LHC (LHCG) 10-Q 9 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	May 07, 2019
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Trading Symbol	LHCG
Entity Registrant Name	LHC Group, Inc
Entity Central Index Key	0001303313
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Emerging Growth Company	false
Entity Small Business	false
Entity Common Stock, Shares Outstanding		31,493,105

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Current assets:
Cash	$ 38,520	$ 49,363
Receivables:
Patient accounts receivable	268,559	252,592
Other receivables	5,517	6,658
Amounts due from governmental entities	1,010	830
Total receivables	275,086	260,080
Prepaid income taxes	7,690	11,788
Prepaid expenses	25,604	24,775
Other current assets	19,422	20,899
Total current assets	366,322	366,905
Property, building and equipment, net of accumulated depreciation of $58,932 and $55,253, respectively	83,040	79,563
Goodwill	1,164,999	1,161,717
Intangible assets, net of accumulated amortization of $15,549 and $15,176, respectively	291,954	297,379
Assets held for sale	2,500	2,850
Operating lease right of use asset	84,805	0
Other assets	20,237	20,301
Total assets	2,013,857	1,928,715
Current liabilities:
Accounts payable and other accrued liabilities	70,698	77,135
Salaries, wages, and benefits payable	102,500	84,254
Self-insurance reserves	31,899	32,776
Current operating lease liabilities	24,454	0
Current portion of long-term debt	0	7,773
Amounts due to governmental entities	4,475	4,174
Total current liabilities	234,026	206,112
Deferred income taxes	43,676	43,306
Income taxes payable	4,481	4,297
Revolving credit facility	239,000	235,000
Long term notes payable	0	930
Operating lease payable	61,985	0
Total liabilities	583,168	489,645
Noncontrolling interest — redeemable	15,060	14,596
LHC Group, Inc. stockholders’ equity:
Preferred stock – $0.01 par value; 5,000,000 shares authorized; none issued or outstanding	0	0
Common stock — $0.01 par value; 60,000,000 shares authorized in 2019 and 2018; 35,816,333 and 35,636,414 shares issued in 2019 and 2018, respectively	358	356
Treasury stock — 5,044,230 and 4,958,721shares at cost, respectively	(56,951)	(49,374)
Additional paid-in capital	940,135	937,968
Retained earnings	446,831	427,975
Total LHC Group, Inc. stockholders’ equity	1,330,373	1,316,925
Noncontrolling interest — non-redeemable	85,256	107,549
Total equity	1,415,629	1,424,474
Total liabilities and equity	$ 2,013,857	$ 1,928,715

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Property, building and equipment, accumulated depreciation	$ 58,932	$ 55,253
Intangible assets, accumulated amortization	$ 15,549	$ 15,176
Preferred Stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred Stock, shares authorized	5,000,000	5,000,000
Preferred Stock, shares issued	0	0
Preferred Stock, shares outstanding	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized	60,000,000	60,000,000
Common stock, shares issued	35,816,333	35,636,414
Treasury stock at cost, shares	5,044,230	4,958,721

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Statement [Abstract]
Net service revenue	$ 502,585	$ 291,054
Cost of service revenue	320,992	188,618
Gross margin	181,593	102,436
General and administrative expenses	145,221	92,031
Other intangible impairment charge	6,319	0
Operating income	30,053	10,405
Interest expense	(3,052)	(1,450)
Income before income taxes and noncontrolling interest	27,001	8,955
Income tax expense	3,600	977
Net income	23,401	7,978
Less net income attributable to noncontrolling interests	4,545	2,983
Net income attributable to LHC Group, Inc.’s common stockholders	$ 18,856	$ 4,995
Earnings per share:
Basic (usd per share)	$ 0.61	$ 0.28
Diluted (usd per share)	$ 0.60	$ 0.28
Weighted average shares outstanding:
Basic (in shares)	30,837	17,790
Diluted (in shares)	31,187	18,039

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY - USD ($) $ in Thousands		Total	Common Stock	Treasury	Additional Paid-In Capital	Retained Earnings	Noncontrolling Interest Non Redeemable	Net Equity [Member]
Beginning balance, Amount at Dec. 31, 2017		$ 506,591	$ 226	$ (42,249)	$ 126,490	$ 364,401	$ 57,723
Beginning balance (in shares) at Dec. 31, 2017			22,640,046
Beginning balance, Treasury (in shares) at Dec. 31, 2017				4,890,504
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	[1]	5,592				4,995	597
Acquired noncontrolling interest		1,235					1,235
Noncontrolling interest distributions		(615)					(615)
Sale of noncontrolling interest					(2,029)		5,583	$ 3,554
NCI acquired, net of sales					(44)		(12)	$ (56)
Nonvested stock compensation		1,601			1,601
Restricted share grants			$ 2		(2)
Restricted stock vesting (in shares)			165,567
Treasury shares redeemed to pay income tax		(3,467)		$ (3,467)	0
Treasury shares redeemed to pay income tax (in shares)				56,772
Issuance of common stock under Employee Stock Purchase Plan		332	$ 0		332
Issuance of common stock under Employee Stock Purchase Plan (in shares)			5,534
Ending balance, Amount at Mar. 31, 2018		514,767	$ 228	$ (45,716)	126,348	369,396	64,511
Ending balance (in shares) at Mar. 31, 2018			22,811,147
Ending balance, Treasury (in shares) at Mar. 31, 2018				4,947,276
Beginning balance, Amount at Dec. 31, 2018		$ 1,424,474	$ 356	$ (49,374)	937,968	427,975	107,549
Beginning balance (in shares) at Dec. 31, 2018			35,636,414
Beginning balance, Treasury (in shares) at Dec. 31, 2018		(4,958,721)		4,958,721
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	[1]	$ 20,542				18,856	1,686
Acquired noncontrolling interest		820					820
Noncontrolling interest distributions		(6,799)					(6,799)
NCI acquired, net of sales		(18,000)					(18,000)
Nonvested stock compensation		1,804			1,804
Restricted share grants		2	$ 2		0
Restricted stock vesting (in shares)			174,562
Treasury shares redeemed to pay income tax		$ (7,692)		$ (7,577)	(115)
Treasury shares redeemed to pay income tax (in shares)		(59,967)		85,509
Issuance of common stock under Employee Stock Purchase Plan		$ 478	$ 0		478
Issuance of common stock under Employee Stock Purchase Plan (in shares)		5,357	5,357
Ending balance, Amount at Mar. 31, 2019		$ 1,415,629	$ 358	$ (56,951)	$ 940,135	$ 446,831	$ 85,256
Ending balance (in shares) at Mar. 31, 2019			35,816,333
Ending balance, Treasury (in shares) at Mar. 31, 2019		(5,044,230)		5,044,230
[1]	Net income excludes net income attributable to noncontrolling interest-redeemable of $2.9 million and $2.4 million during the three months ending March 31, 2019 and 2018, respectively. Noncontrolling interest-redeemable is reflected outside of permanent equity on the condensed consolidated balance sheets. See Note 8 of the Notes to Condensed Consolidated Financial Statements.

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Statement of Stockholders' Equity [Abstract]
Net income attributable to noncontrolling interest-redeemable	$ 2,859	$ 2,400

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Operating activities:
Net income	$ 23,401	$ 7,978
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	4,202	3,293
Operating Lease Right of Use Amortization	7,399	0
Stock-based compensation expense	1,804	1,601
Deferred income taxes	1,578	(1,926)
Gain (loss) on disposal of assets	56	(187)
Impairment of intangibles and other	6,319	0
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(16,284)	(7,111)
Prepaid expenses and other assets	470	3,881
Prepaid income taxes	1,883	2,458
Accounts payable and accrued expenses	471	24,859
Income taxes payable	184
Net amounts due to/from governmental entities	(55)	(1,011)
Net cash provided by operating activities	31,428	33,835
Investing activities:
Purchases of property, building and equipment	(2,801)	(2,551)
Cash payments for business combinations	(1,413)	(2,770)
Net cash used in investing activities	(4,214)	(5,321)
Financing activities:
Proceeds from line of credit	17,000	13,000
Payments on line of credit	(13,000)	(32,000)
Proceeds from employee stock purchase plan	478	332
Payments on debt	(7,650)	(64)
Noncontrolling interest distributions	(9,194)	(3,086)
Withholding taxes paid on stock-based compensation	(7,577)	(3,467)
Purchase of additional controlling interest	(18,000)	(55)
Exercise of options	(114)
Sale of noncontrolling interest	0	3,322
Net cash (used in) financing activities	(38,057)	(22,018)
Change in cash	(10,843)	6,496
Cash at beginning of period	49,363	2,849
Cash at beginning of period	38,520	9,345
Supplemental disclosures of cash flow information:
Interest paid	2,855	1,397
Income taxes paid	318	$ 792
Right-of-use assets obtained in exchange for new operating lease liabilities	91,174
Capital expenditures accrued	$ 4,600

Organization

Organization	3 Months Ended
	Mar. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization	Organization LHC Group, Inc. (the “Company”) is a health care provider specializing in the post-acute continuum of care. The Company provides home health services, hospice services, home and community-based services, facility-based services, the latter primarily through long-term acute care hospitals (“LTACHs”), and healthcare innovations services ("HCI"). On April 1, 2018, the Company completed a "merger of equals" business combination (the "Merger") with Almost Family, Inc. ("Almost Family"). As a result, the financial results of the Company for the first quarter of 2019 includes the operating results of Almost Family, while the financial results of the Company for the first quarter of 2018 do not. See Note 3 to Condensed Consolidated Financial Statements. As of March 31, 2019 , the Company, through its wholly- and majority-owned subsidiaries, equity joint ventures, controlled affiliates, and management agreements operated 752 service locations in 35 states within the continental United States and the District of Columbia. Unaudited Interim Financial Information The accompanying unaudited condensed consolidated balance sheets as of March 31, 2019 and December 31, 2018 , and the related unaudited condensed consolidated statements of income for the three months ended March 31, 2019 and 2018 , condensed consolidated statements of changes in equity for the three months ended March 31, 2019 and 2018, condensed consolidated statements of cash flows for the three months ended March 31, 2019 and 2018 , and related notes (collectively, these financial statements are referred to as the "interim financial statements" and together with the related notes are referred to herein as the “interim financial information”) have been prepared by the Company. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) have been included. Operating results for the three months ended March 31, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019 . Certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented. This report should be read in conjunction with the Company’s consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2018 (the "2018 Form 10-K"). The 2018 Form 10-K was filed with the Securities and Exchange Commission (the “SEC”) on February 28, 2019 , and includes information and disclosures not included herein.

