, 2023		15,121
Beginning balance at Dec. 31, 2023	186,618	$ 15	195,546	0	8,132	(17,075)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net Income (Loss)	(7,565)				(7,565)
Foreign currency translation adjustment	108			108
Forfeiture of common stock (in shares)		(55)
Issuance of restricted stock (in shares)		495
Stock-based compensation	2,300		2,300
Treasury stock acquired	(359)					(359)
Ending balance (in shares) at Jun. 30, 2024		15,561
Ending balance at Jun. 30, 2024	181,102	$ 15	197,846	108	567	(17,434)
Beginning balance (in shares) at Mar. 31, 2024		15,572
Beginning balance at Mar. 31, 2024	184,673	$ 15	196,346	113	5,616	(17,417)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net Income (Loss)	(5,049)				(5,049)
Foreign currency translation adjustment	(5)			(5)
Forfeiture of common stock (in shares)		(11)
Stock-based compensation	1,500		1,500
Treasury stock acquired	(17)					(17)
Ending balance (in shares) at Jun. 30, 2024		15,561
Ending balance at Jun. 30, 2024	$ 181,102	$ 15	$ 197,846	$ 108	$ 567	$ (17,434)

v3.24.2.u1

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Operating Activities:
Net income (loss)	$ (7,565)	$ 247
Adjustments to net income (loss):
Provision for credit losses	358	181
Deferred taxes	(5,224)	(1,533)
Stock-based compensation	2,300	1,124
Depreciation	800	1,095
Gain on sale of business	(1,250)	0
Amortization of acquisition-related intangibles	6,253	8,029
Amortization of software development costs	8,722	3,312
Amortization of deferred finance costs	213	180
Non-cash operating lease costs	897	1,211
Loss on disposal of property and equipment	0	117
Changes in operating assets and liabilities:
Accounts receivable	654	(3,806)
Financing receivables	506	940
Inventories	(318)	(178)
Prepaid expenses and other current assets	1,502	(2,017)
Accounts payable	5,750	7,448
Deferred revenue	1,769	(1,705)
Operating lease liabilities	(583)	(1,067)
Other liabilities	(2,375)	(2,278)
Prepaid income taxes	(679)	(1,110)
Net cash provided by operating activities	11,730	10,190
Investing Activities:
Purchase of business, net of cash acquired	(664)	0
Sale of business, net of cash and cash equivalents sold	21,410	0
Investment in software development	(9,324)	(12,143)
Purchase of property and equipment	(306)	(72)
Net cash provided by (used in) investing activities	11,116	(12,215)
Financing Activities:
Payments of long-term debt principal	(5,750)	(1,750)
Proceeds from revolving line of credit	21,072	11,602
Payments of revolving line of credit	(33,379)	(5,000)
Debt issuance costs	(529)	0
Treasury stock purchases	(358)	(2,532)
Net cash provided by (used in) financing activities	(18,944)	2,320
Increase in cash and cash equivalents	3,902	295
Change in cash and cash equivalents included in assets sold	(41)	0
Cash and cash equivalents at beginning of period	3,848	6,951
Cash and cash equivalents at end of period	7,709	7,246
Supplemental disclosure of cash flow information:
Cash paid for interest	8,312	3,413
Cash paid for income taxes	$ 2,190	$ 1,783

v3.24.2.u1

BASIS OF PRESENTATION	6 Months Ended
	Jun. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BASIS OF PRESENTATION	BASIS OF PRESENTATION Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (the “SEC”) and include all adjustments that, in the opinion of management, are necessary for a fair presentation of the results of the periods presented. All such adjustments are considered of a normal recurring nature. Quarterly results of operations are not necessarily indicative of annual results. Certain footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) have been condensed or omitted. The condensed consolidated balance sheet as of December 31, 2023 was derived from the audited consolidated balance sheet at that date. These unaudited condensed consolidated financial statements should be read in conjunction with the audited financial statements of TruBridge, Inc. (“TruBridge” or the “Company”) for the year ended December 31, 2023 and the notes thereto contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023. In May 2024, the Company realigned its reporting structure due to certain organizational changes. As a result, the Company changed from three reportable segments of (i) Revenue Cycle Management (“RCM”), (ii) Electronic Health Records (“EHR”), and (iii) Patient Engagement to two reportable segments of (i) RCM and (ii) EHR. The Patient Engagement segment results have been transitioned into the EHR segment. This change is intended to improve connectivity and alignment between the two business units to better serve our clients and more accurately reflect how the Company’s management views and operates the business. All prior segment information has been recast to reflect the Company's new segment structure and current period presentation. Refer to Note 17 - Segment Reporting for more information. During the third quarter of 2023, we changed the presentation of certain costs previously recorded within the expense captions of "Product development" and "General and administrative" to better comply with the disclosure requirements of Staff Accounting Bulletin Topic 11.B. Miscellaneous Disclosure: Depreciation and Depletion Excluded from Cost of Sales. These changes are summarized as follows: •Amortization expense associated with capitalized software development costs, previously recorded within the expense caption of "Product development," has been combined with amounts previously recorded within the expense caption "Amortization of acquisition-related intangibles" and reflected in a newly-presented expense caption of "Amortization." •Depreciation expense previously recorded within the expense caption of "General and administrative" has been reclassified within the newly-presented expense caption of "Depreciation." •The expense caption previously labeled as "Costs of sales" has been renamed "Costs of revenue (exclusive of amortization and depreciation)," with the previously reported reference to "Gross profit" removed from the current presentation. The following table provides the amounts reclassified for the three and six months ended June 30, 2023. Three Months Ended June 30, 2023 (in thousands) As previously reported Re-classifications As reclassified As currently reported Costs of revenue (exclusive of amortization and depreciation) RCM $ 27,119  $ —  $ 27,119  $ 27,119  EHR 17,014  —  17,014  17,014  Other expenses Product development 10,595  (1,826) 8,769  8,769  Sales and marketing 8,132  —  8,132  8,132  General and administrative 19,654  (597) 19,057  19,057  Amortization of acquisition-related intangibles 4,014  (4,014) —  —  Amortization —  5,840  5,840  5,840  Depreciation —  597  597  597  Six Months Ended June 30, 2023 (in thousands) As previously reported Re-classifications As reclassified As currently reported Costs of revenue (exclusive of amortization and depreciation) RCM $ 54,302  $ —  $ 54,302  $ 54,302  EHR 34,008  —  34,008  34,008  Other expenses Product development 20,434  (3,313) 17,121  17,121  Sales and marketing 15,089  —  15,089  15,089  General and administrative 34,604  (1,094) 33,510  33,510  Amortization of acquisition-related intangibles 8,029  (8,029) —  —  Amortization —  11,341  11,341  11,341  Depreciation —  1,095  1,095  1,095  Principles of Consolidation The condensed consolidated financial statements of TruBridge include the accounts of the Company and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated.

v3.24.2.u1

RECENT ACCOUNTING PRONOUNCEMENTS	6 Months Ended
	Jun. 30, 2024
Accounting Changes and Error Corrections [Abstract]
RECENT ACCOUNTING PRONOUNCEMENTS	RECENT ACCOUNTING PRONOUNCEMENTS New Accounting Standards Adopted in 2024 There were no new accounting standards required to be adopted in 2024 that would have a material impact on our consolidated financial statements. New Accounting Standards Yet to be Adopted In November 2023, the FASB issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures” (“ASU 2023-07”), which is intended to improve reportable segment disclosure requirements, primarily through additional and more detailed information about a reportable segment's expenses. The guidance is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The guidance is to be applied retrospectively to all prior periods presented in the financial statements. Upon transition, the segment expense categories and amounts disclosed in the prior periods should be based on the significant segment expense categories identified and disclosed in the period of adoption. The Company is currently evaluating the potential impact of adopting this new guidance on its disclosures.

v3.24.2.u1

REVENUE RECOGNITION	6 Months Ended
	Jun. 30, 2024
Revenue from Contract with Customer [Abstract]
REVENUE RECOGNITION	REVENUE RECOGNITION Our contracts with customers can include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately versus together may require significant judgment. Our contracts are generally distinct and accounted for as separate performance obligations. Revenue is recognized upon transfer of control of promised products or services to clients in an amount that reflects the consideration we expect to receive in exchange for those products and services. The Company employs the 5-step revenue recognition model under ASC 606, Revenue from Contracts with Customers, to: (1) identify the contract with the client, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when (or as) the entity satisfies a performance obligation. Revenue is recognized net of shipping charges and any taxes collected from clients, which are subsequently remitted to governmental authorities. •Revenue Cycle Management Our revenue cycle management (“RCM”) business unit provides an array of business processing services (“BPS'’) consisting of accounts receivable management, private pay services, insurance services, medical coding, electronic billing, statement processing, payroll processing, and contract management. Fees are recognized over the period of the client contractual relationship as the services are performed based on the stand-alone selling price (“SSP”), net of discounts. SSP for BPS services is determined based on observable stand-alone selling prices. Fees for many of these services are invoiced, and revenue recognized accordingly, based on the volume of transactions or a percentage of client accounts receivable collections. Payment is due monthly for BPS with certain amounts varying based on utilization and/or volumes. Our RCM business unit also provides professional IT services. Revenue from professional IT services is recognized as the services are performed based on SSP, which is determined by observable stand-alone selling prices. Payment is due monthly as services are performed. Lastly, our RCM business unit also provides certain software solutions and related support under Software as a Service (“SaaS”) arrangements and time-based software licenses. Revenue from SaaS arrangements is recognized in a manner consistent with SaaS arrangements for electronic health records (“EHR”) software, as discussed below. Revenue from time-based software licenses is recognized upon delivery to the client (“point in time”) and revenue from non-license components (i.e., support) is recognized ratably over the respective contract term (“over time”). SSP for time-based licenses is determined using the residual approach, while the non-license component is based on cost plus reasonable margin. •Electronic Health Records The Company enters into contractual obligations to sell perpetual software licenses, installation, conversion, and related training services, software application support, hardware, and hardware maintenance services to acute care community hospitals. The Company also enters into contractual obligations to sell time-based software licenses, implementation and customization professional services, and software application support services to a variety of healthcare organizations, including hospital systems, health ministries, and government and non-profit organizations. •Non-recurring Revenues •Perpetual software licenses and installation, conversion, and related training services are not considered separate and distinct performance obligations due to the proprietary nature of our software and are, therefore, accounted for as a single performance obligation on a module-by-module basis. Revenue is recognized as each module's implementation is completed based on the module's SSP, net of discounts. We determine each module's SSP using the residual method. Fees for licenses and installation, conversion, and related training services are typically due in three installments: (1) at placement of order, (2) upon installation of software and commencement of training, and (3) upon satisfactory completion of monthly accounting cycle or end-of-month operation by application and as applicable for each application. Often, short-term and/or long-term financing arrangements are provided for software implementations; refer to Note 11 - Financing Receivables for further information. EHR implementations include a system warranty that terminates thirty days from the software go-live date, the date which the client begins using the system in a live environment. •Hardware revenue is recognized separately from software licenses at the point in time it is delivered to the client. The SSP of hardware is cost plus a reasonable margin and revenue is recognized on a gross basis. Payment is generally due upon delivery of the hardware to the client. Standard manufacturer warranties apply to hardware. •Perpetual software licenses are sold only to one re-seller client and are considered a separate and distinct performance obligation. Revenue is recognized at the point in time perpetual licenses are delivered to the client, which occurs at the time of sale. The SSP of perpetual licenses is directly observable. Payment is generally due upon delivery of licenses. •Implementation and customization services are considered a separate and distinct performance obligation. Revenue is recognized over time based on SSP, which is generally directly observable. Payment for professional services is typically due in two installments: (1) upon signature of the agreement and (2) upon customer acceptance of the delivered services. •Recurring Revenues •Software application support and hardware maintenance services sold with software licenses and hardware are separate and distinct performance obligations. Revenue for support and maintenance services is recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three to five years. Payment is due monthly for support and maintenance services provided. •Subscriptions to third-party content revenue is recognized as a separate performance obligation ratably over the subscription term based on SSP, which is cost plus a reasonable margin, and revenue is recognized on a gross basis. Payment is due monthly for subscriptions to third party content. •SaaS arrangements for EHR software and related conversion and training services are considered a single performance obligation. Revenue is recognized on a monthly basis as the SaaS service is provided to the client over the contract term. Payment is due monthly for SaaS services provided. •Term-based software licenses are considered a separate and distinct performance obligation. Revenue is recognized based on SSP, which is directly observable, at the point in time the term-based licenses are delivered to the client or upon annual renewal. Payment is generally due upon delivery of licenses or upon annual renewal. •Software application support services sold with software licenses are separate and distinct performance obligations. The related revenues are recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three to five years. Payment is generally due for the full amount of annual support fees at the beginning of an annual license term. Refer to Note 17 - Segment Reporting for further information, including revenue by client base (acute care or post-acute care) bifurcated by recurring and non-recurring revenue. Deferred Revenue Deferred revenue represents amounts invoiced to clients for which the services under contract have not been completed and revenue has not been recognized, including annual renewals of certain software subscriptions and customer deposits for implementations to be performed at a later date. Revenue is recognized ratably over the life of the software subscriptions as services are provided and at the point-in-time when implementations have been completed. The following table details deferred revenue for the six months ended June 30, 2024 and 2023, included in the condensed consolidated balance sheets: (In thousands) Six Months Ended June 30, 2024 Six Months Ended June 30, 2023 Beginning balance $ 8,677  $ 11,590  Deferred revenue recorded 8,230  10,623  Less deferred revenue recognized as revenue (7,065) (12,328) Ending balance $ 9,842  $ 9,885  The deferred revenue recorded during the six months ended June 30, 2024 and 2023 is comprised primarily of the annual renewals of certain software subscriptions billed during the first quarter of each year and deposits collected for future EHR installations. The deferred revenue recognized as revenue during the six months ended June 30, 2024 and 2023 is comprised primarily of the periodic recognition of annual renewals that were deferred until earned and deposits for future EHR installations that were earned during the period. Costs to Obtain and Fulfill a Contract with a Customer Costs to obtain a contract include the commission costs related to SaaS and RCM arrangements, which are capitalized and amortized ratably over the expected life of the customer contract. As a practical expedient, we generally recognize the incremental costs of obtaining a contract as an expense when incurred if the amortization period of the asset would have been one year or less. Costs to obtain a contract are expensed within the caption “Expenses - Sales and marketing” in the accompanying condensed consolidated statements of operations. Contract fulfillment costs related to the implementation of SaaS arrangements are capitalized and amortized ratably over the expected life of the customer contract. Costs to fulfill contracts consist of the payroll costs for the implementation of SaaS arrangements, including time for training, conversions, and installation that is necessary for the software to be utilized. Contract fulfillment costs are expensed within the caption “Costs of revenue (exclusive of amortization and depreciation) - EHR” in the accompanying condensed consolidated statements of operations. Costs to obtain and fulfill contracts related to SaaS and RCM arrangements are included within the “Prepaid expenses and other current assets” and "Other assets, net of current portion" line items on our condensed consolidated balance sheets. The following table details the costs to obtain and fulfill contracts with customers for the six months ended June 30, 2024 and 2023: (In thousands) Six Months Ended June 30, 2024 Six Months Ended June 30, 2023 Beginning balance $ 13,115  $ 11,577  Costs to obtain and fulfill contracts capitalized 3,430  3,690  Less costs to obtain and fulfill contracts recognized as expense (3,649) (2,691) Ending balance $ 12,896  $ 12,576  Remaining Performance Obligations Disclosures regarding remaining performance obligations are not considered material as the overwhelming majority of the Company's remaining performance obligations either (a) are related to contracts with an expected duration of one year or less, or (b) exhibit revenue recognition in the amount to which the Company has the right to invoice.

