Document And Entity Information
Document And Entity Information - shares | 9 Months Ended | |
Sep. 30, 2023 | Oct. 24, 2023 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Sep. 30, 2023 | |
Document Fiscal Period Focus | Q3 | |
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 | Sep. 30, 2023 | Dec. 31, 2022 |
Current assets | ||
Cash | $ 79,750 | $ 79,961 |
Accounts receivable, net of allowances for credit losses | 121,112 | 125,501 |
Prepaid expenses and other current assets | 10,387 | 17,345 |
Total current assets | 211,249 | 222,807 |
Property and equipment, net of accumulated depreciation and amortization | 20,516 | 21,182 |
Other assets | ||
Goodwill | 662,981 | 582,837 |
Intangibles, net of accumulated amortization | 93,799 | 72,188 |
Operating lease assets, net | 47,183 | 38,980 |
Total other assets | 803,963 | 694,005 |
Total assets | 1,035,728 | 937,994 |
Current liabilities | ||
Accounts payable | 21,375 | 22,092 |
Accrued payroll | 51,774 | 44,937 |
Accrued expenses | 34,952 | 27,507 |
Operating lease liabilities, current portion | 11,434 | 10,801 |
Government stimulus advances | 7,836 | 12,912 |
Accrued workers' compensation insurance | 12,268 | 12,897 |
Total current liabilities | 139,639 | 131,146 |
Long-term liabilities | ||
Long-term debt, net of debt issuance costs | 163,917 | 131,772 |
Long-term operating lease liabilities | 41,632 | 35,479 |
Other long-term liabilities | 6,206 | 6,057 |
Total long-term liabilities | 211,755 | 173,308 |
Total liabilities | 351,394 | 304,454 |
Stockholders' equity | ||
Common stock-$.001 par value; 40,000 authorized and 16,214 and 16,128 shares issued and outstanding as of September 30, 2023 and December 31, 2022, respectively | 16 | 16 |
Additional paid-in capital | 401,064 | 393,208 |
Retained earnings | 283,254 | 240,316 |
Total stockholders' equity | 684,334 | 633,540 |
Total liabilities and stockholders' equity | $ 1,035,728 | $ 937,994 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares | Sep. 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 | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Income Statement [Abstract] | ||||
Net service revenues | $ 270,721 | $ 240,495 | $ 782,300 | $ 704,070 |
Cost of service revenues | 183,991 | 165,310 | 534,837 | 483,100 |
Gross profit | 86,730 | 75,185 | 247,463 | 220,970 |
General and administrative expenses | 60,271 | 54,228 | 174,028 | 162,476 |
Depreciation and amortization | 3,620 | 3,441 | 10,449 | 10,571 |
Total operating expenses | 63,891 | 57,669 | 184,477 | 173,047 |
Operating income | 22,839 | 17,516 | 62,986 | 47,923 |
Interest income | (580) | (83) | (977) | (249) |
Interest expense | 3,199 | 2,472 | 7,991 | 6,278 |
Total interest expense, net | 2,619 | 2,389 | 7,014 | 6,029 |
Income before income taxes | 20,220 | 15,127 | 55,972 | 41,894 |
Income tax expense | 4,809 | 3,584 | 13,034 | 10,631 |
Net income | $ 15,411 | $ 11,543 | $ 42,938 | $ 31,263 |
Net income per common share | ||||
Basic income per share | $ 0.96 | $ 0.73 | $ 2.69 | $ 1.97 |
Diluted income per share | $ 0.95 | $ 0.71 | $ 2.63 | $ 1.94 |
Weighted average number of common shares and potential common shares outstanding: | ||||
Basic | 16,012 | 15,872 | 15,988 | 15,846 |
Diluted | 16,286 | 16,184 | 16,307 | 16,146 |
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 | 129 | |||
Forfeiture of shares of common stock under restricted stock award agreements, shares | (4) | |||
Stock-based compensation | 7,945 | 7,945 | ||
Shares issued for exercise of stock options | 1,285 | 1,285 | ||
Shares issued for exercise of stock options, shares | 25 | |||
Net income | 31,263 | 31,263 | ||
Balance at Sep. 30, 2022 | 614,837 | $ 16 | 389,267 | 225,554 |
Balance, shares at Sep. 30, 2022 | 16,090 | |||
Balance at Jun. 30, 2022 | 599,777 | $ 16 | 385,750 | 214,011 |
Balance, shares at Jun. 30, 2022 | 16,081 | |||
Forfeiture of shares of common stock under restricted stock award agreements, shares | (1) | |||
Stock-based compensation | 2,780 | 2,780 | ||
Shares issued for exercise of stock options | 737 | 737 | ||
Shares issued for exercise of stock options, shares | 10 | |||
Net income | 11,543 | 11,543 | ||
Balance at Sep. 30, 2022 | 614,837 | $ 16 | 389,267 | 225,554 |
Balance, shares at Sep. 30, 2022 | 16,090 | |||
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 | 7,831 | 7,831 | ||
Shares issued for exercise of stock options | 25 | 25 | ||
Net income | 42,938 | 42,938 | ||
Balance at Sep. 30, 2023 | 684,334 | $ 16 | 401,064 | 283,254 |
Balance, shares at Sep. 30, 2023 | 16,214 | |||
Balance at Jun. 30, 2023 | 666,351 | $ 16 | 398,492 | 267,843 |
Balance, shares at Jun. 30, 2023 | 16,214 | |||
Stock-based compensation | 2,572 | 2,572 | ||
Net income | 15,411 | 15,411 | ||
Balance at Sep. 30, 2023 | $ 684,334 | $ 16 | $ 401,064 | $ 283,254 |
Balance, shares at Sep. 30, 2023 | 16,214 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2023 | Sep. 30, 2022 | |
Cash flows from operating activities: | ||
Net income | $ 42,938 | $ 31,263 |
Adjustments to reconcile net income to net cash provided by operating activities, net of acquisitions: | ||
Depreciation and amortization | 10,449 | 10,571 |
Deferred income taxes | 246 | 413 |
Stock-based compensation | 7,831 | 7,945 |
Amortization of debt issuance costs under the credit facility | 645 | 645 |
Provision for credit losses | 508 | 481 |
Impairment of operating lease assets | 8 | 1,174 |
Changes in operating assets and liabilities, net of acquisitions: | ||
Accounts receivable | 9,929 | 18,232 |
Prepaid expenses and other current assets | 6,277 | 10,568 |
Government stimulus advances | (5,528) | 16,985 |
Accounts payable | (2,118) | (693) |
Accrued payroll | 4,464 | (10,421) |
Accrued expenses and other long-term liabilities | 6,549 | (6,345) |
Net cash provided by (used in) operating activities | 82,198 | 80,818 |
Cash flows from investing activities: | ||
Acquisitions of businesses, net of cash acquired | (109,800) | (84,490) |
Purchases of property and equipment | (4,134) | (2,864) |
Net cash used in investing activities | (113,934) | (87,354) |
Cash flows from financing activities: | ||
Payments on revolver loan — credit facility | (78,500) | (105,000) |
Proceeds from borrowings on revolver — credit facility | 110,000 | 47,000 |
Cash received from exercise of stock options | 25 | 1,285 |
Net cash provided by (used in) financing activities | 31,525 | (56,715) |
Net change in cash | (211) | (63,251) |
Cash, at beginning of period | 79,961 | 168,895 |
Cash, at end of period | 79,750 | 105,644 |
Supplemental disclosures of cash flow information: | ||
Cash paid for interest | 7,364 | 5,589 |
Cash paid for income taxes | $ 10,565 | $ 629 |
Pay vs Performance Disclosure
Pay vs Performance Disclosure - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Pay vs Performance Disclosure | ||||
Net Income (Loss) | $ 15,411 | $ 11,543 | $ 42,938 | $ 31,263 |
Insider Trading Arrangements
Insider Trading Arrangements | 9 Months Ended |
Sep. 30, 2023 | |
Trading Arrangements, by Individual | |
Rule 10b5-1 Arrangement Adopted | false |
Non-Rule 10b5-1 Arrangement Adopted | false |
Rule 10b5-1 Arrangement Terminated | false |
Non-Rule 10b5-1 Arrangement Terminated | false |
Nature of Operations, Consolida
Nature of Operations, Consolidation, and Presentation of Financial Statements | 9 Months Ended |
Sep. 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 | 9 Months Ended |
Sep. 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 September 30, For the Nine Months Ended September 30, (Amounts in thousands) (Amounts in thousands) 2023 2022 2023 2022 Weighted average number of shares outstanding for basic per share 16,012 15,872 15,988 15,846 Effect of dilutive potential shares: Stock options 227 255 239 244 Restricted stock awards 47 57 80 56 Adjusted weighted average shares outstanding for diluted per share 16,286 16,184 16,307 16,146 Anti-dilutive shares: Stock options 111 111 61 111 Restricted stock awards 1 36 1 3 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. 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 8 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 | 9 Months Ended |
Sep. 30, 2023 | |
Leases [Abstract] | |