Significant Accounting Policies

Significant Accounting Policies	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements, and the reported revenue and expenses during the reporting period. Actual results could differ from those estimates. Critical Accounting Policies The Company’s most critical accounting policies relate to revenue recognition. Net Service Revenue Net service revenue is reported at the amount that reflects the consideration the Company expects to receive in exchange for providing services. Receipts are from Medicare, Medicaid, and other commercial or managed care insurance programs for services rendered, are subject to adjustment based upon implicit price concessions for retroactive revenue adjustments by third-party payors, settlements of audits, and claims reviews. The estimated uncollectible amounts due from these payors are considered implicit price concessions that are a direct reduction to net service revenue. The Company assesses the patient's ability to pay for their healthcare services at the time of patient admission based on the Company's verification of the patient's insurance coverage under the Medicare, Medicaid, and other commercial or managed care insurance programs. Medicare contributes to the net service revenue of the Company’s home health, hospice, facility-based, and healthcare innovations services. Medicaid and other payors contribute to the net service revenue of all of the Company's segments. Performance obligations are determined based on the nature of the services provided by the Company. The majority of the Company's performance obligations are to provide services to patients based on medical necessity and the bundle of services to be provided to achieve the goals established in the contract, while the healthcare innovations segment's performance obligations are largely to provide care, assessments and management services under various customer contracts. Revenue for performance obligations that are satisfied over time is recognized based on actual charges incurred in relation to total expected charges over the measurement period of the performance obligation, which depicts the transfer of services and related benefits received by the patient and customers over the term of the contract to satisfy the obligations. The Company measures the satisfaction of the performance obligations as services are provided. The Company's performance obligations relate to contracts with a duration of less than one year. Therefore, the Company has elected to apply the optional exemption provided by ASC 606 - Revenue Recognition, and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. Any unsatisfied or partially unsatisfied performance obligations at the end of a reporting period are generally completed prior to the patient being discharged. The Company determines the transaction price for the majority of its performance obligations based on gross charges for services provided, reduced by contractual adjustments provided to third-party payors and implicit price concessions. The Company determines estimates of explicit price concessions, principally contractual adjustments based on established agreements with payors, and implicit price concessions based on historical collection experience. Estimates of explicit and implicit price concessions are periodically reviewed to ensure they encompass the Company's current contract terms, are reflective of the Company's current patient mix, and are indicative of the Company's historic collections to ensure net service revenue is recognized at the expected transaction price. As a result, revenue is recorded in amounts equal to expected cash receipts for services when rendered. The following table sets forth the percentage of net service revenue earned by category of payor for the three months ended March 31, 2019 and 2018 : Three Months Ended 2019 2018 Home health: Medicare 71.3 % 71.2 % Medicaid 1.0 0.9 Managed Care, Commercial, and Other 27.7 27.9 100.0 % 100.0 % Hospice: Medicare 92.4 % 92.3 % Medicaid 0.3 0.6 Managed Care, Commercial, and Other 7.3 7.1 100.0 % 100.0 % Home and Community-Based Services: Medicaid 25.1 % 17.3 % Managed Care, Commercial, and Other 74.9 82.7 100.0 % 100.0 % Facility-Based Services: Medicare 57.4 % 64.0 % Managed Care, Commercial, and Other 42.6 36.0 100.0 % 100.0 % HCI: Medicare 22.2 % — % Medicaid 0.5 — Managed Care, Commercial, and Other 77.3 — 100.0 % — % Medicare The Company's home health, hospice, and facility-based segments recognize revenue under their respective Medicare programs, which are discussed in more detail below. The home health segment's Medicare patients, including certain Medicare Advantage patients, are classified into one of 153 home health resource groups prior to receiving services. Based on the patient’s home health resource group, the Company is entitled to receive a standard prospective Medicare payment for delivering care over a 60 -day period referred to as an episode. The Company elects to use the same 60-day length of episode that Medicare recognizes as standard but accelerates revenue upon discharge to align with a patient's episode length, if less than the expected 60 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 an episode of care within the reporting period. Final payments from Medicare will reflect base payment adjustments for case-mix and geographic wage differences and a 2% sequestration reduction. In addition, final payments may reflect one of four retroactive adjustments to the total reimbursement: (a) an outlier payment if the patient’s care was unusually costly; (b) a low utilization adjustment if the number of visits was fewer than five ; (c) a partial payment if the patient transferred to another provider before completing the episode; or (d) a payment adjustment based upon the level of therapy services required. The retroactive adjustments outlined above are recognized in net service revenue when the event causing the adjustment occurs and during the period in which the services are provided to the patient. The Company reviews these adjustments to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustments is subsequently resolved. Net service revenue and related patient accounts receivable are recorded at amounts estimated to be realized from Medicare for services rendered. The Company's hospice services segment is reimbursed by Medicare under a per diem payment system based on the daily needs determined for patients' basis. The hospice segment receives one of four predetermined daily rates based upon the level of care the Company furnishes. Each level of care is contingent upon the patient's medical necessity and is a separate and distinct performance obligation, which depicts the transfer of services and related benefits received by the patient over the term of the contract to satisfy such obligations. The Company records net service revenue for hospice services based on the promulgated per diem rate over time as services are provided, in satisfaction of performance obligation. Hospice payments are subject to variable consideration through an inpatient cap and an overall Medicare payment cap. The inpatient cap relates to individual programs receiving more than 20% of their total Medicare reimbursement from inpatient care services, and the overall Medicare payment cap relates to individual programs receiving reimbursements in excess of a “cap amount,” determined by Medicare to be payment equal to six months of hospice care for the aggregate base of hospice patients, indexed for inflation. The determination for each cap is made annually based on the 12 -month period ending on October 31 of each year. The Company monitors its limits on a provider-by-provider basis and records an estimate of its liability for reimbursements received in excess of the cap amount, if any, in the reporting period. The Company reviews these estimates to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustments is subsequently resolved. The Company's facility-based services segment is reimbursed primarily by Medicare for services provided under the long-term acute care hospital ("LTACH") prospective payment system. Each patient is assigned a long-term care diagnosis-related group. The Company is paid a predetermined fixed amount intended to reflect the average cost of treating a Medicare LTACH patient classified in that particular long-term care diagnosis-related group. For selected LTACH patients, the amount may be further adjusted based on length-of-stay and facility-specific costs, as well as in instances where a patient is discharged and subsequently re-admitted, among other factors. The Company calculates the adjustment based on a historical average of these types of adjustments for LTACH claims paid. Similar to other Medicare prospective payment systems, the rate is also adjusted for geographic wage differences. Net service revenue adjustments resulting from reviews and audits of Medicare cost report settlements are considered implicit price concessions for LTACHs and are measured at expected value. The Company reviews these estimates to ensure that it is probable that a significant reversal in the amount of LTACH services cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustments is subsequently resolved. Net service revenue for the Company’s LTACH services that are satisfied over time is recognized based on actual charges incurred in relation to total expected charges, which depicts the transfer of services and related benefits received by the customer over the service period to satisfy the obligations. Non-Medicare Revenues Each of the Company's segments recognize revenue from various non-Medicare payor sources. Revenue from these payor sources are derived from services provided under a per visit, per hour or per unit basis, per assessment or per member per month basis. Such fee for service revenues are calculated and recorded using payor-specific or patient-specific fee schedules based on the contracted rates in each underlying third party payor or services agreement or out of network rates, as applicable. Net service revenue is recognized as such services are provided and costs for delivery of such services are incurred. Contingent Service Revenues The Company’s Healthcare Innovations segment provides strategic health management services to Accountable Care Organizations (“ACOs”) that have been approved to participate in the Medicare Shared Savings Program (“MSSP”). The HCI segment maintains service agreements with ACOs that provide for sharing of MSSP payments received by the ACO, if any. ACOs are legal entities that contract with Centers for Medicare and Medicaid Services ("CMS") to provide services to the Medicare fee-for-service population for a specified annual period with the goal of providing better care for the individual, improving health for populations and lowering costs. ACOs share savings with CMS to the extent that the actual costs of serving assigned beneficiaries are below certain trended benchmarks of such beneficiaries and certain quality performance measures are achieved. The generation of shared savings is the performance obligation of each ACO, which only become certain upon the final issuance of unembargoed calculations by CMS, generally in the third quarter of each calendar year. As of March 31, 2019, no net service revenue was recognized related to potential MSSP payments for savings generated for the program periods that will end December 31, 2018 , if any, as it remains unclear as to if performance obligations have been met by any ACO served by the HCI segment. Accounts Receivable The Company reports accounts receivable net of estimates of variable consideration and implicit price concessions. Accounts receivable are uncollateralized and primarily consist of amounts due from Medicare, Medicaid, other third-party payors, and to a lesser degree patients. The Company establishes allowances for explicit and implicit price concessions to reduce the carrying amount of such receivables to their estimated net realizable value. The credit risk associated with receivables from other payors is limited due to the significance of Medicare as the primary payor. The Company believes the credit risk associated with its Medicare accounts, which have historically exceeded 50% of its patient accounts receivable, is limited due to (i) the historical collection rate from Medicare and (ii) the fact that Medicare is a U.S. government payor. The Company does not believe that there are any other significant concentrations of receivables from any particular payor that would subject it to any significant credit risk in the collection of accounts receivable. The amount of the provision for implicit price concessions is based upon the Company's assessment of historical and expected net collections, business and economic conditions, and trends in government reimbursement. Uncollectible accounts are written off when the Company has determined that the account will not be collected. A portion of the estimated Medicare prospective payment system reimbursement from each submitted home nursing episode is received in the form of a request for anticipated payment (“RAP”). The Company submits a RAP for 60% of the estimated reimbursement for the initial episode at the start of care. The full amount of the episode is billed after the episode has been completed. If a final bill is not submitted within the greater of 120 days from the start of the episode, or 60 days from the date the RAP was paid, any RAP received for that episode will be recouped by Medicare from any other Medicare claims in process for that particular provider. The RAP and final claim must then be resubmitted. For subsequent episodes of care contiguous with the first episode for a particular patient, the Company submits a RAP for 50% of the estimated reimbursement. The Company’s services to the Medicare population are paid at prospectively set amounts that can be determined at the time services are rendered. The Company’s Medicaid reimbursements are based on a predetermined fee schedule applied to each individual service it provides. The Company’s managed care contracts and other in or out of network payors provide for payments based upon a predetermined fee schedule or an episodic basis. The Company is able to calculate actual amounts to be received at the patient level and to adjust the gross charges down to the actual amount at the time of billing. This negates the need to record an estimated explicit price concessions when reporting net service revenue for each reporting period. Other Significant Accounting Policies Earnings Per Share Basic per share information is computed by dividing the relevant amounts from the condensed consolidated statements of income by the weighted-average number of shares outstanding during the period, under the treasury stock method. Diluted per share information is also computed using the treasury stock method, by dividing the relevant amounts from the condensed consolidated statements of income by the weighted-average number of shares outstanding plus potentially dilutive shares. The following table sets forth shares used in the computation of basic and diluted per share information and, with respect to the data provided for the three months ended March 31, 2019 (amounts in thousands). Three Months Ended 2019 2018 Weighted average number of shares outstanding for basic per share calculation 30,837 17,790 Effect of dilutive potential shares: Nonvested stock 350 249 Adjusted weighted average shares for diluted per share calculation 31,187 18,039 Anti-dilutive shares 141 170 Recently Adopted Accounting Pronouncements In February 2016, the FASB issued ASU No. 2016-02, Leases, ("ASU 2016-02"), as modified by ASUs 2018-01, 2018-10, 2018-11 and 2018-20 (collectively, ASU 2016-02), which requires lessees to recognize leases with terms exceeding 12 months on the Company's Consolidated Balance Sheet. Qualifying leases were classified as finance or operating right-of-use ("ROU") assets and lease liabilities. The new standard was effective for the Company on January 1, 2019. ASU 2016-02 provides a number of optional practical expedients in transition and the Company (a) elected the 'package of practical expedients', which permitted the Company not to reassess under the new standard the Company's prior conclusions about lease identification, lease classification and initial direct costs, (b) elected all the use-of-hindsight or the practical expedient pertaining to land easements; the latter not being applicable to the Company, and (c) elected all the new standard's available transition practical expedients. Adoption of this standard increased total assets and total liabilities by $84.8 million , primarily for the Company's operating leased office space for locations in each segment. The adoption did not change the Company's leasing activities. ASU 2016-02 also provides practical expedients for an entity's ongoing accounting. The Company elected the short-term recognition exemption for certain medical devices and storage space leases that qualify, which means it will not recognize ROU assets or lease liabilities, including not recognizing ROU assets or lease liabilities for existing short-term leases of these assets in transition. See Note 9 of the Notes to Condensed Consolidated Financial Statements. Recently Issued Accounting Pronouncements In January 2017, the FASB issued ASU 2017-04, Intangibles - Goodwill and Other: Simplifying the Test for Goodwill Impairment , which requires an entity to no longer perform a hypothetical purchase price allocation to measure goodwill impairment. Instead, impairment will be measured using the difference between the carrying amount and the fair value of the reporting unit. This ASU is effective for annual and interim periods in fiscal years beginning after December 15, 2019.

