Addus HomeCare (ADUS) 10-K 18 Mar 19 2018 FY Annual report Financial data

Document And Entity Information

Document And Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2018	Mar. 01, 2019	Jun. 30, 2018
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2018
Document Fiscal Period Focus	FY
Document Fiscal Year Focus	2018
Entity Registrant Name	Addus HomeCare Corp
Entity Central Index Key	0001468328
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 Shell Company	false
Entity Common Stock, Shares Outstanding		13,177,598
Entity Public Float			$ 443,506,647
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Current assets
Cash	$ 70,406	$ 53,754
Accounts receivable, net of allowances	108,000	93,533
Prepaid expenses and other current assets	7,098	8,379
Total current assets	185,504	155,666
Property and equipment, net of accumulated depreciation and amortization	10,658	7,489
Other assets
Goodwill	135,442	90,339
Intangibles, net of accumulated amortization	23,784	16,596
Deferred tax assets, net		1,601
Total other assets	159,226	108,536
Total assets	355,388	271,691
Current liabilities
Accounts payable	12,238	7,381
Current portion of long-term debt, net of debt issuance costs	62	3,099
Accrued expenses	49,204	44,596
Total current liabilities	61,504	55,076
Long-term liabilities
Long-term debt, less current portion, net of debt issuance costs	17,222	39,860
Deferred tax liabilities, net	494
Other long-term liabilities	635	446
Total long-term liabilities	18,351	40,306
Total liabilities	79,855	95,382
Stockholders’ equity
Common stock—$.001 par value; 40,000 authorized and 13,126 and 11,632 shares issued and outstanding as of December 31, 2018 and 2017, respectively	13	12
Additional paid-in capital	177,683	95,963
Retained earnings	97,837	80,334
Total stockholders’ equity	275,533	176,309
Total liabilities and stockholders’ equity	$ 355,388	$ 271,691

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2018	Dec. 31, 2017
Statement Of Financial Position [Abstract]
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	40,000,000	40,000,000
Common stock, shares issued	13,126,000	11,632,000
Common stock, shares outstanding	13,126,000	11,632,000

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Statement [Abstract]
Net service revenues	$ 518,119	$ 425,994	$ 400,929
Cost of service revenues	379,843	310,119	294,593
Gross profit	138,276	115,875	106,336
General and administrative expenses	105,025	76,902	76,840
Loss (gain) on sale of assets	38	(2,467)	0
Depreciation and amortization	8,642	6,663	6,647
Provision for doubtful accounts	272	8,409	7,373
Total operating expenses	113,977	89,507	90,860
Operating income from continuing operations	24,299	26,368	15,476
Interest income	(2,592)	(66)	(2,812)
Interest expense	5,016	4,472	2,332
Total interest expense (income), net	2,424	4,406	(480)
Other income	0	217	206
Income from continuing operations before income taxes	21,875	22,179	16,162
Income tax expense	4,498	8,645	4,099
Net income from continuing operations	17,377	13,534	12,063
Earnings from discontinued operations	126	147	97
Net income	$ 17,503	$ 13,681	$ 12,160
Basic income per share
Continuing operations	$ 1.44	$ 1.18	$ 1.06
Discontinued operations	0.01	0.01	0.01
Basic income per share	1.45	1.19	1.07
Diluted income per share
Continuing operations	1.40	1.16	1.06
Discontinued operations	0.01	0.01	0.01
Diluted income per share	$ 1.41	$ 1.17	$ 1.07
Weighted average number of common shares and potential common shares outstanding:
Basic	12,049	11,470	11,292
Diluted	12,383	11,623	11,349

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]
Balance at Dec. 31, 2015	$ 141,580	$ 11	$ 87,076	$ 54,493
Balance, shares at Dec. 31, 2015		11,108
Issuance of shares of common stock under restricted stock award agreements, Shares		108
Forfeiture of shares of common stock under restricted stock award agreements, shares		(69)
Stock-based compensation	1,072		1,072
Excess tax benefit from exercise of stock options	1,090		1,090
Shares issued for exercise of stock options	3,016	$ 1	3,015
Shares issued for exercise of stock options, shares		380
Net income	12,160			12,160
Balance at Dec. 31, 2016	158,918	$ 12	92,253	66,653
Balance, shares at Dec. 31, 2016		11,527
Issuance of shares of common stock under restricted stock award agreements, Shares		90
Forfeiture of shares of common stock under restricted stock award agreements, shares		(36)
Stock-based compensation	2,552		2,552
Shares issued for exercise of stock options	1,158		1,158
Shares issued for exercise of stock options, shares		51
Net income	13,681			13,681
Balance at Dec. 31, 2017	176,309	$ 12	95,963	80,334
Balance, shares at Dec. 31, 2017		11,632
Issuance of shares of common stock under restricted stock award agreements, Shares		78
Forfeiture of shares of common stock under restricted stock award agreements, shares		(16)
Stock-based compensation	4,109		4,109
Shares issued for exercise of stock options	994		994
Shares issued for exercise of stock options, shares		42
Shares issued in secondary offering, net of offering costs	76,618	$ 1	76,617
Shares issued in secondary offering, net of offering costs, shares		1,390
Net income	17,503			17,503
Balance at Dec. 31, 2018	$ 275,533	$ 13	$ 177,683	$ 97,837
Balance, shares at Dec. 31, 2018		13,126

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net income	$ 17,503	$ 13,681	$ 12,160
Adjustments to reconcile net income to net cash provided by (used in) operating activities, net of acquisitions:
Depreciation and amortization	8,642	6,663	6,647
Non-cash restructuring		383	2,550
Deferred income taxes	(43)	1,754	(1,328)
Stock-based compensation	4,109	2,552	1,072
Amortization of debt issuance costs under the terminated credit facility		1,484	357
Amortization of debt issuance costs under the credit facility	606	382
Provision for doubtful accounts	272	8,409	7,373
Contingent consideration	(847)
(Loss) gain on sale of assets	38	(2,467)	0
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	(2,169)	19,412	(33,601)
Prepaid expenses and other current assets	1,964	(2,364)	(282)
Accounts payable	4,235	1,103	(776)
Accrued expenses and other long-term liabilities	(1,107)	1,779	5,085
Net cash provided by (used in) operating activities	33,203	52,771	(743)
Cash flows from investing activities:
Proceeds from the sale of assets		3,702
Acquisitions of businesses, net of cash acquired	(62,440)	(24,354)	(20,026)
Purchases of property and equipment	(5,349)	(3,616)	(1,712)
Net cash used in investing activities	(67,789)	(24,268)	(21,738)
Cash flows from financing activities:
Borrowings on revolver- credit facility	20,000	30,000
Borrowings on revolver- terminated credit facility		20,000	27,000
Borrowings on term loan- credit facility	60,420	45,000
Borrowings on term loan- terminated credit facility			25,000
Payments on revolver- credit facility		(30,000)
Payments on revolver- terminated credit facility		(20,000)	(27,000)
Payments on term loan- credit facility	(104,858)	(563)
Payments on term loan- terminated credit facility		(24,063)	(938)
Payments on capital lease obligations	(1,013)	(1,432)	(1,175)
Payments for debt issuance costs under the credit facility	(923)	(2,862)
Payments for debt issuance costs under the terminated credit facility			(503)
Proceeds from issuance of common stock, net of issuance costs	76,618
Cash received from exercise of stock options	994	1,158	3,016
Excess tax benefit from exercise of stock options			1,090
Payment on contingent earn-out obligation			(100)
Net cash provided by financing activities	51,238	17,238	26,390
Net change in cash	16,652	45,741	3,909
Cash, at beginning of period	53,754	8,013	4,104
Cash, at end of period	70,406	53,754	8,013
Supplemental disclosures of cash flow information:
Cash paid for interest	4,339	2,261	2,322
Cash paid for income taxes	$ 4,314	6,838	5,087
Supplemental disclosures of non-cash investing and financing activities
Property and equipment acquired through capital lease obligations			618
Tax benefit related to the amortization of tax goodwill in excess of book basis		$ 206	$ 203

Significant Accounting Policies

Significant Accounting Policies	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Significant Accounting Policies	1. Significant Accounting Policies Basis of Presentation and Description of Business The Consolidated Financial Statements include the accounts of Addus HomeCare Corporation (“Holdings”) and its subsidiaries (together with Holdings, the “Company,” “we,” “us,” or “our”). The Company operates as three reportable business segments as a multi-state provider of personal care, hospice and home health services in the home. The Company’s personal care services provide non-medical assistance with activities of daily living, primarily persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill and disabled. The Company’s hospice segment provides physical, emotional and spiritual care for people who are terminally ill as well as for their families. The Company’s 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 Company’s payor clients include federal, state and local governmental agencies, managed care organizations, commercial insurers and private individuals. As of December 31, 2018, the Company provided services to over 39,000 consumers in 24 states through 156 offices. Principles of Consolidation All intercompany balances and transactions have been eliminated in consolidation. The Company used the cost method to account for its investments in joint ventures in which it owned 10% equity interests. The Company sold such investments on October 1, 2017. See Note 4, 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 Consolidated Balance Sheets. These reclassifications have no effect on the reported net income for the years ended December 31, 2018, 2017 and 2016. Revenue Recognition On January 1, 2018, the Company adopted Accounting Standards Update (“ASU”) 2014-09, Revenue from Contracts with Customers provision for doubtful accounts 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 aggregate cap limits the amount of Medicare reimbursement a hospice may receive, based on the number of Medicare patients served. For the year ended December 31, 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 mainly under contracts with Medicare and managed care organizations. 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 a 60-day episode 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 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. Accounts Receivable and We are paid for our services primarily by federal, state and local agencies under Medicaid programs, managed care organizations, commercial insurance companies and private consumers. While our accounts receivable are uncollateralized, our credit risk is somewhat limited due to the significance of governmental payors to our results of operations. Laws and regulations governing the governmental programs in which we participate are complex and subject to interpretation. Amounts collected may be different than amounts billed due to client eligibility issues, insufficient or incomplete documentation, services at levels other than authorized and other reasons unrelated to credit risk. 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 provision for doubtful accounts with Revenue from Contracts with Customers provision for doubtful accounts December 31, 2018 and 2017, t was $0.7 million and $10.5 million, which is included in the account receivable, net of allowances on the Company’s Consolidated Balance Sheets. 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 3—10 years Leasehold improvements Lesser of useful life or lease term 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 Intangible Assets The Company’s identifiable intangible assets consist of customer and referral relationships, trade names, trademarks, state licenses and non-compete agreements. The Company uses various valuation techniques to determine initial 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. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from three to twenty-five years 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. The Company estimates the fair value of these intangible assets using the income approach. In accordance with ASC Topic 350, Goodwill and Other Intangible Assets, intangible assets with indefinite useful lives are not amortized. We test intangible assets with indefinite useful lives 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. No impairment charge was recorded for the years ended December 31, 2018, 2017 or 2016. As of December 31, 2018 and 2017, intangibles, net of accumulated depreciation and amortization was $23.8 million and $16.6 million, respectively, included in the Company’s Consolidated Balance Sheets. 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. In accordance with ASU 2015-03, Simplifying the Presentation of Debt Issuance Costs, the Company has classified the debt issuance costs as current portion of long-term debt or long-term debt, less current portion as of December 31, 2018 and 2017. Workers’ Compensation Program The Company’s workers’ compensation insurance program has a $0.4 million deductible component. The Company recognizes its obligations associated with this program in the period the claim is incurred. The cost of both the claims reported and claims incurred but not reported, up to the deductible, have been accrued based on historical claims experience, industry statistics and an actuarial analysis performed by an independent third party. The Company monitors its claims quarterly and adjusts its reserves accordingly. These costs are recorded primarily as the cost of services on the Consolidated Statements of Income. As of December 31, 2018 and 2017, the Company recorded $15.2 million and $12.6 million, respectively, in accrued workers’ compensation insurance. The accrued workers’ compensation insurance is included in accrued expenses on the Company’s Consolidated Balance Sheets. As of December 31, 2018 and 2017, respectively, the Company recorded $1.7 million and $0.5 million, respectively, in workers’ compensation insurance recovery receivables. The workers’ compensation insurance recovery receivable is included in prepaid expenses and other current assets on the Company’s Consolidated Balance Sheets. 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. As the amount and timing of the receipt of these payments are not certain, the interest income is recognized when received and reported in the statement of income caption, “Interest income.” For the years ended December 31, 2018 and 2016, the Company received $2.3 million and $2.8 million, respectively, in prompt payment interest. For the year ended December 31, 2017, the Company did not receive any prompt payment interest. While the Company may be owed additional prompt payment interest in the future, the amount, timing and intent to provide receipt of such payments remains uncertain, and the Company will continue to recognize prompt payment interest income upon satisfaction of these constraints. 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 Consolidated Statement of Income when incurred. Other Income In fiscal year 2017 and 2016, other income consisted of income distributions received from investments in joint ventures. The Company recognized the net accumulated earnings only to the extent distributed by the joint ventures on the date received. Income Tax Expense The Company accounts for income taxes under the provisions of ASC Topic 740, Income Taxes. The Company recognizes interest and penalties accrued related to uncertain tax positions in interest expense and penalties within operating expenses on the Consolidated Statements of Income. Stock-based Compensation The Company currently has one stock incentive plan, the 2017 Omnibus Incentive Plan (the “2017 Plan”), under which new grants of stock-based employee compensation are made. The Company accounts for stock-based compensation in accordance with ASC Topic 718, Stock Compensation . Compensation expense is recognized, net of estimated forfeitures, on a straight-line basis under the 2017 Plan over the vesting period of the equity awards based on the grant date fair value of the options and restricted stock awards. Beginning January 1, 2017, the Company began utilizing the Black-Scholes Option Pricing Model to value the Company’s options, as the Company believes it is a more widely accepted and understood valuation model. Prior to January 1, 2017, the Company utilized the Enhanced Hull-White Trinomial Model to value our options. The determination of the fair value of stock-based payments utilizing the Black-Scholes Model and the Enhanced Hull-White Trinomial Model is affected by our stock price and a number of assumptions, including expected volatility, risk-free interest rate, expected term, expected dividends yield, expected forfeiture rate, expected turn-over rate and the expected exercise multiple. Stock-based compensation expense was $4.1 million, $2.5 million and $1.1 million for the years ended December 31, 2018, 2017 and 2016, respectively. 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 year ended December 31, 2018 were approximately 683,000 stock options outstanding, of which approximately 247,000 were dilutive. In addition, there were approximately 149,000 restricted stock awards outstanding, of which approximately 88,000 were dilutive for the year ended December 31, 2018. Included in the Company’s calculation of diluted earnings per share for the year ended December 31, 2017 were approximately 479,000 stock options outstanding, of which approximately 101,000 were dilutive. In addition, there were approximately 143,000 restricted stock awards outstanding, of which approximately 52,000 were dilutive for the year ended December 31, 2017. Included in the Company’s calculation of diluted earnings per share for the year ended December 31, 2016 were approximately 405,000 stock options outstanding, of which approximately 30,000 were dilutive. In addition, there were approximately 103,000 restricted stock awards outstanding, of which approximately 27,000 were dilutive for the year ended December 31, 2016. Estimates The financial statements are prepared by management in conformity with U.S. Generally Accepted Accounting Principles (“GAAP”) and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: implicit price concession, Fair Value Measurements The Company’s financial instruments consist of cash, accounts receivable, payables and debt. The carrying amounts reported on the Company’s 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 years ended December 31, 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. Recently Adopted Accounting Pronouncements In May 2014, the Accounting Standards Board (“FASB”) issued ASU 2014-09, Revenue from Contracts with Customers In August 2016, the FASB issued ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments. Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) ASU 2018-10, ASU 2018-11 and ASU 2018-20 (collectively will not have a material impact to our results of operations or liquidity In June 2016, the FASB issued ASU 2016-13, Financial Instruments—Credit Losses (Topic 326) Measurement of Credit Losses on Financial Instruments. In January 2017, the FASB issued ASU 2017-04, Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment. 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

Correction to Prior Period Fina

Correction to Prior Period Financial Statements	12 Months Ended
	Dec. 31, 2018
Accounting Changes And Error Corrections [Abstract]
Correction to Prior Period Financial Statements	2. Correction to Prior Period Financial Statements The Company identified errors in the Company’s previously issued Consolidated Financial Statements related to revenues and provision for doubtful accounts that resulted in a cumulative understatement of net income and stockholders’ equity of $1.2 million. Specifically, the cumulative errors included an understatement of revenues in the amount of $1.5 million, an understatement of provision for doubtful accounts of $0.1 million and an increase of $0.2 million in cumulative incremental tax expense. Additionally, the Company discovered overpayments by payors, which are to be refunded or utilized by the payor of $3.1 million that should have been reclassified from accounts receivable to accounts payable. In evaluating whether the previously issued Consolidated Financial Statements were materially misstated for the interim or annual periods prior to December 31, 2018, the Company applied the guidance of ASC 250, Accounting Changes and Error Corrections, SEC Staff Accounting Bulletin (“SAB”) Topic 1.M, Assessing Materiality and SAB Topic 1.N, Considering the Effects of Prior Year Misstatements when Quantifying Misstatements in Current Year Financial Statements and concluded that the effect of the errors on prior period financial statements was immaterial; however, the cumulative effect of correcting all of the prior period misstatements in the current year would be material to the current year consolidated financial statements. The guidance states that prior-year misstatements which, if corrected in the current year would materially misstate the current year’s financial statements, must be corrected by adjusting prior year financial statements, even though such correction previously was and continues to be immaterial to the prior-year financial statements. Correcting prior-year financial statements for such “immaterial misstatements” does not require previously filed reports to be amended. The cumulative effect of adjustments required to correct the misstatements in the financial statements years prior to 2017 are reflected in the revised opening retained earnings balance as of January 1, 2016. The cumulative effect of those adjustments on all periods prior to 2016 increased retained earnings as of January 1, 2016 by $1.0 million. Additionally, the Consolidated Statements of Income and Consolidated Statement of Cash Flows have been adjusted to reflect the correction for the years ended December 31, 2017 and December 31, 2016. The Company’s consolidated financial statements have been revised from the amounts previously reported to correct these errors as shown in the tables below. We also corrected our financial statements for each of the interim periods in the years ended December 31, 2018 and 2017, see Note 20. Consolidated Balance Sheet as of December 31, 2017 (in thousands): As Previously As Reported Corrections Revised Accounts receivable, net of allowances $ 88,952 $ 4,581 $ 93,533 Total assets 267,110 4,581 271,691 Accounts payable 4,271 3,110 7,381 Accrued expenses 44,354 242 44,596 Total liabilities 92,030 3,352 95,382 Total stockholders’ equity 175,080 1,229 176,309 Total liabilities and stockholders’ equity 267,110 4,581 271,691 Consolidated Statements of Income (in thousands): For the Years Ended December 31, 2017 2016 As As Previously As Previously As Reported Corrections Revised Reported Corrections Revised Net service revenues $ 425,715 $ 279 $ 425,994 $ 400,688 $ 241 $ 400,929 Gross profit 115,596 279 115,875 106,095 241 106,336 Provision for doubtful accounts 8,259 150 8,409 7,373 — 7,373 Total operating expenses 89,357 150 89,507 90,860 — 90,860 Operating income from continuing operations 26,239 129 26,368 15,235 241 15,476 Income from continuing operations before income taxes 22,050 129 22,179 15,921 241 16,162 Income tax expense 8,589 56 8,645 3,994 105 4,099 Net income from continuing operations 13,461 73 13,534 11,927 136 12,063 Net income $ 13,608 $ 73 $ 13,681 $ 12,024 $ 136 $ 12,160 Consolidated Statements of Cash Flows (in thousands): For the Years Ended December 31, 2017 2016 As As Previously As Previously As Reported Corrections Revised Reported Corrections Revised Net income $ 13,608 $ 73 $ 13,681 $ 12,024 $ 136 $ 12,160 Provision for doubtful accounts 8,259 150 8,409 7,373 — 7,373 Accounts receivable 21,023 (1,611 ) 19,412 (32,606 ) (995 ) (33,601 ) Accounts payable (229 ) 1,332 1,103 (1,530 ) 754 (776 ) Accrued expenses 1,723 56 1,779 4,980 105 5,085 Net cash provided by (used in) operating activities $ 52,771 $ — $ 52,771 $ (743 ) $ — $ (743 )

