LHC (LHCG) 10-Q 8 May 20 2020 Q1 Quarterly report Financial data

Cover page

Cover page - shares	3 Months Ended
	Mar. 31, 2020	May 05, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Mar. 31, 2020
Entity File Number	001-33989
Entity Registrant Name	LHC Group, Inc
Entity Central Index Key	0001303313
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Amendment Flag	false
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	71-0918189
Entity Address, Address Line One	901 Hugh Wallis Road South
Entity Address, City or Town	Lafayette
Entity Address, State or Province	LA
Entity Address, Postal Zip Code	70508
City Area Code	337
Local Phone Number	233-1307
Title of 12(b) Security	Common Stock, par value of $0.01
Trading Symbol	LHCG
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		31,588,641

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash	$ 8,308	$ 31,672
Receivables:
Patient accounts receivable	351,763	284,962
Other receivables	11,984	10,832
Total receivables	363,747	295,794
Prepaid income taxes	14,189	9,652
Prepaid expenses	33,032	21,304
Other current assets	20,217	21,852
Total current assets	439,493	380,274
Property, building and equipment, net of accumulated depreciation of $73,963 and $69,441, respectively	107,622	97,908
Goodwill	1,234,191	1,219,972
Intangible assets, net of accumulated amortization of $16,748 and $16,431, respectively	310,870	305,556
Assets held for sale	2,500	2,500
Operating lease right of use asset	96,078	95,452
Other assets	21,528	38,633
Total assets	2,212,282	2,140,295
Current liabilities:
Accounts payable and other accrued liabilities	75,215	83,572
Salaries, wages, and benefits payable	108,337	85,631
Self-insurance reserves	33,482	31,188
Current operating lease liabilities	33,444	28,701
Amounts due to governmental entities	1,931	1,880
Total current liabilities	252,409	230,972
Deferred income taxes	64,865	60,498
Income taxes payable	6,165	3,867
Revolving credit facility	298,071	253,000
Operating lease payable	65,396	69,556
Total liabilities	686,906	617,893
Noncontrolling interest — redeemable	19,431	15,151
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; 36,297,106 and 36,129,280 shares issued, and 31,100,826 and 30,992,390 shares outstanding, respectively	363	361
Treasury stock — 5,196,280 and 5,136,890 shares at cost, respectively	(67,182)	(60,060)
Additional paid-in capital	951,330	949,321
Retained earnings	545,725	523,701
Total LHC Group, Inc. stockholders’ equity	1,430,236	1,413,323
Noncontrolling interest — non-redeemable	75,709	93,928
Total stockholders' equity	1,505,945	1,507,251
Total liabilities and stockholders' equity	$ 2,212,282	$ 2,140,295

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Property, building and equipment, accumulated depreciation	$ 73,963	$ 69,441
Intangible assets, accumulated amortization	$ 16,748	$ 16,431
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	60,000,000	60,000,000
Common stock, shares issued (in shares)	36,297,106	36,129,280
Common stock, shares outstanding (in shares)	31,100,826	30,992,390
Treasury stock at cost, shares (in shares)	5,196,280	5,136,890

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Statement [Abstract]
Net service revenue	$ 512,871	$ 502,585
Cost of service revenue (excluding depreciation and amortization)	321,202	320,992
Gross margin	191,669	181,593
General and administrative expenses	157,866	145,221
Impairment of intangibles and other	0	6,319
Operating income	33,803	30,053
Interest expense	(2,768)	(3,052)
Income before income taxes and noncontrolling interest	31,035	27,001
Income tax expense	3,359	3,600
Net income	27,676	23,401
Less net income attributable to noncontrolling interests	5,652	4,545
Net income attributable to LHC Group, Inc.’s common stockholders	$ 22,024	$ 18,856
Earnings per share:
Basic (usd per share)	$ 0.71	$ 0.61
Diluted (usd per share)	$ 0.70	$ 0.60
Weighted average shares outstanding:
Basic (in shares)	31,020,000	30,837,000
Diluted (in shares)	31,303,000	31,187,000

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
Beginning balance, Amount at Dec. 31, 2018	$ 1,424,474	$ 358	$ (49,373)	$ 937,965	$ 427,975	$ 107,549
Beginning balance (in shares) at Dec. 31, 2018		35,835,348
Beginning balance, Treasury (in shares) at Dec. 31, 2018			5,029,429
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	20,542				18,856	1,686
Acquired noncontrolling interest	820					820
Noncontrolling interest distributions	(6,799)					(6,799)
Purchase of additional controlling interest	(18,000)					(18,000)
Nonvested stock compensation	1,804			1,804
Issuance of vested stock	2	$ 2
Issuance of vested stock (in shares)		174,562
Treasury shares redeemed to pay income tax	(6,841)		$ (6,726)	(115)
Treasury shares redeemed to pay income tax (in shares)			61,465
Exercise of options	(850)	$ 1	$ (851)
Exercise of options (in shares)		44,387	24,044
Issuance of common stock under Employee Stock Purchase Plan (in shares)		5,357
Issuance of common stock under Employee Stock Purchase Plan	478			478
Ending balance, Amount at Mar. 31, 2019	1,415,630	$ 361	$ (56,950)	940,132	446,831	85,256
Ending balance (in shares) at Mar. 31, 2019		36,059,654
Ending balance, Treasury (in shares) at Mar. 31, 2019			5,114,938
Beginning balance, Amount at Dec. 31, 2019	$ 1,507,251	$ 361	$ (60,060)	949,321	523,701	93,928
Beginning balance (in shares) at Dec. 31, 2019		36,129,280
Beginning balance, Treasury (in shares) at Dec. 31, 2019	5,136,890		5,136,890
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	$ 24,123				22,024	2,099
Acquired noncontrolling interest	2,880					2,880
Noncontrolling interest distributions	(2,093)					(2,093)
Purchase of additional controlling interest	(23,575)			(2,470)		(21,105)
Nonvested stock compensation	3,680			3,680
Issuance of vested stock	2	$ 2
Issuance of vested stock (in shares)		163,163
Treasury shares redeemed to pay income tax	$ (6,933)		$ (7,122)	189
Treasury shares redeemed to pay income tax (in shares)	59,390		59,390
Issuance of common stock under Employee Stock Purchase Plan (in shares)	4,663	4,663
Issuance of common stock under Employee Stock Purchase Plan	$ 610			610
Ending balance, Amount at Mar. 31, 2020	$ 1,505,945	$ 363	$ (67,182)	$ 951,330	$ 545,725	$ 75,709
Ending balance (in shares) at Mar. 31, 2020		36,297,106
Ending balance, Treasury (in shares) at Mar. 31, 2020	5,196,280		5,196,280

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating activities:
Net income	$ 27,676	$ 23,401
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	5,133	4,202
Amortization of operating lease right of use asset	8,512	7,399
Stock-based compensation expense	3,680	1,804
Deferred income taxes	4,367	1,578
Amortization of operating leases	(13)	0
Loss on disposal of assets	47	56
Impairment of intangibles and other	0	6,319
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(67,470)	(16,284)
Prepaid expenses	(11,728)	(1,069)
Other assets	2,268	1,539
Prepaid income taxes	(4,537)	1,883
Accounts payable and accrued expenses	(11,159)	(10,413)
Salaries, wages, and benefits payable	24,826	16,169
Operating lease liabilities	(8,415)	(5,285)
Income taxes payable	2,298	184
Net amounts due to/from governmental entities	51	(55)
Net cash (used in) provided by operating activities	(24,464)	31,428
Investing activities:
Purchases of property, building and equipment	(13,502)	(2,801)
Proceeds from sale of property, building and equipment	1,149	0
Cash received (paid) for acquisitions	3,125	(1,413)
Net cash used in investing activities	(9,228)	(4,214)
Financing activities:
Proceeds from line of credit	188,728	17,000
Payments on line of credit	(143,657)	(13,000)
Proceeds from employee stock purchase plan	610	478
Payments on debt	0	(7,650)
Noncontrolling interest distributions	(4,874)	(9,194)
Withholding taxes paid on stock-based compensation	(7,064)	(7,577)
Purchase of additional controlling interest	(23,575)	(18,000)
Exercise of vested awards and stock options	160
Exercise of vested awards and stock options		(114)
Net cash provided by (used in) financing activities	10,328	(38,057)
Change in cash	(23,364)	(10,843)
Cash at beginning of period	31,672	49,363
Cash at end of period	8,308	38,520
Supplemental disclosures of cash flow information:
Interest paid	2,830	2,855
Income taxes paid	1,269	318
Non-Cash Operating Activity:
Operating right of use assets in exchange for lease obligations	9,041	91,174
Non-Cash Investing Activity:
Accrued capital expenditures	$ 2,226	$ 4,600

