LHC (LHCG) 10-Q 6 May 21 2021 Q1 Quarterly report Financial data

Cover page

Cover page - shares	3 Months Ended
	Mar. 31, 2021	May 04, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2021
Document Transition Report	false
Entity File Number	001-33989
Entity Registrant Name	LHC Group, Inc
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		31,666,163
Entity Central Index Key	0001303313
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Current assets:
Cash	$ 292,317	$ 286,569
Receivables:
Patient accounts receivable	331,715	301,209
Other receivables	9,821	11,522
Amounts due from governmental entities	223	0
Total receivables	341,759	312,731
Prepaid expenses	26,038	22,058
Other current assets	23,561	25,664
Total current assets	683,675	647,022
Property, building and equipment, net of accumulated depreciation of $86,521 and $82,721, respectively	139,663	138,366
Goodwill	1,259,127	1,259,147
Intangible assets, net of accumulated amortization of $17,963 and $17,659, respectively	314,532	315,355
Assets held for sale	3,137	1,900
Operating lease right of use asset	101,193	100,046
Other assets	21,527	21,518
Total assets	2,522,854	2,483,354
Current liabilities:
Accounts payable and other accrued liabilities	63,975	64,864
Salaries, wages, and benefits payable	110,327	88,666
Self-insurance reserves	33,893	35,103
Income tax payable	22,382	21,464
Government stimulus advance	93,257	93,257
Contract liabilities - deferred revenue	317,962	317,962
Current operating lease liabilities	32,627	32,676
Amounts due to governmental entities	1,164	1,516
Current liabilities - deferred employer payroll tax	25,928	25,928
Total current liabilities	701,515	681,436
Deferred income taxes	54,954	47,237
Income taxes payable	6,404	6,203
Revolving credit facility	0	20,000
Other long term liabilities	25,928	25,928
Long-term operating lease liabilities	71,431	70,275
Total liabilities	860,232	851,079
Noncontrolling interest — redeemable	17,939	18,921
Commitments and contingencies
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; 36,507,148 and 36,355,497 shares issued, and 31,240,270 and 31,139,840 shares outstanding, respectively	365	364
Treasury stock — 5,266,878 and 5,215,657 shares at cost, respectively	(78,552)	(69,011)
Additional paid-in capital	966,201	962,120
Retained earnings	669,956	635,297
Total LHC Group, Inc. stockholders’ equity	1,557,970	1,528,770
Noncontrolling interest — non-redeemable	86,713	84,584
Total stockholders' equity	1,644,683	1,613,354
Total liabilities and stockholders' equity	$ 2,522,854	$ 2,483,354

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Property, building and equipment, accumulated depreciation	$ 86,521	$ 82,721
Accumulated amortization	$ 17,963	$ 17,659
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)	36,507,148	36,355,497
Common stock, shares outstanding (in shares)	31,240,270	31,139,840
Treasury stock at cost, shares (in shares)	5,266,878	5,215,657

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Statement [Abstract]
Net service revenue	$ 524,835	$ 512,871
Cost of service revenue (excluding depreciation and amortization)	310,272	321,202
Gross margin	214,563	191,669
General and administrative expenses	163,249	157,866
Impairment of intangibles and other	177	0
Operating income	51,137	33,803
Interest expense	(263)	(2,768)
Income before income taxes and noncontrolling interest	50,874	31,035
Income tax expense	9,441	3,359
Net income	41,433	27,676
Less net income attributable to noncontrolling interests	6,774	5,652
Net income attributable to LHC Group, Inc.’s common stockholders	$ 34,659	$ 22,024
Earnings per share:
Basic (usd per share)	$ 1.11	$ 0.71
Diluted (usd per share)	$ 1.10	$ 0.70
Weighted average shares outstanding:
Basic (in shares)	31,165	31,020
Diluted (in shares)	31,432	31,303
Revenue, Product and Service [Extensible List]	us-gaap:ServiceMember
Cost, Product and Service [Extensible List]	us-gaap:ServiceMember

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, 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
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	[1]	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
Issuance of common stock under Employee Stock Purchase Plan (in shares)			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
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income attributable to noncontrolling interest-redeemable		3,600
Beginning balance, Amount at Dec. 31, 2020		$ 1,613,354	$ 364	$ (69,011)	962,120	635,297	84,584
Beginning balance (in shares) at Dec. 31, 2020			36,355,497
Beginning balance, treasury (in shares) at Dec. 31, 2020		5,215,657		5,215,657
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	[2]	$ 39,128				34,659	4,469
Noncontrolling interest distributions		(2,417)					(2,417)
Purchase of additional controlling interest		(142)			(81)		(61)
Sale of noncontrolling interest		138					138
Nonvested stock compensation		3,513			3,513
Issuance of vested stock		1	$ 1
Issuance of vested stock (in shares)			148,447
Treasury shares redeemed to pay income tax		$ (9,541)		$ (9,541)
Treasury shares redeemed to pay income tax (in shares)				51,221
Issuance of common stock under Employee Stock Purchase Plan (in shares)		3,204	3,204
Issuance of common stock under Employee Stock Purchase Plan		$ 649			649
Ending balance, Amount at Mar. 31, 2021		$ 1,644,683	$ 365	$ (78,552)	$ 966,201	$ 669,956	$ 86,713
Ending balance (in shares) at Mar. 31, 2021			36,507,148
Ending balance, treasury (in shares) at Mar. 31, 2021		5,266,878		5,266,878
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income attributable to noncontrolling interest-redeemable		$ 2,305
[1]	Net income excludes net income attributable to noncontrolling interest-redeemable of $3.6 million during the three months ended March 31, 2020. Noncontrolling interest-redeemable is reflected outside of permanent equity on the condensed consolidated balance sheets. See Note 8 of the Notes to Condensed Consolidated Financial Statements.
[2]	Net income excludes net income attributable to noncontrolling interest-redeemable of $2.3 million during the three months ended March 31, 2021. Noncontrolling interest-redeemable is reflected outside of permanent equity on the condensed consolidated balance sheets. See Note 8 of the Notes to Condensed Consolidated Financial Statements.

