Document And Entity Information
Document And Entity Information - shares | 3 Months Ended | |
Mar. 31, 2024 | Apr. 30, 2024 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Mar. 31, 2024 | |
Document Fiscal Period Focus | Q1 | |
Document Fiscal Year Focus | 2024 | |
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 | 16,370,336 | |
Document Quarterly Report | true | |
Document Transition Report | false | |
Entity Interactive Data Current | Yes | |
Entity Incorporation, State or Country Code | DE | |
Title of 12(b) Security | Common Stock, $0.001 par value | |
Security Exchange Name | NASDAQ |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Current assets | ||
Cash | $ 76,719 | $ 64,791 |
Accounts receivable, net of allowances | 104,727 | 115,499 |
Prepaid expenses and other current assets | 10,401 | 19,714 |
Total current assets | 191,847 | 200,004 |
Property and equipment, net of accumulated depreciation and amortization | 23,872 | 24,011 |
Other assets | ||
Goodwill | 663,391 | 662,995 |
Intangibles, net of accumulated amortization | 90,191 | 91,983 |
Operating lease assets, net | 44,699 | 45,433 |
Total other assets | 798,281 | 800,411 |
Total assets | 1,014,000 | 1,024,426 |
Current liabilities | ||
Accounts payable | 22,022 | 26,183 |
Accrued payroll | 44,022 | 56,551 |
Accrued expenses | 38,772 | 33,236 |
Operating lease liabilities, current portion | 11,307 | 11,339 |
Government stimulus advances | 13,548 | 5,765 |
Accrued workers' compensation insurance | 11,920 | 12,043 |
Total current liabilities | 141,591 | 145,117 |
Long-term liabilities | ||
Long-term debt, less current portion, net of debt issuance costs | 99,347 | 124,132 |
Long-term operating lease liabilities | 39,044 | 39,711 |
Other long-term liabilities | 8,875 | 8,772 |
Total long-term liabilities | 147,266 | 172,615 |
Total liabilities | 288,857 | 317,732 |
Stockholders' equity | ||
Common stock-$.001 par value; 40,000 authorized and 16,370 and 16,227 shares issued and outstanding as of March 31, 2024 and December 31, 2023, respectively | 16 | 16 |
Additional paid-in capital | 406,465 | 403,846 |
Retained earnings | 318,662 | 302,832 |
Total stockholders' equity | 725,143 | 706,694 |
Total liabilities and stockholders' equity | $ 1,014,000 | $ 1,024,426 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares | Mar. 31, 2024 | Dec. 31, 2023 |
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 | 16,370,000 | 16,227,000 |
Common stock, shares outstanding | 16,370,000 | 16,227,000 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Income Statement [Abstract] | ||
Net service revenues | $ 280,746 | $ 251,599 |
Cost of service revenues | 192,569 | 173,184 |
Gross profit | 88,177 | 78,415 |
General and administrative expenses | 61,063 | 56,360 |
Depreciation and amortization | 3,469 | 3,447 |
Total operating expenses | 64,532 | 59,807 |
Operating income | 23,645 | 18,608 |
Interest income | (423) | (106) |
Interest expense | 2,758 | 2,461 |
Total interest expense, net | 2,335 | 2,355 |
Income before income taxes | 21,310 | 16,253 |
Income tax expense | 5,480 | 3,578 |
Net income | $ 15,830 | $ 12,675 |
Net income per common share | ||
Basic income per share | $ 0.99 | $ 0.79 |
Diluted income per share | $ 0.97 | $ 0.78 |
Weighted average number of common shares and potential common shares outstanding: | ||
Basic | 16,063 | 15,949 |
Diluted | 16,373 | 16,297 |
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, 2022 | $ 633,540 | $ 16 | $ 393,208 | $ 240,316 |
Balance, shares at Dec. 31, 2022 | 16,128 | |||
Issuance of shares of common stock under restricted stock award agreements, shares | 76 | |||
Stock-based compensation | 2,646 | 2,646 | ||
Shares issued for exercise of stock options | 25 | 25 | ||
Net income | 12,675 | 12,675 | ||
Balance at Mar. 31, 2023 | 648,886 | $ 16 | 395,879 | 252,991 |
Balance, shares at Mar. 31, 2023 | 16,204 | |||
Balance at Dec. 31, 2023 | 706,694 | $ 16 | 403,846 | 302,832 |
Balance, shares at Dec. 31, 2023 | 16,227 | |||
Issuance of shares of common stock under restricted stock award agreements, shares | 143 | |||
Stock-based compensation | 2,619 | 2,619 | ||
Net income | 15,830 | 15,830 | ||
Balance at Mar. 31, 2024 | $ 725,143 | $ 16 | $ 406,465 | $ 318,662 |
Balance, shares at Mar. 31, 2024 | 16,370 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Cash flows from operating activities: | ||
Net income | $ 15,830 | $ 12,675 |
Adjustments to reconcile net income to net cash provided by (used in) operating activities, net of acquisitions: | ||
Depreciation and amortization | 3,469 | 3,447 |
Deferred income taxes | 131 | (72) |
Stock-based compensation | 2,619 | 2,646 |
Amortization of debt issuance costs under the credit facility | 215 | 215 |
Provision for credit losses | 224 | 144 |
Changes in operating assets and liabilities, net of acquisitions: | ||
Accounts receivable | 10,552 | 85 |
Prepaid expenses and other current assets | 9,331 | 7,030 |
Government stimulus advances | 7,783 | (2,345) |
Accounts payable | (4,332) | (494) |
Accrued payroll | (12,529) | (10,901) |
Accrued expenses and other long-term liabilities | 5,385 | 6,369 |
Net cash provided by operating activities | 38,678 | 18,799 |
Cash flows from investing activities: | ||
Acquisitions of businesses, net of cash acquired | (400) | (965) |
Purchases of property and equipment | (1,350) | (777) |
Net cash used in investing activities | (1,750) | (1,742) |
Cash flows from financing activities: | ||
Payments on revolver - credit facility | (25,000) | (23,500) |
Cash received from exercise of stock options | 25 | |
Net cash (used in) provided by financing activities | (25,000) | (23,475) |
Net change in cash | 11,928 | (6,418) |
Cash, at beginning of period | 64,791 | 79,961 |
Cash, at end of period | 76,719 | 73,543 |
Supplemental disclosures of cash flow information: | ||
Cash paid for interest | 2,527 | 2,310 |
Cash paid (refunded) for income taxes | $ 13 | $ (39) |
Nature of Operations, Consolida
Nature of Operations, Consolidation, and Presentation of Financial Statements | 3 Months Ended |
Mar. 31, 2024 | |
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, 2023 has been derived from the Company’s audited financial statements for the year ended December 31, 2023 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, 2023 included in our Annual Report on Form 10-K, which includes information and disclosures not included herein. In the opinion of management, these financial statements reflect all adjustments of a normal, recurring nature necessary for the fair statement of our financial position, results of operations, and cash flows for the interim periods presented in conformity with GAAP. Our results for any interim period are not necessarily indicative of results for a full year or any other interim period. Principles of Consolidation These Unaudited Condensed Consolidated Financial Statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 3 Months Ended |
Mar. 31, 2024 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | 2. Summary of Significant Accounting Policies Estimates The financial statements are prepared by management in conformity with GAAP and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: revenue recognition, goodwill and intangibles in business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from those estimates. Computation of Weighted Average Shares The following table sets forth the computation of basic and diluted common shares: For the Three Months Ended March 31, (Amounts in thousands) 2024 2023 Weighted average number of shares outstanding for basic per share calculation 16,063 15,949 Effect of dilutive potential shares: Stock options 227 251 Restricted stock awards 83 97 Adjusted weighted average shares for diluted per share calculation 16,373 16,297 Anti-dilutive shares: Stock options 61 61 Restricted stock awards — — Recently Adopted Accounting Pronouncements In October 2021, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2021-08, Accounting for Contract Assets and Contract Liabilities from Contracts with Customers (Topic 805) . This ASU requires an acquirer in a business combination to recognize and measure contract assets and contract liabilities (deferred revenue) from acquired contracts using the revenue recognition guidance in Topic 606. At the acquisition date, the acquirer applies the revenue model as if it had originated the acquired contracts. The ASU was adopted prospectively on January 1, 2023 . The additional disclosures required did no t have a material impact on our consolidated financial statements. Recently Issued Accounting Pronouncements In November 2023, the FASB issued ASU 2023-07, Improvements to Reportable Segment Disclosures , which expands reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. The