Addus HomeCare (ADUS) 10-Q 5 Nov 24 2024 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2024	Oct. 29, 2024
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2024
Document Fiscal Period Focus	Q3
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		18,133,115
Document Quarterly Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Title of 12(b) Security	Common Stock, $0.001 par value
Security Exchange Name	NASDAQ

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets
Cash	$ 222,852	$ 64,791
Accounts receivable, net of allowances	96,600	115,499
Prepaid expenses and other current assets	13,362	19,714
Total current assets	332,814	200,004
Property and equipment, net of accumulated depreciation and amortization	23,716	24,011
Other assets
Goodwill	663,614	662,995
Intangibles, net of accumulated amortization	86,606	91,983
Operating lease assets, net	44,535	45,433
Other long-term assets	1,616
Total other assets	796,371	800,411
Total assets	1,152,901	1,024,426
Current liabilities
Accounts payable	27,726	26,183
Accrued payroll	57,982	56,551
Accrued expenses	34,257	33,236
Operating lease liabilities, current portion	11,155	11,339
Government stimulus advances	13,655	5,765
Accrued workers' compensation insurance	13,043	12,043
Total current liabilities	157,818	145,117
Long-term liabilities
Long-term debt, net of debt issuance costs		124,132
Long-term operating lease liabilities	38,608	39,711
Other long-term liabilities	8,841	8,772
Total long-term liabilities	47,449	172,615
Total liabilities	205,267	317,732
Stockholders' equity
Common stock $.001 par value; 40,000 authorized and 18,133 and 16,227 shares issued and outstanding as of September 30, 2024 and December 31, 2023, respectively	18	16
Additional paid-in capital	590,712	403,846
Retained earnings	356,904	302,832
Total stockholders' equity	947,634	706,694
Total liabilities and stockholders' equity	$ 1,152,901	$ 1,024,426

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 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	18,133,000	16,227,000
Common stock, shares outstanding	18,133,000	16,227,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Net service revenues	$ 289,787	$ 270,721	$ 857,455	$ 782,300
Cost of service revenues	197,583	183,991	583,916	534,837
Gross profit	92,204	86,730	273,539	247,463
General and administrative expenses	62,805	60,271	187,444	174,028
Depreciation and amortization	3,446	3,620	10,316	10,449
Total operating expenses	66,251	63,891	197,760	184,477
Operating income	25,953	22,839	75,779	62,986
Interest income	(1,908)	(580)	(2,805)	(977)
Interest expense	573	3,199	5,445	7,991
Total interest (income) expense, net	(1,335)	2,619	2,640	7,014
Income before income taxes	27,288	20,220	73,139	55,972
Income tax expense	7,125	4,809	19,067	13,034
Net income	$ 20,163	$ 15,411	$ 54,072	$ 42,938
Net income per common share
Basic income per share	$ 1.13	$ 0.96	$ 3.24	$ 2.69
Diluted income per share	$ 1.10	$ 0.95	$ 3.17	$ 2.63
Weighted average number of common shares and potential common shares outstanding:
Basic	17,868	16,012	16,707	15,988
Diluted	18,255	16,286	17,065	16,307

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		86
Stock-based compensation	7,831		7,831
Shares issued for exercise of stock options	25		25
Net income	42,938			42,938
Balance at Sep. 30, 2023	684,334	$ 16	401,064	283,254
Balance, shares at Sep. 30, 2023		16,214
Balance at Jun. 30, 2023	666,351	$ 16	398,492	267,843
Balance, shares at Jun. 30, 2023		16,214
Stock-based compensation	2,572		2,572
Net income	15,411			15,411
Balance at Sep. 30, 2023	684,334	$ 16	401,064	283,254
Balance, shares at Sep. 30, 2023		16,214
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		151
Forfeiture of shares of common stock under restricted stock award agreements, shares		(5)
Stock-based compensation	8,307		8,307
Shares issued for exercise of stock options	2,983		2,983
Shares issued for exercise of stock options, shares		35
Shares issued in public offering, net of offering costs,Shares	175,578	$ 2	175,576
Shares issued in public offering, net of offering costs, Shares		1,725
Net income	54,072			54,072
Balance at Sep. 30, 2024	947,634	$ 18	590,712	356,904
Balance, shares at Sep. 30, 2024		18,133
Balance at Jun. 30, 2024	921,655	$ 18	584,896	336,741
Balance, shares at Jun. 30, 2024		18,100
Forfeiture of shares of common stock under restricted stock award agreements, shares		(2)
Stock-based compensation	2,833		2,833
Shares issued for exercise of stock options	2,983		2,983
Shares issued for exercise of stock options, shares		35
Net income	20,163			20,163
Balance at Sep. 30, 2024	$ 947,634	$ 18	$ 590,712	$ 356,904
Balance, shares at Sep. 30, 2024		18,133

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities:
Net income	$ 54,072	$ 42,938
Adjustments to reconcile net income to net cash provided by operating activities, net of acquisitions:
Depreciation and amortization	10,316	10,449
Deferred income taxes	188	246
Stock-based compensation	8,307	7,831
Amortization of debt issuance costs under the credit facility	644	645
Provision for credit losses	812	508
Gain on disposal of assets	(13)
Loss on termination of operating leases	9
Impairment of operating lease assets		8
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	17,868	9,929
Prepaid expenses and other current assets	6,187	6,277
Government stimulus advances	7,890	(5,528)
Accounts payable	1,003	(2,118)
Accrued payroll	1,431	4,464
Accrued expenses and other long-term liabilities	(2,698)	6,549
Net cash provided by operating activities	106,016	82,198
Cash flows from investing activities:
Acquisitions of businesses, net of cash acquired	(400)	(109,800)
Purchases of property and equipment	(4,353)	(4,134)
Proceeds received from disposal of assets	29
Proceeds received from divestiture of business	4,600
Net cash used in investing activities	(124)	(113,934)
Cash flows from financing activities:
Payments on revolver loan — credit facility	(126,353)	(78,500)
Proceeds from borrowings on revolver — credit facility		110,000
Proceeds from public offering	175,578
Payment for debt issuance costs	(39)
Cash received from exercise of stock options	2,983	25
Net cash provided by financing activities	52,169	31,525
Net change in cash	158,061	(211)
Cash, at beginning of period	64,791	79,961
Cash, at end of period	222,852	79,750
Supplemental disclosures of cash flow information:
Cash paid for interest	4,801	7,364
Cash paid for income taxes	$ 19,436	$ 10,565

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 20,163	$ 15,411	$ 54,072	$ 42,938

Insider Trading Arrangements

Insider Trading Arrangements - shares	3 Months Ended
	Sep. 30, 2024	Jan. 21, 2016
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	During the quarter ending September 30, 2024, each of the following directors and Section 16 officers adopted a Rule 10b5-1 Trading Arrangement (as defined in Item 408(a) of Regulation S-K) to sell common shares: Name Title Adoption Date Expiration Date (1) Shares Vesting and Subject to Sell-To-Cover (2) Other Shares Being Sold (Subject to Certain Conditions) R. Dirk Allison Chief Executive Officer and Chairman of the Board August 26, 2024 August 26, 2025 n/a 87,500 (3) ( 1) Each plan will expire on the date represented in the table or upon the earlier completion of all transactions contemplated by the arrangement. (2) This column indicates the total number of shares vesting in connection with equity awards, not the number of shares to be sold. The actual number of shares to be sold will be a smaller number based on whatever is required to satisfy payment of applicable withholding taxes under sell-to-cover arrangements. (3) Mr. Allison became CEO of the Company in early 2016 and, in connection with that appointment, received a grant of options with respect to 150,000 shares on January 21, 2016, of which 87,500 remain outstanding and unexercised. Those options have a ten-year term and are thus forfeited if not exercised by early 2026. Mr. Allison has established this plan in order to effectuate an orderly process for exercising and selling before the date of forfeiture. Each trading arrangement noted above is intended to satisfy the affirmative defense in Rule 10b5-1(c). No other director or Section 16 officer adopted or terminated any Rule 10b5-1 trading arrangements or non-Rule 10b5-1 trading arrangements, as such terms are defined in Item 408(a) of Regulation S-K, during the quarter ending September 30, 2024 .
R. Dirk Allison
Trading Arrangements, by Individual
Name	R. Dirk Allison
Title	Chief Executive Officer and Chairman of the Board
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	August 26, 2024
Expiration Date	August 26, 2025
Aggregate Available	87,500
Other Director and Officer
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Stock Option Grant [Member] | R. Dirk Allison
Trading Arrangements, by Individual
Arrangement Duration	10 years
Aggregate Available		150,000

