Addus HomeCare (ADUS) 10-Q 1 Nov 22 2022 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2022	Oct. 25, 2022
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2022
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2022
Entity Registrant Name	ADDUS HOMECARE CORPORATION
Entity Central Index Key	0001468328
Trading Symbol	ADUS
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Current Reporting Status	Yes
Entity Address, State or Province	TX
Entity File Number	001-34504
Entity Tax Identification Number	20-5340172
Entity Address, Address Line One	6303 Cowboys Way
Entity Address, Address Line Two	Suite 600
Entity Address, City or Town	Frisco
Entity Address, Postal Zip Code	75034
City Area Code	469
Local Phone Number	535-8200
Entity Common Stock, Shares Outstanding		16,110,364
Document Quarterly Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Title of 12(b) Security	Common Stock, $0.001 par value
Security Exchange Name	NASDAQ

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Current assets
Cash	$ 105,644	$ 168,895
Accounts receivable, net of allowances for credit losses	126,253	136,955
Prepaid expenses and other current assets	8,245	18,491
Total current assets	240,142	324,341
Property and equipment, net of accumulated depreciation and amortization	17,428	18,483
Other assets
Goodwill	575,205	504,392
Intangibles, net of accumulated amortization	72,655	64,321
Operating lease assets, net	40,503	36,048
Total other assets	688,363	604,761
Total assets	945,933	947,585
Current liabilities
Accounts payable	19,545	19,358
Accrued payroll	35,084	44,083
Accrued expenses	39,557	37,077
Government stimulus advances	21,158	4,173
Accrued workers' compensation insurance	12,844	12,998
Total current liabilities	128,188	117,689
Long-term liabilities
Long-term debt, net of debt issuance costs	163,557	220,912
Long-term operating lease liabilities	37,168	32,859
Other long-term liabilities	2,183	1,781
Total long-term liabilities	202,908	255,552
Total liabilities	331,096	373,241
Stockholders' equity
Common stock -$.001 par value; 40,000 authorized and 16,081 and 15,940 shares issued and outstanding as of September 30, 2022 and December 31, 2021, respectively	16	16
Additional paid-in capital	389,267	380,037
Retained earnings	225,554	194,291
Total stockholders' equity	614,837	574,344
Total liabilities and stockholders' equity	$ 945,933	$ 947,585

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2022	Dec. 31, 2021
Statement Of Financial Position [Abstract]
Common stock, par value	$ 1	$ 1
Common stock, shares authorized	40,000,000	40,000,000
Common stock, shares issued	16,090,000	15,940,000
Common stock, shares outstanding	16,090,000	15,940,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Income Statement [Abstract]
Net service revenues	$ 240,495	$ 216,662	$ 704,070	$ 639,857
Cost of service revenues	165,310	149,616	483,100	442,804
Gross profit	75,185	67,046	220,970	197,053
General and administrative expenses	54,228	46,280	162,476	139,881
Depreciation and amortization	3,441	3,406	10,571	10,594
Total operating expenses	57,669	49,686	173,047	150,475
Operating income	17,516	17,360	47,923	46,578
Interest income	(83)	(37)	(249)	(90)
Interest expense	2,472	1,614	6,278	4,092
Total interest expense, net	2,389	1,577	6,029	4,002
Income before income taxes	15,127	15,783	41,894	42,576
Income tax expense	3,584	4,206	10,631	10,508
Net income	$ 11,543	$ 11,577	$ 31,263	$ 32,068
Net income per common share
Basic income per share	$ 0.73	$ 0.74	$ 1.97	$ 2.04
Diluted income per share	$ 0.71	$ 0.72	$ 1.94	$ 2
Weighted average number of common shares and potential common shares outstanding:
Basic	15,872	15,748	15,846	15,727
Diluted	16,184	16,030	16,146	16,060

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]
Balance at Dec. 31, 2020	$ 518,676	$ 16	$ 369,495	$ 149,165
Balance, shares at Dec. 31, 2020		15,826
Issuance of shares of common stock under restricted stock award agreements, shares		88
Forfeiture of shares of common stock under restricted stock award agreements, shares		(5)
Stock-based compensation	7,105		7,105
Shares issued for exercise of stock options	202		202
Shares issued for exercise of stock options, shares		4
Net income	32,068			32,068
Balance at Sep. 30, 2021	558,051	$ 16	376,802	181,233
Balance, shares at Sep. 30, 2021		15,913
Balance at Jun. 30, 2021	544,055	$ 16	374,383	169,656
Balance, shares at Jun. 30, 2021		15,917
Forfeiture of shares of common stock under restricted stock award agreements, shares		(5)
Stock-based compensation	2,341		2,341
Shares issued for exercise of stock options	78		78
Shares issued for exercise of stock options, shares		1
Net income	11,577			11,577
Balance at Sep. 30, 2021	558,051	$ 16	376,802	181,233
Balance, shares at Sep. 30, 2021		15,913
Balance at Dec. 31, 2021	574,344	$ 16	380,037	194,291
Balance, shares at Dec. 31, 2021		15,940
Forfeiture of shares of common stock under restricted stock award agreements, shares		(4)
Stock-based compensation	7,945		7,945
Shares issued for exercise of stock options	1,285		1,285
Shares issued for exercise of stock options, shares		25
Net income	31,263			31,263
Balance at Sep. 30, 2022	614,837	$ 16	389,267	225,554
Balance, shares at Sep. 30, 2022		16,090
Balance at Jun. 30, 2022	599,777	$ 16	385,750	214,011
Balance, shares at Jun. 30, 2022		16,081
Issuance of shares of common stock under restricted stock award agreements, shares		129
Forfeiture of shares of common stock under restricted stock award agreements, shares		(1)
Stock-based compensation	2,780		2,780
Shares issued for exercise of stock options	737		737
Shares issued for exercise of stock options, shares		10
Net income	11,543			11,543
Balance at Sep. 30, 2022	$ 614,837	$ 16	$ 389,267	$ 225,554
Balance, shares at Sep. 30, 2022		16,090

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash flows from operating activities:
Net income	$ 31,263	$ 32,068
Adjustments to reconcile net income to net cash provided by (used in) operating activities, net of acquisitions:
Depreciation and amortization	10,571	10,594
Deferred income taxes	413	605
Stock-based compensation	7,945	7,105
Amortization of debt issuance costs under the credit facility	645	590
Provision for credit losses	481	744
Impairment of operating lease assets	1,174
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	18,232	(1,906)
Prepaid expenses and other current assets	10,568	(3,610)
Government stimulus advances	16,985	(24,413)
Accounts payable	(693)	(780)
Accrued payroll	(10,421)	(4,553)
Accrued expenses and other long-term liabilities	(6,345)	(2,157)
Net cash provided by (used in) operating activities	80,818	14,287
Cash flows from investing activities:
Acquisitions of businesses, net of cash acquired	(84,490)	(29,219)
Purchases of property and equipment	(2,864)	(3,214)
Net cash used in investing activities	(87,354)	(32,433)
Cash flows from financing activities:
Payments on revolver loan — credit facility	(105,000)
Proceeds from borrowings on revolver — credit facility	47,000	46,395
Payments on term loan — credit facility		(18,130)
Payment for debt issuance costs		(3,020)
Cash received from exercise of stock options	1,285	202
Net cash used in financing activities	(56,715)	25,447
Net change in cash	(63,251)	7,301
Cash, at beginning of period	168,895	145,078
Cash, at end of period	105,644	152,379
Supplemental disclosures of cash flow information:
Cash paid for interest	5,589	3,648
Cash paid for income taxes	$ 629	$ 14,767

Nature of Operations, Consolida

Nature of Operations, Consolidation, and Presentation of Financial Statements	9 Months Ended
	Sep. 30, 2022
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Nature of Operations, Consolidation, and Presentation of Financial Statements	1. Nature of Operations, Consolidation, and Presentation of Financial Statements Addus HomeCare Corporation (“Holdings”) and its subsidiaries (together with Holdings, the “Company”, “we”, “us” or “our”) operate as a multi-state provider of three distinct but related business segments providing in-home services. In its personal care services segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy. The Company’s payors include federal, state and local governmental agencies, managed care organizations, commercial insurers and private individuals. Basis of Presentation The accompanying Unaudited Condensed Consolidated Financial Statements and related notes have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”) for Quarterly Reports on Form 10-Q. The accompanying balance sheet as of December 31, 2021 has been derived from the Company’s audited financial statements for the year ended December 31, 2021 previously filed with the SEC. Accordingly, these financial statements do not include all of the information and note disclosures required by accounting principles generally accepted in the United States of America (“GAAP”) for annual financial statements and should be read in conjunction with our consolidated financial statements and notes thereto for the year ended December 31, 2021 included in our Annual Report on Form 10-K, which includes information and disclosures not included herein. In the opinion of management, these financial statements reflect all adjustments of a normal, recurring nature necessary for the fair statement of our financial position, results of operations, and cash flows for the interim periods presented in conformity with GAAP. Our results for any interim period are not necessarily indicative of results for a full year or any other interim period. Principles of Consolidation These Unaudited Condensed Consolidated Financial Statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Estimates The financial statements are prepared by management in conformity with GAAP and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: revenue recognition, goodwill and intangibles in business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from those estimates. Computation of Weighted Average Shares The following table sets forth the computation of basic and diluted common shares: For the Three Months Ended September 30, For the Nine Months Ended September 30, (Amounts in thousands) (Amounts in thousands) 2022 2021 2022 2021 Weighted average number of shares outstanding for basic per share 15,872 15,748 15,846 15,727 Effect of dilutive potential shares: Stock options 255 267 244 288 Restricted stock awards 57 15 56 45 Adjusted weighted average shares outstanding for diluted per share 16,184 16,030 16,146 16,060 Anti-dilutive shares: Stock options 111 73 111 73 Restricted stock awards 36 125 3 73 Recently Adopted Accounting Pronouncements In November 2021, the FASB issued ASU 2021-10, Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance . ASU 2021-10 requires entities to disclose certain information about the nature of certain governmental assistance received, including the nature of the transaction and the related accounting policy, the financial statement line items impacted by the assistance, as well as the significant terms and conditions of the transactions. The ASU was adopted as of January 1, 2022 and did no t have an impact on the Company’s results of operations or liquidity. Recently Issued Accounting Pronouncements In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting . ASU 2020-04 provides optional expedients and exceptions for applying GAAP to contract modifications and hedging relationships, and other transactions subject to meeting certain criteria, that reference LIBOR or another reference rate expected to be discontinued. The ASU provides companies with optional guidance to ease the potential accounting burden associated with transitioning away from reference rates that are expected to be discontinued. Therefore, it will be in effect for a limited time through December 31, 2022. The ASU can be adopted no later than December 1, 2022 with early adoption permitted. On July 30, 2021, the Company entered into the Second Amendment to the Credit Agreement as discussed further in Note 8. The Credit Agreement contains hardwired fallback language that contemplates a transition from LIBOR, specifically identifies the secured overnight financing rate (“SOFR”) as the replacement reference rate and details the mechanism for transition at LIBOR cessation, which is anticipated to occur on June 30, 2023. The transition to SOFR is not expected to have a material impact on the Company’s results of operations or liquidity.

