U.S. Physical Therapy (USPH) 10-K 14 Mar 18 2017 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2017	Mar. 14, 2018	Jun. 30, 2017
Document And Entity Information [Abstract]
Entity Registrant Name	U S PHYSICAL THERAPY INC /NV
Entity Central Index Key	885,978
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			$ 475.4
Entity Common Stock, Shares Outstanding		12,671,386
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	FY
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2017

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Current assets:
Cash and cash equivalents	$ 21,933	$ 20,047
Patient accounts receivable, less allowance for doubtful accounts of $2,273 and $1,792, respectively	44,707	38,840
Accounts receivable - other	5,655	2,649
Other current assets	4,786	4,428
Total current assets	77,081	65,964
Fixed assets:
Furniture and equipment	51,100	48,426
Leasehold improvements	29,760	26,765
Fixed assets, gross	80,860	75,191
Less accumulated depreciation and amortization	60,475	56,018
Fixed assets, net	20,385	19,173
Goodwill	271,338	226,806
Other identifiable intangible assets, net	48,954	38,060
Other assets	1,224	1,228
Total assets	418,982	351,231
Current liabilities:
Accounts payable - trade	2,165	1,634
Accrued expenses	33,342	21,756
Current portion of notes payable	4,044	1,227
Total current liabilities	39,551	24,617
Notes payable, net of current portion	2,728	4,596
Revolving line of credit	54,000	46,000
Mandatorily redeemable non-controlling interests	327	69,190
Deferred taxes	10,875	15,736
Deferred rent	2,116	1,575
Other long-term liabilities	743	829
Total liabilities	110,340	162,543
Redeemable non-controlling interests	102,572	0
Commitments and contingencies (Note 16)
U.S. Physical Therapy, Inc. ("USPH") shareholders' equity:
Preferred stock, $.01 par value, 500,000 shares authorized, no shares issued and outstanding	0	0
Common stock, $.01 par value, 20,000,000 shares authorized, 14,809,299 and 14,732,699 shares issued, respectively	148	147
Additional paid-in capital	73,940	68,687
Retained earnings	162,406	150,342
Treasury stock at cost, 2,214,737 shares	(31,628)	(31,628)
Total USPH shareholders' equity	204,866	187,548
Non-controlling interests	1,204	1,140
Total USPH shareholders' equity and non-controlling interests	206,070	188,688
Total liabilities, redeemable non-controlling interests, USPH shareholders' equity and non-controlling interests	$ 418,982	$ 351,231

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Current assets:
Allowance for doubtful accounts, patient accounts receivable	$ 2,273	$ 1,792
U. S. Physical Therapy, Inc. shareholders' equity:
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	500,000	500,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	20,000,000	20,000,000
Common stock, shares issued (in shares)	14,809,299	14,732,699
Treasury stock, shares (in shares)	2,214,737	2,214,737

CONSOLIDATED STATEMENTS OF NET

CONSOLIDATED STATEMENTS OF NET INCOME - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
CONSOLIDATED STATEMENTS OF NET INCOME [Abstract]
Net patient revenues	$ 389,226	$ 348,839	$ 324,293
Other revenues	24,825	7,707	7,009
Net revenues	414,051	356,546	331,302
Operating costs:
Salaries and related costs	237,067	198,495	180,514
Rent, supplies, contract labor and other	82,096	71,868	68,046
Provision for doubtful accounts	3,672	4,040	4,170
Closure costs	599	131	211
Total operating costs	323,434	274,534	252,941
Gross Profit	90,617	82,012	78,361
Corporate office costs	35,889	32,479	31,067
Operating income	54,728	49,533	47,294
Interest and other income, net	88	93	81
Interest expense:
Mandatorily redeemable non-controlling interests - change in redemption value	(12,894)	(6,169)	(2,670)
Mandatorily redeemable non-controlling interests - earnings allocable	(6,055)	(4,057)	(3,538)
Debt and other	(2,111)	(1,252)	(1,031)
Total interest expense	(21,060)	(11,478)	(7,239)
Income before taxes	33,756	38,148	40,136
Provision for income taxes	6,032	11,880	13,647
Net income	27,724	26,268	26,489
Less: net income attributable to non-controlling interests	(5,468)	(5,717)	(5,874)
Net income attributable to USPH shareholders	$ 22,256	$ 20,551	$ 20,615
Basic and diluted earnings per share attributable to USPH shareholders (in dollars per share)	$ 1.76	$ 1.64	$ 1.66
Shares used in computation - basic and diluted (in shares)	12,570	12,500	12,392
Dividends declared per common share (in dollars per share)	$ 0.80	$ 0.68	$ 0.60

CONSOLIDATED STATEMENTS OF CHAN

CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY - USD ($) shares in Thousands, $ in Thousands	Common Stock [Member]	Additional Paid-In Capital [Member]	Retained Earnings [Member]	Treasury Stock [Member]	Total Shareholders' Equity [Member]	Non-controlling Interests [Member]	Total
Beginning balance at Dec. 31, 2014	$ 145	$ 58,799	$ 125,135	$ (31,628)	$ 152,451	$ 1,488	$ 153,939
Beginning balance (in shares) at Dec. 31, 2014	14,487			(2,215)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Proceeds from exercise of stock options	$ 1	4	0	$ 0	5	0	5
Proceeds from exercise of stock options (in shares)	1			0
Net tax benefit from exercise of stock options	$ 0	947	0	$ 0	947	0	947
Issuance of restricted stock	$ 0	0	0	$ 0	0	0	0
Issuance of restricted stock (in shares)	148			0
Compensation expense - restricted stock/equity-based awards	$ 0	4,491	0	$ 0	4,491	0	4,491
Transfer of compensation liability for certain stock issued pursuant to long-term incentive plans	0	446	0	0	446	0	446
Acquisitions and sales of non-controlling interests	0	(449)	0	0	(449)	(217)	(666)
Distribution to non-controlling interest partners	0	0	0	0	0	(5,892)	(5,892)
Dividends payable to USPT shareholders	0	0	(7,449)	0	(7,449)	0	(7,449)
Net income	0	0	20,615	0	20,615	5,874	26,489
Ending balance at Dec. 31, 2015	$ 146	64,238	138,301	$ (31,628)	171,057	1,253	172,310
Ending balance (in shares) at Dec. 31, 2015	14,636			(2,215)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of restricted stock	$ 1	0	0	$ 0	1	0	1
Issuance of restricted stock (in shares)	97
Compensation expense - restricted stock/equity-based awards	$ 0	4,962	0	0	4,962	0	4,962
Transfer of compensation liability for certain stock issued pursuant to long-term incentive plans	0	211	0	0	211	0	211
Acquisitions and sales of non-controlling interests	0	(533)	0	0	(533)	(112)	(645)
Adjustment for prior year acquisitions of non-controlling interest - tax true up	0	(191)	0	0	(191)	0	(191)
Distribution to non-controlling interest partners	0	0	0	0	0	(5,718)	(5,718)
Dividends payable to USPT shareholders	0	0	(8,510)	0	(8,510)	0	(8,510)
Net income	0	0	20,551	0	20,551	5,717	26,268
Ending balance at Dec. 31, 2016	$ 147	68,687	150,342	$ (31,628)	187,548	1,140	188,688
Ending balance (in shares) at Dec. 31, 2016	14,733			(2,215)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of restricted stock	$ 1	0	0	$ 0	1	0	1
Issuance of restricted stock (in shares)	76			0
Revaluation of redeemable non-controlling interest	$ 0	0	(126)	$ 0	(126)	0	(126)
Compensation expense - restricted stock/equity-based awards	0	5,032	0	0	5,032	0	5,032
Transfer of compensation liability for certain stock issued pursuant to long-term incentive plans	0	165	0	0	165	0	165
Acquisitions and sales of non-controlling interests	0	56	0	0	56	(20)	36
Distribution to non-controlling interest partners	0	0	0	0	0	(5,300)	(5,300)
Dividends payable to USPT shareholders	0	0	(10,066)	0	(10,066)	0	(10,066)
Other	0	0	0	0	0	160	160
Net income	0	0	22,256	0	22,256	5,224	27,480
Ending balance at Dec. 31, 2017	$ 148	$ 73,940	$ 162,406	$ (31,628)	$ 204,866	$ 1,204	$ 206,070
Ending balance (in shares) at Dec. 31, 2017	14,809			(2,215)

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
OPERATING ACTIVITIES
Net income including non-controlling interests	$ 27,724	$ 26,268	$ 26,489
Adjustments to reconcile net income including non-controlling interests to net cash provided by operating activities:
Depreciation and amortization	9,710	8,779	7,952
Provision for doubtful accounts	3,672	4,040	4,170
Equity-based awards compensation expense	5,032	4,962	4,491
Excess tax benefit from equity-based rewards	0	0	(947)
Deferred income tax	(4,864)	2,979	5,953
Other	621	152	264
Changes in operating assets and liabilities:
Increase in patient accounts receivable	(3,447)	(3,275)	(5,519)
Increase in accounts receivable - other	(3,022)	(400)	(852)
Decrease (increase) in other assets	2,086	(1,399)	(1,375)
Increase (decrease) in accounts payable and accrued expenses	6,979	2,994	(7,011)
Increase in mandatorily redeemable non-controlling interests	11,579	5,598	2,509
Increase in other liabilities	456	352	1,396
Net cash provided by operating activities	56,526	51,050	37,520
INVESTING ACTIVITIES
Purchase of fixed assets	(7,095)	(8,260)	(6,263)
Purchase of businesses, net of cash acquired	(36,682)	(23,623)	(18,965)
Sale of non-controlling interest, net of purchases	121	(670)	(968)
Proceeds on sale of fixed assets	81	61	71
Net cash used in investing activities	(43,575)	(32,492)	(26,125)
FINANCING ACTIVITIES
Distributions to non-controlling interests	(5,572)	(5,718)	(5,892)
Cash dividends paid to shareholders - funded	(10,066)	(8,510)	(7,449)
Proceeds from revolving line of credit	93,000	168,000	103,000
Payments on revolving line of credit	(85,000)	(166,000)	(93,500)
Payments to settle mandatorily redeemable non-controlling interests	(2,361)	(1,262)	(6,115)
Principal payments on notes payable	(1,227)	(800)	(884)
Tax benefit from equity-based rewards	0	0	947
Other	161	1	5
Net cash used in financing activities	(11,065)	(14,289)	(9,888)
Net increase in cash and cash equivalents	1,886	4,269	1,507
Cash and cash equivalents - beginning of period	20,047	15,778	14,271
Cash and cash equivalents - end of period	21,933	20,047	15,778
Cash paid during the period for:
Income taxes	8,543	10,584	7,779
Interest	2,113	784	884
Non-cash investing and financing transactions during the period:
Purchase of business - seller financing portion	2,150	1,000	1,800
Acquisition of non-controlling interest - seller financing portion	0	387	0
Payment to settle redeemable non-controlling interest - financing portion	0	127	3,077
Receivable from sale of non-controlling interests	$ 0	$ (138)	$ 0

Organization, Nature of Operati

Organization, Nature of Operations and Basis of Presentation	12 Months Ended
	Dec. 31, 2017
Organization, Nature of Operations and Basis of Presentation [Abstract]
Organization, Nature of Operations and Basis of Presentation	1. Organization, Nature of Operations and Basis of Presentation U.S. Physical Therapy, Inc. and its subsidiaries (together, the “Company”) operate outpatient physical therapy clinics that provide pre-and post-operative care and treatment for orthopedic-related disorders, sports-related injuries, preventative care, rehabilitation of injured workers and neurological-related injuries. As of December 31, 2017, the Company owned and/or operated 578 clinics in 41 states. The clinics’ business primarily originates from physician referrals. The principal sources of payment for the clinics’ services are managed care programs, commercial health insurance, Medicare/Medicaid, workers’ compensation insurance and proceeds from personal injury cases. In addition to the Company’s ownership and operation of outpatient physical therapy clinics, it also manages physical therapy facilities for third parties, such as physicians and hospitals, with 32 such third-party facilities under management as of December 31, 2017. In March 2017, the Company acquired a 55% interest in a company which is a leading provider of workforce performance solutions. Services provided include onsite injury prevention and rehabilitation, performance optimization and ergonomic assessments. The majority of these services are contracted with and paid for directly by employers including a number of Fortune 500 companies. Other clients include large insurers and their contractors. The consolidated financial statements include the accounts of U.S. Physical Therapy, Inc. and its subsidiaries. All significant intercompany transactions and balances have been eliminated. The Company primarily operates through subsidiary clinic partnerships, in which the Company generally owns a 1% general partnership interest and a 49% to 99% limited partnership interest. The managing therapist of each clinic owns the remaining limited partnership interest in the majority of the clinics (hereinafter referred to as “Clinic Partnership”). To a lesser extent, the Company operates some clinics through wholly-owned subsidiaries under profit sharing arrangements with therapists (hereinafter referred to as “Wholly-Owned Facilities”). During the last three years, the Company completed the following multi-clinic acquisitions: Date % Interest Acquired Number of Clinics 2017 January 2017 Acquisition January 1 70% 17 May 2017 Acquisition May 31 70% 4 June 2017 Acquisition June 30 60% 9 October 2017 Acquisition October 31 70% 9 2016 February 2016 Acquisition February 29 55% 8 November 2016 Acquisition November 30 60% 12 2015 January 2015 Acquisition January 31 60% 9 April 2015 Acquisition April 30 70% 3 June 2015 Acquisition June 30 70% 4 December 2015 Acquisition December 31 59% 4 Also, during the year of 2017, the Company purchased the assets and business of two physical therapy clinics in separate transactions. One clinic was consolidated with an existing clinic and the other operates as a satellite clinic of one of the existing partnerships. In addition to the multi-clinic acquisitions, the Company acquired two single clinic practices in separate transactions during 2016. During 2015, the Company acquired a 60% interest in a single clinic practice. The results of operations of the acquired clinics have been included in the Company’s consolidated financial statements since the date of their respective acquisition. The Company intends to continue to pursue additional acquisition opportunities, develop new clinics and open satellite clinics. Clinic Partnerships For non-acquired Clinic Partnerships, the earnings and liabilities attributable to the non-controlling interests, typically owned by the managing therapist, directly or indirectly, are recorded within the balance sheets and income statements as non-controlling interests. For acquired Clinic Partnerships with mandatorily redeemable non-controlling interests, the earnings and liabilities attributable to the non-controlling interest are recorded within the consolidated statements of income line item: Interest expense – mandatorily redeemable non-controlling interests – earnings allocable Mandatorily redeemable non-controlling interests net income attributable to non-controlling interests redeemable non-controlling interests Effective December 31, 2017, the Company entered into amendments to its acquired limited partnership agreements replacing the mandatory redemption feature. No monetary consideration was paid to the partners to amend the agreements. The amended limited partnership agreements provide that, upon certain events, the Company has a call right (the “Call Right”) and the selling entity has a put right (the “Put Right”) for the purchase and sale of the limited partnership interest held by the partner. Once triggered, the Put Right and the Call Right do not expire, even upon an individual partner’s death, and contain no mandatory redemption feature. The purchase price of the partner’s limited partnership interest upon the exercise of either the Put Right or the Call Right is calculated per the terms of the respective agreements. The Company accounted for the amendment of its limited partnership agreements as an extinguishment of the outstanding Seller Entity Interests, as defined in Footnote 5, classified as liabilities through the issuance of new Seller Entity Interests classified in temporary equity. Pursuant to ASC 470-50-40-2, the Company removed the outstanding liability-classified Seller Entity Interests at their carrying amounts, recognized the new temporary-equity-classified Seller Entity Interests at their fair value, and recorded no gain or loss on extinguishment as management believes the redemption value (i.e. the carrying amount) and fair value are the same. In summary, the redemption values of the mandatorily redeemable non-controlling interest (previously classified as liabilities) were reclassified as redeemable non-controlling interest (temporary equity) at fair value on the December 31, 2017 consolidated balance sheet. The remaining balance of $327,000 in the line item – Mandatorily redeemable non-controlling interests Wholly-Owned Facilities For Wholly-Owned Facilities with profit sharing arrangements, an appropriate accrual is recorded for the amount of profit sharing due the clinic partners/directors. The amount is expensed as compensation and included in clinic operating costs—salaries and related costs. The respective liability is included in current liabilities— accrued expenses

