Almost Family (AFAM) 10-K 14 Mar 14 2013 FY Annual report Financial data

Document_and_Entity_Informatio

Document and Entity Information (USD $)	12 Months Ended
	Dec. 31, 2013	Mar. 07, 2014	Jun. 30, 2013
Document and Entity Information	'	'	'
Entity Registrant Name	'ALMOST FAMILY INC	'	'
Entity Central Index Key	'0000799231	'	'
Document Type	'10-K	'	'
Document Period End Date	31-Dec-13	'	'
Amendment Flag	'false	'	'
Current Fiscal Year End Date	'--12-31	'	'
Entity Well-known Seasoned Issuer	'No	'	'
Entity Voluntary Filers	'No	'	'
Entity Current Reporting Status	'Yes	'	'
Entity Filer Category	'Accelerated Filer	'	'
Entity Public Float	'	'	$158,216,813
Entity Common Stock, Shares Outstanding	'	9,410,553	'
Document Fiscal Year Focus	'2013	'	'
Document Fiscal Period Focus	'FY	'	'

CONSOLIDATED_STATEMENTS_OF_INC

CONSOLIDATED STATEMENTS OF INCOME (USD $)	12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
CONSOLIDATED STATEMENTS OF INCOME	'	'	'
Net service revenues	$357,812	$342,448	$331,440
Cost of service revenues (excluding depreciation and amortization)	191,268	177,549	163,128
Gross margin	166,544	164,899	168,312
General and administrative expenses:	'	'	'
Salaries and benefits	102,367	96,406	95,113
Other	45,312	39,643	39,889
Deal and transition costs	4,322	588	662
Total general and administrative expenses	152,001	136,637	135,664
Operating income	14,543	28,262	32,648
Interest expense, net	-169	-104	-180
Income before income taxes	14,374	28,158	32,468
Income tax expense	-6,020	-11,047	-12,822
Net income from continuing operations	8,354	17,111	19,646
Discontinued operations:	'	'	'
(Loss) gain from operations, net of tax of ($89), $108, and $757	-477	173	1,156
Gain on sale, net of tax of $971	171	'	'
(Loss) gain on discontinued operations	-306	173	1,156
Net income	8,048	17,284	20,802
Net loss attributable to noncontrolling interest	178	'	'
Net income attributable to Almost Family, Inc.	$8,226	$17,284	$20,802
Per share amounts-basic:	'	'	'
Average shares outstanding (in shares)	9,279	9,285	9,278
Income from continued operations attributable to Almost Family, Inc. (in dollars per share)	$0.92	$1.84	$2.12
Discontinued operations (in dollars per share)	($0.03)	$0.02	$0.12
Net income attributable to Almost Family, Inc. (in dollars per share)	$0.89	$1.86	$2.24
Per share amounts-diluted:	'	'	'
Average shares outstanding (in shares)	9,374	9,324	9,360
Income from continued operations attributable to Almost Family, Inc. (in dollars per share)	$0.91	$1.84	$2.10
Discontinued operations (in dollars per share)	($0.03)	$0.01	$0.12
Net income attributable to Almost Family, Inc. (in dollars per share)	$0.88	$1.85	$2.22

CONSOLIDATED_STATEMENTS_OF_INC1

CONSOLIDATED STATEMENTS OF INCOME (Parenthetical) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Discontinued operations:	'	'	'
(Loss) gain from operations, tax	($89)	$108	$757
Gain on sale, tax	$971	'	'

CONSOLIDATED_BALANCE_SHEETS

CONSOLIDATED BALANCE SHEETS (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
CURRENT ASSETS:	'	'
Cash and cash equivalents	$12,246	$26,120
Accounts receivable - net	61,651	49,971
Prepaid expenses and other current assets	10,278	6,968
Deferred tax assets	11,532	6,580
TOTAL CURRENT ASSETS	95,707	89,639
PROPERTY AND EQUIPMENT - NET	8,142	5,401
GOODWILL	192,575	132,014
OTHER INTANGIBLE ASSETS	55,075	19,967
OTHER ASSETS	774	781
OTHER ASSETS, HELD FOR SALE	'	1,457
TOTAL ASSETS	352,273	249,259
CURRENT LIABILITIES:	'	'
Accounts payable	11,526	4,599
Accrued other liabilities	38,916	21,874
Current portion - notes payable and capital leases	702	625
TOTAL CURRENT LIABILITIES	51,144	27,098
LONG-TERM LIABILITIES:	'	'
Revolving credit facility	56,000	'
Deferred tax liabilities	25,580	16,785
Other liabilities	1,856	1,061
TOTAL LONG-TERM LIABILITIES	83,436	17,846
TOTAL LIABILITIES	134,580	44,944
NONCONTROLLING INTEREST REDEEMABLE	3,639	'
STOCKHOLDERS' EQUITY:	'	'
Preferred stock, par value $0.05; authorized 2,000 shares; none issued or outstanding	'	'
Common stock, par value $0.10; authorized 25,000; 9,500 and 9,421 issued and outstanding	950	942
Treasury stock, at cost, 92 and 91 shares	-2,340	-2,320
Additional paid-in capital	103,858	101,945
Noncontrolling interest - nonredeemable	-203	'
Retained earnings	111,789	103,748
TOTAL STOCKHOLDERS' EQUITY	214,054	204,315
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY	$352,273	$249,259

CONSOLIDATED_BALANCE_SHEETS_Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, except Per Share data, unless otherwise specified
CONSOLIDATED BALANCE SHEETS	'	'
Preferred stock, par value (in dollars per share)	$0.05	$0.05
Preferred stock, authorized shares	2,000	2,000
Preferred stock, issued shares	0	0
Preferred stock, outstanding shares	0	0
Common stock, par value (in dollars per share)	$0.10	$0.10
Common stock, authorized shares	25,000	25,000
Common stock, issued shares	9,500	9,421
Common stock, outstanding shares	9,500	9,421
Treasury stock, shares	92	91

CONSOLIDATED_STATEMENTS_OF_STO

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (USD $)	Total	Common Stock	Treasury Stock	Additional Paid-in Capital	Retained Earnings	Non-controlling Interest - Non-redeemable	Non-controlling Interest - Redeemable
In Thousands, unless otherwise specified
Balance at Dec. 31, 2010	$182,168	$924	($139)	$97,073	$84,310	'	'
Balance (in shares) at Dec. 31, 2010	'	9,243	-4	'	'	'	'
Increase (Decrease) in Stockholders' Equity	'	'	'	'	'	'	'
Options exercised, Stock award maturities, net of shares surrendered or withheld	353	13	-292	632	'	'	'
Options exercised, Stock award maturities, net of shares surrendered or withheld (in shares)	'	125	-9	'	'	'	'
Share awards and related compensation	1,423	1	'	1,422	'	'	'
Share awards and related compensation (in shares)	'	13	'	'	'	'	'
Tax benefit (loss) from exercise of non-qualified stock options	1,551	'	'	1,551	'	'	'
Net income attributable to Almost Family, Inc.	20,802	'	'	'	20,802	'	'
Balance at Dec. 31, 2011	206,297	938	-431	100,678	105,112	'	'
Balance (in shares) at Dec. 31, 2011	'	9,381	-13	'	'	'	'
Increase (Decrease) in Stockholders' Equity	'	'	'	'	'	'	'
Options exercised, Stock award maturities, net of shares surrendered or withheld	70	1	'	69	'	'	'
Options exercised, Stock award maturities, net of shares surrendered or withheld (in shares)	'	11	'	'	'	'	'
Share awards and related compensation	-415	3	-1,889	1,471	'	'	'
Share awards and related compensation (in shares)	'	29	-78	'	'	'	'
Special dividend	-18,648	'	'	'	-18,648	'	'
Tax benefit (loss) from exercise of non-qualified stock options	-273	'	'	-273	'	'	'
Net income attributable to Almost Family, Inc.	17,284	'	'	'	17,284	'	'
Balance at Dec. 31, 2012	204,315	942	-2,320	101,945	103,748	'	'
Balance (in shares) at Dec. 31, 2012	9,421	9,421	-91	'	'	'	'
Increase (Decrease) in Stockholders' Equity	'	'	'	'	'	'	'
Options exercised, Stock award maturities, net of shares surrendered or withheld	-2	1	-20	17	'	'	'
Options exercised, Stock award maturities, net of shares surrendered or withheld (in shares)	'	1	-1	'	'	'	'
Share awards and related compensation	1,465	5	'	1,460	'	'	'
Share awards and related compensation (in shares)	'	52	'	'	'	'	'
Tax benefit (loss) from exercise of non-qualified stock options	-62	'	'	-62	'	'	'
Stock provided in acquisitions	500	2	'	498	'	'	'
Stock provided in acquisitions (in shares)	'	26	'	'	'	'	'
Acquired noncontrolling interest	210	'	'	'	'	-210	-3,639
Net loss noncontrolling interests - redeemable	'	'	'	'	'	'	-185
Noncontrolling Interests - redeemable fair value accretion	-185	'	'	'	-185	'	185
Net loss noncontrolling interests - nonredeemable	-7	'	'	'	'	7	'
Net income attributable to Almost Family, Inc.	8,226	'	'	'	8,226	'	'
Balance at Dec. 31, 2013	$214,054	$950	($2,340)	$103,858	$111,789	$203	$3,639
Balance (in shares) at Dec. 31, 2013	9,500	9,500	-92	'	'	'	'

CONSOLIDATED_STATEMENTS_OF_CAS

CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Cash flows from operating activities:	'	'	'
Net income	$8,048	$17,284	$20,802
(Loss) gain on discontinued operations, net of tax	-306	173	1,156
Net income from continuing operations	8,354	17,111	19,646
Adjustments to reconcile income to net cash provided by operating activities:	'	'	'
Depreciation and amortization	2,863	2,552	2,796
Provision for uncollectible accounts	5,488	2,761	2,361
Stock-based compensation	1,465	1,473	1,423
Deferred income taxes	2,099	3,753	4,371
Net cash provided by operating activities	20,269	27,650	30,597
(Increase) decrease in:	'	'	'
Accounts receivable	-893	-8,708	-1,187
Prepaid expenses and other current assets	4,243	-1,129	632
Other assets	235	228	252
(Decrease) increase in:	'	'	'
Accounts payable and accrued expenses	-4,080	-1,705	-5,185
Net cash provided by operating activities	19,774	16,336	25,109
Cash flows from investing activities:	'	'	'
Capital expenditures	-2,505	-2,427	-2,859
Acquisitions, net of cash acquired	-88,465	-536	-38,064
Net cash used in investing activities	-90,970	-2,963	-40,923
Cash flows from financing activities:	'	'	'
Credit facility borrowings	56,000	'	'
Proceeds from stock option exercises	11	70	288
Purchase of common stock in connection with share awards	-20	-1,889	-440
Tax benefit from stock-based compensation	-62	'	1,614
Payment of special dividend	'	-18,562	'
Principal payments on notes payable	-720	-1,200	-696
Net cash used in financing activities	55,209	-21,581	766
Cash flows from discontinued operations:	'	'	'
Operating activities	-970	695	828
Investing activities	3,083	-60	-30
Net cash from discontinued operations	2,113	635	798
Net (decrease) increase in cash and cash equivalents	-13,874	-7,573	-14,250
Cash and cash equivalents at beginning of period	26,120	33,693	47,943
Cash and cash equivalents at end of period	12,246	26,120	33,693
Supplemental disclosures of cash flow information:	'	'	'
Cash payment of interest, net of amounts capitalized	97	104	180
Cash payment of taxes	6,084	8,352	8,778
Summary of non-cash investing and financing activities:	'	'	'
Acquisitions funded by notes payable	1,500	'	1,000
Acquisitions funded by stock	500	'	'
Settlement of Directors Deferred Compensation Plan	'	'	501
Dividends declared, not paid	'	$86	'