Basis of Presentation and Signi

Basis of Presentation and Significant Events	3 Months Ended
	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Significant Events	Organization LHC Group, Inc. (the “Company”) is a health care provider specializing in the post-acute continuum of care. The Company provides services through five segments: home health, hospice, home and community-based services, facility-based services, the latter primarily through long-term acute care hospitals (“LTACHs”), and healthcare innovations services ("HCI"). As of March 31, 2020 , the Company, through its wholly- and majority-owned subsidiaries, equity joint ventures, controlled affiliates, and management agreements operated 820 service locations in 35 states within the continental United States and the District of Columbia. COVID-19 The effects of the worldwide pandemic caused by the outbreak of SARS-CoV-2 (“COVID-19”) have impacted our business. For example, the Company has experienced increased costs associated with obtaining personal protective equipment and other medical supplies in an effort to protect the safety and well-being of the Company's clinicians and patients across the country. Additionally, the emergence of stay-at-home and physical distancing orders and other restrictions on movement and economic activity intended to reduce the spread of COVID-19 during the second half of March 2020 have required us to alter our clinical, operational, and business processes. Taken together, however, as further described in this Quarterly Report on Form 10-Q, the net impact of COVID-19 was not material to the results of operations during the three months ended March 31, 2020. Unaudited Interim Financial Information The accompanying unaudited condensed consolidated balance sheets as of March 31, 2020 and December 31, 2019 , and the related unaudited condensed consolidated statements of income for the three months ended March 31, 2020 and 2019 , condensed consolidated statements of changes in equity for the three months ended March 31, 2020 and 2019, condensed consolidated statements of cash flows for the three months ended March 31, 2020 and 2019 , 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, 2020 are not necessarily indicative of the results that may be expected for the year ending December 31, 2020 . 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, 2019 (the "2019 Form 10-K"). The 2019 Form 10-K was filed with the Securities and Exchange Commission (the “SEC”) on February 27, 2020 , and includes information and disclosures not included herein. Immaterial Correction of an Error During the three months ended March 31, 2020, the Company increased the reported number of common shares issued by 44,387 and decreased the reported number of treasury shares by 24,044 for the three months ended March 31, 2019 due to the exclusion of reporting the number of common shares issued as a result of the exercise of certain outstanding stock options and the number of treasury shares redeemed to pay income tax associated with such stock option exercises. For further details of this noted item, see Note 2 of the Notes to Consolidated Financial Statements in the 2019 10K filed with the SEC on February 27, 2020. The Company has evaluated the effects both qualitatively and quantitatively, and concluded that they did not have a material impact on previously issued financial statements for the three months ended March 31, 2019.

Significant Accounting Policies

Significant Accounting Policies	3 Months Ended
	Mar. 31, 2020
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 from contracts with customers is recognized in the period the performance obligations are satisfied under the Company's contracts by transferring the requested services to patients in amounts that reflect the consideration to which is expected to be received in exchange for providing patient care, which is the transaction price allocated to the services provided in accordance with Accounting Standards Update ("ASU") 2014-09, Revenue from Contracts with Customers (Topic 606) and ASU 2015-14 , Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date (collectively, "ASC 606"). Net service revenue is recognized as performance obligations are satisfied, which can vary depending on the type of services provided. The performance obligation is the delivery of patient care in accordance with the requested services outlined in physicians' orders, which are based on specific goals for each patient. The performance obligations are associated with contracts in duration of less than one year; therefore, the optional exemption provided by ASC 606 was elected resulting in the Company not being required to disclose the aggregate amount of the transaction price allocated to the performance obligations that are unsatisfied or partially unsatisfied as of the end of the reporting period. The Company's unsatisfied or partially unsatisfied performance obligations are primarily completed when the patients are discharged and typically occur within days or weeks of the end of the period. The Company determines the transaction price based on gross charges for services provided, reduced by estimates for explicit and implicit price concessions. Explicit price concessions include contractual adjustments provided to patients and third-party payors. Implicit price concessions include discounts provided to self-pay, uninsured patients or other payors, adjustments resulting from regulatory reviews, audits, billing reviews and other matters. Subsequent changes to the estimate of the transaction price are recorded as adjustments to net service revenue in the period of change. Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay (i.e. change in credit risk) are recorded as a provision for doubtful accounts within general and administrative expenses. Explicit price concessions are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third-party payors and others for services provided. Implicit price concessions are recorded for self-pay, uninsured patients and other payors by major payor class based on historical collection experience and current economic conditions, representing the difference between amounts billed and amounts expected to be collected. The Company assesses the ability to collect for the healthcare services provided at the time of patient admission based on the verification of the patient's insurance coverage under Medicare, Medicaid, and other commercial or managed care insurance programs. Amounts due from third-party payors, primarily commercial health insurers and government programs (Medicare and Medicaid), include variable consideration for retroactive revenue adjustments due to settlements of audits and reviews. The Company has determined estimates for price concessions related to regulatory reviews based on historical experience and success rates in the claim appeals and adjudication process. Revenue is recorded at amounts estimated to be realizable for services provided. The following table sets forth the percentage of net service revenue earned by category of payor for the three months ended March 31, 2020 and 2019 : Three Months Ended 2020 2019 Home health: Medicare 68.2 % 71.3 % Managed Care, Commercial, and Other 31.8 28.7 100.0 % 100.0 % Hospice: Medicare 92.0 % 92.4 % Managed Care, Commercial, and Other 8.0 7.6 100.0 % 100.0 % Home and Community-Based Services: Medicaid 20.6 % 25.1 % Managed Care, Commercial, and Other 79.4 74.9 100.0 % 100.0 % Facility-Based Services: Medicare 54.8 % 57.4 % Managed Care, Commercial, and Other 45.2 42.6 100.0 % 100.0 % HCI: Medicare 24.6 % 22.2 % Managed Care, Commercial, and Other 75.4 77.8 100.0 % 100.0 % Medicare The following describes the payment models in effect during the three months ended March 31, 2020. Such payment models have been subject to temporary adjustments made by the Centers for Medicare and Medicaid Services ("CMS") in response to COVID-19 pandemic as described elsewhere by this Quarterly Report on Form 10-Q. Home Health Services Effective January 1, 2020, the Patient Driven Groupings Model ("PDGM") became the new payment model for services provided to Medicare patients with dates of service on or after the effective date, including certain Medicare Advantage patients. PDGM was implemented by CMS. Under PDGM, the initial certification of Medicare patient eligibility, plan of care, and comprehensive assessment is for a 60-day episode of care; however, unlike the former Medicare prospective payment system ("PPS"), where each 60-day episode of care could not be final billed until the episode was completed, PDGM provides for each 30-day period within the episode of care to be final billed upon completion. As a result of PDGM, the Company now completes its final billing after each 30-day period instead of the form 60-day period under PPS. For each 30 -day period, the patient is classified into one of 432 home health resource groups prior to receiving services. Each 30 -day period is placed into a subgroup falling under the following categories: (i) timing being early or late, (ii) admission source being community or institutional, (iii) one of 12 clinical groupings based on the patient's principal diagnosis, (iv) functional impairment level of low, medium, or high, and (v) a co-morbidity adjustment of none, low, or high based on the patient's secondary diagnoses. Each 30-day period payment from Medicare reflects base payment adjustments for case-mix, geographic wage differences, and a 2% sequestration reduction. In addition, payments may reflect one of three retroactive adjustments to the total reimbursement: (a) an outlier payment if the patient’s care was unusually costly; (b) a low utilization adjustment whereby the number of visits is dependent on the clinical grouping; and/or (c) a partial payment if the patient transferred to another provider or from another provider before completing the episode. 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. Hospice The Company records revenue on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The Company receives one of four predetermined daily rates based upon the level of care provided by the Company, which can be routine care, general inpatient care, continuous home care, and respite care. There are two separate payment rates for routine care: payment for the first 60 days of care and care beyond 60 days. In addition to the two routine rates, the Company may also receive a service intensity add-on ("SIA"). The SIA is based on visits made in the last seven days of life by a registered nurse or medical social worker for patients in a routine level of care. The performance obligation is the delivery of hospice services to the patient, as determined by a physician, each day the patient is on hospice care. Adjustments to Medicare revenue are made from regulatory reviews, audits, billing reviews and other matters. The Company estimates the impact of these adjustments based on our historical experience. 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 12 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. Facility-Based Services Gross revenue is recorded as services are provided under the 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. Non-Medicare Revenues Other sources of net service revenue for all segments fall into Medicaid, managed care or other payors of the Company's services. Medicaid reimbursement is based on a predetermined fee schedule applied to each service provided. Therefore, revenue is recognized for Medicaid services as services are provided based on this fee schedule. The Company's managed care and other payors reimburse the Company based upon a predetermined fee schedule or an episodic basis, depending on the terms of the applicable contract. Accordingly, the Company recognizes revenue from managed care and other payors as services are provided, such costs are incurred, and estimates of expected payments are known for each different payor, thus the Company's revenue is recorded at the estimated transaction price. Contingent Service Revenues The HCI segment provides strategic health management services to Affordable Care Organizations ("ACOs") that have been approved to participate in the Medicare Shared Savings Program ("MSSP"). The HCI segment has service agreements with ACOs that provide for sharing of MSSP payments received by the ACO, if any. ACOs are legal entities that contract with 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 year. Patient Accounts Receivable The Company reports patient accounts receivable from services rendered at their estimated transaction price, which includes price concessions based on the amounts expected to be due from payors. The Company's patient accounts receivable is uncollateralized and primarily consist of amounts due from Medicare, Medicaid, other third-party payors, and to a lesser degree patients. The credit risk 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 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 from any particular payor that would subject it to any significant credit risk in the collection of patient accounts receivable. A portion of the estimated Medicare PDGM system reimbursement from each submitted home nursing episode is received in the form of a request for anticipated payment (“RAP”). For a standard 60-day episode of care, the Company will submit two RAPs, one for the first 30-day period and a second for the next 30-day period. The Company submits a RAP for 20% of the estimated reimbursement for each of the 30-day periods at the start of care. A final bill is submitted at the end of each 30-day period. If a final bill is not submitted within the greater of 120 days from the start of the 30-day period, or 60 days from the date the RAP was paid, any RAP received for that 30-day period 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. 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, 2020 and 2019 (amounts in thousands): Three Months Ended 2020 2019 Weighted average number of shares outstanding for basic per share calculation 31,020 30,837 Effect of dilutive potential shares: Nonvested stock 283 350 Adjusted weighted average shares for diluted per share calculation 31,303 31,187 Anti-dilutive shares 120 141 Recently Adopted 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 was effective for annual and interim periods in fiscal years beginning after December 15, 2019, and did not have a significant impact to the Company. In June 2016, the FASB issued ASU 2016-13, Measurement of Credit Losses on Financial Instruments which amends Financial Instruments - Credit Losses ("Topic 326"). ASU 2016-13 provides guidance for measuring credit losses on financial instruments. Early adoption is permitted. The amendments in this ASU should be applied retrospectively. This ASU was effective for annual and interim periods in fiscal years beginning after December 15, 2019, and did not have a significant impact to the Company.