Acquisitions and Joint Venture

Acquisitions and Joint Venture Activities	3 Months Ended
	Mar. 31, 2019
Business Combinations [Abstract]
Acquisitions and Joint Venture Activities	and Joint Venture Activities The Merger On April 1, 2018, the Company completed the Merger with Almost Family. At the effective time of the Merger on April 1, 2018, each outstanding share of common stock of Almost Family, other than certain canceled shares, was converted into the right to receive 0.9150 shares of the Company’s common stock and cash in lieu of any fractional shares of any Company common stock that Almost Family shareholders would otherwise have been entitled to receive. As a result, the Company issued approximately 12.8 million shares of its common stock to former stockholders of Almost Family, while also converting outstanding employee share awards, which resulted in total merger consideration of approximately $795.4 million . The Company was determined to be the accounting acquirer in the Merger. The Company's final valuation analysis of identifiable assets and liabilities assumed for the Merger in accordance with the requirements of ASC Topic 805, Business Combinations, are presented in the table below (amounts in thousands): Merger consideration Stock $ 795,412 Fair value of total consideration transferred Recognized amounts of identifiable assets acquired and liabilities assumed: Cash and cash equivalents 16,547 Patient accounts receivable 89,635 Prepaid income taxes 47 Prepaid expenses and other current assets 11,490 Property and equipment 11,144 Trade names 76,090 Certificates of needs/licenses 76,505 Customer relationships 13,970 Assets held for sale 2,500 Deferred income taxes 4,821 Accounts payable (43,027 ) Accrued other liabilities (57,243 ) Seller notes payable (12,145 ) NCI - Redeemable (8,034 ) Long term income taxes payable (3,786 ) Line of credit (106,800 ) NCI - Nonredeemable (36,609 ) Other assets and (liabilities), net (178 ) Total identifiable assets and liabilities 34,927 Goodwill $ 760,485 Trade names, certificates of need and licenses are indefinite-lived assets and, therefore, not subject to amortization. Acquired trade names that are not being used actively are amortized over the estimated useful life on the straight line basis. Trade names are valued using the relief from royalty method, a form of the income approach. Certificates of need are valued using the replacement cost approach based on registration fees and opportunity costs. Licenses are valued based on the estimated direct costs associated with recreating the asset, including opportunity costs based on an income approach. In the case of states with a moratorium in place, the licenses are valued using the multi-period excess earnings method. The other identifiable assets include customer relationships that are amortized over 20.0 years . Customer relationships were valued using the multi-period excess earnings method. Noncontrolling interest is valued at fair value. Acquisitions The Company acquired the majority-ownership of three home health agencies during the three months ended March 31, 2019 . The total aggregate purchase price for these transactions was $1.7 million , of which $1.4 million was paid in cash. The purchase prices were determined based on the Company’s analysis of comparable acquisitions and the target market’s potential future cash flows. Substantially all of the preliminary allocation of the purchase price for the acquisitions were allocated to goodwill of $1.8 million , of which $0.5 million relates to noncontrolling interest goodwill, indefinite lived intangibles-trade names of $0.3 million , and Certificates of need/licenses of $ 0.5 million . Acquired noncontrolling interest was $0.8 million . Goodwill generated from the acquisitions was recognized based on the expected contributions of each acquisition to the overall corporate strategy. The Company expects its portion of goodwill to be fully tax deductible. The acquisitions were accounted for under the acquisition method of accounting. Accordingly, the accompanying interim financial information includes the results of operations of the acquired entities from the date of acquisition. Joint Venture Activities During the three months ended March 31, 2019 , the Company acquired the minority ownership interests associated with certain agencies previously operated within one of its equity joint ventures, whereby such agencies became wholly-owned subsidiaries of the Company. The total consideration for the purchase of such ownership interests was $18.0 million , which was paid in cash. The transaction was accounted for as an equity transaction.

Goodwill and Intangibles

Goodwill and Intangibles	3 Months Ended
	Mar. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangibles	Goodwill and Intangibles The changes in recorded goodwill by reporting unit for the three months ended March 31, 2019 were as follows (amounts in thousands): Home health reporting unit Hospice reporting unit Home and community-based services reporting unit Facility-based reporting unit HCI reporting unit Total Balance as of December 31, 2018 $ 822,602 $ 118,583 $ 165,583 $ 14,194 $ 40,755 $ 1,161,717 Acquisitions 1,278 — — — — 1,278 Noncontrolling interests 532 — — — — 532 Adjustments and disposals............................................ 856 14 495 — 107 1,472 Balance as of March 31, 2019 $ 825,268 $ 118,597 $ 166,078 $ 14,194 $ 40,862 $ 1,164,999 The allocation of goodwill from acquisitions purchased during the three months ended March 31, 2019 for each reporting unit is preliminary and subject to change once the valuation analysis required by ASC 805, Business Combinations is finalized. In assigning fair value acquired in acquisitions as required by ASC 805, Business Combinations, the Company had assigned fair value to Certificates of need or license moratoria, as applicable, in certain states. During the first quarter of 2019, the Company recorded $6.0 million of moratoria fair value impairment as a result of the Centers for Medicare and Medicaid Services (“CMS”) action to remove all federal moratoria with regard to Medicare provider enrollment. Additionally, the Company recorded $0.3 million of disposals of intangible assets, which consist of licenses and Certificates of needs, due to the closure of underperforming locations. The disposal and impairment were classified in impairment of intangibles and other on the Company's consolidated statements of income. The following tables summarize the changes in intangible assets during the three months ended March 31, 2019 and December 31, 2018 (amounts in thousands): 2019 2018 Indefinite-lived intangible assets: Trade Names $ 156,401 $ 156,049 Certificates of Need/Licenses 122,915 128,577 Net Total 279,316 284,626 Definite-lived intangible assets: Trade Names Gross carrying amount 10,127 10,127 Accumulated amortization (8,984 ) (8,817 ) Net total 1,143 1,310 Non-compete agreements Gross carrying amount 6,238 5,980 Accumulated amortization (5,790 ) (5,729 ) Net total 448 251 Customer relationships Gross carrying amount 11,822 11,822 Accumulated amortization (775 ) (630 ) Net total 11,047 11,192 Total definite-lived intangible assets Gross carrying amount 28,187 27,929 Accumulated amortization (15,549 ) (15,176 ) Net total 12,638 12,753 Total intangible assets: Gross carrying amount 307,503 312,555 Accumulated amortization (15,549 ) (15,176 ) Net total $ 291,954 $ 297,379 Remaining useful lives for trade names, customer relationships, and non-compete agreements were 8.6 , 19.0 and 2.8 years, respectively, at March 31, 2019 . Similar periods at December 31, 2018 were 8.8 , 19.3 , and 2.8 years for trade names, customer relationships, and non-compete agreements, respectively. Intangible assets (net of accumulated amortization) in the amount of $233.4 million were related to the home health services segment, $32.3 million were related to the hospice services segment, $10.3 million were related to the home and community-based services segment, $4.1 million were related to the facility-based services segment, and $11.8 million were related to the HCI services segment as of March 31, 2019 . Amortization expense was recorded in general and administrative expenses.

Debt

Debt	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Debt	Debt Credit Facility On March 30, 2018 , the Company entered into a Credit Agreement with JPMorgan Chase Bank, N.A., which was effective on April 2, 2018 (the "Credit Agreement"). The Credit Agreement provides a senior, secured revolving line of credit commitment with a maximum principal borrowing limit of $500.0 million , which includes an additional $200.0 million accordion expansion feature, and a letter of credit sub-limit equal to $50.0 million . The expiration date of the Credit Agreement is March 30, 2023 . The Company’s obligations under the Credit Agreement are secured by substantially all of the assets of the Company and its wholly-owned subsidiaries (subject to customary exclusions), which assets include the Company’s equity ownership of its wholly-owned subsidiaries and its equity ownership in joint venture entities. The Company’s wholly-owned subsidiaries also guarantee the obligations of the Company under the Credit Agreement. Revolving loans under the Credit Agreement bear interest at, as selected by the Company, either a (a) Base Rate, which is defined as a fluctuating rate per annum equal to the highest of (1) the Federal Funds Rate in effect on such day plus 0.5% (2) the Prime Rate in effect on such day and (3) the Eurodollar Rate for a one month interest period on such day plus 1.5% , plus a margin ranging from 0.50% to 1.25% per annum or (b) Eurodollar rate plus a margin ranging from 1.50% to 2.25% per annum, with pricing varying based on the Company's quarterly consolidated Leverage Ratio. Swing line loans bear interest at the Base Rate. The Company is limited to 15 Eurodollar borrowings outstanding at any time. The Company is required to pay a commitment fee for the unused commitments at rates ranging from 0.20% to 0.35% per annum depending upon the Company’s quarterly consolidated Leverage Ratio. The Base Rate as of March 31, 2019 was 6.25% and the LIBOR rate was 4.25% . As of March 31, 2019 , the effective interest rate on outstanding borrowings under the New Credit Agreement was 4.25% . As of March 31, 2019 , the Company had $239.0 million drawn, letters of credit issued in the amount of $22.3 million , and $238.7 million of remaining borrowing capacity available under the New Credit Agreement. At December 31, 2018 , the Company had $235.0 million drawn and letters of credit issued in the amount of $30.4 million under the Credit Facility. Under the terms of the Credit Agreement, the Company is required to maintain certain financial ratios and comply with certain financial covenants. The Credit Agreement permits the Company to make certain restricted payments, such as purchasing shares of its stock, within certain parameters, provided the Company maintains compliance with those financial ratios and covenants after giving effect to such restricted payments. The Company was in compliance with its debt covenants under the Credit Agreement at March 31, 2019 .

