Document And Entity Information
Document And Entity Information | 9 Months Ended |
Sep. 30, 2023 shares | |
Document And Entity Information [Abstract] | |
Document Type | 10-Q |
Document Quarterly Report | true |
Document Fiscal Period Focus | Q3 |
Document Period End Date | Sep. 30, 2023 |
Document Transition Report | false |
Entity File Number | 1-8351 |
Entity Registrant Name | CHEMED CORPORATION |
Entity Incorporation, State or Country Code | DE |
Entity Tax Identification Number | 31-0791746 |
Entity Address, Address Line One | 255 E. Fifth Street |
Entity Address, Address Line Two | Suite 2600 |
Entity Address, City or Town | Cincinnati |
Entity Address, State or Province | OH |
Entity Address, Postal Zip Code | 45202 |
City Area Code | 513 |
Local Phone Number | 762-6690 |
Entity Current Reporting Status | Yes |
Entity Interactive Data Current | Yes |
Entity Filer Category | Large Accelerated Filer |
Entity Small Business | false |
Entity Emerging Growth Company | false |
Entity Shell Company | false |
Title of 12(b) Security | Capital Stock $1 Par Value |
Trading Symbol | CHE |
Security Exchange Name | NYSE |
Entity Common Stock, Shares Outstanding | 15,062,308 |
Amendment Flag | false |
Entity Central Index Key | 0000019584 |
Current Fiscal Year End Date | --12-31 |
Document Fiscal Year Focus | 2023 |
Consolidated Balance Sheets
Consolidated Balance Sheets - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Current assets | ||
Cash and cash equivalents | $ 173,150 | $ 74,126 |
Accounts receivable less allowances | 168,031 | 139,408 |
Inventories | 12,511 | 10,272 |
Prepaid income taxes | 11,337 | 18,515 |
Prepaid expenses | 29,510 | 30,291 |
Total current assets | 394,539 | 272,612 |
Investments of deferred compensation plans held in trust | 104,410 | 93,196 |
Properties and equipment, at cost, less accumulated depreciation of $347,909 (2022- $335,920) | 205,462 | 199,714 |
Lease right of use asset | 123,353 | 135,662 |
Identifiable intangible assets less accumulated amortization of $46,449 (2022 - $67,716) | 92,768 | 99,726 |
Goodwill | 584,977 | 581,295 |
Other assets | 56,570 | 59,807 |
Total Assets | 1,562,079 | 1,442,012 |
Current liabilities | ||
Accounts payable | 56,508 | 41,884 |
Current portion of long-term debt | 5,000 | |
Income taxes | 5,135 | |
Accrued insurance | 61,122 | 58,515 |
Accrued compensation | 74,865 | 87,350 |
Accrued legal | 6,626 | 4,456 |
Short-term lease liability | 37,615 | 38,996 |
Other current liabilities | 55,348 | 61,004 |
Total current liabilities | 297,219 | 297,205 |
Deferred income taxes | 30,381 | 38,613 |
Long-term debt | 92,500 | |
Deferred compensation liabilities | 102,815 | 92,330 |
Long-term lease liability | 99,346 | 110,513 |
Other liabilities | 13,075 | 12,136 |
Total Liabilities | 542,836 | 643,297 |
Commitments and contingencies (Note 10) | ||
STOCKHOLDERS' EQUITY | ||
Capital stock - authorized 80,000,000 shares $1 par; issued 37,013,253 shares (2022 - 36,795,792 shares) | 37,013 | 36,796 |
Paid-in capital | 1,254,356 | 1,149,899 |
Retained earnings | 2,362,928 | 2,197,918 |
Treasury stock - 22,005,711 shares (2022 - 21,920,993 shares) | (2,637,102) | (2,588,145) |
Deferred compensation payable in Company stock | 2,048 | 2,247 |
Total Stockholders' Equity | 1,019,243 | 798,715 |
Total Liabilities and Stockholders' Equity | $ 1,562,079 | $ 1,442,012 |
Consolidated Balance Sheets (Pa
Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Consolidated Balance Sheets [Abstract] | ||
Properties and equipment, at cost, accumulated depreciation | $ 347,909 | $ 335,920 |
Identifiable intangible assets, accumulated amortization | $ 46,449 | $ 67,716 |
Capital stock - authorized | 80,000,000 | 80,000,000 |
Capital stock - par value | $ 1 | $ 1 |
Capital stock - issued | 37,013,253 | 36,795,792 |
Treasury stock | 22,005,711 | 21,920,993 |
Consolidated Statements Of Inco
Consolidated Statements Of Income - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Consolidated Statements Of Income [Abstract] | ||||
Service revenues and sales | $ 564,532 | $ 526,472 | $ 1,678,505 | $ 1,588,309 |
Cost of services provided and goods sold (excluding depreciation) | 362,358 | 346,934 | 1,107,256 | 1,020,307 |
Selling, general and administrative expenses | 99,602 | 83,992 | 294,684 | 261,799 |
Depreciation | 12,858 | 12,154 | 37,778 | 37,006 |
Amortization | 2,521 | 2,520 | 7,548 | 7,558 |
Other operating expense/(income) | 343 | 15 | 2,064 | (530) |
Total costs and expenses | 477,682 | 445,615 | 1,449,330 | 1,326,140 |
Income from operations | 86,850 | 80,857 | 229,175 | 262,169 |
Interest expense | (444) | (1,271) | (2,766) | (2,983) |
Other income/(expense) - net | 6,859 | (3,115) | 8,365 | (11,907) |
Income before income taxes | 93,265 | 76,471 | 234,774 | 247,279 |
Income taxes | (18,307) | (19,598) | (52,318) | (59,781) |
Net income | $ 74,958 | $ 56,873 | $ 182,456 | $ 187,498 |
Earnings Per Share: | ||||
Net income | $ 4.97 | $ 3.82 | $ 12.14 | $ 12.55 |
Average number of shares outstanding | 15,075 | 14,888 | 15,034 | 14,935 |
Diluted Earnings Per Share: | ||||
Net income | $ 4.93 | $ 3.78 | $ 12.02 | $ 12.41 |
Average number of shares outstanding | 15,200 | 15,042 | 15,178 | 15,114 |
Cash Dividends Per Share | $ 0.40 | $ 0.38 | $ 1.16 | $ 1.10 |
Consolidated Statements Of Cash
Consolidated Statements Of Cash Flows - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2023 | Sep. 30, 2022 | |
Cash Flows from Operating Activities | ||
Net income | $ 182,456 | $ 187,498 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 45,326 | 44,564 |
Stock option expense | 22,376 | 19,343 |
(Benefit)/provision for deferred income taxes | (8,232) | 10,408 |
Noncash long-term incentive compensation | 6,637 | 4,343 |
Litigation settlements | 2,050 | |
Noncash directors' compensation | 1,444 | 1,170 |
Amortization of debt issuance costs | 500 | 247 |
Changes in operating assets and liabilities: | ||
(Increase)/decrease in accounts receivable | (27,843) | 16,166 |
Increase in inventories | (2,239) | (360) |
Decrease in prepaid expenses | 781 | 1,257 |
Decrease in accounts payable and other current liabilities | (15,815) | (15,765) |
Change in current income taxes | 12,314 | (10,277) |
Net change in lease assets and liabilities | (892) | 313 |
Increase in other assets | (8,622) | (42,424) |
Increase/(decrease) in other liabilities | 11,426 | (6,555) |
Other sources/(uses) | 69 | (241) |
Net cash provided by operating activities | 221,736 | 209,687 |
Cash Flows from Investing Activities | ||
Capital expenditures | (45,075) | (39,066) |
Proceeds from sale of fixed assets | 506 | 2,037 |
Business combinations, net of cash acquired | (3,994) | (2,044) |
Other uses | (409) | (841) |
Net cash used by investing activities | (48,972) | (39,914) |
Cash Flows from Financing Activities | ||
Payments on other long-term debt | (97,500) | (1,250) |
Proceeds from other long-term debt | 100,000 | |
Proceeds from exercise of stock options | 58,277 | 17,128 |
Purchases of treasury stock | (27,769) | (101,539) |
Dividends paid | (17,446) | (16,391) |
Change in cash overdrafts payable | 16,182 | 5,535 |
Capital stock surrendered to pay taxes on stock-based compensation | (5,446) | (12,497) |
Debt issuance costs | (1,584) | |
Payments on revolving line of credit | (299,400) | |
Proceeds from revolving line of credit | 116,500 | |
Other sources/(uses) | (38) | (1,389) |
Net cash used by financing activities | (73,740) | (194,887) |
Increase/(Decrease) in Cash and Cash Equivalents | 99,024 | (25,114) |
Cash and cash equivalents at beginning of period | 74,126 | 32,895 |
Cash and cash equivalents at end of period | $ 173,150 | $ 7,781 |
Consolidated Statements Of Chan
Consolidated Statements Of Changes In Stockholders' Equity - USD ($) $ in Thousands | Capital Stock [Member] | Paid-In Capital [Member] | Retained Earnings [Member] | Treasury Stock-At Cost [Member] | Deferred Compensation Payable In Company Stock [Member] | Total |
Balance at Dec. 31, 2021 | $ 36,514 | $ 1,044,341 | $ 1,970,311 | $ (2,430,094) | $ 2,201 | $ 623,273 |
Net income | 187,498 | 187,498 | ||||
Dividends paid | (16,391) | (16,391) | ||||
Stock awards and exercise of stock options | 156 | 57,172 | (27,842) | 29,486 | ||
Purchases of treasury stock | (101,098) | (101,098) | ||||
Other | (1,352) | (107) | 107 | (1,352) | ||
Balance at Sep. 30, 2022 | 36,670 | 1,100,161 | 2,141,418 | (2,559,141) | 2,308 | 721,416 |
Balance at Jun. 30, 2022 | 36,651 | 1,089,129 | 2,090,214 | (2,533,306) | 2,272 | 684,960 |
Net income | 56,873 | 56,873 | ||||
Dividends paid | (5,669) | (5,669) | ||||
Stock awards and exercise of stock options | 19 | 12,295 | (1,916) | 10,398 | ||
Purchases of treasury stock | (23,884) | (23,884) | ||||
Other | (1,263) | (35) | 36 | (1,262) | ||
Balance at Sep. 30, 2022 | 36,670 | 1,100,161 | 2,141,418 | (2,559,141) | 2,308 | 721,416 |
Balance at Dec. 31, 2022 | 36,796 | 1,149,899 | 2,197,918 | (2,588,145) | 2,247 | 798,715 |
Net income | 182,456 | 182,456 | ||||
Dividends paid | (17,446) | (17,446) | ||||
Stock awards and exercise of stock options | 217 | 104,457 | (21,386) | 83,288 | ||
Purchases of treasury stock | (27,769) | (27,769) | ||||
Other | 198 | (199) | (1) | |||
Balance at Sep. 30, 2023 | 37,013 | 1,254,356 | 2,362,928 | (2,637,102) | 2,048 | 1,019,243 |
Balance at Jun. 30, 2023 | 36,996 | 1,240,415 | 2,294,004 | (2,621,657) | 2,321 | 952,079 |
Net income | 74,958 | 74,958 | ||||
Dividends paid | (6,034) | (6,034) | ||||
Stock awards and exercise of stock options | 17 | 14,462 | (1,372) | 13,107 | ||
Purchases of treasury stock | (14,344) | (14,344) | ||||
Other | (521) | 271 | (273) | (523) | ||
Balance at Sep. 30, 2023 | $ 37,013 | $ 1,254,356 | $ 2,362,928 | $ (2,637,102) | $ 2,048 | $ 1,019,243 |
Consolidated Statements Of Ch_2
Consolidated Statements Of Changes In Stockholders' Equity (Parenthetical) - $ / shares | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Consolidated Statements Of Changes In Stockholders' Equity [Abstract] | ||||
Dividends paid per share | $ 0.40 | $ 0.38 | $ 1.16 | $ 1.10 |
Basis Of Presentation
Basis Of Presentation | 9 Months Ended |
Sep. 30, 2023 | |
Basis Of Presentation [Abstract] | |
Basis Of Presentation | 1. Basis of Presentation As used herein, the terms “We,” “Company” and “Chemed” refer to Chemed Corporation or Chemed Corporation and its consolidated subsidiaries. We have prepared the accompanying unaudited consolidated financial statements of Chemed in accordance with Rule 10-01 of SEC Regulation S-X. Consequently, we have omitted certain disclosures required under generally accepted accounting principles in the United States (“GAAP”) for complete financial statements. The December 31, 2022 balance sheet data were derived from audited financial statements but do not include all disclosures required by GAAP. However, in our opinion, the financial statements presented herein contain all adjustments, consisting only of normal recurring adjustments, necessary to state fairly our financial position, results of operations and cash flows. The results of operations for the three and nine months ended September 30, 2023 are not necessarily indicative of the results that may be expected for the year ending December 31, 2023 or any other future period, and we make no representations related thereto. These financial statements are prepared on the same basis as and should be read in conjunction with the audited Consolidated Financial Statements and related Notes included in our Annual Report on Form 10-K for the year ended December 31, 2022. CLOUD COMPUTING As of September 30, 2023, Roto-Rooter has no significant capitalized implementation costs related to cloud computing. VITAS utilizes a human resources system that is considered a cloud computing arrangement. We have capitalized approximately $ 5.6 million related to implementation of this project which is included in prepaid assets in the accompanying balance sheets. The VITAS human resource system was placed into service in January 2020 and is being amortized over 5.7 years. For the three months ended September 30, 2023 and 2022, $ 249,000 has been amortized, respectively. For the nine months ended September 30, 2023 and 2022, $ 746,000 has been amortized, respectively. INCOME TAXES Our effective income tax rate was 19.6 % in the third quarter of 2023 compared to 25.6 % during the third quarter of 2022. Excess tax benefit on stock options exercised reduced