v3.24.2.u1

BUSINESS COMBINATIONS AND DISPOSITIONS	6 Months Ended
	Jun. 30, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]
BUSINESS COMBINATIONS AND DISPOSITIONS	BUSINESS COMBINATIONS AND DISPOSITIONS Sale of American HealthTech, Inc. On January 16, 2024, we entered into a Stock Purchase Agreement (the “Purchase Agreement”), by and among the Company, American HealthTech, Inc. a Mississippi corporation (“AHT”), and Healthland Inc., a Minnesota corporation and an indirect, wholly-owned subsidiary of the Company (“Healthland” and, together with the Company, the “Seller Parties”) and PointClickCare Technologies USA Corp., a Delaware corporation (“Buyer”). The Transaction (hereinafter defined) also closed on January 16, 2024. Under the Purchase Agreement, Buyer purchased from Healthland all of the issued and outstanding capital stock of AHT (the “Transaction”), with AHT becoming a wholly-owned subsidiary of Buyer. Prior to this transaction, results for AHT were reported within our EHR operating segment. The Purchase Agreement provides for an aggregate purchase price (the “Purchase Price”) of $25 million (the “Base Cash Consideration”), subject to adjustments based on working capital, cash, indebtedness and transaction expenses of AHT. Additionally, pursuant to the Purchase Agreement, a total of approximately $3.75 million was withheld from the Base Cash Consideration at the closing and deposited by Buyer into various escrow accounts with an escrow agent, including $2.5 million as a general indemnity escrow and $1 million as a special indemnity escrow. Based upon the adjustments and the various escrow holdbacks, Buyer paid a net amount of approximately $21.41 million to Healthland at the closing. The Purchase Price was subject to a post-closing true-up. In connection with the closing of the Transaction, Buyer has provided offers of employment to certain key employees of the Company that primarily supported AHT’s business. The Purchase Agreement contains customary representations, warranties and covenants. The representations and warranties made by the Seller Parties to Buyer cover a broad range of items related to, among other things, the business and financial condition of AHT. Subject to certain exceptions and limitations, the Seller Parties have agreed to indemnify Buyer for certain breaches of representations, warranties and covenants and certain other enumerated items. Such limitations on the Seller Parties’ indemnification obligations are subject to various exceptions for certain fundamental representations, tax representations, special representations, and fraud. Subject to certain exceptions and limitations, Buyer has likewise agreed to indemnify the Seller Parties for certain breaches of representations, warranties and covenants and certain other enumerated items. As part of the divestiture, as of January 16, 2024 we entered into a transition services agreement (“TSA”) with Buyer to assist them in the transition of certain functions, including, but not limited to, information technology, finance and accounting, for 18 months in accordance with the terms of this agreement. Aside from these customary transition services, there is no continuing involvement after the disposal. The Company has $0.6 million in receivables from Buyer for the TSA services reflected under the caption “Accounts receivable” in the condensed consolidated balance sheet. The Company finalized the accounting for the sale during the three months ended March 31, 2024 and has recorded a $1.25 million gain on sale, which is reflected under the caption “Other income” in the condensed consolidated statement of operations. The accompanying condensed consolidated balance sheet as of December 31, 2023 includes amounts related to this Transaction under the captions "Assets of held for sale disposal group" and "Liabilities of held for sale disposal group," the details of which are as follows as of December 31, 2023: (In thousands) Assets of held for sale disposal group Accounts receivable, net $ 3,087  Financing receivables, net 37  Prepaid expenses 34  Software costs, net 3,386  Intangibles, net 11,739  Goodwill 7,694  Total $ 25,977  Liabilities of held for sale disposal group Accounts payable $ 178  Other accrued liabilities 576  Deferred tax liability 223  Total $ 977  The following table presents the pretax loss for AHT that is included in our condensed consolidated statement of operations for the three and six months ended June 30, 2024 and 2023: Three Months Ended June 30, Six Months Ended June 30, (In thousands) 2024 2023 2024 2023 Pretax loss $ —  $ (505) $ (241) $ (376) Acquisition of Viewgol, LLC On October 16, 2023, the Company acquired all of the assets and liabilities of Viewgol, LLC (“Viewgol”), a Delaware limited liability company, pursuant to a Securities Purchase Agreement dated October 16, 2023. Based in Frisco, Texas, Viewgol is a provider of ambulatory RCM analytics and complementary outsourcing services with an extensive offshore presence we intend to leverage and grow to accommodate the growing demand for RCM services by our pre-existing acute care customers. Consideration for the acquisition included cash (net of cash of the acquired entity) of $37.4 million (inclusive of seller's transaction expenses). Also included in the acquisition consideration were contingent earnout payments of (i) up to $21.5 million based on the Viewgol business achieving earnings before interest, taxes, depreciation, and amortization (“EBITDA”) of $6.0 million or more during fiscal year 2024 (the “EBITDA Earnout Amount”), and (ii) up to $10.0 million based on the number of productive agents the Viewgol business hires in India in fiscal year 2024 (the “Offshore Earnout Amount”); provided, however, that none of the Offshore Earnout Amounts may be earned if the EBITDA Earnout Amount’s minimum EBITDA threshold of $6.0 million is not achieved during fiscal 2024. During 2023, we incurred approximately $4.7 million of pre-tax acquisition expenses in our condensed consolidated statements of operations. Our acquisition of Viewgol was treated as a purchase in accordance with ASC 805, Business Combinations, which requires allocation of the purchase price to the estimated fair values of assets and liabilities acquired in the transaction. Our allocation of the purchase price was based on management's judgment after evaluating several factors, including a valuation assessment. The preliminary estimated fair values of assets acquired and liabilities assumed as of December 31, 2023, and as updated through June 30, 2024, are as follows: (In thousands) Purchase Price Allocation as of December 31, 2023 Purchase Price Allocation as of June 30, 2024 Acquired cash $ 1,449  $ 1,449  Accounts receivable 2,233  2,233  Prepaid expenses 132  132  Property and equipment 1,112  1,112  Intangible assets 17,720  17,720  Goodwill 17,263  17,927  Accounts payable and accrued liabilities (711) (711) Contingent consideration (1,044) (1,044) Net assets acquired $ 38,154  $ 38,818  In April 2024, the Company paid an additional $0.7 million for working capital adjustments which is reflected under the caption “Goodwill” in the condensed consolidated balance sheet. The intangible assets in the table above are being amortized on a straight-line basis over their estimated useful lives. The amortization is included under the caption “Amortization of acquisition-related intangibles” in our condensed consolidated statements of operations. The fair value measurements of tangible and intangible assets and liabilities (including those related to contingent consideration) were based on significant inputs not observable in the market and thus represent Level 3 measurements within the fair value measurement hierarchy (see Note 16 - Fair Value). Level 3 inputs included, among others, discount rates that we estimated would be used by a market participant in valuing these assets and liabilities, projections of revenues and cash flows, client attrition rates and market comparables. Our condensed consolidated statement of operations for the six months ended June 30, 2024 includes revenue of $9.9 million and net income of $3.7 million attributed to the Viewgol acquisition.

v3.24.2.u1

PROPERTY AND EQUIPMENT	6 Months Ended
	Jun. 30, 2024
Property, Plant and Equipment [Abstract]
PROPERTY AND EQUIPMENT	PROPERTY AND EQUIPMENT Property and equipment, net was comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Land $ 2,848  $ 2,848  Buildings and improvements 8,487  8,481  Computer equipment 10,363  10,104  Leasehold improvements 631  631  Office furniture and fixtures 626  586  Automobiles 18  18  Property and equipment, gross 22,973  22,668  Less: accumulated depreciation (14,494) (13,694) Property and equipment, net $ 8,479  $ 8,974

v3.24.2.u1

SOFTWARE DEVELOPMENT	6 Months Ended
	Jun. 30, 2024
Research and Development [Abstract]
SOFTWARE DEVELOPMENT	SOFTWARE DEVELOPMENT Software development costs are accounted for in accordance with ASC 350-40, Internal-Use Software. We capitalize incurred labor costs for software development from the time the preliminary project phase is completed until the software is available for general release. Research and development costs and other computer software maintenance costs related to software development are expensed as incurred. We amortize capitalized software value on a straight-line basis over that estimated useful life of five years. If the actual useful life of the asset is determined to be shorter than our estimated useful life, we will amortize the remaining book value over the remaining actual useful life, or the asset may be deemed to be impaired and, accordingly, a write-down of the value of the asset may be recorded as a charge to earnings. Amortization begins when the related software features are placed in service. In the normal course of business, we occasionally abandon software development projects due to various reasons. During the three months ended June 30, 2024 we recognized $2.9 million of accelerated amortization with respect to a change in estimated useful life of an abandoned software development project. Software development costs, net was comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Software development costs $ 60,673  $ 51,349  Less: accumulated amortization (20,932) (12,210) Software development costs, net $ 39,741  $ 39,139

v3.24.2.u1

OTHER ACCRUED LIABILITIES	6 Months Ended
	Jun. 30, 2024
Payables and Accruals [Abstract]
OTHER ACCRUED LIABILITIES	OTHER ACCRUED LIABILITIES Other accrued liabilities was comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Salaries and benefits $ 6,219  $ 5,194  Severance 2,781  5,806  Commissions 945  1,185  Contingent consideration 1,044  1,044  Operating lease liabilities, current portion 1,349  1,804  Other 5,143  4,859  Other accrued liabilities $ 17,481  $ 19,892

v3.24.2.u1

NET INCOME (LOSS) PER SHARE	6 Months Ended
	Jun. 30, 2024
Earnings Per Share [Abstract]
NET INCOME (LOSS) PER SHARE	NET INCOME (LOSS) PER SHARE The Company presents basic and diluted earnings per share (“EPS”) data for its common stock. Basic EPS is calculated by dividing the net income attributable to stockholders of the Company by the weighted average number of shares of common stock outstanding during the period. Diluted EPS is determined by adjusting the net income attributable to stockholders of the Company and the weighted average number of shares of common stock outstanding during the period for the effects of all dilutive potential common shares, including awards under stock-based compensation arrangements. The Company's unvested restricted stock awards (see Note 10 - Stock-Based Compensation and Equity) are considered participating securities under ASC 260, Earnings Per Share, because they entitle holders to non-forfeitable rights to dividends until the awards vest or are forfeited. When a company has a security that qualifies as a “participating security,” the Codification requires the use of the two-class method when computing basic EPS. The two-class method is an earnings allocation formula that determines EPS for each class of common stock and participating security according to dividends declared (or accumulated) and participation rights in undistributed earnings. In determining the amount of net income to allocate to common stockholders, income is allocated to both common stock and participating securities based on their respective weighted average shares outstanding for the period, with net income attributable to common stockholders ultimately equaling net income less net income attributable to participating securities. Diluted EPS for the Company's common stock is computed using the more dilutive of the two-class method or the treasury stock method. The following is a calculation of the basic and diluted EPS for the Company's common stock, including a reconciliation between net income and net income attributable to common stockholders: Three Months Ended June 30, Six Months Ended June 30, (In thousands, except per share data) 2024 2023 2024 2023 Net income (loss) $ (5,049) $ (2,837) $ (7,565) $ 247  Less: Net (income) loss attributable to participating securities 216  64  263  (5) Net income (loss) attributable to common stockholders $ (4,833) $ (2,773) $ (7,302) $ 242  Weighted average shares outstanding used in basic per common share computations 14,313  14,200  14,273  14,168  Add: Dilutive potential common shares —  —  —  —  Weighted average shares outstanding used in diluted per common share computations 14,313  14,200  14,273  14,168  Basic EPS $ (0.34) $ (0.20) $ (0.51) $ 0.02  Diluted EPS $ (0.34) $ (0.20) $ (0.51) $ 0.02  During 2022, 2023, and 2024, performance share awards were granted to certain executive officers and key employees of the Company that will result in the issuance of common stock if the predefined performance criteria are met. The awards provide for an aggregate target of 512,103 shares, of which none have been included in the calculation of diluted EPS for the three and six months ended June 30, 2024 because the related threshold award performance levels have not been achieved as of June 30, 2024. See Note 10 - Stock-Based Compensation and Equity for more information.

v3.24.2.u1

INCOME TAXES	6 Months Ended
	Jun. 30, 2024
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES The Company determines the tax provision for interim periods using an estimate of our annual effective tax rate ("ETR"), adjusted for discrete items, if any, that are taken into account in the relevant period. Each quarter we update our estimate of the annual ETR, and if our estimated tax rate changes, we make a cumulative adjustment. If a reliable estimate of the annual ETR cannot be made, the actual ETR for the year to date may be the best estimate of the annual ETR. For the three months ended June 30, 2024, our effective tax rate decreased to 29.6% from 36.8% in the same period in 2023. This reduction was primarily driven by a decrease in the impact of state deferred taxes and the research and development (R&D) tax credit generated during the current quarter compared to the prior-year quarter. Similarly, our effective tax rate for the six months ended June 30, 2024 decreased to 32.9% from 141.2% for the six months ended June 30, 2023. This improvement was largely due to the R&D tax credit, which provided an incremental benefit of 21.0% compared to the first six months of 2023. The significantly higher effective tax rate in the prior year was primarily driven by a disproportionate impact of tax credits and non-conforming state deferred taxes relative to the pretax loss.