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Operating activities:
Net income	$ 41,433	$ 27,676
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	4,999	5,133
Amortization of operating lease right of use asset	8,918	8,512
Stock-based compensation expense	3,513	3,680
Deferred income taxes	7,717	4,367
Amortization of operating leases	0	(13)
Loss on disposal of assets	31	47
Impairment of intangibles and other	177	0
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(28,805)	(67,470)
Prepaid expenses	(3,980)	(11,728)
Other assets	1,627	2,268
Prepaid income taxes	0	(4,537)
Accounts payable and accrued expenses	(2,894)	(11,159)
Salaries, wages, and benefits payable	20,451	24,826
Operating lease liabilities	(8,925)	(8,415)
Income taxes payable	1,119	2,298
Net amounts due to/from governmental entities	(575)	51
Net cash provided by (used in) operating activities	44,806	(24,464)
Investing activities:
Purchases of property, building and equipment	(4,849)	(13,502)
Proceeds from sale of property, building and equipment	45	1,149
Cash received (paid) for acquisitions	0	3,125
Proceeds from sale of an entity	200	0
Net cash used in investing activities	(4,604)	(9,228)
Financing activities:
Proceeds from line of credit	0	188,728
Payments on line of credit	(20,000)	(143,657)
Proceeds from employee stock purchase plan	649	610
Noncontrolling interest distributions	(5,704)	(4,874)
Withholding taxes paid on stock-based compensation	(9,541)	(7,064)
Purchase of additional controlling interest	(142)	(23,575)
Exercise of vested awards and stock options	0	160
Sale of noncontrolling interest	284	0
Net cash (used in) provided by financing activities	(34,454)	10,328
Change in cash	5,748	(23,364)
Cash at beginning of period	286,569	31,672
Cash at end of period	292,317	8,308
Supplemental disclosures of cash flow information:
Interest paid	495	2,830
Income taxes paid	621	1,269
Non-Cash Operating Activity:
Operating right of use assets in exchange for lease obligations	11,748	9,041
Non-Cash Investing Activity:
Accrued capital expenditures	$ 1,973	$ 2,226

Basis of Presentation and Signi

Basis of Presentation and Significant Events	3 Months Ended
	Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Significant Events	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, 2021, the Company, through its wholly- and majority-owned subsidiaries, equity joint ventures, controlled affiliates, and management agreements operated 829 service locations in 35 states within the continental United States and the District of Columbia. COVID-19 Update SARS-CoV-2 ("COVID-19") continues to spread and various responses related to stay-at-home restrictions, travel restrictions, and other public health and safety measures continue to evolve. We communicate with our clinicians and other employees all updated policies and procedures as we monitor changes related to the pandemic. Policies and procedures related to social distancing and cleaning procedures remain in place as the safety of our patients and employees are vital. The effects of COVID-19 continue to materially impact our business. As a result, operating results for the three months ended March 31, 2021 may not be indicative of the results that may be expected for the year ending December 31, 2021, and operating results for the three months ended March 31, 2021 may not be directly comparable to operating results for the three months ended March 31, 2020. CARES Act In response to COVID-19, the U.S. Government enacted the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") on March 27, 2020. The CARES Act was passed to provide $100 billion of Provider Relief Funds for distribution to eligible providers who provided diagnoses, testing, or care for individuals with a possible or actual case of COVID-19, specifically to reimburse providers for health care related expenses related to the prevention of the spread of COVID-19, preparations for treating cases of COVID-19 positive patients, and for lost revenues attributable to COVID-19. The CARES Act also provided financial hardship relief to Medicare providers impacted by the COVID-19 pandemic in order to provide necessary funds when there is a disruption in Medicare claims submission and/or Medicare claims processing by distributing funds through the Accelerated and Advanced Payments Program ("AAPP"). In addition, the CARES Act suspended the 2% sequestration payment adjustments on Medicare patient claims with dates of service from May 1 through December 31, 2020, suspended the application of site-neutral payment for LTACH admissions that were admitted during the Public Health Emergency ("PHE"), and delayed payment of the employer portion of social security tax. On April 14, 2021, Congress passed legislation to continue the suspension of sequestration payment adjustments of Medicare patient claims through December 31, 2021. Provider Relief Fund As of March 31, 2021, the Company had $93.3 million in payments from the Provider Relief Fund. T he Company intends to return these funds to the government and has recorded a short-term liability of $93.3 million in government stimulus advance in our condensed consolidated balance sheets. AAPP As of March 31, 2021, the Company had $318.0 million of accelerated payments under the AAPP, which was recorded in contract liabilities - deferred revenue i n our condensed consolidated balance sheets in accordance with Accounting Standards Update ("ASU") 2014-09, Revenue from Contracts with Customers ("Topic 606") . On October 1, 2020, the repayment and recoupment terms for AAPP funds were amended by the Continuing Appropriations Act, 2021 and Other Extensions Act, which provides that recoupment will begin one year from the date the AAPP funds were received. Under these revised terms, recoupment of AAPP will occur under a tiered approach. Beginning in the second quarter of 2021 and continuing for 11 months, CMS will recoup 25% of Medicare payments otherwise owed to the Company. If any amount of AAPP funds that we received from CMS remain unpaid after the initial 11 month period, CMS will recoup 50% of Medicare payments otherwise owed to the Company during the following six months. Interest will begin accruing on any amount of the AAPP funds that we received from CMS that remain unpaid following those recoupment periods. CMS will issue a repayment letter to the Company for any such outstanding amounts, which must be paid in full within 30 days from the date of the letter. The Company intends to repay the full amount before any interest accrues. Other During the three months ended March 31, 2021, the Company recognized $6.4 million of net service revenue due to the suspension of the 2% sequestration payment adjustment. During the three months ended March 31, 2021, the Company recognized $8.9 million of net service revenue due to the suspension of LTACH site-neutral payments. A s of March 31, 2021, the Company deferred $51.8 million of employer social security taxes, $25.9 million of which was recorded in current liabilities - deferred employer payroll tax and $25.9 million of which was recorded in other long term liabilities on our condensed consolidated balance sheets. Unaudited Interim Financial Information The accompanying unaudited condensed consolidated balance sheets as of March 31, 2021 and December 31, 2020, the related unaudited condensed consolidated statements of income for the three months ended March 31, 2021 and 2020, the unaudited condensed consolidated statements of changes in equity for the three months ended March 31, 2021 and 2020, the unaudited condensed consolidated statements of cash flows for the three months ended March 31, 2021 and 2020, 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, 2021 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021. 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, 2020 (the "2020 Form 10-K"). The 2020 Form 10-K was filed with the Securities and Exchange Commission (the “SEC”) on February 26, 2021, and includes information and disclosures not included herein.

