0000950170-23-005160 | 10-K | XBRL Viewer

Employee Benefit Plans	12 Months Ended
Dec. 31, 2022
Retirement Benefits [Abstract]
Employee Benefit Plans	10. Employee Benefit Plans The 401(k) retirement plan is a defined contribution plan that provides for matching contributions by the Company to all non-union employees. Matching contributions are discretionary and subject to change by management. Under the provisions of the 401(k) plan, employees can contribute up to the maximum percentage and limits allowable under the U.S. Revenue Code. The Company provided contributions totaling $0.4 million, $0.4 million and $0.3 million for the years ended December 31, 2022, 2021 and 2020, respectively.

Employee Benefit Plans

12 Months Ended

Dec. 31, 2022

10. Employee Benefit Plans

The 401(k) retirement plan is a defined contribution plan that provides for matching contributions by the Company to all non-union employees. Matching contributions are discretionary and subject to change by management. Under the provisions of the 401(k) plan, employees can contribute up to the maximum percentage and limits allowable under the U.S. Revenue Code. The Company provided contributions totaling $0.4 million, $0.4 million and $0.3 million for the years ended December 31, 2022, 2021 and 2020, respectively.

- Definition

The entire disclosure for retirement benefits.

+ References

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+ Details

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2022

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment

Property and equipment consisted of the following:


	December 31,
	2022			2021
	(Amounts in Thousands)
Computer software	$	19,675		$	13,541
Computer equipment		12,343			10,313
Leasehold improvements		10,746			9,712
Furniture and equipment		5,534			5,220
Transportation equipment		194			194
		48,492			38,980
Less: accumulated depreciation and amortization		(27,310	)		(20,497	)
	$	21,182		$	18,483

Stock Options And Restricted Stock Awards

12 Months Ended

Dec. 31, 2022

Share-Based Payment Arrangement [Abstract]

Stock Options And Restricted Stock Awards

9. Stock Options and Restricted Stock Awards

The Board approved the 2017 Omnibus Incentive Plan (“the 2017 Plan”) as of April 27, 2017, which was approved by our shareholders on June 14, 2017. The 2017 Plan was intended to replace our existing incentive compensation plan, the 2009 Stock Incentive Plan (“the 2009 Plan”). All awards are now granted from the 2017 Plan. Outstanding awards under the 2009 Plan will continue to be governed by the 2009 Plan and the agreements under which they were granted.

The 2017 Plan allows us to grant performance-based incentive awards and equity-based awards (each an “Award”) to eligible employees, directors and consultants in the form of Stock Options, Stock Appreciation Rights, Restricted Stock, Deferred Stock Units/Restricted Stock Units, Other Stock Units or Performance Awards. The Company’s Board believes that the 2017 Plan is necessary to continue the Company’s effectiveness in attracting, motivating and retaining employees, directors and consultants with appropriate experience and to increase the grantees’ alignment of interest with the Company’s shareholders.

Under the 2017 Plan, Awards may be made in shares of our common stock. Subject to adjustment as provided by the terms of the 2017 Plan, the maximum aggregate number of shares of common stock with respect to which awards may be granted under the 2017 Plan will be 1,182,270, less the number of shares subject to awards that are granted pursuant to the 2009 Plan after March 31, 2017. The aggregate awards granted during any calendar year to any single Participant cannot exceed (i) 500,000 shares subject to stock options or stock appreciation rights (“SARs”) or (ii) 300,000 shares subject to Awards denominated in shares of common stock (whether or not settled in common stock). These individual annual limitations are cumulative in that any shares of common stock or cash for which Awards are permitted to be granted to a Participant during a fiscal year are not covered by an Award in that fiscal year, the number of shares of common stock will automatically increase in the subsequent fiscal years during the term of the 2017 Plan until the earlier of the time the increase has been granted to the Participant, or the end of the third fiscal year following the year to which such increase relates. At December 31, 2022, there were 350,317 shares of common stock available for future grant under the 2017 Plan.

Any shares of common stock subject to an Award under the 2017 Plan that are forfeited, canceled, settled in cash or otherwise terminated without a distribution of shares to a Participant, or that are delivered by attestation or withheld by the Company in connection with an option exercise or the payment of any required income tax withholding upon an option exercise or the vesting of restricted stock, will be deemed available for Awards under the 2017 Plan. Additionally, any shares of common stock subject to an Award under the 2009 Plan that are forfeited, canceled, settled in cash or otherwise terminated without a distribution of shares to a participant, or that are delivered by attestation or withheld by the Company in connection with an option exercise or the payment of

any required income tax withholding upon an option exercise or the vesting of restricted stock, will be deemed available for Awards under the 2017 Plan.

Stock options are awarded with a strike price equal to the fair market value based on the closing price of our common stock on the date of grant. Options granted typically vest over a service period ranging from three to four years and expire ten years from the date of grant. Restricted shares typically vest over a service period ranging from one to four years and expire ten years from date of grant.

The exercise prices of stock options outstanding on December 31, 2022 range from $19.71 to $92.00. Restricted stock awards are full-value awards.

Stock Options

A summary of stock option activity and weighted average exercise price for the year ended December 31, 2022 follows:


	Options (Amounts in Thousands)			Weighted Average Exercise Price
Outstanding, beginning of period		493		$	41.77
Granted		38			88.42
Exercised		(63	)		40.55
Forfeited/Cancelled		—			—
Outstanding, end of period		468		$	45.72

The weighted-average estimated fair value of employee stock options granted was calculated using the Black-Scholes Option Pricing Model in 2022 and 2021. The Company did not grant any stock options in 2020. The related assumptions follow:


	2022		2021		2020
	Grants		Grants		Grants
Weighted average fair value	$	32.96	$	32.71	$	—
Risk-free discount rate	1.76% - 2.86%		0.65%			—
Expected life	4.2 years		4.1 years			—
Dividend yield		—		—		—
Volatility	43%		45%			—

Stock option compensation expense totaled $1.2 million, $1.4 million and $2.0 million for the years ended December 31, 2022, 2021 and 2020, respectively. As of December 31, 2022, there was $1.9 million of total unrecognized compensation cost that is expected to be recognized over a weighted average period of 2.3 years.

The intrinsic value of vested and outstanding stock options was $24.1 million and $1.0 million, respectively, as of December 31, 2022.

As of December 31, 2022, there were 390,026 and 78,125 shares of stock options vested and unvested, respectively.

The intrinsic value of stock options exercised during the years ended December 31, 2022, 2021 and 2020 was $3.5 million, $1.8 million and $7.5 million, respectively.

Restricted Stock Awards

A summary of unvested restricted stock awards activity and weighted average grant date fair value for the year ended December 31, 2022 follows:


	Restricted Stock Awards (Amounts in Thousands)			Weighted Average Grant Date Fair Value
Unvested restricted stock awards, beginning of period		159		$	104.91
Awarded		130			71.91
Vested		(74	)		95.73
Forfeited		(5	)		85.53
Unvested restricted stock awards, end of period		210		$	88.22

The fair value of restricted stock awards that vested during the year ended December 31, 2022 was $5.4 million.

Restricted stock award compensation expense totaled $9.4 million, $8.0 million and $4.0 million for the years ended December 31, 2022, 2021 and 2020, respectively. As of December 31, 2022, there was $10.9 million of total unrecognized compensation cost that is expected to be recognized over a weighted average period of 1.7 years.

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

5. Goodwill and Intangible Assets

A summary of goodwill by segment and related adjustments is provided below:


	Goodwill
	Hospice			Personal Care		Home Health		Total
	(Amounts In Thousands)
Goodwill at December 31, 2020	$	314,833		$	152,448	$	1,791	$	469,072
Additions for acquisitions		13,370			115		21,579		35,064
Adjustments to previously recorded goodwill		131			125		—		256
Goodwill at December 31, 2021		328,334			152,688		23,370		504,392
Additions for acquisitions		69,446			—		8,910		78,356
Adjustments to previously recorded goodwill		(52	)		—		141		89
Goodwill at December 31, 2022	$	397,728		$	152,688	$	32,421	$	582,837

In 2022, the Company recognized goodwill in the hospice segment of $69.4 million related to the acquisition of JourneyCare and $8.9 million with the acquisition of Apple Home in the home health segment. In connection with the acquisition of Armada in 2021, the Company recognized goodwill in its hospice and home health segments of $13.4 million and $15.0 million, respectively, and $6.5 million with the acquisition of Summit in 2021 in our home health segment.

Goodwill adjustments to previously recorded goodwill are generally related to accounts receivable and accrued expenses based on the final valuations. See Note 3 to the Notes to Consolidated Financial Statements for additional information regarding the acquisitions made by the Company in 2021 and 2022.

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 one 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.

Goodwill and certain state licenses are not amortized pursuant to ASC Topic 350. We test intangible assets with indefinite useful lives for impairment at the reporting unit level on an annual basis, as of October 1, or whenever potential impairment triggers occur, such as a significant change in business climate or regulatory changes that would indicate that an impairment may have occurred. The Company estimates the fair value of the reporting unit using both a discounted cash flow model as well as a market multiple model. The cash flow forecasts are adjusted by an appropriate discount rate based on the Company’s estimate of a market participant’s weighted-average cost of capital. These models are both based on the Company’s best estimate of future revenues and operating costs and are reconciled to the Company’s consolidated market capitalization, with consideration of the amount a potential acquirer would be required to pay, in the form of a control premium. The determination of fair value in the Company’s goodwill impairment analysis is based on an estimate of fair value for each reporting unit utilizing known and estimated inputs at the evaluation date. Some of those inputs include, but are not limited to, the most recent price of the Company’s common stock and fair value of long term debt, estimates of future revenue and expense growth, estimated market multiples, expected capital expenditures, income tax rates and cost of invested capital. Significant assumptions used in the analysis included a 9.5% discount rate and long-term revenue growth rates that ranged from 3.5% to 7.0%. For the fiscal year 2022 impairment test, the fair value of the reporting units exceeded their respective carrying values (commonly referred to as “headroom”) by at least 100% in the personal care segment, by 75% in the home health segment, and 67% in the hospice segment. The Company did not record any impairment charges for the years ended December 31, 2022, 2021 or 2020.

The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following at December 31, 2022 and 2021:


	Customer and referral relationships			Trade names and trademarks			Non- competition agreements			State Licenses			Total
	(Amounts in Thousands)
Intangible assets with indefinite lives	$	—		$	—		$	—		$	27,108		$	27,108
Intangible assets subject to amortization:
Gross carrying amount		44,672			52,046			6,785			12,517			116,020
Accumulated amortization		(38,088	)		(21,058	)		(4,785	)		(7,009	)		(70,940	)
Intangible assets subject to amortization, net		6,584			30,988			2,000			5,508			45,080
Net balance at December 31, 2022	$	6,584		$	30,988		$	2,000		$	32,616		$	72,188

Intangible assets with indefinite lives	$	—		$	—		$	—		$	21,124		$	21,124
Intangible assets subject to amortization:
Gross carrying amount		44,672			42,926			6,785			12,508			106,891
Accumulated amortization		(36,342	)		(18,494	)		(3,831	)		(5,027	)		(63,694	)
Intangible assets subject to amortization, net		8,330			24,432			2,954			7,481			43,197
Net balance at December 31, 2021	$	8,330		$	24,432		$	2,954		$	28,605		$	64,321

During the year ended December 31, 2022, the Company acquired indefinite-lived state licenses and trade names of $4.8 million and $9.0 million, respectively, related to the acquisition of JourneyCare. During the year ended December 31, 2022, the Company acquired indefinite lived state licenses and trade names of $1.2 million and $0.1 million, respectively, related to the acquisition of Apple Home.

During the year ended December 31, 2021, the Company acquired indefinite lived state licenses and non-competition agreements of $0.4 million and $0.6 million, respectively, related to the acquisition of Armada.

Amortization expense related to the identifiable intangible assets amounted to $7.2 million, $8.5 million and $7.1 million for the years ended December 31, 2022, 2021 and 2020, respectively.

The weighted average remaining useful life of identifiable intangible assets as of December 31, 2022 is 9.8 years.

The estimated future intangible amortization expense is as follows:


For the year ended December 31,	Total (Amount in Thousands)
2023	$	6,857
2024		6,534
2025		4,911
2026		4,287
2027		3,665
Thereafter		18,826
Total, intangible assets subject to amortization	$	45,080

Stock Options And Restricted Stock Awards (Summary of Unvested Restricted Stock Awards and Weighted Average Grant Date Fair Value) (Details) - Restricted Stock [Member] shares in Thousands	12 Months Ended
	Dec. 31, 2022 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested restricted stock awards at beginning of period \| shares	159
Awarded \| shares	130
Vested \| shares	(74)
Forfeited \| shares	(5)
Unvested restricted stock awards at end of period \| shares	210
Weighted Average Grant Date Fair Value beginning of period \| $ / shares	$ 104.91
Weighted Average Grant Date Fair Value, Awarded \| $ / shares	71.91
Weighted Average Grant Date Fair Value, Vested \| $ / shares	95.73
Weighted Average Grant Date Fair Value, Forfeited \| $ / shares	85.53
Weighted Average Grant Date Fair Value end of period \| $ / shares	$ 88.22

Long-Term Debt

12 Months Ended

Dec. 31, 2022

Long-Term Debt, Unclassified [Abstract]

Long-Term Debt

7. Long-Term Debt

Long-term debt consisted of the following:


	December 31,
	2022			2021
	(Amounts in Thousands)
Revolving loan under the credit facility	$	134,853		$	224,853
Term loan under the credit facility		—			—
Less unamortized issuance costs		(3,081	)		(3,941	)
Total		131,772			220,912
Less current maturities		—			—
Long-term debt	$	131,772		$	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 Annual Report on Form 10-K, “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 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.

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 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.

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

The Company drew approximately $47.0 million under its credit facility to fund, in part, the JourneyCare and Apple Home acquisitions. At December 31, 2022, the Company had a total of $134.9 million of revolving loans, with an interest rate of 6.13%, outstanding on its credit facility. After giving effect to the amount drawn on its credit facility, approximately $8.2 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 $380.2 million of capacity and $237.2 million available for borrowing under its credit facility.

The Company drew approximately $29.0 million under its credit facility to fund the acquisition of Armada on August 1, 2021. At 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. After giving effect to the amount drawn on its credit facility, approximately $8.2 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 $376.6 million of capacity and $143.6 million available for borrowing under its credit facility.

Income Taxes (Current and Deferred Federal and State Income Tax Provision from Continuing Operations) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Current
Federal	$ 7,075	$ 4,603	$ 10,230
State	3,090	2,398	3,312
Deferred
Federal	3,118	6,407	(3,690)
State	863	1,864	(1,043)
Provision for income taxes	$ 14,146	$ 15,272	$ 8,809

- Definition

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

+ References + Details

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

Summary of Goodwill by Segment and Related Adjustments

A summary of goodwill by segment and related adjustments is provided below:


	Goodwill
	Hospice			Personal Care		Home Health		Total
	(Amounts In Thousands)
Goodwill at December 31, 2020	$	314,833		$	152,448	$	1,791	$	469,072
Additions for acquisitions		13,370			115		21,579		35,064
Adjustments to previously recorded goodwill		131			125		—		256
Goodwill at December 31, 2021		328,334			152,688		23,370		504,392
Additions for acquisitions		69,446			—		8,910		78,356
Adjustments to previously recorded goodwill		(52	)		—		141		89
Goodwill at December 31, 2022	$	397,728		$	152,688	$	32,421	$	582,837

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 at December 31, 2022 and 2021:


	Customer and referral relationships			Trade names and trademarks			Non- competition agreements			State Licenses			Total
	(Amounts in Thousands)
Intangible assets with indefinite lives	$	—		$	—		$	—		$	27,108		$	27,108
Intangible assets subject to amortization:
Gross carrying amount		44,672			52,046			6,785			12,517			116,020
Accumulated amortization		(38,088	)		(21,058	)		(4,785	)		(7,009	)		(70,940	)
Intangible assets subject to amortization, net		6,584			30,988			2,000			5,508			45,080
Net balance at December 31, 2022	$	6,584		$	30,988		$	2,000		$	32,616		$	72,188

Intangible assets with indefinite lives	$	—		$	—		$	—		$	21,124		$	21,124
Intangible assets subject to amortization:
Gross carrying amount		44,672			42,926			6,785			12,508			106,891
Accumulated amortization		(36,342	)		(18,494	)		(3,831	)		(5,027	)		(63,694	)
Intangible assets subject to amortization, net		8,330			24,432			2,954			7,481			43,197
Net balance at December 31, 2021	$	8,330		$	24,432		$	2,954		$	28,605		$	64,321

Schedule of Future Amortization of Intangible Assets

The estimated future intangible amortization expense is as follows:


For the year ended December 31,	Total (Amount in Thousands)
2023	$	6,857
2024		6,534
2025		4,911
2026		4,287
2027		3,665
Thereafter		18,826
Total, intangible assets subject to amortization	$	45,080

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

Property and Equipment (Schedule of Property and Equipment) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 48,492	$ 38,980
Less: accumulated depreciation and amortization	(27,310)	(20,497)
Property and equipment, net	21,182	18,483
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	12,343	10,313
Furniture and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	5,534	5,220
Transportation Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	194	194
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	10,746	9,712
Computer Software [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 19,675	$ 13,541

Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2022

Accounting Policies [Abstract]

Principles of Consolidation

All intercompany balances and transactions have been eliminated in consolidation.

