Addus HomeCare (ADUS) 10-Q 8 Nov 18 2018 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2018	Oct. 31, 2018
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2018
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2,018
Entity Registrant Name	Addus HomeCare Corp
Entity Central Index Key	1,468,328
Trading Symbol	adus
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		13,098,355

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Current assets
Cash	$ 147,477	$ 53,754
Accounts receivable, net	106,653	88,952
Prepaid expenses and other current assets	6,935	8,379
Total current assets	261,065	151,085
Property and equipment, net of accumulated depreciation and amortization	9,453	7,489
Other assets
Goodwill	134,063	90,339
Intangibles, net of accumulated amortization	26,197	16,596
Deferred tax assets, net		1,601
Total other assets	160,260	108,536
Total assets	430,778	267,110
Current liabilities
Accounts payable	6,737	4,271
Current portion of long-term debt, net of debt issuance costs	2,318	3,099
Contingent earn-out obligation	847
Accrued expenses	52,436	44,354
Total current liabilities	62,338	51,724
Long-term liabilities
Long-term debt, less current portion, net of debt issuance costs	98,891	39,860
Deferred tax liabilities, net	1,098
Other long-term liabilities	641	446
Total long-term liabilities	100,630	40,306
Total liabilities	162,968	92,030
Stockholders' equity
Common stock-$.001 par value; 40,000 authorized and 13,097 and 11,632 shares issued and outstanding as of September 30, 2018 and December 31, 2017, respectively	13	12
Additional paid-in capital	175,991	95,963
Retained earnings	91,806	79,105
Total stockholders' equity	267,810	175,080
Total liabilities and stockholders' equity	$ 430,778	$ 267,110

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2018	Dec. 31, 2017
Condensed Consolidated Balance Sheets [Abstract]
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	40,000,000	40,000,000
Common stock, shares issued	13,097,000	11,632,000
Common stock, shares outstanding	13,097,000	11,632,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Condensed Consolidated Statements of Income [Abstract]
Net service revenues	$ 137,631	$ 108,592	$ 378,315	$ 313,758
Cost of service revenues	100,926	79,539	277,985	228,877
Gross profit	36,705	29,053	100,330	84,881
General and administrative expenses	28,218	19,359	76,084	57,239
Gain on sale of assets				(2,065)
Provision for doubtful accounts	49	2,106	214	6,208
Depreciation and amortization	2,535	1,781	6,676	4,811
Total operating expenses	30,802	23,246	82,974	66,193
Operating income	5,903	5,807	17,356	18,688
Interest income	(113)	(30)	(2,468)	(50)
Interest expense	1,543	870	3,836	3,629
Total interest expense, net	1,430	840	1,368	3,579
Other income		64		165
Income before income taxes	4,473	5,031	15,988	15,274
Income tax expense	927	1,623	3,287	4,908
Net income	$ 3,546	$ 3,408	$ 12,701	$ 10,366
Net income per common share
Basic income per share	$ 0.29	$ 0.30	$ 1.08	$ 0.90
Diluted income per share	$ 0.28	$ 0.29	$ 1.06	$ 0.89
Weighted average number of common shares and potential common shares outstanding:
Basic	12,179	11,486	11,740	11,464
Diluted	12,569	11,631	12,037	11,616

Condensed Consolidated Statem_2

Condensed Consolidated Statement of Stockholders' Equity - 9 months ended Sep. 30, 2018 - USD ($) shares in Thousands, $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Total
Balance at Dec. 31, 2017	$ 12	$ 95,963	$ 79,105	$ 175,080
Balance, shares at Dec. 31, 2017	11,632
Issuance of shares of common stock under restricted stock award agreements, Shares	74
Forfeiture of shares of common stock under restricted stock award agreements, shares	(16)
Stock-based compensation		2,961		2,961
Shares issued for exercise of stock options		450		450
Shares issued for exercise of stock options, shares	17
Shares issued in secondary offering, net of offering costs	$ 1	76,617		76,618
Shares issued in secondary offering, net of offering costs, shares	1,390
Net income			12,701	12,701
Balance at Sep. 30, 2018	$ 13	$ 175,991	$ 91,806	$ 267,810
Balance, shares at Sep. 30, 2018	13,097

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Cash flows from operating activities:
Net income	$ 12,701	$ 10,366
Adjustments to reconcile net income to net cash provided by operating activities, net of acquisitions:
Depreciation and amortization	6,676	4,811
Deferred income taxes	397
Non-cash restructuring		383
Stock-based compensation	2,961	1,818
Amortization of debt issuance costs under the terminated credit facility		1,484
Amortization of debt issuance costs under the credit facility	450	235
Provision for doubtful accounts	214	6,208
Gain on sale of assets		(2,065)
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	(5,284)	15,451
Prepaid expenses and other current assets	2,007	(281)
Accounts payable	1,844	418
Accrued expenses and other long-term liabilities	2,713	3,750
Net cash provided by operating activities	24,679	42,578
Cash flows from investing activities:
Proceeds from the sale of assets		2,400
Acquisitions of businesses, net of cash acquired	(62,347)	(22,419)
Purchases of property and equipment	(3,384)	(3,089)
Net cash used in investing activities	(65,731)	(23,108)
Cash flows from financing activities:
Borrowings on revolver - credit facility		30,000
Proceeds from issuance of common stock, net of offering costs	76,618
Borrowings on revolver - terminated credit facility		20,000
Borrowings on term loan - credit facility	60,420	45,000
Payments on revolver-terminated credit facility		(20,000)
Payments on revolver-credit facility		(30,000)
Payments on term loan- credit facility	(1,688)
Payments on term loan - terminated credit facility		(24,063)
Payments for debt issuance costs under the credit facility	(73)	(2,823)
Payments on capital lease obligations	(952)	(1,067)
Cash received from exercise of stock options	450	1,158
Net cash provided by financing activities	134,775	18,205
Net change in cash	93,723	37,675
Cash, at beginning of period	53,754	8,013
Cash, at end of period	147,477	45,688
Supplemental disclosures of cash flow information:
Cash paid for interest	3,202	1,538
Cash paid for income taxes	4,234	$ 5,357
Supplemental disclosures of non-cash investing and financing activities
Contingent and deferred consideration accrued for acquisition	$ 847

Nature of Operations, Consolida

Nature of Operations, Consolidation, and Presentation of Financial Statements	9 Months Ended
	Sep. 30, 2018
Nature of Operations, 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 three 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. 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, 2017 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 and have not been audited by our independent auditors. Principles of Consolidation These unaudited condensed consolidated financial statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All significant intercompany accounts and transactions have been eliminated in consolidation. The Company used the cost method to account for its investment in joint ventures in which it owned 10% equity interests. The Company sold such investments on October 1, 2017. See Note 3 "Gain on Sale of Assets" for additional information. Reclassification of Prior Period Balances Certain reclassifications have been made to prior period amounts to conform to the current-year presentation including the reporting of other long-term liabilities as a separate line item on the Unaudited Condensed Consolidated Balance Sheets. These reclassifications have no effect on the reported net income. Recently Adopted Accounting Pronouncements In May 2014, the Financial Accounting Standards Board ("FASB") issued Accounting Standard Update ("ASU") 2014-09, Revenue from Contracts with Customers , which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. ASU 2014-09 replaced most existing revenue recognition guidance in GAAP. The Company adopted the new standard on January 1, 2018, and elected to adopt using the modified retrospective method. See Note 2 for additional information regarding the adoption. In August 2016, the FASB issued ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments. This standard amends and adjusts how cash receipts and cash payments are presented and classified in the statement of cash flows. We adopted the standard on a retrospective basis on January 1, 2018. ASU 2016-15 did not have an impact on our Condensed Consolidated Statements of Cash Flows. Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842), which replaces existing leasing rules with a comprehensive lease measurement and recognition standard and expanded disclosure requirements. ASU 2016-02 will require lessees to recognize most leases on their balance sheets as liabilities, with corresponding "right-of-use" assets and is effective for annual reporting periods beginning after December 15, 2018, subject to early adoption. For income statement recognition purposes, leases will be classified as either a finance or an operating lease. In July 2018, the FASB issued ASU 2018-11, Leases (Topic 842) Targeted Improvements , which amends ASU 2016-02 to provide an additional transition method option. Under the new transition method, an entity initially applies the new lease standard at the adoption date, versus at the beginning of the earliest period presented, and recognizes a cumulative-effect adjustment to the opening balance of retained earnings in the period of adoption. Upon initial evaluation, the Company believes that the new standard will have a material impact on its consolidated balance sheets but it will not affect its liquidity. The Company has secured new software to account for the change in accounting for leases and is currently assessing the impact of adopting this standard. In June 2016, the FASB issued ASU 2016-13, Financial Instruments—Credit Losses (Topic 326) : Measurement of Credit Losses on Financial Instruments. ASU 2016-13 changes the impairment model for most financial assets and certain other instruments. Under the new standard, entities holding financial assets and net investment in leases that are not accounted for at fair value through net income are to be presented at the net amount expected to be collected. An allowance for credit losses will be a valuation account that will be deducted from the amortized cost basis of the financial asset to present the net carrying value at the amount expected to be collected on the financial asset. ASU 2016-13 is effective as of January 1, 2020. Early adoption is permitted. The Company is currently evaluating the impact of ASU 2016-13. In January 2017, the FASB issued ASU 2017-04, Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment. The new guidance eliminates the requirement to calculate the implied fair value of goodwill (i.e., Step 2 of the current goodwill impairment test) to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit's carrying amount over its fair value (i.e., measure the charge based on the current Step 1). ASU 2017-04 is effective for annual and any interim impairment tests for periods beginning after December 15, 2019. Early adoption is permitted. The Company is currently assessing the impact of adopting this standard. In August 2018, the FASB issued ASU 2018-15, Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That is a Service Contract . ASU 2018-15 requires customers in a hosting arrangement that is a service contract to follow the internal-use software guidance in Accounting Standards Codification ("ASC") 350-40 to determine which implementation costs to capitalize as assets or expense as incurred. The ASU is effective for annual periods, including interim periods within those annual periods, beginning after December 15, 2019. Early adoption is permitted. The Company is currently assessing the impact of adopting this standard.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2018
Summary of Significant Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Revenue Recognition On January 1, 2018, the Company adopted ASU 2014-09, Revenue from Contracts with Customers , which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. The Company adopted the standard using the modified retrospective approach and did not record a cumulative catch-up adjustment as the timing and measurement of revenue for the Company's customers is similar to its prior revenue recognition model. However, the majority of what historically was classified as provision for doubtful accounts expense under operating expenses is now treated as an implicit price concession factored into net service revenues. Personal Care The majority of the Company's net service revenues are generated from providing personal care services directly to consumers under contracts with state, local and other governmental agencies, managed care organizations, commercial insurers and private consumers. Generally, these contracts, which are negotiated based on current contracting practices as appropriate for the payor, establish the terms of a customer relationship and set the broad range of terms for services to be performed at a stated rate. However, the contracts do not give rise to rights and obligations until an order is placed with the Company. When an order is placed, it creates the performance obligation to provide a defined quantity of service hours, or authorized hours, per consumer. The Company satisfies its performance obligations over time, given that consumers simultaneously receive and consume the benefits provided by the Company as the services are performed. As the Company has a right to consideration from customers commensurate with the value provided to customers from the performance completed over a given invoice period, the Company has elected to use the practical expedient for measuring progress toward satisfaction of performance obligations and recognizes patient service revenue in the amount to which the Company has a right to invoice. Hospice Revenue The Company generates net service revenues from providing hospice services to consumers who are terminally ill as well as for their families. Net service revenues are recognized as services are provided and costs for delivery of such services are incurred. The estimated payment rates are daily rates for each of the levels of care the Company delivers. Hospice companies are subject to two specific payment limit caps under the Medicare program each federal fiscal year: the inpatient cap and the aggregate cap. The inpatient cap limits the number of inpatient care days provided to no more than 20% of the total days of hospice care provided for the year. The aggregate cap limits the amount of Medicare reimbursement a hospice may receive, based on the number of Medicare patients served. For federal fiscal year 2018, which ended September 30, 2018, the Company was below the payment limits and did not record a cap liability. Home Health Revenue The Company also generates net service revenues from providing home healthcare services directly to consumers under contracts with Medicare. Generally, these contracts, which are negotiated based on current contracting practices as appropriate for the payor, establish the terms of a relationship and set the broad range of terms for services to be performed on an episodic basis at a stated rate. Home health Medicare services are paid under the Medicare Home Health Prospective Payment System ("HHPPS"), which is based on 60 day episodes of care. The HHPPS permits multiple, continuous episodes per patient. Medicare payment rates for episodes under HHPPS vary based on the severity of the patient's condition as determined by the Company's assessment of a patient's Home Health Resource Group score. The Company elects to use the same 60-day length of episode that Medicare recognizes as standard but accelerates revenue upon discharge to align with a patient's episode length if less than the expected 60 days, which depicts the transfer of services and related benefits received by the patient over the term of the contract necessary to satisfy the obligations. The Company recognizes revenue based on the number of days elapsed during an episode of care within the reporting period. The Company satisfies its performance obligations as consumers receive and consume the benefits provided by the Company as the services are performed. As the Company has a right to consideration from Medicare commensurate with the services provided to customers from the performance completed over a given episodic period, the Company has elected to use the practical expedient for measuring progress toward satisfaction of performance obligations. Under this method recognizing revenue ratably over the episode based on beginning and ending dates is a reasonable proxy for the transfer of benefit of the service. Allowance for Doubtful Accounts For 2017, the Company established its allowance for doubtful accounts to the extent it was probable that a portion or all of a particular account will not be collected. The Company established its provision for doubtful accounts primarily by reviewing the creditworthiness of significant customers and through evaluations over the collectability of the receivables. An allowance for doubtful accounts was maintained at a level that the Company's management believed was sufficient to cover potential losses. In 2018, subsequent adjustments that are determined to be the result of an adverse change in the payor's ability to pay are recognized as bad debt expense due to the adoption of ASU 2014-09, Revenue from Contracts with Customers . The Company recorded $ 2.4 6.8 Property and Equipment Property and equipment are recorded at cost and depreciated over the estimated useful lives of the related assets by use of the straight-line method. Maintenance and repairs are charged to expense as incurred. The estimated useful lives of the property and equipment are as follows: Computer equipment 3 – 5 years Furniture and equipment 5 – 7 years Transportation equipment 5 years Computer software 5 –10 years Leasehold improvements Lesser of useful life or lease term, unless probability of lease renewal is likely Goodwill The Company's carrying value of goodwill is the excess of the purchase price over the fair value of the net assets acquired from various acquisitions. In accordance with ASC Topic 350, Goodwill and Other Intangible Assets , goodwill and intangible assets with indefinite useful lives are not amortized. The Company tests goodwill for impairment at the reporting unit level on an annual basis, as of October 1, or whenever potential impairment triggers occur, such as a significant change in business climate or regulatory changes that would indicate that an impairment may have occurred. The Company may use a qualitative test, known as "Step 0," or a two no No Intangible Assets The Company's identifiable intangible assets consist of customer and referral relationships, trade names, 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 two twenty-five Intangible assets with finite lives are amortized using the estimated economic benefit method over the useful life and assessed for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The Company would recognize an impairment loss when the estimated future non-discounted cash flows associated with the intangible asset is less than the carrying value. An impairment charge would then be recorded for the excess of the carrying value over the fair value. No The Company uses various valuation techniques to determine fair value of its intangible assets, including relief-from-royalty, income approach, discounted cash flow analysis, and multi-period excess earnings, which use significant unobservable inputs, or Level 3 inputs, as defined by the fair value hierarchy. Under these valuation approaches, we are required to make estimates and assumptions about future market growth and trends, forecasted revenue and costs, expected periods over which the assets will be utilized, appropriate discount rates and other variables. The Company bases its fair value estimates on assumptions the Company believes to be reasonable but which are unpredictable and inherently uncertain. Actual future results may differ from those estimates. Debt Issuance Costs The Company amortizes debt issuance costs on a straight-line method over the term of the related debt. This method approximates the effective interest method. The Company has classified the debt issuance costs as current portion of long-term debt or long-term debt, less current portion as of September 30, 2018 and December 31, 2017. Workers' Compensation Program The Company's workers' compensation insurance program has a $ 0.4 14.8 12.6 1.4 0.5 Interest Income Illinois law entitles designated service program providers to receive a prompt payment interest penalty based on qualifying services approved for payment that remain unpaid after a designated period of time. The Company accounted for the interest income in accordance with ASC 606. The interest income was recognized when the State of Illinois approved a prompt payment interest penalty during the nine months ended September 30, 2018, removing the constraint related to the amount and intent to pay the prompt payment interest. For the three months ended September 30, 2018, the Company did not receive any prompt payment interest. For the nine months ended September 30, 2018, the Company received $ 2.3 no Interest Expense The Company's interest expense consists of interest and unused credit line fees on its credit facilities, interest on its capital lease obligations, and amortization and write-off of debt issuance costs, which is reported in the statement of income when incurred. Other Income Other income consisted of income distributions received from investments in joint ventures. The Company accounted for this income in accordance with ASC Topic 325, Investments—Other. The Company recognized the net accumulated earnings only to the extent distributed by the joint ventures on the date received. The Company subsequently sold these equity investments on October 1, 2017 (see Note 3). Income Tax Expense The Company accounts for income taxes under the provisions of ASC Topic 740, Income Taxes. The objective of accounting for income taxes is to recognize the amount of taxes payable or refundable for the current year and deferred tax liabilities and assets for the future tax consequences of events that have been recognized in its financial statements or tax returns. Deferred taxes, resulting from differences between the financial and tax basis of the Company's assets and liabilities, are also adjusted for changes in tax rates and tax laws when changes are enacted. ASC Topic 740 also requires that deferred tax assets be reduced by a valuation allowance if it is more likely than not that some portion or all of the deferred tax asset will not be realized. ASC Topic 740 also prescribes a recognition threshold and measurement process for recording in the financial statements uncertain tax positions taken or expected to be taken in a tax return. In addition, ASC Topic 740 provides guidance on derecognition, classification, accounting in interim periods and disclosure requirements for uncertain tax positions. Stock-based Compensation The Company currently has one Stock Compensation . Under the 2017 Plan, compensation expense is recognized on a straight-line basis over the vesting period of the equity awards based on the grant date fair value of the options and restricted stock awards. The Company uses the Black-Scholes Option Pricing Model to value the Company's options. The determination of the fair value of stock-based payments utilizing the Black-Scholes Model is affected by the Company's stock price and a number of assumptions, including expected volatility, risk-free interest rate, expected term, and expected dividends yield. Stock-based compensation expense was $ 1.1 0.7 3.0 1.8 Diluted Net Income Per Common Share Diluted net income per common share, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The Company's outstanding securities that may potentially dilute the common stock are stock options and restricted stock awards. Included in the Company's calculation of diluted earnings per share for the three and nine months ended September 30, 2018 were approximately 708,000 307,000 213,000 148,000 83,000 83,000 Included in the Company's calculation of diluted earnings per share for the three and nine months ended September 30, 2017 were approximately 479,000 102,000 102,000 148,000 43,000 50,000 Shareholders' Equity On August 20, 2018, the Company, together with Eos Capital Partners III, L.P. (the "Selling Stockholder") completed a secondary public offering of an aggregate 2,100,000 0.001 59.00 1,075,267 1,024,733 59.1 315,000 17.5 for general corporate purposes, including to potentially fund a portion of any future acquisitions that the Company may complete. The Company did not receive any of the proceeds from the sale of the Secondary Shares. The secondary offering resulted in an increase to additional paid in capital of approximately $ 76.6 5.4 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: the implicit price concessions factored into net service revenues, allowance for doubtful accounts, reserve for self-insurance claims, accounting for stock-based compensation, accounting for income taxes, business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from those estimates. Fair Value Measurements The Company's financial instruments consist of cash, accounts receivable, payables and debt. The carrying amounts reported on the Company's Unaudited Condensed Consolidated Balance Sheets for cash, accounts receivable, accounts payable and accrued expenses approximate fair value because of the short-term nature of these instruments. The carrying value of the Company's long-term debt with variable interest rates approximates fair value based on instruments with similar terms using level 2 inputs as defined under ASC Topic 820 Fair Value Measurement . The Company applies fair value techniques on a non-recurring basis associated with valuing potential impairment losses related to goodwill, if required, and indefinite-lived intangible assets and also when determining the fair value of contingent consideration, if applicable. To determine the fair value in these situations, the Company uses Level 3 inputs, under ASC Topic 820 and defined as unobservable inputs in which little or no market data exists; therefore requiring an entity to develop its own assumptions, such as discounted cash flows, or if available, what a market participant would pay on the measurement date. The Company uses various valuation techniques to determine fair value of its intangible assets, including relief-from-royalty, income approach, discounted cash flow analysis, and multi-period excess earnings, which use significant unobservable inputs, or Level 3 inputs, as defined by the fair value hierarchy. Under these valuation approaches, we are required to make estimates and assumptions about future market growth and trends, forecasted revenue and costs, expected periods over which the assets will be utilized, appropriate discount rates and other variables. Going Concern In connection with the preparation of the financial statements for the three and nine months ended September 30, 2018 and 2017, the Company conducted an evaluation as to whether there were conditions and events, considered in the aggregate, which raised substantial doubt as to the entity's ability to continue as a going concern within one year after the date of the issuance, or the date of availability, of the financial statements to be issued. The evaluation concluded that there did not appear to be evidence of substantial doubt of the entity's ability to continue as a going concern.