Leases | 3. Leases Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows: September 30, 2023 December 31, 2022 (Amounts in Thousands) Operating lease assets, net $ 47,183 $ 38,980 Short-term operating lease liabilities 11,434 10,801 Long-term operating lease liabilities 41,632 35,479 Total operating lease liabilities $ 53,066 $ 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 September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Operating lease costs $ 3,344 $ 3,251 $ 9,678 $ 8,888 Short-term lease costs 249 589 949 2,251 Total lease costs 3,593 3,840 10,627 11,139 Less: sublease income ( 704 ) ( 176 ) ( 2,104 ) ( 529 ) Total lease costs, net $ 2,889 $ 3,664 $ 8,523 $ 10,610 Lease Term and Discount Rate Weighted average remaining lease terms and discount rates were as follows: September 30, 2023 December 31, 2022 Operating leases: Weighted average remaining lease term (years) 6.39 5.82 Weighted average discount rate 5.36 % 3.98 % Maturity of Lease Liabilities Remaining operating lease payments as of September 30, 2023 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2024 $ 3,678 2025 13,434 2026 10,242 2027 7,943 2028 6,057 Thereafter 22,354 Total future minimum rental commitments 63,708 Less: Imputed interest ( 10,642 ) Total lease liabilities $ 53,066 Supplemental cash flows information For the Nine Months Ended September 30, (Amounts in Thousands) 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 10,702 $ 9,752 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 15,903 $ 13,130 |
Acquisitions
Acquisitions | 3 Months Ended |
Sep. 30, 2023 | |
Business Combinations [Abstract] | |
Acquisitions | 4. Acquisitions The Company’s acquisitions have been accounted for in accordance with ASC Topic 805, Business Combinations , and the resulting goodwill and other intangible assets were accounted for under ASC Topic 350, Goodwill and Other Intangible Assets . Under business combination accounting, the assets and liabilities are generally recognized at their fair values, with the difference between the consideration transferred, excluding transaction costs, and the fair values of the assets acquired and liabilities assumed recognized as goodwill. The results of each business acquisition are included on the Unaudited Condensed Consolidated Statements of Income from the date of the acquisition. Management’s assessment of qualitative factors affecting goodwill for each acquisition includes estimates of market share at the date of purchase, ability to grow in the market, synergy with existing Company operations and the payor profile in the markets. Tennessee Quality Care On August 1, 2023, we 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”). The purchase price was approximately $ 111.2 million, including the amount of acquired excess cash held by Tennessee Quality Care at the closing of the acquisition (approximately $ 2.4 million), and is subject to the completion of working capital and related adjustments. The Tennessee Quality Care acquisition was funded with a combination of a $ 110.0 million draw on the Company ’ s revolving credit facility and available cash. With the purchase of Tennessee Quality Care, the Company expanded its services within its hospice and home health segments in Tennessee. The related acquisition and integration costs were $ 0.5 million and $ 2.1 million for the three and nine months ended September 30, 2023, respectively. These costs were included in general and administrative expenses on the Unaudited Condensed Consolidated Statements of Income and were expen sed as incurred. Based upon management’s valuations, which are preliminary and subject to the completion of working capital and related adjustments, the fair values of the assets and liabilities acquired are as follows: Total Goodwill $ 79,318 Identifiable intangible assets 26,740 Cash 2,368 Accounts receivable 5,593 Property and equipment 307 Operating lease assets, net 194 Other assets 200 Accrued expenses ( 1,115 ) Accrued payroll ( 2,303 ) Long-term operating lease liabilities ( 73 ) Total purchase price $ 111,229 Identifiable intangible assets acquired included $ 7.5 million in a trade name and $ 19.2 million of indefinite-lived state licenses. The preliminary estimated fair value of identifiable intangible assets was determined with the assistance of a valuation specialist, using Level 3 inputs as defined under ASC Topic 820. The fair value analysis and related valuations reflect the conclusions of management. All estimates, key assumptions, and forecasts were either provided by or reviewed by the Company. The goodwill and intangible assets acquired are deductible for tax purposes. The Tennessee Quality Care acquisition accounted for $ 6.9 million of net service revenues and $ 1.5 million of operating income for each of the three and nine months ended September 30, 2023, respectively. The following table contains unaudited pro forma condensed consolidated income statement information of the Company for the three and nine months ended September 30, 2023 as if the Tennessee Quality Care acquisition closed on January 1, 2022. For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Net service revenues $ 274,559 $ 249,262 $ 808,408 $ 730,227 Operating income 25,310 18,871 68,951 53,049 Net income 17,512 11,755 46,031 32,695 Net income per common share Basic income per share $ 1.09 $ 0.74 $ 2.88 $ 2.06 Diluted income per share $ 1.08 $ 0.73 $ 2.82 $ 2.03 The pro forma disclosures in the table above include adjustments for amortization of intangible assets, tax expense and acquisition costs to reflect results that are more representative of the combined results of the transactions as if the operations of Tennessee Quality Care had been acquired effective January 1, 2022. This pro forma information is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred. In addition, future results may vary significantly from the results reflected in the pro forma information. The unaudited pro forma financial information does not reflect the impact of future events that may occur after the acquisition, such as anticipated cost savings from operating synergies. |
Goodwill and Intangible Assets
Goodwill and Intangible Assets | 9 Months Ended |
Sep. 30, 2023 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Goodwill and Intangible Assets | 5. Goodwill and Intangible Assets A summary of the goodwill and related adjustments is provided below: Hospice Personal Care Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2022 $ 397,728 $ 152,688 $ 32,421 $ 582,837 Additions for acquisitions 23,114 601 56,204 79,919 Adjustments to previously recorded goodwill 225 225 Goodwill as of September 30, 2023 $ 420,842 $ 153,289 $ 88,850 $ 662,981 In connection with the acquisition of Coastal Nursecare of Florida, Inc. (“CareStaff”) , the Company recognized goodwill in its personal care segment of $ 0.6 million during the nine months ended September 30, 2023. In connection with the Tennessee Quality Care acquisition, the Company recognized goodwill in its hospice and home health segments of $ 23.1 million and $ 56.2 million during the nine months ended September 30, 2023, respectively. The Company’s identifiable intangible assets consist of customer and referral relationships, trade names and trademarks, non-competition agreements and state licenses. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from five to twenty-five years . Customer and referral relationships are amortized systematically over the periods of expected economic benefit, which range from five to ten years . The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of September 30, 2023: Customer Trade Non- State Total (Amounts in Thousands) Intangible assets with indefinite lives $ — $ — $ — $ 46,328 $ 46,328 Intangible assets subject to amortization: Gross carrying amount 44,672 59,567 6,785 12,670 123,694 Accumulated amortization ( 39,203 ) ( 23,104 ) ( 5,397 ) ( 8,519 ) ( 76,223 ) Intangible assets subject to amortization, net 5,469 36,463 1,388 4,151 47,471 Total intangible assets at September 30, 2023 $ 5,469 $ 36,463 $ 1,388 $ 50,479 $ 93,799 In connection with the Tennessee Quality Care acquisition, the Company recognized a trade name of $ 2.1 million and indefinite-lived state licenses of $ 7.6 million in its hospice segment during the nine months ended September 30, 2023. The Company recognized a trade name of $ 5.4 million and indefinite-lived state licenses of $ 11.6 million in its home health segment during the nine months ended September 30, 2023. See Note 4 for additional information regarding the acquisition. Amortization expense related to the intangible assets was $ 1.8 million and $ 5.3 milli on for the three and nine months ended September 30, 2023 , respectively, and $ 1.8 million and $ 5.4 million for the three and nine months ended September 30, 2022, respectively. The weighted average remaining useful lives of identifiable intangible assets as of September 30, 2023 was 10.3 years. |
Details of Certain Balance Shee
Details of Certain Balance Sheet Accounts | 9 Months Ended |
Sep. 30, 2023 | |
Details Of Certain Balance Sheet Accounts [Abstract] | |