v3.24.2.u1

STOCK-BASED COMPENSATION AND EQUITY	6 Months Ended
	Jun. 30, 2024
Share-Based Payment Arrangement [Abstract]
STOCK-BASED COMPENSATION AND EQUITY	STOCK-BASED COMPENSATION AND EQUITY Stock-based compensation expense is measured at the grant date based on the fair value of the award, and is recognized as an expense over the employees’ or non-employee directors’ requisite service period. The following table details total stock-based compensation expense for the three and six months ended June 30, 2024 and 2023, included in the condensed consolidated statements of operations: Three Months Ended June 30, Six Months Ended June 30, (In thousands) 2024 2023 2024 2023 Costs of revenue (exclusive of amortization and depreciation) $ 230  $ 140  $ 266  $ 320  Other expenses 1,271  (263) 2,034  804  Pre-tax stock-based compensation expense 1,501  (123) 2,300  1,124  Less: income tax effect (315) 27  (483) (247) Net stock-based compensation expense $ 1,186  $ (96) $ 1,817  $ 877  The Company's stock-based compensation awards are in the form of restricted stock and performance share awards granted pursuant to the Company's Amended and Restated 2019 Incentive Plan (the "Plan"). As of June 30, 2024, there was $10.9 million of unrecognized compensation expense related to unvested and unearned, as applicable, stock-based compensation arrangements granted under the Plan, which is expected to be recognized over a weighted-average period of 2.1 years. Restricted Stock The Company grants restricted stock to executive officers, certain key employees and non-employee directors under the Plan with the fair value of the awards representing the fair value of the common stock on the date the restricted stock is granted. During the vesting period, recipients of restricted stock are entitled to dividends and possess voting rights. Shares of restricted stock generally vest in equal annual installments over the applicable vesting period, which ranges from one to three years. The Company records expenses for these grants on a straight-line basis over the applicable vesting periods. A summary of restricted stock activity under the Plan during the six months ended June 30, 2024 and 2023 is as follows: Six Months Ended June 30, 2024 Six Months Ended June 30, 2023 Shares Weighted-Average Grant Date Fair Value Per Share Shares Weighted-Average Grant Date Fair Value Per Share Unvested restricted stock outstanding at beginning of period 343,315  $ 29.08  281,161  $ 32.24  Granted 495,003  10.03  186,822  29.23  Vested (151,642) 30.95  (139,760) 31.33  Forfeited (54,603) 12.84  —  —  Unvested restricted stock outstanding at end of period 632,073  $ 14.57  328,223  $ 30.92  Performance Share Awards The Company grants performance share awards to executive officers and certain key employees under the Plan, with the number of shares of common stock earned and issuable under each award determined at the end of a three-year performance period, based on the Company's achievement of performance goals predetermined by the Compensation Committee of the Board of Directors at the time of grant. These performance share awards include a modifier to the total number of shares earned based on the Company's total shareholder return (“TSR”) compared to a small-cap stock market index. If certain levels of the performance objective are met, the award results in the issuance of shares of common stock corresponding to such level. Performance share awards that result in the issuance of shares of common stock are not subject to time-based vesting at the conclusion of the three-year performance period. In the event that the Company's financial performance meets the predetermined targets for the performance objectives of the performance share awards, the Company will issue each award recipient the number of shares of common stock equal to the target award specified in the individual's underlying performance share award agreement. In the event the financial results of the Company exceed the predetermined targets, additional shares up to the maximum award may be issued. In the event the financial results of the Company fall below the predetermined targets, a reduced number of shares may be issued. If the financial results of the Company fall below the threshold performance levels, no shares may be issued. The total number of shares issued for the performance share award may be increased, decreased, or unchanged based on the TSR modifier described above. The recipients of performance share awards do not receive dividends or possess voting rights during the performance period and, accordingly, the fair value of the performance share awards is the quoted market value of TruBridge’s common stock on the grant date less the present value of the expected dividends not received during the relevant period. The TSR modifier applicable to the performance share awards is considered a market condition and therefore is reflected in the grant date fair value of the award. A Monte Carlo simulation has been used to account for this market condition in the grant date fair value of the award. Expense related to performance share awards is recognized using ratable straight-line amortization over the three-year performance period. In the event the Company determines it is no longer probable that the minimum performance level will be achieved, all previously recognized compensation expense related to the applicable awards is reversed in the period such a determination is made. A summary of performance share award activity under the Plan during the six months ended June 30, 2024 and 2023 is as follows, based on the target award amounts set forth in the performance share award agreements: Six Months Ended June 30, 2024 Six Months Ended June 30, 2023 Shares Weighted-Average Grant Date Fair Value Per Share Shares Weighted-Average Grant Date Fair Value Per Share Performance share awards outstanding at beginning of period 273,791  $ 33.17  252,375  $ 31.84  Granted 323,461  10.03  122,071  31.21  Forfeited or unearned (85,149) 37.98  (96,069) 26.96  Performance share awards outstanding at end of period 512,103  $ 18.60  278,377  $ 33.25  Stock Repurchases On September 4, 2020, our Board of Directors approved a stock repurchase program under which we were authorized to repurchase up to $30.0 million of our common stock through September 3, 2022. On July 27, 2022, the Board of Directors extended the expiration date of the stock repurchase program to September 4, 2024. We repurchased 49,789 shares during the six months ended June 30, 2023, and there were no additional shares repurchased during the six months ended June 30, 2024. The approximate dollar value of shares that may yet be repurchased under the stock repurchase program was $16.5 million as of June 30, 2024. Any future stock repurchase transactions may be made through open market purchases, privately-negotiated transactions, or otherwise in compliance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended. Any repurchase activity will depend on many factors, such as the availability of shares of our common stock, general market conditions, the trading price of our common stock, alternative uses for capital, the Company’s financial performance, compliance with the terms of our Amended and Restated Credit Agreement and other factors. Concurrent with the authorization of this stock repurchase program in September 2020, the Board of Directors opted to indefinitely suspend all quarterly dividends. In addition to shares repurchased under the approved stock repurchase program, we purchased 42,979 and 37,989 shares as of June 30, 2024 and 2023, respectively, to fund required tax withholdings. Shares withheld to cover required tax withholdings related to the vesting of restricted stock do not reduce our total share repurchase authority. Common Stock Rights Agreement On March 26, 2024, the Company’s board of directors declared a dividend of one right (a “Right”) for each of the Company’s issued and outstanding shares of common stock. The dividend was paid to the stockholders of record at the close of business on April 4, 2024. The complete description and terms of the Rights are set forth in the Rights Agreement, dated as of March 26, 2024, by and between the Company and ComputerShare Trust Company, N.A. as rights agent, as amended by the Amendment to the Rights Agreement dated as of April 22, 2024 (as amended, the “Rights Agreement”). Each Right initially entitles the registered holder, subject to the terms of the Rights Agreement, to purchase from the Company one half of a share of common stock, at an exercise price of $28.00 for each one half of a share of common stock (equivalent to $56.00 for each whole share of common stock), subject to certain adjustments. The Rights currently are not exercisable and will only become exercisable upon the occurrence of certain events as described in the Rights Agreement. The Rights will expire prior to the earliest of (i) the close of business on March 25, 2025, or such later date as may be established by the Board prior to the expiration of the Rights; (ii) the time at which the Rights are redeemed pursuant to the Rights Agreement; (iii) the time at which the Rights are exchanged pursuant to the Rights Agreement; and (iv) upon the occurrence of certain transactions (the earliest of (i), (ii), (iii) and (iv) is referred to as the “Expiration Date”). The Company analyzed the terms governing the Rights under ASC 480 - Distinguishing Liabilities from Equity and concluded that the Rights are a freestanding financial instrument that qualifies for liability classification. Specifically, the provisions within the Rights Agreement provide for scenarios outside of the Company’s control that may require the Company to settle a portion of the Rights in cash, rather than in shares of common stock. The Rights are only exercisable upon the occurrence of certain events, which have not occurred as of the end of the reporting period, and the Company does not consider it likely that these events will occur in the future. As it is not considered likely that these events will occur, the Company considers the likelihood of exercise to be remote and has not ascribed value to the Rights as of June 30, 2024. The Company will continue to monitor the likelihood of exercise in future reporting periods.

v3.24.2.u1

FINANCING RECEIVABLES	6 Months Ended
	Jun. 30, 2024
Receivables [Abstract]
FINANCING RECEIVABLES	FINANCING RECEIVABLES Short-Term Payment Plans The Company provides fixed monthly payment arrangements ("short-term payment plans") over terms ranging from three to twelve months for certain add-on software installations. As a practical expedient, we do not adjust the amount of consideration recognized as revenue for the financing component as unearned income when we expect payment within one year or less. These receivables, included in the current portion of financing receivables, were comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Short-term payment plans, gross $ 1,119  $ 788  Less: allowance for losses (56) (39) Short-term payment plans, net $ 1,063  $ 749  Long-Term Financing Arrangements Additionally, the Company provides financing for purchases of its information and patient care solutions to certain healthcare providers under long-term financing arrangements expiring in various years through 2030. Under long-term financing arrangements, the transaction price is adjusted by a discount rate that reflects market conditions that would be used for a separate financing transaction between the Company and licensee at contract inception, and takes into account the credit characteristics of the licensee and market interest rates as of the date of the agreement. As such, the amount of fixed fee revenue recognized at the beginning of the license term will be reduced by the calculated financing component. As payments are received from the licensee, the Company recognizes a portion of the financing component as interest income, reported as other income in the condensed consolidated statements of operations. These receivables typically have terms from two to seven years. The components of these receivables were as follows at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Long-term financing arrangements, gross $ 4,284  $ 5,212  Less: allowance for expected credit losses (332) (377) Less: unearned income (271) (361) Long-term financing arrangements, net $ 3,681  $ 4,474  Future minimum payments to be received subsequent to June 30, 2024 are as follows: (In thousands) Years Ending December 31, 2024 $ 1,671  2025 2,195  2026 276  2027 69  2028 62  Thereafter 11  Total minimum payments to be received 4,284  Less: allowance for expected credit losses (332) Less: unearned income (271) Receivables, net $ 3,681  Credit Quality of Financing Receivables and Allowance for Expected Credit Losses The following table is a roll-forward of the allowance for expected credit losses for the six months ended June 30, 2024 and year ended December 31, 2023: (In thousands) Balance at Beginning of Period Provision Charge-offs Recoveries Sale of AHT Balance at End of Period June 30, 2024 $ 416  $ (26) $ —  $ —  $ (2) $ 388  December 31, 2023 $ 549  $ (133) $ —  $ —  $ —  $ 416  The Company’s financing receivables are comprised of a single portfolio segment, as the balances are all derived from short-term payment plan arrangements and long-term financing arrangements within our target market of community hospitals. The Company evaluates the credit quality of its financing receivables based on a combination of factors, including, but not limited to, customer collection experience, current and future economic conditions, the customer’s financial condition, and known risk characteristics impacting the respective customer base of community hospitals, the most notable of which relate to enacted and potential changes in Medicare and Medicaid reimbursement rates as community hospitals typically generate a significant portion of their revenues and related cash flows from beneficiaries of these programs. In addition to specific account identification, the Company utilizes historical collection experience to establish the allowance for expected credit losses. Financing receivables are written off only after the Company has exhausted all collection efforts. Customer payments are considered past due if a scheduled payment is not received within contractually agreed upon terms. To facilitate customer collection and credit monitoring efforts, financing receivable amounts are invoiced and reclassified to trade accounts receivable when they become due, with all invoiced amounts placed on nonaccrual status. As a result, all past due amounts related to the Company’s financing receivables are included in trade accounts receivable in the accompanying condensed consolidated balance sheets. The following is an analysis of the age of financing receivables amounts (excluding short-term payment plans) that have been reclassified to trade accounts receivable and were past due as of June 30, 2024 and December 31, 2023: (In thousands) 1 to 90 Days Past Due 91 to 180 Days Past Due 181 + Days Past Due Total Past Due June 30, 2024 $ 594  $ 235  $ 518  $ 1,347  December 31, 2023 $ 857  $ 231  $ 323  $ 1,411  From time to time, the Company may agree to alternative payment terms outside of the terms of the original financing receivable agreement due to customer difficulties in achieving the original terms. In general, such alternative payment arrangements do not result in a re-aging of the related receivables. Rather, payments pursuant to any alternative payment arrangements are applied to the already outstanding invoices beginning with the oldest outstanding invoices as the payments are received. Because amounts are reclassified to trade accounts receivable when they become due, there are no past due amounts included within financing receivables, current portion, net or financing receivables, net of current portion in the accompanying condensed consolidated balance sheets. The Company utilizes an aging of trade accounts receivable as the primary credit quality indicator for its financing receivables, which is facilitated by the reclassification of customer payment amounts to trade accounts receivable when they become due. The table below categorizes customer financing receivable balances (excluding short-term payment plans) based on the age of the oldest payment outstanding that has been reclassified to trade accounts receivable: (In thousands) June 30, 2024 December 31, 2023 Stratification of uninvoiced client financing receivables based on aging of related trade accounts receivable: Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due $ 2,347  $ 1,068  Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due 579  1,720  Uninvoiced client financing receivables related to trade accounts receivable that are 181 + Days Past Due 975  965  Total uninvoiced client financing receivables balances of clients with a trade accounts receivable $ 3,901  $ 3,753  Total uninvoiced client financing receivables of clients with no related trade accounts receivable 112  1,098  Total financing receivables with contractual maturities of one year or less 1,119  788  Less: allowance for expected credit losses (388) (416) Total financing receivables $ 4,744  $ 5,223

v3.24.2.u1

INTANGIBLE ASSETS AND GOODWILL	6 Months Ended
	Jun. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
INTANGIBLE ASSETS AND GOODWILL	INTANGIBLE ASSETS AND GOODWILL The following tables summarize the gross carrying amounts, accumulated amortization and accumulated impairment of identifiable intangible assets with definite lives by major class as of June 30, 2024 and December 31, 2023: June 30, 2024 (In thousands) Customer Relationships Trademark Developed Technology Non-Compete Agreements Total Gross carrying amount, beginning of period $ 116,470  $ 7,720  $ 31,900  $ 1,620  $ 157,710  Accumulated amortization (45,441) (5,378) (20,905) (684) (72,408) Accumulated impairment —  (2,342) —  —  (2,342) Net intangible assets as of June 30, 2024 $ 71,029  $ —  $ 10,995  $ 936  $ 82,960  Weighted average remaining years of useful life 8.0 0.0 8.2 3.0 8.1 December 31, 2023 (In thousands) Customer Relationships Trademark Developed Technology Non-Compete Agreements Total Gross carrying amount, beginning of period $ 132,170  $ 12,320  $ 40,800  $ 1,400  $ 186,690  Intangible assets acquired 16,100  —  1,400  220  17,720  Accumulated amortization (63,686) (6,974) (29,934) (522) (101,116) Accumulated impairment —  (2,342) (2,342) Held for sale (8,735) (3,004) (11,739) Net intangible assets as of December 31, 2023 $ 75,849  $ —  $ 12,266  $ 1,098  $ 89,213  During the fourth quarter of 2023, the Company committed to the Company-wide rebranding and legal entity consolidation initiative that culminated in the change of the Company’s corporate name to “TruBridge, Inc.” on March 4, 2024. As a result of this initiative, it was expected that certain of the Company’s brand names and related trademarks would cease to be used, resulting in total trademark impairment recorded during the year ended December 31, 2023 of $2.3 million. Of the total trademark impairment charge, $1.0 million is derived from our RCM segment, $1.2 million is derived from our EHR segment, and $0.1 million is derived from our former Patient Engagement segment. The following table represents the remaining amortization of definite-lived intangible assets as of June 30, 2024: (In thousands) For the year ended December 31, 2024 $ 6,253  2025 12,190  2026 11,517  2027 10,497  2028 10,203  Thereafter 32,300  Total $ 82,960  The following table sets forth the change in the carrying value of our goodwill balances by reportable segment for the six months ended June 30, 2024: (In thousands) RCM EHR Total Gross value at December 31, 2023 $ 79,084  $ 136,432  $ 215,516  Accumulated impairment —  (35,913) (35,913) Held for sale —  (7,694) (7,694) Carrying value at December 31, 2023 79,084  92,825  171,909  Purchase price adjustment (Viewgol) 664  —  664  Gross value at June 30, 2024 79,748  128,738  208,486  Accumulated impairment —  (35,913) (35,913) Carrying value as of June 30, 2024 $ 79,748  $ 92,825  $ 172,573  Goodwill is evaluated for impairment annually on October 1, or more frequently if indicators of impairment are present or changes in circumstances suggest that impairment may exist. During the first quarter of 2024, our share price experienced a sustained decline resulting in a decrease in our market capitalization. This decline in share price was identified as a triggering event requiring a quantitative assessment for goodwill impairment in all of our reporting segments. We assessed goodwill in each of our reporting segments for impairment as of March 31, 2024, by using a combination of the income and market valuation approaches. Under the income approach, we used a discounted cash flow model, which utilizes present values of cash flows to estimate fair value. Our forecasted cash flows reflected conditions as of March 31, 2024, and reflected management’s anticipated business outlook for each reporting unit, which requires the use of estimates. The market approach applied selected trading multiples of companies comparable to the respective reporting units to the Company’s financial measures. Trading multiples selected for each reporting unit varied from the low end of the range of guideline public companies up to the median depending on the specific characteristics of each reporting unit. The income approach was given significantly more weight in determining the fair values. The approaches, which qualify as Level 3 within the fair value hierarchy, incorporate a number of market participant assumptions including, but not limited to, future cash flows, growth rates, and discount rates. The assumptions about future cash flows and growth rates are based on the Company’s forecasts and long-term plans. Discount rate assumptions are based on an assessment of the inherent risk of the respective reporting units. These quantitative evaluations of the fair values of each of our reporting units resulted in no impairment as of March 31, 2024. Given that the fair values of the reporting units are based on management’s best estimates, if actual results should differ from those estimates, impairment charges may be required in future periods. Our share price continued to experience sustained decline during the first half of the second quarter of 2024. This decline in share price was identified as a triggering event requiring a quantitative assessment for goodwill impairment in all of our reporting segments. On May 14, 2024, the Company announced a reorganization of its operating and reporting segment structure. This restructuring resulted in another triggering event requiring a quantitative assessment for goodwill impairment in our reporting units immediately pre- and post- reorganization as of that date. We utilized the same goodwill valuation approach as described above. These quantitative evaluations of the fair values of the goodwill in each of our reporting units resulted in no impairment.