Leases

Leases	9 Months Ended
	Sep. 30, 2022
Leases [Abstract]
Leases	3. Leases Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows: September 30, 2022 December 31, 2021 (Amounts in Thousands) Operating lease assets, net $ 40,503 $ 36,048 Short-term operating lease liabilities (in accrued expenses) 10,866 9,774 Long-term operating lease liabilities 37,168 32,859 Total operating lease liabilities $ 48,034 $ 42,633 Lease Costs Components of lease costs were reported in general and administrative expenses in the Company’s Unaudited Condensed Consolidated Statements of Income as follows: For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Operating lease costs $ 3,251 $ 2,789 $ 8,888 $ 8,341 Short-term lease costs 589 197 2,251 572 Total lease costs 3,840 2,986 11,139 8,913 Less: sublease income ( 176 ) ( 177 ) ( 529 ) ( 480 ) Total lease costs, net $ 3,664 $ 2,809 $ 10,610 $ 8,433 Lease Term and Discount Rate Weighted average remaining lease terms and discount rates were as follows: September 30, 2022 December 31, 2021 Operating leases: Weighted average remaining lease term (years) 5.98 6.39 Weighted average discount rate 3.92 % 3.91 % Maturity of Lease Liabilities Remaining operating lease payments as of September 30, 2022 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2023 $ 12,379 2024 10,645 2025 7,816 2026 5,756 2027 4,433 Thereafter 13,070 Total future minimum rental commitments 54,099 Less: Imputed interest ( 6,065 ) Total lease liabilities $ 48,034 Supplemental cash flows information For the Nine Months Ended September 30, (Amounts in Thousands) 2022 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 9,752 $ 8,237 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 13,130 $ 5,706

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2022
Business Combinations [Abstract]
Acquisitions	4. Acquisitions The Company’s acquisitions have been accounted for in accordance with ASC Topic 805, Business Combinations , and the resulting goodwill and other intangible assets were accounted for under ASC Topic 350, Goodwill and Other Intangible Assets . Under business combination accounting, the assets and liabilities are generally recognized at their fair values and the difference between the consideration transferred, excluding transaction costs, and the fair values of the assets and liabilities is recognized as goodwill. The results of each business acquisition are included on the Unaudited Condensed Consolidated Statements of Income from the date of the acquisition. Management’s assessment of qualitative factors affecting goodwill for each acquisition includes estimates of market share at the date of purchase, ability to grow in the market, synergy with existing Company operations and the payor profile in the markets. JourneyCare On February 1, 2022, the Company completed the acquisition of the hospice and palliative operations of JourneyCare Inc. (“JourneyCare”). The purchase price was approximately $ 86.6 million, including the amount of acquired excess cash held by JourneyCare at the closing of the acquisition (approximately $ 0.5 million) plus the finalization of net working capital payable to seller of $ 1.6 million. The JourneyCare acquisition was funded with a combination of a $ 35.0 million draw on the Company’s revolving credit facility and availa ble cash. With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois. The related acquisition costs were $ 0.1 million and $ 0.5 million for the three and nine months ended September 30, 2022, respectively, and integration costs were $ 0.8 million and $ 3.9 million for the three and nine months ended September 30, 2022, respectively. These costs were included in general and administrative expenses on the Unaudited Condensed Consolidated Statements of Income and were expensed as incurred. Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows: Total Goodwill $ 70,724 Identifiable intangible assets 13,792 Cash 500 Accounts receivable 8,171 Property and equipment 1,194 Operating lease assets, net 3,728 Other assets 333 Accrued expenses ( 6,799 ) Accrued payroll ( 1,511 ) Long-term operating lease liabilities ( 3,537 ) Total purchase price $ 86,595 Identifiable intangible assets acquired included $ 9.0 million in a trade name and $ 4.8 million of indefinite lived state licenses. The preliminary estimated fair value of identifiable intangible assets was determined with the assistance of a valuation specialist, using Level 3 inputs as defined under ASC Topic 820. The fair value analysis and related valuations reflect the conclusions of management. All estimates, key assumptions, and forecasts were either provided by or reviewed by the Company. The goodwill and intangible assets acquired are deductible for tax purposes. Th e JourneyCare acquisition accounted for $ 12.2 million and $ 35.3 million of net service revenues and $ 2.4 million and $ 7.0 million of operating income for the three and nine months ended September 30, 2022, respectively. The following table contains unaudited pro forma condensed consolidated income statement information of the Company for the three and nine months ended September 30, 2022 as if the JourneyCare acquisition closed on January 1, 2021. For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2022 2021 Net service revenues $ 231,439 $ 709,283 $ 683,828 Operating income 20,852 46,537 48,136 Net income 14,140 30,347 33,234 Net income per common share - Basic income per share $ 0.90 $ 1.92 $ 2.11 Diluted income per share $ 0.88 $ 1.88 $ 2.07 The pro forma disclosures in the table above include adjustments for amortization of intangible assets, tax expense and acquisition costs to reflect results that are more representative of the combined results of the transactions as if the operations of JourneyCare had been acquired effective January 1, 2021. This pro forma information is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred. In addition, future results may vary significantly from the results reflected in the pro forma information. The unaudited pro forma financial information does not reflect the impact of future events that may occur after the acquisition, such as anticipated cost savings from operating synergies.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2022
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	5. Goodwill and Intangible Assets A summary of the goodwill and related adjustments is provided below: Hospice Personal Care Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2021 $ 328,334 $ 152,688 $ 23,370 $ 504,392 Additions for acquisitions 70,724 70,724 Adjustments to previously recorded goodwill ( 52 ) 141 89 Goodwill as of September 30, 2022 $ 399,006 $ 152,688 $ 23,511 $ 575,205 In connection with the JourneyCare acquisition, the Company recognized goodwill in its hospice segment of $ 70.7 million, during the nine months ended September 30, 2022. See Note 4 for additional information regarding the acquisition. The Company’s identifiable intangible assets consist of customer and referral relationships, trade names and trademarks, non-competition agreements and state licenses. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from five to twenty-five years . Customer and referral relationships are amortized systematically over the periods of expected economic benefit, which range from five to ten years . The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of September 30, 2022: Customer Trade Non- State Total (Amounts in Thousands) Intangible assets with indefinite lives — — — 25,891 25,891 Intangible assets subject to amortization: Gross carrying amount 44,672 51,941 6,785 12,517 115,915 Accumulated amortization ( 37,652 ) ( 20,402 ) ( 4,581 ) ( 6,516 ) ( 69,151 ) Intangible assets subject to amortization, net 7,020 31,539 2,204 6,001 46,764 Total intangible assets at September 30, 2022 $ 7,020 $ 31,539 $ 2,204 $ 31,892 $ 72,655 In connection with the JourneyCare acquisition, the Company recognized a trade name of $ 9.0 million and indefinite lived state licenses of $ 4.8 million in its hospice segment during the three months ended March 31, 2022. See Note 4 f or additional information regarding the acquisition. Amortization expense related to the intangible assets was $ 1.8 million and $ 5.4 milli on for the three and nine months ended September 30, 2022 , respectively, and $ 1.9 million and $ 6.2 million for the three and nine months ended September 30, 2021, respectively. The weighted average remaining useful lives of identifiable intangible assets as of September 30, 2022 was 10.0 years.

Details of Certain Balance Shee

Details of Certain Balance Sheet Accounts	9 Months Ended
	Sep. 30, 2022
Details Of Certain Balance Sheet Accounts [Abstract]
Details of Certain Balance Sheet Accounts	6. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consisted of the following: September 30, 2022 December 31, 2021 (Amounts in Thousands) Prepaid workers' compensation and liability insurance $ 2,244 $ 3,206 Workers' compensation insurance receivable 788 1,559 Income tax receivable - 7,556 Other 5,213 6,170 Total prepaid expenses and other current assets $ 8,245 $ 18,491 Accrued expenses consisted of the following: September 30, 2022 December 31, 2021 (Amounts in Thousands) Current portion of operating lease liabilities $ 10,866 $ 9,774 Payor advances (1) 4,856 6,485 Accrued health insurance 5,847 5,200 Accrued professional fees 3,135 2,978 Accrued income & business tax 4,491 2,281 Other 10,362 10,359 Total accrued expenses $ 39,557 $ 37,077 (1) Represents the deferred portion of payments received from payors for COVID-19 reimbursements which will be recognized as we incur specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel) or will be returned to the extent such related expenses are not incurred.