Details of Certain Balance Sheet Accounts | 6. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consisted of the following: September 30, 2023 December 31, 2022 (Amounts in Thousands) Prepaid payroll $ — $ 7,566 Prepaid workers' compensation and liability insurance 2,549 3,399 Prepaid licensing fees 4,392 3,722 Workers' compensation insurance receivable 587 666 Other 2,859 1,992 Total prepaid expenses and other current assets $ 10,387 $ 17,345 Accrued expenses consisted of the following: September 30, 2023 December 31, 2022 (Amounts in Thousands) Accrued health benefits $ 8,630 $ 5,152 Payor advances (1) 1,770 4,473 Accrued professional fees 6,015 3,576 Accrued payroll and other taxes 9,169 6,175 Other 9,368 8,131 Total accrued expenses $ 34,952 $ 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 | 9 Months Ended |
Sep. 30, 2023 | |
Risks and Uncertainties [Abstract] | |
Government Actions to Mitigate COVID-19's Impact | 7. Government Actions to Mitigate COVID-19’s Impact The acute phase of the coronavirus (“COVID-19”) global pandemic has faded, but the future course of COVID-19 remains uncertain. 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, including relief for healthcare providers in 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”), as well as 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 rep orts to the state in which the funds originated. Funds may be subject to recoupment if not expended or if they are expended on non-approved uses. During the nine months ended September 30, 2023, the Company received additional state funding provided by the ARPA in an aggregate amount of $ 2.0 million. The Company recorded revenue of $ 0.2 million for certain states that met the revenue recognition criteria. The Company deferred the remaining $ 1.8 million, which was received from states with specific spending plans and reporting requirements. Of the total state funding received by the Company pursuant to the ARPA through September 30, 2023, the Company utilized $ 2.1 million and $ 6.9 million during the three and nine months ended September 30, 2023, respectively, primarily for caregivers and adding support to recruiting and retention efforts, and included as a reduction of cost of service revenues in the Company’s Unaudited Condensed Consolidated Statements of Income. As of September 30, 2023, the deferred portion of ARPA funding of $ 7.8 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 $ 1.4 million for the nine months ended September 30, 2022. In the home health segment, Medicare sequester relief resulted in an increase in net service revenues of $ 0.3 million for the nine months ended September 30, 2022. |
Long-Term Debt
Long-Term Debt | 9 Months Ended |
Sep. 30, 2023 | |
Long-Term Debt, Unclassified [Abstract] | |
Long-Term Debt | 8. Long-Term Debt Long-term debt consisted of the following: September 30, 2023 December 31, 2022 (Amounts in Thousands) Revolving loan under the credit facility $ 166,353 $ 134,853 Less unamortized issuance costs ( 2,436 ) ( 3,081 ) Long-term debt $ 163,917 $ 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 nine months ended September 30, 2023 , the Company (i) drew $ 110.0 million under its credit facility to fund, in part, the Tennessee Quality Care acquisition and (ii) repaid $ 78.5 million under the revolving credit facility. During the nine months ended September 30, 2022, the Company drew $ 47.0 million under its credit facility to fund, in part, the acquisition of the operations of JourneyCare Inc. (“JourneyCare”) and the acquisition of Apple Home HealthCare, LTD (“Apple Home”). At September 30, 2023, the Company had a total of $ 166.4 million of revolving loans, with an interest rate of 7.17 %, outstanding on its credit facility. After giving effect to the amount drawn on its credit facility, approximately $ 8.1 million of outstanding letters of credit and borrowing limits based on an advance multiple of adjusted EBITDA (as defined in the Credit Agreement), the Company had $ 450.0 million of capacity and $ 275.6 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 September 30, 2023, the Company was in compliance with all financial covenants under the Credit Agreement. |
Income Taxes
Income Taxes | 9 Months Ended |
Sep. 30, 2023 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | 9. Income Taxes The effective income tax rates were 23.8 % and 23.7 % for the three months ended September 30, 2023 and 2022 , respectively. The effective income tax rates were 23.3 % and 25.4 % for the nine months ended September 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 | 9 Months Ended |
Sep. 30, 2023 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 10. Commitments and Contingencies Legal Proceedings From time to time, the Company is subject to legal and/or administrative proceedings incidental to its business. On June 2, 2021, the Company received a $ 6.5 million Request for Repayment from Palmetto, GBA, LLC (“Palmetto”), a Medicare administrative contractor, regarding Ambercare Hospice Inc. (“Ambercare”), our subsidiary that provides hospice services in New Mexico. In 2018, the Office of Audit Services (“OAS”), under the HHS Office of Inspector General, initiated a clinical review of certain hospice claims billed during a timeframe from January 1, 2016 to December 31, 2017. The OAS review concluded that certain payments to Ambercare for hospice services during the review period were made in error. The Company acquired Ambercare in May 2018 and has a contractual right to full indemnification from any potential losses from the OAS review and has been fully reimbursed for the amount of the Request for Repayment through the terms of the Ambercare purchase agreement. The Company disputes the results of the OAS review and related asserted billing errors and is in the process of filing administrative appeals. At this stage, the Company cannot predict the ultimate outcome of the appeal process. It is the opinion of management that the outcome of pending legal and/or administrative proceedings will not have a material effect on the Company’s Unaudited Condensed Consolidated Balance Sheets and Unaudited Condensed Consolidated Statements of Income. |
Segment Information
Segment Information | 9 Months Ended |
Sep. 30, 2023 | |
Segment Reporting [Abstract] | |
Segment Information | 11. Segment Information Operating segments are defined as components of a company that engage in business activities from which it may earn revenues and incur expenses, and for which separate financial information is available and is regularly reviewed by the Company’s chief operating decision makers, to assess the performance of the individual segments and make decisions about resources to be allocated to the segments. The Company operates as a multi-state provider of three distinct but related business segments providing in-home services. In its personal care segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy. The tables below set forth information about the Company’s reportable segments, along with the items necessary to reconcile the segment information to the totals reported in the accompanying Unaudited Condensed Consolidated Financial Statements. Segment assets are not reviewed by the Company’s chief operating decision maker function and therefore are not disclosed below. Segment operating income consists of revenue generated by a segment, less the direct costs of service revenues and general and administrative expenses that are incurred directly by the segment. Unallocated general and administrative costs are those costs for functions performed in a centralized manner and therefore not attributable to a particular segment. These costs include accounting, finance, human resources, legal, information technology, corporate office support and facility costs and overall corporate management. For the Three Months Ended September 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 201,882 $ 53,121 $ 15,718 $ 270,721 Cost of services revenues 145,808 28,155 10,028 183,991 Gross profit 56,074 24,966 5,690 86,730 General and administrative expenses 16,096 13,246 4,131 33,473 Segment operating income $ 39,978 $ 11,720 $ 1,559 $ 53,257 For the Three Months Ended September 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 179,180 $ 51,359 $ 9,956 $ 240,495 Cost of services revenues 131,968 25,695 7,647 165,310 Gross profit 47,212 25,664 2,309 75,185 General and administrative expenses 15,238 12,550 2,410 30,198 Segment operating income $ 31,974 $ 13,114 $ ( 101 ) $ 44,987 For the Three Months Ended September 30, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 53,257 $ 44,987 Items not allocated at segment level: Other general and administrative expenses 26,798 24,030 Depreciation and amortization 3,620 3,441 Interest income ( 580 ) ( 83 ) Interest expense 3,199 2,472 Income before income taxes $ 20,220 $ 15,127 For the Nine Months Ended September 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 590,227 $ 152,414 $ 39,659 $ 782,300 Cost of services revenues 428,163 82,028 24,646 534,837 Gross profit 162,064 70,386 15,013 247,463 General and administrative expenses 48,299 39,028 9,653 96,980 Segment operating income $ 113,765 $ 31,358 $ 5,360 $ 150,483 For the Nine Months Ended September 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 523,142 $ 151,160 $ 29,768 $ 704,070 Cost of services revenues 386,940 74,659 21,501 483,100 Gross profit 136,202 76,501 8,267 220,970 General and administrative expenses 45,688 37,298 7,270 90,256 Segment operating income $ 90,514 $ 39,203 $ 997 $ 130,714 For the Nine Months Ended September 30, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 150,483 $ 130,714 Items not allocated at segment level: Other general and administrative expenses 77,048 72,220 Depreciation and amortization 10,449 10,571 Interest income ( 977 ) ( 249 ) Interest expense 7,991 6,278 Income before income taxes $ 55,972 $ 41,894 |