Stockholder's Equity

Stockholder's Equity	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
Stockholder's Equity	Stockholder’s Equity Equity Based Awards The 2018 Incentive Plan is administered by the Compensation Committee of the Company’s Board of Directors. The total number of shares of the Company's common stock originally reserved were 2,210,544 shares of our common stock and a total of 2,047,244 shares are currently available for issuance. A variety of discretionary awards for employees, officers, directors, and consultants are authorized under the 2018 Incentive Plan, including incentive or non-qualified stock options and restricted stock, restricted stock units and performance-based awards. All awards must be evidenced by a written award certificate which will include the provisions specified by the Compensation Committee of the Board of Directors. The Compensation Committee determines the exercise price for stock options, which cannot be less than the fair market value of the Company’s common stock as of the date of grant. Almost Family had Stock and Incentive Compensation Plans that provided for stock awards of the Company's common stock to employees, non-employee directors, or independent contractors. Almost Family issued restricted shares and/or option awards to employees and non-employee directors. Under the change of control provisions of the Almost Family plans, all outstanding restricted stock, performance restricted stock, and options became non-forfeitable in conjunction with the Merger. Share Based Compensation Nonvested Stock During the three months ended March 31, 2019 , the Company granted 10,800 and 3,600 nonvested shares of common stock to independent directors and members of the Transitional Advisory Council, respectively under the Second Amended and Restated 2005 Non-Employee Directors Compensation Plan. The shares vest 100% on the one year anniversary date. During the three months ended March 31, 2019 , one new director was granted 3,500 nonvested shares of common stock under the Second Amended and Restated 2005 Non-Employee Directors Compensation Plan, which shares vest 33% at the grant date, then 33% on each of the first two anniversaries of the grant date. During the three months ended March 31, 2019 , employees were granted 128,930 nonvested shares of common stock pursuant to the 2018 Incentive Plan. The shares vest over a period of five years , conditioned on continued employment. The fair value of nonvested shares of common stock is determined based on the closing trading price of the Company’s common stock on the grant date. The weighted average grant date fair value of nonvested shares of common stock granted during the three months ended March 31, 2019 was $67.16 . The following table represents the share grants activity for the three months ended March 31, 2019 : Restricted stock Options Number of shares Weighted average grant date fair value Number of shares Weighted average grant date fair value Share grants outstanding as of December 31, 2018 574,285 $ 49.68 161,807 $ 38.08 Granted 146,830 $ 108.93 — $ — Vested or exercised (174,562 ) $ 42.29 (44,387 ) $ 34.87 Share grants outstanding as of March 31, 2019 546,553 $ 67.16 117,420 $ 39.73 As of March 31, 2019 , there was $29.6 million of total unrecognized compensation cost related to nonvested shares of common stock granted. That cost is expected to be recognized over the weighted average period of 3.39 years . The Company records compensation expense related to nonvested stock awards at the grant date for shares of common stock that are awarded fully vested, and over the vesting term on a straight line basis for shares of common stock that vest over time. The Company estimates forfeitures at the time of grant and revises the estimate in subsequent periods if actual forfeitures differ. The Company recorded $1.8 million and $1.6 million of compensation expense related to nonvested stock grants for each of the three months ended March 31, 2019 and 2018 , respectively. Employee Stock Purchase Plan In 2006, the Company adopted the Employee Stock Purchase Plan whereby eligible employees may purchase the Company’s common stock at 95% of the market price on the last day of the calendar quarter. There were 250,000 shares of common stock initially reserved for the plan. In 2013 , the Company adopted the Amended and Restated Employee Stock Purchase Plan, which reserved an additional 250,000 shares of common stock to the plan. The table below details the shares of common stock issued during 2019 : Number of shares Per share price Shares available as of December 31, 2018 152,344 Shares issued during the three months ended March 31, 2019 5,357 $ 89.19 Shares available as of March 31, 2019 146,987 Treasury Stock In conjunction with the vesting of the nonvested shares of common stock or the exercise of stock options, recipients incur personal income tax obligations. The Company allows the recipients to turn in shares of common stock to satisfy minimum tax obligations. During the three months ended March 31, 2019 , the Company redeemed 59,967 shares of common stock valued at $6.6 million , related to share vesting tax obligations. In addition, the Company redeemed 24,044 shares of common stock valued at $0.9 million , related to the exercise of options. Such shares are held as treasury stock and are available for reissuance by the Company. Additionally, shares were submitted by employees in lieu of exercise price that would have otherwise been due on exercise of stock options, which shares are held in treasury stock and are available for reissuance by the Company.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Contingencies Regulatory Matters The Company provides services in a highly regulated industry and is a party to various proceedings and regulatory and other governmental and internal audits and investigations in the ordinary course of business (including audits by Zone Program Integrity Contractors ("ZPICs") and Recovery Audit Contractors ("RACs") and investigations resulting from the Company's obligation to self-report suspected violations of law). Management cannot predict the ultimate outcome of any regulatory and other governmental and internal audits and investigations. While such audits and investigations are the subject of administrative appeals, the appeals process, even if successful, may take several years to resolve. The Department of Justice, CMS, or other federal and state enforcement and regulatory agencies may conduct additional investigations related to the Company's businesses. These audits and investigations have caused and could potentially continue to cause delays in collections, recoupments from governmental payors. Currently, the Company has recorded $16.9 million in other assets, which are from government payors related to the disputed finding of pending appeals of ZPIC audits. Additionally, these audits may subject the Company to sanctions, damages, extrapolation of damage findings, additional recoupments, fines, and other penalties (some of which may not be covered by insurance), which may, either individually or in the aggregate, have a material adverse effect on the Company's business and financial condition. Merger Related Litigation On January 18, 2018, Jordan Rosenblatt, a purported shareholder of Almost Family filed a complaint for violations of the Securities Exchange Act of 1934 in the United States District Court for the Western District of Kentucky, styled Rosenblatt v. Almost Family, Inc., et al. , Case No. 3:18-cv-40-TBR (the “Rosenblatt Action”). The Rosenblatt Action was filed against the Company, Almost Family, Almost Family’s board of directors, and Merger Sub. The complaint in the Rosenblatt Action (“Rosenblatt Complaint”) asserts, among other things, that the Form S-4 Registration Statement (“Registration Statement”) filed on December 21, 2017 in connection with the Merger contained false and misleading statements with respect to the Merger. The Rosenblatt Action sought, among other things, an injunction enjoining the Merger from closing and an award of attorneys’ fees and costs. In addition to the Rosenblatt Action, two additional complaints were filed against Almost Family in the United States District Court for the District of Delaware (the "Delaware Actions") alleging similar violations as the Rosenblatt Action. These Delaware Actions also sought, among other things, to enjoin both the vote of the Almost Family stockholders with respect to the Merger and the closing of the Merger, monetary damages, and an award of attorneys’ fees and costs from Almost Family. On February 22, 2018, plaintiffs in the Delaware Actions moved for a preliminary injunction to enjoin the merger of Almost Family and Merger Sub. Then, on March 2, 2018, the Delaware Actions were transferred to the United States District Court for the Western District of Kentucky. Shortly thereafter, on March 12, 2018, Almost Family, the Company, and Merger Sub opposed the plaintiffs’ motion for a preliminary injunction, and the court heard oral argument on the plaintiffs’ motion for a preliminary injunction on March 19, 2018. On March 22, 2018, the court denied plaintiffs’ motion for preliminary injunction. The next day, on March 23, 2018, one of the plaintiffs in the Delaware Actions moved to consolidate the Delaware Actions with the Rosenblatt Action and for the appointment of a lead plaintiff. On December 19, 2018, the Court granted the motion to consolidate, appointed Leonard Stein, a purported Almost Family shareholder, as the Lead Plaintiff, and approved Stein's selection of Lead Counsel. On February 1, 2019, Lead Plaintiff filed his Consolidated Amended Class Action Complaint (the "Consolidated Complaint"). The Consolidated Complaint asserts claims against Almost Family, the Company and Almost Family's board of directors for violations of Section 14(a) of the 1934 Act in connection with the dissemination of the Company's and Almost Family's Proxy Statement concerning the Merger, and asserts breach of fiduciary duty claims and claims for violations of Section 20(a) of the 1934 Act against Almost Family's former board of directors. The Consolidated Complaint seeks, among other things, monetary damages and an award of attorneys' fees and costs. We believe that the claims asserted in these lawsuits are entirely without merit and intend to defend these lawsuits vigorously. Other Litigation We are involved in various other legal proceedings arising in the ordinary course of business. Although the results of litigation cannot be predicted with certainty, we believe the outcome of pending litigation will not have a material adverse effect, after considering the effect of our insurance coverage, on our consolidated financial information. Joint Venture Buy/Sell Provisions Most of the Company’s joint ventures include a buy/sell option that grants to the Company and its joint venture partners the right to require the other joint venture party to either purchase all of the exercising member’s membership interests or sell to the exercising member all of the non-exercising member’s membership interest, at the non-exercising member’s option, within 30 days of the receipt of notice of the exercise of the buy/sell option. In some instances, the purchase price is based on a multiple of the historical or future earnings before income taxes and depreciation and amortization of the equity joint venture at the time the buy/sell option is exercised. In other instances, the buy/sell purchase price will be negotiated by the partners and subject to a fair market valuation process. Compliance The laws and regulations governing the Company’s operations, along with the terms of participation in various government programs, regulate how the Company does business, the services offered and its interactions with patients and the public. These laws and regulations, and their interpretations, are subject to frequent change. Changes in existing laws or regulations, or their interpretations, or the enactment of new laws or regulations could materially and adversely affect the Company’s operations and financial condition. The Company is subject to various routine and non-routine governmental reviews, audits and investigations. In recent years, federal and state civil and criminal enforcement agencies have heightened and coordinated their oversight efforts related to the health care industry, including referral practices, cost reporting, billing practices, joint ventures and other financial relationships among health care providers. Violation of the laws governing the Company’s operations, or changes in the interpretation of those laws, could result in the imposition of fines, civil or criminal penalties and/or termination of the Company’s rights to participate in federal and state-sponsored programs and suspension or revocation of the Company’s licenses. The Company believes that it is in material compliance with all applicable laws and regulations.

Noncontrolling interest

Noncontrolling interest	3 Months Ended
	Mar. 31, 2019
Noncontrolling Interest [Abstract]
Noncontrolling interest	Noncontrolling interests The Company classifies noncontrolling interests of its joint venture parties based upon a review of the legal provisions governing the redemption of such interests. In each of the Company’s joint ventures, those provisions are embodied within the joint venture’s operating agreement. For joint ventures with operating agreement provisions that establish an obligation for the Company to purchase the third party partners’ noncontrolling interests other than as a result of events that lead to a liquidation of the joint venture, such noncontrolling interests are classified as redeemable noncontrolling interests in temporary equity. For joint ventures with operating agreement provisions that establish an obligation that the Company purchase the third party partners’ noncontrolling interests, but which obligation is triggered by events that lead to a liquidation of the joint venture, such noncontrolling interests are classified as nonredeemable noncontrolling interests in permanent equity. Additionally, for joint ventures with operating agreement provisions that do not establish an obligation for the Company to purchase the third party partners’ noncontrolling interests (e.g., where the Company has the option, but not the obligation, to purchase the third party partners’ noncontrolling interests), such noncontrolling interests are classified as nonredeemable noncontrolling interests in permanent equity. The Company’s equity joint ventures that are classified as redeemable noncontrolling interests are subject to operating agreement provisions that require the Company to purchase the noncontrolling partner’s interest upon the occurrence of certain triggering events, which are defined as the bankruptcy of the partner or the partner’s exclusion from the Medicare or Medicaid programs. These triggering events and the related repurchase provisions are specific to each redeemable equity joint venture, since the triggering of a repurchase obligation for any one redeemable noncontrolling interest in an equity joint venture does not necessarily impact any of the other redeemable noncontrolling interests in other equity joint ventures. Upon the occurrence of a triggering event requiring the purchase of a redeemable noncontrolling interest, the Company would be required to purchase the noncontrolling partner’s interest based upon a valuation methodology set forth in the applicable joint venture agreement. Redeemable noncontrolling interests and nonredeemable noncontrolling interests are initially recorded at their fair value as of the closing date of the transaction establishing the joint venture. Such fair values are determined using various accepted valuation methods, including the income approach, the market approach, the cost approach, and a combination of one or more of these approaches. A number of facts and circumstances concerning the operation of the joint venture are evaluated for each transaction, including (but not limited to) the ability to choose management, control over acquiring or liquidating assets, and controlling the joint venture’s strategy and direction, in order to determine the fair value of the noncontrolling interest. Based upon the Company’s evaluation of the redemption provisions concerning redeemable noncontrolling interests as of March 31, 2019 , the Company determined in accordance with authoritative accounting guidance that it was not probable that an event otherwise requiring redemption of any redeemable noncontrolling interest would occur (i.e., the date for such event was not set or such event is not certain to occur). Therefore, none of the redeemable noncontrolling interests were identified as mandatorily redeemable interests at such times, and the Company did not record any values in respect of any mandatorily redeemable interests. Subsequent to the closing date of the transaction establishing the joint venture, the Company records adjustments to the carrying amounts of noncontrolling interests during each reporting period to reflect (a) comprehensive income (loss) attributed to each noncontrolling interest, which is calculated by multiplying the noncontrolling interest percentage by the comprehensive income (loss) of the joint venture’s operations, (b) dividends paid to the noncontrolling interest partner, and (c) any other transactions that increase or decrease the Company’s ownership interest in each joint venture, as a result of which the Company retains its controlling interest. If the Company determines that, based upon its analysis as of the end of each reporting period in accordance with authoritative accounting guidance, that it is not probable that an event would occur to otherwise require the redemption of a redeemable noncontrolling interest (i.e., the date for such event is not set or such event is not certain to occur), then the Company does not adjust the recorded amount of such redeemable noncontrolling interest. The carrying amount of each redeemable equity instrument presented in temporary equity for the three months ended March 31, 2019 is not less than the initial amount reported for each instrument. The following table summarizes the activity of noncontrolling interest-redeemable for the three months ended March 31, 2019 (amounts in thousands): Balance as of December 31, 2018 $ 14,596 Net income attributable to noncontrolling interest-redeemable 2,859 Noncontrolling interest-redeemable distributions (2,395 ) Balance as of March 31, 2019 $ 15,060

Leases

Leases	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Leases	Leases The Company adopted ASU 2016-02 on January 1, 2019, which resulted in the recognition of a right to use asset and liability for certain operating leases on the Company's Consolidated Balance Sheets in 2019. The Company determines if a contract contains a lease at inception and recognizes operating lease right of use assets and operating lease liabilities based on the present value of the future minimum lease payments at the lease commencement date. The Company's leases do not provide implicit rates. Therefore, the Company used an incremental borrowing rate based on the information available at the lease commencement date in determining the present value of future payments. Lease expense is recognized on a straight-line basis over the lease term. The Company's operating lease obligations relate to office leases, which have remaining lease terms of one to nine years. Some lease obligations include options to extend the leases based on individual lease agreements and may include options to terminate the leases within one year. The Company elected the 'package of practical expedient', which permitted the Company to not recognize the operating lease right of use assets or liabilities for short term leases, which are those leases with a term of twelve months or less at the lease commencement date. Expenses associated with lease expense was $12.4 million for the three months ended March 31, 2019. Information related to the Company's operating lease right of use assets and related lease liabilities for the office leases were as follows (amounts in thousands): Three months ended March 31, 2019 Cash paid for operating lease liabilities $ 6,775 Right-of-use assets obtained in exchange for new operating lease liabilities $ 91,174 Weighted-average remaining lease term 4.63 Weighted-average discount rate 4.75 % Maturities of operating lease liabilities as of March 31, 2019 were as follows (amounts in thousands): Year ending December 31, 2019 (remaining) $ 24,871 2020 23,041 2021 17,174 2022 10,334 2023 (and thereafter) 17,056 Total future minimum lease payments 92,476 Less imputed interest (6,037 ) Total $ 86,439