v3.24.2.u1

LONG-TERM DEBT	6 Months Ended
	Jun. 30, 2024
Debt Disclosure [Abstract]
LONG-TERM DEBT	LONG-TERM DEBT Long-term debt was comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Term loan facility $ 58,125  $ 63,875  Revolving credit facility 123,416  135,723  Debt obligations 181,541  199,598  Less: unamortized debt issuance costs (1,503) (1,187) Debt obligation, net 180,038  198,411  Less: current portion (3,074) (3,141) Long-term debt $ 176,964  $ 195,270  As of June 30, 2024, the carrying value of debt approximated the fair value due to the variable interest rate, which reflected the market rate. Credit Agreement In conjunction with our acquisition of Healthland Holding Inc. in January 2016, we entered into a syndicated credit agreement with Regions Bank ("Regions") serving as administrative agent, which provided for a $125 million term loan facility and a $50 million revolving credit facility. On June 16, 2020, we entered into an Amended and Restated Credit Agreement that increased the aggregate principal amount of our credit facilities to $185 million, including a $75 million term loan facility and a $110 million revolving credit facility. On May 2, 2022, we entered into a First Amendment (the "First Amendment") to the Amended and Restated Credit Agreement that increased the aggregate principal amount of our credit facilities to $230 million, which includes a $70 million term loan facility and a $160 million revolving credit facility. There are no limitations on borrowing under the revolving credit facility other than that as of a date of borrowing there cannot be an ongoing event of default and there cannot be an event of default that would result from a new credit extension. In addition, the interest rate provisions of the First Amendment reflect the transition from the London Interbank Offered Rate ("LIBOR") to the Secured Overnight Financing Rate ("SOFR") as the new benchmark interest rate for each loan. Each of our credit facilities continues to bear interest at a rate per annum equal to an applicable margin plus, at our option, either (1) the Adjusted SOFR rate for the relevant interest period, subject to a floor of 0.50%, (2) an alternate base rate determined by reference to the greater of (a) the prime lending rate of Regions, (b) the federal funds rate for the relevant interest period plus one half of one percent per annum and (c) the one month SOFR rate, subject to the aforementioned floor, plus one percent per annum, or (3) a combination of (1) and (2). The applicable margin for SOFR loans and the letter of credit fee ranges from 1.8% to 3.0%. The applicable margin for base rate loans ranges from 0.8% to 2.0%, in each case based on the Company's consolidated net leverage ratio. Principal payments with respect to the term loan facility are due on the last day of each fiscal quarter beginning June 30, 2022, with quarterly principal payments of approximately $0.9 million through March 31, 2027, with maturity on May 2, 2027 or such earlier date as the obligations under the Amended and Restated Credit Agreement, as amended by the First Amendment, become due and payable pursuant to the terms of such agreement. Any principal outstanding under the revolving credit facility is due and payable on the maturity date. Anticipated annual future maturities of the term loan facility and revolving credit facility are as follows as of June 30, 2024: (In thousands) 2024 $ 1,750  2025 3,500  2026 3,500  2027 172,791  $ 181,541  Our credit facilities are secured pursuant to the Amended and Restated Credit Agreement, dated as of June 16, 2020, among the parties identified as obligors therein and Regions, as collateral agent, on a first priority basis by a security interest in substantially all of the tangible and intangible assets (subject to certain exceptions) of the Company and certain subsidiaries of the Company, as guarantors (collectively, the “Subsidiary Guarantors”), including certain registered intellectual property and the capital stock of certain of the Company’s direct and indirect subsidiaries. Our obligations under the Amended and Restated Credit Agreement are also guaranteed by the Subsidiary Guarantors. The First Amendment provides incremental facility capacity of $75 million, subject to certain conditions. The Amended and Restated Credit Agreement, as amended by the First Amendment, includes a number of restrictive covenants that, among other things and in each case subject to certain exceptions and baskets, impose operating and financial restrictions on the Company and the Subsidiary Guarantors, including the ability to incur additional debt; incur liens and encumbrances; make certain restricted payments, including paying dividends on the Company's equity securities or payments to redeem, repurchase, or retire the Company's equity securities (which are subject to our compliance, on a pro forma basis to give effect to the restricted payment, with the fixed charge coverage ratio and consolidated net leverage ratio described below); enter into certain restrictive agreements; make investments, loans and acquisitions; merge or consolidate with any other person; dispose of assets; enter into sale and leaseback transactions; engage in transactions with affiliates; and materially alter the business we conduct. The First Amendment requires the Company to maintain a minimum fixed charge coverage ratio of 1.25:1.00 throughout the duration of such agreement. Under the First Amendment, the Company is required to comply with a maximum consolidated net leverage ratio of 3.50:1.00. Further, under the First Amendment, in connection with any acquisition by the Company exceeding $25 million, the Company may elect to increase the maximum permitted consolidated net leverage ratio for the fiscal quarter in which the acquisition occurs and each of the following three fiscal quarters by 0.50:1.00 above the otherwise permitted maximum. If the consolidated net leverage ratio is less than 2.50:1.00, there is no limit on the incremental facility. The Amended and Restated Credit Agreement also contains customary representations and warranties, affirmative covenants and events of default. On March 10, 2023, the calculation of the fixed charge coverage ratio was amended pursuant to the Second Amendment to the Amended and Restated Credit Agreement in order to specifically exclude from the definition of fixed charges the Company's share repurchases conducted during the third and fourth quarters of 2022. As of September 30, 2023, we were not in compliance with the fixed charge coverage ratio required by the Amended and Restated Credit Agreement. On November 8, 2023, the Company and the Subsidiary Guarantors entered into a Waiver with Regions Bank, as administrative agent, and various other lenders, which provided for a one-time waiver of this failure as an event of default. As of December 31, 2023, the Company was similarly not in compliance with the fixed charge coverage ratio required by the Amended and Restated Credit Agreement, and a one-time waiver was provided in conjunction with the Fourth Amendment to the Amended and Restated Credit Agreement (described below). Any failure by us to comply with this or another covenant in the future may result in an event of default. There can be no assurance that we will be able to continue to comply with this covenant or obtain amendments or waivers to avoid future covenant violations, or that such amendments or waivers will be available on commercially acceptable terms. The First Amendment removed the requirement that the Company mandatorily prepay the credit facilities with excess cash flow generated during the prior fiscal year. The Company is permitted to voluntarily prepay the credit facilities at any time without penalty, subject to customary “breakage” costs with respect to prepayments of SOFR rate loans made on a day other than the last day of any applicable interest period. Credit Facility - Third Amendment On January 16, 2024, the Company entered into a Third Amendment (the “Third Amendment”) to the Amended and Restated Credit Agreement, dated as of June 16, 2020, by and among the Company; the Subsidiary Guarantors; Regions Bank, as administrative agent and collateral agent; and various other lenders from time to time. Capitalized terms used but not defined herein shall have the meanings ascribed to them in the Credit Agreement. The Third Amendment modified the term “Consolidated EBITDA” to provide that the following amounts will be added back to Consolidated Net Income: (i) the reasonably expected value of all earn-out consideration in connection with any Permitted Acquisition, provided that the aggregate amount of fees and out-of-pocket expenses incurred in connection with anticipated Permitted Acquisitions which are not consummated during any period of four fiscal quarters ending on or after the Closing Date will not exceed the greater of $7 million and 10% of Consolidated EBITDA; (ii) any fees, costs or expenses related to the implementation of cost savings, operating expense reductions and synergies related to Permitted Acquisitions, restructurings and other initiatives; and (iii) costs and expenses related to the previously disclosed U.S. Securities and Exchange Commission investigation that occurred during the fiscal year ended December 31, 2023, in an aggregate amount not to exceed $1.25 million. Additionally, the Third Amendment (y) removed from the maximum aggregate amount of fees and expenses that can be added back to Consolidated Net Income any losses resulting from any Asset Sales or Involuntary Disposition and (z) increased the maximum amount of fees and expenses that can be added back to Consolidated Net Income related to savings initiatives, Equity Transactions, the incurrence of Indebtedness and amendments to the Credit Documents from 10% to 15% of Consolidated EBITDA (determined prior to giving effect to such adjustments). Credit Facility - Fourth Amendment On February 29, 2024, the Company entered into a Fourth Amendment (the “Fourth Amendment”) to the Credit Agreement, by and among the Company; the Subsidiary Guarantors; the Administrative Agent; and various other lenders. Capitalized terms used but not defined herein shall have the meanings ascribed to them in the Credit Agreement. The Fourth Amendment modified the term “Consolidated EBITDA” to provide that the additional following amounts will be added back to Consolidated Net Income: (i) costs and expenses related to the voluntary early retirement program during the fiscal year ending December 31, 2023; and (ii) fees, costs and expenses in categories identified to the Administrative Agent to the extent incurred during the fiscal year ending December 31, 2024, in an aggregate amount not to exceed $7.25 million. Additionally, the modified definition of “Consolidated EBITDA” limits the amount of pro forma “run rate” cost savings, operating expense reductions and synergies (collectively, “Savings”) related to the Viewgol acquisition that can be added back to Consolidated Net Income to an aggregate amount not to exceed $6.6 million; however, Savings related to the Viewgol acquisition are not subject to the cap of 15% of Consolidated EBITDA that otherwise applies to Savings related to Permitted Acquisitions, restructurings or cost savings initiatives. Finally, the consolidated fixed charge coverage ratio covenant was decreased from 1.25:1.00 to 1.15:1.00 for each fiscal quarter ending March 31, 2024 through and including December 31, 2024. We believe that we were in compliance with the covenants contained in the Amended and Restated Credit Agreement, as amended, as of June 30, 2024.

v3.24.2.u1

OPERATING LEASES	6 Months Ended
	Jun. 30, 2024
Leases [Abstract]
OPERATING LEASES	OPERATING LEASES The Company leases office space in various locations in Alabama, Pennsylvania, Maryland, Mississippi, and Washington. These leases have terms expiring from 2024 through 2029 but do contain optional extension terms. Leases with an initial term of 12 months or less are not recorded on the balance sheet; we recognize lease expense for these leases on a straight-line basis over the lease term. On April 30, 2023, the company terminated its lease agreement for approximately 12,500 square feet of office space in Plymouth, Minnesota. Pursuant to a Termination of Lease Agreement dated April 18, 2023, the Company paid $1.1 million to the landlord as consideration for the early termination. In connection with the lease termination, the Company derecognized the assets and liabilities associated with the operating lease and recorded a $0.1 million loss on the disposal of leasehold improvement. Supplemental balance sheet information related to operating leases was as follows: (In thousands) June 30, 2024 December 31, 2023 Operating lease assets: Operating lease assets $ 3,861  $ 5,192  Operating lease liabilities: Other accrued liabilities 1,349 1,804 Operating lease liabilities, net of current portion 2,512  3,074  Total operating lease liabilities $ 3,861  $ 4,878  Weighted average remaining lease term in years 3.8 4 Weighted average discount rate 4.1% 4.2% Because our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at the lease commencement date in determining the present value of lease payments. We used the incremental borrowing rate on January 1, 2019, for operating leases that commenced prior to that date. The future minimum lease payments payable under these operating leases subsequent to June 30, 2024 are as follows: (In thousands) 2024 $ 825  2025 1,008  2026 962  2027 678  2028 462  Thereafter 231  Total lease payments 4,166  Less imputed interest (305) Total $ 3,861  Total lease expense for the six months ended June 30, 2024 and 2023 was $0.6 million and $1.1 million, respectively. Total cash paid for amounts included in the measurement of lease liabilities within operating cash flows from operating leases for the six months ended June 30, 2024 and 2023 was $0.6 million and $1.1 million, respectively.

v3.24.2.u1

COMMITMENTS AND CONTINGENCIES	6 Months Ended
	Jun. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIESFrom time to time, the Company is involved in routine litigation that arises in the ordinary course of business. Management does not believe it is reasonably possible that such matters will have a material adverse effect on the Company’s financial statements. The Company recorded a liability of $1.0 million related to contingent consideration for Viewgol's former equity holders as of December 31, 2023 and June 30, 2024.

v3.24.2.u1

FAIR VALUE	6 Months Ended
	Jun. 30, 2024
Fair Value Disclosures [Abstract]
FAIR VALUE	FAIR VALUE FASB Codification topic, Fair Value Measurements and Disclosures, establishes a framework for measuring fair value and expands financial statement disclosures about fair value measurements. Fair value is the price that would be received to sell an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. The Codification does not require any new fair value measurements, but rather applies to all other accounting pronouncements that require or permit fair value measurements. The Codification requires that assets and liabilities carried at fair value be classified and disclosed in one of the following three categories: Level 1: Quoted market prices in active markets for identical assets or liabilities. Level 2: Observable market-based inputs or unobservable inputs that are corroborated by market data. Level 3: Unobservable inputs that are not corroborated by market data. At June 30, 2024, we measured the fair value of contingent consideration that represents the potential earnout incentive for Viewgol’s former equity holders. We estimated the fair value of this contingent consideration based on the probability of Viewgol meeting EBITDA targets (subject to certain pro-forma adjustments). The following table summarizes the carrying amount and fair value of the contingent consideration at June 30, 2024: Fair Value at June 30, 2024 Using (In thousands) Carrying Amount at June 30, 2024 Quoted Price in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Description Contingent consideration $ 1,044  $ —  $ —  $ 1,044  Total $ 1,044  $ —  $ —  $ 1,044  The following table summarizes the carrying amount and fair value of the contingent consideration at December 31, 2023: Fair Value at December 31, 2023 Using (In thousands) Carrying Amount at December 31, 2023 Quoted Price in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Description Contingent consideration $ 1,044  $ —  $ —  $ 1,044  Total $ 1,044  $ —  $ —  $ 1,044

