Almost Family (AFAM) 10-Q 7 Nov 14 2014 Q3 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	9 Months Ended
	Sep. 30, 2014	Nov. 05, 2014
Document and Entity Information	'	'
Entity Registrant Name	'ALMOST FAMILY INC	'
Entity Central Index Key	'0000799231	'
Document Type	'10-Q	'
Document Period End Date	30-Sep-14	'
Amendment Flag	'false	'
Current Fiscal Year End Date	'--12-31	'
Entity Current Reporting Status	'Yes	'
Entity Filer Category	'Accelerated Filer	'
Entity Common Stock, Shares Outstanding	'	9,475,831
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q3	'

CONSOLIDATED_BALANCE_SHEETS

CONSOLIDATED BALANCE SHEETS (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
CURRENT ASSETS:	'	'
Cash and cash equivalents	$5,358	$12,246
Accounts receivable - net	72,092	61,651
Prepaid expenses and other current assets	9,344	10,278
Deferred tax assets	14,398	11,532
TOTAL CURRENT ASSETS	101,192	95,707
PROPERTY AND EQUIPMENT - NET	6,119	8,142
GOODWILL	190,656	192,575
OTHER INTANGIBLE ASSETS	56,308	55,075
OTHER ASSETS	614	774
TOTAL ASSETS	354,889	352,273
CURRENT LIABILITIES:	'	'
Accounts payable	10,326	11,526
Accrued other liabilities	40,333	38,916
Current portion of notes payable and capital leases	92	702
TOTAL CURRENT LIABILITIES	50,751	51,144
LONG-TERM LIABILITIES:	'	'
Revolving credit facility	52,525	56,000
Deferred tax liabilities	21,016	25,580
Other	2,420	1,856
TOTAL LONG-TERM LIABILITIES	75,961	83,436
TOTAL LIABILITIES	126,712	134,580
Redeemable Noncontrolling Interest, Carrying Amount	'	'
NONCONTROLLING INTEREST - REDEEMABLE	3,639	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; 9,562 and 9,500 issued and outstanding	956	950
Treasury stock, at cost, 94 and 92 shares of common stock	-2,393	-2,340
Additional paid-in capital	105,189	103,858
Noncontrolling interest - nonredeemable	-170	-203
Retained earnings	120,956	111,789
TOTAL STOCKHOLDERS' EQUITY	224,538	214,054
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY	$354,889	$352,273

CONSOLIDATED_BALANCE_SHEETS_Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, except Per Share data, unless otherwise specified
CONSOLIDATED BALANCE SHEETS	'	'
Common stock, par value (in dollars per share)	$0.10	$0.10
Common stock, authorized shares	25,000	25,000
Common stock, issued shares	9,562	9,500
Common stock, outstanding shares	9,562	9,500
Treasury stock, shares	94	92

CONSOLIDATED_STATEMENTS_OF_INC

CONSOLIDATED STATEMENTS OF INCOME (USD $)	3 Months Ended		9 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
CONSOLIDATED STATEMENTS OF INCOME	'	'	'	'
Net service revenues	$123,742	$88,471	$368,711	$260,325
Cost of service revenues (excluding depreciation & amortization)	66,487	47,375	197,446	138,967
Gross margin	57,255	41,096	171,265	121,358
General and administrative expenses:	'	'	'	'
Salaries and benefits	34,992	25,569	104,596	74,755
Other	13,244	10,891	43,966	32,106
Deal and transition costs	1,655	848	6,012	987
Total general and administrative expenses	49,891	37,308	154,574	107,848
Operating income	7,364	3,788	16,691	13,510
Interest expense, net	-396	-11	-1,073	-40
Income before income taxes	6,968	3,777	15,618	13,470
Income tax expense	-2,810	-1,462	-6,245	-5,264
Net income from continuing operations	4,158	2,315	9,373	8,206
Discontinued operations:	'	'	'	'
Loss from operations, net of tax of ($26), ($72), ($116) and ($74)	-38	-186	-173	-476
Gain on sale, net of tax of $973	'	'	'	168
Loss on discontinued operations	-38	-186	-173	-308
Net income	4,120	2,129	9,200	7,898
Net income - noncontrolling interests	-338	'	-185	'
Net Income , Attributable to Almost Family, Inc.	$3,782	$2,129	$9,015	$7,898
Per share amounts-basic:	'	'	'	'
Average shares outstanding (in shares)	9,347	9,302	9,326	9,269
Continued operations (in dollars per share)	$0.41	$0.25	$0.99	$0.89
Discontinued operation (in dollars per share)	'	($0.02)	($0.02)	($0.03)
Net income (in dollars per share)	$0.41	$0.23	$0.97	$0.86
Per share amounts-diluted:	'	'	'	'
Average shares outstanding (in shares)	9,443	9,348	9,444	9,354
Continued operations (in dollars per share)	$0.40	$0.25	$0.97	$0.88
Discontinued operation (in dollars per share)	'	($0.02)	($0.02)	($0.03)
Net income (in dollars per share)	$0.40	$0.23	$0.95	$0.85

CONSOLIDATED_STATEMENTS_OF_INC1

CONSOLIDATED STATEMENTS OF INCOME (Parenthetical) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Discontinued operations:	'	'	'	'
Gain on sale, tax	'	$973	'	'
Discontinued operations, tax benefits	($26)	($72)	($116)	($74)