Fair Value of Financial Instrum

Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2019
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	Fair Value of Financial Instruments The carrying amounts of the Company’s cash, receivables, accounts payable and accrued liabilities approximate their fair values because of their short maturity. The estimated fair value of intangible assets acquired was calculated using level 3 inputs based on the present value of anticipated future benefits. For the three months ended March 31, 2019 , the carrying value of the Company’s long-term debt approximates fair value, as the interest rates approximate current rates.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Segment Information	Segment Information The Company's reporting segments include (1) home health services, (2) hospice services, (3) home and community-based services, (4) facility-based services and (5) healthcare innovations (“HCI”). Reportable segments have been identified based upon how management has organized the business by services provided to customers and how the chief operating decision maker manages the business and allocates resources, consistent with the criteria in ASC 280, Segment Reporting. The home health segment provides skilled medical services in patients’ homes largely to enable recipients to reduce or avoid periods of hospitalization and/or nursing home care. During the three months ended March 31, 2019, 71.3% of the home health services segment revenues were generated from the Medicare program, while the balance is generated from Medicaid and private insurance programs. The hospice segment services are largely provided in patients’ homes and generally require specialized hospice nursing skills. Hospice services segment revenues are generated on a per diem basis and are primarily from Medicare, which accounted for 92.4% of hospice services segment revenues during the three months ended March 31, 2019. The home and community-based segment provides traditional home and community-based services (generally provided by paraprofessional staff such as home health aides), which are generally of a custodial rather than skilled nature. Home and community-based services segment revenues are generated on a shift or hourly basis and are primarily from Managed Care, Commercial, and Other payor sources, which accounted for 74.9% of home and community-based services segment revenues during the three months ended March 31, 2019. The facility-based segment services includes services primarily provided through LTACHs. The facility-based services segment is reimbursed primarily by Medicare under the LTACH prospective payment system, which accounted for 57.4% of facility-based services segment revenue during the three months ended March 31, 2019. The HCI segment combines reporting on the Company’s developmental activities outside its other business segments. The HCI segment includes (a) Imperium Health Management, LLC, an ACO enablement company, (b) Long Term Solutions, Inc., an in-home assessment company serving the long-term care insurance industry, and (c) certain assets operated by Advanced Care House Calls, which provides primary medical care for patients with chronic and acute illnesses who have difficulty traveling to a doctor’s office. These activities are intended to ultimately, whether directly or indirectly, to benefit the Company’s patients and payors through the enhanced provision of services in the Company’s other segments. The activities all share a common goal of improving patient experiences and quality outcomes, while lowering costs. They include, but are not limited to, items such as: technology, information, population health management, risk-sharing, care-coordination and transitions, clinical advancements, enhanced patient engagement and informed clinical decision and technology enabled in-home clinical assessments. The accounting policies of the segments are the same as those described in the summary of significant accounting policies, as described in Note 2 of the Notes to Condensed Consolidated Financial Statements. The following tables summarize the Company’s segment information for the three months ended March 31, 2019 and 2018 (amounts in thousands): Three Months Ended March 31, 2019 Home health services Hospice services Home and community-based services Facility-based services HCI Total Net service revenue $ 363,035 $ 51,736 $ 51,785 $ 27,701 $ 8,328 $ 502,585 Cost of service revenue 226,123 33,176 39,855 17,732 4,106 320,992 General and administrative expenses 104,839 14,853 10,982 9,177 5,370 145,221 Other intangible impairment charge 6,318 1 — — — 6,319 Operating income (loss) 25,755 3,706 948 792 (1,148 ) 30,053 Interest expense (2,138 ) (343 ) (301 ) (180 ) (90 ) (3,052 ) Income (loss) before income taxes and noncontrolling interest 23,617 3,363 647 612 (1,238 ) 27,001 Income tax expense (benefit) 3,208 446 151 5 (210 ) 3,600 Net income (loss) 20,409 2,917 496 607 (1,028 ) 23,401 Less net income (loss) attributable to noncontrolling interests 3,780 601 (310 ) 481 (7 ) 4,545 Net income (loss) attributable to LHC Group, Inc.’s common stockholders $ 16,629 $ 2,316 $ 806 $ 126 $ (1,021 ) $ 18,856 Total assets $ 1,421,000 $ 220,347 $ 226,991 $ 79,257 $ 66,262 $ 2,013,857 Three Months Ended March 31, 2018 Home health services Hospice services Home and community-based services Facility-based services HCI Total Net service revenue $ 204,187 $ 42,626 $ 14,091 $ 30,150 $ — $ 291,054 Cost of service revenue 130,161 28,018 10,790 19,649 — 188,618 General and administrative expenses 66,289 13,298 3,298 9,146 — 92,031 Operating income 7,737 1,310 3 1,355 — 10,405 Interest expense (1,088 ) (218 ) (72 ) (72 ) — (1,450 ) Income (loss) before income taxes and noncontrolling interest 6,649 1,092 (69 ) 1,283 — 8,955 Income tax expense 722 111 (15 ) 159 — 977 Net income (loss) 5,927 981 (54 ) 1,124 — 7,978 Less net income attributable to noncontrolling interests 2,236 417 21 309 — 2,983 Net income (loss) attributable to LHC Group, Inc.’s common stockholders $ 3,691 $ 564 $ (75 ) $ 815 $ — $ 4,995 Total assets $ 530,197 $ 157,338 $ 47,819 $ 69,969 $ — $ 805,323

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The effective tax rate for the three months ended March 31, 2019 and 2018 benefited from $2.4 million and $0.7 million , respectively, of excess tax benefits associated with stock-based compensation arrangements. U.S. GAAP prescribes a recognition threshold and measurement attribute for the accounting and financial statement disclosure of tax positions taken or expected to be taken in a tax return. The evaluation of a tax position is a two-step process. The first step requires the Company to determine whether it is more likely than not that a tax position will be sustained upon examination based on the technical merits of the position. The second step requires the Company to recognize in the financial statements each tax position that meets the more likely than not criteria, measured at the amount of benefit that has a greater than 50% likelihood of being realized. The Company’s unrecognized tax benefits would affect the tax rate, if recognized. The Company includes the full amount of unrecognized tax benefits in other noncurrent liabilities in the Company's Consolidated Balance Sheets. The Company anticipates it is reasonably possible an increase or decrease in the amount of unrecognized tax benefits could be made in the next twelve months. However, the Company does not presently anticipate that any increase or decrease in unrecognized tax benefits will be material to the consolidated financial statements. The amount recognized as of March 31, 2019 was $4.5 million .