our income tax expenses by $ 225,000 and $ 450,000 for the quarters ended September 30, 2023 and 2022, respectively. Our effective income tax rate was 22.3 % in the first nine months of 2023 compared to 24.2 % during the first nine months of 2022. Excess tax benefit on stock options exercised reduced our income tax expenses by $ 3.4 million and $ 4.4 million for the first nine months ended September 30, 2023 and 2022, respectively. During the third quarter of 2023, the Company recognized a tax benefit from realignment of its state and local corporate tax structure based on the location of operating resources and profitability by business segment. This benefit includes a reduction in current state and local tax expense and a one time benefit of $ 4.2 million in reduction of deferred tax liabilities reflecting the lower tax rates. NON-CASH TRANSACTIONS Included in the accompanying Consolidated Balance Sheets are $ 744,000 and $ 1.9 million of capitalized property and equipment which were not paid for as of September 30, 2023 and December 31, 2022, respectively. Accrued property and equipment purchases have been excluded from capital expenditures in the accompanying Consolidated Statements of Cash Flow. There are no material non-cash amounts included in interest expense for any period presented. BUSINESS COMBINATIONS We account for acquired businesses using the acquisition method of accounting. All assets acquired and liabilities assumed are recorded at their respective fair values at the date of acquisition. The determination of fair value involves estimates and the use of valuation techniques when market value is not readily available. We use various techniques to determine fair value in accordance with accepted valuation models, primarily the income approach. The significant assumptions used in developing fair values include, but are not limited to, revenue growth rates, the amount and timing of future cash flows, discount rates, useful lives, royalty rates and future tax rates. The excess of purchase price over the fair value of assets and liabilities acquired is recorded as goodwill. See Note 17 for discussion of recent acquisitions. Quarterly amortization of intangible assets is mainly driven by two Roto-Rooter franchise acquisitions completed in 2019. The total purchase price of these acquisitions was $ 138.0 million. As part of the purchase price allocation, approximately $ 59.2 million was determined to be the value of reacquired franchise rights which are being amortized over the remaining life of each franchise agreement. The average remaining life on the reacquired franchise agreements was approximately seven years . Quarterly amortization of reacquired franchise rights for these two acquisitions is approximately $ 2.0 million ($ 8.1 million annualized through 2026). This contrasts to quarterly franchise fees historically collected from these two franchisees of approximately $ 470,000 ($ 1.9 million annualized). ESTIMATES The preparation of consolidated financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect amounts reported in the consolidated financial statements and accompanying Notes. Actual results could differ from those estimates. Disclosures of after-tax expenses and adjustments are based on estimates of the effective income tax rates for the applicable segments. |
Revenue Recognition
Revenue Recognition | 9 Months Ended |
Sep. 30, 2023 | |
Revenue Recognition [Abstract] | |
Revenue Recognition | 2. Revenue Recognition In May 2014, the FASB issued Accounting Standards Update “ASU No. 2014-09 – Revenue from Contracts with Customers.” The standard and subsequent amendments are intended to develop a common revenue standard for removing inconsistencies and weaknesses, improve comparability, provide for more useful information to users through improved disclosure requirements and simplify the preparation of financial statements. The standard is also referred to as Accounting Standards Codification No. 606 (“ASC 606”). VITAS Service revenue for VITAS is reported at the amount that reflects the ultimate consideration we expect to receive in exchange for providing patient care. These amounts are due from third-party payors, primarily commercial health insurers and government programs (Medicare and Medicaid), and include variable consideration for revenue adjustments due to settlements of audits and reviews, as well as certain hospice-specific revenue capitations. Amounts are generally billed monthly or subsequent to patient discharge. Subsequent changes in the transaction price initially recognized are not significant. Hospice services are provided on a daily basis and the type of service provided is determined based on a physician’s determination of each patient’s specific needs on that given day. Reimbursement rates for hospice services are on a per diem basis regardless of the type of service provided or the payor. Reimbursement rates from government programs are established by the appropriate governmental agency and are standard across all hospice providers. Reimbursement rates from health insurers are negotiated with each payor and generally structured to closely mirror the Medicare reimbursement model. The types of hospice services provided and associated reimbursement model for each are as follows: Routine Home Care occurs when a patient receives hospice care in their home, including a nursing home setting. The routine home care rate is paid for each day that a patient is in a hospice program and is not receiving one of the other categories of hospice care. For Medicare patients, the routine home care rate reflects a two-tiered rate, with a higher rate for the first 60 days of a hospice patient’s care and a lower rate for days 61 and after. In addition, there is a Service Intensity Add-on payment which covers direct home care visits conducted by a registered nurse or social worker in the last seven days of a hospice patient’s life, reimbursed up to 4 hours per day in 15 minute increments at the continuous home care rate. General Inpatient Care occurs when a patient requires services in a controlled setting for a short period of time for pain control or symptom management which cannot be managed in other settings. General inpatient care services must be provided in a Medicare or Medicaid certified hospital or long-term care facility or at a freestanding inpatient hospice facility with the required registered nurse staffing. Continuous Home Care is provided to patients while at home, including a nursing home setting, during periods of crisis when intensive monitoring and care, primarily nursing care, is required in order to achieve palliation or management of acute medical symptoms. Continuous home care requires a minimum of 8 hours of care within a 24-hour day, which begins at midnight. The care must be predominantly nursing care provided by either a registered nurse or licensed nurse practitioner. While the published Medicare continuous home care rates are daily rates, Medicare pays for continuous home care in 15 minute increments. This 15 minute rate is calculated by dividing the daily rate by 96. Respite Care permits a hospice patient to receive services on an inpatient basis for a short period of time in order to provide relief for the patient’s family or other caregivers from the demands of caring for the patient. A hospice can receive payment for respite care for a given patient for up to five consecutive days at a time, after which respite care is reimbursed at the routine home care rate. Each level of care represents a separate promise under the contract of care and is provided independently for each patient contingent upon the patient’s specific medical needs as determined by a physician. However, the clinical criteria used to determine a patient’s level of care is consistent across all patients, given that, each patient is subject to the same payor rules and regulations. As a result, we have concluded that each level of care is capable of being distinct and is distinct in the context of the contract. Furthermore, we have determined that each level of care represents a stand ready service provided as a series of either days or hours of patient care. We believe that the performance obligations for each level of care meet criteria to be satisfied over time. VITAS recognizes revenue based on the service output. VITAS believes this to be the most faithful depiction of the transfer of control of services as the patient simultaneously receives and consumes the benefits provided by our performance. Revenue is recognized on a daily or hourly basis for each patient in accordance with the reimbursement model for each type of service. VITAS’ performance obligations relate to contracts with an expected duration of less than one year. Therefore, VITAS has elected to apply the optional exception provided in ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The unsatisfied or partially satisfied performance obligations referred to above relate to bereavement services provided to patients’ families for at least 12 months after discharge. Care is provided to patients regardless of their ability to pay. Patients who meet our criteria for charity care are provided care without charge. There is no revenue or associated accounts receivable in the accompanying Consolidated Financial Statements related to charity care. The cost of providing charity care for the quarter ended September 30, 2023 and 2022 was $ 2.0 million and $ 1.9 million, respectively. The cost of providing charity care during the first nine months ended September 30, 2023 and 2022 was $ 6.1 million and $ 5.9 million, respectively. The cost of charity care is included in cost of services provided and goods sold and is calculated by taking the ratio of charity care days to total days of care and multiplying by the total cost of care. Generally, patients who are covered by third-party payors are responsible for related deductibles and coinsurance which vary in amount. VITAS also provides service to patients without a reimbursement source and may offer those patients discounts from standard charges. VITAS estimates the transaction price for patients with deductibles and coinsurance, along with those uninsured patients, based on historical experience and current conditions. The estimate of any contractual adjustments, discounts or implicit price concessions reduces the amount of revenue initially recognized. Subsequent changes to the estimate of the transaction price are recorded as adjustments to patient service revenue in the period of change. Subsequent changes that are determined to be the result of an adverse change in the patients’ ability to pay (i.e. change in credit risk) are recorded as bad debt expense. VITAS has no material adjustments related to subsequent changes in the estimate of the transaction price or subsequent changes as the result of an adverse change in the patient’s ability to pay for any period reported. Laws and regulations concerning government programs, including Medicare and Medicaid, are complex and subject to varying interpretation and change over time. Medicare and Medicaid programs have broad authority to audit and review compliance with such laws and regulations and impose payment suspensions or modifications when merited. Additionally, the contracts we have with commercial health insurance payors provide for retroactive audit and review of claims. Settlement with third party payors for retroactive adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. The variable consideration is estimated based on the terms of the payment agreement, existing correspondence from the payor and our historical settlement activity. These estimates are adjusted in future periods, as new information becomes available. We are subject to certain limitations on Medicare payments for services which are considered variable consideration, as follows: Inpatient Cap. If the number of inpatient care days any hospice program provides to Medicare beneficiaries exceeds 20 % of the total days of hospice care such program provided to all Medicare patients for an annual period beginning September 28, the days in excess of the 20 % figure may be reimbursed only at the routine homecare rate. None of VITAS’ hospice programs exceeded the payment limits on inpatient services during the three months ended September 30, 2023 and 2022. Medicare Cap. We are also subject to a