Gain on Sale of Assets

Gain on Sale of Assets	9 Months Ended
	Sep. 30, 2018
Gain on Sale of Assets [Abstract]
Gain on Sale of Assets	3. Gain on Sale of Assets Given the Company's focus on providing services to consumers in their homes, effective March 1, 2017, the Company ceased the adult day services business and completed its sale of substantially all of the assets used in three 2.4 2.1 three On October 1, 2017, the Company sold its 10 two 1.3 0.4

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2018
Acquisitions [Abstract]
Acquisitions	4. Acquisitions On May 1, 2018, the Company completed its acquisition of all the outstanding securities of Ambercare Corporation ("Ambercare"). The purchase price was approximately $ 39.6 12.0 0.8 $1.4 The Company's acquisition of Ambercare has been accounted for in accordance with ASC Topic 805, Business Combinations , and the resulting goodwill and other intangible assets was accounted for under ASC Topic 350, Goodwill and Other Intangible Assets . The acquisition was recorded at its fair value as of May 1, 2018. Under business combination accounting, the Ambercare purchase price was $51.6 million and was allocated to Ambercare's net tangible and identifiable intangible assets based on their estimated fair values. Based upon management's valuation, which is preliminary and subject to completion of working capital adjustments, the total purchase price has been allocated as follows: (Amounts in Thousands) Goodwill $ 28,082 Cash 12,008 Identifiable intangible assets 10,413 Accounts receivable 6,638 Other assets 440 Property and equipment 171 Accrued liabilities (3,732 ) Deferred tax liability (2,302 ) Capital lease (93 ) Accounts payable (3 ) Total purchase price allocation $ 51,622 Management's assessment of qualitative factors affecting goodwill for Ambercare includes estimates of market share at the date of purchase, ability to grow in the market, synergy with existing Company operations, and the payor profile in the market. The Company acquired the outstanding stock of Ambercare. Identifiable intangible assets acquired consist of trade names, customer relationships and state licenses (see Note 2 for estimated useful lives of the Company's identifiable intangible assets). The preliminary estimated fair value of identifiable intangible assets was determined, using Level 3 inputs as defined under ASC Topic 820, with the assistance of a valuation specialist. The goodwill and intangible assets acquired are non-deductible for tax purposes. The Ambercare acquisition accounted for $ 13.4 22.6 2.0 3.8 On April 1, 2018, the Company acquired certain assets of Arcadia Home Care & Staffing ("Arcadia"), expanding its personal care services. The total consideration for the transaction was $ 18.9 0.8 1.4 The Company's acquisition of Arcadia has been accounted for in accordance with ASC Topic 805 and the resulting goodwill and other intangible assets was accounted for under ASC Topic 350. The acquisition was recorded at its fair value as of April 1, 2018. Under business combination accounting, the Arcadia purchase price was $18.9 million and was allocated to Arcadia's net tangible and identifiable intangible assets based on their estimated fair values. Based upon management's valuation, which is preliminary and subject to completion of working capital and other adjustments, the total purchase price has been allocated as follows: (Amounts in Thousands) Goodwill $ 12,389 Accounts receivable 5,317 Identifiable intangible assets 2,947 Property and equipment 155 Other assets 92 Accrued liabilities (1,540 ) Accounts payable (508 ) Total purchase price allocation $ 18,852 Management's assessment of qualitative factors affecting goodwill for Arcadia includes estimates of market share at the date of purchase, ability to grow in the market, synergy with existing Company operations, and the payor profile in the market. Identifiable intangible assets acquired consist of trade name, customer relationships and state licenses (see Note 2 for estimated useful lives of the Company's identifiable intangible assets). The preliminary estimated fair value of identifiable intangible assets was determined, using Level 3 inputs as defined under ASC Topic 820, with the assistance of a valuation specialist. The goodwill and intangible assets acquired are deductible for tax purposes. The Arcadia acquisition accounted for $ 10.9 21.7 1.6 3.2 In September 2018, the Company acquired certain assets of affiliate branches of Arcadia for $0.6 $0.6 Effective January 1, 2018, the Company acquired certain assets of LifeStyle Options, Inc. ("LifeStyle") in order to expand private pay services in Illinois. The total consideration for the transaction was $ 4.1 3.3 0.8 48,000 The Company's acquisition of LifeStyle has been accounted for in accordance with ASC Topic 805 and the resulting goodwill and other intangible assets was accounted for under ASC Topic 350. The acquisition was recorded at its fair value as of January 1, 2018. Under business combination accounting, the LifeStyle purchase price was $4.1 million and was allocated to LifeStyle's net tangible and identifiable intangible assets based on their estimated fair values. Based upon management's valuation, the total purchase price has been allocated as follows: Total (Amounts in Thousands) Goodwill $ 2,751 Identifiable intangible assets 1,152 Accounts receivable 573 Other assets 32 Property and equipment 18 Accrued liabilities (291 ) Accounts payable (105 ) Total purchase price allocation $ 4,130 Management's assessment of qualitative factors affecting goodwill for LifeStyle includes estimates of market share at the date of purchase, ability to grow in the market, synergy with existing Company operations, and the payor profile in the market. Identifiable intangible assets acquired consist of trade name and customer relationships (see Note 2 for estimated useful lives of the Company's identifiable intangible assets). The estimated fair value of identifiable intangible assets was determined, using Level 3 inputs as defined under ASC Topic 820, with the assistance of a valuation specialist. The goodwill and intangible assets acquired are deductible for tax purposes. The LifeStyle acquisition accounted for $ 1.5 4.5 0.1 0.4 Effective October 1, 2017, the Company acquired certain assets of Community Partnered Resources, Inc. d/b/a Sun Cities Caregivers and d/b/a Sun Cities Homecare ("Sun Cities"), in the State of Arizona, to enhance operations in a target market. The total consideration for the transaction was comprised of $ 2.3 0.2 The Company's acquisition of Sun Cities has been accounted for in accordance with ASC Topic 805 and the resulting goodwill and other intangible assets was accounted for under ASC Topic 350. The acquisition was recorded at its fair value as of October 1, 2017. Under business combination accounting, the Sun Cities purchase price was $2.3 million and was allocated to net tangible and identifiable intangible assets of Sun Cities based on their estimated fair values. Based upon management's valuation, the total purchase price has been allocated as follows: Total (Amounts in Thousands) Goodwill $ 1,089 Identifiable intangible assets 682 Accounts receivable 254 Cash 321 Other assets 10 Accrued liabilities (86 ) Accounts payable (14 ) Total purchase price allocation $ 2,256 Management's assessment of qualitative factors affecting goodwill for Sun Cities includes estimates of market share at the date of purchase, ability to grow in the market, synergy with existing Company operations, and the payor profile in the market. Identifiable intangible assets acquired consist of trade name and customer relationships (see Note 2 for estimated useful lives of the Company's identifiable intangible assets). The estimated fair value of identifiable intangible assets was determined, using Level 3 inputs as defined under ASC Topic 820, with the assistance of a valuation specialist. The goodwill and intangible assets acquired are deductible for tax purposes. The Sun Cities acquisition accounted for $ 0.7 $1.8 0.1 On April 24, 2017, the Company entered into a definitive securities purchase agreement with HB Management Group, Inc. to purchase Options Services, Inc. d/b/a Options Home Care ("Options Home Care"). On August 1, 2017, the Company completed its acquisition of all the outstanding securities of Options Home Care for a total purchase price of $ 22.6 20 0.8 The Company's acquisition of Options Home Care has been accounted for in accordance with ASC Topic 805 and the resulting goodwill and other intangible assets was accounted for under ASC Topic 350. The acquisition was recorded at its fair value as of August 1, 2017. Under business combination accounting, the Options purchase price was $22.6 million and was allocated to Options Home Care's net tangible and identifiable intangible assets based on their estimated fair values. Based upon management's valuation, the total purchase price has been allocated as follows: Total (Amounts in Thousands) Goodwill $ 16,671 Identifiable intangible assets 5,324 Accounts receivable 1,084 Cash 205 Other assets 41 Accrued liabilities (701 ) Total purchase price allocation $ 22,624 Management's assessment of qualitative factors affecting goodwill for Options Home Care includes estimates of market share at the date of purchase, ability to grow in the market, synergy with existing Company operations, and, the payor profile in the market. Identifiable intangible assets acquired consist of trade names and customer relationships (see Note 2 for estimated useful lives of the Company's identifiable intangible assets). The estimated fair value of identifiable intangible assets was determined with the assistance of a valuation specialist. The goodwill and intangible assets acquired are deductible for tax purposes. The Options Home Care acquisition accounted for $ 4.5 3.3 0.9 0.2 13.4 3.3 2.4 0.2 The following table contains unaudited pro forma condensed consolidated income statement information of the Company had the acquisitions of Ambercare, Arcadia, LifeStyle, Sun Cities and Options Home Care closed on January 1, 2017. For the Three Months Ended September 30, (Amounts in Thousands) 2018 2017 Net service revenues $ 137,631 $ 135,440 Operating income 7,758 8,418 Net income $ 5,332 $ 3,317 Net income per common share Basic income per share $ 0.44 $ 0.29 Diluted income per share $ 0.42 $ 0.29 For the Nine Months Ended September 30, (Amounts in Thousands) 2018 2017 Net service revenues $ 410,552 $ 398,948 Operating income 28,833 25,336 Net income $ 18,415 $ 9,118 Net income per common share Basic income per share $ 1.57 $ 0.80 Diluted income per share $ 1.53 $ 0.78 The pro forma disclosures in the table above include adjustments for amortization of intangible assets, tax expense and acquisition costs to reflect results that are more representative of the combined results of the transactions as if Ambercare, Arcadia, LifeStyle, Sun Cities and Options Home Care had been acquired effective January 1, 2017. This pro forma information is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred. In addition, future results may vary significantly from the results reflected in the pro forma information. The unaudited pro forma financial information does not reflect the impact of future events that may occur after the acquisition, such as anticipated cost savings from operating synergies.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2018
Goodwill and Intangible Assets [Abstract]
Goodwill and Intangible Assets	5. Goodwill and Intangible Assets A summary of the goodwill activity for the nine months ended September 30, 2018 is provided below: Goodwill Personal Care Hospice Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2017 $ 90,339 $ — $ — $ 90,339 Additions for acquisitions 22,185 19,040 2,499 43,724 Goodwill as of September 30, 2018 $ 112,524 $ 19,040 $ 2,499 $ 134,063 The Company's identifiable intangible assets consist of customer and referral relationships, trade names, 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 two twenty-five The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of September 30, 2018 and December 31, 2017: Customer Trade and referral names and Non-competition State relationships trademarks agreements Licenses Total (Amounts in Thousands) Gross balance at December 31, 2017 $ 39,017 $ 14,641 $ 2,155 $ — $ 55,813 Accumulated amortization (29,147 ) (8,198 ) (1,872 ) — (39,217 ) Net balance at December 31, 2017 9,870 6,443 283 — 16,596 Gross balance at January 1, 2018 39,017 14,641 2,155 — 55,813 Additions for acquisitions 5,209 6,927 — 2,376 14,512 Accumulated amortization (32,131 ) (9,942 ) (1,954 ) (101 ) (44,128 ) Net balance at September 30, 2018 $ 12,095 $ 11,626 $ 201 $ 2,275 $ 26,197 Amortization expense related to the identifiable intangible assets amounted to $ 1.9 4.9 1.2 3.3

