0001564590-22-017417 | 10-Q | XBRL Viewer

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Document And Entity Information - shares	3 Months Ended
Document And Entity Information - shares	Mar. 31, 2022	Apr. 26, 2022
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2022
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2022
Entity Registrant Name	ADDUS HOMECARE CORPORATION
Entity Central Index Key	0001468328
Trading Symbol	ADUS
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Current Reporting Status	Yes
Entity File Number	001-34504
Entity Tax Identification Number	20-5340172
Entity Address, Address Line One	6303 Cowboys Way
Entity Address, Address Line Two	Suite 600
Entity Address, City or Town	Frisco
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	75034
City Area Code	469
Local Phone Number	535-8200
Entity Common Stock, Shares Outstanding		16,071,408
Document Quarterly Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Title of 12(b) Security	Common Stock, $0.001 par value
Security Exchange Name	NASDAQ

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets
Cash	$ 124,763	$ 168,895
Accounts receivable, net of allowances	136,808	136,955
Prepaid expenses and other current assets	14,658	18,491
Total current assets	276,229	324,341
Property and equipment, net of accumulated depreciation and amortization	19,073	18,483
Other assets
Goodwill	574,086	504,392
Intangibles, net of accumulated amortization	76,300	64,321
Operating lease assets, net	41,523	36,048
Total other assets	691,909	604,761
Total assets	987,211	947,585
Current liabilities
Accounts payable	21,004	19,358
Accrued payroll	27,720	44,083
Accrued expenses	38,820	37,077
Government stimulus advances	4,173	4,173
Accrued workers' compensation insurance	12,640	12,998
Total current liabilities	104,357	117,689
Long-term liabilities
Long-term debt, less current portion, net of debt issuance costs	256,127	220,912
Long-term operating lease liabilities	39,049	32,859
Other long-term liabilities	1,900	1,781
Total long-term liabilities	297,076	255,552
Total liabilities	401,433	373,241
Stockholders' equity
Common stock—$.001 par value; 40,000 authorized and 16,068 and 15,940 shares issued and outstanding as of March 31, 2022 and December 31, 2021, respectively	16	16
Additional paid-in capital	383,001	380,037
Retained earnings	202,761	194,291
Total stockholders' equity	585,778	574,344
Total liabilities and stockholders' equity	$ 987,211	$ 947,585

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2022	Dec. 31, 2021
Statement Of Financial Position [Abstract]
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	40,000,000	40,000,000
Common stock, shares issued	16,068,000	15,940,000
Common stock, shares outstanding	16,068,000	15,940,000

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Income Statement [Abstract]
Net service revenues	$ 226,634	$ 205,302
Cost of service revenues	156,448	144,105
Gross profit	70,186	61,197
General and administrative expenses	53,152	45,426
Depreciation and amortization	3,521	3,601
Total operating expenses	56,673	49,027
Operating income	13,513	12,170
Interest income	(58)	(22)
Interest expense	1,820	1,216
Total interest expense, net	1,762	1,194
Income before income taxes	11,751	10,976
Income tax expense	3,281	2,082
Net income	$ 8,470	$ 8,894
Net income per common share
Basic income per share	$ 0.54	$ 0.57
Diluted income per share	$ 0.53	$ 0.55
Weighted average number of common shares and potential common shares outstanding:
Basic	15,811	15,694
Diluted	16,079	16,069

Condensed Consolidated Statements of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]
Balance at Dec. 31, 2020	$ 518,676	$ 16	$ 369,495	$ 149,165
Balance, shares at Dec. 31, 2020		15,826
Issuance of shares of common stock under restricted stock award agreements, shares		75
Stock-based compensation	2,239		2,239
Shares issued for exercise of stock options	101		101
Shares issued for exercise of stock options, shares		2
Net income	8,894			8,894
Balance at Mar. 31, 2021	529,910	$ 16	371,835	158,059
Balance, shares at Mar. 31, 2021		15,903
Balance at Dec. 31, 2021	574,344	$ 16	380,037	194,291
Balance, shares at Dec. 31, 2021		15,940
Issuance of shares of common stock under restricted stock award agreements, shares		115
Stock-based compensation	2,485		2,485
Shares issued for exercise of stock options	479		479
Shares issued for exercise of stock options, shares		13
Net income	8,470			8,470
Balance at Mar. 31, 2022	$ 585,778	$ 16	$ 383,001	$ 202,761
Balance, shares at Mar. 31, 2022		16,068

- Definition

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

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- Definition

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

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+ Details

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash flows from operating activities:
Net income	$ 8,470	$ 8,894
Adjustments to reconcile net income to net cash provided by (used in) operating activities, net of acquisitions:
Depreciation and amortization	3,521	3,601
Deferred income taxes	126	165
Stock-based compensation	2,485	2,239
Amortization of debt issuance costs under the credit facility	215	184
Provision for doubtful accounts	158	252
Impairment of operating lease assets	1,174
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	7,121	(6,397)
Prepaid expenses and other current assets	4,161	(1,007)
Government stimulus advances		(11,719)
Accounts payable	1,386	(290)
Accrued payroll	(17,443)	(15,313)
Accrued expenses and other long-term liabilities	(5,391)	1,025
Net cash provided by (used in) operating activities	5,983	(18,366)
Cash flows from investing activities:
Acquisitions of businesses, net of cash acquired	(84,490)
Purchases of property and equipment	(1,104)	(1,021)
Net cash used in investing activities	(85,594)	(1,021)
Cash flows from financing activities:
Payments on term loan — credit facility		(245)
Borrowings on revolver — credit facility	35,000
Cash received from exercise of stock options	479	101
Net cash provided by (used in) financing activities	35,479	(144)
Net change in cash	(44,132)	(19,531)
Cash, at beginning of period	168,895	145,078
Cash, at end of period	124,763	125,547
Supplemental disclosures of cash flow information:
Cash paid for interest	$ 1,619	$ 1,174

Nature of Operations, Consolidation, and Presentation of Financial Statements

3 Months Ended

Mar. 31, 2022

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Nature of Operations, Consolidation, and Presentation of Financial Statements

1. Nature of Operations, Consolidation, and Presentation of Financial Statements

Addus HomeCare Corporation (“Holdings”) and its subsidiaries (together with Holdings, the “Company”, “we”, “us” or “our”) operate as a multi-state provider of three distinct but related business segments providing in-home services. In its personal care services segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy. The Company’s payors include federal, state and local governmental agencies, managed care organizations, commercial insurers and private individuals.

Basis of Presentation

The accompanying Unaudited Condensed Consolidated Financial Statements and related notes have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”) for Quarterly Reports on Form 10-Q. The accompanying balance sheet as of December 31, 2021 has been derived from the Company’s audited financial statements for the year ended December 31, 2021 previously filed with the SEC. Accordingly, these financial statements do not include all of the information and note disclosures required by accounting principles generally accepted in the United States of America (“GAAP”) for annual financial statements and should be read in conjunction with our consolidated financial statements and notes thereto for the year ended December 31, 2021 included in our Annual Report on Form 10-K, which includes information and disclosures not included herein.

In the opinion of management, these financial statements reflect all adjustments of a normal, recurring nature necessary for the fair statement of our financial position, results of operations, and cash flows for the interim periods presented in conformity with GAAP. Our results for any interim period are not necessarily indicative of results for a full year or any other interim period.

Principles of Consolidation

These Unaudited Condensed Consolidated Financial Statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.

Summary of Significant Accounting Policies

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies

Estimates

The financial statements are prepared by management in conformity with GAAP and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: revenue recognition, goodwill and intangibles in business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from those estimates.

Computation of Weighted Average Shares

The following table sets forth the computation of basic and diluted common shares for the three months ended March 31, 2022 and 2021:

	For the Three Months Ended March 31,
	(Amounts in thousands)
	2022		2021
Weighted average number of shares outstanding for basic per share calculation		15,811		15,694
Effect of dilutive potential shares:
Stock options		235		311
Restricted stock awards		33		64
Adjusted weighted average shares for diluted per share calculation		16,079		16,069
Anti-dilutive shares:
Stock options		92		—
Restricted stock awards		77		75

Recently Adopted Accounting Pronouncements

In November 2021, the FASB issued ASU 2021-10, Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance. ASU 2021-10 requires entities to disclose certain information about the nature of certain governmental assistance received, including the nature of the transaction and the related accounting policy, the financial statement line items impacted by the assistance, as well as the significant terms and conditions of the transactions. The ASU was adopted as of January 1, 2022 and did not have an impact on the Company’s results of operations or liquidity.