Medicare annual per-beneficiary cap (“Medicare cap”). Compliance with the Medicare cap is measured in one of two ways based on a provider election. The “streamlined” method compares total Medicare payments received under a Medicare provider number with respect to services provided to all Medicare hospice care beneficiaries in the program or programs covered by that Medicare provider number with the product of the per-beneficiary cap amount and the number of Medicare beneficiaries electing hospice care for the first time from that hospice program or programs from September 28 through September 27 of the following year. At September 30, 2023, all our programs except one are using the “streamlined” method. The “proportional” method compares the total Medicare payments received under a Medicare provider number with respect to services provided to all Medicare hospice care beneficiaries in the program or programs covered by the Medicare provider number between September 28 and September 27 of the following year with the product of the per beneficiary cap amount and a pro-rated number of Medicare beneficiaries receiving hospice services from that program during the same period. The pro-rated number of Medicare beneficiaries is calculated based on the ratio of days the beneficiary received hospice services during the measurement period to the total number of days the beneficiary received hospice services. We actively monitor each of our hospice programs, by provider number, as to their specific admission, discharge rate and median length of stay data in an attempt to determine whether revenues are likely to exceed the annual per-beneficiary Medicare cap. Should we determine that revenues for a program are likely to exceed the Medicare cap based on projected trends, we attempt to institute corrective actions, which include changes to the patient mix and increased patient admissions. However, should we project our corrective action will not prevent that program from exceeding its Medicare cap, we estimate revenue recognized during the government fiscal year that will require repayment to the Federal government under the Medicare cap and record an adjustment to revenue of an amount equal to a ratable portion of our best estimate for the year. For VITAS’ patients in the nursing home setting in which Medicaid pays the nursing home room and board, VITAS serves as a pass-through between Medicaid and the nursing home. We are responsible for paying the nursing home for that patient’s room and board. Medicaid reimburses us for 95 % of the amount we have paid. This results in a 5 % net expense for VITAS related to nursing home room and board. This transaction creates a performance obligation in that VITAS is facilitating room and board being delivered to our patient. As a result, the 5 % net expense is recognized as a contra-revenue account under ASC 606 in the accompanying financial statements. The composition of patient care service revenue by payor and level of care for the quarter ended September 30, 2023 is as follows (in thousands): Medicare Medicaid Commercial Total Routine home care $ 269,954 $ 11,187 $ 6,248 $ 287,389 Continuous care 20,160 870 1,002 22,032 Inpatient care 23,983 2,197 1,638 27,818 $ 314,097 $ 14,254 $ 8,888 $ 337,239 All other revenue - self-pay, respite care, etc. 3,562 Subtotal $ 340,801 Medicare cap adjustment ( 125 ) Implicit price concessions ( 4,302 ) Room and board, net ( 2,646 ) Net revenue $ 333,728 The composition of patient care service revenue by payor and level of care for the quarter ended September 30, 2022 is as follows (in thousands): Medicare Medicaid Commercial Total Routine home care $ 239,670 $ 10,822 $ 5,761 $ 256,253 Continuous care 17,083 787 730 18,600 Inpatient care 21,391 1,838 1,297 24,526 $ 278,144 $ 13,447 $ 7,788 $ 299,379 All other revenue - self-pay, respite care, etc. 3,240 Subtotal $ 302,619 Medicare cap adjustment ( 618 ) Implicit price concessions ( 2,952 ) Room and board, net ( 2,513 ) Net revenue $ 296,536 The composition of patient care service revenue by payor and level of care for nine months ended September 30, 2023 is as follows (in thousands): Medicare Medicaid Commercial Total Routine home care $ 781,639 $ 33,143 $ 17,772 $ 832,554 Continuous care 58,071 2,384 2,599 63,054 Inpatient care 73,402 6,477 4,433 84,312 $ 913,112 $ 42,004 $ 24,804 $ 979,920 All other revenue - self-pay, respite care, etc. 9,738 Subtotal $ 989,658 Medicare cap adjustment ( 5,625 ) Implicit price concessions ( 10,650 ) Room and board, net ( 8,317 ) Net revenue $ 965,066 The composition of patient care service revenue by payor and level of care for the nine months ended September 30, 2022 is as follows (in thousands): Medicare Medicaid Commercial Total Routine home care $ 722,035 $ 32,848 $ 16,637 $ 771,520 Continuous care 53,103 2,337 2,277 57,717 Inpatient care 66,412 5,608 3,694 75,714 $ 841,550 $ 40,793 $ 22,608 $ 904,951 All other revenue - self-pay, respite care, etc. 9,461 Subtotal $ 914,412 Medicare cap adjustment ( 5,118 ) Implicit price concessions ( 8,992 ) Room and board, net ( 6,796 ) Net revenue $ 893,506 Roto-Rooter Roto-Rooter provides plumbing, drain cleaning, excavation, water restoration and other related services to both residential and commercial customers primarily in the United States. Services are provided through a network of company-owned branches, independent contractors and franchisees. Service revenue for Roto-Rooter is reported at the amount that reflects the ultimate consideration we expect to receive in exchange for providing services. Roto-Rooter owns and operates branches focusing mainly on large population centers in the United States. Roto-Rooter’s primary lines of business in company-owned branches consist of plumbing, sewer and drain cleaning, excavation and water restoration. For purposes of ASC 606 analysis, plumbing, sewer and drain cleaning, and excavation have been combined into one portfolio and are referred to as “short-term core services”. Water restoration is analyzed as a separate portfolio. The following describes the key characteristics of these portfolios: Short-term Core Services are plumbing, drain and sewer cleaning and excavation services. These services are provided to both commercial and residential customers. The duration of services provided in this category range from a few hours to a few days. There are no significant warranty costs or on-going obligations to the customer once a service has been completed. For residential customers, payment is received at the time of job completion before the Roto-Rooter technician leaves the residence. Commercial customers may be granted credit subject to internally designated authority limits and credit check guidelines. If credit is granted, payment terms are generally 30 days or less. Each job in this category is a distinct service with a distinct performance obligation to the customer. Revenue is recognized at the completion of each job. Variable consideration consists of pre-invoice discounts and post-invoice discounts. Pre-invoice discounts are given in the form of coupons or price concessions. Post-invoice discounts consist of credit memos generally granted to resolve customer service issues. Variable consideration is estimated based on historical activity and recorded at the time service is completed. Water Restoration Services involve the remediation of water and humidity after a flood. These services are provided to both commercial and residential customers. The duration of services provided in this category generally ranges from 3 to 5 days. There are no significant warranties or on-going obligations to the customer once service has been completed. The majority of these services are paid by the customer’s insurance company. Variable consideration relates primarily to allowances taken by insurance companies upon payment. Variable consideration is estimated based on historical activity and recorded at the time service is completed. For both short-term core services and water restoration services, Roto-Rooter satisfies its performance obligation at a point in time. The services provided generally involve fixing plumbing, drainage or flood-related issues at the customer’s property. At the time service is complete, the customer acknowledges its obligation to pay for service and its satisfaction with the service performed. This provides evidence that the customer has accepted the service and Roto-Rooter is now entitled to payment. As such, Roto-Rooter recognizes revenue for these services upon completion of the job and receipt of customer acknowledgement. Roto-Rooter’s performance obligations for short-term core services and water restoration services relate to contracts with an expected duration of less than a year. Therefore, Roto-Rooter has elected to apply the optional exception provided in ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. Roto-Rooter does not have significant unsatisfied or partially unsatisfied performance obligations at the time of initial revenue recognition for short-term core or water restoration services. Roto-Rooter owns the rights to certain territories and contracts with independent third-parties to operate the territory under Roto-Rooter’s registered trademarks (“Independent Contractors”). Such contracts are for a specified term but cancellable by either party without penalty with 90 days’ advance notice. Under the terms of these arrangements, Roto-Rooter provides certain back office support and advertising along with a limited license to use Roto-Rooter’s registered trademarks. The Independent Contractor is responsible for all day-to-day management of the business including staffing decisions and pricing of services provided. All performance obligations of Roto-Rooter cease at the termination of the arrangement. Independent Contractors pay Roto-Rooter a standard fee calculated as a percentage of their cash collection from weekly sales. The primary value for the Independent Contractors under these arrangements is the right to use Roto-Rooter’s registered trademarks. Roto-Rooter recognizes revenue from Independent Contractors over-time (weekly) as the Independent Contractor’s labor sales are completed and payment from customers are received. Payment from Independent Contractors is also received on a weekly basis. The use of Roto-Rooter’s registered trademarks and advertising provides immediate value to the Independent Contractor as a result of Roto-Rooter’s nationally recognized brand. Therefore, over-time recognition provides the most faithful depiction of the transfer of services as the customer simultaneously receives and consumes the benefits provided. There is no significant variable consideration related to these arrangements. Roto-Rooter has licensed the rights to operate under Roto-Rooter’s registered trademarks in other territories to franchisees. Each such contract is for a 10 year term but cancellable by Roto-Rooter for cause with 60 day advance notice without penalty. The franchisee may cancel the contract for any reason with 60 days advance notice without penalty. Under the terms of the contract, Roto-Rooter provides national advertising and consultation on various aspects of operating a Roto-Rooter business along with the right to use Roto-Rooter’s registered trademarks. The franchisee is responsible for all day- to-day management of the business including staffing decisions, pricing of services provided and local advertising spend and placement. All performance obligations of Roto-Rooter cease at the termination of the arrangement. Franchisees pay Roto-Rooter a standard monthly fee based on the population within the franchise territory. The standard fee is revised on a yearly basis based on changes in the Consumer Price Index for All Urban Consumers. The primary value for the franchisees under this arrangement is the right to use Roto-Rooter’s registered trademarks. Roto-Rooter recognizes revenue from franchisees over-time (monthly). Payment from franchisees is also received on a monthly basis. The use of Roto-Rooter’s registered trademarks and advertising provides immediate value to the franchisees as a result of Roto-Rooter’s nationally recognized brand. Therefore, over-time recognition provides the most faithful depiction of the transfer of services as the customer simultaneously receives and consumes the benefits provided. There is no significant variable consideration related to these arrangements. The composition of disaggregated revenue for the third quarter is as follows (in thousands): September 30, 2023 2022 Drain cleaning $ 59,164 $ 62,764 Plumbing 49,113 48,737 Excavation 56,904 54,164 Other 334 193 Subtotal - short term core 165,515 165,858 Water restoration 45,435 43,645 Independent contractors 20,509 20,474 Franchisee fees 1,457 1,559 Other 4,246 4,030 Gross revenue 237,162 235,566 Implicit price concessions and credit memos ( 6,358 ) ( 5,630 ) Net revenue $ 230,804 $ 229,936 The composition of disaggregated revenue for the first nine months is as follows (in thousands): September 30, 2023 2022 Drain cleaning $ 186,016 $ 193,983 Plumbing 148,285 145,294 Excavation 174,032 164,898 Other 711 513 Subtotal - short term core 509,044 504,688 Water restoration 141,176 127,678 Independent contractors 65,684 62,897 Franchisee fees 4,195 4,246 Other 13,292 12,462 Gross revenue 733,391 711,971 Implicit price concessions and credit memos ( 19,952 ) ( 17,168 ) Net revenue $ 713,439 $ 694,803 |