Details of Certain Balance Shee

Details of Certain Balance Sheet Accounts	9 Months Ended
	Sep. 30, 2018
Details of Certain Balance Sheet Accounts [Abstract]
Details of Certain Balance Sheet Accounts	6. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consisted of the following: September 30, 2018 December 31, 2017 (Amounts in Thousands) Prepaid health insurance $ 1,457 $ 2,901 Workers' compensation insurance receivable 1,375 543 Prepaid rent 1,208 555 Prepaid workers' compensation and liability insurance 1,251 1,332 Other 1,644 3,048 $ 6,935 $ 8,379 Accrued expenses consisted of the following: September 30, 2018 December 31, 2017 (Amounts in Thousands) Accrued payroll $ 27,236 $ 19,783 Accrued workers' compensation insurance 14,846 12,574 Accrued health insurance (1) 4,165 6,471 Accrued professional fees 1,242 1,312 Accrued payroll taxes 1,540 1,065 Other 3,407 3,149 $ 52,436 $ 44,354 (1) The Company provides health insurance coverage to qualified union employees providing personal care services in Illinois through a Taft-Hartley multi-employer health and welfare plan under Section 302(c)(5) of the Labor Management Relations Act of 1947. The Company's insurance contributions equal the amount reimbursed by the State of Illinois. Contributions are due within five Amounts due of $ 1.2 2.3

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2018
Long-Term Debt [Abstract]
Long-Term Debt	7. Long-Term Debt Long-term debt consisted of the following: September 30, 2018 December 31, 2017 (Amounts in Thousands) Term loan under the credit facility $ 103,170 $ 44,438 Capital leases 142 1,002 Less unamortized issuance costs (2,103 ) (2,481 ) Total $ 101,209 $ 42,959 Less current maturities (2,318 ) (3,099 ) Long-term debt $ 98,891 $ 39,860 Capital Leases On May 1, 2018, with the acquisition of Ambercare, the Company acquired the remainder of a capital lease with Ford Motor Credit Company LLC. The 48 6.88% On July 12, 2014, September 11, 2014 and April 13, 2015, the Company executed three 48 2.7 1.4 0.4 3.0 3.6 Effective October 1, 2016, the Company entered into a 25 0.6 11.1 An analysis of the leased property under capital leases by major classes is as follows. Asset Balances at September 30, 2018 Classes of Property (Amounts in Thousands) Leasehold improvements $ 1,484 Furniture and equipment 868 Computer equipment 635 Computer software 303 Transportation equipment 107 Total 3,397 Less: accumulated depreciation and amortization (1,772 ) $ 1,625 The future minimum payments for capital leases as of September 30, 2018 are as follows: Capital Lease (Amounts In Thousands) 2018 $ 65 2019 67 2020 20 Total minimum lease payments 152 Less: amount representing estimated executory costs (such as taxes, maintenance and insurance), including profit thereon, included in total minimum lease payments (5 ) Net minimum lease payments 147 Less: amount representing interest (1) (5 ) Present value of net minimum lease payments (2 ) $ 142 (1) Amount necessary to reduce net minimum lease payments to present value calculated at the Company's incremental borrowing rate at lease inception. (2) Included in the balance sheet as $ 114,000 28,000 Amended and Restated Senior Secured Credit Facility On October 31, 2018, the Company amended and restated its existing Credit Agreement (the "New Credit Agreement") with certain lenders and Capital One, National Association as a lender and swing line lender and as agent for all lenders. This amended and restated credit facility totals $ 269.6 250.0 19.6 250.0 May 8, 2023 January 31, 2019 0.75 1.50 0.50 0.00 1.00 1.75 2.50 3.75 4.25 $1.1 Addus HealthCare, Inc. ("Addus HealthCare") is the borrower, and its parent, Holdings, and substantially all of Holdings' subsidiaries are guarantors under this amended and restated credit facility, and it is secured 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 New 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 Company pays a fee ranging from 0.20 0.35 The New 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 New 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 New Credit Agreement), a requirement to stay below a maximum Total Net Leverage Ratio (as defined in the New Credit Agreement) and a requirement to stay below a maximum permitted amount of capital expenditures, as well as 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 Senior Secured Credit Facility Prior to October 31, 2018, the Company was party to a credit agreement (the "Credit Agreement") with certain lenders and Capital One, N.A., as a lender and swing lender and as agent for all lenders. This credit facility totaled $ 250.0 125.0 125.0 45.0 80.0 May 8, 2022 4.25 2.9 Interest on the Company's credit facility was payable at (x) the sum of (i) an applicable margin ranging from 1.50 2.25 0.50 0.00 1.00 2.50 3.25 The Company paid a fee ranging from 0.25% to 0.50% based on the applicable leverage ratio times the unused portion of the revolving portion of the credit facility. During the nine months ended September 30, 2018, the Company drew a total of approximately $ 60.4 no As of September 30, 2018, the Company had a total of $ 103.2 4.60 88.6 As of December 31, 2017, the Company had a total of $ 44.4 3.86 105.1 Terminated Senior Secured Credit Facility Prior to May 8, 2017, the Company was a party to the Terminated Senior Secured Credit Agreement with certain lenders and Fifth Third Bank, as agent and letters of credit issuer. The Terminated Senior Secured Credit Facility provided a $ 100.0 25.0 50.0 November 10, 2020 35.0

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2018
Income Taxes [Abstract]
Income Taxes	8. Income Taxes A reconciliation of the statutory federal tax rate of 21.0% for the three and nine months ended September 30, 2018 and 35.0% for the three and nine months ended September 30, 2017 is summarized as follows: Three Months Ended September 30, 2018 2017 Federal income tax at statutory rate 21.0 % 35.0 % State and local taxes, net of federal benefit 5.3 4.4 Jobs tax credits, net (10.0 ) (7.7 ) Nondeductible permanent items 2.0 0.5 Other 2.4 — Effective income tax rate 20.7 % 32.2 % Nine Months Ended September 30, 2018 2017 Federal income tax at statutory rate 21.0 % 35.0 % State and local taxes, net of federal benefit 6.5 4.9 Jobs tax credits, net (9.3 ) (7.5 ) Nondeductible permanent items 1.5 0.5 Other 0.9 (0.8 ) Effective income tax rate 20.6 % 32.1 % On December 22, 2017, the President of the United States signed into law the Tax Cuts and Jobs Act ("Tax Reform Act"). The legislation significantly changes U.S. tax law by, among other things, lowering corporate income tax rates. The Tax Reform Act permanently reduces the U.S. corporate income tax rate from a maximum of 35.0 21.0 20.7 32.2 0.2 0.4 In December 2017, the Securities and Exchange Commission issued Staff Accounting Bulletin No. 118, Income Tax Accounting Implications of the Tax Cuts and Job Act , ("SAB 118") to address the application of GAAP in situations when a registrant does not have the necessary information available, prepared, or analyzed (including computations) in reasonable detail to complete the accounting for certain income tax effects of the Tax Reform Act. Additional work is necessary for a more detailed analysis of our deferred tax assets and liabilities as well as potential correlative adjustments. During the measurement period, impacts of the law are expected to be recorded at the time a reasonable estimate for all or a portion of the effects can be made and provisional amounts can be recognized and adjusted as information becomes available, prepared or analyzed. No additional estimated amounts were finalized during the quarter ending September 30, 2018.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2018
Commitments and Contingencies [Abstract]
Commitments and Contingencies	9. Commitments and Contingencies Legal Proceedings From time to time, the Company is subject to legal and/or administrative proceedings incidental to its business. It is the opinion of management that the outcome of pending legal and/or administrative proceedings will not have a material effect on the Company's Unaudited Condensed Consolidated Balance Sheets and Unaudited Condensed Consolidated Statements of Income. On January 20, 2016, the Company was served with a lawsuit filed in the United States District Court for the Northern District of Illinois against the Company and Cigna Corporation by Stop Illinois Marketing Fraud, LLC, a qui tam relator formed for the purpose of bringing this action. In the action, the plaintiff alleges, inter alia, violations of the federal False Claims Act relating primarily to allegations of violations of the federal Anti-Kickback Statute and allegedly, improper referrals of patients from the Company's home care division to the Company's home health business, substantially all of which was sold in 2013. The plaintiff seeks to recover damages, fees and costs under the federal False Claims Act including treble damages, civil penalties and its attorneys' fees. The U.S. government has declined to intervene at this time. Plaintiff amended its complaint on April 4, 2016 to include additional allegations in support of its False Claims Act claims, including alleged violations of the federal Anti-Kickback Statute. The Company and Cigna Corporation filed a motion to dismiss the amended complaint on June 6, 2016. On February 3, 2017, the Court granted Cigna Corporation's motion to dismiss in full, and granted the Company's motion to dismiss in part, allowing Plaintiff another chance to amend its complaint. Plaintiff timely filed a second amended complaint on March 10, 2017, withdrawing its conspiracy claim under the Federal False Claims Act and adding an explicit claim under the Illinois False Claims Act for the same underlying kickback allegations. On April 7, 2017, the Company filed a partial motion to dismiss the Second Amended Complaint. On May 24, 2017, the State of Illinois filed notice that it was declining to intervene in the plaintiff's claim under the Illinois False Claims Act. On March 21, 2018, the Court granted the Company's motion to dismiss the Second Amended Complaint in part and narrowed the lawsuit to whether the federal False Claims Act was violated with respect to home health services provided at three senior living facilities in Illinois. The Company intends to defend the litigation vigorously and believes the case will not have a material adverse effect on its business, financial condition or results of operations. Employment Agreements The Company has entered into employment agreements with certain members of senior management. The terms of these agreements are up to four A substantial percentage of the Company's workforce is represented by the Service Employees International Union ("SEIU"). The Company has a national agreement with the SEIU. Wages and benefits are negotiated at the local level at various times throughout the year. These negotiations are often initiated when the Company receives increases in hourly rates from various state agencies. Upon expiration of these collective bargaining agreements, the Company may not be able to negotiate labor agreements on satisfactory terms with these labor unions.