Nature of Operations, Consolida

Nature of Operations, Consolidation, and Presentation of Financial Statements	9 Months Ended
	Sep. 30, 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	9 Months Ended
	Sep. 30, 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 September 30, For the Nine Months Ended September 30, (Amounts in thousands) (Amounts in thousands) 2024 2023 2024 2023 Weighted average number of shares outstanding for basic per share 17,868 16,012 16,707 15,988 Effect of dilutive potential shares: Stock options 278 227 254 239 Restricted stock awards 109 47 104 80 Adjusted weighted average shares outstanding for diluted per share 18,255 16,286 17,065 16,307 Anti-dilutive shares: Stock options — 111 — 61 Restricted stock awards — 1 — 1 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.

Public Offering

Public Offering	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Public Offering	3. Public Offering On June 28, 2024, the Company completed a public offering of an aggregate 1,725,000 shares of common stock, par value $ 0.001 per share, including 225,000 shares of common stock sold pursuant to the exercise in full by the underwriters of their option to purchase additional shares, at a public offering price of $ 108.00 per share (the “Public Offering”). The Company received net proceeds of approximately $ 175.6 million, after deducting underwriting discounts and estimated offering expenses of approximately $ 10.7 million. The Company used approximately $ 81.4 million from the net proceeds of the Public Offering for the repayment of indebtedness outstanding under its credit facility and may use any remaining net proceeds of the Public Offering for general corporate purposes, including the Company’s previously announced planned acquisition of the personal care assets of Gentiva and any future acquisitions or investments. The Public Offering resulted in an increase to additional paid in capital of approximately $ 175.6 million on the Company’s Unaudited Condensed Consolidated Balance Sheets at June 30, 2024.

Acquisition and Divestiture

Acquisition and Divestiture	9 Months Ended
	Sep. 30, 2024
Business Combinations [Abstract]
Acquisition and Divestiture	4. Acquisition and Divestiture Acquisition On June 8, 2024, the Company entered into a definitive stock and asset purchase agreement (the “Gentiva Purchase Agreement”) to acquire the personal care operations of Curo Health Services, LLC, a Delaware limited liability company which does business as Gentiva (“Gentiva”), consisting of equity interests and certain assets and liabilities, for a purchase price of approximately $ 350.0 million, payable in full in cash at the closing, subject to typical adjustments for working capital and other customary items (collectively, the “Gentiva Acquisition”). The acquired business operates in Arizona, Arkansas, California, Missouri, North Carolina, Tennessee and Texas, and serves approximately 16,000 patients. The Company expects to close this acquisition following completion of regulatory approvals and subject to customary closing conditions and fund it through the Company’s existing revolving credit facility and a portion of the net proceeds from the Public Offering. Divestiture On May 21, 2024, the Company entered into a definitive asset purchase agreement to sell all of the Company’s New York operations for a purchase price of up to $ 23.0 million in cash, subject to certain adjustments, including adjustments for future operating requirements (the “New York Asset Sale”). The Company entered into a consulting agreement with the purchaser on May 21, 2024, as the transfer of clients and caregivers and payment for assets pursuant to the New York Asset Sale is occurring over time as regulatory approvals are received, coordination of the transfer of clients and caregivers occurs, and the change of control takes place. In connection with this transaction, the Company will cease operations in New York. During the three and nine months ended September 30, 2024 , the Company recorded $ 1.0 million and $ 1.7 million in consulting fees, respectively, and received a $ 4.6 million initial payment on the acquisition. The New York Asset Sale did not qualify as a discontinued operation because it did not represent a strategic shift that has or will have a major effect on the Company’s operation or financial results. As of May 21, 2024, the Company’s New York personal care operations met the criteria to be classified as held for sale. The carrying value does not exceed the fair market value and will result in a gain on divestiture once the transaction closes. See Note 14 to the Notes to Unaudited Condensed Consolidated Financial Statements, Subsequent Events , for additional details regarding the treatment of the New York Asset Sale. The carrying amounts of the assets and liabilities associated with our New York personal care operations included in our Unaudited Condensed Consolidated Balance Sheets as of September 30, 2024 were as follows (amounts in thousands): September 30, 2024 Assets Current assets Accounts receivable, net of allowances $ 8,311 Prepaid expenses and other current assets 25 Total current assets 8,336 Property and equipment, net of accumulated depreciation and amortization 29 Other assets Goodwill 3,801 Intangibles, net of accumulated amortization 4,203 Operating lease assets, net 3,510 Total other assets 11,514 Total assets $ 19,879 Liabilities Current liabilities Accounts payable $ 6,020 Accrued payroll 3,338 Accrued expenses 680 Operating lease liabilities, current portion 751 Total current liabilities 10,789 Long-term liabilities Other long-term liabilities 2,661 Total liabilities $ 13,450

Leases

Leases	9 Months Ended
	Sep. 30, 2024
Leases [Abstract]
Leases	5. Leases Amounts reported on the Company’s Unaudited Condensed Consolidated Balance Sheets for operating leases were as follows: September 30, 2024 December 31, 2023 (Amounts in Thousands) Operating lease assets, net $ 44,535 $ 45,433 Short-term operating lease liabilities (in accrued expenses ) 11,155 11,339 Long-term operating lease liabilities 38,608 39,711 Total operating lease liabilities $ 49,763 $ 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 September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Operating lease costs $ 3,393 $ 3,344 $ 10,062 $ 9,678 Short-term lease costs 167 249 547 949 Total lease costs 3,560 3,593 10,609 10,627 Less: sublease income ( 596 ) ( 704 ) ( 1,685 ) ( 2,104 ) Total lease costs, net $ 2,964 $ 2,889 $ 8,924 $ 8,523 Lease Term and Discount Rate Weighted average remaining lease terms and discount rates were as follows: September 30, 2024 December 31, 2023 Operating leases: Weighted average remaining lease term (years) 5.81 6.26 Weighted average discount rate 5.99 % 5.47 % Maturity of Lease Liabilities Remaining operating lease payments as of September 30, 2024 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2025 $ 13,786 2026 11,097 2027 8,506 2028 6,322 2029 5,722 Thereafter 14,019 Total future minimum rental commitments 59,452 Less: Imputed interest ( 9,689 ) Total lease liabilities $ 49,763 Supplemental Cash Flows Information For the Nine Months Ended September 30, (Amounts in Thousands) 2024 2023 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 10,925 $ 10,702 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 7,683 $ 15,903