COVID-19 Pandemic

COVID-19 Pandemic	9 Months Ended
	Sep. 30, 2022
Risks And Uncertainties [Abstract]
COVID-19 Pandemic	7. COVID-19 Pandemic In recognition of the significant threat to the liquidity of financial markets posed by the COVID-19 pandemic, the Federal Reserve and Congress took dramatic actions to provide liquidity to businesses and the banking system in the United States, as described below. Provider Relief Fund One of the primary sources of relief for healthcare providers is the Provider Relief Fund, which has been funded through the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) and related legislation. Provider Relief Fund payments are intended to compensate healthcare providers for lost revenues and health care related expenses incurred in response to the COVID-19 pandemic and are not required to be repaid, provided that recipients attest to and comply with certain terms and conditions, including limitations on balance billing and not using funds received from the Provider Relief Fund to reimburse expenses or losses that other sources are obligated to reimburse. Commercial organizations that receive and expend annual total awards of $ 750,000 or more in federal funding, including payments received through the Provider Relief Fund, are subject to federal audit requirements. In November 2020, the Company received grants in an aggregate principal amount of $ 13.7 million from the Provider Relief Fund, and fully utilized these funds as of December 31, 2021, including $ 0.4 million and $ 11.7 million during the three and nine months ended September 30, 2021, respectively, for healthcare related expenses, including retention payments, attributable to COVID-19 that were unreimbursed by other sources. We properly and fully documented the use of such funds in reports submitted to the U.S. Department of Health & Human Services (“HHS”) in the quarter ended March 31, 2022. During the quarter ended September 30, 2022, we submitted an unmodified audit report to HHS in accordance with Generally Accepted Government Auditing Standards, as required for commercial organizations that received and expended total awards of $ 750,000 or more. Payroll tax deferral The CARES Act also provided for certain federal income and other tax changes, including allowing for the deferral of the employer portion of Social Security payroll taxes through December 31, 2020. The Company received a cash benefit of approximately $ 7.1 million related to the deferral of employer payroll taxes for 2020 under the CARES Act, for the period April 2, 2020 through June 30, 2020. As of September 30, 2022 and December 31, 2021, the deferred portion of employer Social Security payroll taxes was $ 4.1 million, which is included within Government stimulus advances on the Company’s Unaudited Condensed Consolidated Balance Sheets. The payroll tax deferral requires that the remaining deferred payroll taxes be paid by December 31, 2022. ARPA Spending Plans The American Rescue Plan Act of 2021 (“ARPA”), which became law on March 11, 2021, provides for $ 350 billion in relief funding for eligible state, local, territorial, and Tribal governments to mitigate the fiscal effects of the COVID-19 public health emergency. Additionally, the law provides for a 10 -percentage point increase in federal matching funds for Medicaid home and community based services (“HCBS”) from April 1, 2021, through March 31, 2022, provided the state satisfied certain conditions. States are permitted to use the state funds equivalent to the additional federal funds through March 31, 2025. States must use the monies attributable to this matching fund increase to supplement, not supplant, their level of state spending for the implementation of activities enhanced under the Medicaid HCBS in effect as of April 1, 2021. HCBS spending plans for the additional matching funds vary by state, but common initiatives in which the Company is participating include those aimed at strengthening the provider workforce (e.g., efforts to recruit, retain, and train direct service providers). The Company is required to properly and fully document the use of such funds in reports to the state in which the funds originated. Funds may be subject to recoupment if not expended or if they are expended on non-approved uses During the nine months ended September 30, 2022, the Company received state funding provided by the ARPA in an aggregate am ount of $ 22.4 million. The Company recorded revenue of $ 1.7 million and related cost of service revenues of $ 1.3 million for certain states that met the reven ue recognition criteria. The Company deferred the remaining $ 20.7 million, which was received from states with specific spending plans and reporting requirements. The Company utilize d $ 3.2 million and $ 3.6 million of these funds during the three and nine months ended September 30, 2022, respectively, primarily for caregivers and adding support to recruiting and retention efforts, included as a reduction of cost of service revenues in the Company’s Unaudited Condensed Consolidated Statements of Income. As of September 30, 2022, the deferred portion of ARPA funding was $ 17.0 million, which is included within Government stimulus advances on the Company’s Unaudited Condensed Consolidated Balance Sheets. Medicare sequester The CARES Act and related laws temporarily lifted the Medicare sequester which would have otherwise reduced payments to Medicare providers by 2 %, as required by the Budget Control Act of 2011, from May 1, 2020, through December 31, 2021. Congress further delayed these sequestration cuts through March 31, 2022, and reduced the sequestration adjustment to 1 % from April 1 through June 30, 2022. The full 2 % reduction resumed July 1, 2022. These sequestration cuts have been extended through 2030, with the reductions for 2030 set to increase to 2.25 % for the first six months and to 3 % for the second six months. In the hospice segment, Medicare sequester relief r esulted in an increase in net service revenues of $ 0.0 million and $ 0.7 million for the three months ended September 30, 2022 and 2021, respectively, and $ 1.4 million and $ 2.1 million for the nine months ended September 30, 2022 and 2021, respectively. In the home health segment, Medicare sequester relief resulted in an increase in net service revenues of $ 0.0 million and $ 0.1 million for the three months ended September 30, 2022 and 2021, respectively, and $ 0.3 million for both nine month periods ended September 30, 2022 and 2021. The ARPA increases the federal budget deficit in a manner that triggers an additional statutorily mandated sequestration under the Pay-As-You-Go Act of 2010 (“PAYGO Act”). As a result, an additional Medicare payment reduction of up to 4 % was required to take effect in January 2022. However, Congress delayed implementation of this payment reduction until 2023. We cannot currently determine if, or to what extent, our business, results of operations, financial condition or liquidity will ultimately be impacted by mandated sequestration triggers under the PAYGO Act, or if or when the mandated sequestration will occur. For the three and nine months ended September 30, 2022, COVID-19-related expenses in our personal care segment were approximately $ 0.9 million and $ 3.7 million, respectively, and are included in cost of service revenues on the Consolidated Statements of Income . For the three and nine months ended September 30, 2021, COVID-19-related expenses in our personal care segment were approximately $ 1.3 million and $ 14.6 million, respectively, which were offset by $ 0.4 million and $ 11.7 million, respectively, related to the utilization of a portion of the funds received from the Provider Relief Fund in November 2020 and included in cost of service revenues on the Condensed Consolidated Statements of Income. Additionally, the Company recognized revenue of $ 1.3 million and $ 4.3 million attributable to temporary rate increases from certain payors in our personal care segment for the three and nine months ended September 30, 2022, respectively, and $ 1.3 million and $ 6.1 million for the three and nine months ended September 30, 2021, respectively. For the three and nine months ended September 30, 2021, COVID-19-related expenses in our hospice segment were approximately $ 1.9 million, which were offset by $ 1.9 million, related to the utilization of a portion of the funds received from the Queen City Hospice Provider Relief Fund and included in cost of service revenues on the Condensed Consolidated Statements of Income. Although the United States has experienced a moderation of infection and related hospitalization rates, there continues to be a significant number of COVID-19 cases and deaths in the United States and throughout the world. Given the longer-term uncertainties associated with the COVID-19 pandemic, it is impossible to predict the effect and ultimate impact of the COVID-19 pandemic on the Company as conditions related to the COVID-19 pandemic continue to evolve.