Significant Accounting Policies

Significant Accounting Policies	3 Months Ended
	Mar. 31, 2021
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 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, 2021 and 2020: Three Months Ended 2021 2020 Home health: Medicare 64.1 % 68.2 % Managed Care, Commercial, and Other 35.9 31.8 100.0 % 100.0 % Hospice: Medicare 94.1 % 92.0 % Managed Care, Commercial, and Other 5.9 8.0 100.0 % 100.0 % Home and community-based services: Medicaid 29.2 % 20.6 % Managed Care, Commercial, and Other 70.8 79.4 100.0 % 100.0 % Facility-based services: Medicare 52.7 % 54.8 % Managed Care, Commercial, and Other 47.3 45.2 100.0 % 100.0 % HCI: Medicare 21.3 % 24.6 % Managed Care, Commercial, and Other 78.7 75.4 100.0 % 100.0 % Medicare The following describes the payment models in effect during the three months ended March 31, 2021. Such payment models have been subject to temporary adjustments made by CMS in response to COVID-19 pandemic as described elsewhere in this Quarterly Report on Form 10-Q. The 2% sequestration reduction adjustment was suspended for patient claims with dates of service that began May 1, 2020 through December 31, 2021. Home Health Services The Company records revenue as services are provided under the Patient Driven Groupings Model ("PDGM"). 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 and geographic wage differences. 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 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 September 30 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 Accountable 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. 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, 2021 and 2020 (amounts in thousands): Three Months Ended 2021 2020 Weighted average number of shares outstanding for basic per share calculation 31,165 31,020 Effect of dilutive potential shares: Nonvested stock 267 283 Adjusted weighted average shares for diluted per share calculation 31,432 31,303 Anti-dilutive shares 120 120 Assets Held for Sale As of March 31, 2021, the Company's assets held for sale was $3.1 million, which consisted of property and fixed assets of one hospice facility in Knoxville, Tennessee and one pharmacy operation in Lafayette, Louisiana. During the three months ended March 31, 2021, the Company entered into an Asset Purchase Agreement with a buyer concerning the sale of one pharmacy operation located in Lafayette, Louisiana. The sale occurred during the second quarter of 2021 for a purchase price of $1.2 million. Recently Adopted Accounting Pronouncements In December 2019, the FASB issued ASU 2019-12, Simplifications to accounting for income taxes, which removes certain exceptions to the general principles of Topic 740 and adds guidance to reduce complexity in accounting for income taxes. The Company adopted the new guidance effective January 1, 2021. The adoption of the new guidance did not have a material impact to the Company.

Divestiture and Joint Venture A

Divestiture and Joint Venture Activities	3 Months Ended
	Mar. 31, 2021
Equity Method Investments and Joint Ventures [Abstract]
Divestiture and Joint Venture Activities	Joint Venture Activities Divestiture During the three months ended March 31, 2021, the Company sold its controlling membership interests in a home health agency previously operated as an equity joint venture. The total consideration for this controlling interest sale was $0.2 million. The transaction was accounted for as a loss on the sale of an entity and recorded in general and administrative expenses. Joint Venture Activities During the three months ended March 31, 2021, the Company purchased the noncontrolling membership interest in one of our equity joint venture partnerships, whereby the agency became a wholly-owned subsidiary of the Company. The total consideration for this noncontrolling interest purchase was $0.1 million. The transaction was accounted for as an equity transaction. During the three months ended March 31, 2021, the Company sold a noncontrolling membership interest in a home health agency previously operated as an equity joint venture. The total consideration for this noncontrolling interest sale was $0.3 million. The transaction was accounted for as an equity transaction.

Goodwill and Intangibles

Goodwill and Intangibles	3 Months Ended
	Mar. 31, 2021
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, 2021 were as follows (amounts in thousands): Home health reporting unit Hospice Home and community-based services Facility-based HCI reporting unit Total Goodwill: Balance as of December 31, 2020 $ 884,000 $ 151,742 $ 166,773 $ 15,770 $ 40,862 $ 1,259,147 Disposals (20) — — — — (20) Balance as of March 31, 2021 $ 883,980 $ 151,742 $ 166,773 $ 15,770 $ 40,862 $ 1,259,127 Intangible assets: Balance as of December 31, 2020 $ 226,004 $ 44,732 $ 24,208 $ 5,311 $ 15,100 $ 315,355 Amortization (117) (38) (2) (2) (145) (304) Disposals (519) — — — — (519) Balance as of March 31, 2021 $ 225,368 $ 44,694 $ 24,206 $ 5,309 $ 14,955 $ 314,532 The Company did record an impairment of $0.2 million related to the closure of underperforming locations. The amount of disposal of goodwill was determined using prices of comparable business in the market and the amount of disposal of the Medicare license was its carrying value at the time of closure. This was recorded in impairment of intangibles and other on the company's consolidated statements of income. In addition, the Company divested a Certificate of Need of $0.4 million, which was accounted for as a loss on the sale of an entity and recorded in general and administrative expenses. The following tables summarize the changes in intangible assets during the three months ended March 31, 2021 and December 31, 2020 (amounts in thousands): 2021 2020 Indefinite-lived intangible assets: Trade names $ 168,699 $ 168,700 Certificates of Need/Licenses 134,494 135,013 Net total $ 303,193 $ 303,713 Definite-lived intangible assets: Trade names Gross carrying amount $ 10,212 $ 10,212 Accumulated amortization (9,514) (9,480) Net total $ 698 $ 732 Non-compete agreements Gross carrying amount $ 7,267 $ 7,267 Accumulated amortization (6,512) (6,387) Net total $ 755 $ 880 Customer relationships Gross carrying amount $ 11,823 $ 11,822 Accumulated amortization (1,937) (1,792) Net total $ 9,886 $ 10,030 Total definite-lived intangible assets Gross carrying amount $ 29,302 $ 29,301 Accumulated amortization (17,963) (17,659) Net total $ 11,339 $ 11,642 Total intangible assets: Gross carrying amount $ 332,495 $ 333,014 Accumulated amortization (17,963) (17,659) Net total $ 314,532 $ 315,355 Remaining useful lives for trade names, customer relationships, and non-compete agreements were 8.5, 17.0, and 2.9 years, respectively, at March 31, 2021. Similar periods at December 31, 2020 were 8.8, 17.3, and 2.9 years for trade names, customer relationships, and non-compete agreements, respectively. Amortization expense was $0.3 million for each of the three months ended March 31, 2021 and 2020, respectively. Amortization expense was recorded in general and administrative expenses.