Segments
Segments | 9 Months Ended |
Sep. 30, 2023 | |
Segments [Abstract] | |
Segments | 3. Segments Service revenues and sales by business segment are shown in Note 2. After-tax income/(loss) by business segment are as follows (in thousands): Three months ended September 30, Nine months ended September 30, 2023 2022 2023 2022 VITAS $ 44,331 $ 26,086 $ 95,223 $ 97,779 Roto-Rooter 50,327 47,586 142,354 138,595 Total 94,658 73,672 237,577 236,374 Corporate ( 19,700 ) ( 16,799 ) ( 55,121 ) ( 48,876 ) Net income $ 74,958 $ 56,873 $ 182,456 $ 187,498 We report corporate administrative expenses and unallocated investing and financing income and expense not directly related to either segment as “Corporate”. |
Earnings Per Share
Earnings Per Share | 9 Months Ended |
Sep. 30, 2023 | |
Earnings Per Share [Abstract] | |
Earnings Per Share | 4. Earnings per Share Earnings per share (“EPS”) are computed using the weighted average number of shares of capital stock outstanding. Earnings and diluted earnings per share are computed as follows (in thousands, except per share data): Net Income For the Three Months Ended September 30, Income Shares Earnings per Share 2023 Earnings $ 74,958 15,075 $ 4.97 Dilutive stock options - 82 Nonvested stock awards - 43 Diluted earnings $ 74,958 15,200 $ 4.93 2022 Earnings $ 56,873 14,888 $ 3.82 Dilutive stock options - 118 Nonvested stock awards - 36 Diluted earnings $ 56,873 15,042 $ 3.78 Net Income For the Nine Months Ended September 30, Income Shares Earnings per Share 2023 Earnings $ 182,456 15,034 $ 12.14 Dilutive stock options - 98 Nonvested stock awards - 46 Diluted earnings $ 182,456 15,178 $ 12.02 2022 Earnings $ 187,498 14,935 $ 12.55 Dilutive stock options - 140 Nonvested stock awards - 39 Diluted earnings $ 187,498 15,114 $ 12.41 For the three and nine months ended September 30, 2023, there were 309,336 stock options excluded from the computation of dilutive earnings per share because they would have been anti-dilutive. For the three and nine months ended September 30, 2022, there were 592,000 and 593,000 , respectively, stock options excluded from the computation of dilutive earnings per share because they would have been anti-dilutive. |
Long-Term Debt And Lines Of Cre
Long-Term Debt And Lines Of Credit | 9 Months Ended |
Sep. 30, 2023 | |
Long-Term Debt And Lines Of Credit [Abstract] | |
Long-Term Debt And Lines Of Credit | 5. Long-Term Debt and Lines of Credit On June 28, 2022, we replaced our existing credit facility with a fifth amended and restated Credit Agreement (“2022 Credit Facilities”). Terms of the 2022 Credit Facilities consist of a five-year $ 450.0 million revolver as well as a five-year $ 100.0 million term loan. Principal payments of $ 1.25 million on the term loan are due on the last day of each fiscal quarter , with a final payment due at the end of the agreement. The 2022 Credit Facilities have a floating interest rate that is generally the secured overnight financing rate (“SOFR”) plus an additional tiered rate which varies based on our current leverage ratio. As of September 30, 2023, the interest rate is SOFR plus 100 basis points. The 2022 Credit Facilities include an expansion feature that provides the Company the opportunity to increase its revolver and or term loan by an additional $ 250.0 million. We made prepayments totaling $ 75.0 million in the first quarter of 2023, on the $ 100.0 million term loan. We paid the remaining balance of $ 21.3 million on April 28, 2023. There were no prepayment penalties associated with this repayment. There are no significant deferred debt issuance costs capitalized related to the term loan. This prepayment reduced the total borrowing capacity of the 2022 Credit Facilities from $ 550.0 million to $ 450.0 million. The 2022 Credit Facilities contain the following quarterly financial covenants effective as of September 30, 2023: Description Requirement Leverage Ratio (Consolidated Indebtedness/Consolidated Adj. EBITDA) < 3.50 to 1.00 Interest Coverage Ratio (Consolidated Adj. EBITDA/Consolidated Interest Expense) > 3.00 to 1.00 We are in compliance with all debt covenants as of September 30, 2023. We have issued $ 45.3 million in standby letters of credit as of September 30, 2023, mainly for insurance purposes. Issued letters of credit reduce our available credit under the 2022 Credit Facilities. As of September 30, 2023, we have approximately $ 404.8 million of unused lines of credit available and eligible to be drawn down under the revolving credit facility. |
Other Income_(Expense) _ Net
Other Income/(Expense) – Net | 9 Months Ended |
Sep. 30, 2023 | |
Other Income/(Expense) – Net [Abstract] | |
Other Income/(Expense) – Net | 6. Other Income/(Expense) – Net Other income/(expense) – net comprises the following (in thousands): Three months ended September 30, Nine months ended September 30, 2023 2022 2023 2022 Market value adjustment on assets held in deferred compensation trust $ 4,257 $ ( 3,176 ) $ 5,441 $ ( 12,196 ) Interest income 2,600 62 2,863 288 Other-net 2 ( 1 ) 61 1 Total other income/(expense) - net $ 6,859 $ ( 3,115 ) $ 8,365 $ ( 11,907 ) |
Leases
Leases | 9 Months Ended |
Sep. 30, 2023 | |
Leases [Abstract] | |
Leases | 7. Leases Chemed and each of its operating subsidiaries are service companies. As such, real estate leases comprise the largest lease obligation (and conversely, right of use asset) in our lease portfolio. VITAS has leased office space, as well as space for inpatient units (“IPUs”) and/or contract beds within hospitals. Roto-Rooter mainly has leased office space. Our leases have remaining terms of under 1 year to 10 years, some of which include options to extend the lease for up to 5 years , and some of which include options to terminate the lease within 1 year . Roto-Rooter purchases equipment and leases it to certain of its Independent Contractors. We analyzed these leases in accordance with ASC 842 and determined they are operating leases. As a result, Roto-Rooter capitalizes the equipment underlying these leases, depreciates the equipment and recognizes rental income. We do no t currently have any finance leases, therefore all lease information disclosed is related to operating leases. The components of balance sheet information related to leases were as follows: September 30, December 31, 2023 2022 Assets Operating lease assets $ 123,353 $ 135,662 Liabilities Current operating leases 37,615 38,996 Noncurrent operating leases 99,346 110,513 Total operating lease liabilities $ 136,961 $ 149,509 The components of lease expense for the third quarter are as follows (in thousands): Three months ended September 30, 2023 2022 Lease Expense (a) Operating lease expense $ 14,999 $ 12,936 Sublease income ( 23 ) ( 45 ) Net lease expense $ 14,976 $ 12,891 The components of lease expense for the first nine months are as follows (in thousands ): Nine months ended September 30, 2023 2022 Lease Expense (a) Operating lease expense $ 44,811 $ 39,230 Sublease income ( 70 ) ( 136 ) Net lease expense $ 44,741 $ 39,094 (a) Includes short-term leases and variable lease costs, which are immaterial. Included in both cost of services provided and goods sold and selling, general and administrative expenses. The components of cash flow information related to leases were as follows: Nine months ended September 30, 2023 2022 Cash paid for amounts included in the measurement of lease liabilities Operating cash flows from leases $ 37,352 $ 37,650 Leased assets obtained in exchange for new operating lease liabilities $ 21,630 $ 41,855 Weighted Average Remaining Lease Term at September 30, 2023 Operating leases 4.39 years Weighted Average Discount Rate at September 30, 2023 Operating leases 2.87 % Maturity of Operating Lease Liabilities (in thousands) 2023 $ 11,649 2024 41,093 2025 33,289 2026 26,016 2027 15,005 Thereafter 19,234 Total lease payments $ 146,286 Less: interest ( 9,325 ) Total liability recognized on the balance sheet $ 136,961 For leases commencing prior to April 2019, minimum rental payments exclude payments to landlords for real estate taxes and common area maintenance. Operating lease payments include $ 2.7 million related to extended lease terms that are reasonably certain of being exercised and exclude $ 201,000 of lease payments for leases signed but not yet commenced. |
Stock-Based Compensation Plans
Stock-Based Compensation Plans | 9 Months Ended |
Sep. 30, 2023 | |
Stock-Based Compensation Plans [Abstract] | |
Stock-Based Compensation Plans | 8. Stock-Based Compensation Plans On February 17, 2023, the Compensation/Incentive Committee of the Board of Directors (“CIC”) granted 6,078 Performance Stock Units (“PSUs”) that vest contingent upon the achievement of certain total shareholder return (“TSR”) targets as compared to the TSR of a group of peer companies for the three-year period ending December 31, 2025, the date at which such awards vest. The cumulative compensation cost of the TSR-based PSU award to be recorded over the three-year service period is $ 5.1 million. On February 17, 2023, the CIC also granted 6,078 PSUs that vest contingent upon the achievement of certain earnings per share (“EPS”) targets for the three-year period ending December 31, 2025. At the end of each reporting period, the Company estimates the number of shares that it believes will ultimately be earned and records the corresponding expense over the service period of the award. We currently estimate the cumulative compensation cost of the EPS-based PSUs to be recorded over the three-year service period is $ 4.2 million . |
Retirement Plans
Retirement Plans | 9 Months Ended |
Sep. 30, 2023 | |
Retirement Plans [Abstract] | |
Retirement Plans | 9. Retirement Plans All of the Company’s plans that provide retirement and similar benefits are defined contribution plans. These expenses include the impact of market gains and losses on assets held in deferred compensation plans and are recorded in selling, general and administrative expenses. Net gains for the Company’s retirement and profit-sharing plans, excess benefit plans and other similar plans are as follows (in thousands): Three months ended September 30, Nine months ended September 30, 2023 2022 2023 2022 $ 8,551 $ 2,091 $ 19,974 $ 5,647 |
Legal And Regulatory Matters
Legal And Regulatory Matters | 9 Months Ended |
Sep. 30, 2023 | |
Legal And Regulatory Matters [Abstract] | |