Significant Payors
Significant Payors | 9 Months Ended |
Sep. 30, 2023 | |
Significant Payors [Abstract] | |
Significant Payors | 12. Significant Payors The Company’s revenue by payor type was as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of State, local and other governmental programs $ 101,821 50.4 % $ 88,448 49.4 % $ 297,541 50.4 % $ 257,817 49.4 % Managed care organizations 93,583 46.4 83,199 46.4 272,758 46.2 241,164 46.1 Private pay 3,990 2.0 4,521 2.6 12,354 2.1 13,758 2.6 Commercial insurance 1,631 0.8 1,870 1.0 4,937 0.8 5,988 1.1 Other 856 0.4 1,142 0.6 2,637 0.5 4,415 0.8 Total personal care segment net service revenues $ 201,882 100.0 % $ 179,180 100.0 % $ 590,227 100.0 % $ 523,142 100.0 % Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Medicare $ 47,313 89.1 % $ 46,537 90.6 % $ 137,432 90.2 % $ 137,174 90.8 % Commercial insurance 3,640 6.8 2,772 5.4 8,916 5.8 7,742 5.1 Managed care organizations 1,808 3.4 1,815 3.5 5,022 3.3 5,498 3.6 Other 360 0.7 235 0.5 1,044 0.7 746 0.5 Total hospice segment net service revenues $ 53,121 100.0 % $ 51,359 100.0 % $ 152,414 100.0 % $ 151,160 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Medicare $ 11,325 72.1 % $ 7,320 73.5 % $ 29,306 73.9 % $ 21,727 73.0 % Managed care organizations 3,445 21.9 1,998 20.1 8,239 20.8 6,160 20.7 Other 948 6.0 638 6.4 2,114 5.3 1,881 6.3 Total home health segment net service revenues $ 15,718 100.0 % $ 9,956 100.0 % $ 39,659 100.0 % $ 29,768 100.0 % The Company derives a significant amount of its revenue from its operations in Illinois, New Mexico and New York. The percentages of segment revenue for each of these significant states were as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Illinois $ 105,206 52.1 % $ 92,804 51.8 % $ 306,711 52.0 % $ 266,284 50.9 % New Mexico 28,347 14.0 26,912 15.0 84,969 14.3 78,825 15.1 New York (1) 22,989 11.4 20,997 11.7 68,910 11.7 63,510 12.1 All other states 45,340 22.5 38,467 21.5 129,637 22.0 114,523 21.9 Total personal care segment net service revenues $ 201,882 100.0 % $ 179,180 100.0 % $ 590,227 100.0 % $ 523,142 100.0 % (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, amended the 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 submitted 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, which allowed the Company to continue its CDPAP fiscal intermediary operations. However, the Company decided at that time to suspend materially all of its new fee-for-service patient admissions in the CDPAP program through County Social Service Departments. On June 6, 2023, the New York State Department of Health notified the Company that it had received a contract award. Under this contract, the Company is providing services to all current payors and has resumed new fee-for-service patient admissions through County Social Service Departments in the CDPAP program. Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Ohio $ 18,916 35.6 % $ 18,139 35.3 % $ 55,363 36.3 % $ 51,714 34.2 % Illinois 12,477 23.5 12,188 23.7 34,750 22.8 35,290 23.3 New Mexico 7,619 14.3 7,789 15.2 23,688 15.5 23,867 15.8 All other states 14,109 26.6 13,243 25.8 38,612 25.4 40,289 26.7 Total hospice segment net service revenues $ 53,121 100.0 % $ 51,359 100.0 % $ 152,414 100.0 % $ 151,160 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of New Mexico $ 8,040 51.2 % $ 8,375 84.1 % $ 25,277 63.7 % $ 24,954 83.8 % Illinois 2,909 18.5 1,581 15.9 9,539 24.1 4,814 16.2 Tennessee 4,769 30.3 — — 4,843 12.2 — — Total home health segment net service revenues $ 15,718 100.0 % $ 9,956 100.0 % $ 39,659 100.0 % $ 29,768 100.0 % 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 44.5 % and 44.3 % of our net service revenues for the three months ended September 30, 2023, and 2022, respectively, and accounted for 44.9 % and 43.5 % of our net service revenues for the nine months ended September 30, 2023 and 2022, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.5 % and 21.0 % of the Company’s net service revenues for the three months ended September 30, 2023 and 2022, respectively, and accounted for 21.2 % and 20.8 % of the Company’s net service revenues for the nine months ended September 30, 2023 and 2022, respectively. The related receivables due from the Illinois Department on Aging represented 20.5 % and 18.0 % of the Company’s net accounts receivable at September 30, 2023 and December 31, 2022 , respectively. |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 9 Months Ended |
Sep. 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 September 30, For the Nine Months Ended September 30, (Amounts in thousands) (Amounts in thousands) 2023 2022 2023 2022 Weighted average number of shares outstanding for basic per share 16,012 15,872 15,988 15,846 Effect of dilutive potential shares: Stock options 227 255 239 244 Restricted stock awards 47 57 80 56 Adjusted weighted average shares outstanding for diluted per share 16,286 16,184 16,307 16,146 Anti-dilutive shares: Stock options 111 111 61 111 Restricted stock awards 1 36 1 3 |
Recently 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. 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 8 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) | 9 Months Ended |
Sep. 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 September 30, For the Nine Months Ended September 30, (Amounts in thousands) (Amounts in thousands) 2023 2022 2023 2022 Weighted average number of shares outstanding for basic per share 16,012 15,872 15,988 15,846 Effect of dilutive potential shares: Stock options 227 255 239 244 Restricted stock awards 47 57 80 56 Adjusted weighted average shares outstanding for diluted per share 16,286 16,184 16,307 16,146 Anti-dilutive shares: Stock options 111 111 61 111 Restricted stock awards 1 36 1 3 |
Leases (Tables)
Leases (Tables) | 9 Months Ended |
Sep. 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: September 30, 2023 December 31, 2022 (Amounts in Thousands) Operating lease assets, net $ 47,183 $ 38,980 Short-term operating lease liabilities 11,434 10,801 Long-term operating lease liabilities 41,632 35,479 Total operating lease liabilities $ 53,066 $ 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 September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Operating lease costs $ 3,344 $ 3,251 $ 9,678 $ 8,888 Short-term lease costs 249 589 949 2,251 Total lease costs 3,593 3,840 10,627 11,139 Less: sublease income ( 704 ) ( 176 ) ( 2,104 ) ( 529 ) Total lease costs, net $ 2,889 $ 3,664 $ 8,523 $ 10,610 |
Schedule of Weighted Average Remaining Lease Terms and Discount Rates | Weighted average remaining lease terms and discount rates were as follows: September 30, 2023 December 31, 2022 Operating leases: Weighted average remaining lease term (years) 6.39 5.82 Weighted average discount rate 5.36 % 3.98 % |
Summary of Remaining Operating Lease Payments | Remaining operating lease payments as of September 30, 2023 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2024 $ 3,678 2025 13,434 2026 10,242 2027 7,943 2028 6,057 Thereafter 22,354 Total future minimum rental commitments 63,708 Less: Imputed interest ( 10,642 ) Total lease liabilities $ 53,066 |
Supplemental Cash Flows Information | For the Nine Months Ended September 30, (Amounts in Thousands) 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 10,702 $ 9,752 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 15,903 $ 13,130 |
Acquisitions (Tables)