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2022
Long Term Debt [Abstract]
Long-Term Debt	8. Long-Term Debt Long-term debt consisted of the following: September 30, 2022 December 31, 2021 (Amounts in Thousands) Revolving loan under the credit facility $ 166,853 $ 224,853 Less unamortized issuance costs ( 3,296 ) ( 3,941 ) Long-term debt $ 163,557 $ 220,912 Amended and Restated Senior Secured Credit Facility On October 31, 2018, the Company entered into the Amended and Restated Credit Agreement, dated as of October 31, 2018, with certain lenders and Capital One, National Association, as a lender and as agent for all lenders, as amended by the First Amendment to Amended and Restated Credit Agreement, dated as of September 12, 2019, and as further amended by the Second Amendment to Amended and Restated Credit Agreement, dated as of July 30, 2021 (as amended, the “Credit Agreement”; as used throughout this Quarterly Report on Form 10-Q, “credit facility” shall mean the credit facility evidenced by the Credit Agreement). The credit facility consists of a $ 600.0 million revolving credit facility and a $ 125.0 million incremental loan facility, which incremental loan facility may be for term loans or an increase to the revolving loan commitments. The maturity of this credit facility is July 30, 2026 . Interest on the credit facility may be payable at (x) the sum of (i) an applicable margin ranging from 0.75 % to 1.50 % based on the applicable senior net leverage ratio plus (ii) a base rate equal to the greatest of (a) the rate of interest last quoted by The Wall Street Journal as the “prime rate,” (b) the sum of the federal funds rate plus a margin of 0.50 % and (c) the sum of the adjusted LIBOR that would be applicable to a loan with an interest period of one month advanced on the applicable day (not to be less than 0.00 %) plus a margin of 1.00 % or (y) the sum of (i) an applicable margin ranging from 1.75 % to 2.50 % based on the applicable senior net leverage ratio plus (ii) the offered rate per annum for similar dollar deposits for the applicable interest period that appears on Reuters Screen LIBOR01 Page (not to be less than zero). Swing loans may not be LIBOR loans. The availability of additional draws under this credit facility is conditioned, among other things, upon (after giving effect to such draws) the Total Net Leverage Ratio (as defined in the Credit Agreement) not exceeding 3.75 :1.00. In certain circumstances, in connection with a Material Acquisition (as defined in the Credit Agreement), the Company can elect to increase its Total Net Leverage Ratio compliance covenant to 4.25 :1.00 for the then current fiscal quarter and the three succeeding fiscal quarters. Addus HealthCare, Inc. (“Addus HealthCare”) is the borrower, and its parent, Holdings, and substantially all of Holdings’ subsidiaries are guarantors under this credit facility, and it is collateralized by a first priority security interest in all of the Company’s and the other credit parties’ current and future tangible and intangible assets, including the shares of stock of the borrower and subsidiaries. The Credit Agreement contains affirmative and negative covenants customary for credit facilities of this type, including limitations on the Company with respect to liens, indebtedness, guaranties, investments, distributions, mergers and acquisitions and dispositions of assets. The Credit Agreement contains customary affirmative covenants regarding, among other things, the maintenance of records, compliance with laws, maintenance of permits, maintenance of insurance and property and payment of taxes. The Credit Agreement also contains certain customary financial covenants and negative covenants that, among other things, include a requirement to maintain a minimum Interest Coverage Ratio (as defined in the Credit Agreement), a requirement to stay below a maximum Total Net Leverage Ratio (as defined in the Credit Agreement) and a requirement to stay below a maximum permitted amount of capital expenditures. The Credit Agreement also contains restrictions on guarantees, indebtedness, liens, investments and loans, subject to customary carve outs, a restriction on dividends (provided that Addus HealthCare may make distributions to the Company in an amount that does not exceed $ 7.5 million in any year absent of an event of default, plus limited exceptions for tax and administrative distributions), a restriction on the ability to consummate acquisitions (without the consent of the lenders) under its credit facility subject to compliance with the Total Net Leverage Ratio (as defined in the Credit Agreement thresholds), restrictions on mergers, dispositions of assets, and affiliate transactions, and restrictions on fundamental changes and lines of business. The Company pays a fee ranging from 0.20 % to 0.35 % based on the applicable senior net leverage ratio times the unused portion of the revolving loan portion of the credit facility. The credit facility contains hardwired fallback language that contemplates a transition from LIBOR, and specifically identifies SOFR as the replacement reference rate and details the mechanism for transition at LIBOR cessation, which is anticipated to occur on June 30, 2023. The transition to SOFR is not expected to have a material impact on the Company’s results of operations or liquidity. During the nine months ended September 30, 2022 , the Company (i) drew $ 47.0 million under its credit facility to fund, in part, the JourneyCare and Apple Home acquisitions and (ii) repaid $ 105.0 million under the revolving credit facility. During the nine months ended September 30, 2021, the Company drew $ 29.0 million under its credit facility. At September 30, 2022, the Company had a total of $ 166.9 million of revolving loans, with an interest rate of 5.11 %, outstanding on its credit facility. After giving effect to the amount drawn on its credit facility, approximately $ 8.1 million of outstanding letters of credit and borrowing limits based on an advance multiple of adjusted EBITDA (as defined in the Credit Agreement), the Company had $ 375.5 million of capacity and $ 200.5 million available for borrowing under its credit facility. As of December 31, 2021, the Company had a total of $ 224.9 million of revolving loans, with an interest rate of 2.10 %, outstanding on its credit facility. As of September 30, 2022, the Company was in compliance with all financial covenants under the Credit Agreement.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Income Taxes	9. Income Taxes The effective income tax rates were 23.7 % and 26.6 % for the three months ended September 30, 2022 and 2021, respectively. The difference between our federal statutory and effective income tax rates is principally due to the inclusion of state taxes, non-deductible compensation and an excess tax expense, partially offset by the use of federal employment tax credits. The effective income tax rates were 25.4 % and 24.7 % for the nine months ended September 30, 2022 and 2021 , respectively. For the nine months ended September 30, 2022, the difference between our federal statutory and effective income tax rates was principally due to the inclusion of state taxes, non-deductible compensation, and excess tax expense, partially offset by the use of federal employment tax credits. For the nine months ended September 30, 2022 and 2021, the effective tax rates were inclusive of an excess tax expense of 0.8 % and an excess tax benefit of 2.1 %, respectively. The excess tax expense or benefit is a discrete item, related to the vesting of equity shares, which requires the Company to recognize the expense or benefit fully in the period. An excess tax expense results if the Company’s cumulative costs of the award recognized exceed the income tax deduction on the Unaudited Condensed Consolidated Statements of Income, whereas an excess tax benefit results if the Company’s cumulative costs of the award recognized are less than the income tax deduction on the Unaudited Condensed Consolidated Statements of Income.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2022
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	10. Commitments and Contingencies Legal Proceedings From time to time, the Company is subject to legal and/or administrative proceedings incidental to its business. On June 2, 2021, the Company received a $ 6.5 million Request for Repayment from Palmetto, GBA, LLC (“Palmetto”), a Medicare administrative contractor, regarding Ambercare Hospice Inc. (“Ambercare”), our subsidiary that provides hospice services in New Mexico. In 2018, the Office of Audit Services (“OAS”), under the HHS Office of Inspector General, initiated a clinical review of certain hospice claims billed during a timeframe from January 1, 2016 to December 31, 2017. The OAS review concluded that certain payments to Ambercare for hospice services during the review period were made in error. The Company acquired Ambercare in May 2018 and has a contractual right to full indemnification from any potential losses from the OAS review through the terms of the Ambercare purchase agreement. The Company disputes the results of the OAS review and related asserted billing errors and is in the process of filing administrative appeals. At this stage, the Company cannot predict the ultimate outcome of the appeal process. It is the opinion of management that the outcome of pending legal and/or administrative proceedings will not have a material effect on the Company’s Unaudited Condensed Consolidated Balance Sheets and Unaudited Condensed Consolidated Statements of Income.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Segment Information	11. Segment Information Operating segments are defined as components of a company that engage in business activities from which it may earn revenues and incur expenses, and for which separate financial information is available and is regularly reviewed by the Company’s chief operating decision makers, to assess the performance of the individual segments and make decisions about resources to be allocated to the segments. The Company operates as a multi-state provider of three distinct but related business segments providing in-home services. In its personal care segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy. The tables below set forth information about the Company’s reportable segments, along with the items necessary to reconcile the segment information to the totals reported in the accompanying Unaudited Condensed Consolidated Financial Statements. Segment assets are not reviewed by the Company’s chief operating decision maker function and therefore are not disclosed below. Segment operating income consists of revenue generated by a segment, less the direct costs of service revenues and general and administrative expenses that are incurred directly by the segment. Unallocated general and administrative costs are those costs for functions performed in a centralized manner and therefore not attributable to a particular segment. These costs include accounting, finance, human resources, legal, information technology, corporate office support and facility costs and overall corporate management. For the Three Months Ended September 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 179,180 $ 51,359 $ 9,956 $ 240,495 Cost of services revenues $ 131,968 $ 25,695 $ 7,647 165,310 Gross profit $ 47,212 $ 25,664 $ 2,309 75,185 General and administrative expenses $ 15,238 $ 12,550 $ 2,410 30,198 Segment operating income $ 31,974 $ 13,114 $ ( 101 ) $ 44,987 For the Three Months Ended September 30, 2021 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 169,609 $ 39,095 $ 7,958 $ 216,662 Cost of services revenues 125,647 18,992 4,977 149,616 Gross profit 43,962 20,103 2,981 67,046 General and administrative expenses 15,166 8,880 1,477 25,523 Segment operating income $ 28,796 $ 11,223 $ 1,504 $ 41,523 For the Three Months Ended September 30, 2022 2021 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 44,987 $ 41,523 Items not allocated at segment level: Other general and administrative expenses 24,030 20,757 Depreciation and amortization 3,441 3,406 Interest income ( 83 ) ( 37 ) Interest expense 2,472 1,614 Income before income taxes $ 15,127 $ 15,783 For the Nine Months Ended September 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 523,142 $ 151,160 $ 29,768 $ 704,070 Cost of services revenues 386,940 74,659 21,501 483,100 Gross profit 136,202 76,501 8,267 220,970 General and administrative expenses 45,688 37,298 7,270 90,256 Segment operating income $ 90,514 $ 39,203 $ 997 $ 130,714 For the Nine Months Ended September 30, 2021 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 510,744 $ 112,098 $ 17,015 $ 639,857 Cost of services revenues 375,744 56,500 10,560 442,804 Gross profit 135,000 55,598 6,455 197,053 General and administrative expenses 46,807 26,016 3,410 76,233 Segment operating income $ 88,193 $ 29,582 $ 3,045 $ 120,820 For the Nine Months Ended September 30, 2022 2021 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 130,714 $ 120,820 Items not allocated at segment level: Other general and administrative expenses 72,220 63,648 Depreciation and amortization 10,571 10,594 Interest income ( 249 ) ( 90 ) Interest expense 6,278 4,092 Income before income taxes $ 41,894 $ 42,576

