Addus HomeCare (ADUS) 10-Q 2 Nov 21 2021 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2021	Oct. 25, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2021
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2021
Entity Registrant Name	ADDUS HOMECARE CORPORATION
Entity Central Index Key	0001468328
Trading Symbol	ADUS
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Current Reporting Status	Yes
Entity Address, State or Province	TX
Entity File Number	001-34504
Entity Tax Identification Number	20-5340172
Entity Address, Address Line One	6303 Cowboys Way
Entity Address, Address Line Two	Suite 600
Entity Address, City or Town	Frisco
Entity Address, Postal Zip Code	75034
City Area Code	469
Local Phone Number	535-8200
Entity Common Stock, Shares Outstanding		15,927,411
Document Quarterly Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Title of 12(b) Security	Common Stock, $0.001 par value
Security Exchange Name	NASDAQ

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets
Cash	$ 152,379	$ 145,078
Accounts receivable, net	133,814	132,650
Prepaid expenses and other current assets	13,514	9,969
Total current assets	299,707	287,697
Property and equipment, net of accumulated depreciation and amortization	18,614	19,749
Other assets
Goodwill	497,919	469,072
Intangibles, net of accumulated amortization	66,332	71,549
Deferred tax assets, net	5,919	6,524
Operating lease assets, net	36,424	37,991
Total other assets	606,594	585,136
Total assets	924,915	892,582
Current liabilities
Accounts payable	23,167	23,705
Accrued payroll	31,626	35,815
Accrued expenses	35,780	37,564
Government stimulus advances	7,674	32,087
Accrued workers' compensation insurance	14,286	13,759
Current portion of long-term debt		971
Total current liabilities	112,533	143,901
Long-term liabilities
Long-term debt, less current portion, net of debt issuance costs	220,707	193,901
Long-term operating lease liabilities	33,509	35,516
Other long-term liabilities	115	588
Total long-term liabilities	254,331	230,005
Total liabilities	366,864	373,906
Stockholders' equity
Common stock—$.001 par value; 40,000 authorized and 15,913 and 15,826 shares issued and outstanding as of September 30, 2021 and December 31, 2020, respectively	16	16
Additional paid-in capital	376,802	369,495
Retained earnings	181,233	149,165
Total stockholders' equity	558,051	518,676
Total liabilities and stockholders' equity	$ 924,915	$ 892,582

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2021	Dec. 31, 2020
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	15,913,000	15,826,000
Common stock, shares outstanding	15,913,000	15,826,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement [Abstract]
Net service revenues	$ 216,662	$ 193,987	$ 639,857	$ 568,779
Cost of service revenues	149,616	137,686	442,804	401,646
Gross profit	67,046	56,301	197,053	167,133
General and administrative expenses	46,280	40,733	139,881	125,470
Depreciation and amortization	3,406	3,045	10,594	8,872
Total operating expenses	49,686	43,778	150,475	134,342
Operating income	17,360	12,523	46,578	32,791
Interest income	(37)	(87)	(90)	(576)
Interest expense	1,614	680	4,092	2,309
Total interest expense, net	1,577	593	4,002	1,733
Income before income taxes	15,783	11,930	42,576	31,058
Income tax expense	4,206	2,811	10,508	6,374
Net income	$ 11,577	$ 9,119	$ 32,068	$ 24,684
Net income per common share
Basic income per share	$ 0.74	$ 0.58	$ 2.04	$ 1.59
Diluted income per share	$ 0.72	$ 0.57	$ 2	$ 1.55
Weighted average number of common shares and potential common shares outstanding:
Basic	15,748	15,618	15,727	15,573
Diluted	16,030	15,957	16,060	15,934

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, 2019	$ 475,592	$ 15	$ 359,545	$ 116,032
Balance, shares at Dec. 31, 2019		15,617
Issuance of shares of common stock under restricted stock award agreements, shares		81
Forfeiture of shares of common stock under restricted stock award agreements, shares		(6)
Stock-based compensation	3,987		3,987
Shares issued for exercise of stock options	3,337	$ 1	3,336
Shares issued for exercise of stock options, shares		109
Net income	24,684			24,684
Balance at Sep. 30, 2020	507,600	$ 16	366,868	140,716
Balance, shares at Sep. 30, 2020		15,801
Balance at Jun. 30, 2020	494,861	$ 16	363,248	131,597
Balance, shares at Jun. 30, 2020		15,665
Issuance of shares of common stock under restricted stock award agreements, shares		81
Stock-based compensation	1,462		1,462
Shares issued for exercise of stock options	2,158		2,158
Shares issued for exercise of stock options, shares		55
Net income	9,119			9,119
Balance at Sep. 30, 2020	507,600	$ 16	366,868	140,716
Balance, shares at Sep. 30, 2020		15,801
Balance at Dec. 31, 2020	518,676	$ 16	369,495	149,165
Balance, shares at Dec. 31, 2020		15,826
Issuance of shares of common stock under restricted stock award agreements, shares		88
Forfeiture of shares of common stock under restricted stock award agreements, shares		(5)
Stock-based compensation	7,105		7,105
Shares issued for exercise of stock options	202		202
Shares issued for exercise of stock options, shares		4
Net income	32,068			32,068
Balance at Sep. 30, 2021	558,051	$ 16	376,802	181,233
Balance, shares at Sep. 30, 2021		15,913
Balance at Jun. 30, 2021	544,055	$ 16	374,383	169,656
Balance, shares at Jun. 30, 2021		15,917
Forfeiture of shares of common stock under restricted stock award agreements, shares		(5)
Stock-based compensation	2,341		2,341
Shares issued for exercise of stock options	78		78
Shares issued for exercise of stock options, shares		1
Net income	11,577			11,577
Balance at Sep. 30, 2021	$ 558,051	$ 16	$ 376,802	$ 181,233
Balance, shares at Sep. 30, 2021		15,913

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash flows from operating activities:
Net income	$ 32,068	$ 24,684
Adjustments to reconcile net income to net cash provided by operating activities, net of acquisitions:
Depreciation and amortization	10,594	8,872
Deferred income taxes	605	51
Stock-based compensation	7,105	3,987
Amortization of debt issuance costs under the credit facility	590	554
Provision for doubtful accounts	744	681
Loss (gain) of disposal of assets and asset impairment		1,242
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	(1,906)	30,746
Prepaid expenses and other current assets	(3,610)	(2,592)
Government stimulus advances	(24,413)	7,141
Accounts payable	(780)	(2,496)
Accrued payroll	(4,553)	(4,567)
Accrued expenses and other long-term liabilities	(2,157)	4,996
Net cash provided by operating activities	14,287	73,299
Cash flows from investing activities:
Purchases of property and equipment	(3,214)	(5,893)
Acquisitions of businesses, net of cash acquired	(29,219)	(11,869)
Proceeds from disposal of assets		255
Net cash used in investing activities	(32,433)	(17,507)
Cash flows from financing activities:
Borrowings on revolver — credit facility	46,395
Payments on term loan — credit facility	(18,130)	(490)
Payments for debt issuance costs	(3,020)
Cash received from exercise of stock options	202	3,337
Other		(22)
Net cash provided by financing activities	25,447	2,825
Net change in cash	7,301	58,617
Cash, at beginning of period	145,078	111,714
Cash, at end of period	152,379	170,331
Supplemental disclosures of cash flow information:
Cash paid for interest	3,648	1,869
Cash paid for income taxes	$ 14,767	$ 9,119

Nature of Operations, Consolida

Nature of Operations, Consolidation, and Presentation of Financial Statements	9 Months Ended
	Sep. 30, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Nature of Operations, Consolidation, and Presentation of Financial Statements	1. Nature of Operations, Consolidation, and Presentation of Financial Statements Addus HomeCare Corporation (“Holdings”) and its subsidiaries (together with Holdings, the “Company”, “we”, “us” or “our”) operate as a multi-state provider of three distinct but related business segments providing in-home services. In its personal care services segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy. The Company’s payors include federal, state and local governmental agencies, managed care organizations, commercial insurers and private individuals. Basis of Presentation The accompanying Unaudited Condensed Consolidated Financial Statements and related notes have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”) for Quarterly Reports on Form 10-Q. The accompanying balance sheet as of December 31, 2020 has been derived from the Company’s audited financial statements for the year ended December 31, 2020 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, 2020 included in our Annual Report on Form 10-K, which includes information and disclosures not included herein. In the opinion of management, these financial statements reflect all adjustments of a normal, recurring nature necessary for the fair statement of our financial position, results of operations, and cash flows for the interim periods presented in conformity with GAAP. Our results for any interim period are not necessarily indicative of results for a full year or any other interim period. Principles of Consolidation These Unaudited Condensed Consolidated Financial Statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2021
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 U.S. Generally Accepted Accounting Principles (“GAAP”) and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: revenue recognition, allowance for doubtful accounts, intangible assets acquired in business combinations and, when required, the quantitative impairment assessment of goodwill and indefinite lived intangible assets. Actual results could differ from those estimates. Diluted Net Income Per Common Share Diluted net income per common share, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The Company’s outstanding securities that may potentially dilute the common stock are stock options and restricted stock awards. As of September 30, 2021 and 2020, dilutive stock options outstanding were approximately 521,000 and 523,000, respectively, and dilutive restricted stock awards outstanding were approximately 162,000 and 149,000, respectively. Included in the Company’s calculation of diluted earnings per share for the three and nine months ended September 30, 2021, dilutive stock options outstanding were approximately 267,000 and 288,000, respectively. In addition, dilutive restricted stock awards outstanding were approximately 16,000 and 44,000 for the three and nine months ended September 30, 2021, respectively. Included in the Company’s calculation of diluted earnings per share for the three and nine months ended September 30, 2020, dilutive stock options outstanding were approximately 301,000 and 303,000, respectively. In addition, dilutive restricted stock awards outstanding were approximately 38,000 and 58,000 for the three and nine months ended September 30, 2020, respectively. Recently Adopted Accounting Pronouncements In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes Recently Issued Accounting Pronouncements In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting

Leases

Leases	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Leases	3. Leases Amounts reported in the Company’s Unaudited Condensed Consolidated Balance Sheets as of September 30, 2021 and December 31, 2020 for operating leases were as follows: September 30, 2021 December 31, 2020 (Amounts in Thousands) Operating lease assets, net $ 36,424 $ 37,991 Short-term operating lease liabilities (in accrued expenses) 9,713 9,283 Long-term operating lease liabilities 33,509 35,516 Total operating lease liabilities $ 43,222 $ 44,799 Lease Costs Components of lease costs were reported in general and administrative expenses in the Company’s Unaudited Condensed Consolidated Statements of Income as follows: For the Three Months Ended September 30, (Amounts in Thousands) For the Nine Months Ended September 30, (Amounts in Thousands) 2021 2020 2021 2020 Operating lease costs $ 2,789 $ 2,285 $ 8,341 $ 6,524 Short-term lease costs 197 147 572 575 Less: sublease income (177 ) (74 ) (480 ) (224 ) Total lease costs, net $ 2,809 $ 2,358 $ 8,433 $ 6,875 Lease Term and Discount Rate Weighted average remaining lease terms and discount rates were as follows: September 30, 2021 December 31, 2020 Operating leases: Weighted average remaining lease term 6.55 6.97 Weighted average discount rate 3.95 % 4.18 % Maturity of Lease Liabilities Remaining operating lease payments as of September 30, 2021 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2022 $ 2,765 2023 10,717 2024 8,657 2025 6,520 2026 3,883 Thereafter 16,786 Total future minimum rental commitments 49,328 Less: Imputed interest (6,106 ) Total lease liabilities $ 43,222 Supplemental cash flows information For the Nine Months Ended September 30, (Amounts in Thousands) 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 8,237 $ 6,472 Right-of-use assets obtained in exchange for lease obligations: Operating leases 5,706 21,399

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2021
Business Combinations [Abstract]
Acquisitions	4. Acquisitions The Company’s acquisitions have been accounted for in accordance with ASC Topic 805, Business Combinations Goodwill and Other Intangible Assets Management’s assessment of qualitative factors affecting goodwill for each acquisition 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 markets. Armada Skilled Homecare On August 1, 2021, we completed the acquisition of Armada Skilled Homecare of New Mexico LLC, Armada Hospice of New Mexico LLC and Armada Hospice of Santa Fe LLC (collectively, “Armada”) for approximately $29.8 million, including the amount of acquired excess cash held by Armada at the closing of the acquisition (approximately $0.7 million). The purchase of Armada was funded with the Company’s revolving credit facility. With the purchase of Armada, the Company expanded its home health and hospice services in the state of New Mexico. The related acquisition and integration costs were $ Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows: Total (Amounts in Thousands) Goodwill $ 28,479 Identifiable intangible assets 990 Cash 653 Property and equipment 40 Other assets 29 Accrued payroll (400 ) Total purchase price $ 29,791 Identifiable intangible assets acquired included $0.6 million of non-competition agreements with estimated useful lives of five years and $0.4 million of indefinite lived state licenses. The preliminary estimated fair value of identifiable intangible assets was determined with the assistance of a valuation specialist, using Level 3 inputs as defined under ASC Topic 820. 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. Queen City Hospice On December 4, 2020, we completed the acquisition of . The purchase price was approximately $ million, including the amount of acquired excess cash held by Queen City Hospice at the closing of the acquisition (approximately $ million). The purchase of Queen City Hospice was funded with the Company’s revolving credit facility and available cash. With the purchase of Queen City Hospice, the Company expanded its hospice services in the state of Ohio. The related acquisition costs were $0.2 million for the nine months ended September 30, 2021 and the integration costs were $ million and $2.1 million for the three and nine months ended September 30, 2021, respectively. These costs were included in general and administrative expenses on the Unaudited Condensed Consolidated Statements of Income and were expensed as incurred. Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows: Total (Amounts in Thousands) Goodwill $ 169,302 Identifiable intangible assets 20,015 Cash 15,444 Accounts receivable 5,922 Property and equipment 759 Operating lease assets, net 3,028 Other assets 85 Accounts payable (2,281 ) Accrued payroll (1,555 ) Accrued expenses (503 ) Government stimulus advances (12,694 ) Long-term operating lease liabilities (2,765 ) Total purchase price $ 194,757 Identifiable intangible assets acquired included $11.0 million in trade names and $1.5 million of non-competition agreements with estimated useful lives of fifteen years and five years, respectively, and $7.5 million of indefinite lived state licenses. The preliminary estimated fair value of identifiable intangible assets was determined with the assistance of a valuation specialist, using Level 3 inputs as defined under ASC Topic 820. 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. County Homemakers On November 1, 2020, we completed the acquisition of County Homemakers, Inc. (“County Homemakers”). The purchase price was approximately $15.8 million, including the amount of acquired excess cash held by County Homemakers at the closing of the acquisition (approximately $1.1 million). The purchase of County Homemakers was funded with the Company’s available cash. With the purchase of County Homemakers, the Company expanded its personal care services in the state of Pennsylvania. The related integration costs were $0.2 million for the nine months ended September 30, 2021. These costs were included in general and administrative expenses on the Unaudited Condensed Consolidated Statements of Income and were expensed as incurred. Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows: Total (Amounts in Thousands) Goodwill $ 13,475 Identifiable intangible assets 474 Cash 1,104 Accounts receivable 1,395 Property and equipment 52 Operating lease assets, net 485 Other assets 40 Accounts payable (96 ) Accrued payroll (586 ) Accrued expenses (37 ) Long-term operating lease liabilities (485 ) Total purchase price $ 15,821 Identifiable intangible assets acquired included approximately $0.3 million in state licenses and $0.1 million in trade names with estimated useful lives of eight years and one year, respectively. The preliminary estimated fair value of identifiable intangible assets was determined with the assistance of a valuation specialist, using Level 3 inputs as defined under ASC Topic 820. 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. A Plus Health Care On July 1, 2020, we completed the acquisition of A Plus Health Care, Inc. (“A Plus”). The purchase price was approximately $14.5 million, including the amount of acquired excess cash held by A Plus at the closing of the acquisition (approximately $2.8 million). The purchase of A Plus was funded with the Company’s available cash. With the purchase of A Plus, the Company expanded its personal care services in the state of Montana. The related integration costs were $0.1 million for the nine months ended September 30, 2021 and acquisition costs were $0.3 million for the three and nine months ended September 30, 2020 Based upon management’s final valuations, the fair values of the assets and liabilities acquired are as follows: Total (Amounts in Thousands) Goodwill $ 9,732 Identifiable intangible assets 1,523 Cash 2,819 Accounts receivable 1,009 Operating lease assets, net 180 Other assets 26 Accounts payable (34 ) Accrued expenses (353 ) Accrued payroll (275 ) Long-term operating lease liabilities (100 ) Total purchase price $ 14,527 Identifiable intangible assets acquired included $1.4 million in trade names with an estimated useful life of fifteen years. The estimated fair value of identifiable intangible assets was determined with the assistance of a valuation specialist, using Level 3 inputs as defined under ASC Topic 820. 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. SunLife Home Care On December 1, 2020, we completed the acquisition of SunLife Home Care (“SunLife”) for approximately $1.7 million and recorded goodwill of $1.6 million. With the purchase of SunLife, the Company expanded its personal care services in the state of Arizona. The following table contains unaudited pro forma condensed consolidated income statement information of the Company for the three and nine months ended September 30, 2021 and 2020 as if each of the acquisitions of Armada, Queen City Hospice, County Homemakers and A Plus closed on January 1, 2020. For the Three Months Ended September 30, (Amounts in Thousands) For the Nine Months Ended September 30, (Amounts in Thousands) 2021 2020 2021 2020 Net service revenues $ 218,474 $ 216,479 $ 652,908 $ 637,695 Operating income 17,613 14,458 48,135 39,331 Net income 11,832 10,586 33,341 29,930 Net income per common share Basic income per share $ 0.75 $ 0.68 $ 2.12 $ 1.92 Diluted income per share $ 0.74 $ 0.66 $ 2.08 $ 1.88 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 Armada, Queen City, Hospice, County Homemakers and A Plus had been acquired effective January 1, 2020. 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, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	5. Goodwill and Intangible Assets The goodwill for the Company was $497.9 million and $469.1 million as of September 30, 2021 and December 31, 2020, respectively. A summary of the goodwill activity for the nine months ended September 30, 2021 is provided below: Goodwill Hospice Personal Care Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2020 $ 314,833 $ 152,448 $ 1,791 $ 469,072 Additions for acquisitions 13,379 115 15,100 28,594 Adjustments to previously recorded goodwill 95 158 — 253 Goodwill as of September 30, 2021 $ 328,307 $ 152,721 $ 16,891 $ 497,919 The Company’s identifiable intangible assets consist of customer and referral relationships, trade names and trademarks, non-competition agreements and state licenses. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from one to twenty-five years. Customer and referral relationships are amortized systematically over the periods of expected economic benefit, which range from five to ten years. In connection with the acquisition of Armanda, the Company recognized goodwill in its hospice and home health segments of $13.4 million and $15.1 million, respectively, during the three and nine months ended September 30, 2021. See Note 4 for additional information regarding the acquisition. The carrying amount and accumulated amortization of each identifiable intangible asset category consisted of the following as of September 30, 2021: Customer and referral relationships Trade names and trademarks Non- competition agreements State Licenses Total (Amounts in Thousands) Intangible assets with indefinite lives $ — $ — $ — $ 21,221 $ 21,221 Intangible assets subject to amortization: Gross carrying amount 44,672 42,926 6,785 12,507 106,890 Accumulated amortization (35,866 ) (17,800 ) (3,579 ) (4,534 ) (61,779 ) Intangible assets subject to amortization, net 8,806 25,126 3,206 7,973 45,111 Total intangible assets at September 30, 2021 $ 8,806 $ 25,126 $ 3,206 $ 29,194 $ 66,332 Amortization expense related to the identifiable intangible assets amounted to $1.9 million and $6.2 million for the three and nine months ended September 30, 2021, respectively, and $1.7 million and $5.3 million for the three and nine months ended September 30, 2020, respectively.