Subsequent Event

Subsequent Event	3 Months Ended
	Mar. 31, 2019
Subsequent Events [Abstract]
Subsequent Event	Subsequent Event On April 1, 2019, the Company entered into a joint venture with Geisinger Home Health and Hospice ("Geisinger"), whereby the Company acquired a majority interest in Geisinger’s home health and hospice providers located in Danville and Bloomsburg, Pennsylvania, and Geisinger acquired a minority interest in the Company’s home health providers located in Harrisburg and Hazel Township, Pennsylvania. Through this joint venture, the Company is scheduled to also acquire a majority interest in Geisinger's home health and hospice providers located in Egg Harbor Township, New Jersey on June 1, 2019, subject to customary closing conditions.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements, and the reported revenue and expenses during the reporting period. Actual results could differ from those estimates.
Critical Accounting Policies	Critical Accounting Policies The Company’s most critical accounting policies relate to revenue recognition.
Revenue Recognition	Net Service Revenue Net service revenue is reported at the amount that reflects the consideration the Company expects to receive in exchange for providing services. Receipts are from Medicare, Medicaid, and other commercial or managed care insurance programs for services rendered, are subject to adjustment based upon implicit price concessions for retroactive revenue adjustments by third-party payors, settlements of audits, and claims reviews. The estimated uncollectible amounts due from these payors are considered implicit price concessions that are a direct reduction to net service revenue. The Company assesses the patient's ability to pay for their healthcare services at the time of patient admission based on the Company's verification of the patient's insurance coverage under the Medicare, Medicaid, and other commercial or managed care insurance programs. Medicare contributes to the net service revenue of the Company’s home health, hospice, facility-based, and healthcare innovations services. Medicaid and other payors contribute to the net service revenue of all of the Company's segments. Performance obligations are determined based on the nature of the services provided by the Company. The majority of the Company's performance obligations are to provide services to patients based on medical necessity and the bundle of services to be provided to achieve the goals established in the contract, while the healthcare innovations segment's performance obligations are largely to provide care, assessments and management services under various customer contracts. Revenue for performance obligations that are satisfied over time is recognized based on actual charges incurred in relation to total expected charges over the measurement period of the performance obligation, which depicts the transfer of services and related benefits received by the patient and customers over the term of the contract to satisfy the obligations. The Company measures the satisfaction of the performance obligations as services are provided. The Company's performance obligations relate to contracts with a duration of less than one year. Therefore, the Company has elected to apply the optional exemption provided by ASC 606 - Revenue Recognition, and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. Any unsatisfied or partially unsatisfied performance obligations at the end of a reporting period are generally completed prior to the patient being discharged. The Company determines the transaction price for the majority of its performance obligations based on gross charges for services provided, reduced by contractual adjustments provided to third-party payors and implicit price concessions. The Company determines estimates of explicit price concessions, principally contractual adjustments based on established agreements with payors, and implicit price concessions based on historical collection experience. Estimates of explicit and implicit price concessions are periodically reviewed to ensure they encompass the Company's current contract terms, are reflective of the Company's current patient mix, and are indicative of the Company's historic collections to ensure net service revenue is recognized at the expected transaction price. As a result, revenue is recorded in amounts equal to expected cash receipts for services when rendered. The following table sets forth the percentage of net service revenue earned by category of payor for the three months ended March 31, 2019 and 2018 : Three Months Ended 2019 2018 Home health: Medicare 71.3 % 71.2 % Medicaid 1.0 0.9 Managed Care, Commercial, and Other 27.7 27.9 100.0 % 100.0 % Hospice: Medicare 92.4 % 92.3 % Medicaid 0.3 0.6 Managed Care, Commercial, and Other 7.3 7.1 100.0 % 100.0 % Home and Community-Based Services: Medicaid 25.1 % 17.3 % Managed Care, Commercial, and Other 74.9 82.7 100.0 % 100.0 % Facility-Based Services: Medicare 57.4 % 64.0 % Managed Care, Commercial, and Other 42.6 36.0 100.0 % 100.0 % HCI: Medicare 22.2 % — % Medicaid 0.5 — Managed Care, Commercial, and Other 77.3 — 100.0 % — % Medicare The Company's home health, hospice, and facility-based segments recognize revenue under their respective Medicare programs, which are discussed in more detail below. The home health segment's Medicare patients, including certain Medicare Advantage patients, are classified into one of 153 home health resource groups prior to receiving services. Based on the patient’s home health resource group, the Company is entitled to receive a standard prospective Medicare payment for delivering care over a 60 -day period referred to as an episode. The Company elects to use the same 60-day length of episode that Medicare recognizes as standard but accelerates revenue upon discharge to align with a patient's episode length, if less than the expected 60 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 an episode of care within the reporting period. Final payments from Medicare will reflect base payment adjustments for case-mix and geographic wage differences and a 2% sequestration reduction. In addition, final payments may reflect one of four retroactive adjustments to the total reimbursement: (a) an outlier payment if the patient’s care was unusually costly; (b) a low utilization adjustment if the number of visits was fewer than five ; (c) a partial payment if the patient transferred to another provider before completing the episode; or (d) a payment adjustment based upon the level of therapy services required. The retroactive adjustments outlined above are recognized in net service revenue when the event causing the adjustment occurs and during the period in which the services are provided to the patient. The Company reviews these adjustments to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustments is subsequently resolved. Net service revenue and related patient accounts receivable are recorded at amounts estimated to be realized from Medicare for services rendered. The Company's hospice services segment is reimbursed by Medicare under a per diem payment system based on the daily needs determined for patients' basis. The hospice segment receives one of four predetermined daily rates based upon the level of care the Company furnishes. Each level of care is contingent upon the patient's medical necessity and is a separate and distinct performance obligation, which depicts the transfer of services and related benefits received by the patient over the term of the contract to satisfy such obligations. The Company records net service revenue for hospice services based on the promulgated per diem rate over time as services are provided, in satisfaction of performance obligation. Hospice payments are subject to variable consideration through an inpatient cap and an overall Medicare payment cap. The inpatient cap relates to individual programs receiving more than 20% of their total Medicare reimbursement from inpatient care services, and the overall Medicare payment cap relates to individual programs receiving reimbursements in excess of a “cap amount,” determined by Medicare to be payment equal to six months of hospice care for the aggregate base of hospice patients, indexed for inflation. The determination for each cap is made annually based on the 12 -month period ending on October 31 of each year. The Company monitors its limits on a provider-by-provider basis and records an estimate of its liability for reimbursements received in excess of the cap amount, if any, in the reporting period. The Company reviews these estimates to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustments is subsequently resolved. The Company's facility-based services segment is reimbursed primarily by Medicare for services provided under the long-term acute care hospital ("LTACH") prospective payment system. Each patient is assigned a long-term care diagnosis-related group. The Company is paid a predetermined fixed amount intended to reflect the average cost of treating a Medicare LTACH patient classified in that particular long-term care diagnosis-related group. For selected LTACH patients, the amount may be further adjusted based on length-of-stay and facility-specific costs, as well as in instances where a patient is discharged and subsequently re-admitted, among other factors. The Company calculates the adjustment based on a historical average of these types of adjustments for LTACH claims paid. Similar to other Medicare prospective payment systems, the rate is also adjusted for geographic wage differences. Net service revenue adjustments resulting from reviews and audits of Medicare cost report settlements are considered implicit price concessions for LTACHs and are measured at expected value. The Company reviews these estimates to ensure that it is probable that a significant reversal in the amount of LTACH services cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustments is subsequently resolved. Net service revenue for the Company’s LTACH services that are satisfied over time is recognized based on actual charges incurred in relation to total expected charges, which depicts the transfer of services and related benefits received by the customer over the service period to satisfy the obligations. Non-Medicare Revenues Each of the Company's segments recognize revenue from various non-Medicare payor sources. Revenue from these payor sources are derived from services provided under a per visit, per hour or per unit basis, per assessment or per member per month basis. Such fee for service revenues are calculated and recorded using payor-specific or patient-specific fee schedules based on the contracted rates in each underlying third party payor or services agreement or out of network rates, as applicable. Net service revenue is recognized as such services are provided and costs for delivery of such services are incurred. Contingent Service Revenues The Company’s Healthcare Innovations segment provides strategic health management services to Accountable Care Organizations (“ACOs”) that have been approved to participate in the Medicare Shared Savings Program (“MSSP”). The HCI segment maintains service agreements with ACOs that provide for sharing of MSSP payments received by the ACO, if any. ACOs are legal entities that contract with Centers for Medicare and Medicaid Services ("CMS") to provide services to the Medicare fee-for-service population for a specified annual period with the goal of providing better care for the individual, improving health for populations and lowering costs. ACOs share savings with CMS to the extent that the actual costs of serving assigned beneficiaries are below certain trended benchmarks of such beneficiaries and certain quality performance measures are achieved. The generation of shared savings is the performance obligation of each ACO, which only become certain upon the final issuance of unembargoed calculations by CMS, generally in the third quarter of each calendar year. As of March 31, 2019, no net service revenue was recognized related to potential MSSP payments for savings generated for the program periods that will end December 31, 2018 , if any, as it remains unclear as to if performance obligations have been met by any ACO served by the HCI segment.
Accounts Receivable	Accounts Receivable The Company reports accounts receivable net of estimates of variable consideration and implicit price concessions. Accounts receivable are uncollateralized and primarily consist of amounts due from Medicare, Medicaid, other third-party payors, and to a lesser degree patients. The Company establishes allowances for explicit and implicit price concessions to reduce the carrying amount of such receivables to their estimated net realizable value. The credit risk associated with receivables from other payors is limited due to the significance of Medicare as the primary payor. The Company believes the credit risk associated with its Medicare accounts, which have historically exceeded 50% of its patient accounts receivable, is limited due to (i) the historical collection rate from Medicare and (ii) the fact that Medicare is a U.S. government payor. The Company does not believe that there are any other significant concentrations of receivables from any particular payor that would subject it to any significant credit risk in the collection of accounts receivable. The amount of the provision for implicit price concessions is based upon the Company's assessment of historical and expected net collections, business and economic conditions, and trends in government reimbursement. Uncollectible accounts are written off when the Company has determined that the account will not be collected. A portion of the estimated Medicare prospective payment system reimbursement from each submitted home nursing episode is received in the form of a request for anticipated payment (“RAP”). The Company submits a RAP for 60% of the estimated reimbursement for the initial episode at the start of care. The full amount of the episode is billed after the episode has been completed. If a final bill is not submitted within the greater of 120 days from the start of the episode, or 60 days from the date the RAP was paid, any RAP received for that episode will be recouped by Medicare from any other Medicare claims in process for that particular provider. The RAP and final claim must then be resubmitted. For subsequent episodes of care contiguous with the first episode for a particular patient, the Company submits a RAP for 50% of the estimated reimbursement. The Company’s services to the Medicare population are paid at prospectively set amounts that can be determined at the time services are rendered. The Company’s Medicaid reimbursements are based on a predetermined fee schedule applied to each individual service it provides. The Company’s managed care contracts and other in or out of network payors provide for payments based upon a predetermined fee schedule or an episodic basis. The Company is able to calculate actual amounts to be received at the patient level and to adjust the gross charges down to the actual amount at the time of billing. This negates the need to record an estimated explicit price concessions when reporting net service revenue for each reporting period.
Earnings Per Share	Earnings Per Share Basic per share information is computed by dividing the relevant amounts from the condensed consolidated statements of income by the weighted-average number of shares outstanding during the period, under the treasury stock method. Diluted per share information is also computed using the treasury stock method, by dividing the relevant amounts from the condensed consolidated statements of income by the weighted-average number of shares outstanding plus potentially dilutive shares.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In February 2016, the FASB issued ASU No. 2016-02, Leases, ("ASU 2016-02"), as modified by ASUs 2018-01, 2018-10, 2018-11 and 2018-20 (collectively, ASU 2016-02), which requires lessees to recognize leases with terms exceeding 12 months on the Company's Consolidated Balance Sheet. Qualifying leases were classified as finance or operating right-of-use ("ROU") assets and lease liabilities. The new standard was effective for the Company on January 1, 2019. ASU 2016-02 provides a number of optional practical expedients in transition and the Company (a) elected the 'package of practical expedients', which permitted the Company not to reassess under the new standard the Company's prior conclusions about lease identification, lease classification and initial direct costs, (b) elected all the use-of-hindsight or the practical expedient pertaining to land easements; the latter not being applicable to the Company, and (c) elected all the new standard's available transition practical expedients. Adoption of this standard increased total assets and total liabilities by $84.8 million , primarily for the Company's operating leased office space for locations in each segment. The adoption did not change the Company's leasing activities. ASU 2016-02 also provides practical expedients for an entity's ongoing accounting. The Company elected the short-term recognition exemption for certain medical devices and storage space leases that qualify, which means it will not recognize ROU assets or lease liabilities, including not recognizing ROU assets or lease liabilities for existing short-term leases of these assets in transition. See Note 9 of the Notes to Condensed Consolidated Financial Statements.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In January 2017, the FASB issued ASU 2017-04, Intangibles - Goodwill and Other: Simplifying the Test for Goodwill Impairment , which requires an entity to no longer perform a hypothetical purchase price allocation to measure goodwill impairment. Instead, impairment will be measured using the difference between the carrying amount and the fair value of the reporting unit. This ASU is effective for annual and interim periods in fiscal years beginning after December 15, 2019.

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Percentage of Net Service Revenue Earned by Category of Payor	The following table sets forth the percentage of net service revenue earned by category of payor for the three months ended March 31, 2019 and 2018 : Three Months Ended 2019 2018 Home health: Medicare 71.3 % 71.2 % Medicaid 1.0 0.9 Managed Care, Commercial, and Other 27.7 27.9 100.0 % 100.0 % Hospice: Medicare 92.4 % 92.3 % Medicaid 0.3 0.6 Managed Care, Commercial, and Other 7.3 7.1 100.0 % 100.0 % Home and Community-Based Services: Medicaid 25.1 % 17.3 % Managed Care, Commercial, and Other 74.9 82.7 100.0 % 100.0 % Facility-Based Services: Medicare 57.4 % 64.0 % Managed Care, Commercial, and Other 42.6 36.0 100.0 % 100.0 % HCI: Medicare 22.2 % — % Medicaid 0.5 — Managed Care, Commercial, and Other 77.3 — 100.0 % — %
Shares Used in Computation of Basic and Diluted Per Share Information	The following table sets forth shares used in the computation of basic and diluted per share information and, with respect to the data provided for the three months ended March 31, 2019 (amounts in thousands). Three Months Ended 2019 2018 Weighted average number of shares outstanding for basic per share calculation 30,837 17,790 Effect of dilutive potential shares: Nonvested stock 350 249 Adjusted weighted average shares for diluted per share calculation 31,187 18,039 Anti-dilutive shares 141 170

Acquisitions and Joint Ventur_2

Acquisitions and Joint Venture Activities (Tables)	3 Months Ended
	Mar. 31, 2019
Business Combinations [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The Company was determined to be the accounting acquirer in the Merger. The Company's final valuation analysis of identifiable assets and liabilities assumed for the Merger in accordance with the requirements of ASC Topic 805, Business Combinations, are presented in the table below (amounts in thousands): Merger consideration Stock $ 795,412 Fair value of total consideration transferred Recognized amounts of identifiable assets acquired and liabilities assumed: Cash and cash equivalents 16,547 Patient accounts receivable 89,635 Prepaid income taxes 47 Prepaid expenses and other current assets 11,490 Property and equipment 11,144 Trade names 76,090 Certificates of needs/licenses 76,505 Customer relationships 13,970 Assets held for sale 2,500 Deferred income taxes 4,821 Accounts payable (43,027 ) Accrued other liabilities (57,243 ) Seller notes payable (12,145 ) NCI - Redeemable (8,034 ) Long term income taxes payable (3,786 ) Line of credit (106,800 ) NCI - Nonredeemable (36,609 ) Other assets and (liabilities), net (178 ) Total identifiable assets and liabilities 34,927 Goodwill $ 760,485

Goodwill and Intangibles (Table

Goodwill and Intangibles (Tables)	3 Months Ended
	Mar. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Changes in Recorded Goodwill by Reporting Unit	The changes in recorded goodwill by reporting unit for the three months ended March 31, 2019 were as follows (amounts in thousands): Home health reporting unit Hospice reporting unit Home and community-based services reporting unit Facility-based reporting unit HCI reporting unit Total Balance as of December 31, 2018 $ 822,602 $ 118,583 $ 165,583 $ 14,194 $ 40,755 $ 1,161,717 Acquisitions 1,278 — — — — 1,278 Noncontrolling interests 532 — — — — 532 Adjustments and disposals............................................ 856 14 495 — 107 1,472 Balance as of March 31, 2019 $ 825,268 $ 118,597 $ 166,078 $ 14,194 $ 40,862 $ 1,164,999
Summary of Changes in Intangible Assets	he following tables summarize the changes in intangible assets during the three months ended March 31, 2019 and December 31, 2018 (amounts in thousands): 2019 2018 Indefinite-lived intangible assets: Trade Names $ 156,401 $ 156,049 Certificates of Need/Licenses 122,915 128,577 Net Total 279,316 284,626 Definite-lived intangible assets: Trade Names Gross carrying amount 10,127 10,127 Accumulated amortization (8,984 ) (8,817 ) Net total 1,143 1,310 Non-compete agreements Gross carrying amount 6,238 5,980 Accumulated amortization (5,790 ) (5,729 ) Net total 448 251 Customer relationships Gross carrying amount 11,822 11,822 Accumulated amortization (775 ) (630 ) Net total 11,047 11,192 Total definite-lived intangible assets Gross carrying amount 28,187 27,929 Accumulated amortization (15,549 ) (15,176 ) Net total 12,638 12,753 Total intangible assets: Gross carrying amount 307,503 312,555 Accumulated amortization (15,549 ) (15,176 ) Net total $ 291,954 $ 297,379
Summary of Changes in Intangible Assets	he following tables summarize the changes in intangible assets during the three months ended March 31, 2019 and December 31, 2018 (amounts in thousands): 2019 2018 Indefinite-lived intangible assets: Trade Names $ 156,401 $ 156,049 Certificates of Need/Licenses 122,915 128,577 Net Total 279,316 284,626 Definite-lived intangible assets: Trade Names Gross carrying amount 10,127 10,127 Accumulated amortization (8,984 ) (8,817 ) Net total 1,143 1,310 Non-compete agreements Gross carrying amount 6,238 5,980 Accumulated amortization (5,790 ) (5,729 ) Net total 448 251 Customer relationships Gross carrying amount 11,822 11,822 Accumulated amortization (775 ) (630 ) Net total 11,047 11,192 Total definite-lived intangible assets Gross carrying amount 28,187 27,929 Accumulated amortization (15,549 ) (15,176 ) Net total 12,638 12,753 Total intangible assets: Gross carrying amount 307,503 312,555 Accumulated amortization (15,549 ) (15,176 ) Net total $ 291,954 $ 297,379

Stockholder's Equity (Tables)