amendments in the ASU require, among other things, disclosure of significant segment expenses that are regularly provided to an entity's chief operating decision maker (“CODM”) and a description of other segment items (the difference between segment revenue less the segment expenses disclosed under the significant expense principle and each reported measure of segment profit or loss) by reportable segment, as well as disclosure of the title and position of the CODM, and an explanation of how the CODM uses the reported measure(s) of segment profit or loss in assessing segment performance and deciding how to allocate resources. Annual disclosures are required for fiscal years beginning after December 15, 2023 and interim disclosures are required for periods within fiscal years beginning after December 15, 2024. Retrospective application is required, and early adoption is permitted. These requirements will result in expanded disclosures. In December 2023, the FASB issued ASU 2023-09, Improvement to Income Tax Disclosures , which requires disclosure of disaggregated income taxes paid, prescribes standard categories for the components of the effective tax rate reconciliation, and modifies other income tax-related disclosures. ASU 2023-09 is effective for fiscal years beginning after December 15, 2024, may be applied prospectively or retrospectively, and allows for early adoption . These requirements are no t expected to have an impact on the Company's financial statements and will expand income tax disclosures. |
Leases
Leases | 3 Months Ended |
Mar. 31, 2024 | |
Leases [Abstract] | |
Leases | 3. Leases Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows: March 31, 2024 December 31, 2023 (Amounts in Thousands) Operating lease assets, net $ 44,699 $ 45,433 Short-term operating lease liabilities (in accrued expenses ) 11,307 11,339 Long-term operating lease liabilities 39,044 39,711 Total operating lease liabilities $ 50,351 $ 51,050 Lease Costs Components of lease costs were reported in general and administrative expenses in the Company’s Unaudited Condensed Consolidated Statements of Income as follows: For the Three Months Ended March 31, 2024 2023 Operating lease costs $ 3,296 $ 3,042 Short-term lease costs 201 416 Total lease costs 3,497 3,458 Less: sublease income ( 598 ) ( 700 ) Total lease costs, net $ 2,899 $ 2,758 Lease Term and Discount Rate Weighted average remaining lease terms and discount rates were as follows: March 31, 2024 December 31, 2023 Operating leases: Weighted average remaining lease term 6.11 6.26 Weighted average discount rate 5.64 % 5.47 % Maturity of Lease Liabilities Remaining operating lease payments as of March 31, 2024 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended March 31, 2025 $ 10,663 2026 11,299 2027 8,959 2028 6,493 2029 5,496 Thereafter 17,390 Total future minimum rental commitments 60,300 Less: Imputed interest ( 9,949 ) Total lease liabilities $ 50,351 Supplemental cash flows information For the Three Months Ended March 31, (Amounts in Thousands) 2024 2023 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 3,589 $ 3,374 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 2,137 $ 10,836 |
Goodwill and Intangible Assets
Goodwill and Intangible Assets | 3 Months Ended |
Mar. 31, 2024 | |
Goodwill And Intangible Assets Disclosure [Abstract] | |
Goodwill and Intangible Assets | 4. Goodwill and Intangible Assets A summary of the goodwill and related adjustments is provided below: Hospice Personal Care Home Total (Amounts in Thousands) Goodwill as of December 31, 2023 $ 432,799 $ 153,276 $ 76,920 $ 662,995 Additions for acquisition — 400 — 400 Adjustments to previously recorded goodwill ( 54 ) — 50 ( 4 ) Goodwill as of March 31, 2024 $ 432,745 $ 153,676 $ 76,970 $ 663,391 On March 9, 2024, the Company completed its acquisition of the operations of Upstate Home Care Solutions (“Upstate”) for $ 0.4 million. With the purchase of Upstate, the Company expanded its personal care services segment in South Carolina. In connection with the Upstate acquisition, the Company recognized goodwill in its personal care segment of $ 0.4 million during the three months ended March 31, 2024. The Company’s identifiable intangible assets consist of customer and referral relationships, trade names and trademarks, non-competition agreements and state licenses. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from one to twenty 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: March 31, 2024 December 31, 2023 (Amounts in Thousands) (Amounts in Thousands) Estimated Useful Life Gross carrying value Accumulated amortization Net carrying value Gross carrying value Accumulated amortization Net carrying value Customer and referral relationships 5 - 10 years $ 44,672 $ ( 39,907 ) $ 4,765 $ 44,672 $ ( 39,566 ) $ 5,106 Trade names and trademarks 1 - 20 years 59,566 ( 24,608 ) 34,958 59,566 ( 23,857 ) 35,709 Non-competition agreement 3 - 5 years 6,785 ( 5,805 ) 980 6,785 ( 5,601 ) 1,184 State Licenses 6 - 10 years 12,671 ( 9,511 ) 3,160 12,671 ( 9,015 ) 3,656 State Licenses Indefinite 46,328 — 46,328 46,328 — 46,328 Total intangible assets $ 170,022 $ ( 79,831 ) $ 90,191 $ 170,022 $ ( 78,039 ) $ 91,983 Amortization expense related to the intangible assets w as $ 1.8 million a nd $ 1.7 million for the three months ended March 31, 2024 and 2023, respectively. The weighted average remaining useful lives of identifiable intangible assets as of March 31, 2024 wa s 10.14 ye ars. |
Details of Certain Balance Shee
Details of Certain Balance Sheet Accounts | 3 Months Ended |
Mar. 31, 2024 | |
Details Of Certain Balance Sheet Accounts [Abstract] | |
Details of Certain Balance Sheet Accounts | 5. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consisted of the following: March 31, 2024 December 31, 2023 (Amounts in Thousands) Prepaid payroll $ — $ 8,735 Prepaid workers' compensation and liability insurance 2,329 3,696 Prepaid licensing fees 5,651 4,481 Workers' compensation insurance receivable 699 577 Other 1,722 2,225 Total prepaid expenses and other current assets $ 10,401 $ 19,714 Accrued expenses consisted of the following: March 31, 2024 December 31, 2023 (Amounts in Thousands) Accrued health benefits 7,297 7,400 Payor advances (1) 429 1,218 Accrued professional fees 9,112 7,304 Accrued payroll and other taxes 13,013 8,572 Other 8,921 8,742 Total accrued expenses $ 38,772 $ 33,236 (1) Represents the deferred portion of payments received from payors for COVID-19 reimbursements which will be recognized as we incur specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel) or will be returned to the extent such related expenses are not incurred. |
Government Actions to Mitigate
Government Actions to Mitigate COVID-19's Impact | 3 Months Ended |
Mar. 31, 2024 | |
Risks And Uncertainties [Abstract] | |
Government Actions to Mitigate COVID-19's Impact | 6. Government Actions to Mitigate COVID-19’s Impact The acute phase of the COVID-19 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 Stability Act (“CARES Act”), which was expanded by the Paycheck Protection Program and Health Care Enhancement (“PPPHCE”) Act, and the Consolidated Appropriations Act, 2021 (“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 provided for a 10 percentage point increase in federal matching funds for Medicaid home and community-based services (“HCBS”) from April 1, 2021, through March 31, 2022, provided the state satisfied certain conditions. States are permitted to use the state funds equivalent to the additional federal funds through March 31, 2025. States must use the monies attributable to this matching fund increase to supplement, not supplant, their level of state spending for the implementation of activities enhanced under the Medicaid HCBS in effect as of April 1, 2021. HCBS spending plans for the additional matching funds vary by state, but common initiatives in which the Company is participating include those aimed at strengthening the provider workforce (e.g., efforts to recruit, retain, and train direct service providers). The Company is required to properly and fully document the use of such funds in reports to the state in which the funds originated. Funds may be subject to recoupment if not expended or if they are expended on non-approved uses. During the three months ended March 31, 2024, the Company received additional state funding provided by the ARPA in an aggregate amount of $ 10.2 million. Th e Company did no t record revenue and related costs of service revenue during the three months ended March 31, 2024, because revenue recognition criteria were not met. Instead, the Company deferred recogn ition of the entire $ 10.2 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 March 31, 2024, the Company u tilized $ 2.4 million during the three months ended March 31, 2024, primarily for caregivers and adding support to recruiting and retention efforts, included as a reduction of cost of service revenues in the Company’s Unaudited Condensed Consolidated Statements of Income. As of March 31, 2024, the deferred portion of ARPA fu nding of $ 13.5 million is incl uded within Government stimulus advances on the Company’s Unaudited Condensed Consolidated Balance Sheets. Medicare Sequester The CARES Act and related legislation also include other provisions offering financial relief, including, for example, temporarily suspending the Medicare sequester, which would have otherwise reduced payments to Medicare providers by 2 % as required by the Budget Control Act of 2011. The sequestration adjustment resumed with a 1 % reduction beginning April 1, 2022, and a 2 % reduction beginning July 1, 2022. These sequestration cuts have been extended through April 2032. The ARPA increased the federal budget deficit in a manner that triggers an additional statutorily mandated sequestration under the PAYGO Act. As a result, an additional Medicare payment reduction of up to 4 % was required to take effect in January 2022. However, Congress has delayed implementation of this payment reduction until 2025. |
