Addus HomeCare (ADUS) 10-Q 1 Aug 23 2023 Q2 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2023	Jul. 25, 2023
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2023
Document Fiscal Period Focus	Q2
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		16,214,653
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	Jun. 30, 2023	Dec. 31, 2022
Current assets
Cash	$ 84,188	$ 79,961
Accounts receivable, net of allowances	104,252	125,501
Prepaid expenses and other current assets	19,350	17,345
Total current assets	207,790	222,807
Property and equipment, net of accumulated depreciation and amortization	19,607	21,182
Other assets
Goodwill	583,656	582,837
Intangibles, net of accumulated amortization	68,859	72,188
Operating lease assets, net	48,472	38,980
Total other assets	700,987	694,005
Total assets	928,384	937,994
Current liabilities
Accounts payable	20,699	22,092
Accrued payroll	47,795	44,937
Accrued expenses	31,966	27,507
Operating lease liabilities, current portion	11,334	10,801
Government stimulus advances	9,959	12,912
Accrued workers' compensation insurance	12,149	12,897
Total current liabilities	133,902	131,146
Long-term liabilities
Long-term debt, net of debt issuance costs	78,702	131,772
Long-term operating lease liabilities	43,214	35,479
Other long-term liabilities	6,215	6,057
Total long-term liabilities	128,131	173,308
Total liabilities	262,033	304,454
Stockholders' equity
Common stock -$.001 par value; 40,000 authorized and 16,214 and 16,128 shares issued and outstanding as of June 30, 2022 and December 31, 2022, respectively	16	16
Additional paid-in capital	398,492	393,208
Retained earnings	267,843	240,316
Total stockholders' equity	666,351	633,540
Total liabilities and stockholders' equity	$ 928,384	$ 937,994

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 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	16,214,000	16,128,000
Common stock, shares outstanding	16,214,000	16,128,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Income Statement [Abstract]
Net service revenues	$ 259,980	$ 236,940	$ 511,579	$ 463,574
Cost of service revenues	177,662	161,342	350,846	317,790
Gross profit	82,318	75,598	160,733	145,784
General and administrative expenses	57,397	55,095	113,757	108,247
Depreciation and amortization	3,382	3,609	6,829	7,130
Total operating expenses	60,779	58,704	120,586	115,377
Operating income	21,539	16,894	40,147	30,407
Interest income	(291)	(108)	(397)	(166)
Interest expense	2,331	1,986	4,792	3,806
Total interest expense, net	2,040	1,878	4,395	3,640
Income before income taxes	19,499	15,016	35,752	26,767
Income tax expense	4,647	3,766	8,225	7,047
Net income	$ 14,852	$ 11,250	$ 27,527	$ 19,720
Net income per common share
Basic income per share	$ 0.93	$ 0.71	$ 1.72	$ 1.25
Diluted income per share	$ 0.91	$ 0.70	$ 1.69	$ 1.22
Weighted average number of common shares and potential common shares outstanding:
Basic	16,002	15,854	15,975	15,833
Diluted	16,283	16,131	16,304	16,113

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		130
Forfeiture of shares of common stock under restricted stock award agreements, shares		(3)
Stock-based compensation	5,165		5,165
Shares issued for exercise of stock options	548		548
Shares issued for exercise of stock options, shares		14
Net income	19,720			19,720
Balance at Jun. 30, 2022	599,777	$ 16	385,750	214,011
Balance, shares at Jun. 30, 2022		16,081
Balance at Mar. 31, 2022	585,778	$ 16	383,001	202,761
Balance, shares at Mar. 31, 2022		16,068
Issuance of shares of common stock under restricted stock award agreements, shares		15
Forfeiture of shares of common stock under restricted stock award agreements, shares		(3)
Stock-based compensation	2,680		2,680
Shares issued for exercise of stock options	69		69
Shares issued for exercise of stock options, shares		1
Net income	11,250			11,250
Balance at Jun. 30, 2022	599,777	$ 16	385,750	214,011
Balance, shares at Jun. 30, 2022		16,081
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		86
Stock-based compensation	5,259		5,259
Shares issued for exercise of stock options	25		25
Net income	27,527			27,527
Balance at Jun. 30, 2023	666,351	$ 16	398,492	267,843
Balance, shares at Jun. 30, 2023		16,214
Balance at Mar. 31, 2023	648,886	$ 16	395,879	252,991
Balance, shares at Mar. 31, 2023		16,204
Issuance of shares of common stock under restricted stock award agreements, shares		10
Stock-based compensation	2,613		2,613
Net income	14,852			14,852
Balance at Jun. 30, 2023	$ 666,351	$ 16	$ 398,492	$ 267,843
Balance, shares at Jun. 30, 2023		16,214

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash flows from operating activities:
Net income	$ 27,527	$ 19,720
Adjustments to reconcile net income to net cash provided by (used in) operating activities, net of acquisitions:
Depreciation and amortization	6,829	7,130
Deferred income taxes	165	291
Stock-based compensation	5,259	5,165
Amortization of debt issuance costs under the credit facility	430	430
Provision for credit losses	313	318
Impairment of operating lease assets		1,174
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	21,395	20,249
Prepaid expenses and other current assets	(4,018)	7,909
Government stimulus advances	(3,382)	12,562
Accounts payable	(597)	1,398
Accrued payroll	2,788	(5,756)
Accrued expenses and other long-term liabilities	3,704	(8,088)
Net cash provided by operating activities	60,413	62,502
Cash flows from investing activities:
Acquisitions of businesses, net of cash acquired	(940)	(84,490)
Purchases of property and equipment	(1,771)	(1,538)
Net cash used in investing activities	(2,711)	(86,028)
Cash flows from financing activities:
Payments on revolver loan — credit facility	(53,500)	(60,000)
Proceeds from borrowings on revolver — credit facility		35,000
Cash received from exercise of stock options	25	548
Net cash used in financing activities	(53,475)	(24,452)
Net change in cash	4,227	(47,978)
Cash, at beginning of period	79,961	168,895
Cash, at end of period	84,188	120,917
Supplemental disclosures of cash flow information:
Cash paid for interest	4,416	3,403
Cash paid for income taxes	$ 6,767
Acquisition consideration payable included in accrued expenses		$ 1,605

