Addus HomeCare (ADUS) 10-Q 2 May 23 2023 Q1 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	3 Months Ended
	Mar. 31, 2023	Apr. 25, 2023
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2023
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2023
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		16,204,341
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	Mar. 31, 2023	Dec. 31, 2022
Current assets
Cash	$ 73,543	$ 79,961
Accounts receivable, net of allowances	125,441	125,501
Prepaid expenses and other current assets	10,226	17,345
Total current assets	209,210	222,807
Property and equipment, net of accumulated depreciation and amortization	20,248	21,182
Other assets
Goodwill	583,972	582,837
Intangibles, net of accumulated amortization	70,604	72,188
Operating lease assets, net	47,049	38,980
Total other assets	701,625	694,005
Total assets	931,083	937,994
Current liabilities
Accounts payable	21,758	22,092
Accrued payroll	34,105	44,937
Accrued expenses	34,018	27,507
Operating lease liabilities, current portion	11,099	10,801
Government stimulus advances	10,996	12,912
Accrued workers' compensation insurance	12,683	12,897
Total current liabilities	124,659	131,146
Long-term liabilities
Long-term debt, less current portion, net of debt issuance costs	108,487	131,772
Long-term operating lease liabilities	42,994	35,479
Other long-term liabilities	6,057	6,057
Total long-term liabilities	157,538	173,308
Total liabilities	282,197	304,454
Stockholders' equity
Common stock -$.001 par value; 40,000 authorized and 16,204 and 16,128 shares issued and outstanding as of March 31, 2023 and December 31, 2022, respectively	16	16
Additional paid-in capital	395,879	393,208
Retained earnings	252,991	240,316
Total stockholders' equity	648,886	633,540
Total liabilities and stockholders' equity	$ 931,083	$ 937,994

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2023	Dec. 31, 2022
Statement Of Financial Position [Abstract]
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	40,000,000	40,000,000
Common stock, shares issued	16,204,000	16,128,000
Common stock, shares outstanding	16,204,000	16,128,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Statement [Abstract]
Net service revenues	$ 251,599	$ 226,634
Cost of service revenues	173,184	156,448
Gross profit	78,415	70,186
General and administrative expenses	56,360	53,152
Depreciation and amortization	3,447	3,521
Total operating expenses	59,807	56,673
Operating income	18,608	13,513
Interest income	(106)	(58)
Interest expense	2,461	1,820
Total interest expense, net	2,355	1,762
Income before income taxes	16,253	11,751
Income tax expense	3,578	3,281
Net income	$ 12,675	$ 8,470
Net income per common share
Basic income per share	$ 0.79	$ 0.54
Diluted income per share	$ 0.78	$ 0.53
Weighted average number of common shares and potential common shares outstanding:
Basic	15,949	15,811
Diluted	16,297	16,079

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, 2021	$ 574,344	$ 16	$ 380,037	$ 194,291
Balance, shares at Dec. 31, 2021		15,940
Issuance of shares of common stock under restricted stock award agreements, shares		115
Stock-based compensation	2,485		2,485
Shares issued for exercise of stock options	479		479
Shares issued for exercise of stock options, shares		13
Net income	8,470			8,470
Balance at Mar. 31, 2022	585,778	$ 16	383,001	202,761
Balance, shares at Mar. 31, 2022		16,068
Balance at Dec. 31, 2022	633,540	$ 16	393,208	240,316
Balance, shares at Dec. 31, 2022		16,128
Issuance of shares of common stock under restricted stock award agreements, shares		76
Stock-based compensation	2,646		2,646
Shares issued for exercise of stock options	25		25
Net income	12,675			12,675
Balance at Mar. 31, 2023	$ 648,886	$ 16	$ 395,879	$ 252,991
Balance, shares at Mar. 31, 2023		16,204

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Cash flows from operating activities:
Net income	$ 12,675	$ 8,470
Adjustments to reconcile net income to net cash provided by (used in) operating activities, net of acquisitions:
Depreciation and amortization	3,447	3,521
Deferred income taxes	(72)	126
Stock-based compensation	2,646	2,485
Amortization of debt issuance costs under the credit facility	215	215
Provision for credit losses	144	158
Impairment of operating lease assets	0	1,174
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	85	7,121
Prepaid expenses and other current assets	7,030	4,161
Government stimulus advances	(2,345)	0
Accounts payable	(494)	1,386
Accrued payroll	(10,901)	(17,443)
Accrued expenses and other long-term liabilities	6,369	(5,391)
Net cash provided by operating activities	18,799	5,983
Cash flows from investing activities:
Acquisitions of businesses, net of cash acquired	(965)	(84,490)
Purchases of property and equipment	(777)	(1,104)
Net cash used in investing activities	(1,742)	(85,594)
Cash flows from financing activities:
Payments on term loan — credit facility	(23,500)
Borrowings on revolver - credit facility	0	35,000
Cash received from exercise of stock options	25	479
Net cash (used in) provided by financing activities	(23,475)	35,479
Net change in cash	(6,418)	(44,132)
Cash, at beginning of period	79,961	168,895
Cash, at end of period	73,543	124,763
Supplemental disclosures of cash flow information:
Cash paid for interest	$ 2,310	$ 1,619