Secondary Offering

Secondary Offering	12 Months Ended
	Dec. 31, 2018
Class Of Stock Disclosures [Abstract]
Secondary Offering	3. Secondary Offering 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 shares of common stock, par value $0.001 per share at a purchase price per share to the public of $59.00. Pursuant to the terms and conditions of the Underwriting Agreement, 1,075,267 shares of Common Stock were issued and sold by the Company (the “Primary Shares”) and 1,024,733 shares of Common Stock were sold by the Selling Stockholder (the “Secondary Shares”). The Company received net proceeds of approximately $59.1 million from the sale of 1,075,267

Gain on Sale of Assets

Gain on Sale of Assets	12 Months Ended
	Dec. 31, 2018
Disposal Group Not Discontinued Operation Disposal Disclosures [Abstract]
Gain on Sale of Assets	4. Gain on Sale of Assets On October 1, 2017, the Company sold its 10% membership interests in two joint ventures with LHC Group, Inc. (“LHCG”), which were previously reported as Investments in joint ventures on the Company’s Consolidated Balance Sheets at December 31, 2016. The Company received proceeds of approximately $1.3 million and recorded a pre-tax gain of $0.4 million on the sale of its membership interest. In order to 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 adult day services centers in Illinois. The Company received proceeds of approximately $2.4 million and recorded a pre-tax gain of $2.1 million on the sale of the three adult day services centers.

Discontinued Operations

Discontinued Operations	12 Months Ended
	Dec. 31, 2018
Discontinued Operations And Disposal Groups [Abstract]
Discontinued Operations	5. Discontinued Operations Effective March 1, 2013, the Company sold substantially all of the assets used in its home health business (the “2013 Home Health Business”) in Arkansas, Nevada and South Carolina, and 90% of the 2013 Home Health Business in California and Illinois, to subsidiaries of LHC Group, Inc. (“LHCG”) for a cash consideration of $20.0 million. The Company held a 10% ownership interest in the 2013 Home Health Business in California and Illinois from March 1, 2013 to October 1, 2017, when it sold its interest as described in Note 4. On December 30, 2013, the Company sold one home health agency in Pennsylvania for approximately $0.2 million. The results of the 2013 Home Health Business and the Pennsylvania home health agency sold are reflected as discontinued operations for all periods presented herein. As a condition of the sale of the 2013 Home Health Business to subsidiaries of LHCG, the Company is responsible for any adjustments to Medicare and Medicaid billings prior to the closing of the sale. As of December 31, 2017, the related liability was $0.2 million, and the Company determined that no further accrual is required as of December 31, 2018. For the years ended December 31, 2018, 2017 and 2016, the Company reduced the indemnification reserve accrual by $0.2 million for each year, respectively, for periods no longer subject to Medicare audits. This amount is reflected as a reduction in general and administrative expense of discontinued operations and reflected in the table below. The following table presents the net service revenues and earnings attributable to discontinued operations, which include the financial results for the years ended December 31, 2018, 2017 and 2016: 2018 2017 2016 (Amounts in Thousands) Net service revenues $ — $ — $ — Income before income taxes 174 245 163 Income tax expense 48 98 66 Net income from discontinued operations $ 126 $ 147 $ 97

Acquisitions

Acquisitions	12 Months Ended
	Dec. 31, 2018
Business Combinations [Abstract]
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 million plus the amount of excess cash held by Ambercare at closing (approximately $12.0 million). The purchase of Ambercare was funded by a delayed draw term loan under the Company’s credit facility. With the purchase of Ambercare, the Company expanded its personal care operations and acquired hospice and home health operations in the state of New Mexico. Following this acquisition the Company operates a hospice segment and home health segment. The related acquisition costs of $0.8 million and integration cost of $1.6 million for the year ended December 31, 2018, were included in general and administrative expenses on the Company’s Consolidated Statements of Income, and were expensed as incurred. The results of Ambercare are included on the Company’s Consolidated Statements of Income from the date of the acquisition. The Company’s acquisition of Ambercare has been accounted for in accordance with ASC Topic 805, Business Combinations Goodwill and Other Intangible Assets intangible assets based on their estimated fair values. Based upon management’s valuation, which is preliminary and subject to the completion of working capital adjustments, the total purchase price has been allocated as follows Total (Amounts in Thousands) Goodwill $ 28,831 Cash 12,028 Identifiable intangible assets 9,944 Accounts receivable 6,512 Other assets 442 Property and equipment 154 Accrued liabilities (4,073 ) Deferred tax liability (2,138 ) Capital lease (75 ) 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 all of the outstanding stock of Ambercare. Identifiable intangible assets acquired consist of trade names and customer relationships, with the estimated useful lives of the respective assets ranging from three to fifteen years, as well as indefinite lived state licenses. 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 $36.7 million of net service revenues and $7.1 million of net income prior to corporate allocation for the year ended December 31, 2018. 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 million and was funded by a delayed draw term loan under the Company’s credit facility. The related acquisition costs were $0.8 million and $0.4 million for the years ended December 31, 2018 and 2017, respectively, and integration cost of $1.1 million for the year ended December 31, 2018, were included in general and administrative expenses on the Company’s Consolidated Statements of Income, and were expensed as incurred. The results of operations from this acquired entity are included in the Company’s Consolidated Statements of Income from the date of the acquisition. 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 the completion of working capital adjustments, Total (Amounts in Thousands) Goodwill $ 13,072 Accounts receivable 5,317 Identifiable intangible assets 2,264 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 and the estimated useful lives of the respective assets, which range from seven to fifteen years. 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 $32.7 million of net service revenues and $4.7 million of net income prior to corporate allocation for the year ended December 31, 2018. In September 2018, the Company acquired certain assets of affiliate branches of Arcadia for $0.6 million using cash on hand, the Company recorded goodwill of $0.6 million on the Company’s Consolidated Balance Sheets. Goodwill generated from the acquisition is primarily attributable to expected synergies with existing Company operations and the goodwill acquired is deductible for tax purposes. Pro forma results of the operations related to the acquisition are not included in the pro forma presentation as they are not material to the Company’s Consolidated Statements of Income. 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 million, comprised of $3.3 million in cash and $0.8 million, representing the estimated fair value of contingent consideration, subject to the achievement of certain performance targets set forth in an earn-out agreement. The related acquisition costs of $0.2 million for the year ended December 31, 2017, were included in general and administrative expenses on the Company’s Consolidated Statements of Income, and were expensed as incurred. The results of operations from this acquired entity are included in the Company’s Consolidated Statements of Income from the date of the acquisition. 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 and the estimated useful lives of the respective assets, which range from ten to fifteen years. 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 $5.8 million of net service revenues and $0.5 million of net income prior to corporate allocation for the year ended December 31, 2018. 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 an advantageous market. The total consideration for the transaction was comprised of $2.3 million in cash. The related acquisition costs were $0.1 million and $0.1 million for the years ended December 31, 2018 and 2017, respectively, were included in general and administrative expenses on the Company’s Consolidated Statements of Income, and were expensed as incurred. 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 Sun Cities’ 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 $ 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 presence of managed care payors in the market. Identifiable intangible assets acquired consist of trade name and customer relationships and the estimated useful lives of the respective assets, which range from seven to fifteen years. The Sun Cities acquisition accounted for $2.4 million and $0.7 million of net service revenues and $0.2 million and $14.8 thousands of net income prior to corporate allocation for the years ended December 31, 2018 and 2017, respectively. 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 million (the “Options Purchase Price”). Options Home Care is a provider of personal care services in more than 20 counties in New Mexico and the acquisition expands the footprint of the Company’s existing operations in the state. The related acquisition costs were $0.1 million and $0.7 million for the years ended December 31, 2018 and 2017, respectively, and integration costs of $0.1 million for the year ended December 31, 2017, were included in general and administrative expenses on the Company’s Consolidated Statements of Income, and were expensed as incurred. 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 were 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 presence of managed care payors in the market. Identifiable intangible assets acquired consist of trade name and customer relationships and the estimated useful lives of the respective assets, which range from three to ten years. The Options Home Care acquisition accounted for $17.8 million and $8.0 million of net service revenues and $3.4 million and $0.5 million of net income prior to corporate allocation for the years ended December 31, 2018 and 2017, respectively. The following table contains unaudited pro forma Consolidated Income Statement information of the Company as if each of the acquisitions of Ambercare, Arcadia, LifeStyle, Sun Cities and Options Home Care closed on January 1, 2017. For the Years Ended December 31, (Amounts in Thousands) 2018 2017 Net service revenues $ 550,326 $ 534,647 Operating income from continuing operations 36,985 33,293 Net income from continuing operations 24,346 10,174 Earnings from discontinued operations 126 147 Net income $ 24,472 $ 10,321 Net income per common share Basic income per share Continuing operations $ 2.02 $ 0.89 Discontinued operations 0.01 0.01 Basic income per share $ 2.03 $ 0.90 Diluted income per share Continuing operations $ 1.97 $ 0.88 Discontinued operations 0.01 0.01 Diluted income per share $ 1.98 $ 0.89 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.

Property and Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2018
Property Plant And Equipment [Abstract]
Property and Equipment	7. Property and Equipment Property and equipment consisted of the following: December 31, 2018 2017 (Amounts in Thousands) Computer equipment $ 3,768 $ 2,770 Furniture and equipment 3,161 3,392 Transportation equipment 156 152 Leasehold improvements 2,962 2,749 Computer software 6,712 3,269 16,759 12,332 Less: accumulated depreciation and amortization (6,101 ) (4,843 ) $ 10,658 $ 7,489 Computer software includes $1.3 million and $1.0 million of internally developed software for the years ended December 31, 2018 and 2017. Depreciation and amortization expense related to computer equipment and software and leasehold improvements totaled $2.5 million, $2.0 million and $1.7 million for the years ended December 31, 2018, 2017 and 2016, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	8. Goodwill and Intangible Assets The Company did not record any impairment charges for the years ended December 31, 2018, 2017 or 2016. The goodwill for the Company was $135.4 million and $90.3 million as of December 31, 2018 and 2017, respectively. See Note 6 for additional information regarding the acquisitions made by the Company for the years ending December 31, 2018 and 2017, respectively. A summary of goodwill and related adjustments is provided below: Goodwill Personal Care Hospice Home Health Total (Amounts In Thousands) Goodwill at December 31, 2016 $ 72,688 $ — $ — $ 72,688 Additions for acquisitions 17,857 — — 17,857 Adjustments to previously recorded goodwill (206 ) — — (206 ) Goodwill at December 31, 2017 90,339 — — 90,339 Additions for acquisitions 22,135 22,200 865 45,200 Adjustments to previously recorded goodwill (97 ) (97 ) Goodwill at December 31, 2018 $ 112,377 $ 22,200 $ 865 $ 135,442 The Company’s identifiable intangible assets consist of customer and referral relationships, trade names, trademarks and non-compete agreements. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from three to twenty-five years. Goodwill and certain state licenses are not amortized pursuant to ASC Topic 350. For the year ending December 31, 2018, adjustments to the previously recorded goodwill are primarily adjustments to accounts receivable based on the final valuations. For the year ending December 31, 2017, adjustments to the previously recorded goodwill are primarily credits related to amortization of tax goodwill in excess of book basis. The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following at December 31, 2018 and 2017: Customer and referral relationships Trade names and trademarks Non- competition agreements State Licenses Total (Amounts in Thousands) Gross balance at January 1, 2017 $ 34,672 $ 13,261 $ 2,155 $ — $ 50,088 Other (281 ) — — — (281 ) Additions for acquisitions 4,626 1,380 — — 6,006 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 Intangible assets with indefinite lives Additions for acquisitions — — — 2,871 2,871 Intangible assets subject to amortization Gross balances 39,017 14,641 2,155 — 55,813 Additions for acquisitions 3,339 6,910 — 241 10,490 Accumulated amortization, intangible assets subject to amortization (32,752 ) (10,638 ) (1,981 ) (19 ) (45,390 ) Net book value, intangible assets subject to amortization 9,604 10,913 174 222 20,913 Net Balance at December 31, 2018 $ 9,604 $ 10,913 $ 174 $ 3,093 $ 23,784 Amortization expense related to the identifiable intangible assets amounted to $6.2 million, $4.7 million and $4.9 million for the years ended December 31, 2018, 2017 and 2016, respectively. The weighted average remaining lives of identifiable intangible assets as of December 31, 2018 is 8.8 years. The estimated future intangible amortization expense is as follows: For the year ended December 31, Total (Amount in Thousands) 2019 $ 5,013 2020 3,400 2021 2,758 2022 1,724 2023 1,406 Thereafter 6,612 Total, intangible assets subject to amortization $ 20,913

Details of Certain Balance Shee

Details of Certain Balance Sheet Accounts	12 Months Ended
	Dec. 31, 2018
Details Of Certain Balance Sheet Accounts [Abstract]
Details of Certain Balance Sheet Accounts	9. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consist of the following: December 31, 2018 2017 (Amounts in Thousands) Prepaid workers’ compensation and liability insurance $ 1,840 $ 1,332 Workers’ compensation insurance receivable 1,692 543 Prepaid rent 1,191 555 Health insurance receivable 564 2,349 Other 1,811 3,600 $ 7,098 $ 8,379 Accrued expenses consisted of the following: December 31, 2018 2017 (Amounts in Thousands) Accrued payroll $ 22,449 $ 19,783 Accrued workers’ compensation insurance 15,169 12,574 Accrued health insurance (1) 3,926 6,471 Accrued professional fees 2,260 1,312 Accrued payroll taxes 769 1,065 Other 4,631 3,391 $ 49,204 $ 44,596 (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. Amounts due of $0.6 million and $2.3 million for health insurance reimbursements and contributions were reflected in prepaid insurance and accrued insurance at December 31, 2018 and 2017, respectively. The Company’s workers’ compensation program has a $0.4 million deductible component. The Company recognizes its obligations associated with this program in the period the claim is incurred. The cost of both the claims reported and claims incurred but not reported, up to the deductible, have been accrued based on historical claims experience, industry statistics and an actuarial analysis performed by an independent third party. The future claims payments related to the workers’ compensation program are secured by letters of credit. These letters of credit totaled $10.8 million and $11.8 million at December 31, 2018 and 2017.