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ 14,852	$ 11,250	$ 27,527	$ 19,720

Insider Trading Arrangements

Insider Trading Arrangements	6 Months Ended
	Jun. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false

Nature of Operations, Consolida

Nature of Operations, Consolidation, and Presentation of Financial Statements	6 Months Ended
	Jun. 30, 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	6 Months Ended
	Jun. 30, 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 June 30, For the Six Months Ended June 30, (Amounts in thousands) (Amounts in thousands) 2023 2022 2023 2022 Weighted average number of shares outstanding for basic per share 16,002 15,854 15,975 15,833 Effect of dilutive potential shares: Stock options 237 241 245 237 Restricted stock awards 44 36 84 43 Adjusted weighted average shares outstanding for diluted per share 16,283 16,131 16,304 16,113 Anti-dilutive shares: Stock options 61 111 61 111 Restricted stock awards 77 81 1 19 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 the London Inter-Bank Offered Rate (“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 Third Amendment to Amended and Restated Credit Agreement dated as of April 26, 2023, the Company amended its credit facility to replace LIBOR with the secured overnight financing rate as administered by the Federal Reserve Bank of New York (“SOFR”) as the benchmark reference rate for loans under its credit facility. The transition to SOFR did not and is not expected to have a material impact on the Company’s results of operations or liquidity.

Leases

Leases	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Leases	3. Leases Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows: June 30, 2023 December 31, 2022 (Amounts in Thousands) Operating lease assets, net $ 48,472 $ 38,980 Short-term operating lease liabilities 11,334 10,801 Long-term operating lease liabilities 43,214 35,479 Total operating lease liabilities $ 54,548 $ 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 June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Operating lease costs $ 3,292 $ 3,103 $ 6,334 $ 5,904 Short-term lease costs 284 911 700 1,662 Total lease costs 3,576 4,014 7,034 7,566 Less: sublease income ( 700 ) ( 176 ) ( 1,399 ) ( 353 ) Total lease costs, net $ 2,876 $ 3,838 $ 5,635 $ 7,213 Lease Term and Discount Rate Weighted average remaining lease terms and discount rates were as follows: June 30, 2023 December 31, 2022 Operating leases: Weighted average remaining lease term (years) 6.55 5.82 Weighted average discount rate 5.25 % 3.98 % Maturity of Lease Liabilities Remaining operating lease payments as of June 30, 2023 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended June 30, 2024 $ 13,803 2025 11,485 2026 8,535 2027 6,605 2028 5,532 Thereafter 19,698 Total future minimum rental commitments 65,658 Less: Imputed interest ( 11,110 ) Total lease liabilities $ 54,548 Supplemental cash flows information For the Six Months Ended June 30, (Amounts in Thousands) 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 7,010 $ 6,476 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 14,415 $ 11,319

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 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 Health Total (Amounts in Thousands) Goodwill as of December 31, 2022 $ 397,728 $ 152,688 $ 32,421 $ 582,837 Additions for acquisitions — 599 599 Adjustments to previously recorded goodwill — — 220 220 Goodwill as of June 30, 2023 $ 397,728 $ 153,287 $ 32,641 $ 583,656 On January 1, 2023, the Company completed the 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 six months ended June 30, 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 June 30, 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 12,670 116,174 Accumulated amortization ( 38,840 ) ( 22,366 ) ( 5,193 ) ( 8,023 ) ( 74,423 ) Intangible assets subject to amortization, net 5,832 29,680 1,592 4,647 41,751 Total intangible assets at June 30, 2023 $ 5,832 $ 29,680 $ 1,592 $ 31,755 $ 68,859 Amortization expense related to the intangible assets was $ 1.7 million and $ 3.5 million for the three and six months ended June 30, 2023 , respectively, and $ 1.8 million and $ 3.6 million for the three and six months ended June 30, 2022, respectively. The weighted average remaining useful lives of identifiable intangible assets as of June 30, 2023 was 9.6 years.

Details of Certain Balance Shee

Details of Certain Balance Sheet Accounts	6 Months Ended
	Jun. 30, 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: June 30, 2023 December 31, 2022 (Amounts in Thousands) Prepaid payroll $ 8,240 $ 7,566 Prepaid workers' compensation and liability insurance 3,571 3,399 Prepaid licensing fees 4,638 3,722 Workers' compensation insurance receivable 582 666 Other 2,319 1,992 Total prepaid expenses and other current assets $ 19,350 $ 17,345 Accrued expenses consisted of the following: June 30, 2023 December 31, 2022 (Amounts in Thousands) Accrued health benefits 6,921 5,152 Payor advances (1) 2,136 4,473 Accrued professional fees 5,933 3,576 Accrued payroll and other taxes 8,747 6,175 Other 8,229 8,131 Total accrued expenses $ 31,966 $ 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	6 Months Ended
	Jun. 30, 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. Although the acute phase of the COVID-19 pandemic has faded, the World Health organization has ended its public health emergency declaration, and 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. However, compared to earlier periods, the number of COVID-19 infections and related hospitalizations has significantly declined. 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 took 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 The 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 six months ended June 30, 2023, the Company received additional state funding provided by the ARPA in an aggregate amount of $ 1.9 million. The Company recorded revenue of $ 0.2 million for certain states that met the revenue recognition criteria. The Company deferred the remaining $ 1.7 million, which was received from states with specific spending plans and reporting requirements. The Company utilized $ 2.4 million and 4.8 million of these funds during the three and six months ended June 30, 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 June 30, 2023, the deferred portion of ARPA funding of $ 10.0 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 the first six months of 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 $ 0.5 million for the three months ended June 30, 2023 and 2022, respectively and $ 0.0 million and $ 1.4 million for the six months ended June 30, 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 $ 0.1 for the three months ended June 30, 2023 and 2022 respectively and $ 0.0 million and $ 0.3 million for the six months ended June 30, 2023 and 2022, respectively.