Debt

Debt	3 Months Ended
	Mar. 31, 2021
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, 2021 was 4.00% and the LIBOR rate was 1.88%. On March 5, 2021, the ICE Benchmark Administration, the administrator of LIBOR, announced its intention to cease the publication of LIBOR settings for 1-month, 3-month, 6-month, and 12-month LIBOR borrowings immediately on June 30, 2023. The announcement did not identify any successor administrator. As of March 31, 2021, the Company had letters of credit issued in the amount of $25.4 million, and $474.6 million of remaining borrowing capacity available under the Credit Agreement. At December 31, 2020, the Company had $20.0 million drawn and letters of credit issued in the amount of $25.4 million under the Credit Facility.

Stockholder's Equity

Stockholder's Equity	3 Months Ended
	Mar. 31, 2021
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 1,754,704 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, 2021, the Company granted 7,200 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, 2021, employees and a consultant were granted 105,560 and 5,735 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 the 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 following table represents the share grants activity for the three months ended March 31, 2021: Restricted stock Options Number of Weighted Number of shares Weighted Share grants outstanding as of December 31, 2020 469,631 $ 89.69 74,235 $ 42.07 Granted 118,495 185.00 — — Vested or exercised (146,645) 185.61 — — Share grants outstanding as of March 31, 2021 441,481 $ 119.64 74,235 $ 42.07 As of March 31, 2021, there was $48.4 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 3.33 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 $3.5 million and $3.7 million of compensation expense related to nonvested stock grants for the three months ended March 31, 2021 and 2020, 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 2021: Number of Per share Shares available as of December 31, 2020 118,136 Shares issued during the three months ended March 31, 2021 3,204 $ 202.66 Shares available as of March 31, 2021 114,932 Treasury Stock

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2021
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. 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, 2021
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, 2021, 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, 2021 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, 2021 (amounts in thousands): Balance as of December 31, 2020 $ 18,921 Net income attributable to noncontrolling interest-redeemable 2,305 Noncontrolling interest-redeemable distributions (3,287) Balance as of March 31, 2021 $ 17,939

Leases

Leases	3 Months Ended
	Mar. 31, 2021
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 five years. The facility based leases have renewal options for periods ranging from one to nine 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. 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. The Company 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. As of March 31, 2021, the weighted-average remaining lease term was 4.10 and weighted-average discount rate was 4.42%. The following table summarizes the operating lease right of use assets and related lease payables in our condensed consolidated balance sheets at March 31, 2021 and December 31, 2020 (amounts in thousands): March 31, 2021 December 31, 2020 Operating lease right of use asset 101,193 100,046 Current operating lease liabilities 32,627 32,676 Long-term operating lease liabilities 71,431 70,275 The components of lease costs for operating leases for the three months ended March 31, 2021 and 2020 were as follows (amounts in thousands): Three months ended March 31, 2021 2020 Operating lease cost $ 12,190 $ 11,348 Short-term lease cost 855 760 Variable lease cost 1,013 982 Total lease costs $ 14,058 $ 13,090 Maturities of operating lease liabilities as of March 31, 2021 were as follows (amounts in thousands): Month ending March 31, 2021 $ 28,148 2022 30,115 2023 21,877 2024 14,296 Thereafter 19,168 Total future minimum lease payments 113,604 Less: Imputed interest (9,546) Total $ 104,058

Fair Value of Financial Instrum

Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	Fair Value of Financial InstrumentsThe carrying amounts of the Company’s cash, receivables, accounts payable and accrued liabilities approximate their fair values because of their short maturity.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2021
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, 2021 and 2020 (amounts in thousands): Three Months Ended March 31, 2021 Home health services Hospice services Home and community-based services Facility-based services HCI Total Net service revenue $ 373,828 $ 62,734 $ 49,125 $ 33,369 $ 5,779 $ 524,835 Cost of service revenue (excluding depreciation and amortization) 212,373 38,570 34,872 21,175 3,282 310,272 General and administrative expenses 119,397 18,127 11,529 11,257 2,939 163,249 Impairment of intangibles and other 177 — — — — 177 Operating income (loss) 41,881 6,037 2,724 937 (442) 51,137 Interest expense (182) (36) (24) (14) (7) (263) Income (loss) before income taxes and noncontrolling interest 41,699 6,001 2,700 923 (449) 50,874 Income tax expense (benefit) 7,890 1,067 518 57 (91) 9,441 Net income (loss) 33,809 4,934 2,182 866 (358) 41,433 Less net income (loss) attributable to non controlling interests 4,849 1,015 279 657 (26) 6,774 Net income (loss) attributable to LHC Group, Inc.'s common stockholder $ 28,960 $ 3,919 $ 1,903 $ 209 $ (332) $ 34,659 Total assets $ 1,785,486 $ 308,009 $ 262,538 $ 97,692 $ 69,129 $ 2,522,854 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 (excluding depreciation and amortization) 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 noncontrolling interests 4,606 967 (155) 243 (9) 5,652 Net income (loss) attributable to LHC Group, Inc.'s common stockholders $ 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