Long-Term Debt

Long-Term Debt	12 Months Ended
	Dec. 31, 2018
Long Term Debt [Abstract]
Long-Term Debt	10. Long-Term Debt Long-term debt consisted of the following: December 31, 2018 2017 (Amounts in Thousands) Term loan under the credit facility $ — $ 44,438 Revolving loan under the credit facility 20,000 — Capital leases 81 1,002 Less unamortized issuance costs (2,797 ) (2,481 ) Total 17,284 42,959 Less current maturities (62 ) (3,099 ) Long-term debt $ 17,222 $ 39,860 Amended and Restated Senior Secured Credit Facility On October 31, 2018, the Company amended and restated its Existing Credit Agreement, as hereinafter defined (the “New Credit Agreement,” and together with the Existing Credit Agreement, our “credit facility”) 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 million, inclusive of a $250.0 million revolving loan and a $19.6 million delayed draw term loan, and amends and restates the Company’s existing senior secured credit facility totaling $250.0 million. The maturity of this amended and restated credit facility is May 8, 2023, with borrowing under the delayed draw term loan available until June 30, 2019. Interest on the Company’s amended and restated credit facility may be payable at (x) the sum of (i) an applicable margin ranging from 0.75% to 1.50% based on the applicable senior net leverage ratio plus (ii) a base rate equal to the greatest of (a) the rate of interest last quoted by The Wall Street Journal as the “prime rate,” (b) the sum of the federal funds rate plus a margin of 0.50% and (c) the sum of the adjusted LIBOR that would be applicable to a loan with an interest period of one month advanced on the applicable day (not to be less than 0.00%) plus a margin of 1.00% or (y) the sum of (i) an applicable margin ranging from 1.75% to 2.50% based on the applicable senior net leverage ratio plus (ii) the offered rate per annum for similar dollar deposits for the applicable interest period that appears on Reuters Screen LIBOR01 Page (not to be less than zero). Swing loans may not be LIBOR loans. The availability of additional draws under this amended and restated credit facility is conditioned, among other things, upon (after giving effect to such draws) the Total Net Leverage Ratio (as defined in the New Credit Agreement) not exceeding 3.75:1.00. In certain circumstances, in connection with a Material Acquisition (as defined in the New Credit Agreement), the Company can elect to increase its Total Net Leverage Ratio compliance covenant to 4.25:1.00 for the then current fiscal quarter and the three succeeding fiscal quarters. In connection with this amended and restated credit facility, the Company incurred approximately $0.9 million of debt issuance costs. 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% to 0.35% based on the applicable senior net leverage ratio times the unused portion of the revolving portion of the amended and restated credit facility. 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 million in any year absent of an event of default, plus limited exceptions for tax and administrative distributions), a restriction to consummate acquisitions under our credit facility if we exceed certain Total Net Leverage Ratio (as defined in the New Credit Agreement) thresholds without the consent of the lenders, restrictions on mergers, dispositions of assets, and affiliate transactions, and restrictions on fundamental changes and lines of business. As of December 31, 2018, the Company was in compliance with all of its New Credit Agreement covenants. During the year ended December 31, 2018, the Company drew a total of approximately of $60.4 million of delayed draws terms under its credit facility to fund the acquisition of Ambercare and Arcadia. As of December 31, 2018, the Company had a total of $20.0 million of revolving loans outstanding with an interest rate of 4.35% on our credit facility and the total availability under the revolving credit loan facility was $142.9 million. As of December 31, 2017, the Company had a total of $44.4 million of term loans outstanding with an interest rate of 3.86% on our credit facility and the total availability under the revolving credit loan facility was $105.1 million. Senior Secured Credit Facility Prior to October 31, 2018, the Company was party to a credit agreement (the “Existing Credit Agreement”) with certain lenders and Capital One, National Association, as a lender and swing lender and as agent for all lenders. This credit facility totals $250.0 million, replaced the Company’s previous senior secured credit facility totaling $125.0 million (“Terminated Senior Secured Credit Facility”, see description below for more details), and terminated the Company’s Second Amended and Restated Credit and Guaranty Agreement, dated as of November 10, 2015, as modified by the May 24, 2016 amendment, between the Company, certain lenders and Fifth Third Bank, as agent, which evidenced the Terminated Senior Secured Credit Facility. The credit facility was to mature on May 8, 2022, Addus HealthCare was the borrower, and its parent, Holdings, and substantially all of Holdings’ subsidiaries, were guarantors under the credit facility. The credit facility was secured by a first priority security interest in all of the Company’s and the other credit parties’ then and future tangible and intangible assets, including the shares of stock of the borrower and subsidiaries. Interest on the Company’s credit facility was payable at (x) the sum of (i) an applicable margin ranging from 1.50% to 2.25% based on the applicable senior leverage ratio plus (ii) a base rate equal to the greatest of (a) the rate of interest last quoted by The Wall Street Journal as the “prime rate,” (b) the sum of the federal funds rate plus a margin of 0.50% and (c) the sum of the adjusted LIBOR that would be applicable to a loan with an interest period of one month advanced on the applicable day (not to be less than 0.00%) plus a margin of 1.00% or (y) the sum of (i) an applicable margin ranging from 2.50% to 3.25% based on the applicable leverage ratio plus (ii) the offered rate per annum for the applicable interest period that appears on Reuters Screen LIBOR01 Page. Swing loans may not be LIBOR loans. 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. On October 31, 2018, we repaid in full the outstanding debt balance of $102.6 million together with accrued interest of $0.5 million and amended and restated the Existing Credit Agreement. Terminated Senior Secured Credit Facility Prior to May 8, 2017, the Company was a party to the Terminated Senior Secured Credit Facility with certain lenders and Fifth Third Bank, as agent and letters of credit issuer. The Terminated Senior Secured Credit Facility provided a $100.0 million revolving line of credit, a delayed draw term loan facility of up to $25.0 million and an uncommitted incremental term loan facility of up to $50.0 million, which was to expire on November 10, 2020 and included a $35.0 million sublimit for the issuance of letters of credit. Substantially all of the subsidiaries of Holdings were co-borrowers, and Holdings had guaranteed the borrowers’ obligations under the Terminated Senior Secured Credit Facility. The Terminated Senior Secured Credit Facility was secured by a first priority security interest in all of Holdings’ and the borrowers’ then and future tangible and intangible assets, including the shares of stock of the borrowers. On May 8, 2017, the Company repaid the outstanding debt balance of $23.8 million together with accrued interest of $0.1 million and terminated the Terminated Senior Secured Credit Facility. In connection with the termination, the Company wrote off the unamortized debt issuance costs under the Terminated Senior Secured Credit Facility in the amount of $1.3 million, which was included in interest expense on the Company’s Consolidated Statements of Income. For the period January 1, 2017 through May 7, 2017, the Company drew and subsequently repaid $20.0 million of the Company’s revolving credit line to fund operations. As of December 31, 2016, the Company had a total of $24.1 million outstanding on the Terminated Senior Secured Credit Facility and the total availability under the revolving credit loan facility was $79.7 million. Capital Leases As of December 31, 2018 and 2017 the Company has various capital leases (the underlying assets are included in “Property and equipment net of accumulated depreciation and amortization” in the accompanying Consolidated Balance Sheets). The capital lease obligations totaled $0.1 million and $1.1 million at December 31, 2018 and 2017, respectively. These require monthly payments through August 2020 and have implicit interest rates that range from 3.64% to 7.72%. At the end of the term, the Company has the option to purchase the assets for $1 per lease agreement.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Income Taxes	11. Income Taxes The current and deferred federal and state income tax provision from continuing operations, are comprised of the following: December 31, 2018 2017 2016 (Amounts in Thousands) Current Federal $ 2,969 $ 5,828 $ 4,486 State 1,588 1,079 927 Deferred Federal (47 ) 1,672 (1,147 ) State (12 ) 66 (167 ) Provision for income taxes $ 4,498 $ 8,645 $ 4,099 The tax effects of certain temporary differences between the Company’s book and tax bases of assets and liabilities give rise to significant portions of the deferred income tax assets (liabilities) at December 31, 2018 and 2017. The deferred tax assets (liabilities) consisted of the following: December 31, 2018 2017 (Amounts in Thousands) Deferred tax assets Long-term Accounts receivable allowances $ 4,118 $ 2,917 Accrued compensation 2,257 1,919 Accrued workers’ compensation 3,677 3,274 Transaction costs 1,020 898 Reserves — 47 Restructuring costs 160 293 Stock-based compensation 576 811 Other 279 138 Total long-term deferred tax assets 12,087 10,297 Deferred tax liabilities Long-term Goodwill and intangible assets (11,048 ) (7,301 ) Property and equipment (903 ) (749 ) Prepaid insurance (508 ) (359 ) Other (122 ) (1 ) Total long-term deferred tax liabilities (12,581 ) (8,410 ) Valuation allowance — (286 ) Total net deferred tax assets/(liabilities) $ (494 ) $ 1,601 Management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income in making this assessment. A reconciliation for continuing operation of the statutory federal tax rate of 21.0%, 35.0% and 35.0% and to the effective income tax rate, for the years ended December 31, 2018, 2017, and 2016, is summarized as follows: December 31, 2018 2017 2016 Federal income tax at statutory rate 21.0 % 35.0 % 35.0 % State and local taxes, net of federal benefit 6.3 5.1 5.2 Jobs tax credits, net (10.0 ) (6.1 ) (15.8 ) 162(m) disallowance for executive compensation 4.2 1.3 — Nondeductible permanent items 2.1 0.4 0.9 2017 Tax Reform Act — 4.0 — Excess tax benefit (2.6 ) (0.6 ) — Other (0.4 ) (0.1 ) 0.2 Effective income tax rate 20.6 % 39.0 % 25.5 % 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 changed U.S. tax law by, among other things, lowering corporate income tax rates. The Tax Reform Act permanently reduced the U.S. corporate income tax rate from a maximum of 35.0% to a flat 21.0% rate, effective January 1, 2018. The effective income tax rate was 20.6%, 39.0% and 25.5% for the years ended December 31, 2018, 2017 and 2016, respectively. The difference between our federal statutory and effective income tax rates are principally due to the inclusion of state taxes and the use of federal employment tax credits. Shortly after the “Tax Reform Act” was enacted, the SEC staff issued Staff Accounting Bulletin No. 118, “Income Tax Accounting Implications of the Tax Cuts and Jobs Act” (“SAB 118”), which provides guidance on accounting for the Tax Act’s impact. SAB 118 provided a measurement period, which in no case should extend beyond one year from the Tax Act enactment date, during which a company acting in good faith may complete the accounting for the impacts of the Tax Act under ASC Topic 740. In accordance with the expiration of the SAB 118 measurement period, we completed the assessment of the income tax effects of the Tax Act in the fourth quarter of 2018, with no adjustments recorded to the provisional amounts. The Company is subject to taxation in the jurisdictions in which it operates. The Company continues to remain subject to examination by U.S. federal authorities for the years 2015 through 2017 and for various state authorities for the years 2013 through 2017. The total amount of unrecognized tax benefits under ASC Topic 740 at December 31, 2018 was $0.2 million. If recognized, the entire amount would favorably impact the effective tax rate in future periods. Interest and penalties related to income tax liability are recognized in interest expense and general and administrative expense, respectively. The company does not anticipate that the total amount of unrecognized tax benefits will significantly increase or decrease the effective tax rate within 12 months of December 31, 2018. A reconciliation of the gross unrecognized tax benefits (excluding interest and penalties) for the years ended December 31, 2018, 2017, and 2016 follows: 2018 2017 2016 (Amounts in Thousands) Balance as of January 1, $ 261 $ 210 $ 113 Additions for current year tax positions — 51 97 Increases for prior year tax positions — — — Settlements of prior year tax positions — — — Expiration of statutes (40 ) — — Balance as of December 31, $ 221 $ 261 $ 210

Stock Options And Restricted St

Stock Options And Restricted Stock Awards	12 Months Ended
	Dec. 31, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Options And Restricted Stock Awards	12. Stock Options and Restricted Stock Awards The Board approved the 2017 Omnibus Incentive Plan (“the 2017 Plan”) as of April 27, 2017, which was approved by our shareholders on June 14, 2017. The 2017 Plan was intended to replace our existing incentive compensation plan, the 2009 Stock Incentive Plan. Outstanding awards under the 2009 Plan will continue to be governed by the 2009 Plan and the agreements under which they were granted. The 2009 Plan authorized the issuance of up to 1,500,000 shares of the Company’s stock. The 2017 Plan, like the 2009 Plan, allows us to grant performance-based incentive awards and equity-based awards (each an “Award”) to eligible employees, directors and consultants in the form of Stock Options, Stock Appreciation Rights, Restricted Stock, Deferred Stock Units/Restricted Stock Units, Other Stock Units or Performance Awards. The Board believes that the 2017 Plan is necessary to continue the Company’s effectiveness in attracting, motivating and retaining employees, directors and consultants with appropriate experience and to increase the grantees’ alignment of interest with the shareholders. Under the 2017 Plan, Awards may be made in shares of our common stock. Subject to adjustment as provided by the terms of the 2017 Plan, the maximum aggregate number of shares of common stock with respect to which awards may be granted under the 2017 Plan will be 1,182,270, less the number of shares subject to awards that are granted pursuant to the 2009 Plan after March 31, 2017. The aggregate awards granted during any calendar year to any single Participant cannot exceed (i) 500,000 shares subject to stock options or stock appreciation rights (“SARs”) or (ii) 300,000 shares subject to Awards denominated in shares of common stock (whether or not settled in common stock). These individual annual limitations are cumulative in that any shares of common stock or cash for which Awards are permitted to be granted to a Participant during a fiscal year are not covered by an Award in that fiscal year, the number of shares of common stock will automatically increase in the subsequent fiscal years during the term of the 2017 Plan until the earlier of the time the increase has been granted to the Participant, or the end of the third fiscal year following the year to which such increase relates. Any shares of common stock subject to an Award under the 2017 Plan that are forfeited, canceled, settled in cash or otherwise terminated without a distribution of shares to a participant, or that are delivered by attestation or withheld by the Company in connection with an option exercise or the payment of any required income tax withholding upon an option exercise or the vesting of restricted stock, will be deemed available for Awards under the 2017 Plan. Additionally, any shares of common stock subject to an Award under the 2009 Plan that are forfeited, canceled, settled in cash or otherwise terminated without a distribution of shares to a participant, or that are delivered by attestation or withheld by the Company in connection with an option exercise or the payment of any required income tax withholding upon an option exercise or the vesting of restricted stock, will be deemed available for Awards under the 2017 Plan. Stock options were awarded with a strike price at the fair market value equal to the closing price of our common stock on the date of grant for both the 2009 and 2017 Plans. Options granted under the 2009 and 2017 Plans typically vest over a service period ranging from three to four years and expire ten years from the date of grant. Restricted shares granted under the 2009 and 2017 Plans typically vest over a service period ranging from one to four years and expire ten years from date of grant. The exercise price of stock options outstanding on December 31, 2018 range from $4.62 to $71.00. Restricted stock awards are full-value awards. There were 0.8 million shares available for grant under the 2017 Plan at December 31, 2018. Stock Options A summary of stock option activity and weighted average exercise price is as follows: For The Year Ended December 31, 2018 Options (Amounts in Thousands) Weighted Average Exercise Price Outstanding, beginning of period 479 $ 23.91 Granted 278 38.10 Exercised (42 ) 23.50 Forfeited/Cancelled (32 ) 26.20 Outstanding, end of period 683 $ 29.60 The weighted-average estimated fair value of employee stock options granted as calculated using the Black-Scholes Option Pricing Model in 2018 and 2017 and the Enhanced Hull-White Trinomial Model in 2016, and the related assumptions follow: For the Year Ended December 31, 2018 2017 2016 Grants Grants Grants Weighted average fair value $ 14.72 $ 12.97 $ 9.32 Risk-free discount rate 2.32% - 2.84% 1.67% - 1.85% 1.70% - 2.02% Expected life 4.1 - 4.2 years 3.6 - 4.2 years 8.2 years Dividend yield — — — Volatility 45% 47% 47% Expected turn-over rate N/A N/A 2% Expected exercise multiple N/A N/A 2.2 Stock option compensation expense totaled $2.0 million, $1.1 million and $0.6 million for the years ended December 31, 2018, 2017 and 2016, respectively. As of December 31, 2018, there was $4.7 million of total unrecognized compensation cost that is expected to be recognized over a weighted average period of 2.2 years. The intrinsic value of vested and outstanding stock options was $8.5 million and $17.7 million as of December 31, 2018. As of December 31, 2018, there were 180,442 and 502,687 shares of stock options vested and unvested respectively. The intrinsic value of stock options exercised during the year ended December 31, 2018, 2017 and 2016 was $1.8 million, $0.5 million and $3.9 million, respectively. Restricted Stock Awards The following table summarizes the status of unvested restricted stock awards outstanding at December 31, 2018: For The Year Ended December 31, 2018 Restricted Stock Awards (Amounts in Thousands) Weighted Average Grant Date Fair Value Unvested restricted stock awards, beginning of period 143 $ 29.30 Awarded 77 42.70 Vested (55 ) 30.10 Forfeited (16 ) 28.00 Unvested restricted stock awards, end of period 149 $ 36.10 The fair market value of restricted stock awards that vested during the year ended December 31, 2018 was $2.0 million. Restricted stock award compensation expense totaled $2.1 million, $1.4 million and $0.5 million for the years ended December 31, 2018, 2017 and 2016, respectively. As of December 31, 2018, there was $3.7 million of total unrecognized compensation costs that are expected to be recognized over a weighted average period of 1.8 years.

Operating Leases

Operating Leases	12 Months Ended
	Dec. 31, 2018
Leases Operating [Abstract]
Operating Leases	13. Operating Leases The Company leases its branch office space under various operating leases that expire at various dates through 2025. The Company also leases office space in Frisco, TX and Downers Grove, IL which both serve as support centers. The Company is typically responsible for real estate taxes, maintenance, insurance and common area costs. A number of the office leases also contain escalation and renewal option clauses. Aggregate rental expense for all operating leases amounted to $6.0 million, $3.9 million and $3.8 million for the years ended December 31, 2018, 2017 and 2016, respectively. The following is a schedule of the future minimum payments under non-cancelable operating leases, exclusive of taxes and other operating expenses. Rent (Amount in Thousands) 2019 $ 6,374 2020 4,820 2021 3,460 2022 2,377 2023 2,130 Thereafter 1,382 Total $ 20,543 We have a sublease related to our leased space in Downers Grove. During the years ended December 31, 2018 and 2017, we recognized sublease income of $0.3 million and $0.1 million, respectively .

Employee Benefit Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2018
Compensation And Retirement Disclosure [Abstract]
Employee Benefit Plans	14. Employee Benefit Plans The 401(k) retirement plan is a defined contribution plan that provides for matching contributions by the Company to all non-union employees. Matching contributions are discretionary and subject to change by management. Under the provisions of the 401(k) plan, employees can contribute up to the maximum percentage and limits allowable under the U.S. Revenue Code. The Company provided a matching contribution, equal to 6.0% of the employees’ contributions, totaling $0.3 million, $44.0 thousand and $31.1 thousand for the years ended December 31, 2018, 2017 and 2016, respectively. The Company acquired Ambercare on May 1, 2018. During the year ended December 31, 2018, Ambercare accounted for $0.2 million of the Company’s matching contribution.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2018
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	15. 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 our Consolidated Balance Sheets and 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 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 During 2017, the Company entered into employment agreements with certain members of senior management. The terms of these agreements are up to four years with the potential to auto-renew and include non-compete and nondisclosure provisions, as well as provide for defined severance payments in the event of termination. 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. A substantial percentage of the Company’s workforce is represented by the Service Employees International Union (“SEIU”) through local collective bargaining agreements. These agreements are re-negotiated at various intervals. 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	12 Months Ended
	Dec. 31, 2018
Restructuring And Related Activities [Abstract]
Severance and Restructuring	16. Severance and Restructuring 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. In 2016, the Company initiated steps to streamline its operations. The Company incurred total expenses related to these initiatives of approximately $1.9 million, $1.7 million and $8.0 million for the years ended December 31, 2018, 2017 and 2016, respectively. The expenses recorded for the year ended December 31, 2018, primarily relates to terminated employees resulting mainly from changes made to the management team during the year and other professional fees. The expenses recorded for the year ended December 31, 2017 included costs related to terminate employees resulting mainly from changes made to the management team made during the year, fees related to the termination of professional services relationships, other contract termination costs and asset write-offs. The expenses recorded for the year ended December 31, 2016 included costs related to terminated employees as a result primarily of the closure of the contact center and other changes made to the executive leadership team made during the year and other direct costs associated with implementing these initiatives including contract termination costs, accelerated depreciation and asset write-offs. The following provides the components of and changes in our severance and restructuring accruals: Employee Termination Costs Restructuring and Other (Amounts in Thousands) Balance at December 31, 2016 $ 1,326 $ 1,786 Provision 1,038 627 Utilization (1,802 ) (1,336 ) Balance at December 31, 2017 $ 562 $ 1,077 Provision 647 564 Utilization (1,129 ) (1,056 ) Balance at December 31, 2018 $ 80 $ 585 The aforementioned accruals are included in accrued expenses on the Consolidated Balance Sheets and the aforementioned expenses are included in general and administrative expenses on the Consolidated Statements of Income. The remaining employee termination costs accrual, as of December 31, 2018 is expected to be paid by the end of 2019.