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	6. Goodwill and Intangible Assets A summary of the goodwill and related adjustments is provided below: Hospice Personal Care Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2023 $ 432,799 $ 153,276 $ 76,920 $ 662,995 Additions for acquisitions — 400 — 400 Adjustments to previously recorded goodwill 41 — 178 219 Goodwill as of September 30, 2024 $ 432,840 $ 153,676 $ 77,098 $ 663,614 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 nine months ended September 30, 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: September 30, 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 $ ( 40,588 ) $ 4,084 $ 44,672 $ ( 39,566 ) $ 5,106 Trade names and trademarks 1 - 20 years 59,566 ( 26,112 ) 33,454 59,566 ( 23,857 ) 35,709 Non-competition agreement 3 - 5 years 6,785 ( 6,213 ) 572 6,785 ( 5,601 ) 1,184 State Licenses 6 - 10 years 12,671 ( 10,503 ) 2,168 12,671 ( 9,015 ) 3,656 State Licenses Indefinite 46,328 — 46,328 46,328 — 46,328 Total intangible assets $ 170,022 $ ( 83,416 ) $ 86,606 $ 170,022 $ ( 78,039 ) $ 91,983 Amortization expense related to the intangible assets was $ 1.8 million and $ 5.4 million for the three and nine months ended September 30, 2024 , respectively, and $ 1.8 million and $ 5.3 million for the three and nine months ended September 30, 2023, respectively. The weighted average remaining useful lives of identifiable intangible assets as of September 30, 2024 was 10.0 years.

Details of Certain Balance Shee

Details of Certain Balance Sheet Accounts	9 Months Ended
	Sep. 30, 2024
Details Of Certain Balance Sheet Accounts [Abstract]
Details of Certain Balance Sheet Accounts	7. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consisted of the following: September 30, 2024 December 31, 2023 (Amounts in Thousands) Prepaid payroll $ 2,585 $ 8,735 Prepaid workers' compensation and liability insurance 3,112 3,696 Prepaid licensing fees 4,361 4,481 Workers' compensation insurance receivable 837 577 Other 2,467 2,225 Total prepaid expenses and other current assets $ 13,362 $ 19,714 Accrued expenses consisted of the following: September 30, 2024 December 31, 2023 (Amounts in Thousands) Accrued health benefits $ 6,032 $ 7,400 Payor advances (1) — 1,218 Accrued professional fees 7,038 7,304 Accrued payroll and other taxes 7,213 8,572 Other (2) 13,974 8,742 Total accrued expenses $ 34,257 $ 33,236 (1) Represents the deferred portion of payments received from payors for COVID-19 reimbursements which was recognized as we incurred specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel). (2) Includes a $ 4.6 million initial payment received for the New York Asset Sale as of September 30, 2024 .

Government Actions to Mitigate

Government Actions to Mitigate COVID-19's Impact	9 Months Ended
	Sep. 30, 2024
Risks and Uncertainties [Abstract]
Government Actions to Mitigate COVID-19's Impact	8. Government Actions to Mitigate COVID-19’s Impact While the acute phase of the COVID-19 pandemic has faded, 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 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 and nine months ended September 30, 2024 , the Company received additional state funding provided by the ARPA in an aggregate amount of $ 3.2 million and $ 15.4 million, respectively. Of the total state funding received by the Company pursuant to the ARPA through September 30, 2024 , the Company utilized $ 2.6 million and $ 7.5 million during the three and nine months ended September 30, 2024, respectively, 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 September 30, 2024 , the deferred portion of ARPA funding of $ 13.7 million is included 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	9 Months Ended
	Sep. 30, 2024
Long-Term Debt, Unclassified [Abstract]
Long-Term Debt	9. Long-Term Debt Long-term debt consisted of the following: September 30, 2024 December 31, 2023 (Amounts in Thousands) Revolving loan under the credit facility $ — $ 126,353 Less unamortized issuance costs (1) — ( 2,221 ) Long-term debt $ — $ 124,132 (1) As of September 30, 2024 , unamortized issuance costs of $ 1.6 million are recorded in Other long-term assets on the Company ’ s Unaudited Condensed Consolidated Balance Sheets. 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). As discussed further in Note 14, the credit facility consists of a $ 650.0 million revolving credit facility and a $ 150.0 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, 2028 . 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 nine months ended September 30, 2024, the Company did no t draw on its credit facility and repaid all amounts owed under the revolving credit facility. During the nine months ended September 30, 2023, the Company (i) drew $ 110.0 million under its credit facility to fund, in part, the Tennessee Quality Care acquisition and (ii) repaid $ 78.5 million under the revolving credit facility. As of September 30, 2024 , the Company had no revolving loans outstanding on its credit facility. After giving effect to the amount drawn on its credit facility, approximately $ 8.0 million of outstanding letters of credit and borrowing limits based on an advance multiple of adjusted EBITDA (as defined in the Credit Agreement), the Company had $ 511.5 million of capacity and $ 503.5 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 September 30, 2024 , the Company was in compliance with all financial covenants under the Credit Agreement.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2024
Income Tax Disclosure [Abstract]
Income Taxes	10. Income Taxes The effective income tax rates were 26.1 % and 23.8 % for the three months ended September 30, 2024 and 2023, respectively. The effective income tax rates were 26.1 % and 23.3 % for the nine months ended September 30, 2024 and 2023 , respectively. The difference between our federal statutory rate of 21 % and our effective income tax rates is principally due to the inclusion of state taxes and non-deductible compensation, partially offset by the use of federal employment tax credits.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	11. 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	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Segment Information	12. 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 CODM, 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 CODM function and therefore are not disclosed below. Segment operating income consists of revenue generated by a segment, less the direct costs of service revenues and general and administrative expenses that are incurred directly by the segment. Unallocated general and administrative costs are those costs for functions performed in a centralized manner and therefore not attributable to a particular segment. These costs include accounting, finance, human resources, legal, information technology, corporate office support and facility costs and overall corporate management. For the Three Months Ended September 30, 2024 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 215,433 $ 57,309 $ 17,045 $ 289,787 Cost of services revenues 156,273 30,469 10,841 197,583 Gross profit 59,160 26,840 6,204 92,204 General and administrative expenses 17,489 14,070 4,338 35,897 Segment operating income $ 41,671 $ 12,770 $ 1,866 $ 56,307 For the Three Months Ended September 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 201,882 $ 53,121 $ 15,718 $ 270,721 Cost of services revenues 145,808 28,155 10,028 183,991 Gross profit 56,074 24,966 5,690 86,730 General and administrative expenses 16,096 13,246 4,131 33,473 Segment operating income $ 39,978 $ 11,720 $ 1,559 $ 53,257 For the Three Months Ended September 30, 2024 2023 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 56,307 $ 53,257 Items not allocated at segment level: Other general and administrative expenses 26,908 26,798 Depreciation and amortization 3,446 3,620 Interest income ( 1,908 ) ( 580 ) Interest expense 573 3,199 Income before income taxes $ 27,288 $ 20,220 For the Nine Months Ended September 30, 2024 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 636,253 $ 169,202 $ 52,000 $ 857,455 Cost of services revenues 461,564 89,166 33,186 583,916 Gross profit 174,689 80,036 18,814 273,539 General and administrative expenses 49,907 40,975 13,447 104,329 Segment operating income $ 124,782 $ 39,061 $ 5,367 $ 169,210 For the Nine Months Ended September 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 590,227 $ 152,414 $ 39,659 $ 782,300 Cost of services revenues 428,163 82,028 24,646 534,837 Gross profit 162,064 70,386 15,013 247,463 General and administrative expenses 48,299 39,028 9,653 96,980 Segment operating income $ 113,765 $ 31,358 $ 5,360 $ 150,483 For the Nine Months Ended September 30, 2024 2023 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 169,210 $ 150,483 Items not allocated at segment level: Other general and administrative expenses 83,115 77,048 Depreciation and amortization 10,316 10,449 Interest income ( 2,805 ) ( 977 ) Interest expense 5,445 7,991 Income before income taxes $ 73,139 $ 55,972