SUMMARY_OF_SIGNIFICANT_ACCOUNT

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	12 Months Ended
	Dec. 31, 2013
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	'
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	'
	NOTE 1 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
	Basis of Consolidation and Description Of Business
	The consolidated financial statements include the accounts of Almost Family, Inc. (a Delaware corporation) and its wholly-owned subsidiaries (collectively “Almost Family” or the “Company”). The Company is a leading, regionally focused provider of home health services and has service locations in Florida, Ohio, Kentucky, Connecticut, New Jersey, Massachusetts, Missouri, Indiana, Illinois, Pennsylvania, Tennessee, Georgia, Mississippi and Alabama (in order of revenue significance).
	The Company was incorporated in Delaware in 1985.  Through a predecessor that merged into the Company in 1991, the Company has been providing health care services, primarily home health care, since 1976.  All material intercompany transactions and accounts have been eliminated in consolidation.
	On December 6, 2013, the Company completed the acquisition of Omni Home Health Holdings, Inc. (“SunCrest”).  Branded principally under the SunCrest name, its subsidiaries own and operate 66 Medicare-certified home health agencies and 9 private duty agencies in Florida, Tennessee, Georgia, Pennsylvania, Kentucky, Illinois, Indiana, Mississippi and Alabama.  On October 4, 2013, the Company acquired a controlling interest in Imperium Health Management, LLC (“Imperium”), a development-stage enterprise that provides strategic health management services to Accountable Care Organizations (“ACO’s”).  On July 17, 2013, the Company acquired the assets of the Medicare-certified home health agencies owned by Indiana Home Care Network (“IHCN”).  The acquisitions are more fully described in Note 12, “Acquisitions”. The results of operations for SunCrest and IHCN are principally reported within the Company’s Visiting Nurse reportable segment, while Imperium results are currently included in general and administrative expenses.  Results of operations are included from the acquisition date to December 31, 2013.
	Cash and Cash Equivalents
	The Company considers all highly liquid debt instruments purchased with an original maturity of three months or less to be cash equivalents.
	Uninsured deposits at December 31, 2013 and 2012 were approximately $9,449 and $24,515, respectively.  These amounts have been deposited with national financial institutions.
	Property and Equipment
	Property and equipment are stated at cost. Depreciation is computed using the straight-line method over the estimated useful lives (generally two to ten years for medical and office equipment and three years for internally developed software).  Leasehold improvements are depreciated over the terms of the respective leases (generally three to ten years).
	Goodwill and Other Intangible Assets
	Goodwill and indefinite lived intangible assets acquired are stated at fair value at the date of acquisition.  Subsequent to acquisition, the Company conducts annual reviews for impairment, or more frequently if circumstances indicate impairment may have occurred, under Accounting Standards Codification (ASC) Topic 350, Intangibles — Goodwill and Other.  The Company has completed its most recent annual impairment tests as of December 31, 2013 and determined that no impairment existed.
	Other intangible assets consist of licenses, certificates of need, noncompete agreements, and trade names.   Licenses, certificates of need and trade names have indefinite lives and are not amortized.  Finite-lived intangible assets are amortized on a straight-line basis over their estimated useful lives, such as the cost of non-compete agreements for which their estimated useful life is usually 3 years, beginning after the earn-out period, if any.
	The following table summarizes the activity related to the Company’s goodwill and other intangible assets for 2013 and 2012:
					Other Intangible Assets
		Goodwill			Certificates			Trade Names			Non-compete			Total
					of Need and						Agreements
					Licenses
	Balances at 12-31-11	$	132,653		$	9,091		$	10,421		$	197		$	19,709
	Additions	208			300			—			30			330
	Adjustments	610			—			—			—			—
	Amortization	—			—			—			(72		)	(72		)
	Balances at 12-31-12	$	133,471		$	9,391		$	10,421		$	155		$	19,967
	Additions	60,561			28,930			6,270			—			35,200
	Disposals	(1,457		)	—			—			—			—
	Amortization	—			—			—			(92		)	(92		)
	Balances at 12-31-13	$	192,575		$	38,321		$	16,691		$	63		$	55,075
	At December 31, 2013, the Visiting Nurse (VN) segment includes $155,004, $37,541, $13,311 and $13, while the Personal Care (PC) segment includes $37,571, $780, $3,380 and $50 of total goodwill, certificates of need and licenses, trade names and non-compete agreements, respectively.  At December 31, 2012, the Visiting Nurse (VN) segment includes $102,497, $8,781, $7,701 and $8, while the Personal Care (PC) segment includes $30,447, $610, $2,720 and $163 of total goodwill, certificates of need and licenses, trade names and non-compete agreements, respectively.  Additions were due to acquisitions (Note 12) and disposals were due to asset dispositions (Note 11).
	Capitalization Policies
	Maintenance, repairs and minor replacements are charged to expense as incurred.  Major renovations and replacements are capitalized to appropriate property and equipment accounts.  Upon sale or retirement of property, the cost and related accumulated depreciation are eliminated from the accounts and the related gain or loss is recognized in income.
	The Company capitalizes the cost of internally developed computer software for the Company’s own use.  Software development costs of approximately $647, $968 and $535 were capitalized in the years ended December 31, 2013, 2012 and 2011, respectively.
	Insurance Programs
	The Company bears significant insurance risk under its large-deductible workers’ compensation insurance program and its self-insured employee health program.  Under the workers’ compensation insurance program, the Company bears risk up to $250 per incident, after which stop-loss coverage is maintained.  The Company purchases stop-loss insurance for the employee health plan that places a specific limit, generally $300, on its exposure for any individual covered life.
	Malpractice and general patient liability claims for incidents which may give rise to litigation have been asserted against the Company by various claimants.  The claims are in various stages of processing and some may ultimately be brought to trial.  The Company is aware of incidents that have occurred through December 31, 2013 that may result in the assertion of additional claims.  The Company currently carries professional and general liability insurance coverage (on a claims made basis) for this exposure with no deductible.  The Company also carries D&O coverage (also on a claims made basis) for potential claims against the Company’s directors and officers, including securities actions, with deductibles ranging from $100 to $250 per claim.
	The Company records estimated liabilities for its insurance programs based on information provided by the third-party plan administrators, historical claims experience, the life cycle of claims, expected costs of claims incurred but not paid, and expected costs to settle unpaid claims.  The Company monitors its estimated insurance-related liabilities and recoveries, if any, on a monthly basis and as required by ASU No. 2010-24, Health Care Entities (Topic 954): Presentation of Insurance Claims and Related Insurance Recoveries, records amounts due under insurance policies in other current assets, while recording the estimated carrier liability in other current liabilities.  As facts change, it may become necessary to make adjustments that could be material to the Company’s results of operations and financial condition.
	Accounting for Income Taxes
	The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements or tax returns.  Under this method, deferred tax assets and liabilities are determined based on the difference between the Company’s book and tax bases of assets and liabilities and tax carry-forwards using enacted tax rates in effect for the year in which the differences are expected to reverse.  The effect of changes in tax rates on deferred taxes is recognized in the period in which the enactment dates change.  Valuation allowances are established when necessary on a jurisdictional basis to reduce deferred tax assets to the amounts expected to be realized.
	Seasonality
	The Company’s VN segment operations located in Florida (which generated approximately 41% of that segment’s revenues in 2013) normally experience higher admissions during the first quarter and lower admissions during the third quarter than in the other quarters due to seasonal population fluctuations.
	Net Service Revenues
	The Company is paid for its services primarily by federal and state third-party reimbursement programs, commercial insurance companies, and patients. Revenues are recorded at established rates in the period during which the services are rendered.  Appropriate allowances to give recognition to third party payment arrangements are recorded when the services are rendered.
	Approximately 71% of the Company’s net service revenues are derived from the Medicare program.  Net service revenues are recorded under the Medicare prospective payment program (PPS) based on a 60-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a) changes in the base episode payments established by the Medicare program; (b) adjustments to the base episode payments for case mix and geographic wages; (c) a low utilization payment adjustment (LUPA) if the number of visits was fewer than five; (d) a partial payment if a patient is transferred to another provider or if a patient is received from another provider before completing the episode; (e) a payment adjustment based upon the level of therapy services required (thresholds set at 6, 14 and 20 visits); (f) an outlier payment if the patient’s care was unusually costly (capped at 10% of total reimbursement); (g) the number of episodes of care provided to a patient; and (h) a 2% reduction for sequestration.
	At the beginning of each Medicare episode the Company calculates an estimate of the amount of expected reimbursement based on the variables outlined above and recognizes Medicare revenue on an episode-by-episode basis during the course of each episode over its expected number of visits.  Over the course of each episode, as changes in the variables become known, adjustments are calculated and recorded as needed to reflect changes in expectations for that episode from those established at the start of the 60 day period until its ultimate outcome at the end of the 60 day period is known.
	Substantially all remaining revenues are earned on a per visit, hour or unit basis (as opposed to episodic).  For all services provided, the Company uses either payor-specific or patient-specific fee schedules for the recording of revenues at the amounts actually expected to be received.
	Laws and regulations governing the Medicare and Medicaid programs are extremely complex and subject to interpretation.  It is common for issues to arise related to: 1) medical coding, particularly with respect to Medicare, 2) patient eligibility, particularly related to Medicaid, and 3) other reasons unrelated to credit risk, all of which may result in adjustments to recorded revenue amounts.  The Company continuously evaluates the potential for revenue adjustments and when appropriate provides allowances for losses based upon the best available information.  There is at least a reasonable possibility that recorded estimates could change by material amounts in the near term.  Changes in estimates related to prior periods decreased revenues by approximately $114, $75, and $215 in the years ended December 31, 2013, 2012 and 2011, respectively.
	Revenue and Receivable Concentrations
	The following table sets forth the percent of the Company’s revenues generated from Medicare, state Medicaid programs and other payors for the year ended December 31:
		2013		2012		2011
	Medicare	71.3	%	71.7	%	77.1	%
	Medicaid & other government programs:
	Ohio	13.1	%	13.7	%	9	%
	Connecticut	7	%	6.6	%	6.2	%
	Kentucky	2.3	%	2.7	%	2.8	%
	Florida	0.7	%	0.5	%	0.6	%
	Others	0.5	%	0.3	%	0.4	%
	Subtotal	23.6	%	23.8	%	19	%
	All other payors	5.1	%	4.5	%	3.9	%
	Total	100	%	100	%	100	%
	Concentrations in the Company’s accounts receivable were as follows as of December 31:
		2013					2012
		Amount			Percent		Amount			Percent
	Medicare	$	45,607		56	%	$	34,882		59.1	%
	Medicaid & other government programs:
Ohio	6,310			7.7	%	6,092			10.3	%
Connecticut	5,201			6.4	%	6,081			10.3	%
Kentucky	3,793			4.7	%	2,931			5	%
Tennessee	4,365			5.4	%	—			0	%
Others	2,696			2.6	%	1,014			1.8	%
Subtotal	21,765			26.7	%	16,118			27.4	%
All other payors	14,115			17.3	%	7,978			13.5	%
Subtotal	81,487			100	%	58,978			100	%
Third party payable	(4,250		)			(3,771		)
Allowances	(15,586		)			(5,236		)
Total	$	61,651				$	49,971
Variations between years are largely attributable to the SunCrest acquisition.
At December 31, 2013 and 2012, the Company had $4,250 and $3,771 of payables outstanding primarily related to filed or estimated cost reports with the Kentucky Medicaid program.
The ability of payors to meet their obligations depends upon their financial stability, future legislation and regulatory actions.  The Company does not believe there are any significant credit risks associated with receivables from Federal and state third-party reimbursement programs. The allowance for uncollectible accounts principally consists of management’s estimate of amounts that may prove uncollectible for coverage, eligibility and technical reasons.
Payor Mix Concentrations and Related Aging of Accounts Receivable
The approximate breakdown by payor classification as a percent of total accounts receivable, net of contractual allowances, if any, at December 31, 2013 and 2012 is set forth in the following tables:
	2013
Payor	0-90		91-180		181-365		>1 yr.		Total
Medicare	30	%	12	%	5	%	3	%	50	%
Medicaid & Government	18	%	4	%	4	%	7	%	33	%
Self Pay	4	%	1	%	1	%	1	%	7	%
Insurance	4	%	1	%	2	%	3	%	10	%
Total	56	%	18	%	12	%	14	%	100	%
	2012
Payor	0-90		91-180		181-365		>1 yr.		Total
Medicare	39	%	14	%	5	%	2	%	60	%
Medicaid & Government	20	%	3	%	2	%	2	%	27	%
Self Pay	2	%	1	%	0	%	1	%	4	%
Insurance	4	%	2	%	2	%	1	%	9	%
Total	65	%	20	%	9	%	6	%	100	%
Variations between years are largely attributable to the SunCrest acquisition.
Allowance for Uncollectible Accounts by Payor Mix and Related Aging
The Company records an estimated allowance for uncollectible accounts by applying estimated bad debt percentages to its accounts receivable aging.  The percentages to be applied by payor type are based on the Company’s historical collection and loss experience.  The Company’s effective allowances for uncollectible accounts as a percent of accounts receivable were as follows at December 31, 2013 and 2012:
	2013
Payor	0-90		91-180		181-365		>1 yr.		>2 yrs.
Medicare	0	%	1	%	9	%	100	%	100	%
Medicaid & Government	2	%	16	%	49	%	92	%	100	%
Self Pay	5	%	36	%	80	%	87	%	100	%
Insurance	5	%	22	%	38	%	87	%	100	%
Total	1	%	8	%	33	%	92	%	100	%
	2012
Payor	0-90		91-180		181-365		>1 yr.		>2 yrs.
Medicare	0	%	1	%	9	%	100	%	100	%
Medicaid & Government	1	%	11	%	31	%	71	%	100	%
Self Pay	1	%	4	%	34	%	77	%	100	%
Insurance	6	%	17	%	44	%	79	%	100	%
Total	1	%	4	%	23	%	82	%	100	%
Variations between years are largely attributable to the SunCrest acquisition.
The Company’s allowance for uncollectible accounts at December 31, 2013 and 2012 was approximately $15,586 and $5,236, respectively.  The increase is primarily due to the SunCrest acquisition.
Contingent Service Revenues
The Company, through its Imperium acquisition, provides strategic health management services to ACOs that have been approved to participate in the Medicare Shared Savings Program (“MSSP”).  While the Company does not have ownership interests in ACO’s, it does have service agreements with ACOs that provide for sharing of MSSPs received by the ACO, if any.
ACOs are entities that contract with CMS to serve the Medicare fee-for-service population with the goal of better care for individuals, improved health for populations and lower costs.  ACOs share savings with CMS to the extent that the actual costs of serving assigned beneficiaries are below certain trended benchmarks of such beneficiaries and certain quality performance measures are achieved.  The MSSP is relatively new and therefore has limited historical experience, which impacts the Company’s ability to accurately accumulate and interpret the data available for calculating an ACOs’ shared savings, if any.  MSSP payments are not recognized in revenue until actually received.  The Company recorded no MSSP revenue for the year ended December 31, 2013.
Net Income per Share
Net income per share is presented as a unit of basic shares outstanding and diluted shares outstanding.  Diluted shares outstanding is computed based on the weighted average number of common shares and common equivalent shares outstanding. Common equivalent shares result from dilutive stock options and unvested restricted shares.  The following table is a reconciliation of basic to diluted shares used in the earnings per share calculation for the year ended December 31:
	2013		2012		2011
Basic weighted average outstanding shares	9,279		9,285		9,278
Dilutive effect of outstanding compensation awards	95		39		82
Diluted weighted average outstanding shares	9,374		9,324		9,360
The assumed conversions to common stock of 195, 218, and 125 of the Company’s outstanding stock options were excluded from the diluted EPS computation in 2013, 2012, and 2011, respectively, because these items, on an individual basis, have an anti-dilutive effect on diluted EPS.
Use of Estimates
The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Financial Statement Reclassifications
Certain prior period amounts and data have been reclassified in the financial statements and related notes in order to conform to the 2013 presentation.  Such reclassifications had no effect on previously reported net income.
Stock-Based Compensation
Stock options and restricted stock are granted under various stock compensation programs to employees and independent directors.  The Company accounts for such grants in accordance with ASC Topic 718, Compensation — Stock Compensation and amortizes the fair value of awards, after estimated forfeiture, on a straight-line basis over the requisite service periods.
Accounting for Leases
The Company accounts for operating leases using the straight-line rents method, which amortizes contracted total rents due evenly over the lease term.
Advertising Costs
The Company expenses the costs of advertising as incurred.  Advertising expense was $325, $316 and $370 for the years ended December 31, 2013, 2012, and 2011, respectively.

ACCRUED_LIABILITIES

ACCRUED LIABILITIES	12 Months Ended
	Dec. 31, 2013
ACCRUED LIABILITIES	'
ACCRUED LIABILITIES	'
	NOTE 2 - ACCRUED LIABILITIES
	Accrued liabilities consist of the following as of December 31:
		2013		2012
	Wages and employee benefits	$	20,664	$	10,450
	Insurance accruals	11,640		9,700
	Accrued taxes	856		381
	Accrued professional fees and other	5,756		1,343
		$	38,916	$	21,874

PROPERTY_AND_EQUIPMENT_NET

PROPERTY AND EQUIPMENT, NET	12 Months Ended
	Dec. 31, 2013
PROPERTY AND EQUIPMENT, NET	'
PROPERTY AND EQUIPMENT, NET	'
	NOTE 3 - PROPERTY AND EQUIPMENT, NET
	Property and equipment, net, consist of the following as of December 31:
		2013			2012
	Leasehold improvements	$	1,448		$	781
	Medical equipment	1,671			641
	Computer equipment	14,625			8,060
	Internally developed software	1,404			2,689
	Office and other equipment	5,071			3,330
	Vehicles	387			—
		24,606			15,501
	Less accumulated depreciation	(16,464		)	(10,100		)
		$	8,142		$	5,401
	Depreciation and amortization expense is recorded in general and administrative expenses - other and was $2,611, $2,315 and $2,522 for the years ended December 31, 2013, 2012 and 2011, respectively.

REVOLVING_CREDIT_FACILITY

REVOLVING CREDIT FACILITY	12 Months Ended
	Dec. 31, 2013
REVOLVING CREDIT FACILITY	'
REVOLVING CREDIT FACILITY	'
	NOTE 4 - REVOLVING CREDIT FACILITY
	At December 31, 2013, the Company had a $125 million senior secured revolving credit facility with JP Morgan Chase Bank, NA, as Administrative Agent, Bank of America, as Syndication Agent and certain other lenders (the “Facility”).  The facility consists of a $125 million credit line with a maturity date of December 2, 2015 and an “accordion” feature providing for potential future expansion of the facility to $175 million.  Borrowings (other than letters of credit) under the credit facility are at either the bank’s prime rate plus a margin (ranging from 1.25% to 2.25%, currently 1.25%) or LIBOR plus a margin (ranging from 2.25% to 3.25%, currently 2.25%).  The margin for prime rate or LIBOR borrowings is determined by the Company’s leverage.  Borrowings under the Facility are secured by a first priority perfected security interest in all tangible and intangible assets of the Company, and all existing and future direct and indirect subsidiaries of the Company, as guarantors.
	The weighted average prime rate-based interest rates were 4.50% and 4.50% for the year ended December 31, 2013 and 2012, respectively.  The weighted average LIBOR rate was 2.52% and 2.68% for 2013 and 2012, respectively.  The Company pays a commitment fee quarterly of 0.30% to 0.50% on the average daily unused facility balance based on leverage. Borrowings are subject to various covenants including a multiple of 3.0 times earnings before interest, taxes, depreciation and amortization (“EBITDA”). “EBITDA” may include “Acquired EBITDA” from proforma acquisitions pursuant to a calculation rider, up to 50% of “Adjusted EBITDA”, as defined. Borrowings under the facility may be used for general corporate purposes, including acquisitions. As of December 31, 2013, the formula permitted $25.2 million to be used. The Company has irrevocable letters of credit totaling $7.1 million outstanding in connection with its self-insurance programs. Thus, a total of $18.1 million was available for use at December 31, 2013. The Facility is subject to various financial covenants. As of December 31, 2013, the Company was in compliance with the covenants. Under the most restrictive of its covenants, the Company was required to maintain minimum net worth of at least $160.6 million at December 31, 2013.  At such date, the Company’s net worth was approximately $214.1 million.