CONSOLIDATED_STATEMENTS_OF_CAS

CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013
Cash flows from operating activities:	'	'
Net income	$9,200	$7,898
(Loss) gain on discontinued operations, net of tax	-173	-308
Net income from continuing operations	9,373	8,206
Adjustments to reconcile income to net cash of operating activities:	'	'
Depreciation and amortization	3,165	2,004
Provision for uncollectible accounts	6,745	3,884
Stock-based compensation	1,337	1,039
Deferred income taxes	1,577	1,108
Net cash (used in) provided by operating activities	22,197	16,241
Change in certain net assets and liabilities, net of the effects of acquisitions:	'	'
Accounts receivable	-23,290	-1,602
Prepaid expenses and other current assets	235	-131
Other assets	160	151
Accounts payable and accrued expenses	-176	-270
Net cash from operating activities	-874	14,389
Cash flows from investing activities:	'	'
Capital expenditures	-870	-1,620
Acquisitions, net of cash acquired	-969	-12,011
Net cash from investing activities	-1,839	-13,631
Cash flows from financing activities:	'	'
Credit facility repayments, net	-3,475	'
Proceeds from exercise of stock options	39	4
Purchase of common stock in connection with share awards	-52	'
Tax impact of share awards	-39	-61
Payment of special dividend in connection with share awards	-35	'
Principal payments on notes payable and capital leases	-655	-532
Net cash from financing activities	-4,217	-589
Cash flows from discontinued operations:	'	'
Operating activities	40	-1,268
Investing activities	2	3,075
Net cash from discontinued operations	42	1,807
Net change in cash and cash equivalents	-6,888	1,976
Cash and cash equivalents at beginning of period	12,246	26,120
Cash and cash equivalents at end of period	$5,358	$28,096

Accounting_Policies

Accounting Policies	9 Months Ended
	Sep. 30, 2014
Accounting Policies	'
Accounting Policies	'
	1.Accounting Policies
	Basis of Presentation
	The accompanying unaudited consolidated financial statements for the three and nine months ended September 30, 2014 and 2013 have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (SEC).  Certain information and footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States have been omitted pursuant to such rules and regulations.  Accordingly, the reader of this Form 10-Q is referred to Almost Family, Inc.’s (the “Company”) Annual Report on Form 10-K/A for the year ended December 31, 2013 for further information.  In the opinion of management of the Company, the accompanying unaudited consolidated financial statements reflect all adjustments (consisting of normal recurring adjustments) necessary to present fairly the financial position at September 30, 2014, the results of operations for the three and nine month periods ended September 30, 2014 and 2013 and cash flows for the nine month periods ended September 30, 2014 and 2013.  The results of operations for the three and nine month periods ended September 30, 2014 are not necessarily indicative of the operating results for the year.
	On December 6, 2013, the Company completed the acquisition of Omni Home Health Holdings, Inc. (“SunCrest”).  Branded principally under the SunCrest name, its subsidiaries owned and operated 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 provided strategic health management services to Accountable Care Organizations (“ACOs”).  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 10, “Acquisitions.”  The results of operations for SunCrest and IHCN are principally reported within the Company’s Visiting Nurse (VN) reportable segment, while Imperium results are currently included in general and administrative expenses.  Results of operations for each acquisition are included from the acquisition date forward.
	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.
	Recently Issued Accounting Pronouncements
	In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers (Topic 606), which impacts virtually all aspects of an entity’s revenue recognition.  The core principle of the new standard is that revenue should be recognized to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services.  The standard is effective for annual reporting periods beginning after December 15, 2016.  The Company has not yet completed its assessment of the impact of the new standard, including possible transition alternatives, on the Company’s financial statements.
	In April 2014, the FASB issued ASU No. 2014-08, Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity, which changes the criteria for determining which disposals can be presented as discontinued operations and modifies the related disclosure requirements.  To qualify as a discontinued operation the standard requires a disposal to represent a strategic shift that has, or will have, a major effect on an entity’s operations and financial results.  The standard also expands the disclosures for discontinued operations and requires new disclosures related to individually material dispositions that do not qualify as discontinued operations.  The standard is effective prospectively for fiscal years beginning after December 15, 2014, with early adoption permitted.  The implementation of this standard is not expected to have a material impact on the Company’s financial statements, but could impact the reporting of any future dispositions.
	Discontinued Operations
	In the first quarter of 2014, the Company’s VN segment exited a market in the Northeast through the closure of a branch location.  In conjunction with the SunCrest acquisition, the Company acquired some operations which had been discontinued prior to acquisition.  During the quarter ended June 30, 2013, the Company completed the sale of two Alabama locations, which operated in the VN segment.  The operations and any related gain on sale for these operations were reclassified from continuing operations into discontinued operations for all periods presented.  Unless otherwise noted, amounts in these Notes to Consolidated Financial Statements exclude amounts attributable to discontinued operations.
	Contingent Service Revenues
	Through its Imperium ACO enablement company, the Company 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 MSSP payments received by the ACO, if any.  ACOs are entities that contract with Centers for Medicare and Medicaid Services (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 persuasive evidence of an arrangement exists, services have been rendered, the payment is fixed and determinable and collectability is assured.  The Company had $1.6 million in MSSP revenue for the quarter and nine-month periods ended September 30, 2014, which is included in general and administrative expenses.