Details of Certain Balance Shee

Details of Certain Balance Sheet Accounts	9 Months Ended
	Sep. 30, 2021
Details Of Certain Balance Sheet Accounts [Abstract]
Details of Certain Balance Sheet Accounts	6. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consisted of the following: September 30, 2021 December 31, 2020 (Amounts in Thousands) Prepaid payroll taxes $ 2,256 $ — Prepaid workers' compensation and liability insurance 1,969 2,838 Workers' compensation insurance receivable 1,748 1,860 Income tax receivable 1,614 — Health insurance receivable 565 528 Other 5,362 4,743 Total prepaid expenses and other current assets $ 13,514 $ 9,969 Accrued expenses consisted of the following: September 30, 2021 December 31, 2020 (Amounts in Thousands) Current portion of operating lease liabilities $ 9,713 $ 9,283 Payor advances (1) 6,684 4,206 Accrued health insurance 4,380 5,607 Accrued professional fees 2,860 4,220 Accrued payroll taxes 1,199 4,543 Other 10,944 9,705 Total accrued expenses $ 35,780 $ 37,564 (1) Represents the deferred portion of payments received from payors for COVID-19 reimbursements which will be recognized as we incur specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel) or will be returned to the extent such related expenses are not incurred . Government stimulus advances consisted of the following: September 30, 2021 December 31, 2020 (Amounts in Thousands) Payroll tax deferral $ 7,141 $ 7,141 Provider Relief Fund 533 12,252 CMS advanced payment program — Queen City Hospice — 10,801 Provider Relief Fund — Queen City Hospice — 1,893 Total government stimulus advances $ 7,674 $ 32,087 In recognition of the significant threat to the liquidity of financial markets posed by the COVID-19 pandemic, the Federal Reserve and Congress have taken dramatic actions to provide liquidity to businesses and the banking system in the United States. One of the primary sources of relief for healthcare providers is the CARES Act, which was expanded by the PPPHCE Act, and the CAA. The American Rescue Plan Act of 2021 (“ARPA”), another relief package with numerous provisions that affect healthcare providers, was signed into law in March 2021. See Note 9 for additional information regarding government actions to mitigate COVID-19’s impact. Provider Relief Fund In total, the CARES Act and other relief legislation include over $178 billion in funding to be distributed through the Provider Relief Fund to eligible providers, including public entities and Medicare- and/or Medicaid-enrolled providers. In November 2020, the Company received grants in an aggregate principal amount of $13.7 million from the Provider Relief Fund, for which we had previously applied. The Company utilized $0.4 million and $11.7 million of these funds for the three and nine months ended September 30, 2021, respectively, for healthcare related expenses, including retention payments, attributable to COVID-19 that were unreimbursed by other sources. In accordance with the current guidance issued by HHS, the Company expects to utilize additional funds through December 31, 2021, at which point we anticipate any unused funds will be returned. We are required to properly and fully document the use of such funds in reports to HHS, which must be submitted no later than March 31, 2022. The Company’s ability to utilize and retain some or all of such funds will depend on the magnitude, timing and nature of the impact of the COVID-19 pandemic, as well as the terms and conditions of the funds received. Queen City Hospice administered retention payments totaling $1.9 million to caregivers for the nine months ended September 30, 2021, which we believe to be necessary to secure and maintain adequate personnel. Commercial organizations that receive and expend annual total awards of $750,000 or more in federal funding, including payments received through the Provider Relief Fund, are subject to federal audit requirements Medicare Accelerated and Advance Payment Program – Queen City Hospice The CARES Act expanded the Medicare Accelerated and Advance Payment Program to increase cash flow to providers impacted by the COVID-19 pandemic. Hospice and home health providers were able to request an advance or accelerated payment of up to 100% of the Medicare payment amount for a three-month Payroll tax deferral The CARES Act also provides for certain federal income and other tax changes, including allowing for the deferral of the employer portion of Social Security payroll taxes through December 31, 2020. The payroll tax deferral requires that the deferred payroll taxes be paid over two years, with half of the amount required to be paid by December 31, 2021 and the other half by December 31, 2022. The Company received a cash benefit of approximately $7.1 million related to the deferral of employer payroll taxes for 2020 under the CARES Act, for the period April 2, 2020 through June 30, 2020. Effective July 1, 2020, the Company began paying its deferred portion of employer Social Security payroll taxes and expects to repay half of the $7.1 million in the fourth quarter of 2021.

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2021
Long Term Debt [Abstract]
Long-Term Debt	7. Long-Term Debt Long-term debt consisted of the following: September 30, 2021 December 31, 2020 (Amounts in Thousands) Revolving loan under the credit facility $ 224,853 $ 178,458 Term loan under the credit facility — 18,130 Less unamortized issuance costs (4,146 ) (1,716 ) Total $ 220,707 $ 194,872 Less current maturities — (971 ) Long-term debt $ 220,707 $ 193,901 Amended and Restated Senior Secured Credit Facility On October 31, 2018, the Company entered into the Amended and Restated Credit Agreement, dated as of October 31, 2018, with certain lenders and Capital One, National Association, as a lender and as agent for all lenders (as amended by the Amendment (as hereinafter defined) and the Second Amendment (as hereinafter defined), the “Credit Agreement”). This credit facility totaled $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. 0.75 4.25 Addus HealthCare, Inc. (“Addus HealthCare”) is the borrower, and its parent, Holdings, and substantially all of Holdings’ subsidiaries are guarantors under this credit facility, and it is collateralized by a first priority security interest in all of the Company’s and the other credit parties’ current and future tangible and intangible assets, including the shares of stock of the borrower and subsidiaries. The Credit Agreement contains affirmative and negative covenants customary for credit facilities of this type, including limitations on the Company with respect to liens, indebtedness, guaranties, investments, distributions, mergers and acquisitions and dispositions of assets. The Company pays a fee ranging from 0.20% to 0.35% based on the applicable senior net leverage ratio times the unused portion of the revolving loan portion of the credit facility. The Credit Agreement contains customary affirmative covenants regarding, among other things, the maintenance of records, compliance with laws, maintenance of permits, maintenance of insurance and property and payment of taxes. The Credit Agreement also contains certain customary financial covenants and negative covenants that, among other things, include a requirement to maintain a minimum Interest Coverage Ratio (as defined in the Credit Agreement), a requirement to stay below a maximum Total Net Leverage Ratio (as defined in the Credit Agreement) and a requirement to stay below a maximum permitted amount of capital expenditures. The Credit Agreement also contains restrictions on guarantees, indebtedness, liens, investments and loans, subject to customary carve outs, a restriction on dividends (provided that Addus HealthCare may make distributions to the Company in an amount that does not exceed $7.5 million in any year absent of an event of default, plus limited exceptions for tax and administrative distributions), a restriction on the ability to consummate acquisitions (without the consent of the lenders) under its credit facility subject to compliance with the Total Net Leverage Ratio (as defined in the Credit Agreement thresholds), restrictions on mergers, dispositions of assets, and affiliate transactions, and restrictions on fundamental changes and lines of business. As of September 30, 2021, the Company was in compliance with all financial covenants under the Credit Agreement. On September 12, 2019, the Company entered into a First Amendment (the “First Amendment”) to its Credit Agreement. The First Amendment increased the Company’s credit facility by $50.0 million in incremental revolving loans, for an aggregate $300.0 million in revolving loans. The First Amendment provides that future incremental loans may be for term loans or an increase to the revolving loan commitments. The First Amendment further provides that the proceeds of such $50.0 million incremental revolving loans may be used for, among other things, general corporate purposes. On July 30, 2021, the Company entered into the Second Amendment to its Credit Agreement. The Second Amendment, among other things, reallocated and refinanced the Company’s outstanding initial term loans as revolving loans (such that the Company has no outstanding initial term loans and no further initial term loans may be borrowed) and increased the Company’s revolving credit facility to an aggregate amount of $600.0 million. Moreover, the Second Amendment increased the Company’s incremental loan facility to an aggregate amount $125.0 million, which incremental loan facility may be for term loans or an increase to the revolving loan commitments. The maturity of the revolving credit facility was also extended from May 8, 2023 to July 30, 2026. Additionally, the Credit Agreement contemplates a transition from LIBOR, specifically identifies SOFR as the replacement reference rate and details the mechanism for transition at LIBOR cessation, which is anticipated to occur on June 30, 2023. The transition to SOFR is not expected to have a material impact on the Company’s results of operations or liquidity. In connection with the Second Amendment, we incurred approximately $3.0 million of debt issuance costs. During the nine months ended September 30, 2021, the Company drew $29.0 million under its credit facility to fund the acquisition of Armada. During the nine months ended September 30, 2020, the Company had no draws under its credit facility. As of September 30, 2021, the Company had a total of $224.9 million of revolving loans, with an interest rate of 2.08% , . and $18.1 million of term loans, with an interest rate of 1.90%, outstanding on its credit facility

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2021
Income Tax Disclosure [Abstract]
Income Taxes	8. Income Taxes The effective income tax rates were 26.6% and 23.6% for the three months ended September 30, 2021 and 2020, respectively. The difference between our federal statutory and effective income tax rates is principally due to the inclusion of state taxes and non-deductible compensation partially offset by the use of federal employment tax credits. The effective income tax rates were 24.7% and 20.5% for the nine months ended September 30, 2021 and 2020, respectively