Acquisitions (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Business Combinations [Abstract] | |
Schedule of Fair Values of Assets and Liabilities | Based upon management’s valuations, which are preliminary and subject to the completion of working capital and related adjustments, the fair values of the assets and liabilities acquired are as follows: Total Goodwill $ 79,318 Identifiable intangible assets 26,740 Cash 2,368 Accounts receivable 5,593 Property and equipment 307 Operating lease assets, net 194 Other assets 200 Accrued expenses ( 1,115 ) Accrued payroll ( 2,303 ) Long-term operating lease liabilities ( 73 ) Total purchase price $ 111,229 |
Unaudited Pro Forma Condensed Consolidated Income Statement Information | The following table contains unaudited pro forma condensed consolidated income statement information of the Company for the three and nine months ended September 30, 2023 as if the Tennessee Quality Care acquisition closed on January 1, 2022. For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Net service revenues $ 274,559 $ 249,262 $ 808,408 $ 730,227 Operating income 25,310 18,871 68,951 53,049 Net income 17,512 11,755 46,031 32,695 Net income per common share Basic income per share $ 1.09 $ 0.74 $ 2.88 $ 2.06 Diluted income per share $ 1.08 $ 0.73 $ 2.82 $ 2.03 |
Goodwill and Intangible Assets
Goodwill and Intangible Assets (Tables) | 9 Months Ended |
Sep. 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 23,114 601 56,204 79,919 Adjustments to previously recorded goodwill 225 225 Goodwill as of September 30, 2023 $ 420,842 $ 153,289 $ 88,850 $ 662,981 |
Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset | The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of September 30, 2023: Customer Trade Non- State Total (Amounts in Thousands) Intangible assets with indefinite lives $ — $ — $ — $ 46,328 $ 46,328 Intangible assets subject to amortization: Gross carrying amount 44,672 59,567 6,785 12,670 123,694 Accumulated amortization ( 39,203 ) ( 23,104 ) ( 5,397 ) ( 8,519 ) ( 76,223 ) Intangible assets subject to amortization, net 5,469 36,463 1,388 4,151 47,471 Total intangible assets at September 30, 2023 $ 5,469 $ 36,463 $ 1,388 $ 50,479 $ 93,799 |
Details of Certain Balance Sh_2
Details of Certain Balance Sheet Accounts (Tables) | 9 Months Ended |
Sep. 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: September 30, 2023 December 31, 2022 (Amounts in Thousands) Prepaid payroll $ — $ 7,566 Prepaid workers' compensation and liability insurance 2,549 3,399 Prepaid licensing fees 4,392 3,722 Workers' compensation insurance receivable 587 666 Other 2,859 1,992 Total prepaid expenses and other current assets $ 10,387 $ 17,345 |
Schedule of Accrued Expenses | Accrued expenses consisted of the following: September 30, 2023 December 31, 2022 (Amounts in Thousands) Accrued health benefits $ 8,630 $ 5,152 Payor advances (1) 1,770 4,473 Accrued professional fees 6,015 3,576 Accrued payroll and other taxes 9,169 6,175 Other 9,368 8,131 Total accrued expenses $ 34,952 $ 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) | 9 Months Ended |
Sep. 30, 2023 | |
Long-Term Debt, Unclassified [Abstract] | |
Schedule of Long-Term Debt | Long-term debt consisted of the following: September 30, 2023 December 31, 2022 (Amounts in Thousands) Revolving loan under the credit facility $ 166,353 $ 134,853 Less unamortized issuance costs ( 2,436 ) ( 3,081 ) Long-term debt $ 163,917 $ 131,772 |
Segment Information (Tables)
Segment Information (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Segment Reporting [Abstract] | |
Summary of Segment Information | For the Three Months Ended September 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 201,882 $ 53,121 $ 15,718 $ 270,721 Cost of services revenues 145,808 28,155 10,028 183,991 Gross profit 56,074 24,966 5,690 86,730 General and administrative expenses 16,096 13,246 4,131 33,473 Segment operating income $ 39,978 $ 11,720 $ 1,559 $ 53,257 For the Three Months Ended September 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 179,180 $ 51,359 $ 9,956 $ 240,495 Cost of services revenues 131,968 25,695 7,647 165,310 Gross profit 47,212 25,664 2,309 75,185 General and administrative expenses 15,238 12,550 2,410 30,198 Segment operating income $ 31,974 $ 13,114 $ ( 101 ) $ 44,987 For the Three Months Ended September 30, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 53,257 $ 44,987 Items not allocated at segment level: Other general and administrative expenses 26,798 24,030 Depreciation and amortization 3,620 3,441 Interest income ( 580 ) ( 83 ) Interest expense 3,199 2,472 Income before income taxes $ 20,220 $ 15,127 For the Nine Months Ended September 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 590,227 $ 152,414 $ 39,659 $ 782,300 Cost of services revenues 428,163 82,028 24,646 534,837 Gross profit 162,064 70,386 15,013 247,463 General and administrative expenses 48,299 39,028 9,653 96,980 Segment operating income $ 113,765 $ 31,358 $ 5,360 $ 150,483 For the Nine Months Ended September 30, 2022 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 523,142 $ 151,160 $ 29,768 $ 704,070 Cost of services revenues 386,940 74,659 21,501 483,100 Gross profit 136,202 76,501 8,267 220,970 General and administrative expenses 45,688 37,298 7,270 90,256 Segment operating income $ 90,514 $ 39,203 $ 997 $ 130,714 For the Nine Months Ended September 30, 2023 2022 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 150,483 $ 130,714 Items not allocated at segment level: Other general and administrative expenses 77,048 72,220 Depreciation and amortization 10,449 10,571 Interest income ( 977 ) ( 249 ) Interest expense 7,991 6,278 Income before income taxes $ 55,972 $ 41,894 |
Significant Payors (Tables)
Significant Payors (Tables) | 9 Months Ended |
Sep. 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 September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of State, local and other governmental programs $ 101,821 50.4 % $ 88,448 49.4 % $ 297,541 50.4 % $ 257,817 49.4 % Managed care organizations 93,583 46.4 83,199 46.4 272,758 46.2 241,164 46.1 Private pay 3,990 2.0 4,521 2.6 12,354 2.1 13,758 2.6 Commercial insurance 1,631 0.8 1,870 1.0 4,937 0.8 5,988 1.1 Other 856 0.4 1,142 0.6 2,637 0.5 4,415 0.8 Total personal care segment net service revenues $ 201,882 100.0 % $ 179,180 100.0 % $ 590,227 100.0 % $ 523,142 100.0 % Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Medicare $ 47,313 89.1 % $ 46,537 90.6 % $ 137,432 90.2 % $ 137,174 90.8 % Commercial insurance 3,640 6.8 2,772 5.4 8,916 5.8 7,742 5.1 Managed care organizations 1,808 3.4 1,815 3.5 5,022 3.3 5,498 3.6 Other 360 0.7 235 0.5 1,044 0.7 746 0.5 Total hospice segment net service revenues $ 53,121 100.0 % $ 51,359 100.0 % $ 152,414 100.0 % $ 151,160 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Medicare $ 11,325 72.1 % $ 7,320 73.5 % $ 29,306 73.9 % $ 21,727 73.0 % Managed care organizations 3,445 21.9 1,998 20.1 8,239 20.8 6,160 20.7 Other 948 6.0 638 6.4 2,114 5.3 1,881 6.3 Total home health segment net service revenues $ 15,718 100.0 % $ 9,956 100.0 % $ 39,659 100.0 % $ 29,768 100.0 % |
Schedule of Revenue by Geographic Location | The percentages of segment revenue for each of these significant states were as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Illinois $ 105,206 52.1 % $ 92,804 51.8 % $ 306,711 52.0 % $ 266,284 50.9 % New Mexico 28,347 14.0 26,912 15.0 84,969 14.3 78,825 15.1 New York (1) 22,989 11.4 20,997 11.7 68,910 11.7 63,510 12.1 All other states 45,340 22.5 38,467 21.5 129,637 22.0 114,523 21.9 Total personal care segment net service revenues $ 201,882 100.0 % $ 179,180 100.0 % $ 590,227 100.0 % $ 523,142 100.0 % (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, amended the 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 submitted 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, which allowed the Company to continue its CDPAP fiscal intermediary operations. However, the Company decided at that time to suspend materially all of its new fee-for-service patient admissions in the CDPAP program through County Social Service Departments. On June 6, 2023, the New York State Department of Health notified the Company that it had received a contract award. Under this contract, the Company is providing services to all current payors and has resumed new fee-for-service patient admissions through County Social Service Departments in the CDPAP program. Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of Ohio $ 18,916 35.6 % $ 18,139 35.3 % $ 55,363 36.3 % $ 51,714 34.2 % Illinois 12,477 23.5 12,188 23.7 34,750 22.8 35,290 23.3 New Mexico 7,619 14.3 7,789 15.2 23,688 15.5 23,867 15.8 All other states 14,109 26.6 13,243 25.8 38,612 25.4 40,289 26.7 Total hospice segment net service revenues $ 53,121 100.0 % $ 51,359 100.0 % $ 152,414 100.0 % $ 151,160 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Amount % of Amount % of Amount % of Amount % of New Mexico $ 8,040 51.2 % $ 8,375 84.1 % $ 25,277 63.7 % $ 24,954 83.8 % Illinois 2,909 18.5 1,581 15.9 9,539 24.1 4,814 16.2 Tennessee 4,769 30.3 — — 4,843 12.2 — — Total home health segment net service revenues $ 15,718 100.0 % $ 9,956 100.0 % $ 39,659 100.0 % $ 29,768 100.0 % |