Segment_Data

Segment Data	9 Months Ended
	Sep. 30, 2014
Segment Data	'
Segment Data	'
	2.Segment Data
	The Company has two reportable segments, VN and Personal Care (PC), which operate locations in Florida, Ohio, Tennessee, Kentucky, Connecticut, New Jersey, Massachusetts, Indiana, Pennsylvania, Georgia, Missouri, Illinois, Mississippi and Alabama.  Reportable segments have been identified based upon how management has organized the business by services provided to customers and the criteria in ASC 280, Segment Reporting.  The Company does not allocate certain expenses to the reportable segments.  These expenses, including Imperium, are included in corporate expenses.
	The 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.  Approximately 91% of the VN segment revenues are generated from the Medicare program while the balance is generated from Medicaid and private insurance programs.  VN Medicare revenues include revenues from all Medicare sources including traditional Medicare and Medicare Advantage, whether paid on a per episode basis or a per visit basis.
	The 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 77% 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.
		Three Months Ended						Nine Months Ended
		September 30,						September 30,
		2014			2013			2014			2013
	Net service revenues:
	Visiting Nurse	$	97,835		$	67,455		$	293,029		$	200,007
	Personal Care	25,907			21,016			75,682			60,318
		123,742			88,471			368,711			260,325
	Operating income before corporate expenses:
	Visiting Nurse	12,544			7,389			35,487			22,562
	Personal Care	2,873			2,566			8,733			7,739
		15,417			9,955			44,220			30,301
	Corporate expenses	6,398			5,319			21,517			15,804
	Deal and transition costs	1,655			848			6,012			987
	Operating income	7,364			3,788			16,691			13,510
	Interest expense, net	(396		)	(11		)	(1,073		)	(40		)
	Income tax expense	(2,810		)	(1,462		)	(6,245		)	(5,264		)
	Net income from continuing operations	$	4,158		$	2,315		$	9,373		$	8,206

Capitalized_Software_Developme

Capitalized Software Development Costs	9 Months Ended
	Sep. 30, 2014
Capitalized Software Development Costs	'
Capitalized Software Development Costs	'
	3.Capitalized Software Development Costs
	The Company capitalizes the cost of internally generated computer software developed for the Company’s own use.  Software development costs of approximately $74 and $119 were capitalized in the three months ended September 30, 2014 and 2013, respectively.  Software development costs of approximately $266 and $524 were capitalized in the nine months ended September 30, 2014 and 2013, respectively.  Capitalized software development costs are amortized over the estimated useful life, generally three years, once the software is ready for its intended use.

Goodwill_and_Other_Intangible_

Goodwill and Other Intangible Assets	9 Months Ended
	Sep. 30, 2014
Goodwill and Other Intangible Assets	'
Goodwill and Other Intangible Assets	'
	4.Goodwill and Other Intangible Assets
	The Company conducts annual reviews for impairment, or more frequently if circumstances indicate impairment may have occurred.  Other intangible assets consist of certificates of need and licenses, trade names and non-compete agreements.  Finite-lived intangible assets are amortized on a straight-line basis over their estimated useful lives.  Licenses, provider numbers, certificates of need and trade names have indefinite lives and are reviewed at least annually for possible impairment, or whenever events or changes in circumstances indicate that carrying amounts may not be recoverable.  The Company completed its most recent annual impairment test of goodwill and other indefinite-lived intangible assets as of December 31, 2013 and determined that no impairment existed.
	The following table summarizes the activity related to goodwill and other intangible assets for 2014:
					Other Intangible Assets
		Goodwill			Certificates		Trade		Non-compete			Total
					of Need and		Names		Agreements
					Licenses
	Balances at 12-31-13	$	192,575		$	38,321	$	16,691	$	63		$	55,075
	Acquisitions	—			1,290		—		—			1,290
	Changes	(1,919		)	—		—		—			—
	Amortization	—			—		—		(57		)	(57		)
	Balances at 9-30-14	$	190,656		$	39,611	$	16,691	$	6		$	56,308
	At September 30, 2014, the VN segment includes $153,085, $38,831, $13,311 and $0, while the PC segment includes $37,571, $780, $3,380 and $6 of total goodwill, certificates of need and licenses, trade names and non-compete agreements, respectively.  At September 30, 2013, the VN segment included $110,396, $9,881, $7,768 and $75, while the PC segment included $30,974, $610, $2,720 and $66 of total goodwill, certificates of need and licenses, trade names and non-compete agreements, respectively.  Acquisitions primarily related to the Caldwell County Home Health acquisition in April of 2014.  Changes to goodwill primarily include VN segment acquisition adjustments related to the SunCrest acquisition.  Please refer to Note 10, “Acquisitions” for further discussion.  Amortization expense recognized on finite-lived intangible assets for the third quarter of 2014 and 2013 was $11 and $26, respectively, and for the nine month period ending September 30, 2014 and 2013 was $57 and $71, respectively.

Revolving_Credit_Facility

Revolving Credit Facility	9 Months Ended
	Sep. 30, 2014
Revolving Credit Facility.	'
Revolving Credit Facility	'
	5.Revolving Credit Facility
	At September 30, 2014, 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%, 1.75% at September 30, 2014) or the London Interbank Offered Rate (LIBOR) plus a margin (ranging from 2.25% to 3.25%, 2.50% at September 30, 2014).  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 4.83% and 4.50% for the three months ended September 30, 2014 and 2013, respectively.  The weighted average LIBOR rates were 2.90% and 2.51% for the three months ended September 30, 2014 and 2013, respectively.  The Company pays a quarterly commitment fee 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, income tax, 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 September 30, 2014, the formula permitted $44.4 million to be used.  The Company had irrevocable letters of credit totaling $7.5 million outstanding in connection with the Company’s self-insurance programs, which resulted in a total of $36.9 million being available for use at September 30, 2014.  As of September 30, 2014, the Company was in compliance with the Facility’s various financial covenants.  Under the most restrictive of its covenants, the Company was required to maintain minimum net worth of at least $161.2 million at September 30, 2014.  At such date, the Company’s net worth was approximately $224.5 million.