Recently Issued Accounting Pronouncements

In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. ASU 2020-04 provides optional expedients and exceptions for applying GAAP to contract modifications and hedging relationships, and other transactions subject to meeting certain criteria, that reference LIBOR or another reference rate expected to be discontinued. The ASU provides companies with optional guidance to ease the potential accounting burden associated with transitioning away from reference rates that are expected to be discontinued. Therefore, it will be in effect for a limited time through December 31, 2022. The ASU can be adopted no later than December 1, 2022 with early adoption permitted. On July 30, 2021, the Company entered into the Second Amendment to the Credit Agreement as discussed further in Note 8. The Credit Agreement contains hardwired fallback language that contemplates a transition from LIBOR, specifically identifies the secured overnight financing rate (“SOFR”) as the replacement reference rate and details the mechanism for transition at LIBOR cessation, which is anticipated to occur on June 30, 2023. The transition to SOFR is not expected to have a material impact on the Company’s results of operations or liquidity.

Leases

3 Months Ended

Mar. 31, 2022

Leases [Abstract]

Leases

3. Leases

Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows:

	March 31, 2022		December 31, 2021
	(Amounts in Thousands)
Operating lease assets, net	$	41,523	$	36,048

Short-term operating lease liabilities (in accrued expenses)		10,766		9,774
Long-term operating lease liabilities		39,049		32,859
Total operating lease liabilities	$	49,815	$	42,633

Lease Costs

Components of lease costs were reported in general and administrative expenses in the Company’s Unaudited Condensed Consolidated Statements of Income as follows:

	For the Three Months Ended March 31, (Amounts in Thousands)
	2022			2021
Operating lease costs	$	2,801		$	2,777
Short-term lease costs		751			181
Total lease costs		3,552			2,958
Less: sublease income		(177	)		(151	)
Total lease costs, net	$	3,375		$	2,807

Lease Term and Discount Rate

Weighted average remaining lease terms and discount rates were as follows:

	March 31, 2022			December 31, 2021
Operating leases:
Weighted average remaining lease term		6.27			6.39
Weighted average discount rate		3.80	%		3.91	%

Maturity of Lease Liabilities

Remaining operating lease payments as of March 31, 2022 were as follows:

	Operating Leases
	(Amounts in Thousands)
Due in the 12-month period ended March 31,
2023	$	12,329
2024		10,706
2025		8,476
2026		5,493
2027		4,574
Thereafter		14,748
Total future minimum rental commitments		56,326
Less: Imputed interest		(6,511	)
Total lease liabilities	$	49,815

Supplemental cash flows information

	For the Three Months Ended March 31,
	(Amounts in Thousands)
	2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	3,194	$	2,517

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	9,199	$	2,675

Acquisitions

3 Months Ended

Mar. 31, 2022

Business Combinations [Abstract]

Acquisitions

4. Acquisitions

The Company’s acquisitions have been accounted for in accordance with ASC Topic 805, Business Combinations, and the resulting goodwill and other intangible assets were accounted for under ASC Topic 350, Goodwill and Other Intangible Assets. Under business combination accounting, the assets and liabilities are generally recognized at their fair values and the difference between the consideration transferred, excluding transaction costs, and the fair values of the assets and liabilities is recognized as goodwill. The results of each business acquisition are included on the Unaudited Condensed Consolidated Statements of Income from the date of the acquisition.

Management’s assessment of qualitative factors affecting goodwill for each acquisition includes estimates of market share at the date of purchase, ability to grow in the market, synergy with existing Company operations and the payor profile in the markets.

JourneyCare

On February 1, 2022, we completed the acquisition of the operations of JourneyCare Inc. (“JourneyCare”). The purchase price was approximately $85.0 million, including the amount of acquired excess cash held by JourneyCare at the closing of the acquisition (approximately $0.5 million). The JourneyCare acquisition was funded with a combination of a $35.0 million draw on the Company’s revolving credit facility and available cash. With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois. The related acquisition and integration costs were $0.3 million and $1.8 million, respectively, for the three months ended March 31, 2022. These costs were included in general and administrative expenses on the Unaudited Condensed Consolidated Statements of Income and were expensed as incurred.

Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows:

	Total (Amounts in Thousands)
Goodwill	$	70,153
Identifiable intangible assets		13,792
Cash		500
Accounts receivable		7,080
Operating lease assets, net		3,728
Other assets		280
Property and equipment		1,194
Accrued expenses		(6,714	)
Accrued payroll		(1,486	)
Long-term operating lease liabilities		(3,537	)
Total purchase price	$	84,990

Identifiable intangible assets acquired included $9.0 million in a trade name and $4.8 million of indefinite lived state licenses. The preliminary estimated fair value of identifiable intangible assets was determined with the assistance of a valuation specialist, using Level 3 inputs as defined under ASC Topic 820. The fair value analysis and related valuations reflect the conclusions of management. All estimates, key assumptions, and forecasts were either provided by or reviewed by the Company. The goodwill and intangible assets acquired are deductible for tax purposes.

The JourneyCare acquisition accounted for $9.5 million of net service revenues and $2.0 million of operating income for the three months ended March 31, 2022.

The following table contains unaudited pro forma condensed consolidated income statement information of the Company for the three months ended March 31, 2022 as if the JourneyCare acquisition closed on January 1, 2021.

	For the Three Months Ended March 31, (Amounts in Thousands)
	2022		2021
Net service revenues	$	231,847	$	219,920
Operating income		12,240		10,936
Net income		7,629		7,894
Net income per common share
Basic income per share	$	0.48	$	0.50
Diluted income per share	$	0.47	$	0.49

The pro forma disclosures in the table above include adjustments for amortization of intangible assets, tax expense and acquisition costs to reflect results that are more representative of the combined results of the transactions as if the operations of JourneyCare had been acquired effective January 1, 2021. This pro forma information is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred. In addition, future results may vary significantly from the results reflected in the pro forma information. The unaudited pro forma financial information does not reflect the impact of future events that may occur after the acquisition, such as anticipated cost savings from operating synergies.

Goodwill and Intangible Assets

3 Months Ended

Mar. 31, 2022

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

5. Goodwill and Intangible Assets

A summary of the goodwill and related adjustments is provided below:

	Hospice			Personal Care		Home Health			Total
	(Amounts in Thousands)
Goodwill as of December 31, 2021	$	328,334		$	152,688	$	23,370		$	504,392
Additions for acquisitions		70,153			—		—			70,153
Adjustments to previously recorded goodwill		(113	)		—		(346	)		(459	)
Goodwill as of March 31, 2022	$	398,374		$	152,688	$	23,024		$	574,086

In connection with the JourneyCare acquisition, the Company recognized goodwill in its hospice segment of $70.2 million, during the three months ended March 31, 2022. See Note 4 for additional information regarding the acquisition.

The Company’s identifiable intangible assets consist of customer and referral relationships, trade names and trademarks, non-competition agreements and state licenses. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from five to twenty-five years. Customer and referral relationships are amortized systematically over the periods of expected economic benefit, which range from five to ten years.

The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of March 31, 2022:

	Customer and referral relationships			Trade names and trademarks			Non- competition agreements			State Licenses			Total
	(Amounts in Thousands)
Intangible assets with indefinite lives	$	—		$	—		$	—		$	25,901		$	25,901
Intangible assets subject to amortization:
Gross carrying amount		44,672			51,941			6,785			12,508			115,906
Accumulated amortization		(36,779	)		(19,126	)		(4,081	)		(5,521	)		(65,507	)
Intangible assets subject to amortization, net		7,893			32,815			2,704			6,987			50,399
Total intangible assets at March 31, 2022	$	7,893		$	32,815		$	2,704		$	32,888		$	76,300

In connection with the JourneyCare acquisition, the Company recognized a trade name of $9.0 million and indefinite lived state licenses of $4.8 million in its hospice segment during the three months ended March 31, 2022. See Note 4 for additional information regarding the acquisition.

Amortization expense related to the intangible assets was $1.8 million and $2.2 million for the three months ended March 31, 2022 and 2021, respectively. The weighted average remaining useful lives of identifiable intangible assets as of March 31, 2022 was 10.2 years.

Details of Certain Balance Sheet Accounts

3 Months Ended

Mar. 31, 2022

Details Of Certain Balance Sheet Accounts [Abstract]

Details of Certain Balance Sheet Accounts

6. Details of Certain Balance Sheet Accounts

Prepaid expenses and other current assets consisted of the following:

	March 31, 2022		December 31, 2021
	(Amounts in Thousands)
Income tax receivable	$	4,333	$	7,556
Prepaid workers' compensation and liability insurance		2,070		3,206
Workers' compensation insurance receivable		1,073		1,559
Other		7,182		6,170
Total prepaid expenses and other current assets	$	14,658	$	18,491

Accrued expenses consisted of the following:

	March 31, 2022		December 31, 2021
	(Amounts in Thousands)
Current portion of operating lease liabilities	$	10,766	$	9,774
Accrued health insurance		6,637		5,200
Payor advances⁽¹⁾		5,866		6,485
Accrued professional fees		3,357		2,978
Other		12,194		12,640
Total accrued expenses	$	38,820	$	37,077

(1)

Represents the deferred portion of payments received from payors for COVID-19 reimbursements which will be recognized as we incur specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel) or will be returned to the extent such related expenses are not incurred.