Severance and Restructuring

Severance and Restructuring	9 Months Ended
	Sep. 30, 2018
Severance and Restructuring [Abstract]
Severance and Restructuring	10. Severance and Restructuring In 2016, the Company initiated steps to streamline its operations. The Company incurred total expenses related to these initiatives of approximately $ 0.3 0.6 1.4 1.5 The following provides the components of and changes in our severance and restructuring accruals: Employee Termination Restructuring Costs and Other (Amounts in Thousands) Balance at December 31, 2017 $ 562 $ 1,077 Provision 610 285 Utilization (856 ) (755 ) Balance at September 30, 2018 $ 316 $ 607 Employee termination costs represent accrued severance payable to terminated employees with employment and/or separation agreements with the Company. Restructuring and other costs consists of the accrual related to lease commitments and write-offs of leasehold improvements and unused office space and property and equipment resulting from the closure of three adult day services centers in Illinois. The aforementioned accruals are included in Accrued Expenses on the Unaudited Condensed Consolidated Balance Sheets and the aforementioned expenses are included in General and Administrative Expenses on the Unaudited Condensed Consolidated Statements of Income.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2018
Segment Information [Abstract]
Segment Information	11. Segment Information Operating segments are defined as components of a company that engage in business activities from which it may earn revenues and incur expenses, and for which separate financial information is available and is regularly reviewed by our chief operating decision makers, to assess the performance of the individual segments and make decisions about resources to be allocated to the segments. Our operations involve servicing patients through our three Our personal care segment provides non-medical assistance with activities of daily living, primarily to persons who are at risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. Our hospice segment provides physical, emotional and spiritual care for people who are terminally ill as well as for their families. Our home health segment provides services that are primarily medical in nature to individuals who may require assistance during an illness or after surgery, and include skilled nursing and physical, occupational and speech therapy. The tables below set forth information about our reportable segments for the three and nine months ended September 30, 2018 and 2017 along with the items necessary to reconcile the segment information to the totals reported in the accompanying consolidated financial statements. Segment assets are not reviewed by the company's chief decision makers and therefore are not disclosed below. Segment operating income consists of the net service revenues 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, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 128,094 $ 7,116 $ 2,421 $ 137,631 Cost of services revenues 95,428 3,777 1,721 100,926 Gross profit 32,666 3,339 700 36,705 Provision for doubtful accounts 48 1 — 49 General and administrative expenses 10,446 1,474 604 12,524 Segment operating income $ 22,172 $ 1,864 $ 96 $ 24,132 For the Nine Months Ended September 30, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 362,606 $ 11,765 $ 3,944 $ 378,315 Cost of services revenues 268,815 6,351 2,819 277,985 Gross profit 93,791 5,414 1,125 100,330 Provision for doubtful accounts 210 3 1 214 General and administrative expenses 29,073 2,326 946 32,345 Segment operating income $ 64,508 $ 3,085 $ 178 $ 67,771 For the Three For the Nine Months Ended Months Ended Segment Reconciliation: September 30, 2018 September 30, 2018 (Amounts in Thousands) Total segment operating income $ 24,132 $ 67,771 Items not allocated at segment level: Other general and administrative expenses 15,694 43,739 Depreciation and amortization 2,535 6,676 Interest income (113 ) (2,468 ) Interest expense 1,543 3,836 Income before income taxes $ 4,473 $ 15,988 For the Three Months Ended September 30, 2017 (Amounts in thousands) Personal Care Hospice Home Health Total Net service revenues $ 108,592 $ — $ — $ 108,592 Cost of services revenues 79,539 — — 79,539 Gross profit 29,053 — — 29,053 Provision for doubtful accounts 2,106 — — 2,106 General and administrative expenses 7,957 — — 7,957 Segment operating income $ 18,990 $ — $ — $ 18,990 For the Nine Months Ended September 30, 2017 (Amounts in thousands) Personal Care Hospice Home Health Total Net service revenues $ 313,758 $ — $ — $ 313,758 Cost of services revenues 228,877 — — 228,877 Gross profit 84,881 — — 84,881 Provision for doubtful accounts 6,208 — — 6,208 General and administrative expenses 24,129 — — 24,129 Segment operating income $ 54,544 $ — $ — $ 54,544 For the Three For the Nine Months Ended Months Ended Segment Reconciliation: September 30, 2017 September 30, 2017 (Amounts in thousands) Total segment operating income $ 18,990 $ 54,544 Items not allocated at segment level: Other general and administrative expenses 11,402 33,110 Gain on sale of assets — (2,065 ) Depreciation and amortization 1,781 4,811 Interest income (30 ) (50 ) Interest expense 870 3,629 Other income (64 ) (165 ) Income before income taxes $ 5,031 $ 15,274

Significant Payors

Significant Payors	9 Months Ended
	Sep. 30, 2018
Significant Payors [Abstract]
Significant Payors	12. Significant Payors For the three and nine months ended September 30, 2018 and 2017 the Company's revenue by payor type was as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2018 2017 2018 2017 % of % of % of % of Segment Segment Segment Segment Amount Net Service Amount Net Service Amount Net Service Amount Net Service (in Thousands) Revenues (in Thousands) Revenues (in Thousands) Revenues (in Thousands) Revenues State, local and other governmental programs $ 73,606 57.5 % $ 69,073 63.6 % $ 213,011 58.7 % $ 203,409 64.8 % Managed care organizations 45,271 35.3 36,866 34.0 126,809 35.0 102,055 32.5 Private pay 5,549 4.3 1,959 1.8 14,861 4.1 6,230 2.0 Commercial insurance 1,869 1.5 694 0.6 4,271 1.2 2,064 0.7 Other 1,799 1.4 — — 3,654 1.0 — — Total personal care segment net service revenues $ 128,094 100.0 % $ 108,592 100.0 % $ 362,606 100.0 % $ 313,758 100.0 % Hospice For the Three Months Ended For the Nine Months Ended September 30, September 30, 2018 2018 Amount % of Segment Net Amount % of Segment Net (in Thousands) Service Revenues (in Thousands) Service Revenues Medicare $ 6,677 93.8 % $ 11,030 93.8 % Managed care organizations 426 6.0 721 6.1 Other 13 0.2 14 0.1 Total hospice segment net service revenues $ 7,116 100.0 % $ 11,765 100.0 % Home Health For the Three Months Ended For the Three Months Ended September 30, September 30, 2018 2018 Amount % of Segment Net Amount % of Segment Net (in Thousands) Service Revenues (in Thousands) Service Revenues Medicare $ 2,184 90.2 % $ 3,588 91.0 % Managed care organizations 221 9.1 329 8.3 Other 16 0.7 27 0.7 Total home health segment net service revenues $ 2,421 100.0 % $ 3,944 100.0 % The percentages of segment revenue for each of the Company's significant states for the three and nine months ended September 30, 2018 and 2017 were as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2018 2017 2018 2017 % of % of % of % of Segment Segment Segment Segment Amount Net Service Amount Net Service Amount Net Service Amount Net Service (in Thousands) Revenues (in Thousands) Revenues (in Thousands) Revenues (in Thousands) Revenues Illinois $ 58,863 46.0 $ 56,813 52.3 $ 174,457 48.2 $ 165,370 52.7 New York 16,814 13.1 14,904 13.7 47,999 13.2 43,562 13.9 New Mexico 16,013 12.5 10,645 9.8 42,594 11.7 24,854 7.9 All other states 36,404 28.4 26,230 24.2 97,556 26.9 79,972 25.5 Total personal care segment net service revenues $ 128,094 100.0 $ 108,592 100.0 $ 362,606 100.0 $ 313,758 100.0 Hospice For the Three Months Ended For the Nine Months Ended September 30, September 30, 2018 2018 Amount % of Segment Net Amount % of Segment Net (in Thousands) Service Revenues (in Thousands) Service Revenues New Mexico 7,116 100.0 % 11,765 100.0 % Total hospice segment net service revenues $ 7,116 100.0 % $ 11,765 100.0 % Home Health For the Three Months Ended For the Nine Months Ended September 30, September 30, 2018 2018 Amount % of Segment Net Amount % of Segment Net (in Thousands) Service Revenues (in Thousands) Service Revenues New Mexico 2,421 100.0 % 3,944 100.0 % Total home health segment net service revenues $ 2,421 100.0 % $ 3,944 100.0 % A substantial portion of the Company's net service revenues and accounts receivable are derived from services performed for state and local governmental agencies. The Illinois Department on Aging, the largest payor program for our Illinois personal care operations, accounted for 29.5 36.6 31.8 36.6 The related receivables due from the Illinois Department on Aging represented 27.4 37.5

Concentration of Cash

Concentration of Cash	9 Months Ended
	Sep. 30, 2018
Concentration of Cash [Abstract]
Concentration of Cash	13. Concentration of Cash Financial instruments that potentially subject the Company to significant concentrations of credit risk consist principally of cash. The Company maintains cash with financial institutions which, at times, may exceed federally insured limits. The Company believes it is not exposed to any significant credit risk on cash.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2018
Subsequent Events [Abstract]
Subsequent Events	14. Subsequent Events On October 31, 2018, the Company amended and restated its existing Credit Agreement with certain lenders and Capital One, N.A as a lender and swing line lender and as agent for all lenders. See Note 7, "Amended and Restated Senior Secured Credit Facility" for additional information. Effective October 31, 2018, the Company entered into a definitive agreement to acquire the assets of VIP Health Care Services for approximately $28.0 On November 5, 2018 we amended and restated the employment agreements of each of our named executive officers in order to: (i) increase the amount of severance that would be payable on certain terminations of employment in connection with a change in control (as defined in the employment agreements), from two times annual compensation to three times annual compensation (as defined in the employment agreements) in the case of our chief executive officer, and from one times annual compensation to two times annual compensation (as defined in the employment agreements) in the case of our other named executive officers; (ii) provide that the enhanced severance for terminations of employment in connection with a change in control would be payable if the named executive officers self-terminated for good reason (as defined in the employment agreements); (iii) stipulate that severance for terminations of employment in connection with a change in control would include any unpaid bonus for a performance period completed prior to termination (the chief executive officer already had this right); and (iv) adjust the duration of non-competition and non-solicitation periods to match the number of years of annual compensation that the named executive officer would receive in severance. Copies of these employment agreements are attached to this Quarterly Report on 10-Q as Exhibits 10.3 through 10.8, and are incorporated herein by reference.