Nature of Operations, Consolida

Nature of Operations, Consolidation, and Presentation of Financial Statements	3 Months Ended
	Mar. 31, 2023
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, 2022 has been derived from the Company’s audited financial statements for the year ended December 31, 2022 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, 2022 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	3 Months Ended
	Mar. 31, 2023
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 March 31, (Amounts in thousands) 2023 2022 Weighted average number of shares outstanding for basic per share calculation 15,949 15,811 Effect of dilutive potential shares: Stock options 251 235 Restricted stock awards 97 33 Adjusted weighted average shares for diluted per share calculation 16,297 16,079 Anti-dilutive shares: Stock options 61 92 Restricted stock awards — 77 Recently Adopted Accounting Pronouncements In October 2021, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2021-08, Accounting for Contract Assets and Contract Liabilities from Contracts with Customers (Topic 805) . This ASU requires an acquirer in a business combination to recognize and measure contract assets and contract liabilities (deferred revenue) from acquired contracts using the revenue recognition guidance in Topic 606. At the acquisition date, the acquirer applies the revenue model as if it had originated the acquired contracts. The ASU was adopted prospectively on January 1, 2023 . The additional disclosures required did no t have a material impact on our consolidated financial statements. 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 was in effect for a limited time through December 31, 2022. The ASU could be adopted no later than December 1, 2022 with early adoption permitted. As discussed further in Note 7 and pursuant to the Second Amendment to Amended and Restated Credit Agreement dated as of July 30, 2021, the 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	3 Months Ended
	Mar. 31, 2023
Leases [Abstract]
Leases	3. Leases Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows: March 31, 2023 December 31, 2022 (Amounts in Thousands) Operating lease assets, net $ 47,049 $ 38,980 Short-term operating lease liabilities (in accrued expenses) 11,099 10,801 Long-term operating lease liabilities 42,994 35,479 Total operating lease liabilities $ 54,093 $ 46,280 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 March 31, 2023 2022 Operating lease costs $ 3,042 $ 2,801 Short-term lease costs 416 751 Total lease costs 3,458 3,552 Less: sublease income ( 700 ) ( 177 ) Total lease costs, net $ 2,758 $ 3,375 Lease Term and Discount Rate Weighted average remaining lease terms and discount rates were as follows: March 31, 2023 December 31, 2022 Operating leases: Weighted average remaining lease term 6.68 5.82 Weighted average discount rate 5.04 % 3.98 % Maturity of Lease Liabilities Remaining operating lease payments as of March 31, 2023 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended March 31, 2024 $ 13,454 2025 11,420 2026 8,226 2027 6,471 2028 5,262 Thereafter 20,218 Total future minimum rental commitments 65,051 Less: Imputed interest ( 10,958 ) Total lease liabilities $ 54,093 Supplemental cash flows information For the Three Months Ended March 31, (Amounts in Thousands) 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 3,374 $ 3,194 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 10,836 $ 9,199

Goodwill and Intangible Assets

Goodwill and Intangible Assets	3 Months Ended
	Mar. 31, 2023
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	4. Goodwill and Intangible Assets A summary of the goodwill and related adjustments is provided below: Hospice Personal Care Home Total (Amounts in Thousands) Goodwill as of December 31, 2022 $ 397,728 $ 152,688 $ 32,421 $ 582,837 Additions for acquisition — 599 — 599 Adjustments to previously recorded goodwill — — 536 536 Goodwill as of March 31, 2023 $ 397,728 $ 153,287 $ 32,957 $ 583,972 On January 1, 2023, the Company completed its acquisition of Coastal Nursecare of Florida, Inc. (“CareStaff”) for approximately $ 1.0 million. With the purchase of CareStaff, the Company expanded its personal care services segment in Florida. In connection with the CareStaff acquisition, the Company recognized goodwill in its personal care segment of $ 0.6 million during the three months ended March 31, 2023. The Company’s identifiable intangible assets consist of customer and referral relationships, trade names and trademarks, non-competition agreements and state licenses. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from one to twenty-five years . Customer and referral relationships are amortized systematically over the periods of expected economic benefit, which range from five to ten years . The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of March 31, 2023: Customer Trade Non- State Total (Amounts in Thousands) Intangible assets with indefinite lives $ — $ — $ — $ 27,108 $ 27,108 Intangible assets subject to amortization: Gross carrying amount 44,672 52,046 6,785 12,671 116,174 Accumulated amortization ( 38,471 ) ( 21,712 ) ( 4,989 ) ( 7,506 ) ( 72,678 ) Intangible assets subject to amortization, net 6,201 30,334 1,796 5,165 43,496 Total intangible assets at March 31, 2023 $ 6,201 $ 30,334 $ 1,796 $ 32,273 $ 70,604 A mortization expense related to the intangible assets was $ 1.7 million and $ 1.8 million for the three months ended March 31, 2023 and 2022, respectively. The weighted average remaining useful lives of identifiable intangible assets as of March 31, 2023 w as 9.7 years.

Details of Certain Balance Shee

Details of Certain Balance Sheet Accounts	3 Months Ended
	Mar. 31, 2023
Details Of Certain Balance Sheet Accounts [Abstract]
Details of Certain Balance Sheet Accounts	5. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consisted of the following: March 31, 2023 December 31, 2022 (Amounts in Thousands) Prepaid payroll $ — $ 7,566 Prepaid workers' compensation and liability insurance 2,138 3,399 Prepaid Licensing fees 4,657 3,722 Workers' compensation insurance receivable 606 666 Other 2,825 1,992 Total prepaid expenses and other current assets $ 10,226 $ 17,345 Accrued expenses consisted of the following: March 31, 2023 December 31, 2022 (Amounts in Thousands) Accrued health insurance 8,524 5,152 Payor advances (1) 2,893 4,473 Accrued professional fees 4,253 3,576 Accrued payroll and other taxes 9,893 6,175 Other 8,455 8,131 Total accrued expenses $ 34,018 $ 27,507 (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.