Stockholder's Equity (Tables)	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
Nonvested Stock Activity	The following table represents the share grants activity for the three months ended March 31, 2019 : Restricted stock Options Number of shares Weighted average grant date fair value Number of shares Weighted average grant date fair value Share grants outstanding as of December 31, 2018 574,285 $ 49.68 161,807 $ 38.08 Granted 146,830 $ 108.93 — $ — Vested or exercised (174,562 ) $ 42.29 (44,387 ) $ 34.87 Share grants outstanding as of March 31, 2019 546,553 $ 67.16 117,420 $ 39.73
Shares of Common Stock Issued Under Employee Stock Purchase Plan	The table below details the shares of common stock issued during 2019 : Number of shares Per share price Shares available as of December 31, 2018 152,344 Shares issued during the three months ended March 31, 2019 5,357 $ 89.19 Shares available as of March 31, 2019 146,987

Noncontrolling interest (Tables

Noncontrolling interest (Tables)	3 Months Ended
	Mar. 31, 2019
Noncontrolling Interest [Abstract]
Summary of Activity of Noncontrolling Interest-Redeemable	The following table summarizes the activity of noncontrolling interest-redeemable for the three months ended March 31, 2019 (amounts in thousands): Balance as of December 31, 2018 $ 14,596 Net income attributable to noncontrolling interest-redeemable 2,859 Noncontrolling interest-redeemable distributions (2,395 ) Balance as of March 31, 2019 $ 15,060

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Assets And Liabilities, Lessee	Information related to the Company's operating lease right of use assets and related lease liabilities for the office leases were as follows (amounts in thousands): Three months ended March 31, 2019 Cash paid for operating lease liabilities $ 6,775 Right-of-use assets obtained in exchange for new operating lease liabilities $ 91,174 Weighted-average remaining lease term 4.63 Weighted-average discount rate 4.75 %
Lessee, Operating Lease, Liability, Maturity	Maturities of operating lease liabilities as of March 31, 2019 were as follows (amounts in thousands): Year ending December 31, 2019 (remaining) $ 24,871 2020 23,041 2021 17,174 2022 10,334 2023 (and thereafter) 17,056 Total future minimum lease payments 92,476 Less imputed interest (6,037 ) Total $ 86,439

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Segment Information	The following tables summarize the Company’s segment information for the three months ended March 31, 2019 and 2018 (amounts in thousands): Three Months Ended March 31, 2019 Home health services Hospice services Home and community-based services Facility-based services HCI Total Net service revenue $ 363,035 $ 51,736 $ 51,785 $ 27,701 $ 8,328 $ 502,585 Cost of service revenue 226,123 33,176 39,855 17,732 4,106 320,992 General and administrative expenses 104,839 14,853 10,982 9,177 5,370 145,221 Other intangible impairment charge 6,318 1 — — — 6,319 Operating income (loss) 25,755 3,706 948 792 (1,148 ) 30,053 Interest expense (2,138 ) (343 ) (301 ) (180 ) (90 ) (3,052 ) Income (loss) before income taxes and noncontrolling interest 23,617 3,363 647 612 (1,238 ) 27,001 Income tax expense (benefit) 3,208 446 151 5 (210 ) 3,600 Net income (loss) 20,409 2,917 496 607 (1,028 ) 23,401 Less net income (loss) attributable to noncontrolling interests 3,780 601 (310 ) 481 (7 ) 4,545 Net income (loss) attributable to LHC Group, Inc.’s common stockholders $ 16,629 $ 2,316 $ 806 $ 126 $ (1,021 ) $ 18,856 Total assets $ 1,421,000 $ 220,347 $ 226,991 $ 79,257 $ 66,262 $ 2,013,857 Three Months Ended March 31, 2018 Home health services Hospice services Home and community-based services Facility-based services HCI Total Net service revenue $ 204,187 $ 42,626 $ 14,091 $ 30,150 $ — $ 291,054 Cost of service revenue 130,161 28,018 10,790 19,649 — 188,618 General and administrative expenses 66,289 13,298 3,298 9,146 — 92,031 Operating income 7,737 1,310 3 1,355 — 10,405 Interest expense (1,088 ) (218 ) (72 ) (72 ) — (1,450 ) Income (loss) before income taxes and noncontrolling interest 6,649 1,092 (69 ) 1,283 — 8,955 Income tax expense 722 111 (15 ) 159 — 977 Net income (loss) 5,927 981 (54 ) 1,124 — 7,978 Less net income attributable to noncontrolling interests 2,236 417 21 309 — 2,983 Net income (loss) attributable to LHC Group, Inc.’s common stockholders $ 3,691 $ 564 $ (75 ) $ 815 $ — $ 4,995 Total assets $ 530,197 $ 157,338 $ 47,819 $ 69,969 $ — $ 805,323

Organization - Additional Infor

Organization - Additional Information (Details)	Mar. 31, 2019LocationState
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of service providers operated | Location	752
Number of states in which Company operates | State	35

Significant Accounting Polici_4

Significant Accounting Policies - Percentage of Net Service Revenue Earned by Category of Payor (Details)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Home health services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	100.00%	100.00%
Hospice services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	100.00%	100.00%
Home and community-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	100.00%	100.00%
Facility-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	100.00%	100.00%
HCI
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	100.00%	0.00%
Medicare | Home health services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	71.30%	71.20%
Medicare | Hospice services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	92.40%	92.30%
Medicare | Facility-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	57.40%	64.00%
Medicare | HCI
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	22.20%	0.00%
Medicaid | Home health services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	1.00%	0.90%
Medicaid | Hospice services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	0.30%	0.60%
Medicaid | Home and community-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	25.10%	17.30%
Medicaid | HCI
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	0.50%	0.00%
Managed Care, Commercial, and Other | Home health services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	27.70%	27.90%
Managed Care, Commercial, and Other | Hospice services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	7.30%	7.10%
Managed Care, Commercial, and Other | Home and community-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	74.90%	82.70%
Managed Care, Commercial, and Other | Facility-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	42.60%	36.00%
Managed Care, Commercial, and Other | HCI
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	77.30%	0.00%

Significant Accounting Polici_5

Significant Accounting Policies - Additional Information (Details) $ in Millions	3 Months Ended
	Mar. 31, 2019GroupvisitPeriodicRate	Jan. 01, 2019USD ($)
Accounting Policies [Abstract]
Number of Medicare home health resource groups | Group	153
Number of days from date RAP paid to submit final Medicare bill	60 days
Medicare sequestration reduction for episodes beginning after March 31, 2013	2.00%
Low utilization adjustment visits | visit	5
Selected hospice, periodic rate used to calculate revenue	1
Number of hospice, periodic rates used to calculate revenue	4
Minimum percentage of Medicare reimbursement from inpatient care services that subjects individual programs to inpatient cap	20.00%
Determination period for hospice Medicare inpatient reimbursement cap	12 months
Medicare credit risk for accounts receivable	50.00%
Reimbursement for initial episode of care	60.00%
Number of days from start of episode to submit final Medicare bill	120 days
Reimbursement for subsequent episodes of care	50.00%
Accounting Standards Update 2016-02
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Increased total assets and total liabilities by adoption of lease standard | $		$ 84.8

Significant Accounting Polici_6

Significant Accounting Policies - Shares Used in Computation of Basic and Diluted Per Share Information (Details) - shares	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Accounting Policies [Abstract]
Weighted average number of shares outstanding for basic per share calculation (in shares)	30,837	17,790
Effect of dilutive potential shares:
Nonvested stock (in shares)	350	249
Adjusted weighted average shares for diluted per share calculation (in shares)	31,187	18,039
Anti-dilutive shares (in shares)	141	170

Acquisitions and Joint Ventur_3

Acquisitions and Joint Venture Activities - Additional Information (Details) $ in Thousands, shares in Millions	Apr. 01, 2018USD ($)shares	Mar. 31, 2019USD ($)Agencysubsidiary	Mar. 31, 2018USD ($)	Dec. 31, 2018USD ($)
Business Acquisition [Line Items]
Preliminary merger consideration	$ 795,400
Goodwill		$ 1,164,999		$ 1,161,717
Payments to Noncontrolling Interests		18,000	$ 55
Home health services
Business Acquisition [Line Items]
Goodwill		$ 825,268		$ 822,602
Equity joint ventures
Business Acquisition [Line Items]
Number of subsidiaries | subsidiary		1
Payments to Noncontrolling Interests		$ 18,000
Almost Family
Business Acquisition [Line Items]
Exchange ratio	91.50%
Shares of the Company issued (in shares) | shares	12.8
Goodwill	$ 760,485
Almost Family | Trade Names
Business Acquisition [Line Items]
Indefinite-lived intangible assets	76,090
Almost Family | Certificates of need/licenses
Business Acquisition [Line Items]
Indefinite-lived intangible assets	$ 76,505
Home health agencies and hospice agency
Business Acquisition [Line Items]
Preliminary merger consideration		1,700
Cash paid to for acquisitions		1,400
Goodwill		1,800
Goodwill, noncontrolling interest		500
Acquired nonontrolling interest		800
Home health agencies and hospice agency | Trade Names
Business Acquisition [Line Items]
Indefinite-lived intangible assets		300
Home health agencies and hospice agency | Certificates of need/licenses
Business Acquisition [Line Items]
Indefinite-lived intangible assets		$ 500
Home health agencies and hospice agency | Home health services
Business Acquisition [Line Items]
Number of agencies | Agency		3
Customer relationships | Almost Family
Business Acquisition [Line Items]
Amortization period	20 years

Acquisitions and Joint Ventur_4

Acquisitions and Joint Venture Activities - Almost Family Merger (Details) - USD ($) $ in Thousands	Apr. 01, 2018	Mar. 31, 2019	Dec. 31, 2018
Recognized amounts of identifiable assets acquired and liabilities assumed:
Preliminary goodwill		$ 1,164,999	$ 1,161,717
Almost Family
Business Acquisition [Line Items]
Stock	$ 795,412
Recognized amounts of identifiable assets acquired and liabilities assumed:
Cash and cash equivalents	16,547
Patient accounts receivable	89,635
Prepaid income taxes	47
Prepaid expenses and other current assets	11,490
Property and equipment	11,144
Customer relationships	13,970
Assets held for sale	2,500
Deferred income taxes	4,821
Accounts payable	(43,027)
Accrued other liabilities	(57,243)
Seller notes payable	(12,145)
NCI- Redeemable	(8,034)
Long term income taxes payable	(3,786)
Line of credit	(106,800)
NCI- Nonredeemable	(36,609)
Other assets and (liabilities), net	(178)
Total identifiable assets and liabilities	34,927
Preliminary goodwill	760,485
Almost Family | Trade name
Recognized amounts of identifiable assets acquired and liabilities assumed:
Indefinite-lived intangible assets	76,090
Almost Family | Certificates of need/licenses
Recognized amounts of identifiable assets acquired and liabilities assumed:
Indefinite-lived intangible assets	$ 76,505

Goodwill and Intangibles - Sche

Goodwill and Intangibles - Schedule of Changes in Recorded Goodwill by Reporting Unit (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Goodwill [Roll Forward]
Balance at beginning of period	$ 1,161,717
Acquisitions	1,278
Noncontrolling interests	532
Adjustments and disposals	1,472
Balance at end of period	1,164,999
Home health reporting unit
Goodwill [Roll Forward]
Balance at beginning of period	822,602
Acquisitions	1,278
Noncontrolling interests	532
Adjustments and disposals	856
Balance at end of period	825,268
Hospice reporting unit
Goodwill [Roll Forward]
Balance at beginning of period	118,583
Acquisitions	0
Noncontrolling interests	0
Adjustments and disposals	14
Balance at end of period	118,597
Home and community-based services reporting unit
Goodwill [Roll Forward]
Balance at beginning of period	165,583
Acquisitions	0
Noncontrolling interests	0
Adjustments and disposals	495
Balance at end of period	166,078
Facility-based reporting unit
Goodwill [Roll Forward]
Balance at beginning of period	14,194
Acquisitions	0
Noncontrolling interests	0
Adjustments and disposals	0
Balance at end of period	14,194
HCI reporting unit
Goodwill [Roll Forward]
Balance at beginning of period	40,755
Acquisitions	0
Noncontrolling interests	0
Adjustments and disposals	107
Balance at end of period	$ 40,862