Significant Payors

Significant Payors	9 Months Ended
	Sep. 30, 2022
Significant Payors [Abstract]
Significant Payors	12. Significant Payors The Company’s revenue by payor type was as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of State, local and other governmental programs $ 88,448 49.4 % $ 83,821 49.5 % $ 257,817 49.4 % $ 253,052 49.5 % Managed care organizations 83,199 46.4 76,890 45.3 241,164 46.1 231,211 45.3 Private pay 4,521 2.6 4,934 2.9 13,758 2.6 14,883 2.9 Commercial insurance 1,870 1.0 2,459 1.4 5,988 1.1 7,481 1.5 Other 1,142 0.6 1,505 0.9 4,415 0.8 4,117 0.8 Total personal care segment net service revenues $ 179,180 100.0 % $ 169,609 100.0 % $ 523,142 100.0 % $ 510,744 100.0 % Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of Medicare $ 46,537 90.6 % $ 36,280 92.7 % $ 137,174 90.8 % $ 104,715 93.4 % Commercial insurance 2,772 5.4 1,154 3.0 7,742 5.1 2,648 2.4 Managed care organizations 1,815 3.5 1,514 3.9 5,498 3.6 4,396 3.9 Other 235 0.5 147 0.4 746 0.5 339 0.3 Total hospice segment net service revenues $ 51,359 100.0 % $ 39,095 100.0 % $ 151,160 100.0 % $ 112,098 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of Medicare $ 7,320 73.5 % $ 6,372 80.1 % $ 21,727 73.0 % $ 13,699 80.5 % Managed care organizations 1,998 20.1 1,218 15.3 6,160 20.7 2,838 16.7 Other 638 6.4 368 4.6 1,881 6.3 478 2.8 Total home health segment net service revenues $ 9,956 100.0 % $ 7,958 100.0 % $ 29,768 100.0 % $ 17,015 100.0 % The Company derives a significant amount of its revenue from its operations in Illinois, New Mexico and New York. The percentages of segment revenue for each of these significant states were as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of Illinois $ 92,804 51.8 % $ 81,959 48.3 % $ 266,284 50.9 % $ 240,131 47.0 % New Mexico 26,912 15.0 24,214 14.3 78,825 15.1 73,291 14.3 New York (1) 20,997 11.7 24,127 14.2 63,510 12.1 77,237 15.1 All other states 38,467 21.5 39,309 23.2 114,523 21.9 120,085 23.6 Total personal care segment net service revenues $ 179,180 100.0 % $ 169,609 100.0 % $ 523,142 100.0 % $ 510,744 100.0 % (1) In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure CDPAP fiscal intermediaries. The Company was not selected in the initial RFO process. We submitted a formal protest in response to the selection process, which was filed and accepted in March 2021, but we have not received a response to the formal protest. The Company continues to consider other arrangements and to pursue our protest of the award. The New York fiscal year 2023 state budget, passed in April 2022, amends the current Fiscal Intermediary RFO process to authorize all fiscal intermediaries that submitted an RFO application and served at least 200 clients in New York City or 50 clients in other counties between January 1, 2020 and March 31, 2020 to contract with the New York State Department of Health and continue to operate in all counties contained in their application, if the fiscal intermediary submits an attestation and supporting information to the New York State Department of Health no later than November 29, 2022. Under this provision, the Company is allowed to continue to contract with all of its current payors for CDPAP services, as of the contract award date, which is anticipated to be January 15, 2023. The Company continues to assess the future of its participation in this program. Given the status of the program, the Company has suspended materially all of its new patient admissions under the New York CDPAP program. Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of Ohio $ 18,139 35.3 % $ 15,868 40.6 % $ 51,714 34.2 % $ 44,676 39.8 % Illinois (2) 12,188 23.7 — — 35,290 23.3 — — New Mexico 7,789 15.2 9,268 23.7 23,867 15.8 27,216 24.3 All other states 13,243 25.8 13,959 35.7 40,289 26.7 40,206 35.9 Total hospice segment net service revenues $ 51,359 100.0 % $ 39,095 100.0 % $ 151,160 100.0 % $ 112,098 100.0 % (2) With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois . Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of New Mexico $ 8,375 84.1 % $ 7,958 100.0 % $ 24,954 83.8 % $ 17,015 100.0 % Illinois (3) 1,581 15.9 — — 4,814 16.2 — — Total home health segment net service revenues $ 9,956 100.0 % $ 7,958 100.0 % $ 29,768 100.0 % $ 17,015 100.0 % (3) With the acquisition of Summit Home Health, LLC (“Summit”) on October 1, 2021, the Company expanded its home health services in the state of Illinois . A substantial portion of the Company’s revenue and accounts receivable are derived from services performed for federal, state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 44.3 %, and 37.8 % of our net service revenues for the three months ended September 30, 2022, and 2021, respectively, and accounted for 43.5 % and 37.5 % of our net service revenues for the nine months ended September 30, 2022 and 2021, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 21.0 % and 21.3 % of the Company’s net service revenues for the three months ended September 30, 2022 and 2021, respectively, and accounted for 20.8 % and 21.4 % of the Company’s net service revenues for the nine months ended September 30, 2022 and 2021, respectively. The related receivables due from the Illinois Department on Aging represented 15.3 % and 16.1 % of the Company’s net accounts receivable at September 30, 2022 and December 31, 2021 , respectively.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2022
Subsequent Events [Abstract]
Subsequent Events	13. Subsequent Events On October 1, 2022 , we completed the acquisition of Apple Home HealthCare, LTD ("Apple Home") for approximately $ 12.2 million, with funding provided by drawing on the Company's revolving credit facility. In addition to the initial consideration, the total purchase price also includes potential additional contingent consideration to the previous owners of Apple Home of up to approximately $ 2 million. The contingent consideration will vary based upon performance relative to certain agreed upon earnings targets in 2022 and 2023. With the purchase of Apple Home, the Company expanded clinical services to its home health segment in Illinois. The initial accounting is not yet complete, therefore the related business combination disclosures have not been presented as the Company is currently in the process of valuing the assets acquired and liabilities assumed in the transaction.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying Unaudited Condensed Consolidated Financial Statements and related notes have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”) for Quarterly Reports on Form 10-Q. The accompanying balance sheet as of December 31, 2021 has been derived from the Company’s audited financial statements for the year ended December 31, 2021 previously filed with the SEC. Accordingly, these financial statements do not include all of the information and note disclosures required by accounting principles generally accepted in the United States of America (“GAAP”) for annual financial statements and should be read in conjunction with our consolidated financial statements and notes thereto for the year ended December 31, 2021 included in our Annual Report on Form 10-K, which includes information and disclosures not included herein. In the opinion of management, these financial statements reflect all adjustments of a normal, recurring nature necessary for the fair statement of our financial position, results of operations, and cash flows for the interim periods presented in conformity with GAAP. Our results for any interim period are not necessarily indicative of results for a full year or any other interim period.
Principles of Consolidation	Principles of Consolidation These Unaudited Condensed Consolidated Financial Statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Estimates	Estimates The financial statements are prepared by management in conformity with GAAP and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: revenue recognition, goodwill and intangibles in business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from those estimates.
Computation of Weighted Average Shares	Computation of Weighted Average Shares The following table sets forth the computation of basic and diluted common shares: For the Three Months Ended September 30, For the Nine Months Ended September 30, (Amounts in thousands) (Amounts in thousands) 2022 2021 2022 2021 Weighted average number of shares outstanding for basic per share 15,872 15,748 15,846 15,727 Effect of dilutive potential shares: Stock options 255 267 244 288 Restricted stock awards 57 15 56 45 Adjusted weighted average shares outstanding for diluted per share 16,184 16,030 16,146 16,060 Anti-dilutive shares: Stock options 111 73 111 73 Restricted stock awards 36 125 3 73
Recently Issued and Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In November 2021, the FASB issued ASU 2021-10, Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance . ASU 2021-10 requires entities to disclose certain information about the nature of certain governmental assistance received, including the nature of the transaction and the related accounting policy, the financial statement line items impacted by the assistance, as well as the significant terms and conditions of the transactions. The ASU was adopted as of January 1, 2022 and did no t have an impact on the Company’s results of operations or liquidity. Recently Issued Accounting Pronouncements In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting . ASU 2020-04 provides optional expedients and exceptions for applying GAAP to contract modifications and hedging relationships, and other transactions subject to meeting certain criteria, that reference LIBOR or another reference rate expected to be discontinued. The ASU provides companies with optional guidance to ease the potential accounting burden associated with transitioning away from reference rates that are expected to be discontinued. Therefore, it will be in effect for a limited time through December 31, 2022. The ASU can be adopted no later than December 1, 2022 with early adoption permitted. On July 30, 2021, the Company entered into the Second Amendment to the Credit Agreement as discussed further in Note 8. The Credit Agreement contains hardwired fallback language that contemplates a transition from LIBOR, specifically identifies the secured overnight financing rate (“SOFR”) as the replacement reference rate and details the mechanism for transition at LIBOR cessation, which is anticipated to occur on June 30, 2023. The transition to SOFR is not expected to have a material impact on the Company’s results of operations or liquidity.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Computation of Basic and Diluted Common Shares	The following table sets forth the computation of basic and diluted common shares: For the Three Months Ended September 30, For the Nine Months Ended September 30, (Amounts in thousands) (Amounts in thousands) 2022 2021 2022 2021 Weighted average number of shares outstanding for basic per share 15,872 15,748 15,846 15,727 Effect of dilutive potential shares: Stock options 255 267 244 288 Restricted stock awards 57 15 56 45 Adjusted weighted average shares outstanding for diluted per share 16,184 16,030 16,146 16,060 Anti-dilutive shares: Stock options 111 73 111 73 Restricted stock awards 36 125 3 73

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2022
Leases [Abstract]
Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases	Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows: September 30, 2022 December 31, 2021 (Amounts in Thousands) Operating lease assets, net $ 40,503 $ 36,048 Short-term operating lease liabilities (in accrued expenses) 10,866 9,774 Long-term operating lease liabilities 37,168 32,859 Total operating lease liabilities $ 48,034 $ 42,633
Components of Lease Costs Reported in General and Administrative Expenses in Unaudited Condensed Consolidated Statements of Income	Components of lease costs were reported in general and administrative expenses in the Company’s Unaudited Condensed Consolidated Statements of Income as follows: For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Operating lease costs $ 3,251 $ 2,789 $ 8,888 $ 8,341 Short-term lease costs 589 197 2,251 572 Total lease costs 3,840 2,986 11,139 8,913 Less: sublease income ( 176 ) ( 177 ) ( 529 ) ( 480 ) Total lease costs, net $ 3,664 $ 2,809 $ 10,610 $ 8,433
Schedule of Weighted Average Remaining Lease Terms and Discount Rates	Weighted average remaining lease terms and discount rates were as follows: September 30, 2022 December 31, 2021 Operating leases: Weighted average remaining lease term (years) 5.98 6.39 Weighted average discount rate 3.92 % 3.91 %
Summary of Remaining Operating Lease Payments	Remaining operating lease payments as of September 30, 2022 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2023 $ 12,379 2024 10,645 2025 7,816 2026 5,756 2027 4,433 Thereafter 13,070 Total future minimum rental commitments 54,099 Less: Imputed interest ( 6,065 ) Total lease liabilities $ 48,034
Supplemental Cash Flows Information	For the Nine Months Ended September 30, (Amounts in Thousands) 2022 2021 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 9,752 $ 8,237 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 13,130 $ 5,706

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2022
Business Combinations [Abstract]
Schedule of Fair Values of Assets and Liabilities	Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows: Total Goodwill $ 70,724 Identifiable intangible assets 13,792 Cash 500 Accounts receivable 8,171 Property and equipment 1,194 Operating lease assets, net 3,728 Other assets 333 Accrued expenses ( 6,799 ) Accrued payroll ( 1,511 ) Long-term operating lease liabilities ( 3,537 ) Total purchase price $ 86,595
Unaudited Pro Forma Condensed Consolidated Income Statement Information	The following table contains unaudited pro forma condensed consolidated income statement information of the Company for the three and nine months ended September 30, 2022 as if the JourneyCare acquisition closed on January 1, 2021. For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2022 2021 Net service revenues $ 231,439 $ 709,283 $ 683,828 Operating income 20,852 46,537 48,136 Net income 14,140 30,347 33,234 Net income per common share - Basic income per share $ 0.90 $ 1.92 $ 2.11 Diluted income per share $ 0.88 $ 1.88 $ 2.07

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2022
Goodwill And Intangible Assets Disclosure [Abstract]
Summary of Goodwill and Related Adjustments	A summary of the goodwill and related adjustments is provided below: Hospice Personal Care Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2021 $ 328,334 $ 152,688 $ 23,370 $ 504,392 Additions for acquisitions 70,724 70,724 Adjustments to previously recorded goodwill ( 52 ) 141 89 Goodwill as of September 30, 2022 $ 399,006 $ 152,688 $ 23,511 $ 575,205
Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset	The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of September 30, 2022: Customer Trade Non- State Total (Amounts in Thousands) Intangible assets with indefinite lives — — — 25,891 25,891 Intangible assets subject to amortization: Gross carrying amount 44,672 51,941 6,785 12,517 115,915 Accumulated amortization ( 37,652 ) ( 20,402 ) ( 4,581 ) ( 6,516 ) ( 69,151 ) Intangible assets subject to amortization, net 7,020 31,539 2,204 6,001 46,764 Total intangible assets at September 30, 2022 $ 7,020 $ 31,539 $ 2,204 $ 31,892 $ 72,655

Details of Certain Balance Sh_2

Details of Certain Balance Sheet Accounts (Tables)	9 Months Ended
	Sep. 30, 2022
Details Of Certain Balance Sheet Accounts [Abstract]
Schedule of Prepaid Expenses and Other Current Assets	Prepaid expenses and other current assets consisted of the following: September 30, 2022 December 31, 2021 (Amounts in Thousands) Prepaid workers' compensation and liability insurance $ 2,244 $ 3,206 Workers' compensation insurance receivable 788 1,559 Income tax receivable - 7,556 Other 5,213 6,170 Total prepaid expenses and other current assets $ 8,245 $ 18,491
Schedule of Accrued Expenses	Accrued expenses consisted of the following: September 30, 2022 December 31, 2021 (Amounts in Thousands) Current portion of operating lease liabilities $ 10,866 $ 9,774 Payor advances (1) 4,856 6,485 Accrued health insurance 5,847 5,200 Accrued professional fees 3,135 2,978 Accrued income & business tax 4,491 2,281 Other 10,362 10,359 Total accrued expenses $ 39,557 $ 37,077 (1) Represents the deferred portion of payments received from payors for COVID-19 reimbursements which will be recognized as we incur specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel) or will be returned to the extent such related expenses are not incurred.