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The effective tax rate for the three months ended March 31, 2021 and 2020 benefited from $2.1 million and $1.2 million, respectively, of excess tax benefits associated with stock-based compensation arrangements. U.S. GAAP prescribes a recognition threshold and measurement attribute for the accounting and financial statement disclosure of tax positions taken or expected to be taken in a tax return. The evaluation of a tax position is a two-step process. The first step requires the Company to determine whether it is more likely than not that a tax position will be sustained upon examination based on the technical merits of the position. The second step requires the Company to recognize in the financial statements each tax position that meets the more likely than not criteria, measured at the amount of benefit that has a greater than 50% likelihood of being realized. The Company’s unrecognized tax benefits would affect the tax rate, if recognized. The Company includes the full amount of unrecognized tax benefits in income taxes payable in 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. As of March 31, 2021 and December 31, 2020, the Company recognized $6.4 million and $6.2 million, respectively, in unrecognized tax benefits.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2021
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.
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 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. Medicare The following describes the payment models in effect during the three months ended March 31, 2021. Such payment models have been subject to temporary adjustments made by CMS in response to COVID-19 pandemic as described elsewhere in this Quarterly Report on Form 10-Q. The 2% sequestration reduction adjustment was suspended for patient claims with dates of service that began May 1, 2020 through December 31, 2021. Home Health Services The Company records revenue as services are provided under the Patient Driven Groupings Model ("PDGM"). 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 and geographic wage differences. 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 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 September 30 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.
Patient Accounts Receivable	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.
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 December 2019, the FASB issued ASU 2019-12, Simplifications to accounting for income taxes, which removes certain exceptions to the general principles of Topic 740 and adds guidance to reduce complexity in accounting for income taxes. The Company adopted the new guidance effective January 1, 2021. The adoption of the new guidance did not have a material impact to the Company.

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2021
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, 2021 and 2020: Three Months Ended 2021 2020 Home health: Medicare 64.1 % 68.2 % Managed Care, Commercial, and Other 35.9 31.8 100.0 % 100.0 % Hospice: Medicare 94.1 % 92.0 % Managed Care, Commercial, and Other 5.9 8.0 100.0 % 100.0 % Home and community-based services: Medicaid 29.2 % 20.6 % Managed Care, Commercial, and Other 70.8 79.4 100.0 % 100.0 % Facility-based services: Medicare 52.7 % 54.8 % Managed Care, Commercial, and Other 47.3 45.2 100.0 % 100.0 % HCI: Medicare 21.3 % 24.6 % Managed Care, Commercial, and Other 78.7 75.4 100.0 % 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, 2021 and 2020 (amounts in thousands): Three Months Ended 2021 2020 Weighted average number of shares outstanding for basic per share calculation 31,165 31,020 Effect of dilutive potential shares: Nonvested stock 267 283 Adjusted weighted average shares for diluted per share calculation 31,432 31,303 Anti-dilutive shares 120 120

Goodwill and Intangibles (Table

Goodwill and Intangibles (Tables)	3 Months Ended
	Mar. 31, 2021
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, 2021 were as follows (amounts in thousands): Home health reporting unit Hospice Home and community-based services Facility-based HCI reporting unit Total Goodwill: Balance as of December 31, 2020 $ 884,000 $ 151,742 $ 166,773 $ 15,770 $ 40,862 $ 1,259,147 Disposals (20) — — — — (20) Balance as of March 31, 2021 $ 883,980 $ 151,742 $ 166,773 $ 15,770 $ 40,862 $ 1,259,127 Intangible assets: Balance as of December 31, 2020 $ 226,004 $ 44,732 $ 24,208 $ 5,311 $ 15,100 $ 315,355 Amortization (117) (38) (2) (2) (145) (304) Disposals (519) — — — — (519) Balance as of March 31, 2021 $ 225,368 $ 44,694 $ 24,206 $ 5,309 $ 14,955 $ 314,532
Summary of Changes in Intangible Assets, Indefinite	The following tables summarize the changes in intangible assets during the three months ended March 31, 2021 and December 31, 2020 (amounts in thousands): 2021 2020 Indefinite-lived intangible assets: Trade names $ 168,699 $ 168,700 Certificates of Need/Licenses 134,494 135,013 Net total $ 303,193 $ 303,713 Definite-lived intangible assets: Trade names Gross carrying amount $ 10,212 $ 10,212 Accumulated amortization (9,514) (9,480) Net total $ 698 $ 732 Non-compete agreements Gross carrying amount $ 7,267 $ 7,267 Accumulated amortization (6,512) (6,387) Net total $ 755 $ 880 Customer relationships Gross carrying amount $ 11,823 $ 11,822 Accumulated amortization (1,937) (1,792) Net total $ 9,886 $ 10,030 Total definite-lived intangible assets Gross carrying amount $ 29,302 $ 29,301 Accumulated amortization (17,963) (17,659) Net total $ 11,339 $ 11,642 Total intangible assets: Gross carrying amount $ 332,495 $ 333,014 Accumulated amortization (17,963) (17,659) Net total $ 314,532 $ 315,355
Summary of Changes in Intangible Assets, Finite	The following tables summarize the changes in intangible assets during the three months ended March 31, 2021 and December 31, 2020 (amounts in thousands): 2021 2020 Indefinite-lived intangible assets: Trade names $ 168,699 $ 168,700 Certificates of Need/Licenses 134,494 135,013 Net total $ 303,193 $ 303,713 Definite-lived intangible assets: Trade names Gross carrying amount $ 10,212 $ 10,212 Accumulated amortization (9,514) (9,480) Net total $ 698 $ 732 Non-compete agreements Gross carrying amount $ 7,267 $ 7,267 Accumulated amortization (6,512) (6,387) Net total $ 755 $ 880 Customer relationships Gross carrying amount $ 11,823 $ 11,822 Accumulated amortization (1,937) (1,792) Net total $ 9,886 $ 10,030 Total definite-lived intangible assets Gross carrying amount $ 29,302 $ 29,301 Accumulated amortization (17,963) (17,659) Net total $ 11,339 $ 11,642 Total intangible assets: Gross carrying amount $ 332,495 $ 333,014 Accumulated amortization (17,963) (17,659) Net total $ 314,532 $ 315,355

Stockholder's Equity (Tables)