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	9. Commitments and Contingencies Government Actions to Mitigate COVID-19’s Impact On January 31, 2020, the Secretary of the U.S. Department of Health and Human Services (“HHS”) declared a national public health emergency due to a novel coronavirus. In March 2020, the World Health Organization declared the outbreak of COVID-19, a disease caused by this novel coronavirus, a pandemic. This disease continues to impact the United States and other parts of the world. In recognition of the significant threat to the liquidity of financial markets posed by the COVID-19 pandemic, the Federal Reserve and Congress have taken dramatic actions to provide liquidity to businesses and the banking system in the United States. For example, on March 27, 2020, the CARES Act, a sweeping stimulus bill intended to bolster the U.S. economy, was enacted. The PPPHCE Act and the CAA both expansions of the CARES Act, were signed into law on April 24, 2020 and December 27, 2020, respectively. In total, the CARES Act, the PPPHCE Act and CAA authorize On March 11, 2021, the ARPA was signed into law, another COVID-19 relief package with numerous provisions that affect healthcare providers, including additional funding targeted to specified healthcare providers and to improve coronavirus testing and vaccine-related activities. In addition to the Provider Relief Fund, the CARES Act and related laws include temporary changes to Medicare and Medicaid payment rules and relief from certain accounting provisions. For example, the laws temporarily lift the Medicare sequester, which would have otherwise reduced payments to Medicare providers by 2% as required by the Budget Control Act of 2011, from May 1, 2020, through December 31, 2021 (but also extend sequestration through 2030). In the hospice segment, Medicare sequester relief resulted in an increase in net service revenues of $0.7 million and $0.5 million, for the three months ended September 30, 2021 and 2020, respectively, and $2.1 million and $0.8 million for the nine months ended September 30, 2021 and 2020, respectively. In the home health segment, Medicare sequester relief resulted in an net service revenues However, the ARPA increases the federal budget deficit in a manner that triggers an additional statutorily mandated sequestration under the Pay-As-You-Go Act of 2010 (“PAYGO Act”). As a result, absent congressional action, Medicare spending will be reduced by up to 4% in fiscal year 2022, to begin to take effect in January 2022, in addition to the existing sequestration requirements of the Budget Control Act of 2011. We cannot currently determine if, or to what extent, our business, results of operations, financial condition or liquidity will ultimately be impacted by mandated sequestration triggers under the PAYGO Act, or if the mandated sequestration will occur. While conditions related to the COVID-19 pandemic have improved in the United States as vaccinations have become widely available, during the third quarter of 2021, the number of COVID-19 cases and deaths increased in the United States due in part to the emergence of a new variant of the novel coronavirus that causes COVID-19, as well as low vaccination rates in many parts of the country. In response, various governmental authorities and private businesses in the United States continued to implement, or reinstituted, certain mitigation strategies, such as masking and vaccine requirements. The rate of new cases and deaths in the United States are currently decreasing again but longer-term trends are unknown. As such, it is impossible to predict the effect and ultimate impact of the COVID-19 pandemic on the Company as conditions related to the COVID-19 pandemic continue to evolve. See Note 6 for additional information regarding government stimulus advances associated with the COVID-19 pandemic that the Company has received. Legal Proceedings From time to time, the Company is subject to legal and/or administrative proceedings incidental to its business. On June 2, 2021, the Company received a $6.5 million Request for Repayment from Palmetto, GBA, LLC (“Palmetto”), a Medicare administrative contractor, regarding Ambercare Hospice Inc. (“Ambercare”), our subsidiary that provides hospice services in New Mexico. In 2018, the Office of Audit Services (“OAS”), under the HHS Office of Inspector General, initiated a clinical review of certain hospice claims billed during a timeframe from January 1, 2016 to December 31, 2017. The OAS review concluded that certain payments to Ambercare for hospice services during the review period were made in error. The Company acquired Ambercare in May 2018 and has a contractual right to full indemnification from any potential losses from the OAS review through the terms of the Ambercare purchase agreement. The Company disputes the results of the OAS review and related asserted billing errors and is in the process of filing administrative appeals. At this stage, the Company cannot predict the ultimate outcome of the appeal process. It is the opinion of management that the outcome of pending legal and/or administrative proceedings will not have a material effect on the Company’s Unaudited Condensed Consolidated Balance Sheets and Unaudited Condensed Consolidated Statements of Income.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
Segment Information	10. Segment Information Operating segments are defined as components of a company that engage in business activities from which it may earn revenues and incur expenses, and for which separate financial information is available and is regularly reviewed by the Company’s chief operating decision makers, to assess the performance of the individual segments and make decisions about resources to be allocated to the segments. The Company operates as a multi-state provider of three distinct but related business segments providing in-home services. In its personal care segment, the Company provides non-medical assistance with activities of daily living, primarily to persons who are at increased risk of hospitalization or institutionalization, such as the elderly, chronically ill or disabled. In its hospice segment, the Company provides physical, emotional and spiritual care for people who are terminally ill as well as related services for their families. In its home health segment, the Company provides services that are primarily medical in nature to individuals who may require assistance during an illness or after hospitalization and include skilled nursing and physical, occupational and speech therapy. The tables below set forth information about the Company’s reportable segments for the three and nine months ended September 30, 2021 and 2020, along with the items necessary to reconcile the segment information to the totals reported in the accompanying Unaudited Condensed Consolidated Financial Statements. Segment assets are not reviewed by the Company’s chief operating decision maker function and therefore are not disclosed below. Segment operating income consists of revenue generated by a segment, less the direct costs of service revenues and general and administrative expenses that are incurred directly by the segment. Unallocated general and administrative costs are those costs for functions performed in a centralized manner and therefore not attributable to a particular segment. These costs include accounting, finance, human resources, legal, information technology, corporate office support and facility costs and overall corporate management. For the Three Months Ended September 30, 2021 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 169,609 $ 39,095 $ 7,958 $ 216,662 Cost of services revenues 125,647 18,992 4,977 149,616 Gross profit 43,962 20,103 2,981 67,046 General and administrative expenses 15,166 8,880 1,477 25,523 Segment operating income $ 28,796 $ 11,223 $ 1,504 $ 41,523 For the Three Months Ended September 30, 2020 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 165,916 $ 23,986 $ 4,085 $ 193,987 Cost of services revenues 124,493 10,508 2,685 137,686 Gross profit 41,423 13,478 1,400 56,301 General and administrative expenses 14,837 5,904 925 21,666 Segment operating income $ 26,586 $ 7,574 $ 475 $ 34,635 For the Three Months Ended September 30, 2021 2020 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 41,523 $ 34,635 Items not allocated at segment level: Other general and administrative expenses 20,757 19,067 Depreciation and amortization 3,406 3,045 Interest income (37 ) (87 ) Interest expense 1,614 680 Income before income taxes $ 15,783 $ 11,930 For the Nine Months Ended September 30, 2021 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 510,744 $ 112,098 $ 17,015 $ 639,857 Cost of services revenues 375,744 56,500 10,560 442,804 Gross profit 135,000 55,598 6,455 197,053 General and administrative expenses 46,807 26,016 3,410 76,233 Segment operating income $ 88,193 $ 29,582 $ 3,045 $ 120,820 For the Nine Months Ended September 30, 2020 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 482,849 $ 73,723 $ 12,207 $ 568,779 Cost of services revenues 359,344 33,749 8,553 401,646 Gross profit 123,505 39,974 3,654 167,133 General and administrative expenses 45,042 18,658 2,831 66,531 Segment operating income $ 78,463 $ 21,316 $ 823 $ 100,602 For the Nine Months Ended September 30, 2021 2020 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 120,820 $ 100,602 Items not allocated at segment level: Other general and administrative expenses 63,648 58,939 Depreciation and amortization 10,594 8,872 Interest income (90 ) (576 ) Interest expense 4,092 2,309 Income before income taxes $ 42,576 $ 31,058

Significant Payors

Significant Payors	9 Months Ended
	Sep. 30, 2021
Significant Payors [Abstract]
Significant Payors	11. Significant Payors For the three and nine months ended September 30, 2021 and 2020, the Company’s revenue by payor type was as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 83,821 49.5 % $ 85,344 51.5 % $ 253,052 49.5 % $ 242,751 50.3 % Managed care organizations 76,890 45.3 71,700 43.2 231,211 45.3 213,087 44.1 Private pay 4,934 2.9 5,193 3.1 14,883 2.9 15,449 3.2 Commercial insurance 2,459 1.4 2,498 1.5 7,481 1.5 7,468 1.5 Other 1,505 0.9 1,181 0.7 4,117 0.8 4,094 0.9 Total personal care segment net service revenues $ 169,609 100.0 % $ 165,916 100.0 % $ 510,744 100.0 % $ 482,849 100.0 % Hospice For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 36,278 92.8 % $ 22,404 93.4 % $ 104,715 93.4 % $ 68,372 92.8 % Managed care organizations 1,514 3.9 1,130 4.7 4,396 3.9 3,710 5.0 Other 1,303 3.3 452 1.9 2,987 2.7 1,641 2.2 Total hospice segment net service revenues $ 39,095 100.0 % $ 23,986 100.0 % $ 112,098 100.0 % $ 73,723 100.0 % Home Health For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 6,372 80.1 % $ 3,188 78.0 % $ 13,699 80.5 % $ 9,667 79.2 % Managed care organizations 1,218 15.3 829 20.3 2,838 16.7 2,325 19.0 Other 368 4.6 68 1.7 478 2.8 215 1.8 Total home health segment net service revenues $ 7,958 100.0 % $ 4,085 100.0 % $ 17,015 100.0 % $ 12,207 100.0 % The Company derives a significant amount of its revenue from its operations in Illinois, New York and New Mexico. The percentages of segment revenue for each of these significant states for the three and nine months ended September 30, 2021 and 2020 were as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 81,959 48.3 % $ 74,448 44.9 % $ 240,131 47.0 % $ 215,047 44.6 % New York 24,127 14.2 28,381 17.1 77,237 15.1 87,463 18.1 New Mexico 24,214 14.3 21,878 13.2 73,291 14.3 64,402 13.3 All other states 39,309 23.2 41,209 24.8 120,085 23.6 115,937 24.0 Total personal care segment net service revenues $ 169,609 100.0 % $ 165,916 100.0 % $ 510,744 100.0 % $ 482,849 100.0 % Hospice For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 Ohio $ 15,868 40.6 % $ — — % $ 44,676 39.8 % $ — — % New Mexico 9,268 23.7 10,979 45.8 27,216 24.3 33,431 45.3 All other states 13,959 35.7 13,007 54.2 40,206 35.9 40,292 54.7 Total hospice segment net service revenues $ 39,095 100.0 % $ 23,986 100.0 % $ 112,098 100.0 % $ 73,723 100.0 % With the acquisition of Queen City Hospice, the Company expanded our hospice services in the state of Ohio. Home Health For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 7,958 100.0 % $ 4,085 100.0 % $ 17,015 100.0 % $ 12,207 100.0 % Total home health segment net service revenues $ 7,958 100.0 % $ 4,085 100.0 % $ 17,015 100.0 % $ 12,207 100.0 % A substantial portion of the Company’s revenue and accounts receivable are derived from services performed for federal, state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 37.8%, and 38.5% of our net service revenues for the three months ended September 30, 2021, and 2020, respectively, and accounted for 37.5% and 37.8% of our net service revenues for the nine months ended September 30, 2021 and 2020, respectively. The related receivables due from the Illinois Department on Aging represented 14.4% and 15.9% of the Company’s net accounts receivable at September 30, 2021 and December 31, 2020, respectively.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2021
Subsequent Events [Abstract]
Subsequent Events	12. Subsequent Events On October 1, 2021, we completed the acquisition of Summit Home Health, LLC (“Summit”) for approximately $8.1 million, with funding provided by available cash. With the purchase of Summit, the Company added clinical services to its home health segment in Illinois. The initial accounting is incomplete, therefore the related business combination disclosures cannot be completed. 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, 2021
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying Unaudited Condensed Consolidated Financial Statements and related notes have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”) for Quarterly Reports on Form 10-Q. The accompanying balance sheet as of December 31, 2020 has been derived from the Company’s audited financial statements for the year ended December 31, 2020 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, 2020 included in our Annual Report on Form 10-K, which includes information and disclosures not included herein. In the opinion of management, these financial statements reflect all adjustments of a normal, recurring nature necessary for the fair statement of our financial position, results of operations, and cash flows for the interim periods presented in conformity with GAAP. Our results for any interim period are not necessarily indicative of results for a full year or any other interim period.
Principles of Consolidation	Principles of Consolidation These Unaudited Condensed Consolidated Financial Statements include the accounts of Addus HomeCare Corporation, and its subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Estimates	Estimates The financial statements are prepared by management in conformity with U.S. Generally Accepted Accounting Principles (“GAAP”) and include estimated amounts and certain disclosures based on assumptions about future events. The Company’s critical accounting estimates include the following areas: revenue recognition, allowance for doubtful accounts, intangible assets acquired in business combinations and, when required, the quantitative impairment assessment of goodwill and indefinite lived intangible assets. Actual results could differ from those estimates.
Diluted Net Income Per Common Share	Diluted Net Income Per Common Share Diluted net income per common share, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The Company’s outstanding securities that may potentially dilute the common stock are stock options and restricted stock awards. As of September 30, 2021 and 2020, dilutive stock options outstanding were approximately 521,000 and 523,000, respectively, and dilutive restricted stock awards outstanding were approximately 162,000 and 149,000, respectively. Included in the Company’s calculation of diluted earnings per share for the three and nine months ended September 30, 2021, dilutive stock options outstanding were approximately 267,000 and 288,000, respectively. In addition, dilutive restricted stock awards outstanding were approximately 16,000 and 44,000 for the three and nine months ended September 30, 2021, respectively. Included in the Company’s calculation of diluted earnings per share for the three and nine months ended September 30, 2020, dilutive stock options outstanding were approximately 301,000 and 303,000, respectively. In addition, dilutive restricted stock awards outstanding were approximately 38,000 and 58,000 for the three and nine months ended September 30, 2020, respectively.
Recently Issued and Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes Recently Issued Accounting Pronouncements In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases	Amounts reported in the Company’s Unaudited Condensed Consolidated Balance Sheets as of September 30, 2021 and December 31, 2020 for operating leases were as follows: September 30, 2021 December 31, 2020 (Amounts in Thousands) Operating lease assets, net $ 36,424 $ 37,991 Short-term operating lease liabilities (in accrued expenses) 9,713 9,283 Long-term operating lease liabilities 33,509 35,516 Total operating lease liabilities $ 43,222 $ 44,799
Components of Lease Costs Reported in General and Administrative Expenses in Unaudited Condensed Consolidated Statements of Income	Components of lease costs were reported in general and administrative expenses in the Company’s Unaudited Condensed Consolidated Statements of Income as follows: For the Three Months Ended September 30, (Amounts in Thousands) For the Nine Months Ended September 30, (Amounts in Thousands) 2021 2020 2021 2020 Operating lease costs $ 2,789 $ 2,285 $ 8,341 $ 6,524 Short-term lease costs 197 147 572 575 Less: sublease income (177 ) (74 ) (480 ) (224 ) Total lease costs, net $ 2,809 $ 2,358 $ 8,433 $ 6,875
Schedule of Weighted Average Remaining Lease Terms and Discount Rates	Weighted average remaining lease terms and discount rates were as follows: September 30, 2021 December 31, 2020 Operating leases: Weighted average remaining lease term 6.55 6.97 Weighted average discount rate 3.95 % 4.18 %
Summary of Remaining Operating Lease Payments	Remaining operating lease payments as of September 30, 2021 were as follows: Operating Leases (Amounts in Thousands) Due in the 12-month period ended September 30, 2022 $ 2,765 2023 10,717 2024 8,657 2025 6,520 2026 3,883 Thereafter 16,786 Total future minimum rental commitments 49,328 Less: Imputed interest (6,106 ) Total lease liabilities $ 43,222
Supplemental Cash Flows Information	For the Nine Months Ended September 30, (Amounts in Thousands) 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 8,237 $ 6,472 Right-of-use assets obtained in exchange for lease obligations: Operating leases 5,706 21,399