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2022
Long Term Debt [Abstract]
Schedule of Long-Term Debt	Long-term debt consisted of the following: September 30, 2022 December 31, 2021 (Amounts in Thousands) Revolving loan under the credit facility $ 166,853 $ 224,853 Less unamortized issuance costs ( 3,296 ) ( 3,941 ) Long-term debt $ 163,557 $ 220,912

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Summary of Segment Information	For the Three Months Ended September 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 179,180 $ 51,359 $ 9,956 $ 240,495 Cost of services revenues $ 131,968 $ 25,695 $ 7,647 165,310 Gross profit $ 47,212 $ 25,664 $ 2,309 75,185 General and administrative expenses $ 15,238 $ 12,550 $ 2,410 30,198 Segment operating income $ 31,974 $ 13,114 $ ( 101 ) $ 44,987 For the Three Months Ended September 30, 2021 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 169,609 $ 39,095 $ 7,958 $ 216,662 Cost of services revenues 125,647 18,992 4,977 149,616 Gross profit 43,962 20,103 2,981 67,046 General and administrative expenses 15,166 8,880 1,477 25,523 Segment operating income $ 28,796 $ 11,223 $ 1,504 $ 41,523 For the Three Months Ended September 30, 2022 2021 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 44,987 $ 41,523 Items not allocated at segment level: Other general and administrative expenses 24,030 20,757 Depreciation and amortization 3,441 3,406 Interest income ( 83 ) ( 37 ) Interest expense 2,472 1,614 Income before income taxes $ 15,127 $ 15,783 For the Nine Months Ended September 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 523,142 $ 151,160 $ 29,768 $ 704,070 Cost of services revenues 386,940 74,659 21,501 483,100 Gross profit 136,202 76,501 8,267 220,970 General and administrative expenses 45,688 37,298 7,270 90,256 Segment operating income $ 90,514 $ 39,203 $ 997 $ 130,714 For the Nine Months Ended September 30, 2021 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 510,744 $ 112,098 $ 17,015 $ 639,857 Cost of services revenues 375,744 56,500 10,560 442,804 Gross profit 135,000 55,598 6,455 197,053 General and administrative expenses 46,807 26,016 3,410 76,233 Segment operating income $ 88,193 $ 29,582 $ 3,045 $ 120,820 For the Nine Months Ended September 30, 2022 2021 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 130,714 $ 120,820 Items not allocated at segment level: Other general and administrative expenses 72,220 63,648 Depreciation and amortization 10,571 10,594 Interest income ( 249 ) ( 90 ) Interest expense 6,278 4,092 Income before income taxes $ 41,894 $ 42,576

Significant Payors (Tables)

Significant Payors (Tables)	9 Months Ended
	Sep. 30, 2022
Significant Payors [Abstract]
Schedule of Revenue by Payor Type	The Company’s revenue by payor type was as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of State, local and other governmental programs $ 88,448 49.4 % $ 83,821 49.5 % $ 257,817 49.4 % $ 253,052 49.5 % Managed care organizations 83,199 46.4 76,890 45.3 241,164 46.1 231,211 45.3 Private pay 4,521 2.6 4,934 2.9 13,758 2.6 14,883 2.9 Commercial insurance 1,870 1.0 2,459 1.4 5,988 1.1 7,481 1.5 Other 1,142 0.6 1,505 0.9 4,415 0.8 4,117 0.8 Total personal care segment net service revenues $ 179,180 100.0 % $ 169,609 100.0 % $ 523,142 100.0 % $ 510,744 100.0 % Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of Medicare $ 46,537 90.6 % $ 36,280 92.7 % $ 137,174 90.8 % $ 104,715 93.4 % Commercial insurance 2,772 5.4 1,154 3.0 7,742 5.1 2,648 2.4 Managed care organizations 1,815 3.5 1,514 3.9 5,498 3.6 4,396 3.9 Other 235 0.5 147 0.4 746 0.5 339 0.3 Total hospice segment net service revenues $ 51,359 100.0 % $ 39,095 100.0 % $ 151,160 100.0 % $ 112,098 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of Medicare $ 7,320 73.5 % $ 6,372 80.1 % $ 21,727 73.0 % $ 13,699 80.5 % Managed care organizations 1,998 20.1 1,218 15.3 6,160 20.7 2,838 16.7 Other 638 6.4 368 4.6 1,881 6.3 478 2.8 Total home health segment net service revenues $ 9,956 100.0 % $ 7,958 100.0 % $ 29,768 100.0 % $ 17,015 100.0 %
Schedule of Revenue by Geographic Location	The percentages of segment revenue for each of these significant states were as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of Illinois $ 92,804 51.8 % $ 81,959 48.3 % $ 266,284 50.9 % $ 240,131 47.0 % New Mexico 26,912 15.0 24,214 14.3 78,825 15.1 73,291 14.3 New York (1) 20,997 11.7 24,127 14.2 63,510 12.1 77,237 15.1 All other states 38,467 21.5 39,309 23.2 114,523 21.9 120,085 23.6 Total personal care segment net service revenues $ 179,180 100.0 % $ 169,609 100.0 % $ 523,142 100.0 % $ 510,744 100.0 % (1) In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure CDPAP fiscal intermediaries. The Company was not selected in the initial RFO process. We submitted a formal protest in response to the selection process, which was filed and accepted in March 2021, but we have not received a response to the formal protest. The Company continues to consider other arrangements and to pursue our protest of the award. The New York fiscal year 2023 state budget, passed in April 2022, amends the current Fiscal Intermediary RFO process to authorize all fiscal intermediaries that submitted an RFO application and served at least 200 clients in New York City or 50 clients in other counties between January 1, 2020 and March 31, 2020 to contract with the New York State Department of Health and continue to operate in all counties contained in their application, if the fiscal intermediary submits an attestation and supporting information to the New York State Department of Health no later than November 29, 2022. Under this provision, the Company is allowed to continue to contract with all of its current payors for CDPAP services, as of the contract award date, which is anticipated to be January 15, 2023. The Company continues to assess the future of its participation in this program. Given the status of the program, the Company has suspended materially all of its new patient admissions under the New York CDPAP program. Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of Ohio $ 18,139 35.3 % $ 15,868 40.6 % $ 51,714 34.2 % $ 44,676 39.8 % Illinois (2) 12,188 23.7 — — 35,290 23.3 — — New Mexico 7,789 15.2 9,268 23.7 23,867 15.8 27,216 24.3 All other states 13,243 25.8 13,959 35.7 40,289 26.7 40,206 35.9 Total hospice segment net service revenues $ 51,359 100.0 % $ 39,095 100.0 % $ 151,160 100.0 % $ 112,098 100.0 % (2) With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois . Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2022 2021 2022 2021 Amount % of Amount % of Amount % of Amount % of New Mexico $ 8,375 84.1 % $ 7,958 100.0 % $ 24,954 83.8 % $ 17,015 100.0 % Illinois (3) 1,581 15.9 — — 4,814 16.2 — — Total home health segment net service revenues $ 9,956 100.0 % $ 7,958 100.0 % $ 29,768 100.0 % $ 17,015 100.0 % (3) With the acquisition of Summit Home Health, LLC (“Summit”) on October 1, 2021, the Company expanded its home health services in the state of Illinois .

Nature of Operations, Consoli_2

Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details)	9 Months Ended
	Sep. 30, 2022 Segment
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Number of operating segments	3

Summary of Significant Accoun_4

Summary of Significant Accounting Policies (Computation of Basic and Diluted Common Shares) (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Summary Of Significant Accounting Policies [Line Items]
Weighted average number of shares outstanding for basic per share calculation	15,872	15,748	15,846	15,727
Effect of dilutive potential shares:
Adjusted weighted average shares outstanding for diluted per share	16,184	16,030	16,146	16,060
Stock Options [Member]
Effect of dilutive potential shares:
Effect of dilutive potential shares	255	267	244	288
Anti-dilutive shares:
Anti-dilutive shares	111	73	111	73
Restricted Stock Awards [Member]
Effect of dilutive potential shares:
Effect of dilutive potential shares	57	15	56	45
Anti-dilutive shares:
Anti-dilutive shares	36	125	3	73

Summary of Significant Accoun_5

Summary of Significant Accounting Policies (Narrative) (Details) - ASU 2021-10 [Member]	Sep. 30, 2022
Summary Of Significant Accounting Policies [Line Items]
Change in accounting principle, accounting standards update, adopted	true
Change in accounting principle, accounting standards update, immaterial effect	true
Change in accounting principle, accounting standards update, adoption date	Jan. 01, 2022

Leases (Amounts Reported in Una

Leases (Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Leases [Abstract]
Operating lease assets, net	$ 40,503	$ 36,048
Short-term operating lease liabilities (in accrued expenses)	$ 10,866	$ 9,774
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued expenses	Accrued expenses
Long-term operating lease liabilities	$ 37,168	$ 32,859
Total operating lease liabilities	$ 48,034	$ 42,633

Leases (Components of Lease Cos

Leases (Components of Lease Costs Reported in General and Administrative Expenses in Unaudited Condensed Consolidated Statements of Income) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Leases [Abstract]
Operating lease costs	$ 3,251	$ 2,789	$ 8,888	$ 8,341
Short-term lease costs	589	197	2,251	572
Total lease costs	3,840	2,986	11,139	8,913
Less: sublease income	(176)	(177)	(529)	(480)
Total lease costs, net	$ 3,664	$ 2,809	$ 10,610	$ 8,433