Long-Term Debt

Long-Term Debt	6 Months Ended
	Jun. 30, 2023
Long-Term Debt, Unclassified [Abstract]
Long-Term Debt	7. Long-Term Debt Long-term debt consisted of the following: June 30, 2023 December 31, 2022 (Amounts in Thousands) Revolving loan under the credit facility $ 81,353 $ 134,853 Less unamortized issuance costs ( 2,651 ) ( 3,081 ) Long-term debt $ 78,702 $ 131,772 Amended and Restated Senior Secured Credit Facility On October 31, 2018, the Company entered into the Amended and Restated Credit Agreement, 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, as further amended by the Second Amendment to Amended and Restated Credit Agreement, dated as of July 30, 2021, and as further amended by the Third Amendment to Amended and Restated Credit Agreement, dated as of April 26, 2023 (as described below, the “Third Amendment”) (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 . On April 26, 2023, the Company entered into the Third Amendment to replace LIBOR with SOFR as the benchmark reference rate for loans under its credit facility. The Third Amendment did not amend any other terms of the Credit Agreement. 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 Term SOFR (as published by the CME Group Benchmark Administrative Limited) for an interest period of one month for such applicable day plus 0.10 % (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 rate per annum equal to the sum of Term SOFR (as published by the CME Group Benchmark Administrative Limited) for the applicable interest period plus 0.10 % (not to be less than zero ). Swing loans may not be SOFR loans. The transition to SOFR did not and 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 six months ended June 30, 2023, the Company did not draw on its credit facility and repaid $ 53.5 million under the revolving credit facility. During the six months ended June 30, 2022, the Company drew $ 35.0 million under its credit facility to fund, in part, the JourneyCare acquisition and repaid $ 60 million under the revolving credit facility. At June 30, 2023, the Company had a total of $ 81.4 million of revolving loans, with an interest rate of 6.95 %, 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 Company had $ 409.3 million of capacity and $ 319.9 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 June 30, 2023, the Company was in compliance with all financial covenants under the Credit Agreement.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2023
Income Tax Disclosure [Abstract]
Income Taxes	8. Income Taxes The effective income tax rates were 23.8 % and 25.1 % for the three months ended June 30, 2023 and 2022 , respectively. The effective income tax rates were 23.0 % and 26.3 % for the six months ended June 30, 2023 and 2022, respectively. The difference between our federal statutory rate of 21 % and our effective income tax rates is principally due to the inclusion of state taxes and non-deductible compensation, partially offset by the use of federal employment tax credits.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 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	6 Months Ended
	Jun. 30, 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 June 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 198,314 $ 50,210 $ 11,456 $ 259,980 Cost of services revenues 143,972 26,606 7,084 177,662 Gross profit 54,342 23,604 4,372 82,318 General and administrative expenses 16,267 12,768 2,641 31,676 Segment operating income $ 38,075 $ 10,836 $ 1,731 $ 50,642 For the Three Months Ended June 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 174,330 $ 52,074 $ 10,536 $ 236,940 Cost of services revenues 128,682 25,522 7,138 161,342 Gross profit 45,648 26,552 3,398 75,598 General and administrative expenses 15,447 13,036 2,501 30,984 Segment operating income $ 30,201 $ 13,516 $ 897 $ 44,614 For the Three Months Ended June 30, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 50,642 $ 44,614 Items not allocated at segment level: Other general and administrative expenses 25,721 24,111 Depreciation and amortization 3,382 3,609 Interest income ( 291 ) ( 108 ) Interest expense 2,331 1,986 Income before income taxes $ 19,499 $ 15,016 For the Six Months Ended June 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 388,346 $ 99,292 $ 23,941 $ 511,579 Cost of services revenues 282,355 53,873 14,618 350,846 Gross profit 105,991 45,419 9,323 160,733 General and administrative expenses 32,202 25,783 5,521 63,506 Segment operating income $ 73,788 $ 19,636 $ 3,803 $ 97,227 For the Six Months Ended June 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 343,962 $ 99,801 $ 19,811 $ 463,574 Cost of services revenues 254,973 48,963 13,854 317,790 Gross profit 88,989 50,838 5,957 145,784 General and administrative expenses 30,451 24,748 4,860 60,059 Segment operating income $ 58,538 $ 26,090 $ 1,097 $ 85,725 For the Six Months Ended June 30, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 97,227 $ 85,725 Items not allocated at segment level: Other general and administrative expenses 50,251 48,188 Depreciation and amortization 6,829 7,130 Interest income ( 397 ) ( 166 ) Interest expense 4,792 3,806 Income before income taxes $ 35,752 $ 26,767