Long-Term Debt
Long-Term Debt | 3 Months Ended |
Mar. 31, 2024 | |
Long Term Debt [Abstract] | |
Long-Term Debt | 7. Long-Term Debt Long-term debt consisted of the following: March 31, 2024 December 31, 2023 (Amounts in Thousands) Revolving loan under the credit facility $ 101,353 $ 126,353 Less unamortized issuance costs ( 2,006 ) ( 2,221 ) Long-term debt $ 99,347 $ 124,132 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 the Secured Overnight Financing Rate (“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. The transition to SOFR did not and is not expected to have a material impact on the Company’s results of operations or liquidity. 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. Addus HealthCare, Inc. (“Addus HealthCare”) is the borrower, and its parent, Holdings, and substantially all of Holdings’ subsidiaries are guarantors under this credit facility, and it is collateralized by a first priority security interest in all of the Company’s and the other credit parties’ current and future tangible and intangible assets, including the shares of stock of the borrower and subsidiaries. The Credit Agreement contains affirmative and negative covenants customary for credit facilities of this type, including limitations on the Company with respect to liens, indebtedness, guaranties, investments, distributions, mergers and acquisitions and dispositions of assets. The availability of additional draws under this credit facility is conditioned, among other things, upon (after giving effect to such draws) the Total Net Leverage Ratio (as defined in the Credit Agreement) not exceeding 3.75 :1.00. In certain circumstances, in connection with a Material Acquisition (as defined in the Credit Agreement), the Company can elect to increase its Total Net Leverage Ratio compliance covenant to 4.25 :1.00 for the then current fiscal quarter and the three succeeding fiscal quarters. The Company pays a fee ranging from 0.20 % to 0.35 % based on the applicable senior net leverage ratio times the unused portion of the revolving loan portion of the credit facility. The Credit Agreement contains customary affirmative covenants regarding, among other things, the maintenance of records, compliance with laws, maintenance of permits, maintenance of insurance and property and payment of taxes. The Credit Agreement also contains certain customary financial covenants and negative covenants that, among other things, include a requirement to maintain a minimum Interest Coverage Ratio (as defined in the Credit Agreement), a requirement to stay below a maximum Total Net Leverage Ratio (as defined in the Credit Agreement) and a requirement to stay below a maximum permitted amount of capital expenditures. The Credit Agreement also contains restrictions on guarantees, indebtedness, liens, investments and loans, subject to customary carve outs, a restriction on dividends (provided that Addus HealthCare may make distributions to the Company in an amount that does not exceed $ 7.5 million in any year absent of an event of default, plus limited exceptions for tax and administrative distributions), a restriction on the ability to consummate acquisitions (without the consent of the lenders) under its credit facility subject to compliance with the Total Net Leverage Ratio (as defined in the Credit Agreement) thresholds, restrictions on mergers, dispositions of assets, and affiliate transactions, and restrictions on fundamental changes and lines of business. During the three months ended March 31, 2024 , the Company did no t draw on its credit facility and repaid $ 25.0 million under the revolving credit facility. At March 31, 2024, the Company had a total of $ 101.4 million of revolving loans, with an interest rate of 7.18 %, outstanding on its credit facility. After giving effect to the amount drawn on its credit facility, approximately $ 8.0 million of outstanding letters of credit and borrowing limits based on an advance multiple of adjusted EBITDA (as defined in the Credit Agreement), the Compan y had $ 486.9 of capacity and $ 377.5 million available for borrowing under its credit facility. As of December 31, 2023, the Company had a total of $ 126.4 million of revolving loans, with an interest rate of 7.21 %, outstanding on its credit facility. As of March 31, 2024 , the Company was in compliance with all financial covenants under the Credit Agreement. |
Income Taxes
Income Taxes | 3 Months Ended |
Mar. 31, 2024 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | 8. Income Taxes The effective income tax rates were 25.7 % and 22.0 % for the three months ended March 31, 2024 and 2023, respectively. For the three months ended March 31, 2024, the difference between our federal statutory and effective income tax rates was principally due to the inclusion of state taxes and non-deductible compensation, partially offset by the use of federal employment tax credits and excess tax benefit. For the three months ended March 31, 2024 and 2023 , the effective tax rates were inclusive of an excess tax benefit of 0.1 % and 1.2 %, respectively. The excess tax expense or benefit is a discrete item, related to the vesting of equity shares, which requires the Company to recognize the expense or benefit fully in the period. An excess tax expense results if the Company’s cumulative costs of the award recognized exceed the income tax deduction, whereas an excess tax benefit results if the Company’s cumulative costs of the award recognized are less than the income tax deduction. |
Commitments and Contingencies
Commitments and Contingencies | 3 Months Ended |
Mar. 31, 2024 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 9. Commitments and Contingencies Legal Proceedings From time to time, the Company is subject to legal and/or administrative proceedings incidental to its business. It is the opinion of management that the outcome of pending legal and/or administrative proceedings will not have a material effect on the Company’s Unaudited Condensed Consolidated Balance Sheets and Unaudited Condensed Consolidated Statements of Income. |
Segment Information
Segment Information | 3 Months Ended |
Mar. 31, 2024 | |
Segment Reporting [Abstract] | |