Acquisitions and Joint Venture

Acquisitions and Joint Venture Activities	3 Months Ended
	Mar. 31, 2020
Business Combinations [Abstract]
Acquisitions and Joint Venture Activities	Acquisitions and Joint Venture Activities Acquisitions The Company acquired the majority-ownership of six home health agencies, three hospice agencies, and four home and community-based agencies during the three months ended March 31, 2020 . The total aggregate purchase price for these transactions was $13.9 million . The purchase prices were determined based on the Company’s analysis of comparable acquisitions and the target market’s potential future cash flows. The Company funded these acquisitions in 2019 by paying cash consideration of $16.4 million . During the three months ended March 31, 2020, the Company received $3.1 million from an equity joint venture partnership for the partner's noncontrolling interest for one of the Company's acquired home health and hospice agencies. The total cash consideration includes adjustments for assets acquired and liabilities assumed. 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. The following table summarizes the amounts of the assets acquired and liabilities assumed at the acquisition dates, as well as their fair value at the acquisition dates and the noncontrolling interest acquired during the three months ended March 31, 2020 : Fair value of total consideration transferred Recognized amounts of identifiable assets acquired and liabilities assumed: Trade name $ 1,944 Certificates of need/licenses 3,584 Other assets and (liabilities), net (407 ) Total identifiable assets $ 5,121 Noncontrolling interest $ 6,388 Goodwill, including noncontrolling interest of $4,660 $ 14,614 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. Noncontrolling interest is recorded at fair value. Joint Venture Activities During the three months ended March 31, 2020 , the Company purchased a portion of the noncontrolling membership interest in one of our equity joint venture partnerships, which prior to the purchase was classified as a nonredeemable noncontrolling interest in permanent equity. As a result of the purchase, the Company retained its controlling financial interests in the joint venture partnership and the noncontrolling interest of our partner will continue to be classified as a nonredeemable noncontrolling interest in permanent equity. Total consideration for this noncontrolling interest purchase was $23.6 million .

Goodwill and Intangibles

Goodwill and Intangibles	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangibles	Goodwill and Intangibles The changes in recorded goodwill and intangible assets by reporting unit for the three months ended March 31, 2020 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 Goodwill: Balance as of December 31, 2019 $ 867,924 $ 128,875 $ 166,629 $ 15,682 $ 40,862 $ 1,219,972 Acquisitions 7,254 2,700 — — — 9,954 Noncontrolling interests 2,863 1,797 — — — 4,660 Adjustments and disposals (79 ) (316 ) — — — (395 ) Balance as of March 31, 2020 $ 877,962 $ 133,056 $ 166,629 $ 15,682 $ 40,862 $ 1,234,191 Intangible assets: Balance as of December 31, 2019 $ 219,872 $ 40,590 $ 24,096 $ 5,317 $ 15,681 $ 305,556 Acquisitions 4,700 930 — — — 5,630 Amortization (137 ) (23 ) (10 ) (1 ) (145 ) (316 ) Balance as of March 31, 2020 $ 224,435 $ 41,497 $ 24,086 $ 5,316 $ 15,536 $ 310,870 The allocation of goodwill from acquisitions purchased during the three months ended March 31, 2020 for each reporting unit is preliminary and subject to change once the valuation analysis required by ASC 805, Business Combinations is finalized. The following tables summarize the changes in intangible assets during the three months ended March 31, 2020 and December 31, 2019 (amounts in thousands): 2020 2019 Indefinite-lived intangible assets: Trade Names $ 165,417 $ 163,499 Certificates of Need/Licenses 133,273 129,689 Net Total $ 298,690 $ 293,188 Definite-lived intangible assets: Trade Names Gross carrying amount $ 10,209 $ 10,182 Accumulated amortization (9,303 ) (9,229 ) Net total $ 906 $ 953 Non-compete agreements Gross carrying amount $ 6,897 $ 6,795 Accumulated amortization (6,089 ) (5,991 ) Net total $ 808 $ 804 Customer relationships Gross carrying amount $ 11,822 $ 11,822 Accumulated amortization (1,356 ) (1,211 ) Net total $ 10,466 $ 10,611 Total definite-lived intangible assets Gross carrying amount $ 28,928 $ 28,799 Accumulated amortization (16,748 ) (16,431 ) Net total $ 12,180 $ 12,368 Total intangible assets: Gross carrying amount $ 327,618 $ 321,987 Accumulated amortization (16,748 ) (16,431 ) Net total $ 310,870 $ 305,556 Remaining useful lives for trade names, customer relationships, and non-compete agreements were 9.5 , 18.0 , and 2.7 years, respectively, at March 31, 2020 . Similar periods at December 31, 2019 were 9.8 , 18.2 , and 2.8 years for trade names, customer relationships, and non-compete agreements, respectively. Amortization expense was $0.3 million and $0.4 million during the three months ended March 31, 2020 and 2019, respectively. Amortization expense was recorded in general and administrative expenses.