Significant Payors

Significant Payors	6 Months Ended
	Jun. 30, 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 June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of State, local and other governmental programs $ 100,399 50.6 % $ 85,462 49.0 % $ 195,721 50.4 % $ 169,370 49.2 % Managed care organizations 91,276 46.0 80,577 46.2 179,176 46.1 157,967 45.9 Private pay 4,137 2.2 4,610 2.7 8,363 2.2 9,236 2.7 Commercial insurance 1,637 0.8 2,093 1.2 3,306 0.9 4,117 1.2 Other 865 0.4 1,588 0.9 1,781 0.4 3,272 1.0 Total personal care segment net service revenues $ 198,314 100.0 % $ 174,330 100.0 % $ 388,346 100.0 % $ 343,962 100.0 % Hospice Segment For the Three Months Ended June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Medicare $ 45,566 90.7 % $ 47,152 90.5 % $ 90,122 90.8 % $ 90,637 90.8 % Commercial insurance 2,726 5.4 2,726 5.2 5,273 5.3 4,970 5.0 Managed care organizations 1,567 3.1 1,968 3.8 3,214 3.2 3,683 3.7 Other 352 0.8 228 0.5 684 0.7 511 0.5 Total hospice segment net service revenues $ 50,210 100.0 % $ 52,074 100.0 % $ 99,293 100.0 % $ 99,801 100.0 % Home Health Segment For the Three Months Ended June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Medicare $ 8,716 76.1 % $ 7,592 72.1 % $ 17,988 75.1 % $ 14,404 72.7 % Managed care organizations 2,251 19.6 2,262 21.5 4,789 20.0 4,166 21.0 Other 489 4.3 682 6.4 1,164 4.9 1,241 6.3 Total home health segment net service revenues $ 11,456 100.0 % $ 10,536 100.0 % $ 23,941 100.0 % $ 19,811 100.0 % 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 June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Illinois $ 103,864 52.4 % $ 88,797 50.9 % $ 202,279 52.1 % $ 173,480 50.4 % New Mexico 27,907 14.1 26,473 15.2 56,381 14.5 51,912 15.1 New York (1) 23,841 12.0 21,127 12.1 45,727 11.8 42,513 12.4 All other states 42,702 21.5 37,933 21.8 83,959 21.6 76,057 22.1 Total personal care segment net service revenues $ 198,314 100.0 % $ 174,330 100.0 % $ 388,346 100.0 % $ 343,962 100.0 % (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 anticipated contract award date of April 1, 2023. On June 6, 2023, the New York State Department of Health notified the Company of a contract award. The Company has resumed services under this contract to all current payors. Hospice Segment For the Three Months Ended June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Ohio $ 19,332 38.5 % $ 17,245 33.1 % $ 37,783 38.1 % $ 33,574 33.7 % Illinois 11,606 23.1 13,561 26.0 23,087 23.3 16,078 16.1 New Mexico 6,540 13.0 7,846 15.1 13,026 13.1 23,102 23.1 All other states 12,732 25.4 13,422 25.8 25,397 25.5 27,047 27.1 Total hospice segment net service revenues $ 50,210 100.0 % $ 52,074 100.0 % $ 99,293 100.0 % $ 99,801 100.0 % Home Health Segment For the Three Months Ended June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of New Mexico $ 8,093 70.6 % $ 9,070 86.1 % $ 17,209 71.9 % $ 16,579 83.7 % Illinois 3,363 29.4 1,466 13.9 6,732 28.1 3,232 16.3 Total home health segment net service revenues $ 11,456 100.0 % $ 10,536 100.0 % $ 23,941 100.0 % $ 19,811 100.0 % 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 45.7 %, and 43.8 % of our net service revenues for the three months ended June 30, 2023, and 2022, respectively, and accounted for 45.4 % and 41.6 % of our net service revenues for the six months ended June 30, 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 June 30, 2023 and 2022, respectively, and accounted for 21.5 % and 20.7 % of the Company’s net service revenues for the six months ended June 30, 2023 and 2022, respectively. The related receivables due from the Illinois Department on Aging represented 13.0 % and 18.0 % of the Company’s net accounts receivable at June 30, 2023 and December 31, 2022 , respectively.

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2023
Subsequent Events [Abstract]
Subsequent Events	12. Subsequent Events On August 1, 2023 , the Company completed the acquisition of American Home Care, LLC, a Tennessee limited liability company (“AHC”) and its subsidiaries, Homecare, LLC, a Tennessee limited liability company (“Homecare”), Tennessee Valley Home Care, LLC (d/b/a Tennessee Quality Care – Home Health), a Tennessee limited liability company (“TQC – Home Health”), and Tri-County Home Health and Hospice, LLC (d/b/a Tennessee Quality Care - Hospice), a Tennessee limited liability company (“TQC – Hospice”, and collectively with AHC, Homecare, and TQC – Home Health “Tennessee Quality Care”) for approximately $ 106 million, with funding provided by drawing on the Company’s revolving credit facility pursuant to the terms of the Membership Interests Purchase Agreement dated as of June 28, 2023. With the purchase of Tennessee Quality Care, the Company expanded its services within its hospice and home health segments in Tennessee. The initial accounting is not yet complete as the Company is currently in the process of valuing the assets acquired and liabilities assumed in the transaction. Therefore, the related business combination disclosures have not been presented.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 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 June 30, For the Six Months Ended June 30, (Amounts in thousands) (Amounts in thousands) 2023 2022 2023 2022 Weighted average number of shares outstanding for basic per share 16,002 15,854 15,975 15,833 Effect of dilutive potential shares: Stock options 237 241 245 237 Restricted stock awards 44 36 84 43 Adjusted weighted average shares outstanding for diluted per share 16,283 16,131 16,304 16,113 Anti-dilutive shares: Stock options 61 111 61 111 Restricted stock awards 77 81 1 19
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 the London Inter-Bank Offered Rate (“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 Third Amendment to Amended and Restated Credit Agreement dated as of April 26, 2023, the Company amended its credit facility to replace LIBOR with the secured overnight financing rate as administered by the Federal Reserve Bank of New York (“SOFR”) as the benchmark reference rate for loans under its credit facility. The transition to SOFR did not and 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)	6 Months Ended
	Jun. 30, 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 June 30, For the Six Months Ended June 30, (Amounts in thousands) (Amounts in thousands) 2023 2022 2023 2022 Weighted average number of shares outstanding for basic per share 16,002 15,854 15,975 15,833 Effect of dilutive potential shares: Stock options 237 241 245 237 Restricted stock awards 44 36 84 43 Adjusted weighted average shares outstanding for diluted per share 16,283 16,131 16,304 16,113 Anti-dilutive shares: Stock options 61 111 61 111 Restricted stock awards 77 81 1 19

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 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: June 30, 2023 December 31, 2022 (Amounts in Thousands) Operating lease assets, net $ 48,472 $ 38,980 Short-term operating lease liabilities 11,334 10,801 Long-term operating lease liabilities 43,214 35,479 Total operating lease liabilities $ 54,548 $ 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 June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Operating lease costs $ 3,292 $ 3,103 $ 6,334 $ 5,904 Short-term lease costs 284 911 700 1,662 Total lease costs 3,576 4,014 7,034 7,566 Less: sublease income ( 700 ) ( 176 ) ( 1,399 ) ( 353 ) Total lease costs, net $ 2,876 $ 3,838 $ 5,635 $ 7,213
Schedule of Weighted Average Remaining Lease Terms and Discount Rates	Weighted average remaining lease terms and discount rates were as follows: June 30, 2023 December 31, 2022 Operating leases: Weighted average remaining lease term (years) 6.55 5.82 Weighted average discount rate 5.25 % 3.98 %
Summary of Remaining Operating Lease Payments	Remaining operating lease payments as of June 30, 2023 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended June 30, 2024 $ 13,803 2025 11,485 2026 8,535 2027 6,605 2028 5,532 Thereafter 19,698 Total future minimum rental commitments 65,658 Less: Imputed interest ( 11,110 ) Total lease liabilities $ 54,548
Supplemental Cash Flows Information	For the Six Months Ended June 30, (Amounts in Thousands) 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 7,010 $ 6,476 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 14,415 $ 11,319

