Addus HomeCare (ADUS) 10-Q 8 Nov 19 2019 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2019	Nov. 01, 2019
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2019
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2019
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 Current Reporting Status	Yes
Entity Address, State or Province	TX
Entity File Number	001-34504
Entity Tax Identification Number	20-5340172
Entity Address, Address Line One	6801 Gaylord Parkway,
Entity Address, Address Line Two	Suite 110
Entity Address, City or Town	Frisco
Entity Address, Postal Zip Code	75034
City Area Code	(469)
Local Phone Number	535-8200
Entity Common Stock, Shares Outstanding		15,559,260
Document Quarterly Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Title of 12(b) Security	Common Stock, $0.001 par value
Security Exchange Name	NASDAQ

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Current assets
Cash	$ 239,609	$ 70,406
Accounts receivable, net of allowances	138,045	108,000
Prepaid expenses and other current assets	8,822	7,098
Total current assets	386,476	185,504
Property and equipment, net of accumulated depreciation and amortization	11,527	10,658
Other assets
Goodwill	162,016	135,442
Intangibles, net of accumulated amortization	41,119	23,784
Operating lease right of use assets, net	17,972
Total other assets	221,107	159,226
Total assets	619,110	355,388
Current liabilities
Accounts payable	14,741	12,238
Accrued payroll	27,043	22,449
Accrued expenses	19,133	11,586
Accrued workers’ compensation insurance	14,399	15,169
Current portion of long-term debt	970	62
Total current liabilities	76,286	61,504
Long-term liabilities
Long-term debt, less current portion, net of debt issuance costs	59,248	17,222
Long-term operating lease liabilities	12,559
Deferred tax liabilities, net	866	494
Other long-term liabilities	163	635
Total long-term liabilities	72,836	18,351
Total liabilities	149,122	79,855
Stockholders’ equity
Common stock—$.001 par value; 40,000 authorized and 15,559 and 13,126 shares issued and outstanding as of September 30, 2019 and December 31, 2018, respectively	15	13
Additional paid-in capital	356,889	177,683
Retained earnings	113,084	97,837
Total stockholders’ equity	469,988	275,533
Total liabilities and stockholders’ equity	$ 619,110	$ 355,388

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2019	Dec. 31, 2018
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	15,559,000	13,126,000
Common stock, shares outstanding	15,559,000	13,126,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement [Abstract]
Net service revenues	$ 169,803	$ 137,716	$ 458,749	$ 378,449
Cost of service revenues	123,817	100,926	334,719	277,985
Gross profit	45,986	36,790	124,030	100,464
General and administrative expenses	35,950	28,267	95,429	76,298
Depreciation and amortization	2,756	2,535	7,365	6,676
Total operating expenses	38,706	30,802	102,794	82,974
Operating income from continuing operations	7,280	5,988	21,236	17,490
Interest income	(786)	(113)	(1,096)	(2,468)
Interest expense	866	1,543	2,164	3,836
Total interest expense, net	80	1,430	1,068	1,368
Income from continuing operations before income taxes	7,200	4,558	20,168	16,122
Income tax expense	1,759	927	4,347	3,287
Net income from continuing operations	5,441	3,631	15,821	12,835
Net loss from discontinued operations	(574)		(574)
Net income	$ 4,867	$ 3,631	$ 15,247	$ 12,835
Basic income per share
Continuing operations	$ 0.40	$ 0.29	$ 1.19	$ 1.08
Discontinued operations	(0.04)		(0.04)
Basic income per share	0.36	0.29	1.15	1.08
Diluted income per share
Continuing operations	0.38	0.28	1.16	1.06
Discontinued operations	(0.04)		(0.04)
Diluted income per share	$ 0.34	$ 0.28	$ 1.12	$ 1.06
Weighted average number of common shares and potential common shares outstanding:
Basic	13,766	12,179	13,271	11,740
Diluted	14,203	12,569	13,687	12,037

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]
Balance at Dec. 31, 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		74
Forfeiture of shares of common stock under restricted stock award agreements, shares		(16)
Stock-based compensation	2,961		2,961
Shares issued for exercise of stock options	450		450
Shares issued for exercise of stock options, shares		17
Shares issued in Public Offering, net of offering costs	76,618	$ 1	76,617
Shares issued in Public Offering, net of offering costs,shares		1,390
Net income	12,835			12,835
Balance at Sep. 30, 2018	269,173	$ 13	175,991	93,169
Balance, shares at Sep. 30, 2018		13,097
Balance at Jun. 30, 2018	187,637	$ 12	98,087	89,538
Balance, shares at Jun. 30, 2018		11,697
Issuance of shares of common stock under restricted stock award agreements, shares		5
Stock-based compensation	1,105		1,105
Shares issued for exercise of stock options	182		182
Shares issued for exercise of stock options, shares		5
Shares issued in Public Offering, net of offering costs	76,618	$ 1	76,617
Shares issued in Public Offering, net of offering costs,shares		1,390
Net income	3,631			3,631
Balance at Sep. 30, 2018	269,173	$ 13	175,991	93,169
Balance, shares at Sep. 30, 2018		13,097
Balance at Dec. 31, 2018	275,533	$ 13	177,683	97,837
Balance, shares at Dec. 31, 2018		13,126
Issuance of shares of common stock under restricted stock award agreements, shares		64
Forfeiture of shares of common stock under restricted stock award agreements, shares		(4)
Stock-based compensation	4,186		4,186
Shares issued for exercise of stock options	2,077		2,077
Shares issued for exercise of stock options, shares		73
Shares issued in Public Offering, net of offering costs	172,945	$ 2	172,943
Shares issued in Public Offering, net of offering costs,shares		2,300
Net income	15,247			15,247
Balance at Sep. 30, 2019	469,988	$ 15	356,889	113,084
Balance, shares at Sep. 30, 2019		15,559
Balance at Jun. 30, 2019	289,341	$ 13	181,111	108,217
Balance, shares at Jun. 30, 2019		13,219
Issuance of shares of common stock under restricted stock award agreements, shares		1
Forfeiture of shares of common stock under restricted stock award agreements, shares		(4)
Stock-based compensation	1,470		1,470
Shares issued for exercise of stock options	1,365		1,365
Shares issued for exercise of stock options, shares		43
Shares issued in Public Offering, net of offering costs	172,945	$ 2	172,943
Shares issued in Public Offering, net of offering costs,shares		2,300
Net income	4,867			4,867
Balance at Sep. 30, 2019	$ 469,988	$ 15	$ 356,889	$ 113,084
Balance, shares at Sep. 30, 2019		15,559

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net income	$ 15,247	$ 12,835
Adjustments to reconcile net income to net cash provided by operating activities, net of acquisitions:
Depreciation and amortization	7,365	6,676
Deferred income taxes	372	397
Stock-based compensation	4,186	2,961
Amortization of debt issuance costs under the credit facility	533	450
Provision for doubtful accounts	168	214
Loss of disposal of assets	(90)
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	(22,291)	(5,418)
Prepaid expenses and other current assets	2,822	2,007
Accounts payable	1,856	1,844
Accrued expenses and other long-term liabilities	(2,084)	2,713
Net cash provided by operating activities	8,084	24,679
Cash flows from investing activities:
Acquisitions of businesses, net of cash acquired	(53,224)	(62,347)
Purchases of property and equipment	(3,077)	(3,384)
Net cash used in investing activities	(56,301)	(65,731)
Cash flows from financing activities:
Proceeds from issuance of common stock, net of offering costs	172,945	76,618
Borrowings on revolver — credit facility	23,458
Borrowings on term loan — credit facility	19,600	60,420
Payments on term loan — credit facility	(245)	(1,688)
Payments for debt issuance costs under the credit facility	(361)	(73)
Payments on financing lease obligations	(54)	(952)
Cash received from exercise of stock options	2,077	450
Net cash provided by financing activities	217,420	134,775
Net change in cash	169,203	93,723
Cash, at beginning of period	70,406	53,754
Cash, at end of period	239,609	147,477
Supplemental disclosures of cash flow information:
Cash paid for interest	1,594	3,202
Cash paid for income taxes	5,808	4,234
Supplemental disclosures of non-cash investing and financing activities:
Contingent and deferred consideration accrued for acquisition		$ 847
Leasehold improvements acquired through tenant allowances	$ 682

Nature of Operations, Consolida

Nature of Operations, Consolidation, and Presentation of Financial Statements	9 Months Ended
	Sep. 30, 2019
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Nature of Operations, Consolidation, and Presentation of Financial Statements	1. Nature of Operations, Consolidation, and Presentation of Financial Statements Addus HomeCare Corporation (“Holdings”) and its subsidiaries (together with Holdings, the “Company”, “we”, “us” or “our”) operate as a multi-state provider of three distinct but related business segments providing in-home services. In its personal care services segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy. Basis of Presentation The accompanying Condensed Consolidated Financial Statements and related notes have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”) for Quarterly Reports on Form 10-Q. The accompanying balance sheet as of December 31, 2018 has been derived from the Company’s audited financial statements for the year ended December 31, 2018 previously filed with the SEC. Accordingly, these financial statements do not include all of the information and note disclosures required by accounting principles generally accepted in the United States of America (“GAAP”) for annual financial statements and should be read in conjunction with our consolidated financial statements and notes thereto for the year ended December 31, 2018 included in our Annual Report on Form 10-K, which includes information and disclosures not included herein. In the opinion of management, these financial statements reflect all adjustments of a normal, recurring nature necessary for the fair statement of our financial position, results of operations, and cash flows for the interim periods presented in conformity with GAAP. Our results for any interim period are not necessarily indicative of results for a full year or any other interim period and have not been audited by our independent auditors. Principles of Consolidation These Condensed Consolidated Financial Statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2019
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Estimates The financial statements are prepared by management in conformity with GAAP and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: implicit price concessions, reserve for workers’ compensation insurance claims, accounting for stock-based compensation, accounting for income taxes, business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from these estimates. Diluted Net Income Per Common Share Basic earnings per share is calculated using our weighted-average outstanding common shares. Diluted net income per common share, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The Company’s outstanding securities that may potentially dilute the common stock are stock options and restricted stock awards. Included in the Company’s calculation of diluted earnings per share for the three and nine months ended September 30, 2019 were approximately 650,000 stock options outstanding, of which approximately 359,000 and 335,000 respectively, were dilutive. In addition, there were approximately 147,000 restricted stock awards outstanding, 78,000 and 81,000 of which were dilutive for the three and nine months ended September 30, 2019, respectively. Included in the Company’s calculation of diluted earnings per share for the three and nine months ended September 30, 2018 were approximately 708,000 stock options outstanding, of which approximately 307,000 and 213,000 respectively, were dilutive. In addition, there were approximately 148,000 restricted stock awards outstanding, 83,000 and 83,000 of which were dilutive for the three and nine months ended September 30, 2018, respectively. Recently Adopted Accounting Pronouncements In February 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2016-02, Leases (Topic 842) Leases (Topic 842) Targeted Improvements We elected the package of practical expedients available for expired or existing contracts, which allowed us to carryforward our historical assessments of (1) whether contracts are, or contain, leases, (2) lease classification and (3) initial direct costs. Recently Issued Accounting Pronouncements 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