Significant Payors

Significant Payors	9 Months Ended
	Sep. 30, 2024
Significant Payors [Abstract]
Significant Payors	13. Significant Payors The Company’s revenue by payor type was as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of State, local and other governmental programs $ 116,702 54.2 % $ 101,821 50.4 % $ 337,458 53.0 % $ 297,541 50.4 % Managed care organizations 93,321 43.3 93,584 46.4 281,732 44.3 272,758 46.2 Private pay 3,599 1.7 3,990 2.0 11,194 1.8 12,354 2.1 Commercial insurance 1,415 0.7 1,631 0.8 4,368 0.7 4,937 0.8 Other 396 0.1 856 0.4 1,501 0.2 2,637 0.5 Total personal care segment net service revenues $ 215,433 100.0 % $ 201,882 100.0 % $ 636,253 100.0 % $ 590,227 100.0 % Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of Medicare $ 52,413 91.5 % $ 47,313 89.1 % $ 154,187 91.1 % $ 137,432 90.2 % Commercial insurance 2,892 5.0 3,640 6.8 8,870 5.2 8,916 5.8 Managed care organizations 1,821 3.2 1,808 3.4 5,518 3.3 5,022 3.3 Other 183 0.3 360 0.7 627 0.4 1,044 0.7 Total hospice segment net service revenues $ 57,309 100.0 % $ 53,121 100.0 % $ 169,202 100.0 % $ 152,414 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of Medicare $ 12,036 70.6 % $ 11,325 72.1 % $ 36,216 69.6 % $ 29,306 73.9 % Managed care organizations 4,215 24.7 3,445 21.9 13,291 25.6 8,239 20.8 Other 794 4.7 948 6.0 2,493 4.8 2,114 5.3 Total home health segment net service revenues $ 17,045 100.0 % $ 15,718 100.0 % $ 52,000 100.0 % $ 39,659 100.0 % During the three and nine months ended September 30, 2024 and 2023 , the Company derived a significant amount of its revenue from its operations in Illinois, New Mexico, New York, Ohio and Tennessee. The percentages of segment revenue for each of these significant states were as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of Illinois $ 111,916 51.9 % $ 105,206 52.1 % $ 330,265 51.9 % $ 306,711 52.0 % New Mexico 28,962 13.4 28,347 14.0 86,573 13.6 84,969 14.3 New York (1) 21,406 9.9 22,989 11.4 68,239 10.7 68,910 11.7 All other states 53,149 24.8 45,340 22.5 151,176 23.8 129,637 22.0 Total personal care segment net service revenues $ 215,433 100.0 % $ 201,882 100.0 % $ 636,253 100.0 % $ 590,227 100.0 % (1) The selection process for CDPAP fiscal intermediaries has changed significantly in recent years and the program continues to be an area of focus for New York governmental authorities. As a result of the changes and uncertainty in the state, the Company determined that its New York personal care operations no longer fit its growth strategy and reached an agreement to divest these operations. See Note 4 to the Notes to Unaudited Condensed Consolidated Financial Statements, Acquisition and Divestiture , for additional details regarding our divestiture. Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of Ohio $ 21,531 37.6 % $ 18,916 35.6 % $ 62,400 36.9 % $ 55,363 36.3 % Illinois 13,289 23.2 12,477 23.5 38,544 22.8 34,750 22.8 New Mexico 6,951 12.1 7,619 14.3 21,361 12.6 23,688 15.5 All other states 15,538 27.1 14,109 26.6 46,897 27.7 38,613 25.4 Total hospice segment net service revenues $ 57,309 100.0 % $ 53,121 100.0 % $ 169,202 100.0 % $ 152,414 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of New Mexico $ 8,090 47.4 % $ 8,040 51.2 % $ 24,166 46.5 % $ 25,277 63.7 % Illinois 2,413 14.2 2,909 18.5 8,397 16.1 9,539 24.1 Tennessee 6,542 38.4 4,769 30.3 19,437 37.4 4,843 12.2 Total home health segment net service revenues $ 17,045 100.0 % $ 15,718 100.0 % $ 52,000 100.0 % $ 39,659 100.0 % 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 38.6 %, and 38.9 % of our net service revenues for the three months ended September 30, 2024, and 2023, respectively, and accounted for 38.5 % and 39.2 % of our net service revenues for the nine months ended September 30, 2024 and 2023, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 21.4 % and 20.5 % of the Company’s net service revenues for the three months ended September 30, 2024 and 2023, respectively, and accounted for 21.1 % and 21.2 % of the Company’s net service revenues for the nine months ended September 30, 2024 and 2023, respectively. The related receivables due from the Illinois Department on Aging represented 21.7 % and 25.8 % of the Company’s net accounts receivable at September 30, 2024 and December 31, 2023 , respectively.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2024
Subsequent Events [Abstract]
Subsequent Events	14. Subsequent Events Fourth Amendment to Credit Agreement On October 22, 2024, the Company entered into a Fourth Amendment to Amended and Restated Credit Agreement (the “Fourth Amendment”) with certain lenders and Capital One, National Association, as a lender and as agent for all lenders, which further amended the Credit Agreement. The Fourth Amendment, among other things, (i) increased the Company’s revolving credit facility to an aggregate amount of $ 650,000,000 , (ii) increased the Company’s incremental loan facility to an aggregate amount of $ 150,000,000 , and (iii) extended the maturity date of the credit facility from July 30, 2026 to July 30, 2028 . New York Disposition Treatment In October 2024, the Company qualified for sale consideration of the New York Asset Sale. As a result, the Company will deconsolidate the results of its New York operations and record a gain on divestiture. The New York Asset Sale purchase price of up to $ 23 million includes 50 % cash consideration, paid out as an initial payment of $ 4.6 million and $ 6.9 million paid pro rata as a deferred payment as caregivers are transferred and 50 % in the form of contingent consideration for the Company’s CDPAP business.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 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 September 30, For the Nine Months Ended September 30, (Amounts in thousands) (Amounts in thousands) 2024 2023 2024 2023 Weighted average number of shares outstanding for basic per share 17,868 16,012 16,707 15,988 Effect of dilutive potential shares: Stock options 278 227 254 239 Restricted stock awards 109 47 104 80 Adjusted weighted average shares outstanding for diluted per share 18,255 16,286 17,065 16,307 Anti-dilutive shares: Stock options — 111 — 61 Restricted stock awards — 1 — 1
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)	9 Months Ended
	Sep. 30, 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 September 30, For the Nine Months Ended September 30, (Amounts in thousands) (Amounts in thousands) 2024 2023 2024 2023 Weighted average number of shares outstanding for basic per share 17,868 16,012 16,707 15,988 Effect of dilutive potential shares: Stock options 278 227 254 239 Restricted stock awards 109 47 104 80 Adjusted weighted average shares outstanding for diluted per share 18,255 16,286 17,065 16,307 Anti-dilutive shares: Stock options — 111 — 61 Restricted stock awards — 1 — 1