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2021
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 for the three and nine months ended September 30, 2021 and 2020 as if each of the acquisitions of Armada, Queen City Hospice, County Homemakers and A Plus closed on January 1, 2020. For the Three Months Ended September 30, (Amounts in Thousands) For the Nine Months Ended September 30, (Amounts in Thousands) 2021 2020 2021 2020 Net service revenues $ 218,474 $ 216,479 $ 652,908 $ 637,695 Operating income 17,613 14,458 48,135 39,331 Net income 11,832 10,586 33,341 29,930 Net income per common share Basic income per share $ 0.75 $ 0.68 $ 2.12 $ 1.92 Diluted income per share $ 0.74 $ 0.66 $ 2.08 $ 1.88
Armada Skilled Homecare [Member]
Business Acquisition [Line Items]
Schedule of Fair Values of Assets and Liabilities	Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows: Total (Amounts in Thousands) Goodwill $ 28,479 Identifiable intangible assets 990 Cash 653 Property and equipment 40 Other assets 29 Accrued payroll (400 ) Total purchase price $ 29,791
Queen City Hospice [Member]
Business Acquisition [Line Items]
Schedule of Fair Values of Assets and Liabilities	Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows: Total (Amounts in Thousands) Goodwill $ 169,302 Identifiable intangible assets 20,015 Cash 15,444 Accounts receivable 5,922 Property and equipment 759 Operating lease assets, net 3,028 Other assets 85 Accounts payable (2,281 ) Accrued payroll (1,555 ) Accrued expenses (503 ) Government stimulus advances (12,694 ) Long-term operating lease liabilities (2,765 ) Total purchase price $ 194,757
County Homemakers [Member]
Business Acquisition [Line Items]
Schedule of Fair Values of Assets and Liabilities	Based upon management’s valuations, which are preliminary and subject to completion of working capital adjustments, the fair values of the assets and liabilities acquired are as follows: Total (Amounts in Thousands) Goodwill $ 13,475 Identifiable intangible assets 474 Cash 1,104 Accounts receivable 1,395 Property and equipment 52 Operating lease assets, net 485 Other assets 40 Accounts payable (96 ) Accrued payroll (586 ) Accrued expenses (37 ) Long-term operating lease liabilities (485 ) Total purchase price $ 15,821
A Plus Health Cares Inc
Business Acquisition [Line Items]
Schedule of Fair Values of Assets and Liabilities	Based upon management’s final valuations, the fair values of the assets and liabilities acquired are as follows: Total (Amounts in Thousands) Goodwill $ 9,732 Identifiable intangible assets 1,523 Cash 2,819 Accounts receivable 1,009 Operating lease assets, net 180 Other assets 26 Accounts payable (34 ) Accrued expenses (353 ) Accrued payroll (275 ) Long-term operating lease liabilities (100 ) Total purchase price $ 14,527

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2021
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, 2021 is provided below: Goodwill Hospice Personal Care Home Health Total (Amounts in Thousands) Goodwill as of December 31, 2020 $ 314,833 $ 152,448 $ 1,791 $ 469,072 Additions for acquisitions 13,379 115 15,100 28,594 Adjustments to previously recorded goodwill 95 158 — 253 Goodwill as of September 30, 2021 $ 328,307 $ 152,721 $ 16,891 $ 497,919
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, 2021: Customer and referral relationships Trade names and trademarks Non- competition agreements State Licenses Total (Amounts in Thousands) Intangible assets with indefinite lives $ — $ — $ — $ 21,221 $ 21,221 Intangible assets subject to amortization: Gross carrying amount 44,672 42,926 6,785 12,507 106,890 Accumulated amortization (35,866 ) (17,800 ) (3,579 ) (4,534 ) (61,779 ) Intangible assets subject to amortization, net 8,806 25,126 3,206 7,973 45,111 Total intangible assets at September 30, 2021 $ 8,806 $ 25,126 $ 3,206 $ 29,194 $ 66,332

Details of Certain Balance Sh_2

Details of Certain Balance Sheet Accounts (Tables)	9 Months Ended
	Sep. 30, 2021
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, 2021 December 31, 2020 (Amounts in Thousands) Prepaid payroll taxes $ 2,256 $ — Prepaid workers' compensation and liability insurance 1,969 2,838 Workers' compensation insurance receivable 1,748 1,860 Income tax receivable 1,614 — Health insurance receivable 565 528 Other 5,362 4,743 Total prepaid expenses and other current assets $ 13,514 $ 9,969
Schedule of Accrued Expenses	Accrued expenses consisted of the following: September 30, 2021 December 31, 2020 (Amounts in Thousands) Current portion of operating lease liabilities $ 9,713 $ 9,283 Payor advances (1) 6,684 4,206 Accrued health insurance 4,380 5,607 Accrued professional fees 2,860 4,220 Accrued payroll taxes 1,199 4,543 Other 10,944 9,705 Total accrued expenses $ 35,780 $ 37,564 (1) Represents the deferred portion of payments received from payors for COVID-19 reimbursements which will be recognized as we incur specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel) or will be returned to the extent such related expenses are not incurred .
Schedule of Government Stimulus Advances	Government stimulus advances consisted of the following: September 30, 2021 December 31, 2020 (Amounts in Thousands) Payroll tax deferral $ 7,141 $ 7,141 Provider Relief Fund 533 12,252 CMS advanced payment program — Queen City Hospice — 10,801 Provider Relief Fund — Queen City Hospice — 1,893 Total government stimulus advances $ 7,674 $ 32,087

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2021
Long Term Debt [Abstract]
Schedule of Long-Term Debt	Long-term debt consisted of the following: September 30, 2021 December 31, 2020 (Amounts in Thousands) Revolving loan under the credit facility $ 224,853 $ 178,458 Term loan under the credit facility — 18,130 Less unamortized issuance costs (4,146 ) (1,716 ) Total $ 220,707 $ 194,872 Less current maturities — (971 ) Long-term debt $ 220,707 $ 193,901