Segment Information

Segment Information	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Segment Information	17. 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 a company’s chief operating decision makers, to assess the performance of the individual segments and make decisions about resources to be allocated to the segments. Our operations involve servicing patients through our three reportable business segments: personal care, hospice and home health. As a result of the acquisition of Ambercare on May 1, 2018, we began reporting the hospice and home health segments. 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 years ended December 31, 2018, 2017 and 2016 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 Year Ended December 31, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 492,413 $ 18,850 $ 6,856 $ 518,119 Cost of services revenues 365,264 10,010 4,569 379,843 Gross profit 127,149 8,840 2,287 138,276 Provision for doubtful accounts 265 5 2 272 General and administrative expenses 44,463 3,737 1,543 49,743 Segment operating income $ 82,421 $ 5,098 $ 742 $ 88,261 For the Year Ended December 31, 2017 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 425,994 $ — $ — $ 425,994 Cost of services revenues 310,119 — — 310,119 Gross profit 115,875 — — 115,875 Provision for doubtful accounts 8,409 — — 8,409 General and administrative expenses 35,655 — — 35,655 Segment operating income $ 71,811 $ — $ — $ 71,811 For the Year Ended December 31, 2016 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 400,929 $ — $ — $ 400,929 Cost of services revenues 294,593 — — 294,593 Gross profit 106,336 — — 106,336 Provision for doubtful accounts 7,373 — — 7,373 General and administrative expenses 37,927 — — 37,927 Segment operating income $ 61,036 $ — $ — $ 61,036 For the Years Ended December 31, (Amounts in Thousands) 2018 2017 2016 Segment Reconciliation: Total segment operating income $ 88,261 $ 71,811 $ 61,036 Items not allocated at segment level: Other general and administrative expenses 55,282 41,247 38,913 Loss (gain) on sale of assets 38 (2,467 ) — Depreciation and amortization 8,642 6,663 6,647 Interest income (2,592 ) (66 ) (2,812 ) Interest expense 5,016 4,472 2,332 Other income — (217 ) (206 ) Income before income taxes $ 21,875 $ 22,179 $ 16,162

Significant Payors

Significant Payors	12 Months Ended
	Dec. 31, 2018
Significant Payors [Abstract]
Significant Payors	18. Significant Payors For 2018, 2017 and 2016, our revenue by payor type was as follows: Personal Care 2018 2017 2016 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues State, local and other governmental programs $ 286,787 58.2 % $ 273,525 64.2 % $ 282,540 70.5 % Managed care organizations 173,884 35.3 140,993 33.1 104,413 26.0 Private pay 20,060 4.1 8,739 2.1 9,644 2.4 Commercial insurance 6,190 1.3 2,737 0.6 4,332 1.1 Other 5,492 1.1 — — — — Total personal care segment net service revenues $ 492,413 100.0 % $ 425,994 100.0 % $ 400,929 100.0 % Hospice 2018 Amount (in Thousands) % of Segment Net Service Revenues Medicare $ 17,652 93.6 % Managed care organizations 1,047 5.6 Other 151 0.8 Total segment net service revenues $ 18,850 100.0 % Home Health 2018 Amount (in Thousands) % of Segment Net Service Revenues Medicare $ 6,034 88.0 % Managed care organizations 752 11.0 Other 70 1.0 Total segment net service revenues $ 6,856 100.0 % The Company derives a significant amount of its net service revenues from its operations in Illinois, New York and New Mexico. The percentages of total revenue for each of these significant states for 2018, 2017 and 2016 were as follows: Personal Care 2018 2017 2016 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Illinois $ 233,990 47.5 % $ 224,257 52.6 % $ 215,162 53.6 % New York 65,117 13.2 37,588 8.8 51,718 12.9 New Mexico 58,914 12.0 58,360 13.7 29,924 7.5 All other states 134,392 27.3 105,789 24.9 104,125 26.0 Total personal care segment net service revenues $ 492,413 100.0 % $ 425,994 100.0 % $ 400,929 100.0 % Hospice 2018 Amount (in Thousands) % of Segment Net Service Revenues New Mexico $ 18,850 100.0 % Total hospice segment net service revenues $ 18,850 100.0 % Home Health 2018 Amount (in Thousands) % of Segment Net Service Revenues New Mexico $ 6,856 100.0 % Total home health segment net service revenues $ 6,856 100.0 % A substantial portion of the Company’s net service revenues and accounts receivables are derived from services performed for federal, state and local governmental agencies. The Illinois Department on Aging accounted for 31.0%, 36.5% and 42.1% of the Company’s net service revenues for 2018, 2017, and 2016, respectively. The related receivables due from the Illinois Department on Aging represented 22.5% and 37.5% of the Company’s net accounts receivable at December 31, 2018 and 2017, respectively.

Concentration of Cash

Concentration of Cash	12 Months Ended
	Dec. 31, 2018
Risks And Uncertainties Abstract
Concentration of Cash	19. Concentration of Cash The Company owns financial instruments that potentially subject the Company to significant concentrations of credit risk include 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.

Unaudited Summarized Quarterly

Unaudited Summarized Quarterly Financial Information	12 Months Ended
	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Unaudited Summarized Quarterly Financial Information	20. Unaudited Summarized Quarterly Financial Information The following is a summary of the Company’s unaudited quarterly results of operations. See Note 2. Corrections to Prior Period Financial Statements. Year Ended December 31, 2018 Year Ended December 31, 2017 Dec. 31 Sept. 30 Jun. 30 Mar. 31 Dec. 31 Sept. 30 Jun. 30 Mar. 31 (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 139,669 $ 137,716 $ 131,258 $ 109,476 $ 112,028 $ 108,662 $ 103,629 $ 101,675 Gross profit 37,810 36,790 35,743 27,933 30,785 29,123 28,581 27,386 Operating income from continuing operations 6,809 5,988 6,913 4,589 7,470 5,877 5,991 7,030 Net income from continuing operations 4,542 3,631 4,318 4,886 3,000 3,464 2,756 4,314 Earnings from discontinued operations 126 — — — 147 — — — Net income $ 4,668 $ 3,631 $ 4,318 $ 4,886 $ 3,147 $ 3,464 $ 2,756 $ 4,314 Average shares outstanding: Basic 12,964 12,179 11,533 11,502 11,488 11,486 11,470 11,434 Diluted 13,381 12,569 11,838 11,696 11,638 11,631 11,622 11,581 Income per common share: Basic Continuing operations $ 0.35 $ 0.29 $ 0.37 $ 0.42 $ 0.26 $ 0.30 $ 0.24 $ 0.38 Discontinued operations 0.01 — — — 0.01 — — — Basic net income per share $ 0.36 $ 0.29 $ 0.37 $ 0.42 $ 0.27 $ 0.30 $ 0.24 $ 0.38 Diluted net income per share Continuing operations $ 0.34 $ 0.28 $ 0.36 $ 0.42 $ 0.26 $ 0.29 $ 0.24 $ 0.37 Discontinued operations 0.01 — — — 0.01 — — — Diluted net income per share $ 0.35 $ 0.28 $ 0.36 $ 0.42 $ 0.27 $ 0.29 $ 0.24 $ 0.37 As described in Note 2 above, the Company identified errors in the Company’s previously issue Consolidated Financial Statements related to revenues and provision for doubtful accounts. The following are the effects of the corrections, of the errors on the Company’s unaudited quarterly results of operations. For the Three Months Ended March 31, 2018 For the Three Months Ended March 31, 2017 Previously reported Adjusted As adjusted Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 109,448 $ 28 $ 109,476 $ 101,606 $ 69 $ 101,675 Gross profit 27,905 28 27,933 27,317 69 27,386 Operating income from continuing operations 4,561 28 4,589 6,961 69 7,030 Net income from continuing operations 4,858 28 4,886 4,259 55 4,314 Net income 4,858 28 4,886 4,259 55 4,314 Income per common share: Basic $ 0.42 $ — $ 0.42 $ 0.37 $ 0.01 $ 0.38 Diluted $ 0.42 $ — $ 0.42 $ 0.37 $ — $ 0.37 For the Three Months Ended June 30, 2018 For the Three Months Ended June 30, 2017 Previously reported Adjusted As adjusted Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 131,237 $ 21 $ 131,258 $ 103,559 $ 70 $ 103,629 Gross profit 35,722 21 35,743 28,511 70 28,581 Operating income from continuing operations 6,892 21 6,913 5,921 70 5,991 Net income from continuing operations 4,297 21 4,318 2,700 56 2,756 Net income 4,297 21 4,318 2,700 56 2,756 Income per common share: Basic $ 0.37 $ — $ 0.37 $ 0.24 $ — $ 0.24 Diluted $ 0.36 $ — $ 0.36 $ 0.23 $ 0.01 $ 0.24 For the Three Months Ended September 30, 2018 For the Three Months Ended September 30, 2017 Previously reported Adjusted As adjusted Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 137,631 $ 85 $ 137,716 $ 108,592 $ 70 $ 108,662 Gross profit 36,705 85 36,790 29,053 70 29,123 Operating income from continuing operations 5,903 85 5,988 5,807 70 5,877 Net income from continuing operations 3,546 85 3,631 3,408 56 3,464 Net income 3,546 85 3,631 3,408 56 3,464 Income per common share: Basic $ 0.29 $ — $ 0.29 $ 0.30 $ — $ 0.30 Diluted $ 0.28 $ — $ 0.28 $ 0.29 $ — $ 0.29 For the Three Months Ended December 30, 2017 Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 111,958 $ 70 $ 112,028 Gross profit 30,715 70 30,785 Operating income from continuing operations 7,550 (80 ) 7,470 Net income from continuing operations 3,094 (94 ) 3,000 Net income 3,241 (94 ) 3,147 Income per common share: Basic $ 0.28 $ (0.01 ) $ 0.27 Diluted $ 0.28 $ (0.01 ) $ 0.27

Valuation And Qualifying Accoun

Valuation And Qualifying Accounts	12 Months Ended
	Dec. 31, 2018
Valuation And Qualifying Accounts [Abstract]
Valuation And Qualifying Accounts	(Amounts in Thousands) Allowance for doubtful accounts Balance at beginning of period Additions/ charges Deductions* Balance at end of period Year ended December 31, 2018 Allowance for doubtful accounts $ 10,537 272 10,138 $ 671 Year ended December 31, 2017 Allowance for doubtful accounts $ 7,363 8,259 5,085 $ 10,537 Year ended December 31, 2016 Allowance for doubtful accounts $ 4,850 7,373 4,860 $ 7,363 * Write-offs, net of recoveries 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 provision for doubtful accounts with the adoption of ASU 2014-09, Revenue from Contracts with Customers

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation All intercompany balances and transactions have been eliminated in consolidation. The Company used the cost method to account for its investments in joint ventures in which it owned 10% equity interests. The Company sold such investments on October 1, 2017. See Note 4, 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 Consolidated Balance Sheets. These reclassifications have no effect on the reported net income for the years ended December 31, 2018, 2017 and 2016.
Revenue Recognition	Revenue Recognition On January 1, 2018, the Company adopted Accounting Standards Update (“ASU”) 2014-09, Revenue from Contracts with Customers provision for doubtful accounts 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 aggregate cap limits the amount of Medicare reimbursement a hospice may receive, based on the number of Medicare patients served. For the year ended December 31, 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 mainly under contracts with Medicare and managed care organizations. 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 a 60-day episode 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 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.
Accounts Receivable and Allowance for Doubtful Accounts	Accounts Receivable and We are paid for our services primarily by federal, state and local agencies under Medicaid programs, managed care organizations, commercial insurance companies and private consumers. While our accounts receivable are uncollateralized, our credit risk is somewhat limited due to the significance of governmental payors to our results of operations. Laws and regulations governing the governmental programs in which we participate are complex and subject to interpretation. Amounts collected may be different than amounts billed due to client eligibility issues, insufficient or incomplete documentation, services at levels other than authorized and other reasons unrelated to credit risk. 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 provision for doubtful accounts with Revenue from Contracts with Customers provision for doubtful accounts December 31, 2018 and 2017, t was $0.7 million and $10.5 million, which is included in the account receivable, net of allowances on the Company’s Consolidated Balance Sheets.
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 3—10 years Leasehold improvements Lesser of useful life or lease term
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
Intangible Assets	Intangible Assets The Company’s identifiable intangible assets consist of customer and referral relationships, trade names, trademarks, state licenses and non-compete agreements. The Company uses various valuation techniques to determine initial 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. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from three to twenty-five years 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. The Company estimates the fair value of these intangible assets using the income approach. In accordance with ASC Topic 350, Goodwill and Other Intangible Assets, intangible assets with indefinite useful lives are not amortized. We test intangible assets with indefinite useful lives 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. No impairment charge was recorded for the years ended December 31, 2018, 2017 or 2016. As of December 31, 2018 and 2017, intangibles, net of accumulated depreciation and amortization was $23.8 million and $16.6 million, respectively, included in the Company’s Consolidated Balance Sheets.
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. In accordance with ASU 2015-03, Simplifying the Presentation of Debt Issuance Costs, the Company has classified the debt issuance costs as current portion of long-term debt or long-term debt, less current portion as of December 31, 2018 and 2017.
Workers' Compensation Program	Workers’ Compensation Program The Company’s workers’ compensation insurance program has a $0.4 million deductible component. The Company recognizes its obligations associated with this program in the period the claim is incurred. The cost of both the claims reported and claims incurred but not reported, up to the deductible, have been accrued based on historical claims experience, industry statistics and an actuarial analysis performed by an independent third party. The Company monitors its claims quarterly and adjusts its reserves accordingly. These costs are recorded primarily as the cost of services on the Consolidated Statements of Income. As of December 31, 2018 and 2017, the Company recorded $15.2 million and $12.6 million, respectively, in accrued workers’ compensation insurance. The accrued workers’ compensation insurance is included in accrued expenses on the Company’s Consolidated Balance Sheets. As of December 31, 2018 and 2017, respectively, the Company recorded $1.7 million and $0.5 million, respectively, in workers’ compensation insurance recovery receivables. The workers’ compensation insurance recovery receivable is included in prepaid expenses and other current assets on the Company’s Consolidated Balance Sheets.
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. As the amount and timing of the receipt of these payments are not certain, the interest income is recognized when received and reported in the statement of income caption, “Interest income.” For the years ended December 31, 2018 and 2016, the Company received $2.3 million and $2.8 million, respectively, in prompt payment interest. For the year ended December 31, 2017, the Company did not receive any prompt payment interest. While the Company may be owed additional prompt payment interest in the future, the amount, timing and intent to provide receipt of such payments remains uncertain, and the Company will continue to recognize prompt payment interest income upon satisfaction of these constraints.
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 Consolidated Statement of Income when incurred.
Other Income	Other Income In fiscal year 2017 and 2016, other income consisted of income distributions received from investments in joint ventures. The Company recognized the net accumulated earnings only to the extent distributed by the joint ventures on the date received.
Income Tax Expense	Income Tax Expense The Company accounts for income taxes under the provisions of ASC Topic 740, Income Taxes. The Company recognizes interest and penalties accrued related to uncertain tax positions in interest expense and penalties within operating expenses on the Consolidated Statements of Income.
Stock-Based Compensation	Stock-based Compensation The Company currently has one stock incentive plan, the 2017 Omnibus Incentive Plan (the “2017 Plan”), under which new grants of stock-based employee compensation are made. The Company accounts for stock-based compensation in accordance with ASC Topic 718, Stock Compensation . Compensation expense is recognized, net of estimated forfeitures, on a straight-line basis under the 2017 Plan over the vesting period of the equity awards based on the grant date fair value of the options and restricted stock awards. Beginning January 1, 2017, the Company began utilizing the Black-Scholes Option Pricing Model to value the Company’s options, as the Company believes it is a more widely accepted and understood valuation model. Prior to January 1, 2017, the Company utilized the Enhanced Hull-White Trinomial Model to value our options. The determination of the fair value of stock-based payments utilizing the Black-Scholes Model and the Enhanced Hull-White Trinomial Model is affected by our stock price and a number of assumptions, including expected volatility, risk-free interest rate, expected term, expected dividends yield, expected forfeiture rate, expected turn-over rate and the expected exercise multiple. Stock-based compensation expense was $4.1 million, $2.5 million and $1.1 million for the years ended December 31, 2018, 2017 and 2016, respectively.
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 year ended December 31, 2018 were approximately 683,000 stock options outstanding, of which approximately 247,000 were dilutive. In addition, there were approximately 149,000 restricted stock awards outstanding, of which approximately 88,000 were dilutive for the year ended December 31, 2018. Included in the Company’s calculation of diluted earnings per share for the year ended December 31, 2017 were approximately 479,000 stock options outstanding, of which approximately 101,000 were dilutive. In addition, there were approximately 143,000 restricted stock awards outstanding, of which approximately 52,000 were dilutive for the year ended December 31, 2017. Included in the Company’s calculation of diluted earnings per share for the year ended December 31, 2016 were approximately 405,000 stock options outstanding, of which approximately 30,000 were dilutive. In addition, there were approximately 103,000 restricted stock awards outstanding, of which approximately 27,000 were dilutive for the year ended December 31, 2016.
Estimates	Estimates The financial statements are prepared by management in conformity with U.S. Generally Accepted Accounting Principles (“GAAP”) and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: implicit price concession,
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 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 years ended December 31, 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.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In May 2014, the Accounting Standards Board (“FASB”) issued ASU 2014-09, Revenue from Contracts with Customers In August 2016, the FASB issued ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) ASU 2018-10, ASU 2018-11 and ASU 2018-20 (collectively will not have a material impact to our results of operations or liquidity In June 2016, the FASB issued ASU 2016-13, Financial Instruments—Credit Losses (Topic 326) Measurement of Credit Losses on Financial Instruments. In January 2017, the FASB issued ASU 2017-04, Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment. 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

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2018
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 3—10 years Leasehold improvements Lesser of useful life or lease term