Nature of Operations, Consoli_2

Nature of Operations, Consolidation, and Presentation of Financial Statements (Policy)	9 Months Ended
	Sep. 30, 2018
Nature of Operations, Consolidation, and Presentation of Financial Statements [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. 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, 2017 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 and have not been audited by our independent auditors.
Principles of Consolidation	Principles of Consolidation These unaudited condensed consolidated financial statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All significant intercompany accounts and transactions have been eliminated in consolidation. The Company used the cost method to account for its investment in joint ventures in which it owned 10% equity interests. The Company sold such investments on October 1, 2017. See Note 3 "Gain on Sale of Assets" for additional information.
Reclassification of Prior Period Balances	Reclassification of Prior Period Balances Certain reclassifications have been made to prior period amounts to conform to the current-year presentation including the reporting of other long-term liabilities as a separate line item on the Unaudited Condensed Consolidated Balance Sheets. These reclassifications have no effect on the reported net income.
Recently Issued and Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In May 2014, the Financial Accounting Standards Board ("FASB") issued Accounting Standard Update ("ASU") 2014-09, Revenue from Contracts with Customers , which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. ASU 2014-09 replaced most existing revenue recognition guidance in GAAP. The Company adopted the new standard on January 1, 2018, and elected to adopt using the modified retrospective method. See Note 2 for additional information regarding the adoption. In August 2016, the FASB issued ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments. This standard amends and adjusts how cash receipts and cash payments are presented and classified in the statement of cash flows. We adopted the standard on a retrospective basis on January 1, 2018. ASU 2016-15 did not have an impact on our Condensed Consolidated Statements of Cash Flows. Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842), which replaces existing leasing rules with a comprehensive lease measurement and recognition standard and expanded disclosure requirements. ASU 2016-02 will require lessees to recognize most leases on their balance sheets as liabilities, with corresponding "right-of-use" assets and is effective for annual reporting periods beginning after December 15, 2018, subject to early adoption. For income statement recognition purposes, leases will be classified as either a finance or an operating lease. In July 2018, the FASB issued ASU 2018-11, Leases (Topic 842) Targeted Improvements , which amends ASU 2016-02 to provide an additional transition method option. Under the new transition method, an entity initially applies the new lease standard at the adoption date, versus at the beginning of the earliest period presented, and recognizes a cumulative-effect adjustment to the opening balance of retained earnings in the period of adoption. Upon initial evaluation, the Company believes that the new standard will have a material impact on its consolidated balance sheets but it will not affect its liquidity. The Company has secured new software to account for the change in accounting for leases and is currently assessing the impact of adopting this standard. In June 2016, the FASB issued ASU 2016-13, Financial Instruments—Credit Losses (Topic 326) : Measurement of Credit Losses on Financial Instruments. ASU 2016-13 changes the impairment model for most financial assets and certain other instruments. Under the new standard, entities holding financial assets and net investment in leases that are not accounted for at fair value through net income are to be presented at the net amount expected to be collected. An allowance for credit losses will be a valuation account that will be deducted from the amortized cost basis of the financial asset to present the net carrying value at the amount expected to be collected on the financial asset. ASU 2016-13 is effective as of January 1, 2020. Early adoption is permitted. The Company is currently evaluating the impact of ASU 2016-13. In January 2017, the FASB issued ASU 2017-04, Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment. The new guidance eliminates the requirement to calculate the implied fair value of goodwill (i.e., Step 2 of the current goodwill impairment test) to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit's carrying amount over its fair value (i.e., measure the charge based on the current Step 1). ASU 2017-04 is effective for annual and any interim impairment tests for periods beginning after December 15, 2019. Early adoption is permitted. The Company is currently assessing the impact of adopting this standard. In August 2018, the FASB issued ASU 2018-15, Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That is a Service Contract . ASU 2018-15 requires customers in a hosting arrangement that is a service contract to follow the internal-use software guidance in Accounting Standards Codification ("ASC") 350-40 to determine which implementation costs to capitalize as assets or expense as incurred. The ASU is effective for annual periods, including interim periods within those annual periods, beginning after December 15, 2019. Early adoption is permitted. The Company is currently assessing the impact of adopting this standard.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policy)	9 Months Ended
	Sep. 30, 2018
Summary of Significant Accounting Policies [Abstract]
Revenue Recognition	Revenue Recognition On January 1, 2018, the Company adopted ASU 2014-09, Revenue from Contracts with Customers , which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. The Company adopted the standard using the modified retrospective approach and did not record a cumulative catch-up adjustment as the timing and measurement of revenue for the Company's customers is similar to its prior revenue recognition model. However, the majority of what historically was classified as provision for doubtful accounts expense under operating expenses is now treated as an implicit price concession factored into net service revenues. Personal Care The majority of the Company's net service revenues are generated from providing personal care services directly to consumers under contracts with state, local and other governmental agencies, managed care organizations, commercial insurers and private consumers. Generally, these contracts, which are negotiated based on current contracting practices as appropriate for the payor, establish the terms of a customer relationship and set the broad range of terms for services to be performed at a stated rate. However, the contracts do not give rise to rights and obligations until an order is placed with the Company. When an order is placed, it creates the performance obligation to provide a defined quantity of service hours, or authorized hours, per consumer. The Company satisfies its performance obligations over time, given that consumers simultaneously receive and consume the benefits provided by the Company as the services are performed. As the Company has a right to consideration from customers commensurate with the value provided to customers from the performance completed over a given invoice period, the Company has elected to use the practical expedient for measuring progress toward satisfaction of performance obligations and recognizes patient service revenue in the amount to which the Company has a right to invoice. Hospice Revenue The Company generates net service revenues from providing hospice services to consumers who are terminally ill as well as for their families. Net service revenues are recognized as services are provided and costs for delivery of such services are incurred. The estimated payment rates are daily rates for each of the levels of care the Company delivers. Hospice companies are subject to two specific payment limit caps under the Medicare program each federal fiscal year: the inpatient cap and the aggregate cap. The inpatient cap limits the number of inpatient care days provided to no more than 20% of the total days of hospice care provided for the year. The aggregate cap limits the amount of Medicare reimbursement a hospice may receive, based on the number of Medicare patients served. For federal fiscal year 2018, which ended September 30, 2018, the Company was below the payment limits and did not record a cap liability. Home Health Revenue The Company also generates net service revenues from providing home healthcare services directly to consumers under contracts with Medicare. Generally, these contracts, which are negotiated based on current contracting practices as appropriate for the payor, establish the terms of a relationship and set the broad range of terms for services to be performed on an episodic basis at a stated rate. Home health Medicare services are paid under the Medicare Home Health Prospective Payment System ("HHPPS"), which is based on 60 day episodes of care. The HHPPS permits multiple, continuous episodes per patient. Medicare payment rates for episodes under HHPPS vary based on the severity of the patient's condition as determined by the Company's assessment of a patient's Home Health Resource Group score. The Company elects to use the same 60-day length of episode that Medicare recognizes as standard but accelerates revenue upon discharge to align with a patient's episode length if less than the expected 60 days, which depicts the transfer of services and related benefits received by the patient over the term of the contract necessary to satisfy the obligations. The Company recognizes revenue based on the number of days elapsed during an episode of care within the reporting period. The Company satisfies its performance obligations as consumers receive and consume the benefits provided by the Company as the services are performed. As the Company has a right to consideration from Medicare commensurate with the services provided to customers from the performance completed over a given episodic period, the Company has elected to use the practical expedient for measuring progress toward satisfaction of performance obligations. Under this method recognizing revenue ratably over the episode based on beginning and ending dates is a reasonable proxy for the transfer of benefit of the service.
Allowance for Doubtful Accounts	Allowance for Doubtful Accounts For 2017, the Company established its allowance for doubtful accounts to the extent it was probable that a portion or all of a particular account will not be collected. The Company established its provision for doubtful accounts primarily by reviewing the creditworthiness of significant customers and through evaluations over the collectability of the receivables. An allowance for doubtful accounts was maintained at a level that the Company's management believed was sufficient to cover potential losses. In 2018, subsequent adjustments that are determined to be the result of an adverse change in the payor's ability to pay are recognized as bad debt expense due to the adoption of ASU 2014-09, Revenue from Contracts with Customers . The Company recorded $ 2.4 6.8
Property and Equipment	Property and Equipment Property and equipment are recorded at cost and depreciated over the estimated useful lives of the related assets by use of the straight-line method. Maintenance and repairs are charged to expense as incurred. The estimated useful lives of the property and equipment are as follows: Computer equipment 3 – 5 years Furniture and equipment 5 – 7 years Transportation equipment 5 years Computer software 5 –10 years Leasehold improvements Lesser of useful life or lease term, unless probability of lease renewal is likely
Goodwill	Goodwill The Company's carrying value of goodwill is the excess of the purchase price over the fair value of the net assets acquired from various acquisitions. In accordance with ASC Topic 350, Goodwill and Other Intangible Assets , goodwill and intangible assets with indefinite useful lives are not amortized. The Company tests goodwill for impairment at the reporting unit level on an annual basis, as of October 1, or whenever potential impairment triggers occur, such as a significant change in business climate or regulatory changes that would indicate that an impairment may have occurred. The Company may use a qualitative test, known as "Step 0," or a two no No
Intangible Assets	Intangible Assets The Company's identifiable intangible assets consist of customer and referral relationships, trade names, 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 two twenty-five Intangible assets with finite lives are amortized using the estimated economic benefit method over the useful life and assessed for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The Company would recognize an impairment loss when the estimated future non-discounted cash flows associated with the intangible asset is less than the carrying value. An impairment charge would then be recorded for the excess of the carrying value over the fair value. No The Company uses various valuation techniques to determine fair value of its intangible assets, including relief-from-royalty, income approach, discounted cash flow analysis, and multi-period excess earnings, which use significant unobservable inputs, or Level 3 inputs, as defined by the fair value hierarchy. Under these valuation approaches, we are required to make estimates and assumptions about future market growth and trends, forecasted revenue and costs, expected periods over which the assets will be utilized, appropriate discount rates and other variables. The Company bases its fair value estimates on assumptions the Company believes to be reasonable but which are unpredictable and inherently uncertain. Actual future results may differ from those estimates.
Debt Issuance Costs	Debt Issuance Costs The Company amortizes debt issuance costs on a straight-line method over the term of the related debt. This method approximates the effective interest method. The Company has classified the debt issuance costs as current portion of long-term debt or long-term debt, less current portion as of September 30, 2018 and December 31, 2017.
Workers' Compensation Program	Workers' Compensation Program The Company's workers' compensation insurance program has a $ 0.4 14.8 12.6 1.4 0.5
Interest Income	Interest Income Illinois law entitles designated service program providers to receive a prompt payment interest penalty based on qualifying services approved for payment that remain unpaid after a designated period of time. The Company accounted for the interest income in accordance with ASC 606. The interest income was recognized when the State of Illinois approved a prompt payment interest penalty during the nine months ended September 30, 2018, removing the constraint related to the amount and intent to pay the prompt payment interest. For the three months ended September 30, 2018, the Company did not receive any prompt payment interest. For the nine months ended September 30, 2018, the Company received $ 2.3 no
Interest Expense	Interest Expense The Company's interest expense consists of interest and unused credit line fees on its credit facilities, interest on its capital lease obligations, and amortization and write-off of debt issuance costs, which is reported in the statement of income when incurred.
Other Income	Other Income Other income consisted of income distributions received from investments in joint ventures. The Company accounted for this income in accordance with ASC Topic 325, Investments—Other. The Company recognized the net accumulated earnings only to the extent distributed by the joint ventures on the date received. The Company subsequently sold these equity investments on October 1, 2017 (see Note 3).
Income Tax Expenses	Income Tax Expense The Company accounts for income taxes under the provisions of ASC Topic 740, Income Taxes. The objective of accounting for income taxes is to recognize the amount of taxes payable or refundable for the current year and deferred tax liabilities and assets for the future tax consequences of events that have been recognized in its financial statements or tax returns. Deferred taxes, resulting from differences between the financial and tax basis of the Company's assets and liabilities, are also adjusted for changes in tax rates and tax laws when changes are enacted. ASC Topic 740 also requires that deferred tax assets be reduced by a valuation allowance if it is more likely than not that some portion or all of the deferred tax asset will not be realized. ASC Topic 740 also prescribes a recognition threshold and measurement process for recording in the financial statements uncertain tax positions taken or expected to be taken in a tax return. In addition, ASC Topic 740 provides guidance on derecognition, classification, accounting in interim periods and disclosure requirements for uncertain tax positions.
Stock-Based Compensation	Stock-based Compensation The Company currently has one Stock Compensation . Under the 2017 Plan, compensation expense is recognized on a straight-line basis over the vesting period of the equity awards based on the grant date fair value of the options and restricted stock awards. The Company uses the Black-Scholes Option Pricing Model to value the Company's options. The determination of the fair value of stock-based payments utilizing the Black-Scholes Model is affected by the Company's stock price and a number of assumptions, including expected volatility, risk-free interest rate, expected term, and expected dividends yield. Stock-based compensation expense was $ 1.1 0.7 3.0 1.8
Diluted Net Income Per Common Share	Diluted Net Income Per Common Share Diluted net income per common share, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The Company's outstanding securities that may potentially dilute the common stock are stock options and restricted stock awards. Included in the Company's calculation of diluted earnings per share for the three and nine months ended September 30, 2018 were approximately 708,000 307,000 213,000 148,000 83,000 83,000 Included in the Company's calculation of diluted earnings per share for the three and nine months ended September 30, 2017 were approximately 479,000 102,000 102,000 148,000 43,000 50,000
Shareholders' Equity	Shareholders' Equity On August 20, 2018, the Company, together with Eos Capital Partners III, L.P. (the "Selling Stockholder") completed a secondary public offering of an aggregate 2,100,000 0.001 59.00 1,075,267 1,024,733 59.1 315,000 17.5 for general corporate purposes, including to potentially fund a portion of any future acquisitions that the Company may complete. The Company did not receive any of the proceeds from the sale of the Secondary Shares. The secondary offering resulted in an increase to additional paid in capital of approximately $ 76.6 5.4
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: the implicit price concessions factored into net service revenues, allowance for doubtful accounts, reserve for self-insurance claims, accounting for stock-based compensation, accounting for income taxes, business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from those estimates.
Fair Value Measurements	Fair Value Measurements The Company's financial instruments consist of cash, accounts receivable, payables and debt. The carrying amounts reported on the Company's Unaudited Condensed Consolidated Balance Sheets for cash, accounts receivable, accounts payable and accrued expenses approximate fair value because of the short-term nature of these instruments. The carrying value of the Company's long-term debt with variable interest rates approximates fair value based on instruments with similar terms using level 2 inputs as defined under ASC Topic 820 Fair Value Measurement . The Company applies fair value techniques on a non-recurring basis associated with valuing potential impairment losses related to goodwill, if required, and indefinite-lived intangible assets and also when determining the fair value of contingent consideration, if applicable. To determine the fair value in these situations, the Company uses Level 3 inputs, under ASC Topic 820 and defined as unobservable inputs in which little or no market data exists; therefore requiring an entity to develop its own assumptions, such as discounted cash flows, or if available, what a market participant would pay on the measurement date. The Company uses various valuation techniques to determine fair value of its intangible assets, including relief-from-royalty, income approach, discounted cash flow analysis, and multi-period excess earnings, which use significant unobservable inputs, or Level 3 inputs, as defined by the fair value hierarchy. Under these valuation approaches, we are required to make estimates and assumptions about future market growth and trends, forecasted revenue and costs, expected periods over which the assets will be utilized, appropriate discount rates and other variables.
Going Concern	Going Concern In connection with the preparation of the financial statements for the three and nine months ended September 30, 2018 and 2017, the Company conducted an evaluation as to whether there were conditions and events, considered in the aggregate, which raised substantial doubt as to the entity's ability to continue as a going concern within one year after the date of the issuance, or the date of availability, of the financial statements to be issued. The evaluation concluded that there did not appear to be evidence of substantial doubt of the entity's ability to continue as a going concern.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2018
Summary of Significant Accounting Policies [Abstract]
Estimated Useful Lives of Property and Equipment	Computer equipment 3 – 5 years Furniture and equipment 5 – 7 years Transportation equipment 5 years Computer software 5 – 10 years Leasehold improvements Lesser of useful life or lease term, unless probability of lease renewal is likely