Fair_Value_Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2014
Fair Value Measurements	'
Fair Value Measurements	'
	6.Fair Value Measurements
	The Company’s financial instruments consist of cash, accounts receivable, payables and debt instruments.  The carrying values of cash, accounts receivable and payables are considered representative of their respective fair values due to the short-term nature of these instruments.  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.  The Company does not have any assets or liabilities carried at fair value that are measured on a recurring basis.

StockBased_Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2014
Stock-Based Compensation	'
Stock-Based Compensation	'
	7.Stock-Based Compensation
	The Company issues both restricted share and option awards to employees and non-employee directors.  Restricted share awards to employees cliff vest on the third anniversary, while option share awards vest annually in 25% increments over four years.  Stock option grant date fair values are determined at the date of grant using a Monte Carlo option valuation model with suboptimal exercise behavior.  Changes in awards outstanding are summarized as follows:
		Restricted shares				Options
		Shares		Wtd Avg. Grant		Shares		Wtd Avg.
				Price				Exercise Price
	December 31, 2013	100		$	24.12	383		$	24.52
	Granted	60		23.27		70		24.28
	Vested or exercised	(38	)	24.01		(2	)	19.4
	Forfeited	—		—		(7	)	23.37
	September 30, 2014	122		$	22.68	444		$	24.53

Earnings_per_Common_Share

Earnings per Common Share	9 Months Ended
	Sep. 30, 2014
Earnings per Common Share	'
Earnings per Common Share	'
	8.Earnings per Common Share
	A reconciliation of the weighted average shares outstanding used in the calculation of basic and diluted earnings per common share is as follows:
		Three Months Ended		Nine Months Ended
		September 30,		September 30,
		2014	2013	2014	2013
	Basic weighted average outstanding shares	9,347	9,302	9,326	9,269
	Add common equivalent shares representing shares issuable upon exercise of dilutive awards	96	46	118	85
	Diluted weighted average number of shares	9,443	9,348	9,444	9,354
	Anti-dilutive shares excluded from calculation	96	377	96	254

Commitments_and_Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2014
Commitments and Contingencies	'
Commitments and Contingencies	'
	9.Commitments and Contingencies
	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 September 30, 2014 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 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.
	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, president and chief executive officer, 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 October 2, 2012, the Court entered an order granting the independent directors’ motion to dismiss and dismissing the complaint with prejudice, of which order two plaintiffs filed an appeal with the Kentucky Court of Appeals.  After briefing was complete, the Board received a demand letter dated July 17, 2013, from counsel for one of the derivative plaintiff shareholders.  The Board appointed a Special Litigation Committee to respond to the shareholder demand.  The Special Litigation Committee completed its investigation and presented its findings to the Board on June 25, 2014.  The Special Litigation Committee concluded that it would not be in the best interest of the Company or its shareholders to pursue the claims raised in the shareholder demand.  In accordance with the instruction from the Kentucky Court of Appeals to file a motion to redocket the appeal once the Special Litigation Committee responded to the shareholder demand, the Company moved to redocket the case and dismiss the appeal.  On September 15, 2014, the Kentucky Court of Appeals granted a joint motion to dismiss the appeal. Accordingly, the Kentucky state court proceedings stand dismissed with prejudice.
	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 filed in the Jefferson Circuit Court described in the preceding paragraph.  The U.S. District Court granted the defendants’ motion to stay the lawsuit pending further order of the Court.  On October 31, 2014, the parties filed a joint Stipulation and Agreed Order for Dismissal with the Court. The Court entered the Order on November 5, 2014, effectively concluding all litigation in regard to these matters.

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2014
Acquisitions	'
Acquisitions	'
	10.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 for tax purposes, unless otherwise noted.  The purchase price allocations for the SunCrest and subsequent acquisitions remain 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 owned and operated 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 which is expected to be finalized in 2014.  The purchase price consisted of cash consideration of $75.1 million and a $1.5 million note payable, net of acquired cash balances of $2.2 million.   The following table summarizes the approximate fair values of the assets acquired and liabilities assumed in the SunCrest acquisition, which includes adjustments to accounts receivable and deferred taxes as the Company continues to gather facts on underlying accounts.
	Accounts Receivable	$	10,270
	Property, plant & equipment	2,276
	Other assets	2,432
	Goodwill	42,143
	Other intangibles	33,390
	Assets acquired	90,511
	Liabilities assumed	(13,954		)
	Net assets acquired	$	76,557
	Amortizable goodwill and intangibles acquired in the SunCrest acquisition are expected to provide an annual tax deduction approximating $7.9 million through 2023.
	The unaudited proforma results of operations for the Company as if the SunCrest acquisition had been made at the beginning of 2013 are as follows:
		Three months			Nine months ended
		ended			September 30,
		September 30,
		2013			2013
	Revenues	$	121,732		$	372,855
	Net income from continuing operations	$	2,406		$	9,294
	Net income	$	2,220		$	8,986
	Earnings per share from continuing operations
	Basic	$	0.26		$	1.00
	Diluted	$	0.24		$	0.96
	Earnings per share
	Basic	$	0.26		$	0.97
	Diluted	$	0.24		$	0.96
	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 2013.  In addition, future results may vary from the results reflected in such information.
	On October 4, 2013, the Company acquired 61.5% of Imperium, a development-stage enterprise that provides strategic health management services to Accountable Care Organizations (ACOs).  The Company’s investment was $5.8 million, of which $3.0 million remained in Imperium for general purposes.  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 that becomes exercisable five years after the initial investment date.  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.  Final allocation of the purchase price resulted in $9.9 million to goodwill, $1.8 million to identified intangibles with the remainder allocated to property plant and equipment and accounts receivable.