COVID-19 Pandemic

3 Months Ended

Mar. 31, 2022

Risks And Uncertainties [Abstract]

COVID-19 Pandemic

7. COVID-19 Pandemic

In recognition of the significant threat to the liquidity of financial markets posed by the COVID-19 pandemic, the Federal Reserve and Congress took dramatic actions to provide liquidity to businesses and the banking system in the United States, as described below.

Provider Relief Fund

One of the primary sources of relief for healthcare providers is the Provider Relief Fund, which has been funded through the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) and related legislation. Provider Relief Fund payments are intended to compensate healthcare providers for lost revenues and health care related expenses incurred in response to the COVID-19 pandemic and are not required to be repaid, provided that recipients attest to and comply with certain terms and conditions, including limitations on balance billing and not using funds received from the Provider Relief Fund to reimburse expenses or losses that other sources are obligated to reimburse. Commercial organizations that receive and expend annual total awards of $750,000 or more in federal funding, including payments received through the Provider Relief Fund, are subject to federal audit requirements.

In November 2020, the Company received grants in an aggregate principal amount of $13.7 million from the Provider Relief Fund, and fully utilized these funds as of December 31, 2021, including $0.9 million during the three months ended March 31, 2021, for healthcare related expenses, including retention payments, attributable to COVID-19 that were unreimbursed by other sources. We were required to properly and fully document the use of such funds in reports to the U.S. Department of Health & Human Services (“HHS”), which we were required to submit no later than March 31, 2022. We have submitted the required reports.

Payroll tax deferral

The CARES Act also provided for certain federal income and other tax changes, including allowing for the deferral of the employer portion of Social Security payroll taxes through December 31, 2020. The Company received a cash benefit of approximately $7.1 million related to the deferral of employer payroll taxes for 2020 under the CARES Act, for the period April 2, 2020 through June 30, 2020. As of March 31, 2022 and December 31, 2021, the deferred portion of employer Social Security payroll taxes was $4.1 million, which is included within Government stimulus advances on the Company’s Unaudited Condensed Consolidated Balance Sheets. The payroll tax deferral requires that the remaining deferred payroll taxes be paid by December 31, 2022.

ARPA Spending Plans

The American Rescue Plan Act of 2021 (“ARPA”), which became law on March 11, 2021, provides for $350 billion in relief funding for eligible state, local, territorial, and Tribal governments to mitigate the fiscal effects of the COVID-19 public health emergency. Additionally, the law provides for a 10-percentage point increase in federal matching funds for Medicaid home and community based services (“HCBS”) from April 1, 2021, through March 31, 2022, provided the state satisfied certain conditions. States are permitted to use the state funds equivalent to the additional federal funds through March 31, 2024. States must use the monies attributable to this matching fund increase to supplement, not supplant, their level of state spending for the implementation of activities enhanced under the Medicaid HCBS in effect as of April 1, 2021.

Medicare sequester

The CARES Act and related laws temporarily lifted the Medicare sequester which would have otherwise reduced payments to Medicare providers by 2%, as required by the Budget Control Act of 2011, from May 1, 2020, through December 31, 2021 (but also extended sequestration through 2030). Congress further delayed these sequestration cuts through March 31, 2022, and reduced the sequestration adjustment to 1% from April 1 through June 30, 2022. The full 2% reduction is currently scheduled to resume July 1, 2022. These sequestration cuts have been extended through 2030, with the reductions for 2030 set to increase to 2.25% for the first six months and to 3% for the second six months.

In the hospice segment, Medicare sequester relief resulted in an increase in net service revenues of $0.9 million and $0.7 million for the three months ended March 31, 2022 and 2021, respectively. In the home health segment, Medicare sequester relief resulted in an increase in net service revenues of $0.2 million and $0.1 million for the three months ended March 31, 2022 and 2021, respectively.

The ARPA increases the federal budget deficit in a manner that triggers an additional statutorily mandated sequestration under the Pay-As-You-Go Act of 2010 (“PAYGO Act”). As a result, an additional Medicare payment reduction of up to 4% was required to take effect in January 2022. However, Congress delayed implementation of this payment reduction until 2023. We cannot currently determine if, or to what extent, our business, results of operations, financial condition or liquidity will ultimately be impacted by mandated sequestration triggers under the PAYGO Act, or if or when the mandated sequestration will occur.

For the three months ended March 31, 2022 and 2021, COVID-19-related expenses in our personal care segment were approximately $1.7 million and $0.9 million, respectively, and are included in cost of service revenues on the Consolidated Statements of Income. Additionally, the Company recognized revenue of $1.4 million and $1.8 million attributable to temporary rate increases from certain payors in our personal care segment for the three months ended March 31, 2022 and 2021, respectively.

Although the United States has recently experienced a moderation of infection and related hospitalization rates, there continues to be a significant number of COVID-19 cases and deaths in the United States and throughout the world. Given the longer-term uncertainties associated with the COVID-19 pandemic, it is impossible to predict the effect and ultimate impact of the COVID-19 pandemic on the Company as conditions related to the COVID-19 pandemic continue to evolve.

Long-Term Debt

3 Months Ended

Mar. 31, 2022

Long Term Debt [Abstract]

Long-Term Debt

8. Long-Term Debt

Long-term debt consisted of the following:

	March 31, 2022			December 31, 2021
	(Amounts in Thousands)
Revolving loan under the credit facility	$	259,853		$	224,853
Less unamortized issuance costs		(3,726	)		(3,941	)
Long-term debt	$	256,127		$	220,912

Amended and Restated Senior Secured Credit Facility

On October 31, 2018, the Company entered into the Amended and Restated Credit Agreement, dated as of October 31, 2018, with certain lenders and Capital One, National Association, as a lender and as agent for all lenders, as amended by the First Amendment to Amended and Restated Credit Agreement, dated as of September 12, 2019, and as further amended by the Second Amendment to Amended and Restated Credit Agreement, dated as of July 30, 2021 (as amended, the “Credit Agreement”; as used throughout this Quarterly Report on Form 10-Q, “credit facility” shall mean the credit facility evidenced by the Credit Agreement). The credit facility consists of a $600.0 million revolving credit facility and a $125.0 million incremental loan facility, which incremental loan facility may be for term loans or an increase to the revolving loan commitments. The maturity of this credit facility is July 30, 2026. Interest on the credit facility may be payable at (x) the sum of (i) an applicable margin ranging from 0.75% to 1.50% based on the applicable senior net leverage ratio plus (ii) a base rate equal to the greatest of (a) the rate of interest last quoted by The Wall Street Journal as the “prime rate,” (b) the sum of the federal funds rate plus a margin of 0.50% and (c) the sum of the adjusted LIBOR that would be applicable to a loan with an interest period of one month advanced on the applicable day (not to be less than 0.00%) plus a margin of 1.00% or (y) the sum of (i) an applicable margin ranging from 1.75% to 2.50% based on the applicable senior net leverage ratio plus (ii) the offered rate per annum for similar dollar deposits for the applicable interest period that appears on Reuters Screen LIBOR01 Page (not to be less than zero). Swing loans may not be LIBOR loans. The availability of additional draws under this credit facility is conditioned, among other things, upon (after giving effect to such draws) the Total Net Leverage Ratio (as defined in the Credit Agreement) not exceeding 3.75:1.00. In certain circumstances, in connection with a Material Acquisition (as defined in the Credit Agreement), the Company can elect to increase its Total Net Leverage Ratio compliance covenant to 4.25:1.00 for the then current fiscal quarter and the three succeeding fiscal quarters.

Addus HealthCare, Inc. (“Addus HealthCare”) is the borrower, and its parent, Holdings, and substantially all of Holdings’ subsidiaries are guarantors under this credit facility, and it is collateralized by a first priority security interest in all of the Company’s and the other credit parties’ current and future tangible and intangible assets, including the shares of stock of the borrower and subsidiaries. The Credit Agreement

contains affirmative and negative covenants customary for credit facilities of this type, including limitations on the Company with respect to liens, indebtedness, guaranties, investments, distributions, mergers and acquisitions and dispositions of assets.