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2018
Ambercare Corporation [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	(Amounts in Thousands) Goodwill $ 28,082 Cash 12,008 Identifiable intangible assets 10,413 Accounts receivable 6,638 Other assets 440 Property and equipment 171 Accrued liabilities (3,732 ) Deferred tax liability (2,302 ) Capital lease (93 ) Accounts payable (3 ) Total purchase price allocation $ 51,622
Arcadia Home Care And Staffing [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	(Amounts in Thousands) Goodwill $ 12,389 Accounts receivable 5,317 Identifiable intangible assets 2,947 Property and equipment 155 Other assets 92 Accrued liabilities (1,540 ) Accounts payable (508 ) Total purchase price allocation $ 18,852
Lifestyle Options, Inc. [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	Total (Amounts in Thousands) Goodwill $ 2,751 Identifiable intangible assets 1,152 Accounts receivable 573 Other assets 32 Property and equipment 18 Accrued liabilities (291 ) Accounts payable (105 ) Total purchase price allocation $ 4,130
Sun Cities Homecare [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	Total (Amounts in Thousands) Goodwill $ 1,089 Identifiable intangible assets 682 Accounts receivable 254 Cash 321 Other assets 10 Accrued liabilities (86 ) Accounts payable (14 ) Total purchase price allocation $ 2,256
Options Home Care [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	Total (Amounts in Thousands) Goodwill $ 16,671 Identifiable intangible assets 5,324 Accounts receivable 1,084 Cash 205 Other assets 41 Accrued liabilities (701 ) Total purchase price allocation $ 22,624
Ambercare, Arcadia, LifeStyle, Sun Cities And Options Home Care [Member]
Business Acquisition [Line Items]
Unaudited Pro Forma Condensed Consolidated Income Statement Information	For the Three Months Ended September 30, (Amounts in Thousands) 2018 2017 Net service revenues $ 137,631 $ 135,440 Operating income 7,758 8,418 Net income $ 5,332 $ 3,317 Net income per common share Basic income per share $ 0.44 $ 0.29 Diluted income per share $ 0.42 $ 0.29 For the Nine Months Ended September 30, (Amounts in Thousands) 2018 2017 Net service revenues $ 410,552 $ 398,948 Operating income 28,833 25,336 Net income $ 18,415 $ 9,118 Net income per common share Basic income per share $ 1.57 $ 0.80 Diluted income per share $ 1.53 $ 0.78

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2018
Goodwill and Intangible Assets [Abstract]
Summary of Goodwill and Related Adjustments	Goodwill Personal Care Hospice Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2017 $ 90,339 $ — $ — $ 90,339 Additions for acquisitions 22,185 19,040 2,499 43,724 Goodwill as of September 30, 2018 $ 112,524 $ 19,040 $ 2,499 $ 134,063
Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset	Customer Trade and referral names and Non-competition State relationships trademarks agreements Licenses Total (Amounts in Thousands) Gross balance at December 31, 2017 $ 39,017 $ 14,641 $ 2,155 $ — $ 55,813 Accumulated amortization (29,147 ) (8,198 ) (1,872 ) — (39,217 ) Net balance at December 31, 2017 9,870 6,443 283 — 16,596 Gross balance at January 1, 2018 39,017 14,641 2,155 — 55,813 Additions for acquisitions 5,209 6,927 — 2,376 14,512 Accumulated amortization (32,131 ) (9,942 ) (1,954 ) (101 ) (44,128 ) Net balance at September 30, 2018 $ 12,095 $ 11,626 $ 201 $ 2,275 $ 26,197

Details of Certain Balance Sh_2

Details of Certain Balance Sheet Accounts (Tables)	9 Months Ended
	Sep. 30, 2018
Details of Certain Balance Sheet Accounts [Abstract]
Schedule of Prepaid Expenses and Other Current Assets	September 30, 2018 December 31, 2017 (Amounts in Thousands) Prepaid health insurance $ 1,457 $ 2,901 Workers' compensation insurance receivable 1,375 543 Prepaid rent 1,208 555 Prepaid workers' compensation and liability insurance 1,251 1,332 Other 1,644 3,048 $ 6,935 $ 8,379
Schedule of Accrued Expenses	September 30, 2018 December 31, 2017 (Amounts in Thousands) Accrued payroll $ 27,236 $ 19,783 Accrued workers' compensation insurance 14,846 12,574 Accrued health insurance (1) 4,165 6,471 Accrued professional fees 1,242 1,312 Accrued payroll taxes 1,540 1,065 Other 3,407 3,149 $ 52,436 $ 44,354 (1) The Company provides health insurance coverage to qualified union employees providing personal care services in Illinois through a Taft-Hartley multi-employer health and welfare plan under Section 302(c)(5) of the Labor Management Relations Act of 1947. The Company's insurance contributions equal the amount reimbursed by the State of Illinois. Contributions are due within five business days from the date the funds are received from the State of Illinois. Amounts due of $1.2 million and $2.3 million for health insurance reimbursements and contributions were reflected in prepaid insurance and accrued insurance as of September 30, 2018 and December 31, 2017, respectively.

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2018
Long-Term Debt [Abstract]
Schedule of Long-Term Debt	September 30, 2018 December 31, 2017 (Amounts in Thousands) Term loan under the credit facility $ 103,170 $ 44,438 Capital leases 142 1,002 Less unamortized issuance costs (2,103 ) (2,481 ) Total $ 101,209 $ 42,959 Less current maturities (2,318 ) (3,099 ) Long-term debt $ 98,891 $ 39,860
Schedule of Leased Property Under Capital Leases	Asset Balances at September 30, 2018 Classes of Property (Amounts in Thousands) Leasehold improvements $ 1,484 Furniture and equipment 868 Computer equipment 635 Computer software 303 Transportation equipment 107 Total 3,397 Less: accumulated depreciation and amortization (1,772 ) $ 1,625
Schedule of Future Minimum Payments for Capital Leases	Capital Lease (Amounts In Thousands) 2018 $ 65 2019 67 2020 20 Total minimum lease payments 152 Less: amount representing estimated executory costs (such as taxes, maintenance and insurance), including profit thereon, included in total minimum lease payments (5 ) Net minimum lease payments 147 Less: amount representing interest (1) (5 ) Present value of net minimum lease payments (2 ) $ 142 (1) Amount necessary to reduce net minimum lease payments to present value calculated at the Company's incremental borrowing rate at lease inception. (2) Included in the balance sheet as $114,000 of the current portion of long-term debt and $28,000 of the long-term debt, less current portion.

Income Taxes (Tables)

Income Taxes (Tables)	9 Months Ended
	Sep. 30, 2018
Income Taxes [Abstract]
Reconciliation of Statutory Federal Tax Rate	Three Months Ended September 30, 2018 2017 Federal income tax at statutory rate 21.0 % 35.0 % State and local taxes, net of federal benefit 5.3 4.4 Jobs tax credits, net (10.0 ) (7.7 ) Nondeductible permanent items 2.0 0.5 Other 2.4 — Effective income tax rate 20.7 % 32.2 % Nine Months Ended September 30, 2018 2017 Federal income tax at statutory rate 21.0 % 35.0 % State and local taxes, net of federal benefit 6.5 4.9 Jobs tax credits, net (9.3 ) (7.5 ) Nondeductible permanent items 1.5 0.5 Other 0.9 (0.8 ) Effective income tax rate 20.6 % 32.1 %

Severance and Restructuring (Ta

Severance and Restructuring (Tables)	9 Months Ended
	Sep. 30, 2018
Severance and Restructuring [Abstract]
Components of and Changes in Severance and Restructuring Accruals	Employee Termination Restructuring Costs and Other (Amounts in Thousands) Balance at December 31, 2017 $ 562 $ 1,077 Provision 610 285 Utilization (856 ) (755 ) Balance at September 30, 2018 $ 316 $ 607

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2018
Segment Information [Abstract]
Summary Of Segment Information	For the Three Months Ended September 30, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 128,094 $ 7,116 $ 2,421 $ 137,631 Cost of services revenues 95,428 3,777 1,721 100,926 Gross profit 32,666 3,339 700 36,705 Provision for doubtful accounts 48 1 — 49 General and administrative expenses 10,446 1,474 604 12,524 Segment operating income $ 22,172 $ 1,864 $ 96 $ 24,132 For the Nine Months Ended September 30, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 362,606 $ 11,765 $ 3,944 $ 378,315 Cost of services revenues 268,815 6,351 2,819 277,985 Gross profit 93,791 5,414 1,125 100,330 Provision for doubtful accounts 210 3 1 214 General and administrative expenses 29,073 2,326 946 32,345 Segment operating income $ 64,508 $ 3,085 $ 178 $ 67,771 For the Three For the Nine Months Ended Months Ended Segment Reconciliation: September 30, 2018 September 30, 2018 (Amounts in Thousands) Total segment operating income $ 24,132 $ 67,771 Items not allocated at segment level: Other general and administrative expenses 15,694 43,739 Depreciation and amortization 2,535 6,676 Interest income (113 ) (2,468 ) Interest expense 1,543 3,836 Income before income taxes $ 4,473 $ 15,988 For the Three Months Ended September 30, 2017 (Amounts in thousands) Personal Care Hospice Home Health Total Net service revenues $ 108,592 $ — $ — $ 108,592 Cost of services revenues 79,539 — — 79,539 Gross profit 29,053 — — 29,053 Provision for doubtful accounts 2,106 — — 2,106 General and administrative expenses 7,957 — — 7,957 Segment operating income $ 18,990 $ — $ — $ 18,990 For the Nine Months Ended September 30, 2017 (Amounts in thousands) Personal Care Hospice Home Health Total Net service revenues $ 313,758 $ — $ — $ 313,758 Cost of services revenues 228,877 — — 228,877 Gross profit 84,881 — — 84,881 Provision for doubtful accounts 6,208 — — 6,208 General and administrative expenses 24,129 — — 24,129 Segment operating income $ 54,544 $ — $ — $ 54,544 For the Three For the Nine Months Ended Months Ended Segment Reconciliation: September 30, 2017 September 30, 2017 (Amounts in thousands) Total segment operating income $ 18,990 $ 54,544 Items not allocated at segment level: Other general and administrative expenses 11,402 33,110 Gain on sale of assets — (2,065 ) Depreciation and amortization 1,781 4,811 Interest income (30 ) (50 ) Interest expense 870 3,629 Other income (64 ) (165 ) Income before income taxes $ 5,031 $ 15,274

Significant Payors (Tables)

Significant Payors (Tables)	9 Months Ended
	Sep. 30, 2018
Significant Payors [Abstract]
Revenue by Payor Type	Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2018 2017 2018 2017 % of % of % of % of Segment Segment Segment Segment Amount Net Service Amount Net Service Amount Net Service Amount Net Service (in Thousands) Revenues (in Thousands) Revenues (in Thousands) Revenues (in Thousands) Revenues State, local and other governmental programs $ 73,606 57.5 % $ 69,073 63.6 % $ 213,011 58.7 % $ 203,409 64.8 % Managed care organizations 45,271 35.3 36,866 34.0 126,809 35.0 102,055 32.5 Private pay 5,549 4.3 1,959 1.8 14,861 4.1 6,230 2.0 Commercial insurance 1,869 1.5 694 0.6 4,271 1.2 2,064 0.7 Other 1,799 1.4 — — 3,654 1.0 — — Total personal care segment net service revenues $ 128,094 100.0 % $ 108,592 100.0 % $ 362,606 100.0 % $ 313,758 100.0 % Hospice For the Three Months For the Nine Months Ended September 30, Ended September 30, 2018 2018 Amount % of Segment Net Amount % of Segment Net (in Thousands) Service Revenues (in Thousands) Service Revenues Medicare $ 6,677 93.8 % $ 11,030 93.8 % Managed care organizations 426 6.0 721 6.1 Other 13 0.2 14 0.1 Total hospice segment net service revenues $ 7,116 100.0 % $ 11,765 100.0 % Home Health For the Three Months For the Nine Months Ended September 30, Ended September 30, 2018 2018 Amount % of Segment Net Amount % of Segment Net (in Thousands) Service Revenues (in Thousands) Service Revenues Medicare $ 2,184 90.2 % $ 3,588 91.0 % Managed care organizations 221 9.1 329 8.3 Other 16 0.7 27 0.7 Total home health segment net service revenues $ 2,421 100.0 % $ 3,944 100.0 %
Percentage of Total Revenue by Geographic Location	The percentages of segment revenue for each of the Company's significant states for the three and nine months ended September 30, 2018 and 2017 were as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2018 2017 2018 2017 % of % of % of % of Segment Segment Segment Segment Amount Net Service Amount Net Service Amount Net Service Amount Net Service (in Thousands) Revenues (in Thousands) Revenues (in Thousands) Revenues (in Thousands) Revenues Illinois $ 58,863 46.0 % $ 56,813 52.3 % $ 174,457 48.2 % $ 165,370 52.7 % New York 16,814 13.1 14,904 13.7 47,999 13.2 43,562 13.9 New Mexico 16,013 12.5 10,645 9.8 42,594 11.7 24,854 7.9 All other states 36,404 28.4 26,230 24.2 97,556 26.9 79,972 25.5 Total personal care segment net service revenues $ 128,094 100.0 % $ 108,592 100.0 % $ 362,606 100.0 % $ 313,758 100.0 % Hospice For the Three Months Ended For the Nine Months Ended September 30, September 30, 2018 2018 Amount % of Segment Net Amount % of Segment Net (in Thousands) Service Revenues (in Thousands) Service Revenues New Mexico 7,116 100.0 % 11,765 100.0 % Total hospice segment net service revenues $ 7,116 100.0 % $ 11,765 100.0 % Home Health For the Three Months Ended For the Nine Months Ended September 30, September 30, 2018 2018 Amount % of Segment Net Amount % of Segment Net (in Thousands) Service Revenues (in Thousands) Service Revenues New Mexico 2,421 100.0 % 3,944 100.0 % Total home health segment net service revenues $ 2,421 100.0 % $ 3,944 100.0 %