Legal And Regulatory Matters | 10. Legal and Regulatory Matters The VITAS segment of the Company’s business operates in a heavily-regulated industry. As a result, the Company is subjected to inquiries and investigations by various government agencies, which can result in penalties including repayment obligations, funding withholding, or debarment, as well as to lawsuits, including qui tam actions. The following sections describe the various ongoing material lawsuits and investigations of which the Company is currently aware. Other than as described below, it is not possible at this time for us to estimate either the timing or outcome of any of those matters, or whether any potential loss, or range of potential losses, is probable or reasonably estimable. Regulatory Matters and Litigation On October 30, 2017, the Company entered into a settlement agreement to resolve civil litigation under the False Claims Act brought by the United States Department of Justice (“DOJ”) on behalf of the OIG and various relators concerning VITAS, filed in the U.S. District Court of the Western District of Missouri. The Company denied any violation of law and agreed to settlement without admission of wrongdoing. In connection with the settlement, VITAS and certain of its subsidiaries entered into a corporate integrity agreement (“CIA”) on October 30, 2017 with a five-year term. The CIA formalized various aspects of VITAS’ already existing Compliance Program and contained requirements designed to document compliance with federal healthcare program requirements. On June 22, 2023, the OIG confirmed that VITAS has satisfied its requirements under the CIA and that the CIA was concluded. On October 16, 2020, VITAS received a Civil Investigative Demand (“CID”) issued by the U.S. Department of Justice (“DOJ”) pursuant to the False Claims Act concerning allegations of the submission of false claims for hospice services for which reimbursement was sought from federal healthcare programs, including Medicare. The CID requested information regarding 32 patients from our Florida operations. On November 30, 2022, VITAS received a Letter of Declination from the DOJ, informing VITAS that the United States was declining to intervene in this case giving rise to the CID, United States Ex. Rel. O’Keefe v VITAS Healthcare Corporation , et al . that was unsealed on November 15, 2022. On April 6, 2023, the relator dismissed the case, without prejudice, with the consent of the United States. VITAS is one of a group of hospice providers selected by the OIG’s Office of Audit Services (“OAS”) for inclusion in an audit of the provision of elevated level-of-care hospice services. On July 14, 2022, VITAS received the final audit report from OAS. Per this report, the OAS audit examined VITAS inpatient and continuous care claims for the period April 2017 to March 2019. The audit covered a total population of 50,850 claims representing total Medicare reimbursement of $ 210.0 million during this two-year time period. From this population, OAS selected 100 claims, representing $ 688,000 of reimbursement, for detailed review. The final OAS audit report includes a series of recommendations, including that VITAS repay approximately $ 140.0 million of the $ 210.0 million VITAS received from Medicare for hospice services during this two-year period, despite the fact that at the time of the release of the results of the audit, many of the disputed claims were time-barred from being challenged. VITAS believes that the OAS audit process and related final report contains significant flaws including its methodology, medical reviews, technical reviews, proposed extrapolation methodology, and contravenes the “reasonable physician standard” set forth in the appliable Aseracare precedent. On August 29, 2022, six weeks subsequent to the OAS finalizing its audit, VITAS received a demand letter from its Medicare Administrative Contractor (“MAC”) seeking repayment of $ 50.3 million. This demand letter is $ 90.0 million lower than the final OAS audit recommendation, as a significant portion of the 100 claims reviewed are closed pursuant to applicable law and ineligible to be reopened. VITAS timely filed its initial appeal of the overpayment decision and deposited $ 50.3 million under the “Immediate Recoupment” process to preserve its appeal rights. To date, VITAS has been refunded $ 2.5 million of the amount deposited and continues to appeal the remaining claims. The amount deposited has been recorded as an “other long-term asset” in the consolidated balance sheets, as detailed in Note 13. Regardless of the outcome of any of the preceding matters, dealing with the various regulatory agencies and opposing parties can adversely affect us through defense costs, potential payments, withholding of governmental funding, diversion of management time, and related publicity. Although the Company intends to defend them vigorously, there can be no assurance that those suits will not have a material adverse effect on the Company. |
Concentration Of Risk
Concentration Of Risk | 9 Months Ended |
Sep. 30, 2023 | |
Concentration Of Risk [Abstract] | |
Concentration Of Risk | 11. Concentration of Risk As of September 30, 2023, and December 31, 2022, approximately 73 % and 64 %, respectively, of VITAS’ total accounts receivable balance were from Medicare and 21 % and 29 %, respectively, of VITAS’ total accounts receivable balance were due from various state Medicaid or managed Medicaid programs. Combined accounts receivable from Medicare, Medicaid, and managed Medicaid represent approximately 79 % of the consolidated net accounts receivable in the accompanying consolidated balance sheets as of September 30, 2023. VITAS has a pharmacy services contract with one service provider for specified pharmacy services related to its hospice operations. Similarly, VITAS obtains the majority of its medical supplies from a single vendor. A large majority of VITAS’ pharmaceutical and medical supplies purchases are from these vendors. The pharmaceutical and medical supplies purchased by VITAS are available through many providers in the United States. However, a disruption from VITAS’ main service providers could adversely impact VITAS’ operations, including temporary logistical challenges and increased cost associated with getting medication and medical supplies to our patients. |
Cash Overdrafts and Cash Equiva
Cash Overdrafts and Cash Equivalents | 9 Months Ended |
Sep. 30, 2023 | |
Cash Overdrafts and Cash Equivalents [Abstract] | |
Cash Overdrafts and Cash Equivalents | 12. Cash Overdrafts and Cash Equivalents There are $ 16.2 million in cash overdrafts payable included in accounts payable at September 30, 2023. There were no cash overdrafts payable included in accounts payable at December 31, 2022. From time to time throughout the year, we invest excess cash in money market funds with major commercial banks. We closely monitor the creditworthiness of the institutions with which we invest our overnight funds. In the third quarter of 2023, Chemed began investing excess cash in a money market fund holding US Treasuries. Deposits and withdrawals are made daily, based on the Company’s excess cash balance. There are no penalties associated with withdrawals. The accounts bear interest at a normal market rate. |
Other Assets
Other Assets | 9 Months Ended |
Sep. 30, 2023 | |
Other Assets [Abstract] | |
Other Assets | 13. Other Assets Other assets comprise the following (in thousands): September 30, December 31, 2023 2022 Deposit with OAS $ 47,756 $ 50,274 Cash surrender value life insurance 3,647 3,636 Noncurrent advances and deposits 2,223 2,368 Other long-term receivable 1,718 1,826 Deferred debt costs 1,226 1,703 $ 56,570 $ 59,807 |
Other Current Liabilities
Other Current Liabilities | 9 Months Ended |
Sep. 30, 2023 | |
Other Current Liabilities [Abstract] | |
Other Current Liabilities | 14 . Other Current Liabilities September 30, December 31, 2023 2022 Healthcare worker retention bonus $ 14,638 $ 19,634 Medicare Cap 10,870 14,380 Accrued advertising 2,899 2,516 All other 26,941 24,474 $ 55,348 $ 61,004 There are no individual amounts exceeding 5 % of the total current liabilities in the “all other” line item for either period presented. |
Financial Instruments
Financial Instruments | 9 Months Ended |
Sep. 30, 2023 | |
Financial Instruments [Abstract] | |
Financial Instruments | 15. Financial Instruments FASB’s authoritative guidance on fair value measurements defines a hierarchy which prioritizes the inputs in fair value measurements. Level 1 measurements are measurements using quoted prices in active markets for identical assets or liabilities. Level 2 measurements use significant other observable inputs. Level 3 measurements are measurements using significant unobservable inputs which require a company to develop its own assumptions. In recording the fair value of assets and liabilities, companies must use the most reliable measurement available. The following shows the carrying value, fair value and the hierarchy for our financial instruments as of September 30, 2023 (in thousands): Fair Value Measure Carrying Value Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Investments of deferred compensation plans held in trust $ 104,410 $ 104,410 $ - $ - The following shows the carrying value, fair value and the hierarchy for our financial instruments as of December 31, 2022 (in thousands): Fair Value Measure Carrying Value Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Investments of deferred compensation plans held in trust $ 93,196 $ 93,196 $ - $ - Long-term debt and current portion of long-term debt 97,500 - 97,500 - For cash and cash equivalents, accounts receivable and accounts payable, the carrying amount is a reasonable estimate of fair value because of the liquidity and short-term nature of these instruments. As further described in Note 5, our outstanding long-term debt has a floating interest rate that is reset at short-term intervals, generally 30 or 60 days. The interest rate we pay also includes an additional amount based on our current leverage ratio. As such, we believe our borrowings reflect significant nonperformance risks, mainly credit risk. Based on these factors, we believe the fair value of our long-term debt approximates its carrying value. |
Capital Stock Repurchase Plan T
Capital Stock Repurchase Plan Transactions | 9 Months Ended |
Sep. 30, 2023 | |
Capital Stock Repurchase Plan Transactions [Abstract] | |
Capital Stock Repurchase Plan Transactions | 16. Capital Stock Repurchase Plan Transactions We repurchased the following capital stock: Three months ended September 30, Nine months ended September 30, 2023 2022 2023 2022 Total cost of repurchased shares (in thousands) $ 14,344 $ 23,884 $ 27,769 $ 101,098 Shares repurchased 28,457 50,000 53,457 207,500 Weighted average price per share $ 504.07 $ 477.68 $ 519.46 $ 487.22 In May and November 2021, the Board of Directors authorized a total of $ 600.0 million for additional stock repurchase under Chemed’s existing share repurchase program. We currently have $ 60.1 million of authorization remaining under this share repurchase plan. |
Acquisitions
Acquisitions | 9 Months Ended |
Sep. 30, 2023 | |
Acquisitions [Abstract] | |
Acquisitions | 17. Acquisitions On June 1, 2023 Roto-Rooter completed the acquisition of one franchise in South Carolina for $ 305,000 in cash. On September 26, 2023 Roto-Rooter completed the acquisition of one franchise in Georgia for $ 3.689 million in cash. In 2022, VITAS purchased the hospice assets of one Florida provider for $ 1.24 million in cash. Roto-Rooter completed the acquisition of three franchises and the related assets in New Jersey for a total of $ 2.29 million in cash . Goodwill is assessed for impairment on a yearly basis as of October 1. All goodwill recognized is deductible for tax purposes. Shown below is movement in Goodwill (in thousands): VITAS Roto-Rooter Total Balance at December 31, 2022 $ 334,063 $ 247,232 $ 581,295 Business combinations - 3,682 3,682 Balance at September 30, 2023 $ 334,063 $ 250,914 $ 584,977 |
Basis Of Presentation (Policy)
Basis Of Presentation (Policy) | 9 Months Ended |
Sep. 30, 2023 | |
Basis Of Presentation [Abstract] | |
Basis Of Presentation | As used herein, the terms “We,” “Company” and “Chemed” refer to Chemed Corporation or Chemed Corporation and its consolidated subsidiaries. We have prepared the accompanying unaudited consolidated financial statements of Chemed in accordance with Rule 10-01 of SEC Regulation S-X. Consequently, we have omitted certain disclosures required under generally accepted accounting principles in the United States (“GAAP”) for complete financial statements. The December 31, 2022 balance sheet data were derived from audited financial statements but do not include all disclosures required by GAAP. However, in our opinion, the financial statements presented herein contain all adjustments, consisting only of normal recurring adjustments, necessary to state fairly our financial position, results of operations and cash flows. The results of operations for the three and nine months ended September 30, 2023 are not necessarily indicative of the results that may be expected for the year ending December 31, 2023 or any other future period, and we make no representations related thereto. These financial statements are prepared on the same basis as and should be read in conjunction with the audited Consolidated Financial Statements and related Notes included in our Annual Report on Form 10-K for the year ended December 31, 2022. |