Segment Information | 10. Segment Information Operating segments are defined as components of a company that engage in business activities from which it may earn revenues and incur expenses, and for which separate financial information is available and is regularly reviewed by the Company’s chief operating decision makers, to assess the performance of the individual segments and make decisions about resources to be allocated to the segments. The Company operates as a multi-state provider of three distinct but related business segments providing in-home services. In its personal care segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy. The tables below set forth information about the Company’s reportable segments, along with the items necessary to reconcile the segment information to the totals reported in the accompanying Unaudited Condensed Consolidated Financial Statements. Segment assets are not reviewed by the Company’s chief operating decision maker function and therefore are not disclosed below. Segment operating income consists of revenue generated by a segment, less the direct costs of service revenues and general and administrative expenses that are incurred directly by the segment. Unallocated general and administrative costs are those costs for functions performed in a centralized manner and therefore not attributable to a particular segment. These costs include accounting, finance, human resources, legal, information technology, corporate office support and facility costs and overall corporate management. For the Three Months Ended March 31, 2024 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 208,003 $ 55,863 $ 16,880 $ 280,746 Cost of services revenues 152,536 28,967 11,066 192,569 Gross profit 55,467 26,896 5,814 88,177 General and administrative expenses 15,445 13,439 4,537 33,421 Segment operating income $ 40,022 $ 13,457 $ 1,277 54,756 For the Three Months Ended March 31, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 190,032 $ 49,082 $ 12,485 $ 251,599 Cost of services revenues 138,383 27,267 7,534 173,184 Gross profit 51,649 21,815 4,951 78,415 General and administrative expenses 15,935 13,015 2,879 31,829 Segment operating income $ 35,714 $ 8,800 $ 2,072 $ 46,586 For the Three Months Ended March 31, 2024 2023 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 54,756 $ 46,586 Items not allocated at segment level: Other general and administrative expenses 27,642 24,531 Depreciation and amortization 3,469 3,447 Interest income ( 423 ) ( 106 ) Interest expense 2,758 2,461 Income before income taxes $ 21,310 $ 16,253 |
Significant Payors
Significant Payors | 3 Months Ended |
Mar. 31, 2024 | |
Significant Payors [Abstract] | |
Significant Payors | 11. Significant Payors The Company’s revenue by payor type was as follows: Personal Care Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment State, local and other governmental programs $ 107,754 51.8 % $ 95,320 50.1 % Managed care organizations 94,276 45.3 87,901 46.3 Private pay 3,906 1.9 4,226 2.2 Commercial insurance 1,486 0.7 1,669 0.9 Other 581 0.3 916 0.5 Total personal care segment net service revenues $ 208,003 100.0 % $ 190,032 100.0 % Hospice Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment Medicare $ 50,652 90.7 % $ 44,556 90.7 % Commercial insurance 3,134 5.6 2,547 5.2 Managed care organizations 1,817 3.3 1,647 3.4 Other 260 0.4 332 0.7 Total hospice segment net service revenues $ 55,863 100.0 % $ 49,082 100.0 % Home Health Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment Medicare $ 11,663 69.1 % $ 9,270 74.2 % Managed care organizations 4,400 26.1 2,539 20.3 Other 817 4.8 676 5.5 Total home health segment net service revenues $ 16,880 100.0 % $ 12,485 100.0 % The Company derives a significant amount of its revenue from its operations in Illinois, New Mexico, New York and Ohio. The percentages of segment revenue for each of these significant states were as follows: Personal Care Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment Illinois $ 107,575 51.8 % $ 98,414 51.8 % New Mexico 28,967 13.9 28,474 15.0 New York (1) 23,534 11.3 21,885 11.5 All other states 47,927 23.0 41,259 21.7 Total personal care segment net service revenues $ 208,003 100.0 % $ 190,032 100.0 % (1) In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure Consumer Directed Personal Assistance Program (“CDPAP”) fiscal intermediaries. The Company was not one of the entities selected to enter into contracts as a Lead Fiscal Intermediary through the initial RFO process. However, the New York legislature intervened in 2022, authorizing fiscal intermediary applicants who satisfied certain criteria to continue operating in all counties contained in their RFO application. Although the Company was permitted to continue its CDPAP fiscal intermediary operations, the Company decided in November 2022 to suspend materially all of its new fee-for-service patient admissions through County Social Service Departments in the CDPAP. On June 6, 2023, the New York State Department of Health (“NYSDOH”) 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. The CDPAP continues to be a focus for changes by New York governmental authorities. For example, the New York fiscal year 2025 budget will replace the CDPAP fiscal intermediaries with a single statewide fiscal intermediary with a stated deadline of April 1, 2025. The statewide fiscal intermediary, which will be selected by the NYSDOH, will be able to subcontract with several entities to facilitate the delivery of fiscal intermediary services. All service providers seeking to offer services under CDPAP will be required to contract with the statewide fiscal intermediary or its contractors in order to offer services. The Company does not currently believe it is likely to be selected as the single statewide fiscal intermediary and it is not possible at this time to assess the likelihood of becoming a subcontractor or the financial terms of any such arrangement. At this time, it is difficult to predict the details of the implementation of these modifications and their final timeline and, thus, their impact on the Company’s business and operations. However, we expect this could have a negative impact on our New York CDPAP business, though it would not be material to our business as a whole. Hospice Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment Ohio $ 20,236 36.2 % $ 18,451 37.6 % Illinois 12,252 21.9 11,480 23.4 New Mexico 7,515 13.5 6,486 13.2 All other states 15,860 28.4 12,665 25.8 Total hospice segment net service revenues $ 55,863 100.0 % $ 49,082 100.0 % Home Health Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment New Mexico $ 7,777 46.1 % $ 9,116 73.0 % Illinois 2,942 17.4 3,369 27.0 Tennessee 6,161 36.5 — — Total home health segment net service revenues $ 16,880 100.0 % $ 12,485 100.0 % A substantial portion of the Company’s revenue and accounts receivable are derived from services performed for federal, state and local governmental agencies. The personal care segment derives a significant amount of its net service revenues in Illinois, which represented 38.3 % and 39.1 % of our net service revenues for the three months ended March 31, 2024 and 2023, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.8 % and 21.5 % of the Company’s net service revenues for the three months ended March 31, 2024 and 2023, respectively. The related receivables due from the Illinois Department on Aging represented 18.0 % and 20.7 % of the Company’s net accounts receivable at March 31, 2024 and December 31, 2023 , respectively. |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 3 Months Ended |
Mar. 31, 2024 | |
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, 2023 has been derived from the Company’s audited financial statements for the year ended December 31, 2023 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, 2023 included in our Annual Report on Form 10-K, which includes information and disclosures not included herein. In the opinion of management, these financial statements reflect all adjustments of a normal, recurring nature necessary for the fair statement of our financial position, results of operations, and cash flows for the interim periods presented in conformity with GAAP. Our results for any interim period are not necessarily indicative of results for a full year or any other interim period. |
Principles of Consolidation | Principles of Consolidation These Unaudited Condensed Consolidated Financial Statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. |
Estimates | Estimates The financial statements are prepared by management in conformity with GAAP and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: revenue recognition, goodwill and intangibles in business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from those estimates. |
Computation of Weighted Average Shares | Computation of Weighted Average Shares The following table sets forth the computation of basic and diluted common shares: For the Three Months Ended March 31, (Amounts in thousands) 2024 2023 Weighted average number of shares outstanding for basic per share calculation 16,063 15,949 Effect of dilutive potential shares: Stock options 227 251 Restricted stock awards 83 97 Adjusted weighted average shares for diluted per share calculation 16,373 16,297 Anti-dilutive shares: Stock options 61 61 Restricted stock awards — — |