Correction to Prior Period Fi_2

Correction to Prior Period Financial Statements (Tables)	12 Months Ended
	Dec. 31, 2018
Accounting Changes And Error Corrections [Abstract]
Schedule of Error Corrections and Prior Period Adjustments	Consolidated Balance Sheet as of December 31, 2017 (in thousands): As Previously As Reported Corrections Revised Accounts receivable, net of allowances $ 88,952 $ 4,581 $ 93,533 Total assets 267,110 4,581 271,691 Accounts payable 4,271 3,110 7,381 Accrued expenses 44,354 242 44,596 Total liabilities 92,030 3,352 95,382 Total stockholders’ equity 175,080 1,229 176,309 Total liabilities and stockholders’ equity 267,110 4,581 271,691 Consolidated Statements of Income (in thousands): For the Years Ended December 31, 2017 2016 As As Previously As Previously As Reported Corrections Revised Reported Corrections Revised Net service revenues $ 425,715 $ 279 $ 425,994 $ 400,688 $ 241 $ 400,929 Gross profit 115,596 279 115,875 106,095 241 106,336 Provision for doubtful accounts 8,259 150 8,409 7,373 — 7,373 Total operating expenses 89,357 150 89,507 90,860 — 90,860 Operating income from continuing operations 26,239 129 26,368 15,235 241 15,476 Income from continuing operations before income taxes 22,050 129 22,179 15,921 241 16,162 Income tax expense 8,589 56 8,645 3,994 105 4,099 Net income from continuing operations 13,461 73 13,534 11,927 136 12,063 Net income $ 13,608 $ 73 $ 13,681 $ 12,024 $ 136 $ 12,160 Consolidated Statements of Cash Flows (in thousands): For the Years Ended December 31, 2017 2016 As As Previously As Previously As Reported Corrections Revised Reported Corrections Revised Net income $ 13,608 $ 73 $ 13,681 $ 12,024 $ 136 $ 12,160 Provision for doubtful accounts 8,259 150 8,409 7,373 — 7,373 Accounts receivable 21,023 (1,611 ) 19,412 (32,606 ) (995 ) (33,601 ) Accounts payable (229 ) 1,332 1,103 (1,530 ) 754 (776 ) Accrued expenses 1,723 56 1,779 4,980 105 5,085 Net cash provided by (used in) operating activities $ 52,771 $ — $ 52,771 $ (743 ) $ — $ (743 ) For the Three Months Ended March 31, 2018 For the Three Months Ended March 31, 2017 Previously reported Adjusted As adjusted Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 109,448 $ 28 $ 109,476 $ 101,606 $ 69 $ 101,675 Gross profit 27,905 28 27,933 27,317 69 27,386 Operating income from continuing operations 4,561 28 4,589 6,961 69 7,030 Net income from continuing operations 4,858 28 4,886 4,259 55 4,314 Net income 4,858 28 4,886 4,259 55 4,314 Income per common share: Basic $ 0.42 $ — $ 0.42 $ 0.37 $ 0.01 $ 0.38 Diluted $ 0.42 $ — $ 0.42 $ 0.37 $ — $ 0.37 For the Three Months Ended June 30, 2018 For the Three Months Ended June 30, 2017 Previously reported Adjusted As adjusted Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 131,237 $ 21 $ 131,258 $ 103,559 $ 70 $ 103,629 Gross profit 35,722 21 35,743 28,511 70 28,581 Operating income from continuing operations 6,892 21 6,913 5,921 70 5,991 Net income from continuing operations 4,297 21 4,318 2,700 56 2,756 Net income 4,297 21 4,318 2,700 56 2,756 Income per common share: Basic $ 0.37 $ — $ 0.37 $ 0.24 $ — $ 0.24 Diluted $ 0.36 $ — $ 0.36 $ 0.23 $ 0.01 $ 0.24 For the Three Months Ended September 30, 2018 For the Three Months Ended September 30, 2017 Previously reported Adjusted As adjusted Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 137,631 $ 85 $ 137,716 $ 108,592 $ 70 $ 108,662 Gross profit 36,705 85 36,790 29,053 70 29,123 Operating income from continuing operations 5,903 85 5,988 5,807 70 5,877 Net income from continuing operations 3,546 85 3,631 3,408 56 3,464 Net income 3,546 85 3,631 3,408 56 3,464 Income per common share: Basic $ 0.29 $ — $ 0.29 $ 0.30 $ — $ 0.30 Diluted $ 0.28 $ — $ 0.28 $ 0.29 $ — $ 0.29 For the Three Months Ended December 30, 2017 Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 111,958 $ 70 $ 112,028 Gross profit 30,715 70 30,785 Operating income from continuing operations 7,550 (80 ) 7,470 Net income from continuing operations 3,094 (94 ) 3,000 Net income 3,241 (94 ) 3,147 Income per common share: Basic $ 0.28 $ (0.01 ) $ 0.27 Diluted $ 0.28 $ (0.01 ) $ 0.27

Discontinued Operations (Tables

Discontinued Operations (Tables)	12 Months Ended
	Dec. 31, 2018
Discontinued Operations And Disposal Groups [Abstract]
Schedule of Net Service Revenues and Earnings Attributable to Discontinued Operations	2018 2017 2016 (Amounts in Thousands) Net service revenues $ — $ — $ — Income before income taxes 174 245 163 Income tax expense 48 98 66 Net income from discontinued operations $ 126 $ 147 $ 97

Acquisitions (Tables)

Acquisitions (Tables)	12 Months Ended
	Dec. 31, 2018
Ambercare Corporation, Inc. [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	Total (Amounts in Thousands) Goodwill $ 28,831 Cash 12,028 Identifiable intangible assets 9,944 Accounts receivable 6,512 Other assets 442 Property and equipment 154 Accrued liabilities (4,073 ) Deferred tax liability (2,138 ) Capital lease (75 ) Accounts payable (3 ) Total purchase price allocation $ 51,622
Arcadia Home Care And Staffing [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	Total (Amounts in Thousands) Goodwill $ 13,072 Accounts receivable 5,317 Identifiable intangible assets 2,264 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 Years Ended December 31, (Amounts in Thousands) 2018 2017 Net service revenues $ 550,326 $ 534,647 Operating income from continuing operations 36,985 33,293 Net income from continuing operations 24,346 10,174 Earnings from discontinued operations 126 147 Net income $ 24,472 $ 10,321 Net income per common share Basic income per share Continuing operations $ 2.02 $ 0.89 Discontinued operations 0.01 0.01 Basic income per share $ 2.03 $ 0.90 Diluted income per share Continuing operations $ 1.97 $ 0.88 Discontinued operations 0.01 0.01 Diluted income per share $ 1.98 $ 0.89

Property and Equipment (Tables)

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2018
Property Plant And Equipment [Abstract]
Schedule of Property and Equipment	Property and equipment consisted of the following: December 31, 2018 2017 (Amounts in Thousands) Computer equipment $ 3,768 $ 2,770 Furniture and equipment 3,161 3,392 Transportation equipment 156 152 Leasehold improvements 2,962 2,749 Computer software 6,712 3,269 16,759 12,332 Less: accumulated depreciation and amortization (6,101 ) (4,843 ) $ 10,658 $ 7,489

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Schedule of Goodwill and Related Adjustments	A summary of goodwill and related adjustments is provided below: Goodwill Personal Care Hospice Home Health Total (Amounts In Thousands) Goodwill at December 31, 2016 $ 72,688 $ — $ — $ 72,688 Additions for acquisitions 17,857 — — 17,857 Adjustments to previously recorded goodwill (206 ) — — (206 ) Goodwill at December 31, 2017 90,339 — — 90,339 Additions for acquisitions 22,135 22,200 865 45,200 Adjustments to previously recorded goodwill (97 ) (97 ) Goodwill at December 31, 2018 $ 112,377 $ 22,200 $ 865 $ 135,442
Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset	The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following at December 31, 2018 and 2017: Customer and referral relationships Trade names and trademarks Non- competition agreements State Licenses Total (Amounts in Thousands) Gross balance at January 1, 2017 $ 34,672 $ 13,261 $ 2,155 $ — $ 50,088 Other (281 ) — — — (281 ) Additions for acquisitions 4,626 1,380 — — 6,006 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 Intangible assets with indefinite lives Additions for acquisitions — — — 2,871 2,871 Intangible assets subject to amortization Gross balances 39,017 14,641 2,155 — 55,813 Additions for acquisitions 3,339 6,910 — 241 10,490 Accumulated amortization, intangible assets subject to amortization (32,752 ) (10,638 ) (1,981 ) (19 ) (45,390 ) Net book value, intangible assets subject to amortization 9,604 10,913 174 222 20,913 Net Balance at December 31, 2018 $ 9,604 $ 10,913 $ 174 $ 3,093 $ 23,784
Schedule of Future Amortization of Intangible Assets	The estimated future intangible amortization expense is as follows: For the year ended December 31, Total (Amount in Thousands) 2019 $ 5,013 2020 3,400 2021 2,758 2022 1,724 2023 1,406 Thereafter 6,612 Total, intangible assets subject to amortization $ 20,913

Details of Certain Balance Sh_2

Details of Certain Balance Sheet Accounts (Tables)	12 Months Ended
	Dec. 31, 2018
Details Of Certain Balance Sheet Accounts [Abstract]
Schedule of Prepaid Expenses and Other Current Assets	December 31, 2018 2017 (Amounts in Thousands) Prepaid workers’ compensation and liability insurance $ 1,840 $ 1,332 Workers’ compensation insurance receivable 1,692 543 Prepaid rent 1,191 555 Health insurance receivable 564 2,349 Other 1,811 3,600 $ 7,098 $ 8,379
Schedule of Accrued Expenses	Accrued expenses consisted of the following: December 31, 2018 2017 (Amounts in Thousands) Accrued payroll $ 22,449 $ 19,783 Accrued workers’ compensation insurance 15,169 12,574 Accrued health insurance (1) 3,926 6,471 Accrued professional fees 2,260 1,312 Accrued payroll taxes 769 1,065 Other 4,631 3,391 $ 49,204 $ 44,596 (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. Amounts due of $0.6 million and $2.3 million for health insurance reimbursements and contributions were reflected in prepaid insurance and accrued insurance at December 31, 2018 and 2017, respectively.

Long-Term Debt (Tables)

Long-Term Debt (Tables)	12 Months Ended
	Dec. 31, 2018
Long Term Debt [Abstract]
Schedule of Long-Term Debt	December 31, 2018 2017 (Amounts in Thousands) Term loan under the credit facility $ — $ 44,438 Revolving loan under the credit facility 20,000 — Capital leases 81 1,002 Less unamortized issuance costs (2,797 ) (2,481 ) Total 17,284 42,959 Less current maturities (62 ) (3,099 ) Long-term debt $ 17,222 $ 39,860

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Current and Deferred Federal and State Income Tax Provision from Continuing Operations	The current and deferred federal and state income tax provision from continuing operations, are comprised of the following: December 31, 2018 2017 2016 (Amounts in Thousands) Current Federal $ 2,969 $ 5,828 $ 4,486 State 1,588 1,079 927 Deferred Federal (47 ) 1,672 (1,147 ) State (12 ) 66 (167 ) Provision for income taxes $ 4,498 $ 8,645 $ 4,099
Deferred Tax Assets And Liabilities	The tax effects of certain temporary differences between the Company’s book and tax bases of assets and liabilities give rise to significant portions of the deferred income tax assets (liabilities) at December 31, 2018 and 2017. The deferred tax assets (liabilities) consisted of the following: December 31, 2018 2017 (Amounts in Thousands) Deferred tax assets Long-term Accounts receivable allowances $ 4,118 $ 2,917 Accrued compensation 2,257 1,919 Accrued workers’ compensation 3,677 3,274 Transaction costs 1,020 898 Reserves — 47 Restructuring costs 160 293 Stock-based compensation 576 811 Other 279 138 Total long-term deferred tax assets 12,087 10,297 Deferred tax liabilities Long-term Goodwill and intangible assets (11,048 ) (7,301 ) Property and equipment (903 ) (749 ) Prepaid insurance (508 ) (359 ) Other (122 ) (1 ) Total long-term deferred tax liabilities (12,581 ) (8,410 ) Valuation allowance — (286 ) Total net deferred tax assets/(liabilities) $ (494 ) $ 1,601
Reconciliation of Statutory Federal Tax Rate	A reconciliation for continuing operation of the statutory federal tax rate of 21.0%, 35.0% and 35.0% and to the effective income tax rate, for the years ended December 31, 2018, 2017, and 2016, is summarized as follows: December 31, 2018 2017 2016 Federal income tax at statutory rate 21.0 % 35.0 % 35.0 % State and local taxes, net of federal benefit 6.3 5.1 5.2 Jobs tax credits, net (10.0 ) (6.1 ) (15.8 ) 162(m) disallowance for executive compensation 4.2 1.3 — Nondeductible permanent items 2.1 0.4 0.9 2017 Tax Reform Act — 4.0 — Excess tax benefit (2.6 ) (0.6 ) — Other (0.4 ) (0.1 ) 0.2 Effective income tax rate 20.6 % 39.0 % 25.5 %
Reconciliation of Gross Unrecognized Tax Benefits Excluding Interest and Penalties	A reconciliation of the gross unrecognized tax benefits (excluding interest and penalties) for the years ended December 31, 2018, 2017, and 2016 follows: 2018 2017 2016 (Amounts in Thousands) Balance as of January 1, $ 261 $ 210 $ 113 Additions for current year tax positions — 51 97 Increases for prior year tax positions — — — Settlements of prior year tax positions — — — Expiration of statutes (40 ) — — Balance as of December 31, $ 221 $ 261 $ 210

Stock Options And Restricted _2

Stock Options And Restricted Stock Awards (Tables)	12 Months Ended
	Dec. 31, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Summary of Stock Option Activity and Weighted Average Exercise Price	For The Year Ended December 31, 2018 Options (Amounts in Thousands) Weighted Average Exercise Price Outstanding, beginning of period 479 $ 23.91 Granted 278 38.10 Exercised (42 ) 23.50 Forfeited/Cancelled (32 ) 26.20 Outstanding, end of period 683 $ 29.60
Weighted-Average Estimated Fair Value of Employee Stock Options Granted	For the Year Ended December 31, 2018 2017 2016 Grants Grants Grants Weighted average fair value $ 14.72 $ 12.97 $ 9.32 Risk-free discount rate 2.32% - 2.84% 1.67% - 1.85% 1.70% - 2.02% Expected life 4.1 - 4.2 years 3.6 - 4.2 years 8.2 years Dividend yield — — — Volatility 45% 47% 47% Expected turn-over rate N/A N/A 2% Expected exercise multiple N/A N/A 2.2
Summary of Status of Unvested Restricted Stock Awards Outstanding	For The Year Ended December 31, 2018 Restricted Stock Awards (Amounts in Thousands) Weighted Average Grant Date Fair Value Unvested restricted stock awards, beginning of period 143 $ 29.30 Awarded 77 42.70 Vested (55 ) 30.10 Forfeited (16 ) 28.00 Unvested restricted stock awards, end of period 149 $ 36.10

Operating Leases (Tables)

Operating Leases (Tables)	12 Months Ended
	Dec. 31, 2018
Leases Operating [Abstract]
Schedule of Future Minimum Payments Under Non-cancelable Operating Leases, Exclusive of Taxes and Other Operating Expenses	The following is a schedule of the future minimum payments under non-cancelable operating leases, exclusive of taxes and other operating expenses. Rent (Amount in Thousands) 2019 $ 6,374 2020 4,820 2021 3,460 2022 2,377 2023 2,130 Thereafter 1,382 Total $ 20,543

Severance and Restructuring (Ta

Severance and Restructuring (Tables)	12 Months Ended
	Dec. 31, 2018
Restructuring And Related Activities [Abstract]
Components of and Changes in Severance and Restructuring Accruals	The following provides the components of and changes in our severance and restructuring accruals: Employee Termination Costs Restructuring and Other (Amounts in Thousands) Balance at December 31, 2016 $ 1,326 $ 1,786 Provision 1,038 627 Utilization (1,802 ) (1,336 ) Balance at December 31, 2017 $ 562 $ 1,077 Provision 647 564 Utilization (1,129 ) (1,056 ) Balance at December 31, 2018 $ 80 $ 585

Segment Information (Tables)

Segment Information (Tables)	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Summary Of Segment Information	For the Year Ended December 31, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 492,413 $ 18,850 $ 6,856 $ 518,119 Cost of services revenues 365,264 10,010 4,569 379,843 Gross profit 127,149 8,840 2,287 138,276 Provision for doubtful accounts 265 5 2 272 General and administrative expenses 44,463 3,737 1,543 49,743 Segment operating income $ 82,421 $ 5,098 $ 742 $ 88,261 For the Year Ended December 31, 2017 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 425,994 $ — $ — $ 425,994 Cost of services revenues 310,119 — — 310,119 Gross profit 115,875 — — 115,875 Provision for doubtful accounts 8,409 — — 8,409 General and administrative expenses 35,655 — — 35,655 Segment operating income $ 71,811 $ — $ — $ 71,811 For the Year Ended December 31, 2016 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 400,929 $ — $ — $ 400,929 Cost of services revenues 294,593 — — 294,593 Gross profit 106,336 — — 106,336 Provision for doubtful accounts 7,373 — — 7,373 General and administrative expenses 37,927 — — 37,927 Segment operating income $ 61,036 $ — $ — $ 61,036 For the Years Ended December 31, (Amounts in Thousands) 2018 2017 2016 Segment Reconciliation: Total segment operating income $ 88,261 $ 71,811 $ 61,036 Items not allocated at segment level: Other general and administrative expenses 55,282 41,247 38,913 Loss (gain) on sale of assets 38 (2,467 ) — Depreciation and amortization 8,642 6,663 6,647 Interest income (2,592 ) (66 ) (2,812 ) Interest expense 5,016 4,472 2,332 Other income — (217 ) (206 ) Income before income taxes $ 21,875 $ 22,179 $ 16,162

Significant Payors (Tables)

Significant Payors (Tables)	12 Months Ended
	Dec. 31, 2018
Significant Payors [Abstract]
Schedule of Revenue by Payor Type	For 2018, 2017 and 2016, our revenue by payor type was as follows: Personal Care 2018 2017 2016 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues State, local and other governmental programs $ 286,787 58.2 % $ 273,525 64.2 % $ 282,540 70.5 % Managed care organizations 173,884 35.3 140,993 33.1 104,413 26.0 Private pay 20,060 4.1 8,739 2.1 9,644 2.4 Commercial insurance 6,190 1.3 2,737 0.6 4,332 1.1 Other 5,492 1.1 — — — — Total personal care segment net service revenues $ 492,413 100.0 % $ 425,994 100.0 % $ 400,929 100.0 % Hospice 2018 Amount (in Thousands) % of Segment Net Service Revenues Medicare $ 17,652 93.6 % Managed care organizations 1,047 5.6 Other 151 0.8 Total segment net service revenues $ 18,850 100.0 % Home Health 2018 Amount (in Thousands) % of Segment Net Service Revenues Medicare $ 6,034 88.0 % Managed care organizations 752 11.0 Other 70 1.0 Total segment net service revenues $ 6,856 100.0 %
Schedule of Revenue by Geographic Location	The Company derives a significant amount of its net service revenues from its operations in Illinois, New York and New Mexico. The percentages of total revenue for each of these significant states for 2018, 2017 and 2016 were as follows: Personal Care 2018 2017 2016 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Illinois $ 233,990 47.5 % $ 224,257 52.6 % $ 215,162 53.6 % New York 65,117 13.2 37,588 8.8 51,718 12.9 New Mexico 58,914 12.0 58,360 13.7 29,924 7.5 All other states 134,392 27.3 105,789 24.9 104,125 26.0 Total personal care segment net service revenues $ 492,413 100.0 % $ 425,994 100.0 % $ 400,929 100.0 % Hospice 2018 Amount (in Thousands) % of Segment Net Service Revenues New Mexico $ 18,850 100.0 % Total hospice segment net service revenues $ 18,850 100.0 % Home Health 2018 Amount (in Thousands) % of Segment Net Service Revenues New Mexico $ 6,856 100.0 % Total home health segment net service revenues $ 6,856 100.0 %