Income_Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2014
Income Taxes	'
Income Taxes	'
	11.Income Taxes
	The Company’s effective income tax rates from continuing operations for the three and nine month periods ended September 30, 2014 and 2013 were approximately 42.4% and 39.5%, respectively, and 40.5% and 39.2%, respectively.  The lower income tax rate in 2013 occurred primarily due to the Work Opportunity Tax Credit (WOTC) not being extended for 2012 until 2013 which resulted in our 2013 effective tax rate including the WOTC benefit for 2 years (2013 and 2012).  The WOTC has not yet been extended for 2014.
	Accounting principles generally accepted in the United States prescribe a recognition threshold and measurement attribute for the accounting and financial statement disclosure of tax positions taken or expected to be taken in a tax return.  The evaluation of a tax position is a two-step process.  The first step requires the Company to determine whether it is more likely than not that a tax position will be sustained upon examination based on the technical merits of the position.  The second step requires the Company to recognize in the financial statements each tax position that meets the more likely than not criteria, measured at the amount of benefit that has a greater than 50% likelihood of being realized.  The Company had $0.7 million of unrecognized tax benefits at September 30, 2014, the total amount of which, if recognized, would affect the tax rate.  The Company includes the full amount of unrecognized tax benefits in other liabilities in the Consolidated Balance Sheets.  Additionally, the Company may from time to time be assessed interest and penalties by tax jurisdictions.  Any such assessments historically have been immaterial to the Company’s financial results and are classified as other general and administrative expenses in the consolidated statements of income.

Subsequent_Events

Subsequent Events	9 Months Ended
	Sep. 30, 2014
Subsequent Events	'
Subsequent Events	'
	12.Subsequent Events
	Management has evaluated all events and transactions that occurred after September 30, 2014.  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.

Accounting_Policies_Policies

Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2014
Accounting Policies	'
Basis of Presentation	'
	Basis of Presentation
	The accompanying unaudited consolidated financial statements for the three and nine months ended September 30, 2014 and 2013 have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (SEC).  Certain information and footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States have been omitted pursuant to such rules and regulations.  Accordingly, the reader of this Form 10-Q is referred to Almost Family, Inc.’s (the “Company”) Annual Report on Form 10-K/A for the year ended December 31, 2013 for further information.  In the opinion of management of the Company, the accompanying unaudited consolidated financial statements reflect all adjustments (consisting of normal recurring adjustments) necessary to present fairly the financial position at September 30, 2014, the results of operations for the three and nine month periods ended September 30, 2014 and 2013 and cash flows for the nine month periods ended September 30, 2014 and 2013.  The results of operations for the three and nine month periods ended September 30, 2014 are not necessarily indicative of the operating results for the year.
	On December 6, 2013, the Company completed the acquisition of Omni Home Health Holdings, Inc. (“SunCrest”).  Branded principally under the SunCrest name, its subsidiaries owned and operated 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 provided strategic health management services to Accountable Care Organizations (“ACOs”).  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 10, “Acquisitions.”  The results of operations for SunCrest and IHCN are principally reported within the Company’s Visiting Nurse (VN) reportable segment, while Imperium results are currently included in general and administrative expenses.  Results of operations for each acquisition are included from the acquisition date forward.
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.
Recently Issued Accounting Pronouncements	'
	Recently Issued Accounting Pronouncements
	In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers (Topic 606), which impacts virtually all aspects of an entity’s revenue recognition.  The core principle of the new standard is that revenue should be recognized to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services.  The standard is effective for annual reporting periods beginning after December 15, 2016.  The Company has not yet completed its assessment of the impact of the new standard, including possible transition alternatives, on the Company’s financial statements.
	In April 2014, the FASB issued ASU No. 2014-08, Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity, which changes the criteria for determining which disposals can be presented as discontinued operations and modifies the related disclosure requirements.  To qualify as a discontinued operation the standard requires a disposal to represent a strategic shift that has, or will have, a major effect on an entity’s operations and financial results.  The standard also expands the disclosures for discontinued operations and requires new disclosures related to individually material dispositions that do not qualify as discontinued operations.  The standard is effective prospectively for fiscal years beginning after December 15, 2014, with early adoption permitted.  The implementation of this standard is not expected to have a material impact on the Company’s financial statements, but could impact the reporting of any future dispositions.
Discontinued Operations	'
	Discontinued Operations
	In the first quarter of 2014, the Company’s VN segment exited a market in the Northeast through the closure of a branch location.  In conjunction with the SunCrest acquisition, the Company acquired some operations which had been discontinued prior to acquisition.  During the quarter ended June 30, 2013, the Company completed the sale of two Alabama locations, which operated in the VN segment.  The operations and any related gain on sale for these operations were reclassified from continuing operations into discontinued operations for all periods presented.  Unless otherwise noted, amounts in these Notes to Consolidated Financial Statements exclude amounts attributable to discontinued operations.
Contingent Service Revenues	'
	Contingent Service Revenues
	Through its Imperium ACO enablement company,  the Company 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 MSSP payments received by the ACO, if any.  ACOs are entities that contract with Centers for Medicare and Medicaid Services (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 persuasive evidence of an arrangement exists, services have been rendered, the payment is fixed and determinable and collectability is assured.  The Company had $1.6 million in MSSP revenue for the quarter and nine-month periods ended September 30, 2014, which is included in general and administrative expenses.