Nature of Operations, Consoli_2
Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details) | 9 Months Ended |
Sep. 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 | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Summary Of Significant Accounting Policies [Line Items] | ||||
Weighted average number of shares outstanding for basic per share calculation | 16,012 | 15,872 | 15,988 | 15,846 |
Effect of dilutive potential shares: | ||||
Adjusted weighted average shares outstanding for diluted per share calculation | 16,286 | 16,184 | 16,307 | 16,146 |
Employee Stock Option | ||||
Effect of dilutive potential shares: | ||||
Effect of dilutive potential shares | 227 | 255 | 239 | 244 |
Anti-dilutive shares: | ||||
Anti-dilutive shares | 111 | 111 | 61 | 111 |
Restricted Stock Awards [Member] | ||||
Effect of dilutive potential shares: | ||||
Effect of dilutive potential shares | 47 | 57 | 80 | 56 |
Anti-dilutive shares: | ||||
Anti-dilutive shares | 1 | 36 | 1 | 3 |
Summary of Significant Accoun_5
Summary of Significant Accounting Policies (Narrative) (Details) - ASU 2021-08 [Member] | Sep. 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 | Sep. 30, 2023 | Dec. 31, 2022 |
Leases [Abstract] | ||
Operating lease assets, net | $ 47,183 | $ 38,980 |
Short-term operating lease liabilities | 11,434 | 10,801 |
Long-term operating lease liabilities | 41,632 | 35,479 |
Total operating lease liabilities | $ 53,066 | $ 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 | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Leases [Abstract] | ||||
Operating lease costs | $ 3,344 | $ 3,251 | $ 9,678 | $ 8,888 |
Short-term lease costs | 249 | 589 | 949 | 2,251 |
Total lease costs | 3,593 | 3,840 | 10,627 | 11,139 |
Less: sublease income | (704) | (176) | (2,104) | (529) |
Total lease costs, net | $ 2,889 | $ 3,664 | $ 8,523 | $ 10,610 |
Leases (Schedule of Weighted Av
Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details) | Sep. 30, 2023 | Dec. 31, 2022 |
Leases [Abstract] | ||
Weighted average remaining lease term (years) | 6 years 4 months 20 days | 5 years 9 months 25 days |
Weighted average discount rate | 5.36% | 3.98% |
Leases (Summary of Remaining Op
Leases (Summary of Remaining Operating Lease Payments) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Leases [Abstract] | ||
2024 | $ 3,678 | |
2025 | 13,434 | |
2026 | 10,242 | |
2027 | 7,943 | |
2028 | 6,057 | |
Thereafter | 22,354 | |
Total future minimum rental commitments | 63,708 | |
Less: Imputed interest | (10,642) | |
Total lease liabilities | $ 53,066 | $ 46,280 |
Leases (Supplemental Cash Flows
Leases (Supplemental Cash Flows Information) (Details) - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2023 | Sep. 30, 2022 | |
Cash paid for amounts included in the measurement of lease liabilities: | ||
Operating cash flows from operating leases | $ 10,702 | $ 9,752 |
Right-of-use assets obtained in exchange for lease obligations: | ||
Operating leases | $ 15,903 | $ 13,130 |
Acquisitions (Narrative) (Detai
Acquisitions (Narrative) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | |||
Aug. 01, 2023 | Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Business Acquisition [Line Items] | |||||
Total purchase price for business acquisition | $ 109,800 | $ 84,490 | |||
Net service revenues | $ 270,721 | $ 240,495 | 782,300 | 704,070 | |
Operating income | 22,839 | $ 17,516 | 62,986 | $ 47,923 | |
Tennessee Quality Care [Member] | |||||
Business Acquisition [Line Items] | |||||
Net service revenues | 6,900 | 6,900 | |||
Operating income | 1,500 | 1,500 | |||
Tennessee Quality Care [Member] | Trade Names [Member] | |||||
Business Acquisition [Line Items] | |||||
Identifiable intangible assets acquired | $ 7,500 | ||||
Tennessee Quality Care [Member] | State Licenses [Member] | |||||
Business Acquisition [Line Items] | |||||
Indefinite lived intangible assets acquired | 19,200 | ||||
Tennessee Quality Care [Member] | Tennessee [Member] | |||||
Business Acquisition [Line Items] | |||||
Total purchase price for business acquisition | 111,200 | ||||
Acquisition related costs | 500 | 500 | |||
Integration costs | $ 2,100 | $ 2,100 | |||
Excess cash held by acquired business | 2,400 | ||||
Tennessee Quality Care [Member] | Tennessee [Member] | Revolving Credit Facility [Member] | |||||
Business Acquisition [Line Items] | |||||
Line of credit outstanding amount | $ 110,000 |
Acquisitions (Schedule of Fair
Acquisitions (Schedule of Fair Values of Assets and Liabilities) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Aug. 01, 2023 | Dec. 31, 2022 |
Business Acquisition [Line Items] | |||
Goodwill | $ 662,981 | $ 582,837 | |
Tennessee Quality Care [Member] | |||
Business Acquisition [Line Items] | |||
Goodwill | $ 79,318 | ||
Identifiable intangible assets | 26,740 | ||
Cash | 2,368 | ||
Accounts receivable | 5,593 | ||
Property and equipment | 307 | ||
Operating lease assets, net | 194 | ||
Other assets | 200 | ||
Accrued expenses | (1,115) | ||
Accrued payroll | (2,303) | ||
Long-term operating lease liabilities | (73) | ||
Total purchase price | $ 111,229 |
Acquisitions (Unaudited Pro For
Acquisitions (Unaudited Pro Forma Condensed Consolidated Income Statement Information) (Details) - Tennessee Quality Care [Member] - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Business Acquisition [Line Items] | ||||
Net service revenues | $ 274,559 | $ 249,262 | $ 808,408 | $ 730,227 |
Operating income | 25,310 | 18,871 | 68,951 | 53,049 |
Net income | $ 17,512 | $ 11,755 | $ 46,031 | $ 32,695 |
Basic income per share | $ 1.09 | $ 0.74 | $ 2.88 | $ 2.06 |
Diluted income per share | $ 1.08 | $ 0.73 | $ 2.82 | $ 2.03 |
Goodwill and Intangible Asset_2
Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands | 9 Months Ended |
Sep. 30, 2023 USD ($) | |
Goodwill [Line Items] | |
Goodwill, at Beginning of Period | $ 582,837 |
Additions for acquisitions | 79,919 |
Adjustments to previously recorded goodwill | 225 |
Goodwill, at End of Period | 662,981 |
Hospice [Member] | |
Goodwill [Line Items] | |
Goodwill, at Beginning of Period | 397,728 |
Additions for acquisitions | 23,114 |
Goodwill, at End of Period | 420,842 |
Personal Care [Member] | |
Goodwill [Line Items] | |
Goodwill, at Beginning of Period | 152,688 |
Additions for acquisitions | 601 |
Goodwill, at End of Period | 153,289 |
Home Health [Member] | |
Goodwill [Line Items] | |
Goodwill, at Beginning of Period | 32,421 |
Additions for acquisitions | 56,204 |
Adjustments to previously recorded goodwill | 225 |
Goodwill, at End of Period | $ 88,850 |
Goodwill and Intangible Asset_3
Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | |||
Aug. 01, 2023 | Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Goodwill [Line Items] | |||||
Additions for acquisitions | $ 79,919 | ||||
Amortization expense | $ 1,800 | $ 1,800 | $ 5,300 | $ 5,400 | |
Weighted average remaining useful lives of identifiable intangible assets | 10 years 3 months 18 days | 10 years 3 months 18 days | |||
Minimum [Member] | |||||
Goodwill [Line Items] | |||||
Intangible assets, estimated useful lives | 5 years | 5 years | |||
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 | |||
Hospice [Member] | |||||
Goodwill [Line Items] | |||||
Additions for acquisitions | $ 23,114 | ||||
Home Health [Member] | |||||
Goodwill [Line Items] | |||||
Additions for acquisitions | 56,204 | ||||
Personal Care [Member] | |||||
Goodwill [Line Items] | |||||
Additions for acquisitions | 601 | ||||
Coastal Nursecare of Florida Inc [Member] | Personal Care [Member] | |||||
Goodwill [Line Items] | |||||
Additions for acquisitions | 600 | ||||
Tennessee Quality Care [Member] | Trade Names [Member] | |||||
Goodwill [Line Items] | |||||
Identifiable intangible assets acquired | $ 7,500 | ||||
Tennessee Quality Care [Member] | State Licenses [Member] | |||||
Goodwill [Line Items] | |||||
Indefinite lived intangible assets acquired | $ 19,200 | ||||
Tennessee Quality Care [Member] | Hospice [Member] | |||||
Goodwill [Line Items] | |||||
Additions for acquisitions | 23,100 | ||||
Tennessee Quality Care [Member] | Hospice [Member] | Trade Names [Member] | |||||