Significant Accounting Policies

Significant Accounting Policies	12 Months Ended
	Dec. 31, 2017
Significant Accounting Policies [Abstract]
Significant Accounting Policies	2. Significant Accounting Policies Cash Equivalents The Company maintains its cash and cash equivalents at financial institutions. The Company considers all highly liquid investments with a maturity of three months or less when purchased to be cash equivalents. The combined account balances at several institutions typically exceed Federal Deposit Insurance Corporation (“FDIC”) insurance coverage and, as a result, there is a concentration of credit risk related to amounts on deposit in excess of FDIC insurance coverage. Management believes that this risk is not significant. Long-Lived Assets Fixed assets are stated at cost. Depreciation is computed on the straight-line method over the estimated useful lives of the related assets. Estimated useful lives for furniture and equipment range from three to eight years and for software purchased from three to seven years. Leasehold improvements are amortized over the shorter of the related lease term or estimated useful lives of the assets, which is generally three to five years. Impairment of Long-Lived Assets and Long-Lived Assets to Be Disposed Of The Company reviews property and equipment and intangible assets with finite lives for impairment upon the occurrence of certain events or circumstances that indicate the related amounts may be impaired. Assets to be disposed of are reported at the lower of the carrying amount or fair value less costs to sell. Goodwill Goodwill represents the excess of the amount paid and fair value of the non-controlling interests over the fair value of the acquired business assets, which include certain identifiable intangible assets. Historically, goodwill has been derived from acquisitions and, prior to 2009, from the purchase of some or all of a particular local management’s equity interest in an existing clinic. Effective January 1, 2009, if the purchase price of a non-controlling interest by the Company exceeds or is less than the book value at the time of purchase, any excess or shortfall is recognized as an adjustment to additional paid-in capital. The fair value of goodwill and other identifiable intangible assets with indefinite lives are tested for impairment annually and upon the occurrence of certain events, and are written down to fair value if considered impaired. The Company evaluates goodwill for impairment on at least an annual basis (in its third quarter) by comparing the fair value of its reporting units to the carrying value of each reporting unit including related goodwill. The Company evaluates indefinite lived tradenames using the relief from royalty method in conjunction with its annual goodwill impairment test. The Company operates a one segment business which is made up of various clinics within partnerships. The partnerships are components of regions and are aggregated to the operating segment level for the purpose of determining the Company’s reporting units when performing its annual goodwill impairment test. In 2017, 2016 and 2015, there were six regions. In addition to the six regions, in 2017, the impairment test included a separate analysis for the workforce performance solutions business, a separate reporting unit. An impairment loss generally would be recognized when the carrying amount of the net assets of a reporting unit, inclusive of goodwill and other identifiable intangible assets, exceeds the estimated fair value of the reporting unit. The estimated fair value of a reporting unit is determined using two factors: (i) earnings prior to taxes, depreciation and amortization for the reporting unit multiplied by a price/earnings ratio used in the industry and (ii) a discounted cash flow analysis. A weight is assigned to each factor and the sum of each weight times the factor is considered the estimated fair value. For 2017, the factors (i.e., price/earnings ratio, discount rate and residual capitalization rate) were updated to reflect current market conditions. The evaluation of goodwill in 2017, 2016 and 2015 did not result in any goodwill amounts that were deemed impaired. The Company has not identified any triggering events occurring after the testing date that would impact the impairment testing results obtained. The Company will continue to monitor for any triggering events or other indicators of impairment. Mandatorily Redeemable Non-Controlling Interests The non-controlling interests that are reflected as mandatorily redeemable non-controlling interests in the consolidated financial statements consist of those owners who have certain redemption rights, whether currently exercisable or not, and which currently, or in the future, require that the Company purchase the non-controlling interest of those owners at a predetermined formula based on a multiple of trailing twelve months earnings performance as defined in the respective limited partnership agreements. The redemption rights are triggered at such time as both of the following events have occurred: 1) termination of the owner’s employment, regardless of the reason for such termination, and 2) the passage of specified number of years after the closing of the transaction, typically three to five years, as defined in the limited partnership agreement. On the date the Company acquires a controlling interest in a partnership and the limited partnership agreement for such partnership contains mandatory redemption rights, the fair value of the non-controlling interest is recorded in the long-term liabilities section of the consolidated balance sheet under the caption – Mandatorily redeemable non-controlling interests Interest expense – mandatorily redeemable non-controlling interests – change in redemption value and Interest expense – mandatorily redeemable non-controlling interests – earnings allocable As previously mentioned due to amendments of the limited partnership agreements entered into by the Company, the redemption values of the mandatorily redeemable non-controlling interest (previously classified as liabilities) were amended and are now classified as redeemable non-controlling interest (temporary equity) at fair value on the December 31, 2017 consolidated balance sheet. Redeemable Non-Controlling Interests The non-controlling interests that are reflected as redeemable non-controlling interests in the consolidated financial statements consist of those owners and the Company have certain redemption rights, whether currently exercisable or not, and which currently, or in the future, require that the Company purchase or the owner sell the non-controlling interest held by the owner, if certain conditions are met. The purchase price is derived at a predetermined formula based on a multiple of trailing twelve months earnings performance as defined in the respective limited partnership agreements. The redemption rights can be triggered by the owner or the Company at such time as both of the following events have occurred: 1) termination of the owner’s employment, regardless of the reason for such termination, and 2) the passage of specified number of years after the closing of the transaction, typically three to five years, as defined in the limited partnership agreement. The redemption rights are not automatic or mandatory (even upon death) and require either the owner or the Company to exercise its rights when the conditions triggering the redemption rights have been satisfied. On the date the Company acquires a controlling interest in a partnership and the limited partnership agreement for such partnership contains redemption rights not under the control of the Company, the fair value of the non-controlling interest is recorded in the consolidated balance sheet under the caption – Redeemable non-controlling interests Non-Controlling Interests The Company recognizes non-controlling interests, in which the Company has no obligation but the right to purchase the non-controlling interests, as equity in the consolidated financial statements separate from the parent entity’s equity. The amount of net income attributable to non-controlling interests is included in consolidated net income on the face of the statements of net income. Changes in a parent entity’s ownership interest in a subsidiary that do not result in deconsolidation are treated as equity transactions if the parent entity retains its controlling financial interest. The Company recognizes a gain or loss in net income when a subsidiary is deconsolidated. Such gain or loss is measured using the fair value of the non-controlling equity investment on the deconsolidation date. When the purchase price of a non-controlling interest by the Company exceeds the book value at the time of purchase, any excess or shortfall is recognized as an adjustment to additional paid-in capital. Additionally, operating losses are allocated to non-controlling interests even when such allocation creates a deficit balance for the non-controlling interest partner. Revenue Recognition Revenues are recognized in the period in which services are rendered. Net patient revenues (patient revenues less estimated contractual adjustments) are reported at the estimated net realizable amounts from third-party payors, patients and others for services rendered. The Company has agreements with third-party payors that provide for payments to the Company at amounts different from its established rates. The allowance for estimated contractual adjustments is based on terms of payor contracts and historical collection and write-off experience. The Company determines allowances for doubtful accounts based on the specific agings and payor classifications at each clinic. The provision for doubtful accounts is included in clinic operating costs in the statements of net income. Patient accounts receivable, which are stated at the historical carrying amount net of contractual allowances, write-offs and allowance for doubtful accounts, includes only those amounts the Company estimates to be collectible. Medicare Reimbursement The Medicare program reimburses outpatient rehabilitation providers based on the Medicare Physician Fee Schedule (‘‘MPFS’’). For services provided in 2018, a 0.5% increase has been applied to the fee schedule payment rates; for services provided in 2019, a 0.25% increase will be applied to the fee schedule payment rates, subject to an adjustment beginning in 2019 under the Merit-Based Incentive Payment System (“MIPS”). For services provided in 2020 through 2025, a 0.0% percent update will be applied each year to the fee schedule payment rates, subject to adjustments under MIPS and any alternative payment models (“APMs”). Beginning in 2019, payments to individual therapists (Physical/Occupational Therapist in Private Practice) under the fee schedule may be subject to adjustment based on performance in MIPS, which measures performance based on certain quality metrics, resource use, and meaningful use of electronic health records. Under the MIPS requirements, a provider's performance is assessed according to established performance standards and used to determine an adjustment factor that is then applied to the professional's payment for a year. Each year from 2019 through 2024 professionals who receive a significant share of their revenues through an APM (such as accountable care organizations or bundled payment arrangements) that involves risk of financial losses and a quality measurement component will receive a 5% bonus. The bonus payment for APM participation is intended to encourage participation and testing of new APMs and to promote the alignment of incentives across payors. The specifics of the MIPS and APM adjustments beginning in 2019 and 2020, respectively, will be subject to future notice and comment rule-making. The Budget Control Act of 2011 increased the federal debt ceiling in connection with deficit reductions over the next ten years, and requires automatic reductions in federal spending by approximately $1.2 trillion. Payments to Medicare providers are subject to these automatic spending reductions, subject to a 2% cap. On April 1, 2013, a 2% reduction to Medicare payments was implemented. The Bipartisan Budget Act of 2015, enacted on November 2, 2015, extended the 2% reductions to Medicare payments through fiscal year 2025. The Bipartisan Budget Act of 2018, enacted on February 9, 2018, extends the 2% reductions to Medicare payments through fiscal year 2027. Historically, the total amount paid by Medicare in any one year for outpatient physical therapy, occupational therapy, and/or speech-language pathology services provided to any Medicare beneficiary was subject to an annual dollar limit (i.e., the ‘‘Therapy Cap’’ or ‘‘Limit’’). For 2017, the annual Limit on outpatient therapy services was $1,980 for combined Physical Therapy and Speech Language Pathology services and $1,980 for Occupational Therapy services. As a result of Bipartisan Budget Act of 2018, the Therapy Caps have been eliminated, effective as of January 1, 2018. Under the Middle Class Tax Relief and Job Creation Act of 2012 (‘‘MCTRA’’), since October 1, 2012, patients who met or exceeded $3,700 in therapy expenditures during a calendar year have been subject to a manual medical review to determine whether applicable payment criteria are satisfied. The $3,700 threshold is applied to Physical Therapy and Speech Language Pathology Services; a separate $3,700 threshold is applied to the Occupational Therapy. The MACRA directed CMS to modify the manual medical review process such that those reviews will no longer apply to all claims exceeding the $3,700 threshold and instead will be determined on a targeted basis based on a variety of factors that CMS considers appropriate The Bipartisan Budget Act of 2018 extends the targeted medical review indefinitely, but reduces the threshold to $3,000 through December 31, 2027. For 2028, the threshold amount will be increased by the percentage increase in the Medicare Economic Index (“MEI”) for 2028 and in subsequent years the threshold amount will increase based on the corresponding percentage increase in the MEI for such subsequent year. CMS adopted a multiple procedure payment reduction (‘‘MPPR’’) for therapy services in the final update to the MPFS for calendar year 2011. The MPPR applied to all outpatient therapy services paid under Medicare Part B — occupational therapy, physical therapy and speech-language pathology. Under the policy, the Medicare program pays 100% of the practice expense component of the Relative Value Unit (‘‘RVU’’) for the therapy procedure with the highest practice expense RVU, then reduces the payment for the practice expense component for the second and subsequent therapy procedures or units of service furnished during the same day for the same patient, regardless of whether those therapy services are furnished in separate sessions. Since 2013, the practice expense component for the second and subsequent therapy service furnished during the same day for the same patient was reduced by 50%. In addition, the MCTRA directed CMS to implement a claims-based data collection program to gather additional data on patient function during the course of therapy in order to better understand patient conditions and outcomes. All practice settings that provide outpatient therapy services are required to include this data on the claim form. Since 2013, therapists have been required to report new codes and modifiers on the claim form that reflect a patient’s functional limitations and goals at initial evaluation, periodically throughout care, and at discharge. Reporting of these functional limitation codes and modifiers are required on the claim for payment. Medicare claims for outpatient therapy services furnished by therapy assistants on or after January 1, 2022 must include a modifier indicating the service was furnished by a therapy assistant. CMS is required to develop a modifier to mark services provided by a therapy assistant by January 1, 2019, and then submitted claims have to report the modifier mark starting January 1, 2020. Outpatient therapy services furnished on or after January 1, 2022 in whole or part by a therapy assistant will be paid at an amount equal to 85% of the payment amount otherwise applicable for the service. Statutes, regulations, and payment rules governing the delivery of therapy services to Medicare beneficiaries are complex and subject to interpretation. We believe that we are in compliance, in all material respects, with all applicable laws and regulations and are not aware of any pending or threatened investigations involving allegations of potential wrongdoing that would have a material effect on the our financial statements as of December 31, 2017. Compliance with such laws and regulations can be subject to future government review and interpretation, as well as significant regulatory action including fines, penalties, and exclusion from the Medicare program. Net patient revenue from Medicare were approximately $92.6 million, $81.8 million and $73.2 million, respectively, for 2017, 2016 and 2015. Management Contract Revenues Management contract revenues, which are included in other revenues, are derived from contractual arrangements whereby the Company manages a clinic for third party owners. The Company does not have any ownership interest in these clinics. Typically, revenues are determined based on the number of visits conducted at the clinic and recognized when services are performed. Costs, typically salaries for the Company’s employees, are recorded when incurred. Workforce Performance Solutions Revenue Revenue from the workforce performance solutions business, which are also included in other revenues, are derived from Revenues are determined based on the number of hours and respective rate for services provided. Contractual Allowances Contractual allowances result from the differences between the rates charged for services performed and expected reimbursements by both insurance companies and government sponsored healthcare programs for such services. Medicare regulations and the various third party payors and managed care contracts are often complex and may include multiple reimbursement mechanisms payable for the services provided in Company clinics. The Company estimates contractual allowances based on its interpretation of the applicable regulations, payor contracts and historical calculations. Each month the Company estimates its contractual allowance for each clinic based on payor contracts and the historical collection experience of the clinic and applies an appropriate contractual allowance reserve percentage to the gross accounts receivable balances for each payor of the clinic. Based on the Company’s historical experience, calculating the contractual allowance reserve percentage at the payor level is sufficient to allow the Company to provide the necessary detail and accuracy with its collectability estimates. However, the services authorized and provided and related reimbursement are subject to interpretation that could result in payments that differ from the Company’s estimates. Payor terms are periodically revised necessitating continual review and assessment of the estimates made by management. The Company’s billing system does not capture the exact change in its contractual allowance reserve estimate from period to period in order to assess the accuracy of its revenues and hence its contractual allowance reserves. Management regularly compares its cash collections to corresponding net revenues measured both in the aggregate and on a clinic-by-clinic basis. In the aggregate, historically the difference between net revenues and corresponding cash collections has generally reflected a difference within approximately 1% of net revenues. Additionally, analysis of subsequent period’s contractual write-offs on a payor basis reflects a difference within approximately 1% between the actual aggregate contractual reserve percentage as compared to the estimated contractual allowance reserve percentage associated with the same period end balance. As a result, the Company believes that a change in the contractual allowance reserve estimate would not likely be more than 1% at December 31, 2017. Income Taxes Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The Company recognizes the financial statement benefit of a tax position only after determining that the relevant tax authority would more likely than not sustain the position following an audit. For tax positions meeting the more-likely-than-not threshold, the amount to be recognized in the financial statements is the largest benefit that has a greater than 50 percent likelihood of being realized upon ultimate settlement with the relevant tax authority. The Tax Cuts and Jobs Act of 2017 (the “TCJA”) was passed by Congress on December 20, 2017 and signed into law by President Trump on December 22, 2017. The TCJA makes significant changes to U.S. corporate income tax laws including a decrease in the corporate income tax rate to 21% effective January 1, 2018. As a result, the Company revalued its deferred tax assets and liabilities. Based on a review and analysis as of December 31, 2017, the Company estimated a reduction of its net deferred tax liabilities by $4.3 million thereby reducing its provision for income taxes by such amount for the 2017 year. The Company did not have any accrued interest or penalties associated with any unrecognized tax benefits nor was any interest expense recognized during the twelve months ended December 31, 2017 and 2016. The Company will book any interest or penalties, if required, in interest and other expense, as appropriate. Fair Values of Financial Instruments The carrying amounts reported in the consolidated balance sheets for cash and cash equivalents, accounts receivable, accounts payable and notes payable approximate their fair values due to the short-term maturity of these financial instruments. The carrying amount under the Amended Credit Agreement (as defined in Note 10) approximates its fair value. The interest rate on the Credit Agreement, which is tied to the Eurodollar Rate, is set at various short-term intervals, as detailed in the Credit Agreement. Segment Reporting Operating segments are components of an enterprise for which separate financial information is available that is evaluated regularly by chief operating decision makers in determining the allocation of resources and in assessing performance. The Company identifies operating segments based on management responsibility and believes it meets the criteria for aggregating its operating segments into a single reporting segment. Use of Estimates In preparing the Company’s consolidated financial statements, management makes certain estimates and assumptions, especially in relation to, but not limited to, goodwill impairment, allowance for receivables, tax provision and contractual allowances, that affect the amounts reported in the consolidated financial statements and related disclosures. Actual results may differ from these estimates. Self-Insurance Program The Company utilizes a self-insurance plan for its employee group health and dental insurance coverage administered by a third party. Predetermined loss limits have been arranged with the insurance company to minimize the Company’s maximum liability and cash outlay. Accrued expenses include the estimated incurred but unreported costs to settle unpaid claims and estimated future claims. Management believes that the current accrued amounts are sufficient to pay claims arising from self-insurance claims incurred through December 31, 2017. Restricted Stock Restricted stock issued to employees and directors is subject to continued employment or continued service on the board, respectively. Generally, restrictions on the stock granted to employees lapse in equal annual installments on the following four anniversaries of the date of grant. For those shares granted to directors, the restrictions will lapse in equal quarterly installments during the first year after the date of grant. For those granted to officers, the restriction will lapse in equal quarterly installments during the four years following the date of grant. Compensation expense for grants of restricted stock is recognized based on the fair value per share on the date of grant amortized over the vesting period. The restricted stock issued is included in basic and diluted shares for the earnings per share computation. Recently Issued Accounting Guidance In January 2017, the FASB issued ASU 2017-04, Simplifying the Test for Goodwill Impairment (Topic 350), which eliminates the requirement to calculate the implied fair value of goodwill to measure a goodwill impairment change. ASU 2017-04 is effective prospectively for fiscal years, and the interim periods within those years, beginning after December 15, 2019. The Company does not expect adoption of this ASU to have a material impact. In February 2016, the FASB issued amended accounting guidance (ASU 2016-02, Leases) which replaced most existing lease accounting guidance under U. S. generally accepted accounting principles. Among other changes, the amended guidance requires that a right-to-use asset, which is an asset that represents the lessee’s right to use, and a lease liability, which is a lessee’s obligation to make lease payments arising for a lease measured on a discounted basis, be recognized on the balance sheet by lessees for those leases with a term of greater than 12 months. The amended guidance is effective for reporting periods beginning after December 15, 2018; however, early adoption is permitted. Entities can use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements or recognize the cumulative effect of applying the new standard as an adjustment to the opening balance of retained earnings. Since the Company leases all but one of its clinic facilities, upon adoption, the Company will recognize significant assets and liabilities on the consolidated balance sheets as a result of the operating lease obligations of the Company. Operating lease expense will still be recognized as rent expense on a straight-line basis over the respective lease terms in the consolidated statements of income. The Company will implement the new standard beginning January 1, 2019. The Company’s implementation efforts are focused on populating the data in a lease accounting software package and developing internal controls in order to account for its leases under the new standard. In May 2014, March 2016, April 2016, and December 2016, the FASB issued ASU 2014-09, Revenue from Contracts with Customers, ASU 2016-08, Revenue from Contracts with Customers, Principal versus Agent Considerations, ASU 2016-10, Revenue from Contracts with Customers, Identifying Performance Obligations and Licensing, ASU 2016-12, Revenue from Contracts with Customers, Narrow Scope Improvements and Practical Expedients, and ASU 2016-20, Technical Corrections and Improvements to Topic 606, Revenue from Contracts with Customer (collectively “the standards”), respectively, which supersede most of the current revenue recognition requirements. The core principle of the new guidance is that an entity should recognize revenue 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. New disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers are also required. The original standards were effective for fiscal years beginning after December 15, 2016; however, in July 2015, the FASB approved a one-year deferral of these standards, with a new effective date for fiscal years beginning after December 15, 2017. The standards require the selection of a retrospective or cumulative effect transition method. The Company implemented the new standard beginning January 1, 2018 using a modified retrospective transition method. Adoption of the new standard did not result in material changes to the presentation of net revenues and bad debt expense in the consolidated statements of income, and the presentation of the amount of income from operations and net income will be unchanged upon adoption of the new standards. The principal change relates to how the new standard requires healthcare providers to estimate the amount of variable consideration to be included in the transaction price up to an amount which is probable that a significant reversal will not occur. The most common form of variable consideration the Company experiences are amounts for services provided that are ultimately not realizable from a customer. Under the current standards, the Company’s estimate for unrealizable amounts is recorded as a reduction of revenue. Under the new standards, the Company’s estimate for unrealizable amounts will continue to be recognized as a reduction to revenue. The bad debt expense historically reported will not materially change. Subsequent Event The Company has evaluated events occurring after the balance sheet date for possible disclosure as a subsequent event through the date that these consolidated financial statements were issued. No disclosures were required.