Government Actions to Mitigate

Government Actions to Mitigate COVID-19's Impact	3 Months Ended
	Mar. 31, 2023
Risks And Uncertainties [Abstract]
Government Actions to Mitigate COVID-19's Impact	6. Government Actions to Mitigate COVID-19’s Impact In March 2020, the World Health Organization declared the novel coronavirus (“COVID-19”) outbreak a global pandemic. The COVID-19 pandemic continues to cause disruption in the economy, in terms of increased costs and disruptions in the labor market. Although vaccines and booster shots for the COVID-19 virus have become widely available in the United States, COVID-19 has continued to result in a significant number of hospitalizations, and the future course of the pandemic remains uncertain, particularly due to the spread of COVID-19 variants. We will continue to closely monitor the impact of COVID-19 on all aspects of our business, including the impacts to our employees, patients and suppliers. In recognition of the significant threat to the liquidity of financial markets posed by the COVID-19 pandemic, the Federal Reserve and Congress have taken dramatic actions to provide liquidity to businesses and the banking system in the United States. One of the primary sources of relief for healthcare providers is the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), which was expanded by the Paycheck Protection Program and Health Care Enhancement (“PPPHCE”) Act, and the Consolidated Appropriations Act (“CAA”). Another relief package with numerous provisions that affect healthcare providers is the American Rescue Plan Act of 2021 (“ARPA”). ARPA Spending Plans ARPA provides for $ 350 billion in relief funding for eligible state, local, territorial, and Tribal governments to mitigate the fiscal effects of the COVID-19 public health emergency. Additionally, the law provides for a 10 -percentage point increase in federal matching funds for Medicaid home and community-based services (“HCBS”) from April 1, 2021, through March 31, 2022, provided the state satisfied certain conditions. States are permitted to use the state funds equivalent to the additional federal funds through March 31, 2025. States must use the monies attributable to this matching fund increase to supplement, not supplant, their level of state spending for the implementation of activities enhanced under the Medicaid HCBS in effect as of April 1, 2021. HCBS spending plans for the additional matching funds vary by state, but common initiatives in which the Company is participating include those aimed at strengthening the provider workforce (e.g., efforts to recruit, retain, and train direct service providers). The Company is required to properly and fully document the use of such funds in reports to the state in which the funds originated. Funds may be subject to recoupment if not expended or if they are expended on non-approved uses. During the three months ended March 31, 2023, the Company received state funding provided by the ARPA in an aggregate amount of $ 0.4 million. The Company did no t record revenue and related costs of service revenue during the three months ended March 31, 2023, because revenue recognition criteria were not met. The Company deferred the remaining $ 11.0 million, which was received from states with specific spending plans and reporting requirements. The Company utilized $ 2.4 million of these funds during the three months ended March 31, 2023, 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 March 31, 2023, the deferred portion of ARPA funding of $ 11.0 million 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 March 31, 2022. The sequestration payment adjustment was phased back in with a 1 % reduction beginning April 1, 2022, and returned to 2 % on July 1, 2022. These sequestration cuts have been extended through 2032. The ARPA increases the federal budget deficit in a manner that triggers an additional statutorily mandated sequestration under the Pay- As-You-Go Act of 2010 (“PAYGO Act”). As a result, an additional Medicare payment reduction of up to 4 % was required to take effect in January 2022. However, Congress delayed implementation of this payment reduction until 2025. In the hospice segment, Medicare sequester relief resulted in an increase in net service revenues of $ 0.0 million and $ 0.9 million for the three months ended March 31, 2023 and 2022, respectively. In the home health segment, Medicare sequester relief resulted in an increase in net service revenues of $ 0.0 million and $ 0.2 million for the three months ended March 31, 2023 and 2022, respectively.

Long-Term Debt

Long-Term Debt	3 Months Ended
	Mar. 31, 2023
Long Term Debt [Abstract]
Long-Term Debt	7. Long-Term Debt Long-term debt consisted of the following: March 31, 2023 December 31, 2022 (Amounts in Thousands) Revolving loan under the credit facility $ 111,353 $ 134,853 Less unamortized issuance costs ( 2,866 ) ( 3,081 ) Long-term debt $ 108,487 $ 131,772 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 Credit Agreement contains hardwired fallback language that contemplates a transition from LIBOR, specifically identifies the Secured Overnight Financing Rate (“SOFR”) as the replacement reference rate and details the mechanism for transition at LIBOR cessation, which is anticipated to occur on June 30, 2023. The transition to SOFR is not expected to have a material impact on the Company’s results of operations or liquidity. Addus HealthCare, Inc. (“Addus HealthCare”) is the borrower, and its parent, Holdings, and substantially all of Holdings’ subsidiaries are guarantors under this credit facility, and it is collateralized by a first priority security interest in all of the Company’s and the other credit parties’ current and future tangible and intangible assets, including the shares of stock of the borrower and subsidiaries. The Credit Agreement contains affirmative and negative covenants customary for credit facilities of this type, including limitations on the Company with respect to liens, indebtedness, guaranties, investments, distributions, mergers and acquisitions and dispositions of assets. The availability of additional draws under this credit facility is conditioned, among other things, upon (after giving effect to such draws) the Total Net Leverage Ratio (as defined in the Credit Agreement) not exceeding 3.75 :1.00. In certain circumstances, in connection with a Material Acquisition (as defined in the Credit Agreement), the Company can elect to increase its Total Net Leverage Ratio compliance covenant to 4.25 :1.00 for the then current fiscal quarter and the three succeeding fiscal quarters. The Company pays a fee ranging from 0.20 % to 0.35 % based on the applicable senior net leverage ratio times the unused portion of the revolving loan portion of the credit facility. The Credit Agreement contains customary affirmative covenants regarding, among other things, the maintenance of records, compliance with laws, maintenance of permits, maintenance of insurance and property and payment of taxes. The Credit Agreement also contains certain customary financial covenants and negative covenants that, among other things, include a requirement to maintain a minimum Interest Coverage Ratio (as defined in the Credit Agreement), a requirement to stay below a maximum Total Net Leverage Ratio (as defined in the Credit Agreement) and a requirement to stay below a maximum permitted amount of capital expenditures. The Credit Agreement also contains restrictions on guarantees, indebtedness, liens, investments and loans, subject to customary carve outs, a restriction on dividends (provided that Addus HealthCare may make distributions to the Company in an amount that does not exceed $ 7.5 million in any year absent of an event of default, plus limited exceptions for tax and administrative distributions), a restriction on the ability to consummate acquisitions (without the consent of the lenders) under its credit facility subject to compliance with the Total Net Leverage Ratio (as defined in the Credit Agreement) thresholds, restrictions on mergers, dispositions of assets, and affiliate transactions, and restrictions on fundamental changes and lines of business. During the three months ended March 31, 2023, the Company did not draw on its credit facility and repaid $ 23.5 million under the revolving credit facility. At March 31, 2023, the Company had a total of $ 111.4 million of revolving loans, with an interest rate of 6.59 %, outstanding on its credit facility. After giving effect to the amount drawn on its credit facility, approximately $ 8.0 million of outstanding letters of credit and borrowing limits based on an advance multiple of adjusted EBITDA (as defined in the Credit Agreement), the Compan y had $ 395.1 of capacity and $ 275.7 million available for borrowing under its credit facility. As of December 31, 2022, the Company had a total of $ 134.9 million of revolving loans, with an interest rate of 6.13 %, outstanding on its credit facility. As of March 31, 2023, the Company was in compliance with all financial covenants under the Credit Agreement.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	8. Income Taxes The effective income tax rates were 22.0 % and 27.9 % for the three months ended March 31, 2023 and 2022, respectively. For the three months ended March 31, 2023, the difference between our federal statutory and effective income tax rates was principally due to the inclusion of state taxes and non-deductible compensation, partially offset by the use of federal employment tax credits and excess tax benefit. For the three months ended March 31, 2023 and 2022, the effective tax rates were inclusive of an excess tax benefit of 1.2 % and an excess tax expense of 2.7 %, 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	3 Months Ended
	Mar. 31, 2023
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	9. 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	3 Months Ended
	Mar. 31, 2023
Segment Reporting [Abstract]
Segment Information	10. 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 March 31, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 190,032 $ 49,082 $ 12,485 $ 251,599 Cost of services revenues 138,383 27,267 7,534 173,184 Gross profit 51,649 21,815 4,951 78,415 General and administrative expenses 15,935 13,015 2,879 31,829 Segment operating income $ 35,714 $ 8,800 $ 2,072 $ 46,586 For the Three Months Ended March 31, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 169,632 $ 47,727 $ 9,275 $ 226,634 Cost of services revenues 126,291 23,441 6,716 156,448 Gross profit 43,341 24,286 2,559 70,186 General and administrative expenses 15,004 11,712 2,359 29,075 Segment operating income $ 28,337 $ 12,574 $ 200 $ 41,111 For the Three Months Ended March 31, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 46,586 $ 41,111 Items not allocated at segment level: Other general and administrative expenses 24,531 24,077 Depreciation and amortization 3,447 3,521 Interest income ( 106 ) ( 58 ) Interest expense 2,461 1,820 Income before income taxes $ 16,253 $ 11,751