Debt

Debt	3 Months Ended
	Mar. 31, 2020
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, 2020 was 4.00% and the LIBOR rate was 2.69% . As of March 31, 2020 , the effective interest rate on outstanding borrowings under the New Credit Agreement was 3.29% . As of March 31, 2020 , the Company had $298.1 million drawn, letters of credit issued in the amount of $24.9 million , and $177.0 million of remaining borrowing capacity available under the Credit Agreement. At December 31, 2019 , the Company had $253.0 million drawn and letters of credit issued in the amount of $28.4 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, 2020

Stockholder's Equity

Stockholder's Equity	3 Months Ended
	Mar. 31, 2020
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 and a total of 1,879,169 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. Share Based Compensation Nonvested Stock During the three months ended March 31, 2020 , the Company granted 9,900 nonvested shares of common stock to independent directors 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, 2020 , one retired director was granted 775 nonvested shares of common stock under the Second Amended and Restated 2005 Non-Employee Directors Compensation Plan, which shares vest 100% at the grant date. During the three months ended March 31, 2020 , employees and a consultant were granted 108,710 and 10,890 shares, respectively, of nonvested shares of common stock pursuant to the 2018 Incentive Plan. The shares vest over a period of five years , conditioned on continued employment and in accordance with consulting agreement. 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, 2020 was $123.01 . The following table represents the share grants activity for the three months ended March 31, 2020 : 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, 2019 534,331 $ 71.01 98,756 $ 40.71 Granted 130,275 123.01 — — Vested or exercised (163,923 ) 121.65 — — Share grants outstanding as of March 31, 2020 500,683 $ 87.67 98,756 $ 40.71 As of March 31, 2020 , there was $40.0 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 3.40 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 to ensure that total compensation expense recognized is at least equal to the value of vested awards. The Company recorded $3.7 million and $1.8 million of compensation expense related to nonvested stock grants for the three months ended March 31, 2020 and 2019, 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 2020 : Number of shares Per share price Shares available as of December 31, 2019 132,449 Shares issued during the three months ended March 31, 2020 4,663 $ 130.87 Shares available as of March 31, 2020 127,786 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, 2020 , the Company redeemed 59,390 shares of common stock valued at $7.1 million , related to share vesting tax obligations. Such shares are held as treasury stock and are available for reissuance by the Company.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Contingencies 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 due 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. 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”) asserted, 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. 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. On February 22, 2018, plaintiffs in the Delaware Actions moved for a preliminary injunction to enjoin the merger of Almost Family and Merger Sub. 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 asserted 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 asserted 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. On February 11, 2020, the court granted the Company's motion to dismiss and the Company's motion to strike and dismissed Lead Plaintiff's federal claims with prejudice and state law claims without prejudice. On March 12, 2020, Lead Plaintiff appealed the court's decision to the United States Court of Appeals for the Sixth Circuit. On April 17, 2020, Lead Plaintiff moved to voluntarily dismiss his appeal, and on April 23, 2020, the United States Court of Appeals for the Sixth Circuit granted Lead Plaintiff's motion and dismissed the appeal, and thus the case is now terminated. We are involved in various 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. Legal fees related to all legal matters are expensed as incurred. 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. The Company has not received notice from any joint venture partners of their intent to exercise the terms of the buy/sell agreement nor has the Company notified any joint venture partners of its intent to exercise the terms of the buy/sell agreement. 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 interests

Noncontrolling interests	3 Months Ended
	Mar. 31, 2020
Noncontrolling Interest [Abstract]
Noncontrolling interests	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, 2020 , 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, 2020 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, 2020 (amounts in thousands): Balance as of December 31, 2019 $ 15,151 Net income attributable to noncontrolling interest-redeemable 3,553 Noncontrolling interest-redeemable distributions (2,781 ) Acquired noncontrolling interest-redeemable 3,508 Balance as of March 31, 2020 $ 19,431

Leases

Leases	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Leases	Leases The Company determines if a contract contains a lease at inception date. The Company's leases are operating leases, primarily for office and office equipment, that expire at various dates over the next nine years . The office leases have renewal options for periods ranging from one to five years . As it is not reasonably certain these renewal options will be exercised, the options were not considered in the lease term, and payments associated with the option years are excluded from lease payments. The office leases also generally have termination options, which allow for early termination of the lease; however, as the exercise of such options is not reasonably certain, the options were not considered in determining the lease term; payments for the full lease term are included in the lease payments. Additionally, the leases do not contain any material residual value guarantees. Payments due under operating leases include fixed and variable payments. These variable payments for the Company's office leases can include operating expenses, utilities, property taxes, insurance, common area maintenance, and other facility-related expense. Additionally, any leases with terms less than one year were not recognized as operating lease right of use assets or payables for short term leases in accordance with the election of ‘package of practical expedient’ under ASU 2016-02 and recognizes operating lease right of use assets and operating lease payable 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. During the three months ended March 31, 2020 and 2019, the Company incurred operating lease costs of $12.1 million and $12.4 million , respectively. There were no costs associated with impairments of operating lease right of use assets. 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): For the Three Months Ended March 31, 2020 2019 Cash paid for operating lease liabilities $ 9,587 $ 6,775 Right-of-use assets obtained in exchange for new operating lease liabilities $ 9,041 $ 91,174 As of March 31, 2020 2019 Weighted-average remaining lease term 4.42 4.63 Weighted-average discount rate 4.69 % 4.75 % Maturities of operating lease liabilities as of March 31, 2020 were as follows (amounts in thousands): Month ending March 31, 2020 $ 26,310 2021 29,523 2022 20,421 2023 13,209 2024 7,665 Thereafter 12,000 Total future minimum lease payments 109,128 Less: Imputed interest (10,288 ) Total $ 98,840

Fair Value of Financial Instrum

Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2020
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, 2020 , 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, 2020
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) HCI. 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. 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 following tables summarize the Company’s segment information for the three months ended March 31, 2020 and 2019 (amounts in thousands): Three Months Ended March 31, 2020 Home health services Hospice services Home and community-based services Facility-based services HCI Total Net service revenue $ 367,821 $ 60,531 $ 48,464 $ 29,681 $ 6,374 $ 512,871 Cost of service revenue 220,440 38,034 38,453 20,342 3,933 321,202 General and administrative expenses 116,023 16,626 11,459 10,380 3,378 157,866 Operating income (loss) 31,358 5,871 (1,448 ) (1,041 ) (937 ) 33,803 Interest expense (1,900 ) (303 ) (266 ) (219 ) (80 ) (2,768 ) Income (loss) before income taxes and noncontrolling interest 29,458 5,568 (1,714 ) (1,260 ) (1,017 ) 31,035 Income tax expense (benefit) 3,289 608 (206 ) (199 ) (133 ) 3,359 Net income (loss) 26,169 4,960 (1,508 ) (1,061 ) (884 ) 27,676 Less net income (loss) attributable to non controlling interests 4,606 967 (155 ) 243 (9 ) 5,652 Net income (loss) attributable to LHC Group, Inc.'s common stockholder $ 21,563 $ 3,993 $ (1,353 ) $ (1,304 ) $ (875 ) $ 22,024 Total assets $ 1,548,224 $ 251,354 $ 252,846 $ 90,791 $ 69,067 $ 2,212,282 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

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The effective tax rate for the three months ended March 31, 2020 and 2019 benefited from $1.2 million of excess tax benefits associated with stock-based compensation arrangements and $2.2 million ( $4.3 million and $2.1 million , as further described below) associated with increased tax benefits associated with the Coronavirus Aid, Relief, and Economic Security Act (the "CARES Act"). For the three months ended March 31, 2019, the effective tax rate benefited from $2.4 million of excess tax benefits associated with stock-based compensation arrangements. In response to the COVID-19 pandemic, the CARES Act was signed into law in March 2020. The CARES Act lifts certain deduction limitations originally imposed by the Tax Cuts and Jobs Act of 2017 ("2017 Tax Act"). Corporate taxpayers may carryback net operating losses ("NOLs") originating during 2018 through 2020 for up to five years, which was not previously allowed under the 2017 Tax Act. The CARES Act also eliminates the 80% of taxable income limitations by allowing corporate entities to fully utilize NOL carryforwards to offset taxable income in 2018, 2019, or 2020. Taxpayers may generally deduct interest up to the sum of 50% of adjusted taxable income plus business interest income (30% limit under the 2017 Tax Act) for tax years beginning January 1, 2019 and 2020. The CARES Act allows taxpayers with alternative minimum tax credits to claim a refund in 2020 for the entire amount of the credits instead of recovering the credits through refunds over a period of years, as originally enacted by the 2017 Tax Act. In addition, the CARES Act raises the corporate charitable deduction limit to 25% of taxable income and makes qualified improvement property generally eligible for 15-year cost-recovery and 100% bonus depreciation. The effective tax rate for the three months ended March 31, 2020 benefited from a $4.3 million impact from the enactment of the CARES Act. There was no material impact to our net deferred tax assets as of March 31, 2020. 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 Condensed 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 impact of the CARES Act increased unrecognized tax benefits by $2.1 million , which also had an impact on the Company's effective tax rate for the three months ended March 31, 2020. As of March 31, 2020 and December 31, 2019, the Company recognized $6.2 million and $3.9 million , respectively, in unrecognized tax benefits.