Recently Issued and Adopted Accounting Pronouncements | Recently Adopted Accounting Pronouncements In October 2021, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2021-08, Accounting for Contract Assets and Contract Liabilities from Contracts with Customers (Topic 805) . This ASU requires an acquirer in a business combination to recognize and measure contract assets and contract liabilities (deferred revenue) from acquired contracts using the revenue recognition guidance in Topic 606. At the acquisition date, the acquirer applies the revenue model as if it had originated the acquired contracts. The ASU was adopted prospectively on January 1, 2023 . The additional disclosures required did no t have a material impact on our consolidated financial statements. Recently Issued Accounting Pronouncements In November 2023, the FASB issued ASU 2023-07, Improvements to Reportable Segment Disclosures , which expands reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. The amendments in the ASU require, among other things, disclosure of significant segment expenses that are regularly provided to an entity's chief operating decision maker (“CODM”) and a description of other segment items (the difference between segment revenue less the segment expenses disclosed under the significant expense principle and each reported measure of segment profit or loss) by reportable segment, as well as disclosure of the title and position of the CODM, and an explanation of how the CODM uses the reported measure(s) of segment profit or loss in assessing segment performance and deciding how to allocate resources. Annual disclosures are required for fiscal years beginning after December 15, 2023 and interim disclosures are required for periods within fiscal years beginning after December 15, 2024. Retrospective application is required, and early adoption is permitted. These requirements will result in expanded disclosures. In December 2023, the FASB issued ASU 2023-09, Improvement to Income Tax Disclosures , which requires disclosure of disaggregated income taxes paid, prescribes standard categories for the components of the effective tax rate reconciliation, and modifies other income tax-related disclosures. ASU 2023-09 is effective for fiscal years beginning after December 15, 2024, may be applied prospectively or retrospectively, and allows for early adoption . These requirements are no t expected to have an impact on the Company's financial statements and will expand income tax disclosures. |
Summary of Significant Accoun_3
Summary of Significant Accounting Policies (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Accounting Policies [Abstract] | |
Computation of Basic and Diluted Common Shares | The following table sets forth the computation of basic and diluted common shares: For the Three Months Ended March 31, (Amounts in thousands) 2024 2023 Weighted average number of shares outstanding for basic per share calculation 16,063 15,949 Effect of dilutive potential shares: Stock options 227 251 Restricted stock awards 83 97 Adjusted weighted average shares for diluted per share calculation 16,373 16,297 Anti-dilutive shares: Stock options 61 61 Restricted stock awards — — |
Leases (Tables)
Leases (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Leases [Abstract] | |
Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases | Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows: March 31, 2024 December 31, 2023 (Amounts in Thousands) Operating lease assets, net $ 44,699 $ 45,433 Short-term operating lease liabilities (in accrued expenses ) 11,307 11,339 Long-term operating lease liabilities 39,044 39,711 Total operating lease liabilities $ 50,351 $ 51,050 |
Components of Lease Costs Reported in General and Administrative Expenses in Unaudited Condensed Consolidated Statements of Income | Components of lease costs were reported in general and administrative expenses in the Company’s Unaudited Condensed Consolidated Statements of Income as follows: For the Three Months Ended March 31, 2024 2023 Operating lease costs $ 3,296 $ 3,042 Short-term lease costs 201 416 Total lease costs 3,497 3,458 Less: sublease income ( 598 ) ( 700 ) Total lease costs, net $ 2,899 $ 2,758 |
Schedule of Weighted Average Remaining Lease Terms and Discount Rates | Weighted average remaining lease terms and discount rates were as follows: March 31, 2024 December 31, 2023 Operating leases: Weighted average remaining lease term 6.11 6.26 Weighted average discount rate 5.64 % 5.47 % |
Summary of Remaining Operating Lease Payments | Remaining operating lease payments as of March 31, 2024 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended March 31, 2025 $ 10,663 2026 11,299 2027 8,959 2028 6,493 2029 5,496 Thereafter 17,390 Total future minimum rental commitments 60,300 Less: Imputed interest ( 9,949 ) Total lease liabilities $ 50,351 |
Supplemental Cash Flows Information | For the Three Months Ended March 31, (Amounts in Thousands) 2024 2023 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 3,589 $ 3,374 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 2,137 $ 10,836 |
Goodwill and Intangible Assets
Goodwill and Intangible Assets (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Goodwill And Intangible Assets Disclosure [Abstract] | |
Summary of Goodwill and Related Adjustments | A summary of the goodwill and related adjustments is provided below: Hospice Personal Care Home Total (Amounts in Thousands) Goodwill as of December 31, 2023 $ 432,799 $ 153,276 $ 76,920 $ 662,995 Additions for acquisition — 400 — 400 Adjustments to previously recorded goodwill ( 54 ) — 50 ( 4 ) Goodwill as of March 31, 2024 $ 432,745 $ 153,676 $ 76,970 $ 663,391 |
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: March 31, 2024 December 31, 2023 (Amounts in Thousands) (Amounts in Thousands) Estimated Useful Life Gross carrying value Accumulated amortization Net carrying value Gross carrying value Accumulated amortization Net carrying value Customer and referral relationships 5 - 10 years $ 44,672 $ ( 39,907 ) $ 4,765 $ 44,672 $ ( 39,566 ) $ 5,106 Trade names and trademarks 1 - 20 years 59,566 ( 24,608 ) 34,958 59,566 ( 23,857 ) 35,709 Non-competition agreement 3 - 5 years 6,785 ( 5,805 ) 980 6,785 ( 5,601 ) 1,184 State Licenses 6 - 10 years 12,671 ( 9,511 ) 3,160 12,671 ( 9,015 ) 3,656 State Licenses Indefinite 46,328 — 46,328 46,328 — 46,328 Total intangible assets $ 170,022 $ ( 79,831 ) $ 90,191 $ 170,022 $ ( 78,039 ) $ 91,983 |
Details of Certain Balance Sh_2
Details of Certain Balance Sheet Accounts (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Details Of Certain Balance Sheet Accounts [Abstract] | |
Schedule of Prepaid Expenses and Other Current Assets | Prepaid expenses and other current assets consisted of the following: March 31, 2024 December 31, 2023 (Amounts in Thousands) Prepaid payroll $ — $ 8,735 Prepaid workers' compensation and liability insurance 2,329 3,696 Prepaid licensing fees 5,651 4,481 Workers' compensation insurance receivable 699 577 Other 1,722 2,225 Total prepaid expenses and other current assets $ 10,401 $ 19,714 |
Schedule of Accrued Expenses | Accrued expenses consisted of the following: March 31, 2024 December 31, 2023 (Amounts in Thousands) Accrued health benefits 7,297 7,400 Payor advances (1) 429 1,218 Accrued professional fees 9,112 7,304 Accrued payroll and other taxes 13,013 8,572 Other 8,921 8,742 Total accrued expenses $ 38,772 $ 33,236 (1) Represents the deferred portion of payments received from payors for COVID-19 reimbursements which will be recognized as we incur specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel) or will be returned to the extent such related expenses are not incurred. |
Long-Term Debt (Tables)
Long-Term Debt (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Long Term Debt [Abstract] | |
Schedule of Long-Term Debt | Long-term debt consisted of the following: March 31, 2024 December 31, 2023 (Amounts in Thousands) Revolving loan under the credit facility $ 101,353 $ 126,353 Less unamortized issuance costs ( 2,006 ) ( 2,221 ) Long-term debt $ 99,347 $ 124,132 |
Segment Information (Tables)
Segment Information (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Segment Reporting [Abstract] | |
Summary of Segment Information | For the Three Months Ended March 31, 2024 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 208,003 $ 55,863 $ 16,880 $ 280,746 Cost of services revenues 152,536 28,967 11,066 192,569 Gross profit 55,467 26,896 5,814 88,177 General and administrative expenses 15,445 13,439 4,537 33,421 Segment operating income $ 40,022 $ 13,457 $ 1,277 54,756 For the Three Months Ended March 31, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 190,032 $ 49,082 $ 12,485 $ 251,599 Cost of services revenues 138,383 27,267 7,534 173,184 Gross profit 51,649 21,815 4,951 78,415 General and administrative expenses 15,935 13,015 2,879 31,829 Segment operating income $ 35,714 $ 8,800 $ 2,072 $ 46,586 For the Three Months Ended March 31, 2024 2023 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 54,756 $ 46,586 Items not allocated at segment level: Other general and administrative expenses 27,642 24,531 Depreciation and amortization 3,469 3,447 Interest income ( 423 ) ( 106 ) Interest expense 2,758 2,461 Income before income taxes $ 21,310 $ 16,253 |
Significant Payors (Tables)
Significant Payors (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Significant Payors [Abstract] | |