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 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 Health Total (Amounts in Thousands) Goodwill as of December 31, 2022 $ 397,728 $ 152,688 $ 32,421 $ 582,837 Additions for acquisitions — 599 599 Adjustments to previously recorded goodwill — — 220 220 Goodwill as of June 30, 2023 $ 397,728 $ 153,287 $ 32,641 $ 583,656
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 June 30, 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 12,670 116,174 Accumulated amortization ( 38,840 ) ( 22,366 ) ( 5,193 ) ( 8,023 ) ( 74,423 ) Intangible assets subject to amortization, net 5,832 29,680 1,592 4,647 41,751 Total intangible assets at June 30, 2023 $ 5,832 $ 29,680 $ 1,592 $ 31,755 $ 68,859

Details of Certain Balance Sh_2

Details of Certain Balance Sheet Accounts (Tables)	6 Months Ended
	Jun. 30, 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: June 30, 2023 December 31, 2022 (Amounts in Thousands) Prepaid payroll $ 8,240 $ 7,566 Prepaid workers' compensation and liability insurance 3,571 3,399 Prepaid licensing fees 4,638 3,722 Workers' compensation insurance receivable 582 666 Other 2,319 1,992 Total prepaid expenses and other current assets $ 19,350 $ 17,345
Schedule of Accrued Expenses	Accrued expenses consisted of the following: June 30, 2023 December 31, 2022 (Amounts in Thousands) Accrued health benefits 6,921 5,152 Payor advances (1) 2,136 4,473 Accrued professional fees 5,933 3,576 Accrued payroll and other taxes 8,747 6,175 Other 8,229 8,131 Total accrued expenses $ 31,966 $ 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)	6 Months Ended
	Jun. 30, 2023
Long-Term Debt, Unclassified [Abstract]
Schedule of Long-Term Debt	Long-term debt consisted of the following: June 30, 2023 December 31, 2022 (Amounts in Thousands) Revolving loan under the credit facility $ 81,353 $ 134,853 Less unamortized issuance costs ( 2,651 ) ( 3,081 ) Long-term debt $ 78,702 $ 131,772

Segment Information (Tables)

Segment Information (Tables)	6 Months Ended
	Jun. 30, 2023
Segment Reporting [Abstract]
Summary of Segment Information	For the Three Months Ended June 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 198,314 $ 50,210 $ 11,456 $ 259,980 Cost of services revenues 143,972 26,606 7,084 177,662 Gross profit 54,342 23,604 4,372 82,318 General and administrative expenses 16,267 12,768 2,641 31,676 Segment operating income $ 38,075 $ 10,836 $ 1,731 $ 50,642 For the Three Months Ended June 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 174,330 $ 52,074 $ 10,536 $ 236,940 Cost of services revenues 128,682 25,522 7,138 161,342 Gross profit 45,648 26,552 3,398 75,598 General and administrative expenses 15,447 13,036 2,501 30,984 Segment operating income $ 30,201 $ 13,516 $ 897 $ 44,614 For the Three Months Ended June 30, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 50,642 $ 44,614 Items not allocated at segment level: Other general and administrative expenses 25,721 24,111 Depreciation and amortization 3,382 3,609 Interest income ( 291 ) ( 108 ) Interest expense 2,331 1,986 Income before income taxes $ 19,499 $ 15,016 For the Six Months Ended June 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 388,346 $ 99,292 $ 23,941 $ 511,579 Cost of services revenues 282,355 53,873 14,618 350,846 Gross profit 105,991 45,419 9,323 160,733 General and administrative expenses 32,202 25,783 5,521 63,506 Segment operating income $ 73,788 $ 19,636 $ 3,803 $ 97,227 For the Six Months Ended June 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 343,962 $ 99,801 $ 19,811 $ 463,574 Cost of services revenues 254,973 48,963 13,854 317,790 Gross profit 88,989 50,838 5,957 145,784 General and administrative expenses 30,451 24,748 4,860 60,059 Segment operating income $ 58,538 $ 26,090 $ 1,097 $ 85,725 For the Six Months Ended June 30, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 97,227 $ 85,725 Items not allocated at segment level: Other general and administrative expenses 50,251 48,188 Depreciation and amortization 6,829 7,130 Interest income ( 397 ) ( 166 ) Interest expense 4,792 3,806 Income before income taxes $ 35,752 $ 26,767

Significant Payors (Tables)