Public Offering

Public Offering	9 Months Ended
	Sep. 30, 2019
Equity [Abstract]
Public Offering	3. Public Offering On September 9, 2019, the Company completed a public offering of an aggregate 2,300,000 shares of common stock, par value $0.001 per share, including 300,000 shares of common stock sold pursuant to the exercise in full by the underwriters of their option to purchase additional shares at a public offering price of $79.50 per share (the “Public Offering”). The Company received . The Company used approximately $130.0 million from the net proceeds of the Public Offering to fund the purchase price for the Company’s acquisition of Hospice Partners of America, LLC (“Hospice Partners”), on October 1, 2019 and may use any remaining net proceeds of the Public Offering for general corporate purposes, including future acquisitions or investments, and the repayment of indebtedness outstanding under the Company’s amended and restated credit facility. The Public Offering resulted in an increase to additional paid in capital of approximately $172.9 million on the Company’s Condensed Consolidated Balance Sheet at September 30, 2019.

Leases

Leases	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
Leases	4. Leases We have historically entered into operating leases for local branches, our corporate headquarters and certain equipment. The Company’s current leases have expiration dates through 2029. Certain of our arrangements have free rent periods and/or escalating rent payment provisions. We recognize rent expense on a straight-line basis over the lease term. Certain of the Company’s leases include termination options and renewal options for periods ranging from one to five years. Because we are not reasonably certain to exercise these renewal options, the options generally are not considered in determining the lease term, and payments associated with the option years are excluded from lease payments. When available, we use the rate implicit in the lease to discount lease payments to present value; however, most of our leases do not provide a readily determinable implicit rate. Therefore, we must estimate our incremental borrowing rate to discount the lease payments based on information available at lease commencement. Amounts reported in the Condensed September 30, 2019 (Amounts in Thousands) Operating lease right of use assets, net $ 17,972 Short-term operating lease liabilities (in accrued expenses) 5,928 Long-term operating lease liabilities 12,559 Total operating lease liabilities $ 18,487 Leases Costs Components of lease cost were reported in general and administrative expenses in the Condensed Consolidated Statements of Income as follows: For the Three Months Ended September 30, 2019 For the Nine Months Ended September 30, 2019 (Amounts in Thousands) (Amounts in Thousands) Operating lease costs $ 1,897 $ 5,101 Short-term lease costs 222 382 Total lease cost $ 2,119 $ 5,483 Lease Term and Discount Rate Weighte d average remaining lease terms and discount rates for the nine months ended September 30, 2019 were as follows: 2019 Operating leases: Weighted average remaining lease term in years 3.58 Weighted average discount rate 5.50 % Maturity of Lease Liabilities A summary of our remaining operating lease payments as of September 30, 2019 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2020 $ 6,598 2021 5,796 2022 3,882 2023 2,288 2024 1,251 Thereafter 663 Total future minimum rental commitments 20,478 Less: Imputed interest (1,991 ) Total lease liabilities $ 18,487 As required by ASC 842, the future minimum operating lease payments on non-cancelable leases as of December 31, 2018 under the accounting standards in effect as of that period were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended December 31, 2019 $ 6,374 2020 4,820 2021 3,460 2022 2,377 2023 2,130 Thereafter 1,382 Total future minimum rental commitments $ 20,543 Supplemental cash flow information For the Nine Months Ended September 30, 2019 (Amounts in Thousands) Supplemental Cash Flows Information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 5,393 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 5,536 Financing Leases Some of our financing leases include provisions to purchase the asset at the conclusion of the lease. The treatment of these leases remains consistent and the transition does not have an impact on the accounting for these leases. Financing leases were not material as of September 30, 2019 and December 31, 2018.

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2019
Business Combinations [Abstract]
Acquisitions	5. Acquisitions Alliance Home Health Care On August 1, 2019, the Company completed the acquisition of all of the assets of Alliance Home Health Care (“Alliance”). The purchase price was approximately $23.5 million. The purchase of Alliance was funded through the Company’s revolving credit facility. With the purchase of Alliance, the Company expanded its personal care, home health and hospice operations in the state of New Mexico. The related acquisition costs of $0.3 million for the three and nine months ended September 30, 2019 were included in general and administrative expenses on the Condensed Consolidated Statements of Income and were expensed as incurred. The results of Alliance are included on the Condensed Consolidated Statements of Income from the date of the acquisition. The Company’s acquisition of Alliance has been accounted for in accordance with ASC Topic 805, Business Combinations Goodwill and Other Intangible Assets Total (Amounts in Thousands) Goodwill $ 15,973 Identifiable intangible assets 5,422 Cash 1,172 Accounts receivable 1,936 Other assets 95 Accounts payable (296 ) Other liabilities (844 ) Total purchase price allocation $ 23,458 Management’s assessment of qualitative factors affecting goodwill for Alliance 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 $1.1 million in state licenses, with an estimated useful life of ten years and $4.3 million of state licenses with an indefinite life. 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 fair value analysis and related valuations reflect the conclusions of management. All estimates, key assumptions, and forecasts were either provided by or reviewed by the Company. The goodwill and intangible assets acquired are deductible for tax purposes. The Alliance acquisition accounted for $3.4 million of net service revenues and $0.8 million of operating income for the three and nine months ended September 30, 2019. VIP Health Care Services On June 1, 2019, the Company completed the acquisition of all of the assets of VIP Health Care Services (“VIP”). The purchase price was approximately $29.9 million. The purchase of VIP was funded through a combination of the Company’s delayed draw term loan portion of its credit facility and available cash. With the purchase of VIP, the Company expanded its personal care operations in the state of New York and into the New York City metropolitan area. The related acquisition costs were $0.4 million for the nine months ended September 30, 2019 and integration costs were $0.2 million and $0.3 million for the three and nine months ended September 30, 2019. These costs were included in general and administrative expenses on the Condensed Consolidated Statements of Income and were expensed as incurred. The results of VIP are included on the Condensed Consolidated Statements of Income from the date of the acquisition. The Company’s acquisition of VIP has been accounted for in accordance with ASC Topic 805, Business Combinations Goodwill and Other Intangible Assets Total (Amounts in Thousands) Goodwill $ 10,374 Identifiable intangible assets 15,370 Cash 110 Accounts receivable 5,986 Other assets 2,308 Property and equipment 27 Accounts payable (385 ) Accrued expenses (747 ) Accrued payroll (1,571 ) Other liabilities (1,554 ) Total purchase price allocation $ 29,918 Management’s assessment of qualitative factors affecting goodwill for VIP 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 state licenses and customer relationships, with estimated useful lives of six and eight years, respectively. 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 VIP acquisition accounted for $13.2 million and $17.6 million of net service revenues for the three and nine months ended September 30, 2019, respectively and $0.4 million and $0.1 million of operating loss for the three and nine months ended September 30, 2019, respectively. Ambercare Corporation On May 1, 2018, the Company completed the acquisition of all the issued and 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 New Mexico personal care operations and entered into its hospice and home health segments in the state of New Mexico. The related acquisition costs were $0.6 million for the nine months ended September 30, 2018. The related integration costs were $0.3 million for the nine months ended September 30, 2019, and $0.7 million and $0.8 million for the three and nine months ended September 30, 2018, respectively. These costs were included in general and administrative expenses on the Condensed Consolidated Statements of Income and were expensed as incurred. The results of Ambercare are included on the Condensed 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 Based upon management’s valuations, which are now final, 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 expenses (4,073 ) Deferred tax liability (2,138 ) Financing 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 estimated useful lives ranging from three to fifteen years, as well as indefinite lived state licenses. 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 non-deductible for tax purposes. The Ambercare acquisition accounted for $17.3 million and $47.8 million of net service revenues for the three and nine months ended September 30, 2019, respectively, and $13.4 million and $22.6 million of net service revenues for each of the three and nine months ended September 30, 2018, respectively. $2.0 million and $3.8 million of for the three and nine months ended September 30, 2018, respectively. Arcadia Home Care & Staffing 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 was $0.6 million for the nine months ended September 30, 2018 and the integration costs were $0.7 million and $0.8 million for the three and nine months ended September 30, 2018, respectively. These costs were included in general and administrative expenses on the Condensed Consolidated Statements of Income and were expensed as incurred. The results of operations from this acquired entity are included in the Condensed 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 were 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 valuations, which are now final, the total purchase price has been allocated as follows: Total (Amounts in Thousands) Goodwill $ 13,072 Accounts receivable 5,317 Identifiable intangible assets 2,264 Property and equipment 155 Other assets 92 Accrued expenses (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, with estimated useful lives ranging from seven 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 Arcadia acquisition accounted for $11.6 million and $32.9 million of net service revenues for the three and nine months September 30, 2019, respectively, and $10.9 million and $21.7 million $1.6 million and $3.2 million of for each of the three and nine months ended September 30, 2018, respectively LifeStyle Options, Inc. 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. As of December 31, 2018, the performance targets were not met and the contingent consideration was remeasured to zero. The Company’s acquisition of LifeStyle 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 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 valuations, which are now final, the total purchase price is final and 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 expenses (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, with estimated useful lives ranging 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 $1.2 million and $3.7 million of net service revenues for the three and nine months ended September 30, 2019, respectively, and $1.5 million and $4.5 million for the three and nine months ended September 30, 2018, respectively. for the three and nine months ended September 30, 2019, was $0.1 million and $0.4 million of for the three and nine months ended September 30, 2018, respectively . The following table contains unaudited pro forma condensed consolidated income statement information of the Company had the acquisitions of Alliance, VIP, Ambercare and Arcadia closed on January 1, 2018. For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 (Amounts in Thousands) (Amounts in Thousands) Net service revenues $ 171,432 $ 160,899 $ 494,796 $ 465,258 Operating income 8,146 8,458 22,213 31,799 Net income from continuing operations 6,393 3,904 16,527 20,261 Net loss from discontinued operations (574 ) — (574 ) — Net income $ 5,819 $ 3,904 $ 15,953 $ 20,261 Net income per common share Basic income per share Continuing operations $ 0.46 $ 0.32 $ 1.25 $ 1.73 Discontinued operations (0.04 ) — (0.04 ) — Basic income per share $ 0.42 $ 0.32 $ 1.21 $ 1.73 Diluted income per share Continuing operations $ 0.45 $ 0.31 $ 1.21 $ 1.68 Discontinued operations (0.04 ) — (0.04 ) — Diluted income per share $ 0.41 $ 0.31 $ 1.17 $ 1.68 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 Alliance, VIP, Ambercare and Arcadia had been acquired effective January 1, 2018. This pro forma information is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred. In addition, future results may vary significantly from the results reflected in the pro forma information. The unaudited pro forma financial information does not reflect the impact of future events that may occur after the acquisition, such as anticipated cost savings from operating synergies.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	6. Goodwill and Intangible Assets A summary of the goodwill activity for the nine months ended September 30, 2019 is provided below: Goodwill Personal Care Hospice Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2018 $ 112,377 $ 22,200 $ 865 $ 135,442 Additions for acquisitions 12,701 13,028 861 26,590 Adjustments to previously recorded goodwill (51 ) 33 2 (16 ) Goodwill as of September 30, 2019 $ 125,027 $ 35,261 $ 1,728 $ 162,016 The Company’s identifiable intangible assets consist of customer and referral relationships, trade names, trademarks and non-competition 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. The Company recognized goodwill in the personal care segment of $10.4 million related to the acquisition of VIP during the nine months ended September 30, 2019. In connection with the acquisition of Alliance on August 1, 2019, the Company recognized goodwill in the personal care, hospice and home health segments of $2.1 million, $13.0 million and $0.9 million, respectively. The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of September 30, 2019: Customer and referral relationships Trade names and trademarks Non- competition agreements State Licenses Total (Amounts in Thousands) Intangible assets with indefinite lives: $ — $ — $ — $ 7,186 $ 7,186 Intangible assets subject to amortization: Gross carrying amount 48,028 21,566 2,155 12,020 83,769 Accumulated amortization (34,898 ) (12,246 ) (2,063 ) (629 ) (49,836 ) Intangible assets subject to amortization, net 13,130 9,320 92 11,391 33,933 Total intangible assets at September 30, 2019 $ 13,130 $ 9,320 $ 92 $ 18,577 $ 41,119 During the nine months ended September 30, 2019, the Company acquired state licenses and customer relationships of $10.7 million and $4.7 million, respectively, related to the acquisition of VIP and state licenses of $5.4 million related to the acquisition of Alliance. Amortization expense related to the identifiable intangible assets amounted to $1.8 million and $4.4 million for the three and nine months ended September 30, 2019, respectively, and $1.9 million and $4.9 million for the three and nine months ended September 30, 2018, respectively. The weighted average remaining lives of identifiable intangible assets as of September 30, 2019 is 7.8 years.