Subsequent Event

Subsequent Event	3 Months Ended
	Mar. 31, 2020
Subsequent Events [Abstract]
Subsequent Event	Subsequent Event The COVID-19 outbreak has adversely impacted economic activity and conditions worldwide, including workforces, liquidity, capital markets, consumer behavior, supply chains, and macroeconomic conditions. After the declaration of a national emergency in the United States on March 13, 2020, Governors in most states in which the Company operates have instituted stay-at-home policies that remain in place. In response to COVID-19, the U.S. Government enacted the Coronavirus Aid, Relief, and Economic Security Act (the "CARES Act") on March 27, 2020. At March 31, 2020, management was aware that under the CARES Act, the following portions of the CARES Act would provide additional cash to the Company; however, the terms and conditions of each were not know until April 2020. • $100 billion Provider Relief Fund. Provides funds to health care providers who provide or provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19, with payments to be used to prevent, prepare for, and respond to COVID-19, and shall reimburse us for health care related expense or lost revenues attributable to COVID-19. As of May 5, 2020, the Company received $87.5 million of the Provider Relief Fund. • CMS's Accelerated and Advance Payments Program ("AAPP"). Provides financial hardship relief to Medicare providers impacted by the COVID-19 pandemic in order to provide necessary funds when there is a disruption in claims submission and/or claims processing. As of May 5, 2020, the Company received $307.6 million of accelerated and advance payments. • Suspension of the 2% sequestration payment adjustment . CMS suspended the 2% sequestration on patient claims with dates of services from May 1 through December 31, 2020 to provide for additional funding to providers. • Waiver of the application of site-neutral payment. Under Section 1886(m)(6)(A)(i) of the Act for LTACH admissions that are completed in response to the public health emergency ("PHE") and occur during the COVID-19 PHE period, the claims processing systems will be updated to pay all LTACH cases admitted during the COVID-19 PHE period at the LTACH PPS standard federal rate, effective for claims with an admission date occurring on or after January 27, 2020 through the end of the PHE period. • Delayed payment of employer portion of social security tax . Provides relief for companies from paying for the 2020 employer portion of social security tax with 50% of the payments delayed to be paid by December 31, 2021 and the second 50% to be paid by December 31, 2022. The Company anticipates that all AAPP funds received by the Company will begin to become due 120 days after the Company's receipt of such funds. Thereafter, the AAPP funds that the Company received will be automatically recouped from amounts otherwise payable to the Company, until all such funds have been completely repaid. Additionally, the funds the Company received by the Provider Relief Fund could be potentially subject to repayment if those funds are not fully utilized to address the lost revenues and/or increased costs associated with the Company's direct efforts associated with COVID-19. Management concluded that the above portions of the CARES Act that directly impact the Company were a Type II subsequent event under ASC 855 and will be accounted for during the three months ended June 30, 2020, as the terms and conditions of such payments were not known at March 31, 2020.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2020
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.
Net Service Revenue	Net Service Revenue Net service revenue from contracts with customers is recognized in the period the performance obligations are satisfied under the Company's contracts by transferring the requested services to patients in amounts that reflect the consideration to which is expected to be received in exchange for providing patient care, which is the transaction price allocated to the services provided in accordance with Accounting Standards Update ("ASU") 2014-09, Revenue from Contracts with Customers (Topic 606) and ASU 2015-14 , Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date (collectively, "ASC 606"). Net service revenue is recognized as performance obligations are satisfied, which can vary depending on the type of services provided. The performance obligation is the delivery of patient care in accordance with the requested services outlined in physicians' orders, which are based on specific goals for each patient. The performance obligations are associated with contracts in duration of less than one year; therefore, the optional exemption provided by ASC 606 was elected resulting in the Company not being required to disclose the aggregate amount of the transaction price allocated to the performance obligations that are unsatisfied or partially unsatisfied as of the end of the reporting period. The Company's unsatisfied or partially unsatisfied performance obligations are primarily completed when the patients are discharged and typically occur within days or weeks of the end of the period. The Company determines the transaction price based on gross charges for services provided, reduced by estimates for explicit and implicit price concessions. Explicit price concessions include contractual adjustments provided to patients and third-party payors. Implicit price concessions include discounts provided to self-pay, uninsured patients or other payors, adjustments resulting from regulatory reviews, audits, billing reviews and other matters. Subsequent changes to the estimate of the transaction price are recorded as adjustments to net service revenue in the period of change. Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay (i.e. change in credit risk) are recorded as a provision for doubtful accounts within general and administrative expenses. Explicit price concessions are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third-party payors and others for services provided. Implicit price concessions are recorded for self-pay, uninsured patients and other payors by major payor class based on historical collection experience and current economic conditions, representing the difference between amounts billed and amounts expected to be collected. The Company assesses the ability to collect for the healthcare services provided at the time of patient admission based on the verification of the patient's insurance coverage under Medicare, Medicaid, and other commercial or managed care insurance programs. Amounts due from third-party payors, primarily commercial health insurers and government programs (Medicare and Medicaid), include variable consideration for retroactive revenue adjustments due to settlements of audits and reviews. The Company has determined estimates for price concessions related to regulatory reviews based on historical experience and success rates in the claim appeals and adjudication process. Revenue is recorded at amounts estimated to be realizable for services provided. Home Health Services Effective January 1, 2020, the Patient Driven Groupings Model ("PDGM") became the new payment model for services provided to Medicare patients with dates of service on or after the effective date, including certain Medicare Advantage patients. PDGM was implemented by CMS. Under PDGM, the initial certification of Medicare patient eligibility, plan of care, and comprehensive assessment is for a 60-day episode of care; however, unlike the former Medicare prospective payment system ("PPS"), where each 60-day episode of care could not be final billed until the episode was completed, PDGM provides for each 30-day period within the episode of care to be final billed upon completion. As a result of PDGM, the Company now completes its final billing after each 30-day period instead of the form 60-day period under PPS. For each 30 -day period, the patient is classified into one of 432 home health resource groups prior to receiving services. Each 30 -day period is placed into a subgroup falling under the following categories: (i) timing being early or late, (ii) admission source being community or institutional, (iii) one of 12 clinical groupings based on the patient's principal diagnosis, (iv) functional impairment level of low, medium, or high, and (v) a co-morbidity adjustment of none, low, or high based on the patient's secondary diagnoses. Each 30-day period payment from Medicare reflects base payment adjustments for case-mix, geographic wage differences, and a 2% sequestration reduction. In addition, payments may reflect one of three retroactive adjustments to the total reimbursement: (a) an outlier payment if the patient’s care was unusually costly; (b) a low utilization adjustment whereby the number of visits is dependent on the clinical grouping; and/or (c) a partial payment if the patient transferred to another provider or from another provider before completing the episode. 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. Hospice The Company records revenue on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The Company receives one of four predetermined daily rates based upon the level of care provided by the Company, which can be routine care, general inpatient care, continuous home care, and respite care. There are two separate payment rates for routine care: payment for the first 60 days of care and care beyond 60 days. In addition to the two routine rates, the Company may also receive a service intensity add-on ("SIA"). The SIA is based on visits made in the last seven days of life by a registered nurse or medical social worker for patients in a routine level of care. The performance obligation is the delivery of hospice services to the patient, as determined by a physician, each day the patient is on hospice care. Adjustments to Medicare revenue are made from regulatory reviews, audits, billing reviews and other matters. The Company estimates the impact of these adjustments based on our historical experience. 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 12 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. Facility-Based Services Gross revenue is recorded as services are provided under the 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. Non-Medicare Revenues Other sources of net service revenue for all segments fall into Medicaid, managed care or other payors of the Company's services. Medicaid reimbursement is based on a predetermined fee schedule applied to each service provided. Therefore, revenue is recognized for Medicaid services as services are provided based on this fee schedule. The Company's managed care and other payors reimburse the Company based upon a predetermined fee schedule or an episodic basis, depending on the terms of the applicable contract. Accordingly, the Company recognizes revenue from managed care and other payors as services are provided, such costs are incurred, and estimates of expected payments are known for each different payor, thus the Company's revenue is recorded at the estimated transaction price. Contingent Service Revenues
Patient Accounts Receivable	Accounts Receivable The Company reports patient accounts receivable from services rendered at their estimated transaction price, which includes price concessions based on the amounts expected to be due from payors. The Company's patient accounts receivable is uncollateralized and primarily consist of amounts due from Medicare, Medicaid, other third-party payors, and to a lesser degree patients. The credit risk 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 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 from any particular payor that would subject it to any significant credit risk in the collection of patient accounts receivable. A portion of the estimated Medicare PDGM system reimbursement from each submitted home nursing episode is received in the form of a request for anticipated payment (“RAP”). For a standard 60-day episode of care, the Company will submit two RAPs, one for the first 30-day period and a second for the next 30-day period. The Company submits a RAP for 20% of the estimated reimbursement for each of the 30-day periods at the start of care. A final bill is submitted at the end of each 30-day period. If a final bill is not submitted within the greater of 120 days from the start of the 30-day period, or 60 days from the date the RAP was paid, any RAP received for that 30-day period 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.
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 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 was effective for annual and interim periods in fiscal years beginning after December 15, 2019, and did not have a significant impact to the Company. In June 2016, the FASB issued ASU 2016-13, Measurement of Credit Losses on Financial Instruments which amends Financial Instruments - Credit Losses ("Topic 326"). ASU 2016-13 provides guidance for measuring credit losses on financial instruments. Early adoption is permitted. The amendments in this ASU should be applied retrospectively. This ASU was effective for annual and interim periods in fiscal years beginning after December 15, 2019, and did not have a significant impact to the Company.