v3.24.2.u1

SEGMENT REPORTING	6 Months Ended
	Jun. 30, 2024
Segment Reporting [Abstract]
SEGMENT REPORTING	SEGMENT REPORTING Our chief operating decision makers ("CODM") previously identified the following three operating and reportable segments: RCM, EHR, and Patient Engagement. In May 2024, the Company made a number of changes to its organizational structure and management system to better align the Company's operating model with its strategic initiatives. As a result, the Company changed from three operating and reportable segments of (i) RCM, (ii) EHR and (iii) Patient Engagement to two operating and reportable segments of (i) EHR and (ii) RCM. These two segments are distinct business units with unique market dynamics and opportunities. They represent the components of the Company for which separate financial information is available and is utilized on a regular basis by the CODM in assessing segment performance and in allocating the Company's resources. The Patient Engagement segment results were transitioned into the EHR segment for all periods presented. Management evaluates the performance of the segments based on revenues and adjusted EBITDA. Management believes adjusted EBITDA is a useful measure to assess the performance and liquidity of the Company as it provides meaningful operating results by excluding the effects of expenses that are not reflective of its operating business performance. Our CODM group is comprised of the Chief Executive Officer, Chief Operating Officer, and Chief Financial Officer. Accounting policies for each of the reportable segments are the same as those used on a consolidated basis. Adjusted EBITDA consists of GAAP net income (loss) as reported and adjusts for (i) depreciation expense; (ii) amortization of software development costs; (iii) amortization of acquisition-related intangibles; (iv) stock-based compensation; (v) severance; (vi) other non-recurring charges; (vii) interest expense and other, net; and (viii) the provision (benefit) for income taxes. There are no intersegment revenues to be eliminated in computing segment revenue. The CODM do not evaluate operating segments nor make decisions regarding operating segments based on assets. Consequently, we do not disclose total assets by reportable segment. The following table presents a summary of the revenues and adjusted EBITDA of our two operating segments for the three and six months ended June 30, 2024 and 2023: Three Months Ended June 30, Six Months Ended June 30, (In thousands) 2024 2023 2024 2023 Revenues by segment: RCM $ 54,108  $ 47,760  $ 107,146  $ 96,391  EHR Recurring revenue Acute EHR 26,666  30,013  54,160  59,353  Post-acute EHR —  3,729  582  7,636  Total recurring EHR revenue 26,666  33,742  54,742  66,989  Non-recurring revenue Acute EHR 3,956  2,775  6,008  6,750  Post-acute EHR —  345  81  725  Total non-recurring EHR revenue 3,956  3,120  6,089  7,475  Total EHR revenue $ 30,622  $ 36,862  $ 60,831  $ 74,464  Total revenues $ 84,730  $ 84,622  $ 167,977  $ 170,855  Adjusted EBITDA by segment: RCM $ 7,804  $ 5,682  $ 14,202  13,580  EHR 4,770  5,545  7,826  12,289  Total adjusted EBITDA $ 12,574  $ 11,227  $ 22,028  $ 25,869  The following table reconciles net income to adjusted EBITDA: Three Months Ended June 30, Six Months Ended June 30, (In thousands) 2024 2023 2024 2023 Net income (loss), as reported $ (5,049) $ (2,837) (7,565) 247  Deferred revenue and other purchase accounting adjustments —  —  —  —  Depreciation expense 400  597  800  1,095  Amortization of software development costs 5,980  1,826  8,722  3,312  Amortization of acquisition-related intangibles 3,126  4,014  6,253  8,029  Stock-based compensation 1,501  (123) 2,300  1,124  Severance and other non-recurring charges 4,586  6,819  8,430  7,920  Interest expense 4,151  2,586  8,051  4,988  Gain on sale of AHT —  —  (1,250) —  Provision (benefit) for income taxes (2,121) (1,655) (3,713) (846) Total adjusted EBITDA $ 12,574  $ 11,227  $ 22,028  $ 25,869  Certain of the items excluded or adjusted to arrive at adjusted EBITDA are described below: •Amortization of acquisition-related intangibles - Acquisition-related amortization expense is a non-cash expense arising primarily from the acquisition of intangibles in connection with acquisitions or investments. We exclude acquisition-related amortization expense from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of new acquisitions and full amortization of previously acquired intangible assets. •Stock-based compensation - Stock-based compensation expense is a non-cash expense arising from the grant of stock-based awards. We exclude stock-based compensation expense from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of the timing and valuation of grants of new stock-based awards, including grants in connection with acquisitions. •Severance and other non-recurring charges - We exclude severance expenses (primarily related to costs associated with our recent business transformation initiative) and other non-recurring charges (such as interest income, service charges, and other (income)/loss, and foreign currency (gain)/loss) from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods.

v3.24.2.u1

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Pay vs Performance Disclosure
Net income (loss)	$ (5,049)	$ (2,837)	$ (7,565)	$ 247

v3.24.2.u1

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

v3.24.2.u1

BASIS OF PRESENTATION (Policies)	6 Months Ended
	Jun. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (the “SEC”) and include all adjustments that, in the opinion of management, are necessary for a fair presentation of the results of the periods presented. All such adjustments are considered of a normal recurring nature. Quarterly results of operations are not necessarily indicative of annual results. Certain footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) have been condensed or omitted. The condensed consolidated balance sheet as of December 31, 2023 was derived from the audited consolidated balance sheet at that date. These unaudited condensed consolidated financial statements should be read in conjunction with the audited financial statements of TruBridge, Inc. (“TruBridge” or the “Company”) for the year ended December 31, 2023 and the notes thereto contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023.
Principles of Consolidation	Principles of Consolidation The condensed consolidated financial statements of TruBridge include the accounts of the Company and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated.
Recent Account Pronouncements	RECENT ACCOUNTING PRONOUNCEMENTS New Accounting Standards Adopted in 2024 There were no new accounting standards required to be adopted in 2024 that would have a material impact on our consolidated financial statements. New Accounting Standards Yet to be Adopted In November 2023, the FASB issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures” (“ASU 2023-07”), which is intended to improve reportable segment disclosure requirements, primarily through additional and more detailed information about a reportable segment's expenses. The guidance is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The guidance is to be applied retrospectively to all prior periods presented in the financial statements. Upon transition, the segment expense categories and amounts disclosed in the prior periods should be based on the significant segment expense categories identified and disclosed in the period of adoption. The Company is currently evaluating the potential impact of adopting this new guidance on its disclosures.
Revenue Recognition	Our contracts with customers can include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately versus together may require significant judgment. Our contracts are generally distinct and accounted for as separate performance obligations. Revenue is recognized upon transfer of control of promised products or services to clients in an amount that reflects the consideration we expect to receive in exchange for those products and services. The Company employs the 5-step revenue recognition model under ASC 606, Revenue from Contracts with Customers, to: (1) identify the contract with the client, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when (or as) the entity satisfies a performance obligation. Revenue is recognized net of shipping charges and any taxes collected from clients, which are subsequently remitted to governmental authorities. •Revenue Cycle Management Our revenue cycle management (“RCM”) business unit provides an array of business processing services (“BPS'’) consisting of accounts receivable management, private pay services, insurance services, medical coding, electronic billing, statement processing, payroll processing, and contract management. Fees are recognized over the period of the client contractual relationship as the services are performed based on the stand-alone selling price (“SSP”), net of discounts. SSP for BPS services is determined based on observable stand-alone selling prices. Fees for many of these services are invoiced, and revenue recognized accordingly, based on the volume of transactions or a percentage of client accounts receivable collections. Payment is due monthly for BPS with certain amounts varying based on utilization and/or volumes. Our RCM business unit also provides professional IT services. Revenue from professional IT services is recognized as the services are performed based on SSP, which is determined by observable stand-alone selling prices. Payment is due monthly as services are performed. Lastly, our RCM business unit also provides certain software solutions and related support under Software as a Service (“SaaS”) arrangements and time-based software licenses. Revenue from SaaS arrangements is recognized in a manner consistent with SaaS arrangements for electronic health records (“EHR”) software, as discussed below. Revenue from time-based software licenses is recognized upon delivery to the client (“point in time”) and revenue from non-license components (i.e., support) is recognized ratably over the respective contract term (“over time”). SSP for time-based licenses is determined using the residual approach, while the non-license component is based on cost plus reasonable margin. •Electronic Health Records The Company enters into contractual obligations to sell perpetual software licenses, installation, conversion, and related training services, software application support, hardware, and hardware maintenance services to acute care community hospitals. The Company also enters into contractual obligations to sell time-based software licenses, implementation and customization professional services, and software application support services to a variety of healthcare organizations, including hospital systems, health ministries, and government and non-profit organizations. •Non-recurring Revenues •Perpetual software licenses and installation, conversion, and related training services are not considered separate and distinct performance obligations due to the proprietary nature of our software and are, therefore, accounted for as a single performance obligation on a module-by-module basis. Revenue is recognized as each module's implementation is completed based on the module's SSP, net of discounts. We determine each module's SSP using the residual method. Fees for licenses and installation, conversion, and related training services are typically due in three installments: (1) at placement of order, (2) upon installation of software and commencement of training, and (3) upon satisfactory completion of monthly accounting cycle or end-of-month operation by application and as applicable for each application. Often, short-term and/or long-term financing arrangements are provided for software implementations; refer to Note 11 - Financing Receivables for further information. EHR implementations include a system warranty that terminates thirty days from the software go-live date, the date which the client begins using the system in a live environment. •Hardware revenue is recognized separately from software licenses at the point in time it is delivered to the client. The SSP of hardware is cost plus a reasonable margin and revenue is recognized on a gross basis. Payment is generally due upon delivery of the hardware to the client. Standard manufacturer warranties apply to hardware. •Perpetual software licenses are sold only to one re-seller client and are considered a separate and distinct performance obligation. Revenue is recognized at the point in time perpetual licenses are delivered to the client, which occurs at the time of sale. The SSP of perpetual licenses is directly observable. Payment is generally due upon delivery of licenses. •Implementation and customization services are considered a separate and distinct performance obligation. Revenue is recognized over time based on SSP, which is generally directly observable. Payment for professional services is typically due in two installments: (1) upon signature of the agreement and (2) upon customer acceptance of the delivered services. •Recurring Revenues •Software application support and hardware maintenance services sold with software licenses and hardware are separate and distinct performance obligations. Revenue for support and maintenance services is recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three to five years. Payment is due monthly for support and maintenance services provided. •Subscriptions to third-party content revenue is recognized as a separate performance obligation ratably over the subscription term based on SSP, which is cost plus a reasonable margin, and revenue is recognized on a gross basis. Payment is due monthly for subscriptions to third party content. •SaaS arrangements for EHR software and related conversion and training services are considered a single performance obligation. Revenue is recognized on a monthly basis as the SaaS service is provided to the client over the contract term. Payment is due monthly for SaaS services provided. •Term-based software licenses are considered a separate and distinct performance obligation. Revenue is recognized based on SSP, which is directly observable, at the point in time the term-based licenses are delivered to the client or upon annual renewal. Payment is generally due upon delivery of licenses or upon annual renewal. •Software application support services sold with software licenses are separate and distinct performance obligations. The related revenues are recognized based on SSP, which is the renewal price, ratably over the life of the contract, which is generally three to five years. Payment is generally due for the full amount of annual support fees at the beginning of an annual license term. Refer to Note 17 - Segment Reporting for further information, including revenue by client base (acute care or post-acute care) bifurcated by recurring and non-recurring revenue. Deferred Revenue Deferred revenue represents amounts invoiced to clients for which the services under contract have not been completed and revenue has not been recognized, including annual renewals of certain software subscriptions and customer deposits for implementations to be performed at a later date. Revenue is recognized ratably over the life of the software subscriptions as services are provided and at the point-in-time when implementations have been completed. The deferred revenue recorded during the six months ended June 30, 2024 and 2023 is comprised primarily of the annual renewals of certain software subscriptions billed during the first quarter of each year and deposits collected for future EHR installations. The deferred revenue recognized as revenue during the six months ended June 30, 2024 and 2023 is comprised primarily of the periodic recognition of annual renewals that were deferred until earned and deposits for future EHR installations that were earned during the period. Costs to Obtain and Fulfill a Contract with a Customer Costs to obtain a contract include the commission costs related to SaaS and RCM arrangements, which are capitalized and amortized ratably over the expected life of the customer contract. As a practical expedient, we generally recognize the incremental costs of obtaining a contract as an expense when incurred if the amortization period of the asset would have been one year or less. Costs to obtain a contract are expensed within the caption “Expenses - Sales and marketing” in the accompanying condensed consolidated statements of operations. Contract fulfillment costs related to the implementation of SaaS arrangements are capitalized and amortized ratably over the expected life of the customer contract. Costs to fulfill contracts consist of the payroll costs for the implementation of SaaS arrangements, including time for training, conversions, and installation that is necessary for the software to be utilized. Contract fulfillment costs are expensed within the caption “Costs of revenue (exclusive of amortization and depreciation) - EHR” in the accompanying condensed consolidated statements of operations. Remaining Performance Obligations Disclosures regarding remaining performance obligations are not considered material as the overwhelming majority of the Company's remaining performance obligations either (a) are related to contracts with an expected duration of one year or less, or (b) exhibit revenue recognition in the amount to which the Company has the right to invoice.
Net Income (Loss) Per Share	The Company presents basic and diluted earnings per share (“EPS”) data for its common stock. Basic EPS is calculated by dividing the net income attributable to stockholders of the Company by the weighted average number of shares of common stock outstanding during the period. Diluted EPS is determined by adjusting the net income attributable to stockholders of the Company and the weighted average number of shares of common stock outstanding during the period for the effects of all dilutive potential common shares, including awards under stock-based compensation arrangements. The Company's unvested restricted stock awards (see Note 10 - Stock-Based Compensation and Equity) are considered participating securities under ASC 260, Earnings Per Share, because they entitle holders to non-forfeitable rights to dividends until the awards vest or are forfeited. When a company has a security that qualifies as a “participating security,” the Codification requires the use of the two-class method when computing basic EPS. The two-class method is an earnings allocation formula that determines EPS for each class of common stock and participating security according to dividends declared (or accumulated) and participation rights in undistributed earnings. In determining the amount of net income to allocate to common stockholders, income is allocated to both common stock and participating securities based on their respective weighted average shares outstanding for the period, with net income attributable to common stockholders ultimately equaling net income less net income attributable to participating securities. Diluted EPS for the Company's common stock is computed using the more dilutive of the two-class method or the treasury stock method.
Income Taxes	The Company determines the tax provision for interim periods using an estimate of our annual effective tax rate ("ETR"), adjusted for discrete items, if any, that are taken into account in the relevant period. Each quarter we update our estimate of the annual ETR, and if our estimated tax rate changes, we make a cumulative adjustment. If a reliable estimate of the annual ETR cannot be made, the actual ETR for the year to date may be the best estimate of the annual ETR.
Fair Value	FASB Codification topic, Fair Value Measurements and Disclosures, establishes a framework for measuring fair value and expands financial statement disclosures about fair value measurements. Fair value is the price that would be received to sell an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. The Codification does not require any new fair value measurements, but rather applies to all other accounting pronouncements that require or permit fair value measurements. The Codification requires that assets and liabilities carried at fair value be classified and disclosed in one of the following three categories: Level 1: Quoted market prices in active markets for identical assets or liabilities. Level 2: Observable market-based inputs or unobservable inputs that are corroborated by market data. Level 3: Unobservable inputs that are not corroborated by market data.