Unaudited Summarized Quarterl_2

Unaudited Summarized Quarterly Financial Information (Tables)	12 Months Ended
	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Schedule of Quarterly Results of Operations	The following is a summary of the Company’s unaudited quarterly results of operations. See Note 2. Corrections to Prior Period Financial Statements. Year Ended December 31, 2018 Year Ended December 31, 2017 Dec. 31 Sept. 30 Jun. 30 Mar. 31 Dec. 31 Sept. 30 Jun. 30 Mar. 31 (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 139,669 $ 137,716 $ 131,258 $ 109,476 $ 112,028 $ 108,662 $ 103,629 $ 101,675 Gross profit 37,810 36,790 35,743 27,933 30,785 29,123 28,581 27,386 Operating income from continuing operations 6,809 5,988 6,913 4,589 7,470 5,877 5,991 7,030 Net income from continuing operations 4,542 3,631 4,318 4,886 3,000 3,464 2,756 4,314 Earnings from discontinued operations 126 — — — 147 — — — Net income $ 4,668 $ 3,631 $ 4,318 $ 4,886 $ 3,147 $ 3,464 $ 2,756 $ 4,314 Average shares outstanding: Basic 12,964 12,179 11,533 11,502 11,488 11,486 11,470 11,434 Diluted 13,381 12,569 11,838 11,696 11,638 11,631 11,622 11,581 Income per common share: Basic Continuing operations $ 0.35 $ 0.29 $ 0.37 $ 0.42 $ 0.26 $ 0.30 $ 0.24 $ 0.38 Discontinued operations 0.01 — — — 0.01 — — — Basic net income per share $ 0.36 $ 0.29 $ 0.37 $ 0.42 $ 0.27 $ 0.30 $ 0.24 $ 0.38 Diluted net income per share Continuing operations $ 0.34 $ 0.28 $ 0.36 $ 0.42 $ 0.26 $ 0.29 $ 0.24 $ 0.37 Discontinued operations 0.01 — — — 0.01 — — — Diluted net income per share $ 0.35 $ 0.28 $ 0.36 $ 0.42 $ 0.27 $ 0.29 $ 0.24 $ 0.37
Schedule of Error Corrections and Prior Period Adjustments	Consolidated Balance Sheet as of December 31, 2017 (in thousands): As Previously As Reported Corrections Revised Accounts receivable, net of allowances $ 88,952 $ 4,581 $ 93,533 Total assets 267,110 4,581 271,691 Accounts payable 4,271 3,110 7,381 Accrued expenses 44,354 242 44,596 Total liabilities 92,030 3,352 95,382 Total stockholders’ equity 175,080 1,229 176,309 Total liabilities and stockholders’ equity 267,110 4,581 271,691 Consolidated Statements of Income (in thousands): For the Years Ended December 31, 2017 2016 As As Previously As Previously As Reported Corrections Revised Reported Corrections Revised Net service revenues $ 425,715 $ 279 $ 425,994 $ 400,688 $ 241 $ 400,929 Gross profit 115,596 279 115,875 106,095 241 106,336 Provision for doubtful accounts 8,259 150 8,409 7,373 — 7,373 Total operating expenses 89,357 150 89,507 90,860 — 90,860 Operating income from continuing operations 26,239 129 26,368 15,235 241 15,476 Income from continuing operations before income taxes 22,050 129 22,179 15,921 241 16,162 Income tax expense 8,589 56 8,645 3,994 105 4,099 Net income from continuing operations 13,461 73 13,534 11,927 136 12,063 Net income $ 13,608 $ 73 $ 13,681 $ 12,024 $ 136 $ 12,160 Consolidated Statements of Cash Flows (in thousands): For the Years Ended December 31, 2017 2016 As As Previously As Previously As Reported Corrections Revised Reported Corrections Revised Net income $ 13,608 $ 73 $ 13,681 $ 12,024 $ 136 $ 12,160 Provision for doubtful accounts 8,259 150 8,409 7,373 — 7,373 Accounts receivable 21,023 (1,611 ) 19,412 (32,606 ) (995 ) (33,601 ) Accounts payable (229 ) 1,332 1,103 (1,530 ) 754 (776 ) Accrued expenses 1,723 56 1,779 4,980 105 5,085 Net cash provided by (used in) operating activities $ 52,771 $ — $ 52,771 $ (743 ) $ — $ (743 ) For the Three Months Ended March 31, 2018 For the Three Months Ended March 31, 2017 Previously reported Adjusted As adjusted Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 109,448 $ 28 $ 109,476 $ 101,606 $ 69 $ 101,675 Gross profit 27,905 28 27,933 27,317 69 27,386 Operating income from continuing operations 4,561 28 4,589 6,961 69 7,030 Net income from continuing operations 4,858 28 4,886 4,259 55 4,314 Net income 4,858 28 4,886 4,259 55 4,314 Income per common share: Basic $ 0.42 $ — $ 0.42 $ 0.37 $ 0.01 $ 0.38 Diluted $ 0.42 $ — $ 0.42 $ 0.37 $ — $ 0.37 For the Three Months Ended June 30, 2018 For the Three Months Ended June 30, 2017 Previously reported Adjusted As adjusted Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 131,237 $ 21 $ 131,258 $ 103,559 $ 70 $ 103,629 Gross profit 35,722 21 35,743 28,511 70 28,581 Operating income from continuing operations 6,892 21 6,913 5,921 70 5,991 Net income from continuing operations 4,297 21 4,318 2,700 56 2,756 Net income 4,297 21 4,318 2,700 56 2,756 Income per common share: Basic $ 0.37 $ — $ 0.37 $ 0.24 $ — $ 0.24 Diluted $ 0.36 $ — $ 0.36 $ 0.23 $ 0.01 $ 0.24 For the Three Months Ended September 30, 2018 For the Three Months Ended September 30, 2017 Previously reported Adjusted As adjusted Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 137,631 $ 85 $ 137,716 $ 108,592 $ 70 $ 108,662 Gross profit 36,705 85 36,790 29,053 70 29,123 Operating income from continuing operations 5,903 85 5,988 5,807 70 5,877 Net income from continuing operations 3,546 85 3,631 3,408 56 3,464 Net income 3,546 85 3,631 3,408 56 3,464 Income per common share: Basic $ 0.29 $ — $ 0.29 $ 0.30 $ — $ 0.30 Diluted $ 0.28 $ — $ 0.28 $ 0.29 $ — $ 0.29 For the Three Months Ended December 30, 2017 Previously reported Adjusted As adjusted (Amounts and Shares in Thousands, Except Per Share Data) Net service revenues $ 111,958 $ 70 $ 112,028 Gross profit 30,715 70 30,785 Operating income from continuing operations 7,550 (80 ) 7,470 Net income from continuing operations 3,094 (94 ) 3,000 Net income 3,241 (94 ) 3,147 Income per common share: Basic $ 0.28 $ (0.01 ) $ 0.27 Diluted $ 0.28 $ (0.01 ) $ 0.27

Significant Accounting Polici_4

Significant Accounting Policies (Narrative) (Details)	Oct. 01, 2017	Dec. 31, 2018USD ($)stateshares	Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Mar. 31, 2018USD ($)	Dec. 31, 2017USD ($)shares	Sep. 30, 2017USD ($)	Jun. 30, 2017USD ($)	Mar. 31, 2017USD ($)	Dec. 31, 2018USD ($)segmentitemstateshares	Dec. 31, 2017USD ($)shares	Dec. 31, 2016USD ($)shares
Summary Of Significant Accounting Policies [Line Items]
Number of reportable business segments | segment										3
Number of consumers | item										39,000
Number of offices | state										156
Number of states in which the company operates | state		24								24
Revenues		$ 139,669,000	$ 137,716,000	$ 131,258,000	$ 109,476,000	$ 112,028,000	$ 108,662,000	$ 103,629,000	$ 101,675,000	$ 518,119,000	$ 425,994,000	$ 400,929,000
Accounts receivable, allowance for doubtful accounts		700,000				10,500,000				700,000	10,500,000
Goodwill impairment charge										0	0	0
Goodwill		135,442,000				90,339,000				135,442,000	90,339,000	72,688,000
Impairment of finite-lived intangible assets										0	0	0
Intangibles, net of accumulated depreciation and amortization		23,784,000				16,596,000				23,784,000	16,596,000
Deductible component of workers' compensation										400,000
Accrued workers' compensation insurance		15,169,000				12,574,000				15,169,000	12,574,000
Workers' compensation insurance recovery receivables		$ 1,692,000				$ 543,000				1,692,000	543,000
Interest income received										$ 2,300,000	0	2,800,000
Number of stock incentive plans | item										1
Stock-based compensation expense										$ 4,100,000	$ 2,500,000	$ 1,100,000
Shares of restricted stock awards included in calculation | shares										149,000	143,000	103,000
Stock Options [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock-based compensation expense										$ 2,000,000	$ 1,100,000	$ 600,000
Number of stock options included in calculation | shares		683,000				479,000				683,000	479,000	405,000
Number of dilutive shares outstanding | shares										247,000	101,000	30,000
Restricted Stock [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock-based compensation expense										$ 2,100,000	$ 1,400,000	$ 500,000
Number of dilutive shares outstanding | shares										88,000	52,000	27,000
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, estimated useful lives										3 years
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, estimated useful lives										25 years
Accounting Standards Update 2014-09 [Member]
Summary Of Significant Accounting Policies [Line Items]
Revenues										$ (9,700,000)
Revenues										$ (9,700,000)
LHC Group, Inc. [Member]
Summary Of Significant Accounting Policies [Line Items]
Equity ownership percentage sold in joint venture	10.00%

Significant Accounting Polici_5

Significant Accounting Policies (Estimated Useful Lives of Property and Equipment) (Details)	12 Months Ended
	Dec. 31, 2018
Transportation Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	5 years
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment useful life	Lesser of useful life or lease term
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	3 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

Correction to Prior Period Fi_3

Correction to Prior Period Financial Statements (Narrative) (Details) $ in Millions	12 Months Ended
	Dec. 31, 2018USD ($)
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Cumulative understatement of net income and stockholders equity	$ 1.2
Corrections [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Cumulative effect of adjustments required to correct misstatements in financial statements years prior to 2017	1
Error Related to Understatement of Revenues [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Cumulative understatement of net income and stockholders equity	1.5
Error Related to Understatement of Bad Debt Expense [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Cumulative understatement of net income and stockholders equity	0.1
Error Related to Cumulative Incremental Tax Expense [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Cumulative understatement of net income and stockholders equity	0.2
Error Related To Overpayments By Payors Reclassified From Accounts Receivable to Accounts Payable [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Cumulative error in accounts payable	$ 3.1

Correction to Prior Period Fi_4

Correction to Prior Period Financial Statements (Consolidated Balance Sheet as of December 31, 2017) (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Accounts receivable, net of allowances	$ 108,000	$ 93,533
Total assets	355,388	271,691
Accounts payable	12,238	7,381
Accrued expenses	49,204	44,596
Total liabilities	79,855	95,382
Total stockholders’ equity	275,533	176,309	$ 158,918	$ 141,580
Total liabilities and stockholders’ equity	$ 355,388	271,691
As Previously Reported [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Accounts receivable, net of allowances		88,952
Total assets		267,110
Accounts payable		4,271
Accrued expenses		44,354
Total liabilities		92,030
Total stockholders’ equity		175,080
Total liabilities and stockholders’ equity		267,110
Corrections [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Accounts receivable, net of allowances		4,581
Total assets		4,581
Accounts payable		3,110
Accrued expenses		242
Total liabilities		3,352
Total stockholders’ equity		1,229
Total liabilities and stockholders’ equity		$ 4,581

Correction to Prior Period Fi_5

Correction to Prior Period Financial Statements (Consolidated Statements of Income) (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Net service revenues	$ 139,669	$ 137,716	$ 131,258	$ 109,476	$ 112,028	$ 108,662	$ 103,629	$ 101,675	$ 518,119	$ 425,994	$ 400,929
Gross profit	37,810	36,790	35,743	27,933	30,785	29,123	28,581	27,386	138,276	115,875	106,336
Provision for doubtful accounts									272	8,409	7,373
Total operating expenses									113,977	89,507	90,860
Operating income from continuing operations	6,809	5,988	6,913	4,589	7,470	5,877	5,991	7,030	24,299	26,368	15,476
Income from continuing operations before income taxes									21,875	22,179	16,162
Income tax expense									4,498	8,645	4,099
Net income from continuing operations	4,542	3,631	4,318	4,886	3,000	3,464	2,756	4,314	17,377	13,534	12,063
Net income	$ 4,668	3,631	4,318	4,886	3,147	3,464	2,756	4,314	$ 17,503	13,681	12,160
As Previously Reported [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Net service revenues		137,631	131,237	109,448	111,958	108,592	103,559	101,606		425,715	400,688
Gross profit		36,705	35,722	27,905	30,715	29,053	28,511	27,317		115,596	106,095
Provision for doubtful accounts										8,259	7,373
Total operating expenses										89,357	90,860
Operating income from continuing operations		5,903	6,892	4,561	7,550	5,807	5,921	6,961		26,239	15,235
Income from continuing operations before income taxes										22,050	15,921
Income tax expense										8,589	3,994
Net income from continuing operations		3,546	4,297	4,858	3,094	3,408	2,700	4,259		13,461	11,927
Net income		3,546	4,297	4,858	3,241	3,408	2,700	4,259		13,608	12,024
Corrections [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Net service revenues		85	21	28	70	70	70	69		279	241
Gross profit		85	21	28	70	70	70	69		279	241
Provision for doubtful accounts										150
Total operating expenses										150
Operating income from continuing operations		85	21	28	(80)	70	70	69		129	241
Income from continuing operations before income taxes										129	241
Income tax expense										56	105
Net income from continuing operations		85	21	28	(94)	56	56	55		73	136
Net income		$ 85	$ 21	$ 28	$ (94)	$ 56	$ 56	$ 55		$ 73	$ 136

Correction to Prior Period Fi_6

Correction to Prior Period Financial Statements (Consolidated Statements of of Cash Flows) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Net income	$ 17,503	$ 13,681	$ 12,160
Provision for doubtful accounts	272	8,409	7,373
Accounts receivable	(2,169)	19,412	(33,601)
Accounts payable	4,235	1,103	(776)
Accrued expenses		1,779	5,085
Net cash provided by (used in) operating activities	$ 33,203	52,771	(743)
As Previously Reported [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Net income		13,608	12,024
Provision for doubtful accounts		8,259	7,373
Accounts receivable		21,023	(32,606)
Accounts payable		(229)	(1,530)
Accrued expenses		1,723	4,980
Net cash provided by (used in) operating activities		52,771	(743)
Corrections [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Net income		73	136
Provision for doubtful accounts		150
Accounts receivable		(1,611)	(995)
Accounts payable		1,332	754
Accrued expenses		$ 56	$ 105

Secondary Offering (Narrative)

Secondary Offering (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands	Aug. 20, 2018	Dec. 31, 2018	Dec. 31, 2017
Class Of Stock [Line Items]
Common stock, par value		$ 0.001	$ 0.001
Proceeds from issuance of common stock, net of issuance costs		$ 76,618
Repayment of credit facility			$ 30,000
Shares issued in secondary offering, net of offering costs		$ 76,618
Issuance costs	$ 5,400
Term Loan [Member] | Credit Facility [Member]
Class Of Stock [Line Items]
Repayment of credit facility	$ 102,600
Common Stock [Member]
Class Of Stock [Line Items]
Shares issued in secondary offering, net of offering costs, shares	2,100,000	1,390,000
Common stock, par value	$ 0.001
Purchase price per share	$ 59
Shares issued in secondary offering, net of offering costs		$ 1
Common Stock [Member] | Primary Shares [Member]
Class Of Stock [Line Items]
Shares issued in secondary offering, net of offering costs, shares	1,075,267
Proceeds from issuance of common stock, net of issuance costs	$ 59,100
Common Stock [Member] | Secondary Shars [Member]
Class Of Stock [Line Items]
Shares issued in secondary offering, net of offering costs, shares	1,024,733
Common Stock [Member] | Over-Allotment Option [Member]
Class Of Stock [Line Items]
Shares issued in secondary offering, net of offering costs, shares	315,000
Proceeds from issuance of common stock, net of issuance costs	$ 17,500
Additional Paid-in Capital [Member]
Class Of Stock [Line Items]
Shares issued in secondary offering, net of offering costs	$ 76,600	$ 76,617

Gain on Sale of Assets (Narrati

Gain on Sale of Assets (Narrative) (Details) $ in Thousands	Oct. 01, 2017USD ($)entity	Mar. 01, 2017USD ($)item	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)
Gain on sale of adult day services centers			$ (38)	$ 2,467	$ 0
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	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

Discontinued Operations (Narrat

Discontinued Operations (Narrative) (Details) - 2013 Home Health Business [Member]	Oct. 01, 2017	Dec. 30, 2013USD ($)item	Mar. 01, 2013USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Equity ownership percentage sold in joint venture			90.00%
Discontinued operation, percentage of ownership retained			10.00%
LHC Group, Inc. [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Equity ownership percentage sold in joint venture	10.00%
Discontinued operation, cash consideration from sale of assets			$ 20,000,000
Billing adjustments liabilities related to indemnification reserves				$ 0	$ 200,000
Reduction of indemnification reserve accrual				$ (200,000)	$ (200,000)	$ (200,000)
Pennsylvania [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Discontinued operation, cash consideration from sale of assets		$ 200,000
Number of home health agency sold | item		1

Discontinued Operations (Schedu

Discontinued Operations (Schedule of Net Service Revenues and Earnings Attributable to Discontinued Operations) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Discontinued Operations And Disposal Groups [Abstract]
Income before income taxes	$ 174	$ 245	$ 163
Income tax expense	48	98	66
Net income from discontinued operations	$ 126	$ 147	$ 97

Acquisitions (Narrative) (Detai

Acquisitions (Narrative) (Details)

May 01, 2018USD ($)

Apr. 01, 2018USD ($)

Jan. 01, 2018USD ($)

Oct. 01, 2017USD ($)

Aug. 01, 2017USD ($)item

Sep. 30, 2018USD ($)

Dec. 31, 2018USD ($)

Sep. 30, 2018USD ($)

Jun. 30, 2018USD ($)

Mar. 31, 2018USD ($)

Dec. 31, 2017USD ($)

Sep. 30, 2017USD ($)

Jun. 30, 2017USD ($)

Mar. 31, 2017USD ($)

Dec. 31, 2018USD ($)

Dec. 31, 2017USD ($)

Dec. 31, 2016USD ($)

Business Acquisition [Line Items]