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
Summary of Segment Information	For the Three Months Ended September 30, 2021 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 169,609 $ 39,095 $ 7,958 $ 216,662 Cost of services revenues 125,647 18,992 4,977 149,616 Gross profit 43,962 20,103 2,981 67,046 General and administrative expenses 15,166 8,880 1,477 25,523 Segment operating income $ 28,796 $ 11,223 $ 1,504 $ 41,523 For the Three Months Ended September 30, 2020 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 165,916 $ 23,986 $ 4,085 $ 193,987 Cost of services revenues 124,493 10,508 2,685 137,686 Gross profit 41,423 13,478 1,400 56,301 General and administrative expenses 14,837 5,904 925 21,666 Segment operating income $ 26,586 $ 7,574 $ 475 $ 34,635 For the Three Months Ended September 30, 2021 2020 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 41,523 $ 34,635 Items not allocated at segment level: Other general and administrative expenses 20,757 19,067 Depreciation and amortization 3,406 3,045 Interest income (37 ) (87 ) Interest expense 1,614 680 Income before income taxes $ 15,783 $ 11,930 For the Nine Months Ended September 30, 2021 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 510,744 $ 112,098 $ 17,015 $ 639,857 Cost of services revenues 375,744 56,500 10,560 442,804 Gross profit 135,000 55,598 6,455 197,053 General and administrative expenses 46,807 26,016 3,410 76,233 Segment operating income $ 88,193 $ 29,582 $ 3,045 $ 120,820 For the Nine Months Ended September 30, 2020 (Amounts in Thousands) Personal Care Hospice Home Health Total Net service revenues $ 482,849 $ 73,723 $ 12,207 $ 568,779 Cost of services revenues 359,344 33,749 8,553 401,646 Gross profit 123,505 39,974 3,654 167,133 General and administrative expenses 45,042 18,658 2,831 66,531 Segment operating income $ 78,463 $ 21,316 $ 823 $ 100,602 For the Nine Months Ended September 30, 2021 2020 (Amounts in Thousands) Segment reconciliation: Total segment operating income $ 120,820 $ 100,602 Items not allocated at segment level: Other general and administrative expenses 63,648 58,939 Depreciation and amortization 10,594 8,872 Interest income (90 ) (576 ) Interest expense 4,092 2,309 Income before income taxes $ 42,576 $ 31,058

Significant Payors (Tables)

Significant Payors (Tables)	9 Months Ended
	Sep. 30, 2021
Significant Payors [Abstract]
Schedule of Revenue by Payor Type	For the three and nine months ended September 30, 2021 and 2020, the Company’s revenue by payor type was as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 83,821 49.5 % $ 85,344 51.5 % $ 253,052 49.5 % $ 242,751 50.3 % Managed care organizations 76,890 45.3 71,700 43.2 231,211 45.3 213,087 44.1 Private pay 4,934 2.9 5,193 3.1 14,883 2.9 15,449 3.2 Commercial insurance 2,459 1.4 2,498 1.5 7,481 1.5 7,468 1.5 Other 1,505 0.9 1,181 0.7 4,117 0.8 4,094 0.9 Total personal care segment net service revenues $ 169,609 100.0 % $ 165,916 100.0 % $ 510,744 100.0 % $ 482,849 100.0 % Hospice For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 36,278 92.8 % $ 22,404 93.4 % $ 104,715 93.4 % $ 68,372 92.8 % Managed care organizations 1,514 3.9 1,130 4.7 4,396 3.9 3,710 5.0 Other 1,303 3.3 452 1.9 2,987 2.7 1,641 2.2 Total hospice segment net service revenues $ 39,095 100.0 % $ 23,986 100.0 % $ 112,098 100.0 % $ 73,723 100.0 % Home Health For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 6,372 80.1 % $ 3,188 78.0 % $ 13,699 80.5 % $ 9,667 79.2 % Managed care organizations 1,218 15.3 829 20.3 2,838 16.7 2,325 19.0 Other 368 4.6 68 1.7 478 2.8 215 1.8 Total home health segment net service revenues $ 7,958 100.0 % $ 4,085 100.0 % $ 17,015 100.0 % $ 12,207 100.0 %
Schedule of Revenue by Geographic Location	The Company derives a significant amount of its revenue from its operations in Illinois, New York and New Mexico. The percentages of segment revenue for each of these significant states for the three and nine months ended September 30, 2021 and 2020 were as follows: Personal Care For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 81,959 48.3 % $ 74,448 44.9 % $ 240,131 47.0 % $ 215,047 44.6 % New York 24,127 14.2 28,381 17.1 77,237 15.1 87,463 18.1 New Mexico 24,214 14.3 21,878 13.2 73,291 14.3 64,402 13.3 All other states 39,309 23.2 41,209 24.8 120,085 23.6 115,937 24.0 Total personal care segment net service revenues $ 169,609 100.0 % $ 165,916 100.0 % $ 510,744 100.0 % $ 482,849 100.0 % Hospice For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 Ohio $ 15,868 40.6 % $ — — % $ 44,676 39.8 % $ — — % New Mexico 9,268 23.7 10,979 45.8 27,216 24.3 33,431 45.3 All other states 13,959 35.7 13,007 54.2 40,206 35.9 40,292 54.7 Total hospice segment net service revenues $ 39,095 100.0 % $ 23,986 100.0 % $ 112,098 100.0 % $ 73,723 100.0 % With the acquisition of Queen City Hospice, the Company expanded our hospice services in the state of Ohio. Home Health For the Three Months Ended September 30, For the Nine Months Ended September 30, 2021 2020 2021 2020 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 $ 7,958 100.0 % $ 4,085 100.0 % $ 17,015 100.0 % $ 12,207 100.0 % Total home health segment net service revenues $ 7,958 100.0 % $ 4,085 100.0 % $ 17,015 100.0 % $ 12,207 100.0 %

Nature of Operations, Consoli_2

Nature of Operations, Consolidation, and Presentation of Financial Statements (Narrative) (Details)	9 Months Ended
	Sep. 30, 2021segment
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, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
ASU 2019-12 [Member]
Summary Of Significant Accounting Policies [Line Items]
Change in accounting principle, accounting standards update, adopted	true		true
Change in accounting principle, accounting standards update, immaterial effect	true		true
Change in accounting principle, accounting standards update, adoption date	Jan. 1, 2021		Jan. 1, 2021
Stock Options [Member]
Summary Of Significant Accounting Policies [Line Items]
Number of potential diluted securities outstanding	521,000	523,000	521,000	523,000
Number of securities included in calculation of diluted earnings per share	267,000	301,000	288,000	303,000
Restricted Stock [Member]
Summary Of Significant Accounting Policies [Line Items]
Number of potential diluted securities outstanding	162,000	149,000	162,000	149,000
Number of securities included in calculation of diluted earnings per share	16,000	38,000	44,000	58,000

Leases (Amounts Reported in Una

Leases (Amounts Reported in Unaudited and Audited Condensed Consolidated Balance Sheets for Operating Leases) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Leases [Abstract]
Operating lease assets, net	$ 36,424	$ 37,991
Short-term operating lease liabilities (in accrued expenses)	$ 9,713	$ 9,283
Operating lease, liability, current, statement of financial position [Extensible List]	us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent	us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent
Long-term operating lease liabilities	$ 33,509	$ 35,516
Total operating lease liabilities	$ 43,222	$ 44,799

Leases (Components of Lease Cos

Leases (Components of Lease Costs Reported in General and Administrative Expenses in Unaudited Condensed Consolidated Statements of Income) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Leases [Abstract]
Operating lease costs	$ 2,789	$ 2,285	$ 8,341	$ 6,524
Short-term lease costs	197	147	572	575
Less: sublease income	(177)	(74)	(480)	(224)
Total lease costs, net	$ 2,809	$ 2,358	$ 8,433	$ 6,875

Leases (Schedule of Weighted Av

Leases (Schedule of Weighted Average Remaining Lease Terms and Discount Rates) (Details)	Sep. 30, 2021	Dec. 31, 2020
Leases [Abstract]
Weighted average remaining lease term	6 years 6 months 18 days	6 years 11 months 19 days
Weighted average discount rate	3.95%	4.18%

Leases (Summary of Remaining Op

Leases (Summary of Remaining Operating Lease Payments) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Leases [Abstract]
2022	$ 2,765
2023	10,717
2024	8,657
2025	6,520
2026	3,883
Thereafter	16,786
Total future minimum rental commitments	49,328
Less: Imputed interest	(6,106)
Total lease liabilities	$ 43,222	$ 44,799

Leases (Supplemental Cash Flows

Leases (Supplemental Cash Flows Information) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 8,237	$ 6,472
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 5,706	$ 21,399

Acquisitions (Narrative) (Detai

Acquisitions (Narrative) (Details) - USD ($) $ in Thousands	Aug. 01, 2021	Dec. 04, 2020	Dec. 01, 2020	Nov. 01, 2020	Jul. 01, 2020	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Business Acquisition [Line Items]
Total purchase price for business acquisition								$ 29,219	$ 11,869
Goodwill						$ 497,919		497,919		$ 469,072
Armada Skilled Homecare [Member]
Business Acquisition [Line Items]
Goodwill	$ 28,479
Armada Skilled Homecare [Member] | Non-competition Agreements [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired	$ 600
Intangible assets, estimated useful lives	5 years
Armada Skilled Homecare [Member] | State Licenses [Member]
Business Acquisition [Line Items]
Indefinite lived intangible assets acquired	$ 400
Armada Skilled Homecare [Member] | New Mexico [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition	29,800
Acquisition related costs						300		300
Integration costs						400		400
Excess cash held by acquired business	$ 700
Queen City Hospice [Member]
Business Acquisition [Line Items]
Goodwill		$ 169,302
Queen City Hospice [Member] | Non-competition Agreements [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired		$ 1,500
Intangible assets, estimated useful lives		5 years
Queen City Hospice [Member] | State Licenses [Member]
Business Acquisition [Line Items]
Indefinite lived intangible assets acquired		$ 7,500
Queen City Hospice [Member] | Trade Names [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired		$ 11,000
Intangible assets, estimated useful lives		15 years
Queen City Hospice [Member] | Ohio [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition		$ 194,800
Acquisition related costs								200
Integration costs						$ 400		2,100
Excess cash held by acquired business		$ 15,400
County Homemakers [Member]
Business Acquisition [Line Items]
Goodwill				$ 13,475
County Homemakers [Member] | State Licenses [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired				$ 300
Intangible assets, estimated useful lives				8 years
County Homemakers [Member] | Trade Names [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired				$ 100
Intangible assets, estimated useful lives				1 year
County Homemakers [Member] | Pennsylvania [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition				$ 15,800
Integration costs								200
Excess cash held by acquired business				$ 1,100
A Plus Health Cares Inc
Business Acquisition [Line Items]
Goodwill					$ 9,732
A Plus Health Cares Inc | Trade Names [Member]
Business Acquisition [Line Items]
Identifiable intangible assets acquired					$ 1,400
Intangible assets, estimated useful lives					15 years
A Plus Health Cares Inc | Montana [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition					$ 14,500
Acquisition related costs							$ 300		$ 300
Integration costs								$ 100
Excess cash held by acquired business					$ 2,800
SunLife Hospice [Member]
Business Acquisition [Line Items]
Total purchase price for business acquisition			$ 1,700
Goodwill			$ 1,600