Significant Payors

Significant Payors	3 Months Ended
	Mar. 31, 2023
Significant Payors [Abstract]
Significant Payors	11. Significant Payors The Company’s revenue by payor type was as follows: Personal Care Segment For the Three Months Ended March 31, 2023 2022 Amount % of Segment Amount % of Segment State, local and other governmental programs $ 95,320 50.1 % $ 83,908 49.5 % Managed care organizations 87,901 46.3 77,390 45.6 Private pay 4,226 2.2 4,626 2.7 Commercial insurance 1,669 0.9 2,024 1.2 Other 916 0.5 1,684 1.0 Total personal care segment net service revenues $ 190,032 100.0 % $ 169,632 100.0 % Hospice Segment For the Three Months Ended March 31, 2023 2022 Amount % of Segment Amount % of Segment Medicare $ 44,556 90.7 % $ 43,485 91.1 % Commercial insurance 2,547 5.2 2,244 4.7 Managed care organizations 1,647 3.4 1,715 3.6 Other 332 0.7 283 0.6 Total hospice segment net service revenues $ 49,082 100.0 % $ 47,727 100.0 % Home Health Segment For the Three Months Ended March 31, 2023 2022 Amount % of Segment Amount % of Segment Medicare $ 9,270 74.2 % $ 6,812 73.5 % Managed care organizations 2,539 20.3 1,904 20.5 Other 676 5.5 559 6.0 Total home health segment net service revenues $ 12,485 100.0 % $ 9,275 100.0 % 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 March 31, 2023 2022 Amount % of Segment Amount % of Segment Illinois $ 98,414 51.8 % $ 84,693 49.9 % New Mexico 28,474 15.0 25,440 15.0 New York (1) 21,885 11.5 21,385 12.6 All other states 41,259 21.7 38,114 22.5 Total personal care segment net service revenues $ 190,032 100.0 % $ 169,632 100.0 % (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. The New York fiscal year 2023 state budget, passed in April 2022, amends the current Fiscal Intermediary RFO process to authorize all fiscal intermediaries that submitted an RFO application and served at least 200 clients in New York City or 50 clients in other counties between January 1, 2020 and March 31, 2020 to contract with the New York State Department of Health and continue to operate in all counties contained in their application, if the fiscal intermediary submits an attestation and supporting information to the New York State Department of Health no later than November 29, 2022. The Company submitted an attestation on November 22, 2022. Under this provision, the Company is allowed to continue to contract with all of its current payors for CDPAP services, as of the contract award date, which was anticipated to be April 1, 2023. However, the New York State Department of Health has not yet awarded these contracts. The Company continues to assess the future of its participation in this program. Given the current profitability of the program, the Company has suspended materially all of its new fee-for-service patient admissions through County Social Service Departments in the CDPAP program. Hospice Segment For the Three Months Ended March 31, 2023 2022 Amount % of Segment Amount % of Segment Ohio $ 18,451 37.6 % $ 16,328 34.2 % Illinois 11,480 23.4 9,541 20.0 New Mexico 6,486 13.2 8,233 17.3 All other states 12,665 25.8 13,625 28.5 Total hospice segment net service revenues $ 49,082 100.0 % $ 47,727 100.0 % Home Health Segment For the Three Months Ended March 31, 2023 2022 Amount % of Segment Amount % of Segment New Mexico $ 9,116 73.0 % $ 7,509 81.0 % Illinois 3,369 27.0 1,766 19 Total home health segment net service revenues $ 12,485 100.0 % $ 9,275 100.0 % 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 39.1 % and 37.4 % of our net service revenues for the three months ended March 31, 2023 and 2022, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 21.5 % and 20.7 % of the Company’s net service revenues for the three months ended March 31, 2023 and 2022, respectively. The related receivables due from the Illinois Department on Aging represented 20.7 % and 18.0 % of the Company’s net accounts receivable at March 31, 2023 and December 31, 2022 , respectively.