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2020
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, 2020 and 2019 : Three Months Ended 2020 2019 Home health: Medicare 68.2 % 71.3 % Managed Care, Commercial, and Other 31.8 28.7 100.0 % 100.0 % Hospice: Medicare 92.0 % 92.4 % Managed Care, Commercial, and Other 8.0 7.6 100.0 % 100.0 % Home and Community-Based Services: Medicaid 20.6 % 25.1 % Managed Care, Commercial, and Other 79.4 74.9 100.0 % 100.0 % Facility-Based Services: Medicare 54.8 % 57.4 % Managed Care, Commercial, and Other 45.2 42.6 100.0 % 100.0 % HCI: Medicare 24.6 % 22.2 % Managed Care, Commercial, and Other 75.4 77.8 100.0 % 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, 2020 and 2019 (amounts in thousands): Three Months Ended 2020 2019 Weighted average number of shares outstanding for basic per share calculation 31,020 30,837 Effect of dilutive potential shares: Nonvested stock 283 350 Adjusted weighted average shares for diluted per share calculation 31,303 31,187 Anti-dilutive shares 120 141

Acquisitions and Joint Ventur_2

Acquisitions and Joint Venture Activities (Tables)	3 Months Ended
	Mar. 31, 2020
Business Combinations [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table summarizes the amounts of the assets acquired and liabilities assumed at the acquisition dates, as well as their fair value at the acquisition dates and the noncontrolling interest acquired during the three months ended March 31, 2020 : Fair value of total consideration transferred Recognized amounts of identifiable assets acquired and liabilities assumed: Trade name $ 1,944 Certificates of need/licenses 3,584 Other assets and (liabilities), net (407 ) Total identifiable assets $ 5,121 Noncontrolling interest $ 6,388 Goodwill, including noncontrolling interest of $4,660 $ 14,614

Goodwill and Intangibles (Table

Goodwill and Intangibles (Tables)	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Changes in Recorded Goodwill by Reporting Unit	The changes in recorded goodwill and intangible assets by reporting unit for the three months ended March 31, 2020 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 Goodwill: Balance as of December 31, 2019 $ 867,924 $ 128,875 $ 166,629 $ 15,682 $ 40,862 $ 1,219,972 Acquisitions 7,254 2,700 — — — 9,954 Noncontrolling interests 2,863 1,797 — — — 4,660 Adjustments and disposals (79 ) (316 ) — — — (395 ) Balance as of March 31, 2020 $ 877,962 $ 133,056 $ 166,629 $ 15,682 $ 40,862 $ 1,234,191 Intangible assets: Balance as of December 31, 2019 $ 219,872 $ 40,590 $ 24,096 $ 5,317 $ 15,681 $ 305,556 Acquisitions 4,700 930 — — — 5,630 Amortization (137 ) (23 ) (10 ) (1 ) (145 ) (316 ) Balance as of March 31, 2020 $ 224,435 $ 41,497 $ 24,086 $ 5,316 $ 15,536 $ 310,870
Summary of Changes in Intangible Assets	The following tables summarize the changes in intangible assets during the three months ended March 31, 2020 and December 31, 2019 (amounts in thousands): 2020 2019 Indefinite-lived intangible assets: Trade Names $ 165,417 $ 163,499 Certificates of Need/Licenses 133,273 129,689 Net Total $ 298,690 $ 293,188 Definite-lived intangible assets: Trade Names Gross carrying amount $ 10,209 $ 10,182 Accumulated amortization (9,303 ) (9,229 ) Net total $ 906 $ 953 Non-compete agreements Gross carrying amount $ 6,897 $ 6,795 Accumulated amortization (6,089 ) (5,991 ) Net total $ 808 $ 804 Customer relationships Gross carrying amount $ 11,822 $ 11,822 Accumulated amortization (1,356 ) (1,211 ) Net total $ 10,466 $ 10,611 Total definite-lived intangible assets Gross carrying amount $ 28,928 $ 28,799 Accumulated amortization (16,748 ) (16,431 ) Net total $ 12,180 $ 12,368 Total intangible assets: Gross carrying amount $ 327,618 $ 321,987 Accumulated amortization (16,748 ) (16,431 ) Net total $ 310,870 $ 305,556
Summary of Changes in Intangible Assets	The following tables summarize the changes in intangible assets during the three months ended March 31, 2020 and December 31, 2019 (amounts in thousands): 2020 2019 Indefinite-lived intangible assets: Trade Names $ 165,417 $ 163,499 Certificates of Need/Licenses 133,273 129,689 Net Total $ 298,690 $ 293,188 Definite-lived intangible assets: Trade Names Gross carrying amount $ 10,209 $ 10,182 Accumulated amortization (9,303 ) (9,229 ) Net total $ 906 $ 953 Non-compete agreements Gross carrying amount $ 6,897 $ 6,795 Accumulated amortization (6,089 ) (5,991 ) Net total $ 808 $ 804 Customer relationships Gross carrying amount $ 11,822 $ 11,822 Accumulated amortization (1,356 ) (1,211 ) Net total $ 10,466 $ 10,611 Total definite-lived intangible assets Gross carrying amount $ 28,928 $ 28,799 Accumulated amortization (16,748 ) (16,431 ) Net total $ 12,180 $ 12,368 Total intangible assets: Gross carrying amount $ 327,618 $ 321,987 Accumulated amortization (16,748 ) (16,431 ) Net total $ 310,870 $ 305,556

Stockholder's Equity (Tables)

Stockholder's Equity (Tables)	3 Months Ended
	Mar. 31, 2020
Equity [Abstract]
Share Grants Activity	The following table represents the share grants activity for the three months ended March 31, 2020 : 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, 2019 534,331 $ 71.01 98,756 $ 40.71 Granted 130,275 123.01 — — Vested or exercised (163,923 ) 121.65 — — Share grants outstanding as of March 31, 2020 500,683 $ 87.67 98,756 $ 40.71
Shares of Common Stock Issued Under Employee Stock Purchase Plan	The table below details the shares of common stock issued during 2020 : Number of shares Per share price Shares available as of December 31, 2019 132,449 Shares issued during the three months ended March 31, 2020 4,663 $ 130.87 Shares available as of March 31, 2020 127,786

Noncontrolling interests (Table

Noncontrolling interests (Tables)	3 Months Ended
	Mar. 31, 2020
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, 2020 (amounts in thousands): Balance as of December 31, 2019 $ 15,151 Net income attributable to noncontrolling interest-redeemable 3,553 Noncontrolling interest-redeemable distributions (2,781 ) Acquired noncontrolling interest-redeemable 3,508 Balance as of March 31, 2020 $ 19,431

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2020
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): For the Three Months Ended March 31, 2020 2019 Cash paid for operating lease liabilities $ 9,587 $ 6,775 Right-of-use assets obtained in exchange for new operating lease liabilities $ 9,041 $ 91,174 As of March 31, 2020 2019 Weighted-average remaining lease term 4.42 4.63 Weighted-average discount rate 4.69 % 4.75 %
Lessee, Operating Lease, Liability, Maturity	Maturities of operating lease liabilities as of March 31, 2020 were as follows (amounts in thousands): Month ending March 31, 2020 $ 26,310 2021 29,523 2022 20,421 2023 13,209 2024 7,665 Thereafter 12,000 Total future minimum lease payments 109,128 Less: Imputed interest (10,288 ) Total $ 98,840