The Credit Agreement contains customary affirmative covenants regarding, among other things, the maintenance of records, compliance with laws, maintenance of permits, maintenance of insurance and property and payment of taxes. The Credit Agreement also contains certain customary financial covenants and negative covenants that, among other things, include a requirement to maintain a minimum Interest Coverage Ratio (as defined in the Credit Agreement), a requirement to stay below a maximum Total Net Leverage Ratio (as defined in the Credit Agreement) and a requirement to stay below a maximum permitted amount of capital expenditures. The Credit Agreement also contains restrictions on guarantees, indebtedness, liens, investments and loans, subject to customary carve outs, a restriction on dividends (provided that Addus HealthCare may make distributions to the Company in an amount that does not exceed $7.5 million in any year absent of an event of default, plus limited exceptions for tax and administrative distributions), a restriction on the ability to consummate acquisitions (without the consent of the lenders) under its credit facility subject to compliance with the Total Net Leverage Ratio (as defined in the Credit Agreement thresholds), restrictions on mergers, dispositions of assets, and affiliate transactions, and restrictions on fundamental changes and lines of business.

The Company pays a fee ranging from 0.20% to 0.35% based on the applicable senior net leverage ratio times the unused portion of the revolving loan portion of the credit facility. The credit facility contains hardwired fallback language that contemplates a transition from LIBOR, and specifically identifies SOFR as the replacement reference rate and details the mechanism for transition at LIBOR cessation, which is anticipated to occur on June 30, 2023. The transition to SOFR is not expected to have a material impact on the Company’s results of operations or liquidity.

During the three months ended March 31, 2022, the Company drew $35.0 million under its credit facility to fund, in part, the JourneyCare acquisition. During the three months ended March 31, 2021, the Company had no draws under its credit facility.

At March 31, 2022, the Company had a total of $259.9 million of revolving loans, with an interest rate of 2.46%, outstanding on its credit facility. After giving effect to the amount drawn on its credit facility, approximately $8.1 million of outstanding letters of credit and borrowing limits based on an advance multiple of adjusted EBITDA (as defined in the Credit Agreement), the Company had $377.6 million of capacity and $109.6 million available for borrowing under its credit facility. As of December 31, 2021, the Company had a total of $224.9 million of revolving loans, with an interest rate of 2.10%, outstanding on its credit facility.

As of March 31, 2022, the Company was in compliance with all financial covenants under the Credit Agreement.

Income Taxes

3 Months Ended

Mar. 31, 2022

Income Tax Disclosure [Abstract]

Income Taxes

9. Income Taxes

The effective income tax rates were 27.9% and 19.0% for the three months ended March 31, 2022 and 2021, respectively.

The difference between our federal statutory and effective income tax rates is principally due to the inclusion of state taxes, non-deductible compensation and an excess tax expense, partially offset by the use of federal employment tax credits. For the three months ended March 31, 2022 and 2021, the effective tax rates were inclusive of an excess tax expense of 2.7% and an excess tax benefit of 7.4%, respectively. The excess tax expense or benefit is a discrete item, related to the vesting of equity shares, which requires the Company to recognize the expense fully in the period. An excess tax expense or benefit results if the Company’s cumulative costs of the award recognized exceed the income tax deduction on the Unaudited Condensed Consolidated Statements of Income, whereas an excess tax benefit results if the Company’s cumulative costs of the award recognized are less than the income tax deduction on the Unaudited Condensed Consolidated Statements of Income.

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 21
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 17
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32809-109319

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-URI http://asc.fasb.org/extlink&oid=122134291&loc=d3e330036-122817

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 14
-URI http://asc.fasb.org/extlink&oid=121826272&loc=d3e32705-109319

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 270
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6424409&loc=d3e44925-109338

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-URI http://asc.fasb.org/topic&trid=2144680

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 30
-Section 50
-Paragraph 2
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=6424122&loc=d3e41874-109331

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

Commitments and Contingencies

3 Months Ended

Mar. 31, 2022

Commitments And Contingencies Disclosure [Abstract]

Commitments and Contingencies

10. Commitments and Contingencies

Legal Proceedings

From time to time, the Company is subject to legal and/or administrative proceedings incidental to its business.

On June 2, 2021, the Company received a $6.5 million Request for Repayment from Palmetto, GBA, LLC (“Palmetto”), a Medicare administrative contractor, regarding Ambercare Hospice Inc. (“Ambercare”), our subsidiary that provides hospice services in New Mexico. In 2018, the Office of Audit Services (“OAS”), under the HHS Office of Inspector General, initiated a clinical review of certain hospice claims billed during a timeframe from January 1, 2016 to December 31, 2017. The OAS review concluded that certain payments to Ambercare for hospice services during the review period were made in error. The Company acquired Ambercare in May 2018 and has a contractual right to full indemnification from any potential losses from the OAS review through the terms of the Ambercare purchase agreement. The Company disputes the results of the OAS review and related asserted billing errors and is in the process of filing administrative appeals. At this stage, the Company cannot predict the ultimate outcome of the appeal process.

It is the opinion of management that the outcome of pending legal and/or administrative proceedings will not have a material effect on the Company’s Unaudited Condensed Consolidated Balance Sheets and Unaudited Condensed Consolidated Statements of Income.

Segment Information

3 Months Ended

Mar. 31, 2022

Segment Reporting [Abstract]

Segment Information

11. Segment Information

Operating segments are defined as components of a company that engage in business activities from which it may earn revenues and incur expenses, and for which separate financial information is available and is regularly reviewed by the Company’s chief operating decision makers, to assess the performance of the individual segments and make decisions about resources to be allocated to the segments. The Company operates as a multi-state provider of three distinct but related business segments providing in-home services.

In its personal care segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy.

The tables below set forth information about the Company’s reportable segments for the three months ended March 31, 2022 and 2021 along with the items necessary to reconcile the segment information to the totals reported in the accompanying Unaudited Condensed Consolidated Financial Statements. Segment assets are not reviewed by the Company’s chief operating decision maker function and therefore are not disclosed below.

Segment operating income consists of revenue generated by a segment, less the direct costs of service revenues and general and administrative expenses that are incurred directly by the segment. Unallocated general and administrative costs are those costs for functions performed in a centralized manner and therefore not attributable to a particular segment. These costs include accounting, finance, human resources, legal, information technology, corporate office support and facility costs and overall corporate management.

	For the Three Months Ended March 31, 2022
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	169,632	$	47,727	$	9,275	$	226,634
Cost of services revenues		126,291		23,441		6,716		156,448
Gross profit		43,341		24,286		2,559		70,186
General and administrative expenses		15,004		11,712		2,359		29,075
Segment operating income	$	28,337	$	12,574	$	200	$	41,111

	For the Three Months Ended March 31, 2021
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	164,868	$	36,094	$	4,340	$	205,302
Cost of services revenues		122,839		18,596		2,670		144,105
Gross profit		42,029		17,498		1,670		61,197
General and administrative expenses		15,283		8,463		965		24,711
Segment operating income	$	26,746	$	9,035	$	705	$	36,486

	For the Three Months Ended March 31,
	2022			2021
	(Amounts in Thousands)
Segment reconciliation:
Total segment operating income	$	41,111		$	36,486

Items not allocated at segment level:
Other general and administrative expenses		24,077			20,715
Depreciation and amortization		3,521			3,601
Interest income		(58	)		(22	)
Interest expense		1,820			1,216
Income before income taxes	$	11,751		$	10,976

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8924-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Name Accounting Standards Codification
-Topic 280
-URI http://asc.fasb.org/topic&trid=2134510

+ Details

Significant Payors

3 Months Ended

Mar. 31, 2022

Significant Payors [Abstract]

Significant Payors

12. Significant Payors

For the three months ended March 31, 2022 and 2021, the Company’s revenue by payor type was as follows:


Personal Care Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
State, local and other governmental programs	$	83,908		49.5	%	$	80,849		49.0	%
Managed care organizations		77,390		45.6			75,456		45.8
Private pay		4,626		2.7			4,903		3.0
Commercial insurance		2,024		1.2			2,346		1.4
Other		1,684		1.0			1,314		0.8
Total personal care segment net service revenues	$	169,632		100.0	%	$	164,868		100.0	%


Hospice Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	43,485		91.1	%	$	33,985		94.2	%
Commercial insurance		2,244		4.7			533		1.5
Managed care organizations		1,715		3.6			1,487		4.1
Other		283		0.6			89		0.2
Total hospice segment net service revenues	$	47,727		100.0	%	$	36,094		100.0	%


Home Health Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	6,812		73.4	%	$	3,502		80.7	%
Managed care organizations		1,904		20.5			798		18.4
Other		559		6.1			40		0.9
Total home health segment net service revenues	$	9,275		100.0	%	$	4,340		100.0	%

The Company derives a significant amount of its revenue from its operations in Illinois, New Mexico and New York. The percentages of segment revenue for each of these significant states for the three months ended March 31, 2022 and 2021 were as follows:


Personal Care Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Illinois	$	84,693		49.9	%	$	73,385		44.5	%
New Mexico		25,440		15.0			23,593		14.3
New York ⁽¹⁾		21,385		12.6			27,575		16.7
All other states		38,114		22.5			40,315		24.5
Total personal care segment net service revenues	$	169,632		100.0	%	$	164,868		100.0	%

(1)

In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure CDPAP fiscal intermediaries. The Company was not selected in the initial RFO process. We submitted a formal protest in response to the selection process, which was filed and accepted in March 2021, but we have not yet received a response to the formal protest. The Company continues to consider other arrangements and to pursue our protest of the award. The New York fiscal year 2023 state budget, passed in April 2022, amends the current Fiscal Intermediary RFO process to authorize all fiscal intermediaries that submitted an RFO application and served at least 200 clients in New York City or 50 clients in other counties between January 1, 2020 and March 31, 2020 to contract with the New York State Department of Health and continue to operate in all counties contained in their application. Under this provision, the Company would be allowed to continue to contract with all of its current payors for CDPAP services. The Company is currently assessing the future of its participation in this program. Given the status of the program, the Company has suspended materially all of its new patient admissions under the New York CDPAP program.