Stockholder's Equity (Tables)	3 Months Ended
	Mar. 31, 2021
Equity [Abstract]
Share Grants Activity	The following table represents the share grants activity for the three months ended March 31, 2021: Restricted stock Options Number of Weighted Number of shares Weighted Share grants outstanding as of December 31, 2020 469,631 $ 89.69 74,235 $ 42.07 Granted 118,495 185.00 — — Vested or exercised (146,645) 185.61 — — Share grants outstanding as of March 31, 2021 441,481 $ 119.64 74,235 $ 42.07
Shares of Common Stock Issued Under Employee Stock Purchase Plan	The table below details the shares of common stock issued during 2021: Number of Per share Shares available as of December 31, 2020 118,136 Shares issued during the three months ended March 31, 2021 3,204 $ 202.66 Shares available as of March 31, 2021 114,932

Noncontrolling interests (Table

Noncontrolling interests (Tables)	3 Months Ended
	Mar. 31, 2021
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, 2021 (amounts in thousands): Balance as of December 31, 2020 $ 18,921 Net income attributable to noncontrolling interest-redeemable 2,305 Noncontrolling interest-redeemable distributions (3,287) Balance as of March 31, 2021 $ 17,939

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2021
Leases [Abstract]
Assets And Liabilities, Lessee	The following table summarizes the operating lease right of use assets and related lease payables in our condensed consolidated balance sheets at March 31, 2021 and December 31, 2020 (amounts in thousands): March 31, 2021 December 31, 2020 Operating lease right of use asset 101,193 100,046 Current operating lease liabilities 32,627 32,676 Long-term operating lease liabilities 71,431 70,275
Lease, Cost	The components of lease costs for operating leases for the three months ended March 31, 2021 and 2020 were as follows (amounts in thousands): Three months ended March 31, 2021 2020 Operating lease cost $ 12,190 $ 11,348 Short-term lease cost 855 760 Variable lease cost 1,013 982 Total lease costs $ 14,058 $ 13,090
Lessee, Operating Lease, Liability, Maturity	Maturities of operating lease liabilities as of March 31, 2021 were as follows (amounts in thousands): Month ending March 31, 2021 $ 28,148 2022 30,115 2023 21,877 2024 14,296 Thereafter 19,168 Total future minimum lease payments 113,604 Less: Imputed interest (9,546) Total $ 104,058

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Schedule of Segment Information	The following tables summarize the Company’s segment information for the three months ended March 31, 2021 and 2020 (amounts in thousands): Three Months Ended March 31, 2021 Home health services Hospice services Home and community-based services Facility-based services HCI Total Net service revenue $ 373,828 $ 62,734 $ 49,125 $ 33,369 $ 5,779 $ 524,835 Cost of service revenue (excluding depreciation and amortization) 212,373 38,570 34,872 21,175 3,282 310,272 General and administrative expenses 119,397 18,127 11,529 11,257 2,939 163,249 Impairment of intangibles and other 177 — — — — 177 Operating income (loss) 41,881 6,037 2,724 937 (442) 51,137 Interest expense (182) (36) (24) (14) (7) (263) Income (loss) before income taxes and noncontrolling interest 41,699 6,001 2,700 923 (449) 50,874 Income tax expense (benefit) 7,890 1,067 518 57 (91) 9,441 Net income (loss) 33,809 4,934 2,182 866 (358) 41,433 Less net income (loss) attributable to non controlling interests 4,849 1,015 279 657 (26) 6,774 Net income (loss) attributable to LHC Group, Inc.'s common stockholder $ 28,960 $ 3,919 $ 1,903 $ 209 $ (332) $ 34,659 Total assets $ 1,785,486 $ 308,009 $ 262,538 $ 97,692 $ 69,129 $ 2,522,854 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 (excluding depreciation and amortization) 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 noncontrolling interests 4,606 967 (155) 243 (9) 5,652 Net income (loss) attributable to LHC Group, Inc.'s common stockholders $ 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

Basis of Presentation and Sig_2

Basis of Presentation and Significant Events - Organization (Details)	3 Months Ended
	Mar. 31, 2021segmentLocationState
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of operating segments | segment	5
Number of service providers operated | Location	829
Number of states in which Company operates | State	35

Basis of Presentation and Sig_3

Basis of Presentation and Significant Events - COVID-19 (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Adjustments Due to Legislation [Line Items]
Proceeds from Provider Relief Funds	$ 93,300
Government stimulus advance	93,257		$ 93,257
Contract liabilities - deferred revenue	317,962		$ 317,962
Net service revenue	524,835	$ 512,871
Sequestration Payment Adjustment
Adjustments Due to Legislation [Line Items]
Net service revenue	6,400
Suspension of LTACH
Adjustments Due to Legislation [Line Items]
Net service revenue	8,900
Due From Legislation
Adjustments Due to Legislation [Line Items]
Employee-related liabilities	51,800
Due From Legislation | Other Current Liabilities
Adjustments Due to Legislation [Line Items]
Employee-related liabilities	25,900
Due From Legislation | Other Noncurrent Liabilities
Adjustments Due to Legislation [Line Items]
Employee-related liabilities	$ 25,900

Significant Accounting Polici_4

Significant Accounting Policies - Percentage of Net Service Revenue Earned by Category of Payor (Details)	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
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	64.10%	68.20%
Medicare | Hospice services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	94.10%	92.00%
Medicare | Facility-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	52.70%	54.80%
Medicare | HCI
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	21.30%	24.60%
Managed Care, Commercial, and Other | Home health services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	35.90%	31.80%
Managed Care, Commercial, and Other | Hospice services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	5.90%	8.00%
Managed Care, Commercial, and Other | Home and community-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	70.80%	79.40%
Managed Care, Commercial, and Other | Facility-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	47.30%	45.20%
Managed Care, Commercial, and Other | HCI
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	78.70%	75.40%
Medicaid | Home and community-based services
Disaggregation of Revenue [Line Items]
Percentage of net service revenue	29.20%	20.60%

Significant Accounting Polici_5

Significant Accounting Policies - Additional Information (Details) $ in Thousands	3 Months Ended	4 Months Ended
	Mar. 31, 2021USD ($)segmentPeriodicRateGroup	Apr. 30, 2020	Dec. 31, 2020USD ($)
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 | PeriodicRate	1
Number of hospice, periodic rates used to calculate revenue | PeriodicRate	4
Percentage subject to inpatient cap	20.00%
Determination period for hospice Medicare inpatient reimbursement cap	12 months
Assets held for sale | $	$ 3,137		$ 1,900
Consideration transferred | $	$ 1,200
Hospice Facility
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Number of held for sale asset | segment	1
Pharmacy
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Number of held for sale asset | segment	1