Cloud Computing | CLOUD COMPUTING As of September 30, 2023, Roto-Rooter has no significant capitalized implementation costs related to cloud computing. VITAS utilizes a human resources system that is considered a cloud computing arrangement. We have capitalized approximately $ 5.6 million related to implementation of this project which is included in prepaid assets in the accompanying balance sheets. The VITAS human resource system was placed into service in January 2020 and is being amortized over 5.7 years. For the three months ended September 30, 2023 and 2022, $ 249,000 has been amortized, respectively. For the nine months ended September 30, 2023 and 2022, $ 746,000 has been amortized, respectively. |
Income Taxes | INCOME TAXES Our effective income tax rate was 19.6 % in the third quarter of 2023 compared to 25.6 % during the third quarter of 2022. Excess tax benefit on stock options exercised reduced our income tax expenses by $ 225,000 and $ 450,000 for the quarters ended September 30, 2023 and 2022, respectively. Our effective income tax rate was 22.3 % in the first nine months of 2023 compared to 24.2 % during the first nine months of 2022. Excess tax benefit on stock options exercised reduced our income tax expenses by $ 3.4 million and $ 4.4 million for the first nine months ended September 30, 2023 and 2022, respectively. During the third quarter of 2023, the Company recognized a tax benefit from realignment of its state and local corporate tax structure based on the location of operating resources and profitability by business segment. This benefit includes a reduction in current state and local tax expense and a one time benefit of $ 4.2 million in reduction of deferred tax liabilities reflecting the lower tax rates. |
Non-Cash Transactions | NON-CASH TRANSACTIONS Included in the accompanying Consolidated Balance Sheets are $ 744,000 and $ 1.9 million of capitalized property and equipment which were not paid for as of September 30, 2023 and December 31, 2022, respectively. Accrued property and equipment purchases have been excluded from capital expenditures in the accompanying Consolidated Statements of Cash Flow. There are no material non-cash amounts included in interest expense for any period presented. |
Business Combinations | BUSINESS COMBINATIONS We account for acquired businesses using the acquisition method of accounting. All assets acquired and liabilities assumed are recorded at their respective fair values at the date of acquisition. The determination of fair value involves estimates and the use of valuation techniques when market value is not readily available. We use various techniques to determine fair value in accordance with accepted valuation models, primarily the income approach. The significant assumptions used in developing fair values include, but are not limited to, revenue growth rates, the amount and timing of future cash flows, discount rates, useful lives, royalty rates and future tax rates. The excess of purchase price over the fair value of assets and liabilities acquired is recorded as goodwill. See Note 17 for discussion of recent acquisitions. Quarterly amortization of intangible assets is mainly driven by two Roto-Rooter franchise acquisitions completed in 2019. The total purchase price of these acquisitions was $ 138.0 million. As part of the purchase price allocation, approximately $ 59.2 million was determined to be the value of reacquired franchise rights which are being amortized over the remaining life of each franchise agreement. The average remaining life on the reacquired franchise agreements was approximately seven years . Quarterly amortization of reacquired franchise rights for these two acquisitions is approximately $ 2.0 million ($ 8.1 million annualized through 2026). This contrasts to quarterly franchise fees historically collected from these two franchisees of approximately $ 470,000 ($ 1.9 million annualized). |
Estimates | ESTIMATES The preparation of consolidated financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect amounts reported in the consolidated financial statements and accompanying Notes. Actual results could differ from those estimates. Disclosures of after-tax expenses and adjustments are based on estimates of the effective income tax rates for the applicable segments. |
Revenue Recognition (Tables)
Revenue Recognition (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Revenue Recognition [Abstract] | |
Schedule Of Patient Care Service Revenue | The composition of patient care service revenue by payor and level of care for the quarter ended September 30, 2023 is as follows (in thousands): Medicare Medicaid Commercial Total Routine home care $ 269,954 $ 11,187 $ 6,248 $ 287,389 Continuous care 20,160 870 1,002 22,032 Inpatient care 23,983 2,197 1,638 27,818 $ 314,097 $ 14,254 $ 8,888 $ 337,239 All other revenue - self-pay, respite care, etc. 3,562 Subtotal $ 340,801 Medicare cap adjustment ( 125 ) Implicit price concessions ( 4,302 ) Room and board, net ( 2,646 ) Net revenue $ 333,728 The composition of patient care service revenue by payor and level of care for the quarter ended September 30, 2022 is as follows (in thousands): Medicare Medicaid Commercial Total Routine home care $ 239,670 $ 10,822 $ 5,761 $ 256,253 Continuous care 17,083 787 730 18,600 Inpatient care 21,391 1,838 1,297 24,526 $ 278,144 $ 13,447 $ 7,788 $ 299,379 All other revenue - self-pay, respite care, etc. 3,240 Subtotal $ 302,619 Medicare cap adjustment ( 618 ) Implicit price concessions ( 2,952 ) Room and board, net ( 2,513 ) Net revenue $ 296,536 The composition of patient care service revenue by payor and level of care for nine months ended September 30, 2023 is as follows (in thousands): Medicare Medicaid Commercial Total Routine home care $ 781,639 $ 33,143 $ 17,772 $ 832,554 Continuous care 58,071 2,384 2,599 63,054 Inpatient care 73,402 6,477 4,433 84,312 $ 913,112 $ 42,004 $ 24,804 $ 979,920 All other revenue - self-pay, respite care, etc. 9,738 Subtotal $ 989,658 Medicare cap adjustment ( 5,625 ) Implicit price concessions ( 10,650 ) Room and board, net ( 8,317 ) Net revenue $ 965,066 The composition of patient care service revenue by payor and level of care for the nine months ended September 30, 2022 is as follows (in thousands): Medicare Medicaid Commercial Total Routine home care $ 722,035 $ 32,848 $ 16,637 $ 771,520 Continuous care 53,103 2,337 2,277 57,717 Inpatient care 66,412 5,608 3,694 75,714 $ 841,550 $ 40,793 $ 22,608 $ 904,951 All other revenue - self-pay, respite care, etc. 9,461 Subtotal $ 914,412 Medicare cap adjustment ( 5,118 ) Implicit price concessions ( 8,992 ) Room and board, net ( 6,796 ) Net revenue $ 893,506 |
Schedule Of Disaggregated Revenue | The composition of disaggregated revenue for the third quarter is as follows (in thousands): September 30, 2023 2022 Drain cleaning $ 59,164 $ 62,764 Plumbing 49,113 48,737 Excavation 56,904 54,164 Other 334 193 Subtotal - short term core 165,515 165,858 Water restoration 45,435 43,645 Independent contractors 20,509 20,474 Franchisee fees 1,457 1,559 Other 4,246 4,030 Gross revenue 237,162 235,566 Implicit price concessions and credit memos ( 6,358 ) ( 5,630 ) Net revenue $ 230,804 $ 229,936 The composition of disaggregated revenue for the first nine months is as follows (in thousands): September 30, 2023 2022 Drain cleaning $ 186,016 $ 193,983 Plumbing 148,285 145,294 Excavation 174,032 164,898 Other 711 513 Subtotal - short term core 509,044 504,688 Water restoration 141,176 127,678 Independent contractors 65,684 62,897 Franchisee fees 4,195 4,246 Other 13,292 12,462 Gross revenue 733,391 711,971 Implicit price concessions and credit memos ( 19,952 ) ( 17,168 ) Net revenue $ 713,439 $ 694,803 |
Segments (Tables)
Segments (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Segments [Abstract] | |
Segment Data | Three months ended September 30, Nine months ended September 30, 2023 2022 2023 2022 VITAS $ 44,331 $ 26,086 $ 95,223 $ 97,779 Roto-Rooter 50,327 47,586 142,354 138,595 Total 94,658 73,672 237,577 236,374 Corporate ( 19,700 ) ( 16,799 ) ( 55,121 ) ( 48,876 ) Net income $ 74,958 $ 56,873 $ 182,456 $ 187,498 |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Earnings Per Share [Abstract] | |
Schedule Of Computation Of Earnings Per Share | Net Income For the Three Months Ended September 30, Income Shares Earnings per Share 2023 Earnings $ 74,958 15,075 $ 4.97 Dilutive stock options - 82 Nonvested stock awards - 43 Diluted earnings $ 74,958 15,200 $ 4.93 2022 Earnings $ 56,873 14,888 $ 3.82 Dilutive stock options - 118 Nonvested stock awards - 36 Diluted earnings $ 56,873 15,042 $ 3.78 Net Income For the Nine Months Ended September 30, Income Shares Earnings per Share 2023 Earnings $ 182,456 15,034 $ 12.14 Dilutive stock options - 98 Nonvested stock awards - 46 Diluted earnings $ 182,456 15,178 $ 12.02 2022 Earnings $ 187,498 14,935 $ 12.55 Dilutive stock options - 140 Nonvested stock awards - 39 Diluted earnings $ 187,498 15,114 $ 12.41 |
Long-Term Debt And Lines of C_2
Long-Term Debt And Lines of Credit (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Long-Term Debt And Lines Of Credit [Abstract] | |
Financial Debt Covenants | Description Requirement Leverage Ratio (Consolidated Indebtedness/Consolidated Adj. EBITDA) < 3.50 to 1.00 Interest Coverage Ratio (Consolidated Adj. EBITDA/Consolidated Interest Expense) > 3.00 to 1.00 |
Other Income_(Expense) _ Net (T
Other Income/(Expense) – Net (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Other Income/(Expense) – Net [Abstract] | |
Schedule Of Other Income/(Expense) – Net | Three months ended September 30, Nine months ended September 30, 2023 2022 2023 2022 Market value adjustment on assets held in deferred compensation trust $ 4,257 $ ( 3,176 ) $ 5,441 $ ( 12,196 ) Interest income 2,600 62 2,863 288 Other-net 2 ( 1 ) 61 1 Total other income/(expense) - net $ 6,859 $ ( 3,115 ) $ 8,365 $ ( 11,907 ) |
Leases (Tables)
Leases (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Leases [Abstract] | |
Components Of Balance Sheet Information Related To Leases | September 30, December 31, 2023 2022 Assets Operating lease assets $ 123,353 $ 135,662 Liabilities Current operating leases 37,615 38,996 Noncurrent operating leases 99,346 110,513 Total operating lease liabilities $ 136,961 $ 149,509 |
Components Of Lease Expense | Three months ended September 30, 2023 2022 Lease Expense (a) Operating lease expense $ 14,999 $ 12,936 Sublease income ( 23 ) ( 45 ) Net lease expense $ 14,976 $ 12,891 The components of lease expense for the first nine months are as follows (in thousands ): Nine months ended September 30, 2023 2022 Lease Expense (a) Operating lease expense $ 44,811 $ 39,230 Sublease income ( 70 ) ( 136 ) Net lease expense $ 44,741 $ 39,094 (a) Includes short-term leases and variable lease costs, which are immaterial. Included in both cost of services provided and goods sold and selling, general and administrative expenses. |
Components Of Cash Flow Information Related To Leases | Nine months ended September 30, 2023 2022 Cash paid for amounts included in the measurement of lease liabilities Operating cash flows from leases $ 37,352 $ 37,650 Leased assets obtained in exchange for new operating lease liabilities $ 21,630 $ 41,855 Weighted Average Remaining Lease Term at September 30, 2023 Operating leases 4.39 years Weighted Average Discount Rate at September 30, 2023 Operating leases 2.87 % |
Summary Of Maturity Of Operating Lease Liabilities | Maturity of Operating Lease Liabilities (in thousands) 2023 $ 11,649 2024 41,093 2025 33,289 2026 26,016 2027 15,005 Thereafter 19,234 Total lease payments $ 146,286 Less: interest ( 9,325 ) Total liability recognized on the balance sheet $ 136,961 |
Retirement Plans (Tables)
Retirement Plans (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Retirement Plans [Abstract] | |
Schedule Of Expenses For Retirement, Profit-Sharing Plans, Excess Benefit Plans And Other Similar Plans | Three months ended September 30, Nine months ended September 30, 2023 2022 2023 2022 $ 8,551 $ 2,091 $ 19,974 $ 5,647 |
Other Assets (Tables)
Other Assets (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Other Assets [Abstract] | |