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2020
Segment Reporting [Abstract]
Schedule of Segment Information	The following tables summarize the Company’s segment information for the three months ended March 31, 2020 and 2019 (amounts in thousands): Three Months Ended March 31, 2020 Home health services Hospice services Home and community-based services Facility-based services HCI Total Net service revenue $ 367,821 $ 60,531 $ 48,464 $ 29,681 $ 6,374 $ 512,871 Cost of service revenue 220,440 38,034 38,453 20,342 3,933 321,202 General and administrative expenses 116,023 16,626 11,459 10,380 3,378 157,866 Operating income (loss) 31,358 5,871 (1,448 ) (1,041 ) (937 ) 33,803 Interest expense (1,900 ) (303 ) (266 ) (219 ) (80 ) (2,768 ) Income (loss) before income taxes and noncontrolling interest 29,458 5,568 (1,714 ) (1,260 ) (1,017 ) 31,035 Income tax expense (benefit) 3,289 608 (206 ) (199 ) (133 ) 3,359 Net income (loss) 26,169 4,960 (1,508 ) (1,061 ) (884 ) 27,676 Less net income (loss) attributable to non controlling interests 4,606 967 (155 ) 243 (9 ) 5,652 Net income (loss) attributable to LHC Group, Inc.'s common stockholder $ 21,563 $ 3,993 $ (1,353 ) $ (1,304 ) $ (875 ) $ 22,024 Total assets $ 1,548,224 $ 251,354 $ 252,846 $ 90,791 $ 69,067 $ 2,212,282 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

Basis of Presentation and Sig_2

Basis of Presentation and Significant Events (Details)	3 Months Ended
	Mar. 31, 2019shares	Mar. 31, 2020LocationState
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of service providers operated | Location		820
Number of states in which Company operates | State		35
Shares Correction
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Common shares issued increase	44,387
Treasury shares issued decrease	24,044

Significant Accounting Polici_4

Significant Accounting Policies - Percentage of Net Service Revenue Earned by Category of Payor (Details)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
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%	100.00%
Medicare | Home health services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	68.20%	71.30%
Medicare | Hospice services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	92.00%	92.40%
Medicare | Facility-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	54.80%	57.40%
Medicare | HCI
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	24.60%	22.20%
Medicaid | Home and community-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	20.60%	25.10%
Managed Care, Commercial, and Other | Home health services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	31.80%	28.70%
Managed Care, Commercial, and Other | Hospice services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	8.00%	7.60%
Managed Care, Commercial, and Other | Home and community-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	79.40%	74.90%
Managed Care, Commercial, and Other | Facility-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	45.20%	42.60%
Managed Care, Commercial, and Other | HCI
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	75.40%	77.80%

Significant Accounting Polici_5

Significant Accounting Policies - Additional Information (Details)	3 Months Ended
	Mar. 31, 2020GroupPeriodicRate
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Number of days from date RAP paid to submit final Medicare bill	30 days
Number of Medicare home health resource groups | Group	432
Medicare sequestration reduction for episodes beginning after March 31, 2013	2.00%
Selected hospice, periodic rate used to calculate revenue	1
Number of hospice, periodic rates used to calculate revenue	4
Percentage subject to inpatient cap	20.00%
Determination period for hospice Medicare inpatient reimbursement cap	12 months
Reimbursement for initial episode of care	20.00%
Number of days from start of episode to submit final Medicare bill	120 days
Maximum
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Number of days from date RAP paid to submit final Medicare bill	60 days

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, 2020	Mar. 31, 2019
Accounting Policies [Abstract]
Weighted average number of shares outstanding for basic per share calculation (in shares)	31,020,000	30,837,000
Effect of dilutive potential shares:
Nonvested stock (in shares)	283,000	350,000
Adjusted weighted average shares for diluted per share calculation (in shares)	31,303,000	31,187,000
Anti-dilutive shares (in shares)	120,000	141,000

Acquisitions and Joint Ventur_3

Acquisitions and Joint Venture Activities - Narrative (Details) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)Agencyagency
Business Acquisition [Line Items]
Total consideration for this noncontrolling interest purchase	$ 23.6
Home Health Agencies
Business Acquisition [Line Items]
Number of agencies | Agency	6
Hospice Agencies
Business Acquisition [Line Items]
Number of agencies | Agency	3
Home and Community Based
Business Acquisition [Line Items]
Number of agencies | agency	4
Home health agencies and hospice agency
Business Acquisition [Line Items]
Consideration transferred	$ 13.9
Cash paid to for acquisitions	16.4
Cash proceeds from joint venture	$ 3.1

Acquisitions and Joint Ventur_4

Acquisitions and Joint Venture Activities - Price Allocation (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill	$ 1,234,191	$ 1,219,972
Home health agencies and hospice agency
Business Acquisition [Line Items]
Other assets and (liabilities), net	(407)
Total identifiable assets and liabilities	5,121
Noncontrolling interest	6,388
Goodwill	14,614
Goodwill, Noncontrolling interest portion	4,660
Trade Names | Home health agencies and hospice agency
Business Acquisition [Line Items]
Indefinite-lived intangible assets	1,944
Certificates of need/licenses | Home health agencies and hospice agency
Business Acquisition [Line Items]
Indefinite-lived intangible assets	$ 3,584

Goodwill and Intangibles - Sche

Goodwill and Intangibles - Schedule of Changes in Recorded Goodwill by Reporting Unit (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Goodwill [Roll Forward]
Balance as of December 31, 2019	$ 1,219,972
Acquisitions	9,954
Noncontrolling interests	4,660
Adjustments and disposals	(395)
Balance as of March 31, 2020	1,234,191
Intangible assets:
Balance as of December 31, 2019	305,556
Acquisitions	5,630
Amortization	(316)	$ (400)
Balance as of March 31, 2020	310,870
Home health reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2019	867,924
Acquisitions	7,254
Noncontrolling interests	2,863
Adjustments and disposals	(79)
Balance as of March 31, 2020	877,962
Intangible assets:
Balance as of December 31, 2019	219,872
Acquisitions	4,700
Amortization	(137)
Balance as of March 31, 2020	224,435
Hospice reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2019	128,875
Acquisitions	2,700
Noncontrolling interests	1,797
Adjustments and disposals	(316)
Balance as of March 31, 2020	133,056
Intangible assets:
Balance as of December 31, 2019	40,590
Acquisitions	930
Amortization	(23)
Balance as of March 31, 2020	41,497
Home and community-based services reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2019	166,629
Acquisitions	0
Noncontrolling interests	0
Adjustments and disposals	0
Balance as of March 31, 2020	166,629
Intangible assets:
Balance as of December 31, 2019	24,096
Acquisitions	0
Amortization	(10)
Balance as of March 31, 2020	24,086
Facility-based reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2019	15,682
Acquisitions	0
Noncontrolling interests	0
Adjustments and disposals	0
Balance as of March 31, 2020	15,682
Intangible assets:
Balance as of December 31, 2019	5,317
Acquisitions	0
Amortization	(1)
Balance as of March 31, 2020	5,316
HCI reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2019	40,862
Acquisitions	0
Noncontrolling interests	0
Adjustments and disposals	0
Balance as of March 31, 2020	40,862
Intangible assets:
Balance as of December 31, 2019	15,681
Acquisitions	0
Amortization	(145)
Balance as of March 31, 2020	$ 15,536

Goodwill and Intangibles - Addi

Goodwill and Intangibles - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Amortization of intangible assets	$ 316	$ 400
Trade name
Finite-Lived Intangible Assets [Line Items]
Useful life	9 years 6 months		9 years 9 months 18 days
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Useful life	18 years		18 years 2 months 12 days
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Useful life	2 years 8 months 12 days		2 years 9 months 18 days

Goodwill and Intangibles - Summ

Goodwill and Intangibles - Summary of Changes in Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 298,690	$ 293,188
Gross carrying amount, definite-lived intangible assets	28,928	28,799
Accumulated amortization	(16,748)	(16,431)
Net total	12,180	12,368
Gross carrying amount, intangible assets	327,618	321,987
Net total	310,870	305,556
Trade Names
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	10,209	10,182
Accumulated amortization	(9,303)	(9,229)
Net total	906	953
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	6,897	6,795
Accumulated amortization	(6,089)	(5,991)
Net total	808	804
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	11,822	11,822
Accumulated amortization	(1,356)	(1,211)
Net total	10,466	10,611
Trade Names
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	165,417	163,499
Certificates of Need/Licenses
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 133,273	$ 129,689

Debt - Additional Information (

Debt - Additional Information (Details)	Apr. 02, 2018USD ($)Instrument	Mar. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 500,000,000
Credit facility maximum borrowing capacity under accordion feature	200,000,000
Letter of credit, sub-limit amount	$ 50,000,000
Interest rate percentage		3.29%
Line of credit facility drawn		$ 298,071,000	$ 253,000,000
Letter of credit outstanding		24,900,000	$ 28,400,000
Available credit under agreement		$ 177,000,000
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		4.00%
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		2.69%