Significant Accounting Polici_6

Significant Accounting Policies - Shares Used in Computation of Basic and Diluted Per Share Information (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Accounting Policies [Abstract]
Weighted average number of shares outstanding for basic per share calculation (in shares)	31,165	31,020
Effect of dilutive potential shares:
Nonvested stock (in shares)	267	283
Adjusted weighted average shares for diluted per share calculation (in shares)	31,432	31,303
Anti-dilutive shares (in shares)	120	120

Divestiture and Joint Venture_2

Divestiture and Joint Venture Activities (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2021USD ($)
Health Agency, Second Transaction
Schedule of Equity Method Investments [Line Items]
Payments to acquire interest	$ 100
Discontinued Operations, Disposed of by Sale | Home Health Agencies
Schedule of Equity Method Investments [Line Items]
Proceeds from sale of an entity	200
Discontinued Operations, Disposed of by Sale | Health Agency, Second Transaction
Schedule of Equity Method Investments [Line Items]
Proceeds from sale of an entity	$ 300

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, 2021	Mar. 31, 2020
Goodwill [Roll Forward]
Balance as of December 31, 2020	$ 1,259,147
Disposals	(20)
Balance as of March 31, 2021	1,259,127
Intangible assets:
Balance as of December 31, 2020	315,355
Amortization	(304)	$ (300)
Disposals	(519)
Balance as of March 31, 2021	314,532
Home health reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2020	884,000
Disposals	(20)
Balance as of March 31, 2021	883,980
Intangible assets:
Balance as of December 31, 2020	226,004
Amortization	(117)
Disposals	(519)
Balance as of March 31, 2021	225,368
Hospice reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2020	151,742
Disposals	0
Balance as of March 31, 2021	151,742
Intangible assets:
Balance as of December 31, 2020	44,732
Amortization	(38)
Disposals	0
Balance as of March 31, 2021	44,694
Home and community-based services reporting  unit
Goodwill [Roll Forward]
Balance as of December 31, 2020	166,773
Disposals	0
Balance as of March 31, 2021	166,773
Intangible assets:
Balance as of December 31, 2020	24,208
Amortization	(2)
Disposals	0
Balance as of March 31, 2021	24,206
Facility-based reporting  unit
Goodwill [Roll Forward]
Balance as of December 31, 2020	15,770
Disposals	0
Balance as of March 31, 2021	15,770
Intangible assets:
Balance as of December 31, 2020	5,311
Amortization	(2)
Disposals	0
Balance as of March 31, 2021	5,309
HCI reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2020	40,862
Disposals	0
Balance as of March 31, 2021	40,862
Intangible assets:
Balance as of December 31, 2020	15,100
Amortization	(145)
Disposals	0
Balance as of March 31, 2021	$ 14,955

Goodwill and Intangibles - Addi

Goodwill and Intangibles - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Finite-Lived Intangible Assets [Line Items]
Impairment of intangible asset	$ 200
Amortization of intangible assets	$ 304	$ 300
Trade name
Finite-Lived Intangible Assets [Line Items]
Useful life	8 years 6 months		8 years 9 months 18 days
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Useful life	17 years		17 years 3 months 18 days
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Useful life	2 years 10 months 24 days		2 years 10 months 24 days
Certificate of Need
Finite-Lived Intangible Assets [Line Items]
Disposal of intangible asset	$ 400

Goodwill and Intangibles - Summ

Goodwill and Intangibles - Summary of Changes in Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 303,193	$ 303,713
Gross carrying amount, definite-lived intangible assets	29,302	29,301
Accumulated amortization	(17,963)	(17,659)
Net total	11,339	11,642
Gross carrying amount, intangible assets	332,495	333,014
Net total	314,532	315,355
Trade Names
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	10,212	10,212
Accumulated amortization	(9,514)	(9,480)
Net total	698	732
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	7,267	7,267
Accumulated amortization	(6,512)	(6,387)
Net total	755	880
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	11,823	11,822
Accumulated amortization	(1,937)	(1,792)
Net total	9,886	10,030
Trade Names
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	168,699	168,700
Certificates of Need/Licenses
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 134,494	$ 135,013

Debt - Additional Information (

Debt - Additional Information (Details)	Apr. 02, 2018USD ($)Instrument	Mar. 31, 2021USD ($)	Dec. 31, 2020USD ($)
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
Line of credit facility drawn		$ 0	$ 20,000,000
Letter of credit outstanding		25,400,000	$ 25,400,000
Available credit under agreement		$ 474,600,000
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		1.88%

Stockholder's Equity - Addition

Stockholder's Equity - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	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	$ 48,400
Weighted average period of cost recognized	3 years 3 months 29 days
Compensation expense related to nonvested stock grants	$ 3,500	$ 3,700
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
Treasury shares redeemed to pay income tax	$ 9,541	$ 6,933
Employee
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares redeemed to satisfy personal tax obligations (in shares)	51,221
Treasury shares redeemed to pay income tax	$ 9,500
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)					1,754,704
2018 Long-Term Incentive Plan | Employee
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested stock grants to employees (in shares)	105,560
Period of vested shares	5 years
2018 Long-Term Incentive Plan | Consultants
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested stock grants to employees (in shares)	5,735
Second Amended and Restated 2005 Non-Employee Directors Compensation Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of directors' stock grant vested on one year anniversary date	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)	7,200

Stockholder's Equity - Nonveste

Stockholder's Equity - Nonvested Stock Activity (Details)	3 Months Ended
	Mar. 31, 2021$ / sharesshares
Restricted stock
Number of shares
Share grants outstanding, beginning balance | shares	469,631
Granted (in shares) | shares	118,495
Vested (in shares) | shares	(146,645)
Share grants outstanding, ending balance | shares	441,481
Weighted average grant date fair value
Beginning balance, Weighted average grant date fair value (in dollars per share) | $ / shares	$ 89.69
Granted (in dollars per share) | $ / shares	185
Vested (in dollars per share) | $ / shares	185.61
Ending balance, Weighted average grant date fair value (in dollars per share) | $ / shares	$ 119.64
Options
Number of shares
Share grants outstanding, beginning balance | shares	74,235
Granted (in shares) | shares	0
Vested or exercised (in shares) | shares	0
Share grants outstanding, ending balance | shares	74,235
Weighted average grant date fair value
Share grants outstanding, beginning balance (in dollars per share) | $ / shares	$ 42.07
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	$ 42.07