FAIR_VALUE_MEASUREMENTS

FAIR VALUE MEASUREMENTS	12 Months Ended
	Dec. 31, 2013
FAIR VALUE MEASUREMENTS	'
FAIR VALUE MEASUREMENTS	'
	NOTE 5 - FAIR VALUE MEASUREMENTS
	The Company’s financial instruments consist of cash, accounts receivable, payables and debt instruments.  Due to their short-term nature, the book values of cash, accounts receivable and payables are considered representative of their respective fair values.  The fair value of the Company’s debt instruments approximates their carrying values as substantially all of such debt instruments have rates which fluctuate with changes in market rates.
	As of December 31, 2013, the Company does not have any assets or liabilities carried at fair value that are measured on a recurring basis.

INCOME_TAXES

INCOME TAXES	12 Months Ended
	Dec. 31, 2013
INCOME TAXES	'
INCOME TAXES	'
	NOTE 6 - INCOME TAXES
	The provision for income taxes consists of the following as of December 31:
		2013			2012			2011
	Federal - current	$	3,557		$	6,113		$	7,210
	State and local - current	364			1,181			1,241
	Deferred	2,099			3,753			4,371
		$	6,020		$	11,047		$	12,822
	A reconciliation of the statutory to the effective rate of the Company is as follows as of December 31:
		2013		2012		2011
	Tax provision using statutory rate	35	%	35	%	35	%
	State and local taxes, net of Federal benefit	5.7	%	4.1	%	3.9	%
	Valuation allowance	-0.6	%	-0.6	%	0	%
	Noncontrolling interest related	0.5	%	0	%	0	%
	Other, net	1.3	%	0.7	%	0.6	%
	Tax provision for continuing operations	41.9	%	39.2	%	39.5	%
	The Company has provided a valuation allowance against certain net deferred tax assets based upon management’s estimation of realizability of those assets through future taxable income.  This valuation allowance was based in large part on the Company’s history of generating operating income or losses in individual tax locales and expectations for the future.  The Company’s ability to generate the expected amounts of taxable income from future operations to realize its recorded net deferred tax assets is dependent upon general economic conditions, competitive pressures on revenues and margins and legislation and regulation at all levels of government.  There can be no assurances that the Company will meet its expectations of future taxable income.  However, management has considered the above factors in reaching its conclusion that it is more likely than not that future taxable income will be sufficient to realize the deferred tax assets (net of valuation allowance) as of December 31, 2013.
	During 2013, the valuation allowance increased by $19 million due to a change in expected realizability of deferred tax assets for states operating loss carry-forwards.
	The principal tax carry-forwards and temporary differences were as follows as of December 31:
		2013			2012
	Deferred tax assets
	Non-deductible reserves and allowances	$	9,520		$	4,331
	Insurance accruals	2,372			2,212
	Net operating loss carryforwards	1,160			1,251
		13,052			7,794
	Valuation allowance	(979		)	(960		)
	Deferred tax assets	12,073			6,834
	Deferred tax liabilities
	Intangibles	(24,509		)	(15,525		)
	Accelerated depreciation	(1,612		)	(1,514		)
	Deferred tax liabilities	(26,121		)	(17,039		)
	Net deferred tax liabilities	$	(14,048	)	$	(10,205	)
	Deferred tax (liabilities) assets are reflected in the accompanying balance sheet as:
	Current assets	11,532			6,580
	Long-term liabilities	(25,580		)	(16,785		)
	Net deferred tax liabilities	$	(14,048	)	$	(10,205	)
	The Company had book goodwill of $109.0 million and $57.5 million at December 31, 2013 and 2012, respectively, which was not deductible for tax purposes.
	State operating loss carry-forwards totaling $22.8 million at December 31, 2013 are being carried forward in jurisdictions where the Company is permitted to use tax losses from prior periods to reduce future taxable income.  If not used to offset future taxable income, these losses will expire between 2014 and 2033.  Due to uncertainty regarding the Company’s ability to use some of the carry-forwards, a valuation allowance has been established on $19.0 million of state net operating loss carry-forwards.  Based on the Company’s historical record of producing taxable income and expectations for the future, the Company has concluded that future operating income will be sufficient to give rise to taxable income sufficient to utilize the remaining state net operating loss carry-forwards.
	The Company concluded that there are no significant uncertain tax positions requiring recognition in its financial statements.  For federal tax purposes, the Company is currently subject to examinations for tax years after 2009, while for state purposes, tax years after 2007 are subject to examination, depending on the specific state rules and regulations.  The Internal Revenue Service completed an examination of the December 31, 2011 tax year.
	The Company may from time to time be assessed interest and penalties by major tax jurisdictions, although any such assessments historically have been minimal and immaterial to its financial results.  Assessments for interest and/or penalties are classified in the financial statements as general and administrative - other.

STOCKHOLDERS_EQUITY

STOCKHOLDERS' EQUITY	12 Months Ended
	Dec. 31, 2013
STOCKHOLDERS' EQUITY	'
STOCKHOLDERS' EQUITY	'
	NOTE 7 - STOCKHOLDERS’ EQUITY
	Employee Stock Incentive Plans
	The Company has a 2000 Employee Stock Option Plan which initially provided for options to purchase up to 1,000 shares of the Company’s common stock to key employees, officers and directors.  The Board of Directors determines the amount and terms of the options, which cannot exceed ten years.  At December 31, 2013, options for 121 shares were outstanding under this plan.  There are no shares available for future grant.
	Historically, the Company has issued restricted share and/or option awards to employees and non-employee directors.  The Board of Directors determines the amount and terms of the options, which cannot exceed ten years.  Under both the 2013 and 2007 Stock and Incentive Compensation Plans, restricted share awards cliff vest on the third anniversary, while option share awards vest annually in 25% increments over four years.
	The 2007 Stock and Incentive Compensation Plan provided for stock awards up to 500 shares of the Company’s common stock to employees, non-employee directors or independent contractors, with a maximum number of full value restricted share awards up to 200.    As of December 31, 2013, options for 254 shares were outstanding under this plan, while 162 restricted shares had been awarded.  There are no shares available for future grant.
	The 2013 Stock and Incentive Compensation Plan provides for stock awards up to 700 shares of the Company’s common stock to employees, non-employee directors or independent contractors, with a maximum number of full value restricted share awards up to 200.  As of December 31, 2013, options for 9 shares had been granted and were outstanding under this plan, while 25 restricted shares had been awarded.  There are 666 shares available for future grant.
	Changes in award shares outstanding are summarized as follows:
		Restricted shares					Options
		Shares		Wtd. Avg.			Shares		Wtd. Avg.
				Grant Price					Ex. Price
	December 31, 2010	92		$	33.74		314		$	22.39
	Granted	20		36.69			32		36.69
	Vested or Exercised	(35	)	26.81			(38	)	10.86
	Forfeited	(6	)	34.76			(16	)	(28.05		)
	December 31, 2011	71		$	37.85		292		$	25.15
	Granted	29		24.16			63		24.16
	Vested or Exercised	(44	)	37.61			(11	)	6.49
	Forfeited	(6	)	28.55			(3	)	(20.19		)
	December 31, 2012	50		$	31.35		341		$	25.62
	Granted	58		20.29			68		20.71
	Vested or Exercised	(8	)	19.57			(2	)	12.29
	Forfeited	—		—			(24	)	(30.29		)
	December 31, 2013	100		$	24.12		383		$	24.52
	The following table summarizes information about stock options at December 31, 2013:
		Options Outstanding							Options Exercisable
	Range of	Shares		Wtd. Avg.		Wtd. Avg.			Shares		Wtd. Avg.	Wtd. Avg.
	Exercise			Remaining		Exercise					Remaining	Exercise
	Price			Contractual		Price					Contractual	Price
				Life							Life
	$4.00-20.00	7		0.87		$	4.28		7		0.87	$	4.28
	$20.01-30.00	279		5.75		$	21.01		170		3.79	$	20.5
	Over $30.00	97		5.8		$	35.88		82		5.58	$	35.76
		383		5.68		$	24.52		259		4.28	$	24.89
	The following table details exercisable options and related information for the year ended December 31:
		2013			2012			2011
	Exercisable at end of year	259			240			219
	Weighted average price	$	24.89		$	24.33		$	22.21
	Weighted average fair value of options granted during the year	$	9.59		$	10.92		$	18.31
	The following table details unvested options for the year ended December 31, 2013:
		Shares		Wtd. Avg.
				Ex. Price
	December 31, 2012	101		$	28.69
	Vested	34		31.02
	Granted	68		20.71
	Forfeited	(11	)	(28.40		)
	December 31, 2013	124		$	23.77
	The fair value of each option award is estimated on the date of grant using the Monte Carlo option valuation model with suboptimal exercise behavior. The Monte Carlo model places greater emphasis on market evidence and predicts more realistic results because it considers open form information including volatility, employee exercise behaviors and turnover.  Stock options have a contractual term on 10 years.  The following assumptions were used in determining the fair value of option awards for 2013:
	Grant date	Equivalent		Equivalent		Implied
		interest rate		volatility		expected
						lives
	March 1, 2013	1.86	%	40	%	8.33
	Expected volatility is based on an analysis that looks at the unbiased standard deviation of the Company’s common stock over the option term as well as implied volatilities of all long-term exchange traded options for the Company. The expected life of the options represents the period of time that the Company expects the options granted to be outstanding. The risk-free rate is based on the U.S. Treasury yield curve in effect at the time of the grant of the option for the expected term of the instrument. The dividend yield reflects an estimate of dividend payouts over the term of the award.
	As of December 31, 2013, there was $1,878 of total unrecognized compensation cost, after estimated forfeitures, related to unvested share-based compensation granted under the plans.  That cost is expected to be recognized over a weighted-average period of 2.74 years.  The total fair value of option shares vested during the 2013 and 2012 was $363 and $371, respectively.
	Employee Stock Purchase Plan
	The Company has an Employee Stock Purchase Plan (“2009 ESPP”) which, if implemented, could provide employees of the Company and its subsidiaries with an opportunity to participate in the growth of the Company and to further align the interest of the employees with the interests of the Company through the purchase of shares of the Company’s Common Stock.  Under the 2009 ESPP, 300 shares of the Company’s Common Stock have been authorized for issuance.  As of December 31, 2013, all 300 shares remain available.
	Directors Deferred Compensation Plan
	The Company had a Non-Employee Directors Deferred Compensation Plan (the “Deferred Plan”) which allowed Directors to elect to receive fees for Board services in the form of shares of the Company’s common stock.  Directors’ fees were expensed as incurred whether paid in cash or deferred into the Deferred Plan.  The Deferred Plan was terminated as of February 22, 2010 with all shares distributed on February 23, 2011.  During 2012, the Company redeemed 72 shares of stock for $1.7 million related to this distribution.

RETIREMENT_PLAN

RETIREMENT PLAN	12 Months Ended
	Dec. 31, 2013
RETIREMENT PLAN	'
RETIREMENT PLAN	'
	NOTE 8 - RETIREMENT PLAN
	The Company administers a 401(k) defined contribution retirement plan for the benefit of the majority of its employees.  Employees may participate in the plan immediately upon employment.  The Company matches contributions in an amount equal to one-quarter of the first 5% of each participant’s contribution to the plan after completion of one year of service with the Company.  401(k) assets are held by an independent trustee, are not assets of the Company, and accordingly are not reflected in the Company’s balance sheets.  The Company’s retirement plan expense was approximately $550, $509 and $472 for the years ended December 31, 2013, 2012, and 2011, respectively.

COMMITMENTS_AND_CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	12 Months Ended
	Dec. 31, 2013
COMMITMENTS AND CONTINGENCIES	'
COMMITMENTS AND CONTINGENCIES	'
	NOTE 9 - COMMITMENTS AND CONTINGENCIES
	Operating Leases
	The Company leases certain real estate, office space, and equipment under non-cancelable operating leases expiring at various dates through 2019 and which contain various renewal and escalation clauses.  Rent expense amounted to approximately $8,592, $8,656 and $7,703 for years ended December 31, 2013, 2012 and 2011, respectively. At December 31, 2013, minimum rental payments under these leases were as follows:
	2014	$	5,845
	2015	3,961
	2016	1,785
	2017	806
	2018	335
	Thereafter	15
	Total	$	12,747
	Legal Proceedings
	The Company is currently, and from time to time, subject to claims and suits arising in the ordinary course of its business, including claims for damages for personal injuries.  In the opinion of management, after discussions with legal counsel, the ultimate resolution of any of these ordinary course pending claims and legal proceedings will not have a material effect on the Company’s financial position or results of operations.
	As previously disclosed, four derivative complaints were filed in Jefferson Circuit Court, Kentucky, against the members of the Company’s board of directors and chief financial officer.  All four lawsuits named the Company as a nominal defendant and were consolidated into a single action.  All of the complaints and the resulting consolidated complaint refer to an April 27, 2010 The Wall Street Journal article and the subsequent governmental investigations.  On February 13, 2012, the independent directors filed a motion to dismiss the complaint.  On October 2, 2012, the Court entered an order granting the motion to dismiss and dismissing the complaint with prejudice.  On November 1, 2012 the plaintiffs filed an appeal of the Court’s ruling with the Kentucky Court of Appeals.  Briefing to the Court of Appeals is complete.  In the meantime, the Board received a demand letter dated July 17, 2013, from counsel for one of the derivative plaintiff shareholders.  The letter states that the shareholder believes certain of the Company’s officers and directors violated their fiduciary duties based on allegations similar to those described in the consolidated complaint.  The letter requests that the Board take appropriate action against the individuals in question.  The Board is working on a response to the shareholder demand.  As a further result of the demand from the plaintiff shareholder, the Company’s outside directors filed a motion with the Court of Appeals asking the Court to dismiss the appeal as moot.  On March 11, 2014, the Court of Appeals denied the outside directors’ motion to dismiss the appeal as moot.  Moreover, the Court of Appeals on its own motion abated the appeal.  The abatement removed the appeal from the Court’s active appellate docket.  The Court stated that upon the Board’s response to the shareholder demand, the parties should file a motion to redocket the case.
	As previously disclosed, a fifth derivative complaint involving Richard W. Carey was filed in U.S. District Court for the Western District of Kentucky.  The lawsuit names the Company as a nominal defendant and is substantially duplicative of the derivative complaint pending in the Jefferson Circuit Court.  The Court granted the defendants’ motion to stay the lawsuit pending further order of the Court.
	The Company is unable to assess the probable outcome or potential liability, if any, arising from these matters.

