Addus HomeCare (ADUS) 10-Q 7 May 24 2024 Q1 Quarterly report Financial data

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%