Schedule of Revenue by Payor Type | The Company’s revenue by payor type was as follows: Personal Care Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment State, local and other governmental programs $ 107,754 51.8 % $ 95,320 50.1 % Managed care organizations 94,276 45.3 87,901 46.3 Private pay 3,906 1.9 4,226 2.2 Commercial insurance 1,486 0.7 1,669 0.9 Other 581 0.3 916 0.5 Total personal care segment net service revenues $ 208,003 100.0 % $ 190,032 100.0 % Hospice Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment Medicare $ 50,652 90.7 % $ 44,556 90.7 % Commercial insurance 3,134 5.6 2,547 5.2 Managed care organizations 1,817 3.3 1,647 3.4 Other 260 0.4 332 0.7 Total hospice segment net service revenues $ 55,863 100.0 % $ 49,082 100.0 % Home Health Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment Medicare $ 11,663 69.1 % $ 9,270 74.2 % Managed care organizations 4,400 26.1 2,539 20.3 Other 817 4.8 676 5.5 Total home health segment net service revenues $ 16,880 100.0 % $ 12,485 100.0 % |
Schedule of Revenue by Geographic Location | The percentages of segment revenue for each of these significant states were as follows: Personal Care Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment Illinois $ 107,575 51.8 % $ 98,414 51.8 % New Mexico 28,967 13.9 28,474 15.0 New York (1) 23,534 11.3 21,885 11.5 All other states 47,927 23.0 41,259 21.7 Total personal care segment net service revenues $ 208,003 100.0 % $ 190,032 100.0 % (1) In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure Consumer Directed Personal Assistance Program (“CDPAP”) fiscal intermediaries. The Company was not one of the entities selected to enter into contracts as a Lead Fiscal Intermediary through the initial RFO process. However, the New York legislature intervened in 2022, authorizing fiscal intermediary applicants who satisfied certain criteria to continue operating in all counties contained in their RFO application. Although the Company was permitted to continue its CDPAP fiscal intermediary operations, the Company decided in November 2022 to suspend materially all of its new fee-for-service patient admissions through County Social Service Departments in the CDPAP. On June 6, 2023, the New York State Department of Health (“NYSDOH”) 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. The CDPAP continues to be a focus for changes by New York governmental authorities. For example, the New York fiscal year 2025 budget will replace the CDPAP fiscal intermediaries with a single statewide fiscal intermediary with a stated deadline of April 1, 2025. The statewide fiscal intermediary, which will be selected by the NYSDOH, will be able to subcontract with several entities to facilitate the delivery of fiscal intermediary services. All service providers seeking to offer services under CDPAP will be required to contract with the statewide fiscal intermediary or its contractors in order to offer services. The Company does not currently believe it is likely to be selected as the single statewide fiscal intermediary and it is not possible at this time to assess the likelihood of becoming a subcontractor or the financial terms of any such arrangement. At this time, it is difficult to predict the details of the implementation of these modifications and their final timeline and, thus, their impact on the Company’s business and operations. However, we expect this could have a negative impact on our New York CDPAP business, though it would not be material to our business as a whole. Hospice Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment Ohio $ 20,236 36.2 % $ 18,451 37.6 % Illinois 12,252 21.9 11,480 23.4 New Mexico 7,515 13.5 6,486 13.2 All other states 15,860 28.4 12,665 25.8 Total hospice segment net service revenues $ 55,863 100.0 % $ 49,082 100.0 % Home Health Segment For the Three Months Ended March 31, 2024 2023 Amount % of Segment Amount % of Segment New Mexico $ 7,777 46.1 % $ 9,116 73.0 % Illinois 2,942 17.4 3,369 27.0 Tennessee 6,161 36.5 — — Total home health segment net service revenues $ 16,880 100.0 % $ 12,485 100.0 % |
Nature of Operations, Consoli_2
Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details) | 3 Months Ended |
Mar. 31, 2024 Segment | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Number of operating segments | 3 |
Summary of Significant Accoun_4
Summary of Significant Accounting Policies (Computation of Basic and Diluted Common Shares) (Details) - shares shares in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Summary Of Significant Accounting Policies [Line Items] | ||
Weighted average number of shares outstanding for basic per share calculation | 16,063 | 15,949 |
Effect of dilutive potential shares: | ||
Adjusted weighted average shares for diluted per share calculation | 16,373 | 16,297 |
Stock Options [Member] | ||
Effect of dilutive potential shares: | ||
Effect of dilutive potential shares | 227 | 251 |
Anti-dilutive shares: | ||
Anti-dilutive shares | 61 | 61 |
Restricted Stock Awards [Member] | ||
Effect of dilutive potential shares: | ||
Effect of dilutive potential shares | 83 | 97 |
Summary of Significant Accoun_5
Summary of Significant Accounting Policies (Narrative) (Details) | Mar. 31, 2024 |
ASU 2021-08 [Member] | |
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 |
Accounting Standards Update 2023-07 [Member] | |
Summary Of Significant Accounting Policies [Line Items] | |
Change in accounting principle, accounting standards update, early adoption | true |
Accounting Standards Update 2023-09 [Member] | |
Summary Of Significant Accounting Policies [Line Items] | |
Change in accounting principle, accounting standards update, immaterial effect | true |
Change in accounting principle, accounting standards update, early adoption | true |
Leases (Amounts Reported in Una
Leases (Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases) (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Leases [Abstract] | ||
Operating lease assets, net | $ 44,699 | $ 45,433 |
Short-term operating lease liabilities (in accrued expenses) | $ 11,307 | $ 11,339 |
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration] | Accrued expenses | Accrued expenses |
Long-term operating lease liabilities | $ 39,044 | $ 39,711 |
Total operating lease liabilities | $ 50,351 | $ 51,050 |
Leases (Components of Lease Cos
Leases (Components of Lease Costs Reported in General and Administrative Expenses in Unaudited Condensed Consolidated Statements of Income) (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Leases [Abstract] | ||
Operating lease costs | $ 3,296 | $ 3,042 |
Short-term lease costs | 201 | 416 |
Total lease costs | 3,497 | 3,458 |
Less: sublease income | (598) | (700) |
Total lease costs, net | $ 2,899 | $ 2,758 |
Leases (Schedule of Weighted Av
Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details) | Mar. 31, 2024 | Dec. 31, 2023 |
Leases [Abstract] | ||
Weighted average remaining lease term | 6 years 1 month 9 days | 6 years 3 months 3 days |
Weighted average discount rate | 5.64% | 5.47% |
Leases (Summary of Remaining Op
Leases (Summary of Remaining Operating Lease Payments) (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Leases [Abstract] | ||
2025 | $ 10,663 | |
2026 | 11,299 | |
2027 | 8,959 | |
2028 | 6,493 | |
2029 | 5,496 | |
Thereafter | 17,390 | |
Total future minimum rental commitments | 60,300 | |
Less: Imputed interest | (9,949) | |
Total lease liabilities | $ 50,351 | $ 51,050 |
Leases (Supplemental Cash Flows
Leases (Supplemental Cash Flows Information) (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Cash paid for amounts included in the measurement of lease liabilities: | ||
Operating cash flows from operating leases | $ 3,589 | $ 3,374 |
Right-of-use assets obtained in exchange for lease obligations: | ||
Operating leases | $ 2,137 | $ 10,836 |
Goodwill and Intangible Asset_2
Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands | 3 Months Ended |
Mar. 31, 2024 USD ($) | |
Goodwill [Line Items] | |
Goodwill, at Beginning of Period | $ 662,995 |
Additions for acquisitions | 400 |
Adjustments to previously recorded goodwill | (4) |
Goodwill, at End of Period | 663,391 |
Hospice [Member] | |
Goodwill [Line Items] | |
Goodwill, at Beginning of Period | 432,799 |
Adjustments to previously recorded goodwill | (54) |
Goodwill, at End of Period | 432,745 |
Personal Care [Member] | |
Goodwill [Line Items] | |
Goodwill, at Beginning of Period | 153,276 |
Additions for acquisitions | 400 |
Goodwill, at End of Period | 153,676 |
Home Health [Member] | |
Goodwill [Line Items] | |
Goodwill, at Beginning of Period | 76,920 |
Adjustments to previously recorded goodwill | 50 |
Goodwill, at End of Period | $ 76,970 |