Leases (Schedule of Weighted Av

Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details)	Sep. 30, 2022	Dec. 31, 2021
Leases [Abstract]
Weighted average remaining lease term (years)	5 years 11 months 23 days	6 years 4 months 20 days
Weighted average discount rate	3.92%	3.91%

Leases (Summary of Remaining Op

Leases (Summary of Remaining Operating Lease Payments) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Leases [Abstract]
2023	$ 12,379
2024	10,645
2025	7,816
2026	5,756
2027	4,433
Thereafter	13,070
Total future minimum rental commitments	54,099
Less: Imputed interest	(6,065)
Total lease liabilities	$ 48,034	$ 42,633

Leases (Supplemental Cash Flows

Leases (Supplemental Cash Flows Information) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 9,752	$ 8,237
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 13,130	$ 5,706

Acquisitions (Narrative) (Detai

Acquisitions (Narrative) (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
	Feb. 01, 2022	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Business Acquisition [Line Items]
Total purchase price for business acquisition				$ 84,490	$ 29,219
Net service revenues		$ 240,495	$ 216,662	704,070	$ 639,857
JourneyCare [Member]
Business Acquisition [Line Items]
Net service revenues		12,200		35,300
Operating income (loss) from continuing operations		2,400		7,000
JourneyCare [Member] | Trade Names [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired	$ 9,000
JourneyCare [Member] | State Licenses [Member]
Business Acquisition [Line Items]
Indefinite lived intangible assets acquired	4,800
JourneyCare [Member] | Illinois [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition	86,600
Acquisition related costs		100		500
Integration costs		$ 800		$ 3,900
Excess cash held by acquired business	500
Business combination finalization of net working capital payable	1,600
Revolving Credit Loan [Member] | JourneyCare [Member] | Illinois [Member]
Business Acquisition [Line Items]
Line of credit outstanding amount	$ 35,000

Acquisitions (Schedule of Fair

Acquisitions (Schedule of Fair Values of Assets and Liabilities) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Feb. 01, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Goodwill	$ 575,205		$ 504,392
JourneyCare [Member]
Business Acquisition [Line Items]
Goodwill		$ 70,724
Identifiable intangible assets		13,792
Cash		500
Accounts receivable		8,171
Property and equipment		1,194
Operating lease assets, net		3,728
Other assets		333
Accrued expenses		(6,799)
Accrued payroll		(1,511)
Long-term operating lease liabilities		(3,537)
Total purchase price		$ 86,595

Acquisitions (Unaudited Pro For

Acquisitions (Unaudited Pro Forma Condensed Consolidated Income Statement Information) (Details) - JourneyCare [Member] - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Business Acquisition [Line Items]
Net service revenues	$ 231,439	$ 709,283	$ 683,828
Operating income	20,852	46,537	48,136
Net income	$ 14,140	$ 30,347	$ 33,234
Basic income per share	$ 0.90	$ 1.92	$ 2.11
Diluted income per share	$ 0.88	$ 1.88	$ 2.07

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2022 USD ($)
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 504,392
Additions for acquisitions	70,724
Adjustments to previously recorded goodwill	89
Goodwill, at End of Period	575,205
Hospice [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	328,334
Additions for acquisitions	70,724
Adjustments to previously recorded goodwill	(52)
Goodwill, at End of Period	399,006
Personal Care [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	152,688
Goodwill, at End of Period	152,688
Home Health [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	23,370
Adjustments to previously recorded goodwill	141
Goodwill, at End of Period	$ 23,511

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Thousands		3 Months Ended			9 Months Ended
	Feb. 01, 2022	Sep. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Goodwill [Line Items]
Goodwill		$ 575,205			$ 575,205		$ 504,392
Amortization expense		1,800		$ 1,900	$ 5,400	$ 6,200
Weighted average remaining useful lives of identifiable intangible assets					10 years
Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives					5 years
Minimum [Member] | Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives					5 years
Maximum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives					25 years
Maximum [Member] | Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives					10 years
Hospice [Member]
Goodwill [Line Items]
Goodwill		399,006			$ 399,006		$ 328,334
JourneyCare [Member]
Goodwill [Line Items]
Goodwill	$ 70,724
JourneyCare [Member] | Trade Names [Member]
Goodwill [Line Items]
Indefinite lived intangible assets acquired	$ 9,000
JourneyCare [Member] | Hospice [Member]
Goodwill [Line Items]
Goodwill		$ 70,700			$ 70,700
JourneyCare [Member] | Hospice [Member] | Trade Names [Member]
Goodwill [Line Items]
Indefinite lived intangible assets acquired			$ 9,000
JourneyCare [Member] | Hospice [Member] | State Licenses [Member]
Goodwill [Line Items]
Indefinite lived intangible assets acquired			$ 4,800

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	$ 25,891
Intangible assets subject to amortization:
Gross carrying amount	115,915
Accumulated amortization	(69,151)
Intangible assets subject to amortization, net	46,764
Total intangible assets at September 30, 2022	72,655	$ 64,321
Customer And Referral Relationships [Member]
Intangible assets subject to amortization:
Gross carrying amount	44,672
Accumulated amortization	(37,652)
Intangible assets subject to amortization, net	7,020
Total intangible assets at September 30, 2022	7,020
Trade Names and Trademarks [Member]
Intangible assets subject to amortization:
Gross carrying amount	51,941
Accumulated amortization	(20,402)
Intangible assets subject to amortization, net	31,539
Total intangible assets at September 30, 2022	31,539
Noncompete Agreements
Intangible assets subject to amortization:
Gross carrying amount	6,785
Accumulated amortization	(4,581)
Intangible assets subject to amortization, net	2,204
Total intangible assets at September 30, 2022	2,204
State Licenses [Member]
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	25,891
Intangible assets subject to amortization:
Gross carrying amount	12,517
Accumulated amortization	(6,516)
Intangible assets subject to amortization, net	6,001
Total intangible assets at September 30, 2022	$ 31,892

Details of Certain Balance Sh_3

Details of Certain Balance Sheet Accounts (Schedule of Prepaid Expenses and Other Current Assets) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Details Of Certain Balance Sheet Accounts [Abstract]
Prepaid workers' compensation and liability insurance	$ 2,244	$ 3,206
Workers' compensation insurance receivable	788	1,559
Income tax receivable		7,556
Other	5,213	6,170
Total prepaid expenses and other current assets	$ 8,245	$ 18,491

Details of Certain Balance Sh_4

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Details Of Certain Balance Sheet Accounts [Abstract]
Current portion of operating lease liabilities	$ 10,866	$ 9,774
Payor advances	4,856	6,485
Accrued health insurance	5,847	5,200
Accrued professional fees	3,135	2,978
Accrued income & business tax	4,491	2,281
Other	10,362	10,359
Total accrued expenses	$ 39,557	$ 37,077

COVID-19 Pandemic (Narrative) (

COVID-19 Pandemic (Narrative) (Details) - USD ($)			1 Months Ended		3 Months Ended			6 Months Ended		9 Months Ended		12 Months Ended	20 Months Ended
	Jul. 01, 2022	Mar. 11, 2021	Jan. 31, 2022	Nov. 30, 2020	Sep. 30, 2022	Jun. 30, 2022	Sep. 30, 2021	Dec. 31, 2030	Jun. 30, 2030	Sep. 30, 2022	Sep. 30, 2021	Mar. 31, 2022	Dec. 31, 2021	Jun. 30, 2020
Unusual Risk Or Uncertainty [Line Items]
Net service revenues					$ 240,495,000		$ 216,662,000			$ 704,070,000	$ 639,857,000
Hospice [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues					51,359,000		39,095,000			151,160,000	112,098,000
Home Health [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues					9,956,000		7,958,000			29,768,000	17,015,000
Personal Care [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues					179,180,000		169,609,000			523,142,000	510,744,000
CARES Act [Member]
Unusual Risk Or Uncertainty [Line Items]
Amount received from provider relief fund							400,000				11,700,000
Payroll tax deferral					4,100,000					4,100,000			$ 4,100,000	$ 7,100,000
Percentage of reduced payments to Medicare providers	2%												2%
Reduction percentage on sequestration adjustment						1%
CARES Act [Member] | Hospice [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues					0		700,000			1,400,000	2,100,000
Costs and expenses							1,900,000				1,900,000
CARES Act [Member] | Home Health [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues					0		100,000			300,000	300,000
CARES Act [Member] | Personal Care [Member]
Unusual Risk Or Uncertainty [Line Items]
Costs and expenses					900,000		1,300,000			3,700,000	14,600,000
Revenue recognized					1,300,000		1,300,000			4,300,000	6,100,000
CARES Act [Member] | Forecast
Unusual Risk Or Uncertainty [Line Items]
Percentage of reduced payments to Medicare providers								3%	2.25%
ARPA [Member]
Unusual Risk Or Uncertainty [Line Items]
Relief funding to mitigate fiscal effects of COVID-19		$ 350,000,000,000
percentage point increase in federal matching funds												10%
Deferred portion of spending plans					17,000,000					17,000,000
Aggregate principal amount of grants received					20,700,000					20,700,000
Fund distributed to primarily for caregivers and retention efforts					3,200,000					3,600,000
Revenues										1,700,000
Cost of revenue										1,300,000
Aggregate funding amount										22,400,000
PAYGO Act [Member]
Unusual Risk Or Uncertainty [Line Items]
Percentage of additional payment reduction			4%
Provider Relief Fund [Member]
Unusual Risk Or Uncertainty [Line Items]
Aggregate principal amount of grants received				$ 13,700,000
Provider Relief Fund [Member] | CARES Act [Member] | Personal Care [Member]
Unusual Risk Or Uncertainty [Line Items]
Amount received from provider relief fund							400,000				11,700,000
Provider Relief Fund [Member] | CARES Act [Member] | Minimum [Member]
Unusual Risk Or Uncertainty [Line Items]
Annual awards for commercial organizations					$ 750,000					$ 750,000
Queen City Hospice Provider Relief Fund [Member] | Hospice [Member]
Unusual Risk Or Uncertainty [Line Items]
Costs and expenses offset by utilization of portion of funds received							$ 1,900,000				$ 1,900,000