Details of Certain Balance Shee

Details of Certain Balance Sheet Accounts	9 Months Ended
	Sep. 30, 2019
Details Of Certain Balance Sheet Accounts [Abstract]
Details of Certain Balance Sheet Accounts	7. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consisted of the following: September 30, 2019 December 31, 2018 (Amounts in Thousands) Workers’ compensation insurance receivable $ 1,704 $ 1,692 Prepaid workers’ compensation and liability insurance 1,429 1,840 Health insurance receivable 660 564 Other 5,029 3,002 $ 8,822 $ 7,098 Accrued expenses consisted of the following: September 30, 2019 December 31, 2018 (Amounts in Thousands) Current portion of operating lease liabilities $ 5,928 $ — Accrued health insurance 4,139 3,926 Accrued professional fees 3,268 2,260 Accrued payroll taxes 1,681 769 Other 4,117 4,631 $ 19,133 $ 11,586

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2019
Long Term Debt [Abstract]
Long-Term Debt	8. Long-Term Debt Long-term debt consisted of the following: September 30, 2019 December 31, 2018 (Amounts in Thousands) Revolving loan under the credit facility $ 43,458 $ 20,000 Term loan under the credit facility 19,355 — Financing leases 31 81 Less unamortized issuance costs (2,626 ) (2,797 ) Total $ 60,218 $ 17,284 Less current maturities (970 ) (62 ) Long-term debt $ 59,248 $ 17,222 First Amendment to Amended and Restated Senior Secured Credit Facility On September 12, 2019, the Company entered into a First Amendment (the “Amendment”) to its Credit Agreement (as defined below), with certain lenders and Capital One, National Association, as a lender and as agent for all lenders, which amended the Company’s Credit Agreement, dated as of October 31, 2018. The Amendment increased the Company’s amended and restated credit facility by $50.0 million in incremental revolving loans, for an aggregate $300.0 million in revolving loans. The Amendment provides that future incremental loans may be for term loans or an increase to the revolving loan commitments. The Amendment further provides that the proceeds of the incremental revolving loan commitments may be used for, among other things, general corporate purposes. In connection with the modification of this Amendment, the Company incurred approximately $0.4 million of debt issuance costs. Amended and Restated Senior Secured Credit Facility On October 31, 2018, the Company amended and restated its Existing Credit Agreement, as hereinafter defined (as amended by the Amendment, the “Credit Agreement,” and together with the Existing Credit Agreement, the Company’s “amended and restated credit facility” or “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 is evidenced by the Credit Agreement. This amended and restated credit facility amended and restated 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, as extended pursuant to the consent letter, dated January 30, 2019, executed by the Required Lenders (as defined in the Credit Agreement). 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 Credit Agreement) not exceeding 3.75:1.00. In certain circumstances, in connection with a Material Acquisition (as defined in the Credit Agreement), the Company can elect to increase its Total Net Leverage Ratio compliance covenant to 4.25:1.00 for the then current fiscal quarter and the three succeeding fiscal quarters. 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 collateralized by a first priority security interest in all of the Company’s and the other credit parties’ current and future tangible and intangible assets, including the shares of stock of the borrower and subsidiaries. The Credit Agreement contains affirmative and negative covenants customary for credit facilities of this type, including limitations on the Company with respect to liens, indebtedness, guaranties, investments, distributions, mergers and acquisitions and dispositions of assets. The Company pays a fee ranging from 0.20% to 0.35% based on the applicable senior net leverage ratio times the unused portion of the revolving loan portion of the amended and restated credit facility. The Credit Agreement contains customary affirmative covenants regarding, among other things, the maintenance of records, compliance with laws, maintenance of permits, maintenance of insurance and property and payment of taxes. The Credit Agreement also contains certain customary financial covenants and negative covenants that, among other things, include a requirement to maintain a minimum Interest Coverage Ratio (as defined in the Credit Agreement), a requirement to stay below a maximum Total Net Leverage Ratio (as defined in the Credit Agreement) and a requirement to stay below a maximum permitted amount of capital expenditures, 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 on the ability to consummate acquisitions (without the consent of the lenders) under the Company’s credit facility subject to compliance with the Total Net Leverage Ratio (as defined in the Credit Agreement), restrictions on mergers, dispositions of assets, and affiliate transactions, and restrictions on fundamental changes and lines of business. At September 30, 2019, the Company was in compliance with its covenants under the Credit Agreement. The Company drew approximately As of September 30, 2019, the Company had a total of $43.5 million of revolving loans outstanding with an interest rate of 3.85% and the total availability under the revolving loan facility was $134.1 million. The interest rate on the term loan was 3.86% at September 30, 2019. 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% and the total availability under the revolving loan facility was $142.9 million. Senior Secured Credit Facility Prior to October 31, 2018, the Company was a 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 totaled $250.0 million, replaced the Company’s previous senior secured credit facility totaling $125.0 million (“Terminated Senior Secured Credit Facility”), and terminated the Second Amended and Restated Credit and Guaranty Agreement, dated as of November 10, 2015, as modified by the May 24, 2016 amendment (as amended, the “Terminated Senior Secured Credit Agreement”), between the Company, certain lenders and Fifth Third Bank, as agent, which evidenced the Terminated Senior Secured Credit Facility. The credit facility included a $125.0 million revolving loan, a $45.0 million term loan and an $80.0 million delayed draw term loan.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2019
Income Tax Disclosure [Abstract]
Income Taxes	9. Income Taxes The effective income tax rate from continuing operations was 24.4% and 20.3% for the three months ended September 30, 2019 and 2018, respectively, and 21.6% and 20.4% for the nine months ended September 30, 2019 and 2018, respectively. The difference between the federal statutory rate and effective income tax rates is principally due to the inclusion of state taxes and non-deductible compensation, offset by an excess tax benefit and the use of federal employment tax credits.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2019
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	10. Commitments and Contingencies Legal Proceedings From time to time, the Company is subject to legal and/or administrative proceedings incidental to its business. It is the opinion of management that the outcome of pending legal and/or administrative proceedings will not have a material effect on the Condensed Consolidated Balance Sheets and Condensed Consolidated Statements of Income. On January 20, 2016, the Company was served with a lawsuit filed in the United States District Court for the Northern District of Illinois against the Company and Cigna Corporation by Stop Illinois Marketing Fraud, LLC, a qui tam relator formed for the purpose of bringing this action. In the action, the plaintiff alleged, 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 sought 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 declined to intervene. Plaintiff amended its complaint on April 4, 2016 to include additional allegations in support of its False Claims Act claims, including alleged violations of the federal Anti-Kickback Statute. The Company and Cigna Corporation filed a motion to dismiss the amended complaint on June 6, 2016. On February 3, 2017, the Court granted Cigna Corporation’s motion to dismiss in full, and granted the Company’s motion to dismiss in part allowing plaintiff another chance to amend its complaint. Plaintiff timely filed a second amended complaint on March 10, 2017, withdrawing its conspiracy claim under the Federal False Claims Act and adding an explicit claim under the Illinois False Claims Act for the same underlying kickback allegations. On April 7, 2017, the Company filed a partial motion to dismiss the Second Amended Complaint. On May 24, 2017, the State of Illinois filed notice that it was declining to intervene in the plaintiff’s claim under the Illinois False Claims Act. On March 21, 2018, the Court granted the Company’s motion to dismiss the Second Amended Complaint in part and narrowed the lawsuit to whether the federal False Claims Act was violated with respect to home health services provided at three senior living facilities in Illinois. On September 24, 2019, the parties reached an agreement to settle this lawsuit. In connection with the settlement, the Company recognized an expense of $0.6 million in discontinued operations for the three months ended September 30, 2019. The lawsuit was dismissed in full on October 15, 2019. 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, non-solicitation 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 the Company’s 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 the Company’s chief executive officer, and from one times annual compensation to two times annual compensation (as defined in the employment agreements) in the case of the Company’s 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 reimbursement 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.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2019
Segment Reporting [Abstract]
Segment Information	11. Segment Information Operating segments are defined as components of a company that engage in business activities from which it may earn revenues and incur expenses, and for which separate financial information is available and is regularly reviewed by the Company’s chief operating decision makers, to assess the performance of the individual segments and make decisions about resources to be allocated to the segments. The Company operates as a multi-state provider of three distinct but related business segments providing in-home services. In its personal care segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy. The tables below set forth information about the Company’s reportable segments for the three and nine months ended September 30, 2019 and 2018 along with the items necessary to reconcile the segment information to the totals reported in the accompanying condensed consolidated financial statements. Segment assets are not reviewed by the company’s chief operating decision maker function and therefore are not disclosed below. Segment operating income consists of 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. The following tables present revenues disaggregated by revenue source. For the Three Months Ended September 30, 2019 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 154,563 $ 10,874 $ 4,366 $ 169,803 Cost of services revenues 115,504 5,495 2,818 123,817 Gross profit 39,059 5,379 1,548 45,986 General and administrative expenses 15,602 1,824 844 18,270 Segment operating income $ 23,457 $ 3,555 $ 704 $ 27,716 For the Three Months Ended September 30, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 128,179 $ 7,116 $ 2,421 $ 137,716 Cost of services revenues 95,428 3,777 1,721 100,926 Gross profit 32,751 3,339 700 36,790 General and administrative expenses 10,494 1,475 604 12,573 Segment operating income $ 22,257 $ 1,864 $ 96 $ 24,217 For the Three Months Ended September 30, 2019 2018 (Amounts in Thousands) Segment Reconciliation: Total segment operating income $ 27,716 $ 24,217 Items not allocated at segment level: Other general and administrative expenses 17,680 15,694 Depreciation and amortization 2,756 2,535 Interest income (786 ) (113 ) Interest expense 866 1,543 Income before income taxes $ 7,200 $ 4,558 For the Nine Months Ended September 30, 2019 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 421,458 $ 27,228 $ 10,063 $ 458,749 Cost of services revenues 314,329 13,587 6,803 334,719 Gross profit 107,129 13,641 3,260 124,030 General and administrative expenses 41,373 4,962 2,187 48,522 Segment operating income $ 65,756 $ 8,679 $ 1,073 $ 75,508 For the Nine Months Ended September 30, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 362,740 $ 11,765 $ 3,944 $ 378,449 Cost of services revenues 268,815 6,351 2,819 277,985 Gross profit 93,925 5,414 1,125 100,464 General and administrative expenses 29,283 2,329 947 32,559 Segment operating income $ 64,642 $ 3,085 $ 178 $ 67,905 For the Nine Months Ended September 30, 2019 2018 (Amounts in Thousands) Segment Reconciliation: Total segment operating income $ 75,508 $ 67,905 Items not allocated at segment level: Other general and administrative expenses 46,907 43,739 Depreciation and amortization 7,365 6,676 Interest income (1,096 ) (2,468 ) Interest expense 2,164 3,836 Income before income taxes $ 20,168 $ 16,122