Goodwill and Intangible Asset_3
Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Thousands | 3 Months Ended | |||
Mar. 09, 2024 | Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | |
Goodwill [Line Items] | ||||
Goodwill | $ 663,391 | $ 662,995 | ||
Total purchase price for business acquisition | 400 | $ 965 | ||
Amortization expense | $ 1,800 | $ 1,700 | ||
Weighted average remaining useful lives of identifiable intangible assets | 10 years 1 month 20 days | |||
Minimum [Member] | ||||
Goodwill [Line Items] | ||||
Intangible assets, estimated useful lives | 1 year | |||
Minimum [Member] | Customer and Referral Relationships [Member] | ||||
Goodwill [Line Items] | ||||
Intangible assets, estimated useful lives | 5 years | |||
Maximum [Member] | ||||
Goodwill [Line Items] | ||||
Intangible assets, estimated useful lives | 20 years | |||
Maximum [Member] | Customer and Referral Relationships [Member] | ||||
Goodwill [Line Items] | ||||
Intangible assets, estimated useful lives | 10 years | |||
Personal Care [Member] | ||||
Goodwill [Line Items] | ||||
Goodwill | $ 153,676 | $ 153,276 | ||
Upstate Home Care Solutions [Member] | ||||
Goodwill [Line Items] | ||||
Total purchase price for business acquisition | $ 400 | |||
Upstate Home Care Solutions [Member] | Personal Care [Member] | ||||
Goodwill [Line Items] | ||||
Goodwill | $ 400 |
Goodwill and Intangible Asset_4
Goodwill and Intangible Assets (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Intangible assets subject to amortization: | ||
Accumulated amortization | $ (79,831) | $ (78,039) |
Total intangible assets, Gross carrying value | 170,022 | 170,022 |
Total intangible assets, Net carrying value | $ 90,191 | 91,983 |
Minimum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 1 year | |
Maximum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 20 years | |
Customer and Referral Relationships [Member] | ||
Intangible assets subject to amortization: | ||
Gross carrying value | $ 44,672 | 44,672 |
Accumulated amortization | (39,907) | (39,566) |
Net carrying value | $ 4,765 | 5,106 |
Customer and Referral Relationships [Member] | Minimum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 5 years | |
Customer and Referral Relationships [Member] | Maximum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 10 years | |
Trade Names and Trademarks [Member] | ||
Intangible assets subject to amortization: | ||
Gross carrying value | $ 59,566 | 59,566 |
Accumulated amortization | (24,608) | (23,857) |
Net carrying value | $ 34,958 | 35,709 |
Trade Names and Trademarks [Member] | Minimum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 1 year | |
Trade Names and Trademarks [Member] | Maximum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 20 years | |
Non-competition Agreements [Member] | ||
Intangible assets subject to amortization: | ||
Gross carrying value | $ 6,785 | 6,785 |
Accumulated amortization | (5,805) | (5,601) |
Net carrying value | $ 980 | 1,184 |
Non-competition Agreements [Member] | Minimum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 3 years | |
Non-competition Agreements [Member] | Maximum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 5 years | |
State Licenses [Member] | ||
Intangible assets subject to amortization: | ||
Gross carrying value | $ 12,671 | 12,671 |
Accumulated amortization | (9,511) | (9,015) |
Net carrying value | 3,160 | 3,656 |
Indefinite-Lived Intangible Assets (Excluding Goodwill) | $ 46,328 | $ 46,328 |
State Licenses [Member] | Minimum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 6 years | |
State Licenses [Member] | Maximum [Member] | ||
Finite Lived Intangible Assets [Line Items] | ||
Intangible assets, estimated useful lives | 10 years |
Details of Certain Balance Sh_3
Details of Certain Balance Sheet Accounts (Schedule of Prepaid Expenses and Other Current Assets) (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Details Of Certain Balance Sheet Accounts [Abstract] | ||
Prepaid payroll | $ 8,735 | |
Prepaid workers' compensation and liability insurance | $ 2,329 | 3,696 |
Prepaid licensing fees | 5,651 | 4,481 |
Workers' compensation insurance receivable | 699 | 577 |
Other | 1,722 | 2,225 |
Total prepaid expenses and other current assets | $ 10,401 | $ 19,714 |
Details of Certain Balance Sh_4
Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Details Of Certain Balance Sheet Accounts [Abstract] | ||
Accrued health benefits | $ 7,297 | $ 7,400 |
Payor advances | 429 | 1,218 |
Accrued professional fees | 9,112 | 7,304 |
Accrued payroll and other taxes | 13,013 | 8,572 |
Other | 8,921 | 8,742 |
Total accrued expenses | $ 38,772 | $ 33,236 |
Government Actions to Mitigat_2
Government Actions to Mitigate COVID-19's Impact (Narrative) (Details) - USD ($) | 1 Months Ended | 3 Months Ended | 12 Months Ended | |||
Jul. 01, 2022 | Mar. 11, 2021 | Jan. 31, 2022 | Mar. 31, 2024 | Jun. 30, 2022 | Mar. 31, 2022 | |
CARES Act [Member] | ||||||
Government Assistance [Line Items] | ||||||
Percentage of reduced payments to Medicare providers | 2% | 2% | ||||
Reduction percentage on sequestration adjustment | 1% | |||||
ARPA [Member] | ||||||
Government Assistance [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 | $ 13,500,000 | |||||
Aggregate principal amount of grants received | 10,200,000 | |||||
Fund distributed to primarily for caregivers and retention efforts | 2,400,000 | |||||
Revenues | 0 | |||||
Cost of revenue | 0 | |||||
Aggregate funding amount | $ 10,200,000 | |||||
PAYGO Act [Member] | ||||||
Government Assistance [Line Items] | ||||||
Percentage of additional payment reduction | 4% |
Long-Term Debt (Schedule of Lon
Long-Term Debt (Schedule of Long-Term Debt) (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Debt Instrument [Line Items] | ||
Less unamortized issuance costs | $ (2,006) | $ (2,221) |
Long-term debt | 99,347 | 124,132 |
Revolving Credit Loan [Member] | Senior Secured Credit Facility [Member] | ||
Debt Instrument [Line Items] | ||
Long-term debt gross | $ 101,353 | $ 126,353 |
Long-Term Debt (Narrative) (Det
Long-Term Debt (Narrative) (Details) - Credit Agreement [Member] - USD ($) | 3 Months Ended | ||
Apr. 26, 2023 | Mar. 31, 2024 | Dec. 31, 2023 | |
Debt Instrument [Line Items] | |||
Line of credit outstanding amount | $ 486,900,000 | ||
Capital One, National Association [Member] | |||
Debt Instrument [Line Items] | |||
Maximum aggregate loan amount available | 377,500,000 | ||
Debt instrument, maturity date | Jul. 30, 2026 | ||
Debt instrument variable interest rate margin | 1% | ||
Debt instrument total net leverage ratio | 4.25% | ||
Line of credit outstanding amount | 8,000,000 | ||
Capital One, National Association [Member] | 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] | Based On Applicable Senior Leverage Ratio [Member] | Minimum [Member] | |||
Debt Instrument [Line Items] | |||
Debt instrument variable interest rate margin | 0.75% | ||
Capital One, National Association [Member] | Based On Applicable Senior Leverage Ratio [Member] | Maximum [Member] | |||
Debt Instrument [Line Items] | |||
Debt instrument variable interest rate margin | 1.50% | ||
Capital One, National Association [Member] | Based On Applicable Leverage Ratio [Member] | Minimum [Member] | |||
Debt Instrument [Line Items] | |||
Debt instrument variable interest rate margin | 1.75% | ||
Capital One, National Association [Member] | Based On Applicable Leverage Ratio [Member] | Maximum [Member] | |||
Debt Instrument [Line Items] | |||
Debt instrument variable interest rate margin | 2.50% | ||
Capital One, National Association [Member] | Restriction on Dividends [Member] | Maximum [Member] | |||
Debt Instrument [Line Items] | |||
Aggregate amount of dividends and distributions | 7,500,000 | ||
Revolving Credit Loan [Member] | Capital One, National Association [Member] | |||
Debt Instrument [Line Items] | |||
Maximum aggregate loan amount available | 600,000,000 | ||
Proceeds from line of credit | 0 | ||
Repayments of line of credit | 25,000,000 | ||
Line of credit outstanding amount | $ 101,400,000 | $ 126,400,000 | |
Debt instrument stated interest rate | 7.18% | 7.21% | |
Revolving Credit Loan [Member] | Capital One, National Association [Member] | Minimum [Member] | |||
Debt Instrument [Line Items] | |||
Fee charged on unused portion of revolving credit facility | 0.20% | ||
Revolving Credit Loan [Member] | Capital One, National Association [Member] | Maximum [Member] | |||
Debt Instrument [Line Items] | |||
Fee charged on unused portion of revolving credit facility | 0.35% | ||
Incremental Loan Facility [Member] | |||
Debt Instrument [Line Items] | |||
Maximum aggregate loan amount available | $ 125,000,000 |
Income Taxes (Narrative) (Detai