Schedule of Other Assets | September 30, December 31, 2023 2022 Deposit with OAS $ 47,756 $ 50,274 Cash surrender value life insurance 3,647 3,636 Noncurrent advances and deposits 2,223 2,368 Other long-term receivable 1,718 1,826 Deferred debt costs 1,226 1,703 $ 56,570 $ 59,807 |
Other Current Liabilities (Tabl
Other Current Liabilities (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Other Current Liabilities [Abstract] | |
Schedule of Other Current Liabilities | September 30, December 31, 2023 2022 Healthcare worker retention bonus $ 14,638 $ 19,634 Medicare Cap 10,870 14,380 Accrued advertising 2,899 2,516 All other 26,941 24,474 $ 55,348 $ 61,004 |
Financial Instruments (Tables)
Financial Instruments (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Financial Instruments [Abstract] | |
Carrying Value, Fair Value And Hierarchy Of Financial Instruments | The following shows the carrying value, fair value and the hierarchy for our financial instruments as of September 30, 2023 (in thousands): Fair Value Measure Carrying Value Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Investments of deferred compensation plans held in trust $ 104,410 $ 104,410 $ - $ - The following shows the carrying value, fair value and the hierarchy for our financial instruments as of December 31, 2022 (in thousands): Fair Value Measure Carrying Value Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Investments of deferred compensation plans held in trust $ 93,196 $ 93,196 $ - $ - Long-term debt and current portion of long-term debt 97,500 - 97,500 - |
Capital Stock Repurchase Plan_2
Capital Stock Repurchase Plan Transactions (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Capital Stock Repurchase Plan Transactions [Abstract] | |
Schedule Of Repurchased Capital Stock | Three months ended September 30, Nine months ended September 30, 2023 2022 2023 2022 Total cost of repurchased shares (in thousands) $ 14,344 $ 23,884 $ 27,769 $ 101,098 Shares repurchased 28,457 50,000 53,457 207,500 Weighted average price per share $ 504.07 $ 477.68 $ 519.46 $ 487.22 |
Acquisitions (Tables)
Acquisitions (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Acquisitions [Abstract] | |
Schedule Of Movement In Goodwill | VITAS Roto-Rooter Total Balance at December 31, 2022 $ 334,063 $ 247,232 $ 581,295 Business combinations - 3,682 3,682 Balance at September 30, 2023 $ 334,063 $ 250,914 $ 584,977 |
Basis Of Presentation (Narrativ
Basis Of Presentation (Narrative) (Details) $ in Thousands | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||
Sep. 30, 2023 USD ($) | Sep. 30, 2022 USD ($) | Sep. 30, 2023 USD ($) | Sep. 30, 2022 USD ($) | Dec. 31, 2019 USD ($) item | Dec. 31, 2022 USD ($) | |
Effective tax rate | 19.60% | 25.60% | 22.30% | 24.20% | ||
Excess tax benefit on stock options | $ 225 | $ 450 | $ 3,400 | $ 4,400 | ||
Income tax expense (benefit) resulting from realignment of state and local tax structure | (4,200) | |||||
Capitalized property and equipment | 744 | 744 | $ 1,900 | |||
Revenue from Contract with Customer, Including Assessed Tax | 340,801 | 302,619 | 989,658 | 914,412 | ||
VITAS [Member] | Cloud Computing [Member] | ||||||
Capitalized contract cost | 5,600 | 5,600 | ||||
Capitalized contract cost, amortization expense | $ 249 | 249 | $ 746 | 746 | ||
Capitalized contract cost, amortization period | 5 years 8 months 12 days | 5 years 8 months 12 days | ||||
Roto-Rooter [Member] | ||||||
Total purchase price | $ 138,000 | |||||
Reacquired Franchise Rights [Member] | Roto-Rooter [Member] | ||||||
Intangible assets acquired | $ 59,200 | |||||
Quarterly amortization of reacquired franchise agreements | $ 2,000 | |||||
Average remaining life | 7 years | |||||
Reacquired Franchise Rights [Member] | Roto-Rooter [Member] | Annualized Through 2026 [Member] | ||||||
Quarterly amortization of reacquired franchise agreements | $ 8,100 | |||||
Reacquired Franchise Rights [Member] | Franchise Fees [Member] | Roto-Rooter [Member] | ||||||
Revenue from Contract with Customer, Including Assessed Tax | 470 | |||||
Reacquired Franchise Rights [Member] | Franchise Fees [Member] | Roto-Rooter [Member] | Annualized [Member] | ||||||
Revenue from Contract with Customer, Including Assessed Tax | 1,900 | |||||
Roto-Rooter [Member] | ||||||
Revenue from Contract with Customer, Including Assessed Tax | $ 237,162 | 235,566 | 733,391 | 711,971 | ||
Number of completed business combinations | item | 2 | |||||
Roto-Rooter [Member] | Franchise Fees [Member] | ||||||
Revenue from Contract with Customer, Including Assessed Tax | $ 1,457 | $ 1,559 | $ 4,195 | $ 4,246 |
Revenue Recognition (Narrative)
Revenue Recognition (Narrative) (Details) - USD ($) | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Revenue Recognition [line items] | ||||
Charity care cost | $ 2,000,000 | $ 1,900,000 | $ 6,100,000 | $ 5,900,000 |
Service revenue and sales | $ 564,532,000 | $ 526,472,000 | $ 1,678,505,000 | $ 1,588,309,000 |
Roto-Rooter [Member] | ||||
Revenue Recognition [line items] | ||||
Credit payment terms | 30 days | |||
Duration of advance notice of cancellation without penalty for both parties | 90 days | |||
Term of contract | 10 years | |||
Duration of advance notice of cancelation without penatly | 60 days | |||
Roto-Rooter [Member] | Maximum [Member] | ||||
Revenue Recognition [line items] | ||||
Duration of services provided | 5 days | |||
Roto-Rooter [Member] | Minimum [Member] | ||||
Revenue Recognition [line items] | ||||
Duration of services provided | 3 days | |||
VITAS [Member] | ||||
Revenue Recognition [line items] | ||||
Period of tier one care rate | 60 days | |||
Period of tier two care rate | 61 days | |||
Period of services provided after discharge | 12 months | |||
Period of service intensity add-on payment | 7 days | |||
Reimbursement period per day in 15 min. increments | 4 hours | |||
Minimum amount of care per 24-hr period | 8 hours | |||
Percentage of medicaid reimbursement | 95% | |||
Percentage of expenses | 5% | |||
Service revenue and sales | $ 0 | |||
Accounts Receivable, Sale | $ 0 | |||
VITAS [Member] | Adoption of ASC 606 [Member] | ||||
Revenue Recognition [line items] | ||||
Percentage of expenses | 5% | |||
VITAS [Member] | Maximum [Member] | ||||
Revenue Recognition [line items] | ||||
Inpatient cap percentage | 20% |
Revenue Recognition (Schedule O
Revenue Recognition (Schedule Of Patient Care Service Revenue) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | $ 340,801 | $ 302,619 | $ 989,658 | $ 914,412 |
Net revenue | 333,728 | 296,536 | 965,066 | 893,506 |
Routine Home Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 287,389 | 256,253 | 832,554 | 771,520 |
Continuous Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 22,032 | 18,600 | 63,054 | 57,717 |
Inpatient Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 27,818 | 24,526 | 84,312 | 75,714 |
Care Services Total [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 337,239 | 299,379 | 979,920 | 904,951 |
All Other Revenue- Self-pay, Respite Care, Etc. [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 3,562 | 3,240 | 9,738 | 9,461 |
Medicare Cap Adjustment [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Medicare cap adjustment | (125) | (618) | (5,625) | (5,118) |
Implicit Price Concessions [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Implicit price concessions | (4,302) | (2,952) | (10,650) | (8,992) |
Room And Board, Net [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Room and board, net | (2,646) | (2,513) | (8,317) | (6,796) |
Medicare [Member] | Routine Home Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 269,954 | 239,670 | 781,639 | 722,035 |
Medicare [Member] | Continuous Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 20,160 | 17,083 | 58,071 | 53,103 |
Medicare [Member] | Inpatient Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 23,983 | 21,391 | 73,402 | 66,412 |
Medicare [Member] | Care Services Total [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 314,097 | 278,144 | 913,112 | 841,550 |
Medicaid [Member] | Routine Home Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 11,187 | 10,822 | 33,143 | 32,848 |
Medicaid [Member] | Continuous Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 870 | 787 | 2,384 | 2,337 |
Medicaid [Member] | Inpatient Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 2,197 | 1,838 | 6,477 | 5,608 |
Medicaid [Member] | Care Services Total [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 14,254 | 13,447 | 42,004 | 40,793 |
Commercial [Member] | Routine Home Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 6,248 | 5,761 | 17,772 | 16,637 |
Commercial [Member] | Continuous Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 1,002 | 730 | 2,599 | 2,277 |
Commercial [Member] | Inpatient Care [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | 1,638 | 1,297 | 4,433 | 3,694 |
Commercial [Member] | Care Services Total [Member] | ||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | ||||
Care service revenue | $ 8,888 | $ 7,788 | $ 24,804 | $ 22,608 |
Revenue Recognition (Schedule_2
Revenue Recognition (Schedule Of Disaggregated Revenue) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Gross revenue | $ 340,801 | $ 302,619 | $ 989,658 | $ 914,412 |
Net revenue | 333,728 | 296,536 | 965,066 | 893,506 |
Roto-Rooter [Member] | ||||
Gross revenue | 237,162 | 235,566 | 733,391 | 711,971 |
Implicit price concessions and credit memos | (6,358) | (5,630) | (19,952) | (17,168) |
Net revenue | 230,804 | 229,936 | 713,439 | 694,803 |
Roto-Rooter [Member] | Drain cleaning [Member] | ||||
Gross revenue | 59,164 | 62,764 | 186,016 | 193,983 |
Roto-Rooter [Member] | Plumbing [Member] | ||||
Gross revenue | 49,113 | 48,737 | 148,285 | 145,294 |
Roto-Rooter [Member] | Excavation [Member] | ||||
Gross revenue | 56,904 | 54,164 | 174,032 | 164,898 |
Roto-Rooter [Member] | Other [Member] | ||||
Gross revenue | 334 | 193 | 711 | 513 |
Roto-Rooter [Member] | Short-Term Core [Member] | ||||
Gross revenue | 165,515 | 165,858 | 509,044 | 504,688 |
Roto-Rooter [Member] | Water Restoration [Member] | ||||
Gross revenue | 45,435 | 43,645 | 141,176 | 127,678 |
Roto-Rooter [Member] | Independent Contractors [Member] | ||||
Gross revenue | 20,509 | 20,474 | 65,684 | 62,897 |
Roto-Rooter [Member] | Franchise Fees [Member] | ||||
Gross revenue | 1,457 | 1,559 | 4,195 | 4,246 |
Roto-Rooter [Member] | Other [Member] | ||||
Gross revenue | $ 4,246 | $ 4,030 | $ 13,292 | $ 12,462 |
Segments (Segment Data) (Detail
Segments (Segment Data) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Segment Reporting Information [Line Items] | ||||
Net income | $ 74,958 | $ 56,873 | $ 182,456 | $ 187,498 |
Operating Segments [Member] | ||||
Segment Reporting Information [Line Items] | ||||
Net income | 94,658 | 73,672 | 237,577 | 236,374 |
VITAS [Member] | Operating Segments [Member] | ||||
Segment Reporting Information [Line Items] | ||||
Net income | 44,331 | 26,086 | 95,223 | 97,779 |
Roto-Rooter [Member] | Operating Segments [Member] | ||||
Segment Reporting Information [Line Items] | ||||
Net income | 50,327 | 47,586 | 142,354 | 138,595 |
Corporate [Member] | ||||
Segment Reporting Information [Line Items] | ||||
Net income | $ (19,700) | $ (16,799) | $ (55,121) | $ (48,876) |
Earnings Per Share (Narrative)
Earnings Per Share (Narrative) (Details) - shares | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Earnings Per Share [Abstract] | ||||
Excluded stock options, Anti-dilutive | 309,336 | 592,000 | 309,336 | 593,000 |
Earnings Per Share (Schedule Of
Earnings Per Share (Schedule Of Computation Of Earnings Per Share) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Earnings Per Share [Abstract] | ||||
Earnings | $ 74,958 | $ 56,873 | $ 182,456 | $ 187,498 |
Diluted earnings | $ 74,958 | $ 56,873 | $ 182,456 | $ 187,498 |
Earnings, Shares | 15,075 | 14,888 | 15,034 | 14,935 |
Dilutive stock options, Shares | 82 | 118 | 98 | 140 |
Nonvested stock awards, Shares | 43 | 36 | 46 | 39 |
Diluted earnings, Shares | 15,200 | 15,042 | 15,178 | 15,114 |
Earnings, Earnings per Share | $ 4.97 | $ 3.82 | $ 12.14 | $ 12.55 |
Diluted earnings, Earnings per Share | $ 4.93 | $ 3.78 | $ 12.02 | $ 12.41 |
Long-Term Debt And Lines of C_3
Long-Term Debt And Lines of Credit (Narrative) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | |||
Apr. 28, 2023 | Mar. 31, 2023 | Sep. 30, 2023 | Dec. 31, 2022 | Jun. 28, 2022 | |
SOFR [Member] | |||||
Debt Instrument [Line Items] | |||||