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 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: September 30, 2024 December 31, 2023 (Amounts in Thousands) Operating lease assets, net $ 44,535 $ 45,433 Short-term operating lease liabilities (in accrued expenses ) 11,155 11,339 Long-term operating lease liabilities 38,608 39,711 Total operating lease liabilities $ 49,763 $ 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 September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Operating lease costs $ 3,393 $ 3,344 $ 10,062 $ 9,678 Short-term lease costs 167 249 547 949 Total lease costs 3,560 3,593 10,609 10,627 Less: sublease income ( 596 ) ( 704 ) ( 1,685 ) ( 2,104 ) Total lease costs, net $ 2,964 $ 2,889 $ 8,924 $ 8,523
Schedule of Weighted Average Remaining Lease Terms and Discount Rates	Weighted average remaining lease terms and discount rates were as follows: September 30, 2024 December 31, 2023 Operating leases: Weighted average remaining lease term (years) 5.81 6.26 Weighted average discount rate 5.99 % 5.47 %
Summary of Remaining Operating Lease Payments	Remaining operating lease payments as of September 30, 2024 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2025 $ 13,786 2026 11,097 2027 8,506 2028 6,322 2029 5,722 Thereafter 14,019 Total future minimum rental commitments 59,452 Less: Imputed interest ( 9,689 ) Total lease liabilities $ 49,763
Supplemental Cash Flows Information	For the Nine Months Ended September 30, (Amounts in Thousands) 2024 2023 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 10,925 $ 10,702 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 7,683 $ 15,903

Acquisitions and Divestiture (T

Acquisitions and Divestiture (Tables)	9 Months Ended
	Sep. 30, 2024
Business Combinations [Abstract]
Carrying Amounts of the Assets and Liabilities	The carrying amounts of the assets and liabilities associated with our New York personal care operations included in our Unaudited Condensed Consolidated Balance Sheets as of September 30, 2024 were as follows (amounts in thousands): September 30, 2024 Assets Current assets Accounts receivable, net of allowances $ 8,311 Prepaid expenses and other current assets 25 Total current assets 8,336 Property and equipment, net of accumulated depreciation and amortization 29 Other assets Goodwill 3,801 Intangibles, net of accumulated amortization 4,203 Operating lease assets, net 3,510 Total other assets 11,514 Total assets $ 19,879 Liabilities Current liabilities Accounts payable $ 6,020 Accrued payroll 3,338 Accrued expenses 680 Operating lease liabilities, current portion 751 Total current liabilities 10,789 Long-term liabilities Other long-term liabilities 2,661 Total liabilities $ 13,450

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 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 Health Total (Amounts in Thousands) Goodwill as of December 31, 2023 $ 432,799 $ 153,276 $ 76,920 $ 662,995 Additions for acquisitions — 400 — 400 Adjustments to previously recorded goodwill 41 — 178 219 Goodwill as of September 30, 2024 $ 432,840 $ 153,676 $ 77,098 $ 663,614
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: September 30, 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 $ ( 40,588 ) $ 4,084 $ 44,672 $ ( 39,566 ) $ 5,106 Trade names and trademarks 1 - 20 years 59,566 ( 26,112 ) 33,454 59,566 ( 23,857 ) 35,709 Non-competition agreement 3 - 5 years 6,785 ( 6,213 ) 572 6,785 ( 5,601 ) 1,184 State Licenses 6 - 10 years 12,671 ( 10,503 ) 2,168 12,671 ( 9,015 ) 3,656 State Licenses Indefinite 46,328 — 46,328 46,328 — 46,328 Total intangible assets $ 170,022 $ ( 83,416 ) $ 86,606 $ 170,022 $ ( 78,039 ) $ 91,983

Details of Certain Balance Sh_2

Details of Certain Balance Sheet Accounts (Tables)	9 Months Ended
	Sep. 30, 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: September 30, 2024 December 31, 2023 (Amounts in Thousands) Prepaid payroll $ 2,585 $ 8,735 Prepaid workers' compensation and liability insurance 3,112 3,696 Prepaid licensing fees 4,361 4,481 Workers' compensation insurance receivable 837 577 Other 2,467 2,225 Total prepaid expenses and other current assets $ 13,362 $ 19,714
Schedule of Accrued Expenses	Accrued expenses consisted of the following: September 30, 2024 December 31, 2023 (Amounts in Thousands) Accrued health benefits $ 6,032 $ 7,400 Payor advances (1) — 1,218 Accrued professional fees 7,038 7,304 Accrued payroll and other taxes 7,213 8,572 Other (2) 13,974 8,742 Total accrued expenses $ 34,257 $ 33,236 (1) Represents the deferred portion of payments received from payors for COVID-19 reimbursements which was recognized as we incurred specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel). (2) Includes a $ 4.6 million initial payment received for the New York Asset Sale as of September 30, 2024 .

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2024
Long-Term Debt, Unclassified [Abstract]
Schedule of Long-Term Debt	Long-term debt consisted of the following: September 30, 2024 December 31, 2023 (Amounts in Thousands) Revolving loan under the credit facility $ — $ 126,353 Less unamortized issuance costs (1) — ( 2,221 ) Long-term debt $ — $ 124,132 (1) As of September 30, 2024 , unamortized issuance costs of $ 1.6 million are recorded in Other long-term assets on the Company ’ s Unaudited Condensed Consolidated Balance Sheets.

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Summary of Segment Information	For the Three Months Ended September 30, 2024 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 215,433 $ 57,309 $ 17,045 $ 289,787 Cost of services revenues 156,273 30,469 10,841 197,583 Gross profit 59,160 26,840 6,204 92,204 General and administrative expenses 17,489 14,070 4,338 35,897 Segment operating income $ 41,671 $ 12,770 $ 1,866 $ 56,307 For the Three Months Ended September 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 201,882 $ 53,121 $ 15,718 $ 270,721 Cost of services revenues 145,808 28,155 10,028 183,991 Gross profit 56,074 24,966 5,690 86,730 General and administrative expenses 16,096 13,246 4,131 33,473 Segment operating income $ 39,978 $ 11,720 $ 1,559 $ 53,257 For the Three Months Ended September 30, 2024 2023 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 56,307 $ 53,257 Items not allocated at segment level: Other general and administrative expenses 26,908 26,798 Depreciation and amortization 3,446 3,620 Interest income ( 1,908 ) ( 580 ) Interest expense 573 3,199 Income before income taxes $ 27,288 $ 20,220 For the Nine Months Ended September 30, 2024 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 636,253 $ 169,202 $ 52,000 $ 857,455 Cost of services revenues 461,564 89,166 33,186 583,916 Gross profit 174,689 80,036 18,814 273,539 General and administrative expenses 49,907 40,975 13,447 104,329 Segment operating income $ 124,782 $ 39,061 $ 5,367 $ 169,210 For the Nine Months Ended September 30, 2023 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 590,227 $ 152,414 $ 39,659 $ 782,300 Cost of services revenues 428,163 82,028 24,646 534,837 Gross profit 162,064 70,386 15,013 247,463 General and administrative expenses 48,299 39,028 9,653 96,980 Segment operating income $ 113,765 $ 31,358 $ 5,360 $ 150,483 For the Nine Months Ended September 30, 2024 2023 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 169,210 $ 150,483 Items not allocated at segment level: Other general and administrative expenses 83,115 77,048 Depreciation and amortization 10,316 10,449 Interest income ( 2,805 ) ( 977 ) Interest expense 5,445 7,991 Income before income taxes $ 73,139 $ 55,972

Significant Payors (Tables)