SEGMENT_DATA

SEGMENT DATA	12 Months Ended
	Dec. 31, 2013
SEGMENT DATA	'
SEGMENT DATA	'
	NOTE 10 - SEGMENT DATA
	The Company has two reportable segments, VN and PC.  Reportable segments have been identified based upon how management has organized the business by services provided to customers and the criteria in ASC Topic 280, Segment Reporting.  Consistent with information given to the Chief Operating Decision Maker, the Company does not allocate certain corporate expenses, which include expenses related to Imperium, to the reportable segments.  These expenses are included in Unallocated below.  The Company evaluates the performance of its business segments based upon operating income. Intercompany transactions between segments are eliminated.
	The Company’s VN segment provides skilled medical services in patients’ homes largely to enable recipients to reduce or avoid periods of hospitalization and/or nursing home care.  VN Medicare revenues are generated on a per episode basis rather than a fee per visit or day of care.  Approximately 93% of the VN segment revenues are generated from the Medicare program, while the balance is generated from Medicaid and private insurance programs.
	The Company’s PC segment services are also provided in patients’ homes.  These services (generally provided by paraprofessional staff such as home health aides) are generally of a custodial rather than skilled nature.  PC revenues are generated on an hourly basis.  Approximately 86% of the PC segment revenues are generated from Medicaid and other government programs, while the balance is generated from insurance programs and private pay patients.
		Year Ended December 31,
		2013			2012			2011
	Net service revenues
	Visiting Nurse	$	275,813		$	265,401		$	275,184
	Personal Care	81,999			77,047			56,257
		$	357,812		$	342,448		$	331,441
	Operating income
	Visiting Nurse	$	30,749		$	39,142		$	43,815
	Personal Care	10,137			10,029			8,682
	Unallocated	(26,343		)	(20,909		)	(19,849		)
		$	14,543		$	28,262		$	32,648
	Identifiable assets
	Visiting Nurse	$	265,699		$	158,823
	Personal Care	57,654			47,860
	Unallocated	28,920			42,576
		$	352,273		$	249,259
	Identifiable liabilities
	Visiting Nurse	$	42,643		$	9,940
	Personal Care	5,026			4,670
	Unallocated	86,911			30,334
		$	134,580		$	44,944
	Capital expenditures
	Visiting Nurse	$	767		$	680		$	759
	Personal Care	267			648			756
	Unallocated	1,471			1,099			1,344
		$	2,505		$	2,427		$	2,859
	Depreciation and amortization
	Visiting Nurse	$	1,027		$	1,004		$	1,311
	Personal Care	202			156			80
	Unallocated	1,634			1,392			1,405
		$	2,863		$	2,552		$	2,796

DISCONTINUED_OPERATIONS

DISCONTINUED OPERATIONS	12 Months Ended
	Dec. 31, 2013
DISCONTINUED OPERATIONS	'
DISCONTINUED OPERATIONS	'
	NOTE 11 — DISCONTINUED OPERATIONS
	The Company follows the guidance in Accounting Standards Codification (ASC) 205-20, Discontinued Operations and, when appropriate, reclassifies operating units closed, sold or held for sale out of continuing operations and into discontinued operations for all periods presented.  During the quarter ended June 30, 2013, the Company completed the sale of two Alabama locations, which operated in the Visiting Nurse (VN) segment.  The operations and gain on sale related to the Alabama operations were reclassified from continuing operations into discontinued operations for all periods presented.  Other Assets Held for Sale primarily relate to prior period VN segment goodwill that was allocated to the Company’s Alabama operations.  The effective tax rate for discontinued operations is high due primarily to the impact of writing off non-deductible goodwill in addition to providing a valuation allowance for Alabama net operating loss carryforwards.  Unless otherwise noted, amounts in these Notes to Consolidated Financial Statements exclude amounts attributable to discontinued operations.

ACQUISITIONS

ACQUISITIONS	12 Months Ended
	Dec. 31, 2013
ACQUISITIONS	'
ACQUISITIONS	'
	NOTE 12 - ACQUISITIONS
	The Company completed each of the following acquisitions in pursuit of its strategy for operational expansion in the eastern United States through an expanded service base and enhanced position in certain geographic areas.  The purchase price of each acquisition was determined based on the Company’s analysis of comparable acquisitions, expected cash flows and arm’s length negotiation with the sellers.  Each acquisition was included in the Company’s consolidated financial statements from the respective acquisition date.
	Goodwill recognized from the acquisitions primarily relates to expected contributions of each entity to the overall corporate strategy in addition to synergies and acquired workforce, which are not separable from goodwill.  Goodwill and other intangible assets generated in asset purchase transactions are expected to be amortizable for tax purposes on a straight-line basis over 15 years, unless otherwise noted.  Goodwill and other intangible assets generated in stock purchase transactions are not amortizable, unless otherwise noted.  The purchase price allocations for 2013 acquisitions are preliminary as the Company is continuing to obtain information regarding acquired assets and liabilities.
	On December 6, 2013, the Company acquired the stock of SunCrest.  SunCrest and its subsidiaries own and operate 66 Medicare-certified home health agencies and 9 private duty agencies in Florida, Tennessee, Georgia, Pennsylvania, Kentucky, Illinois, Indiana, Mississippi and Alabama.  The total SunCrest purchase price for the stock was $76.6 million, subject to a working capital adjustment.  The purchase price consisted of cash consideration of $75.1 million, of which $1.5 million remained unpaid at December 31, 2013 and a $1.5 million note payable, net of acquired cash balances of $2.2 million.  The following table summarizes to approximate estimated fair values of the assets acquired and liabilities assumed of the SunCrest acquisition.
	Accounts Receivable - net	$	16,237
	Property, plant & equipment	2,276
	Other assets	2,933
	Goodwill	44,096
	Other intangibles	33,390
	Assets acquired	98,932
	Liabilities assumed	(22,375		)
	Net assets acquired	$	76,557
	Amortizable goodwill and intangibles acquired in the SunCrest acquisition are expected to provide an annual tax deduction approximating $2.8 million through 2020.
	The unaudited proforma result of operations for the Company as if the SunCrest acquisition had been made at the beginning of 2013 are as follows:
		Twelve months ended December 31,
		2013			2012
	Revenues	$	495,025		$	496,428
	Net income from continuing operations	$	7,230		$	14,074
	Net income	$	7,102		$	14,247
	Earnings per share from continuing operations
	Basic	$	0.78		$	1.52
	Diluted	$	0.76		$	1.53
	Earnings per share
	Basic	$	0.77		$	1.51
	Diluted	$	0.76		$	1.53
	The proforma information presented above is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred if the transaction described had been completed as of the beginning of 2012.  In addition, future results may vary from the results reflected in such information.
	On October 4, 2013, the Company acquired 61.5% of Imperium for $5.8 million, of which $3.0 million was working capital for Imperium.  Imperium is a development-stage enterprise that provides strategic health management services to ACOs.  Substantially all of the purchase price was allocated to goodwill.  The Company is party to a put and call arrangement with respect to the remaining 38.5% non-controlling interest in Imperium.  The redemption value for both the put and the call arrangement is equal to fair value.  Due to the existing put and call arrangements, the non-controlling interest is considered to be redeemable and is recorded on the balance sheet as a redeemable non-controlling interest outside of permanent equity.  The redeemable non-controlling interest is recognized at the higher of 1) the accumulated earnings associated with the non-controlling interest or 2) the redemption value as of the balance sheet date.
	On July 17, 2013, the Company acquired the assets of the Medicare-certified home agencies owned by IHCN.  IHCN operated six home health agencies primarily in northern Indiana for a total purchase price of $12.5 million consisting of cash and $0.5 million of Almost Family, Inc. common stock.  A preliminary allocation of purchase price resulted primarily in the allocation of $9.9 million to goodwill, $1.8 million to identified intangibles with the remainder primarily due to property plant and equipment and accounts receivable.
	During 2012, the Company completed two small acquisitions to expand existing VN and PC segment operations.
	On August 5, 2011 the Company acquired 100% of the outstanding equity interests of Cambridge Home Health Care Holdings, Inc. (Cambridge) with a cash-free, debt-free balance sheet for an all-cash purchase price of $32.8 million.  Cambridge and its subsidiaries own and operate 37 home health branches with 34 in Ohio and three in western Pennsylvania.  The Cambridge transaction was a 100% acquisition of stock and accordingly, tax deductible goodwill and identified intangibles is limited to $4.0 million.
	On April 1, 2011, the Company acquired the assets of a Medicare-certified home health agency in Cincinnati, Ohio with approximately $5 million in annual revenues for $5.3 million in total consideration consisting of cash and a $1 million note payable.

QUARTERLY_FINANCIAL_DATA_UNAUD

QUARTERLY FINANCIAL DATA - (UNAUDITED)	12 Months Ended
	Dec. 31, 2013
QUARTERLY FINANCIAL DATA - (UNAUDITED)	'
QUARTERLY FINANCIAL DATA - (UNAUDITED)	'
	NOTE 13 - QUARTERLY FINANCIAL DATA— (UNAUDITED)
	Summarized quarterly financial data are as follows for the years ended December 31:
		2013												2012
		Dec. 31			Sept. 30			Jun. 30			Mar. 31			Dec. 31			Sept. 30			Jun. 30		Mar. 31
	Net service revenues	$	96,341		$	88,818		$	86,818		$	85,835		$	85,421		$	83,880		$	85,296	$	87,851
	Gross margin	44,637			41,267			40,470			40,170			40,823			40,077			40,827		43,172
	Income from continuing operations attributable to Almost Family, Inc.	383			2,239			2,584			3,326			3,736			4,147			4,444		4,784
	Discontinued operations	(55		)	(110		)	(61		)	(80		)	(31		)	(48		)	105		147
	Net income attributable to
	Almost Family, Inc.	$	328		$	2,129		$	2,523		$	3,247		$	3,704		$	4,099		$	4,549	$	4,932
	Average shares outstanding
	Basic	9,308			9,302			9,270			9,254			9,280			9,256			9,255		9,268
	Diluted	9,401			9,348			9,348			9,338			9,313			9,315			9,315		9,334
	Net income attributable to Almost Family, Inc. per share
	Basic	$	0.03		$	0.23		$	0.27		$	0.35		$	0.4		$	0.44		$	0.49	$	0.53
	Diluted	$	0.02		$	0.23		$	0.27		$	0.35		$	0.4		$	0.44		$	0.49	$	0.53

SUBSEQUENT_EVENTS

SUBSEQUENT EVENTS	12 Months Ended
	Dec. 31, 2013
SUBSEQUENT EVENTS	'
SUBSEQUENT EVENTS	'
	NOTE 14 - SUBSEQUENT EVENTS
	Management has evaluated all events and transactions that occurred after December 31, 2013.  During this period, the Company had no material subsequent events requiring recognition in the consolidated financial statements or any non-recognized subsequent events requiring disclosure.

SCHEDULE_II_VALUATION_AND_QUAL

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS	12 Months Ended
	Dec. 31, 2013
SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS	'
SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS	'
	ALMOST FAMILY, INC.AND SUBSIDIARIES
	VALUATION AND QUALIFYING ACCOUNTS
	SCHEDULE II
	(In thousands)
		Col. A		Col. B		Col. C		Col. D			Col. E
				Additions/(Deductions)
	Description	Balance at		-1		-2		-3			Balance at
		Beginning		Charged to		Charged to		Deductions			End of
		of Period		Costs and		Other					Period
				Expenses		Accounts
	Allowances:
	Year Ended December 31, 2013	$	5,236	5,526		8,910		(4,086		)	$	15,586
	Year Ended December 31, 2012	$	6,664	$	2,825	$	46	$	(4,299	)	$	5,236
	Year Ended December 31, 2011	7,525		$	2,362	$	732	$	(3,955	)	6,664
	(1)       Charged to bad debt expense.
	(2)       Acquired uncollectible accounts reserves, primarily SunCrest acquisition related.
	(3)       Write-off of accounts.