Stockholder's Equity - Addition

Stockholder's Equity - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2013	Dec. 31, 2006	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total unrecognized compensation cost related to nonvested shares of common stock granted	$ 40,000
Weighted average period of cost recognized	3 years 4 months 24 days
Compensation expense related to nonvested stock grants	$ 3,700	$ 1,800
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)	59,390
Treasury shares redeemed to pay income tax	$ 6,933	$ 6,841
Employee
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Treasury shares redeemed to pay income tax	$ 7,100
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)					1,879,169
2018 Long-Term Incentive Plan | Employee
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period of vested shares	5 years
Nonvested stock grants to employees (in shares)	108,710
Granted (in dollars per share)	$ 123.01
2018 Long-Term Incentive Plan | Consultants
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested stock grants to employees (in shares)	10,890
Second Amended and Restated 2005 Non-Employee Directors Compensation Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested stock grants to Independent directors (in shares)	775
Percentage of directors' stock grant vested on one year anniversary date	100.00%
Period of vested shares	1 year
Second Amended and Restated 2005 Non-Employee Directors Compensation Plan | Director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested stock grants to Independent directors (in shares)	9,900
Percentage of directors' stock grant vested on grant date	100.00%

Stockholder's Equity - Nonveste

Stockholder's Equity - Nonvested Stock Activity (Details)	3 Months Ended
	Mar. 31, 2020$ / sharesshares
Restricted stock
Number of shares
Share grants outstanding, beginning balance | shares	534,331
Granted (in shares) | shares	130,275
Vested (in shares) | shares	(163,923)
Share grants outstanding, ending balance | shares	500,683
Weighted average grant date fair value
Beginning balance, Weighted average grant date fair value (in dollars per share) | $ / shares	$ 71.01
Granted (in dollars per share) | $ / shares	123.01
Vested (in dollars per share) | $ / shares	121.65
Ending balance, Weighted average grant date fair value (in dollars per share) | $ / shares	$ 87.67
Options
Number of shares
Share grants outstanding, beginning balance | shares	98,756
Granted (in shares) | shares	0
Vested or exercised (in shares) | shares	0
Share grants outstanding, ending balance | shares	98,756
Weighted average grant date fair value
Share grants outstanding, beginning balance (in dollars per share) | $ / shares	$ 40.71
Granted (in dollars per share) | $ / shares	0
Vested or exercised (in dollars per share) | $ / shares	0
Share grants outstanding, ending balance (in dollars per share) | $ / shares	$ 40.71

Stockholder's Equity - Shares o

Stockholder's Equity - Shares of Common Stock Issued Under Employee Stock Purchase Plan (Details)	3 Months Ended
	Mar. 31, 2020$ / sharesshares
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Number of shares available, beginning balance (in shares)	132,449
Shares issued during period (in shares)	4,663
Number of shares available, ending balance (in shares)	127,786
Per share price of shares issued during period (in dollars per share) | $ / shares	$ 130.87

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)
Commitments and Contingencies Disclosure [Abstract]
Other assets, amount from government payors	$ 16.9
Period of joint venture buy/sell option	30 days

Noncontrolling interests - Summ

Noncontrolling interests - Summary of Activity of Noncontrolling Interest-Redeemable (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)
Stockholders' Equity Attributable to Noncontrolling Interest [Roll Forward]
Balance as of December 31, 2019	$ 15,151
Net income attributable to noncontrolling interest-redeemable	3,553
Noncontrolling interest-redeemable distributions	(2,781)
Acquired noncontrolling interest-redeemable	3,508
Balance as of March 31, 2020	$ 19,431

Leases (Details)

Leases (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Lessee, Lease, Description [Line Items]
Operating lease term	9 years
Operating lease cost	$ 12.1	$ 12.4
Minimum
Lessee, Lease, Description [Line Items]
Renewal term	1 year
Maximum
Lessee, Lease, Description [Line Items]
Renewal term			5 years

Leases - Information Related to

Leases - Information Related to Leases (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Leases [Abstract]
Cash paid for operating lease liabilities	$ 9,587	$ 6,775
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 9,041	$ 91,174
Weighted-average remaining lease term	4 years 5 months 1 day	4 years 7 months 17 days
Weighted-average discount rate	4.69%	4.75%

Leases - Lease Maturities (Deta

Leases - Lease Maturities (Details) $ in Thousands	Mar. 31, 2020USD ($)
Leases [Abstract]
2020	$ 26,310
2021	29,523
2022	20,421
2023	13,209
2024	7,665
Thereafter	12,000
Total future minimum lease payments	109,128
Less: Imputed interest	(10,288)
Total	$ 98,840

Segment Information - Summary o

Segment Information - Summary of segment Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	$ 512,871	$ 502,585
Cost of service revenue (excluding depreciation and amortization)	321,202	320,992
General and administrative expenses	157,866	145,221
Other intangible impairment charge	0	6,319
Operating income	33,803	30,053
Interest expense	(2,768)	(3,052)
Income before income taxes and noncontrolling interest	31,035	27,001
Income tax expense (benefit)	3,359	3,600
Net income	27,676	23,401
Less net income (loss) attributable to noncontrolling interests	5,652	4,545
Net income attributable to LHC Group, Inc.’s common stockholders	22,024	18,856
Total assets	2,212,282	2,013,857	$ 2,140,295
Home health services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	367,821	363,035
Cost of service revenue (excluding depreciation and amortization)	220,440	226,123
General and administrative expenses	116,023	104,839
Other intangible impairment charge		6,318
Operating income	31,358	25,755
Interest expense	(1,900)	(2,138)
Income before income taxes and noncontrolling interest	29,458	23,617
Income tax expense (benefit)	3,289	3,208
Net income	26,169	20,409
Less net income (loss) attributable to noncontrolling interests	4,606	3,780
Net income attributable to LHC Group, Inc.’s common stockholders	21,563	16,629
Total assets	1,548,224	1,421,000
Hospice services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	60,531	51,736
Cost of service revenue (excluding depreciation and amortization)	38,034	33,176
General and administrative expenses	16,626	14,853
Other intangible impairment charge		1
Operating income	5,871	3,706
Interest expense	(303)	(343)
Income before income taxes and noncontrolling interest	5,568	3,363
Income tax expense (benefit)	608	446
Net income	4,960	2,917
Less net income (loss) attributable to noncontrolling interests	967	601
Net income attributable to LHC Group, Inc.’s common stockholders	3,993	2,316
Total assets	251,354	220,347
Home and community-based services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	48,464	51,785
Cost of service revenue (excluding depreciation and amortization)	38,453	39,855
General and administrative expenses	11,459	10,982
Other intangible impairment charge		0
Operating income	(1,448)	948
Interest expense	(266)	(301)
Income before income taxes and noncontrolling interest	(1,714)	647
Income tax expense (benefit)	(206)	151
Net income	(1,508)	496
Less net income (loss) attributable to noncontrolling interests	(155)	(310)
Net income attributable to LHC Group, Inc.’s common stockholders	(1,353)	806
Total assets	252,846	226,991
Facility-based services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	29,681	27,701
Cost of service revenue (excluding depreciation and amortization)	20,342	17,732
General and administrative expenses	10,380	9,177
Other intangible impairment charge		0
Operating income	(1,041)	792
Interest expense	(219)	(180)
Income before income taxes and noncontrolling interest	(1,260)	612
Income tax expense (benefit)	(199)	5
Net income	(1,061)	607
Less net income (loss) attributable to noncontrolling interests	243	481
Net income attributable to LHC Group, Inc.’s common stockholders	(1,304)	126
Total assets	90,791	79,257
HCI
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	6,374	8,328
Cost of service revenue (excluding depreciation and amortization)	3,933	4,106
General and administrative expenses	3,378	5,370
Other intangible impairment charge		0
Operating income	(937)	(1,148)
Interest expense	(80)	(90)
Income before income taxes and noncontrolling interest	(1,017)	(1,238)
Income tax expense (benefit)	(133)	(210)
Net income	(884)	(1,028)
Less net income (loss) attributable to noncontrolling interests	(9)	(7)
Net income attributable to LHC Group, Inc.’s common stockholders	(875)	(1,021)
Total assets	$ 69,067	$ 66,262

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Excess tax benefits associated with stock-based compensation	$ 1.2		$ 2.4
Valuation allowance increase	2.2
Unrecognized tax benefits	6.2	$ 3.9
Unrecognized tax benefits, period increase	2.1
CARES Act impact, tax benefit	$ 4.3

Subsequent Event (Details)

Subsequent Event (Details) - USD ($) $ in Millions	1 Months Ended	3 Months Ended
	May 05, 2020	Mar. 31, 2020
Subsequent Event [Line Items]
Medicare sequestration adjustment		2.00%
Provider Relief Fund | Subsequent Event
Subsequent Event [Line Items]
Provider Relief Fund proceeds	$ 87.5
Accelerated and advance payments	$ 307.6