Significant Payors

Significant Payors	9 Months Ended
	Sep. 30, 2019
Significant Payors [Abstract]
Significant Payors	12. Significant Payors For the three and nine months ended September 30, 2019 and 2018, the Company’s revenue disaggregated by payor type was as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues 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 $ 75,569 49.0 % $ 73,691 57.5 % $ 222,677 52.8 % $ 213,145 58.7 % Managed care organizations 68,795 44.5 45,271 35.3 170,946 40.6 126,809 35.0 Private pay 5,750 3.7 5,549 4.3 16,001 3.8 14,861 4.1 Commercial insurance 2,697 1.7 1,869 1.5 6,605 1.6 4,271 1.2 Other 1,752 1.1 1,799 1.4 5,229 1.2 3,654 1.0 Total personal care segment net service revenues $ 154,563 100.0 % $ 128,179 100.0 % $ 421,458 100.0 % $ 362,740 100.0 % Hospice For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Medicare $ 10,045 92.3 % $ 6,677 93.8 % $ 25,243 92.7 % $ 11,030 93.8 % Managed care organizations 584 5.4 426 6.0 1,419 5.2 721 6.1 Other 245 2.3 13 0.2 566 2.1 14 0.1 Total hospice segment net service revenues $ 10,874 100.0 % $ 7,116 100.0 % $ 27,228 100.0 % $ 11,765 100.0 % Home Health For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Medicare $ 3,338 76.4 % $ 2,184 90.2 % $ 7,948 79.0 % $ 3,588 91.0 % Managed care organizations 959 22.0 221 9.1 1,872 18.6 329 8.3 Other 69 1.6 16 0.7 243 2.4 27 0.7 Total home health segment net service revenues $ 4,366 100.0 % $ 2,421 100.0 % $ 10,063 100.0 % $ 3,944 100.0 % The percentages of segment revenue for each of the Company’s significant states for the three and nine months ended September 30, 2019 and 2018 were as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues 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 $ 61,958 40.1 % $ 58,948 46.0 % $ 179,444 42.5 % $ 174,591 48.2 % New York 34,913 22.6 16,814 13.1 75,746 18.0 47,999 13.2 New Mexico 19,662 12.7 16,013 12.5 55,006 13.1 42,594 11.7 All other states 38,030 24.6 36,404 28.4 111,262 26.4 97,556 26.9 Total personal care segment net service revenues $ 154,563 100.0 % $ 128,179 100.0 % $ 421,458 100.0 % $ 362,740 100.0 % Hospice For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues New Mexico $ 10,874 100.0 % $ 7,116 100.0 % $ 27,228 100.0 % $ 11,765 100.0 % Total hospice segment net service revenues $ 10,874 100.0 % $ 7,116 100.0 % $ 27,228 100.0 % $ 11,765 100.0 % Home Health For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues New Mexico $ 4,366 100.0 % $ 2,421 100.0 % $ 10,063 100.0 % $ 3,944 100.0 % Total home health segment net service revenues $ 4,366 100.0 % $ 2,421 100.0 % $ 10,063 100.0 % $ 3,944 100.0 % A substantial portion of the Company’s net service revenues and accounts receivable are derived from services performed for state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 36.5% and 42.8% of our total net service revenues for the three months ended September 30, 2019 and 2018, respectively, and accounted for 39.1% and 46.1% of our total net service revenues for the nine months ended September 30, 2019 and 2018, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 22.0% and 29.5% of the Company’s net service revenues for the three months ended September 30, 2019 and 2018, respectively, and accounted for 25.9% and 31.8% of the Company’s net service revenues for the nine months ended September 30, 2019 and 2018, respectively. The related receivables due from the Illinois Department on Aging represented 18.9% and 22.5% of the Company’s net accounts receivable at September 30, 2019 and December 31, 2018, respectively.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2019
Subsequent Events [Abstract]
Subsequent Events	13. Subsequent Events On October 1, 2019, the Company completed the acquisition of Hospice Partners for approximately $130.0 million, subject to customary adjustments for working capital and other items. The Company funded this acquisition with a portion of the net proceeds of the Company’s Public Offering. With the purchase of Hospice Partners, the Company expanded its hospice operations through 21 locations across Idaho, Kansas, Missouri, Oregon, Texas and Virginia. The Company is currently assessing the fair value of identifiable net assets acquired.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2019
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying Condensed Consolidated Financial Statements and related notes have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”) for Quarterly Reports on Form 10-Q. The accompanying balance sheet as of December 31, 2018 has been derived from the Company’s audited financial statements for the year ended December 31, 2018 previously filed with the SEC. Accordingly, these financial statements do not include all of the information and note disclosures required by accounting principles generally accepted in the United States of America (“GAAP”) for annual financial statements and should be read in conjunction with our consolidated financial statements and notes thereto for the year ended December 31, 2018 included in our Annual Report on Form 10-K, which includes information and disclosures not included herein. In the opinion of management, these financial statements reflect all adjustments of a normal, recurring nature necessary for the fair statement of our financial position, results of operations, and cash flows for the interim periods presented in conformity with GAAP. Our results for any interim period are not necessarily indicative of results for a full year or any other interim period and have not been audited by our independent auditors.
Principles of Consolidation	Principles of Consolidation These Condensed Consolidated Financial Statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Estimates	Estimates The financial statements are prepared by management in conformity with GAAP and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: implicit price concessions, reserve for workers’ compensation insurance claims, accounting for stock-based compensation, accounting for income taxes, business combinations and when required, the quantitative assessment of goodwill. Actual results could differ from these estimates.
Diluted Net Income Per Common Share	Diluted Net Income Per Common Share Basic earnings per share is calculated using our weighted-average outstanding common shares. Diluted net income per common share, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The Company’s outstanding securities that may potentially dilute the common stock are stock options and restricted stock awards. Included in the Company’s calculation of diluted earnings per share for the three and nine months ended September 30, 2019 were approximately 650,000 stock options outstanding, of which approximately 359,000 and 335,000 respectively, were dilutive. In addition, there were approximately 147,000 restricted stock awards outstanding, 78,000 and 81,000 of which were dilutive for the three and nine months ended September 30, 2019, respectively. Included in the Company’s calculation of diluted earnings per share for the three and nine months ended September 30, 2018 were approximately 708,000 stock options outstanding, of which approximately 307,000 and 213,000 respectively, were dilutive. In addition, there were approximately 148,000 restricted stock awards outstanding, 83,000 and 83,000 of which were dilutive for the three and nine months ended September 30, 2018, respectively.
Recently Issued and Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In February 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2016-02, Leases (Topic 842) Leases (Topic 842) Targeted Improvements We elected the package of practical expedients available for expired or existing contracts, which allowed us to carryforward our historical assessments of (1) whether contracts are, or contain, leases, (2) lease classification and (3) initial direct costs. Recently Issued Accounting Pronouncements 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