Revenue Recognition

Net service revenue is recognized at the amount that reflects the consideration the Company expects to receive in exchange for providing services directly to consumers. Receipts are from federal, state and local governmental agencies, managed care organizations, commercial insurers and private consumers for services rendered. The Company assesses the consumers’ ability to pay at the time of their admission based on the Company’s verification of the customer’s insurance coverage under the Medicare, Medicaid, and other commercial or managed care insurance programs. Laws and regulations governing the governmental programs in which the Company participates are complex and subject to interpretation. Net service revenues related to uninsured accounts, or self-pay, is recorded net of implicit price concessions estimated based on historical collection experience to reduce revenue to the estimated amount the Company expects to collect. Amounts collected from all sources may be less than amounts billed due to implicit price concessions, resulting from client eligibility issues, insufficient or incomplete documentation, services at levels other than authorized, pricing differences and other reasons unrelated to credit risk. The Company monitors our net service revenues and collections from these sources and records any necessary adjustment to net service revenues based upon management’s assessment of historical write offs and expected net collections, business and economic conditions, trends in federal, state and private employer healthcare coverage and other collection indicators.

The initial estimate of net service revenues is determined by reducing the standard charge by any contractual adjustments, discounts and implicit price concessions. Subsequent changes to the estimate of net service revenues are generally recorded in the period of the change. Changes in estimates of implicit price concessions, discounts and contractual adjustments recognized during the year ended December 31, 2022 for performance obligations satisfied in years prior to 2022 resulted in an increase to net service revenue of approximately $8.8 million. Changes in estimates of implicit price concessions, discounts and contractual adjustments recognized during the year ended December 31, 2021 for performance obligations satisfied in years prior to 2021 resulted in an increase to net service revenue of approximately $5.7 million. Subsequent changes that are determined to be the result of an adverse change in the patient’s ability to pay are recorded as bad debt expense.

Personal Care

The majority of the Company’s net service revenues are generated from providing personal care services directly to consumers under contracts with state, local and other governmental agencies, managed care organizations, commercial insurers and private consumers. Generally, these contracts, which are negotiated based on current contracting practices as appropriate for the payor, establish the terms of a customer relationship and set the broad range of terms for services to be performed at a stated rate. However, the contracts do not give rise to rights and obligations until an order is placed with the Company. When an order is placed, it creates the performance obligation to provide a defined quantity of service hours, or authorized hours, per consumer. The Company satisfies its performance obligations over time, given that consumers simultaneously receive and consume the benefits provided by the Company as the services are performed. As the Company has a right to consideration from customers commensurate with the value provided to customers from the performance completed over a given invoice period, the Company has elected to use the practical expedient for measuring progress toward satisfaction of performance obligations and recognizes patient service revenue in the amount to which the Company has a right to invoice.

Hospice Revenue

The Company generates net service revenues from providing hospice services to consumers who are terminally ill as well as related services for their families. Net service revenues are recognized as services are provided and costs for delivery of such services are incurred. The estimated payment rates are daily rates for each of the levels of care the Company delivers. Hospice companies are subject to two specific payment limit caps under the Medicare program each federal fiscal year, the inpatient cap and the aggregate cap. The inpatient cap limits the number of inpatient care days provided to no more than 20% of the total days of hospice care provided to Medicare patients for the year. If a hospice exceeds the number of allowable inpatient care days, the hospice must refund any amounts received for inpatient care that exceed the total of: (i) the product of the total reimbursement paid to the hospice for inpatient care multiplied by the ratio of the maximum number of allowable inpatient days to the actual number of inpatient care days furnished by the hospice to Medicare patients; and (ii) the product of the number of actual inpatient days in excess of the limitation multiplied by the routine home care rate. The aggregate cap, which is calculated each federal fiscal year, limits the amount of Medicare reimbursement a hospice may receive, based on the number of Medicare patients served. If a hospice’s Medicare payments exceed its aggregate cap, it must repay Medicare for the excess amount. In federal fiscal year 2023, the aggregate cap is $32,486.92. For the years ended December 31, 2022 and 2021, the Company recorded a liability of $0.9 million and $0.3 million, respectively, related to the Medicare aggregate cap limit.

Home Health Revenue

The Company also generates net service revenues from providing home healthcare services directly to consumers mainly under contracts with Medicare and managed care organizations. Generally, these contracts, which are negotiated based on current contracting practices as appropriate for the payor, establish the terms of a relationship and set the broad range of terms for services to be performed on an episodic basis at a stated rate. Home health Medicare services were paid under the Medicare Home Health Prospective Payment System (“HHPPS”), for the years ended December 31, 2022 and 2021, which are based on 30-day periods of care as a unit of service. The HHPPS permits multiple, continuous periods per patient. Medicare payment rates for periods under HHPPS are determined through use of a case-mix classification system, the Patient-Driven Groupings Model (“PDGM”), which assigns patients to resource groups based on a patient’s clinical characteristics.

The Company elects to use the same 30-day periods that Medicare recognizes as standard but accelerates revenue upon discharge to align with a patient’s episode length if less than the expected 30 days, which depicts the transfer of services and related benefits received by the patient over the term of the contract necessary to satisfy the obligations. The Company recognizes revenue based on the number of days elapsed during a period of care within the reporting period. The Company satisfies its performance obligations as consumers receive and consume the benefits provided by the Company as the services are performed. As the Company has a right to consideration from Medicare commensurate with the services provided to customers from the performance completed over a given episodic period, the Company has elected to use the practical expedient for measuring progress toward satisfaction of performance obligations. Under this method recognizing revenue ratably over the episode based on beginning and ending dates is a reasonable proxy for the transfer of benefit of the service.

Accounts Receivable and Allowances

Accounts receivable is reduced to the amount expected to be collected in future periods for services rendered to customers prior to the balance sheet date. Management estimates the value of accounts receivable, net of allowances for implicit price concessions, based upon historical experience and other factors, including an aging of accounts receivable, evaluation of expected adjustments, past adjustments and collection experience in relation to amounts billed, current contract and reimbursement terms, shifts in payors and other relevant information. Collection of net service revenues the Company expects to receive is normally a function of providing complete and correct billing information to the payors within the various filing deadlines. The evaluation of these historical and other factors involves complex, subjective judgments impacting the determination of the implicit price concession assumption. In addition, the Company compares its cash collections to recorded net service revenues and evaluates its historical allowance, including implicit price concessions, based upon the ultimate resolution of the accounts receivable balance.

Subsequent adjustments to accounts receivable determined to be the result of an adverse change in the payor’s ability to pay are recognized as provision for credit losses. The majority of what historically was classified as provision for credit losses under operating expenses is now treated as an implicit price concession factored into the determination of net service revenues discussed above. Our collection procedures include review of account aging and direct contact with our payors. We have historically not used collection agencies. An uncollectible amount is written off to the allowance account after reasonable collection efforts have been exhausted. As of December 31, 2022 and 2021, the allowance for credit losses balance was $1.6 million and $1.4 million, respectively, which is included in accounts receivable, net of allowances for credit losses on the Company’s Consolidated Balance Sheets.

Activity in the allowance for credit losses is as follows (in thousands):


Allowance for credit losses	Balance at beginning of period		Additions/ charges		Deductions (1)		Balance at end of period
Year ended December 31, 2022
Allowance for credit losses	$	1,433		678		477	$	1,634
Year ended December 31, 2021
Allowance for credit losses	$	973		962		502	$	1,433
Year ended December 31, 2020
Allowance for credit losses	$	962		918		907	$	973

(1) Write-offs, net of recoveries

Property and Equipment

Property and equipment are recorded at cost and depreciated over the estimated useful lives of the related assets by use of the straight-line method. Maintenance and repairs are charged to expense as incurred. The estimated useful lives of the property and equipment are as follows:


Computer equipment		3-5 years
Furniture and equipment		5-7 years
Transportation equipment		5 years
Computer software		3-10 years
Leasehold improvements		Lesser of useful life or lease term

Leases

The Company recognizes a lease liability and a right-of-use (“ROU”) asset for all leases, including operating leases, with a term greater than twelve months on the balance sheet. We have historically entered into operating leases for local branches, our corporate headquarters and certain equipment. The Company’s current leases have expiration dates through 2031. Certain of our arrangements have free rent periods and/or escalating rent payment provisions. We recognize rent expense on a straight-line basis over the lease term. Certain of the Company’s leases include termination options and renewal options for periods ranging from one to five years. Renewal options generally are not considered in determining the lease term, and payments associated with the option years are excluded from lease payments unless we are reasonably certain to exercise the renewal option.

The operating lease liabilities are calculated using the present value of lease payments. If available, we use the rate implicit in the lease to discount lease payments to present value; however, most of our leases do not provide a readily determinable implicit rate. Therefore, we must estimate our incremental borrowing rate to discount the lease payments based on information available at lease commencement.

Operating lease assets are valued based on the initial operating lease liabilities plus any prepaid rent, reduced by tenant improvement allowances. Operating lease assets are tested for impairment in the same manner as our long-lived assets. For the year ended December 31, 2022, the Company recorded $1.2 million in impairment charges on operating lease assets, included within general and administrative expenses, and no material impairment charges for the year ended December 31, 2021. For the year ended December 31, 2020, the Company sublet certain support center office space and incurred an impairment charge of approximately $1.0 million in operating lease assets, included within general and administrative expenses. See Note 2 for additional information related to leases.

Goodwill and Intangible Assets

Under business combination accounting, 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 Company’s significant identifiable intangible assets consist of customer and referral relationships, trade names and trademarks and state licenses. The Company uses various valuation techniques to determine initial fair value of its intangible assets, including relief-from-royalty, income approach, discounted cash flow analysis, and multi-period excess earnings, which use significant unobservable inputs, or Level 3 inputs, as defined by the fair value hierarchy. Under these valuation approaches, we are required to make estimates and assumptions about future market growth and trends, forecasted revenue and costs, expected periods over which the assets will be utilized, appropriate discount rates and other variables. The Company estimates the fair values of the

trade names using the relief-from-royalty method, which requires assumptions such as the long-term growth rates of future revenues, the relief from royalty rate for such revenue, the tax rate and the discount rate. The Company estimates the fair value of existing indefinite-lived state licenses based on a blended approach of the replacement cost method and cost savings method, which involves estimating the total process costs and opportunity costs to obtain a license, by estimating future earnings before interest and taxes and applying an estimated discount rate, tax rate and time to obtain the license. The Company estimates the fair value of existing finite-lived state licenses based on a method of analyzing the definite revenue streams with the license and without the license, which involves estimating revenues and expenses, estimated time to build up to a current revenue base, which is market specific, and the non-licensed revenue allocation, revenue growth rates, discount rate and tax amortization benefits. The Company estimates the fair value of customer and referral relationships based on a multi-period excess earnings method, which involves identifying revenue streams associated with the assets, estimating the attrition rates based upon historical financial data, expenses and cash flows associated with the assets, contributory asset charges, rates of return for specific assets, growth rates, discount rate and tax amortization benefits. The Company estimates the fair value of non-competition agreements based on a method of analyzing the factors to compete and factors not to compete, which involves estimating historical financial data, forecasted financial statements, growth rates, tax amortization benefit, discount rate, review of factors to compete and factors not to compete as well as an assessment of the probability of successful competition for each non-competition agreement.

As of December 31, 2022 and 2021, goodwill was $582.8 million and $504.4 million, respectively, included on the Company’s Consolidated Balance Sheets. The Company’s carrying value of goodwill is the excess of the purchase price over the fair value of the net assets acquired from various acquisitions. In accordance with Accounting Standards Codification (“ASC”) Topic 350, Goodwill and Other Intangible Assets, goodwill and intangible assets with indefinite useful lives are not amortized. The Company tests goodwill for impairment at the reporting unit level on an annual basis, as of October 1, or whenever potential impairment triggers occur, such as a significant change in business climate or regulatory changes that would indicate that an impairment may have occurred. The Company may elect to use a qualitative test to determine whether impairment has occurred, focused on various factors including macroeconomic conditions, market trends, specific reporting unit financial performance and other entity specific events, to determine if it is more likely than not that the fair value of a reporting unit exceeds its carrying value, including goodwill. The Company may also bypass the qualitative assessment and perform a quantitative test. Additionally, it is the Company’s policy to update the fair value calculation of our reporting units and perform the quantitative goodwill impairment test on a periodic basis. The quantitative goodwill impairment test involves comparing the fair value of a reporting unit with its carrying value, including goodwill. If the fair value of a reporting unit exceeds its carrying value, then goodwill is not impaired. If the fair value of a reporting unit is less than its carrying value, then goodwill is impaired to the extent of the difference.

For the years ended December 31, 2022, 2021 and 2020, the Company performed the quantitative analysis to evaluate whether an impairment occurred. Since quoted market prices for our reporting units are not available, the Company relies on widely accepted valuation techniques to determine fair value, including discounted cash flow and market multiple approaches, which capture both the future income potential of the reporting unit and the market behaviors and actions of market participants in the industry that includes the reporting unit. These types of models require us to make assumptions and estimates regarding future cash flows, industry-specific economic factors and the profitability of future business strategies. The discounted cash flow model uses a projection of estimated operating results and cash flows that are discounted using a weighted average cost of capital. The market multiple model estimates fair value based on market multiples of earnings before interest, taxes and depreciation and amortization. Under the discounted cash flow model, the projection uses management’s best estimates of economic and market conditions over the projected period for each reporting unit using significant assumptions such as revenue growth rates and the weighted-average cost of capital.

Based on the totality of the information available, the Company concluded that it was more likely than not that the estimated fair values of our reporting units were greater than their carrying values. Consequently, the Company concluded that there were no impairments for the years ended December 31, 2022, 2021 or 2020. For the fiscal year 2022 impairment tests, the fair value of the reporting units exceeded their respective carrying values (commonly referred to as “headroom”) by at least 100% in the personal care reporting unit, 75% in the home health reporting unit, and 67% in the hospice reporting unit. The Company bases its fair value estimates on assumptions management believes to be reasonable but which are unpredictable and inherently uncertain. Actual future results may differ from those estimates.

As of December 31, 2022 and 2021, intangibles, net of accumulated amortization, was $72.2 million and $64.3 million, respectively, included on the Company’s Consolidated Balance Sheets. The Company’s identifiable intangible assets consist of customer and referral relationships, trade names, trademarks, state licenses and non-competition agreements. Definite-lived intangible assets are amortized using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from one to twenty-five years, and assessed for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. Customer and referral relationships are amortized systematically over the periods of expected economic benefit, which range from five to ten years. The Company would recognize an impairment loss when the estimated future non-discounted cash flows associated with the intangible asset are less than the carrying value. An impairment charge would

then be recorded for the excess of the carrying value over the fair value. The Company estimates the fair value of these intangible assets using the income approach. In accordance with ASC Topic 350, Goodwill and Other Intangible Assets, intangible assets with indefinite useful lives are not amortized. We test intangible assets with indefinite useful lives for impairment at the reporting unit level on an annual basis, as of October 1, or whenever potential impairment triggers occur, such as a significant change in business climate or regulatory changes that would indicate that an impairment may have occurred. No impairment charge was recorded for the years ended December 31, 2022, 2021 or 2020. Amortization of intangible assets is reported in the statement of income caption, “Depreciation and amortization” and not included in the income statement caption cost of service revenues.