Significant Payors (Tables)	9 Months Ended
	Sep. 30, 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 September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of State, local and other governmental programs $ 116,702 54.2 % $ 101,821 50.4 % $ 337,458 53.0 % $ 297,541 50.4 % Managed care organizations 93,321 43.3 93,584 46.4 281,732 44.3 272,758 46.2 Private pay 3,599 1.7 3,990 2.0 11,194 1.8 12,354 2.1 Commercial insurance 1,415 0.7 1,631 0.8 4,368 0.7 4,937 0.8 Other 396 0.1 856 0.4 1,501 0.2 2,637 0.5 Total personal care segment net service revenues $ 215,433 100.0 % $ 201,882 100.0 % $ 636,253 100.0 % $ 590,227 100.0 % Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of Medicare $ 52,413 91.5 % $ 47,313 89.1 % $ 154,187 91.1 % $ 137,432 90.2 % Commercial insurance 2,892 5.0 3,640 6.8 8,870 5.2 8,916 5.8 Managed care organizations 1,821 3.2 1,808 3.4 5,518 3.3 5,022 3.3 Other 183 0.3 360 0.7 627 0.4 1,044 0.7 Total hospice segment net service revenues $ 57,309 100.0 % $ 53,121 100.0 % $ 169,202 100.0 % $ 152,414 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of Medicare $ 12,036 70.6 % $ 11,325 72.1 % $ 36,216 69.6 % $ 29,306 73.9 % Managed care organizations 4,215 24.7 3,445 21.9 13,291 25.6 8,239 20.8 Other 794 4.7 948 6.0 2,493 4.8 2,114 5.3 Total home health segment net service revenues $ 17,045 100.0 % $ 15,718 100.0 % $ 52,000 100.0 % $ 39,659 100.0 %
Schedule of Revenue by Geographic Location	The percentages of segment revenue for each of these significant states were as follows: Personal Care Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of Illinois $ 111,916 51.9 % $ 105,206 52.1 % $ 330,265 51.9 % $ 306,711 52.0 % New Mexico 28,962 13.4 28,347 14.0 86,573 13.6 84,969 14.3 New York (1) 21,406 9.9 22,989 11.4 68,239 10.7 68,910 11.7 All other states 53,149 24.8 45,340 22.5 151,176 23.8 129,637 22.0 Total personal care segment net service revenues $ 215,433 100.0 % $ 201,882 100.0 % $ 636,253 100.0 % $ 590,227 100.0 % (1) The selection process for CDPAP fiscal intermediaries has changed significantly in recent years and the program continues to be an area of focus for New York governmental authorities. As a result of the changes and uncertainty in the state, the Company determined that its New York personal care operations no longer fit its growth strategy and reached an agreement to divest these operations. See Note 4 to the Notes to Unaudited Condensed Consolidated Financial Statements, Acquisition and Divestiture , for additional details regarding our divestiture. Hospice Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of Ohio $ 21,531 37.6 % $ 18,916 35.6 % $ 62,400 36.9 % $ 55,363 36.3 % Illinois 13,289 23.2 12,477 23.5 38,544 22.8 34,750 22.8 New Mexico 6,951 12.1 7,619 14.3 21,361 12.6 23,688 15.5 All other states 15,538 27.1 14,109 26.6 46,897 27.7 38,613 25.4 Total hospice segment net service revenues $ 57,309 100.0 % $ 53,121 100.0 % $ 169,202 100.0 % $ 152,414 100.0 % Home Health Segment For the Three Months Ended September 30, For the Nine Months Ended September 30, 2024 2023 2024 2023 Amount % of Amount % of Amount % of Amount % of New Mexico $ 8,090 47.4 % $ 8,040 51.2 % $ 24,166 46.5 % $ 25,277 63.7 % Illinois 2,413 14.2 2,909 18.5 8,397 16.1 9,539 24.1 Tennessee 6,542 38.4 4,769 30.3 19,437 37.4 4,843 12.2 Total home health segment net service revenues $ 17,045 100.0 % $ 15,718 100.0 % $ 52,000 100.0 % $ 39,659 100.0 %

Nature of Operations, Consoli_2

Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details)	9 Months Ended
	Sep. 30, 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		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Summary Of Significant Accounting Policies [Line Items]
Weighted average number of shares outstanding for basic per share calculation	17,868	16,012	16,707	15,988
Effect of dilutive potential shares:
Adjusted weighted average shares outstanding for diluted per share calculation	18,255	16,286	17,065	16,307
Employee Stock Option
Effect of dilutive potential shares:
Effect of dilutive potential shares	278	227	254	239
Anti-dilutive shares:
Anti-dilutive shares		111		61
Restricted Stock Awards [Member]
Effect of dilutive potential shares:
Effect of dilutive potential shares	109	47	104	80
Anti-dilutive shares:
Anti-dilutive shares		1		1

Summary of Significant Accoun_5

Summary of Significant Accounting Policies (Narrative) (Details)	Sep. 30, 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

Public Offering (Narrative) (De

Public Offering (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands		9 Months Ended
	Jun. 28, 2024	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Class of Stock [Line Items]
Common stock, par value		$ 0.001		$ 0.001
Proceeds from Issuance of Common Stock		$ 175,578
Repayment of indebtedness outstanding under credit facility		$ 126,353	$ 78,500
Common Stock [Member]
Class of Stock [Line Items]
Shares issued in public offering, net of offering costs, Shares		1,725,000
Offering price	$ 108
Public Offering | Common Stock [Member]
Class of Stock [Line Items]
Shares issued in public offering, net of offering costs, Shares	1,725,000
Common stock, par value	$ 0.001
Proceeds from Issuance of Common Stock	$ 175,600
Paid in capital	175,600
Underwriting discounts and estimated offering expenses	10,700
Public Offering | Common Stock [Member] | Revolving Credit Loan
Class of Stock [Line Items]
Repayment of indebtedness outstanding under credit facility	$ 81,400
Allotment | Common Stock [Member]
Class of Stock [Line Items]
Shares issued in public offering, net of offering costs, Shares	225,000

Acquisition and Divestiture (Na

Acquisition and Divestiture (Narrative) (Details) $ in Thousands		3 Months Ended	9 Months Ended
	Jun. 08, 2024 USD ($) Patient	Sep. 30, 2024 USD ($)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	May 21, 2024 USD ($)
Business Acquisition [Line Items]
Total purchase price for business acquisition			$ 400	$ 109,800
Initial payment received			4,600
Asset Purchase Agreement
Business Acquisition [Line Items]
Management fee		$ 4,600	4,600
Initial payment received		$ 1,000	$ 1,700
Maximum [Member] | Asset Purchase Agreement
Business Acquisition [Line Items]
Purchase price					$ 23,000
Gentiva [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition	$ 350,000
Number of Patients Served per Day | Patient	16,000

Acquisition and Divestiture - (

Acquisition and Divestiture - (Schedule of Carrying Amounts of the Assets and Liabilities) (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets
Accounts receivable, net of allowances	$ 96,600	$ 115,499
Prepaid expenses and other current assets	13,362	19,714
Total current assets	332,814	200,004
Property and equipment, net of accumulated depreciation and amortization	23,716	24,011
Other assets
Goodwill	663,614	662,995
Intangibles, net of accumulated amortization	86,606	91,983
Operating lease assets, net	44,535	45,433
Total other assets	796,371	800,411
Total assets	1,152,901	1,024,426
Current liabilities
Accounts payable	27,726	26,183
Accrued payroll	57,982	56,551
Accrued expenses	34,257	33,236
Operating lease liabilities, current portion	11,155	11,339
Total current liabilities	157,818	145,117
Long-term liabilities
Other long-term liabilities	8,841	8,772
Total liabilities	205,267	$ 317,732
New york personal care operations [Member]
Current assets
Accounts receivable, net of allowances	8,311
Prepaid expenses and other current assets	25
Total current assets	8,336
Property and equipment, net of accumulated depreciation and amortization	29
Other assets
Goodwill	3,801
Intangibles, net of accumulated amortization	4,203
Operating lease assets, net	3,510
Total other assets	11,514
Total assets	19,879
Current liabilities
Accounts payable	6,020
Accrued payroll	3,338
Accrued expenses	680
Operating lease liabilities, current portion	751
Total current liabilities	10,789
Long-term liabilities
Other long-term liabilities	2,661
Total liabilities	$ 13,450