Cash paid for acquisition

$ 62,440,000

$ 24,354,000

$ 20,026,000

Net service revenues

$ 139,669,000

$ 137,716,000

$ 131,258,000

$ 109,476,000

$ 112,028,000

$ 108,662,000

$ 103,629,000

$ 101,675,000

518,119,000

425,994,000

400,929,000

Net income from continuing operations

4,542,000

3,631,000

$ 4,318,000

$ 4,886,000

3,000,000

$ 3,464,000

$ 2,756,000

$ 4,314,000

17,377,000

13,534,000

12,063,000

Goodwill

$ 135,442,000

$ 90,339,000

$ 135,442,000

90,339,000

$ 72,688,000

Minimum [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

3 years

Maximum [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

25 years

Ambercare Corporation, Inc. [Member]

Business Acquisition [Line Items]

Total purchase price allocation

$ 51,622,000

Goodwill

28,831,000

Ambercare Corporation, Inc. [Member] | Minimum [Member] | Trade Names, Customer Relationships and State Licenses [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

3 years

Ambercare Corporation, Inc. [Member] | Maximum [Member] | Trade Names, Customer Relationships and State Licenses [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

15 years

Ambercare Corporation, Inc. [Member] | New Mexico [Member]

Business Acquisition [Line Items]

Total purchase price for business acquisition

39,600,000

Cash paid for acquisition

$ 12,000,000

Acquisition related costs

$ 800,000

Integration cost

1,600,000

Net service revenues

36,700,000

Net income from continuing operations

7,100,000

Arcadia Home Care And Staffing [Member]

Business Acquisition [Line Items]

Total purchase price for business acquisition

$ 18,900,000

Acquisition related costs

800,000

400,000

Integration cost

1,100,000

Total purchase price allocation

18,852,000

Net service revenues

32,700,000

Net income from continuing operations

$ 4,700,000

Goodwill

$ 13,072,000

Arcadia Home Care And Staffing [Member] | Minimum [Member] | Trade Names, Customer Relationships and State Licenses [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

7 years

Arcadia Home Care And Staffing [Member] | Maximum [Member] | Trade Names, Customer Relationships and State Licenses [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

15 years

Affiliate Branches of Arcadia [Member]

Business Acquisition [Line Items]

Acquisitions of business cash consideration

$ 600,000

Goodwill

$ 600,000

$ 600,000

Lifestyle Options, Inc. [Member]

Business Acquisition [Line Items]

Total purchase price allocation

$ 4,130,000

Goodwill

2,751,000

Lifestyle Options, Inc. [Member] | Minimum [Member] | Trade Name and Customer Relationships [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

10 years

Lifestyle Options, Inc. [Member] | Maximum [Member] | Trade Name and Customer Relationships [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

15 years

Lifestyle Options, Inc. [Member] | Illinois [Member]

Business Acquisition [Line Items]

Total purchase price for business acquisition

4,100,000

Acquisition related costs

200,000

Net service revenues

5,800,000

Net income from continuing operations

500,000

Acquisitions of business cash consideration

3,300,000

Business acquisition, contingent earn-out obligation

$ 800,000

Sun Cities Homecare [Member]

Business Acquisition [Line Items]

Total purchase price allocation

$ 2,256,000

Goodwill

1,089,000

Sun Cities Homecare [Member] | Minimum [Member] | Trade Name and Customer Relationships [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

7 years

Sun Cities Homecare [Member] | Maximum [Member] | Trade Name and Customer Relationships [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

15 years

Sun Cities Homecare [Member] | Arizona [Member]

Business Acquisition [Line Items]

Total purchase price for business acquisition

$ 2,300,000

Acquisition related costs

$ 100,000

100,000

Net service revenues

2,400,000

700,000

Net income from continuing operations

$ 200,000

14,800

Options Home Care [Member]

Business Acquisition [Line Items]

Total purchase price allocation

$ 22,624,000

Goodwill

16,671,000

Options Home Care [Member] | Minimum [Member] | Trade Name and Customer Relationships [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

3 years

Options Home Care [Member] | Maximum [Member] | Trade Name and Customer Relationships [Member]

Business Acquisition [Line Items]

Intangible assets, estimated useful lives

10 years

Options Home Care [Member] | New Mexico [Member]

Business Acquisition [Line Items]

Total purchase price for business acquisition

$ 22,600,000

Acquisition related costs

$ 100,000

700,000

Integration cost

100,000

Net service revenues

17,800,000

8,000,000

Net income from continuing operations

$ 3,400,000

$ 500,000

Options Home Care [Member] | New Mexico [Member] | Minimum [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	Dec. 31, 2018	May 01, 2018	Apr. 01, 2018	Jan. 01, 2018	Dec. 31, 2017	Oct. 01, 2017	Aug. 01, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill	$ 135,442				$ 90,339			$ 72,688
Ambercare Corporation, Inc. [Member]
Business Acquisition [Line Items]
Goodwill		$ 28,831
Cash		12,028
Identifiable intangible assets		9,944
Accounts receivable		6,512
Other assets		442
Property and equipment		154
Accrued liabilities		(4,073)
Deferred tax liability		(2,138)
Capital lease		(75)
Accounts payable		(3)
Total purchase price allocation		$ 51,622
Arcadia Home Care And Staffing [Member]
Business Acquisition [Line Items]
Goodwill			$ 13,072
Identifiable intangible assets			2,264
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
Cash						321
Identifiable intangible assets						682
Accounts receivable						254
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
Cash							205
Identifiable intangible assets							5,324
Accounts receivable							1,084
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	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Net service revenues	$ 550,326	$ 534,647
Operating income from continuing operations	36,985	33,293
Net income from continuing operations	24,346	10,174
Earnings from discontinued operations	126	147
Net income	$ 24,472	$ 10,321
Basic income per share, Continuing operations	$ 2.02	$ 0.89
Basic income per share, Discontinued operations	0.01	0.01
Basic income per share	2.03	0.90
Diluted income per share, Continuing operations	1.97	0.88
Diluted income per share, Discontinued operations	0.01	0.01
Diluted income per share	$ 1.98	$ 0.89

Property and Equipment (Schedul

Property and Equipment (Schedule of Property and Equipment) (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 16,759	$ 12,332
Less: accumulated depreciation and amortization	(6,101)	(4,843)
Property and equipment, net	10,658	7,489
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	3,768	2,770
Furniture and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	3,161	3,392
Transportation Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	156	152
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	2,962	2,749
Computer Software [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 6,712	$ 3,269

Property and Equipment (Narrati

Property and Equipment (Narrative) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Property and equipment	$ 16,759	$ 12,332
Depreciation and amortization	8,642	6,663	$ 6,647
Internally Developed Software [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	1,300	1,000
Computer Equipment and Software and Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Depreciation and amortization	$ 2,500	$ 2,000	$ 1,700

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Narrative) (Details) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Line Items]
Goodwill impairment charge	$ 0	$ 0	$ 0
Goodwill	135,442,000	90,339,000	72,688,000
Amortization expense	$ 6,200,000	$ 4,700,000	$ 4,900,000
Weighted average remaining lives of identifiable intangible assets	8 years 9 months 18 days
Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives	3 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) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 90,339	$ 72,688
Additions for acquisitions	45,200	17,857
Adjustments to previously recorded goodwill	(97)	(206)
Goodwill, at End of Period	135,442	90,339
Personal Care [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	90,339	72,688
Additions for acquisitions	22,135	17,857
Adjustments to previously recorded goodwill	(97)	(206)
Goodwill, at End of Period	112,377	$ 90,339
Hospice [Member]
Goodwill [Line Items]
Additions for acquisitions	22,200
Goodwill, at End of Period	22,200
Home Health [Member]
Goodwill [Line Items]
Additions for acquisitions	865
Goodwill, at End of Period	$ 865

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Finite Lived Intangible Assets [Line Items]
Gross balance at beginning of period	$ 55,813	$ 50,088
Other		(281)
Additions for acquisitions	10,490	6,006
Accumulated amortization, intangible assets subject to amortization	(45,390)	(39,217)
Net book value, intangible assets subject to amortization	20,913
Net balance at end of period	23,784	16,596
Additions for acquisitions	2,871
Customer And Referral Relationships [Member]
Finite Lived Intangible Assets [Line Items]
Gross balance at beginning of period	39,017	34,672
Other		(281)
Additions for acquisitions	3,339	4,626
Accumulated amortization, intangible assets subject to amortization	(32,752)	(29,147)
Net book value, intangible assets subject to amortization	9,604
Net balance at end of period	9,604	9,870
Trade Names And Trademarks [Member]
Finite Lived Intangible Assets [Line Items]
Gross balance at beginning of period	14,641	13,261
Additions for acquisitions	6,910	1,380
Accumulated amortization, intangible assets subject to amortization	(10,638)	(8,198)
Net book value, intangible assets subject to amortization	10,913
Net balance at end of period	10,913	6,443
Non-competition Agreements [Member]
Finite Lived Intangible Assets [Line Items]
Gross balance at beginning of period	2,155	2,155
Accumulated amortization, intangible assets subject to amortization	(1,981)	(1,872)
Net book value, intangible assets subject to amortization	174
Net balance at end of period	174	$ 283
State Licenses [Member]
Finite Lived Intangible Assets [Line Items]
Additions for acquisitions	241
Accumulated amortization, intangible assets subject to amortization	(19)
Net book value, intangible assets subject to amortization	222
Net balance at end of period	3,093
Additions for acquisitions	$ 2,871

Goodwill And Intangible Asset_5

Goodwill And Intangible Assets (Schedule of Future Amortization of Intangible Assets) (Details) $ in Thousands	Dec. 31, 2018USD ($)
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
2019	$ 5,013
2020	3,400
2021	2,758
2022	1,724
2023	1,406
Thereafter	6,612
Total, intangible assets subject to amortization	$ 20,913

Details of Certain Balance Sh_3

Details of Certain Balance Sheet Accounts (Schedule of Prepaid Expenses and Other Current Assets) (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Details Of Certain Balance Sheet Accounts [Abstract]
Prepaid workers’ compensation and liability insurance	$ 1,840	$ 1,332
Workers' compensation insurance recovery receivables	1,692	543
Prepaid rent	1,191	555
Health insurance receivable	564	2,349
Other	1,811	3,600
Prepaid expense and other current assets	$ 7,098	$ 8,379

Details of Certain Balance Sh_4

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2018	Dec. 31, 2017
Accrued payroll		$ 22,449	$ 19,783
Accrued workers' compensation insurance		15,169	12,574
Accrued health insurance	[1]	3,926	6,471
Accrued professional fees		2,260	1,312
Accrued payroll taxes		769	1,065
Other		4,631	3,391
Accrued Liabilities, Current		49,204	44,596
Health insurance reimbursement and contribution due		$ 600	$ 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. Amounts due of $0.6 million and $2.3 million for health insurance reimbursements and contributions were reflected in prepaid insurance and accrued insurance at December 31, 2018 and 2017, respectively.

Details Of Certain Balance Sh_5

Details Of Certain Balance Sheet Accounts (Narrative) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Details Of Certain Balance Sheet Accounts [Abstract]
Deductible component of workers compensation program	$ 0.4
Letters of credit secure compensation program	$ 10.8	$ 11.8

Long-Term Debt (Schedule of Lon

Long-Term Debt (Schedule of Long-Term Debt) (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Less unamortized issuance costs	$ (2,797)	$ (2,481)
Total	17,284	42,959
Less current maturities	(62)	(3,099)
Long-term debt	17,222	39,860
Revolving Credit Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	20,000
Term Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross		44,438
Capital Leases [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 81	$ 1,002

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details)	May 08, 2017USD ($)	Oct. 31, 2018USD ($)	Oct. 30, 2018	May 07, 2017USD ($)	Dec. 31, 2018USD ($)$ / agreement	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)
Debt Instrument [Line Items]
Proceeds from line of credit						$ 20,000,000	$ 27,000,000
Repayment of credit facility						30,000,000
Cash paid for interest					$ 4,339,000	2,261,000	2,322,000
Capital lease obligations					100,000	1,100,000
Capital Leases [Member]
Debt Instrument [Line Items]
Long -tern debt					$ 81,000	1,002,000
Option to purchase assets per lease agreement | $ / agreement					1
Minimum [Member] | First American Commercial Bancorp
Debt Instrument [Line Items]
Debt instrument stated interest rate					3.64%
Maximum [Member] | First American Commercial Bancorp
Debt Instrument [Line Items]
Debt instrument stated interest rate					7.72%
New Credit Agreement [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available		$ 269,600,000
Debt instrument, maturity date					May 8, 2023
Debt instrument total net leverage ratio			4.25%
Debt issuance costs		900,000
New Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available		250,000,000			$ 142,900,000	105,100,000
Line of credit facility, current borrowing capacity					$ 20,000,000
Debt instrument stated interest rate					4.35%
New Credit Agreement [Member] | Delayed Draw Term Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available		$ 19,600,000
Proceeds from line of credit					$ 60,400,000
New Credit Agreement [Member] | Term Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Line of credit facility, current borrowing capacity						$ 44,400,000
Debt instrument stated interest rate						3.86%
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%	0.25%
New Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [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%	0.50%
New Credit Agreement [Member] | Federal Funds Rate [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin		0.50%
New Credit Agreement [Member] | London Interbank Offered Rate (LIBOR) | Capital One, National Association [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin		1.00%
New Credit Agreement [Member] | London Interbank Offered Rate (LIBOR) | Minimum [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin		0.00%
New Credit Facility [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 250,000,000
Terminated Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Debt instrument, maturity date					Nov. 10, 2020
Repayment of credit facility	23,800,000
Repayment of accrued interest	100,000
Write off of unamortized debt issuance cost	1,300,000
Terminated Senior Secured Credit Facility [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	125,000,000
Terminated Senior Secured Credit Facility [Member] | Revolving Credit Loan [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	100,000,000
Proceeds from line of credit				$ 20,000,000
Line of credit facility remaining amount							79,700,000
Terminated Senior Secured Credit Facility [Member] | Letters of Credit [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	35,000,000
Terminated Senior Secured Credit Facility [Member] | Delayed Draw Term Loan [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	25,000,000
Terminated Senior Secured Credit Facility [Member] | Term Loan [Member] | Revolving Credit Loan [Member]
Debt Instrument [Line Items]
Long -tern debt							$ 24,100,000
Terminated Senior Secured Credit Facility [Member] | Uncommitted Incremental Term Loan [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 50,000,000
Existing Credit Agreement [Member]
Debt Instrument [Line Items]
Repayment of credit facility		$ 102,600,000
Cash paid for interest		$ 500,000
Existing Credit Agreement [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Debt instrument, maturity date	May 8, 2022
Debt issuance costs	$ 2,900,000
Existing Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	125,000,000
Existing Credit Agreement [Member] | Delayed Draw Term Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	80,000,000
Existing Credit Agreement [Member] | Term Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	45,000,000
Existing Credit Agreement [Member] | Uncommitted Incremental Term Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 100,000
Existing Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum ratio used to determine availability of additional draws	4.25%
Credit Agreement [Member] | Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin					0.50%
Credit Agreement [Member] | London Interbank Offered Rate (LIBOR) | Capital One, National Association [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin					1.00%
Credit Agreement [Member] | London Interbank Offered Rate (LIBOR) | Minimum [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin					0.00%
Based On Applicable Senior Leverage Ratio | New Credit Agreement [Member] | Minimum [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin		0.75%
Based On Applicable Senior Leverage Ratio | New Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin		1.50%
Based On Applicable Senior Leverage Ratio | Credit Agreement [Member] | Minimum [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin					1.50%
Based On Applicable Senior Leverage Ratio | Credit Agreement [Member] | Maximum [Member] | Capital One, National Association [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]
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]
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]
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]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin					3.25%
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					$ 7,500,000

Income Taxes (Current and Defer

Income Taxes (Current and Deferred Federal and State Income Tax Provision from Continuing Operations) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Current
Federal	$ 2,969	$ 5,828	$ 4,486
State	1,588	1,079	927
Deferred
Federal	(47)	1,672	(1,147)
State	(12)	66	(167)
Provision for income taxes	$ 4,498	$ 8,645	$ 4,099

Income Taxes (Deferred Tax Asse

Income Taxes (Deferred Tax Assets And Liabilities) (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Income Tax Expense Benefit Continuing Operations Income Tax Reconciliation [Abstract]
Deferred Tax Assets, Accounts receivable allowances	$ 4,118	$ 2,917
Deferred Tax Assets, Accrued compensation	2,257	1,919
Deferred Tax Assets, Accrued workers' compensation	3,677	3,274
Deferred Tax Assets, Transactions Costs	1,020	898
Deferred Tax Assets, Reserves		47
Deferred Tax Assets, Restructuring costs	160	293
Deferred Tax Assets, Stock-based compensation	576	811
Deferred Tax Assets, Other	279	138
Total long-term deferred tax assets	12,087	10,297
Deferred Tax Liabilities, Goodwill and intangible assets	(11,048)	(7,301)
Deferred Tax Liabilities, Property and equipment	(903)	(749)
Deferred Tax Liabilities, Prepaid insurance	(508)	(359)
Deferred Tax Liabilities, Other	(122)	(1)
Total long-term deferred tax liabilities	(12,581)	(8,410)
Valuation allowance		(286)
Total net deferred tax assets/(liabilities)	$ (494)
Total net deferred tax assets/(liabilities)		$ 1,601

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Statutory federal tax rate	21.00%	35.00%	35.00%
Effective income tax rate	20.60%	39.00%	25.50%
Unrecognized tax benefits	$ 221	$ 261	$ 210	$ 113
U.S Federal authorities [Member] | Minimum [Member]
Tax year open for examination		2015
U.S Federal authorities [Member] | Maximum [Member]
Tax year open for examination		2017
State authorities [Member] | Minimum [Member]
Tax year open for examination		2013
State authorities [Member] | Maximum [Member]
Tax year open for examination		2017

Income Taxes (Reconciliation of

Income Taxes (Reconciliation of Statutory Federal Tax Rate) (Details)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Components Of Income Tax Expense Benefit Continuing Operations [Abstract]
Federal income tax at statutory rate	21.00%	35.00%	35.00%
State and local taxes, net of federal benefit	6.30%	5.10%	5.20%
Jobs tax credits, net	(10.00%)	(6.10%)	(15.80%)
162(m) disallowance for executive compensation	4.20%	1.30%
Nondeductible permanent items	2.10%	0.40%	0.90%
2017 Tax Reform Act		4.00%
Excess tax benefit	(2.60%)	(0.60%)
Other	(0.40%)	(0.10%)	0.20%
Effective income tax rate	20.60%	39.00%	25.50%

Income Taxes (Reconciliation _2

Income Taxes (Reconciliation of Gross Unrecognized Tax Benefits Excluding Interest and Penalties) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Components Of Income Tax Expense Benefit Continuing Operations [Abstract]
Balance as of January 1,	$ 261	$ 210	$ 113
Additions for current year tax positions		51	97
Expiration of statutes	(40)
Balance as of December 31,	$ 221	$ 261	$ 210