Debt Issuance Costs

The Company amortizes debt issuance costs on a straight-line method over the term of the related debt. This method approximates the effective interest method. In accordance with ASU 2015-03, Simplifying the Presentation of Debt Issuance Costs, the Company has classified the debt issuance costs as a direct deduction from the carrying amount of the related liability.

Workers' Compensation Program

Workers’ Compensation Program

The Company’s workers’ compensation insurance program has a $0.4 million deductible component. The Company recognizes its obligations associated with this program in the period the claim is incurred. The cost of both the claims reported and claims incurred but not reported, up to the deductible, have been accrued based on historical claims experience, industry statistics and an actuarial analysis. The future claims payments related to the workers’ compensation program are secured by letters of credit. These letters of credit totaled $8.2 million at both December 31, 2022 and 2021. The Company monitors its claims quarterly and adjusts its reserves as necessary in the current period. These costs are recorded primarily as cost of services on the Consolidated Statements of Income. As of December 31, 2022 and 2021, the Company recorded $12.9 million and $13.0 million, respectively, in accrued workers’ compensation insurance on the Company’s Consolidated Balance Sheets. As of December 31, 2022 and 2021, the Company recorded $0.7 million and $1.6 million, respectively, in workers’ compensation insurance receivables. The workers’ compensation insurance receivable is included in prepaid expenses and other current assets on the Company’s Consolidated Balance Sheets.

Interest Expense

Interest expense is reported in the Consolidated Statements of Income when incurred and consists of interest and unused credit line fees on the credit facility.

Income Tax Expense

The Company accounts for income taxes under the provisions of ASC Topic 740, Income Taxes. The objective of accounting for income taxes is to recognize the amount of taxes payable or refundable for the current year and deferred tax assets and liabilities for the future tax consequences of events that have been recognized in its financial statements or tax returns. Deferred taxes, resulting from differences between the financial and tax basis of the Company’s assets and liabilities, are also adjusted for changes in tax rates and tax laws when changes are enacted. ASC Topic 740 also requires that deferred tax assets be reduced by a valuation allowance if it is more likely than not that some portion or all of the deferred tax assets will not be realized. ASC Topic 740 also prescribes a recognition threshold and measurement process for recording in the financial statements uncertain tax positions taken or expected to be taken in a tax return. In addition, ASC Topic 740 provides guidance on derecognition, classification, accounting in interim periods and disclosure requirements for uncertain tax positions. The Company recognizes interest and penalties accrued related to uncertain tax positions in interest expense and penalties within operating expenses on the Consolidated Statements of Income. Uncertain tax positions are immaterial for all periods presented.

Stock-Based Compensation

Stock-based Compensation

The Company currently has one stock incentive plan, the 2017 Omnibus Incentive Plan (the “2017 Plan”), under which new grants of stock-based employee compensation are made. The Company accounts for stock-based compensation in accordance with ASC Topic 718, Stock Compensation. Compensation expense is recognized on a straight-line basis under the 2017 Plan over the vesting period of the equity awards based on the grant date fair value of the options and restricted stock awards. The Company utilizes the Black-Scholes Option Pricing Model to value the Company’s options. Forfeitures are recognized when they occur. Stock-based compensation expense was $10.6 million, $9.4 million and $6.0 million for the years ended December 31, 2022, 2021 and 2020, respectively, included within general and administrative expenses on the Consolidated Statements of Income.

Diluted Net Income Per Common Share

Diluted net income per common share, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The Company’s outstanding securities that may potentially dilute the common stock are stock options and restricted stock awards.

Included in the Company’s calculation of diluted earnings per share for the year ended December 31, 2022 were approximately 468,000 stock options outstanding, of which approximately 248,000 were dilutive. In addition, there were approximately 209,000 restricted stock awards outstanding, of which approximately 72,000 were dilutive for the year ended December 31, 2022.

Included in the Company’s calculation of diluted earnings per share for the year ended December 31, 2021 were approximately 493,000 stock options outstanding, of which approximately 282,000 were dilutive. In addition, there were approximately 159,000 restricted stock awards outstanding, of which approximately 44,000 were dilutive for the year ended December 31, 2021.

Included in the Company’s calculation of diluted earnings per share for the year ended December 31, 2020 were approximately 506,000 stock options outstanding, of which approximately 304,000 were dilutive. In addition, there were approximately 154,000 restricted stock awards outstanding, of which approximately 57,000 were dilutive for the year ended December 31, 2020.

Use of Estimates

Estimates

The financial statements are prepared by management in conformity with U.S. Generally Accepted Accounting Principles (“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 and business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from those estimates.

Fair Value Measurements

The Company’s financial instruments consist of cash, accounts receivable, payables and debt. The carrying amounts reported on the Company’s Consolidated Balance Sheets for cash, accounts receivable, accounts payable and accrued expenses approximate fair value because of the short-term nature of these instruments. The carrying value of the Company’s long-term debt with variable interest rates approximates fair value based on instruments with similar terms using level 2 inputs as defined under ASC Topic 820, Fair Value Measurement.

The Company applies fair value techniques on a non-recurring basis associated with valuing potential impairment losses related to goodwill, if required, and indefinite-lived intangible assets and also when determining the fair value of contingent consideration, if applicable. To determine the fair value in these situations, the Company uses Level 3 inputs, under ASC Topic 820 and defined as unobservable inputs in which little or no market data exists; therefore requiring an entity to develop its own assumptions, such as discounted cash flows, or if available, what a market participant would pay on the measurement date.

The Company uses various valuation techniques to determine fair value of its intangible assets, including relief-from-royalty, income approach, discounted cash flow analysis, and multi-period excess earnings, which use significant unobservable inputs, or Level 3 inputs, as defined by the fair value hierarchy. Under these valuation approaches, we are required to make estimates and assumptions about future market growth and trends, forecasted revenue and costs, expected periods over which the assets will be utilized, appropriate discount rates and other variables.

Going Concern

In connection with the preparation of the financial statements for the years ended December 31, 2022 and 2021, the Company conducted an evaluation as to whether there were conditions and events, considered in the aggregate, which raised substantial doubt as to the entity’s ability to continue as a going concern within one year after the date of the issuance, of the financial statements. Based on the evaluation, we believe that cash flows from operations will be sufficient to meet our ongoing liquidity requirements for at least twelve months from the date of issuance.

Recently Issued and Adopted Accounting Pronouncements

Recently Adopted Accounting Pronouncements

In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. ASU 2019-12 simplifies various aspects related to accounting for income taxes and removes certain exceptions to the general guidance in ASC 740. In addition, the ASU clarifies and amends existing guidance to improve consistent application of its requirements. The ASU was adopted as of January 1, 2021 and did not have an impact on the Company’s results of operations or liquidity.

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 a material 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, 2024. The ASU can be adopted no later than December 1, 2024 with early adoption permitted. As discussed further in Note 7 and pursuant to the Second Amendment to Amended and Restated Credit Agreement, dated as of July 30, 2021, the Company’s 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.

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities:
Net income	$ 46,025	$ 45,126	$ 33,133
Adjustments to reconcile net income to net cash provided by operating activities, net of acquisitions:
Depreciation and amortization	14,060	14,494	12,051
Deferred income taxes	3,908	7,282	(4,652)
Stock-based compensation	10,625	9,434	6,005
Amortization of debt issuance costs under the credit facility	860	804	737
Provision for credit losses	678	962	918
Impairment of assets	1,174		1,256
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	20,592	(3,916)	23,860
Prepaid expenses and other current assets	1,471	(8,599)	(1,973)
Government stimulus advances	8,739	(27,914)	19,393
Accounts payable	2,514	(4,810)	2,159
Accrued payroll	(918)	7,888	5,228
Accrued expenses and other liabilities	(4,618)	(1,263)	11,296
Net cash provided by operating activities	105,110	39,488	109,411
Cash flows from investing activities:
Business acquisition, net of cash acquired	(98,290)	(37,370)	(207,660)
Proceeds on disposal of businesses			255
Purchases of property and equipment	(8,300)	(4,645)	(6,831)
Net cash used in investing activities	(106,590)	(42,015)	(214,236)
Cash flows from financing activities:
Borrowings on revolver — credit facility	47,000	46,395	135,000
Payments on revolver - credit facility	(137,000)
Payments on term loan — credit facility		(18,130)	(735)
Payments on financing lease obligations			(22)
Payments for debt issuance costs under the credit facility		(3,029)
Cash received from exercise of stock options	2,546	1,108	3,946
Net cash (used in) provided by financing activities	(87,454)	26,344	138,189
Net change in cash	(88,934)	23,817	33,364
Cash, at beginning of period	168,895	145,078	111,714
Cash, at end of period	79,961	168,895	145,078
Supplemental disclosures of cash flow information:
Cash paid for interest	7,985	5,094	2,365
Cash paid for income taxes	1,483	17,820	10,590
Supplemental disclosures of non-cash investing and financing activities
Leasehold improvements acquired through tenant allowances	295		5,161
Licensing fees included in fixed assets	$ 4,000
Tax benefit related to the amortization of tax goodwill in excess of book basis		$ 61	$ 225

Leases (Tables)

12 Months Ended

Dec. 31, 2022

Leases [Abstract]

Amounts Reported on Consolidated Balance Sheets for Operating Leases

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


	December 31,
	2022		2021
	(Amounts in Thousands)
Operating lease assets, net	$	38,980	$	36,048
Short-term operating lease liabilities (in accrued expenses)		10,801		9,774
Long-term operating lease liabilities		35,479		32,859
Total operating lease liabilities	$	46,280	$	42,633

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

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


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022			2021			2020
Operating lease costs	$	11,354		$	11,150		$	9,197
Short-term lease costs		2,885			739			761
Total lease costs		14,239			11,889			9,958
Less: sublease income		(951	)		(679	)		(323	)
Total lease costs, net	$	13,288		$	11,210		$	9,635

Schedule of Weighted Average Remaining Lease Terms and Discount Rates

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


	December 31,
	2022			2021			2020
Operating leases:
Weighted average remaining lease term		5.82			6.39			6.97
Weighted average discount rate		3.98	%		3.91	%		4.18	%

Summary of Remaining Operating Lease Payments

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


	Operating Leases
	(Amounts in Thousands)
Due in 12-month period ended December 31,
2023	$	12,470
2024		10,340
2025		7,246
2026		5,602
2027		4,241
Thereafter		12,115
Total future minimum rental commitments		52,014
Less: Imputed interest		(5,734	)
Total lease liabilities	$	46,280

Supplemental Cash Flows Information


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022		2021		2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	13,015	$	11,288	$	8,769
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	14,746	$	7,705	$	25,807

Acquisitions (Unaudited Pro Forma Condensed Consolidated Income Statement Information) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Armada Skilled Homecare [Member]
Business Acquisition [Line Items]
Net service revenues	$ 956,333	$ 936,601
Operating income from continuing operations	67,201	69,081
Net income from continuing operations	$ 44,959	$ 47,622
Queen City Hospice, A Plus and County Homemakers [Member]
Business Acquisition [Line Items]
Net service revenues			$ 831,290
Operating income from continuing operations			45,555
Net income from continuing operations			$ 34,564

Segment Information (Summary of Segment Information) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Segment Reporting Information [Line Items]
Net service revenues	$ 951,120	$ 864,499	$ 764,775
Cost of services revenues	651,381	594,651	538,538
Gross profit	299,739	269,848	226,237
General and administrative expenses	216,942	189,418	169,679
Operating income	68,737	65,936	44,507
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	120,525	101,910	89,635
Operating income	179,214	167,938	136,602
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues	706,507	685,854	647,233
Cost of services revenues	520,617	502,024	480,191
Gross profit	185,890	183,830	167,042
Personal Care [Member] \| Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	60,532	61,565	60,468
Operating income	125,358	122,265	106,574
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues	201,772	152,253	101,297
Cost of services revenues	100,956	75,186	47,197
Gross profit	100,816	77,067	54,100
Hospice [Member] \| Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	49,742	34,632	25,394
Operating income	51,074	42,435	28,706
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues	42,841	26,392	16,245
Cost of services revenues	29,808	17,441	11,150
Gross profit	13,033	8,951	5,095
Home Health [Member] \| Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	10,251	5,713	3,773
Operating income	$ 2,782	$ 3,238	$ 1,322

Government Actions to Mitigate COVID-19's Impact (Tables)

12 Months Ended

Dec. 31, 2022

Government Assistance [Abstract]

Schedule of Government Stimulus Advances

Government stimulus advances consisted of the following:


	December 31,
	2022		2021
	(Amounts in Thousands)
Payroll tax deferral	$	—	$	4,173
ARPA funds		12,912		—
Total government stimulus advances	$	12,912	$	4,173

Leases (Amounts Reported on Consolidated Balance Sheets for Operating Leases) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Operating lease assets, net	$ 38,980	$ 36,048
Short-term operating lease liabilities (in accrued expenses)	$ 10,801	$ 9,774
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued Liabilities, Current	Accrued Liabilities, Current
Long-term operating lease liabilities	$ 35,479	$ 32,859
Total operating lease liabilities	$ 46,280	$ 42,633

Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details)	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Leases [Abstract]
Weighted average remaining lease term	5 years 9 months 25 days	6 years 4 months 20 days	6 years 11 months 19 days
Weighted average discount rate	3.98%	3.91%	4.18%

Segment Information

12 Months Ended

Dec. 31, 2022

Segment Reporting [Abstract]

Segment Information

12. 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 years ended December 31, 2022, 2021 and 2020 along with the items necessary to reconcile the segment information to the totals reported in the accompanying 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 Year Ended December 31, 2022
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	706,507	$	201,772	$	42,841	$	951,120
Cost of services revenues		520,617		100,956		29,808		651,381
Gross profit		185,890		100,816		13,033		299,739
General and administrative expenses		60,532		49,742		10,251		120,525
Segment operating income	$	125,358	$	51,074	$	2,782	$	179,214

	For the Year Ended December 31, 2021
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	685,854	$	152,253	$	26,392	$	864,499
Cost of services revenues		502,024		75,186		17,441		594,651
Gross profit		183,830		77,067		8,951		269,848
General and administrative expenses		61,565		34,632		5,713		101,910
Segment operating income	$	122,265	$	42,435	$	3,238	$	167,938

	For the Year Ended December 31, 2020
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	647,233	$	101,297	$	16,245	$	764,775
Cost of services revenues		480,191		47,197		11,150		538,538
Gross profit		167,042		54,100		5,095		226,237
General and administrative expenses		60,468		25,394		3,773		89,635
Segment operating income	$	106,574	$	28,706	$	1,322	$	136,602


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022			2021			2020
Segment reconciliation:
Total segment operating income	$	179,214		$	167,938		$	136,602

Items not allocated at segment level:
Other general and administrative expenses		96,417			87,508			80,044
Depreciation and amortization		14,060			14,494			12,051
Interest income		(341	)		(268	)		(624	)
Interest expense		8,907			5,806			3,189
Income before income taxes	$	60,171		$	60,398		$	41,942

- 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 https://asc.fasb.org/extlink&oid=126901519&loc=d3e8924-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 34
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8981-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 21
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9031-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (f)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (e)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 26
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8844-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-Section 50
-Paragraph 41
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9038-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (d)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9054-108599

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8657-108599

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-URI https://asc.fasb.org/topic&trid=2134510

+ Details

Property and Equipment

12 Months Ended

Dec. 31, 2022

Property, Plant and Equipment [Abstract]

Property and Equipment

4. Property and Equipment

Property and equipment consisted of the following:


	December 31,
	2022			2021
	(Amounts in Thousands)
Computer software	$	19,675		$	13,541
Computer equipment		12,343			10,313
Leasehold improvements		10,746			9,712
Furniture and equipment		5,534			5,220
Transportation equipment		194			194
		48,492			38,980
Less: accumulated depreciation and amortization		(27,310	)		(20,497	)
	$	21,182		$	18,483

Computer software includes $1.6 million and $1.5 million of internally developed software for the years ended December 31, 2022 and 2021, respectively. Depreciation and amortization expense totaled $6.8 million, $5.9 million and $5.0 million for the years ended December 31, 2022, 2021 and 2020, respectively.