Segment_Data_Tables

Segment Data (Tables)	9 Months Ended
	Sep. 30, 2014
Segment Data	'
Summary of segment data	'
		Three Months Ended						Nine Months Ended
		September 30,						September 30,
		2014			2013			2014			2013
	Net service revenues:
	Visiting Nurse	$	97,835		$	67,455		$	293,029		$	200,007
	Personal Care	25,907			21,016			75,682			60,318
		123,742			88,471			368,711			260,325
	Operating income before corporate expenses:
	Visiting Nurse	12,544			7,389			35,487			22,562
	Personal Care	2,873			2,566			8,733			7,739
		15,417			9,955			44,220			30,301
	Corporate expenses	6,398			5,319			21,517			15,804
	Deal and transition costs	1,655			848			6,012			987
	Operating income	7,364			3,788			16,691			13,510
	Interest expense, net	(396		)	(11		)	(1,073		)	(40		)
	Income tax expense	(2,810		)	(1,462		)	(6,245		)	(5,264		)
	Net income from continuing operations	$	4,158		$	2,315		$	9,373		$	8,206

Goodwill_and_Other_Intangible_1

Goodwill and Other Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2014
Goodwill and Other Intangible Assets	'
Summary of the activity related to goodwill and other intangible assets	'
					Other Intangible Assets
		Goodwill			Certificates		Trade		Non-compete			Total
					of Need and		Names		Agreements
					Licenses
	Balances at 12-31-13	$	192,575		$	38,321	$	16,691	$	63		$	55,075
	Acquisitions	—			1,290		—		—			1,290
	Changes	(1,919		)	—		—		—			—
	Amortization	—			—		—		(57		)	(57		)
	Balances at 9-30-14	$	190,656		$	39,611	$	16,691	$	6		$	56,308

Stockbased_Compensation_Tables

Stock-based Compensation (Tables)	9 Months Ended
	Sep. 30, 2014
Stock-Based Compensation	'
Summary of changes in restricted share and option awards outstanding	'
		Restricted shares				Options
		Shares		Wtd Avg. Grant		Shares		Wtd Avg.
				Price				Exercise Price
	December 31, 2013	100		$	24.12	383		$	24.52
	Granted	60		23.27		70		24.28
	Vested or exercised	(38	)	24.01		(2	)	19.4
	Forfeited	—		—		(7	)	23.37
	September 30, 2014	122		$	22.68	444		$	24.53

Earnings_per_Common_Share_Tabl

Earnings per Common Share (Tables)	9 Months Ended
	Sep. 30, 2014
Earnings per Common Share	'
Schedule of reconciliation of the weighted average shares outstanding used in the calculation of basic and diluted earnings per common share	'
		Three Months Ended		Nine Months Ended
		September 30,		September 30,
		2014	2013	2014	2013
	Basic weighted average outstanding shares	9,347	9,302	9,326	9,269
	Add common equivalent shares representing shares issuable upon exercise of dilutive awards	96	46	118	85
	Diluted weighted average number of shares	9,443	9,348	9,444	9,354
	Anti-dilutive shares excluded from calculation	96	377	96	254

Acquisitions_Tables

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2014
Acquisitions	'
Summary of estimated fair values of the assets acquired and liabilities assumed	'
	Accounts Receivable	$	10,270
	Property, plant & equipment	2,276
	Other assets	2,432
	Goodwill	42,143
	Other intangibles	33,390
	Assets acquired	90,511
	Liabilities assumed	(13,954		)
	Net assets acquired	$	76,557
Schedule of unaudited proforma results of operations	'
		Three months			Nine months ended
		ended			September 30,
		September 30,
		2013			2013
	Revenues	$	121,732		$	372,855
	Net income from continuing operations	$	2,406		$	9,294
	Net income	$	2,220		$	8,986
	Earnings per share from continuing operations
	Basic	$	0.26		$	1.00
	Diluted	$	0.24		$	0.96
	Earnings per share
	Basic	$	0.26		$	0.97
	Diluted	$	0.24		$	0.96

Accounting_Policies_Detail

Accounting Policies (Detail) (Omnihome Health Holdings Inc And Subsidiaries)	0 Months Ended
	Dec. 06, 2013
	Agency
Omnihome Health Holdings Inc And 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

Accounting_Policies_Details_2

Accounting Policies (Details 2) (USD $)	3 Months Ended	9 Months Ended	3 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2014	Jun. 30, 2014
			Visiting Nurse
			Alabama locations
			item
Contingent Service Revenues	'	'	'
Medicare Shared Savings Program Revenue	$1.60	$1.60	'
Discontinued Operations	'	'	'
Numbers of locations sold	'	'	2

Segment_Data_Details

Segment Data (Details) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
			segment
Segment Data	'	'	'	'
Number of reportable segments	'	'	2	'
Segment data	'	'	'	'
Net service revenues	$123,742	$88,471	$368,711	$260,325
Operating income before corporate expenses	15,417	9,955	44,220	30,301
Corporate expenses	6,398	5,319	21,517	15,804
Deal and transition costs	1,655	848	6,012	987
Operating income	7,364	3,788	16,691	13,510
Interest expense, net	-396	-11	-1,073	-40
Income tax expense	-2,810	-1,462	-6,245	-5,264
Net income from continuing operations	4,158	2,315	9,373	8,206
Visiting Nurse	'	'	'	'
Segment data	'	'	'	'
Net service revenues	97,835	67,455	293,029	200,007
Operating income before corporate expenses	12,544	7,389	35,487	22,562
Personal Care	'	'	'	'
Segment data	'	'	'	'
Net service revenues	25,907	21,016	75,682	60,318
Operating income before corporate expenses	$2,873	$2,566	$8,733	$7,739
Medicare program | Visiting Nurse	'	'	'	'
Segment data	'	'	'	'
Segment revenues (as a percent)	91.00%	'	91.00%	'
Medicaid and other government programs | Personal Care	'	'	'	'
Segment data	'	'	'	'
Segment revenues (as a percent)	77.00%	'	77.00%	'