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2023
Subsequent Events [Abstract]
Subsequent Events	12. Subsequent Events On April 26, 2023, the Company entered into a Third Amendment to Amended and Restated Credit Agreement (the “Third Amendment”), by and among Addus HealthCare, Inc., as the borrower, the Company, certain subsidiaries of the Company party thereto, the lenders party thereto and Capital One, National Association, as a lender and as administrative agent for all lenders, which amended the Company’s existing Credit Agreement. The Third Amendment (i) replaces LIBOR with a forward-looking term SOFR-based rate as the applicable benchmark reference rate for loans under the credit facility and (ii) adds a 10 -basis point credit spread adjustment for loans bearing interest based on SOFR. The Third Amendment does not change the interest rate margins applicable to the credit facility.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2023
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, 2022 has been derived from the Company’s audited financial statements for the year ended December 31, 2022 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, 2022 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 March 31, (Amounts in thousands) 2023 2022 Weighted average number of shares outstanding for basic per share calculation 15,949 15,811 Effect of dilutive potential shares: Stock options 251 235 Restricted stock awards 97 33 Adjusted weighted average shares for diluted per share calculation 16,297 16,079 Anti-dilutive shares: Stock options 61 92 Restricted stock awards — 77
Recently Issued and Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In October 2021, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2021-08, Accounting for Contract Assets and Contract Liabilities from Contracts with Customers (Topic 805) . This ASU requires an acquirer in a business combination to recognize and measure contract assets and contract liabilities (deferred revenue) from acquired contracts using the revenue recognition guidance in Topic 606. At the acquisition date, the acquirer applies the revenue model as if it had originated the acquired contracts. The ASU was adopted prospectively on January 1, 2023 . The additional disclosures required did no t have a material impact on our consolidated financial statements. 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 was in effect for a limited time through December 31, 2022. The ASU could be adopted no later than December 1, 2022 with early adoption permitted. As discussed further in Note 7 and pursuant to the Second Amendment to Amended and Restated Credit Agreement dated as of July 30, 2021, the 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)	3 Months Ended
	Mar. 31, 2023
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 March 31, (Amounts in thousands) 2023 2022 Weighted average number of shares outstanding for basic per share calculation 15,949 15,811 Effect of dilutive potential shares: Stock options 251 235 Restricted stock awards 97 33 Adjusted weighted average shares for diluted per share calculation 16,297 16,079 Anti-dilutive shares: Stock options 61 92 Restricted stock awards — 77

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2023
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: March 31, 2023 December 31, 2022 (Amounts in Thousands) Operating lease assets, net $ 47,049 $ 38,980 Short-term operating lease liabilities (in accrued expenses) 11,099 10,801 Long-term operating lease liabilities 42,994 35,479 Total operating lease liabilities $ 54,093 $ 46,280
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 March 31, 2023 2022 Operating lease costs $ 3,042 $ 2,801 Short-term lease costs 416 751 Total lease costs 3,458 3,552 Less: sublease income ( 700 ) ( 177 ) Total lease costs, net $ 2,758 $ 3,375
Schedule of Weighted Average Remaining Lease Terms and Discount Rates	Weighted average remaining lease terms and discount rates were as follows: March 31, 2023 December 31, 2022 Operating leases: Weighted average remaining lease term 6.68 5.82 Weighted average discount rate 5.04 % 3.98 %
Summary of Remaining Operating Lease Payments	Remaining operating lease payments as of March 31, 2023 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended March 31, 2024 $ 13,454 2025 11,420 2026 8,226 2027 6,471 2028 5,262 Thereafter 20,218 Total future minimum rental commitments 65,051 Less: Imputed interest ( 10,958 ) Total lease liabilities $ 54,093
Supplemental Cash Flows Information	For the Three Months Ended March 31, (Amounts in Thousands) 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 3,374 $ 3,194 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 10,836 $ 9,199

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2023
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 Total (Amounts in Thousands) Goodwill as of December 31, 2022 $ 397,728 $ 152,688 $ 32,421 $ 582,837 Additions for acquisition — 599 — 599 Adjustments to previously recorded goodwill — — 536 536 Goodwill as of March 31, 2023 $ 397,728 $ 153,287 $ 32,957 $ 583,972
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 March 31, 2023: Customer Trade Non- State Total (Amounts in Thousands) Intangible assets with indefinite lives $ — $ — $ — $ 27,108 $ 27,108 Intangible assets subject to amortization: Gross carrying amount 44,672 52,046 6,785 12,671 116,174 Accumulated amortization ( 38,471 ) ( 21,712 ) ( 4,989 ) ( 7,506 ) ( 72,678 ) Intangible assets subject to amortization, net 6,201 30,334 1,796 5,165 43,496 Total intangible assets at March 31, 2023 $ 6,201 $ 30,334 $ 1,796 $ 32,273 $ 70,604

Details of Certain Balance Sh_2

Details of Certain Balance Sheet Accounts (Tables)	3 Months Ended
	Mar. 31, 2023
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: March 31, 2023 December 31, 2022 (Amounts in Thousands) Prepaid payroll $ — $ 7,566 Prepaid workers' compensation and liability insurance 2,138 3,399 Prepaid Licensing fees 4,657 3,722 Workers' compensation insurance receivable 606 666 Other 2,825 1,992 Total prepaid expenses and other current assets $ 10,226 $ 17,345
Schedule of Accrued Expenses	Accrued expenses consisted of the following: March 31, 2023 December 31, 2022 (Amounts in Thousands) Accrued health insurance 8,524 5,152 Payor advances (1) 2,893 4,473 Accrued professional fees 4,253 3,576 Accrued payroll and other taxes 9,893 6,175 Other 8,455 8,131 Total accrued expenses $ 34,018 $ 27,507 (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)	3 Months Ended
	Mar. 31, 2023
Long Term Debt [Abstract]
Schedule of Long-Term Debt	Long-term debt consisted of the following: March 31, 2023 December 31, 2022 (Amounts in Thousands) Revolving loan under the credit facility $ 111,353 $ 134,853 Less unamortized issuance costs ( 2,866 ) ( 3,081 ) Long-term debt $ 108,487 $ 131,772