Income Taxes (Narrative) (Details) | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Income Tax Disclosure [Abstract] | ||
Effective income tax rate | 25.70% | 22% |
Percentage of excess tax (benefit) expense included in effective income tax rate | 0.10% | 1.20% |
Segment Information (Narrative)
Segment Information (Narrative) (Details) | 3 Months Ended |
Mar. 31, 2024 Segment | |
Segment Reporting [Abstract] | |
Number of business segments | 3 |
Segment Information (Summary of
Segment Information (Summary of Segment Information) (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Segment Reporting Information [Line Items] | ||
Net service revenues | $ 280,746 | $ 251,599 |
Cost of services revenues | 192,569 | 173,184 |
Gross profit | 88,177 | 78,415 |
General and administrative expenses | 61,063 | 56,360 |
Operating income | 23,645 | 18,608 |
Operating Segments [Member] | ||
Segment Reporting Information [Line Items] | ||
General and administrative expenses | 33,421 | 31,829 |
Operating income | 54,756 | 46,586 |
Personal Care [Member] | ||
Segment Reporting Information [Line Items] | ||
Net service revenues | 208,003 | 190,032 |
Cost of services revenues | 152,536 | 138,383 |
Gross profit | 55,467 | 51,649 |
Personal Care [Member] | Operating Segments [Member] | ||
Segment Reporting Information [Line Items] | ||
General and administrative expenses | 15,445 | 15,935 |
Operating income | 40,022 | 35,714 |
Hospice [Member] | ||
Segment Reporting Information [Line Items] | ||
Net service revenues | 55,863 | 49,082 |
Cost of services revenues | 28,967 | 27,267 |
Gross profit | 26,896 | 21,815 |
Hospice [Member] | Operating Segments [Member] | ||
Segment Reporting Information [Line Items] | ||
General and administrative expenses | 13,439 | 13,015 |
Operating income | 13,457 | 8,800 |
Home Health [Member] | ||
Segment Reporting Information [Line Items] | ||
Net service revenues | 16,880 | 12,485 |
Cost of services revenues | 11,066 | 7,534 |
Gross profit | 5,814 | 4,951 |
Home Health [Member] | Operating Segments [Member] | ||
Segment Reporting Information [Line Items] | ||
General and administrative expenses | 4,537 | 2,879 |
Operating income | $ 1,277 | $ 2,072 |
Segment Information (Segment Re
Segment Information (Segment Reconciliation to Totals reported in the accompanying Consolidated Financial Statements) (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Segment Reporting Information [Line Items] | ||
Operating income | $ 23,645 | $ 18,608 |
Other general and administrative expenses | 27,642 | 24,531 |
Depreciation and amortization | 3,469 | 3,447 |
Interest income | (423) | (106) |
Interest expense | 2,758 | 2,461 |
Income before income taxes | 21,310 | 16,253 |
Operating Segments [Member] | ||
Segment Reporting Information [Line Items] | ||
Operating income | $ 54,756 | $ 46,586 |
Significant Payors (Revenue by
Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Net service revenues | $ 280,746 | $ 251,599 |
Personal Care [Member] | ||
Net service revenues | 208,003 | 190,032 |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | ||
Net service revenues | $ 208,003 | $ 190,032 |
Concentration risk, percentage | 100% | 100% |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | State, Local And Other Governmental Programs [Member] | ||
Net service revenues | $ 107,754 | $ 95,320 |
Concentration risk, percentage | 51.80% | 50.10% |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member] | ||
Net service revenues | $ 94,276 | $ 87,901 |
Concentration risk, percentage | 45.30% | 46.30% |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member] | ||
Net service revenues | $ 3,906 | $ 4,226 |
Concentration risk, percentage | 1.90% | 2.20% |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member] | ||
Net service revenues | $ 1,486 | $ 1,669 |
Concentration risk, percentage | 0.70% | 0.90% |
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member] | ||
Net service revenues | $ 581 | $ 916 |
Concentration risk, percentage | 0.30% | 0.50% |
Hospice [Member] | ||
Net service revenues | $ 55,863 | $ 49,082 |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | ||
Net service revenues | $ 55,863 | $ 49,082 |
Concentration risk, percentage | 100% | 100% |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member] | ||
Net service revenues | $ 50,652 | $ 44,556 |
Concentration risk, percentage | 90.70% | 90.70% |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member] | ||
Net service revenues | $ 1,817 | $ 1,647 |
Concentration risk, percentage | 3.30% | 3.40% |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member] | ||
Net service revenues | $ 3,134 | $ 2,547 |
Concentration risk, percentage | 5.60% | 5.20% |
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member] | ||
Net service revenues | $ 260 | $ 332 |
Concentration risk, percentage | 0.40% | 0.70% |
Home Health [Member] | ||
Net service revenues | $ 16,880 | $ 12,485 |
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | ||
Net service revenues | $ 16,880 | $ 12,485 |
Concentration risk, percentage | 100% | 100% |
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member] | ||
Net service revenues | $ 11,663 | $ 9,270 |
Concentration risk, percentage | 69.10% | 74.20% |
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member] | ||
Net service revenues | $ 4,400 | $ 2,539 |
Concentration risk, percentage | 26.10% | 20.30% |
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member] | ||
Net service revenues | $ 817 | $ 676 |
Concentration risk, percentage | 4.80% | 5.50% |
Significant Payors (Revenue b_2
Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Net service revenues | $ 280,746 | $ 251,599 |
Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member] | ||
Concentration risk, percentage | 38.30% | 39.10% |
Personal Care [Member] | ||
Net service revenues | $ 208,003 | $ 190,032 |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | ||
Net service revenues | $ 208,003 | $ 190,032 |
Concentration risk, percentage | 100% | 100% |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member] | ||
Net service revenues | $ 107,575 | $ 98,414 |
Concentration risk, percentage | 51.80% | 51.80% |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member] | ||
Net service revenues | $ 28,967 | $ 28,474 |
Concentration risk, percentage | 13.90% | 15% |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member] | ||
Net service revenues | $ 23,534 | $ 21,885 |
Concentration risk, percentage | 11.30% | 11.50% |
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member] | ||
Net service revenues | $ 47,927 | $ 41,259 |
Concentration risk, percentage | 23% | 21.70% |
Hospice [Member] | ||
Net service revenues | $ 55,863 | $ 49,082 |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | ||
Net service revenues | $ 55,863 | $ 49,082 |
Concentration risk, percentage | 100% | 100% |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Ohio [Member] | ||
Net service revenues | $ 20,236 | $ 18,451 |
Concentration risk, percentage | 36.20% | 37.60% |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member] | ||
Net service revenues | $ 12,252 | $ 11,480 |
Concentration risk, percentage | 21.90% | 23.40% |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member] | ||
Net service revenues | $ 7,515 | $ 6,486 |
Concentration risk, percentage | 13.50% | 13.20% |
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member] | ||
Net service revenues | $ 15,860 | $ 12,665 |
Concentration risk, percentage | 28.40% | 25.80% |
Home Health [Member] | ||
Net service revenues | $ 16,880 | $ 12,485 |
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | ||
Net service revenues | $ 16,880 | $ 12,485 |
Concentration risk, percentage | 100% | 100% |
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member] | ||
Net service revenues | $ 2,942 | $ 3,369 |
Concentration risk, percentage | 17.40% | 27% |
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Tennessee [Member] | ||
Net service revenues | $ 6,161 | |
Concentration risk, percentage | 36.50% | |
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member] | ||
Net service revenues | $ 7,777 | $ 9,116 |
Concentration risk, percentage | 46.10% | 73% |
Significant Payors (Narrative)
Significant Payors (Narrative) (Details) - Illinois [Member] | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | |
Revenues [Member] | Illinois Department On Aging [Member] | |||
Concentration Risk [Line Items] | |||
Concentration risk, percentage | 20.80% | 21.50% | |
Revenues [Member] | Geographic Concentration Risk [Member] | |||
Concentration Risk [Line Items] | |||
Concentration risk, percentage | 38.30% | 39.10% | |
Accounts Receivable [Member] | Illinois Department On Aging [Member] | |||
Concentration Risk [Line Items] | |||
Concentration risk, percentage | 18% | 20.70% |