Capitalized_Software_Developme1

Capitalized Software Development Costs (Details) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2014	Sep. 30, 2013
				Software development	Software development
Capitalized software development costs	'	'	'	'	'
Software development costs capitalized	$74	$119	$266	'	$524
Amortization period	'	'	'	'3 years	'

Goodwill_and_Other_Intangible_2

Goodwill and Other Intangible Assets (Details) (USD $)	3 Months Ended		9 Months Ended		12 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013	Dec. 31, 2013
Goodwill and Other Intangible Assets	'	'	'	'	'
Impairment loss on goodwill and other intangible assets	'	'	'	'	$0
Goodwill	'	'	'	'	'
Balance at the beginning of the period	'	'	192,575	'	'
Changes	'	'	-1,919	'	'
Balance at the end of the period	190,656	'	190,656	'	192,575
Other Intangible Assets	'	'	'	'	'
Balance at the beginning of the period	'	'	55,075	'	'
Additions	'	'	1,290	'	'
Amortization	-57	'	-57	'	'
Balance at the end of the period	56,308	'	56,308	'	55,075
Amortization expense recognized on finite-lived intangible assets	11	26	57	71	'
Visiting Nurse	'	'	'	'	'
Goodwill	'	'	'	'	'
Balance at the end of the period	153,085	110,396	153,085	110,396	'
Personal Care	'	'	'	'	'
Goodwill	'	'	'	'	'
Balance at the end of the period	37,571	30,974	37,571	30,974	'
Non-compete Agreements	'	'	'	'	'
Other Intangible Assets	'	'	'	'	'
Amortization	-57	'	-57	'	'
Balance at the end of the period	6	'	6	'	63
Non-compete Agreements | Visiting Nurse	'	'	'	'	'
Other Intangible Assets	'	'	'	'	'
Balance at the end of the period	0	75	0	75	'
Non-compete Agreements | Personal Care	'	'	'	'	'
Other Intangible Assets	'	'	'	'	'
Balance at the end of the period	6	66	6	66	'
Certificates of Need and Licenses	'	'	'	'	'
Other Intangible Assets	'	'	'	'	'
Balance at the beginning of the period	'	'	38,321	'	'
Additions	'	'	1,290	'	'
Balance at the end of the period	39,611	'	39,611	'	'
Certificates of Need and Licenses | Visiting Nurse	'	'	'	'	'
Other Intangible Assets	'	'	'	'	'
Balance at the end of the period	38,831	9,881	38,831	9,881	'
Certificates of Need and Licenses | Personal Care	'	'	'	'	'
Other Intangible Assets	'	'	'	'	'
Balance at the end of the period	780	610	780	610	'
Trade Names	'	'	'	'	'
Other Intangible Assets	'	'	'	'	'
Balance at the end of the period	16,691	'	16,691	'	16,691
Trade Names | Visiting Nurse	'	'	'	'	'
Other Intangible Assets	'	'	'	'	'
Balance at the end of the period	13,311	7,768	13,311	7,768	'
Trade Names | Personal Care	'	'	'	'	'
Other Intangible Assets	'	'	'	'	'
Balance at the end of the period	$3,380	$2,720	$3,380	$2,720	'

Revolving_Credit_Facility_Deta

Revolving Credit Facility (Details) (USD $)

Sep. 30, 2014

Dec. 31, 2013

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2014

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

item

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

'

'

'

Interest rate margin per debt instrument (as a percent)

'

'

'

'

'

'

'

1.25%

2.25%

'

'

2.25%

3.25%

Actual interest rate margin (as a percent)

'

'

'

'

'

1.75%

'

'

'

2.50%

'

'

'

Weighted average interest rate (as a percent)

'

'

'

'

'

4.83%

4.50%

'

'

2.90%

2.51%

'

'

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

'

'

44,400,000

'

'

'

'

'

'

'

'

'

'

Irrevocable letters of credit outstanding

'

'

7,500,000

'

'

'

'

'

'

'

'

'

'

Remaining borrowing capacity available for use

'

'

36,900,000

'

'

'

'

'

'

'

'

'

'

Minimum net worth required to be maintained

'

'

161,200,000

'

'

'

'

'

'

'

'

'

'

Company's net worth

$224,538,000

$214,054,000

'

'

'

'

'

'

'

'

'

'

'

StockBased_Compensation_Detail

Stock-Based Compensation (Details) (USD $)	9 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Sep. 30, 2014
Restricted shares	'
Stock-based compensation	'
Vesting period	'3 years
Changes in option awards outstanding, Shares	'
Balance at the beginning of the period (in shares)	100
Number of shares awarded	60
Vested or Exercised (in shares)	-38
Balance at the end of the period (in shares)	122
Changes in option awards, Wtd Avg Ex. Price	'
Balance at the beginning of the period (in dollars per share)	$24.12
Granted (in dollars per share)	$23.27
Vested or Exercised (in dollars per share)	$24.01
Balance at the end of the period (in dollars per share)	$22.68
Option awards	'
Stock-based compensation	'
Vesting period	'4 years
Option share awards vest annually in increments (as a percent)	25.00%
Changes in option awards outstanding, Shares	'
Balance at the beginning of the period (in shares)	383
Number of shares awarded	70
Vested or Exercised (in shares)	-2
Forfeited (in shares)	-7
Balance at the end of the period (in shares)	444
Changes in option awards, Wtd Avg Ex. Price	'
Balance at the beginning of the period (in dollars per share)	$24.52
Granted (in dollars per share)	$24.28
Vested or Exercised (in dollars per share)	$19.40
Forfeited (in dollars per share)	$23.37
Balance at the end of the period (in dollars per share)	$24.53