Acquisitions of Businesses

Acquisitions of Businesses	12 Months Ended
	Dec. 31, 2017
Acquisitions of Businesses [Abstract]
Acquisitions of Businesses	3. Acquisitions of Businesses During 2017, 2016 and 2015, the Company acquired a majority interest in the following multi-clinic physical therapy practices: Date % Interest Acquired Number of Clinics 2017 January 2017 Acquisition January 1 70% 17 May 2017 Acquisition May 31 70% 4 June 2017 Acquisition June 30 60% 9 October 2017 Acquisition October 31 70% 9 2016 February 2016 Acquisition February 29 55% 8 November 2016 Acquisition November 30 60% 12 2015 January 2015 Acquisition January 31 60% 9 April 2015 Acquisition April 30 70% 3 June 2015 Acquisition June 30 70% 4 December 2015 Acquisition December 31 59% 4 On January 1, 2017, the Company acquired a 70% interest in a seventeen-clinic physical therapy practice. The purchase price for the 70% interest was $10.7 million in cash and $0.5 million in a seller note that was payable in two principal installments totaling $250,000 each, plus accrued interest. The first installment was paid in January 2018 and the second installment is due in January 2019. On May 31, 2017, the Company acquired a 70% interest in a four-clinic physical therapy practice. The purchase price for the 70% interest was $2.3 million in cash and $250,000 in a seller note that is payable in two principal installments totaling $125,000 each, plus accrued interest, in May 2018 and 2019. On June 30, 2017, the Company acquired a 60% interest in a nine-clinic physical therapy practice. The purchase price for the 60% interest was $15.8 million in cash and $0.5 million in a seller note that is payable in two principal installments totaling $250,000 each, plus accrued interest, in June 2018 and 2019. On October 31, 2017, the Company acquired a 70% interest in a nine-clinic physical therapy practice and two management contracts with third party providers. The purchase price for the 70% interest was $4.0 million in cash and $0.5 million in a seller note that is payable in two principal installments totaling $250,000 each, plus accrued interest, in October 2018 and 2019. In addition to the above, as previously mentioned in March 2017, the Company acquired a 55% interest in a company which is a leading provider of workforce performance solutions. The purchase price for the 55% interest was $6.2 million in cash and $0.4 million in a seller note that is payable, principal plus accrued interest, in September 2018. Also, in 2017, the Company purchased the assets and business of two physical therapy clinics in separate transactions. One clinic was consolidated with an existing clinic and the other operates as a satellite clinic of one of the existing partnerships. The results of operations of the acquired clinics have been included in the Company’s consolidated financial statements since the date of their respective acquisition. The Company intends to continue to pursue additional acquisition opportunities, develop new clinics and open satellite clinics. The purchase price for the 2017 acquisitions has been preliminarily allocated as follows (in thousands): Cash paid, net of cash acquired $ 36,682 Seller notes 2,150 Total consideration $ 38,832 Estimated fair value of net tangible assets acquired: Total current assets $ 6,248 Total non-current assets 1,818 Total liabilities (2,909 ) Net tangible assets acquired $ 5,157 Referral relationships 3,885 Non-compete 1,224 Tradename 8,439 Goodwill 44,292 Fair value of non-controlling interest (classified as redeemable non-controlling interests) (13,883 ) Fair value of non-controlling interest (originally classified as mandatorily redeemable non-controlling interests) (10,282 ) $ 38,832 On November 30, 2016, the Company acquired a 60% interest in a 12 clinic physical therapy practice. The purchase price for the 60% interest was $11.0 million in cash and $0.5 million in a seller note that is payable in two principal installments of $250,000 each, plus accrued interest. The first installment was paid in November 2017 and the second installment is due in November 2018. On February 29, 2016, the Company acquired a 55% interest in an eight-clinic physical therapy practice. The purchase price for the 55% interest was $13.2 million in cash and $0.5 million in a seller note that is payable in two principal installments of $250,000 each, plus accrued interest. The first installment was paid in February 2017 and the second was paid in February 2018. During 2016, two subsidiaries of the Company each acquired a single clinic therapy practice for an aggregate purchase price of $75,000. The purchase price for the 2016 acquisitions were allocated as follows (in thousands): Cash paid, net of cash acquired $ 23,623 Seller notes 1,000 Total consideration $ 24,623 Fair value of net tangible assets acquired: Total current assets $ 1,372 Total non-current assets 839 Total liabilities (399 ) Net tangible assets acquired $ 1,812 Referral relationships 4,919 Non-compete 847 Tradename 3,802 Goodwill 32,123 Fair value of non-controlling interest (originally classified as mandatorily redeemable non-controlling interests) (18,880 ) $ 24,623 On December 31, 2015, the Company acquired a 59% interest in a four-clinic physical therapy practice. The purchase price was $4.6 million in cash and $400,000 in seller notes payable that were payable in two principal installments of an aggregate of $200,000 each, plus accrued interest. The first payment was paid in December 2016 and the second installment was paid in December 2017. On June 30, 2015, the Company acquired a 70% interest in a four-clinic physical therapy practice. The purchase price was $3.6 million in cash and $0.7 million in seller notes that are payable plus accrued interest, in June 2018. On April 30, 2015, the Company acquired a 70% interest in a three-clinic physical therapy practice. The purchase price was $4.7 million in cash and $150,000 in a seller note that was payable in two principal installments of $75,000 each, plus accrued interest. The first payment was paid in April 2016 and the second installment was paid in April 2017. On January 31, 2015, the Company acquired a 60% interest in a nine-clinic physical therapy practice. The purchase price for the 60% interest was $6.7 million in cash and $0.5 million in a seller note that is payable in two principal installments of $250,000 each, plus accrued interest. This note was paid in full in January 2017. In addition to the multi-clinic acquisitions, on August 31, 2015, the Company acquired a 60% interest in a single physical therapy clinic for $150,000 in cash and $50,000 in a seller note payable plus accrued interest that was paid in August 2016. The purchase prices for the 2015 acquisitions have been allocated as follows (in thousands): Cash paid, net of cash acquired $ 18,965 Seller notes 1,800 Total consideration $ 20,765 Fair value of net tangible assets acquired: Total current assets $ 1,952 Total non-current assets 1,068 Total liabilities (1,067 ) Net tangible assets acquired $ 1,953 Referral relationships 3,655 Non-compete 594 Tradename 3,417 Goodwill 23,437 Fair value of non-controlling interest (12,291 ) $ 20,765 The purchase prices plus the fair value of the non-controlling interests for the acquisition in January 2017 and for the years ended December 31, 2016 and 2015 were allocated to the fair value of the assets acquired, inclusive of identifiable intangible assets, i.e. trade names, referral relationships and non-compete agreements, and liabilities assumed based on the fair values at the acquisition date, with the amount exceeding the fair values being recorded as goodwill are finalized. For the acquisitions occurring on or after February 1, 2017, the Company is in the process of completing its formal valuation analysis to identify and determine the fair value of tangible and identifiable intangible assets acquired and the liabilities assumed. Thus, the final allocation of the purchase price may differ from the preliminary estimates used at December 31, 2017 based on additional information obtained and completion of the valuation of the identifiable intangible assets. Changes in the estimated valuation of the tangible assets acquired, the completion of the valuation of identifiable intangible assets and the completion by the Company of the identification of any unrecorded pre-acquisition contingencies, where the liability is probable and the amount can be reasonably estimated, will likely result in adjustments to goodwill. For the acquisitions in 2016 and 2015, the values assigned to the referral relationships and non-compete agreements are being amortized to expense equally over the respective estimated lives. For referral relationships, the range of the estimated lives was 7½ to 13 years, and for non-compete agreements the estimated lives was five to six years. Generally, the values assigned to tradenames are tested annually for impairment, however with regards to one acquisition in 2013, the tradename was being amortized over the term of the six year agreement in which the Company has acquired the rights to use the specific tradename. In 2016, the remaining value of the tradename was charged to earnings as the Company decided to combine two acquired operations in Georgia; therefore, the tradename under this six year agreement will no longer be used. For the 2017, 2016 and 2015 acquisitions, total current assets primarily represent patient accounts receivable. Total non-current assets are fixed assets, primarily equipment, used in the practices. The consideration paid for each of the acquisitions was derived through arm’s length negotiations. Funding for the cash portions was derived from proceeds from the Company’s revolving credit facility. The results of operations of the acquisitions have been included in the Company’s consolidated financial statements since their respective date of acquisition. Unaudited proforma consolidated financial information for the acquisitions in 2017, 2016 and 2015 acquisitions have not been included as the results, individually and in the aggregate, were not material to current operations.

Non-Controlling Interests

Non-Controlling Interests	12 Months Ended
	Dec. 31, 2017
Non-Controlling Interests [Abstract]
Non-Controlling Interests	4. Non-Controlling Interests During 2017, the Company acquired additional interests in two partnerships included in non-controlling interest. The additional interests purchased in each of the partnerships was 35%. The aggregate purchase price paid was $13,000. Also, during 2017, the Company sold a 2% interest in a partnership for $138,000. The net after-tax difference of $56,000 was credited to additional paid-in capital. During 2016, the Company acquired additional interests in six partnerships included in non-controlling interest. The interests in the partnerships purchased ranged from 2% to 35%. The aggregate purchase price paid was $0.9 million in cash and $0.4 million in a seller note, that is payable in two principal installments of $194,000 each in February 2017 and 2018. The purchase price included $112,000 of undistributed earnings. The remaining $1.2 million, less future tax benefits of $0.5 million, was recognized as an adjustment to additional paid-in capital. During 2016, the Company sold a 4% interest in one partnership and 35% in another. The sales prices included aggregate cash of $138,000 plus notes receivable of $148,000 with payments due monthly based on percentages of distributions and bonuses earned by the purchasers. The total sales price of $286,000, less the tax effect of $110,000, was charged to additional paid-in capital. In 2015, the Company purchased additional interests in six partnerships. The interests in the partnerships purchased ranged from 5% to 35%. The aggregate purchase prices paid were $0.9 million in cash. The purchase prices included an aggregate of $217,000 of undistributed earnings. The remaining $0.7 million, less future tax benefits of $0.3 million, was recognized as an adjustment to additional paid-in capital.

Mandatorily Redeemable Non-Cont

Mandatorily Redeemable Non-Controlling Interest	12 Months Ended
	Dec. 31, 2017
Mandatorily Redeemable Non-Controlling Interest [Abstract]
Mandatorily Redeemable Non-Controlling Interest	5. Mandatorily Redeemable Non-Controlling Interest Prior to the second quarter of 2017, when the Company acquired a majority interest (the “Acquisition”) in a physical therapy clinic business (referred to as “Therapy Practice”), these Acquisitions occurred in a series of steps which are described below. 1. Prior to the Acquisition, the Therapy Practice exists as a separate legal entity (the “Seller Entity”). The Seller Entity is owned by one or more individuals (the “Selling Shareholders”) most of whom are physical therapists that work in the Therapy Practice and provide physical therapy services to patients. 2. In conjunction with the Acquisition, the Seller Entity contributes the Therapy Practice into a newly-formed limited partnership (“NewCo”), in exchange for one hundred percent (100%) of the limited and general partnership interests in NewCo. Therefore, in this step, NewCo becomes a wholly-owned subsidiary of the Seller Entity. 3. The Company enters into an agreement (the “Purchase Agreement”) to acquire from the Seller Entity a majority (ranges from 50% to 90%) of the limited partnership interest and in all 4. The Company and the Seller Entity also execute a partnership agreement (the “Partnership Agreement”) for NewCo that sets forth the rights and obligations of the limited and general partners of NewCo. After the Acquisition, the Company is the general partner of NewCo. 5. As noted above, the Company does not purchase 100% of the limited partnership interests in NewCo and the Seller Entity retains a portion of the limited partnership interest in NewCo (“Seller Entity Interest”). 6. In most cases, some or all of the Selling Shareholders enter into an employment agreement (the “Employment Agreement”) with NewCo with an initial term that ranges from three to five years (the “Employment Term”), with automatic one-year renewals, unless employment is terminated prior to the end of the Employment Term. As a result, a Selling Shareholder becomes an employee (“Employed Selling Shareholder”) of NewCo. The employment of an Employed Selling Shareholder can be terminated by the Employed Selling Shareholder or NewCo, with or without cause, at any time. In a few situations, a Selling Shareholder does not become employed by NewCo and is not involved with NewCo following the closing; in those situations, such Selling Shareholders sell their entire ownership interest in the Seller Entity as of the closing of the Acquisition. 7. The compensation of each Employed Selling Shareholder is specified in the Employment Agreement and is customary and commensurate with his or her responsibilities based on other employees in similar capacities within NewCo, the Company and the industry. 8. The Company and the Selling Shareholder (including both Employed Selling Shareholders and Selling Shareholders not employed by NewCo) execute a non-compete agreement (the “Non-Compete Agreement”) which restricts the Selling Shareholder from engaging in competing business activities for a specified period of time (the “Non-Compete Term”). A Non-Compete Agreement is executed with the Selling Shareholders in all cases. That is, even if the Selling Shareholder does not become an Employed Selling Shareholder, the Selling Shareholder is restricted from engaging in a competing business during the Non-Compete Term. 9. The Non-Compete Term commences as of the date of the Acquisition and expires on the later a. Two years after the date an Employed Selling Shareholders’ employment is terminated (if the Selling Shareholder becomes an Employed Selling Shareholder) or b. Five to six years from the date of the Acquisition, as defined in the Non-Compete Agreement, regardless of whether the Selling Shareholder is employed by NewCo. 10. The Non-Compete Agreement applies to a restricted region which is defined as a 15-mile radius from the Therapy Practice. That is, an Employed Selling Shareholder is permitted to engage in competing businesses or activities outside the 15-mile radius (after such Employed Selling Shareholder no longer is employed by NewCo) and a Selling Shareholder who is not employed by NewCo immediately is permitted to engage in the competing business or activities outside the 15-mile radius. 11. The Partnership Agreement contains provisions for the redemption of the Seller Entity Interest, either at the option of the Company (the “Call Option”) or on a required basis (the “Required Redemption”): a. Required Redemption i. Once the Required Redemption is triggered, the Company is obligated to purchase from the Seller Entity and the Seller Entity is obligated to sell to the Company, the allocable portion of the Seller Entity Interest based on the terminated Selling Shareholder’s pro rata ownership interest in the Seller Entity (the “Allocable Portion”). Required Redemption is triggered when both 1. Termination of an Employed Selling Shareholder’s employment with NewCo, regardless of the reason for such termination, and 2. The expiration of an agreed upon period of time, typically three to five years, as set forth in the relevant Partnership Agreement (the “Holding Period”). ii. In the event an Employed Selling Shareholder’s employment terminates prior to the expiration of the Holding Period, the Required Redemption would occur only b. Call Option i. In the event that an Employed Selling Shareholder’s employment terminates prior to expiration of the Holding Period, the Company has the contractual right, but not the obligation, to acquire the Employed Selling Shareholder’s Allocable Portion of the Seller Entity Interest from the Seller Entity through exercise of the Call Option. c. For the Required Redemption and the Call Option, the purchase price is derived from a formula based on a specified multiple of NewCo’s trailing twelve months of earnings before interest, taxes, depreciation, amortization, and the Company’s internal management fee, plus an Allocable Portion of any undistributed earnings of NewCo (the “Redemption Amount”). NewCo’s earnings are distributed monthly based on available cash within NewCo; therefore the undistributed earnings amount is small, if any. d. The Purchase Price for the initial equity interest purchased by the Company is also based on the same specified multiple of the trailing twelve-month earnings that is used in the Required Redemption noted above. e. Although, the Required Redemption and the Call Option do not have an expiration date, the Seller Entity Interest eventually will be purchased by the Company. f. The Required Redemption and the Call Option never apply to Selling Shareholders who do not become employed by NewCo, since the Company requires that such Selling Shareholders sell their entire ownership interest in the Seller Entity at the closing of the Acquisition. 12. An Employed Selling Shareholder’s ownership of his or her equity interest in the Seller Entity predates the Acquisition and the Company’s purchase of its partnership interest in NewCo. The Employment Agreement and the Non-Compete Agreement do not contain any provision to escrow or “claw back” the equity interest in the Seller Entity held by such Employed Selling Shareholder, nor the Seller Entity Interest in NewCo, in the event of a breach of the employment or non-compete terms. More specifically, even if the Employed Selling Shareholder is terminated for “cause” by NewCo, such Employed Selling Shareholder does not forfeit his or her right to his or her full equity interest in the Seller Entity and the Seller Entity does not forfeit its right to any portion of the Seller Entity Interest. The Company’s only recourse against the Employed Selling Shareholder for breach of either the Employment Agreement or the Non-Compete Agreement is to seek damages and other legal remedies under such agreements. There are no conditions in any of the arrangements with an Employed Selling Shareholder that would result in a forfeiture of the equity interest held in the Seller Entity or of the Seller Entity Interest. As previously mentioned due to amended partnership agreements, the redemption values of the mandatorily redeemable non-controlling interest (previously classified as liabilities) were reclassified as redeemable non-controlling interest (temporary equity) at fair value on the December 31, 2017 consolidated balance sheet. The following table details the changes in the carrying amount of the mandatorily redeemable non-controlling interests (in thousands): Year Ended December 31, 2017 Year Ended December 31, 2016 Beginning balance $ 69,190 $ 45,974 Operating results allocated to mandatorily redeemable non-controlling interest partners 6,055 4,057 Distributions to mandatorily redeemable non-controlling interest partners (7,336 ) (4,628 ) Changes in the redemption value of mandatorily redeemable non-controlling interest 12,894 6,169 Payments for settlement of mandatorily redeemable non-controlling interest (2,361 ) (1,262 ) Purchases of businesses - initial liability related to mandatorily redeemable non-controlling interest 10,282 18,880 Other 119 - Extinguishment of mandatorily redeemable non-controlling interest (88,516 ) - Ending balance $ 327 $ 69,190 The following table categorizes the carrying amount of the mandatorily redeemable non-controlling interests (in thousands): December 31, 2017 December 31, 2016 Contractual time period has lapsed but holder's employment has not been terminated $ 327 $ 24,700 Contractual time period has not lapsed and holder's employment has not been terminated - 46,949 Holder's employment has terminated and contractual time period has expired - - Holder's employment has terminated and contractual time period has not expired - - Redemption value prior to excess distributed earnings $ 327 $ 71,649 Excess distributions over earnings and losses - (2,459 ) $ 327 $ 69,190