Significant Payors (Tables)	6 Months Ended
	Jun. 30, 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 June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of State, local and other governmental programs $ 100,399 50.6 % $ 85,462 49.0 % $ 195,721 50.4 % $ 169,370 49.2 % Managed care organizations 91,276 46.0 80,577 46.2 179,176 46.1 157,967 45.9 Private pay 4,137 2.2 4,610 2.7 8,363 2.2 9,236 2.7 Commercial insurance 1,637 0.8 2,093 1.2 3,306 0.9 4,117 1.2 Other 865 0.4 1,588 0.9 1,781 0.4 3,272 1.0 Total personal care segment net service revenues $ 198,314 100.0 % $ 174,330 100.0 % $ 388,346 100.0 % $ 343,962 100.0 % Hospice Segment For the Three Months Ended June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Medicare $ 45,566 90.7 % $ 47,152 90.5 % $ 90,122 90.8 % $ 90,637 90.8 % Commercial insurance 2,726 5.4 2,726 5.2 5,273 5.3 4,970 5.0 Managed care organizations 1,567 3.1 1,968 3.8 3,214 3.2 3,683 3.7 Other 352 0.8 228 0.5 684 0.7 511 0.5 Total hospice segment net service revenues $ 50,210 100.0 % $ 52,074 100.0 % $ 99,293 100.0 % $ 99,801 100.0 % Home Health Segment For the Three Months Ended June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Medicare $ 8,716 76.1 % $ 7,592 72.1 % $ 17,988 75.1 % $ 14,404 72.7 % Managed care organizations 2,251 19.6 2,262 21.5 4,789 20.0 4,166 21.0 Other 489 4.3 682 6.4 1,164 4.9 1,241 6.3 Total home health segment net service revenues $ 11,456 100.0 % $ 10,536 100.0 % $ 23,941 100.0 % $ 19,811 100.0 %
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 June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Illinois $ 103,864 52.4 % $ 88,797 50.9 % $ 202,279 52.1 % $ 173,480 50.4 % New Mexico 27,907 14.1 26,473 15.2 56,381 14.5 51,912 15.1 New York (1) 23,841 12.0 21,127 12.1 45,727 11.8 42,513 12.4 All other states 42,702 21.5 37,933 21.8 83,959 21.6 76,057 22.1 Total personal care segment net service revenues $ 198,314 100.0 % $ 174,330 100.0 % $ 388,346 100.0 % $ 343,962 100.0 % (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 anticipated contract award date of April 1, 2023. On June 6, 2023, the New York State Department of Health notified the Company of a contract award. The Company has resumed services under this contract to all current payors. Hospice Segment For the Three Months Ended June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Ohio $ 19,332 38.5 % $ 17,245 33.1 % $ 37,783 38.1 % $ 33,574 33.7 % Illinois 11,606 23.1 13,561 26.0 23,087 23.3 16,078 16.1 New Mexico 6,540 13.0 7,846 15.1 13,026 13.1 23,102 23.1 All other states 12,732 25.4 13,422 25.8 25,397 25.5 27,047 27.1 Total hospice segment net service revenues $ 50,210 100.0 % $ 52,074 100.0 % $ 99,293 100.0 % $ 99,801 100.0 % Home Health Segment For the Three Months Ended June 30, For the Six Months Ended June 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of New Mexico $ 8,093 70.6 % $ 9,070 86.1 % $ 17,209 71.9 % $ 16,579 83.7 % Illinois 3,363 29.4 1,466 13.9 6,732 28.1 3,232 16.3 Total home health segment net service revenues $ 11,456 100.0 % $ 10,536 100.0 % $ 23,941 100.0 % $ 19,811 100.0 %

Nature of Operations, Consoli_2

Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details)	6 Months Ended
	Jun. 30, 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		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Summary Of Significant Accounting Policies [Line Items]
Weighted average number of shares outstanding for basic per share calculation	16,002	15,854	15,975	15,833
Effect of dilutive potential shares:
Adjusted weighted average shares outstanding for diluted per share calculation	16,283	16,131	16,304	16,113
Employee Stock Option
Effect of dilutive potential shares:
Effect of dilutive potential shares	237	241	245	237
Anti-dilutive shares:
Anti-dilutive shares	61	111	61	111
Restricted Stock Awards [Member]
Effect of dilutive potential shares:
Effect of dilutive potential shares	44	36	84	43
Anti-dilutive shares:
Anti-dilutive shares	77	81	1	19

Summary of Significant Accoun_5

Summary of Significant Accounting Policies (Narrative) (Details) - ASU 2021-08 [Member]	Jun. 30, 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	Jun. 30, 2023	Dec. 31, 2022
Leases [Abstract]
Operating lease assets, net	$ 48,472	$ 38,980
Short-term operating lease liabilities	11,334	10,801
Long-term operating lease liabilities	43,214	35,479
Total operating lease liabilities	$ 54,548	$ 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		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Leases [Abstract]
Operating lease costs	$ 3,292	$ 3,103	$ 6,334	$ 5,904
Short-term lease costs	284	911	700	1,662
Total lease costs	3,576	4,014	7,034	7,566
Less: sublease income	(700)	(176)	(1,399)	(353)
Total lease costs, net	$ 2,876	$ 3,838	$ 5,635	$ 7,213

Leases (Schedule of Weighted Av

Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details)	Jun. 30, 2023	Dec. 31, 2022
Leases [Abstract]
Weighted average remaining lease term (years)	6 years 6 months 18 days	5 years 9 months 25 days
Weighted average discount rate	5.25%	3.98%

Leases (Summary of Remaining Op

Leases (Summary of Remaining Operating Lease Payments) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Leases [Abstract]
2024	$ 13,803
2025	11,485
2026	8,535
2027	6,605
2028	5,532
Thereafter	19,698
Total future minimum rental commitments	65,658
Less: Imputed interest	(11,110)
Total lease liabilities	$ 54,548	$ 46,280

Leases (Supplemental Cash Flows

Leases (Supplemental Cash Flows Information) (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 7,010	$ 6,476
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 14,415	$ 11,319

Acquisitions (Narrative) (Detai

Acquisitions (Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Business Acquisition [Line Items]
Total purchase price for business acquisition			$ 940	$ 84,490
Net service revenues	$ 259,980	$ 236,940	$ 511,579	$ 463,574

Acquisitions (Schedule of Fair

Acquisitions (Schedule of Fair Values of Assets and Liabilities) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Goodwill	$ 583,656	$ 582,837

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2023 USD ($)
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 582,837
Additions for acquisitions	0
Adjustments to previously recorded goodwill	0
Goodwill, at End of Period	583,656
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
Adjustments to previously recorded goodwill	0
Goodwill, at End of Period	$ 32,641

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Thousands		3 Months Ended		6 Months Ended
	Jan. 01, 2023	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Goodwill [Line Items]
Goodwill		$ 583,656		$ 583,656		$ 582,837
Amortization expense		$ 1,700	$ 1,800	3,500	$ 3,600
Total purchase price for business acquisition				$ 940	$ 84,490
Weighted average remaining useful lives of identifiable intangible assets		9 years 7 months 6 days		9 years 7 months 6 days
Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		1 year		1 year
Minimum [Member] | Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		5 years		5 years
Maximum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		25 years		25 years
Maximum [Member] | Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		10 years		10 years
Personal Care [Member]
Goodwill [Line Items]
Goodwill		$ 153,287		$ 153,287		$ 152,688
CareStaff [Member]
Goodwill [Line Items]
Total purchase price for business acquisition	$ 1,000
CareStaff [Member] | Personal Care [Member]
Goodwill [Line Items]
Goodwill		$ 600		$ 600