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2023
Segment Reporting [Abstract]
Summary of Segment Information	For the Three Months Ended March 31, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 190,032 $ 49,082 $ 12,485 $ 251,599 Cost of services revenues 138,383 27,267 7,534 173,184 Gross profit 51,649 21,815 4,951 78,415 General and administrative expenses 15,935 13,015 2,879 31,829 Segment operating income $ 35,714 $ 8,800 $ 2,072 $ 46,586 For the Three Months Ended March 31, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 169,632 $ 47,727 $ 9,275 $ 226,634 Cost of services revenues 126,291 23,441 6,716 156,448 Gross profit 43,341 24,286 2,559 70,186 General and administrative expenses 15,004 11,712 2,359 29,075 Segment operating income $ 28,337 $ 12,574 $ 200 $ 41,111 For the Three Months Ended March 31, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 46,586 $ 41,111 Items not allocated at segment level: Other general and administrative expenses 24,531 24,077 Depreciation and amortization 3,447 3,521 Interest income ( 106 ) ( 58 ) Interest expense 2,461 1,820 Income before income taxes $ 16,253 $ 11,751

Significant Payors (Tables)

Significant Payors (Tables)	3 Months Ended
	Mar. 31, 2023
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 March 31, 2023 2022 Amount % of Segment Amount % of Segment State, local and other governmental programs $ 95,320 50.1 % $ 83,908 49.5 % Managed care organizations 87,901 46.3 77,390 45.6 Private pay 4,226 2.2 4,626 2.7 Commercial insurance 1,669 0.9 2,024 1.2 Other 916 0.5 1,684 1.0 Total personal care segment net service revenues $ 190,032 100.0 % $ 169,632 100.0 % Hospice Segment For the Three Months Ended March 31, 2023 2022 Amount % of Segment Amount % of Segment Medicare $ 44,556 90.7 % $ 43,485 91.1 % Commercial insurance 2,547 5.2 2,244 4.7 Managed care organizations 1,647 3.4 1,715 3.6 Other 332 0.7 283 0.6 Total hospice segment net service revenues $ 49,082 100.0 % $ 47,727 100.0 % Home Health Segment For the Three Months Ended March 31, 2023 2022 Amount % of Segment Amount % of Segment Medicare $ 9,270 74.2 % $ 6,812 73.5 % Managed care organizations 2,539 20.3 1,904 20.5 Other 676 5.5 559 6.0 Total home health segment net service revenues $ 12,485 100.0 % $ 9,275 100.0 %
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 March 31, 2023 2022 Amount % of Segment Amount % of Segment Illinois $ 98,414 51.8 % $ 84,693 49.9 % New Mexico 28,474 15.0 25,440 15.0 New York (1) 21,885 11.5 21,385 12.6 All other states 41,259 21.7 38,114 22.5 Total personal care segment net service revenues $ 190,032 100.0 % $ 169,632 100.0 % (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. The New York fiscal year 2023 state budget, passed in April 2022, amends the current Fiscal Intermediary RFO process to authorize all fiscal intermediaries that submitted an RFO application and served at least 200 clients in New York City or 50 clients in other counties between January 1, 2020 and March 31, 2020 to contract with the New York State Department of Health and continue to operate in all counties contained in their application, if the fiscal intermediary submits an attestation and supporting information to the New York State Department of Health no later than November 29, 2022. The Company submitted an attestation on November 22, 2022. Under this provision, the Company is allowed to continue to contract with all of its current payors for CDPAP services, as of the contract award date, which was anticipated to be April 1, 2023. However, the New York State Department of Health has not yet awarded these contracts. The Company continues to assess the future of its participation in this program. Given the current profitability of the program, the Company has suspended materially all of its new fee-for-service patient admissions through County Social Service Departments in the CDPAP program. Hospice Segment For the Three Months Ended March 31, 2023 2022 Amount % of Segment Amount % of Segment Ohio $ 18,451 37.6 % $ 16,328 34.2 % Illinois 11,480 23.4 9,541 20.0 New Mexico 6,486 13.2 8,233 17.3 All other states 12,665 25.8 13,625 28.5 Total hospice segment net service revenues $ 49,082 100.0 % $ 47,727 100.0 % Home Health Segment For the Three Months Ended March 31, 2023 2022 Amount % of Segment Amount % of Segment New Mexico $ 9,116 73.0 % $ 7,509 81.0 % Illinois 3,369 27.0 1,766 19 Total home health segment net service revenues $ 12,485 100.0 % $ 9,275 100.0 %

Nature of Operations, Consoli_2

Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details)	3 Months Ended
	Mar. 31, 2023 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
	Mar. 31, 2023	Mar. 31, 2022
Summary Of Significant Accounting Policies [Line Items]
Weighted average number of shares for basic per share calculation	15,949	15,811
Effect of dilutive potential shares:
Adjusted weighted average shares for diluted per share calculation	16,297	16,079
Stock Options [Member]
Effect of dilutive potential shares:
Effect of dilutive potential shares	251	235
Anti-dilutive shares:
Anti-dilutive shares	61	92
Restricted Stock Awards [Member]
Effect of dilutive potential shares:
Effect of dilutive potential shares	97	33
Anti-dilutive shares:
Anti-dilutive shares		77

Summary of Significant Accoun_5

Summary of Significant Accounting Policies (Narrative) (Details) - ASU 2021-08 [Member]	Mar. 31, 2023
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, 2023

Leases (Amounts Reported in Una

Leases (Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Operating lease assets, net	$ 47,049	$ 38,980
Operating lease liabilities, current portion	$ 11,099	$ 10,801
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued expenses	Accrued expenses
Long-term operating lease liabilities	$ 42,994	$ 35,479
Total operating lease liabilities	$ 54,093	$ 46,280

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
	Mar. 31, 2023	Mar. 31, 2022
Leases [Abstract]
Operating lease costs	$ 3,042	$ 2,801
Short-term lease costs	416	751
Total lease costs	3,458	3,552
Less: sublease income	(700)	(177)
Total lease costs, net	$ 2,758	$ 3,375