Redeemable Non-Controlling Inte

Redeemable Non-Controlling Interest	12 Months Ended
	Dec. 31, 2017
Redeemable Non-Controlling Interest [Abstract]
Redeemable Non-Controlling Interest	6. Redeemable Non-Controlling Interest When the Company acquires a majority interest in a Therapy Practice, those Acquisitions occur in a series of steps as described in numbers 1 through 10 of Footnote 5 – Mandatorily Redeemable Non-Controlling Interests. For the Acquisitions that occurred after the first quarter of 2017, the Partnership Agreement contained provisions for the redemption of the Seller Entity Interest, either at the option of the Company (the “Call Right”) or at the option of the Seller Entity (the “Put Right”) as follows: 1. Put Right a. In the event that any Selling Shareholder’s employment is terminated involuntarily by the Company without “Cause” pursuant to such Selling Shareholder’s Employment Agreement prior to the fifth anniversary of the Closing Date, the Seller Entity thereafter shall have an irrevocable right to cause the Company to purchase from Seller Entity the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest at the purchase price described in “3” below. b. In the event that any Selling Shareholder is not employed by NewCo as of the fifth anniversary of the Closing Date and the Company has not exercised its Call Right with respect to the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest, Seller Entity thereafter shall have the Put Right to cause the Company to purchase from Seller Entity the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest at the purchase price described in “3” below. c. In the event that any Selling Shareholder’s employment with NewCo is terminated for any reason on or after the fifth anniversary of the Closing Date, the Seller Entity shall have the Put Right, and upon the exercise of the Put Right, the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest shall be redeemed by the Company at the purchase price described in “3” below. 2. Call Right a. If any Selling Shareholder’s employment by NewCo is terminated (i) pursuant to a voluntary termination by the Selling Shareholder or (ii) by NewCo with “Cause” (as defined in the Selling Shareholder’s Employment Agreement), prior to the fifth anniversary of the Closing Date, the Company thereafter shall have an irrevocable right to purchase from Seller Entity the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest, in each case at the purchase price described in “3” below. b. In the event that any Selling Shareholder’s employment with NewCo is terminated for any reason on or after the fifth anniversary of the Closing Date, the Company shall have the Call Right, and upon the exercise of the Call Right, the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest shall be redeemed by the Company at the purchase price described in “3” below. 3. For the Put Right and the Call Right, the purchase price is derived from a formula based on a specified multiple of NewCo’s trailing twelve months of earnings before interest, taxes, depreciation, amortization, and the Company’s internal management fee, plus an Allocable Percentage of any undistributed earnings of NewCo (the “Redemption Amount”). NewCo’s earnings are distributed monthly based on available cash within NewCo; therefore, the undistributed earnings amount is small, if any. 4. The Purchase Price for the initial equity interest purchased by the Company is also based on the same specified multiple of the trailing twelve-month earnings that is used in the Put Right and the Call Right noted above. 5. The Put Right and the Call Right do not have an expiration date, but the Seller Entity Interest is not required to be purchased by the Company or sold by the Seller Entity. 6. The Put Right and the Call Right never apply to Selling Shareholders who do not become employed by NewCo, since the Company requires that such Selling Shareholders sell their entire ownership interest in the Seller Entity at the closing of the Acquisition. An Employed Selling Shareholder’s ownership of his or her equity interest in the Seller Entity predates the Acquisition and the Company’s purchase of its partnership interest in NewCo. The Employment Agreement and the Non-Compete Agreement do not contain any provision to escrow or “claw back” the equity interest in the Seller Entity held by such Employed Selling Shareholder, nor the Seller Entity Interest in NewCo, in the event of a breach of the employment or non-compete terms. More specifically, even if the Employed Selling Shareholder is terminated for “cause” by NewCo, such Employed Selling Shareholder does not forfeit his or her right to his or her full equity interest in the Seller Entity and the Seller Entity does not forfeit its right to any portion of the Seller Entity Interest. The Company’s only recourse against the Employed Selling Shareholder for breach of either the Employment Agreement or the Non-Compete Agreement is to seek damages and other legal remedies under such agreements. There are no conditions in any of the arrangements with an Employed Selling Shareholder that would result in a forfeiture of the equity interest held in the Seller Entity or of the Seller Entity Interest. For the year ended December 31, 2017, the following table details the changes in the carrying amount (fair value) of the redeemable non-controlling interests (in thousands): Year Ended December 31, 2017 Beginning balance $ - Operating results allocated to redeemable non-controlling interest partners 244 Distributions to redeemable non-controlling interest partners (272 ) Changes in the fair value of redeemable non-controlling interest 201 Purchases of businesses - initial equity related to redeemable non-controlling interest 13,883 Fair value of redeemable non-controlling interest - amended partnership agreements 88,516 Ending balance $ 102,572 As previously mentioned due to amended partnership agreements, the redemption values of the mandatorily redeemable non-controlling interest (previously classified as liabilities) were reclassified as redeemable non-controlling interest (temporary equity) at fair value on the December 31, 2017 consolidated balance sheet. The following table categorizes the carrying amount (fair value) of the redeemable non-controlling interests (in thousands): December 31, 2017 Contractual time period has lapsed but holder's employment has not been terminated $ 33,613 Contractual time period has not lapsed and holder's employment has not been terminated 72,700 Holder's employment has terminated and contractual time period has expired - Holder's employment has terminated and contractual time period has not expired - Redemption value prior to excess distributed earnings $ 106,313 Excess distributions over earnings and losses (3,741 ) $ 102,572

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2017
Goodwill [Abstract]
Goodwill	7. Goodwill The changes in the carrying amount of goodwill as of December 31, 2017 and 2016 consisted of the following (in thousands): Year Ended December 31, 2017 Year Ended December 31, 2016 Beginning balance $ 226,806 $ 195,373 Goodwill acquired during the year 44,292 31,419 Goodwill adjustments for purchase price allocation of businesses acquired in prior year 706 14 Goodwill written-off - closed clinic (466 ) - Ending balance $ 271,338 $ 226,806 In 2017, the Company wrote off the goodwill

Intangible Assets, net

Intangible Assets, net	12 Months Ended
	Dec. 31, 2017
Intangible Assets, net [Abstract]
Intangible Assets, net	8. Intangible Assets, net Intangible assets, net as of December 31, 2017 and 2016 consisted of the following (in thousands): December 31, 2017 December 31, 2016 Tradenames $ 29,673 $ 21,234 Referral relationships, net of accumulated amortization of $7,209 and $5,275, respectively 16,811 14,859 Non-compete agreements, net of accumulated amortization of $4,100 and $3,380, respectively 2,470 1,967 $ 48,954 $ 38,060 Tradenames, referral relationships and non-compete agreements are related to the businesses acquired. The value assigned to tradenames has an indefinite life and is tested at least annually for impairment using the relief from royalty method in conjunction with the Company’s annual goodwill impairment test. The value assigned to referral relationships is being amortized over their respective estimated useful lives which range from 6 to 16 years. Non-compete agreements are amortized over the respective term of the agreements which range from 5 to 6 years. The following table details the amount of amortization expense recorded for intangible assets for the years ended December 31, 2017, 2016 and 2015 (in thousands): Year Ended Year Ended Year Ended December 31, 2017 December 31, 2016 December 31, 2015 Tradenames $ - $ 330 $ 84 Referral relationships 1,934 1,512 1,153 Non-compete agreements 720 525 478 $ 2,654 $ 2,367 $ 1,715 For one acquisition, the value assigned to tradename was being amortized over the term of the six year agreement in which the Company had acquired the right to use the specific tradename. In 2016, the remaining value of this tradename was charged to earnings and included in amortization expense in the above table as the Company decided to combine two acquired operations in Georgia and the tradename under this six year agreement will no longer be used. The remaining balances of the referral relationships and non-compete agreements is expected to be amortized as follows (in thousands): Referral Relationships Non-Compete Agreements Years Annual Amount Years Annual Amount 2018 $ 2,032 2018 $ 763 2019 $ 1,942 2019 $ 691 2020 $ 1,942 2020 $ 477 2021 $ 1,942 2021 $ 399 2022 $ 1,894 2022 $ 140 Thereafter $ 7,059

Accrued Expenses

Accrued Expenses	12 Months Ended
	Dec. 31, 2017
Accrued Expenses [Abstract]
Accrued Expenses	9. Accrued Expenses Accrued expenses as of December 31, 2017 and 2016 consisted of the following (in thousands): December 31, 2017 December 31, 2016 Salaries and related costs $ 16,828 $ 10,569 Credit balances due to patients and payors 4,158 3,880 Group health insurance claims 2,929 2,499 Federal income tax payable 2,833 - Other 6,594 4,808 Total $ 33,342 $ 21,756

Notes Payable

Notes Payable	12 Months Ended
	Dec. 31, 2017
Notes Payable [Abstract]
Notes Payable	10. Notes Payable Notes payable as of December 31, 2017 and 2016 consisted of the following (dollars in thousands): December 31, 2017 December 31, 2016 Credit Agreement average effective interest rate of 3.6% inclusive of unused fee $ 54,000 $ 46,000 Various notes payable with $4,044 plus accrued interest due in the next year, interest accrues in the range of 3.25% through 4.25% per annum 6,772 5,823 60,772 51,823 Less current portion (4,044 ) (1,227 ) Long term portion $ 56,728 $ 50,596 Effective December 5, 2013, the Company entered into an Amended and Restated Credit Agreement with a commitment for a $125.0 million revolving credit facility. This agreement was amended in August 2015, January 2016, March 2017 and November 2017 (hereafter referred to as “Amended Credit Agreement”). The Amended Credit Agreement is unsecured and has loan covenants, including requirements that the Company comply with a consolidated fixed charge coverage ratio and consolidated leverage ratio. Proceeds from the Amended Credit Agreement may be used for working capital, acquisitions, purchases of the Company’s common stock, dividend payments to the Company’s common stockholders, capital expenditures and other corporate purposes. The pricing grid which is based on the Company’s consolidated leverage ratio with the applicable spread over LIBOR ranging from 1.25% to 2.0% or the applicable spread over the Base Rate ranging from 0.1% to 1%. Fees under the Amended Credit Agreement include an unused commitment fee ranging from 0.25% to 0.3% depending on the Company’s consolidated leverage ratio and the amount of funds outstanding under the Amended Credit Agreement. The January 2016 amendment to the Amended Credit Agreement increased the cash and noncash consideration that the Company could pay with respect to acquisitions permitted under the Amended Credit Agreement to $50,000,000 for any fiscal year, and increased the amount the Company may pay in cash dividends to its shareholders in an aggregate amount not to exceed $10,000,000 in any fiscal year. The March 2017 amendment, among other items, increased the amount the Company may pay in cash dividends to its shareholders in an aggregate amount not to exceed $15,000,000 in any fiscal year. The November 2017 amendment, among other items, adjusted the pricing grid as described above, increased the aggregate amount the Company may pay in cash dividends to its shareholders to an amount not to exceed $20,000,000 and extended the maturity date to November 30, 2021. On December 31, 2017, $54.0 million was outstanding on the Credit Agreement resulting in $71.0 million of availability. As of December 31, 2017, the Company was in compliance with all of the covenants thereunder. The Company generally enters into various notes payable as a means of financing a portion of its acquisitions, purchasing of non-controlling interests and paying the settlement of mandatorily redeemable non-controlling interests. In conjunction with the transactions related to these in 2017, the Company entered into notes payable in the aggregate amount of $2.2 million of which an aggregate principal payment of $1.3 million which is due in 2018 and $0.9 million in 2019. Interest accrues in the range of 3.25% to 4.25% per annum and is payable with each principal installment. Aggregate annual payments of principal required pursuant to the Credit Agreement and the various notes payable subsequent to December 31, 2017 are as follows (in thousands): During the twelve months ended December 31, 2018 $ 4,044 During the twelve months ended December 31, 2019 2,728 During the twelve months ended December 31, 2020 - During the twelve months ended December 31, 2021 54,000 $ 60,772

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2017
Income Taxes [Abstract]
Income Taxes	11. Income Taxes Significant components of deferred tax assets and liabilities included in the consolidated balance sheets at December 31, 2017 and 2016 were as follows (in thousands): December 31, 2017 December 31, 2016 Deferred tax assets: Compensation $ 1,529 $ 1,914 Allowance for doubtful accounts 478 572 Lease obligations - closed clinics 54 57 Deferred tax assets $ 2,061 $ 2,543 Deferred tax liabilities: Depreciation and amortization $ (12,590 ) $ (17,896 ) Other (346 ) (383 ) Deferred tax liabilities (12,936 ) (18,279 ) Net deferred tax liability $ (10,875 ) $ (15,736 ) As a result of TCJA, the Company revalued its deferred tax assets and liabilities as of December 31, 2017. Based on a review and analysis as of December 31, 2017, the Company estimated a reduction of its net deferred tax liabilities by $4.3 million thereby reducing its provision for income taxes by such amount for the 2017 year. The deferred tax assets and liabilities related to purchased interests not yet finalized may result in an immaterial adjustment. Also during 2017, the Company recorded an adjustment to the deferred tax assets having the effect of reducing its net deferred tax liability of $1.2 million related to acquisitions of non-controlling interests in 2016 based on a detailed reconciliation of its federal and state taxes payable and receivable accounts along with its federal and state deferred tax asset and liability accounts. The offset to this adjustment was a reduction in the previously reported tax receivable of approximately $1.7 million and a charge to current year provision for income taxes of $0.3 million. At December 31, 2017, the Company had a federal income tax payable of $2.8 million (included in current liabilities – accrued expenses on the accompanying consolidated balance sheet) and a state income tax receivable of $2.2 million. As of December 31, 2016, the Company had a federal tax receivable of $0.7 million and a state tax receivable of $1.5 million (prior to adjustment of $1.7 million: state tax receivable adjustment $0.6 million and federal tax receivable adjustment of $1.1 million). The tax receivables are included in other current assets on the accompanying consolidated balance sheets. The differences between the federal tax rate and the Company’s effective tax rate for results of continuing operations for the years ended December 31, 2017, 2016 and 2015 were as follows (in thousands): December 31, 2017 December 31, 2016 December 31, 2015 U. S. tax at statutory rate $ 9,900 35.0 % $ 11,351 35.0 % $ 11,991 35.0 % Tax legislation adjustment $ (4,325 ) -15.3 % - - - - State income taxes, net of federal benefit and tax reform 1,060 3.7 % 945 2.9 % 1,337 3.9 % Excess equity compensation deduction (1,139 ) -4.0 % (911 ) -2.8 % - - Non-deductible expenses 560 2.0 % 495 1.5 % 319 0.9 % Other (24 ) -0.1 % - - - - $ 6,032 21.3 % $ 11,880 36.6 % $ 13,647 39.8 % In March 2016, the FASB issued guidance to simplify some provisions in stock compensation accounting. The Company adopted this guidance in the fourth quarter of 2016. Prior to this guidance, excess tax benefits were recorded in additional paid-in capital, but became a component of the income tax provision/benefit in the period in which they occurred. For 2016, the adoption resulted in a reduction of the income tax provision by $1.0 million. For 2017, the excess equity compensation deduction amount was $1.3 million. The federal tax portion is shown above as excess equity compensation deduction. Significant components of the provision for income taxes for the years ended December 31, 2017, 2016 and 2015 were as follows (in thousands): December 31, 2017 December 31, 2016 December 31, 2015 Current: Federal $ 9,332 $ 7,620 $ 6,502 State 1,564 1,281 1,192 Total current 10,896 8,901 7,694 Deferred: Federal (5,233 ) 2,548 5,302 State 369 431 651 Total deferred (4,864 ) 2,979 5,953 Total income tax provision $ 6,032 $ 11,880 $ 13,647 For 2017, 2016 and 2015, the Company performed a detailed reconciliation of its federal and state taxes payable and receivable accounts along with its federal and state deferred tax asset and liability accounts. As a result of this detailed analysis, the Company recorded an increase in the income tax provision of $312,000, $34,000 and $147,000 for 2017, 2016, and 2015, respectively. The Company considers this reconciliation process to be an annual control. The Company is required to establish a valuation allowance for deferred tax assets if, based on the weight of available evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers the projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable income and projections for future taxable income in the periods which the deferred tax assets are deductible, management believes that a valuation allowance is not required, as it is more likely than not that the results of future operations will generate sufficient taxable income to realize the deferred tax assets. The Company’s U.S. federal returns remain open to examination for 2014 through 2016 and U.S. state jurisdictions are open for periods ranging from 2013 through 2016. The Company does not believe that it has any significant uncertain tax positions at December 31, 2017, nor is this expected to change within the next twelve months due to the settlement and expiration of statutes of limitation. The Company did not have any accrued interest or penalties associated with any unrecognized tax benefits nor was any interest expense recognized during the years ended December 31, 2017, 2016 and 2015.

Equity Based Plans

Equity Based Plans	12 Months Ended
	Dec. 31, 2017
Equity Based Plans [Abstract]
Equity Based Plans	12. Equity Based Plans The Company has the following equity based plans with outstanding equity grants: The Amended and Restated 1999 Employee Stock Option Plan (the “Amended 1999 Plan”) permits the Company to grant to non-employee directors and employees of the Company up to 600,000 non-qualified options to purchase shares of common stock and restricted stock (subject to proportionate adjustments in the event of stock dividends, splits, and similar corporate transactions). The exercise prices of options granted under the Amended 1999 Plan are determined by the Compensation Committee. The period within which each option will be exercisable is determined by the Compensation Committee. The Amended 1999 Plan was approved by the shareholders of the Company at the 2008 Shareholders Meeting on May 20, 2008. The Amended and Restated 2003 Stock Option Plan (the “Amended 2003 Plan”) permits the Company to grant to key employees and outside directors of the Company incentive and non-qualified options and shares of restricted stock covering up to 2,100,000 shares of common stock (subject to proportionate adjustments in the event of stock dividends, splits, and similar corporate transactions). The material terms of the Amended 2003 Plan was reapproved by the shareholders of the Company at the 2015 Shareholders Meeting on May 19, 2015 and an increase in the number of shares authorized for issuance from 1,750,000 to 2,100,000 was approved at the 2016 Shareholders Meeting on March 17, 2016. A cumulative summary of equity plans as of December 31, 2017 follows: Authorized Restricted Stock Issued Outstanding Stock Options Stock Options Exercised Stock Options Exercisable Shares Available for Grant Equity Plans Amended 1999 Plan 600,000 416,402 - 139,791 - 7,775 Amended 2003 Plan 2,100,000 839,957 - 778,300 - 481,743 2,700,000 1,256,359 - 918,091 - 489,518 During 2017, 2016 and 2015, the Company granted the following shares of restricted stock to directors, officers and employees pursuant to its equity plans as follows: Year Granted Number of Shares Weighted Average Fair Value Per Share 2017 79,475 $ 62.19 2016 101,790 $ 51.59 2015 147,928 $ 41.66 During 2017, 2016 and 2015, the following shares were cancelled due to employee terminations prior to restrictions lapsing: Year Cancelled Number of Shares Weighted Average Fair Value Per Share 2017 2,875 $ 63.12 2016 4,965 $ 35.78 2015 - - Generally, restrictions on the stock granted to employees lapse in equal annual installments on the following four anniversaries of the date of grant. For those shares granted to directors, the restrictions will lapse in equal quarterly installments during the first year after the date of grant. For those granted to officers, the restriction will lapse in equal quarterly installments during the four years following the date of grant. As of December 31, 2017, there were 174,602 shares outstanding for which restrictions had not lapsed. The restrictions will lapse in 2018 through 2021. Compensation expense for grants of restricted stock is recognized based on the fair value on the date of grant. Compensation expense for restricted stock grants was $5.0 million, $5.0 million and $4.5 million, respectively, for 2017, 2016 and 2015. As of December 31, 2017, the remaining $6.6 million of compensation expense will be recognized from 2018 through 2021.

Preferred Stock

Preferred Stock	12 Months Ended
	Dec. 31, 2017
Preferred Stock [Abstract]
Preferred Stock	13. Preferred Stock The Board is empowered, without approval of the shareholders, to cause shares of preferred stock to be issued in one or more series and to establish the number of shares to be included in each such series and the rights, powers, preferences and limitations of each series. There are no provisions in the Company’s Articles of Incorporation specifying the vote required by the holders of preferred stock to take action. All such provisions would be set out in the designation of any series of preferred stock established by the Board. The bylaws of the Company specify that, when a quorum is present at any meeting, the vote of the holders of at least a majority of the outstanding shares entitled to vote who are present, in person or by proxy, shall decide any question brought before the meeting, unless a different vote is required by law or the Company’s Articles of Incorporation. Because the Board has the power to establish the preferences and rights of each series, it may afford the holders of any series of preferred stock, preferences, powers, and rights, voting or otherwise, senior to the right of holders of common stock. The issuance of the preferred stock could have the effect of delaying or preventing a change in control of the Company.