Stock Options And Restricted _3

Stock Options And Restricted Stock Awards (Narrative) (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock option compensation expense	$ 4.1	$ 2.5	$ 1.1
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock option compensation expense	2	1.1	0.6
Unrecognized compensation cost	$ 4.7
Unrecognized compensation cost recognition period	2 years 2 months 12 days
Intrinsic value on vested stock options	$ 8.5
Intrinsic value on outstanding stock options	$ 17.7
Share-based compensation number of shares vested	180,442
Share-based compensation number of shares unvested	502,687
Intrinsic value on exercised stock options	$ 1.8	0.5	3.9
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock option compensation expense	2.1	$ 1.4	$ 0.5
Unrecognized compensation cost	$ 3.7
Unrecognized compensation cost recognition period	1 year 9 months 18 days
Fair market value of vested restricted stock awards	$ 2
2009 Stock Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum shares of stock awards authorized for issuance	1,500,000
2017 Omnibus Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum shares of stock awards authorized for issuance	1,182,270
Share-based compensation number of shares available for grant	800,000
2017 Omnibus Incentive Plan [Member] | Stock options or stock appreciation rights "SARs" [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum shares of stock awards authorized for issuance	500,000
2017 Omnibus Incentive Plan [Member] | Awards denominated in shares of common stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum shares of stock awards authorized for issuance	300,000
2017 Omnibus Incentive Plan [Member] | Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price of stock options outstanding, lower range limit	$ 4.62
Exercise price of stock options outstanding, upper range limit	$ 71
2009 and 2017 Stock Incentive Plan [Member] | Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment award, expiration period	10 years
2009 and 2017 Stock Incentive Plan [Member] | Stock Options [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment vesting period	3 years
2009 and 2017 Stock Incentive Plan [Member] | Stock Options [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment vesting period	4 years
2009 and 2017 Stock Incentive Plan [Member] | Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment award, expiration period	10 years
2009 and 2017 Stock Incentive Plan [Member] | Restricted Stock [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment vesting period	1 year
2009 and 2017 Stock Incentive Plan [Member] | Restricted Stock [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based payment vesting period	4 years

Stock Options And Restricted _4

Stock Options And Restricted Stock Awards (Summary of Stock Option Activity and Weighted Average Exercise Price) (Details) - Stock Options [Member] shares in Thousands	12 Months Ended
	Dec. 31, 2018$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options, Outstanding, beginning of period shares | shares	479
Options, Granted shares | shares	278
Options, Exercised shares | shares	(42)
Options, Forfeited/Cancelled shares | shares	(32)
Options, Outstanding, end of period shares | shares	683
Weighted Average Exercise Price, Outstanding, beginning of period | $ / shares	$ 23.91
Weighted Average Exercise Price, Granted | $ / shares	38.10
Weighted Average Exercise Price, Exercised | $ / shares	23.50
Weighted Average Exercise Price, Forfeited/Cancelled | $ / shares	26.20
Weighted Average Exercise Price, Outstanding, end of period | $ / shares	$ 29.60

Stock Options And Restricted _5

Stock Options And Restricted Stock Awards (Weighted-Average Estimated Fair Value of Employee Stock Options Granted) (Details) - Stock Options [Member] - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average fair value	$ 14.72	$ 12.97	$ 9.32
Risk-free discount rate, minimum	2.32%	1.67%	1.70%
Risk-free discount rate, maximum	2.84%	1.85%	2.02%
Expected life			8 years 2 months 12 days
Volatility	45.00%	47.00%	47.00%
Expected turn-over rate			2.00%
Expected exercise multiple			$ 2.2
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected life	4 years 1 month 6 days	3 years 7 months 6 days
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected life	4 years 2 months 12 days	4 years 2 months 12 days

Stock Options And Restricted _6

Stock Options And Restricted Stock Awards (Summary of Status of Unvested Restricted Stock Awards Outstanding) (Details) - Restricted Stock [Member] shares in Thousands	12 Months Ended
	Dec. 31, 2018$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested restricted stock awards at beginning of period | shares	143
Awarded | shares	77
Vested | shares	(55)
Forfeited | shares	(16)
Unvested restricted stock awards at end of period | shares	149
Weighted Average Grant Date Fair Value beginning of period | $ / shares	$ 29.30
Weighted Average Grant Date Fair Value, Awarded | $ / shares	42.70
Weighted Average Grant Date Fair Value, Vested | $ / shares	30.10
Weighted Average Grant Date Fair Value, Forfeited | $ / shares	28
Weighted Average Grant Date Fair Value end of period | $ / shares	$ 36.10

Operating Leases (Narrative) (D

Operating Leases (Narrative) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Leases Operating [Abstract]
Rent expense	$ 6	$ 3.9	$ 3.8
Sublease income recognized	$ 0.3	$ 0.1

Operating Leases (Schedule of F

Operating Leases (Schedule of Future Minimum Payments Under Non-cancelable Operating Leases, Exclusive of Taxes and Other Operating Expenses) (Details) $ in Thousands	Dec. 31, 2018USD ($)
Leases Operating [Abstract]
2019	$ 6,374
2020	4,820
2021	3,460
2022	2,377
2023	2,130
Thereafter	1,382
Total	$ 20,543

Employee Benefit Plans (Narrati

Employee Benefit Plans (Narrative) (Details) - 401(k) Retirement Plan [Member] - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Defined Contribution Plan Disclosure [Line Items]
Matching percentage for retirement plan	6.00%	6.00%	6.00%
Company matching contribution amount	$ 300,000	$ 44,000	$ 31,100
Ambercare Corporation, Inc. [Member]
Defined Contribution Plan Disclosure [Line Items]
Company matching contribution amount	$ 200,000

Commitments and Contingencies (

Commitments and Contingencies (Narrative) (Details)	12 Months Ended
	Dec. 31, 2018Facility	Nov. 05, 2018Time
Commitments And Contingencies [Line Items]
Amended and restated employment agreement date	Nov. 5, 2018
Senior Management [Member] | Maximum [Member]
Commitments And Contingencies [Line Items]
Employment agreement term	4 years
Chief Executive Officer [Member]
Commitments And Contingencies [Line Items]
Number of annual compensation times on termination of employment		2
Amended Number of Annual Compensation Times on Termination of Employment		3
Executive Officer [Member]
Commitments And Contingencies [Line Items]
Number of annual compensation times on termination of employment		1
Amended Number of Annual Compensation Times on Termination of Employment		2
Illinois [Member]
Commitments And Contingencies [Line Items]
Number of senior living facilities | Facility	3

Severance and Restructuring (Na

Severance and Restructuring (Narrative) (Details) $ in Millions	12 Months Ended
	Dec. 31, 2018USD ($)item	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)
Total expenses related to streamlining initiatives | $	$ 1.9	$ 1.7	$ 8
Illinois [Member]
Number of adult day centers closed | item	3

Severance and Restructuring (Co

Severance and Restructuring (Components of and Changes in Severance and Restructuring Accruals) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Restructuring Cost and Reserve [Line Items]
Provision		$ 383	$ 2,550
Employee Termination Costs [Member]
Restructuring Cost and Reserve [Line Items]
Balance	$ 562	1,326
Provision	647	1,038
Utilization	(1,129)	(1,802)
Balance	80	562	1,326
Restructuring and Other [Member]
Restructuring Cost and Reserve [Line Items]
Balance	1,077	1,786
Provision	564	627
Utilization	(1,056)	(1,336)
Balance	$ 585	$ 1,077	$ 1,786

Segment Information (Narrative)

Segment Information (Narrative) (Details)	12 Months Ended
	Dec. 31, 2018segment
Segment Reporting [Abstract]
Number of reportable business segments	3

Segment Information (Summary Of

Segment Information (Summary Of Segment Information) (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Segment Reporting Information [Line Items]
Net service revenues	$ 139,669	$ 137,716	$ 131,258	$ 109,476	$ 112,028	$ 108,662	$ 103,629	$ 101,675	$ 518,119	$ 425,994	$ 400,929
Cost of services revenues									379,843	310,119	294,593
Gross profit	37,810	36,790	35,743	27,933	30,785	29,123	28,581	27,386	138,276	115,875	106,336
Provision for doubtful accounts									272	8,409	7,373
General and administrative expenses									105,025	76,902	76,840
Operating income from continuing operations	$ 6,809	$ 5,988	$ 6,913	$ 4,589	$ 7,470	$ 5,877	$ 5,991	$ 7,030	24,299	26,368	15,476
Other general and administrative expenses									55,282	41,247	38,913
Loss (gain) on sale of assets									38	(2,467)	0
Depreciation and amortization									8,642	6,663	6,647
Interest income									(2,592)	(66)	(2,812)
Interest expense									5,016	4,472	2,332
Other income									0	(217)	(206)
Income before income taxes									21,875	22,179	16,162
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses									49,743	35,655	37,927
Operating income from continuing operations									88,261	71,811	61,036
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues									492,413	425,994	400,929
Cost of services revenues									365,264	310,119	294,593
Gross profit									127,149	115,875	106,336
Provision for doubtful accounts									265	8,409	7,373
Personal Care [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses									44,463	35,655	37,927
Operating income from continuing operations									82,421	71,811	61,036
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues									18,850	0	0
Cost of services revenues									10,010	0	0
Gross profit									8,840	0	0
Provision for doubtful accounts									5	0	0
Hospice [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses									3,737	0	0
Operating income from continuing operations									5,098	0	0
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues									6,856	0	0
Cost of services revenues									4,569	0	0
Gross profit									2,287	0	0
Provision for doubtful accounts									2	0	0
Home Health [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses									1,543	0	0
Operating income from continuing operations									$ 742	$ 0	$ 0

Significant Payors (Revenue by

Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Net service revenues	$ 139,669	$ 137,716	$ 131,258	$ 109,476	$ 112,028	$ 108,662	$ 103,629	$ 101,675	$ 518,119	$ 425,994	$ 400,929
Personal Care [Member]
Net service revenues									492,413	425,994	400,929
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues									$ 492,413	$ 425,994	$ 400,929
Concentration risk, percentage									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									$ 286,787	$ 273,525	$ 282,540
Concentration risk, percentage									58.20%	64.20%	70.50%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues									$ 173,884	$ 140,993	$ 104,413
Concentration risk, percentage									35.30%	33.10%	26.00%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member]
Net service revenues									$ 20,060	$ 8,739	$ 9,644
Concentration risk, percentage									4.10%	2.10%	2.40%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues									$ 6,190	$ 2,737	$ 4,332
Concentration risk, percentage									1.30%	0.60%	1.10%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues									$ 5,492
Concentration risk, percentage									1.10%
Hospice [Member]
Net service revenues									$ 18,850	$ 0	$ 0
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues									$ 18,850
Concentration risk, percentage									100.00%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues									$ 1,047
Concentration risk, percentage									5.60%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues									$ 151
Concentration risk, percentage									0.80%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues									$ 17,652
Concentration risk, percentage									93.60%
Home Health [Member]
Net service revenues									$ 6,856	$ 0	$ 0
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues									$ 6,856
Concentration risk, percentage									100.00%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues									$ 752
Concentration risk, percentage									11.00%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues									$ 70
Concentration risk, percentage									1.00%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues									$ 6,034
Concentration risk, percentage									88.00%

Significant Payors (Revenue b_2

Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Net service revenues	$ 139,669	$ 137,716	$ 131,258	$ 109,476	$ 112,028	$ 108,662	$ 103,629	$ 101,675	$ 518,119	$ 425,994	$ 400,929
Personal Care [Member]
Net service revenues									492,413	425,994	400,929
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues									$ 492,413	$ 425,994	$ 400,929
Concentration risk, percentage									100.00%	100.00%	100.00%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues									$ 233,990	$ 224,257	$ 215,162
Concentration risk, percentage									47.50%	52.60%	53.60%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member]
Net service revenues									$ 65,117	$ 37,588	$ 51,718
Concentration risk, percentage									13.20%	8.80%	12.90%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues									$ 58,914	$ 58,360	$ 29,924
Concentration risk, percentage									12.00%	13.70%	7.50%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues									$ 134,392	$ 105,789	$ 104,125
Concentration risk, percentage									27.30%	24.90%	26.00%
Hospice [Member]
Net service revenues									$ 18,850	$ 0	$ 0
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues									$ 18,850
Concentration risk, percentage									100.00%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues									$ 18,850
Concentration risk, percentage									100.00%
Home Health [Member]
Net service revenues									$ 6,856	$ 0	$ 0
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues									$ 6,856
Concentration risk, percentage									100.00%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues									$ 6,856
Concentration risk, percentage									100.00%

Significant Payors (Narrative)

Significant Payors (Narrative) (Details) - Illinois Department On Aging [Member]	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenues [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	31.00%	36.50%	42.10%
Accounts Receivable [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	22.50%	37.50%

Unaudited Summarized Quarterl_3

Unaudited Summarized Quarterly Financial Information (Schedule of Quarterly Results of Operations) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Net service revenues	$ 139,669	$ 137,716	$ 131,258	$ 109,476	$ 112,028	$ 108,662	$ 103,629	$ 101,675	$ 518,119	$ 425,994	$ 400,929
Gross profit	37,810	36,790	35,743	27,933	30,785	29,123	28,581	27,386	138,276	115,875	106,336
Operating income from continuing operations	6,809	5,988	6,913	4,589	7,470	5,877	5,991	7,030	24,299	26,368	15,476
Net income from continuing operations	4,542	3,631	4,318	4,886	3,000	3,464	2,756	4,314	17,377	13,534	12,063
Earnings from discontinued operations	126				147
Net income	$ 4,668	$ 3,631	$ 4,318	$ 4,886	$ 3,147	$ 3,464	$ 2,756	$ 4,314	$ 17,503	$ 13,681	$ 12,160
Average shares outstanding:
Basic	12,964	12,179	11,533	11,502	11,488	11,486	11,470	11,434	12,049	11,470	11,292
Diluted	13,381	12,569	11,838	11,696	11,638	11,631	11,622	11,581	12,383	11,623	11,349
Basic
Continuing operations	$ 0.35	$ 0.29	$ 0.37	$ 0.42	$ 0.26	$ 0.30	$ 0.24	$ 0.38	$ 1.44	$ 1.18	$ 1.06
Discontinued operations	0.01				0.01				0.01	0.01	0.01
Basic income per share	0.36	0.29	0.37	0.42	0.27	0.30	0.24	0.38	1.45	1.19	1.07
Diluted net income per share
Continuing operations	0.34	0.28	0.36	0.42	0.26	0.29	0.24	0.37	1.40	1.16	1.06
Discontinued operations	0.01				0.01				0.01	0.01	0.01
Diluted income per share	$ 0.35	$ 0.28	$ 0.36	$ 0.42	$ 0.27	$ 0.29	$ 0.24	$ 0.37	$ 1.41	$ 1.17	$ 1.07

Unaudited Summarized Quarterl_4

Unaudited Summarized Quarterly Financial Information (Schecule of Effects of Corrections of Errors on Unaudited Quarterly Results of Operations) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information Disclosure [Line Items]
Net service revenues	$ 139,669	$ 137,716	$ 131,258	$ 109,476	$ 112,028	$ 108,662	$ 103,629	$ 101,675	$ 518,119	$ 425,994	$ 400,929
Gross profit	37,810	36,790	35,743	27,933	30,785	29,123	28,581	27,386	138,276	115,875	106,336
Operating income from continuing operations	6,809	5,988	6,913	4,589	7,470	5,877	5,991	7,030	24,299	26,368	15,476
Net income from continuing operations	4,542	3,631	4,318	4,886	3,000	3,464	2,756	4,314	17,377	13,534	12,063
Net income	$ 4,668	$ 3,631	$ 4,318	$ 4,886	$ 3,147	$ 3,464	$ 2,756	$ 4,314	$ 17,503	$ 13,681	$ 12,160
Basic	$ 0.36	$ 0.29	$ 0.37	$ 0.42	$ 0.27	$ 0.30	$ 0.24	$ 0.38	$ 1.45	$ 1.19	$ 1.07
Diluted	$ 0.35	$ 0.28	$ 0.36	$ 0.42	$ 0.27	$ 0.29	$ 0.24	$ 0.37	$ 1.41	$ 1.17	$ 1.07
As Previously Reported [Member]
Quarterly Financial Information Disclosure [Line Items]
Net service revenues		$ 137,631	$ 131,237	$ 109,448	$ 111,958	$ 108,592	$ 103,559	$ 101,606		$ 425,715	$ 400,688
Gross profit		36,705	35,722	27,905	30,715	29,053	28,511	27,317		115,596	106,095
Operating income from continuing operations		5,903	6,892	4,561	7,550	5,807	5,921	6,961		26,239	15,235
Net income from continuing operations		3,546	4,297	4,858	3,094	3,408	2,700	4,259		13,461	11,927
Net income		$ 3,546	$ 4,297	$ 4,858	$ 3,241	$ 3,408	$ 2,700	$ 4,259		13,608	12,024
Basic		$ 0.29	$ 0.37	$ 0.42	$ 0.28	$ 0.30	$ 0.24	$ 0.37
Diluted		$ 0.28	$ 0.36	$ 0.42	$ 0.28	$ 0.29	$ 0.23	$ 0.37
Corrections [Member]
Quarterly Financial Information Disclosure [Line Items]
Net service revenues		$ 85	$ 21	$ 28	$ 70	$ 70	$ 70	$ 69		279	241
Gross profit		85	21	28	70	70	70	69		279	241
Operating income from continuing operations		85	21	28	(80)	70	70	69		129	241
Net income from continuing operations		85	21	28	(94)	56	56	55		73	136
Net income		$ 85	$ 21	$ 28	$ (94)	$ 56	$ 56	$ 55		$ 73	$ 136
Basic					$ (0.01)			$ 0.01
Diluted					$ (0.01)		$ 0.01

Valuation And Qualifying Acco_2

Valuation And Qualifying Accounts (Details) - Allowance For Doubtful Accounts [Member] - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at beginning of period		$ 10,537	$ 7,363	$ 4,850
Additions/charges		272	8,259	7,373
Deductions	[1]	10,138	5,085	4,860
Balance at end of period		$ 671	$ 10,537	$ 7,363
[1]	Write-offs, net of recoveries

Valuation And Qualifying Acco_3

Valuation And Qualifying Accounts (Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Valuation and Qualifying Accounts Disclosure [Line Items]
Revenues	$ 139,669	$ 137,716	$ 131,258	$ 109,476	$ 112,028	$ 108,662	$ 103,629	$ 101,675	$ 518,119	$ 425,994	$ 400,929
Accounting Standards Update 2014-09 [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Revenues									$ (9,700)