Nature of Operations, Consoli_3

Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details) - segment	Oct. 01, 2017	Sep. 30, 2018
Number of operating segments		3
LHC Group, Inc. [Member]
Equity ownership percentage sold in joint venture	10.00%

Summary of Significant Accoun_4

Summary of Significant Accounting Policies (Narrative) (Details) $ / shares in Units, $ in Thousands	Aug. 22, 2018USD ($)shares	Aug. 20, 2018USD ($)$ / sharesshares	Sep. 30, 2018USD ($)$ / sharesshares	Sep. 30, 2017USD ($)shares	Sep. 30, 2018USD ($)$ / sharesitemshares	Sep. 30, 2017USD ($)shares	Dec. 31, 2017USD ($)$ / shares
Summary Of Significant Accounting Policies [Line Items]
Revenues			$ 137,631	$ 108,592	$ 378,315	$ 313,758
Goodwill impairment charge			0	0	0	0	$ 0
Impairment of finite-lived intangible assets			0	0	0	0
Deductible component of workers' compensation					400
Accrued workers' compensation insurance			14,846		14,846		12,574
Workers' compensation insurance recovery receivables			1,375		1,375		$ 543
Interest income received				0	$ 2,300	0
Number of stock incentive plans | item					1
Stock based compensation expense			$ 1,100	$ 700	$ 3,000	$ 1,800
Common stock, par value | $ / shares			$ 0.001		$ 0.001		$ 0.001
Proceeds from issuance of common stock, net of issuance costs					$ 76,618
Increase to additional paid in capital from secondary offering					76,618
Accounting Standards Update 2014-09 [Member]
Summary Of Significant Accounting Policies [Line Items]
Revenues			$ (2,400)		$ (6,800)
Common Stock [Member]
Summary Of Significant Accounting Policies [Line Items]
Shares issued during period | shares					1,390,000
Increase to additional paid in capital from secondary offering					$ 1
Common Stock [Member] | Secondary Public Offering [Member]
Summary Of Significant Accounting Policies [Line Items]
Shares issued during period | shares		2,100,000
Common stock, par value | $ / shares		$ 0.001
Purchase price per share | $ / shares		$ 59
Common Stock [Member] | Primary Shares [Member]
Summary Of Significant Accounting Policies [Line Items]
Shares issued during period | shares		1,075,267
Proceeds from issuance of common stock, net of issuance costs		$ 59,100
Common Stock [Member] | Over-Allotment Option [Member]
Summary Of Significant Accounting Policies [Line Items]
Shares issued during period | shares	315,000
Proceeds from issuance of common stock, net of issuance costs	$ 17,500
Home Health [Member]
Summary Of Significant Accounting Policies [Line Items]
Revenues			$ 2,421		$ 3,944
Stock Options [Member]
Summary Of Significant Accounting Policies [Line Items]
Number of stock options included in calculation | shares			708,000	479,000	708,000	479,000
Number of dilutive shares outstanding | shares			307,000	102,000	213,000	102,000
Restricted Stock [Member]
Summary Of Significant Accounting Policies [Line Items]
Number of dilutive shares outstanding | shares			83,000	43,000	83,000	50,000
Shares of restricted stock awards included in calculation | shares					148,000	148,000
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, estimated useful lives					2 years
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, estimated useful lives					25 years
Eos Capital Partners III, L. P [Member] | Common Stock [Member] | Secondary Shars [Member]
Summary Of Significant Accounting Policies [Line Items]
Shares issued during period | shares		1,024,733

Summary of Significant Accoun_5

Summary of Significant Accounting Policies (Estimated Useful Lives of Property and Equipment) (Details)	9 Months Ended
	Sep. 30, 2018
Transportation Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	5 years
Minimum [Member] | Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	3 years
Minimum [Member] | Furniture and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	5 years
Minimum [Member] | Computer Software [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	5 years
Maximum [Member] | Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	5 years
Maximum [Member] | Furniture and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	7 years
Maximum [Member] | Computer Software [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	10 years

Gain on Sale of Assets (Details

Gain on Sale of Assets (Details) $ in Thousands	Oct. 01, 2017USD ($)entity	Mar. 01, 2017USD ($)item	Sep. 30, 2017USD ($)
Gain on sale of adult day services centers			$ 2,065
Illinois [Member]
Number of adult day centers sold | item		3
Proceeds from sale of adult day service centers		$ 2,400
Gain on sale of adult day services centers		$ 2,100
LHC Group, Inc. [Member]
Equity ownership percentage sold in joint venture with LHCG	10.00%
Number of joint ventures where 10% membership interest is sold | entity	2
Proceeds from the sale of investments in joint ventures	$ 1,300
Pre-tax gain from sale of the investments in joint ventures	$ 400

Acquisitions (Narrative) (Detai

Acquisitions (Narrative) (Details) $ in Thousands	May 01, 2018USD ($)	Apr. 01, 2018USD ($)	Jan. 01, 2018USD ($)	Oct. 01, 2017USD ($)	Aug. 01, 2017USD ($)item	Sep. 30, 2018USD ($)	Sep. 30, 2018USD ($)	Sep. 30, 2017USD ($)	Sep. 30, 2018USD ($)	Sep. 30, 2017USD ($)	Dec. 31, 2017USD ($)
Business Acquisition [Line Items]
Goodwill						$ 134,063	$ 134,063		$ 134,063		$ 90,339
Net service revenues							137,631	$ 108,592	378,315	$ 313,758
Ambercare Corporation [Member]
Business Acquisition [Line Items]
Goodwill	$ 28,082
Net service revenues							13,400		22,600
Net income from continuing operations							2,000		3,800
Ambercare Corporation [Member] | New Mexico [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition	39,600
Purchase price credit estimated excess cash held at closing	$ 12,000
Acquisition related costs							800		1,400
Arcadia Home Care And Staffing [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition		$ 18,900
Goodwill		$ 12,389
Acquisition related costs							800		1,400
Net service revenues							10,900		21,700
Net income from continuing operations							1,600		3,200
Affiliate Branches of Arcadia [Member]
Business Acquisition [Line Items]
Acquisitions of business cash consideration						600
Goodwill						$ 600	600		600
Lifestyle Options, Inc. [Member]
Business Acquisition [Line Items]
Goodwill			$ 2,751
Lifestyle Options, Inc. [Member] | Illinois [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition			4,100
Acquisitions of business cash consideration			3,300
Business acquisition, contingent earn-out obligation			800
Acquisition related costs			$ 48
Net service revenues							1,500		4,500
Net income from continuing operations							100		400
Sun Cities Homecare [Member]
Business Acquisition [Line Items]
Goodwill				$ 1,089
Sun Cities Homecare [Member] | Arizona [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition				2,300
Acquisition related costs				$ 200
Net service revenues							700		1,800
Net income from continuing operations							100		100
Options Home Care [Member]
Business Acquisition [Line Items]
Goodwill					$ 16,671
Options Home Care [Member] | New Mexico [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition					22,600
Acquisition related costs					$ 800
Net service revenues							4,500	3,300	13,400	3,300
Net income from continuing operations							$ 900	$ 200	$ 2,400	$ 200
Options Home Care [Member] | Minimum [Member] | New Mexico [Member]
Business Acquisition [Line Items]
Number of counties under personal care services | item					20

Acquisitions (Schedule of Purch

Acquisitions (Schedule of Purchase Price Allocation) (Details) - USD ($) $ in Thousands	Sep. 30, 2018	May 01, 2018	Apr. 01, 2018	Jan. 01, 2018	Dec. 31, 2017	Oct. 01, 2017	Aug. 01, 2017
Business Acquisition [Line Items]
Goodwill	$ 134,063				$ 90,339
Ambercare Corporation [Member]
Business Acquisition [Line Items]
Goodwill		$ 28,082
Identifiable intangible assets		10,413
Accounts receivable		6,638
Cash		12,008
Other assets		440
Property and equipment		171
Accrued liabilities		(3,732)
Deferred tax liability		(2,302)
Capital lease		(93)
Accounts payable		(3)
Total purchase price allocation		$ 51,622
Arcadia Home Care And Staffing [Member]
Business Acquisition [Line Items]
Goodwill			$ 12,389
Identifiable intangible assets			2,947
Accounts receivable			5,317
Other assets			92
Property and equipment			155
Accrued liabilities			(1,540)
Accounts payable			(508)
Total purchase price allocation			$ 18,852
Lifestyle Options, Inc. [Member]
Business Acquisition [Line Items]
Goodwill				$ 2,751
Identifiable intangible assets				1,152
Accounts receivable				573
Other assets				32
Property and equipment				18
Accrued liabilities				(291)
Accounts payable				(105)
Total purchase price allocation				$ 4,130
Sun Cities Homecare [Member]
Business Acquisition [Line Items]
Goodwill						$ 1,089
Identifiable intangible assets						682
Accounts receivable						254
Cash						321
Other assets						10
Accrued liabilities						(86)
Accounts payable						(14)
Total purchase price allocation						$ 2,256
Options Home Care [Member]
Business Acquisition [Line Items]
Goodwill							$ 16,671
Identifiable intangible assets							5,324
Accounts receivable							1,084
Cash							205
Other assets							41
Accrued liabilities							(701)
Total purchase price allocation							$ 22,624

Acquisitions (Unaudited Pro For

Acquisitions (Unaudited Pro Forma Condensed Consolidated Income Statement Information) (Details) - Ambercare, Arcadia, LifeStyle, Sun Cities And Options Home Care [Member] - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Business Acquisition [Line Items]
Net service revenues	$ 137,631	$ 135,440	$ 410,552	$ 398,948
Operating income	7,758	8,418	28,833	25,336
Net income	$ 5,332	$ 3,317	$ 18,415	$ 9,118
Basic income per share	$ 0.44	$ 0.29	$ 1.57	$ 0.80
Diluted income per share	$ 0.42	$ 0.29	$ 1.53	$ 0.78

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Goodwill [Line Items]
Amortization expense	$ 1.9	$ 1.2	$ 4.9	$ 3.3
Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives			2 years
Maximum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives			25 years

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2018USD ($)
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 90,339
Additions for acquisitions	43,724
Goodwill, at End of Period	134,063
Personal Care [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	90,339
Additions for acquisitions	22,185
Goodwill, at End of Period	112,524
Hospice [Member]
Goodwill [Line Items]
Additions for acquisitions	19,040
Goodwill, at End of Period	19,040
Home Health [Member]
Goodwill [Line Items]
Additions for acquisitions	2,499
Goodwill, at End of Period	$ 2,499

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, 2018	Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Gross balance at beginning of period	$ 55,813	$ 55,813
Additions for acquisitions	14,512
Accumulated amortization	(44,128)	(39,217)
Net balance at end of period	26,197	16,596
Customer And Referral Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Gross balance at beginning of period	39,017	39,017
Additions for acquisitions	5,209
Accumulated amortization	(32,131)	(29,147)
Net balance at end of period	12,095	9,870
Trade Names And Trademarks [Member]
Finite-Lived Intangible Assets [Line Items]
Gross balance at beginning of period	14,641	14,641
Additions for acquisitions	6,927
Accumulated amortization	(9,942)	(8,198)
Net balance at end of period	11,626	6,443
State Licenses [Member]
Finite-Lived Intangible Assets [Line Items]
Gross balance at beginning of period
Additions for acquisitions	2,376
Accumulated amortization	(101)
Net balance at end of period	2,275
Non-competition Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Gross balance at beginning of period	2,155	2,155
Accumulated amortization	(1,954)	(1,872)
Net balance at end of period	$ 201	$ 283

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, 2018	Dec. 31, 2017
Details of Certain Balance Sheet Accounts [Abstract]
Prepaid health insurance	$ 1,457	$ 2,901
Workers' compensation insurance receivable	1,375	543
Prepaid rent	1,208	555
Prepaid workers' compensation and liability insurance	1,251	1,332
Other	1,644	3,048
Prepaid expenses and other current assets	$ 6,935	$ 8,379

Details of Certain Balance Sh_4

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands		9 Months Ended
		Sep. 30, 2018	Dec. 31, 2017
Accrued payroll		$ 27,236	$ 19,783
Accrued workers' compensation insurance		14,846	12,574
Accrued health insurance	[1]	4,165	6,471
Accrued professional fees		1,242	1,312
Accrued payroll taxes		1,540	1,065
Other		3,407	3,149
Accrued expenses		52,436	44,354
Health insurance reimbursement and contribution due		$ 1,200	$ 2,300
Illinois [Member]
Contributions due after fund received, period		5 days
[1]	The Company provides health insurance coverage to qualified union employees providing personal care services in Illinois through a Taft-Hartley multi-employer health and welfare plan under Section 302(c)(5) of the Labor Management Relations Act of 1947. The Company's insurance contributions equal the amount reimbursed by the State of Illinois. Contributions are due within five business days from the date the funds are received from the State of Illinois. Amounts due of $1.2 million and $2.3 million for health insurance reimbursements and contributions were reflected in prepaid insurance and accrued insurance as of September 30, 2018 and December 31, 2017, respectively.