Leases (Schedule of Weighted Av

Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details)	Mar. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Weighted average remaining lease term (years)	6 years 8 months 4 days	5 years 9 months 25 days
Weighted average discount rate	5.04%	3.98%

Leases (Summary of Remaining Op

Leases (Summary of Remaining Operating Lease Payments) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Leases [Abstract]
2024	$ 13,454
2025	11,420
2026	8,226
2027	6,471
2028	5,262
Thereafter	20,218
Total future minimum rental commitments	65,051
Less: Imputed interest	(10,958)
Total lease liabilities	$ 54,093	$ 46,280

Leases (Supplemental Cash Flows

Leases (Supplemental Cash Flows Information) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 3,374	$ 3,194
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 10,836	$ 9,199

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($)
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 582,837
Additions for acquisitions	599
Adjustments to previously recorded goodwill	536
Goodwill, at End of Period	583,972
Hospice [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	397,728
Additions for acquisitions	0
Adjustments to previously recorded goodwill	0
Goodwill, at End of Period	397,728
Personal Care [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	152,688
Additions for acquisitions	599
Adjustments to previously recorded goodwill	0
Goodwill, at End of Period	153,287
Home Health [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	32,421
Additions for acquisitions	0
Adjustments to previously recorded goodwill	536
Goodwill, at End of Period	$ 32,957

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Thousands		3 Months Ended
	Jan. 01, 2023	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Goodwill [Line Items]
Goodwill		$ 583,972		$ 582,837
Total purchase price for business acquisition		965	$ 84,490
Amortization expense		$ 1,700	$ 1,800
Weighted average remaining useful lives of identifiable intangible assets		9 years 8 months 12 days
Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		1 year
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
Personal Care [Member]
Goodwill [Line Items]
Goodwill		$ 153,287		$ 152,688
Coastal Nursecare Member
Goodwill [Line Items]
Total purchase price for business acquisition	$ 1,000
CareStaff [Member] | Personal Care [Member]
Goodwill [Line Items]
Goodwill		$ 600

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	$ 27,108
Intangible assets subject to amortization:
Gross carrying amount	116,174
Accumulated amortization	(72,678)
Intangible assets subject to amortization, net	43,496
Total intangible assets at March 31, 2023	70,604	$ 72,188
Customer And Referral Relationships [Member]
Intangible assets subject to amortization:
Gross carrying amount	44,672
Accumulated amortization	(38,471)
Intangible assets subject to amortization, net	6,201
Total intangible assets at March 31, 2023	6,201
Trade Names and Trademarks [Member]
Intangible assets subject to amortization:
Gross carrying amount	52,046
Accumulated amortization	(21,712)
Intangible assets subject to amortization, net	30,334
Total intangible assets at March 31, 2023	30,334
Noncompete Agreements [Member]
Intangible assets subject to amortization:
Gross carrying amount	6,785
Accumulated amortization	(4,989)
Intangible assets subject to amortization, net	1,796
Total intangible assets at March 31, 2023	1,796
State Licenses [Member]
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	27,108
Intangible assets subject to amortization:
Gross carrying amount	12,671
Accumulated amortization	(7,506)
Intangible assets subject to amortization, net	5,165
Total intangible assets at March 31, 2023	$ 32,273

Details of Certain Balance Sh_3

Details of Certain Balance Sheet Accounts (Schedule of Prepaid Expenses and Other Current Assets) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Details Of Certain Balance Sheet Accounts [Abstract]
Prepaid payroll	$ 0	$ 7,566
Prepaid workers' compensation and liability insurance	2,138	3,399
Prepaid Licensing fees	4,657	3,722
Workers' compensation insurance receivable	606	666
Other	2,825	1,992
Total prepaid expenses and other current assets	$ 10,226	$ 17,345

Details of Certain Balance Sh_4

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Details Of Certain Balance Sheet Accounts [Abstract]
Accrued health insurance	$ 8,524	$ 5,152
Payor advances	2,893	4,473
Accrued professional fees	4,253	3,576
Accrued payroll and other taxes	9,893	6,175
Other	8,455	8,131
Total accrued expenses	$ 34,018	$ 27,507

COVID-19 Pandemic (Narrative) (

COVID-19 Pandemic (Narrative) (Details) - USD ($)			1 Months Ended	3 Months Ended			12 Months Ended	20 Months Ended
	Jul. 01, 2022	Mar. 11, 2021	Jan. 31, 2022	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021
Unusual Risk Or Uncertainty [Line Items]
Net service revenues				$ 251,599,000		$ 226,634,000
Hospice [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues				49,082,000		47,727,000
Home Health [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues				12,485,000		9,275,000
CARES Act [Member]
Unusual Risk Or Uncertainty [Line Items]
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		900,000
CARES Act [Member] | Home Health [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues				0		$ 200,000
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				11,000,000
Aggregate principal amount of grants received				11,000,000
Fund distributed to primarily for caregivers and retention efforts				2,400,000
Revenues				0
Cost of revenue				0
Aggregate funding amount				$ 400,000
PAYGO Act [Member]
Unusual Risk Or Uncertainty [Line Items]
Percentage of additional payment reduction			4%

Long-Term Debt (Schedule of Lon

Long-Term Debt (Schedule of Long-Term Debt) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Less unamortized issuance costs	$ (2,866)	$ (3,081)
Long-term debt	108,487	131,772
Revolving Credit Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 111,353	$ 134,853

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) - Credit Agreement [Member] - USD ($)		3 Months Ended
	Jul. 30, 2021	Mar. 31, 2023	Dec. 31, 2022	Jun. 30, 2021
Debt Instrument [Line Items]
Line of credit outstanding amount		$ 395,100,000
Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available		275,700,000
Debt instrument, maturity date	Jul. 30, 2026
Debt instrument total net leverage ratio	4.25%
Line of credit outstanding amount		8,000,000
Capital One, National Association [Member] | Term Loan [Member]
Debt Instrument [Line Items]
Line of credit outstanding amount		$ 111,400,000
Debt instrument stated interest rate		6.59%
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
Line of credit outstanding amount		$ 111,400,000	$ 134,900,000
Debt instrument stated interest rate		6.59%	6.13%
Revolving Credit Loan [Member] | Capital One, National Association [Member] | JourneyCare and Apple Home [Member]
Debt Instrument [Line Items]
Repayments of line of credit		$ 23,500,000
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]
Debt Instrument [Line Items]
Maximum aggregate loan amount available		$ 125,000,000