Goodwill [Line Items] | |||||
Identifiable intangible assets acquired | 2,100 | ||||
Tennessee Quality Care [Member] | Hospice [Member] | State Licenses [Member] | |||||
Goodwill [Line Items] | |||||
Indefinite lived intangible assets acquired | 7,600 | ||||
Tennessee Quality Care [Member] | Home Health [Member] | |||||
Goodwill [Line Items] | |||||
Additions for acquisitions | 56,200 | ||||
Tennessee Quality Care [Member] | Home Health [Member] | Trade Names [Member] | |||||
Goodwill [Line Items] | |||||
Identifiable intangible assets acquired | 5,400 | ||||
Tennessee Quality Care [Member] | Home Health [Member] | State Licenses [Member] | |||||
Goodwill [Line Items] | |||||
Indefinite lived intangible assets acquired | $ 11,600 |
Goodwill and Intangible Asset_4
Goodwill and Intangible Assets (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets with indefinite lives | $ 46,328 | |
Intangible assets subject to amortization: | ||
Gross carrying amount | 123,694 | |
Accumulated amortization | (76,223) | |
Intangible assets subject to amortization, net | 47,471 | |
Total intangible assets at September 30, 2023 | 93,799 | $ 72,188 |
Customer And Referral Relationships [Member] | ||
Intangible assets subject to amortization: | ||
Gross carrying amount | 44,672 | |
Accumulated amortization | (39,203) | |
Intangible assets subject to amortization, net | 5,469 | |
Total intangible assets at September 30, 2023 | 5,469 | |
Trade Names and Trademarks [Member] | ||
Intangible assets subject to amortization: | ||
Gross carrying amount | 59,567 | |
Accumulated amortization | (23,104) | |
Intangible assets subject to amortization, net | 36,463 | |
Total intangible assets at September 30, 2023 | 36,463 | |
Noncompete Agreements | ||
Intangible assets subject to amortization: | ||
Gross carrying amount | 6,785 | |
Accumulated amortization | (5,397) | |
Intangible assets subject to amortization, net | 1,388 | |
Total intangible assets at September 30, 2023 | 1,388 | |
State Licenses [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets with indefinite lives | 46,328 | |
Intangible assets subject to amortization: | ||
Gross carrying amount | 12,670 | |
Accumulated amortization | (8,519) | |
Intangible assets subject to amortization, net | 4,151 | |
Total intangible assets at September 30, 2023 | $ 50,479 |
Details of Certain Balance Sh_3
Details of Certain Balance Sheet Accounts (Schedule of Prepaid Expenses and Other Current Assets) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Details Of Certain Balance Sheet Accounts [Abstract] | ||
Prepaid payroll | $ 7,566 | |
Prepaid workers' compensation and liability insurance | $ 2,549 | 3,399 |
Prepaid licensing fees | 4,392 | 3,722 |
Workers' compensation insurance receivable | 587 | 666 |
Other | 2,859 | 1,992 |
Total prepaid expenses and other current assets | $ 10,387 | $ 17,345 |
Details of Certain Balance Sh_4
Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Details Of Certain Balance Sheet Accounts [Abstract] | ||
Accrued health benefits | $ 8,630 | $ 5,152 |
Payor advances | 1,770 | 4,473 |
Accrued professional fees | 6,015 | 3,576 |
Accrued payroll and other taxes | 9,169 | 6,175 |
Other | 9,368 | 8,131 |
Total accrued expenses | $ 34,952 | $ 27,507 |
Government Actions to Mitigat_2
Government Actions to Mitigate COVID-19's Impact (Narrative) (Details) - USD ($) | 1 Months Ended | 3 Months Ended | 9 Months Ended | 12 Months Ended | 23 Months Ended | |||||
Jul. 01, 2022 | Mar. 11, 2021 | Jan. 31, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | Jun. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | Dec. 31, 2022 | Mar. 31, 2022 | |
Unusual Risk Or Uncertainty [Line Items] | ||||||||||
Net service revenues | $ 270,721,000 | $ 240,495,000 | $ 782,300,000 | $ 704,070,000 | ||||||
Hospice [Member] | ||||||||||
Unusual Risk Or Uncertainty [Line Items] | ||||||||||
Net service revenues | 53,121,000 | 51,359,000 | 152,414,000 | 151,160,000 | ||||||
Home Health [Member] | ||||||||||
Unusual Risk Or Uncertainty [Line Items] | ||||||||||
Net service revenues | 15,718,000 | 9,956,000 | 39,659,000 | 29,768,000 | ||||||
Personal Care [Member] | ||||||||||
Unusual Risk Or Uncertainty [Line Items] | ||||||||||
Net service revenues | 201,882,000 | $ 179,180,000 | 590,227,000 | 523,142,000 | ||||||
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 | 1,400,000 | |||||||||
CARES Act [Member] | Home Health [Member] | ||||||||||
Unusual Risk Or Uncertainty [Line Items] | ||||||||||
Net service revenues | $ 300,000 | |||||||||
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 | 7,800,000 | 7,800,000 | ||||||||
Aggregate principal amount of grants received | 1,800,000 | 1,800,000 | ||||||||
Fund distributed to primarily for caregivers and retention efforts | $ 2,100 | 6,900 | ||||||||
Cost of revenue | 200,000 | |||||||||
Aggregate funding amount | $ 2,000,000 | |||||||||
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 | Sep. 30, 2023 | Dec. 31, 2022 |
Debt Instrument [Line Items] | ||
Less unamortized issuance costs | $ (2,436) | $ (3,081) |
Long-term debt | 163,917 | 131,772 |
Revolving Credit Loan [Member] | Senior Secured Credit Facility [Member] | ||
Debt Instrument [Line Items] | ||
Long-term debt gross | $ 166,353 | $ 134,853 |
Long-Term Debt (Narrative) (Det
Long-Term Debt (Narrative) (Details) - Credit Agreement [Member] - USD ($) | 9 Months Ended | |||
Apr. 26, 2023 | Sep. 30, 2023 | Sep. 30, 2022 | Dec. 31, 2022 | |
Debt Instrument [Line Items] | ||||
Line of credit outstanding amount | $ 450,000,000 | |||
Capital One, National Association [Member] | ||||
Debt Instrument [Line Items] | ||||
Maximum aggregate loan amount available | $ 275,600,000 | |||
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 | 8,100,000 | |||
Capital One, National Association [Member] | Term Loan [Member] | ||||
Debt Instrument [Line Items] | ||||
Line of credit outstanding amount | 166,400,000 | |||
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] | One-Month Secured Overnight Financing Rate (SOFR) [Member] | ||||
Debt Instrument [Line Items] | ||||
Debt instrument variable interest rate margin | 0.10% | |||
Capital One, National Association [Member] | One-Month Secured Overnight Financing Rate (SOFR) [Member] | Minimum [Member] | ||||
Debt Instrument [Line Items] | ||||
Debt instrument variable interest rate margin | 0% | |||
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 | $ 134,900,000 | |||
Debt instrument stated interest rate | 7.17% | 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 | $ 47,000,000 | |||
Revolving Credit Loan [Member] | Capital One, National Association [Member] | Tennessee Quality Care [Member] | ||||
Debt Instrument [Line Items] | ||||
Proceeds from line of credit | $ 110,000,000 | |||
Repayments of line of credit | $ 78,500,000 | |||
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 | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Income Tax Disclosure [Abstract] | ||||
Effective income tax rate | 23.80% | 23.70% | 23.30% | 25.40% |
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) | 9 Months Ended |
Sep. 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 | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Segment Reporting Information [Line Items] | ||||
Net service revenues | $ 270,721 | $ 240,495 | $ 782,300 | $ 704,070 |
Cost of services revenues | 183,991 | 165,310 | 534,837 | 483,100 |
Gross profit | 86,730 | 75,185 | 247,463 | 220,970 |
General and administrative expenses | 60,271 | 54,228 | 174,028 | 162,476 |
Operating income | 22,839 | 17,516 | 62,986 | 47,923 |
Operating Segments [Member] | ||||
Segment Reporting Information [Line Items] | ||||
General and administrative expenses | 33,473 | 30,198 | 96,980 | 90,256 |
Operating income | 53,257 | 44,987 | 150,483 | 130,714 |
Personal Care [Member] | ||||
Segment Reporting Information [Line Items] | ||||
Net service revenues | 201,882 | 179,180 | 590,227 | 523,142 |
Cost of services revenues | 145,808 | 131,968 | 428,163 | 386,940 |
Gross profit | 56,074 | 47,212 | 162,064 | 136,202 |
Personal Care [Member] | Operating Segments [Member] | ||||
Segment Reporting Information [Line Items] | ||||
General and administrative expenses | 16,096 | 15,238 | 48,299 | 45,688 |
Operating income | 39,978 | 31,974 | 113,765 | 90,514 |
Hospice [Member] | ||||
Segment Reporting Information [Line Items] | ||||
Net service revenues | 53,121 | 51,359 | 152,414 | 151,160 |
Cost of services revenues | 28,155 | 25,695 | 82,028 | 74,659 |
Gross profit | 24,966 | 25,664 | 70,386 | 76,501 |
Hospice [Member] | Operating Segments [Member] | ||||
Segment Reporting Information [Line Items] | ||||