Acquisitions (Schedule of Fair

Acquisitions (Schedule of Fair Values of Assets and Liabilities) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Aug. 01, 2021	Dec. 31, 2020	Dec. 04, 2020	Nov. 01, 2020	Jul. 01, 2020
Business Acquisition [Line Items]
Goodwill	$ 497,919		$ 469,072
Armada Skilled Homecare [Member]
Business Acquisition [Line Items]
Goodwill		$ 28,479
Identifiable intangible assets		990
Cash		653
Property and equipment		40
Other assets		29
Accrued payroll		(400)
Total purchase price		$ 29,791
Queen City Hospice [Member]
Business Acquisition [Line Items]
Goodwill				$ 169,302
Identifiable intangible assets				20,015
Cash				15,444
Accounts receivable				5,922
Property and equipment				759
Operating lease assets, net				3,028
Other assets				85
Accounts payable				(2,281)
Accrued expenses				(503)
Accrued payroll				(1,555)
Long-term operating lease liabilities				(2,765)
Government stimulus advances				(12,694)
Total purchase price				$ 194,757
County Homemakers [Member]
Business Acquisition [Line Items]
Goodwill					$ 13,475
Identifiable intangible assets					474
Cash					1,104
Accounts receivable					1,395
Property and equipment					52
Operating lease assets, net					485
Other assets					40
Accounts payable					(96)
Accrued expenses					(37)
Accrued payroll					(586)
Long-term operating lease liabilities					(485)
Total purchase price					$ 15,821
A Plus Health Cares Inc
Business Acquisition [Line Items]
Goodwill						$ 9,732
Identifiable intangible assets						1,523
Cash						2,819
Accounts receivable						1,009
Operating lease assets, net						180
Other assets						26
Accounts payable						(34)
Accrued expenses						(353)
Accrued payroll						(275)
Long-term operating lease liabilities						(100)
Total purchase price						$ 14,527

Acquisitions (Unaudited Pro For

Acquisitions (Unaudited Pro Forma Condensed Consolidated Income Statement Information) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Business Combinations [Abstract]
Net service revenues	$ 218,474	$ 216,479	$ 652,908	$ 637,695
Operating income	17,613	14,458	48,135	39,331
Net income	$ 11,832	$ 10,586	$ 33,341	$ 29,930
Basic income per share	$ 0.75	$ 0.68	$ 2.12	$ 1.92
Diluted income per share	$ 0.74	$ 0.66	$ 2.08	$ 1.88

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Aug. 01, 2021	Dec. 31, 2020
Goodwill [Line Items]
Goodwill	$ 497,919		$ 497,919			$ 469,072
Amortization expense	1,900	$ 1,700	$ 6,200	$ 5,300
Weighted average remaining useful lives of identifiable intangible assets			9 years 4 months 24 days
Armada Skilled Homecare [Member]
Goodwill [Line Items]
Goodwill					$ 28,479
Home Health [Member]
Goodwill [Line Items]
Goodwill	16,891		$ 16,891			1,791
Home Health [Member] | Armada Skilled Homecare [Member]
Goodwill [Line Items]
Goodwill	15,100		15,100
Hospice [Member]
Goodwill [Line Items]
Goodwill	328,307		328,307			314,833
Hospice [Member] | Armada Skilled Homecare [Member]
Goodwill [Line Items]
Goodwill	13,400		$ 13,400
Minimum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives			1 year
Minimum [Member] | Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives			5 years
Maximum [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives			25 years
Maximum [Member] | Customer and Referral Relationships [Member]
Goodwill [Line Items]
Intangible assets, estimated useful lives			10 years
General and Administrative Expense [Member]
Goodwill [Line Items]
Goodwill	$ 497,900		$ 497,900			$ 469,100

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets (Summary of Goodwill and Related Adjustments) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)
Goodwill [Line Items]
Goodwill, at Beginning of Period	$ 469,072
Additions for acquisitions	28,594
Adjustments to previously recorded goodwill	253
Goodwill, at End of Period	497,919
Hospice [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	314,833
Additions for acquisitions	13,379
Adjustments to previously recorded goodwill	95
Goodwill, at End of Period	328,307
Personal Care [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	152,448
Additions for acquisitions	115
Adjustments to previously recorded goodwill	158
Goodwill, at End of Period	152,721
Home Health [Member]
Goodwill [Line Items]
Goodwill, at Beginning of Period	1,791
Additions for acquisitions	15,100
Goodwill, at End of Period	$ 16,891

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, 2021	Dec. 31, 2020
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	$ 21,221
Intangible assets subject to amortization:
Gross carrying amount	106,890
Accumulated amortization	(61,779)
Intangible assets subject to amortization, net	45,111
Total intangible assets at September 30, 2021	66,332	$ 71,549
Customer And Referral Relationships [Member]
Intangible assets subject to amortization:
Gross carrying amount	44,672
Accumulated amortization	(35,866)
Intangible assets subject to amortization, net	8,806
Total intangible assets at September 30, 2021	8,806
Trade Names and Trademarks [Member]
Intangible assets subject to amortization:
Gross carrying amount	42,926
Accumulated amortization	(17,800)
Intangible assets subject to amortization, net	25,126
Total intangible assets at September 30, 2021	25,126
Non-competition Agreements [Member]
Intangible assets subject to amortization:
Gross carrying amount	6,785
Accumulated amortization	(3,579)
Intangible assets subject to amortization, net	3,206
Total intangible assets at September 30, 2021	3,206
State Licenses [Member]
Finite Lived Intangible Assets [Line Items]
Intangible assets with indefinite lives	21,221
Intangible assets subject to amortization:
Gross carrying amount	12,507
Accumulated amortization	(4,534)
Intangible assets subject to amortization, net	7,973
Total intangible assets at September 30, 2021	$ 29,194

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, 2021	Dec. 31, 2020
Details Of Certain Balance Sheet Accounts [Abstract]
Prepaid payroll taxes	$ 2,256
Prepaid workers' compensation and liability insurance	1,969	$ 2,838
Workers' compensation insurance receivable	1,748	1,860
Income tax receivable	1,614
Health insurance receivable	565	528
Other	5,362	4,743
Total prepaid expenses and other current assets	$ 13,514	$ 9,969

Details of Certain Balance Sh_4

Details of Certain Balance Sheet Accounts (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Details Of Certain Balance Sheet Accounts [Abstract]
Current portion of operating lease liabilities	$ 9,713	$ 9,283
Payor advances	6,684	4,206
Accrued health insurance	4,380	5,607
Accrued professional fees	2,860	4,220
Accrued payroll taxes	1,199	4,543
Other	10,944	9,705
Total accrued expenses	$ 35,780	$ 37,564

Details of Certain Balance Sh_5

Details of Certain Balance Sheet Accounts (Schedule of Government Stimulus Advances) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Details Of Certain Balance Sheet Accounts [Line Items]
Payroll tax deferral	$ 7,141	$ 7,141
Provider Relief Fund	533	12,252
Total government stimulus advances	$ 7,674	32,087
Queen City Hospice [Member]
Details Of Certain Balance Sheet Accounts [Line Items]
Provider Relief Fund		1,893
CMS advanced payment program — Queen City Hospice		$ 10,801

Details of Certain Balance Sh_6

Details of Certain Balance Sheet Accounts (Narrative) (Details) - USD ($)	1 Months Ended		3 Months Ended	9 Months Ended
	Nov. 30, 2020	Apr. 30, 2020	Sep. 30, 2021	Sep. 30, 2021	Dec. 31, 2020
Details Of Certain Balance Sheet Accounts [Line Items]
Payroll tax deferral			$ 7,141,000	$ 7,141,000	$ 7,141,000
Queen City Hospice [Member]
Details Of Certain Balance Sheet Accounts [Line Items]
CMS advanced payment program — Queen City Hospice					$ 10,801,000
CARES Act [Member]
Details Of Certain Balance Sheet Accounts [Line Items]
Payroll tax deferral		$ 7,100,000
Total deferred payroll taxes in which expect to repay half of the amount in fourth quarter of 2021		7,100,000
Deferred payroll taxes payment term				2 years
CARES Act [Member] | Provider Relief Fund [Member]
Details Of Certain Balance Sheet Accounts [Line Items]
CARES Act and other relief legislation				$ 178,000,000,000
Aggregate principal amount of grants received	$ 13,700,000
Fund distributed to health care related expenses			400,000	11,700,000
CARES Act [Member] | Provider Relief Fund [Member] | Queen City Hospice [Member]
Details Of Certain Balance Sheet Accounts [Line Items]
Intends to pay retention payments			$ 1,900,000	$ 1,900,000
CARES Act [Member] | Provider Relief Fund [Member] | Minimum [Member]
Details Of Certain Balance Sheet Accounts [Line Items]
Annual awards for commercial organizations		750,000
CARES Act [Member] | Medicare Accelerated And Advance Payment Program [Member] | Queen City Hospice [Member]
Details Of Certain Balance Sheet Accounts [Line Items]
CMS advanced payment program — Queen City Hospice		10,800,000
Repayment of grants		$ 0
Repayment of funds period		2021-03
CARES Act [Member] | Medicare Accelerated And Advance Payment Program [Member] | Hospice and Home Health [Member]
Details Of Certain Balance Sheet Accounts [Line Items]
Medicare payment period		3 months
CARES Act [Member] | Medicare Accelerated And Advance Payment Program [Member] | Maximum [Member] | Hospice and Home Health [Member]
Details Of Certain Balance Sheet Accounts [Line Items]
Request percentage of advance or accelerated payment		100.00%

Long-Term Debt (Schedule of Lon

Long-Term Debt (Schedule of Long-Term Debt) (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Less unamortized issuance costs	$ (4,146)	$ (1,716)
Total	220,707	194,872
Less current maturities		(971)
Long-term debt	220,707	193,901
Revolving Credit Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross	$ 224,853	178,458
Term Loan [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt gross		$ 18,130