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Tax Disclosure [Abstract]
Effective income tax rate	22%	27.90%
Percentage of excess tax (benefit) expense included in effective income tax rate	(1.20%)	2.70%

Commitments and Contingencies (

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

Segment Information (Narrative)

Segment Information (Narrative) (Details)	3 Months Ended
	Mar. 31, 2023 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
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Net service revenues	$ 251,599	$ 226,634
Cost of services revenues	173,184	156,448
Gross profit	78,415	70,186
General and administrative expenses	56,360	53,152
Operating income	18,608	13,513
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	31,829	29,075
Operating income	46,586	41,111
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues	190,032	169,632
Cost of services revenues	138,383	126,291
Gross profit	51,649	43,341
Personal Care [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	15,935	15,004
Operating income	35,714	28,337
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues	49,082	47,727
Cost of services revenues	27,267	23,441
Gross profit	21,815	24,286
Hospice [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	13,015	11,712
Operating income	8,800	12,574
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues	12,485	9,275
Cost of services revenues	7,534	6,716
Gross profit	4,951	2,559
Home Health [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	2,879	2,359
Operating income	$ 2,072	$ 200

Segment Information (Segment Re

Segment Information (Segment Reconciliation to Totals reported in the accompanying Consolidated Financial Statements) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Operating income	$ 18,608	$ 13,513
Other general and administrative expenses	24,531	24,077
Depreciation and amortization	3,447	3,521
Interest income	(106)	(58)
Interest expense	2,461	1,820
Income before income taxes	16,253	11,751
Operating Segments [Member]
Segment Reporting Information [Line Items]
Operating income	$ 46,586	$ 41,111

Significant Payors (Revenue by

Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Net service revenues	$ 251,599	$ 226,634
Personal Care [Member]
Net service revenues	190,032	169,632
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 190,032	$ 169,632
Concentration risk, percentage	100%	100%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | State, Local And Other Governmental Programs [Member]
Net service revenues	$ 95,320	$ 83,908
Concentration risk, percentage	50.10%	49.50%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 87,901	$ 77,390
Concentration risk, percentage	46.30%	45.60%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member]
Net service revenues	$ 4,226	$ 4,626
Concentration risk, percentage	2.20%	2.70%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues	$ 1,669	$ 2,024
Concentration risk, percentage	0.90%	1.20%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 916	$ 1,684
Concentration risk, percentage	0.50%	1%
Hospice [Member]
Net service revenues	$ 49,082	$ 47,727
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 49,082	$ 47,727
Concentration risk, percentage	100%	100%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 44,556	$ 43,485
Concentration risk, percentage	90.70%	91.10%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 1,647	$ 1,715
Concentration risk, percentage	3.40%	3.60%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues	$ 2,547	$ 2,244
Concentration risk, percentage	5.20%	4.70%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 332	$ 283
Concentration risk, percentage	0.70%	0.60%
Home Health [Member]
Net service revenues	$ 12,485	$ 9,275
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 12,485	$ 9,275
Concentration risk, percentage	100%	100%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 9,270	$ 6,812
Concentration risk, percentage	74.20%	73.50%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 2,539	$ 1,904
Concentration risk, percentage	20.30%	20.50%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 676	$ 559
Concentration risk, percentage	5.50%	6%

Significant Payors (Revenue b_2

Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Net service revenues	$ 251,599	$ 226,634
Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Concentration risk, percentage	39.10%	37.40%
Personal Care [Member]
Net service revenues	$ 190,032	$ 169,632
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 190,032	$ 169,632
Concentration risk, percentage	100%	100%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 98,414	$ 84,693
Concentration risk, percentage	51.80%	49.90%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 28,474	$ 25,440
Concentration risk, percentage	15%	15%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member]
Net service revenues	$ 21,885	$ 21,385
Concentration risk, percentage	11.50%	12.60%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 41,259	$ 38,114
Concentration risk, percentage	21.70%	22.50%
Hospice [Member]
Net service revenues	$ 49,082	$ 47,727
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 49,082	$ 47,727
Concentration risk, percentage	100%	100%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Ohio [Member]
Net service revenues	$ 18,451	$ 16,328
Concentration risk, percentage	37.60%	34.20%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 11,480	$ 9,541
Concentration risk, percentage	23.40%	20%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 6,486	$ 8,233
Concentration risk, percentage	13.20%	17.30%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 12,665	$ 13,625
Concentration risk, percentage	25.80%	28.50%
Home Health [Member]
Net service revenues	$ 12,485	$ 9,275
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 12,485	$ 9,275
Concentration risk, percentage	100%	100%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 3,369	$ 1,766
Concentration risk, percentage	27%	19%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 9,116	$ 7,509
Concentration risk, percentage	73%	81%

Significant Payors (Narrative)

Significant Payors (Narrative) (Details) - Illinois [Member]	3 Months Ended		12 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Revenues [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	21.50%	20.70%
Revenues [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	39.10%	37.40%
Accounts Receivable [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	20.70%		18%

Subsequent Events (Narrative) (

Subsequent Events (Narrative) (Details) - Subsequent Event [Member] - Third Amendment and Restated Credit Agreement [Member]	Apr. 26, 2023
Subsequent Event [Line Items]
Term of credit agreement	The Third Amendment (i) replaces LIBOR with a forward-looking term SOFR-based rate as the applicable benchmark reference rate for loans under the credit facility and (ii) adds a 10-basis point credit spread adjustment for loans bearing interest based on SOFR. The Third Amendment does not change the interest rate margins applicable to the credit facility.
Basis point	0.10%