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) $ in Thousands

Oct. 31, 2018USD ($)

Oct. 30, 2018USD ($)

Sep. 30, 2018USD ($)

Sep. 30, 2018USD ($)agreement

Sep. 30, 2017USD ($)

May 01, 2018

Dec. 31, 2017USD ($)

May 07, 2017USD ($)

Oct. 01, 2016USD ($)

Apr. 13, 2015USD ($)

Sep. 11, 2014USD ($)

Jul. 12, 2014USD ($)

Debt Instrument [Line Items]

Proceeds from line of credit

$ 20,000

Repayment of credit facility

$ 30,000

Ford Motor Credit Company LLC [Member]

Debt Instrument [Line Items]

Capital lease agreements term

48 months

Debt instrument stated interest rate

6.88%

First American Commercial Bancorp [Member]

Debt Instrument [Line Items]

Number of capital lease agreements | agreement

3

Capital lease agreements term

48 months

Capital lease agreements amount

$ 400

$ 1,400

$ 2,700

Meridian Leasing Corporation [Member]

Debt Instrument [Line Items]

Capital lease agreements term

25 months

Capital lease agreements amount

$ 600

Debt instrument stated interest rate

11.10%

Minimum [Member] | First American Commercial Bancorp [Member]

Debt Instrument [Line Items]

Debt instrument stated interest rate

3.00%

3.00%

Maximum [Member] | First American Commercial Bancorp [Member]

Debt Instrument [Line Items]

Debt instrument stated interest rate

3.60%

3.60%

New Credit Agreement [Member] | Capital One, National Association [Member]

Debt Instrument [Line Items]

Debt instrument, maturity date

May 8, 2023

New Credit Agreement [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

$ 269,600

Debt issuance costs

1,100

Debt instrument total net leverage ratio

4.25%

New Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

250,000

New Credit Agreement [Member] | Delayed Draw Term Loan [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

$ 19,600

New Credit Agreement [Member] | Minimum [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member]

Debt Instrument [Line Items]

Fee charged on unused portion of revolving credit facility

0.20%

New Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument total net leverage ratio

3.75%

New Credit Agreement [Member] | Maximum [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member]

Debt Instrument [Line Items]

Fee charged on unused portion of revolving credit facility

0.35%

New Credit Agreement [Member] | One Month Libor [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

1.00%

New Credit Agreement [Member] | One Month Libor [Member] | Minimum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

0.00%

New Credit Agreement [Member] | Federal Funds Rate [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

0.50%

Credit Agreement [Member] | Capital One, National Association [Member]

Debt Instrument [Line Items]

Debt instrument, maturity date

May 8, 2022

Credit Agreement [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

$ 250,000

Debt issuance costs

2,900

Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

$ 88,600

$ 88,600

$ 105,100

Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

125,000

Credit Agreement [Member] | Term Loan [Member] | Capital One, National Association [Member]

Debt Instrument [Line Items]

Debt instrument stated interest rate

4.60%

4.60%

3.86%

Line of credit outstanding amount

$ 103,200

$ 103,200

$ 44,400

Credit Agreement [Member] | Term Loan [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

45,000

Credit Agreement [Member] | Delayed Draw Term Loan [Member] | Capital One, National Association [Member]

Debt Instrument [Line Items]

Proceeds from line of credit

$ 0

$ 60,400

Credit Agreement [Member] | Delayed Draw Term Loan [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

$ 80,000

Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Maximum ratio used to determine availability of additional draws

4.25%

Credit Agreement [Member] | One Month Libor [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

1.00%

Credit Agreement [Member] | One Month Libor [Member] | Minimum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

0.00%

Credit Agreement [Member] | Federal Funds Rate [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

0.50%

Terminated Senior Secured Credit Facility [Member]

Debt Instrument [Line Items]

Debt instrument, maturity date

Nov. 10, 2020

Terminated Senior Secured Credit Facility [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

$ 125,000

Terminated Senior Secured Credit Facility [Member] | Revolving Credit Loan [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

$ 100,000

Terminated Senior Secured Credit Facility [Member] | Delayed Draw Term Loan [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

25,000

Terminated Senior Secured Credit Facility [Member] | Uncommitted Incremental Term Loan [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

50,000

Terminated Senior Secured Credit Facility [Member] | Letters of Credit [Member]

Debt Instrument [Line Items]

Maximum aggregate loan amount available

$ 35,000

A & R Credit Agreement [Member] | Delayed Draw Term Loan [Member]

Debt Instrument [Line Items]

Debt instrument, maturity date

Jan. 31, 2019

Restriction on Dividends [Member] | New Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [Member]

Debt Instrument [Line Items]

Aggregate amount of dividends and distributions

$ 7,500

Based On Applicable Senior Leverage Ratio [Member] | New Credit Agreement [Member] | Minimum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

0.75%

Based On Applicable Senior Leverage Ratio [Member] | New Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

1.50%

Based On Applicable Senior Leverage Ratio [Member] | Credit Agreement [Member] | Minimum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

1.50%

Based On Applicable Senior Leverage Ratio [Member] | Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

2.25%

Based On Applicable Leverage Ratio [Member] | New Credit Agreement [Member] | Minimum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

1.75%

Based On Applicable Leverage Ratio [Member] | New Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

2.50%

Based On Applicable Leverage Ratio [Member] | Credit Agreement [Member] | Minimum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

2.50%

Based On Applicable Leverage Ratio [Member] | Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [Member] | Subsequent Event [Member]

Debt Instrument [Line Items]

Debt instrument variable interest rate margin

3.25%

Long-Term Debt (Schedule of Lon

Long-Term Debt (Schedule of Long-Term Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Less unamortized issuance costs	$ (2,103)	$ (2,481)
Total	101,209	42,959
Less current maturities	(2,318)	(3,099)
Long-term debt	98,891	39,860
Term Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	103,170	44,438
Capital Leases [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 142	$ 1,002

Long-Term Debt (Schedule of Lea

Long-Term Debt (Schedule of Leased Property Under Capital Leases) (Details) $ in Thousands	Sep. 30, 2018USD ($)
Capital Leased Assets [Line Items]
Leased property under capital leases	$ 3,397
Less: accumulated depreciation and amortization	(1,772)
Net Leased Property Under Capital Leases	1,625
Leasehold Improvements [Member]
Capital Leased Assets [Line Items]
Leased property under capital leases	1,484
Furniture and Equipment [Member]
Capital Leased Assets [Line Items]
Leased property under capital leases	868
Computer Equipment [Member]
Capital Leased Assets [Line Items]
Leased property under capital leases	635
Computer Software [Member]
Capital Leased Assets [Line Items]
Leased property under capital leases	303
Transportation Equipment [Member]
Capital Leased Assets [Line Items]
Leased property under capital leases	$ 107

Long-Term Debt (Schedule of Fut

Long-Term Debt (Schedule of Future Minimum Payments for Capital Leases) (Details) $ in Thousands	Sep. 30, 2018USD ($)
Long-Term Debt [Abstract]
2,018	$ 65
2,019	67
2,020	20
Total minimum lease payments	152
Less: amount representing estimated executory costs (such as taxes, maintenance and insurance), including profit thereon, included in total minimum lease payments	(5)
Net minimum lease payments	147
Less: amount representing interest	(5)	[1]
Present value of net minimum lease payments	142	[2]
Current obligations under capital leases	114
Noncurrent obligations under capital leases	$ 28
[1]	Amount necessary to reduce net minimum lease payments to present value calculated at the Company's incremental borrowing rate at lease inception.
[2]	Included in the balance sheet as $114,000 of the current portion of long-term debt and $28,000 of the long-term debt, less current portion.

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Income Taxes [Abstract]
Statutory federal tax rate	21.00%	35.00%	21.00%	35.00%	35.00%
Effective income tax rate	20.70%	32.20%	20.60%	32.10%
Increase in provisional valuation allowance related to Tax Cuts and Jobs Act	$ 0.2		$ 0.4

Income Taxes (Reconciliation of

Income Taxes (Reconciliation of Statutory Federal Tax Rate) (Details)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Components of Income Tax Expense (Benefit), Continuing Operations [Abstract]
Federal income tax at statutory rate	21.00%	35.00%	21.00%	35.00%	35.00%
State and local taxes, net of federal benefit	5.30%	4.40%	6.50%	4.90%
Jobs tax credits, net	(10.00%)	(7.70%)	(9.30%)	(7.50%)
Nondeductible permanent items	2.00%	0.50%	1.50%	0.50%
Other	2.40%		0.90%	(0.80%)
Effective income tax rate	20.70%	32.20%	20.60%	32.10%

Commitments and Contingencies (

Commitments and Contingencies (Narrative) (Details)	9 Months Ended
	Sep. 30, 2018
Commitments and Contingencies [Abstract]
Maximum term of employment agreements	4 years

Severance and Restructuring (Na

Severance and Restructuring (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Severance and Restructuring [Abstract]
Total expenses related to streamlining initiatives	$ 0.3	$ 0.6	$ 1.4	$ 1.5

Severance and Restructuring (Co

Severance and Restructuring (Components of and Changes in Severance and Restructuring Accruals) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Restructuring Cost and Reserve [Line Items]
Provision		$ 383
Employee Termination Costs [Member]
Restructuring Cost and Reserve [Line Items]
Balance at beginning of period	$ 562
Provision	610
Utilization	(856)
Balance at end of period	316
Restructuring and Other [Member]
Restructuring Cost and Reserve [Line Items]
Balance at beginning of period	1,077
Provision	285
Utilization	(755)
Balance at end of period	$ 607

Segment Information (Narrative)

Segment Information (Narrative) (Details)	9 Months Ended
	Sep. 30, 2018segment
Segment Information [Abstract]
Number of reportable 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, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Segment Reporting Information [Line Items]
Net service revenues	$ 137,631	$ 108,592	$ 378,315	$ 313,758
Cost of services revenues	100,926	79,539	277,985	228,877
Gross Profit	36,705	29,053	100,330	84,881
Provision for doubtful accounts	49	2,106	214	6,208
General and administrative expenses	28,218	19,359	76,084	57,239
Operating income	5,903	5,807	17,356	18,688
Other general and administrative expenses	15,694	11,402	43,739	33,110
Gain on sale of assets				(2,065)
Depreciation and amortization	2,535	1,781	6,676	4,811
Interest income	(113)	(30)	(2,468)	(50)
Interest Expense	1,543	870	3,836	3,629
Other income		(64)		(165)
Income before income taxes	4,473	5,031	15,988	15,274
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	12,524	7,957	32,345	24,129
Operating income	24,132	18,990	67,771	54,544
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues	128,094	108,592	362,606	313,758
Cost of services revenues	95,428	79,539	268,815	228,877
Gross Profit	32,666	29,053	93,791	84,881
Provision for doubtful accounts	48	2,106	210	6,208
Personal Care [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	10,446	7,957	29,073	24,129
Operating income	22,172	$ 18,990	64,508	$ 54,544
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues	7,116		11,765
Cost of services revenues	3,777		6,351
Gross Profit	3,339		5,414
Provision for doubtful accounts	1		3
Hospice [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	1,474		2,326
Operating income	1,864		3,085
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues	2,421		3,944
Cost of services revenues	1,721		2,819
Gross Profit	700		1,125
Provision for doubtful accounts			1
Home Health [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	604		946
Operating income	$ 96		$ 178

Significant Payors (Narrative)

Significant Payors (Narrative) (Details) - Illinois Department On Aging [Member]	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Revenues [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	29.50%	36.60%	31.80%	36.60%
Accounts Receivable [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			27.40%		37.50%

Significant Payors (Revenue by

Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Net service revenues	$ 137,631	$ 108,592	$ 378,315	$ 313,758
Personal Care [Member]
Net service revenues	128,094	108,592	362,606	313,758
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 128,094	$ 108,592	$ 362,606	$ 313,758
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | State, Local And Other Governmental Programs [Member]
Net service revenues	$ 73,606	$ 69,073	$ 213,011	$ 203,409
Concentration risk, percentage	57.50%	63.60%	58.70%	64.80%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 45,271	$ 36,866	$ 126,809	$ 102,055
Concentration risk, percentage	35.30%	34.00%	35.00%	32.50%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member]
Net service revenues	$ 5,549	$ 1,959	$ 14,861	$ 6,230
Concentration risk, percentage	4.30%	1.80%	4.10%	2.00%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues	$ 1,869	$ 694	$ 4,271	$ 2,064
Concentration risk, percentage	1.50%	0.60%	1.20%	0.70%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 1,799		$ 3,654
Concentration risk, percentage	1.40%		1.00%
Hospice [Member]
Net service revenues	$ 7,116		$ 11,765
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 7,116		$ 11,765
Concentration risk, percentage	100.00%		100.00%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 6,677		$ 11,030
Concentration risk, percentage	93.80%		93.80%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 426		$ 721
Concentration risk, percentage	6.00%		6.10%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 13		$ 14
Concentration risk, percentage	0.20%		0.10%
Home Health [Member]
Net service revenues	$ 2,421		$ 3,944
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 2,421		$ 3,944
Concentration risk, percentage	100.00%		100.00%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 2,184		$ 3,588
Concentration risk, percentage	90.20%		91.00%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 221		$ 329
Concentration risk, percentage	9.10%		8.30%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 16		$ 27
Concentration risk, percentage	0.70%		0.70%

Significant Payors (Percentage

Significant Payors (Percentage of Total Revenue by Geographic Location) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Net service revenues	$ 137,631	$ 108,592	$ 378,315	$ 313,758
Personal Care [Member]
Net service revenues	128,094	108,592	362,606	313,758
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 128,094	$ 108,592	$ 362,606	$ 313,758
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 58,863	$ 56,813	$ 174,457	$ 165,370
Concentration risk, percentage	46.00%	52.30%	48.20%	52.70%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Memebr]
Net service revenues	$ 16,814	$ 14,904	$ 47,999	$ 43,562
Concentration risk, percentage	13.10%	13.70%	13.20%	13.90%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 16,013	$ 10,645	$ 42,594	$ 24,854
Concentration risk, percentage	12.50%	9.80%	11.70%	7.90%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 36,404	$ 26,230	$ 97,556	$ 79,972
Concentration risk, percentage	28.40%	24.20%	26.90%	25.50%
Hospice [Member]
Net service revenues	$ 7,116		$ 11,765
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 7,116		$ 11,765
Concentration risk, percentage	100.00%		100.00%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 7,116		$ 11,765
Concentration risk, percentage	100.00%		100.00%
Home Health [Member]
Net service revenues	$ 2,421		$ 3,944
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 2,421		$ 3,944
Concentration risk, percentage	100.00%		100.00%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 2,421		$ 3,944
Concentration risk, percentage	100.00%		100.00%

Subsequent Events (Narrative) (

Subsequent Events (Narrative) (Details) $ in Millions	Oct. 31, 2018USD ($)
VIP Health Care Services [Member] | Subsequent Event [Member]
Subsequent Events [Line Items]
Business combination agreed purchase price	$ 28