SUMMARY_OF_SIGNIFICANT_ACCOUNT1

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	12 Months Ended
	Dec. 31, 2013
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	'
Basis of Consolidation and Description Of Business	'
	Basis of Consolidation and Description Of Business
	The consolidated financial statements include the accounts of Almost Family, Inc. (a Delaware corporation) and its wholly-owned subsidiaries (collectively “Almost Family” or the “Company”). The Company is a leading, regionally focused provider of home health services and has service locations in Florida, Ohio, Kentucky, Connecticut, New Jersey, Massachusetts, Missouri, Indiana, Illinois, Pennsylvania, Tennessee, Georgia, Mississippi and Alabama (in order of revenue significance).
	The Company was incorporated in Delaware in 1985.  Through a predecessor that merged into the Company in 1991, the Company has been providing health care services, primarily home health care, since 1976.  All material intercompany transactions and accounts have been eliminated in consolidation.
	On December 6, 2013, the Company completed the acquisition of Omni Home Health Holdings, Inc. (“SunCrest”).  Branded principally under the SunCrest name, its subsidiaries own and operate 66 Medicare-certified home health agencies and 9 private duty agencies in Florida, Tennessee, Georgia, Pennsylvania, Kentucky, Illinois, Indiana, Mississippi and Alabama.  On October 4, 2013, the Company acquired a controlling interest in Imperium Health Management, LLC (“Imperium”), a development-stage enterprise that provides strategic health management services to Accountable Care Organizations (“ACO’s”).  On July 17, 2013, the Company acquired the assets of the Medicare-certified home health agencies owned by Indiana Home Care Network (“IHCN”).  The acquisitions are more fully described in Note 12, “Acquisitions”. The results of operations for SunCrest and IHCN are principally reported within the Company’s Visiting Nurse reportable segment, while Imperium results are currently included in general and administrative expenses.  Results of operations are included from the acquisition date to December 31, 2013.
Cash and Cash Equivalents	'
	Cash and Cash Equivalents
	The Company considers all highly liquid debt instruments purchased with an original maturity of three months or less to be cash equivalents.
	Uninsured deposits at December 31, 2013 and 2012 were approximately $9,449 and $24,515, respectively.  These amounts have been deposited with national financial institutions.
Property and Equipment	'
	Property and Equipment
	Property and equipment are stated at cost. Depreciation is computed using the straight-line method over the estimated useful lives (generally two to ten years for medical and office equipment and three years for internally developed software).  Leasehold improvements are depreciated over the terms of the respective leases (generally three to ten years).
Goodwill and Other Intangible Assets	'
	Goodwill and Other Intangible Assets
	Goodwill and indefinite lived intangible assets acquired are stated at fair value at the date of acquisition.  Subsequent to acquisition, the Company conducts annual reviews for impairment, or more frequently if circumstances indicate impairment may have occurred, under Accounting Standards Codification (ASC) Topic 350, Intangibles — Goodwill and Other.  The Company has completed its most recent annual impairment tests as of December 31, 2013 and determined that no impairment existed.
	Other intangible assets consist of licenses, certificates of need, noncompete agreements, and trade names.   Licenses, certificates of need and trade names have indefinite lives and are not amortized.  Finite-lived intangible assets are amortized on a straight-line basis over their estimated useful lives, such as the cost of non-compete agreements for which their estimated useful life is usually 3 years, beginning after the earn-out period, if any.
	The following table summarizes the activity related to the Company’s goodwill and other intangible assets for 2013 and 2012:
					Other Intangible Assets
		Goodwill			Certificates			Trade Names			Non-compete			Total
					of Need and						Agreements
					Licenses
	Balances at 12-31-11	$	132,653		$	9,091		$	10,421		$	197		$	19,709
	Additions	208			300			—			30			330
	Adjustments	610			—			—			—			—
	Amortization	—			—			—			(72		)	(72		)
	Balances at 12-31-12	$	133,471		$	9,391		$	10,421		$	155		$	19,967
	Additions	60,561			28,930			6,270			—			35,200
	Disposals	(1,457		)	—			—			—			—
	Amortization	—			—			—			(92		)	(92		)
	Balances at 12-31-13	$	192,575		$	38,321		$	16,691		$	63		$	55,075
	At December 31, 2013, the Visiting Nurse (VN) segment includes $155,004, $37,541, $13,311 and $13, while the Personal Care (PC) segment includes $37,571, $780, $3,380 and $50 of total goodwill, certificates of need and licenses, trade names and non-compete agreements, respectively.  At December 31, 2012, the Visiting Nurse (VN) segment includes $102,497, $8,781, $7,701 and $8, while the Personal Care (PC) segment includes $30,447, $610, $2,720 and $163 of total goodwill, certificates of need and licenses, trade names and non-compete agreements, respectively.  Additions were due to acquisitions (Note 12) and disposals were due to asset dispositions (Note 11).
Capitalization Policies	'
	Capitalization Policies
	Maintenance, repairs and minor replacements are charged to expense as incurred.  Major renovations and replacements are capitalized to appropriate property and equipment accounts.  Upon sale or retirement of property, the cost and related accumulated depreciation are eliminated from the accounts and the related gain or loss is recognized in income.
	The Company capitalizes the cost of internally developed computer software for the Company’s own use.  Software development costs of approximately $647, $968 and $535 were capitalized in the years ended December 31, 2013, 2012 and 2011, respectively.
Insurance Programs	'
	Insurance Programs
	The Company bears significant insurance risk under its large-deductible workers’ compensation insurance program and its self-insured employee health program.  Under the workers’ compensation insurance program, the Company bears risk up to $250 per incident, after which stop-loss coverage is maintained.  The Company purchases stop-loss insurance for the employee health plan that places a specific limit, generally $300, on its exposure for any individual covered life.
	Malpractice and general patient liability claims for incidents which may give rise to litigation have been asserted against the Company by various claimants.  The claims are in various stages of processing and some may ultimately be brought to trial.  The Company is aware of incidents that have occurred through December 31, 2013 that may result in the assertion of additional claims.  The Company currently carries professional and general liability insurance coverage (on a claims made basis) for this exposure with no deductible.  The Company also carries D&O coverage (also on a claims made basis) for potential claims against the Company’s directors and officers, including securities actions, with deductibles ranging from $100 to $250 per claim.
	The Company records estimated liabilities for its insurance programs based on information provided by the third-party plan administrators, historical claims experience, the life cycle of claims, expected costs of claims incurred but not paid, and expected costs to settle unpaid claims.  The Company monitors its estimated insurance-related liabilities and recoveries, if any, on a monthly basis and as required by ASU No. 2010-24, Health Care Entities (Topic 954): Presentation of Insurance Claims and Related Insurance Recoveries, records amounts due under insurance policies in other current assets, while recording the estimated carrier liability in other current liabilities.  As facts change, it may become necessary to make adjustments that could be material to the Company’s results of operations and financial condition.
Accounting for Income Taxes	'
	Accounting for Income Taxes
	The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements or tax returns.  Under this method, deferred tax assets and liabilities are determined based on the difference between the Company’s book and tax bases of assets and liabilities and tax carry-forwards using enacted tax rates in effect for the year in which the differences are expected to reverse.  The effect of changes in tax rates on deferred taxes is recognized in the period in which the enactment dates change.  Valuation allowances are established when necessary on a jurisdictional basis to reduce deferred tax assets to the amounts expected to be realized.
Net Service Revenues	'
	Net Service Revenues
	The Company is paid for its services primarily by federal and state third-party reimbursement programs, commercial insurance companies, and patients. Revenues are recorded at established rates in the period during which the services are rendered.  Appropriate allowances to give recognition to third party payment arrangements are recorded when the services are rendered.
	Approximately 71% of the Company’s net service revenues are derived from the Medicare program.  Net service revenues are recorded under the Medicare prospective payment program (PPS) based on a 60-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a) changes in the base episode payments established by the Medicare program; (b) adjustments to the base episode payments for case mix and geographic wages; (c) a low utilization payment adjustment (LUPA) if the number of visits was fewer than five; (d) a partial payment if a patient is transferred to another provider or if a patient is received from another provider before completing the episode; (e) a payment adjustment based upon the level of therapy services required (thresholds set at 6, 14 and 20 visits); (f) an outlier payment if the patient’s care was unusually costly (capped at 10% of total reimbursement); (g) the number of episodes of care provided to a patient; and (h) a 2% reduction for sequestration.
	At the beginning of each Medicare episode the Company calculates an estimate of the amount of expected reimbursement based on the variables outlined above and recognizes Medicare revenue on an episode-by-episode basis during the course of each episode over its expected number of visits.  Over the course of each episode, as changes in the variables become known, adjustments are calculated and recorded as needed to reflect changes in expectations for that episode from those established at the start of the 60 day period until its ultimate outcome at the end of the 60 day period is known.
	Substantially all remaining revenues are earned on a per visit, hour or unit basis (as opposed to episodic).  For all services provided, the Company uses either payor-specific or patient-specific fee schedules for the recording of revenues at the amounts actually expected to be received.
	Laws and regulations governing the Medicare and Medicaid programs are extremely complex and subject to interpretation.  It is common for issues to arise related to: 1) medical coding, particularly with respect to Medicare, 2) patient eligibility, particularly related to Medicaid, and 3) other reasons unrelated to credit risk, all of which may result in adjustments to recorded revenue amounts.  The Company continuously evaluates the potential for revenue adjustments and when appropriate provides allowances for losses based upon the best available information.  There is at least a reasonable possibility that recorded estimates could change by material amounts in the near term.  Changes in estimates related to prior periods decreased revenues by approximately $114, $75, and $215 in the years ended December 31, 2013, 2012 and 2011, respectively.
Revenue and Receivable Concentrations	'
	Revenue and Receivable Concentrations
	The following table sets forth the percent of the Company’s revenues generated from Medicare, state Medicaid programs and other payors for the year ended December 31:
		2013		2012		2011
	Medicare	71.3	%	71.7	%	77.1	%
	Medicaid & other government programs:
	Ohio	13.1	%	13.7	%	9	%
	Connecticut	7	%	6.6	%	6.2	%
	Kentucky	2.3	%	2.7	%	2.8	%
	Florida	0.7	%	0.5	%	0.6	%
	Others	0.5	%	0.3	%	0.4	%
	Subtotal	23.6	%	23.8	%	19	%
	All other payors	5.1	%	4.5	%	3.9	%
	Total	100	%	100	%	100	%
	Concentrations in the Company’s accounts receivable were as follows as of December 31:
		2013					2012
		Amount			Percent		Amount			Percent
	Medicare	$	45,607		56	%	$	34,882		59.1	%
	Medicaid & other government programs:
	Ohio	6,310			7.7	%	6,092			10.3	%
	Connecticut	5,201			6.4	%	6,081			10.3	%
	Kentucky	3,793			4.7	%	2,931			5	%
	Tennessee	4,365			5.4	%	—			0	%
	Others	2,696			2.6	%	1,014			1.8	%
	Subtotal	21,765			26.7	%	16,118			27.4	%
	All other payors	14,115			17.3	%	7,978			13.5	%
	Subtotal	81,487			100	%	58,978			100	%
	Third party payable	(4,250		)			(3,771		)
	Allowances	(15,586		)			(5,236		)
	Total	$	61,651				$	49,971
	Variations between years are largely attributable to the SunCrest acquisition.
	At December 31, 2013 and 2012, the Company had $4,250 and $3,771 of payables outstanding primarily related to filed or estimated cost reports with the Kentucky Medicaid program.
	The ability of payors to meet their obligations depends upon their financial stability, future legislation and regulatory actions.  The Company does not believe there are any significant credit risks associated with receivables from Federal and state third-party reimbursement programs. The allowance for uncollectible accounts principally consists of management’s estimate of amounts that may prove uncollectible for coverage, eligibility and technical reasons.
Allowance for Uncollectible Accounts by Payor Mix and Related Aging	'
	Allowance for Uncollectible Accounts by Payor Mix and Related Aging
	The Company records an estimated allowance for uncollectible accounts by applying estimated bad debt percentages to its accounts receivable aging.  The percentages to be applied by payor type are based on the Company’s historical collection and loss experience.  The Company’s effective allowances for uncollectible accounts as a percent of accounts receivable were as follows at December 31, 2013 and 2012:
		2013
	Payor	0-90		91-180		181-365		>1 yr.		>2 yrs.
	Medicare	0	%	1	%	9	%	100	%	100	%
	Medicaid & Government	2	%	16	%	49	%	92	%	100	%
	Self Pay	5	%	36	%	80	%	87	%	100	%
	Insurance	5	%	22	%	38	%	87	%	100	%
	Total	1	%	8	%	33	%	92	%	100	%
		2012
	Payor	0-90		91-180		181-365		>1 yr.		>2 yrs.
	Medicare	0	%	1	%	9	%	100	%	100	%
	Medicaid & Government	1	%	11	%	31	%	71	%	100	%
	Self Pay	1	%	4	%	34	%	77	%	100	%
	Insurance	6	%	17	%	44	%	79	%	100	%
	Total	1	%	4	%	23	%	82	%	100	%
	Variations between years are largely attributable to the SunCrest acquisition.
	The Company’s allowance for uncollectible accounts at December 31, 2013 and 2012 was approximately $15,586 and $5,236, respectively.  The increase is primarily due to the SunCrest acquisition.
Contingent service revenues	'
	Contingent Service Revenues
	The Company, through its Imperium acquisition, provides strategic health management services to ACOs that have been approved to participate in the Medicare Shared Savings Program (“MSSP”).  While the Company does not have ownership interests in ACO’s, it does have service agreements with ACOs that provide for sharing of MSSPs received by the ACO, if any.
	ACOs are entities that contract with CMS to serve the Medicare fee-for-service population with the goal of better care for individuals, improved health for populations and lower costs.  ACOs share savings with CMS to the extent that the actual costs of serving assigned beneficiaries are below certain trended benchmarks of such beneficiaries and certain quality performance measures are achieved.  The MSSP is relatively new and therefore has limited historical experience, which impacts the Company’s ability to accurately accumulate and interpret the data available for calculating an ACOs’ shared savings, if any.  MSSP payments are not recognized in revenue until actually received.  The Company recorded no MSSP revenue for the year ended December 31, 2013.
Net Income per Share	'
	Net Income per Share
	Net income per share is presented as a unit of basic shares outstanding and diluted shares outstanding.  Diluted shares outstanding is computed based on the weighted average number of common shares and common equivalent shares outstanding. Common equivalent shares result from dilutive stock options and unvested restricted shares.  The following table is a reconciliation of basic to diluted shares used in the earnings per share calculation for the year ended December 31:
		2013		2012		2011
	Basic weighted average outstanding shares	9,279		9,285		9,278
	Dilutive effect of outstanding compensation awards	95		39		82
	Diluted weighted average outstanding shares	9,374		9,324		9,360
	The assumed conversions to common stock of 195, 218, and 125 of the Company’s outstanding stock options were excluded from the diluted EPS computation in 2013, 2012, and 2011, respectively, because these items, on an individual basis, have an anti-dilutive effect on diluted EPS.
Use of Estimates	'
	Use of Estimates
	The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Financial Statement Reclassifications	'
	Financial Statement Reclassifications
	Certain prior period amounts and data have been reclassified in the financial statements and related notes in order to conform to the 2013 presentation.  Such reclassifications had no effect on previously reported net income.
Stock-Based Compensation	'
	Stock-Based Compensation
	Stock options and restricted stock are granted under various stock compensation programs to employees and independent directors.  The Company accounts for such grants in accordance with ASC Topic 718, Compensation — Stock Compensation and amortizes the fair value of awards, after estimated forfeiture, on a straight-line basis over the requisite service periods.
Accounting for Leases	'
	Accounting for Leases
	The Company accounts for operating leases using the straight-line rents method, which amortizes contracted total rents due evenly over the lease term.
Advertising Costs	'
	Advertising Costs
	The Company expenses the costs of advertising as incurred.  Advertising expense was $325, $316 and $370 for the years ended December 31, 2013, 2012, and 2011, respectively.

SUMMARY_OF_SIGNIFICANT_ACCOUNT2

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)	12 Months Ended
	Dec. 31, 2013
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	'
Summary of the activity related to goodwill and other intangible assets	'
					Other Intangible Assets
		Goodwill			Certificates			Trade Names			Non-compete			Total
					of Need and						Agreements
					Licenses
	Balances at 12-31-11	$	132,653		$	9,091		$	10,421		$	197		$	19,709
	Additions	208			300			—			30			330
	Adjustments	610			—			—			—			—
	Amortization	—			—			—			(72		)	(72		)
	Balances at 12-31-12	$	133,471		$	9,391		$	10,421		$	155		$	19,967
	Additions	60,561			28,930			6,270			—			35,200
	Disposals	(1,457		)	—			—			—			—
	Amortization	—			—			—			(92		)	(92		)
	Balances at 12-31-13	$	192,575		$	38,321		$	16,691		$	63		$	55,075
Schedule of the Company's revenues generated from Medicare, state Medicaid programs and other payors	'
		2013		2012		2011
	Medicare	71.3	%	71.7	%	77.1	%
	Medicaid & other government programs:
	Ohio	13.1	%	13.7	%	9	%
	Connecticut	7	%	6.6	%	6.2	%
	Kentucky	2.3	%	2.7	%	2.8	%
	Florida	0.7	%	0.5	%	0.6	%
	Others	0.5	%	0.3	%	0.4	%
	Subtotal	23.6	%	23.8	%	19	%
	All other payors	5.1	%	4.5	%	3.9	%
	Total	100	%	100	%	100	%
Schedule of Concentrations in the Company's accounts receivable	'
		2013					2012
		Amount			Percent		Amount			Percent
	Medicare	$	45,607		56	%	$	34,882		59.1	%
	Medicaid & other government programs:
	Ohio	6,310			7.7	%	6,092			10.3	%
	Connecticut	5,201			6.4	%	6,081			10.3	%
	Kentucky	3,793			4.7	%	2,931			5	%
	Tennessee	4,365			5.4	%	—			0	%
	Others	2,696			2.6	%	1,014			1.8	%
	Subtotal	21,765			26.7	%	16,118			27.4	%
	All other payors	14,115			17.3	%	7,978			13.5	%
	Subtotal	81,487			100	%	58,978			100	%
	Third party payable	(4,250		)			(3,771		)
	Allowances	(15,586		)			(5,236		)
	Total	$	61,651				$	49,971
Schedule of approximate breakdown by payor classification as a percent of total accounts receivable, net of contractual allowances	'
		2013
	Payor	0-90		91-180		181-365		>1 yr.		Total
	Medicare	30	%	12	%	5	%	3	%	50	%
	Medicaid & Government	18	%	4	%	4	%	7	%	33	%
	Self Pay	4	%	1	%	1	%	1	%	7	%
	Insurance	4	%	1	%	2	%	3	%	10	%
	Total	56	%	18	%	12	%	14	%	100	%
		2012
	Payor	0-90		91-180		181-365		>1 yr.		Total
	Medicare	39	%	14	%	5	%	2	%	60	%
	Medicaid & Government	20	%	3	%	2	%	2	%	27	%
	Self Pay	2	%	1	%	0	%	1	%	4	%
	Insurance	4	%	2	%	2	%	1	%	9	%
	Total	65	%	20	%	9	%	6	%	100	%
Schedule of the Company's effective allowances for uncollectible accounts as a percent of accounts receivable	'
		2013
	Payor	0-90		91-180		181-365		>1 yr.		>2 yrs.
	Medicare	0	%	1	%	9	%	100	%	100	%
	Medicaid & Government	2	%	16	%	49	%	92	%	100	%
	Self Pay	5	%	36	%	80	%	87	%	100	%
	Insurance	5	%	22	%	38	%	87	%	100	%
	Total	1	%	8	%	33	%	92	%	100	%
		2012
	Payor	0-90		91-180		181-365		>1 yr.		>2 yrs.
	Medicare	0	%	1	%	9	%	100	%	100	%
	Medicaid & Government	1	%	11	%	31	%	71	%	100	%
	Self Pay	1	%	4	%	34	%	77	%	100	%
	Insurance	6	%	17	%	44	%	79	%	100	%
	Total	1	%	4	%	23	%	82	%	100	%
Schedule of reconciliation of basic to diluted shares used in the earnings per share calculation	'
		2013		2012		2011
	Basic weighted average outstanding shares	9,279		9,285		9,278
	Dilutive effect of outstanding compensation awards	95		39		82
	Diluted weighted average outstanding shares	9,374		9,324		9,360

ACCRUED_LIABILITIES_Tables

ACCRUED LIABILITIES (Tables)	12 Months Ended
	Dec. 31, 2013
ACCRUED LIABILITIES	'
Schedule of components of accrued liabilities	'
		2013		2012
	Wages and employee benefits	$	20,664	$	10,450
	Insurance accruals	11,640		9,700
	Accrued taxes	856		381
	Accrued professional fees and other	5,756		1,343
		$	38,916	$	21,874

PROPERTY_AND_EQUIPMENT_NET_Tab

PROPERTY AND EQUIPMENT, NET (Tables)	12 Months Ended
	Dec. 31, 2013
PROPERTY AND EQUIPMENT, NET	'
Schedule of Property and equipment, net	'
		2013			2012
	Leasehold improvements	$	1,448		$	781
	Medical equipment	1,671			641
	Computer equipment	14,625			8,060
	Internally developed software	1,404			2,689
	Office and other equipment	5,071			3,330
	Vehicles	387			—
		24,606			15,501
	Less accumulated depreciation	(16,464		)	(10,100		)
		$	8,142		$	5,401