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
Amounts Reported in Condensed Consolidated Balance Sheets for Operating Leases	Amounts reported in the Condensed September 30, 2019 (Amounts in Thousands) Operating lease right of use assets, net $ 17,972 Short-term operating lease liabilities (in accrued expenses) 5,928 Long-term operating lease liabilities 12,559 Total operating lease liabilities $ 18,487
Components of Lease Cost Reported in General and Administrative Expenses in Condensed Consolidated Statements of Income	Components of lease cost were reported in general and administrative expenses in the Condensed Consolidated Statements of Income as follows: For the Three Months Ended September 30, 2019 For the Nine Months Ended September 30, 2019 (Amounts in Thousands) (Amounts in Thousands) Operating lease costs $ 1,897 $ 5,101 Short-term lease costs 222 382 Total lease cost $ 2,119 $ 5,483
Schedule of Weighted Average Remaining Lease Terms and Discount Rates	Weighte d average remaining lease terms and discount rates for the nine months ended September 30, 2019 were as follows: 2019 Operating leases: Weighted average remaining lease term in years 3.58 Weighted average discount rate 5.50 %
Summary of Remaining Operating Lease Payments	A summary of our remaining operating lease payments as of September 30, 2019 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2020 $ 6,598 2021 5,796 2022 3,882 2023 2,288 2024 1,251 Thereafter 663 Total future minimum rental commitments 20,478 Less: Imputed interest (1,991 ) Total lease liabilities $ 18,487
Summary of Future Minimum Operating Lease Payments	As required by ASC 842, the future minimum operating lease payments on non-cancelable leases as of December 31, 2018 under the accounting standards in effect as of that period were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended December 31, 2019 $ 6,374 2020 4,820 2021 3,460 2022 2,377 2023 2,130 Thereafter 1,382 Total future minimum rental commitments $ 20,543
Supplemental Cash Flows Information	For the Nine Months Ended September 30, 2019 (Amounts in Thousands) Supplemental Cash Flows Information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 5,393 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 5,536

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2019
Alliance Home Health Care [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	Based upon management’s valuation, which is preliminary and subject to completion of working capital adjustments, the total purchase price has been allocated as follows: Total (Amounts in Thousands) Goodwill $ 15,973 Identifiable intangible assets 5,422 Cash 1,172 Accounts receivable 1,936 Other assets 95 Accounts payable (296 ) Other liabilities (844 ) Total purchase price allocation $ 23,458
VIP Health Care Services [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	Based upon management’s valuation, which is preliminary and subject to completion of working capital adjustments, the total purchase price has been allocated as follows: Total (Amounts in Thousands) Goodwill $ 10,374 Identifiable intangible assets 15,370 Cash 110 Accounts receivable 5,986 Other assets 2,308 Property and equipment 27 Accounts payable (385 ) Accrued expenses (747 ) Accrued payroll (1,571 ) Other liabilities (1,554 ) Total purchase price allocation $ 29,918
Ambercare Corporation [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	Based upon management’s valuations, which are now final, 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 expenses (4,073 ) Deferred tax liability (2,138 ) Financing 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	Based upon management’s valuations, which are now final, the total purchase price has been allocated as follows: Total (Amounts in Thousands) Goodwill $ 13,072 Accounts receivable 5,317 Identifiable intangible assets 2,264 Property and equipment 155 Other assets 92 Accrued expenses (1,540 ) Accounts payable (508 ) Total purchase price allocation $ 18,852
Lifestyle Options, Inc. [Member]
Business Acquisition [Line Items]
Schedule of Purchase Price Allocation	Based upon management’s valuations, which are now final, the total purchase price is final and 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 expenses (291 ) Accounts payable (105 ) Total purchase price allocation $ 4,130
VIP, Ambercare and Arcadia [Member]
Business Acquisition [Line Items]
Unaudited Pro Forma Condensed Consolidated Income Statement Information	The following table contains unaudited pro forma condensed consolidated income statement information of the Company had the acquisitions of Alliance, VIP, Ambercare and Arcadia closed on January 1, 2018. For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 (Amounts in Thousands) (Amounts in Thousands) Net service revenues $ 171,432 $ 160,899 $ 494,796 $ 465,258 Operating income 8,146 8,458 22,213 31,799 Net income from continuing operations 6,393 3,904 16,527 20,261 Net loss from discontinued operations (574 ) — (574 ) — Net income $ 5,819 $ 3,904 $ 15,953 $ 20,261 Net income per common share Basic income per share Continuing operations $ 0.46 $ 0.32 $ 1.25 $ 1.73 Discontinued operations (0.04 ) — (0.04 ) — Basic income per share $ 0.42 $ 0.32 $ 1.21 $ 1.73 Diluted income per share Continuing operations $ 0.45 $ 0.31 $ 1.21 $ 1.68 Discontinued operations (0.04 ) — (0.04 ) — Diluted income per share $ 0.41 $ 0.31 $ 1.17 $ 1.68

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Summary of Goodwill and Related Adjustments	A summary of the goodwill activity for the nine months ended September 30, 2019 is provided below: Goodwill Personal Care Hospice Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2018 $ 112,377 $ 22,200 $ 865 $ 135,442 Additions for acquisitions 12,701 13,028 861 26,590 Adjustments to previously recorded goodwill (51 ) 33 2 (16 ) Goodwill as of September 30, 2019 $ 125,027 $ 35,261 $ 1,728 $ 162,016
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 as of September 30, 2019: Customer and referral relationships Trade names and trademarks Non- competition agreements State Licenses Total (Amounts in Thousands) Intangible assets with indefinite lives: $ — $ — $ — $ 7,186 $ 7,186 Intangible assets subject to amortization: Gross carrying amount 48,028 21,566 2,155 12,020 83,769 Accumulated amortization (34,898 ) (12,246 ) (2,063 ) (629 ) (49,836 ) Intangible assets subject to amortization, net 13,130 9,320 92 11,391 33,933 Total intangible assets at September 30, 2019 $ 13,130 $ 9,320 $ 92 $ 18,577 $ 41,119

Details of Certain Balance Sh_2

Details of Certain Balance Sheet Accounts (Tables)	9 Months Ended
	Sep. 30, 2019
Details Of Certain Balance Sheet Accounts [Abstract]
Schedule of Prepaid Expenses and Other Current Assets	Prepaid expenses and other current assets consisted of the following: September 30, 2019 December 31, 2018 (Amounts in Thousands) Workers’ compensation insurance receivable $ 1,704 $ 1,692 Prepaid workers’ compensation and liability insurance 1,429 1,840 Health insurance receivable 660 564 Other 5,029 3,002 $ 8,822 $ 7,098
Schedule of Accrued Expenses	Accrued expenses consisted of the following: September 30, 2019 December 31, 2018 (Amounts in Thousands) Current portion of operating lease liabilities $ 5,928 $ — Accrued health insurance 4,139 3,926 Accrued professional fees 3,268 2,260 Accrued payroll taxes 1,681 769 Other 4,117 4,631 $ 19,133 $ 11,586

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2019
Long Term Debt [Abstract]
Schedule of Long-Term Debt	Long-term debt consisted of the following: September 30, 2019 December 31, 2018 (Amounts in Thousands) Revolving loan under the credit facility $ 43,458 $ 20,000 Term loan under the credit facility 19,355 — Financing leases 31 81 Less unamortized issuance costs (2,626 ) (2,797 ) Total $ 60,218 $ 17,284 Less current maturities (970 ) (62 ) Long-term debt $ 59,248 $ 17,222

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2019
Segment Reporting [Abstract]
Summary of Revenues Disaggregated by Revenue Source	The following tables present revenues disaggregated by revenue source. For the Three Months Ended September 30, 2019 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 154,563 $ 10,874 $ 4,366 $ 169,803 Cost of services revenues 115,504 5,495 2,818 123,817 Gross profit 39,059 5,379 1,548 45,986 General and administrative expenses 15,602 1,824 844 18,270 Segment operating income $ 23,457 $ 3,555 $ 704 $ 27,716 For the Three Months Ended September 30, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 128,179 $ 7,116 $ 2,421 $ 137,716 Cost of services revenues 95,428 3,777 1,721 100,926 Gross profit 32,751 3,339 700 36,790 General and administrative expenses 10,494 1,475 604 12,573 Segment operating income $ 22,257 $ 1,864 $ 96 $ 24,217 For the Three Months Ended September 30, 2019 2018 (Amounts in Thousands) Segment Reconciliation: Total segment operating income $ 27,716 $ 24,217 Items not allocated at segment level: Other general and administrative expenses 17,680 15,694 Depreciation and amortization 2,756 2,535 Interest income (786 ) (113 ) Interest expense 866 1,543 Income before income taxes $ 7,200 $ 4,558 For the Nine Months Ended September 30, 2019 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 421,458 $ 27,228 $ 10,063 $ 458,749 Cost of services revenues 314,329 13,587 6,803 334,719 Gross profit 107,129 13,641 3,260 124,030 General and administrative expenses 41,373 4,962 2,187 48,522 Segment operating income $ 65,756 $ 8,679 $ 1,073 $ 75,508 For the Nine Months Ended September 30, 2018 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 362,740 $ 11,765 $ 3,944 $ 378,449 Cost of services revenues 268,815 6,351 2,819 277,985 Gross profit 93,925 5,414 1,125 100,464 General and administrative expenses 29,283 2,329 947 32,559 Segment operating income $ 64,642 $ 3,085 $ 178 $ 67,905 For the Nine Months Ended September 30, 2019 2018 (Amounts in Thousands) Segment Reconciliation: Total segment operating income $ 75,508 $ 67,905 Items not allocated at segment level: Other general and administrative expenses 46,907 43,739 Depreciation and amortization 7,365 6,676 Interest income (1,096 ) (2,468 ) Interest expense 2,164 3,836 Income before income taxes $ 20,168 $ 16,122