Commitments and Contingencies

12 Months Ended

Dec. 31, 2022

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

11. 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 Consolidated Balance Sheets and Consolidated Statements of Income.

Concentration of Cash

The Company owns financial instruments that potentially subject the Company to significant concentrations of credit risk, including cash. The Company maintains cash with financial institutions which, at times, may exceed federally insured limits. The Company believes it is not exposed to any significant credit risk on cash.

Income Taxes (Reconciliation of Statutory Federal Tax Rate) (Details)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Components of Income Tax Expense (Benefit), Continuing Operations [Abstract]
Federal income tax at statutory rate	21.00%	21.00%	21.00%
State and local taxes, net of federal benefit	5.90%	6.30%	6.00%
162(m) disallowance for executive compensation	3.20%	3.50%	6.00%
Nondeductible penalties		0.60%
Excess tax benefit	(0.40%)	(2.00%)	(5.60%)
Jobs tax credits, net	(5.10%)	(4.10%)	(5.10%)
Nondeductible permanent items			0.40%
Federal/state return to provision	(1.00%)		(1.60%)
Other	(0.10%)	(0.10%)	(0.10%)
Effective income tax rate	23.50%	25.20%	21.00%

Significant Accounting Policies (Narrative) (Details)	12 Months Ended
Significant Accounting Policies (Narrative) (Details)	Dec. 31, 2022 USD ($) Segment Item shares	Dec. 31, 2021 USD ($) shares	Dec. 31, 2020 USD ($) shares	Jun. 30, 2022
Summary Of Significant Accounting Policies [Line Items]
Number of operating segments \| Segment	3
Net service revenues	$ 951,120,000	$ 864,499,000	$ 764,775,000
Contract with customer liability	900,000	300,000
Aggregate market cap	32,486.92
Goodwill impairment charge	0	0	0
Goodwill	582,837,000	504,392,000	469,072,000
Impairment of finite-lived intangible assets	0	0	0
Intangibles, net of accumulated amortization	72,188,000	64,321,000
Deductible component of workers' compensation	400,000
Letters of credit secure compensation program	8,200,000	8,200,000
Accrued workers’ compensation insurance	12,897,000	12,998,000
Workers' compensation insurance recovery receivables	$ 666,000	1,559,000
Number of stock incentive plans \| Item	1
Stock-based compensation expense	$ 10,600,000	9,400,000	6,000,000.0
Stock Options [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock-based compensation expense	$ 1,200,000	$ 1,400,000	$ 2,000,000.0
Number of stock options included in calculation \| shares	468,000	493,000	506,000
Number of dilutive shares outstanding \| shares	248,000	282,000	304,000
Restricted Stock [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock-based compensation expense	$ 9,400,000	$ 8,000,000.0	$ 4,000,000.0
Number of dilutive shares outstanding \| shares	72,000	44,000	57,000
Shares of restricted stock awards included in calculation \| shares	209,000	159,000	154,000
Personal Care [Member]
Summary Of Significant Accounting Policies [Line Items]
Net service revenues	$ 706,507,000	$ 685,854,000	$ 647,233,000
Percent of fair value of reporting unit excess of carrying value	100.00%	100.00%
Goodwill	$ 152,688,000	$ 152,688,000	152,448,000
Home Health [Member]
Summary Of Significant Accounting Policies [Line Items]
Net service revenues	$ 42,841,000	26,392,000	16,245,000
Percent of fair value of reporting unit excess of carrying value	75.00%
Goodwill	$ 32,421,000	23,370,000	1,791,000
Hospice [Member]
Summary Of Significant Accounting Policies [Line Items]
Net service revenues	$ 201,772,000	152,253,000	101,297,000
Percent of fair value of reporting unit excess of carrying value	67.00%			67.00%
Goodwill	$ 397,728,000	328,334,000	314,833,000
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Leases termination and renewal option	1 year
Intangible assets, estimated useful lives	1 year
Minimum [Member] \| Customer and Referral Relationships [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, estimated useful lives	5 years
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Leases termination and renewal option	5 years
Intangible assets, estimated useful lives	25 years
Maximum [Member] \| Customer and Referral Relationships [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, estimated useful lives	10 years
General and Administrative Expenses [Member]
Summary Of Significant Accounting Policies [Line Items]
Operating lease asset, impairment	$ 1,200,000
General and Administrative Expenses [Member] \| Certain Support Center Office Space [Member]
Summary Of Significant Accounting Policies [Line Items]
Operating lease asset, impairment			$ 1,000,000.0
Accounting Standards Update 2014-09 [Member]
Summary Of Significant Accounting Policies [Line Items]
Accounts receivable, allowance for credit losses	1,600,000	1,400,000
Accounting Standards Update 2014-09 [Member] \| Adjustments in Prior Year \| Subsequent Changes [Member]
Summary Of Significant Accounting Policies [Line Items]
Net service revenues	$ 8,800,000	$ 5,700,000
Accounting Standards Update 2019-12
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, 2021
Accounting Standards Update 2021-10 [Member]
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

Significant Accounting Policies (Estimated Useful Lives of Property and Equipment) (Details)	12 Months Ended
	Dec. 31, 2022
Computer Equipment [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	3 years
Computer Equipment [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	5 years
Furniture and Equipment [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	5 years
Furniture and Equipment [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	7 years
Transportation Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	5 years
Computer Software [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	3 years
Computer Software [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	10 years
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Leasehold improvements	Lesser of useful life or lease term

Significant Payors (Narrative) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Concentration Risk [Line Items]
Net service revenues	$ 951,120	$ 864,499	$ 764,775
Operating income	68,737	$ 65,936	$ 44,507
New York [Member] \| CDPAP
Concentration Risk [Line Items]
Net service revenues	$ 39,200
Revenues [Member] \| Geographic Concentration Risk [Member] \| Illinois [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	43.80%	38.20%	37.70%
Revenues [Member] \| Illinois Department On Aging [Member] \| Illinois [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	20.70%	21.40%	23.00%
Accounts Receivable [Member] \| Illinois Department On Aging [Member] \| Illinois [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	18.00%	16.10%

Government Actions to Mitigate COVID-19's Impact (Narrative) (Details) - USD ($)		1 Months Ended		3 Months Ended	12 Months Ended				23 Months Ended
	Jul. 01, 2022	Jan. 31, 2022	Nov. 30, 2020	Jun. 30, 2022	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Mar. 31, 2022	Jun. 30, 2020
Government Assistance [Line Items]
Net service revenues					$ 951,120,000		$ 864,499,000	$ 764,775,000
Payroll tax deferral							4,173,000
Hospice [Member]
Government Assistance [Line Items]
Net service revenues					201,772,000		152,253,000	101,297,000
Home Health [Member]
Government Assistance [Line Items]
Net service revenues					42,841,000		26,392,000	16,245,000
Personal Care [Member]
Government Assistance [Line Items]
Net service revenues					706,507,000		685,854,000	$ 647,233,000
ARPA [Member]
Government Assistance [Line Items]
Relief funding to mitigate fiscal effects of COVID-19						$ 350,000,000,000
percentage point increase in federal matching funds						10.00%
Aggregate funding amount					23,400,000		1,000,000.0
Revenues					1,900,000		1,000,000.0
Cost of revenue					1,500,000		700,000
Fund distributed to primarily for caregivers and retention efforts					8,600,000
Decrease in cost of service revenues					7,000,000.0
Decrease in general and administrative expenses					1,600,000
Deferred portion of spending plans					12,900,000
Aggregate principal amount of grants received					$ 21,500,000
CARES Act [Member]
Government Assistance [Line Items]
Percentage of reduced payments to Medicare providers	2.00%								2.00%
Reduction percentage on sequestration adjustment				1.00%
Deferred payroll taxes payment term					2 years
Payroll tax deferral										$ 7,100,000
Deferred payroll taxes repaid					$ 4,100,000		3,000,000.0
CARES Act [Member] \| Provider Relief Fund [Member]
Government Assistance [Line Items]
Aggregate principal amount of grants received			$ 13,700,000
Fund distributed to health care related expenses							12,300,000
CARES Act [Member] \| Provider Relief Fund [Member] \| Minimum [Member]
Government Assistance [Line Items]
Annual awards for commercial organizations					750,000
CARES Act [Member] \| Hospice [Member]
Government Assistance [Line Items]
Net service revenues					1,400,000		2,900,000
CARES Act [Member] \| Home Health [Member]
Government Assistance [Line Items]
Net service revenues					$ 300,000		$ 500,000
PAYGO Act [Member]
Government Assistance [Line Items]
Percentage of additional payment reduction		4.00%

Stock Options And Restricted Stock Awards (Tables)

12 Months Ended

Dec. 31, 2022

Share-Based Payment Arrangement [Abstract]

Summary of Stock Option Activity and Weighted Average Exercise Price

A summary of stock option activity and weighted average exercise price for the year ended December 31, 2022 follows:


	Options (Amounts in Thousands)			Weighted Average Exercise Price
Outstanding, beginning of period		493		$	41.77
Granted		38			88.42
Exercised		(63	)		40.55
Forfeited/Cancelled		—			—
Outstanding, end of period		468		$	45.72

Weighted-Average Estimated Fair Value of Employee Stock Options Granted


	2022		2021		2020
	Grants		Grants		Grants
Weighted average fair value	$	32.96	$	32.71	$	—
Risk-free discount rate	1.76% - 2.86%		0.65%			—
Expected life	4.2 years		4.1 years			—
Dividend yield		—		—		—
Volatility	43%		45%			—

Summary of Unvested Restricted Stock Awards and Weighted Average Grant Date Fair Value

A summary of unvested restricted stock awards activity and weighted average grant date fair value for the year ended December 31, 2022 follows:


	Restricted Stock Awards (Amounts in Thousands)			Weighted Average Grant Date Fair Value
Unvested restricted stock awards, beginning of period		159		$	104.91
Awarded		130			71.91
Vested		(74	)		95.73
Forfeited		(5	)		85.53
Unvested restricted stock awards, end of period		210		$	88.22

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Details Of Certain Balance Sheet Accounts [Abstract]
Current portion of operating lease liabilities	$ 10,801	$ 9,774
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Total accrued expenses	Total accrued expenses
Payor advances	$ 4,473	$ 6,485
Accrued health insurance	5,152	5,200
Accrued professional fees	3,576	2,978
Accrued payroll taxes	3,525	1,872
Other	10,781	10,768
Total accrued expenses	$ 38,308	$ 37,077

Details of Certain Balance Sheet Accounts

12 Months Ended

Dec. 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:


	December 31,
	2022		2021
	(Amounts in Thousands)
Income tax receivable	$	—	$	7,556
Prepaid payroll		7,566		—
Prepaid workers’ compensation and liability insurance		3,399		3,206
Workers’ compensation insurance receivable		666		1,559
Other		5,714		6,170
Total prepaid expenses and other current assets	$	17,345	$	18,491

Accrued expenses consisted of the following:


	December 31,
	2022		2021
	(Amounts in Thousands)
Current portion of operating lease liabilities	$	10,801	$	9,774
Payor advances (1)		4,473		6,485
Accrued health insurance		5,152		5,200
Accrued professional fees		3,576		2,978
Accrued payroll taxes		3,525		1,872
Other		10,781		10,768
Total accrued expenses	$	38,308	$	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.

Significant Accounting Policies

12 Months Ended

Dec. 31, 2022

Accounting Policies [Abstract]

Significant Accounting Policies

1. Significant Accounting Policies

Basis of Presentation and Description of Business

The Consolidated Financial Statements include the accounts of Addus HomeCare Corporation (“Holdings”) and its subsidiaries (together with Holdings, the “Company,” “we,” “us,” or “our”). The Company operates 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 payor clients include federal, state and local governmental agencies, managed care organizations, commercial insurers and private individuals.

Principles of Consolidation

All intercompany balances and transactions have been eliminated in consolidation.

Revenue Recognition

Personal Care

Hospice Revenue

Home Health Revenue

Accounts Receivable and Allowances

Activity in the allowance for credit losses is as follows (in thousands):


Allowance for credit losses	Balance at beginning of period		Additions/ charges		Deductions (1)		Balance at end of period
Year ended December 31, 2022
Allowance for credit losses	$	1,433		678		477	$	1,634
Year ended December 31, 2021
Allowance for credit losses	$	973		962		502	$	1,433
Year ended December 31, 2020
Allowance for credit losses	$	962		918		907	$	973

(1) Write-offs, net of recoveries

Property and Equipment


Computer equipment		3-5 years
Furniture and equipment		5-7 years
Transportation equipment		5 years
Computer software		3-10 years
Leasehold improvements		Lesser of useful life or lease term

Leases

Goodwill and Intangible Assets

Debt Issuance Costs

Workers’ Compensation Program

Interest Expense

Interest expense is reported in the Consolidated Statements of Income when incurred and consists of interest and unused credit line fees on the credit facility.

Income Tax Expense

Stock-based Compensation

Diluted Net Income Per Common Share

Use of Estimates

Fair Value Measurements

Going Concern

Recently Adopted Accounting Pronouncements

Recently Issued Accounting Pronouncements

Leases (Components of Lease Cost Reported in General and Administrative Expenses in Consolidated Statements of Income) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Leases [Abstract]
Operating lease costs	$ 11,354	$ 11,150	$ 9,197
Short-term lease costs	2,885	739	761
Total lease costs	14,239	11,889	9,958
Less: sublease income	(951)	(679)	(323)
Total lease costs, net	$ 13,288	$ 11,210	$ 9,635

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 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	16,128,000	15,940,000
Common stock, shares outstanding	16,128,000	15,940,000

Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2022

Accounting Policies [Abstract]

Activity in Allowance for Credit Losses

Activity in the allowance for credit losses is as follows (in thousands):


Allowance for credit losses	Balance at beginning of period		Additions/ charges		Deductions (1)		Balance at end of period
Year ended December 31, 2022
Allowance for credit losses	$	1,433		678		477	$	1,634
Year ended December 31, 2021
Allowance for credit losses	$	973		962		502	$	1,433
Year ended December 31, 2020
Allowance for credit losses	$	962		918		907	$	973

(1) Write-offs, net of recoveries

Estimated Useful Lives of Property and Equipment

The estimated useful lives of the property and equipment are as follows:


Computer equipment		3-5 years
Furniture and equipment		5-7 years
Transportation equipment		5 years
Computer software		3-10 years
Leasehold improvements		Lesser of useful life or lease term

Leases (Narrative) (Details) - Frisco, Texas $ in Millions	Nov. 14, 2022 USD ($)
Lessee, Lease, Description [Line Items]
Sublease commencement date	Nov. 14, 2022
Sublease term	2 years
Sublease monthly base rent	$ 0.1

Acquisitions

12 Months Ended

Dec. 31, 2022

Business Combinations [Abstract]

Acquisitions

3. 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 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, the Company completed the acquisition of the hospice and palliative operations of JourneyCare Inc. (“JourneyCare”). The purchase price was approximately $86.6 million, including the amount of acquired excess cash held by JourneyCare at the closing of the acquisition (approximately $0.4 million) plus the finalization of net working capital payable to seller

of $1.6 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 $0.5 million and $4.3 million, respectively, for the year ended December 31, 2022. These costs are included in general and administrative expenses on the 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	$	69,446
Identifiable intangible assets		13,792
Cash		421
Accounts receivable		7,747
Property and equipment		1,194
Operating lease assets, net		3,728
Other assets		317
Accrued expenses		(5,002	)
Accrued payroll		(1,511	)
Long-term operating lease liabilities		(3,537	)
Total purchase price	$	86,595

Identifiable intangible assets acquired included $9.0 million in a trade name and $4.8 million of indefinite-lived state licenses. The 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.