Long-Term Debt (Schedule of Lon

Long-Term Debt (Schedule of Long-Term Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Less unamortized issuance costs	$ (3,296)	$ (3,941)
Long-term debt	163,557	220,912
Revolving Credit Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 166,853	$ 224,853

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) - Credit Agreement [Member] - USD ($)		9 Months Ended
	Jul. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Debt Instrument [Line Items]
Line of credit outstanding amount		$ 375,500,000
Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available		200,500,000
Debt instrument, maturity date	Jul. 30, 2026
Debt instrument total net leverage ratio	4.25%
Line of credit outstanding amount		8,100,000
Capital One, National Association [Member] | Term Loan [Member]
Debt Instrument [Line Items]
Line of credit outstanding amount		$ 166,900,000
Debt instrument stated interest rate		5.11%
Capital One, National Association [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt instrument total net leverage ratio	3.75%
Capital One, National Association [Member] | Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	0.50%
Capital One, National Association [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	1%
Capital One, National Association [Member] | London Interbank Offered Rate (LIBOR) [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	0%
Capital One, National Association [Member] | Based On Applicable Senior Leverage Ratio [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	0.75%
Capital One, National Association [Member] | Based On Applicable Senior Leverage Ratio [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	1.50%
Capital One, National Association [Member] | Based On Applicable Leverage Ratio [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	1.75%
Capital One, National Association [Member] | Based On Applicable Leverage Ratio [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	2.50%
Capital One, National Association [Member] | Restriction on Dividends [Member] | Maximum [Member]
Debt Instrument [Line Items]
Aggregate amount of dividends and distributions		$ 7,500,000
Revolving Credit Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 600,000,000
Proceeds from line of credit			$ 29,000,000
Line of credit outstanding amount		$ 166,900,000		$ 224,900,000
Debt instrument stated interest rate		5.11%		2.10%
Revolving Credit Loan [Member] | Capital One, National Association [Member] | JourneyCare and Apple Home [Member]
Debt Instrument [Line Items]
Proceeds from line of credit		$ 47,000,000
Repayments of line of credit		$ 105,000,000
Revolving Credit Loan [Member] | Capital One, National Association [Member] | Minimum [Member]
Debt Instrument [Line Items]
Fee charged on unused portion of revolving credit facility		0.20%
Revolving Credit Loan [Member] | Capital One, National Association [Member] | Maximum [Member]
Debt Instrument [Line Items]
Fee charged on unused portion of revolving credit facility		0.35%
Incremental Loan Facility [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 125,000,000

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Income Tax Disclosure [Abstract]
Effective income tax rate	23.70%	26.60%	25.40%	24.70%
Percentage of excess tax (benefit) expense included in effective income tax rate			0.80%	(2.10%)

Commitments and Contingencies (

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

Segment Information (Narrative)

Segment Information (Narrative) (Details)	9 Months Ended
	Sep. 30, 2022 Segment
Segment Reporting [Abstract]
Number of business segments	3

Segment Information (Summary of

Segment Information (Summary of Segment Information) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Segment Reporting Information [Line Items]
Net service revenues	$ 240,495	$ 216,662	$ 704,070	$ 639,857
Cost of services revenues	165,310	149,616	483,100	442,804
Gross profit	75,185	67,046	220,970	197,053
General and administrative expenses	54,228	46,280	162,476	139,881
Operating income	17,516	17,360	47,923	46,578
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	30,198	25,523	90,256	76,233
Operating income	44,987	41,523	130,714	120,820
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues	179,180	169,609	523,142	510,744
Cost of services revenues	131,968	125,647	386,940	375,744
Gross profit	47,212	43,962	136,202	135,000
Personal Care [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	15,238	15,166	45,688	46,807
Operating income	31,974	28,796	90,514	88,193
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues	51,359	39,095	151,160	112,098
Cost of services revenues	25,695	18,992	74,659	56,500
Gross profit	25,664	20,103	76,501	55,598
Hospice [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	12,550	8,880	37,298	26,016
Operating income	13,114	11,223	39,203	29,582
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues	9,956	7,958	29,768	17,015
Cost of services revenues	7,647	4,977	21,501	10,560
Gross profit	2,309	2,981	8,267	6,455
Home Health [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	2,410	1,477	7,270	3,410
Operating income	$ 101	$ 1,504	$ 997	$ 3,045

Segment Information (Segment Re

Segment Information (Segment Reconciliation to Totals reported in the accompanying Consolidated Financial Statements) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Segment Reporting Information [Line Items]
Operating income	$ 17,516	$ 17,360	$ 47,923	$ 46,578
Other general and administrative expenses	24,030	20,757	72,220	63,648
Depreciation and amortization	3,441	3,406	10,571	10,594
Interest income	(83)	(37)	(249)	(90)
Interest expense	2,472	1,614	6,278	4,092
Income before income taxes	15,127	15,783	41,894	42,576
Operating Segments [Member]
Segment Reporting Information [Line Items]
Operating income	$ 44,987	$ 41,523	$ 130,714	$ 120,820

Significant Payors (Revenue by

Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Net service revenues	$ 240,495	$ 216,662	$ 704,070	$ 639,857
Personal Care [Member]
Net service revenues	179,180	169,609	523,142	510,744
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 179,180	$ 169,609	$ 523,142	$ 510,744
Concentration risk, percentage	100%	100%	100%	100%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | State, Local And Other Governmental Programs [Member]
Net service revenues	$ 88,448	$ 83,821	$ 257,817	$ 253,052
Concentration risk, percentage	49.40%	49.50%	49.40%	49.50%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 83,199	$ 76,890	$ 241,164	$ 231,211
Concentration risk, percentage	46.40%	45.30%	46.10%	45.30%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member]
Net service revenues	$ 4,521	$ 4,934	$ 13,758	$ 14,883
Concentration risk, percentage	2.60%	2.90%	2.60%	2.90%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues	$ 1,870	$ 2,459	$ 5,988	$ 7,481
Concentration risk, percentage	1%	1.40%	1.10%	1.50%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 1,142	$ 1,505	$ 4,415	$ 4,117
Concentration risk, percentage	0.60%	0.90%	0.80%	0.80%
Hospice [Member]
Net service revenues	$ 51,359	$ 39,095	$ 151,160	$ 112,098
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 51,359	$ 39,095	$ 151,160	$ 112,098
Concentration risk, percentage	100%	100%	100%	100%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 46,537	$ 36,280	$ 137,174	$ 104,715
Concentration risk, percentage	90.60%	92.70%	90.80%	93.40%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 1,815	$ 1,514	$ 5,498	$ 4,396
Concentration risk, percentage	3.50%	3.90%	3.60%	3.90%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues	$ 2,772	$ 1,154	$ 7,742	$ 2,648
Concentration risk, percentage	5.40%	3%	5.10%	2.40%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 235	$ 147	$ 746	$ 339
Concentration risk, percentage	0.50%	0.40%	0.50%	0.30%
Home Health [Member]
Net service revenues	$ 9,956	$ 7,958	$ 29,768	$ 17,015
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 9,956	$ 7,958	$ 29,768	$ 17,015
Concentration risk, percentage	100%	100%	100%	100%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 7,320	$ 6,372	$ 21,727	$ 13,699
Concentration risk, percentage	73.50%	80.10%	73%	80.50%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 1,998	$ 1,218	$ 6,160	$ 2,838
Concentration risk, percentage	20.10%	15.30%	20.70%	16.70%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 638	$ 368	$ 1,881	$ 478
Concentration risk, percentage	6.40%	4.60%	6.30%	2.80%

Significant Payors (Revenue b_2

Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Net service revenues	$ 240,495	$ 216,662	$ 704,070	$ 639,857
Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Concentration risk, percentage	44.30%	37.80%	43.50%	37.50%
Personal Care [Member]
Net service revenues	$ 179,180	$ 169,609	$ 523,142	$ 510,744
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 179,180	$ 169,609	$ 523,142	$ 510,744
Concentration risk, percentage	100%	100%	100%	100%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 92,804	$ 81,959	$ 266,284	$ 240,131
Concentration risk, percentage	51.80%	48.30%	50.90%	47%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 26,912	$ 24,214	$ 78,825	$ 73,291
Concentration risk, percentage	15%	14.30%	15.10%	14.30%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member]
Net service revenues	$ 20,997	$ 24,127	$ 63,510	$ 77,237
Concentration risk, percentage	11.70%	14.20%	12.10%	15.10%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 38,467	$ 39,309	$ 114,523	$ 120,085
Concentration risk, percentage	21.50%	23.20%	21.90%	23.60%
Hospice [Member]
Net service revenues	$ 51,359	$ 39,095	$ 151,160	$ 112,098
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 51,359	$ 39,095	$ 151,160	$ 112,098
Concentration risk, percentage	100%	100%	100%	100%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Ohio [Member]
Net service revenues	$ 18,139	$ 15,868	$ 51,714	$ 44,676
Concentration risk, percentage	35.30%	40.60%	34.20%	39.80%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 12,188		$ 35,290
Concentration risk, percentage	23.70%		23.30%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 7,789	$ 9,268	$ 23,867	$ 27,216
Concentration risk, percentage	15.20%	23.70%	15.80%	24.30%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 13,243	$ 13,959	$ 40,289	$ 40,206
Concentration risk, percentage	25.80%	35.70%	26.70%	35.90%
Home Health [Member]
Net service revenues	$ 9,956	$ 7,958	$ 29,768	$ 17,015
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 9,956	$ 7,958	$ 29,768	$ 17,015
Concentration risk, percentage	100%	100%	100%	100%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 1,581		$ 4,814
Concentration risk, percentage	15.90%		16.20%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 8,375	$ 7,958	$ 24,954	$ 17,015
Concentration risk, percentage	84.10%	100%	83.80%	100%

Significant Payors (Narrative)

Significant Payors (Narrative) (Details) - Illinois [Member]	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Revenues [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	21%	21.30%	20.80%	21.40%
Revenues [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	44.30%	37.80%	43.50%	37.50%
Accounts Receivable [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			15.30%		16.10%

Subsequent Events (Narrative) (

Subsequent Events (Narrative) (Details) - Subsequent Event [Member] - Apple Home [Member] $ in Millions	Oct. 01, 2022 USD ($)
Subsequent Event [Line Items]
Acquisition completed date	Oct. 01, 2022
Business combination consideration transferred	$ 12.2
Potential additional contingent consideration	$ 2