Leases (Amounts Reported in Una

Leases (Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases) (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Leases [Abstract]
Operating lease assets, net	$ 44,535	$ 45,433
Short-term operating lease liabilities (in accrued expenses)	$ 11,155	$ 11,339
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued expenses	Accrued expenses
Long-term operating lease liabilities	$ 38,608	$ 39,711
Total operating lease liabilities	$ 49,763	$ 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		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Leases [Abstract]
Operating lease costs	$ 3,393	$ 3,344	$ 10,062	$ 9,678
Short-term lease costs	167	249	547	949
Total lease costs	3,560	3,593	10,609	10,627
Less: sublease income	(596)	(704)	(1,685)	(2,104)
Total lease costs, net	$ 2,964	$ 2,889	$ 8,924	$ 8,523

Leases (Schedule of Weighted Av

Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details)	Sep. 30, 2024	Dec. 31, 2023
Leases [Abstract]
Weighted average remaining lease term (years)	5 years 9 months 21 days	6 years 3 months 3 days
Weighted average discount rate	5.99%	5.47%

Leases (Summary of Remaining Op

Leases (Summary of Remaining Operating Lease Payments) (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Leases [Abstract]
2025	$ 13,786
2026	11,097
2027	8,506
2028	6,322
2029	5,722
Thereafter	14,019
Total future minimum rental commitments	59,452
Less: Imputed interest	(9,689)
Total lease liabilities	$ 49,763	$ 51,050

Leases (Supplemental Cash Flows

Leases (Supplemental Cash Flows Information) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 10,925	$ 10,702
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 7,683	$ 15,903

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($)
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 662,995
Additions for acquisitions	400
Adjustments to previously recorded goodwill	219
Goodwill, at End of Period	663,614
Hospice [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	432,799
Adjustments to previously recorded goodwill	41
Goodwill, at End of Period	432,840
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	178
Goodwill, at End of Period	$ 77,098

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
	Mar. 09, 2024	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Goodwill [Line Items]
Goodwill		$ 663,614		$ 663,614		$ 662,995
Amortization expense		$ 1,800	$ 1,800	5,400	$ 5,300
Total purchase price for business acquisition				$ 400	$ 109,800
Weighted average remaining useful lives of identifiable intangible assets		10 years		10 years
Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		1 year		1 year
Minimum [Member] | Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		5 years		5 years
Maximum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		20 years		20 years
Maximum [Member] | Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives		10 years		10 years
Personal Care [Member]
Goodwill [Line Items]
Goodwill		$ 153,676		$ 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		$ 400

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Intangible assets subject to amortization:
Accumulated amortization	$ (83,416)	$ (78,039)
Total intangible assets, Gross carrying value	170,022	170,022
Total intangible assets, Net carrying value	$ 86,606	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	(40,588)	(39,566)
Net carrying value	$ 4,084	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	(26,112)	(23,857)
Net carrying value	$ 33,454	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	(6,213)	(5,601)
Net carrying value	$ 572	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	(10,503)	(9,015)
Net carrying value	2,168	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	Sep. 30, 2024	Dec. 31, 2023
Details Of Certain Balance Sheet Accounts [Abstract]
Prepaid payroll	$ 2,585	$ 8,735
Prepaid workers' compensation and liability insurance	3,112	3,696
Prepaid licensing fees	4,361	4,481
Workers' compensation insurance receivable	837	577
Other	2,467	2,225
Total prepaid expenses and other current assets	$ 13,362	$ 19,714

Details of Certain Balance Sh_4

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Details Of Certain Balance Sheet Accounts [Abstract]
Accrued health benefits	$ 6,032	$ 7,400
Payor advances		1,218
Accrued professional fees	7,038	7,304
Accrued payroll and other taxes	7,213	8,572
Other	13,974	8,742
Total accrued expenses	$ 34,257	$ 33,236

Details of Certain Balance Sh_5

Details of Certain Balance Sheet Accounts - Schedule of Accrued Expenses (Parenthetical) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($)
Details Of Certain Balance Sheet Accounts [Abstract]
Initial payment received	$ 4,600

Government Actions to Mitigat_2

Government Actions to Mitigate COVID-19's Impact (Narrative) (Details) - USD ($) $ in Millions			1 Months Ended	3 Months Ended		9 Months Ended	12 Months Ended
	Jul. 01, 2022	Mar. 11, 2021	Jan. 31, 2022	Sep. 30, 2024	Jun. 30, 2022	Sep. 30, 2024	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
percentage point increase in federal matching funds							10%
Deferred portion of spending plans				$ 13.7		$ 13.7
Fund distributed to primarily for caregivers and retention efforts				2.6		7.5
Aggregate funding amount				$ 3.2		$ 15.4
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) $ in Thousands	Dec. 31, 2023 USD ($)
Debt Instrument [Line Items]
Less unamortized issuance costs	$ (2,221)
Long-term debt	124,132
Revolving Credit Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 126,353

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Parenthetical) (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Unamortized issuance costs		$ 2,221
Other Long-term Assets [Member]
Debt Instrument [Line Items]
Unamortized issuance costs	$ 1,600

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) - Credit Agreement [Member] - USD ($)			9 Months Ended
	Oct. 22, 2024	Apr. 26, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Debt Instrument [Line Items]
Line of credit outstanding amount			$ 511,500,000
Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available			503,500,000
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
Capital One, National Association [Member] | Subsequent Event [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 650,000,000
Debt instrument, maturity date	Jul. 30, 2028
Revolving Credit Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Proceeds from line of credit			0
Repayments of line of credit				$ 78,500,000
Line of credit outstanding amount			$ 0		$ 126,400,000
Debt instrument stated interest rate					7.21%
Revolving Credit Loan [Member] | Capital One, National Association [Member] | Tennessee Quality Care [Member]
Debt Instrument [Line Items]
Proceeds from line of credit				$ 110,000,000
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%
Revolving Credit Loan [Member] | Capital One, National Association [Member] | Subsequent Event [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 650,000,000
Incremental Loan Facility [Member] | Subsequent Event [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 150,000,000

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Effective income tax rate	26.10%	23.80%	26.10%	23.30%
Effective income tax, federal statutory rate			21%

Segment Information (Narrative)

Segment Information (Narrative) (Details)	9 Months Ended
	Sep. 30, 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		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Segment Reporting Information [Line Items]
Net service revenues	$ 289,787	$ 270,721	$ 857,455	$ 782,300
Cost of services revenues	197,583	183,991	583,916	534,837
Gross profit	92,204	86,730	273,539	247,463
General and administrative expenses	62,805	60,271	187,444	174,028
Operating income	25,953	22,839	75,779	62,986
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	35,897	33,473	104,329	96,980
Operating income	56,307	53,257	169,210	150,483
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues	215,433	201,882	636,253	590,227
Cost of services revenues	156,273	145,808	461,564	428,163
Gross profit	59,160	56,074	174,689	162,064
Personal Care [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	17,489	16,096	49,907	48,299
Operating income	41,671	39,978	124,782	113,765
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues	57,309	53,121	169,202	152,414
Cost of services revenues	30,469	28,155	89,166	82,028
Gross profit	26,840	24,966	80,036	70,386
Hospice [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	14,070	13,246	40,975	39,028
Operating income	12,770	11,720	39,061	31,358
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues	17,045	15,718	52,000	39,659
Cost of services revenues	10,841	10,028	33,186	24,646
Gross profit	6,204	5,690	18,814	15,013
Home Health [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	4,338	4,131	13,447	9,653
Operating income	$ 1,866	$ 1,559	$ 5,367	$ 5,360