v3.24.2.u1

BASIS OF PRESENTATION (Tables)	6 Months Ended
	Jun. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Amounts Reclassified	The following table provides the amounts reclassified for the three and six months ended June 30, 2023. Three Months Ended June 30, 2023 (in thousands) As previously reported Re-classifications As reclassified As currently reported Costs of revenue (exclusive of amortization and depreciation) RCM $ 27,119  $ —  $ 27,119  $ 27,119  EHR 17,014  —  17,014  17,014  Other expenses Product development 10,595  (1,826) 8,769  8,769  Sales and marketing 8,132  —  8,132  8,132  General and administrative 19,654  (597) 19,057  19,057  Amortization of acquisition-related intangibles 4,014  (4,014) —  —  Amortization —  5,840  5,840  5,840  Depreciation —  597  597  597  Six Months Ended June 30, 2023 (in thousands) As previously reported Re-classifications As reclassified As currently reported Costs of revenue (exclusive of amortization and depreciation) RCM $ 54,302  $ —  $ 54,302  $ 54,302  EHR 34,008  —  34,008  34,008  Other expenses Product development 20,434  (3,313) 17,121  17,121  Sales and marketing 15,089  —  15,089  15,089  General and administrative 34,604  (1,094) 33,510  33,510  Amortization of acquisition-related intangibles 8,029  (8,029) —  —  Amortization —  11,341  11,341  11,341  Depreciation —  1,095  1,095  1,095

v3.24.2.u1

REVENUE RECOGNITION (Tables)	6 Months Ended
	Jun. 30, 2024
Revenue from Contract with Customer [Abstract]
Schedule of Contract with Customer, Asset and Liability	The following table details deferred revenue for the six months ended June 30, 2024 and 2023, included in the condensed consolidated balance sheets: (In thousands) Six Months Ended June 30, 2024 Six Months Ended June 30, 2023 Beginning balance $ 8,677  $ 11,590  Deferred revenue recorded 8,230  10,623  Less deferred revenue recognized as revenue (7,065) (12,328) Ending balance $ 9,842  $ 9,885
Schedule of Capitalized Contract Cost	The following table details the costs to obtain and fulfill contracts with customers for the six months ended June 30, 2024 and 2023: (In thousands) Six Months Ended June 30, 2024 Six Months Ended June 30, 2023 Beginning balance $ 13,115  $ 11,577  Costs to obtain and fulfill contracts capitalized 3,430  3,690  Less costs to obtain and fulfill contracts recognized as expense (3,649) (2,691) Ending balance $ 12,896  $ 12,576

v3.24.2.u1

BUSINESS COMBINATIONS AND DISPOSITIONS (Tables)	6 Months Ended
	Jun. 30, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]
Schedule of Assets and Liabilities of Held for Sale and Results of Disposal Group	The accompanying condensed consolidated balance sheet as of December 31, 2023 includes amounts related to this Transaction under the captions "Assets of held for sale disposal group" and "Liabilities of held for sale disposal group," the details of which are as follows as of December 31, 2023: (In thousands) Assets of held for sale disposal group Accounts receivable, net $ 3,087  Financing receivables, net 37  Prepaid expenses 34  Software costs, net 3,386  Intangibles, net 11,739  Goodwill 7,694  Total $ 25,977  Liabilities of held for sale disposal group Accounts payable $ 178  Other accrued liabilities 576  Deferred tax liability 223  Total $ 977  The following table presents the pretax loss for AHT that is included in our condensed consolidated statement of operations for the three and six months ended June 30, 2024 and 2023: Three Months Ended June 30, Six Months Ended June 30, (In thousands) 2024 2023 2024 2023 Pretax loss $ —  $ (505) $ (241) $ (376)
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The preliminary estimated fair values of assets acquired and liabilities assumed as of December 31, 2023, and as updated through June 30, 2024, are as follows: (In thousands) Purchase Price Allocation as of December 31, 2023 Purchase Price Allocation as of June 30, 2024 Acquired cash $ 1,449  $ 1,449  Accounts receivable 2,233  2,233  Prepaid expenses 132  132  Property and equipment 1,112  1,112  Intangible assets 17,720  17,720  Goodwill 17,263  17,927  Accounts payable and accrued liabilities (711) (711) Contingent consideration (1,044) (1,044) Net assets acquired $ 38,154  $ 38,818

v3.24.2.u1

PROPERTY AND EQUIPMENT (Tables)	6 Months Ended
	Jun. 30, 2024
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property and equipment, net was comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Land $ 2,848  $ 2,848  Buildings and improvements 8,487  8,481  Computer equipment 10,363  10,104  Leasehold improvements 631  631  Office furniture and fixtures 626  586  Automobiles 18  18  Property and equipment, gross 22,973  22,668  Less: accumulated depreciation (14,494) (13,694) Property and equipment, net $ 8,479  $ 8,974

v3.24.2.u1

SOFTWARE DEVELOPMENT (Tables)	6 Months Ended
	Jun. 30, 2024
Research and Development [Abstract]
Schedule of Software Development, Net	Software development costs, net was comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Software development costs $ 60,673  $ 51,349  Less: accumulated amortization (20,932) (12,210) Software development costs, net $ 39,741  $ 39,139

v3.24.2.u1

OTHER ACCRUED LIABILITIES (Tables)	6 Months Ended
	Jun. 30, 2024
Payables and Accruals [Abstract]
Schedule of Other Accrued Liabilities	Other accrued liabilities was comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Salaries and benefits $ 6,219  $ 5,194  Severance 2,781  5,806  Commissions 945  1,185  Contingent consideration 1,044  1,044  Operating lease liabilities, current portion 1,349  1,804  Other 5,143  4,859  Other accrued liabilities $ 17,481  $ 19,892

v3.24.2.u1

NET INCOME (LOSS) PER SHARE (Tables)	6 Months Ended
	Jun. 30, 2024
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following is a calculation of the basic and diluted EPS for the Company's common stock, including a reconciliation between net income and net income attributable to common stockholders: Three Months Ended June 30, Six Months Ended June 30, (In thousands, except per share data) 2024 2023 2024 2023 Net income (loss) $ (5,049) $ (2,837) $ (7,565) $ 247  Less: Net (income) loss attributable to participating securities 216  64  263  (5) Net income (loss) attributable to common stockholders $ (4,833) $ (2,773) $ (7,302) $ 242  Weighted average shares outstanding used in basic per common share computations 14,313  14,200  14,273  14,168  Add: Dilutive potential common shares —  —  —  —  Weighted average shares outstanding used in diluted per common share computations 14,313  14,200  14,273  14,168  Basic EPS $ (0.34) $ (0.20) $ (0.51) $ 0.02  Diluted EPS $ (0.34) $ (0.20) $ (0.51) $ 0.02

v3.24.2.u1

STOCK-BASED COMPENSATION AND EQUITY (Tables)	6 Months Ended
	Jun. 30, 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of Stock-Based Compensation Expense	The following table details total stock-based compensation expense for the three and six months ended June 30, 2024 and 2023, included in the condensed consolidated statements of operations: Three Months Ended June 30, Six Months Ended June 30, (In thousands) 2024 2023 2024 2023 Costs of revenue (exclusive of amortization and depreciation) $ 230  $ 140  $ 266  $ 320  Other expenses 1,271  (263) 2,034  804  Pre-tax stock-based compensation expense 1,501  (123) 2,300  1,124  Less: income tax effect (315) 27  (483) (247) Net stock-based compensation expense $ 1,186  $ (96) $ 1,817  $ 877
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of Activity Under Restricted Stock Plans	A summary of restricted stock activity under the Plan during the six months ended June 30, 2024 and 2023 is as follows: Six Months Ended June 30, 2024 Six Months Ended June 30, 2023 Shares Weighted-Average Grant Date Fair Value Per Share Shares Weighted-Average Grant Date Fair Value Per Share Unvested restricted stock outstanding at beginning of period 343,315  $ 29.08  281,161  $ 32.24  Granted 495,003  10.03  186,822  29.23  Vested (151,642) 30.95  (139,760) 31.33  Forfeited (54,603) 12.84  —  —  Unvested restricted stock outstanding at end of period 632,073  $ 14.57  328,223  $ 30.92
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of Activity Under Restricted Stock Plans	A summary of performance share award activity under the Plan during the six months ended June 30, 2024 and 2023 is as follows, based on the target award amounts set forth in the performance share award agreements: Six Months Ended June 30, 2024 Six Months Ended June 30, 2023 Shares Weighted-Average Grant Date Fair Value Per Share Shares Weighted-Average Grant Date Fair Value Per Share Performance share awards outstanding at beginning of period 273,791  $ 33.17  252,375  $ 31.84  Granted 323,461  10.03  122,071  31.21  Forfeited or unearned (85,149) 37.98  (96,069) 26.96  Performance share awards outstanding at end of period 512,103  $ 18.60  278,377  $ 33.25

v3.24.2.u1

FINANCING RECEIVABLES (Tables)	6 Months Ended
	Jun. 30, 2024
Receivables [Abstract]
Schedule of Components of Short Term Payment Plans	These receivables, included in the current portion of financing receivables, were comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Short-term payment plans, gross $ 1,119  $ 788  Less: allowance for losses (56) (39) Short-term payment plans, net $ 1,063  $ 749
Schedule of Components of Lease Receivables	The components of these receivables were as follows at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Long-term financing arrangements, gross $ 4,284  $ 5,212  Less: allowance for expected credit losses (332) (377) Less: unearned income (271) (361) Long-term financing arrangements, net $ 3,681  $ 4,474
Schedule of Future Minimum Lease Payments to be Received	Future minimum payments to be received subsequent to June 30, 2024 are as follows: (In thousands) Years Ending December 31, 2024 $ 1,671  2025 2,195  2026 276  2027 69  2028 62  Thereafter 11  Total minimum payments to be received 4,284  Less: allowance for expected credit losses (332) Less: unearned income (271) Receivables, net $ 3,681
Schedule of Allowance for Financing Credit Losses	The following table is a roll-forward of the allowance for expected credit losses for the six months ended June 30, 2024 and year ended December 31, 2023: (In thousands) Balance at Beginning of Period Provision Charge-offs Recoveries Sale of AHT Balance at End of Period June 30, 2024 $ 416  $ (26) $ —  $ —  $ (2) $ 388  December 31, 2023 $ 549  $ (133) $ —  $ —  $ —  $ 416
Schedule of Analysis of Age of Financing Receivables Amounts	The following is an analysis of the age of financing receivables amounts (excluding short-term payment plans) that have been reclassified to trade accounts receivable and were past due as of June 30, 2024 and December 31, 2023: (In thousands) 1 to 90 Days Past Due 91 to 180 Days Past Due 181 + Days Past Due Total Past Due June 30, 2024 $ 594  $ 235  $ 518  $ 1,347  December 31, 2023 $ 857  $ 231  $ 323  $ 1,411
Schedule of Financing Receivable Credit Quality Indicators	The table below categorizes customer financing receivable balances (excluding short-term payment plans) based on the age of the oldest payment outstanding that has been reclassified to trade accounts receivable: (In thousands) June 30, 2024 December 31, 2023 Stratification of uninvoiced client financing receivables based on aging of related trade accounts receivable: Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due $ 2,347  $ 1,068  Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due 579  1,720  Uninvoiced client financing receivables related to trade accounts receivable that are 181 + Days Past Due 975  965  Total uninvoiced client financing receivables balances of clients with a trade accounts receivable $ 3,901  $ 3,753  Total uninvoiced client financing receivables of clients with no related trade accounts receivable 112  1,098  Total financing receivables with contractual maturities of one year or less 1,119  788  Less: allowance for expected credit losses (388) (416) Total financing receivables $ 4,744  $ 5,223

v3.24.2.u1

INTANGIBLE ASSETS AND GOODWILL (Tables)	6 Months Ended
	Jun. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Definite-lived Intangible Assets	The following tables summarize the gross carrying amounts, accumulated amortization and accumulated impairment of identifiable intangible assets with definite lives by major class as of June 30, 2024 and December 31, 2023: June 30, 2024 (In thousands) Customer Relationships Trademark Developed Technology Non-Compete Agreements Total Gross carrying amount, beginning of period $ 116,470  $ 7,720  $ 31,900  $ 1,620  $ 157,710  Accumulated amortization (45,441) (5,378) (20,905) (684) (72,408) Accumulated impairment —  (2,342) —  —  (2,342) Net intangible assets as of June 30, 2024 $ 71,029  $ —  $ 10,995  $ 936  $ 82,960  Weighted average remaining years of useful life 8.0 0.0 8.2 3.0 8.1 December 31, 2023 (In thousands) Customer Relationships Trademark Developed Technology Non-Compete Agreements Total Gross carrying amount, beginning of period $ 132,170  $ 12,320  $ 40,800  $ 1,400  $ 186,690  Intangible assets acquired 16,100  —  1,400  220  17,720  Accumulated amortization (63,686) (6,974) (29,934) (522) (101,116) Accumulated impairment —  (2,342) (2,342) Held for sale (8,735) (3,004) (11,739) Net intangible assets as of December 31, 2023 $ 75,849  $ —  $ 12,266  $ 1,098  $ 89,213
Schedule of Remaining Amortization of Definite-lived Intangible Assets	The following table represents the remaining amortization of definite-lived intangible assets as of June 30, 2024: (In thousands) For the year ended December 31, 2024 $ 6,253  2025 12,190  2026 11,517  2027 10,497  2028 10,203  Thereafter 32,300  Total $ 82,960
Schedule of Rollforward of Goodwill Balances	The following table sets forth the change in the carrying value of our goodwill balances by reportable segment for the six months ended June 30, 2024: (In thousands) RCM EHR Total Gross value at December 31, 2023 $ 79,084  $ 136,432  $ 215,516  Accumulated impairment —  (35,913) (35,913) Held for sale —  (7,694) (7,694) Carrying value at December 31, 2023 79,084  92,825  171,909  Purchase price adjustment (Viewgol) 664  —  664  Gross value at June 30, 2024 79,748  128,738  208,486  Accumulated impairment —  (35,913) (35,913) Carrying value as of June 30, 2024 $ 79,748  $ 92,825  $ 172,573

v3.24.2.u1

LONG-TERM DEBT (Tables)	6 Months Ended
	Jun. 30, 2024
Debt Disclosure [Abstract]
Schedule of Long-term Debt	Long-term debt was comprised of the following at June 30, 2024 and December 31, 2023: (In thousands) June 30, 2024 December 31, 2023 Term loan facility $ 58,125  $ 63,875  Revolving credit facility 123,416  135,723  Debt obligations 181,541  199,598  Less: unamortized debt issuance costs (1,503) (1,187) Debt obligation, net 180,038  198,411  Less: current portion (3,074) (3,141) Long-term debt $ 176,964  $ 195,270
Schedule of Annual Future Maturities of the Term Loan Facility and Revolving Credit Facility	Anticipated annual future maturities of the term loan facility and revolving credit facility are as follows as of June 30, 2024: (In thousands) 2024 $ 1,750  2025 3,500  2026 3,500  2027 172,791  $ 181,541

v3.24.2.u1

OPERATING LEASES (Tables)	6 Months Ended
	Jun. 30, 2024
Leases [Abstract]
Schedule of Lease, Supplemental Balance Sheet Information	Supplemental balance sheet information related to operating leases was as follows: (In thousands) June 30, 2024 December 31, 2023 Operating lease assets: Operating lease assets $ 3,861  $ 5,192  Operating lease liabilities: Other accrued liabilities 1,349 1,804 Operating lease liabilities, net of current portion 2,512  3,074  Total operating lease liabilities $ 3,861  $ 4,878  Weighted average remaining lease term in years 3.8 4 Weighted average discount rate 4.1% 4.2%
Schedule of Operating Lease, Liability, Maturity	The future minimum lease payments payable under these operating leases subsequent to June 30, 2024 are as follows: (In thousands) 2024 $ 825  2025 1,008  2026 962  2027 678  2028 462  Thereafter 231  Total lease payments 4,166  Less imputed interest (305) Total $ 3,861

v3.24.2.u1

FAIR VALUE (Tables)	6 Months Ended
	Jun. 30, 2024
Fair Value Disclosures [Abstract]
Carrying Amounts and Fair Value of the Contingent Consideration	The following table summarizes the carrying amount and fair value of the contingent consideration at June 30, 2024: Fair Value at June 30, 2024 Using (In thousands) Carrying Amount at June 30, 2024 Quoted Price in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Description Contingent consideration $ 1,044  $ —  $ —  $ 1,044  Total $ 1,044  $ —  $ —  $ 1,044  The following table summarizes the carrying amount and fair value of the contingent consideration at December 31, 2023: Fair Value at December 31, 2023 Using (In thousands) Carrying Amount at December 31, 2023 Quoted Price in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Description Contingent consideration $ 1,044  $ —  $ —  $ 1,044  Total $ 1,044  $ —  $ —  $ 1,044