INCOME_TAXES_Tables

INCOME TAXES (Tables)	12 Months Ended
	Dec. 31, 2013
INCOME TAXES	'
Schedule of the components of provision for income taxes	'
		2013			2012			2011
	Federal - current	$	3,557		$	6,113		$	7,210
	State and local - current	364			1,181			1,241
	Deferred	2,099			3,753			4,371
		$	6,020		$	11,047		$	12,822
Schedule of reconciliation of the statutory to the effective rate	'
		2013		2012		2011
	Tax provision using statutory rate	35	%	35	%	35	%
	State and local taxes, net of Federal benefit	5.7	%	4.1	%	3.9	%
	Valuation allowance	-0.6	%	-0.6	%	0	%
	Noncontrolling interest related	0.5	%	0	%	0	%
	Other, net	1.3	%	0.7	%	0.6	%
	Tax provision for continuing operations	41.9	%	39.2	%	39.5	%
Schedule of the principal tax carry-forwards and temporary differences	'
		2013			2012
	Deferred tax assets
	Non-deductible reserves and allowances	$	9,520		$	4,331
	Insurance accruals	2,372			2,212
	Net operating loss carryforwards	1,160			1,251
		13,052			7,794
	Valuation allowance	(979		)	(960		)
	Deferred tax assets	12,073			6,834
	Deferred tax liabilities
	Intangibles	(24,509		)	(15,525		)
	Accelerated depreciation	(1,612		)	(1,514		)
	Deferred tax liabilities	(26,121		)	(17,039		)
	Net deferred tax liabilities	$	(14,048	)	$	(10,205	)
	Deferred tax (liabilities) assets are reflected in the accompanying balance sheet as:
	Current assets	11,532			6,580
	Long-term liabilities	(25,580		)	(16,785		)
	Net deferred tax liabilities	$	(14,048	)	$	(10,205	)

STOCKHOLDERS_EQUITY_Tables

STOCKHOLDERS' EQUITY (Tables)	12 Months Ended
	Dec. 31, 2013
STOCKHOLDERS' EQUITY	'
Summary of changes in restricted share and option award outstanding	'
		Restricted shares					Options
		Shares		Wtd. Avg.			Shares		Wtd. Avg.
				Grant Price					Ex. Price
	December 31, 2010	92		$	33.74		314		$	22.39
	Granted	20		36.69			32		36.69
	Vested or Exercised	(35	)	26.81			(38	)	10.86
	Forfeited	(6	)	34.76			(16	)	(28.05		)
	December 31, 2011	71		$	37.85		292		$	25.15
	Granted	29		24.16			63		24.16
	Vested or Exercised	(44	)	37.61			(11	)	6.49
	Forfeited	(6	)	28.55			(3	)	(20.19		)
	December 31, 2012	50		$	31.35		341		$	25.62
	Granted	58		20.29			68		20.71
	Vested or Exercised	(8	)	19.57			(2	)	12.29
	Forfeited	—		—			(24	)	(30.29		)
	December 31, 2013	100		$	24.12		383		$	24.52
Summary of information about stock options	'
		Options Outstanding							Options Exercisable
	Range of	Shares		Wtd. Avg.		Wtd. Avg.			Shares		Wtd. Avg.	Wtd. Avg.
	Exercise			Remaining		Exercise					Remaining	Exercise
	Price			Contractual		Price					Contractual	Price
				Life							Life
	$4.00-20.00	7		0.87		$	4.28		7		0.87	$	4.28
	$20.01-30.00	279		5.75		$	21.01		170		3.79	$	20.5
	Over $30.00	97		5.8		$	35.88		82		5.58	$	35.76
		383		5.68		$	24.52		259		4.28	$	24.89
Schedule of exercisable options and related information	'
		2013			2012			2011
	Exercisable at end of year	259			240			219
	Weighted average price	$	24.89		$	24.33		$	22.21
	Weighted average fair value of options granted during the year	$	9.59		$	10.92		$	18.31
Schedule of unvested options	'
		Shares		Wtd. Avg.
				Ex. Price
	December 31, 2012	101		$	28.69
	Vested	34		31.02
	Granted	68		20.71
	Forfeited	(11	)	(28.40		)
	December 31, 2013	124		$	23.77
Schedule of assumptions used in determining the fair value option awards	'
	Grant date	Equivalent		Equivalent		Implied
		interest rate		volatility		expected
						lives
	March 1, 2013	1.86	%	40	%	8.33

COMMITMENTS_AND_CONTINGENCIES_

COMMITMENTS AND CONTINGENCIES (Tables)	12 Months Ended
	Dec. 31, 2013
COMMITMENTS AND CONTINGENCIES	'
Schedule of minimum rental payments	'
	2014	$	5,845
	2015	3,961
	2016	1,785
	2017	806
	2018	335
	Thereafter	15
	Total	$	12,747

SEGMENT_DATA_Tables

SEGMENT DATA (Tables)	12 Months Ended
	Dec. 31, 2013
SEGMENT DATA	'
Summary of segment data	'
		Year Ended December 31,
		2013			2012			2011
	Net service revenues
	Visiting Nurse	$	275,813		$	265,401		$	275,184
	Personal Care	81,999			77,047			56,257
		$	357,812		$	342,448		$	331,441
	Operating income
	Visiting Nurse	$	30,749		$	39,142		$	43,815
	Personal Care	10,137			10,029			8,682
	Unallocated	(26,343		)	(20,909		)	(19,849		)
		$	14,543		$	28,262		$	32,648
	Identifiable assets
	Visiting Nurse	$	265,699		$	158,823
	Personal Care	57,654			47,860
	Unallocated	28,920			42,576
		$	352,273		$	249,259
	Identifiable liabilities
	Visiting Nurse	$	42,643		$	9,940
	Personal Care	5,026			4,670
	Unallocated	86,911			30,334
		$	134,580		$	44,944
	Capital expenditures
	Visiting Nurse	$	767		$	680		$	759
	Personal Care	267			648			756
	Unallocated	1,471			1,099			1,344
		$	2,505		$	2,427		$	2,859
	Depreciation and amortization
	Visiting Nurse	$	1,027		$	1,004		$	1,311
	Personal Care	202			156			80
	Unallocated	1,634			1,392			1,405
		$	2,863		$	2,552		$	2,796

ACQUISITIONS_Tables

ACQUISITIONS (Tables)	12 Months Ended
	Dec. 31, 2013
ACQUISITIONS	'
Summary of estimated fair values of the assets acquired and liabilities assumed	'
	Accounts Receivable - net	$	16,237
	Property, plant & equipment	2,276
	Other assets	2,933
	Goodwill	44,096
	Other intangibles	33,390
	Assets acquired	98,932
	Liabilities assumed	(22,375		)
	Net assets acquired	$	76,557
Schedule of unaudited proforma result of operations	'
		Twelve months ended December 31,
		2013			2012
	Revenues	$	495,025		$	496,428
	Net income from continuing operations	$	7,230		$	14,074
	Net income	$	7,102		$	14,247
	Earnings per share from continuing operations
	Basic	$	0.78		$	1.52
	Diluted	$	0.76		$	1.53
	Earnings per share
	Basic	$	0.77		$	1.51
	Diluted	$	0.76		$	1.53

QUARTERLY_FINANCIAL_DATA_UNAUD1

QUARTERLY FINANCIAL DATA - (UNAUDITED) (Tables)	12 Months Ended
	Dec. 31, 2013
QUARTERLY FINANCIAL DATA - (UNAUDITED)	'
Summary of quarterly financial data	'
		2013												2012
		Dec. 31			Sept. 30			Jun. 30			Mar. 31			Dec. 31			Sept. 30			Jun. 30		Mar. 31
	Net service revenues	$	96,341		$	88,818		$	86,818		$	85,835		$	85,421		$	83,880		$	85,296	$	87,851
	Gross margin	44,637			41,267			40,470			40,170			40,823			40,077			40,827		43,172
	Income from continuing operations attributable to Almost Family, Inc.	383			2,239			2,584			3,326			3,736			4,147			4,444		4,784
	Discontinued operations	(55		)	(110		)	(61		)	(80		)	(31		)	(48		)	105		147
	Net income attributable to
	Almost Family, Inc.	$	328		$	2,129		$	2,523		$	3,247		$	3,704		$	4,099		$	4,549	$	4,932
	Average shares outstanding
	Basic	9,308			9,302			9,270			9,254			9,280			9,256			9,255		9,268
	Diluted	9,401			9,348			9,348			9,338			9,313			9,315			9,315		9,334
	Net income attributable to Almost Family, Inc. per share
	Basic	$	0.03		$	0.23		$	0.27		$	0.35		$	0.4		$	0.44		$	0.49	$	0.53
	Diluted	$	0.02		$	0.23		$	0.27		$	0.35		$	0.4		$	0.44		$	0.49	$	0.53

SUMMARY_OF_SIGNIFICANT_ACCOUNT3

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details) (SunCrest and its subsidiaries)	0 Months Ended
	Dec. 06, 2013
	item
SunCrest and its subsidiaries	'
Basis of Consolidation and Description Of Business	'
Number of Medicare-certified home health agencies owned and operated	66
Number of private duty agencies owned and operated	9

SUMMARY_OF_SIGNIFICANT_ACCOUNT4

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 2) (USD $)	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013
In Thousands, unless otherwise specified			Medical equipment	Medical equipment	Office equipment	Office equipment	Internally Developed Software	Leasehold improvements	Leasehold improvements
			Minimum	Maximum	Minimum	Maximum		Minimum	Maximum
Cash and Cash Equivalents	'	'	'	'	'	'	'	'	'
Uninsured deposits	$9,449	$24,515	'	'	'	'	'	'	'
Property and equipment	'	'	'	'	'	'	'	'	'
Estimated useful lives	'	'	'2 years	'10 years	'2 years	'10 years	'3 years	'3 years	'10 years

SUMMARY_OF_SIGNIFICANT_ACCOUNT5

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 3) (USD $)

12 Months Ended

12 Months Ended

12 Months Ended

12 Months Ended

In Thousands, unless otherwise specified

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2011

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

item

VN segment

VN segment

PC segment

PC segment

Non-compete Agreements

Non-compete Agreements

Non-compete Agreements

Non-compete Agreements

Non-compete Agreements

Non-compete Agreements

Certificates of Need and Licenses

Certificates of Need and Licenses

Certificates of Need and Licenses

Certificates of Need and Licenses

Certificates of Need and Licenses

Certificates of Need and Licenses

Trade Names

Trade Names

Trade Names

Trade Names

Trade Names

Trade Names

VN segment

VN segment

PC segment

PC segment

VN segment

VN segment

PC segment

PC segment

VN segment

VN segment

PC segment

PC segment

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Impairment loss on goodwill and other intangible assets

$0

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Activity related to goodwill and other intangible assets

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Estimated useful life

'

'

'

'

'

'

'3 years

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Goodwill

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Balance at the beginning of the period

132,014

132,653

155,004

102,497

37,571

30,447

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Additions

60,561

208

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Disposals

-1,457

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Adjustments

'

610

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Balance at the end of the period

192,575

132,014

155,004

102,497

37,571

30,447

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Other Intangible Assets

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Balance at the beginning of the period

19,967

19,709

'

'

'

'

155

197

13

8

50

163

9,391

9,091

37,541

8,781

780

610

10,421

10,421

13,311

7,701

3,380

2,720

Additions

35,200

330

'

'

'

'

'

30

'

'

'

'

28,930

300

'

'

'

'

6,270

'

'

'

'

'

Amortization

-92

-72

'

'

'

'

-92

-72

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Balance at the end of the period

$55,075

$19,967

'

'

'

'

$63

$155

$13

$8

$50

$163

$38,321

$9,391

$37,541

$8,781

$780

$610

$16,691

$10,421

$13,311

$7,701

$3,380

$2,720

Number of acquisitions completed

'

2

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

SUMMARY_OF_SIGNIFICANT_ACCOUNT6

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 4) (Internally developed software, USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2010
Internally developed software	'	'	'
Capitalized software development costs	'	'	'
Software development costs capitalized	$647	$968	$535

SUMMARY_OF_SIGNIFICANT_ACCOUNT7

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 5) (USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified
Large-deductible workers' compensation insurance program | Maximum	'
Insurance Programs	'
Insurance program, Company's risk per incident	$250
Self-insured employee health program	'
Insurance Programs	'
Insurance program, Company's risk per individual covered life	300
Professional liability	'
Insurance Programs	'
Insurance program, Company's risk per claim	0
General liability	'
Insurance Programs	'
Insurance program, Company's risk per claim	0
D&O coverage | Minimum	'
Insurance Programs	'
Insurance program, Company's risk per claim	100
D&O coverage | Maximum	'
Insurance Programs	'
Insurance program, Company's risk per claim	$250

SUMMARY_OF_SIGNIFICANT_ACCOUNT8

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 6) (VN segment, Florida)	Dec. 31, 2013
VN segment | Florida	'
Seasonality	'
Segment revenues (as a percent)	41.00%

SUMMARY_OF_SIGNIFICANT_ACCOUNT9

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 7) (Medicare payment program, USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Net service revenues	'	'	'
Net service revenues (as a percent)	71.00%	'	'
Period of episode payment rate	'60 days	'	'
Outlier payments (as a percent)	10.00%	'	'
Percentage of reduction for sequestration	2.00%	'	'
Decrease in revenues due to changes in estimates related to prior periods	$114	$75	$215
Minimum	'	'	'
Net service revenues	'	'	'
Number of therapy service visits, level one threshold	6	'	'
Number of therapy service visits, level two threshold	14	'	'
Number of therapy service visits, level three threshold	20	'	'
Maximum	'	'	'
Net service revenues	'	'	'
Number of visits for avoiding low utilization payment adjustment	5	'	'

Recovered_Sheet1

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 8) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Concentrations	'	'	'
Concentrations amount, gross	81,487	58,978	'
Third party payable	-4,250	-3,771	'
Allowances	-15,586	-5,236	'
Total	61,651	49,971	'
Revenue | Revenue concentration	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	100.00%	100.00%	100.00%
Revenue | Revenue concentration | Medicare	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	71.30%	71.70%	77.10%
Revenue | Revenue concentration | Medicaid and other government programs	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	23.60%	23.80%	19.00%
Revenue | Revenue concentration | Medicaid and other government programs | Ohio	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	13.10%	13.70%	9.00%
Revenue | Revenue concentration | Medicaid and other government programs | Connecticut	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	7.00%	6.60%	6.20%
Revenue | Revenue concentration | Medicaid and other government programs | Kentucky	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	2.30%	2.70%	2.80%
Revenue | Revenue concentration | Medicaid and other government programs | Florida	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	0.70%	0.50%	0.60%
Revenue | Revenue concentration | Medicaid and other government programs | Others	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	0.50%	0.30%	0.40%
Revenue | Revenue concentration | All other payors	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	5.10%	4.50%	3.90%
Accounts receivable | Revenue concentration | Medicare	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	56.00%	59.10%	'
Concentrations amount, gross	45,607	34,882	'
Accounts receivable | Receivable concentration	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	100.00%	100.00%	'
Accounts receivable | Receivable concentration | Medicaid and other government programs	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	26.70%	27.40%	'
Concentrations amount, gross	21,765	16,118	'
Accounts receivable | Receivable concentration | Medicaid and other government programs | Ohio	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	7.70%	10.30%	'
Concentrations amount, gross	6,310	6,092	'
Accounts receivable | Receivable concentration | Medicaid and other government programs | Connecticut	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	6.40%	10.30%	'
Concentrations amount, gross	5,201	6,081	'
Accounts receivable | Receivable concentration | Medicaid and other government programs | Kentucky	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	4.70%	5.00%	'
Concentrations amount, gross	3,793	2,931	'
Accounts receivable | Receivable concentration | Medicaid and other government programs | Tennessee	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	5.40%	0.00%	'
Concentrations amount, gross	4,365	'	'
Accounts receivable | Receivable concentration | Medicaid and other government programs | Others	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	2.60%	1.80%	'
Concentrations amount, gross	2,696	1,014	'
Accounts receivable | Receivable concentration | All other payors	'	'	'
Concentrations	'	'	'
Concentrations (as a percent)	17.30%	13.50%	'
Concentrations amount, gross	14,115	7,978	'