Significant Payors (Tables)

Significant Payors (Tables)	9 Months Ended
	Sep. 30, 2019
Significant Payors [Abstract]
Schedule of Revenue Disaggregated by Payor Type	For the three and nine months ended September 30, 2019 and 2018, the Company’s revenue disaggregated by payor type was as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues 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 $ 75,569 49.0 % $ 73,691 57.5 % $ 222,677 52.8 % $ 213,145 58.7 % Managed care organizations 68,795 44.5 45,271 35.3 170,946 40.6 126,809 35.0 Private pay 5,750 3.7 5,549 4.3 16,001 3.8 14,861 4.1 Commercial insurance 2,697 1.7 1,869 1.5 6,605 1.6 4,271 1.2 Other 1,752 1.1 1,799 1.4 5,229 1.2 3,654 1.0 Total personal care segment net service revenues $ 154,563 100.0 % $ 128,179 100.0 % $ 421,458 100.0 % $ 362,740 100.0 % Hospice For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Medicare $ 10,045 92.3 % $ 6,677 93.8 % $ 25,243 92.7 % $ 11,030 93.8 % Managed care organizations 584 5.4 426 6.0 1,419 5.2 721 6.1 Other 245 2.3 13 0.2 566 2.1 14 0.1 Total hospice segment net service revenues $ 10,874 100.0 % $ 7,116 100.0 % $ 27,228 100.0 % $ 11,765 100.0 % Home Health For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Medicare $ 3,338 76.4 % $ 2,184 90.2 % $ 7,948 79.0 % $ 3,588 91.0 % Managed care organizations 959 22.0 221 9.1 1,872 18.6 329 8.3 Other 69 1.6 16 0.7 243 2.4 27 0.7 Total home health segment net service revenues $ 4,366 100.0 % $ 2,421 100.0 % $ 10,063 100.0 % $ 3,944 100.0 %
Schedule of Revenue by Geographic Location	The percentages of segment revenue for each of the Company’s significant states for the three and nine months ended September 30, 2019 and 2018 were as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues 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 $ 61,958 40.1 % $ 58,948 46.0 % $ 179,444 42.5 % $ 174,591 48.2 % New York 34,913 22.6 16,814 13.1 75,746 18.0 47,999 13.2 New Mexico 19,662 12.7 16,013 12.5 55,006 13.1 42,594 11.7 All other states 38,030 24.6 36,404 28.4 111,262 26.4 97,556 26.9 Total personal care segment net service revenues $ 154,563 100.0 % $ 128,179 100.0 % $ 421,458 100.0 % $ 362,740 100.0 % Hospice For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues New Mexico $ 10,874 100.0 % $ 7,116 100.0 % $ 27,228 100.0 % $ 11,765 100.0 % Total hospice segment net service revenues $ 10,874 100.0 % $ 7,116 100.0 % $ 27,228 100.0 % $ 11,765 100.0 % Home Health For the Three Months Ended September 30, For the Nine Months Ended September 30, 2019 2018 2019 2018 Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues Amount (in Thousands) % of Segment Net Service Revenues New Mexico $ 4,366 100.0 % $ 2,421 100.0 % $ 10,063 100.0 % $ 3,944 100.0 % Total home health segment net service revenues $ 4,366 100.0 % $ 2,421 100.0 % $ 10,063 100.0 % $ 3,944 100.0 %

Nature of Operations, Consoli_2

Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details)	9 Months Ended
	Sep. 30, 2019segment
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Number of operating segments	3

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Narrative) (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Stock Options [Member]
Summary Of Significant Accounting Policies [Line Items]
Number of stock options included in calculation	650,000	708,000	650,000	708,000
Number of dilutive shares outstanding	359,000	307,000	335,000	213,000
Restricted Stock [Member]
Summary Of Significant Accounting Policies [Line Items]
Number of dilutive shares outstanding	78,000	83,000	81,000	83,000
Shares of restricted stock awards included in calculation			147,000	148,000

Public Offering (Narrative) (De

Public Offering (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands	Oct. 01, 2019	Sep. 09, 2019	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Class of Stock [Line Items]
Common stock, par value			$ 0.001		$ 0.001		$ 0.001
Net proceeds after deducting underwriting discounts and estimated offering expenses					$ 172,945	$ 76,618
Business acquisition purchase price					53,224	62,347
Increase to additional paid in capital from public offering			$ 172,945	$ 76,618	$ 172,945	$ 76,618
Subsequent Event [Member] | Hospice Partners of America, LLC [Member]
Class of Stock [Line Items]
Business acquisition purchase price	$ 130,000
Common Stock [Member]
Class of Stock [Line Items]
Shares issued during period		2,300,000	2,300,000	1,390,000	2,300,000	1,390,000
Common stock, par value		$ 0.001
Public offering price, per share		$ 79.50
Net proceeds after deducting underwriting discounts and estimated offering expenses		$ 172,900
Underwriting discounts and estimated offering expenses		9,900
Increase to additional paid in capital from public offering			$ 2	$ 1	$ 2	$ 1
Additional Paid-in Capital [Member]
Class of Stock [Line Items]
Increase to additional paid in capital from public offering		$ 172,900	$ 172,943	$ 76,617	$ 172,943	$ 76,617
Over-Allotment Option [Member] | Common Stock [Member]
Class of Stock [Line Items]
Shares issued during period		300,000

Leases (Narrative) (Details)

Leases (Narrative) (Details)	9 Months Ended
	Sep. 30, 2019
Lessee Lease [Line Items]
Operating lease expiration dates	expiration dates through 2029
Minimum [Member]
Lessee Lease [Line Items]
Leases termination and renewal option	1 year
Maximum [Member]
Lessee Lease [Line Items]
Leases termination and renewal option	5 years

Leases (Amounts Reported in Con

Leases (Amounts Reported in Condensed Consolidated Balance Sheets for Operating Leases) (Details) $ in Thousands	Sep. 30, 2019USD ($)
Leases [Abstract]
Operating lease right of use assets, net	$ 17,972
Short-term operating lease liabilities (in accrued expenses)	$ 5,928
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	us-gaap:AccruedLiabilitiesCurrent
Long-term operating lease liabilities	$ 12,559
Total operating lease liabilities	$ 18,487

Leases (Components of Lease Cos

Leases (Components of Lease Cost Reported in General and Administrative Expenses in Condensed Consolidated Statements of Income) (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2019
Leases [Abstract]
Operating lease costs	$ 1,897	$ 5,101
Short-term lease costs	222	382
Total lease cost	$ 2,119	$ 5,483

Leases (Schedule of Weighted Av

Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details)	Sep. 30, 2019
Leases [Abstract]
Weighted average remaining lease term in years	3 years 6 months 29 days
Weighted average discount rate	5.50%

Leases (Summary of Remaining Op

Leases (Summary of Remaining Operating Lease Payments) (Details) $ in Thousands	Sep. 30, 2019USD ($)
Leases [Abstract]
2020	$ 6,598
2021	5,796
2022	3,882
2023	2,288
2024	1,251
Thereafter	663
Total future minimum rental commitments	20,478
Less: Imputed interest	(1,991)
Total lease liabilities	$ 18,487

Leases (Summary of Future Minim

Leases (Summary of Future Minimum Operating Lease Payments) (Details) $ in Thousands	Dec. 31, 2018USD ($)
Leases [Abstract]
2019	$ 6,374
2020	4,820
2021	3,460
2022	2,377
2023	2,130
Thereafter	1,382
Total future minimum rental commitments	$ 20,543

Leases (Supplemental Cash Flows

Leases (Supplemental Cash Flows Information) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2019USD ($)
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 5,393
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 5,536