Common Stock

Common Stock	12 Months Ended
	Dec. 31, 2017
Common Stock [Abstract]
Common Stock	14. Common Stock From September 2001 through December 31, 2008, the Board authorized the Company to purchase, in the open market or in privately negotiated transactions, up to 2,250,000 shares of the Company’s common stock. In March 2009, the Board authorized the repurchase of up to 10% or approximately 1,200,000 shares of its common stock (“March 2009 Authorization”). The Amended Credit Agreement permits share repurchases of up to $15,000,000, subject to compliance with covenants. The Company is required to retire shares purchased under the March 2009 Authorization. Under the March 2009 Authorization, the Company has purchased a total of 859,499 shares. There is no expiration date for the share repurchase program. There are currently an additional estimated 207,756 shares (based on the closing price of $72.20 on December 29, 2017, the last business day in 2017) that may be purchased from time to time in the open market or private transactions depending on price, availability and the Company’s cash position. The Company did not purchase any shares of its common stock during 2017 or 2016.

Defined Contribution Plan

Defined Contribution Plan	12 Months Ended
	Dec. 31, 2017
Defined Contribution Plan [Abstract]
Defined Contribution Plan	15. Defined Contribution Plan The Company has several 401(k) profit sharing plans covering all employees with three months of service. For certain plans, the Company makes matching contributions. The Company may also make discretionary contributions of up to 50% of employee contributions. The Company did not make any discretionary contributions for the years ended December 31, 2017, 2016 and 2015. The Company matching contributions totaled $1.5 million, $1.1 million and $0.9 million, respectively, for the years ended December 31, 2017, 2016 and 2015.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2017
Commitments and Contingencies [Abstract]
Commitments and Contingencies	16. Commitments and Contingencies Operating Leases The Company has entered into operating leases for its executive offices and clinic facilities. In connection with these agreements, the Company incurred rent expense of $34.8 million, $30.3 million and $28.3 million for the years ended December 31, 2017, 2016 and 2015, respectively. Several of the leases provide for an annual increase in the rental payment based upon the Consumer Price Index. The majority of the leases provide for renewal periods ranging from one to five years. The agreements to extend the leases typically specify that rental rates would be adjusted to market rates as of each renewal date. The future minimum operating lease commitments for each of the next five years and thereafter and in the aggregate as of December 31, 2017 are as follows (in thousands): 2018 $ 33,357 2019 25,551 2020 21,777 2021 10,919 2022 6,144 Thereafter 5,009 Total $ 102,757 Employment Agreements At December 31, 2017, the Company had outstanding employment agreements with three of its executive officers. These agreements, which presently expire on December 31, 2018, provide for automatic two year renewals at the conclusion of each expiring term or renewal term. All of the agreements contain a provision for annual adjustment of salaries. In addition, the Company has outstanding employment agreements with most of the managing physical therapist partners of the Company’s physical therapy clinics and with certain other clinic employees which obligate subsidiaries of the Company to pay compensation of $30.1 million in 2018 and $15.6 million in the aggregate from 2019 through 2022. In addition, many of the employment agreements with the managing physical therapists provide for monthly bonus payments calculated as a percentage of each clinic’s net revenues (not in excess of operating profits) or operating profits.

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2017
Earnings Per Share [Abstract]
Earnings Per Share	17. Earnings Per Share The computations of basic and diluted earnings per share for the years ended December 31, 2017, 2016 and 2015 are as follows (in thousands, except per share data): Year Ended Year Ended Year Ended December 31, 2017 December 31, 2016 December 31, 2015 Net income attributable to USPh shareholders $ 22,256 $ 20,551 $ 20,615 Charges to additional paid-in capital Revaluation of redeemable non-controlling interests (201 ) - - Tax effect at statutory rate (federal and state) of 39.25% 75 - - $ 22,130 $ 20,551 $ 20,615 Basic and diluted net income per share attributable to USPH shareholders $ 1.76 $ 1.64 $ 1.66 Shares used in computation: Basic and diluted earnings per share - weighted-average shares 12,570 12,500 12,392

Selected Quarterly Financial Da

Selected Quarterly Financial Data (Unaudited)	12 Months Ended
	Dec. 31, 2017
Selected Quarterly Financial Data (Unaudited) [Abstract]
Selected Quarterly Financial Data (Unaudited)	18. Selected Quarterly Financial Data (Unaudited) Q1 2017 Q2 2017 Q3 2017 Q4 2017 Net patient revenues $ 93,654 $ 97,657 $ 96,273 $ 101,642 Net revenues $ 97,565 $ 104,251 $ 103,032 $ 109,203 Operating income $ 12,200 $ 15,678 $ 12,888 $ 13,962 Net income $ 6,034 $ 6,390 $ 6,594 $ 8,706 Net income attributable to USPH shareholders $ 4,816 $ 4,941 $ 5,150 $ 7,349 Basic and diluted earnings per share attributable to common shareholders: $ 0.38 $ 0.39 $ 0.41 $ 0.57 Shares used in computation - basic and diluted 12,528 12,579 12,581 12,593 Q1 2016 Q2 2016 Q3 2016 Q4 2016 Net patient revenues $ 85,049 $ 88,433 $ 86,411 $ 88,946 Net revenues $ 86,908 $ 90,430 $ 88,344 $ 90,864 Operating income $ 11,491 $ 15,033 $ 12,055 $ 10,954 Net income $ 5,953 $ 7,671 $ 6,134 $ 6,510 Net income attributable to USPH shareholders $ 4,488 $ 6,012 $ 4,804 $ 5,247 Basic and diluted earnings per share attributable to common shareholders: $ 0.36 $ 0.48 $ 0.38 $ 0.42 Shares used in computation - basic and diluted 12,448 12,511 12,520 12,519

SCHEDULE II - VALUATION AND QUA

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS	12 Months Ended
	Dec. 31, 2017
SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS [Abstract]
SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS	SCHEDULE II — VALUATION AND QUALIFYING ACCOUNTS U.S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES Balance at Beginning of Period Additions Charged to Costs and Expenses Additions Charged to Other Accounts Deductions Balance at End of Period YEAR ENDED DECEMBER 31, 2017: Reserves and allowances deducted from asset accounts: Allowance for doubtful accounts(1) $ 1,792 $ 3,672 - $ 3,191 (2 ) $ 2,273 YEAR ENDED DECEMBER 31, 2016: Reserves and allowances deducted from asset accounts: Allowance for doubtful accounts $ 1,642 $ 3,906 - $ 3,756 (2 ) $ 1,792 YEAR ENDED DECEMBER 31, 2015: Reserves and allowances deducted from asset accounts: Allowance for doubtful accounts $ 1,867 $ 4,170 - $ 4,395 (2 ) $ 1,642 (1) Related to patient accounts receivable and accounts receivable—other. (2) Uncollectible accounts written off, net of recoveries. * All other schedules are omitted because of the absence of conditions under which they are required or because the required information is shown in the financial statements or notes thereto.

Significant Accounting Polici26

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2017
Significant Accounting Policies [Abstract]
Cash Equivalents	Cash Equivalents The Company maintains its cash and cash equivalents at financial institutions. The Company considers all highly liquid investments with a maturity of three months or less when purchased to be cash equivalents. The combined account balances at several institutions typically exceed Federal Deposit Insurance Corporation (“FDIC”) insurance coverage and, as a result, there is a concentration of credit risk related to amounts on deposit in excess of FDIC insurance coverage. Management believes that this risk is not significant.
Long-Lived Assets	Long-Lived Assets Fixed assets are stated at cost. Depreciation is computed on the straight-line method over the estimated useful lives of the related assets. Estimated useful lives for furniture and equipment range from three to eight years and for software purchased from three to seven years. Leasehold improvements are amortized over the shorter of the related lease term or estimated useful lives of the assets, which is generally three to five years.
Impairment of Long-Lived Assets and Long-Lived Assets to be Disposed of	Impairment of Long-Lived Assets and Long-Lived Assets to Be Disposed Of The Company reviews property and equipment and intangible assets with finite lives for impairment upon the occurrence of certain events or circumstances that indicate the related amounts may be impaired. Assets to be disposed of are reported at the lower of the carrying amount or fair value less costs to sell.
Goodwill	Goodwill Goodwill represents the excess of the amount paid and fair value of the non-controlling interests over the fair value of the acquired business assets, which include certain identifiable intangible assets. Historically, goodwill has been derived from acquisitions and, prior to 2009, from the purchase of some or all of a particular local management’s equity interest in an existing clinic. Effective January 1, 2009, if the purchase price of a non-controlling interest by the Company exceeds or is less than the book value at the time of purchase, any excess or shortfall is recognized as an adjustment to additional paid-in capital. The fair value of goodwill and other identifiable intangible assets with indefinite lives are tested for impairment annually and upon the occurrence of certain events, and are written down to fair value if considered impaired. The Company evaluates goodwill for impairment on at least an annual basis (in its third quarter) by comparing the fair value of its reporting units to the carrying value of each reporting unit including related goodwill. The Company evaluates indefinite lived tradenames using the relief from royalty method in conjunction with its annual goodwill impairment test. The Company operates a one segment business which is made up of various clinics within partnerships. The partnerships are components of regions and are aggregated to the operating segment level for the purpose of determining the Company’s reporting units when performing its annual goodwill impairment test. In 2017, 2016 and 2015, there were six regions. In addition to the six regions, in 2017, the impairment test included a separate analysis for the workforce performance solutions business, a separate reporting unit. An impairment loss generally would be recognized when the carrying amount of the net assets of a reporting unit, inclusive of goodwill and other identifiable intangible assets, exceeds the estimated fair value of the reporting unit. The estimated fair value of a reporting unit is determined using two factors: (i) earnings prior to taxes, depreciation and amortization for the reporting unit multiplied by a price/earnings ratio used in the industry and (ii) a discounted cash flow analysis. A weight is assigned to each factor and the sum of each weight times the factor is considered the estimated fair value. For 2017, the factors (i.e., price/earnings ratio, discount rate and residual capitalization rate) were updated to reflect current market conditions. The evaluation of goodwill in 2017, 2016 and 2015 did not result in any goodwill amounts that were deemed impaired. The Company has not identified any triggering events occurring after the testing date that would impact the impairment testing results obtained. The Company will continue to monitor for any triggering events or other indicators of impairment.
Mandatorily Redeemable Non-Controlling Interests	Mandatorily Redeemable Non-Controlling Interests The non-controlling interests that are reflected as mandatorily redeemable non-controlling interests in the consolidated financial statements consist of those owners who have certain redemption rights, whether currently exercisable or not, and which currently, or in the future, require that the Company purchase the non-controlling interest of those owners at a predetermined formula based on a multiple of trailing twelve months earnings performance as defined in the respective limited partnership agreements. The redemption rights are triggered at such time as both of the following events have occurred: 1) termination of the owner’s employment, regardless of the reason for such termination, and 2) the passage of specified number of years after the closing of the transaction, typically three to five years, as defined in the limited partnership agreement. On the date the Company acquires a controlling interest in a partnership and the limited partnership agreement for such partnership contains mandatory redemption rights, the fair value of the non-controlling interest is recorded in the long-term liabilities section of the consolidated balance sheet under the caption – Mandatorily redeemable non-controlling interests Interest expense – mandatorily redeemable non-controlling interests – change in redemption value and Interest expense – mandatorily redeemable non-controlling interests – earnings allocable As previously mentioned due to amendments of the limited partnership agreements entered into by the Company, the redemption values of the mandatorily redeemable non-controlling interest (previously classified as liabilities) were amended and are now classified as redeemable non-controlling interest (temporary equity) at fair value on the December 31, 2017 consolidated balance sheet.
Redeemable Non-Controlling Interests	Redeemable Non-Controlling Interests The non-controlling interests that are reflected as redeemable non-controlling interests in the consolidated financial statements consist of those owners and the Company have certain redemption rights, whether currently exercisable or not, and which currently, or in the future, require that the Company purchase or the owner sell the non-controlling interest held by the owner, if certain conditions are met. The purchase price is derived at a predetermined formula based on a multiple of trailing twelve months earnings performance as defined in the respective limited partnership agreements. The redemption rights can be triggered by the owner or the Company at such time as both of the following events have occurred: 1) termination of the owner’s employment, regardless of the reason for such termination, and 2) the passage of specified number of years after the closing of the transaction, typically three to five years, as defined in the limited partnership agreement. The redemption rights are not automatic or mandatory (even upon death) and require either the owner or the Company to exercise its rights when the conditions triggering the redemption rights have been satisfied. On the date the Company acquires a controlling interest in a partnership and the limited partnership agreement for such partnership contains redemption rights not under the control of the Company, the fair value of the non-controlling interest is recorded in the consolidated balance sheet under the caption – Redeemable non-controlling interests
Non-Controlling Interests	Non-Controlling Interests The Company recognizes non-controlling interests, in which the Company has no obligation but the right to purchase the non-controlling interests, as equity in the consolidated financial statements separate from the parent entity’s equity. The amount of net income attributable to non-controlling interests is included in consolidated net income on the face of the statements of net income. Changes in a parent entity’s ownership interest in a subsidiary that do not result in deconsolidation are treated as equity transactions if the parent entity retains its controlling financial interest. The Company recognizes a gain or loss in net income when a subsidiary is deconsolidated. Such gain or loss is measured using the fair value of the non-controlling equity investment on the deconsolidation date. When the purchase price of a non-controlling interest by the Company exceeds the book value at the time of purchase, any excess or shortfall is recognized as an adjustment to additional paid-in capital. Additionally, operating losses are allocated to non-controlling interests even when such allocation creates a deficit balance for the non-controlling interest partner.
Revenue Recognition	Revenue Recognition Revenues are recognized in the period in which services are rendered. Net patient revenues (patient revenues less estimated contractual adjustments) are reported at the estimated net realizable amounts from third-party payors, patients and others for services rendered. The Company has agreements with third-party payors that provide for payments to the Company at amounts different from its established rates. The allowance for estimated contractual adjustments is based on terms of payor contracts and historical collection and write-off experience. The Company determines allowances for doubtful accounts based on the specific agings and payor classifications at each clinic. The provision for doubtful accounts is included in clinic operating costs in the statements of net income. Patient accounts receivable, which are stated at the historical carrying amount net of contractual allowances, write-offs and allowance for doubtful accounts, includes only those amounts the Company estimates to be collectible. Medicare Reimbursement The Medicare program reimburses outpatient rehabilitation providers based on the Medicare Physician Fee Schedule (‘‘MPFS’’). For services provided in 2018, a 0.5% increase has been applied to the fee schedule payment rates; for services provided in 2019, a 0.25% increase will be applied to the fee schedule payment rates, subject to an adjustment beginning in 2019 under the Merit-Based Incentive Payment System (“MIPS”). For services provided in 2020 through 2025, a 0.0% percent update will be applied each year to the fee schedule payment rates, subject to adjustments under MIPS and any alternative payment models (“APMs”). Beginning in 2019, payments to individual therapists (Physical/Occupational Therapist in Private Practice) under the fee schedule may be subject to adjustment based on performance in MIPS, which measures performance based on certain quality metrics, resource use, and meaningful use of electronic health records. Under the MIPS requirements, a provider's performance is assessed according to established performance standards and used to determine an adjustment factor that is then applied to the professional's payment for a year. Each year from 2019 through 2024 professionals who receive a significant share of their revenues through an APM (such as accountable care organizations or bundled payment arrangements) that involves risk of financial losses and a quality measurement component will receive a 5% bonus. The bonus payment for APM participation is intended to encourage participation and testing of new APMs and to promote the alignment of incentives across payors. The specifics of the MIPS and APM adjustments beginning in 2019 and 2020, respectively, will be subject to future notice and comment rule-making. The Budget Control Act of 2011 increased the federal debt ceiling in connection with deficit reductions over the next ten years, and requires automatic reductions in federal spending by approximately $1.2 trillion. Payments to Medicare providers are subject to these automatic spending reductions, subject to a 2% cap. On April 1, 2013, a 2% reduction to Medicare payments was implemented. The Bipartisan Budget Act of 2015, enacted on November 2, 2015, extended the 2% reductions to Medicare payments through fiscal year 2025. The Bipartisan Budget Act of 2018, enacted on February 9, 2018, extends the 2% reductions to Medicare payments through fiscal year 2027. Historically, the total amount paid by Medicare in any one year for outpatient physical therapy, occupational therapy, and/or speech-language pathology services provided to any Medicare beneficiary was subject to an annual dollar limit (i.e., the ‘‘Therapy Cap’’ or ‘‘Limit’’). For 2017, the annual Limit on outpatient therapy services was $1,980 for combined Physical Therapy and Speech Language Pathology services and $1,980 for Occupational Therapy services. As a result of Bipartisan Budget Act of 2018, the Therapy Caps have been eliminated, effective as of January 1, 2018. Under the Middle Class Tax Relief and Job Creation Act of 2012 (‘‘MCTRA’’), since October 1, 2012, patients who met or exceeded $3,700 in therapy expenditures during a calendar year have been subject to a manual medical review to determine whether applicable payment criteria are satisfied. The $3,700 threshold is applied to Physical Therapy and Speech Language Pathology Services; a separate $3,700 threshold is applied to the Occupational Therapy. The MACRA directed CMS to modify the manual medical review process such that those reviews will no longer apply to all claims exceeding the $3,700 threshold and instead will be determined on a targeted basis based on a variety of factors that CMS considers appropriate The Bipartisan Budget Act of 2018 extends the targeted medical review indefinitely, but reduces the threshold to $3,000 through December 31, 2027. For 2028, the threshold amount will be increased by the percentage increase in the Medicare Economic Index (“MEI”) for 2028 and in subsequent years the threshold amount will increase based on the corresponding percentage increase in the MEI for such subsequent year. CMS adopted a multiple procedure payment reduction (‘‘MPPR’’) for therapy services in the final update to the MPFS for calendar year 2011. The MPPR applied to all outpatient therapy services paid under Medicare Part B — occupational therapy, physical therapy and speech-language pathology. Under the policy, the Medicare program pays 100% of the practice expense component of the Relative Value Unit (‘‘RVU’’) for the therapy procedure with the highest practice expense RVU, then reduces the payment for the practice expense component for the second and subsequent therapy procedures or units of service furnished during the same day for the same patient, regardless of whether those therapy services are furnished in separate sessions. Since 2013, the practice expense component for the second and subsequent therapy service furnished during the same day for the same patient was reduced by 50%. In addition, the MCTRA directed CMS to implement a claims-based data collection program to gather additional data on patient function during the course of therapy in order to better understand patient conditions and outcomes. All practice settings that provide outpatient therapy services are required to include this data on the claim form. Since 2013, therapists have been required to report new codes and modifiers on the claim form that reflect a patient’s functional limitations and goals at initial evaluation, periodically throughout care, and at discharge. Reporting of these functional limitation codes and modifiers are required on the claim for payment. Medicare claims for outpatient therapy services furnished by therapy assistants on or after January 1, 2022 must include a modifier indicating the service was furnished by a therapy assistant. CMS is required to develop a modifier to mark services provided by a therapy assistant by January 1, 2019, and then submitted claims have to report the modifier mark starting January 1, 2020. Outpatient therapy services furnished on or after January 1, 2022 in whole or part by a therapy assistant will be paid at an amount equal to 85% of the payment amount otherwise applicable for the service. Statutes, regulations, and payment rules governing the delivery of therapy services to Medicare beneficiaries are complex and subject to interpretation. We believe that we are in compliance, in all material respects, with all applicable laws and regulations and are not aware of any pending or threatened investigations involving allegations of potential wrongdoing that would have a material effect on the our financial statements as of December 31, 2017. Compliance with such laws and regulations can be subject to future government review and interpretation, as well as significant regulatory action including fines, penalties, and exclusion from the Medicare program. Net patient revenue from Medicare were approximately $92.6 million, $81.8 million and $73.2 million, respectively, for 2017, 2016 and 2015. Management Contract Revenues Management contract revenues, which are included in other revenues, are derived from contractual arrangements whereby the Company manages a clinic for third party owners. The Company does not have any ownership interest in these clinics. Typically, revenues are determined based on the number of visits conducted at the clinic and recognized when services are performed. Costs, typically salaries for the Company’s employees, are recorded when incurred. Workforce Performance Solutions Revenue Revenue from the workforce performance solutions business, which are also included in other revenues, are derived from Revenues are determined based on the number of hours and respective rate for services provided.
Contractual Allowances	Contractual Allowances Contractual allowances result from the differences between the rates charged for services performed and expected reimbursements by both insurance companies and government sponsored healthcare programs for such services. Medicare regulations and the various third party payors and managed care contracts are often complex and may include multiple reimbursement mechanisms payable for the services provided in Company clinics. The Company estimates contractual allowances based on its interpretation of the applicable regulations, payor contracts and historical calculations. Each month the Company estimates its contractual allowance for each clinic based on payor contracts and the historical collection experience of the clinic and applies an appropriate contractual allowance reserve percentage to the gross accounts receivable balances for each payor of the clinic. Based on the Company’s historical experience, calculating the contractual allowance reserve percentage at the payor level is sufficient to allow the Company to provide the necessary detail and accuracy with its collectability estimates. However, the services authorized and provided and related reimbursement are subject to interpretation that could result in payments that differ from the Company’s estimates. Payor terms are periodically revised necessitating continual review and assessment of the estimates made by management. The Company’s billing system does not capture the exact change in its contractual allowance reserve estimate from period to period in order to assess the accuracy of its revenues and hence its contractual allowance reserves. Management regularly compares its cash collections to corresponding net revenues measured both in the aggregate and on a clinic-by-clinic basis. In the aggregate, historically the difference between net revenues and corresponding cash collections has generally reflected a difference within approximately 1% of net revenues. Additionally, analysis of subsequent period’s contractual write-offs on a payor basis reflects a difference within approximately 1% between the actual aggregate contractual reserve percentage as compared to the estimated contractual allowance reserve percentage associated with the same period end balance. As a result, the Company believes that a change in the contractual allowance reserve estimate would not likely be more than 1% at December 31, 2017.
Income Taxes	Income Taxes Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The Company recognizes the financial statement benefit of a tax position only after determining that the relevant tax authority would more likely than not sustain the position following an audit. For tax positions meeting the more-likely-than-not threshold, the amount to be recognized in the financial statements is the largest benefit that has a greater than 50 percent likelihood of being realized upon ultimate settlement with the relevant tax authority. The Tax Cuts and Jobs Act of 2017 (the “TCJA”) was passed by Congress on December 20, 2017 and signed into law by President Trump on December 22, 2017. The TCJA makes significant changes to U.S. corporate income tax laws including a decrease in the corporate income tax rate to 21% effective January 1, 2018. As a result, the Company revalued its deferred tax assets and liabilities. Based on a review and analysis as of December 31, 2017, the Company estimated a reduction of its net deferred tax liabilities by $4.3 million thereby reducing its provision for income taxes by such amount for the 2017 year. The Company did not have any accrued interest or penalties associated with any unrecognized tax benefits nor was any interest expense recognized during the twelve months ended December 31, 2017 and 2016. The Company will book any interest or penalties, if required, in interest and other expense, as appropriate.
Fair Values of Financial Instruments	Fair Values of Financial Instruments The carrying amounts reported in the consolidated balance sheets for cash and cash equivalents, accounts receivable, accounts payable and notes payable approximate their fair values due to the short-term maturity of these financial instruments. The carrying amount under the Amended Credit Agreement (as defined in Note 10) approximates its fair value. The interest rate on the Credit Agreement, which is tied to the Eurodollar Rate, is set at various short-term intervals, as detailed in the Credit Agreement.
Segment Reporting	Segment Reporting Operating segments are components of an enterprise for which separate financial information is available that is evaluated regularly by chief operating decision makers in determining the allocation of resources and in assessing performance. The Company identifies operating segments based on management responsibility and believes it meets the criteria for aggregating its operating segments into a single reporting segment.
Use of Estimates	Use of Estimates In preparing the Company’s consolidated financial statements, management makes certain estimates and assumptions, especially in relation to, but not limited to, goodwill impairment, allowance for receivables, tax provision and contractual allowances, that affect the amounts reported in the consolidated financial statements and related disclosures. Actual results may differ from these estimates.
Self-Insurance Program	Self-Insurance Program The Company utilizes a self-insurance plan for its employee group health and dental insurance coverage administered by a third party. Predetermined loss limits have been arranged with the insurance company to minimize the Company’s maximum liability and cash outlay. Accrued expenses include the estimated incurred but unreported costs to settle unpaid claims and estimated future claims. Management believes that the current accrued amounts are sufficient to pay claims arising from self-insurance claims incurred through December 31, 2017.
Restricted Stock	Restricted Stock Restricted stock issued to employees and directors is subject to continued employment or continued service on the board, respectively. Generally, restrictions on the stock granted to employees lapse in equal annual installments on the following four anniversaries of the date of grant. For those shares granted to directors, the restrictions will lapse in equal quarterly installments during the first year after the date of grant. For those granted to officers, the restriction will lapse in equal quarterly installments during the four years following the date of grant. Compensation expense for grants of restricted stock is recognized based on the fair value per share on the date of grant amortized over the vesting period. The restricted stock issued is included in basic and diluted shares for the earnings per share computation.
Recently Issued Accounting Guidance	Recently Issued Accounting Guidance In January 2017, the FASB issued ASU 2017-04, Simplifying the Test for Goodwill Impairment (Topic 350), which eliminates the requirement to calculate the implied fair value of goodwill to measure a goodwill impairment change. ASU 2017-04 is effective prospectively for fiscal years, and the interim periods within those years, beginning after December 15, 2019. The Company does not expect adoption of this ASU to have a material impact. In February 2016, the FASB issued amended accounting guidance (ASU 2016-02, Leases) which replaced most existing lease accounting guidance under U. S. generally accepted accounting principles. Among other changes, the amended guidance requires that a right-to-use asset, which is an asset that represents the lessee’s right to use, and a lease liability, which is a lessee’s obligation to make lease payments arising for a lease measured on a discounted basis, be recognized on the balance sheet by lessees for those leases with a term of greater than 12 months. The amended guidance is effective for reporting periods beginning after December 15, 2018; however, early adoption is permitted. Entities can use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements or recognize the cumulative effect of applying the new standard as an adjustment to the opening balance of retained earnings. Since the Company leases all but one of its clinic facilities, upon adoption, the Company will recognize significant assets and liabilities on the consolidated balance sheets as a result of the operating lease obligations of the Company. Operating lease expense will still be recognized as rent expense on a straight-line basis over the respective lease terms in the consolidated statements of income. The Company will implement the new standard beginning January 1, 2019. The Company’s implementation efforts are focused on populating the data in a lease accounting software package and developing internal controls in order to account for its leases under the new standard. In May 2014, March 2016, April 2016, and December 2016, the FASB issued ASU 2014-09, Revenue from Contracts with Customers, ASU 2016-08, Revenue from Contracts with Customers, Principal versus Agent Considerations, ASU 2016-10, Revenue from Contracts with Customers, Identifying Performance Obligations and Licensing, ASU 2016-12, Revenue from Contracts with Customers, Narrow Scope Improvements and Practical Expedients, and ASU 2016-20, Technical Corrections and Improvements to Topic 606, Revenue from Contracts with Customer (collectively “the standards”), respectively, which supersede most of the current revenue recognition requirements. The core principle of the new guidance is that an entity should recognize revenue 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. New disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers are also required. The original standards were effective for fiscal years beginning after December 15, 2016; however, in July 2015, the FASB approved a one-year deferral of these standards, with a new effective date for fiscal years beginning after December 15, 2017. The standards require the selection of a retrospective or cumulative effect transition method. The Company implemented the new standard beginning January 1, 2018 using a modified retrospective transition method. Adoption of the new standard did not result in material changes to the presentation of net revenues and bad debt expense in the consolidated statements of income, and the presentation of the amount of income from operations and net income will be unchanged upon adoption of the new standards. The principal change relates to how the new standard requires healthcare providers to estimate the amount of variable consideration to be included in the transaction price up to an amount which is probable that a significant reversal will not occur. The most common form of variable consideration the Company experiences are amounts for services provided that are ultimately not realizable from a customer. Under the current standards, the Company’s estimate for unrealizable amounts is recorded as a reduction of revenue. Under the new standards, the Company’s estimate for unrealizable amounts will continue to be recognized as a reduction to revenue. The bad debt expense historically reported will not materially change.
Subsequent Event	Subsequent Event The Company has evaluated events occurring after the balance sheet date for possible disclosure as a subsequent event through the date that these consolidated financial statements were issued. No disclosures were required.