JourneyCare accounted for $47.2 million and $9.1 million of the Company’s net service revenues and operating income for the year ended December 31, 2022.

Armada Skilled Homecare

On August 1, 2021, we completed the acquisition of Armada Skilled Homecare of New Mexico LLC, Armada Hospice of New Mexico LLC and Armada Hospice of Santa Fe LLC (collectively, “Armada”) for approximately $29.7 million, including the amount of acquired excess cash held by Armada at the closing of the acquisition (approximately $0.7 million). The purchase of Armada was funded with the Company’s revolving credit facility. With the purchase of Armada, the Company expanded its home health and hospice services in the state of New Mexico. The related acquisition and integration costs were $0.4 million and $0.5 million, respectively, for the year ended December 31, 2021. These costs are included in general and administrative expenses on the Consolidated Statements of Income and were expensed as incurred.

Based upon management’s final valuations, the fair values of the assets and liabilities acquired are as follows:


	Total (Amounts in Thousands)
Goodwill	$	28,287
Identifiable intangible assets		990
Cash		676
Property and equipment		40
Other assets		24
Accounts payable		—
Accrued payroll		(361	)
Total purchase price	$	29,656

Identifiable intangible assets acquired included $0.6 million of non-competition agreements with estimated useful lives of five years and $0.4 million of indefinite-lived state licenses. The 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.

Queen City Hospice

On December 4, 2020, we completed the acquisition of Queen City Hospice, LLC and its affiliate Miracle City Hospice, LLC (together “Queen City Hospice”). The purchase price was approximately $194.8 million, including the amount of acquired excess cash held by Queen City Hospice at the closing of the acquisition (approximately $15.4 million). The purchase of Queen City Hospice was funded with the Company’s revolving credit facility and available cash. With the purchase of Queen City Hospice, the Company expanded its hospice services in the state of Ohio. The related acquisition costs were $1.8 million for the year ended December 31, 2021. For the year ended December 31, 2021, integration costs were $2.2 million. These costs are included in general and administrative expenses on the Consolidated Statements of Income and were expensed as incurred.

Based upon management’s final valuations, the fair values of the assets and liabilities are as follows:


	Total (Amounts in Thousands)
Goodwill	$	169,338
Identifiable intangible assets		20,015
Cash		15,444
Accounts receivable		5,915
Property and equipment		759
Operating lease assets, net		3,028
Other assets		85
Accounts payable		(2,285	)
Accrued payroll		(1,555	)
Accrued expenses		(528	)
Government stimulus advances		(12,694	)
Long-term operating lease liabilities		(2,765	)
Total purchase price	$	194,757

Identifiable intangible assets acquired included $11.0 million in trade names, $1.5 million of non-competition agreements with estimated useful lives of fifteen years and five years, respectively, and $7.5 million of indefinite lived state licenses. The 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.

County Homemakers

On November 1, 2020, we completed the acquisition of County Homemakers. The purchase price was approximately $15.8 million, including the amount of acquired excess cash held by County Homemakers at the closing of the acquisition (approximately $1.1 million). The purchase of County Homemakers was funded with the Company’s available cash. With the purchase of County Homemakers, the Company expanded its personal care services in the state of Pennsylvania. The related integration and acquisition costs were $0.2 million and $0.3 million for the year ended December 31, 2020, respectively. These costs are included in general and administrative expenses on the Consolidated Statements of Income and were expensed as incurred.

Based upon management’s final valuations, the fair values of the assets and liabilities are as follows:


	Total (Amounts in Thousands)
Goodwill	$	13,502
Identifiable intangible assets		474
Cash		1,104
Accounts receivable		1,357
Property and equipment		52
Operating lease assets, net		485
Other assets		40
Accounts payable		(85	)
Accrued payroll		(586	)
Accrued expenses		(37	)
Long-term operating lease liabilities		(485	)
Total purchase price	$	15,821

Identifiable intangible assets acquired included approximately $0.3 million in state licenses and $0.1 million in trade names with estimated useful lives of eight years and one year, respectively. The 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.

A Plus Health Care

On July 1, 2020, we completed the acquisition of A Plus Health Care, Inc. (“A Plus”). The purchase price was approximately $14.5 million, including the amount of acquired excess cash held by A Plus at the closing of the acquisition (approximately $2.8 million). The purchase of A Plus was funded with the Company’s available cash. With the purchase of A Plus, the Company expanded its personal care services in the state of Montana. The related acquisition and integration costs were $0.4 million and $0.3 million, respectively, for the year ended December 31, 2020. These costs are included in general and administrative expenses on the Consolidated Statements of Income and were expensed as incurred.

Based upon management’s final valuations, the fair values of the assets and liabilities are as follows:


	Total (Amounts in Thousands)
Goodwill	$	9,732
Identifiable intangible assets		1,523
Cash		2,819
Accounts receivable		1,009
Operating lease assets, net		180
Other assets		26
Accounts payable		(34	)
Accrued payroll		(275	)
Accrued expenses		(353	)
Long-term operating lease liabilities		(100	)
Total purchase price	$	14,527

Identifiable intangible assets acquired included $1.4 million in trade names with an estimated useful life of fifteen years. The 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.

Other Acquisitions

On October 1, 2022, we completed the acquisition of Apple Home HealthCare LTD (“Apple Home”) for approximately $12.7 million, with funding provided by drawing on the Company’s revolving credit facility. In addition to the initial consideration, the total purchase price also includes potential additional contingent consideration to the previous owners of Apple Home of up to approximately $2 million. The contingent consideration will vary based upon performance relative to certain agreed upon earnings targets in 2022 and 2023. With the purchase of Apple Home, the Company expanded clinical services for its home health segment in Illinois and recorded goodwill of $8.9 million.

On October 1, 2021, we completed the acquisition of Summit Home Health, LLC (“Summit”) for approximately $8.1 million, with funding provided by available cash. With the purchase of Summit, we added clinical services to our home health segment in Illinois and recorded goodwill of $6.5 million.

For the year ended December 31, 2022, the following table contains unaudited pro forma Consolidated Income Statement information of the Company as if the acquisition of JourneyCare closed on January 1, 2021. For the year ended December 31, 2021, the following table contains unaudited pro forma Consolidated Income Statement information of the Company as if the acquisition of Armada closed on January 1, 2020. For the year ended December 31, 2020, the following table contains unaudited pro forma Consolidated Income Statement information of the Company as if each of the acquisitions of Queen City Hospice, A Plus and County Homemakers closed on January 1, 2020.


	For the Years Ended December 31, (Amounts in Thousands, Unaudited)
	2022		2021		2020
Net service revenues	$	956,333	$	936,601	$	831,290
Operating income from continuing operations		67,201		69,081		45,555
Net income from continuing operations		44,959		47,622		34,564

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. 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 (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	$ 27,108	$ 21,124
Intangible assets subject to amortization:
Gross carrying amount	116,020	106,891
Accumulated amortization	(70,940)	(63,694)
Intangible assets subject to amortization, net	45,080	43,197
Net balance at end of period	72,188	64,321
Customer and Referral Relationships [Member]
Intangible assets subject to amortization:
Gross carrying amount	44,672	44,672
Accumulated amortization	(38,088)	(36,342)
Intangible assets subject to amortization, net	6,584	8,330
Net balance at end of period	6,584	8,330
Trade Names and Trademarks [Member]
Intangible assets subject to amortization:
Gross carrying amount	52,046	42,926
Accumulated amortization	(21,058)	(18,494)
Intangible assets subject to amortization, net	30,988	24,432
Net balance at end of period	30,988	24,432
Non-competition Agreements [Member]
Intangible assets subject to amortization:
Gross carrying amount	6,785	6,785
Accumulated amortization	(4,785)	(3,831)
Intangible assets subject to amortization, net	2,000	2,954
Net balance at end of period	2,000	2,954
State Licenses [Member]
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	27,108	21,124
Intangible assets subject to amortization:
Gross carrying amount	12,517	12,508
Accumulated amortization	(7,009)	(5,027)
Intangible assets subject to amortization, net	5,508	7,481
Net balance at end of period	$ 32,616	$ 28,605

Document And Entity Information - USD ($)	12 Months Ended
Document And Entity Information - USD ($)	Dec. 31, 2022	Feb. 17, 2023	Jun. 30, 2022
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2022
Document Fiscal Period Focus	FY
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 Common Stock, Shares Outstanding		16,127,766
Entity Public Float			$ 1,311,167,000
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common Stock, $0.001 par value
Security Exchange Name	NASDAQ
Entity File Number	001-34504
Entity Incorporation, State or Country Code	DE
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
Document Annual Report	true
Document Transition Report	false
ICFR Auditor Attestation Flag	true
Auditor Firm ID	238
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Dallas, Texas
Documents Incorporated by Reference	Certain portions of the registrant’s Definitive Proxy Statement for its 2023 Annual Meeting of Stockholders (which is expected to be filed with the Commission within 120 days after the end of the registrant’s 2021 fiscal year) are incorporated by reference into Part III of this Annual Report on Form 10-K.

Long-Term Debt (Narrative) (Details) - Credit Agreement [Member] - USD ($)			12 Months Ended
	Aug. 01, 2021	Jul. 30, 2021	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Line of credit outstanding amount			$ 8,200,000	$ 8,200,000
Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available			237,200,000	143,600,000
Debt instrument, maturity date		Jul. 30, 2026
Debt instrument total net leverage ratio		4.25%
Line of credit outstanding amount			$ 380,200,000	$ 376,600,000
Capital One, National Association [Member] \| Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument stated interest rate			6.13%	2.10%
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
Line of credit outstanding amount			134,900,000	$ 224,900,000
Revolving Credit Loan [Member] \| Capital One, National Association [Member] \| Armada Skilled Homecare [Member]
Debt Instrument [Line Items]
Proceeds from line of credit	$ 29,000,000.0
Revolving Credit Loan [Member] \| Capital One, National Association [Member] \| The Journey Care and Apple Home Acquisitions [Member]
Debt Instrument [Line Items]
Proceeds from line of credit			$ 47,000,000.0
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]
Debt Instrument [Line Items]
Maximum aggregate loan amount available			$ 125,000,000.0

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, 2019	$ 475,592	$ 15	$ 359,545	$ 116,032
Balance, shares at Dec. 31, 2019		15,617
Issuance of shares of common stock under restricted stock award agreements, shares		88
Forfeiture of shares of common stock under restricted stock award agreements, shares		(6)
Stock-based compensation	6,005		6,005
Shares issued for exercise of stock options	3,946	$ 1	3,945
Shares issued for exercise of stock options, shares		127
Net income	33,133			33,133
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		89
Forfeiture of shares of common stock under restricted stock award agreements, shares		(7)
Stock-based compensation	9,434		9,434
Shares issued for exercise of stock options	1,108		1,108
Shares issued for exercise of stock options, shares		32
Net income	45,126			45,126
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		129
Forfeiture of shares of common stock under restricted stock award agreements, shares		4
Stock-based compensation	10,625		10,625
Shares issued for exercise of stock options	2,546		2,546
Shares issued for exercise of stock options, shares		63
Net income	46,025			46,025
Balance at Dec. 31, 2022	$ 633,540	$ 16	$ 393,208	$ 240,316
Balance, shares at Dec. 31, 2022		16,128

- 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

Acquisitions (Schedule of Fair Values of Assets and Liabilities) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Feb. 01, 2022	Dec. 31, 2021	Aug. 01, 2021	Dec. 31, 2020	Dec. 04, 2020	Nov. 01, 2020	Jul. 01, 2020
Business Acquisition [Line Items]
Goodwill	$ 582,837		$ 504,392		$ 469,072
JourneyCare [Member]
Business Acquisition [Line Items]
Goodwill		$ 69,446
Identifiable intangible assets		13,792
Cash		421
Accounts receivable		7,747
Property and equipment		1,194
Operating lease assets, net		3,728
Other assets		317
Accrued payroll		(1,511)
Accrued expenses		(5,002)
Long-term operating lease liabilities		(3,537)
Total purchase price		$ 86,595
Armada Skilled Homecare [Member]
Business Acquisition [Line Items]
Goodwill				$ 28,287
Identifiable intangible assets				990
Cash				676
Property and equipment				40
Other assets				24
Accrued payroll				(361)
Total purchase price				$ 29,656
Queen City Hospice [Member]
Business Acquisition [Line Items]
Goodwill						$ 169,338
Identifiable intangible assets						20,015
Cash						15,444
Accounts receivable						5,915
Property and equipment						759
Operating lease assets, net						3,028
Other assets						85
Accounts payable						(2,285)
Accrued payroll						(1,555)
Accrued expenses						(528)
Government stimulus advances						(12,694)
Long-term operating lease liabilities						(2,765)
Total purchase price						$ 194,757
County Homemakers [Member]
Business Acquisition [Line Items]
Goodwill							$ 13,502
Identifiable intangible assets							474
Cash							1,104
Accounts receivable							1,357
Property and equipment							52
Operating lease assets, net							485
Other assets							40
Accounts payable							(85)
Accrued payroll							(586)
Accrued expenses							(37)
Long-term operating lease liabilities							(485)
Total purchase price							$ 15,821
A Plus Health Care, Inc [Member]
Business Acquisition [Line Items]
Goodwill								$ 9,732
Identifiable intangible assets								1,523
Cash								2,819
Accounts receivable								1,009
Operating lease assets, net								180
Other assets								26
Accounts payable								(34)
Accrued payroll								(275)
Accrued expenses								(353)
Long-term operating lease liabilities								(100)
Total purchase price								$ 14,527

Acquisitions (Tables)

12 Months Ended

Dec. 31, 2022

Business Acquisition [Line Items]

Unaudited Pro Forma Condensed Consolidated Income Statement Information


	For the Years Ended December 31, (Amounts in Thousands, Unaudited)
	2022		2021		2020
Net service revenues	$	956,333	$	936,601	$	831,290
Operating income from continuing operations		67,201		69,081		45,555
Net income from continuing operations		44,959		47,622		34,564

JourneyCare [Member]

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	$	69,446
Identifiable intangible assets		13,792
Cash		421
Accounts receivable		7,747
Property and equipment		1,194
Operating lease assets, net		3,728
Other assets		317
Accrued expenses		(5,002	)
Accrued payroll		(1,511	)
Long-term operating lease liabilities		(3,537	)
Total purchase price	$	86,595

Armada Skilled Homecare [Member]

Business Acquisition [Line Items]

Schedule of Fair Values of Assets and Liabilities

Based upon management’s final valuations, the fair values of the assets and liabilities acquired are as follows:


	Total (Amounts in Thousands)
Goodwill	$	28,287
Identifiable intangible assets		990
Cash		676
Property and equipment		40
Other assets		24
Accounts payable		—
Accrued payroll		(361	)
Total purchase price	$	29,656

Queen City Hospice [Member]

Business Acquisition [Line Items]

Schedule of Fair Values of Assets and Liabilities

Based upon management’s final valuations, the fair values of the assets and liabilities are as follows:


	Total (Amounts in Thousands)
Goodwill	$	169,338
Identifiable intangible assets		20,015
Cash		15,444
Accounts receivable		5,915
Property and equipment		759
Operating lease assets, net		3,028
Other assets		85
Accounts payable		(2,285	)
Accrued payroll		(1,555	)
Accrued expenses		(528	)
Government stimulus advances		(12,694	)
Long-term operating lease liabilities		(2,765	)
Total purchase price	$	194,757

County Homemakers [Member]

Business Acquisition [Line Items]

Schedule of Fair Values of Assets and Liabilities

Based upon management’s final valuations, the fair values of the assets and liabilities are as follows:


	Total (Amounts in Thousands)
Goodwill	$	13,502
Identifiable intangible assets		474
Cash		1,104
Accounts receivable		1,357
Property and equipment		52
Operating lease assets, net		485
Other assets		40
Accounts payable		(85	)
Accrued payroll		(586	)
Accrued expenses		(37	)
Long-term operating lease liabilities		(485	)
Total purchase price	$	15,821

A Plus Health Care, Inc [Member]

Business Acquisition [Line Items]

Schedule of Fair Values of Assets and Liabilities

Based upon management’s final valuations, the fair values of the assets and liabilities are as follows:


	Total (Amounts in Thousands)
Goodwill	$	9,732
Identifiable intangible assets		1,523
Cash		2,819
Accounts receivable		1,009
Operating lease assets, net		180
Other assets		26
Accounts payable		(34	)
Accrued payroll		(275	)
Accrued expenses		(353	)
Long-term operating lease liabilities		(100	)
Total purchase price	$	14,527

Long-Term Debt (Schedule of Long-Term Debt) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Less unamortized issuance costs	$ (3,081)	$ (3,941)
Total	131,772	220,912
Long-term debt	131,772	220,912
Revolving Credit Loan [Member] \| Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 134,853	$ 224,853

- Definition

Amount, excluding unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

Segment Information (Segment Reconciliation to Totals reported in the accompanying Consolidated Financial Statements) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Segment Reporting Information [Line Items]
Operating income	$ 68,737	$ 65,936	$ 44,507
Other general and administrative expenses	96,417	87,508	80,044
Depreciation and amortization	14,060	14,494	12,051
Interest income	(341)	(268)	(624)
Interest expense	8,907	5,806	3,189
Income before income taxes	60,171	60,398	41,942
Operating Segments [Member]
Segment Reporting Information [Line Items]
Operating income	$ 179,214	$ 167,938	$ 136,602

- 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.