Hospice Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Ohio	$	16,328		34.2	%	$	14,114		39.1	%
Illinois ⁽²⁾		9,541		20.0			—		—
New Mexico		8,233		17.3			9,230		25.6
All other states		13,625		28.5			12,750		35.3
Total hospice segment net service revenues	$	47,727		100.0	%	$	36,094		100.0	%

(2)

With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois.


Home Health Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
New Mexico	$	7,509		81.0	%	$	4,340		100.0	%
Illinois ⁽³⁾		1,766		19.0			—		—
Total home health segment net service revenues	$	9,275		100.0	%	$	4,340		100.0	%

(3)

With the acquisition of Summit Home Health, LLC (“Summit”) on October 1, 2021, the Company expanded its home health services in the state of Illinois.

A substantial portion of the Company’s revenue and accounts receivable are derived from services performed for federal, state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 42.4%, and 35.8% of our net service revenues for the three months ended March 31, 2022, and 2021, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.7% and 20.4% of the Company’s net service revenues for the three months ended March 31, 2022 and 2021, respectively.

The related receivables due from the Illinois Department on Aging represented 16.1% of the Company’s net accounts receivable at both March 31, 2022 and December 31, 2021.

Summary of Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Basis of Presentation

Principles of Consolidation

Estimates

Computation of Weighted Average Shares

The following table sets forth the computation of basic and diluted common shares for the three months ended March 31, 2022 and 2021:

	For the Three Months Ended March 31,
	(Amounts in thousands)
	2022		2021
Weighted average number of shares outstanding for basic per share calculation		15,811		15,694
Effect of dilutive potential shares:
Stock options		235		311
Restricted stock awards		33		64
Adjusted weighted average shares for diluted per share calculation		16,079		16,069
Anti-dilutive shares:
Stock options		92		—
Restricted stock awards		77		75

Recently Issued and Adopted Accounting Pronouncements

Recently Adopted Accounting Pronouncements

Recently Issued Accounting Pronouncements

Summary of Significant Accounting Policies (Tables)

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Computation of Basic and Diluted Common Shares

The following table sets forth the computation of basic and diluted common shares for the three months ended March 31, 2022 and 2021:

	For the Three Months Ended March 31,
	(Amounts in thousands)
	2022		2021
Weighted average number of shares outstanding for basic per share calculation		15,811		15,694
Effect of dilutive potential shares:
Stock options		235		311
Restricted stock awards		33		64
Adjusted weighted average shares for diluted per share calculation		16,079		16,069
Anti-dilutive shares:
Stock options		92		—
Restricted stock awards		77		75

Leases (Tables)

3 Months Ended

Mar. 31, 2022

Leases [Abstract]

Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases

Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows:

	March 31, 2022		December 31, 2021
	(Amounts in Thousands)
Operating lease assets, net	$	41,523	$	36,048

Short-term operating lease liabilities (in accrued expenses)		10,766		9,774
Long-term operating lease liabilities		39,049		32,859
Total operating lease liabilities	$	49,815	$	42,633

Components of Lease Cost Reported in General and Administrative Expenses in Unaudited Condensed Consolidated Statements of Income

Components of lease costs were reported in general and administrative expenses in the Company’s Unaudited Condensed Consolidated Statements of Income as follows:

	For the Three Months Ended March 31, (Amounts in Thousands)
	2022			2021
Operating lease costs	$	2,801		$	2,777
Short-term lease costs		751			181
Total lease costs		3,552			2,958
Less: sublease income		(177	)		(151	)
Total lease costs, net	$	3,375		$	2,807

Schedule of Weighted Average Remaining Lease Terms and Discount Rates

Weighted average remaining lease terms and discount rates were as follows:

	March 31, 2022			December 31, 2021
Operating leases:
Weighted average remaining lease term		6.27			6.39
Weighted average discount rate		3.80	%		3.91	%

Summary of Remaining Operating Lease Payments

Remaining operating lease payments as of March 31, 2022 were as follows:

	Operating Leases
	(Amounts in Thousands)
Due in the 12-month period ended March 31,
2023	$	12,329
2024		10,706
2025		8,476
2026		5,493
2027		4,574
Thereafter		14,748
Total future minimum rental commitments		56,326
Less: Imputed interest		(6,511	)
Total lease liabilities	$	49,815

Supplemental Cash Flows Information

	For the Three Months Ended March 31,
	(Amounts in Thousands)
	2022		2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	3,194	$	2,517

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	9,199	$	2,675

Acquisitions (Tables) - JourneyCare [Member]

3 Months Ended

Mar. 31, 2022

Business Acquisition [Line Items]

Schedule of Fair Values of Assets and Liabilities

Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows:

	Total (Amounts in Thousands)
Goodwill	$	70,153
Identifiable intangible assets		13,792
Cash		500
Accounts receivable		7,080
Operating lease assets, net		3,728
Other assets		280
Property and equipment		1,194
Accrued expenses		(6,714	)
Accrued payroll		(1,486	)
Long-term operating lease liabilities		(3,537	)
Total purchase price	$	84,990

Unaudited Pro Forma Condensed Consolidated Income Statement Information

	For the Three Months Ended March 31, (Amounts in Thousands)
	2022		2021
Net service revenues	$	231,847	$	219,920
Operating income		12,240		10,936
Net income		7,629		7,894
Net income per common share
Basic income per share	$	0.48	$	0.50
Diluted income per share	$	0.47	$	0.49

Goodwill and Intangible Assets (Tables)

3 Months Ended

Mar. 31, 2022

Goodwill And Intangible Assets Disclosure [Abstract]

Summary of Goodwill and Related Adjustments

A summary of the goodwill and related adjustments is provided below:

	Hospice			Personal Care		Home Health			Total
	(Amounts in Thousands)
Goodwill as of December 31, 2021	$	328,334		$	152,688	$	23,370		$	504,392
Additions for acquisitions		70,153			—		—			70,153
Adjustments to previously recorded goodwill		(113	)		—		(346	)		(459	)
Goodwill as of March 31, 2022	$	398,374		$	152,688	$	23,024		$	574,086

Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset

The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of March 31, 2022:

	Customer and referral relationships			Trade names and trademarks			Non- competition agreements			State Licenses			Total
	(Amounts in Thousands)
Intangible assets with indefinite lives	$	—		$	—		$	—		$	25,901		$	25,901
Intangible assets subject to amortization:
Gross carrying amount		44,672			51,941			6,785			12,508			115,906
Accumulated amortization		(36,779	)		(19,126	)		(4,081	)		(5,521	)		(65,507	)
Intangible assets subject to amortization, net		7,893			32,815			2,704			6,987			50,399
Total intangible assets at March 31, 2022	$	7,893		$	32,815		$	2,704		$	32,888		$	76,300

Details of Certain Balance Sheet Accounts (Tables)

3 Months Ended

Mar. 31, 2022

Details Of Certain Balance Sheet Accounts [Abstract]

Schedule of Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consisted of the following:

	March 31, 2022		December 31, 2021
	(Amounts in Thousands)
Income tax receivable	$	4,333	$	7,556
Prepaid workers' compensation and liability insurance		2,070		3,206
Workers' compensation insurance receivable		1,073		1,559
Other		7,182		6,170
Total prepaid expenses and other current assets	$	14,658	$	18,491

Schedule of Accrued Expenses

Accrued expenses consisted of the following:

	March 31, 2022		December 31, 2021
	(Amounts in Thousands)
Current portion of operating lease liabilities	$	10,766	$	9,774
Accrued health insurance		6,637		5,200
Payor advances⁽¹⁾		5,866		6,485
Accrued professional fees		3,357		2,978
Other		12,194		12,640
Total accrued expenses	$	38,820	$	37,077

(1)

Long-Term Debt (Tables)

3 Months Ended

Mar. 31, 2022

Long Term Debt [Abstract]

Schedule of Long-Term Debt

Long-term debt consisted of the following:

	March 31, 2022			December 31, 2021
	(Amounts in Thousands)
Revolving loan under the credit facility	$	259,853		$	224,853
Less unamortized issuance costs		(3,726	)		(3,941	)
Long-term debt	$	256,127		$	220,912

- Definition

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

+ References

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+ Details

Segment Information (Tables)

3 Months Ended

Mar. 31, 2022

Segment Reporting [Abstract]

Summary of Segment Information

	For the Three Months Ended March 31, 2022
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	169,632	$	47,727	$	9,275	$	226,634
Cost of services revenues		126,291		23,441		6,716		156,448
Gross profit		43,341		24,286		2,559		70,186
General and administrative expenses		15,004		11,712		2,359		29,075
Segment operating income	$	28,337	$	12,574	$	200	$	41,111

	For the Three Months Ended March 31, 2021
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	164,868	$	36,094	$	4,340	$	205,302
Cost of services revenues		122,839		18,596		2,670		144,105
Gross profit		42,029		17,498		1,670		61,197
General and administrative expenses		15,283		8,463		965		24,711
Segment operating income	$	26,746	$	9,035	$	705	$	36,486

	For the Three Months Ended March 31,
	2022			2021
	(Amounts in Thousands)
Segment reconciliation:
Total segment operating income	$	41,111		$	36,486

Items not allocated at segment level:
Other general and administrative expenses		24,077			20,715
Depreciation and amortization		3,521			3,601
Interest income		(58	)		(22	)
Interest expense		1,820			1,216
Income before income taxes	$	11,751		$	10,976

Significant Payors (Tables)

3 Months Ended

Mar. 31, 2022

Significant Payors [Abstract]

Schedule of Revenue by Payor Type

For the three months ended March 31, 2022 and 2021, the Company’s revenue by payor type was as follows:


Personal Care Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
State, local and other governmental programs	$	83,908		49.5	%	$	80,849		49.0	%
Managed care organizations		77,390		45.6			75,456		45.8
Private pay		4,626		2.7			4,903		3.0
Commercial insurance		2,024		1.2			2,346		1.4
Other		1,684		1.0			1,314		0.8
Total personal care segment net service revenues	$	169,632		100.0	%	$	164,868		100.0	%


Hospice Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	43,485		91.1	%	$	33,985		94.2	%
Commercial insurance		2,244		4.7			533		1.5
Managed care organizations		1,715		3.6			1,487		4.1
Other		283		0.6			89		0.2
Total hospice segment net service revenues	$	47,727		100.0	%	$	36,094		100.0	%


Home Health Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	6,812		73.4	%	$	3,502		80.7	%
Managed care organizations		1,904		20.5			798		18.4
Other		559		6.1			40		0.9
Total home health segment net service revenues	$	9,275		100.0	%	$	4,340		100.0	%

Schedule of Revenue by Geographic Location

The percentages of segment revenue for each of these significant states for the three months ended March 31, 2022 and 2021 were as follows:


Personal Care Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Illinois	$	84,693		49.9	%	$	73,385		44.5	%
New Mexico		25,440		15.0			23,593		14.3
New York ⁽¹⁾		21,385		12.6			27,575		16.7
All other states		38,114		22.5			40,315		24.5
Total personal care segment net service revenues	$	169,632		100.0	%	$	164,868		100.0	%

(1)


Hospice Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Ohio	$	16,328		34.2	%	$	14,114		39.1	%
Illinois ⁽²⁾		9,541		20.0			—		—
New Mexico		8,233		17.3			9,230		25.6
All other states		13,625		28.5			12,750		35.3
Total hospice segment net service revenues	$	47,727		100.0	%	$	36,094		100.0	%

(2)

With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois.


Home Health Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
New Mexico	$	7,509		81.0	%	$	4,340		100.0	%
Illinois ⁽³⁾		1,766		19.0			—		—
Total home health segment net service revenues	$	9,275		100.0	%	$	4,340		100.0	%

(3)

With the acquisition of Summit Home Health, LLC (“Summit”) on October 1, 2021, the Company expanded its home health services in the state of Illinois.

Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details)	3 Months Ended
	Mar. 31, 2022 segment
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Number of operating segments	3

Summary of Significant Accounting Policies (Computation of Basic and Diluted Common Shares) (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Summary Of Significant Accounting Policies [Line Items]
Weighted average number of shares outstanding for basic per share calculation	15,811	15,694
Effect of dilutive potential shares:
Adjusted weighted average shares for diluted per share calculation	16,079	16,069
Stock Options [Member]
Effect of dilutive potential shares:
Effect of dilutive potential shares	235	311
Anti-dilutive shares:
Anti-dilutive shares	92
Restricted Stock Awards [Member]
Effect of dilutive potential shares:
Effect of dilutive potential shares	33	64
Anti-dilutive shares:
Anti-dilutive shares	77	75

Summary of Significant Accounting Policies (Narrative) (Details) - ASU 2021-10 [Member]	Mar. 31, 2022
Summary Of Significant Accounting Policies [Line Items]
Change in accounting principle, accounting standards update, adopted	true
Change in accounting principle, accounting standards update, immaterial effect	true
Change in accounting principle, accounting standards update, adoption date	Jan. 01, 2022

- Definition

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-SubTopic 10
-Name Accounting Standards Codification
-Section 65
-Paragraph 2
-Publisher FASB
-Subparagraph (a)

Reference 34: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 45
-Paragraph 24
-URI http://asc.fasb.org/extlink&oid=124436220&loc=d3e21930-107793

Reference 35: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 45
-Paragraph 23
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=124436220&loc=d3e21914-107793

+ Details

Leases (Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Operating lease assets, net	$ 41,523	$ 36,048
Short-term operating lease liabilities (in accrued expenses)	$ 10,766	$ 9,774
Operating lease, liability, current, statement of financial position [Extensible List]	Accrued expenses	Accrued expenses
Long-term operating lease liabilities	$ 39,049	$ 32,859
Total operating lease liabilities	$ 49,815	$ 42,633

Leases (Components of Lease Cost Reported in General and Administrative Expenses in Unaudited Condensed Consolidated Statements of Income) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Leases [Abstract]
Operating lease costs	$ 2,801	$ 2,777
Short-term lease costs	751	181
Total lease costs	3,552	2,958
Less: sublease income	(177)	(151)
Total lease costs, net	$ 3,375	$ 2,807

Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details)	Mar. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Weighted average remaining lease term	6 years 3 months 7 days	6 years 4 months 20 days
Weighted average discount rate	3.80%	3.91%

Leases (Summary of Remaining Operating Lease Payments) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Leases [Abstract]
2023	$ 12,329
2024	10,706
2025	8,476
2026	5,493
2027	4,574
Thereafter	14,748
Total future minimum rental commitments	56,326
Less: Imputed interest	(6,511)
Total lease liabilities	$ 49,815	$ 42,633

Leases (Supplemental Cash Flows Information) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 3,194	$ 2,517
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 9,199	$ 2,675

Acquisitions (Narrative) (Details) - USD ($) $ in Thousands		3 Months Ended
Acquisitions (Narrative) (Details) - USD ($) $ in Thousands	Feb. 01, 2022	Mar. 31, 2022	Mar. 31, 2021
Business Acquisition [Line Items]
Total purchase price for business acquisition		$ 84,490
Net service revenues		226,634	$ 205,302
JourneyCare [Member]
Business Acquisition [Line Items]
Net service revenues		9,500
Operating income (loss) from continuing operations		2,000
JourneyCare [Member] \| Trade Names [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired	$ 9,000
JourneyCare [Member] \| State Licenses [Member]
Business Acquisition [Line Items]
Indefinite lived intangible assets acquired	4,800
JourneyCare [Member] \| Illinois [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition	85,000
Acquisition related costs		300
Integration costs		$ 1,800
Excess cash held by acquired business	500
Revolving Credit Loan [Member] \| JourneyCare [Member] \| Illinois [Member]
Business Acquisition [Line Items]
Line of credit outstanding amount	$ 35,000

Acquisitions (Schedule of Fair Values of Assets and Liabilities) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Feb. 01, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Goodwill	$ 574,086		$ 504,392
JourneyCare [Member]
Business Acquisition [Line Items]
Goodwill		$ 70,153
Identifiable intangible assets		13,792
Cash		500
Accounts receivable		7,080
Operating lease assets, net		3,728
Other assets		280
Property and equipment		1,194
Accrued expenses		(6,714)
Accrued payroll		(1,486)
Long-term operating lease liabilities		(3,537)
Total purchase price		$ 84,990