Organization, Nature of Opera27

Organization, Nature of Operations and Basis of Presentation (Tables)	12 Months Ended
	Dec. 31, 2017
Organization, Nature of Operations and Basis of Presentation [Abstract]
Schedule of Multi Clinic Acquisition	During the last three years, the Company completed the following multi-clinic acquisitions: Date % Interest Acquired Number of Clinics 2017 January 2017 Acquisition January 1 70% 17 May 2017 Acquisition May 31 70% 4 June 2017 Acquisition June 30 60% 9 October 2017 Acquisition October 31 70% 9 2016 February 2016 Acquisition February 29 55% 8 November 2016 Acquisition November 30 60% 12 2015 January 2015 Acquisition January 31 60% 9 April 2015 Acquisition April 30 70% 3 June 2015 Acquisition June 30 70% 4 December 2015 Acquisition December 31 59% 4

Acquisitions of Businesses (Tab

Acquisitions of Businesses (Tables)	12 Months Ended
	Dec. 31, 2017
Acquisitions of Businesses [Abstract]
Schedule of Multi Clinic Acquisition	During the last three years, the Company completed the following multi-clinic acquisitions: Date % Interest Acquired Number of Clinics 2017 January 2017 Acquisition January 1 70% 17 May 2017 Acquisition May 31 70% 4 June 2017 Acquisition June 30 60% 9 October 2017 Acquisition October 31 70% 9 2016 February 2016 Acquisition February 29 55% 8 November 2016 Acquisition November 30 60% 12 2015 January 2015 Acquisition January 31 60% 9 April 2015 Acquisition April 30 70% 3 June 2015 Acquisition June 30 70% 4 December 2015 Acquisition December 31 59% 4
Schedule of Preliminary Purchase Prices Allocation	The purchase price for the 2017 acquisitions has been preliminarily allocated as follows (in thousands): Cash paid, net of cash acquired $ 36,682 Seller notes 2,150 Total consideration $ 38,832 Estimated fair value of net tangible assets acquired: Total current assets $ 6,248 Total non-current assets 1,818 Total liabilities (2,909 ) Net tangible assets acquired $ 5,157 Referral relationships 3,885 Non-compete 1,224 Tradename 8,439 Goodwill 44,292 Fair value of non-controlling interest (classified as redeemable non-controlling interests) (13,883 ) Fair value of non-controlling interest (originally classified as mandatorily redeemable non-controlling interests) (10,282 ) $ 38,832 The purchase price for the 2016 acquisitions were allocated as follows (in thousands): Cash paid, net of cash acquired $ 23,623 Seller notes 1,000 Total consideration $ 24,623 Fair value of net tangible assets acquired: Total current assets $ 1,372 Total non-current assets 839 Total liabilities (399 ) Net tangible assets acquired $ 1,812 Referral relationships 4,919 Non-compete 847 Tradename 3,802 Goodwill 32,123 Fair value of non-controlling interest (originally classified as mandatorily redeemable non-controlling interests) (18,880 ) $ 24,623 The purchase prices for the 2015 acquisitions have been allocated as follows (in thousands): Cash paid, net of cash acquired $ 18,965 Seller notes 1,800 Total consideration $ 20,765 Fair value of net tangible assets acquired: Total current assets $ 1,952 Total non-current assets 1,068 Total liabilities (1,067 ) Net tangible assets acquired $ 1,953 Referral relationships 3,655 Non-compete 594 Tradename 3,417 Goodwill 23,437 Fair value of non-controlling interest (12,291 ) $ 20,765

Mandatorily Redeemable Non-Co29

Mandatorily Redeemable Non-Controlling Interest (Tables)	12 Months Ended
	Dec. 31, 2017
Mandatorily Redeemable Non-Controlling Interest [Abstract]
Changes in Carrying Amount of Mandatorily Redeemable Non-Controlling Interest	The following table details the changes in the carrying amount of the mandatorily redeemable non-controlling interests (in thousands): Year Ended December 31, 2017 Year Ended December 31, 2016 Beginning balance $ 69,190 $ 45,974 Operating results allocated to mandatorily redeemable non-controlling interest partners 6,055 4,057 Distributions to mandatorily redeemable non-controlling interest partners (7,336 ) (4,628 ) Changes in the redemption value of mandatorily redeemable non-controlling interest 12,894 6,169 Payments for settlement of mandatorily redeemable non-controlling interest (2,361 ) (1,262 ) Purchases of businesses - initial liability related to mandatorily redeemable non-controlling interest 10,282 18,880 Other 119 - Extinguishment of mandatorily redeemable non-controlling interest (88,516 ) - Ending balance $ 327 $ 69,190
Carrying Amount of Mandatorily Redeemable Non-Controlling Interest	The following table categorizes the carrying amount of the mandatorily redeemable non-controlling interests (in thousands): December 31, 2017 December 31, 2016 Contractual time period has lapsed but holder's employment has not been terminated $ 327 $ 24,700 Contractual time period has not lapsed and holder's employment has not been terminated - 46,949 Holder's employment has terminated and contractual time period has expired - - Holder's employment has terminated and contractual time period has not expired - - Redemption value prior to excess distributed earnings $ 327 $ 71,649 Excess distributions over earnings and losses - (2,459 ) $ 327 $ 69,190

Redeemable Non-Controlling In30

Redeemable Non-Controlling Interest (Tables)	12 Months Ended
	Dec. 31, 2017
Redeemable Non-Controlling Interest [Abstract]
Changes in Carrying Amount (Fair Value) of Redeemable Non-Controlling Interest	For the year ended December 31, 2017, the following table details the changes in the carrying amount (fair value) of the redeemable non-controlling interests (in thousands): Year Ended December 31, 2017 Beginning balance $ - Operating results allocated to redeemable non-controlling interest partners 244 Distributions to redeemable non-controlling interest partners (272 ) Changes in the fair value of redeemable non-controlling interest 201 Purchases of businesses - initial equity related to redeemable non-controlling interest 13,883 Fair value of redeemable non-controlling interest - amended partnership agreements 88,516 Ending balance $ 102,572
Carrying Amount of (Fair Value) Redeemable Non-Controlling Interest	The following table categorizes the carrying amount (fair value) of the redeemable non-controlling interests (in thousands): December 31, 2017 Contractual time period has lapsed but holder's employment has not been terminated $ 33,613 Contractual time period has not lapsed and holder's employment has not been terminated 72,700 Holder's employment has terminated and contractual time period has expired - Holder's employment has terminated and contractual time period has not expired - Redemption value prior to excess distributed earnings $ 106,313 Excess distributions over earnings and losses (3,741 ) $ 102,572

Goodwill (Tables)

Goodwill (Tables)	12 Months Ended
	Dec. 31, 2017
Goodwill [Abstract]
Summary of Changes in Carrying Amount of Goodwill	The changes in the carrying amount of goodwill as of December 31, 2017 and 2016 consisted of the following (in thousands): Year Ended December 31, 2017 Year Ended December 31, 2016 Beginning balance $ 226,806 $ 195,373 Goodwill acquired during the year 44,292 31,419 Goodwill adjustments for purchase price allocation of businesses acquired in prior year 706 14 Goodwill written-off - closed clinic (466 ) - Ending balance $ 271,338 $ 226,806

Intangible Assets, net (Tables)

Intangible Assets, net (Tables)	12 Months Ended
	Dec. 31, 2017
Intangible Assets, net [Abstract]
Intangible Assets, Net	Intangible assets, net as of December 31, 2017 and 2016 consisted of the following (in thousands): December 31, 2017 December 31, 2016 Tradenames $ 29,673 $ 21,234 Referral relationships, net of accumulated amortization of $7,209 and $5,275, respectively 16,811 14,859 Non-compete agreements, net of accumulated amortization of $4,100 and $3,380, respectively 2,470 1,967 $ 48,954 $ 38,060
Amortization Expenses	The following table details the amount of amortization expense recorded for intangible assets for the years ended December 31, 2017, 2016 and 2015 (in thousands): Year Ended Year Ended Year Ended December 31, 2017 December 31, 2016 December 31, 2015 Tradenames $ - $ 330 $ 84 Referral relationships 1,934 1,512 1,153 Non-compete agreements 720 525 478 $ 2,654 $ 2,367 $ 1,715
Amortization of Referral Relationships and Non Competition Agreements	The remaining balances of the referral relationships and non-compete agreements is expected to be amortized as follows (in thousands): Referral Relationships Non-Compete Agreements Years Annual Amount Years Annual Amount 2018 $ 2,032 2018 $ 763 2019 $ 1,942 2019 $ 691 2020 $ 1,942 2020 $ 477 2021 $ 1,942 2021 $ 399 2022 $ 1,894 2022 $ 140 Thereafter $ 7,059

Accrued Expenses (Tables)

Accrued Expenses (Tables)	12 Months Ended
	Dec. 31, 2017
Accrued Expenses [Abstract]
Summary of Accrued Expenses	Accrued expenses as of December 31, 2017 and 2016 consisted of the following (in thousands): December 31, 2017 December 31, 2016 Salaries and related costs $ 16,828 $ 10,569 Credit balances due to patients and payors 4,158 3,880 Group health insurance claims 2,929 2,499 Federal income tax payable 2,833 - Other 6,594 4,808 Total $ 33,342 $ 21,756

Notes Payable (Tables)