Acquisitions (Narrative) (Detai

Acquisitions (Narrative) (Details) - USD ($)	Aug. 01, 2019	Jun. 01, 2019	May 01, 2018	Apr. 01, 2018	Jan. 01, 2018	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Business Acquisition [Line Items]
Total purchase price for business acquisition								$ 53,224,000	$ 62,347,000
Net service revenues						$ 169,803,000	$ 137,716,000	458,749,000	378,449,000
Operating income (loss) from continuing operations						7,200,000	4,558,000	$ 20,168,000	16,122,000
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
Alliance Home Health Care [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition	$ 23,500,000
Acquisition related costs						300,000		$ 300,000
Cash paid for acquisition	1,172,000
Total purchase price allocation	23,458,000
Alliance Home Health Care [Member] | New York [Member]
Business Acquisition [Line Items]
Net service revenues						3,400,000		3,400,000
Operating income (loss) from continuing operations						800,000		$ 800,000
Alliance Home Health Care [Member] | State Licenses [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								10 years
Identifiable intangible assets acquired	1,100,000							$ 5,400,000
Indefinite lived intangible assets acquired	$ 4,300,000
VIP Health Care Services [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition		$ 29,900,000
Acquisition related costs								400,000
Integration costs						200,000		300,000
Cash paid for acquisition		110,000
Total purchase price allocation		$ 29,918,000
VIP Health Care Services [Member] | New York [Member]
Business Acquisition [Line Items]
Net service revenues						13,200,000		17,600,000
Operating income (loss) from continuing operations						(400,000)		$ (100,000)
VIP Health Care Services [Member] | State Licenses [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								6 years
Identifiable intangible assets acquired								$ 10,700,000
VIP Health Care Services [Member] | Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								8 years
Identifiable intangible assets acquired								$ 4,700,000
Ambercare Corporation [Member]
Business Acquisition [Line Items]
Cash paid for acquisition			$ 12,028,000
Total purchase price allocation			51,622,000
Ambercare Corporation [Member] | New Mexico [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition			39,600,000
Acquisition related costs									600,000
Net service revenues						17,300,000	13,400,000	47,800,000	22,600,000
Operating income (loss) from continuing operations						4,700,000	2,000,000	11,800,000	3,800,000
Integration costs							700,000	$ 300,000	800,000
Cash paid for acquisition			$ 12,000,000
Ambercare Corporation [Member] | Trade Name and Customer Relationships [Member] | Minimum [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								3 years
Ambercare Corporation [Member] | Trade Name and Customer Relationships [Member] | Maximum [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								15 years
Arcadia Home Care And Staffing [Member]
Business Acquisition [Line Items]
Acquisition related costs									600,000
Net service revenues						11,600,000	10,900,000	$ 32,900,000	21,700,000
Operating income (loss) from continuing operations						1,800,000	1,600,000	$ 4,400,000	3,200,000
Integration costs							700,000		800,000
Total purchase price allocation				$ 18,852,000
Total purchase price for business acquisition				$ 18,900,000
Arcadia Home Care And Staffing [Member] | Trade Names, Customer Relationships and State Licenses [Member] | Minimum [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								7 years
Arcadia Home Care And Staffing [Member] | Trade Names, Customer Relationships and State Licenses [Member] | Maximum [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								15 years
Lifestyle Options, Inc. [Member]
Business Acquisition [Line Items]
Total purchase price allocation					$ 4,130,000
Lifestyle Options, Inc. [Member] | Illinois [Member]
Business Acquisition [Line Items]
Net service revenues						1,200,000	1,500,000	$ 3,700,000	4,500,000
Operating income (loss) from continuing operations						$ 100,000	$ 100,000	$ 200,000	$ 400,000
Total purchase price for business acquisition					4,100,000
Acquisitions of business cash consideration					3,300,000
Business acquisition, contingent earn-out obligation					$ 800,000
Contingent consideration, remeasured										$ 0
Lifestyle Options, Inc. [Member] | Trade Name and Customer Relationships [Member] | Minimum [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								10 years
Lifestyle Options, Inc. [Member] | Trade Name and Customer Relationships [Member] | Maximum [Member]
Business Acquisition [Line Items]
Intangible assets, estimated useful lives								15 years

Acquisitions (Schedule of Purch

Acquisitions (Schedule of Purchase Price Allocation) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Aug. 01, 2019	Jun. 01, 2019	Dec. 31, 2018	May 01, 2018	Apr. 01, 2018	Jan. 01, 2018
Business Acquisition [Line Items]
Goodwill	$ 162,016			$ 135,442
Alliance Home Health Care [Member]
Business Acquisition [Line Items]
Goodwill		$ 15,973
Identifiable intangible assets		5,422
Cash		1,172
Accounts receivable		1,936
Other assets		95
Accounts payable		(296)
Other liabilities		(844)
Total purchase price allocation		$ 23,458
VIP Health Care Services [Member]
Business Acquisition [Line Items]
Goodwill			$ 10,374
Identifiable intangible assets			15,370
Cash			110
Accounts receivable			5,986
Other assets			2,308
Property and equipment			27
Accounts payable			(385)
Accrued expenses			(747)
Accrued payroll			(1,571)
Other liabilities			(1,554)
Total purchase price allocation			$ 29,918
Ambercare Corporation [Member]
Business Acquisition [Line Items]
Goodwill					$ 28,831
Identifiable intangible assets					9,944
Cash					12,028
Accounts receivable					6,512
Other assets					442
Property and equipment					154
Accounts payable					(3)
Accrued expenses					(4,073)
Deferred tax liability					(2,138)
Financing lease					(75)
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
Accounts payable						(508)
Accrued expenses						(1,540)
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
Accounts payable							(105)
Accrued expenses							(291)
Total purchase price allocation							$ 4,130

Acquisitions (Unaudited Pro For

Acquisitions (Unaudited Pro Forma Condensed Consolidated Income Statement Information) (Details) - VIP, Ambercare and Arcadia [Member] - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Business Acquisition [Line Items]
Net service revenues	$ 171,432	$ 160,899	$ 494,796	$ 465,258
Operating income	8,146	8,458	22,213	31,799
Net income from continuing operations	6,393	3,904	16,527	20,261
Net loss from discontinued operations	(574)		(574)
Net income	$ 5,819	$ 3,904	$ 15,953	$ 20,261
Basic income per share, Continuing operations	$ 0.46	$ 0.32	$ 1.25	$ 1.73
Basic income per share, Discontinued operations	(0.04)		(0.04)
Basic income per share	0.42	0.32	1.21	1.73
Diluted income per share, Continuing operations	0.45	0.31	1.21	1.68
Diluted income per share, Discontinued operations	(0.04)		(0.04)
Diluted income per share	$ 0.41	$ 0.31	$ 1.17	$ 1.68

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2019USD ($)
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 135,442
Additions for acquisitions	26,590
Adjustments to previously recorded goodwill	(16)
Goodwill, at End of Period	162,016
Personal Care [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	112,377
Additions for acquisitions	12,701
Adjustments to previously recorded goodwill	(51)
Goodwill, at End of Period	125,027
Hospice [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	22,200
Additions for acquisitions	13,028
Adjustments to previously recorded goodwill	33
Goodwill, at End of Period	35,261
Home Health [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	865
Additions for acquisitions	861
Adjustments to previously recorded goodwill	2
Goodwill, at End of Period	$ 1,728

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Thousands	Aug. 01, 2019	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Jun. 01, 2019	Dec. 31, 2018
Goodwill [Line Items]
Goodwill		$ 162,016		$ 162,016			$ 135,442
Amortization expense		1,800	$ 1,900	$ 4,400	$ 4,900
Weighted average remaining lives of identifiable intangible assets				7 years 9 months 18 days
Personal Care [Member]
Goodwill [Line Items]
Goodwill		125,027		$ 125,027			112,377
Hospice [Member]
Goodwill [Line Items]
Goodwill		35,261		35,261			22,200
Home Health [Member]
Goodwill [Line Items]
Goodwill		1,728		$ 1,728			$ 865
VIP Health Care Services [Member]
Goodwill [Line Items]
Goodwill						$ 10,374
VIP Health Care Services [Member] | State Licenses [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives				6 years
Finite-lived intangible assets related to acquisition				$ 10,700
VIP Health Care Services [Member] | Customer Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives				8 years
Finite-lived intangible assets related to acquisition				$ 4,700
VIP Health Care Services [Member] | Personal Care [Member]
Goodwill [Line Items]
Goodwill		$ 10,400		$ 10,400
Alliance Home Health Care [Member]
Goodwill [Line Items]
Goodwill	$ 15,973
Alliance Home Health Care [Member] | State Licenses [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives				10 years
Finite-lived intangible assets related to acquisition	1,100			$ 5,400
Alliance Home Health Care [Member] | Personal Care [Member]
Goodwill [Line Items]
Goodwill	2,100
Alliance Home Health Care [Member] | Hospice [Member]
Goodwill [Line Items]
Goodwill	13,000
Alliance Home Health Care [Member] | Home Health [Member]
Goodwill [Line Items]
Goodwill	$ 900
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_4

Goodwill and Intangible Assets (Schedule of Carrying Amount and Accumulated Amortization of Intangible Asset) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives:	$ 7,186
Intangible assets subject to amortization:
Gross carrying amount	83,769
Accumulated amortization	(49,836)
Intangible assets subject to amortization, net	33,933
Total intangible assets at September 30, 2019	41,119	$ 23,784
Customer And Referral Relationships [Member]
Intangible assets subject to amortization:
Gross carrying amount	48,028
Accumulated amortization	(34,898)
Intangible assets subject to amortization, net	13,130
Total intangible assets at September 30, 2019	13,130
Trade Names And Trademarks [Member]
Intangible assets subject to amortization:
Gross carrying amount	21,566
Accumulated amortization	(12,246)
Intangible assets subject to amortization, net	9,320
Total intangible assets at September 30, 2019	9,320
Non-competition Agreements [Member]
Intangible assets subject to amortization:
Gross carrying amount	2,155
Accumulated amortization	(2,063)
Intangible assets subject to amortization, net	92
Total intangible assets at September 30, 2019	92
State Licenses [Member]
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives:	7,186
Intangible assets subject to amortization:
Gross carrying amount	12,020
Accumulated amortization	(629)
Intangible assets subject to amortization, net	11,391
Total intangible assets at September 30, 2019	$ 18,577

Details of Certain Balance Sh_3

Details of Certain Balance Sheet Accounts (Schedule of Prepaid Expenses and Other Current Assets) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Details Of Certain Balance Sheet Accounts [Abstract]
Workers’ compensation insurance receivable	$ 1,704	$ 1,692
Prepaid workers’ compensation and liability insurance	1,429	1,840
Health insurance receivable	660	564
Other	5,029	3,002
Prepaid expense and other current assets	$ 8,822	$ 7,098

Details of Certain Balance Sh_4

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Details Of Certain Balance Sheet Accounts [Abstract]
Current portion of operating lease liabilities	$ 5,928
Accrued health insurance	4,139	$ 3,926
Accrued professional fees	3,268	2,260
Accrued payroll taxes	1,681	769
Other	4,117	4,631
Accrued Liabilities, Current	$ 19,133	$ 11,586

Long-Term Debt (Schedule of Lon

Long-Term Debt (Schedule of Long-Term Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Financing leases	$ 31	$ 81
Less unamortized issuance costs	(2,626)	(2,797)
Total	60,218	17,284
Less current maturities	(970)	(62)
Long-term debt	59,248	17,222
Revolving Credit Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	43,458	$ 20,000
Term Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 19,355