General and administrative expenses | 13,246 | 12,550 | 39,028 | 37,298 |
Operating income | 11,720 | 13,114 | 31,358 | 39,203 |
Home Health [Member] | ||||
Segment Reporting Information [Line Items] | ||||
Net service revenues | 15,718 | 9,956 | 39,659 | 29,768 |
Cost of services revenues | 10,028 | 7,647 | 24,646 | 21,501 |
Gross profit | 5,690 | 2,309 | 15,013 | 8,267 |
Home Health [Member] | Operating Segments [Member] | ||||
Segment Reporting Information [Line Items] | ||||
General and administrative expenses | 4,131 | 2,410 | 9,653 | 7,270 |
Operating income | $ 1,559 | $ (101) | $ 5,360 | $ 997 |
Segment Information (Segment Re
Segment Information (Segment Reconciliation to Totals reported in the accompanying Consolidated Financial Statements) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Segment Reporting Information [Line Items] | ||||
Operating income | $ 22,839 | $ 17,516 | $ 62,986 | $ 47,923 |
Other general and administrative expenses | 26,798 | 24,030 | 77,048 | 72,220 |
Depreciation and amortization | 3,620 | 3,441 | 10,449 | 10,571 |
Interest income | (580) | (83) | (977) | (249) |
Interest expense | 3,199 | 2,472 | 7,991 | 6,278 |
Income before income taxes | 20,220 | 15,127 | 55,972 | 41,894 |
Operating Segments [Member] | ||||
Segment Reporting Information [Line Items] | ||||
Operating income | $ 53,257 | $ 44,987 | $ 150,483 | $ 130,714 |
Significant Payors (Revenue by
Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Net service revenues | $ 270,721 | $ 240,495 | $ 782,300 | $ 704,070 |
Personal Care [Member] | ||||
Net service revenues | 201,882 | 179,180 | 590,227 | 523,142 |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | ||||
Net service revenues | $ 201,882 | $ 179,180 | $ 590,227 | $ 523,142 |
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 | $ 101,821 | $ 88,448 | $ 297,541 | $ 257,817 |
Concentration risk, percentage | 50.40% | 49.40% | 50.40% | 49.40% |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member] | ||||
Net service revenues | $ 93,583 | $ 83,199 | $ 272,758 | $ 241,164 |
Concentration risk, percentage | 46.40% | 46.40% | 46.20% | 46.10% |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member] | ||||
Net service revenues | $ 3,990 | $ 4,521 | $ 12,354 | $ 13,758 |
Concentration risk, percentage | 2% | 2.60% | 2.10% | 2.60% |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member] | ||||
Net service revenues | $ 1,631 | $ 1,870 | $ 4,937 | $ 5,988 |
Concentration risk, percentage | 0.80% | 1% | 0.80% | 1.10% |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member] | ||||
Net service revenues | $ 856 | $ 1,142 | $ 2,637 | $ 4,415 |
Concentration risk, percentage | 0.40% | 0.60% | 0.50% | 0.80% |
Hospice [Member] | ||||
Net service revenues | $ 53,121 | $ 51,359 | $ 152,414 | $ 151,160 |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | ||||
Net service revenues | $ 53,121 | $ 51,359 | $ 152,414 | |
Concentration risk, percentage | 100% | 100% | 100% | 100% |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member] | ||||
Net service revenues | $ 47,313 | $ 46,537 | $ 137,432 | $ 137,174 |
Concentration risk, percentage | 89.10% | 90.60% | 90.20% | 90.80% |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member] | ||||
Net service revenues | $ 1,808 | $ 1,815 | $ 5,022 | $ 5,498 |
Concentration risk, percentage | 3.40% | 3.50% | 3.30% | 3.60% |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member] | ||||
Net service revenues | $ 3,640 | $ 2,772 | $ 8,916 | $ 7,742 |
Concentration risk, percentage | 6.80% | 5.40% | 5.80% | 5.10% |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member] | ||||
Net service revenues | $ 360 | $ 235 | $ 1,044 | $ 746 |
Concentration risk, percentage | 0.70% | 0.50% | 0.70% | 0.50% |
Home Health [Member] | ||||
Net service revenues | $ 15,718 | $ 9,956 | $ 39,659 | $ 29,768 |
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | ||||
Net service revenues | $ 15,718 | $ 9,956 | $ 39,659 | $ 29,768 |
Concentration risk, percentage | 100% | 100% | 100% | 100% |
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member] | ||||
Net service revenues | $ 11,325 | $ 7,320 | $ 29,306 | $ 21,727 |
Concentration risk, percentage | 72.10% | 73.50% | 73.90% | 73% |
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member] | ||||
Net service revenues | $ 3,445 | $ 1,998 | $ 8,239 | $ 6,160 |
Concentration risk, percentage | 21.90% | 20.10% | 20.80% | 20.70% |
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member] | ||||
Net service revenues | $ 948 | $ 638 | $ 2,114 | $ 1,881 |
Concentration risk, percentage | 6% | 6.40% | 5.30% | 6.30% |
Significant Payors (Revenue b_2
Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Net service revenues | $ 270,721 | $ 240,495 | $ 782,300 | $ 704,070 |
Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member] | ||||
Concentration risk, percentage | 44.50% | 44.30% | 44.90% | 43.50% |
Personal Care [Member] | ||||
Net service revenues | $ 201,882 | $ 179,180 | $ 590,227 | $ 523,142 |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | ||||
Net service revenues | $ 201,882 | $ 179,180 | $ 590,227 | $ 523,142 |
Concentration risk, percentage | 100% | 100% | 100% | 100% |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member] | ||||
Net service revenues | $ 105,206 | $ 92,804 | $ 306,711 | $ 266,284 |
Concentration risk, percentage | 52.10% | 51.80% | 52% | 50.90% |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member] | ||||
Net service revenues | $ 28,347 | $ 26,912 | $ 84,969 | $ 78,825 |
Concentration risk, percentage | 14% | 15% | 14.30% | 15.10% |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member] | ||||
Net service revenues | $ 22,989 | $ 20,997 | $ 68,910 | $ 63,510 |
Concentration risk, percentage | 11.40% | 11.70% | 11.70% | 12.10% |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member] | ||||
Net service revenues | $ 45,340 | $ 38,467 | $ 129,637 | $ 114,523 |
Concentration risk, percentage | 22.50% | 21.50% | 22% | 21.90% |
Hospice [Member] | ||||
Net service revenues | $ 53,121 | $ 51,359 | $ 152,414 | $ 151,160 |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | ||||
Net service revenues | $ 53,121 | $ 51,359 | $ 152,414 | $ 151,160 |
Concentration risk, percentage | 100% | 100% | 100% | 100% |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Ohio [Member] | ||||
Net service revenues | $ 18,916 | $ 18,139 | $ 55,363 | $ 51,714 |
Concentration risk, percentage | 35.60% | 35.30% | 36.30% | 34.20% |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member] | ||||
Net service revenues | $ 12,477 | $ 12,188 | $ 34,750 | $ 35,290 |
Concentration risk, percentage | 23.50% | 23.70% | 22.80% | 23.30% |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member] | ||||
Net service revenues | $ 7,619 | $ 7,789 | $ 23,688 | $ 23,867 |
Concentration risk, percentage | 14.30% | 15.20% | 15.50% | 15.80% |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member] | ||||
Net service revenues | $ 14,109 | $ 13,243 | $ 38,612 | $ 40,289 |
Concentration risk, percentage | 26.60% | 25.80% | 25.40% | 26.70% |
Home Health [Member] | ||||
Net service revenues | $ 15,718 | $ 9,956 | $ 39,659 | $ 29,768 |
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | ||||
Net service revenues | $ 15,718 | $ 9,956 | $ 39,659 | $ 29,768 |
Concentration risk, percentage | 100% | 100% | 100% | 100% |
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member] | ||||
Net service revenues | $ 2,909 | $ 1,581 | $ 9,539 | $ 4,814 |
Concentration risk, percentage | 18.50% | 15.90% | 24.10% | 16.20% |
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member] | ||||
Net service revenues | $ 8,040 | $ 8,375 | $ 25,277 | $ 24,954 |
Concentration risk, percentage | 51.20% | 84.10% | 63.70% | 83.80% |
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Tennessee [Member] | ||||
Net service revenues | $ 4,769 | $ 4,843 | ||
Concentration risk, percentage | 30.30% | 12.20% |
Significant Payors (Narrative)
Significant Payors (Narrative) (Details) - Illinois [Member] | 3 Months Ended | 9 Months Ended | 12 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | Dec. 31, 2022 | |
Revenues [Member] | Illinois Department On Aging [Member] | |||||
Concentration Risk [Line Items] | |||||
Concentration risk, percentage | 20.50% | 21% | 21.20% | 20.80% | |
Revenues [Member] | Geographic Concentration Risk [Member] | |||||
Concentration Risk [Line Items] | |||||
Concentration risk, percentage | 44.50% | 44.30% | 44.90% | 43.50% | |
Accounts Receivable [Member] | Illinois Department On Aging [Member] | |||||
Concentration Risk [Line Items] | |||||
Concentration risk, percentage | 20.50% | 18% |