Notes Payable (Tables)	12 Months Ended
	Dec. 31, 2017
Notes Payable [Abstract]
Summary of Credit Agreement and Notes Payable	Notes payable as of December 31, 2017 and 2016 consisted of the following (dollars in thousands): December 31, 2017 December 31, 2016 Credit Agreement average effective interest rate of 3.6% inclusive of unused fee $ 54,000 $ 46,000 Various notes payable with $4,044 plus accrued interest due in the next year, interest accrues in the range of 3.25% through 4.25% per annum 6,772 5,823 60,772 51,823 Less current portion (4,044 ) (1,227 ) Long term portion $ 56,728 $ 50,596
Summary of Aggregate Annual Payments of Principal Required to Revolving Credit Facility	Aggregate annual payments of principal required pursuant to the Credit Agreement and the various notes payable subsequent to December 31, 2017 are as follows (in thousands): During the twelve months ended December 31, 2018 $ 4,044 During the twelve months ended December 31, 2019 2,728 During the twelve months ended December 31, 2020 - During the twelve months ended December 31, 2021 54,000 $ 60,772

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2017
Income Taxes [Abstract]
Schedule of Components of Deferred Tax Assets and Liabilities Included in Consolidated Balance Sheets	Significant components of deferred tax assets and liabilities included in the consolidated balance sheets at December 31, 2017 and 2016 were as follows (in thousands): December 31, 2017 December 31, 2016 Deferred tax assets: Compensation $ 1,529 $ 1,914 Allowance for doubtful accounts 478 572 Lease obligations - closed clinics 54 57 Deferred tax assets $ 2,061 $ 2,543 Deferred tax liabilities: Depreciation and amortization $ (12,590 ) $ (17,896 ) Other (346 ) (383 ) Deferred tax liabilities (12,936 ) (18,279 ) Net deferred tax liability $ (10,875 ) $ (15,736 )
Schedule of Differences Between Federal Tax Rate and Company's Effective Tax Rate for Results of Continuing Operations	The differences between the federal tax rate and the Company’s effective tax rate for results of continuing operations for the years ended December 31, 2017, 2016 and 2015 were as follows (in thousands): December 31, 2017 December 31, 2016 December 31, 2015 U. S. tax at statutory rate $ 9,900 35.0 % $ 11,351 35.0 % $ 11,991 35.0 % Tax legislation adjustment $ (4,325 ) -15.3 % - - - - State income taxes, net of federal benefit and tax reform 1,060 3.7 % 945 2.9 % 1,337 3.9 % Excess equity compensation deduction (1,139 ) -4.0 % (911 ) -2.8 % - - Non-deductible expenses 560 2.0 % 495 1.5 % 319 0.9 % Other (24 ) -0.1 % - - - - $ 6,032 21.3 % $ 11,880 36.6 % $ 13,647 39.8 %
Schedule of Significant Components of Provision for Income Taxes for Continuing Operations	Significant components of the provision for income taxes for the years ended December 31, 2017, 2016 and 2015 were as follows (in thousands): December 31, 2017 December 31, 2016 December 31, 2015 Current: Federal $ 9,332 $ 7,620 $ 6,502 State 1,564 1,281 1,192 Total current 10,896 8,901 7,694 Deferred: Federal (5,233 ) 2,548 5,302 State 369 431 651 Total deferred (4,864 ) 2,979 5,953 Total income tax provision $ 6,032 $ 11,880 $ 13,647

Equity Based Plans (Tables)

Equity Based Plans (Tables)	12 Months Ended
	Dec. 31, 2017
Equity Based Plans [Abstract]
Summary of Cumulative Summary of Equity Plans	A cumulative summary of equity plans as of December 31, 2017 follows: Authorized Restricted Stock Issued Outstanding Stock Options Stock Options Exercised Stock Options Exercisable Shares Available for Grant Equity Plans Amended 1999 Plan 600,000 416,402 - 139,791 - 7,775 Amended 2003 Plan 2,100,000 839,957 - 778,300 - 481,743 2,700,000 1,256,359 - 918,091 - 489,518
Summary of Restricted Stock Granted and Cancelled	During 2017, 2016 and 2015, the Company granted the following shares of restricted stock to directors, officers and employees pursuant to its equity plans as follows: Year Granted Number of Shares Weighted Average Fair Value Per Share 2017 79,475 $ 62.19 2016 101,790 $ 51.59 2015 147,928 $ 41.66 During 2017, 2016 and 2015, the following shares were cancelled due to employee terminations prior to restrictions lapsing: Year Cancelled Number of Shares Weighted Average Fair Value Per Share 2017 2,875 $ 63.12 2016 4,965 $ 35.78 2015 - -

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2017
Commitments and Contingencies [Abstract]
Future Minimum Operating Lease Commitments	The future minimum operating lease commitments for each of the next five years and thereafter and in the aggregate as of December 31, 2017 are as follows (in thousands): 2018 $ 33,357 2019 25,551 2020 21,777 2021 10,919 2022 6,144 Thereafter 5,009 Total $ 102,757

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2017
Earnings Per Share [Abstract]
Computations of Basic and Diluted Earnings Per Share	The computations of basic and diluted earnings per share for the years ended December 31, 2017, 2016 and 2015 are as follows (in thousands, except per share data): Year Ended Year Ended Year Ended December 31, 2017 December 31, 2016 December 31, 2015 Net income attributable to USPh shareholders $ 22,256 $ 20,551 $ 20,615 Charges to additional paid-in capital Revaluation of redeemable non-controlling interests (201 ) - - Tax effect at statutory rate (federal and state) of 39.25% 75 - - $ 22,130 $ 20,551 $ 20,615 Basic and diluted net income per share attributable to USPH shareholders $ 1.76 $ 1.64 $ 1.66 Shares used in computation: Basic and diluted earnings per share - weighted-average shares 12,570 12,500 12,392

Selected Quarterly Financial 39

Selected Quarterly Financial Data (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2017
Selected Quarterly Financial Data (Unaudited) [Abstract]
Summary of Selected Quarterly Financial Data	Q1 2017 Q2 2017 Q3 2017 Q4 2017 Net patient revenues $ 93,654 $ 97,657 $ 96,273 $ 101,642 Net revenues $ 97,565 $ 104,251 $ 103,032 $ 109,203 Operating income $ 12,200 $ 15,678 $ 12,888 $ 13,962 Net income $ 6,034 $ 6,390 $ 6,594 $ 8,706 Net income attributable to USPH shareholders $ 4,816 $ 4,941 $ 5,150 $ 7,349 Basic and diluted earnings per share attributable to common shareholders: $ 0.38 $ 0.39 $ 0.41 $ 0.57 Shares used in computation - basic and diluted 12,528 12,579 12,581 12,593 Q1 2016 Q2 2016 Q3 2016 Q4 2016 Net patient revenues $ 85,049 $ 88,433 $ 86,411 $ 88,946 Net revenues $ 86,908 $ 90,430 $ 88,344 $ 90,864 Operating income $ 11,491 $ 15,033 $ 12,055 $ 10,954 Net income $ 5,953 $ 7,671 $ 6,134 $ 6,510 Net income attributable to USPH shareholders $ 4,488 $ 6,012 $ 4,804 $ 5,247 Basic and diluted earnings per share attributable to common shareholders: $ 0.36 $ 0.48 $ 0.38 $ 0.42 Shares used in computation - basic and diluted 12,448 12,511 12,520 12,519

Organization, Nature of Opera40

Organization, Nature of Operations and Basis of Presentation (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2017USD ($)ClinicStateFacility	Dec. 31, 2016USD ($)Clinic	Dec. 31, 2015USD ($)
Organization, Nature of Operations and Basis of Presentation [Abstract]
Number of clinics operated	578
Number of states where clinics are operated | State	41
Number of third party facilities | Facility	32
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Percentage of general partnership interest owned	1.00%
Percentage of interest acquired	35.00%
Percentage of interest acquired in a single clinic			60.00%
Number of clinic practices acquired	2	2
Number of clinics consolidated with an existing clinic	1
Number of clinics that operate as a satellite clinic with existing partnerships	1
Mandatorily redeemable non-controlling interests | $	$ 327	$ 69,190	$ 45,974
Minimum [Member]
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Percentage of limited partnership interest owned	49.00%
Percentage of interest acquired		2.00%	5.00%
Maximum [Member]
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Percentage of limited partnership interest owned	99.00%
Percentage of interest acquired		35.00%	35.00%
March 2017 Acquisition [Member]
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Percentage of interest acquired	55.00%

Organization, Nature of Opera41

Organization, Nature of Operations and Basis of Presentation - Schedule of Multi Clinic Acquisition (Details) - Clinic	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Percentage of interest acquired	35.00%
Number of clinics	2
January 2017 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date	Jan. 1, 2017
Percentage of interest acquired	70.00%
Number of clinics	17
May 2017 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date	May 31, 2017
Percentage of interest acquired	70.00%
Number of clinics	4
June 2017 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date	Jun. 30, 2017
Percentage of interest acquired	60.00%
Number of clinics	9
October 2017 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date	Oct. 31, 2017
Percentage of interest acquired	70.00%
Number of clinics	9
February 2016 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date		Feb. 29, 2016
Percentage of interest acquired		55.00%
Number of clinics		8
November 2016 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date		Nov. 30, 2016
Percentage of interest acquired		60.00%
Number of clinics		12
January 2015 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date			Jan. 31, 2015
Percentage of interest acquired			60.00%
Number of clinics			9
April 2015 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date			Apr. 30, 2015
Percentage of interest acquired			70.00%
Number of clinics			3
June 2015 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date			Jun. 30, 2015
Percentage of interest acquired			70.00%
Number of clinics			4
December 2015 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date			Dec. 31, 2015
Percentage of interest acquired			59.00%
Number of clinics			4

Significant Accounting Polici42

Significant Accounting Policies (Details)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017USD ($)SegmentRegion	Dec. 31, 2016USD ($)Region	Dec. 31, 2015USD ($)Region	Feb. 09, 2018	Nov. 02, 2015	Apr. 01, 2013
Depreciation Amortization Impairment [Line Items]
Number of business segments | Segment		1
Number of regions | Region		6	6	6
Federal debt ceiling in connection with deficit reductions		10 years
Reductions in federal spending		$ 1,200,000,000,000
Medicare spending cut percentage		2.00%
Expected reduction in Medicare spending percentage						2.00%	2.00%
Combined physical therapy/speech language pathology expenses		$ 3,700
Reduction in combined physical therapy/speech language pathology expenses		$ 3,000
Percentage of practice expense component		100.00%
Percentage reduction for service		50.00%
Percentage of payment for outpatient therapy services		85.00%
Net patient revenue from Medicare accounts		$ 92,600,000	$ 81,800,000	$ 73,200,000
Difference between net revenues and corresponding cash collections, approximately of net revenues		1.00%
Difference between actual aggregate contractual reserve and estimated contractual allowance reserve percentage		1.00%
Maximum contractual allowance reserve estimate		1.00%
Income Tax Disclosure [Line Items]
Corporate income tax rate		35.00%	35.00%	35.00%
Estimated reduction in deferred tax liabilities		$ (4,300,000)
Accrued interest and penalties associated with any unrecognized tax benefits		0	$ 0	$ 0
Interest expense recognized		$ 0	$ 0
Subsequent Event [Member]
Depreciation Amortization Impairment [Line Items]
Expected reduction in Medicare spending percentage					2.00%
Year 2018 [Member]
Depreciation Amortization Impairment [Line Items]
Percentage of increase in medicare payment rates		0.50%
Year 2019 [Member]
Depreciation Amortization Impairment [Line Items]
Percentage of increase in medicare payment rates		0.25%
From 2019 through 2024 [Member]
Depreciation Amortization Impairment [Line Items]
Percentage of bonus payment by APM		5.00%
From 2020 through 2025 [Member]
Depreciation Amortization Impairment [Line Items]
Percentage of increase in medicare payment rates		0.00%
Employee [Member]
Deferred Compensation Arrangement with Individual, Excluding Share-based Payments and Postretirement Benefits [Line Items]
Period in which restrictions lapse on stock granted		4 years
Director [Member]
Deferred Compensation Arrangement with Individual, Excluding Share-based Payments and Postretirement Benefits [Line Items]
Period in which restrictions lapse on stock granted		1 year
Officer [Member]
Deferred Compensation Arrangement with Individual, Excluding Share-based Payments and Postretirement Benefits [Line Items]
Period in which restrictions lapse on stock granted		4 years
Plan [Member]
Income Tax Disclosure [Line Items]
Corporate income tax rate	21.00%
Minimum [Member]
Depreciation Amortization Impairment [Line Items]
Mandatorily redeemable non-controlling interest, redemption rights, commencement period		3 years
Redeemable non-controlling interest, redemption rights, commencement period		3 years
Minimum [Member] | Furniture & Equipment [Member]
Depreciation Amortization Impairment [Line Items]
Estimated useful lives		3 years
Minimum [Member] | Software [Member]
Depreciation Amortization Impairment [Line Items]
Estimated useful lives		3 years
Minimum [Member] | Leasehold Improvements [Member]
Depreciation Amortization Impairment [Line Items]
Estimated useful lives		3 years
Maximum [Member]
Depreciation Amortization Impairment [Line Items]
Mandatorily redeemable non-controlling interest, redemption rights, commencement period		5 years
Redeemable non-controlling interest, redemption rights, commencement period		5 years
Maximum [Member] | Year 2017 [Member]
Depreciation Amortization Impairment [Line Items]
Annual limit on physical therapy and speech language pathology services		$ 1,980
Annual limit occupational therapy services		$ 1,980
Maximum [Member] | Furniture & Equipment [Member]
Depreciation Amortization Impairment [Line Items]
Estimated useful lives		8 years
Maximum [Member] | Software [Member]
Depreciation Amortization Impairment [Line Items]
Estimated useful lives		7 years
Maximum [Member] | Leasehold Improvements [Member]
Depreciation Amortization Impairment [Line Items]
Estimated useful lives		5 years

Acquisitions of Businesses (Det

Acquisitions of Businesses (Details)	Oct. 31, 2017USD ($)ClinicInstallment	Jun. 30, 2017USD ($)ClinicInstallment	May 31, 2017USD ($)ClinicInstallment	Mar. 23, 2017USD ($)	Jan. 01, 2017USD ($)ClinicInstallment	Nov. 30, 2016USD ($)ClinicInstallment	Feb. 29, 2016USD ($)ClinicInstallment	Dec. 31, 2015USD ($)ClinicInstallment	Aug. 31, 2015USD ($)	Jun. 30, 2015USD ($)Clinic	Apr. 30, 2015USD ($)ClinicInstallment	Jan. 31, 2015USD ($)ClinicInstallment	Dec. 31, 2017USD ($)ClinicContractOperation	Dec. 31, 2016USD ($)ClinicSubsidiary	Dec. 31, 2015USD ($)Clinic
Business Acquisition [Line Items]
Number of management contracts | Contract													2
Number of clinics consolidated with an existing clinic | Clinic													1
Number of clinics that operate as a satellite clinic with existing partnerships | Clinic													1
Percentage of interest acquired													35.00%
Number of clinics | Clinic													2
Seller notes issued for acquisition of interest in clinic								$ 1,800,000					$ 2,150,000	$ 1,000,000	$ 1,800,000
Number of acquired operations combined | Operation													2
Cash paid, net of cash acquired													$ 36,682,000	23,623,000	18,965,000
Seller notes								1,800,000					2,150,000	1,000,000	1,800,000
Total consideration								20,765,000					38,832,000	24,623,000	20,765,000
Estimated fair value of net tangible assets acquired: [Abstract]
Total current assets								1,952,000					6,248,000	1,372,000	1,952,000
Total non-current assets								1,068,000					1,818,000	839,000	1,068,000
Total liabilities								(1,067,000)					(2,909,000)	(399,000)	(1,067,000)
Net tangible assets acquired								1,953,000					5,157,000	1,812,000	1,953,000
Referral relationships								3,655,000					3,885,000	4,919,000	3,655,000
Non-compete								594,000					1,224,000	847,000	594,000
Tradename								3,417,000					8,439,000	3,802,000	3,417,000
Goodwill								23,437,000					44,292,000	32,123,000	23,437,000
Fair value of non-controlling interest (classified as redeemable non-controlling interests)													(13,883,000)
Fair value of non-controlling interest (originally classified as mandatorily redeemable non-controlling interests)								(12,291,000)					(10,282,000)	(18,880,000)	(12,291,000)
Total consideration								$ 20,765,000					$ 38,832,000	$ 24,623,000	$ 20,765,000
Minimum [Member]
Business Acquisition [Line Items]
Percentage of interest acquired								5.00%						2.00%	5.00%
Maximum [Member]
Business Acquisition [Line Items]
Percentage of interest acquired								35.00%						35.00%	35.00%
Referral Relationships [Member] | Minimum [Member]
Business Acquisition [Line Items]
Estimated useful lives of acquired intangibles													7 years 6 months
Referral Relationships [Member] | Maximum [Member]
Business Acquisition [Line Items]
Estimated useful lives of acquired intangibles													13 years
Non-compete Agreements [Member] | Minimum [Member]
Business Acquisition [Line Items]
Estimated useful lives of acquired intangibles													5 years
Non-compete Agreements [Member] | Maximum [Member]
Business Acquisition [Line Items]
Estimated useful lives of acquired intangibles													6 years
Tradenames [Member]
Business Acquisition [Line Items]
Estimated useful lives of acquired intangibles													6 years
February 2017 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest														$ 194,000
February 2018 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest														$ 194,000
Acquisition of Seventeen Clinic Practices [Member]
Business Acquisition [Line Items]
Percentage of interest acquired														70.00%
Number of clinics | Clinic					17
Cash paid for acquisition of interest in clinic					$ 10,700,000
Seller notes issued for acquisition of interest in clinic														$ 500,000
Business acquisition number of installments to payment of purchase consideration | Installment					2
Seller notes														$ 500,000
Acquisition of Seventeen Clinic Practices [Member] | January 2018 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest					$ 250,000
Acquisition of Seventeen Clinic Practices [Member] | January 2019 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest					$ 250,000
Workforce Performance Solutions [Member]
Business Acquisition [Line Items]
Percentage of interest acquired				55.00%
Cash paid for acquisition of interest in clinic				$ 6,200,000
Seller notes issued for acquisition of interest in clinic				400,000
Seller notes				$ 400,000
January 2017 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date													Jan. 1, 2017
Percentage of interest acquired													70.00%
Number of clinics | Clinic													17
May 2017 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date													May 31, 2017
Percentage of interest acquired													70.00%
Number of clinics | Clinic													4
June 2017 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date													Jun. 30, 2017
Percentage of interest acquired													60.00%
Number of clinics | Clinic													9
October 2017 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date													Oct. 31, 2017
Percentage of interest acquired													70.00%
Number of clinics | Clinic													9
February 2016 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date														Feb. 29, 2016
Percentage of interest acquired														55.00%
Number of clinics | Clinic														8
November 2016 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date														Nov. 30, 2016
Percentage of interest acquired														60.00%
Number of clinics | Clinic														12
January 2015 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date															Jan. 31, 2015
Percentage of interest acquired								60.00%							60.00%
Number of clinics | Clinic															9
April 2015 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date															Apr. 30, 2015
Percentage of interest acquired								70.00%							70.00%
Number of clinics | Clinic															3
June 2015 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date															Jun. 30, 2015
Percentage of interest acquired								70.00%							70.00%
Number of clinics | Clinic															4
December 2015 Acquisition [Member]
Business Acquisition [Line Items]
Acquisition date															Dec. 31, 2015
Percentage of interest acquired								59.00%							59.00%
Number of clinics | Clinic															4
Acquisition Of Single Clinic Practice [Member]
Business Acquisition [Line Items]
Percentage of interest acquired									60.00%
Cash paid for acquisition of interest in clinic									$ 150,000
Seller notes issued for acquisition of interest in clinic									50,000
Aggregate purchase price for the acquired clinic practices														$ 75,000
Number of subsidiaries acquired clinic practices | Subsidiary														2
Seller notes									50,000
Acquisition Of Single Clinic Practice [Member] | August 2016 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest									$ 50,000
Acquisition Of Three Clinic Practices [Member]
Business Acquisition [Line Items]
Percentage of interest acquired											70.00%
Number of clinics | Clinic											3
Cash paid for acquisition of interest in clinic											$ 4,700,000
Seller notes issued for acquisition of interest in clinic											$ 150,000
Business acquisition number of installments to payment of purchase consideration | Installment											2
Seller notes											$ 150,000
Acquisition Of Three Clinic Practices [Member] | April 2016 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest											75,000
Acquisition Of Three Clinic Practices [Member] | April 2017 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest											$ 75,000
Acquisition Of Four Clinic Practices [Member]
Business Acquisition [Line Items]
Percentage of interest acquired			70.00%					59.00%		70.00%					59.00%
Number of clinics | Clinic			4					4		4
Cash paid for acquisition of interest in clinic			$ 2,300,000					$ 4,600,000		$ 3,600,000
Seller notes issued for acquisition of interest in clinic			$ 250,000					$ 400,000		700,000					$ 400,000
Business acquisition number of installments to payment of purchase consideration | Installment			2					2
Seller notes			$ 250,000					$ 400,000		700,000					$ 400,000
Acquisition Of Four Clinic Practices [Member] | May 2018 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest			125,000
Acquisition Of Four Clinic Practices [Member] | May 2019 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest			$ 125,000
Acquisition Of Four Clinic Practices [Member] | June 2018 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest										$ 700,000
Acquisition Of Four Clinic Practices [Member] | December 2016 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest								200,000
Acquisition Of Four Clinic Practices [Member] | December 2017 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest								$ 200,000
Acquisition Of Eight Clinic Practices [Member]
Business Acquisition [Line Items]
Percentage of interest acquired							55.00%
Number of clinics | Clinic							8
Cash paid for acquisition of interest in clinic							$ 13,200,000
Seller notes issued for acquisition of interest in clinic							$ 500,000
Business acquisition number of installments to payment of purchase consideration | Installment							2
Seller notes							$ 500,000
Acquisition Of Eight Clinic Practices [Member] | February 2017 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest							250,000
Acquisition Of Eight Clinic Practices [Member] | February 2018 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest							$ 250,000
Acquisition Of Nine Clinic Practices [Member]
Business Acquisition [Line Items]
Percentage of interest acquired	70.00%	60.00%										60.00%
Number of clinics | Clinic	9	9										9
Cash paid for acquisition of interest in clinic	$ 4,000,000	$ 15,800,000										$ 6,700,000
Seller notes issued for acquisition of interest in clinic	$ 500,000	$ 500,000										$ 500,000
Business acquisition number of installments to payment of purchase consideration | Installment	2	2										2
Seller notes	$ 500,000	$ 500,000										$ 500,000
Acquisition Of Nine Clinic Practices [Member] | June 2018 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest		250,000
Acquisition Of Nine Clinic Practices [Member] | June 2019 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest		$ 250,000
Acquisition Of Nine Clinic Practices [Member] | October 2018 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest	250,000
Acquisition Of Nine Clinic Practices [Member] | October 2019 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest	$ 250,000
Acquisition Of Nine Clinic Practices [Member] | January 2017 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest												$ 250,000
Acquisition Of Twelve Clinic Practices [Member]
Business Acquisition [Line Items]
Percentage of interest acquired						60.00%
Number of clinics | Clinic						12
Cash paid for acquisition of interest in clinic						$ 11,000,000
Seller notes issued for acquisition of interest in clinic						$ 500,000
Business acquisition number of installments to payment of purchase consideration | Installment						2
Seller notes						$ 500,000
Acquisition Of Twelve Clinic Practices [Member] | November 2017 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest						250,000
Acquisition Of Twelve Clinic Practices [Member] | November 2018 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest						$ 250,000