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-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(10))
-URI https://asc.fasb.org/extlink&oid=126953954&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 https://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
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-Subparagraph (SX 210.9-05(b)(2))
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-Publisher FASB
-Name Accounting Standards Codification
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-Section 50
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-URI https://asc.fasb.org/extlink&oid=126901519&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 https://asc.fasb.org/extlink&oid=120399700&loc=SL114874048-224260

+ Details

Income Taxes (Narrative) (Details)	12 Months Ended
Income Taxes (Narrative) (Details)	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Effective income tax rate	23.50%	25.20%	21.00%
U.S Federal authorities [Member] \| Minimum [Member]
Tax year open for examination	2019
U.S Federal authorities [Member] \| Maximum [Member]
Tax year open for examination	2021
State authorities [Member] \| Minimum [Member]
Tax year open for examination	2017
State authorities [Member] \| Maximum [Member]
Tax year open for examination	2021

Stock Options And Restricted Stock Awards (Summary of Stock Option Activity and Weighted Average Exercise Price) (Details) - Stock Options [Member] - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options, Outstanding, beginning of period shares	493,000
Options, Granted shares	38,000	0
Options, Exercised shares	(63,000)
Options, Outstanding, end of period shares	468,000
Weighted Average Exercise Price, Outstanding, beginning of period	$ 41.77
Weighted Average Exercise Price, Granted	88.42
Weighted Average Exercise Price, Exercised	40.55
Weighted Average Exercise Price, Outstanding, end of period	$ 45.72

Income Taxes (Deferred Tax Assets And Liabilities) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Income Tax Expense (Benefit), Effective Income Tax Rate Reconciliation, Amount [Abstract]
Deferred Tax Assets, Accounts receivable allowances	$ 18,515	$ 14,590
Deferred Tax Assets, Operating lease liabilities	12,472	11,623
Deferred Tax Assets, Accrued compensation	3,676	3,752
Deferred Tax Assets, Accrued workers' compensation	3,296	3,119
Deferred Tax Assets, Transactions Costs	2,056	1,803
Deferred Tax Assets, Stock-based compensation	1,473	1,293
Deferred Tax Assets, Government stimulus advances		1,138
Deferred Tax Assets, Restructuring costs	54	119
Deferred Tax Assets, Other	1,420	793
Total long-term deferred tax assets	42,962	38,230
Deferred Tax Liabilities, Goodwill and intangible assets	(34,310)	(26,097)
Deferred Tax Liabilities, Operating lease assets, net	(10,323)	(9,571)
Deferred Tax Liabilities, Property and equipment	(3,123)	(3,415)
Deferred Tax Liabilities, Insurance premiums	(916)	(876)
Total long-term deferred tax liabilities	(48,672)	(39,959)
Total net deferred tax liabilities	$ (5,710)	$ (1,729)

Acquisitions (Narrative) (Details) - USD ($) $ in Thousands								12 Months Ended
Acquisitions (Narrative) (Details) - USD ($) $ in Thousands	Oct. 01, 2022	Feb. 01, 2022	Oct. 01, 2021	Aug. 01, 2021	Dec. 04, 2020	Nov. 01, 2020	Jul. 01, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Total purchase price for business acquisition								$ 98,290	$ 37,370	$ 207,660
Net service revenues								951,120	864,499	764,775
Operating income								68,737	65,936	44,507
Goodwill								$ 582,837	504,392	469,072
Minimum [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								1 year
Maximum [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								25 years
JourneyCare [Member]
Business Acquisition [Line Items]
Net service revenues								$ 47,200
Operating income								9,100
Goodwill		$ 69,446
JourneyCare [Member] \| State Licenses [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired								4,800
Indefinite lived intangible assets acquired		4,800
JourneyCare [Member] \| Trade Names [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired		9,000						9,000
JourneyCare [Member] \| Illinois [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition		86,600
Excess cash held by acquired business		400
Integration costs								4,300
Business combination finalization of net working capital payable		1,600
Identifiable intangible assets acquired								500
JourneyCare [Member] \| Illinois [Member] \| Revolving Credit Loan [Member]
Business Acquisition [Line Items]
Line of credit outstanding amount		$ 35,000
Armada Skilled Homecare [Member]
Business Acquisition [Line Items]
Goodwill				$ 28,287
Armada Skilled Homecare [Member] \| Non-competition Agreements [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired				$ 600					600
Intangible assets, estimated useful lives				5 years
Armada Skilled Homecare [Member] \| State Licenses [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired									400
Indefinite lived intangible assets acquired				$ 400
Armada Skilled Homecare [Member] \| New Mexico [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition				29,700
Excess cash held by acquired business				$ 700
Acquisition related costs									400
Integration costs									500
Queen City Hospice [Member]
Business Acquisition [Line Items]
Goodwill					$ 169,338
Queen City Hospice [Member] \| Non-competition Agreements [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired					$ 1,500
Intangible assets, estimated useful lives					5 years
Queen City Hospice [Member] \| State Licenses [Member]
Business Acquisition [Line Items]
Indefinite lived intangible assets acquired					$ 7,500
Queen City Hospice [Member] \| Trade Names [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired					$ 11,000
Intangible assets, estimated useful lives					15 years
Queen City Hospice [Member] \| Ohio [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition					$ 194,800
Excess cash held by acquired business					$ 15,400
Acquisition related costs									1,800
Integration costs									$ 2,200
County Homemakers [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired								1,200
Goodwill						$ 13,502
County Homemakers [Member] \| State Licenses [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired						$ 300
Intangible assets, estimated useful lives						8 years
County Homemakers [Member] \| Trade Names [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired						$ 100		$ 100
Intangible assets, estimated useful lives						1 year
County Homemakers [Member] \| Pennsylvania [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition						$ 15,800
Excess cash held by acquired business						$ 1,100
Acquisition related costs										300
Integration costs										200
A Plus Health Care, Inc [Member]
Business Acquisition [Line Items]
Goodwill							$ 9,732
A Plus Health Care, Inc [Member] \| Trade Names [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired							$ 1,400
Intangible assets, estimated useful lives							15 years
A Plus Health Care, Inc [Member] \| Montana [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition							$ 14,500
Excess cash held by acquired business							$ 2,800
Acquisition related costs										400
Integration costs										$ 300
Apple Home [Member]
Business Acquisition [Line Items]
Acquisition completed date	Oct. 01, 2022
Business combination consideration transferred	$ 12,700
Potential additional contingent consideration	2,000
Goodwill	$ 8,900
Summit Home Health, LLC [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition			$ 8,100
Goodwill			$ 6,500

Significant Accounting Policies (Activity in Allowance for Credit Losses) (Details) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2022

Dec. 31, 2021

Dec. 31, 2020

Credit Loss [Abstract]

Balance at beginning of period

$ 1,433

$ 973

$ 962

Provision for credit losses

678

962

918

Deductions

^[1]

477

502

907

Balance at end of period

$ 1,634

$ 1,433

$ 973

[1]	Write-offs, net of recoveries

Income Taxes

12 Months Ended

Dec. 31, 2022

Income Tax Disclosure [Abstract]

Income Taxes

8. Income Taxes

The current and deferred federal and state income tax provision from continuing operations, are comprised of the following:


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022		2021		2020
Current
Federal	$	7,075	$	4,603	$	10,230
State		3,090		2,398		3,312
Deferred
Federal		3,118		6,407		(3,690	)
State		863		1,864		(1,043	)
Provision for income taxes	$	14,146	$	15,272	$	8,809

The tax effects of certain temporary differences between the Company’s book and tax bases of assets and liabilities give rise to significant portions of the deferred income tax assets (liabilities) at December 31, 2022 and 2021. The deferred tax assets (liabilities) consisted of the following:


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022			2021
Deferred tax assets
Long-term
Accounts receivable allowances	$	18,515		$	14,590
Operating lease liabilities		12,472			11,623
Accrued compensation		3,676			3,752
Accrued workers’ compensation		3,296			3,119
Transaction costs		2,056			1,803
Stock-based compensation		1,473			1,293
Government stimulus advances		—			1,138
Restructuring costs		54			119
Other		1,420			793
Total long-term deferred tax assets		42,962			38,230
Deferred tax liabilities
Long-term
Goodwill and intangible assets		(34,310	)		(26,097	)
Operating lease assets, net		(10,323	)		(9,571	)
Property and equipment		(3,123	)		(3,415	)
Insurance premiums		(916	)		(876	)
Total long-term deferred tax liabilities		(48,672	)		(39,959	)
Total net deferred tax (liabilities) assets	$	(5,710	)	$	(1,729	)

Management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers all available evidence in making this assessment.

A reconciliation for continuing operations of the statutory federal tax rate of 21.0% to the effective income tax rate is summarized as follows:


	For the Years Ended December 31,
	2022				2021				2020
Federal income tax at statutory rate		21.0		%		21.0		%		21.0		%
State and local taxes, net of federal benefit		5.9				6.3				6.0
162(m) disallowance for executive compensation		3.2				3.5				6.0
Nondeductible penalties		—				0.6				—
Excess tax benefit		(0.4	)			(2.0	)			(5.6	)
Jobs tax credits, net		(5.1	)			(4.1	)			(5.1	)
Nondeductible permanent items		—				—				0.4
Federal/state return to provision		(1.0	)			—				(1.6	)
Other		(0.1	)			(0.1	)			(0.1	)
Effective income tax rate		23.5		%		25.2		%		21.0		%

The effective income tax rate was 23.5%, 25.2% and 21.0% for the years ended December 31, 2022, 2021 and 2020, respectively. The difference between our federal statutory and effective income tax rates is principally due to the inclusion of state taxes and non-deductible compensation, offset by an excess tax benefit and the use of federal employment tax credits. The excess tax benefit is a discrete item, primarily related to the vesting of equity shares, which requires the Company to recognize the benefit fully in the period.

The Company is subject to taxation in the jurisdictions in which it operates. The Company continues to remain subject to examination by U.S. federal authorities for the years 2019 through 2021 and for various state authorities for the years 2017 through 2021.

- 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
-URI https://asc.fasb.org/extlink&oid=121826272&loc=d3e32857-109319

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)
-URI https://asc.fasb.org/extlink&oid=122134291&loc=d3e330215-122817

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 https://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 https://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 https://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 https://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 https://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 https://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 https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

Stock Options And Restricted Stock Awards (Narrative) (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock option compensation expense	$ 10.6	$ 9.4	$ 6.0
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options, Granted shares	38,000		0
Stock option compensation expense	$ 1.2	1.4	$ 2.0
Unrecognized compensation cost	$ 1.9
Unrecognized compensation cost recognition period	2 years 3 months 18 days
Intrinsic value on vested stock options	$ 24.1
Intrinsic value on outstanding stock options	$ 1.0
Share-based compensation number of shares vested	390,026
Share-based compensation number of shares unvested	78,125
Intrinsic value on exercised stock options	$ 3.5	1.8	7.5
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock option compensation expense	9.4	$ 8.0	$ 4.0
Unrecognized compensation cost	$ 10.9
Unrecognized compensation cost recognition period	1 year 8 months 12 days
Fair market value of vested restricted stock awards	$ 5.4
2017 Omnibus Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum shares of stock awards authorized for issuance	1,182,270
Share-based compensation number of common stock available for grant	350,317
2017 Omnibus Incentive Plan [Member] \| Stock options or stock appreciation rights "SARs" [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum shares of stock awards authorized for issuance	500,000
2017 Omnibus Incentive Plan [Member] \| Awards denominated in shares of common stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum shares of stock awards authorized for issuance	300,000
2017 Omnibus Incentive Plan [Member] \| Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment award, expiration period	10 years
Exercise prices of stock options outstanding, lower range limit	$ 19.71
Exercise prices of stock options outstanding, upper range limit	$ 92.00
2017 Omnibus Incentive Plan [Member] \| Stock Options [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment vesting period	3 years
2017 Omnibus Incentive Plan [Member] \| Stock Options [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment vesting period	4 years
2017 Omnibus Incentive Plan [Member] \| Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment award, expiration period	10 years
2017 Omnibus Incentive Plan [Member] \| Restricted Stock [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment vesting period	1 year
2017 Omnibus Incentive Plan [Member] \| Restricted Stock [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment vesting period	4 years

Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Net service revenues	$ 951,120	$ 864,499	$ 764,775
Revenues [Member] \| Geographic Concentration Risk [Member] \| Illinois [Member]
Concentration risk, percentage	43.80%	38.20%	37.70%
Personal Care [Member]
Net service revenues	$ 706,507	$ 685,854	$ 647,233
Personal Care [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member]
Net service revenues	$ 706,507	$ 685,854	$ 647,233
Concentration risk, percentage	100.00%	100.00%	100.00%
Personal Care [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| Illinois [Member]
Net service revenues	$ 360,778	$ 328,619	$ 288,326
Concentration risk, percentage	51.10%	47.90%	44.60%
Personal Care [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| New York [Member]
Net service revenues	$ 86,592	$ 99,732	$ 115,510
Concentration risk, percentage	12.30%	14.50%	17.80%
Personal Care [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| New Mexico [Member]
Net service revenues	$ 105,315	$ 97,784	$ 86,618
Concentration risk, percentage	14.90%	14.30%	13.40%
Personal Care [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| All Other States [Member]
Net service revenues	$ 153,822	$ 159,719	$ 156,779
Concentration risk, percentage	21.70%	23.30%	24.20%
Hospice [Member]
Net service revenues	$ 201,772	$ 152,253	$ 101,297
Hospice [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member]
Net service revenues	$ 201,772	$ 152,253	$ 101,297
Concentration risk, percentage	100.00%	100.00%	100.00%
Hospice [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| Illinois [Member]
Net service revenues	$ 47,181
Concentration risk, percentage	23.40%
Hospice [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| New Mexico [Member]
Net service revenues	$ 30,722	$ 36,063	$ 42,648
Concentration risk, percentage	15.20%	23.70%	42.10%
Hospice [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| All Other States [Member]
Net service revenues	$ 53,366	$ 54,775	$ 58,649
Concentration risk, percentage	26.40%	36.00%	57.90%
Hospice [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| Ohio [Member]
Net service revenues	$ 70,503	$ 61,415
Concentration risk, percentage	35.00%	40.30%
Home Health [Member]
Net service revenues	$ 42,841	$ 26,392	$ 16,245
Home Health [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member]
Net service revenues	$ 42,841	$ 26,392	$ 16,245
Concentration risk, percentage	100.00%	100.00%	100.00%
Home Health [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| Illinois [Member]
Net service revenues	$ 8,730	$ 1,657
Concentration risk, percentage	20.40%	6.30%
Home Health [Member] \| Revenues [Member] \| Geographic Concentration Risk [Member] \| New Mexico [Member]
Net service revenues	$ 34,111	$ 24,735	$ 16,245
Concentration risk, percentage	79.60%	93.70%	100.00%