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) - USD ($)	Sep. 12, 2019	Aug. 01, 2019	Jun. 01, 2019	Oct. 31, 2018	Oct. 30, 2018	Jun. 30, 2019	Sep. 30, 2019	Dec. 31, 2018	May 08, 2017
Debt Instrument [Line Items]
Debt issuance costs							$ 2,626,000	$ 2,797,000
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
Credit Agreement [Member] | Capital One, National Association [Member] | Delayed Draw Term Loan [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available				$ 19,600,000
Credit Agreement [Member] | Capital One, National Association [Member] | Delayed Draw Term Loan [Member] | Alliance Home Health Care [Member]
Debt Instrument [Line Items]
Proceeds from line of credit		$ 23,500,000
Credit Agreement [Member] | Capital One, National Association [Member] | Revolving Credit Loan [Member] | VIP Health Care Services [Member]
Debt Instrument [Line Items]
Proceeds from line of credit			$ 19,600,000
Credit Agreement [Member] | Capital One, National Association [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt instrument total net leverage ratio				3.75%
Credit Agreement [Member] | Capital One, National Association [Member] | Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin				0.50%
Credit Agreement [Member] | Capital One, National Association [Member] | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Debt instrument variable interest rate margin				1.00%
Credit Agreement [Member] | Capital One, National Association [Member] | London Interbank Offered Rate (LIBOR) | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin				0.00%
Credit Agreement [Member] | Capital One, National Association [Member] | Based On Applicable Senior Leverage Ratio | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin				0.75%
Credit Agreement [Member] | Capital One, National Association [Member] | Based On Applicable Senior Leverage Ratio | Maximum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin				1.50%
Credit Agreement [Member] | Capital One, National Association [Member] | Based On Applicable Leverage Ratio [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin				1.75%
Credit Agreement [Member] | Capital One, National Association [Member] | Based On Applicable Leverage Ratio [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate margin				2.50%
Credit Agreement [Member] | Capital One, National Association [Member] | Restriction on Dividends [Member] | Maximum [Member]
Debt Instrument [Line Items]
Aggregate amount of dividends and distributions							7,500,000
Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Increase in credit facility	$ 50,000,000
Maximum aggregate loan amount available	300,000,000			$ 250,000,000			134,100,000	142,900,000
Debt issuance costs	$ 400,000
Proceeds from line of credit							23,500,000
Line of credit outstanding amount							$ 43,500,000	$ 20,000,000
Debt instrument stated interest rate							3.85%	4.35%
Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member] | Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument stated interest rate							3.86%
Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member] | Minimum [Member]
Debt Instrument [Line Items]
Fee charged on unused portion of revolving credit facility							0.20%
Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member] | Maximum [Member]
Debt Instrument [Line Items]
Fee charged on unused portion of revolving credit facility							0.35%
Existing Credit Agreement [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available									$ 250,000,000
Existing Credit Agreement [Member] | Capital One, National Association [Member] | Delayed Draw Term Loan [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available									80,000,000
Existing Credit Agreement [Member] | Capital One, National Association [Member] | Term Loan [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available									45,000,000
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
Terminated Senior Secured Credit Facility [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available									$ 125,000,000

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Tax Disclosure [Abstract]
Effective income tax rate	24.40%	20.30%	21.60%	20.40%

Commitments and Contingencies (

Commitments and Contingencies (Narrative) (Details) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)Facility
Commitments and Contingencies [Line Items]
Settlement expense in discontinued operation | $	$ 0.6
Senior Management [Member] | Maximum [Member]
Commitments and Contingencies [Line Items]
Employment agreement term	4 years
Illinois [Member]
Commitments and Contingencies [Line Items]
Number of senior living facilities | Facility	3

Segment Information (Narrative)

Segment Information (Narrative) (Details)	9 Months Ended
	Sep. 30, 2019segment
Segment Reporting [Abstract]
Number of business segments	3

Segment Information (Summary of

Segment Information (Summary of Revenues Disaggregated by Revenue Source) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Segment Reporting Information [Line Items]
Net service revenues	$ 169,803	$ 137,716	$ 458,749	$ 378,449
Cost of services revenues	123,817	100,926	334,719	277,985
Gross profit	45,986	36,790	124,030	100,464
General and administrative expenses	35,950	28,267	95,429	76,298
Operating income from continuing operations	7,280	5,988	21,236	17,490
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	18,270	12,573	48,522	32,559
Operating income from continuing operations	27,716	24,217	75,508	67,905
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues	154,563	128,179	421,458	362,740
Cost of services revenues	115,504	95,428	314,329	268,815
Gross profit	39,059	32,751	107,129	93,925
Personal Care [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	15,602	10,494	41,373	29,283
Operating income from continuing operations	23,457	22,257	65,756	64,642
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues	10,874	7,116	27,228	11,765
Cost of services revenues	5,495	3,777	13,587	6,351
Gross profit	5,379	3,339	13,641	5,414
Hospice [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	1,824	1,475	4,962	2,329
Operating income from continuing operations	3,555	1,864	8,679	3,085
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues	4,366	2,421	10,063	3,944
Cost of services revenues	2,818	1,721	6,803	2,819
Gross profit	1,548	700	3,260	1,125
Home Health [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	844	604	2,187	947
Operating income from continuing operations	$ 704	$ 96	$ 1,073	$ 178

Segment Information (Segment Re

Segment Information (Segment Reconciliation to Totals reported in the accompanying Consolidated Financial Statements) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Segment Reporting Information [Line Items]
Operating income	$ 7,280	$ 5,988	$ 21,236	$ 17,490
Other general and administrative expenses	17,680	15,694	46,907	43,739
Depreciation and amortization	2,756	2,535	7,365	6,676
Interest income	(786)	(113)	(1,096)	(2,468)
Interest expense	866	1,543	2,164	3,836
Income from continuing operations before income taxes	7,200	4,558	20,168	16,122
Operating Segments [Member]
Segment Reporting Information [Line Items]
Operating income	$ 27,716	$ 24,217	$ 75,508	$ 67,905

Significant Payors (Revenue Dis

Significant Payors (Revenue Disaggregated by Payor Type) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Net service revenues	$ 169,803	$ 137,716	$ 458,749	$ 378,449
Personal Care [Member]
Net service revenues	154,563	128,179	421,458	362,740
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 154,563	$ 128,179	$ 421,458	$ 362,740
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | State, Local And Other Governmental Programs [Member]
Net service revenues	$ 75,569	$ 73,691	$ 222,677	$ 213,145
Concentration risk, percentage	49.00%	57.50%	52.80%	58.70%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 68,795	$ 45,271	$ 170,946	$ 126,809
Concentration risk, percentage	44.50%	35.30%	40.60%	35.00%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member]
Net service revenues	$ 5,750	$ 5,549	$ 16,001	$ 14,861
Concentration risk, percentage	3.70%	4.30%	3.80%	4.10%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues	$ 2,697	$ 1,869	$ 6,605	$ 4,271
Concentration risk, percentage	1.70%	1.50%	1.60%	1.20%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 1,752	$ 1,799	$ 5,229	$ 3,654
Concentration risk, percentage	1.10%	1.40%	1.20%	1.00%
Hospice [Member]
Net service revenues	$ 10,874	$ 7,116	$ 27,228	$ 11,765
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 10,874	$ 7,116	$ 27,228	$ 11,765
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 584	$ 426	$ 1,419	$ 721
Concentration risk, percentage	5.40%	6.00%	5.20%	6.10%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 245	$ 13	$ 566	$ 14
Concentration risk, percentage	2.30%	0.20%	2.10%	0.10%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 10,045	$ 6,677	$ 25,243	$ 11,030
Concentration risk, percentage	92.30%	93.80%	92.70%	93.80%
Home Health [Member]
Net service revenues	$ 4,366	$ 2,421	$ 10,063	$ 3,944
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 4,366	$ 2,421	$ 10,063	$ 3,944
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 959	$ 221	$ 1,872	$ 329
Concentration risk, percentage	22.00%	9.10%	18.60%	8.30%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 69	$ 16	$ 243	$ 27
Concentration risk, percentage	1.60%	0.70%	2.40%	0.70%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 3,338	$ 2,184	$ 7,948	$ 3,588
Concentration risk, percentage	76.40%	90.20%	79.00%	91.00%

Significant Payors (Revenue by

Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Net service revenues	$ 169,803	$ 137,716	$ 458,749	$ 378,449
Personal Care [Member]
Net service revenues	154,563	128,179	421,458	362,740
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 154,563	$ 128,179	$ 421,458	$ 362,740
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Net service revenues	$ 61,958	$ 58,948	$ 179,444	$ 174,591
Concentration risk, percentage	40.10%	46.00%	42.50%	48.20%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member]
Net service revenues	$ 34,913	$ 16,814	$ 75,746	$ 47,999
Concentration risk, percentage	22.60%	13.10%	18.00%	13.20%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 19,662	$ 16,013	$ 55,006	$ 42,594
Concentration risk, percentage	12.70%	12.50%	13.10%	11.70%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 38,030	$ 36,404	$ 111,262	$ 97,556
Concentration risk, percentage	24.60%	28.40%	26.40%	26.90%
Hospice [Member]
Net service revenues	$ 10,874	$ 7,116	$ 27,228	$ 11,765
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 10,874	$ 7,116	$ 27,228	$ 11,765
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 10,874	$ 7,116	$ 27,228	$ 11,765
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Home Health [Member]
Net service revenues	$ 4,366	$ 2,421	$ 10,063	$ 3,944
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 4,366	$ 2,421	$ 10,063	$ 3,944
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 4,366	$ 2,421	$ 10,063	$ 3,944
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%

Significant Payors (Narrative)

Significant Payors (Narrative) (Details)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Revenues [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	22.00%	29.50%	25.90%	31.80%
Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	36.50%	42.80%	39.10%	46.10%
Accounts Receivable [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			18.90%		22.50%

Subsequent Events (Narrative) (

Subsequent Events (Narrative) (Details) $ in Thousands	Oct. 01, 2019USD ($)location	Sep. 30, 2019USD ($)	Sep. 30, 2018USD ($)
Subsequent Event [Line Items]
Business acquisition purchase price		$ 53,224	$ 62,347
Subsequent Event [Member] | Hospice Partners [Member]
Subsequent Event [Line Items]
Business acquisition purchase price	$ 130,000
Number of locations | location	21