Goodwill and Intangibles - Addi

Goodwill and Intangibles - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2017	Dec. 31, 2018
Indefinite-lived Intangible Assets [Line Items]
Other intangible impairment charge	$ 6,319	$ 0
Disposal of goodwill and intangible assets	300
Intangible assets, net carrying amount	291,954			$ 297,379
Home health services
Indefinite-lived Intangible Assets [Line Items]
Other intangible impairment charge	6,318
Intangible assets, net carrying amount	233,400
Hospice services
Indefinite-lived Intangible Assets [Line Items]
Other intangible impairment charge	1
Intangible assets, net carrying amount	32,300
Home and community-based services
Indefinite-lived Intangible Assets [Line Items]
Other intangible impairment charge	0
Intangible assets, net carrying amount	10,300
Facility-based services
Indefinite-lived Intangible Assets [Line Items]
Other intangible impairment charge	0
Intangible assets, net carrying amount	4,100
HCI reporting unit
Indefinite-lived Intangible Assets [Line Items]
Other intangible impairment charge	0
Intangible assets, net carrying amount	11,800
Certificates of need/licenses
Indefinite-lived Intangible Assets [Line Items]
Other intangible impairment charge	$ 6,000
Trade Names
Indefinite-lived Intangible Assets [Line Items]
Estimated useful life	8 years 6 months 30 days		8 years 9 months 18 days
Customer relationships
Indefinite-lived Intangible Assets [Line Items]
Estimated useful life	19 years
Non-compete agreements
Indefinite-lived Intangible Assets [Line Items]
Estimated useful life	2 years 9 months 18 days		19 years 3 months 18 days

Goodwill and Intangibles - Summ

Goodwill and Intangibles - Summary of Changes in Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 279,316	$ 284,626
Gross carrying amount, definite-lived intangible assets	28,187	27,929
Accumulated amortization	(15,549)	(15,176)
Net total	12,638	12,753
Gross carrying amount, intangible assets	307,503	312,555
Net total	291,954	297,379
Trade Names
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	10,127	10,127
Accumulated amortization	(8,984)	(8,817)
Net total	1,143	1,310
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	6,238	5,980
Accumulated amortization	(5,790)	(5,729)
Net total	448	251
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	11,822	11,822
Accumulated amortization	(775)	(630)
Net total	11,047	11,192
Trade Names
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	156,401	156,049
Certificates of need/licenses
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 122,915	$ 128,577

Debt - Additional Information (

Debt - Additional Information (Details)	Apr. 02, 2018USD ($)Instrument	Mar. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Debt Instrument [Line Items]
Available credit under agreement	$ 500,000,000	$ 238,700,000
Credit facility maximum borrowing capacity under accordion feature	200,000,000
Letter of credit, sub-limit amount	$ 50,000,000
Interest rate percentage		4.25%
Line of credit facility drawn		$ 239,000,000	$ 235,000,000
Letter of credit outstanding		$ 22,300,000	$ 30,400,000
Minimum
Debt Instrument [Line Items]
Commitment fee rates for unused commitments	0.20%
Maximum
Debt Instrument [Line Items]
Commitment fee rates for unused commitments	0.35%
Federal Funds Rate
Debt Instrument [Line Items]
Line of credit facility interest rate	0.50%
Eurodollar
Debt Instrument [Line Items]
Line of credit facility interest rate	1.50%
Line of credit facility, borrowing outstanding | Instrument	15
Eurodollar | Minimum
Debt Instrument [Line Items]
Line of credit facility interest rate	1.50%
Eurodollar | Maximum
Debt Instrument [Line Items]
Line of credit facility interest rate	2.25%
Base rate
Debt Instrument [Line Items]
Line of credit facility interest rate		6.25%
Base rate | Minimum
Debt Instrument [Line Items]
Line of credit facility interest rate	0.50%
Base rate | Maximum
Debt Instrument [Line Items]
Line of credit facility interest rate	1.25%
LIBOR
Debt Instrument [Line Items]
Line of credit facility interest rate		4.25%

Stockholder's Equity - Addition

Stockholder's Equity - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Jun. 07, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested stock grants to Independent directors (in shares)	3,500
Percentage of directors' stock grant vested on one year anniversary date	100.00%
Granted (in dollars per share)	$ 67.16
Total unrecognized compensation cost related to nonvested shares of common stock granted	$ 29,600
Weighted average period of cost recognized	3 years 4 months 20 days
Compensation expense related to nonvested stock grants	$ 1,800	$ 1,600
Price of shares issued under Employee Stock Purchase Plan as a percentage of FMV	95.00%
Number of shares reserved for the Employee Stock Purchase Plan (in shares)	250,000
Additional shares authorized for issuance (in shares)	250,000
Shares redeemed to satisfy personal tax obligations (in shares)	59,967
Treasury shares redeemed to pay income tax	$ 7,692	$ 3,467
Director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested stock grants to Independent directors (in shares)	10,800
Period of vested shares	1 year
Transitional Advisory Council
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested stock grants to Independent directors (in shares)	3,600
Employee
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period of vested shares	5 years
Treasury shares redeemed to pay income tax	$ 6,600
AFAM Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares redeemed to satisfy personal tax obligations (in shares)	24,044
Treasury shares redeemed to pay income tax	$ 900
2018 Long-Term Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock reserved for issuance (in shares)			2,210,544
Common stock available for issuance (in shares)			2,047,244
2018 Long-Term Incentive Plan | Employee
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested stock grants to employees (in shares)	128,930
Second Amended and Restated 2005 Non-Employee Directors Compensation Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of directors' stock grant vested on one year anniversary date	33.00%
Percentage of directors' stock grant vested on grant date	33.00%

Stockholder's Equity - Nonveste

Stockholder's Equity - Nonvested Stock Activity (Details)	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Weighted average grant date fair value
Granted (in dollars per share)	$ 67.16
Restricted stock
Number of shares
Share grants outstanding as of December 31, 2018 | shares	574,285
Granted (in shares) | shares	146,830
Vested (in shares) | shares	(174,562)
Share grants outstanding as of March 31, 2019 | shares	546,553
Weighted average grant date fair value
Beginning balance, Weighted average grant date fair value (in dollars per share)	$ 49.68
Granted (in dollars per share)	108.93
Vested (in dollars per share)	42.29
Ending balance, Weighted average grant date fair value (in dollars per share)	$ 67.16
Options
Number of shares
Share grants outstanding as of December 31, 2018 | shares	161,807
Granted (in shares) | shares	0
Vested or exercised (in shares) | shares	(44,387)
Share grants outstanding as of March 31, 2019 | shares	117,420
Weighted average grant date fair value
Share grants outstanding as of December 31, 2018 (in dollars per share)	$ 38.08
Granted (in dollars per share)	0
Vested or exercised (in dollars per share)	34.87
Share grants outstanding as of March 31, 2019 (in dollars per share)	$ 39.73

Stockholder's Equity - Shares o

Stockholder's Equity - Shares of Common Stock Issued Under Employee Stock Purchase Plan (Details)	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Number of shares available, beginning balance (in shares)	152,344
Shares issued during period (in shares)	5,357
Number of shares available, ending balance (in shares)	146,987
Per share price of shares issued during period (in dollars per share) | $ / shares	$ 89.19

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Commitments and Contingencies Disclosure [Abstract]
Other assets, amount from government payors	$ 16.9
Period of joint venture buy/sell option	30 days

Noncontrolling interest - Summa

Noncontrolling interest - Summary of Activity of Noncontrolling Interest-Redeemable (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Stockholders' Equity Attributable to Noncontrolling Interest [Roll Forward]
Noncontrolling interest-redeemable, beginning balance	$ 14,596
Net income attributable to noncontrolling interest-redeemable	2,859	$ 2,400
Noncontrolling interest-redeemable distributions	(2,395)
Noncontrolling interest-redeemable, ending balance	$ 15,060

Leases (Details)

Leases (Details) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Lessee, Lease, Description [Line Items]
Operating lease termination period	1 year
Lease cost	$ 12.4
Minimum
Lessee, Lease, Description [Line Items]
Operating lease term	1 year
Maximum
Lessee, Lease, Description [Line Items]
Operating lease term	9 years

Leases - Information Related to

Leases - Information Related to Leases (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Leases [Abstract]
Cash paid for operating lease liabilities	$ 6,775
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 91,174
Weighted-average remaining lease term	4 years 7 months 17 days
Weighted-average discount rate	4.75%

Leases - Lease Maturities (Deta

Leases - Lease Maturities (Details) $ in Thousands	Mar. 31, 2019USD ($)
Leases [Abstract]
2019 (remaining)	$ 24,871
2020	23,041
2021	17,174
2022	10,334
2023 (and thereafter)	17,056
Total future minimum lease payments	92,476
Less imputed interest	(6,037)
Total	$ 86,439

Segment Information - Additiona

Segment Information - Additional Information (Details)	3 Months Ended
	Mar. 31, 2019segment
Segment Reporting Information [Line Items]
Number of reportable segments	5
Services segment revenue | Home health services
Segment Reporting Information [Line Items]
Percentage of net service revenue	71.30%
Services segment revenue | Hospice services
Segment Reporting Information [Line Items]
Percentage of net service revenue	92.40%
Services segment revenue | Home and community-based services
Segment Reporting Information [Line Items]
Percentage of net service revenue	74.90%
Services segment revenue | Facility-based services
Segment Reporting Information [Line Items]
Percentage of net service revenue	57.40%

Segment Information - Summary o

Segment Information - Summary of segment Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	$ 502,585	$ 291,054
Cost of service revenue	320,992	188,618
General and administrative expenses	145,221	92,031
Other intangible impairment charge	6,319	0
Operating income	30,053	10,405
Interest expense	(3,052)	(1,450)
Income before income taxes and noncontrolling interest	27,001	8,955
Income tax expense	3,600	977
Net income	23,401	7,978
Less net income (loss) attributable to noncontrolling interests	4,545	2,983
Net income attributable to LHC Group, Inc.’s common stockholders	18,856	4,995
Total assets	2,013,857	805,323	$ 1,928,715
Home health services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	363,035	204,187
Cost of service revenue	226,123	130,161
General and administrative expenses	104,839	66,289
Other intangible impairment charge	6,318
Operating income	25,755	7,737
Interest expense	(2,138)	(1,088)
Income before income taxes and noncontrolling interest	23,617	6,649
Income tax expense	3,208	722
Net income	20,409	5,927
Less net income (loss) attributable to noncontrolling interests	3,780	2,236
Net income attributable to LHC Group, Inc.’s common stockholders	16,629	3,691
Total assets	1,421,000	530,197
Hospice services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	51,736	42,626
Cost of service revenue	33,176	28,018
General and administrative expenses	14,853	13,298
Other intangible impairment charge	1
Operating income	3,706	1,310
Interest expense	(343)	(218)
Income before income taxes and noncontrolling interest	3,363	1,092
Income tax expense	446	111
Net income	2,917	981
Less net income (loss) attributable to noncontrolling interests	601	417
Net income attributable to LHC Group, Inc.’s common stockholders	2,316	564
Total assets	220,347	157,338
Home and community-based services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	51,785	14,091
Cost of service revenue	39,855	10,790
General and administrative expenses	10,982	3,298
Other intangible impairment charge	0
Operating income	948	3
Interest expense	(301)	(72)
Income before income taxes and noncontrolling interest	647	(69)
Income tax expense	151	(15)
Net income	496	(54)
Less net income (loss) attributable to noncontrolling interests	(310)	21
Net income attributable to LHC Group, Inc.’s common stockholders	806	(75)
Total assets	226,991	47,819
Facility-based services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	27,701	30,150
Cost of service revenue	17,732	19,649
General and administrative expenses	9,177	9,146
Other intangible impairment charge	0
Operating income	792	1,355
Interest expense	(180)	(72)
Income before income taxes and noncontrolling interest	612	1,283
Income tax expense	5	159
Net income	607	1,124
Less net income (loss) attributable to noncontrolling interests	481	309
Net income attributable to LHC Group, Inc.’s common stockholders	126	815
Total assets	79,257	69,969
HCI
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	8,328	0
Cost of service revenue	4,106	0
General and administrative expenses	5,370	0
Other intangible impairment charge	0
Operating income	(1,148)	0
Interest expense	(90)	0
Income before income taxes and noncontrolling interest	(1,238)	0
Income tax expense	(210)	0
Net income	(1,028)	0
Less net income (loss) attributable to noncontrolling interests	(7)	0
Net income attributable to LHC Group, Inc.’s common stockholders	(1,021)	0
Total assets	$ 66,262	$ 0

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	Mar. 31, 2019	Mar. 31, 2018
Income Tax Disclosure [Abstract]
Excess tax benefits associated with stock-based compensation	$ 2.4	$ 0.7
Unrecognized tax benefits	$ 4.5