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2022

Income Tax Disclosure [Abstract]

Current and Deferred Federal and State Income Tax Provision from Continuing Operations

The current and deferred federal and state income tax provision from continuing operations, are comprised of the following:


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022		2021		2020
Current
Federal	$	7,075	$	4,603	$	10,230
State		3,090		2,398		3,312
Deferred
Federal		3,118		6,407		(3,690	)
State		863		1,864		(1,043	)
Provision for income taxes	$	14,146	$	15,272	$	8,809

Deferred Tax Assets And Liabilities


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022			2021
Deferred tax assets
Long-term
Accounts receivable allowances	$	18,515		$	14,590
Operating lease liabilities		12,472			11,623
Accrued compensation		3,676			3,752
Accrued workers’ compensation		3,296			3,119
Transaction costs		2,056			1,803
Stock-based compensation		1,473			1,293
Government stimulus advances		—			1,138
Restructuring costs		54			119
Other		1,420			793
Total long-term deferred tax assets		42,962			38,230
Deferred tax liabilities
Long-term
Goodwill and intangible assets		(34,310	)		(26,097	)
Operating lease assets, net		(10,323	)		(9,571	)
Property and equipment		(3,123	)		(3,415	)
Insurance premiums		(916	)		(876	)
Total long-term deferred tax liabilities		(48,672	)		(39,959	)
Total net deferred tax (liabilities) assets	$	(5,710	)	$	(1,729	)

Reconciliation of Statutory Federal Tax Rate

A reconciliation for continuing operations of the statutory federal tax rate of 21.0% to the effective income tax rate is summarized as follows:


	For the Years Ended December 31,
	2022				2021				2020
Federal income tax at statutory rate		21.0		%		21.0		%		21.0		%
State and local taxes, net of federal benefit		5.9				6.3				6.0
162(m) disallowance for executive compensation		3.2				3.5				6.0
Nondeductible penalties		—				0.6				—
Excess tax benefit		(0.4	)			(2.0	)			(5.6	)
Jobs tax credits, net		(5.1	)			(4.1	)			(5.1	)
Nondeductible permanent items		—				—				0.4
Federal/state return to provision		(1.0	)			—				(1.6	)
Other		(0.1	)			(0.1	)			(0.1	)
Effective income tax rate		23.5		%		25.2		%		21.0		%

Leases (Summary of Remaining Operating Lease Payments) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
2023	$ 12,470
2024	10,340
2025	7,246
2026	5,602
2027	4,241
Thereafter	12,115
Total future minimum rental commitments	52,014
Less: Imputed interest	(5,734)
Total lease liabilities	$ 46,280	$ 42,633

Details of Certain Balance Sheet Accounts (Schedule of Prepaid Expenses and Other Current Assets) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Details Of Certain Balance Sheet Accounts [Abstract]
Income tax receivable		$ 7,556
Prepaid payroll	$ 7,566
Prepaid workers’ compensation and liability insurance	3,399	3,206
Workers’ compensation insurance receivable	666	1,559
Other	5,714	6,170
Total prepaid expenses and other current assets	$ 17,345	$ 18,491

Leases

12 Months Ended

Dec. 31, 2022

Leases [Abstract]

Leases

2. Leases

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


	December 31,
	2022		2021
	(Amounts in Thousands)
Operating lease assets, net	$	38,980	$	36,048
Short-term operating lease liabilities (in accrued expenses)		10,801		9,774
Long-term operating lease liabilities		35,479		32,859
Total operating lease liabilities	$	46,280	$	42,633

Lease Costs

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


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022			2021			2020
Operating lease costs	$	11,354		$	11,150		$	9,197
Short-term lease costs		2,885			739			761
Total lease costs		14,239			11,889			9,958
Less: sublease income		(951	)		(679	)		(323	)
Total lease costs, net	$	13,288		$	11,210		$	9,635

Lease Term and Discount Rate

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


	December 31,
	2022			2021			2020
Operating leases:
Weighted average remaining lease term		5.82			6.39			6.97
Weighted average discount rate		3.98	%		3.91	%		4.18	%

Maturity of Lease Liabilities

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


	Operating Leases
	(Amounts in Thousands)
Due in 12-month period ended December 31,
2023	$	12,470
2024		10,340
2025		7,246
2026		5,602
2027		4,241
Thereafter		12,115
Total future minimum rental commitments		52,014
Less: Imputed interest		(5,734	)
Total lease liabilities	$	46,280

Supplemental cash flows information


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022		2021		2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	13,015	$	11,288	$	8,769
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	14,746	$	7,705	$	25,807

Commencing on November 14, 2022, the Company sublet a portion of its corporate headquarters space in Frisco, Texas to a third party under a two-year sublease term for a monthly base rent of $0.1 million.

Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Net service revenues	$ 951,120	$ 864,499	$ 764,775
Personal Care [Member]
Net service revenues	706,507	685,854	647,233
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member]
Net service revenues	$ 706,507	$ 685,854	$ 647,233
Concentration risk, percentage	100.00%	100.00%	100.00%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| State, Local And Other Governmental Programs [Member]
Net service revenues	$ 348,234	$ 338,325	$ 324,670
Concentration risk, percentage	49.30%	49.30%	50.20%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Managed Care Organizations [Member]
Net service revenues	$ 326,778	$ 311,801	$ 287,032
Concentration risk, percentage	46.30%	45.50%	44.30%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Private Pay [Member]
Net service revenues	$ 18,301	$ 19,991	$ 20,398
Concentration risk, percentage	2.60%	2.90%	3.20%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Commercial Insurance [Member]
Net service revenues	$ 7,689	$ 9,820	$ 9,991
Concentration risk, percentage	1.10%	1.40%	1.50%
Personal Care [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Other [Member]
Net service revenues	$ 5,505	$ 5,917	$ 5,142
Concentration risk, percentage	0.70%	0.90%	0.80%
Hospice [Member]
Net service revenues	$ 201,772	$ 152,253	$ 101,297
Hospice [Member] \| Revenues [Member] \| Customer Concentration Risk [Member]
Net service revenues	$ 201,772	$ 152,253	$ 101,297
Concentration risk, percentage	100.00%	100.00%	100.00%
Hospice [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Medicare [Member]
Net service revenues	$ 183,407	$ 142,086	$ 94,068
Concentration risk, percentage	90.90%	93.30%	92.90%
Hospice [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Managed Care Organizations [Member]
Net service revenues	$ 7,353	$ 5,664	$ 4,931
Concentration risk, percentage	3.60%	3.70%	4.90%
Hospice [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Other [Member]
Net service revenues	$ 11,012	$ 4,503	$ 2,298
Concentration risk, percentage	5.50%	3.00%	2.20%
Home Health [Member]
Net service revenues	$ 42,841	$ 26,392	$ 16,245
Home Health [Member] \| Revenues [Member] \| Customer Concentration Risk [Member]
Net service revenues	$ 42,841	$ 26,392	$ 16,245
Concentration risk, percentage	100.00%	100.00%	100.00%
Home Health [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Medicare [Member]
Net service revenues	$ 31,505	$ 20,700	$ 12,765
Concentration risk, percentage	73.50%	78.40%	78.60%
Home Health [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Managed Care Organizations [Member]
Net service revenues	$ 8,698	$ 4,457	$ 3,188
Concentration risk, percentage	20.30%	16.90%	19.60%
Home Health [Member] \| Revenues [Member] \| Customer Concentration Risk [Member] \| Other [Member]
Net service revenues	$ 2,638	$ 1,235	$ 292
Concentration risk, percentage	6.20%	4.70%	1.80%

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2022

Long-Term Debt, Unclassified [Abstract]

Schedule of Long-Term Debt

Long-term debt consisted of the following:


	December 31,
	2022			2021
	(Amounts in Thousands)
Revolving loan under the credit facility	$	134,853		$	224,853
Term loan under the credit facility		—			—
Less unamortized issuance costs		(3,081	)		(3,941	)
Total		131,772			220,912
Less current maturities		—			—
Long-term debt	$	131,772		$	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

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
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-Section S99
-Paragraph 1
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Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 3
-Subparagraph (SX 210.12-04(a))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e24072-122690

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 505
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-URI https://asc.fasb.org/extlink&oid=126973232&loc=d3e21506-112644

Reference 5: http://www.xbrl.org/2003/role/exampleRef
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Reference 7: http://www.xbrl.org/2003/role/exampleRef
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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+ Details

Goodwill and Intangible Assets (Summary of Goodwill by Segment and Related Adjustments) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 504,392	$ 469,072
Additions for acquisitions	78,356	35,064
Adjustments to previously recorded goodwill	89	256
Goodwill, at End of Period	582,837	504,392
Hospice [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	328,334	314,833
Additions for acquisitions	69,446	13,370
Adjustments to previously recorded goodwill	(52)	131
Goodwill, at End of Period	397,728	328,334
Personal Care [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	152,688	152,448
Additions for acquisitions		115
Adjustments to previously recorded goodwill		125
Goodwill, at End of Period	152,688	152,688
Home Health [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	23,370	1,791
Additions for acquisitions	8,910	21,579
Adjustments to previously recorded goodwill	141
Goodwill, at End of Period	$ 32,421	$ 23,370

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Significant Payors (Tables)

12 Months Ended

Dec. 31, 2022

Significant Payors [Abstract]

Schedule of Revenue by Payor Type

For 2022, 2021 and 2020, the Company’s revenue by payor type was as follows:


	Personal Care
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
State, local and other governmental programs	$	348,234		49.3	%	$	338,325		49.3	%	$	324,670		50.2	%
Managed care organizations		326,778		46.3			311,801		45.5			287,032		44.3
Private pay		18,301		2.6			19,991		2.9			20,398		3.2
Commercial insurance		7,689		1.1			9,820		1.4			9,991		1.5
Other		5,505		0.7			5,917		0.9			5,142		0.8
Total personal care segment net service revenues	$	706,507		100.0	%	$	685,854		100.0	%	$	647,233		100.0	%


	Hospice
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	183,407		90.9	%	$	142,086		93.3	%	$	94,068		92.9	%
Managed care organizations		7,353		3.6			5,664		3.7			4,931		4.9
Other		11,012		5.5			4,503		3.0			2,298		2.2
Total hospice segment net service revenues	$	201,772		100.0	%	$	152,253		100.0	%	$	101,297		100.0	%


	Home Health
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	31,505		73.5	%	$	20,700		78.4	%	$	12,765		78.6	%
Managed care organizations		8,698		20.3			4,457		16.9			3,188		19.6
Other		2,638		6.2			1,235		4.7			292		1.8
Total home health segment net service revenues	$	42,841		100.0	%	$	26,392		100.0	%	$	16,245		100.0	%

Schedule of Revenue by Geographic Location

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 2022, 2021 and 2020 were as follows:


	Personal Care
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Illinois	$	360,778		51.1	%	$	328,619		47.9	%	$	288,326		44.6	%
New York		86,592		12.3			99,732		14.5			115,510		17.8
New Mexico		105,315		14.9			97,784		14.3			86,618		13.4
All other states		153,822		21.7			159,719		23.3			156,779		24.2
Total personal care segment net service revenues	$	706,507		100.0	%	$	685,854		100.0	%	$	647,233		100.0	%


	Hospice
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Ohio	$	70,503		35.0	%	$	61,415		40.3	%	$	—		—	%
New Mexico		30,722		15.2			36,063		23.7			42,648		42.1
Illinois		47,181		23.4			—		—			—		—
All other states		53,366		26.4			54,775		36.0			58,649		57.9
Total hospice segment net service revenues	$	201,772		100.0	%	$	152,253		100.0	%	$	101,297		100.0	%

With the acquisition of Queen City Hospice in late 2020, the Company expanded its hospice services in the state of Ohio, and with the JourneyCare acquisition in 2022, the Company also expanded its hospice services in the state of Illinois.


	Home Health
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
New Mexico	$	34,111		79.6	%	$	24,735		93.7	%	$	16,245		100.0	%
Illinois		8,730		20.4			1,657		6.3			—		—
Total home health segment net service revenues	$	42,841		100.0	%	$	26,392		100.0	%	$	16,245		100.0	%

Segment Information (Narrative) (Details)	12 Months Ended
Segment Information (Narrative) (Details)	Dec. 31, 2022 Segment
Segment Reporting [Abstract]
Number of business segments	3

Significant Payors

12 Months Ended

Dec. 31, 2022

Significant Payors [Abstract]

Significant Payors

13. Significant Payors

For 2022, 2021 and 2020, the Company’s revenue by payor type was as follows:


	Personal Care
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
State, local and other governmental programs	$	348,234		49.3	%	$	338,325		49.3	%	$	324,670		50.2	%
Managed care organizations		326,778		46.3			311,801		45.5			287,032		44.3
Private pay		18,301		2.6			19,991		2.9			20,398		3.2
Commercial insurance		7,689		1.1			9,820		1.4			9,991		1.5
Other		5,505		0.7			5,917		0.9			5,142		0.8
Total personal care segment net service revenues	$	706,507		100.0	%	$	685,854		100.0	%	$	647,233		100.0	%


	Hospice
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	183,407		90.9	%	$	142,086		93.3	%	$	94,068		92.9	%
Managed care organizations		7,353		3.6			5,664		3.7			4,931		4.9
Other		11,012		5.5			4,503		3.0			2,298		2.2
Total hospice segment net service revenues	$	201,772		100.0	%	$	152,253		100.0	%	$	101,297		100.0	%


	Home Health
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	31,505		73.5	%	$	20,700		78.4	%	$	12,765		78.6	%
Managed care organizations		8,698		20.3			4,457		16.9			3,188		19.6
Other		2,638		6.2			1,235		4.7			292		1.8
Total home health segment net service revenues	$	42,841		100.0	%	$	26,392		100.0	%	$	16,245		100.0	%


	Personal Care
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Illinois	$	360,778		51.1	%	$	328,619		47.9	%	$	288,326		44.6	%
New York		86,592		12.3			99,732		14.5			115,510		17.8
New Mexico		105,315		14.9			97,784		14.3			86,618		13.4
All other states		153,822		21.7			159,719		23.3			156,779		24.2
Total personal care segment net service revenues	$	706,507		100.0	%	$	685,854		100.0	%	$	647,233		100.0	%


	Hospice
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Ohio	$	70,503		35.0	%	$	61,415		40.3	%	$	—		—	%
New Mexico		30,722		15.2			36,063		23.7			42,648		42.1
Illinois		47,181		23.4			—		—			—		—
All other states		53,366		26.4			54,775		36.0			58,649		57.9
Total hospice segment net service revenues	$	201,772		100.0	%	$	152,253		100.0	%	$	101,297		100.0	%


	Home Health
	For the Years Ended December 31,
	2022					2021					2020
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
New Mexico	$	34,111		79.6	%	$	24,735		93.7	%	$	16,245		100.0	%
Illinois		8,730		20.4			1,657		6.3			—		—
Total home health segment net service revenues	$	42,841		100.0	%	$	26,392		100.0	%	$	16,245		100.0	%

With the acquisition of Summit in 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 state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 43.8%, 38.2% and 37.7% of our net service revenues for the years ended December 31, 2022, 2021 and 2020, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.7%, 21.4% and 23.0% of the Company’s net service revenues for 2022, 2021 and 2020, respectively.

The related receivables due from the Illinois Department on Aging represented 18.0% and 16.1% of the Company’s net accounts receivable at December 31, 2022 and 2021, respectively.

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. 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, if the fiscal intermediary submits an attestation and supporting information to the New York State Department of Health no later than November 29, 2022. The Company submitted an attestation on November 22, 2022. Under this provision, the Company is allowed to continue to contract with all of its current payors for CDPAP services, as of the contract award date, which is anticipated to be April 1, 2023. The Company continues to assess the future of its participation in this program. Given the current profitability of the program, the Company has suspended materially all of its new fee-for-service patient admissions through County Social Service Departments in the CDPAP program.