Acquisitions (Unaudited Pro Forma Condensed Consolidated Income Statement Information) (Details) - JourneyCare [Member] - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Business Acquisition [Line Items]
Net service revenues	$ 231,847	$ 219,920
Operating income	12,240	10,936
Net income	$ 7,629	$ 7,894
Basic income per share	$ 0.48	$ 0.50
Diluted income per share	$ 0.47	$ 0.49

Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2022 USD ($)
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 504,392
Additions for acquisitions	70,153
Adjustments to previously recorded goodwill	(459)
Goodwill, at End of Period	574,086
Hospice [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	328,334
Additions for acquisitions	70,153
Adjustments to previously recorded goodwill	(113)
Goodwill, at End of Period	398,374
Personal Care [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	152,688
Goodwill, at End of Period	152,688
Home Health [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	23,370
Adjustments to previously recorded goodwill	(346)
Goodwill, at End of Period	$ 23,024

Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Thousands		3 Months Ended
	Feb. 01, 2022	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Goodwill [Line Items]
Goodwill		$ 574,086		$ 504,392
Amortization expense		$ 1,800	$ 2,200
Weighted average remaining useful lives of identifiable intangible assets		10 years 2 months 12 days
Hospice [Member]
Goodwill [Line Items]
Goodwill		$ 398,374		$ 328,334
JourneyCare [Member]
Goodwill [Line Items]
Goodwill	$ 70,153
JourneyCare [Member] \| Hospice [Member]
Goodwill [Line Items]
Goodwill		70,200
JourneyCare [Member] \| Trade Names [Member]
Goodwill [Line Items]
Identifiable intangible assets acquired	9,000
JourneyCare [Member] \| Trade Names [Member] \| Hospice [Member]
Goodwill [Line Items]
Identifiable intangible assets acquired		9,000	9,000
JourneyCare [Member] \| State Licenses [Member]
Goodwill [Line Items]
Indefinite lived intangible assets acquired	$ 4,800
JourneyCare [Member] \| State Licenses [Member] \| Hospice [Member]
Goodwill [Line Items]
Indefinite lived intangible assets acquired		$ 4,800	$ 4,800
Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		5 years
Minimum [Member] \| Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		5 years
Maximum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		25 years
Maximum [Member] \| Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		10 years

Goodwill and Intangible Assets (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	$ 25,901
Intangible assets subject to amortization:
Gross carrying amount	115,906
Accumulated amortization	(65,507)
Intangible assets subject to amortization, net	50,399
Total intangible assets at March 31, 2022	76,300	$ 64,321
Customer and Referral Relationships [Member]
Intangible assets subject to amortization:
Gross carrying amount	44,672
Accumulated amortization	(36,779)
Intangible assets subject to amortization, net	7,893
Total intangible assets at March 31, 2022	7,893
Trade Names and Trademarks [Member]
Intangible assets subject to amortization:
Gross carrying amount	51,941
Accumulated amortization	(19,126)
Intangible assets subject to amortization, net	32,815
Total intangible assets at March 31, 2022	32,815
Non-competition Agreements [Member]
Intangible assets subject to amortization:
Gross carrying amount	6,785
Accumulated amortization	(4,081)
Intangible assets subject to amortization, net	2,704
Total intangible assets at March 31, 2022	2,704
State Licenses [Member]
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	25,901
Intangible assets subject to amortization:
Gross carrying amount	12,508
Accumulated amortization	(5,521)
Intangible assets subject to amortization, net	6,987
Total intangible assets at March 31, 2022	$ 32,888

Details of Certain Balance Sheet Accounts (Schedule of Prepaid Expenses and Other Current Assets) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Details Of Certain Balance Sheet Accounts [Abstract]
Income tax receivable	$ 4,333	$ 7,556
Prepaid workers' compensation and liability insurance	2,070	3,206
Workers' compensation insurance receivable	1,073	1,559
Other	7,182	6,170
Total prepaid expenses and other current assets	$ 14,658	$ 18,491

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Details Of Certain Balance Sheet Accounts [Abstract]
Current portion of operating lease liabilities	$ 10,766	$ 9,774
Accrued health insurance	6,637	5,200
Payor advances	5,866	6,485
Accrued professional fees	3,357	2,978
Other	12,194	12,640
Total accrued expenses	$ 38,820	$ 37,077

COVID-19 Pandemic (Narrative) (Details) - USD ($)			1 Months Ended		3 Months Ended			6 Months Ended		12 Months Ended
COVID-19 Pandemic (Narrative) (Details) - USD ($)	Jul. 01, 2022	Mar. 11, 2021	Jan. 31, 2022	Nov. 30, 2020	Jun. 30, 2022	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2030	Jun. 30, 2030	Mar. 31, 2022	Dec. 31, 2021	Jun. 30, 2020
Unusual Risk Or Uncertainty [Line Items]
Net service revenues						$ 226,634,000	$ 205,302,000
Hospice [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues						47,727,000	36,094,000
Home Health [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues						9,275,000	4,340,000
CARES Act [Member]
Unusual Risk Or Uncertainty [Line Items]
Amount received from provider relief fund							900,000
Payroll tax deferral						4,100,000				$ 4,100,000	$ 4,100,000	$ 7,100,000
Percentage of reduced payments to Medicare providers				2.00%
Costs and expenses						1,700,000	900,000
Revenue recognized						1,400,000	1,800,000
CARES Act [Member] \| Hospice [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues						900,000	700,000
CARES Act [Member] \| Home Health [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues						200,000	$ 100,000
CARES Act [Member] \| Forecast
Unusual Risk Or Uncertainty [Line Items]
Percentage of reduced payments to Medicare providers	2.00%							3.00%	2.25%
Reduction percentage on sequestration adjustment					1.00%
ARPA [Member]
Unusual Risk Or Uncertainty [Line Items]
Relief funding to mitigate fiscal effects of COVID-19		$ 350,000,000
percentage point increase in federal matching funds										10.00%
PAYGO Act [Member] \| Maximum [Member]
Unusual Risk Or Uncertainty [Line Items]
Percentage of additional payment reduction			4.00%
Provider Relief Fund [Member]
Unusual Risk Or Uncertainty [Line Items]
Aggregate principal amount of grants received				$ 13,700,000
Provider Relief Fund [Member] \| CARES Act [Member] \| Minimum [Member]
Unusual Risk Or Uncertainty [Line Items]
Annual awards for commercial organizations						$ 750,000

Long-Term Debt (Schedule of Long-Term Debt) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Less unamortized issuance costs	$ (3,726)	$ (3,941)
Long-term debt	256,127	220,912
Revolving Credit Loan [Member] \| Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 259,853	$ 224,853

Long-Term Debt (Narrative) (Details) - Credit Agreement [Member] - USD ($)		3 Months Ended
	Jul. 30, 2021	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Debt Instrument [Line Items]
Line of credit outstanding amount		$ 377,600,000
Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available		109,600,000
Debt instrument, maturity date	Jul. 30, 2026
Debt instrument total net leverage ratio	4.25%
Line of credit outstanding amount		8,100,000
Capital One, National Association [Member] \| Term Loan
Debt Instrument [Line Items]
Line of credit outstanding amount		$ 259,900,000
Debt instrument stated interest rate		2.46%
Capital One, National Association [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Debt instrument total net leverage ratio	3.75%
Capital One, National Association [Member] \| Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	0.50%
Capital One, National Association [Member] \| London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	1.00%
Capital One, National Association [Member] \| London Interbank Offered Rate (LIBOR) \| Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	0.00%
Capital One, National Association [Member] \| Based On Applicable Senior Leverage Ratio \| Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	0.75%
Capital One, National Association [Member] \| Based On Applicable Senior Leverage Ratio \| Maximum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	1.50%
Capital One, National Association [Member] \| Based On Applicable Leverage Ratio [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	1.75%
Capital One, National Association [Member] \| Based On Applicable Leverage Ratio [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	2.50%
Capital One, National Association [Member] \| Restriction on Dividends [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Aggregate amount of dividends and distributions			$ 7,500,000
Revolving Credit Loan [Member] \| Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 600,000,000.0
Proceeds from line of credit			$ 0
Line of credit outstanding amount		$ 259,900,000		$ 224,900,000
Debt instrument stated interest rate		2.46%		2.10%
Revolving Credit Loan [Member] \| Capital One, National Association [Member] \| JourneyCare [Member]
Debt Instrument [Line Items]
Proceeds from line of credit		$ 35,000,000.0
Revolving Credit Loan [Member] \| Capital One, National Association [Member] \| Minimum [Member]
Debt Instrument [Line Items]
Fee charged on unused portion of revolving credit facility			0.20%
Revolving Credit Loan [Member] \| Capital One, National Association [Member] \| Maximum [Member]
Debt Instrument [Line Items]
Fee charged on unused portion of revolving credit facility			0.35%
Incremental Loan Facility [Member] \| Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 125,000,000.0