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands	Jun. 30, 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	(74,423)
Intangible assets subject to amortization, net	41,751
Total intangible assets at June 30, 2023	68,859	$ 72,188
Customer And Referral Relationships [Member]
Intangible assets subject to amortization:
Gross carrying amount	44,672
Accumulated amortization	(38,840)
Intangible assets subject to amortization, net	5,832
Total intangible assets at June 30, 2023	5,832
Trade Names and Trademarks [Member]
Intangible assets subject to amortization:
Gross carrying amount	52,046
Accumulated amortization	(22,366)
Intangible assets subject to amortization, net	29,680
Total intangible assets at June 30, 2023	29,680
Noncompete Agreements
Intangible assets subject to amortization:
Gross carrying amount	6,785
Accumulated amortization	(5,193)
Intangible assets subject to amortization, net	1,592
Total intangible assets at June 30, 2023	1,592
State Licenses [Member]
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	27,108
Intangible assets subject to amortization:
Gross carrying amount	12,670
Accumulated amortization	(8,023)
Intangible assets subject to amortization, net	4,647
Total intangible assets at June 30, 2023	$ 31,755

Details of Certain Balance Sh_3

Details of Certain Balance Sheet Accounts (Schedule of Prepaid Expenses and Other Current Assets) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Details Of Certain Balance Sheet Accounts [Abstract]
Prepaid payroll	$ 8,240	$ 7,566
Prepaid workers' compensation and liability insurance	3,571	3,399
Prepaid licensing fees	4,638	3,722
Workers' compensation insurance receivable	582	666
Other	2,319	1,992
Total prepaid expenses and other current assets	$ 19,350	$ 17,345

Details of Certain Balance Sh_4

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Details Of Certain Balance Sheet Accounts [Abstract]
Accrued health benefits	$ 6,921	$ 5,152
Payor advances	2,136	4,473
Accrued professional fees	5,933	3,576
Accrued payroll and other taxes	8,747	6,175
Other	8,229	8,131
Total accrued expenses	$ 31,966	$ 27,507

Government Actions to Mitigat_2

Government Actions to Mitigate COVID-19's Impact (Narrative) (Details) - USD ($) $ in Thousands			1 Months Ended	3 Months Ended		6 Months Ended		12 Months Ended	20 Months Ended
	Jul. 01, 2022	Mar. 11, 2021	Jan. 31, 2022	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022	Dec. 31, 2021
Unusual Risk Or Uncertainty [Line Items]
Net service revenues				$ 259,980	$ 236,940	$ 511,579	$ 463,574
Hospice [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues				50,210	52,074	99,292	99,801
Home Health [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues				11,456	$ 10,536	23,941	19,811
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	$ 500	0	1,400
CARES Act [Member] | Home Health [Member]
Unusual Risk Or Uncertainty [Line Items]
Net service revenues				0	$ 100	0	$ 300
ARPA [Member]
Unusual Risk Or Uncertainty [Line Items]
Relief funding to mitigate fiscal effects of COVID-19		$ 350,000,000
percentage point increase in federal matching funds								10%
Deferred portion of spending plans				10,000		10,000
Aggregate principal amount of grants received				1,700		1,700
Fund distributed to primarily for caregivers and retention efforts				$ 2,400		4,800
Cost of revenue						200
Aggregate funding amount						$ 1,900
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	Jun. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Less unamortized issuance costs	$ (2,651)	$ (3,081)
Long-term debt	78,702	131,772
Revolving Credit Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 81,353	$ 134,853

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) - Credit Agreement [Member] - USD ($)		6 Months Ended
	Apr. 26, 2023	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022	Jun. 30, 2021
Debt Instrument [Line Items]
Line of credit outstanding amount		$ 409,300,000
Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available		319,900,000
Debt instrument, maturity date	Jul. 30, 2026
Debt instrument variable interest rate margin	1%
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		$ 81,400,000
Debt instrument stated interest rate		6.95%
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] | SOFR [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	0.10%
Capital One, National Association [Member] | SOFR [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	0%
Capital One, National Association [Member] | One-Month SOFR [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin	0.10%
Capital One, National Association [Member] | One-Month SOFR [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		$ 81,400,000		$ 134,900,000
Debt instrument stated interest rate		6.95%		6.13%
Revolving Credit Loan [Member] | Capital One, National Association [Member] | JourneyCare and Apple Home [Member]
Debt Instrument [Line Items]
Proceeds from line of credit			$ 35,000,000
Repayments of line of credit		$ 53,500,000	$ 60,000,000
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]
Debt Instrument [Line Items]
Maximum aggregate loan amount available		$ 125,000,000

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Income Tax Disclosure [Abstract]
Effective income tax rate	23.80%	25.10%	23%	26.30%
Effective income tax, federal statutory rate			21%

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)	6 Months Ended
	Jun. 30, 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		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Segment Reporting Information [Line Items]
Net service revenues	$ 259,980	$ 236,940	$ 511,579	$ 463,574
Cost of services revenues	177,662	161,342	350,846	317,790
Gross profit	82,318	75,598	160,733	145,784
General and administrative expenses	57,397	55,095	113,757	108,247
Operating income	21,539	16,894	40,147	30,407
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	31,676	30,984	63,506	60,059
Operating income	50,642	44,614	97,227	85,725
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues	198,314	174,330	388,346	343,962
Cost of services revenues	143,972	128,682	282,355	254,973
Gross profit	54,342	45,648	105,991	88,989
Personal Care [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	16,267	15,447	32,202	30,451
Operating income	38,075	30,201	73,788	58,538
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues	50,210	52,074	99,292	99,801
Cost of services revenues	26,606	25,522	53,873	48,963
Gross profit	23,604	26,552	45,419	50,838
Hospice [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	12,768	13,036	25,783	24,748
Operating income	10,836	13,516	19,636	26,090
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues	11,456	10,536	23,941	19,811
Cost of services revenues	7,084	7,138	14,618	13,854
Gross profit	4,372	3,398	9,323	5,957
Home Health [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	2,641	2,501	5,521	4,860
Operating income	$ 1,731	$ 897	$ 3,803	$ 1,097