Recovered_Sheet2

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 9) (Accounts receivable net of contractual allowances, Receivable concentration)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Concentrations	'	'
Concentrations (as a percent)	100.00%	100.00%
0-90	'	'
Concentrations	'	'
Concentrations (as a percent)	56.00%	65.00%
91-180	'	'
Concentrations	'	'
Concentrations (as a percent)	18.00%	20.00%
181-365	'	'
Concentrations	'	'
Concentrations (as a percent)	12.00%	9.00%
>1 yr.	'	'
Concentrations	'	'
Concentrations (as a percent)	14.00%	6.00%
Medicare	'	'
Concentrations	'	'
Concentrations (as a percent)	50.00%	60.00%
Medicare | 0-90	'	'
Concentrations	'	'
Concentrations (as a percent)	30.00%	39.00%
Medicare | 91-180	'	'
Concentrations	'	'
Concentrations (as a percent)	12.00%	14.00%
Medicare | 181-365	'	'
Concentrations	'	'
Concentrations (as a percent)	5.00%	5.00%
Medicare | >1 yr.	'	'
Concentrations	'	'
Concentrations (as a percent)	3.00%	2.00%
Medicaid and other government programs	'	'
Concentrations	'	'
Concentrations (as a percent)	33.00%	27.00%
Medicaid and other government programs | 0-90	'	'
Concentrations	'	'
Concentrations (as a percent)	18.00%	20.00%
Medicaid and other government programs | 91-180	'	'
Concentrations	'	'
Concentrations (as a percent)	4.00%	3.00%
Medicaid and other government programs | 181-365	'	'
Concentrations	'	'
Concentrations (as a percent)	4.00%	2.00%
Medicaid and other government programs | >1 yr.	'	'
Concentrations	'	'
Concentrations (as a percent)	7.00%	2.00%
Self Pay	'	'
Concentrations	'	'
Concentrations (as a percent)	7.00%	4.00%
Self Pay | 0-90	'	'
Concentrations	'	'
Concentrations (as a percent)	4.00%	2.00%
Self Pay | 91-180	'	'
Concentrations	'	'
Concentrations (as a percent)	1.00%	1.00%
Self Pay | 181-365	'	'
Concentrations	'	'
Concentrations (as a percent)	1.00%	0.00%
Self Pay | >1 yr.	'	'
Concentrations	'	'
Concentrations (as a percent)	1.00%	1.00%
Insurance	'	'
Concentrations	'	'
Concentrations (as a percent)	10.00%	9.00%
Insurance | 0-90	'	'
Concentrations	'	'
Concentrations (as a percent)	4.00%	4.00%
Insurance | 91-180	'	'
Concentrations	'	'
Concentrations (as a percent)	1.00%	2.00%
Insurance | 181-365	'	'
Concentrations	'	'
Concentrations (as a percent)	2.00%	2.00%
Insurance | >1 yr.	'	'
Concentrations	'	'
Concentrations (as a percent)	3.00%	1.00%

Recovered_Sheet3

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 10) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts	15,586	5,236
0-90	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	1.00%	1.00%
91-180	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	8.00%	4.00%
181-365	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	33.00%	23.00%
>1 yr.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	92.00%	82.00%
>2 yrs.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	100.00%	100.00%
Medicare | 0-90	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	0.00%	0.00%
Medicare | 91-180	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	1.00%	1.00%
Medicare | 181-365	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	9.00%	9.00%
Medicare | >1 yr.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	100.00%	100.00%
Medicare | >2 yrs.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	100.00%	100.00%
Medicaid and other government programs | 0-90	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	2.00%	1.00%
Medicaid and other government programs | 91-180	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	16.00%	11.00%
Medicaid and other government programs | 181-365	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	49.00%	31.00%
Medicaid and other government programs | >1 yr.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	92.00%	71.00%
Medicaid and other government programs | >2 yrs.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	100.00%	100.00%
Self Pay | 0-90	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	5.00%	1.00%
Self Pay | 91-180	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	36.00%	4.00%
Self Pay | 181-365	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	80.00%	34.00%
Self Pay | >1 yr.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	87.00%	77.00%
Self Pay | >2 yrs.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	100.00%	100.00%
Insurance | 0-90	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	5.00%	6.00%
Insurance | 91-180	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	22.00%	17.00%
Insurance | 181-365	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	38.00%	44.00%
Insurance | >1 yr.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	87.00%	79.00%
Insurance | >2 yrs.	'	'
Allowance for uncollectible accounts disclosures	'	'
Allowance for uncollectible accounts as percentage of accounts receivable	100.00%	100.00%

Recovered_Sheet4

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details 11) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Contingent service revenues	'	'	'	'	'	'	'	'	'	'	'
MSSP revenue	'	'	'	'	'	'	'	'	$0	'	'
Net Income per Share	'	'	'	'	'	'	'	'	'	'	'
Basic weighted average outstanding shares	9,308	9,302	9,270	9,254	9,280	9,256	9,255	9,268	9,279	9,285	9,278
Dilutive effect of outstanding compensation awards (in shares)	'	'	'	'	'	'	'	'	95	39	82
Diluted weighted average number of shares	9,401	9,348	9,348	9,338	9,313	9,315	9,315	9,334	9,374	9,324	9,360
Stock options excluded from computation of diluted EPS (in shares)	'	'	'	'	'	'	'	'	195	218	125
Advertising Costs	'	'	'	'	'	'	'	'	'	'	'
Advertising expense	'	'	'	'	'	'	'	'	$325	$316	$370

ACCRUED_LIABILITIES_Details

ACCRUED LIABILITIES (Details) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
ACCRUED LIABILITIES	'	'
Wages and employee benefits	$20,664	$10,450
Insurance accruals	11,640	9,700
Accrued taxes	856	381
Accrued professional fees and other	5,756	1,343
Total accrued liabilities	$38,916	$21,874

PROPERTY_AND_EQUIPMENT_NET_Det

PROPERTY AND EQUIPMENT, NET (Details) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Property and equipment	'	'	'
Property and equipment, gross	$24,606	$15,501	'
Less accumulated depreciation	-16,464	-10,100	'
Property and equipment, net	8,142	5,401	'
Depreciation and amortization	2,611	2,315	2,522
Leasehold improvements	'	'	'
Property and equipment	'	'	'
Property and equipment, gross	1,448	781	'
Medical equipment	'	'	'
Property and equipment	'	'	'
Property and equipment, gross	1,671	641	'
Computer equipment	'	'	'
Property and equipment	'	'	'
Property and equipment, gross	14,625	8,060	'
Internally developed software	'	'	'
Property and equipment	'	'	'
Property and equipment, gross	1,404	2,689	'
Office and other equipment	'	'	'
Property and equipment	'	'	'
Property and equipment, gross	5,071	3,330	'
Vehicles	'	'	'
Property and equipment	'	'	'
Property and equipment, gross	$387	'	'

REVOLVING_CREDIT_FACILITY_Deta

REVOLVING CREDIT FACILITY (Details) (USD $)

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Dec. 31, 2010

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2013

Revolving Credit Facility

Revolving Credit Facility

Revolving Credit Facility

Revolving Credit Facility

Revolving Credit Facility

Revolving Credit Facility

Revolving Credit Facility

Revolving Credit Facility

Revolving Credit Facility

Revolving Credit Facility

Revolving Credit Facility

multiplier

Minimum

Maximum

Prime rate

Prime rate

Prime rate

Prime rate

LIBOR

LIBOR

LIBOR

LIBOR

Minimum

Maximum

Minimum

Maximum

Revolving credit facility

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Revolving credit limit

'

'

'

'

$125,000,000

'

'

'

'

'

'

'

'

'

'

Potential future expansion of the Facility under accordion feature

'

'

'

'

175,000,000

'

'

'

'

'

'

'

'

'

'

Variable rate basis

'

'

'

'

'

'

'

'Bank's prime rate plus a margin

'

'

'

'LIBOR plus a margin

'

'

'

Interest rate margin per debt instrument (as a percent)

'

'

'

'

'

'

'

'

'

1.25%

2.25%

'

'

2.25%

3.25%

Actual interest rate margin (as a percent)

'

'

'

'

'

'

'

1.25%

'

'

'

2.25%

'

'

'

Weighted average interest rate (as a percent)

'

'

'

'

'

'

'

4.50%

4.50%

'

'

2.52%

2.68%

'

'

Quarterly commitment fee on the average daily unused facility balance (as a percent)

'

'

'

'

'

0.30%

0.50%

'

'

'

'

'

'

'

'

EBITDA multiplier

'

'

'

'

3

'

'

'

'

'

'

'

'

'

'

Percentage of acquired EBITDA which can be included in covenants calculation

'

'

'

'

'

'

50.00%

'

'

'

'

'

'

'

'

Borrowing capacity permitted to be used per formula

'

'

'

'

25,200,000

'

'

'

'

'

'

'

'

'

'

Irrevocable letters of credit outstanding

'

'

'

'

7,100,000

'

'

'

'

'

'

'

'

'

'

Remaining borrowing capacity available for use

'

'

'

'

18,100,000

'

'

'

'

'

'

'

'

'

'

Minimum net worth required to be maintained

'

'

'

'

160,600,000

'

'

'

'

'

'

'

'

'

'

Company's net worth

$214,054,000

$204,315,000

$206,297,000

$182,168,000

'

'

'

'

'

'

'

'

'

'

'

INCOME_TAXES_Details

INCOME TAXES (Details) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Provision for income taxes	'	'	'
Federal - current	$3,557,000	$6,113,000	$7,210,000
State and local - current	364,000	1,181,000	1,241,000
Deferred	2,099,000	3,753,000	4,371,000
Total	6,020,000	11,047,000	12,822,000
Reconciliation of the statutory to the effective rate	'	'	'
Tax provision using statutory rate (as a percent)	35.00%	35.00%	35.00%
State and local taxes, net of Federal benefit (as a percent)	5.70%	4.10%	3.90%
Valuation allowance (as a percent)	-0.60%	-0.60%	0.00%
Noncontrolling interest related (as a percent)	0.50%	0.00%	0.00%
Other, net (as a percent)	1.30%	0.70%	0.60%
Tax provision for continuing operations (as a percent)	41.90%	39.20%	39.50%
Increase in valuation allowance due to a change in expected realizability of deferred tax assets for states operating loss carry-forwards	19,000	'	'
Deferred tax assets	'	'	'
Non-deductible reserves and allowances	9,520,000	4,331,000	'
Insurance accruals	2,372,000	2,212,000	'
Net operating loss carryforwards	1,160,000	1,251,000	'
Deferred tax assets, gross	13,052,000	7,794,000	'
Valuation allowance	-979,000	-960,000	'
Deferred tax assets	12,073,000	6,834,000	'
Deferred tax liabilities	'	'	'
Intangibles	-24,509,000	-15,525,000	'
Accelerated depreciation	-1,612,000	-1,514,000	'
Deferred tax liabilities	-26,121,000	-17,039,000	'
Net deferred tax liabilities	-14,048,000	-10,205,000	'
Deferred tax (liabilities) assets are reflected in the accompanying balance sheet as:	'	'	'
Deferred tax assets classified as current assets	11,532,000	6,580,000	'
Deferred tax liabilities classified as long-term liabilities	-25,580,000	-16,785,000	'
Net deferred tax liabilities	-14,048,000	-10,205,000	'
Book value of goodwill not deductible for tax purposes	109,000,000	57,500,000	'
State	'	'	'
Operating loss carry-forwards	'	'	'
Net operating loss carry-forwards	22,800,000	'	'
Valuation allowance	$19,000,000	'	'

STOCKHOLDERS_EQUITY_Details

STOCKHOLDERS' EQUITY (Details) (USD $)	0 Months Ended	12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Mar. 01, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Options Outstanding	'	'	'	'
Shares	'	383	'	'
Wtd. Avg. Remaining Contractual Life	'	'5 years 8 months 5 days	'	'
Wtd. Avg. Exercise Price (in dollars per share)	'	$24.52	'	'
Options Exercisable	'	'	'	'
Shares	'	259	'	'
Wtd. Avg. Remaining Contractual Life	'	'4 years 3 months 11 days	'	'
Wtd. Avg. Exercise Price (in dollars per share)	'	$24.89	'	'
Additional information	'	'	'	'
Unrecognized compensation cost	'	$1,878	'	'
Weighted-average recognition period	'	'2 years 8 months 26 days	'	'
Range of exercise price per share from $4.00 to $20.00	'	'	'	'
Changes in awards, Wtd Avg Grant Price	'	'	'	'
Exercise price, low end of range (in dollars per share)	'	$4	'	'
Exercise price, high end of range (in dollars per share)	'	$20	'	'
Options Outstanding	'	'	'	'
Shares	'	7	'	'
Wtd. Avg. Remaining Contractual Life	'	'10 months 13 days	'	'
Wtd. Avg. Exercise Price (in dollars per share)	'	$4.28	'	'
Options Exercisable	'	'	'	'
Shares	'	7	'	'
Wtd. Avg. Remaining Contractual Life	'	'10 months 13 days	'	'
Wtd. Avg. Exercise Price (in dollars per share)	'	$4.28	'	'
Range of exercise price per share from $20.01 to $30.00	'	'	'	'
Changes in awards, Wtd Avg Grant Price	'	'	'	'
Exercise price, low end of range (in dollars per share)	'	$20.01	'	'
Exercise price, high end of range (in dollars per share)	'	$30	'	'
Options Outstanding	'	'	'	'
Shares	'	279	'	'
Wtd. Avg. Remaining Contractual Life	'	'5 years 9 months	'	'
Wtd. Avg. Exercise Price (in dollars per share)	'	$21.01	'	'
Options Exercisable	'	'	'	'
Shares	'	170	'	'
Wtd. Avg. Remaining Contractual Life	'	'3 years 9 months 14 days	'	'
Wtd. Avg. Exercise Price (in dollars per share)	'	$20.50	'	'
Range of exercise price per share over $30.00	'	'	'	'
Changes in awards, Wtd Avg Grant Price	'	'	'	'
Exercise price, low end of range (in dollars per share)	'	$30	'	'
Options Outstanding	'	'	'	'
Shares	'	97	'	'
Wtd. Avg. Remaining Contractual Life	'	'5 years 9 months 18 days	'	'
Wtd. Avg. Exercise Price (in dollars per share)	'	$35.88	'	'
Options Exercisable	'	'	'	'
Shares	'	82	'	'
Wtd. Avg. Remaining Contractual Life	'	'5 years 6 months 29 days	'	'
Wtd. Avg. Exercise Price (in dollars per share)	'	$35.76	'	'
2000 Employee Stock Option Plan	'	'	'	'
Stock-based compensation	'	'	'	'
Shares available for future grant	'	0	'	'
2007 Stock and Incentive Compensation Plan	'	'	'	'
Stock-based compensation	'	'	'	'
Shares available for future grant	'	0	'	'
2013 Stock and Incentive Compensation Plan	'	'	'	'
Stock-based compensation	'	'	'	'
Shares available for future grant	'	666	'	'
Restricted shares	'	'	'	'
Changes in unvested awards, shares	'	'	'	'
Balance at the beginning of the period (in shares)	'	50	71	92
Granted (in shares)	'	58	29	20
Vested or Exercised (in shares)	'	-8	-44	-35
Forfeited (in shares)	'	'	-6	-6
Balance at the end of the period (in shares)	'	100	50	71
Changes in awards, Wtd Avg Grant Price	'	'	'	'
Balance at the beginning of the period (in dollars per share)	'	$31.35	$37.85	$33.74
Granted (in dollars per share)	'	$20.29	$24.16	$36.69
Vested or Exercised (in dollars per share)	'	$19.57	$37.61	$26.81
Forfeited (in dollars per share)	'	'	$28.55	$34.76
Balance at the end of the period (in dollars per share)	'	$24.12	$31.35	$37.85
Restricted shares | 2007 Stock and Incentive Compensation Plan	'	'	'	'
Stock-based compensation	'	'	'	'
Number of shares of common stock that can be purchased	'	200	'	'
Number of anniversaries	'	'3 years	'	'
Number of shares awarded	'	162	'	'
Restricted shares | 2013 Stock and Incentive Compensation Plan	'	'	'	'
Stock-based compensation	'	'	'	'
Number of shares of common stock that can be purchased	'	200	'	'
Number of anniversaries	'	'3 years	'	'
Number of shares awarded	'	25	'	'
Option award	'	'	'	'
Stock-based compensation	'	'	'	'
Term of options	'	'10 years	'	'
Changes in option awards outstanding, Shares	'	'	'	'
Balance at the beginning of the period (in shares)	'	341	292	314
Granted (in shares)	'	68	63	32
Vested or Exercised (in shares)	'	-2	-11	-38
Forfeited (in shares)	'	-24	-3	-16
Balance at the end of the period (in shares)	'	383	341	292
Changes in option awards, Wtd Avg Ex. Price	'	'	'	'
Balance at the beginning of the period (in dollars per share)	'	$25.62	$25.15	$22.39
Granted (in dollars per share)	'	$20.71	$24.16	$36.69
Vested or Exercised (in dollars per share)	'	$12.29	$6.49	$10.86
Forfeited (in dollars per share)	'	($30.29)	($20.19)	($28.05)
Balance at the end of the period (in dollars per share)	'	$24.52	$25.62	$25.15
Exercisable options and related information	'	'	'	'
Exercisable at end of year (in shares)	'	259	240	219
Weighted average price (in dollars per share)	'	$24.89	$24.33	$22.21
Weighted average fair value of options granted during the year (in dollars per share)	'	$9.59	$10.92	$18.31
Changes in unvested options, Shares	'	'	'	'
Balance at the beginning of the period (in shares)	'	101	'	'
Vested (in shares)	'	34	'	'
Granted (in shares)	'	68	63	32
Forfeited (in shares)	'	-11	'	'
Balance at the end of the period (in shares)	'	124	101	'
Changes in unvested options, Wtd Avg Ex. Price	'	'	'	'
Balance at the beginning of the period (in dollars per share)	'	$28.69	'	'
Vested (in dollars per share)	'	$31.02	'	'
Granted (in dollars per share)	'	$20.71	$24.16	$36.69
Forfeited (in dollars per share)	'	($28.40)	'	'
Balance at the end of the period (in dollars per share)	'	$23.77	$28.69	'
Assumptions used in determining the fair value option awards	'	'	'	'
Equivalent interest rate (as a percent)	1.86%	'	'	'
Equivalent volatility (as a percent)	40.00%	'	'	'
Implied expected lives	'8 years 3 months 29 days	'	'	'
Additional information	'	'	'	'
Total fair value of option shares vested	'	$363	$371	'
Option award | 2000 Employee Stock Option Plan	'	'	'	'
Stock-based compensation	'	'	'	'
Number of shares of common stock that can be purchased	'	1,000	'	'
Term of options	'	'10 years	'	'
Changes in option awards outstanding, Shares	'	'	'	'
Balance at the end of the period (in shares)	'	121	'	'
Option award | 2007 Stock and Incentive Compensation Plan	'	'	'	'
Stock-based compensation	'	'	'	'
Number of shares of common stock that can be purchased	'	500	'	'
Term of options	'	'10 years	'	'
Option share awards vest annually in increments (as a percent)	'	25.00%	'	'
Vesting period	'	'4 years	'	'
Changes in option awards outstanding, Shares	'	'	'	'
Balance at the end of the period (in shares)	'	254	'	'
Option award | 2013 Stock and Incentive Compensation Plan	'	'	'	'
Stock-based compensation	'	'	'	'
Number of shares of common stock that can be purchased	'	700	'	'
Term of options	'	'10 years	'	'
Option share awards vest annually in increments (as a percent)	'	25.00%	'	'
Vesting period	'	'4 years	'	'
Changes in option awards outstanding, Shares	'	'	'	'
Balance at the end of the period (in shares)	'	9	'	'