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) - USD ($)	Jul. 30, 2021	Sep. 12, 2019	Oct. 31, 2018	Oct. 30, 2018	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Debt Instrument [Line Items]
Borrowings on revolver — credit facility					$ 46,395,000
Debt issuance costs					4,146,000		$ 1,716,000
Capital One, National Association [Member] | Term Loan [Member]
Debt Instrument [Line Items]
Line of credit outstanding amount	$ 0
Revolving Credit Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available					600,000,000
Revolving Credit Loan [Member] | Capital One, National Association [Member] | Minimum [Member]
Debt Instrument [Line Items]
Revolving credit facility maturity term	May 8, 2023
Revolving Credit Loan [Member] | Capital One, National Association [Member] | Maximum [Member]
Debt Instrument [Line Items]
Revolving credit facility maturity term	Jul. 30, 2026
Credit Agreement [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available			$ 269,600,000		367,000,000
Debt instrument, maturity date			May 8, 2023
Debt instrument total net leverage ratio				4.25%
Line of credit outstanding amount					8,200,000
Aggregate loan amount available					123,800,000
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] | Term Loan [Member]
Debt Instrument [Line Items]
Line of credit outstanding amount							$ 18,100,000
Debt instrument stated interest rate							1.90%
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]
Maximum aggregate loan amount available		$ 300,000,000	$ 250,000,000
Increase in credit facility		50,000,000
Borrowings on revolver — credit facility		$ 50,000,000
Line of credit outstanding amount					$ 224,900,000		$ 178,500,000
Proceeds from line of credit						$ 0
Debt instrument stated interest rate					2.08%		1.90%
Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member] | Armada Skilled Homecare [Member]
Debt Instrument [Line Items]
Proceeds from line of credit					$ 29,000,000
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%
Second Amendment Credit Agreement [Member] | Revolving Credit Loan [Member] | Capital One, National Association [Member]
Debt Instrument [Line Items]
Maximum aggregate loan amount available	$ 125,000,000
Debt issuance costs	$ 3,000,000

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Effective income tax rate	26.60%	23.60%	24.70%	20.50%
Percentage of excess tax benefit included in effective income tax rage			2.10%	6.80%

Commitments and Contingencies (

Commitments and Contingencies (Narrative) (Details) - USD ($) $ in Thousands	Jun. 02, 2021	Apr. 24, 2020	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2022
Commitments And Contingencies [Line Items]
Net service revenues			$ 216,662	$ 193,987	$ 639,857	$ 568,779
Home Health [Member]
Commitments And Contingencies [Line Items]
Net service revenues			7,958	4,085	17,015	12,207
Hospice [Member]
Commitments And Contingencies [Line Items]
Net service revenues			39,095	23,986	112,098	73,723
PPPHCE Act [Member]
Commitments And Contingencies [Line Items]
Authorized fund to be distributed to health care providers		$ 178,000,000
PPPHCE Act [Member] | Forecast [Member]
Commitments And Contingencies [Line Items]
Percentage of reduced payments to Medicare providers							2.00%
Deferred payroll taxes							4.00%
PPPHCE Act [Member] | Home Health [Member]
Commitments And Contingencies [Line Items]
Net service revenues			100	100	300	200
PPPHCE Act [Member] | Hospice [Member]
Commitments And Contingencies [Line Items]
Net service revenues			$ 700	$ 500	$ 2,100	$ 800
Palmetto [Member]
Commitments And Contingencies [Line Items]
Proceeds from legal settlements	$ 6,500

Segment Information (Narrative)

Segment Information (Narrative) (Details)	9 Months Ended
	Sep. 30, 2021segment
Segment Reporting [Abstract]
Number of business segments	3

Segment Information (Summary Of

Segment Information (Summary Of Segment Information) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Segment Reporting Information [Line Items]
Net service revenues	$ 216,662	$ 193,987	$ 639,857	$ 568,779
Cost of services revenues	149,616	137,686	442,804	401,646
Gross profit	67,046	56,301	197,053	167,133
General and administrative expenses	46,280	40,733	139,881	125,470
Operating income	17,360	12,523	46,578	32,791
Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	25,523	21,666	76,233	66,531
Operating income	41,523	34,635	120,820	100,602
Personal Care [Member]
Segment Reporting Information [Line Items]
Net service revenues	169,609	165,916	510,744	482,849
Cost of services revenues	125,647	124,493	375,744	359,344
Gross profit	43,962	41,423	135,000	123,505
Personal Care [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	15,166	14,837	46,807	45,042
Operating income	28,796	26,586	88,193	78,463
Hospice [Member]
Segment Reporting Information [Line Items]
Net service revenues	39,095	23,986	112,098	73,723
Cost of services revenues	18,992	10,508	56,500	33,749
Gross profit	20,103	13,478	55,598	39,974
Hospice [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	8,880	5,904	26,016	18,658
Operating income	11,223	7,574	29,582	21,316
Home Health [Member]
Segment Reporting Information [Line Items]
Net service revenues	7,958	4,085	17,015	12,207
Cost of services revenues	4,977	2,685	10,560	8,553
Gross profit	2,981	1,400	6,455	3,654
Home Health [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
General and administrative expenses	1,477	925	3,410	2,831
Operating income	$ 1,504	$ 475	$ 3,045	$ 823

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, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Segment Reporting Information [Line Items]
Operating income	$ 17,360	$ 12,523	$ 46,578	$ 32,791
Other general and administrative expenses	20,757	19,067	63,648	58,939
Depreciation and amortization	3,406	3,045	10,594	8,872
Interest income	(37)	(87)	(90)	(576)
Interest expense	1,614	680	4,092	2,309
Income before income taxes	15,783	11,930	42,576	31,058
Operating Segments [Member]
Segment Reporting Information [Line Items]
Operating income	$ 41,523	$ 34,635	$ 120,820	$ 100,602

Significant Payors (Revenue by

Significant Payors (Revenue by Payor Type) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Net service revenues	$ 216,662	$ 193,987	$ 639,857	$ 568,779
Personal Care [Member]
Net service revenues	169,609	165,916	510,744	482,849
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 169,609	$ 165,916	$ 510,744	$ 482,849
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	$ 83,821	$ 85,344	$ 253,052	$ 242,751
Concentration risk, percentage	49.50%	51.50%	49.50%	50.30%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 76,890	$ 71,700	$ 231,211	$ 213,087
Concentration risk, percentage	45.30%	43.20%	45.30%	44.10%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Private Pay [Member]
Net service revenues	$ 4,934	$ 5,193	$ 14,883	$ 15,449
Concentration risk, percentage	2.90%	3.10%	2.90%	3.20%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Commercial Insurance [Member]
Net service revenues	$ 2,459	$ 2,498	$ 7,481	$ 7,468
Concentration risk, percentage	1.40%	1.50%	1.50%	1.50%
Personal Care [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 1,505	$ 1,181	$ 4,117	$ 4,094
Concentration risk, percentage	0.90%	0.70%	0.80%	0.90%
Hospice [Member]
Net service revenues	$ 39,095	$ 23,986	$ 112,098	$ 73,723
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 39,095	$ 23,986	$ 112,098	$ 73,723
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 36,278	$ 22,404	$ 104,715	$ 68,372
Concentration risk, percentage	92.80%	93.40%	93.40%	92.80%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 1,514	$ 1,130	$ 4,396	$ 3,710
Concentration risk, percentage	3.90%	4.70%	3.90%	5.00%
Hospice [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 1,303	$ 452	$ 2,987	$ 1,641
Concentration risk, percentage	3.30%	1.90%	2.70%	2.20%
Home Health [Member]
Net service revenues	$ 7,958	$ 4,085	$ 17,015	$ 12,207
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member]
Net service revenues	$ 7,958	$ 4,085	$ 17,015	$ 12,207
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Net service revenues	$ 6,372	$ 3,188	$ 13,699	$ 9,667
Concentration risk, percentage	80.10%	78.00%	80.50%	79.20%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Managed Care Organizations [Member]
Net service revenues	$ 1,218	$ 829	$ 2,838	$ 2,325
Concentration risk, percentage	15.30%	20.30%	16.70%	19.00%
Home Health [Member] | Revenues [Member] | Customer Concentration Risk [Member] | Other [Member]
Net service revenues	$ 368	$ 68	$ 478	$ 215
Concentration risk, percentage	4.60%	1.70%	2.80%	1.80%

Significant Payors (Revenue b_2

Significant Payors (Revenue by Geographic Location) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Net service revenues	$ 216,662	$ 193,987	$ 639,857	$ 568,779
Revenues [Member] | Geographic Concentration Risk [Member] | Illinois [Member]
Concentration risk, percentage	37.80%	38.50%	37.50%	37.80%
Personal Care [Member]
Net service revenues	$ 169,609	$ 165,916	$ 510,744	$ 482,849
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 169,609	$ 165,916	$ 510,744	$ 482,849
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	$ 81,959	$ 74,448	$ 240,131	$ 215,047
Concentration risk, percentage	48.30%	44.90%	47.00%	44.60%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New York [Member]
Net service revenues	$ 24,127	$ 28,381	$ 77,237	$ 87,463
Concentration risk, percentage	14.20%	17.10%	15.10%	18.10%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | New Mexico [Member]
Net service revenues	$ 24,214	$ 21,878	$ 73,291	$ 64,402
Concentration risk, percentage	14.30%	13.20%	14.30%	13.30%
Personal Care [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 39,309	$ 41,209	$ 120,085	$ 115,937
Concentration risk, percentage	23.20%	24.80%	23.60%	24.00%
Hospice [Member]
Net service revenues	$ 39,095	$ 23,986	$ 112,098	$ 73,723
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 39,095	$ 23,986	$ 112,098	$ 73,723
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	$ 9,268	$ 10,979	$ 27,216	$ 33,431
Concentration risk, percentage	23.70%	45.80%	24.30%	45.30%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | All Other States [Member]
Net service revenues	$ 13,959	$ 13,007	$ 40,206	$ 40,292
Concentration risk, percentage	35.70%	54.20%	35.90%	54.70%
Hospice [Member] | Revenues [Member] | Geographic Concentration Risk [Member] | Ohio [Member]
Net service revenues	$ 15,868		$ 44,676
Concentration risk, percentage	40.60%		39.80%
Home Health [Member]
Net service revenues	$ 7,958	$ 4,085	$ 17,015	$ 12,207
Home Health [Member] | Revenues [Member] | Geographic Concentration Risk [Member]
Net service revenues	$ 7,958	$ 4,085	$ 17,015	$ 12,207
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	$ 7,958	$ 4,085	$ 17,015	$ 12,207
Concentration risk, percentage	100.00%	100.00%	100.00%	100.00%

Significant Payors (Narrative)

Significant Payors (Narrative) (Details) - Illinois [Member]	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Revenues [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	21.30%	22.90%	21.40%	23.10%
Revenues [Member] | Geographic Concentration Risk [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	37.80%	38.50%	37.50%	37.80%
Accounts Receivable [Member] | Illinois Department On Aging [Member]
Concentration Risk [Line Items]
Concentration risk, percentage			14.40%		15.90%

Subsequent Events (Narrative) (

Subsequent Events (Narrative) (Details) - USD ($) $ in Thousands	Oct. 01, 2021	Sep. 30, 2021	Sep. 30, 2020
Subsequent Event [Line Items]
Total purchase price for business acquisition		$ 29,219	$ 11,869
Subsequent Event [Member] | Summit Home Health, LLC [Member]
Subsequent Event [Line Items]
Total purchase price for business acquisition	$ 8,100