Segment Information (Segment Re

Segment Information (Segment Reconciliation to Totals reported in the accompanying Consolidated Financial Statements) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Segment Reporting Information [Line Items]
Operating income	$ 21,539	$ 16,894	$ 40,147	$ 30,407
Other general and administrative expenses	25,721	24,111	50,251	48,188
Depreciation and amortization	3,382	3,609	6,829	7,130
Interest income	(291)	(108)	(397)	(166)
Interest expense	2,331	1,986	4,792	3,806
Income before income taxes	19,499	15,016	35,752	26,767
Operating Segments [Member]
Segment Reporting Information [Line Items]
Operating income	$ 50,642	$ 44,614	$ 97,227	$ 85,725

Significant Payors (Revenue by

Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Net service revenues	$ 259,980	$ 236,940	$ 511,579	$ 463,574
Personal Care [Member]
Net service revenues	198,314	174,330	388,346	343,962
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 198,314	$ 174,330	$ 388,346	$ 343,962
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	$ 100,399	$ 85,462	$ 195,721	$ 169,370
Concentration risk, percentage	50.60%	49%	50.40%	49.20%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 91,276	$ 80,577	$ 179,176	$ 157,967
Concentration risk, percentage	46%	46.20%	46.10%	45.90%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member]
Net service revenues	$ 4,137	$ 4,610	$ 8,363	$ 9,236
Concentration risk, percentage	2.20%	2.70%	2.20%	2.70%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues	$ 1,637	$ 2,093	$ 3,306	$ 4,117
Concentration risk, percentage	0.80%	1.20%	0.90%	1.20%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 865	$ 1,588	$ 1,781	$ 3,272
Concentration risk, percentage	0.40%	0.90%	0.40%	1%
Hospice [Member]
Net service revenues	$ 50,210	$ 52,074	$ 99,292	$ 99,801
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 50,210	$ 52,074	$ 99,293	$ 99,801
Concentration risk, percentage	100%	100%	100%	100%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 45,566	$ 47,152	$ 90,122	$ 90,637
Concentration risk, percentage	90.70%	90.50%	90.80%	90.80%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 1,567	$ 1,968	$ 3,214	$ 3,683
Concentration risk, percentage	3.10%	3.80%	3.20%	3.70%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues	$ 2,726	$ 2,726	$ 5,273	$ 4,970
Concentration risk, percentage	5.40%	5.20%	5.30%	5%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 352	$ 228	$ 684	$ 511
Concentration risk, percentage	0.80%	0.50%	0.70%	0.50%
Home Health [Member]
Net service revenues	$ 11,456	$ 10,536	$ 23,941	$ 19,811
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 11,456	$ 10,536	$ 23,941	$ 19,811
Concentration risk, percentage	100%	100%	100%	100%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 8,716	$ 7,592	$ 17,988	$ 14,404
Concentration risk, percentage	76.10%	72.10%	75.10%	72.70%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 2,251	$ 2,262	$ 4,789	$ 4,166
Concentration risk, percentage	19.60%	21.50%	20%	21%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 489	$ 682	$ 1,164	$ 1,241
Concentration risk, percentage	4.30%	6.40%	4.90%	6.30%

Significant Payors (Revenue b_2

Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Net service revenues	$ 259,980	$ 236,940	$ 511,579	$ 463,574
Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Concentration risk, percentage	45.70%	43.80%	45.40%	41.60%
Personal Care [Member]
Net service revenues	$ 198,314	$ 174,330	$ 388,346	$ 343,962
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 198,314	$ 174,330	$ 388,346	$ 343,962
Concentration risk, percentage	100%	100%	100%	100%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 103,864	$ 88,797	$ 202,279	$ 173,480
Concentration risk, percentage	52.40%	50.90%	52.10%	50.40%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 27,907	$ 26,473	$ 56,381	$ 51,912
Concentration risk, percentage	14.10%	15.20%	14.50%	15.10%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member]
Net service revenues	$ 23,841	$ 21,127	$ 45,727	$ 42,513
Concentration risk, percentage	12%	12.10%	11.80%	12.40%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 42,702	$ 37,933	$ 83,959	$ 76,057
Concentration risk, percentage	21.50%	21.80%	21.60%	22.10%
Hospice [Member]
Net service revenues	$ 50,210	$ 52,074	$ 99,292	$ 99,801
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 50,210	$ 52,074	$ 99,293	$ 99,801
Concentration risk, percentage	100%	100%	100%	100%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Ohio [Member]
Net service revenues	$ 19,332	$ 17,245	$ 37,783	$ 33,574
Concentration risk, percentage	38.50%	33.10%	38.10%	33.70%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 11,606	$ 13,561	$ 23,087	$ 16,078
Concentration risk, percentage	23.10%	26%	23.30%	16.10%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 6,540	$ 7,846	$ 13,026	$ 23,102
Concentration risk, percentage	13%	15.10%	13.10%	23.10%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 12,732	$ 13,422	$ 25,397	$ 27,047
Concentration risk, percentage	25.40%	25.80%	25.50%	27.10%
Home Health [Member]
Net service revenues	$ 11,456	$ 10,536	$ 23,941	$ 19,811
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 11,456	$ 10,536	$ 23,941	$ 19,811
Concentration risk, percentage	100%	100%	100%	100%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 3,363	$ 1,466	$ 6,732	$ 3,232
Concentration risk, percentage	29.40%	13.90%	28.10%	16.30%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 8,093	$ 9,070	$ 17,209	$ 16,579
Concentration risk, percentage	70.60%	86.10%	71.90%	83.70%

Significant Payors (Narrative)

Significant Payors (Narrative) (Details) - Illinois [Member]	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Revenues [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	21.50%	20.70%	21.50%	20.70%
Revenues [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	45.70%	43.80%	45.40%	41.60%
Accounts Receivable [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			13%		18%

Subsequent Events (Narrative) (

Subsequent Events (Narrative) (Details) - Subsequent Event [Member] - American Home Care, LLC [Member] $ in Millions	Aug. 01, 2023 USD ($)
Subsequent Event [Line Items]
Acquisition completed date	Aug. 01, 2023
Business combination consideration transferred	$ 106