Income Taxes (Narrative) (Details)	3 Months Ended
Income Taxes (Narrative) (Details)	Mar. 31, 2022	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Effective income tax rate	27.90%	19.00%
Percentage of excess tax (benefit) expense included in effective income tax rate	2.70%	(7.40%)

Commitments and Contingencies (Narrative) (Details) $ in Millions	Jun. 02, 2021 USD ($)
Palmetto [Member]
Commitments And Contingencies [Line Items]
Request for repayment on legal matter	$ 6.5

Segment Information (Narrative) (Details)	3 Months Ended
Segment Information (Narrative) (Details)	Mar. 31, 2022 segment
Segment Reporting [Abstract]
Number of business segments	3

Segment Information (Summary of Segment Information) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Segment Reporting Information [Line Items]
Net service revenues	$ 226,634	$ 205,302
Cost of services revenues	156,448	144,105
Gross profit	70,186	61,197
General and administrative expenses	53,152	45,426
Operating income	13,513	12,170
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	29,075	24,711
Operating income	41,111	36,486
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues	169,632	164,868
Cost of services revenues	126,291	122,839
Gross profit	43,341	42,029
Personal Care [Member] \| Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	15,004	15,283
Operating income	28,337	26,746
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues	47,727	36,094
Cost of services revenues	23,441	18,596
Gross profit	24,286	17,498
Hospice [Member] \| Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	11,712	8,463
Operating income	12,574	9,035
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues	9,275	4,340
Cost of services revenues	6,716	2,670
Gross profit	2,559	1,670
Home Health [Member] \| Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	2,359	965
Operating income	$ 200	$ 705

Segment Information (Segment Reconciliation to Totals reported in the accompanying Consolidated Financial Statements) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Segment Reporting Information [Line Items]
Operating income	$ 13,513	$ 12,170
Other general and administrative expenses	24,077	20,715
Depreciation and amortization	3,521	3,601
Interest income	(58)	(22)
Interest expense	1,820	1,216
Income before income taxes	11,751	10,976
Operating Segments [Member]
Segment Reporting Information [Line Items]
Operating income	$ 41,111	$ 36,486

- Definition

Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 940
-SubTopic 20
-Section 25
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=123384075&loc=d3e41242-110953

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(10))
-URI http://asc.fasb.org/extlink&oid=123367319&loc=SL114868664-224227

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 220
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(8))
-URI http://asc.fasb.org/extlink&oid=120400993&loc=SL114874131-224263

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 235
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-05(b)(2))
-URI http://asc.fasb.org/extlink&oid=120399901&loc=d3e537907-122884

Reference 9: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8924-108599

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 220
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(15))
-URI http://asc.fasb.org/extlink&oid=120399700&loc=SL114874048-224260

+ Details

Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Net service revenues	$ 226,634	$ 205,302
Personal Care [Member]
Net service revenues	169,632	164,868
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member]
Net service revenues	$ 169,632	$ 164,868
Concentration risk, percentage	100.00%	100.00%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| State, Local And Other Governmental Programs [Member]
Net service revenues	$ 83,908	$ 80,849
Concentration risk, percentage	49.50%	49.00%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Managed Care Organizations [Member]
Net service revenues	$ 77,390	$ 75,456
Concentration risk, percentage	45.60%	45.80%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Private Pay [Member]
Net service revenues	$ 4,626	$ 4,903
Concentration risk, percentage	2.70%	3.00%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Commercial Insurance [Member]
Net service revenues	$ 2,024	$ 2,346
Concentration risk, percentage	1.20%	1.40%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Other [Member]
Net service revenues	$ 1,684	$ 1,314
Concentration risk, percentage	1.00%	0.80%
Hospice [Member]
Net service revenues	$ 47,727	$ 36,094
Hospice [Member] \| Revenues [Member] \| Customer Concentration Risk [Member]
Net service revenues	$ 47,727	$ 36,094
Concentration risk, percentage	100.00%	100.00%
Hospice [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Managed Care Organizations [Member]
Net service revenues	$ 1,715	$ 1,487
Concentration risk, percentage	3.60%	4.10%
Hospice [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Commercial Insurance [Member]
Net service revenues	$ 2,244	$ 533
Concentration risk, percentage	4.70%	1.50%
Hospice [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Other [Member]
Net service revenues	$ 283	$ 89
Concentration risk, percentage	0.60%	0.20%
Hospice [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Medicare
Net service revenues	$ 43,485	$ 33,985
Concentration risk, percentage	91.10%	94.20%
Home Health [Member]
Net service revenues	$ 9,275	$ 4,340
Home Health [Member] \| Revenues [Member] \| Customer Concentration Risk [Member]
Net service revenues	$ 9,275	$ 4,340
Concentration risk, percentage	100.00%	100.00%
Home Health [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Managed Care Organizations [Member]
Net service revenues	$ 1,904	$ 798
Concentration risk, percentage	20.50%	18.40%
Home Health [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Other [Member]
Net service revenues	$ 559	$ 40
Concentration risk, percentage	6.10%	0.90%
Home Health [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Medicare
Net service revenues	$ 6,812	$ 3,502
Concentration risk, percentage	73.40%	80.70%

Significant Payors (Revenue by Geographic Location) (Details) - USD ($)
$ in Thousands

3 Months Ended

Mar. 31, 2022

Mar. 31, 2021

Net service revenues

$ 226,634

$ 205,302

Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]

Concentration risk, percentage

42.40%

35.80%

Personal Care [Member]

Net service revenues

$ 169,632

$ 164,868

Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member]

Net service revenues

$ 169,632

$ 164,868

Concentration risk, percentage

100.00%

Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]

Net service revenues

$ 84,693

$ 73,385

Concentration risk, percentage

49.90%

44.50%

Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member]

Net service revenues

^[1]

$ 21,385

$ 27,575

Concentration risk, percentage

^[1]

12.60%

16.70%

Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]

Net service revenues

$ 25,440

$ 23,593

Concentration risk, percentage

15.00%

14.30%

Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]

Net service revenues

$ 38,114

$ 40,315

Concentration risk, percentage

22.50%

24.50%

Hospice [Member]

Net service revenues

$ 47,727

$ 36,094

Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member]

Net service revenues

$ 47,727

$ 36,094

Concentration risk, percentage

100.00%

Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]

Net service revenues

^[2]

$ 9,541

Concentration risk, percentage

^[2]

20.00%

Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]

Net service revenues

$ 8,233

$ 9,230

Concentration risk, percentage

17.30%

25.60%

Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]

Net service revenues

$ 13,625

$ 12,750

Concentration risk, percentage

28.50%

35.30%

Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Ohio [Member]

Net service revenues

$ 16,328

$ 14,114

Concentration risk, percentage

34.20%

39.10%

Home Health [Member]

Net service revenues

$ 9,275

$ 4,340

Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member]

Net service revenues

$ 9,275

$ 4,340

Concentration risk, percentage

100.00%

Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]

Net service revenues

^[3]

$ 1,766

Concentration risk, percentage

^[3]

19.00%

Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]

Net service revenues

$ 7,509

$ 4,340

Concentration risk, percentage

81.00%

100.00%

[1]	In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure CDPAP fiscal intermediaries. The Company was not selected in the initial RFO process. We submitted a formal protest in response to the selection process, which was filed and accepted in March 2021, but we have not yet received a response to the formal protest. The Company continues to consider other arrangements and to pursue our protest of the award. The New York fiscal year 2023 state budget, passed in April 2022, amends the current Fiscal Intermediary RFO process to authorize all fiscal intermediaries that submitted an RFO application and served at least 200 clients in New York City or 50 clients in other counties between January 1, 2020 and March 31, 2020 to contract with the New York State Department of Health and continue to operate in all counties contained in their application. Under this provision, the Company would be allowed to continue to contract with all of its current payors for CDPAP services. The Company is currently assessing the future of its participation in this program. Given the status of the program, the Company has suspended materially all of its new patient admissions under the New York CDPAP program.
[2]	With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois.
[3]	With the acquisition of Summit Home Health, LLC (“Summit”) on October 1, 2021, the Company expanded its home health services in the state of Illinois.

Significant Payors (Narrative) (Details) - Illinois [Member]	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Revenues [Member] \| Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	20.70%	20.40%
Revenues [Member] \| Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	42.40%	35.80%
Accounts Receivable [Member] \| Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	16.10%		16.10%