v3.24.2.u1

SEGMENT REPORTING (Tables)	6 Months Ended
	Jun. 30, 2024
Segment Reporting [Abstract]
Schedule of Segment Reporting Information, by Segment	The following table presents a summary of the revenues and adjusted EBITDA of our two operating segments for the three and six months ended June 30, 2024 and 2023: Three Months Ended June 30, Six Months Ended June 30, (In thousands) 2024 2023 2024 2023 Revenues by segment: RCM $ 54,108  $ 47,760  $ 107,146  $ 96,391  EHR Recurring revenue Acute EHR 26,666  30,013  54,160  59,353  Post-acute EHR —  3,729  582  7,636  Total recurring EHR revenue 26,666  33,742  54,742  66,989  Non-recurring revenue Acute EHR 3,956  2,775  6,008  6,750  Post-acute EHR —  345  81  725  Total non-recurring EHR revenue 3,956  3,120  6,089  7,475  Total EHR revenue $ 30,622  $ 36,862  $ 60,831  $ 74,464  Total revenues $ 84,730  $ 84,622  $ 167,977  $ 170,855  Adjusted EBITDA by segment: RCM $ 7,804  $ 5,682  $ 14,202  13,580  EHR 4,770  5,545  7,826  12,289  Total adjusted EBITDA $ 12,574  $ 11,227  $ 22,028  $ 25,869
Schedule of Reconciliation of Net Income from Continuing Operations to Adjusted Income (Loss) from Before Interest, Taxes, Depreciation and Amortization	The following table reconciles net income to adjusted EBITDA: Three Months Ended June 30, Six Months Ended June 30, (In thousands) 2024 2023 2024 2023 Net income (loss), as reported $ (5,049) $ (2,837) (7,565) 247  Deferred revenue and other purchase accounting adjustments —  —  —  —  Depreciation expense 400  597  800  1,095  Amortization of software development costs 5,980  1,826  8,722  3,312  Amortization of acquisition-related intangibles 3,126  4,014  6,253  8,029  Stock-based compensation 1,501  (123) 2,300  1,124  Severance and other non-recurring charges 4,586  6,819  8,430  7,920  Interest expense 4,151  2,586  8,051  4,988  Gain on sale of AHT —  —  (1,250) —  Provision (benefit) for income taxes (2,121) (1,655) (3,713) (846) Total adjusted EBITDA $ 12,574  $ 11,227  $ 22,028  $ 25,869

v3.24.2.u1

BASIS OF PRESENTATION - Amounts Reclassified (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	$ 43,342	$ 44,133	$ 85,103	$ 88,310
Other expenses
Product development	8,207	8,769	18,894	17,121
Sales and marketing	7,815	8,132	14,408	15,089
General and administrative	18,878	19,057	38,274	33,510
Amortization of acquisition-related intangibles		0		0
Amortization	9,107	5,840	14,975	11,341
Depreciation	400	597	800	1,095
RCM
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	30,269	27,119	59,866	54,302
EHR
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized	$ 13,073	17,014	$ 25,237	34,008
As previously reported
Other expenses
Product development		10,595		20,434
Sales and marketing		8,132		15,089
General and administrative		19,654		34,604
Amortization of acquisition-related intangibles		4,014		8,029
Amortization		0		0
Depreciation		0		0
As previously reported | RCM
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		27,119		54,302
As previously reported | EHR
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		17,014		34,008
Re-classifications
Other expenses
Product development		(1,826)		(3,313)
Sales and marketing		0		0
General and administrative		(597)		(1,094)
Amortization of acquisition-related intangibles		(4,014)		(8,029)
Amortization		5,840		11,341
Depreciation		597		1,095
Re-classifications | RCM
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		0		0
Re-classifications | EHR
Costs of revenue (exclusive of amortization and depreciation)
Costs to obtain and fulfill contracts capitalized		$ 0		$ 0

v3.24.2.u1

BASIS OF PRESENTATION - Narrative (Details) - segment	2 Months Ended	4 Months Ended
	Jun. 30, 2024	Apr. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of reportable segments	2	3

v3.24.2.u1

REVENUE RECOGNITION - Narrative (Details)	6 Months Ended
	Jun. 30, 2024 installment
Professional services
Revenue from External Customer [Line Items]
Revenue from contract with customer, payment, number of installments	2
EHR
Revenue from External Customer [Line Items]
Revenue from contract with customer, warranty, term	30 days
EHR | Fees
Revenue from External Customer [Line Items]
Revenue from contract with customer, payment, number of installments	3
EHR | Minimum
Revenue from External Customer [Line Items]
Revenue performance obligation, description of timing (in years)	3 years
EHR | Maximum
Revenue from External Customer [Line Items]
Revenue performance obligation, description of timing (in years)	5 years
Patient Engagement | Minimum
Revenue from External Customer [Line Items]
Revenue performance obligation, description of timing (in years)	3 years
Patient Engagement | Maximum
Revenue from External Customer [Line Items]
Revenue performance obligation, description of timing (in years)	5 years

v3.24.2.u1

REVENUE RECOGNITION - Deferred Revenue (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Change in Contract with Customer, Liability [Roll Forward]
Beginning balance	$ 8,677	$ 11,590
Deferred revenue recorded	8,230	10,623
Less deferred revenue recognized as revenue	(7,065)	(12,328)
Ending balance	$ 9,842	$ 9,885

v3.24.2.u1

REVENUE RECOGNITION - Costs to Obtain and Fulfill Contracts (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Capitalized Contract Cost [Roll Forward]
Beginning balance	$ 13,115	$ 11,577
Costs to obtain and fulfill contracts capitalized	3,430	3,690
Less costs to obtain and fulfill contracts recognized as expense	(3,649)	(2,691)
Ending balance	$ 12,896	$ 12,576

v3.24.2.u1

BUSINESS COMBINATIONS AND DISPOSITIONS - Narrative (Details) - USD ($) $ in Thousands			1 Months Ended	3 Months Ended			6 Months Ended		12 Months Ended
	Jan. 16, 2024	Oct. 16, 2023	Apr. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Business Acquisition [Line Items]
Accounts receivable				$ 59,603			$ 59,603		$ 59,723
Gain on sale of business				0		$ 0	1,250	$ 0
Acquisition, cash consideration							664	$ 0
Acquisition, contingent earnout liability				1,044			1,044		1,044
Viewgol, LLC
Business Acquisition [Line Items]
Acquisition, cash consideration		$ 37,400
Acquisition related costs									$ 4,700
Payment for working capital adjustments			$ 700
Revenue of acquiree since acquisition							9,900
Business Combination, Pro Forma Information, Earnings or Loss of Acquiree since Acquisition Date, Actual							3,700
Viewgol, LLC | EBTIDA Earnout
Business Acquisition [Line Items]
Acquisition, contingent earnout liability		21,500
Acquisition, contingent consideration, EBITDA target		6,000
Viewgol, LLC | Offshore Earnout
Business Acquisition [Line Items]
Acquisition, contingent earnout liability		$ 10,000
American HealthTech, Inc.
Business Acquisition [Line Items]
Sale, cash consideration	$ 25,000
Sale, cash consideration held in escrow	3,750
Sale, cash consideration held in indemnity escrow	2,500
Sale, cash consideration held in special indemnity escrow	1,000
Sale, cash consideration, net	$ 21,410
Transition services agreement, period	18 months
Accounts receivable				$ 600			$ 600
Gain on sale of business					$ 1,250

v3.24.2.u1

BUSINESS COMBINATIONS AND DISPOSITIONS - Schedule of Assets and Liabilities of Held for Sale Disposal Group (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Assets of held for sale disposal group
Total	$ 0	$ 25,977
Liabilities of held for sale disposal group
Total	$ 0	977
American HealthTech, Inc.
Assets of held for sale disposal group
Accounts receivable, net		3,087
Financing receivables, net		37
Prepaid expenses		34
Software costs, net		3,386
Intangibles, net		11,739
Goodwill		7,694
Total		25,977
Liabilities of held for sale disposal group
Accounts payable		178
Other accrued liabilities		576
Deferred tax liability		223
Total		$ 977

v3.24.2.u1

BUSINESS COMBINATIONS AND DISPOSITIONS - Results of Disposal Group (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
American HealthTech, Inc.
Business Acquisition [Line Items]
Pretax loss	$ 0	$ (505)	$ (241)	$ (376)

v3.24.2.u1

BUSINESS COMBINATIONS AND DISPOSITIONS - Preliminary Allocation of the Purchase Price Paid (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Goodwill	$ 172,573	$ 171,909
Viewgol, LLC
Business Acquisition [Line Items]
Acquired cash	1,449	1,449
Accounts receivable	2,233	2,233
Prepaid expenses	132	132
Property and equipment	1,112	1,112
Intangible assets	17,720	17,720
Goodwill	17,927	17,263
Accounts payable and accrued liabilities	(711)	(711)
Contingent consideration	(1,044)	(1,044)
Net assets acquired	$ 38,818	$ 38,154

v3.24.2.u1

PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 22,973	$ 22,668
Less: accumulated depreciation	(14,494)	(13,694)
Property and equipment, net	8,479	8,974
Land
Property, Plant and Equipment [Line Items]
Property and equipment, gross	2,848	2,848
Buildings and improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	8,487	8,481
Computer equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	10,363	10,104
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	631	631
Office furniture and fixtures
Property, Plant and Equipment [Line Items]
Property and equipment, gross	626	586
Automobiles
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 18	$ 18

v3.24.2.u1

SOFTWARE DEVELOPMENT - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Finite-Lived Intangible Assets [Line Items]
Amortization of software development costs	$ 5,980	$ 1,826	$ 8,722	$ 3,312
Useful life
Finite-Lived Intangible Assets [Line Items]
Amortization of software development costs	$ 2,900
Software Development
Finite-Lived Intangible Assets [Line Items]
Estimated useful life (in years)	5 years		5 years

v3.24.2.u1

SOFTWARE DEVELOPMENT - Schedule of Software Development Costs, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Research and Development [Abstract]
Software development costs	$ 60,673	$ 51,349
Less: accumulated amortization	(20,932)	(12,210)
Software development costs, net	$ 39,741	$ 39,139

v3.24.2.u1

OTHER ACCRUED LIABILITIES (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Salaries and benefits	$ 6,219	$ 5,194
Severance	2,781	5,806
Commissions	945	1,185
Contingent consideration	1,044	1,044
Operating lease liabilities, current portion	1,349	1,804
Other	5,143	4,859
Other accrued liabilities	$ 17,481	$ 19,892

v3.24.2.u1

NET INCOME (LOSS) PER SHARE - Computation (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Earnings Per Share [Abstract]
Net income (loss)	$ (5,049)	$ (2,837)	$ (7,565)	$ 247
Less: Net (income) loss attributable to participating securities	216	64	263	(5)
Net income (loss) attributable to common stockholders	$ (4,833)	$ (2,773)	$ (7,302)	$ 242
Weighted average shares outstanding used in basic per common share computations (in shares)	14,313	14,200	14,273	14,168
Add: Dilutive potential common shares (in shares)	0	0	0	0
Weighted average shares outstanding used in diluted per common share computations (in shares)	14,313	14,200	14,273	14,168
Basic EPS (in dollars per share)	$ (0.34)	$ (0.20)	$ (0.51)	$ 0.02
Diluted EPS (in dollars per share)	$ (0.34)	$ (0.20)	$ (0.51)	$ 0.02

v3.24.2.u1

NET INCOME (LOSS) PER SHARE - Narrative (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Aggregate target (in shares)	512,103		512,103
Dilutive potential common shares included in the calculation of diluted earnings per share (in shares)	0	0	0	0
Performance Shares
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Dilutive potential common shares included in the calculation of diluted earnings per share (in shares)	0		0

v3.24.2.u1

INCOME TAXES (Details)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Income Tax Disclosure [Abstract]
Effective tax rate (as a percent)	29.60%	36.80%	32.90%	141.20%
R&D tax credits (as a percent)			21.00%

v3.24.2.u1

STOCK-BASED COMPENSATION AND EQUITY - Stock-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Pre-tax stock-based compensation expense	$ 1,501	$ (123)	$ 2,300	$ 1,124
Less: income tax effect	(315)	27	(483)	(247)
Net stock-based compensation expense	1,186	(96)	1,817	877
Costs of revenue (exclusive of amortization and depreciation)
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Pre-tax stock-based compensation expense	230	140	266	320
Other expenses
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Pre-tax stock-based compensation expense	$ 1,271	$ (263)	$ 2,034	$ 804

v3.24.2.u1

STOCK-BASED COMPENSATION AND EQUITY - Narrative (Details) - USD ($)	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Mar. 26, 2024	Sep. 04, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost related to non-vested share-based compensation	$ 10,900,000
Unrecognized compensation cost related to non-vested share-based compensation period of recognition (in years)	2 years 1 month 6 days
Stock repurchase program, authorized amount				$ 30,000,000
Stock repurchased during period (in shares)	0	49,789
Stock repurchase program, remaining authorized repurchase amount	$ 16,500,000
Shares purchased for award (in shares)	42,979	37,989
Dividends declared (in shares)			1
Half of exercise price of rights (in dollars per share)			$ 28.00
Whole of exercise price of rights (in dollars per share)			$ 56.00
One half of common stock (as a percent)			50.00%
Maximum | Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	3 years
Maximum | Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	3 years
Minimum | Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	1 year

v3.24.2.u1

STOCK-BASED COMPENSATION AND EQUITY - Summary of Activity Under Restricted and Performance Stock Plans (Details) - $ / shares	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Performance Shares
Shares
Outstanding at beginning of period (in shares)	273,791	252,375
Granted (in shares)	323,461	122,071
Forfeited or unearned (in shares)	(85,149)	(96,069)
Outstanding at end of period (in shares)	512,103	278,377
Weighted-Average Grant-Date Fair Value
Outstanding at beginning of the period (in dollars per share)	$ 33.17	$ 31.84
Granted (in dollars per share)	10.03	31.21
Forfeited or unearned (in dollars per share)	37.98	26.96
Outstanding at end of the period in dollars per share)	$ 18.60	$ 33.25
Restricted Stock
Shares
Outstanding at beginning of period (in shares)	343,315	281,161
Granted (in shares)	495,003	186,822
Vested (in shares)	(151,642)	(139,760)
Forfeited (in shares)	(54,603)	0
Outstanding at end of period (in shares)	632,073	328,223
Weighted-Average Grant-Date Fair Value
Outstanding at beginning of the period (in dollars per share)	$ 29.08	$ 32.24
Granted (in dollars per share)	10.03	29.23
Vested/Earned and issued (in dollars per share)	30.95	31.33
Forfeited (in dollars per share)	12.84	0
Outstanding at end of the period in dollars per share)	$ 14.57	$ 30.92

v3.24.2.u1

FINANCING RECEIVABLES - Narrative (Details)	6 Months Ended
	Jun. 30, 2024
Minimum | Short-Term Payment Plans
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivable term	3 months
Minimum | Long-Term Financing Arrangement
Accounts, Notes, Loans and Financing Receivable [Line Items]
Financial receivable lease term (in years)	2 years
Maximum | Short-Term Payment Plans
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivable term	12 months
Maximum | Long-Term Financing Arrangement
Accounts, Notes, Loans and Financing Receivable [Line Items]
Financial receivable lease term (in years)	7 years

v3.24.2.u1

FINANCING RECEIVABLES - Short term Payment Plans (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Financing Receivable, Allowance for Credit Loss [Line Items]
Less: allowance for losses	$ (332)	$ (319)
Short-term payment plans, net	4,137	3,997
Short-Term Payment Plans
Financing Receivable, Allowance for Credit Loss [Line Items]
Short-term payment plans, gross	1,119	788
Less: allowance for losses	(56)	(39)
Short-term payment plans, net	$ 1,063	$ 749