Earnings_per_Common_Share_Deta

Earnings per Common Share (Details)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Earnings per Common Share	'	'	'	'
Basic weighted average outstanding (in shares)	9,347	9,302	9,326	9,269
Add common equivalent shares representing shares issuable upon exercise of dilutive awards	96	46	118	85
Diluted weighted average number of shares	9,443	9,348	9,444	9,354
Anti-dilutive shares excluded from calculation	96	377	96	254

Commitments_and_Contingencies_

Commitments and Contingencies (Details) (USD $)	Sep. 30, 2014
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

Commitments_and_Contingencies_1

Commitments and Contingencies (Details 2)	0 Months Ended	9 Months Ended
	Nov. 01, 2012	Sep. 30, 2014
	plaintiff	lawsuit
		claim
Commitments and Contingencies	'	'
Number of lawsuits consolidated into a single action	'	4
Number of claims settled	'	1
Number of claims consolidated into a single class action lawsuit	2	'

Acquisitions_Detail

Acquisitions (Detail) (USD $)	9 Months Ended			0 Months Ended	3 Months Ended	9 Months Ended		0 Months Ended		0 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Dec. 31, 2013	Dec. 06, 2013	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013	Oct. 04, 2013	Oct. 04, 2013	Jul. 17, 2013	Jul. 17, 2013
				Omnihome Health Holdings Inc And Subsidiaries	Omnihome Health Holdings Inc And Subsidiaries	Omnihome Health Holdings Inc And Subsidiaries	Omnihome Health Holdings Inc And Subsidiaries	Imperium Health Management LLC	Imperium Health Management LLC	Indiana Home Care Network	Indiana Home Care Network
				Agency						Agency
Acquisitions	'	'	'	'	'	'	'	'	'	'	'
Period over which goodwill and other intangible assets are expected to be deductible for tax purposes	'15 years	'	'	'	'	'	'	'	'	'	'
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	'	'	'	'	'	'	'
Cash paid	969,000	12,011,000	'	75,100,000	'	'	'	'	'	'	'
Note payable	'	'	'	1,500,000	'	'	'	'	'	'	'
Acquired cash balances	'	'	'	2,200,000	'	'	'	'	'	'	'
Interest acquired (as a percent)	'	'	'	'	'	'	'	'	61.50%	'	'
Imperium investment available for general purposes	'	'	'	'	'	'	'	3,000,000	'	'	'
Noncontrolling interest percentage	'	'	'	'	'	'	'	'	38.50%	'	'
Number of years after acquisition the put and call arrangement become exercisable	'	'	'	'	'	'	'	'5 years	'	'	'
Business Acquisition Purchase Price Allocation Intangible Assets Including Goodwill Expected Annual Tax Deductible Amount	'	'	'	'	'	7,900,000	'	'	'	'	'
Total purchase price	'	'	'	'	'	'	'	'	5,800,000	'	12,500,000
Common stock issued	'	'	'	'	'	'	'	'	'	'	500,000
Purchase price allocated to accounts receivable and property plant and equipment	'	'	'	'	'	'	'	'	'	'	1,800,000
Accounts receivable	'	'	'	'	'	10,270,000	'	'	'	'	'
Property, plant & equipment	'	'	'	'	'	2,276,000	'	'	'	'	'
Other assets	'	'	'	'	'	2,432,000	'	'	'	'	'
Goodwill	190,656,000	'	192,575,000	'	'	42,143,000	'	'	'	'	9,900,000
Other intangibles	'	'	'	'	'	33,390,000	'	'	'	'	'
Assets acquired	'	'	'	'	'	90,511,000	'	'	'	'	'
Liabilities assumed	'	'	'	'	'	-13,954,000	'	'	'	'	'
Net assets acquired	'	'	'	'	'	76,557,000	'	'	'	'	'
Proforma results of operations	'	'	'	'	'	'	'	'	'	'	'
Revenues	'	'	'	'	121,732,000	'	372,855,000	'	'	'	'
Net income from continuing operations	'	'	'	'	2,406,000	'	9,294,000	'	'	'	'
Net income	'	'	'	'	$2,220,000	'	$8,986,000	'	'	'	'
Earnings per share from continuing operations	'	'	'	'	'	'	'	'	'	'	'
Continuing operations - Basic (in dollars per share)	'	'	'	'	$0.26	'	$1	'	'	'	'
Continuing operations - Diluted (in dollars per share)	'	'	'	'	$0.24	'	$0.96	'	'	'	'
Earnings Per Share, Pro Forma [Abstract]	'	'	'	'	'	'	'	'	'	'	'
Basic (in dollars per share)	'	'	'	'	$0.26	'	$0.97	'	'	'	'
Diluted (in dollars per share)	'	'	'	'	$0.24	'	$0.96	'	'	'	'

Income_Taxes_Details

Income Taxes (Details) (USD $)	3 Months Ended		9 Months Ended		12 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013	Dec. 31, 2014	Dec. 31, 2013
Income Taxes	'	'	'	'	'	'
Effective income tax rates (as a percent)	42.40%	40.50%	39.50%	39.20%	'	'
Term of WOTC Benefit	'	'	'	'	'2 years	'2 years
Unrecognized Tax Benefits	$0.70	'	$0.70	'	'	'