STOCKHOLDERS_EQUITY_Details_2

STOCKHOLDERS' EQUITY (Details 2) (USD $)	12 Months Ended
In Millions, except Share data in Thousands, unless otherwise specified	Dec. 31, 2012	Dec. 31, 2013
		Employee stock purchase plan
Employee Stock Purchase Plan	'	'
Number of shares of common stock authorized for issuance	'	300
Number of shares of common stock available	'	300
Directors Deferred Compensation Plan	'	'
Number of shares redeemed	72	'
Share redemption amount	$1.70	'

RETIREMENT_PLAN_Details

RETIREMENT PLAN (Details) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
RETIREMENT PLAN	'	'	'
Employer matching contribution (as a percent)	25.00%	'	'
Voluntary contribution by participating employee (as a percent)	5.00%	'	'
Requisite service period for eligibility of employer matching contribution	'1 year	'	'
Retirement plan expense	$550	$509	$472

COMMITMENTS_AND_CONTINGENCIES_1

COMMITMENTS AND CONTINGENCIES (Details) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Operating Leases	'	'	'
Rent expense	$8,592	$8,656	$7,703
Minimum rental payments	'	'	'
2014	5,845	'	'
2015	3,961	'	'
2016	1,785	'	'
2017	806	'	'
2018	335	'	'
Thereafter	15	'	'
Total	$12,747	'	'

COMMITMENTS_AND_CONTINGENCIES_2

COMMITMENTS AND CONTINGENCIES (Details 2)	0 Months Ended	12 Months Ended
	Nov. 01, 2012	Dec. 31, 2013
	item	Derivative complaints
		claim
Legal Proceedings & Investigations	'	'
Number of lawsuits consolidated into a single action	'	4
Number of derivative plaintiff shareholders for whom a demand letter is received	1	'

SEGMENT_DATA_Details

SEGMENT DATA (Details) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
									segment
SEGMENT DATA	'	'	'	'	'	'	'	'	'	'	'
Number of reportable segments	'	'	'	'	'	'	'	'	2	'	'
Segment data	'	'	'	'	'	'	'	'	'	'	'
Net service revenues	$96,341	$88,818	$86,818	$85,835	$85,421	$83,880	$85,296	$87,851	$357,812	$342,448	$331,440
Operating income	'	'	'	'	'	'	'	'	14,543	28,262	32,648
Identifiable assets	352,273	'	'	'	249,259	'	'	'	352,273	249,259	'
Identifiable liabilities	134,580	'	'	'	44,944	'	'	'	134,580	44,944	'
Capital expenditures	'	'	'	'	'	'	'	'	2,505	2,427	2,859
Depreciation and amortization	'	'	'	'	'	'	'	'	2,863	2,552	2,796
Medicare program	'	'	'	'	'	'	'	'	'	'	'
Segment data	'	'	'	'	'	'	'	'	'	'	'
Segment revenues (as a percent)	71.00%	'	'	'	'	'	'	'	71.00%	'	'
Visiting Nurse	'	'	'	'	'	'	'	'	'	'	'
Segment data	'	'	'	'	'	'	'	'	'	'	'
Net service revenues	'	'	'	'	'	'	'	'	275,813	265,401	275,184
Operating income	'	'	'	'	'	'	'	'	30,749	39,142	43,815
Identifiable assets	265,699	'	'	'	158,823	'	'	'	265,699	158,823	'
Identifiable liabilities	42,643	'	'	'	9,940	'	'	'	42,643	9,940	'
Capital expenditures	'	'	'	'	'	'	'	'	767	680	759
Depreciation and amortization	'	'	'	'	'	'	'	'	1,027	1,004	1,311
Visiting Nurse | Medicare program	'	'	'	'	'	'	'	'	'	'	'
Segment data	'	'	'	'	'	'	'	'	'	'	'
Segment revenues (as a percent)	93.00%	'	'	'	'	'	'	'	93.00%	'	'
Personal Care	'	'	'	'	'	'	'	'	'	'	'
Segment data	'	'	'	'	'	'	'	'	'	'	'
Net service revenues	'	'	'	'	'	'	'	'	81,999	77,047	56,257
Operating income	'	'	'	'	'	'	'	'	10,137	10,029	8,682
Identifiable assets	57,654	'	'	'	47,860	'	'	'	57,654	47,860	'
Identifiable liabilities	5,026	'	'	'	4,670	'	'	'	5,026	4,670	'
Capital expenditures	'	'	'	'	'	'	'	'	267	648	756
Depreciation and amortization	'	'	'	'	'	'	'	'	202	156	80
Personal Care | Medicaid and other government programs	'	'	'	'	'	'	'	'	'	'	'
Segment data	'	'	'	'	'	'	'	'	'	'	'
Segment revenues (as a percent)	86.00%	'	'	'	'	'	'	'	86.00%	'	'
Unallocated	'	'	'	'	'	'	'	'	'	'	'
Segment data	'	'	'	'	'	'	'	'	'	'	'
Operating income	'	'	'	'	'	'	'	'	-26,343	-20,909	-19,849
Identifiable assets	28,920	'	'	'	42,576	'	'	'	28,920	42,576	'
Identifiable liabilities	86,911	'	'	'	30,334	'	'	'	86,911	30,334	'
Capital expenditures	'	'	'	'	'	'	'	'	1,471	1,099	1,344
Depreciation and amortization	'	'	'	'	'	'	'	'	$1,634	$1,392	$1,405

DISCONTINUED_OPERATIONS_Detail

DISCONTINUED OPERATIONS (Details) (Visiting Nurse, Alabama locations)	3 Months Ended
	Jun. 30, 2013
	item
Visiting Nurse | Alabama locations	'
DISCONTINUED OPERATIONS	'
Numbers of locations sold	2

ACQUISITIONS_Details

ACQUISITIONS (Details) (USD $)

12 Months Ended

0 Months Ended

12 Months Ended

0 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Dec. 06, 2013

Dec. 31, 2013

Dec. 31, 2012

Oct. 04, 2013

Jul. 17, 2013

Aug. 05, 2011

Aug. 05, 2011

Aug. 05, 2011

Apr. 02, 2011

item

SunCrest and its subsidiaries

SunCrest and its subsidiaries

SunCrest and its subsidiaries

Imperium

IHCN

Cambridge

Cambridge

Cambridge

Medicare-certified home health agency in Cincinnati, Ohio

item

item

item

Ohio

Western Pennsylvania

item

item

ACQUISITIONS

'

'

'

'

'

'

'

'

'

'

'

'

Amortization period for tax purposes of the intangible assets including goodwill generated in asset purchase transactions

'15 years

'

'

'

'

'

'

'

'

'

'

'

Acquisitions

'

'

'

'

'

'

'

'

'

'

'

'

Number of medicare-certified home health agencies owned and operated

'

'

'

66

'

'

'

6

'

'

'

'

Number of private duty agencies owned and operated

'

'

'

9

'

'

'

'

'

'

'

'

Purchase price

'

'

'

$76,600,000

'

'

$5,800,000

$12,500,000

'

'

'

$5,300,000

Acquired working capital

'

'

'

'

'

'

3,000,000

'

'

'

'

'

Noncontrolling interest percentage

'

'

'

'

'

'

38.50%

'

'

'

'

'

Cash consideration

'

'

'

75,100,000

'

'

'

'

32,800,000

'

'

'

Unpaid consideration

'

'

'

'

1,500,000

'

'

'

'

'

'

'

Note payable

'

'

'

1,500,000

'

'

'

'

'

'

'

1,000,000

Net of acquired cash balances

88,465,000

536,000

38,064,000

2,200,000

'

'

'

'

'

'

'

'

Estimated fair values of the assets acquired and liabilities assumed

'

'

'

'

'

'

'

'

'

'

'

'

Accounts Receivable - net

'

'

'

16,237,000

'

'

'

'

'

'

'

'

Property, plant & equipment

'

'

'

2,276,000

'

'

'

'

'

'

'

'

Other assets

'

'

'

2,933,000

'

'

'

'

'

'

'

'

Goodwill

192,575,000

132,014,000

132,653,000

44,096,000

'

'

'

9,900,000

'

'

'

'

Other intangibles

'

'

'

33,390,000

'

'

'

1,800,000

'

'

'

'

Assets acquired

'

'

'

98,932,000

'

'

'

'

'

'

'

'

Liabilities assumed

'

'

'

-22,375,000

'

'

'

'

'

'

'

'

Net assets acquired

'

'

'

76,557,000

'

'

'

'

'

'

'

'

Annual tax deductible amount of goodwill and intangibles acquired

'

'

'

2,800,000

'

'

'

'

'

'

'

'

Unaudited proforma result of operations

'

'

'

'

'

'

'

'

'

'

'

'

Revenues

'

'

'

'

495,025,000

496,428,000

'

'

'

'

'

'

Net income from continuing operations

'

'

'

'

7,230,000

14,074,000

'

'

'

'

'

'

Net income

'

'

'

'

7,102,000

14,247,000

'

'

'

'

'

'

Interest acquired (as a percent)

'

'

'

'

'

'

61.50%

'

100.00%

'

'

'

Common stock issued

'

'

'

'

'

'

'

500,000

'

'

'

'

Number of acquisitions

'

2

'

'

'

'

'

'

'

'

'

'

Number of home health branches owned and operated

'

'

'

'

'

'

'

'

37

34

3

'

Tax deductible goodwill and identified intangibles

'

'

'

'

'

'

'

'

4,000,000

'

'

'

Annual revenues

'

'

'

'

'

'

'

'

'

'

'

$5,000,000

Earnings per share from continuing operations

'

'

'

'

'

'

'

'

'

'

'

'

Basic (in dollars per share)

'

'

'

'

$0.78

$1.52

'

'

'

'

'

'

Diluted (in dollars per share)

'

'

'

'

$0.76

$1.53

'

'

'

'

'

'

Earnings per share

'

'

'

'

'

'

'

'

'

'

'

'

Basic (in dollars per share)

'

'

'

'

$0.77

$1.51

'

'

'

'

'

'

Diluted (in dollars per share)

'

'

'

'

$0.76

$1.53

'

'

'

'

'

'

QUARTERLY_FINANCIAL_DATA_UNAUD2

QUARTERLY FINANCIAL DATA - (UNAUDITED) (Details) (USD $)	3 Months Ended								12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
QUARTERLY FINANCIAL DATA - (UNAUDITED)	'	'	'	'	'	'	'	'	'	'	'
Net service revenues	$96,341	$88,818	$86,818	$85,835	$85,421	$83,880	$85,296	$87,851	$357,812	$342,448	$331,440
Gross margin	44,637	41,267	40,470	40,170	40,823	40,077	40,827	43,172	166,544	164,899	168,312
Income from continuing operations attributable to Almost Family, Inc.	383	2,239	2,584	3,326	3,736	4,147	4,444	4,784	8,048	17,284	20,802
Discontinued operations	-55	-110	-61	-80	-31	-48	105	147	-306	173	1,156
Net income attributable to Almost Family, Inc.	$328	$2,129	$2,523	$3,247	$3,704	$4,099	$4,549	$4,932	$8,226	$17,284	$20,802
Average shares outstanding	'	'	'	'	'	'	'	'	'	'	'
Basic (in shares)	9,308	9,302	9,270	9,254	9,280	9,256	9,255	9,268	9,279	9,285	9,278
Diluted (in shares)	9,401	9,348	9,348	9,338	9,313	9,315	9,315	9,334	9,374	9,324	9,360
Net income attributable to Almost Family, Inc. per share	'	'	'	'	'	'	'	'	'	'	'
Basic (in dollars per share)	$0.03	$0.23	$0.27	$0.35	$0.40	$0.44	$0.49	$0.53	$0.89	$1.86	$2.24
Diluted (in dollars per share)	$0.02	$0.23	$0.27	$0.35	$0.40	$0.44	$0.49	$0.53	$0.88	$1.85	$2.22

SCHEDULE_II_VALUATION_AND_QUAL1

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS (Details) (Allowance for uncollectible accounts, USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Allowance for uncollectible accounts	'	'	'
Allowance for uncollectible accounts:	'	'	'
Balance at Beginning of Period	$5,236	$6,664	$7,525
Additions/(Deductions) Charged to Costs and Expenses	5,526	2,825	2,362
Additions/(Deductions) Charged to Other Accounts	8,910	46	732
Deductions	-4,086	-4,299	-3,955
Balance at End of Period	$15,586	$5,236	$6,664