The Company recognized approximately $39.2 million from the program for the year ended December 31, 2022.

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Current assets
Cash	$ 79,961	$ 168,895
Accounts receivable, net of allowances	125,501	136,955
Prepaid expenses and other current assets	17,345	18,491
Total current assets	222,807	324,341
Property and equipment, net of accumulated depreciation and amortization	21,182	18,483
Other assets
Goodwill	582,837	504,392
Intangibles, net of accumulated amortization	72,188	64,321
Operating lease assets, net	38,980	36,048
Total other assets	694,005	604,761
Total assets	937,994	947,585
Current liabilities
Accounts payable	22,092	19,358
Accrued payroll	44,937	44,083
Accrued expenses	38,308	37,077
Government stimulus advances	12,912	4,173
Accrued workers’ compensation insurance	12,897	12,998
Total current liabilities	131,146	117,689
Long-term liabilities
Long-term debt, less current portion, net of debt issuance costs	131,772	220,912
Long-term operating lease liabilities	35,479	32,859
Other long-term liabilities	6,057	1,781
Total long-term liabilities	173,308	255,552
Total liabilities	304,454	373,241
Stockholders’ equity
Common stock-$.001 par value; 40,000 authorized and 16,128 and 15,940 shares issued and outstanding as of December 31, 2022 and 2021, respectively	16	16
Additional paid-in capital	393,208	380,037
Retained earnings	240,316	194,291
Total stockholders’ equity	633,540	574,344
Total liabilities and stockholders’ equity	$ 937,994	$ 947,585

Employee Benefit Plans (Narrative) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
401(k) Retirement Plan [Member]
Defined Contribution Plan Disclosure [Line Items]
Company matching contribution amount	$ 0.4	$ 0.4	$ 0.3

Government Actions to Mitigate COVID-19's Impact (Schedule of Government Stimulus Advances) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Government Assistance [Abstract]
Payroll tax deferral		$ 4,173
ARPA funds	$ 12,912
Total government stimulus advances	$ 12,912	$ 4,173

Segment Information (Tables)

12 Months Ended

Dec. 31, 2022

Segment Reporting [Abstract]

Summary of Segment Information


	For the Year Ended December 31, 2022
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	706,507	$	201,772	$	42,841	$	951,120
Cost of services revenues		520,617		100,956		29,808		651,381
Gross profit		185,890		100,816		13,033		299,739
General and administrative expenses		60,532		49,742		10,251		120,525
Segment operating income	$	125,358	$	51,074	$	2,782	$	179,214

	For the Year Ended December 31, 2021
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	685,854	$	152,253	$	26,392	$	864,499
Cost of services revenues		502,024		75,186		17,441		594,651
Gross profit		183,830		77,067		8,951		269,848
General and administrative expenses		61,565		34,632		5,713		101,910
Segment operating income	$	122,265	$	42,435	$	3,238	$	167,938

	For the Year Ended December 31, 2020
	(Amounts in Thousands)
	Personal Care		Hospice		Home Health		Total
Net service revenues	$	647,233	$	101,297	$	16,245	$	764,775
Cost of services revenues		480,191		47,197		11,150		538,538
Gross profit		167,042		54,100		5,095		226,237
General and administrative expenses		60,468		25,394		3,773		89,635
Segment operating income	$	106,574	$	28,706	$	1,322	$	136,602


	For the Years Ended December 31,
	(Amounts in Thousands)
	2022			2021			2020
Segment reconciliation:
Total segment operating income	$	179,214		$	167,938		$	136,602

Items not allocated at segment level:
Other general and administrative expenses		96,417			87,508			80,044
Depreciation and amortization		14,060			14,494			12,051
Interest income		(341	)		(268	)		(624	)
Interest expense		8,907			5,806			3,189
Income before income taxes	$	60,171		$	60,398		$	41,942

Stock Options And Restricted Stock Awards (Weighted-Average Estimated Fair Value of Employee Stock Options Granted) (Details) - Stock Options [Member] - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average fair value	$ 32.96	$ 32.71
Risk-free discount rate, minimum	1.76%	0.65%
Risk-free discount rate, maximum	2.86%
Expected life	4 years 2 months 12 days	4 years 1 month 6 days
Volatility	43.00%	45.00%

Property and Equipment (Narrative) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Property, Plant and Equipment [Line Items]
Property and equipment	$ 48,492	$ 38,980
Depreciation and amortization	14,060	14,494	$ 12,051
Internally Developed Software [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	1,600	1,500
Depreciation and amortization	$ 6,800	$ 5,900	$ 5,000

Government Actions to Mitigate COVID-19"s Impact

12 Months Ended

Dec. 31, 2022

Government Assistance [Abstract]

Government Actions to Mitigate COVID-19's Impact

14. Government Actions to Mitigate COVID-19’s Impact

In March 2020, the World Health Organization declared the novel coronavirus (“COVID-19”) outbreak a global pandemic. The COVID-19 pandemic continues to cause disruption in the economy, in terms of increased costs and disruptions in the labor market. Although vaccines and booster shots for the COVID-19 virus have become widely available in the United States, COVID-19 has continued to result in a significant number of hospitalizations, and the future course of the pandemic remains uncertain, particularly due to the spread of COVID-19 variants. We will continue to closely monitor the impact of COVID-19 on all aspects of our business, including the impacts to our employees, patients and suppliers.

In recognition of the significant threat to the liquidity of financial markets posed by the COVID-19 pandemic, the Federal Reserve and Congress have taken dramatic actions to provide liquidity to businesses and the banking system in the United States. One of the primary sources of relief for healthcare providers is the CARES Act, which was expanded by the Paycheck Protection Program and Health Care Enhancement (“PPPHCE”) Act, and the Consolidated Appropriations Act (“CAA”). The American Rescue Plan Act of 2021 (“ARPA”), one relief package with numerous provisions that affect healthcare providers, was signed into law in March 2021.

ARPA

ARPA 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, 2025. 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.

HCBS spending plans for the additional matching funds vary by state, but common initiatives in which the Company is participating include those aimed at strengthening the provider workforce (e.g., efforts to recruit, retain, and train direct service providers). The Company is required to properly and fully document the use of such funds in reports to the state in which the funds originated. Funds may be subject to recoupment if not expended or if they are expended on non-approved uses. During the year ended December 31, 2021, the Company received state funding provided by the ARPA in aggregate amount of $1.0 million. The Company recorded revenue of $1.0 million and related costs of service revenue of $0.7 million for a state which met the revenue recognition criteria. During the twelve months ended December 31, 2022, the Company received state funding provided by the ARPA in an aggregate amount of $23.4 million. The Company recorded revenue of $1.9 million and related cost of service revenues of $1.5 million for certain states that met the revenue recognition criteria. The Company deferred the remaining $21.5 million, which was received from states with specific spending plans and reporting requirements. The Company utilized $8.6 million of these funds during the twelve months ended December 31 2022, primarily for caregivers and adding support to recruiting and retention efforts, $7.0 million included as a reduction of cost of service revenues and $1.6 million included as a reduction of general and administrative expenses in the Company’s Consolidated Statements of Income. As of December 31, 2022, the deferred portion of ARPA funding was $12.9 million, which is included within Government stimulus advances on the Company’s Consolidated Balance Sheets.

Provider Relief Funds

In addition, the CARES Act authorized funding to be distributed through the Provider Relief Fund to eligible providers, including public entities and Medicare- and/or Medicaid-enrolled providers. In November 2020, the Company received grants in an aggregate principal amount of $13.7 million from the Provider Relief Fund. The Company utilized $12.3 million remaining of these

funds during the year ended December 31, 2021 for healthcare related expenses, including retention payments, attributable to COVID-19 that were unreimbursed by other sources. The Company documented the use of such funds in 2021 in reports to the U.S. Department of Health and Human Services (“HHS”), as required, and submitted the reports to HHS prior to the deadline of March 31, 2022. During the year ended December 31, 2022, we submitted an unmodified audit report to HHS for 2021 in accordance with Generally Accepted Government Auditing Standards, as required for commercial organizations that received and expended total awards of $750,000 or more.

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 March 31, 2022. The sequestration payment adjustment was phased back in with a 1% reduction beginning April 1, 2022, and returned to 2% on July 1, 2022. These sequestration cuts have been extended through 2032.

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 2025.

In the hospice segment, Medicare sequester relief resulted in an increase in net service revenues of $1.4 million and $2.9 million for the years ended December 31, 2022 and 2021, respectively. In the home health segment, Medicare sequester relief resulted in an increase in net service revenues of $0.3 million and $0.5 million for the years ended December 31, 2022 and 2021, respectively

Payroll tax deferral

The CARES Act also provides for certain federal income and other tax changes, including the deferral of the employer portion of Social Security payroll taxes through December 31, 2021. The payroll tax deferral requires that the deferred payroll taxes be paid over two years, with half of the eligible deferred amount required to be paid by December 31, 2021 and the other half by December 31, 2022. 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. Effective July 1, 2020, the Company began paying its deferred portion of employer Social Security payroll taxes and repaid $4.1 million and $3.0 million as of December 31, 2022 and 2021 respectively.

Government stimulus advances consisted of the following:


	December 31,
	2022		2021
	(Amounts in Thousands)
Payroll tax deferral	$	—	$	4,173
ARPA funds		12,912		—
Total government stimulus advances	$	12,912	$	4,173

Public Offering (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Class Of Stock [Line Items]
Common stock, par value	$ 0.001	$ 0.001
Business acquisition purchase price	$ 98,290	$ 37,370	$ 207,660

Details of Certain Balance Sheet Accounts (Tables)

12 Months Ended

Dec. 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:


	December 31,
	2022		2021
	(Amounts in Thousands)
Income tax receivable	$	—	$	7,556
Prepaid payroll		7,566		—
Prepaid workers’ compensation and liability insurance		3,399		3,206
Workers’ compensation insurance receivable		666		1,559
Other		5,714		6,170
Total prepaid expenses and other current assets	$	17,345	$	18,491

Schedule of Accrued Expenses

Accrued expenses consisted of the following:


	December 31,
	2022		2021
	(Amounts in Thousands)
Current portion of operating lease liabilities	$	10,801	$	9,774
Payor advances (1)		4,473		6,485
Accrued health insurance		5,152		5,200
Accrued professional fees		3,576		2,978
Accrued payroll taxes		3,525		1,872
Other		10,781		10,768
Total accrued expenses	$	38,308	$	37,077

(1)

Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Net service revenues	$ 951,120	$ 864,499	$ 764,775
Cost of service revenues	651,381	594,651	538,538
Gross profit	299,739	269,848	226,237
General and administrative expenses	216,942	189,418	169,679
Depreciation and amortization	14,060	14,494	12,051
Total operating expenses	231,002	203,912	181,730
Operating income	68,737	65,936	44,507
Interest income	(341)	(268)	(624)
Interest expense	8,907	5,806	3,189
Total interest expense, net	8,566	5,538	2,565
Income before income taxes	60,171	60,398	41,942
Income tax expense	14,146	15,272	8,809
Net income	$ 46,025	$ 45,126	$ 33,133
Basic income per share
Basic income per share	$ 2.90	$ 2.87	$ 2.12
Diluted income per share
Diluted income per share	$ 2.84	$ 2.81	$ 2.08
Weighted average number of common shares and potential common shares outstanding:
Basic	15,861	15,737	15,596
Diluted	16,181	16,064	15,956

Commitments and Contingencies (Narrative) (Details) $ in Millions	Jun. 02, 2021 USD ($)
Palmetto [Member]
Commitments And Contingencies [Line Items]
Proceeds from legal settlements	$ 6.5

Goodwill and Intangible Assets (Narrative) (Details) - USD ($)					12 Months Ended
	Feb. 01, 2022	Aug. 01, 2021	Dec. 04, 2020	Nov. 01, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Oct. 01, 2022	Jun. 30, 2022	Oct. 01, 2021
Goodwill [Line Items]
Goodwill					$ 582,837,000	$ 504,392,000	$ 469,072,000
Discount rate used in goodwill impairment analysis					9.50%
Goodwill impairment charge					$ 0	0	0
Amortization expense					$ 7,200,000	8,500,000	7,100,000
Weighted average remaining useful lives of identifiable intangible assets					9 years 9 months 18 days
Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives					1 year
Long-term revenue growth rate assumed in goodwill impairment analysis					3.50%
Maximum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives					25 years
Long-term revenue growth rate assumed in goodwill impairment analysis					0.00%
Customer and Referral Relationships [Member] \| Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives					5 years
Customer and Referral Relationships [Member] \| Maximum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives					10 years
Armada Skilled Homecare [Member]
Goodwill [Line Items]
Goodwill		$ 28,287,000
Armada Skilled Homecare [Member] \| State Licenses [Member]
Goodwill [Line Items]
Finite-lived intangible assets related to acquisition						400,000
Armada Skilled Homecare [Member] \| Non-competition Agreements [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		5 years
Finite-lived intangible assets related to acquisition		$ 600,000				600,000
JourneyCare [Member]
Goodwill [Line Items]
Goodwill	$ 69,446,000
JourneyCare [Member] \| State Licenses [Member]
Goodwill [Line Items]
Finite-lived intangible assets related to acquisition					$ 4,800,000
JourneyCare [Member] \| Trade Names [Member]
Goodwill [Line Items]
Finite-lived intangible assets related to acquisition	$ 9,000,000.0				9,000,000.0
Apple Home [Member]
Goodwill [Line Items]
Goodwill								$ 8,900,000
Summit Home Health, LLC [Member]
Goodwill [Line Items]
Goodwill										$ 6,500,000
Queen City Hospice [Member]
Goodwill [Line Items]
Goodwill			$ 169,338,000
Queen City Hospice [Member] \| Trade Names [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives			15 years
Finite-lived intangible assets related to acquisition			$ 11,000,000.0
Queen City Hospice [Member] \| Non-competition Agreements [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives			5 years
Finite-lived intangible assets related to acquisition			$ 1,500,000
County Homemakers [Member]
Goodwill [Line Items]
Goodwill				$ 13,502,000
Finite-lived intangible assets related to acquisition					1,200,000
County Homemakers [Member] \| State Licenses [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives				8 years
Finite-lived intangible assets related to acquisition				$ 300,000
County Homemakers [Member] \| Trade Names [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives				1 year
Finite-lived intangible assets related to acquisition				$ 100,000	100,000
Hospice [Member]
Goodwill [Line Items]
Goodwill					$ 397,728,000	328,334,000	314,833,000
Percent of fair value of reporting unit excess of carrying value					67.00%				67.00%
Hospice [Member] \| Armada Skilled Homecare [Member]
Goodwill [Line Items]
Goodwill						13,400,000
Hospice [Member] \| JourneyCare [Member]
Goodwill [Line Items]
Goodwill					$ 69,400,000
2013 Home Health Business [Member] \| Summit Home Health, LLC [Member]
Goodwill [Line Items]
Goodwill						6,500,000
Home Health [Member]
Goodwill [Line Items]
Goodwill					$ 32,421,000	23,370,000	1,791,000
Percent of fair value of reporting unit excess of carrying value					75.00%
Home Health [Member] \| Armada Skilled Homecare [Member]
Goodwill [Line Items]
Goodwill						15,000,000.0
Home Health [Member] \| Apple Home [Member]
Goodwill [Line Items]
Goodwill					$ 8,900,000
Personal Care [Member]
Goodwill [Line Items]
Goodwill					$ 152,688,000	$ 152,688,000	$ 152,448,000
Percent of fair value of reporting unit excess of carrying value					100.00%	100.00%

Leases (Supplemental Cash Flows Information) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 13,015	$ 11,288	$ 8,769
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 14,746	$ 7,705	$ 25,807

Goodwill And Intangible Assets (Schedule of Future Amortization of Intangible Assets) (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
2023	$ 6,857
2024	6,534
2025	4,911
2026	4,287
2027	3,665
Thereafter	18,826
Intangible assets subject to amortization, net	$ 45,080	$ 43,197