Stockholder's Equity - Shares o

Stockholder's Equity - Shares of Common Stock Issued Under Employee Stock Purchase Plan (Details)	3 Months Ended
	Mar. 31, 2021$ / sharesshares
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Number of shares available, beginning balance (in shares)	118,136
Shares issued during period (in shares)	3,204
Number of shares available, ending balance (in shares)	114,932
Per share price of shares issued during period (in dollars per share) | $ / shares	$ 202.66

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) $ in Millions	3 Months Ended
	Mar. 31, 2021USD ($)
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) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Stockholders' Equity Attributable to Noncontrolling Interest [Roll Forward]
Balance as of December 31, 2020	$ 18,921
Net income attributable to noncontrolling interest-redeemable	2,305	$ 3,600
Noncontrolling interest-redeemable distributions	(3,287)
Balance as of March 31, 2021	$ 17,939

Leases (Details)

Leases (Details)	Mar. 31, 2021
Lessee, Lease, Description [Line Items]
Operating lease term	5 years
Weighted-average remaining lease term	4 years 1 month 6 days
Weighted-average discount rate	4.42%

Leases - Right of Use and Liabi

Leases - Right of Use and Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Leases [Abstract]
Operating lease right of use asset	$ 101,193	$ 100,046
Current operating lease liabilities	32,627	32,676
Long-term operating lease liabilities	$ 71,431	$ 70,275

Leases - Lease Cost (Details)

Leases - Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Leases [Abstract]
Operating lease cost	$ 12,190	$ 11,348
Short-term lease cost	855	760
Variable lease cost	1,013	982
Total lease costs	$ 14,058	$ 13,090

Leases - Lease Maturities (Deta

Leases - Lease Maturities (Details) $ in Thousands	Mar. 31, 2021USD ($)
Leases [Abstract]
2021	$ 28,148
2022	30,115
2023	21,877
2024	14,296
Thereafter	19,168
Total future minimum lease payments	113,604
Less: Imputed interest	(9,546)
Total	$ 104,058

Segment Information - Summary o

Segment Information - Summary of segment Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	$ 524,835	$ 512,871
Cost of service revenue (excluding depreciation and amortization)	310,272	321,202
General and administrative expenses	163,249	157,866
Impairment of intangibles and other	177	0
Operating income	51,137	33,803
Interest expense	(263)	(2,768)
Income before income taxes and noncontrolling interest	50,874	31,035
Income tax expense (benefit)	9,441	3,359
Net income	41,433	27,676
Less net income (loss) attributable to noncontrolling interests	6,774	5,652
Net income attributable to LHC Group, Inc.’s common stockholders	34,659	22,024
Total assets	2,522,854	2,212,282	$ 2,483,354
Home health services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	373,828	367,821
Cost of service revenue (excluding depreciation and amortization)	212,373	220,440
General and administrative expenses	119,397	116,023
Impairment of intangibles and other	177
Operating income	41,881	31,358
Interest expense	(182)	(1,900)
Income before income taxes and noncontrolling interest	41,699	29,458
Income tax expense (benefit)	7,890	3,289
Net income	33,809	26,169
Less net income (loss) attributable to noncontrolling interests	4,849	4,606
Net income attributable to LHC Group, Inc.’s common stockholders	28,960	21,563
Total assets	1,785,486	1,548,224
Hospice services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	62,734	60,531
Cost of service revenue (excluding depreciation and amortization)	38,570	38,034
General and administrative expenses	18,127	16,626
Impairment of intangibles and other	0
Operating income	6,037	5,871
Interest expense	(36)	(303)
Income before income taxes and noncontrolling interest	6,001	5,568
Income tax expense (benefit)	1,067	608
Net income	4,934	4,960
Less net income (loss) attributable to noncontrolling interests	1,015	967
Net income attributable to LHC Group, Inc.’s common stockholders	3,919	3,993
Total assets	308,009	251,354
Home and community-based services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	49,125	48,464
Cost of service revenue (excluding depreciation and amortization)	34,872	38,453
General and administrative expenses	11,529	11,459
Impairment of intangibles and other	0
Operating income	2,724	(1,448)
Interest expense	(24)	(266)
Income before income taxes and noncontrolling interest	2,700	(1,714)
Income tax expense (benefit)	518	(206)
Net income	2,182	(1,508)
Less net income (loss) attributable to noncontrolling interests	279	(155)
Net income attributable to LHC Group, Inc.’s common stockholders	1,903	(1,353)
Total assets	262,538	252,846
Facility-based services
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	33,369	29,681
Cost of service revenue (excluding depreciation and amortization)	21,175	20,342
General and administrative expenses	11,257	10,380
Impairment of intangibles and other	0
Operating income	937	(1,041)
Interest expense	(14)	(219)
Income before income taxes and noncontrolling interest	923	(1,260)
Income tax expense (benefit)	57	(199)
Net income	866	(1,061)
Less net income (loss) attributable to noncontrolling interests	657	243
Net income attributable to LHC Group, Inc.’s common stockholders	209	(1,304)
Total assets	97,692	90,791
HCI
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Net service revenue	5,779	6,374
Cost of service revenue (excluding depreciation and amortization)	3,282	3,933
General and administrative expenses	2,939	3,378
Impairment of intangibles and other	0
Operating income	(442)	(937)
Interest expense	(7)	(80)
Income before income taxes and noncontrolling interest	(449)	(1,017)
Income tax expense (benefit)	(91)	(133)
Net income	(358)	(884)
Less net income (loss) attributable to noncontrolling interests	(26)	(9)
Net income attributable to LHC Group, Inc.’s common stockholders	(332)	(875)
Total assets	$ 69,129	$ 69,067

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Excess tax benefits associated with stock-based compensation	$ 2.1		$ 1.2
Unrecognized tax benefits	$ 6.4	$ 6.2