v3.24.2.u1

FINANCING RECEIVABLES - Components of Receivables (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023	Dec. 31, 2022
Financing Receivable, Recorded Investment, Past Due [Line Items]
Less: allowance for expected credit losses	$ (388)	$ (416)	$ (549)
Total financing receivables	4,744	5,223
Long-Term Financing Arrangement
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	4,284	5,212
Less: allowance for expected credit losses	(332)	(377)
Less: unearned income	(271)	(361)
Total financing receivables	$ 3,681	$ 4,474

v3.24.2.u1

FINANCING RECEIVABLES - Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023	Dec. 31, 2022
Financing Receivable, Recorded Investment, Past Due [Line Items]
Less: allowance for expected credit losses	$ (388)	$ (416)	$ (549)
Total financing receivables	4,744	5,223
Long-Term Financing Arrangement
Financing Receivable, Recorded Investment, Past Due [Line Items]
2024	1,671
2025	2,195
2026	276
2027	69
2028	62
Thereafter	11
Total minimum payments to be received	4,284
Less: allowance for expected credit losses	(332)	(377)
Less: unearned income	(271)	(361)
Total financing receivables	$ 3,681	$ 4,474

v3.24.2.u1

FINANCING RECEIVABLES - Allowance for Financing Credit Losses (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2024	Dec. 31, 2023
Allowance for Doubtful Accounts Receivable [Roll Forward]
Balance at Beginning of Period	$ 416	$ 549
Provision	(26)	(133)
Charge-offs	0	0
Recoveries	0	0
Sale of AHT	(2)	0
Balance at End of Period	$ 388	$ 416

v3.24.2.u1

FINANCING RECEIVABLES - Analysis of Age of Financing Receivables Amounts (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Total Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	$ 1,347	$ 1,411
1 to 90 Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	594	857
91 to 180 Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	235	231
181 + Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Long-term financing arrangements, gross	$ 518	$ 323

v3.24.2.u1

FINANCING RECEIVABLES - Schedule of Financing Receivables (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023	Dec. 31, 2022
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total financing receivables with contractual maturities of one year or less	$ 1,119	$ 788
Less: allowance for expected credit losses	(388)	(416)	$ (549)
Total financing receivables	4,744	5,223
Total Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	1,347	1,411
Total Past Due | Trade Accounts Receivable
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	3,901	3,753
Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	594	857
Uninvoiced client financing receivables related to trade accounts receivable that are 1 to 90 Days Past Due | Trade Accounts Receivable
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	2,347	1,068
Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	235	231
Uninvoiced client financing receivables related to trade accounts receivable that are 91 to 180 Days Past Due | Trade Accounts Receivable
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	579	1,720
Uninvoiced client financing receivables related to trade accounts receivable that are 181 + Days Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	518	323
Uninvoiced client financing receivables related to trade accounts receivable that are 181 + Days Past Due | Trade Accounts Receivable
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	975	965
Total Not Past Due
Financing Receivable, Recorded Investment, Past Due [Line Items]
Total uninvoiced client financing receivables of clients with no related trade accounts receivable	$ 112	$ 1,098

v3.24.2.u1

INTANGIBLE ASSETS AND GOODWILL - Definite-Lived Intangible Assets (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2024	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		$ 157,710	$ 186,690
Intangible assets acquired		17,720
Accumulated amortization	$ (72,408)	(101,116)
Accumulated impairment	(2,342)	(2,342)
Held for sale		(11,739)
Net intangible assets	$ 82,960	89,213
Weighted average remaining years of useful life	8 years 1 month 6 days
Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		116,470	132,170
Intangible assets acquired		16,100
Accumulated amortization	$ (45,441)	(63,686)
Accumulated impairment	0	0
Held for sale		(8,735)
Net intangible assets	$ 71,029	75,849
Weighted average remaining years of useful life	8 years
Trademark
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		7,720	12,320
Intangible assets acquired		0
Accumulated amortization	$ (5,378)	(6,974)
Accumulated impairment	(2,342)	(2,342)
Held for sale		(3,004)
Net intangible assets	$ 0	0
Weighted average remaining years of useful life	0 years
Developed Technology
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		31,900	40,800
Intangible assets acquired		1,400
Accumulated amortization	$ (20,905)	(29,934)
Accumulated impairment	0
Net intangible assets	$ 10,995	12,266
Weighted average remaining years of useful life	8 years 2 months 12 days
Non-Compete Agreements
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount		1,620	$ 1,400
Intangible assets acquired		220
Accumulated amortization	$ (684)	(522)
Accumulated impairment	0
Net intangible assets	$ 936	$ 1,098
Weighted average remaining years of useful life	3 years

v3.24.2.u1

INTANGIBLE ASSETS AND GOODWILL - Narrative (Details) - USD ($) $ in Millions			12 Months Ended
	May 14, 2024	Mar. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Goodwill impairment	$ 0.0	$ 0.0
Trademark
Finite-Lived Intangible Assets [Line Items]
Trademark impairment			$ 2.3
Trademark | RCM
Finite-Lived Intangible Assets [Line Items]
Trademark impairment			1.0
Trademark | EHR
Finite-Lived Intangible Assets [Line Items]
Trademark impairment			1.2
Trademark | Patient Engagement
Finite-Lived Intangible Assets [Line Items]
Trademark impairment			$ 0.1

v3.24.2.u1

INTANGIBLE ASSETS AND GOODWILL - Remaining Amortization of Definite-lived Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
2024	$ 6,253
2025	12,190
2026	11,517
2027	10,497
2028	10,203
Thereafter	32,300
Intangible assets, net	$ 82,960	$ 89,213

v3.24.2.u1

INTANGIBLE ASSETS AND GOODWILL - Schedule of Goodwill (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Dec. 31, 2023
Goodwill [Roll Forward]
Gross value at December 31, 2023	$ 215,516
Purchase price adjustment (Viewgol)	664
Gross value at June 30, 2024	208,486
Accumulated impairment	(35,913)	$ (35,913)
Held for sale		(7,694)
Goodwill	172,573	171,909
RCM
Goodwill [Roll Forward]
Gross value at December 31, 2023	79,084
Purchase price adjustment (Viewgol)	664
Gross value at June 30, 2024	79,748
Accumulated impairment	0	0
Held for sale		0
Goodwill	79,748	79,084
EHR
Goodwill [Roll Forward]
Gross value at December 31, 2023	136,432
Purchase price adjustment (Viewgol)	0
Gross value at June 30, 2024	128,738
Accumulated impairment	(35,913)	(35,913)
Held for sale		(7,694)
Goodwill	$ 92,825	$ 92,825

v3.24.2.u1

LONG-TERM DEBT - Schedule of Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Less: unamortized debt issuance costs	$ (1,503)	$ (1,187)
Debt obligation, net	180,038	198,411
Less: current portion	(3,074)	(3,141)
Long-term debt	176,964	195,270
Line of Credit
Debt Instrument [Line Items]
Debt obligations	181,541	199,598
Line of Credit | Term loan facility
Debt Instrument [Line Items]
Debt obligations	58,125	63,875
Line of Credit | Revolving credit facility
Debt Instrument [Line Items]
Debt obligations	$ 123,416	$ 135,723

v3.24.2.u1

LONG-TERM DEBT - Narrative (Details) - Line of Credit	Feb. 29, 2024 USD ($)	Feb. 28, 2024	Jan. 16, 2024 USD ($)	May 02, 2022 USD ($)	May 22, 2022	Jun. 16, 2020 USD ($)	Jan. 31, 2016 USD ($)
Debt Instrument [Line Items]
Line of credit facility, incremental facility capacity				$ 75,000,000
Fixed charge coverage ratio, minimum	1.15	1.25		1.25
Consolidated leverage ratio, maximum				3.50
Line of credit facility, acquisition connection incremental facility capacity				$ 25,000,000
Quarterly increase in consolidated leverage ratio after acquisition				0.50
Minimum consolidated leverage ratio				2.50
Credit facility, covenant, acquisitions costs, maximum			$ 7,000,000
Credit facility, covenant, acquisitions costs, maximum, percent of consolidated EBITDA (as a percent)			10.00%
Credit facility, covenant, SEC investigation costs and expenses, maximum			$ 1,250,000
Credit facility, covenant, percentage of consolidated EBITDA (as a percent)			15.00%		10.00%
Credit facility, covenant, EBITDA calculation, Administrative Agent expenses, maximum	$ 7,250,000
Credit facility, covenant, EBITDA calculation, savings add back limitation for acquisition	$ 6,600,000
Credit facility, covenant, EBITDA calculation, acquisitions savings add back, percentage, maximum	15.00%
Term loan facility
Debt Instrument [Line Items]
Amount of credit facility				$ 70,000,000		$ 75,000,000	$ 125,000,000
Periodic payment, principal				900,000
Revolving credit facility
Debt Instrument [Line Items]
Amount of credit facility				$ 160,000,000		110,000,000	$ 50,000,000
Interest rate floor				0.50%
Revolving credit facility | Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)				1.00%
Revolving credit facility | Secured Overnight Financing Rate (SOFR) | Minimum
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)				1.80%
Revolving credit facility | Secured Overnight Financing Rate (SOFR) | Maximum
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)				3.00%
Revolving credit facility | Base Rate | Minimum
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)				0.80%
Revolving credit facility | Base Rate | Maximum
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)				2.00%
Revolving credit facility | Federal Funds Rate
Debt Instrument [Line Items]
Basis spread on variable rate (as a percent)				0.50%
Amended and Restated Credit Agreement
Debt Instrument [Line Items]
Amount of credit facility						$ 185,000,000
First Amended and Restated Credit Agreement
Debt Instrument [Line Items]
Amount of credit facility				$ 230,000,000

v3.24.2.u1

LONG-TERM DEBT - Annual Future Maturities (Details) - Line of Credit - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
2024	$ 1,750
2025	3,500
2026	3,500
2027	172,791
Debt obligation, net	$ 181,541	$ 199,598

v3.24.2.u1

OPERATING LEASES - Narrative (Details) $ in Thousands		6 Months Ended
	Apr. 30, 2023 USD ($) ft²	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)
Lessee, Lease, Description [Line Items]
Loss on disposal of property and equipment		$ 0	$ 117
Lease expense		600	1,100
Operating lease, payments		$ 600	$ 1,100
Plymouth, Minnesota Lease
Lessee, Lease, Description [Line Items]
Area of real estate property | ft²	12,500
Payment to terminate lease	$ 1,100
Plymouth, Minnesota Lease | Leasehold improvements
Lessee, Lease, Description [Line Items]
Loss on disposal of property and equipment	$ 100

v3.24.2.u1

OPERATING LEASES - Supplemental Balance Sheet Information (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Leases [Abstract]
Operating lease assets	$ 3,861	$ 5,192
Operating lease liabilities:
Operating lease liabilities, current portion	$ 1,349	$ 1,804
Operating lease liabilities, current portion, location	Other accrued liabilities	Other accrued liabilities
Operating lease liabilities, net of current portion	$ 2,512	$ 3,074
Total operating lease liabilities	$ 3,861	$ 4,878
Weighted average remaining lease term in years	3 years 9 months 18 days	4 years
Weighted average discount rate	4.10%	4.20%

v3.24.2.u1

OPERATING LEASES - Future Minimum Lease Payments Payable Under these Operating Leases (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Leases [Abstract]
2024	$ 825
2025	1,008
2026	962
2027	678
2028	462
Thereafter	231
Total lease payments	4,166
Less imputed interest	(305)
Total	$ 3,861	$ 4,878

v3.24.2.u1

COMMITMENTS AND CONTINGENCIES (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Contingent consideration	$ 1,044	$ 1,044
Viewgol, LLC
Business Acquisition [Line Items]
Contingent consideration	$ 1,000	$ 1,000

v3.24.2.u1

FAIR VALUE (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration	$ 1,044	$ 1,044
Total	1,044	1,044
Quoted Price in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration	0	0
Total	0	0
Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration	0	0
Total	0	0
Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration	1,044	1,044
Total	$ 1,044	$ 1,044

v3.24.2.u1

SEGMENT REPORTING - Narrative (Details) - segment	2 Months Ended	4 Months Ended
	Jun. 30, 2024	Apr. 30, 2024
Segment Reporting [Abstract]
Number of operating segments	2	3
Number of reportable segments	2	3

v3.24.2.u1

SEGMENT REPORTING - Schedule of Segment Reporting Information, by Segment (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Segment Reporting Information [Line Items]
Total revenues	$ 84,730	$ 84,622	$ 167,977	$ 170,855
Total adjusted EBITDA	12,574	11,227	22,028	25,869
RCM
Segment Reporting Information [Line Items]
Total revenues	54,108	47,760	107,146	96,391
Total adjusted EBITDA	7,804	5,682
RCM | Operating Segments
Segment Reporting Information [Line Items]
Total revenues			107,146	96,391
Total adjusted EBITDA			14,202	13,580
EHR
Segment Reporting Information [Line Items]
Total revenues	30,622	36,862	60,831	74,464
Total adjusted EBITDA	4,770	5,545
EHR | Operating Segments
Segment Reporting Information [Line Items]
Total revenues			60,831	74,464
Total adjusted EBITDA			7,826	12,289
Recurring revenue | EHR
Segment Reporting Information [Line Items]
Total revenues	26,666	33,742
Recurring revenue | EHR | Operating Segments
Segment Reporting Information [Line Items]
Total revenues			54,742	66,989
Recurring revenue | Acute EHR
Segment Reporting Information [Line Items]
Total revenues	26,666	30,013
Recurring revenue | Acute EHR | Operating Segments
Segment Reporting Information [Line Items]
Total revenues			54,160	59,353
Recurring revenue | Post-acute EHR
Segment Reporting Information [Line Items]
Total revenues	0	3,729
Recurring revenue | Post-acute EHR | Operating Segments
Segment Reporting Information [Line Items]
Total revenues			582	7,636
Non-recurring revenue | EHR
Segment Reporting Information [Line Items]
Total revenues	3,956	3,120
Non-recurring revenue | EHR | Operating Segments
Segment Reporting Information [Line Items]
Total revenues			6,089	7,475
Non-recurring revenue | Acute EHR
Segment Reporting Information [Line Items]
Total revenues	3,956	2,775
Non-recurring revenue | Acute EHR | Operating Segments
Segment Reporting Information [Line Items]
Total revenues			6,008	6,750
Non-recurring revenue | Post-acute EHR
Segment Reporting Information [Line Items]
Total revenues	$ 0	$ 345
Non-recurring revenue | Post-acute EHR | Operating Segments
Segment Reporting Information [Line Items]
Total revenues			$ 81	$ 725

v3.24.2.u1

SEGMENT REPORTING - Reconciliation of Adjusted Income (Loss) From Before Interest, Taxes, Depreciation And Amortization (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Segment Reporting [Abstract]
Net income (loss)	$ (5,049)	$ (2,837)	$ (7,565)	$ 247
Deferred revenue and other purchase accounting adjustments	0	0	0	0
Depreciation expense	400	597	800	1,095
Amortization of software development costs	5,980	1,826	8,722	3,312
Amortization of acquisition-related intangibles	3,126	4,014	6,253	8,029
Stock-based compensation	1,501	(123)	2,300	1,124
Severance and other non-recurring charges	4,586	6,819	8,430	7,920
Interest expense	4,151	2,586	8,051	4,988
Gain on sale of AHT	0	0	(1,250)	0
Provision (benefit) for income taxes	(2,121)	(1,655)	(3,713)	(846)
Total adjusted EBITDA	$ 12,574	$ 11,227	$ 22,028	$ 25,869

---