Segment Information (Segment Re

Segment Information (Segment Reconciliation to Totals reported in the accompanying Consolidated Financial Statements) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Segment Reporting Information [Line Items]
Total segment operating income	$ 25,953	$ 22,839	$ 75,779	$ 62,986
Other general and administrative expenses	26,908	26,798	83,115	77,048
Depreciation and amortization	3,446	3,620	10,316	10,449
Interest income	(1,908)	(580)	(2,805)	(977)
Interest expense	573	3,199	5,445	7,991
Income before income taxes	27,288	20,220	73,139	55,972
Operating Segments [Member]
Segment Reporting Information [Line Items]
Total segment operating income	$ 56,307	$ 53,257	$ 169,210	$ 150,483

Significant Payors (Revenue by

Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Disaggregation of Revenue [Line Items]
Net service revenues	$ 289,787	$ 270,721	$ 857,455	$ 782,300
Personal Care [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	215,433	201,882	636,253	590,227
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 215,433	$ 201,882	$ 636,253	$ 590,227
Concentration risk, percentage	100%	100%	100%	100%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | State, Local And Other Governmental Programs [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 116,702	$ 101,821	$ 337,458	$ 297,541
Concentration risk, percentage	54.20%	50.40%	53%	50.40%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 93,321	$ 93,584	$ 281,732	$ 272,758
Concentration risk, percentage	43.30%	46.40%	44.30%	46.20%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 3,599	$ 3,990	$ 11,194	$ 12,354
Concentration risk, percentage	1.70%	2%	1.80%	2.10%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 1,415	$ 1,631	$ 4,368	$ 4,937
Concentration risk, percentage	0.70%	0.80%	0.70%	0.80%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 396	$ 856	$ 1,501	$ 2,637
Concentration risk, percentage	0.10%	0.40%	0.20%	0.50%
Hospice [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 57,309	$ 53,121	$ 169,202	$ 152,414
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 57,309	$ 53,121	$ 169,202	$ 152,414
Concentration risk, percentage	100%	100%	100%	100%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 52,413	$ 47,313	$ 154,187	$ 137,432
Concentration risk, percentage	91.50%	89.10%	91.10%	90.20%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 1,821	$ 1,808	$ 5,518	$ 5,022
Concentration risk, percentage	3.20%	3.40%	3.30%	3.30%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 2,892	$ 3,640	$ 8,870	$ 8,916
Concentration risk, percentage	5%	6.80%	5.20%	5.80%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 183	$ 360	$ 627	$ 1,044
Concentration risk, percentage	0.30%	0.70%	0.40%	0.70%
Home Health [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 17,045	$ 15,718	$ 52,000	$ 39,659
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 17,045	$ 15,718	$ 52,000	$ 39,659
Concentration risk, percentage	100%	100%	100%	100%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 12,036	$ 11,325	$ 36,216	$ 29,306
Concentration risk, percentage	70.60%	72.10%	69.60%	73.90%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 4,215	$ 3,445	$ 13,291	$ 8,239
Concentration risk, percentage	24.70%	21.90%	25.60%	20.80%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Disaggregation of Revenue [Line Items]
Net service revenues	$ 794	$ 948	$ 2,493	$ 2,114
Concentration risk, percentage	4.70%	6%	4.80%	5.30%

Significant Payors (Revenue b_2

Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Net service revenues	$ 289,787	$ 270,721	$ 857,455	$ 782,300
Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Concentration risk, percentage	38.60%	38.90%	38.50%	39.20%
Personal Care [Member]
Net service revenues	$ 215,433	$ 201,882	$ 636,253	$ 590,227
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 215,433	$ 201,882	$ 636,253	$ 590,227
Concentration risk, percentage	100%	100%	100%	100%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 111,916	$ 105,206	$ 330,265	$ 306,711
Concentration risk, percentage	51.90%	52.10%	51.90%	52%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 28,962	$ 28,347	$ 86,573	$ 84,969
Concentration risk, percentage	13.40%	14%	13.60%	14.30%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member]
Net service revenues	$ 21,406	$ 22,989	$ 68,239	$ 68,910
Concentration risk, percentage	9.90%	11.40%	10.70%	11.70%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 53,149	$ 45,340	$ 151,176	$ 129,637
Concentration risk, percentage	24.80%	22.50%	23.80%	22%
Hospice [Member]
Net service revenues	$ 57,309	$ 53,121	$ 169,202	$ 152,414
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 57,309	$ 53,121	$ 169,202	$ 152,414
Concentration risk, percentage	100%	100%	100%	100%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Ohio [Member]
Net service revenues	$ 21,531	$ 18,916	$ 62,400	$ 55,363
Concentration risk, percentage	37.60%	35.60%	36.90%	36.30%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 13,289	$ 12,477	$ 38,544	$ 34,750
Concentration risk, percentage	23.20%	23.50%	22.80%	22.80%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 6,951	$ 7,619	$ 21,361	$ 23,688
Concentration risk, percentage	12.10%	14.30%	12.60%	15.50%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 15,538	$ 14,109	$ 46,897	$ 38,613
Concentration risk, percentage	27.10%	26.60%	27.70%	25.40%
Home Health [Member]
Net service revenues	$ 17,045	$ 15,718	$ 52,000	$ 39,659
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 17,045	$ 15,718	$ 52,000	$ 39,659
Concentration risk, percentage	100%	100%	100%	100%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 2,413	$ 2,909	$ 8,397	$ 9,539
Concentration risk, percentage	14.20%	18.50%	16.10%	24.10%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 8,090	$ 8,040	$ 24,166	$ 25,277
Concentration risk, percentage	47.40%	51.20%	46.50%	63.70%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Tennessee
Net service revenues	$ 6,542	$ 4,769	$ 19,437	$ 4,843
Concentration risk, percentage	38.40%	30.30%	37.40%	12.20%

Significant Payors (Narrative)

Significant Payors (Narrative) (Details) - Illinois [Member]	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Revenues [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	21.40%	20.50%	21.10%	21.20%
Revenues [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	38.60%	38.90%	38.50%	39.20%
Accounts Receivable [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			21.70%		25.80%

Subsequent Events (Narrative) (

Subsequent Events (Narrative) (Details) - USD ($)		1 Months Ended	9 Months Ended
	Oct. 22, 2024	Oct. 31, 2024	Sep. 30, 2024
Subsequent Event [Line Items]
Initial payment received			$ 4,600,000
Capital One, National Association [Member] | Credit Agreement [Member]
Subsequent Event [Line Items]
Maximum aggregate loan amount available			$ 503,500,000
Subsequent Event [Member] | Extended Maturity [Member]
Subsequent Event [Line Items]
Debt instrument, maturity date	Jul. 30, 2028
Subsequent Event [Member] | Capital One, National Association [Member] | Credit Agreement [Member]
Subsequent Event [Line Items]
Maximum aggregate loan amount available	$ 650,000,000
Debt instrument, maturity date	Jul. 30, 2028
Subsequent Event [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member] | Credit Agreement [Member]
Subsequent Event [Line Items]
Maximum aggregate loan amount available	$ 650,000,000
Subsequent Event [Member] | Incremental Loan Facility [Member] | Credit Agreement [Member]
Subsequent Event [Line Items]
Maximum aggregate loan amount available	$ 150,000,000
New York Disposition Treatment [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Sale purchase price		$ 23,000,000
Cash consideration		50%
Initial payment received		$ 4,600,000
Deferred payment		$ 6,900,000
Contingent consideration		50%