Basis spread on variable interest rate | 1% | ||||
2022 Credit Facilities [Member] | |||||
Debt Instrument [Line Items] | |||||
Borrowing capacity | $ 450,000 | $ 550,000 | |||
Standby letters of credit | $ 45,300 | ||||
Unused lines of credit | $ 404,800 | ||||
2022 Credit Facilities [Member] | Revolving Credit Facility [Member] | |||||
Debt Instrument [Line Items] | |||||
Credit facility period, years | 5 years | ||||
Amount outstanding | $ 450,000 | ||||
2022 Credit Facilities [Member] | Expansion Feature [Member] | |||||
Debt Instrument [Line Items] | |||||
Borrowing capacity | 250,000 | ||||
2022 Credit Facilities [Member] | Term Loan [Member] | |||||
Debt Instrument [Line Items] | |||||
Credit facility period, years | 5 years | ||||
Periodic principal payments | $ 1,250 | ||||
Frequency of principal payments | last day of each fiscal quarter | ||||
Repayment of long-term debt (Note 3) | $ 21,300 | $ 75,000 | |||
Prepayment penalties | $ 0 | ||||
Amount outstanding | $ 100,000 | ||||
Deferred financing costs | $ 0 |
Long-Term Debt And Lines of C_4
Long-Term Debt And Lines of Credit (Financial Debt Covenants) (Details) | 9 Months Ended |
Sep. 30, 2023 | |
Minimum [Member] | |
Debt Instrument [Line Items] | |
Leverage Ratio (Consolidated Indebtedness/Consolidated Adj. EBITDA), Requirement | 1 |
Interest Coverage Ratio (Consolidated Adj. EBITDA/Consolidated Interest Expense) | 1 |
Maximum [Member] | |
Debt Instrument [Line Items] | |
Leverage Ratio (Consolidated Indebtedness/Consolidated Adj. EBITDA), Requirement | 3.50 |
Interest Coverage Ratio (Consolidated Adj. EBITDA/Consolidated Interest Expense) | 3 |
Other Income_(Expense) _ Net (S
Other Income/(Expense) – Net (Schedule Of Other Income/(Expense) – Net) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Other Income/(Expense) – Net [Abstract] | ||||
Market value adjustment on assets held in deferred compensation trust | $ 4,257 | $ (3,176) | $ 5,441 | $ (12,196) |
Interest income | 2,600 | 62 | 2,863 | 288 |
Other-net | 2 | (1) | 61 | 1 |
Total other income/(expense) - net | $ 6,859 | $ (3,115) | $ 8,365 | $ (11,907) |
Leases (Narrative) (Details)
Leases (Narrative) (Details) | 9 Months Ended |
Sep. 30, 2023 USD ($) | |
Lessee, Lease, Description [Line Items] | |
Finance Lease, Liability | $ 0 |
Finance Lease, Right-of-Use Asset, after Accumulated Amortization | $ 0 |
Option to extend the lease, term | up to 5 years |
Option to terminate the lease, term | within 1 year |
Operating lease payments related to extended lease terms | $ 2,700,000 |
Lease payments for leases signed but not yet commenced | $ 201,000 |
Minimum [Member] | |
Lessee, Lease, Description [Line Items] | |
Remaining terms of leases under operating lease | 1 year |
Maximum [Member] | |
Lessee, Lease, Description [Line Items] | |
Remaining terms of leases under operating lease | 10 years |
Leases (Components Of Balance S
Leases (Components Of Balance Sheet Information Related To Leases) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Assets | ||
Operating lease assets | $ 123,353 | $ 135,662 |
Liabilities | ||
Current operating leases | 37,615 | 38,996 |
Noncurrent operating leases | 99,346 | 110,513 |
Total operating lease liabilities | $ 136,961 | $ 149,509 |
Leases (Components Of Lease Exp
Leases (Components Of Lease Expense) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | ||
Lease Expense | |||||
Operating lease expense | [1] | $ 14,999 | $ 12,936 | $ 44,811 | $ 39,230 |
Sublease income | [1] | (23) | (45) | (70) | (136) |
Net lease expense | [1] | $ 14,976 | $ 12,891 | $ 44,741 | $ 39,094 |
[1] Includes short-term leases and variable lease costs, which are immaterial. Included in both cost of services provided and goods sold and selling, general and administrative expenses. |
Leases (Components Of Cash Flow
Leases (Components Of Cash Flow Information Related To Leases) (Details) - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2023 | Sep. 30, 2022 | |
Cash paid for amounts included in the measurement of lease liabilities | ||
Operating cash flows from leases | $ 37,352 | $ 37,650 |
Leased assets obtained in exchange for new operating lease liabilities | $ 21,630 | $ 41,855 |
Weighted Average Remaining Lease Term, Operating leases | 4 years 4 months 20 days | |
Weighted Average Discount Rate, Operating leases | 2.87% |
Leases (Summary Of Maturity Of
Leases (Summary Of Maturity Of Operating Lease Liabilities) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Leases [Abstract] | ||
2023 | $ 11,649 | |
2024 | 41,093 | |
2025 | 33,289 | |
2026 | 26,016 | |
2027 | 15,005 | |
Thereafter | 19,234 | |
Total lease payments | 146,286 | |
Less: interest | (9,325) | |
Total liability recognized on the balance sheet | $ 136,961 | $ 149,509 |
Stock-Based Compensation Plans
Stock-Based Compensation Plans (Narrative) (Details) - USD ($) $ in Millions | 9 Months Ended | |
Feb. 17, 2023 | Sep. 30, 2023 | |
Performance Based TSR [Member] | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Shares vesting period, years | 3 years | |
Cumulative compensation expense | $ 5.1 | |
Performance Based EPS [Member] | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Shares vesting period, years | 3 years | |
Cumulative compensation expense | $ 4.2 | |
Compensation/Incentive Committee [Member] | Performance Based TSR [Member] | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Shares of stock granted | 6,078 | |
Compensation/Incentive Committee [Member] | Performance Based EPS [Member] | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Shares of stock granted | 6,078 |
Retirement Plans (Schedule Of E
Retirement Plans (Schedule Of Expenses For Retirement, Profit-Sharing Plans, Excess Benefit Plans And Other Similar Plans) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Retirement Plans [Abstract] | ||||
Net (losses)/gains for retirement and profit-sharing plans, excess benefit plans and other similar plans | $ 8,551 | $ 2,091 | $ 19,974 | $ 5,647 |
Legal And Regulatory Matters (N
Legal And Regulatory Matters (Narrative) (Details) $ in Thousands | 9 Months Ended | ||||
Aug. 29, 2022 USD ($) | Jul. 14, 2022 USD ($) item | Oct. 16, 2020 item | Oct. 30, 2017 | Sep. 30, 2023 | |
Audit of provision of elevated level-of-care hospice services [Member] | |||||
Loss Contingencies [Line Items] | |||||
Loss Contingency, Period of Occurrence | two-year | ||||
Number of total care claims | item | 50,850 | ||||
Reimbursement amount over period of occurrence | $ 210,000 | ||||
Number of claims selected | item | 100 | ||||
Amount of reimbursement for claims selected | $ 688 | ||||
Maximum damages sought | $ 140,000 | ||||
Loss Contingency, Damages Sought, Value | $ 50,300 | ||||
Difference between the final OAS audit recommendation and damages sought | 90,000 | ||||
VITAS [Member] | |||||
Loss Contingencies [Line Items] | |||||
Agreement Term | 5 years | ||||
Number of Patients | item | 32 | ||||
Refund of Amount Deposited | $ 2,500 |
Concentration Of Risk (Narrativ
Concentration Of Risk (Narrative) (Details) - item | 9 Months Ended | 12 Months Ended |
Sep. 30, 2023 | Dec. 31, 2022 | |
VITAS [Member] | ||
Concentration Risk [Line Items] | ||
Number of service providers | 1 | |
Medicare [Member] | Accounts Receivable [Member] | Credit Concentration Risk [Member] | ||
Concentration Risk [Line Items] | ||
Concentration risk, percentage | 73% | 64% |
Medicaid [Member] | Accounts Receivable [Member] | Credit Concentration Risk [Member] | ||
Concentration Risk [Line Items] | ||
Concentration risk, percentage | 21% | 29% |
Medicare, Medicaid, And Managed Medicaid [Member] | Accounts Receivable [Member] | Credit Concentration Risk [Member] | ||
Concentration Risk [Line Items] | ||
Concentration risk, percentage | 79% |
Cash Overdrafts and Cash Equi_2
Cash Overdrafts and Cash Equivalents (Narrative) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Cash Overdrafts and Cash Equivalents [Abstract] | ||
Cash overdrafts included in accounts payable | $ 16,200 | $ 0 |
Other Assets (Schedule Of Other
Other Assets (Schedule Of Other Assets) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Other Assets [Abstract] | ||
Deposit with OAS | $ 47,756 | $ 50,274 |
Cash surrender value life insurance | 3,647 | 3,636 |
Noncurrent advances and deposits | 2,223 | 2,368 |
Other long-term receivable | 1,718 | 1,826 |
Deferred debt costs | 1,226 | 1,703 |
Other assets | $ 56,570 | $ 59,807 |
Other Current Liabilities (Deta
Other Current Liabilities (Details) - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2023 | Dec. 31, 2022 | |
Other Current Liabilities [Abstract] | ||
Healthcare worker retention bonus | $ 14,638 | $ 19,634 |
Medicare cap | 10,870 | 14,380 |
Accrued advertising | 2,899 | 2,516 |
All other | 26,941 | 24,474 |
Other current liabilities | $ 55,348 | $ 61,004 |
Percentage of individual amounts of total current liabilities | 5% |
Financial Instruments (Narrativ
Financial Instruments (Narrative) (Details) | 9 Months Ended |
Sep. 30, 2023 | |
Minimum [Member] | |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
Period in which the interest rate will reset | 30 days |
Maximum [Member] | |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
Period in which the interest rate will reset | 60 days |
Financial Instruments (Carrying
Financial Instruments (Carrying Value, Fair Value And Hierarchy Of Financial Instruments) (Details) - USD ($) $ in Thousands | Sep. 30, 2023 | Dec. 31, 2022 |
Carrying Value [Member] | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments of deferred compensation plans held in trust | $ 104,410 | $ 93,196 |
Long-term debt and current portion of long-term debt | 97,500 | |
Quoted Prices In Active Markets For Identical Assets (Level 1) [Member] | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments of deferred compensation plans held in trust | $ 104,410 | 93,196 |
Significant Other Observable Inputs (Level 2) [Member] | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Long-term debt and current portion of long-term debt | $ 97,500 |
Capital Stock Repurchase Plan_3
Capital Stock Repurchase Plan Transactions (Narrative) (Details) - USD ($) $ in Millions | Sep. 30, 2023 | Nov. 30, 2021 | May 31, 2021 |
Capital Stock Repurchase Plan Transactions [Abstract] | |||
Stock repurchase program, amount authorized | $ 600 | $ 600 | |
Stock repurchase program, remaining authorized repurchase amount | $ 60.1 |
Capital Stock Repurchase Plan_4
Capital Stock Repurchase Plan Transactions (Schedule Of Repurchased Capital Stock) (Details) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Capital Stock Repurchase Plan Transactions [Abstract] | ||||
Total cost of repurchased shares | $ 14,344 | $ 23,884 | $ 27,769 | $ 101,098 |
Shares repurchased | 28,457 | 50,000 | 53,457 | 207,500 |
Weighted average price per share | $ 504.07 | $ 477.68 | $ 519.46 | $ 487.22 |
Acquisitions (Narrative) (Detai
Acquisitions (Narrative) (Details) $ in Thousands | 12 Months Ended | |||
Sep. 26, 2023 USD ($) item | Jun. 01, 2023 USD ($) item | Dec. 31, 2022 USD ($) item | Dec. 31, 2019 item | |
Roto-Rooter [Member] | ||||
Asset Acquisition [Line Items] | ||||
Number of completed business combinations | 2 | |||
Roto-Rooter [Member] | Franchise, South Carolina [Member] | ||||
Asset Acquisition [Line Items] | ||||
Number of completed business combinations | 1 | |||
Acquisition, in cash | $ | $ 305 | |||
Roto-Rooter [Member] | Franchise, Georgia [Member] | ||||
Asset Acquisition [Line Items] | ||||
Number of completed business combinations | 1 | |||
Acquisition, in cash | $ | $ 3,689 | |||
Roto-Rooter [Member] | Franchises, New Jersey [Member] | ||||
Asset Acquisition [Line Items] | ||||
Number of completed business combinations | 3 | |||
Acquisition, in cash | $ | $ 2,290 | |||
VITAS [Member] | Florida Provider [Member] | ||||
Asset Acquisition [Line Items] | ||||
Purchase of assets in cash | $ | $ 1,240 | |||
Number of providers assets purchased | 1 |
Acquisitions (Schedule Of Movem
Acquisitions (Schedule Of Movement In Goodwill) (Details) $ in Thousands | 9 Months Ended |
Sep. 30, 2023 USD ($) | |
Goodwill [Line Items] | |
Beginning balance | $ 581,295 |
Business combinations | 3,682 |
Ending balance | 584,977 |
VITAS [Member] | |
Goodwill [Line Items] | |
Beginning balance | 334,063 |
Ending balance | 334,063 |
Roto-Rooter [Member] | |
Goodwill [Line Items] | |
Beginning balance | 247,232 |
Business combinations | 3,682 |
Ending balance | $ 250,914 |