Non-Controlling Interests (Deta

Non-Controlling Interests (Details)	12 Months Ended
	Dec. 31, 2017USD ($)Partnership	Dec. 31, 2016USD ($)InstallmentPartnership	Dec. 31, 2015USD ($)Partnership
Business Acquisition [Line Items]
Number of partnership in which interest acquired | Partnership	2	6	6
Number of partnership in which interest sold | Partnership		1
Purchase price for additional non controlling interest	$ 13,000	$ 900,000	$ 900,000
Seller notes		$ 400,000
Number of installments | Installment		2
Book value of purchase price	$ 138,000	$ 112,000	217,000
Remaining purchase price		1,200,000	700,000
Future tax benefits		$ 500,000	$ 300,000
Sale of non-controlling interest percentage in partnership one	2.00%	4.00%
Sale of additional non-controlling interest percentage in partnership two		35.00%
Cash proceeds from sale of non-controlling interest		$ 138,000
Amount of notes receivable from sale of non-controlling interest		148,000
Total sale price		286,000
Tax effect on sale price	$ 56,000	110,000
Percentage of interest acquired	35.00%
February 2017 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest		194,000
February 2018 [Member]
Business Acquisition [Line Items]
Acquisition cost payable in two principal installments including accrued interest		$ 194,000
Minimum [Member]
Business Acquisition [Line Items]
Percentage of interest acquired		2.00%	5.00%
Maximum [Member]
Business Acquisition [Line Items]
Percentage of interest acquired		35.00%	35.00%

Mandatorily Redeemable Non-Co45

Mandatorily Redeemable Non-Controlling Interest (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2017	Jun. 30, 2017	Dec. 31, 2016
Changes in Carrying Amount of Redeemable Non-Controlling Interest [Roll Forward]
Beginning balance	$ 69,190	$ 45,974
Operating results allocated to mandatorily redeemable non-controlling interest partners	6,055	4,057
Distributions to mandatorily redeemable non-controlling interest partners	(7,336)	(4,628)
Changes in the redemption value of mandatorily redeemable non-controlling interest	12,894	6,169
Payments for settlement of mandatorily redeemable non-controlling interest	(2,361)	(1,262)
Purchases of businesses - initial liability related to mandatorily redeemable non-controlling interest	10,282	18,880
Other	119	0
Extinguishment of mandatorily redeemable non-controlling interest	(88,516)	0
Ending balance	327	69,190
Carrying Amount of Redeemable Non-Controlling Interest [Abstract]
Contractual time period has lapsed but holder's employment has not been terminated			$ 327		$ 24,700
Contractual time period has not lapsed and holder's employment has not been terminated			0		46,949
Holder's employment has terminated and contractual time period has expired			0		0
Holder's employment has terminated and contractual time period has not expired			0		0
Redemption value prior to excess distributed earnings			327		71,649
Excess distributions over earnings and losses			0		(2,459)
Redeemable non-controlling interests	$ 69,190	$ 69,190	$ 327		$ 69,190
Therapy Practice [Member] | Minimum [Member]
Business Acquisition [Line Items]
Business acquisition, percentage of limited partnership acquired				50.00%
Therapy Practice [Member] | Maximum [Member]
Business Acquisition [Line Items]
Business acquisition, percentage of limited partnership acquired				90.00%
Therapy Practice [Member] | NewCo. [Member]
Business Acquisition [Line Items]
Percentage of equity interest of subsidiary contributed for acquisition				100.00%
Business acquisition, percentage of general partnership interest acquired				100.00%
Business acquisition, consideration payable, term of note	2 years
Employment agreement renewal term	1 year
Non-Compete agreement term under condition of termination of employment of employed selling shareholder	2 years
Therapy Practice [Member] | NewCo. [Member] | Minimum [Member]
Business Acquisition [Line Items]
Employment agreement term	3 years
Non-Compete agreement term regardless of whether the selling shareholder is employed	5 years
Required redemption term, under condition of termination of employment of employed selling shareholders	3 years
Therapy Practice [Member] | NewCo. [Member] | Maximum [Member]
Business Acquisition [Line Items]
Employment agreement term	5 years
Non-Compete agreement term regardless of whether the selling shareholder is employed	6 years
Required redemption term, under condition of termination of employment of employed selling shareholders	5 years

Redeemable Non-Controlling In46

Redeemable Non-Controlling Interest (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2017	Dec. 31, 2016
Changes in Carrying Amount (Fair Value) of Redeemable Non-Controlling Interests [Roll Forward]
Beginning balance	$ 0
Operating results allocated to redeemable non-controlling interest partners	6,055	$ 4,057
Distributions to redeemable non-controlling interest partners	(7,336)	(4,628)
Changes in the fair value of redeemable non-controlling interest	12,894	6,169
Purchases of businesses - initial equity related to redeemable non-controlling interest	10,282	18,880
Fair value of redeemable non-controlling interest - amended partnership agreements	2,361	1,262
Ending balance	102,572	0
Carrying Amount (Fair Value) of Redeemable Non-Controlling Interest [Abstract]
Contractual time period has lapsed but holder's employment has not been terminated			$ 327	$ 24,700
Contractual time period has not lapsed and holder's employment has not been terminated			0	46,949
Holder's employment has terminated and contractual time period has expired			0	0
Holder's employment has terminated and contractual time period has not expired			0	0
Redemption value prior to excess distributed earnings			327	71,649
Excess distributions over earnings and losses			0	(2,459)
Redeemable non-controlling interests	0	0	102,572	0
Redeemable Non-Controlling Interest [Member]
Changes in Carrying Amount (Fair Value) of Redeemable Non-Controlling Interests [Roll Forward]
Beginning balance	0
Operating results allocated to redeemable non-controlling interest partners	244
Distributions to redeemable non-controlling interest partners	(272)
Changes in the fair value of redeemable non-controlling interest	201
Purchases of businesses - initial equity related to redeemable non-controlling interest	13,883
Fair value of redeemable non-controlling interest - amended partnership agreements	88,516
Ending balance	102,572	0
Carrying Amount (Fair Value) of Redeemable Non-Controlling Interest [Abstract]
Contractual time period has lapsed but holder's employment has not been terminated			33,613
Contractual time period has not lapsed and holder's employment has not been terminated			72,700
Holder's employment has terminated and contractual time period has expired			0
Holder's employment has terminated and contractual time period has not expired			0
Redemption value prior to excess distributed earnings			106,313
Excess distributions over earnings and losses			(3,741)
Redeemable non-controlling interests	$ 0	$ 0	$ 102,572	$ 0

Goodwill (Details)

Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Roll Forward]
Beginning balance	$ 226,806	$ 195,373
Goodwill acquired during the year	44,292	31,419
Goodwill adjustments for purchase price allocation of businesses acquired in prior year	706	14
Goodwill written-off - closed clinic	(466)	0
Ending balance	$ 271,338	$ 226,806

Intangible Assets, net (Details

Intangible Assets, net (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)Operation
Finite-Lived Intangible Assets [Line Items]
Total	$ 48,954	$ 38,060
Number of acquired operations | Operation		2
Tradenames [Member]
Finite-Lived Intangible Assets [Line Items]
Total	29,673	$ 21,234
Referral Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Total	16,811	14,859
Accumulated amortization	$ 7,209	5,275
Referral Relationships [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	6 years
Referral Relationships [Member] | Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	16 years
Non-compete Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Total	$ 2,470	1,967
Accumulated amortization	$ 4,100	$ 3,380
Non-compete Agreements [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	5 years
Non-compete Agreements [Member] | Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	6 years

Intangible Assets, net - Amorti

Intangible Assets, net - Amortization Expenses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Finite-Lived Intangible Assets [Line Items]
Total amortization expenses	$ 2,654	$ 2,367	$ 1,715
Tradenames [Member]
Finite-Lived Intangible Assets [Line Items]
Total amortization expenses	0	330	84
Referral Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Total amortization expenses	1,934	1,512	1,153
Non-compete Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Total amortization expenses	$ 720	$ 525	$ 478

Intangible Assets, net - Amor50

Intangible Assets, net - Amortization of Referral Relationships and Non-Competition Agreements (Details) $ in Thousands	Dec. 31, 2017USD ($)
Referral Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
2,018	$ 2,032
2,019	1,942
2,020	1,942
2,021	1,942
2,022	1,894
Thereafter	7,059
Non-compete Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
2,018	763
2,019	691
2,020	477
2,021	399
2,022	$ 140

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Payables and Accruals [Abstract]
Salaries and related costs	$ 16,828	$ 10,569
Credit balances due to patients and payors	4,158	3,880
Group health insurance claims	2,929	2,499
Federal income tax payable	2,833	0
Other	6,594	4,808
Total	$ 33,342	$ 21,756

Notes Payable - Summary of Note

Notes Payable - Summary of Notes Payable (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Payments/Long term debt, Total	$ 60,772	$ 51,823
Less current portion	(4,044)	(1,227)
Long term portion	56,728	50,596
Credit Facility [Member]
Debt Instrument [Line Items]
Payments/Long term debt, Total	$ 54,000	46,000
Average effective interest rate	3.60%
3.25 % through 4.25 % notes payable due in next year [Member]
Debt Instrument [Line Items]
Payments/Long term debt, Total	$ 6,772	$ 5,823
Annual installments	$ 4,044
3.25 % through 4.25 % notes payable due in next year [Member] | Maximum [Member]
Debt Instrument [Line Items]
Percentage of interest accrued	4.25%
3.25 % through 4.25 % notes payable due in next year [Member] | Minimum [Member]
Debt Instrument [Line Items]
Percentage of interest accrued	3.25%

Notes Payable (Details)

Notes Payable (Details) - USD ($)	1 Months Ended			12 Months Ended
	Nov. 30, 2017	Mar. 31, 2017	Jan. 31, 2016	Dec. 31, 2017	Dec. 05, 2013
Debt Instrument [Line Items]
Aggregate principal payment due in 2018				$ 4,044,000
Aggregate principal payment due in 2019				2,728,000
Notes Payable [Member]
Debt Instrument [Line Items]
Aggregate amount of notes payable				2,200,000
Aggregate principal payment due in 2018				1,300,000
Aggregate principal payment due in 2019				$ 900,000
Minimum [Member]
Debt Instrument [Line Items]
Spread on Libor variable rate				1.25%
Spread on variable rate				0.10%
Percentage of unused commitment fee				0.25%
Minimum [Member] | Notes Payable [Member]
Debt Instrument [Line Items]
Average effective interest rate				3.25%
Maximum [Member]
Debt Instrument [Line Items]
Spread on Libor variable rate				2.00%
Spread on variable rate				1.00%
Percentage of unused commitment fee				0.30%
Maximum [Member] | Notes Payable [Member]
Debt Instrument [Line Items]
Average effective interest rate				4.25%
Credit Agreement [Member]
Debt Instrument [Line Items]
Cash and noncash consideration with respect to acquisition after amendment			$ 50,000,000
Credit Agreement [Member] | Maximum [Member]
Debt Instrument [Line Items]
Cash dividends after amendment	$ 20,000,000	$ 15,000,000	$ 10,000,000
Credit Facility [Member]
Debt Instrument [Line Items]
Revolving credit facility commitment					$ 125,000,000
Revolving credit facility maturity date				Nov. 30, 2021
Remaining revolving credit outstanding				$ 71,000,000

Notes Payable - Summary of Aggr

Notes Payable - Summary of Aggregate Annual Payments of Principal Required to Revolving Credit Facility (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Long Term Debt By Maturity [Abstract]
During the twelve months ended December 30, 2018	$ 4,044
During the twelve months ended December 30, 2019	2,728
During the twelve months ended December 30, 2020	0
During the twelve months ended December 30, 2021	54,000
Payments/Long term debt, Total	$ 60,772	$ 51,823

Income Taxes - Schedule of Comp

Income Taxes - Schedule of Components of Deferred Tax Assets and Liabilities Included in Consolidated Balance Sheets (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Deferred tax assets [Abstract]
Compensation	$ 1,529	$ 1,914
Allowance for doubtful accounts	478	572
Lease obligations - closed clinics	54	57
Deferred tax assets	2,061	2,543
Deferred tax liabilities [Abstract]
Depreciation and amortization	(12,590)	(17,896)
Other	(346)	(383)
Deferred tax liabilities	(12,936)	(18,279)
Net deferred tax liability	$ (10,875)	$ (15,736)

Income Taxes (Details)

Income Taxes (Details) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Examination [Line Items]
Estimated reduction in deferred tax liabilities	$ (4,300,000)
Income tax payable	2,833,000	$ 0
Decrease in net deferred tax liability related to acquisitions of non-controlling interests	(1,200,000)
Charge to current year provision for income taxes	300,000
Offset to adjustment, reduction in the previously reported tax receivable		1,700,000
Reduction of the income tax provision	1,300,000	1,000,000
Increase in current state income tax provision	312,000	34,000	$ 147,000
Accrued interest and penalties associated with any unrecognized tax benefits	0	0	0
Interest expense recognized	0	0	$ 0
Federal [Member]
Income Tax Examination [Line Items]
Income tax payable	$ 2,800,000
Offset to adjustment, reduction in the previously reported tax receivable		1,100,000
Tax receivable included in other current assets		700,000
Federal [Member] | Minimum [Member]
Income Tax Examination [Line Items]
Periods open for examination	2,014
Federal [Member] | Maximum [Member]
Income Tax Examination [Line Items]
Periods open for examination	2,016
State [Member]
Income Tax Examination [Line Items]
Offset to adjustment, reduction in the previously reported tax receivable		600,000
Tax receivable included in other current assets	$ 2,200,000	$ 1,500,000
State [Member] | Minimum [Member]
Income Tax Examination [Line Items]
Periods open for examination	2,013
State [Member] | Maximum [Member]
Income Tax Examination [Line Items]
Periods open for examination	2,016

Income Taxes - Schedule of Diff

Income Taxes - Schedule of Differences Between Federal Tax Rate and Company's Effective Tax Rate for Results of Continuing Operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Taxes [Abstract]
U.S. tax at statutory rate	$ 9,900	$ 11,351	$ 11,991
Tax legislation adjustment	(4,325)	0	0
State income taxes, net of federal benefit and tax reform	1,060	945	1,337
Excess equity compensation deduction	(1,139)	(911)	0
Non-deductible expenses	560	495	319
Other	(24)	0	0
Total income tax provision	$ 6,032	$ 11,880	$ 13,647
U.S. tax at statutory rate	35.00%	35.00%	35.00%
Tax legislation adjustment	(15.30%)	0.00%	0.00%
State income taxes, net of federal benefit and tax reform	3.70%	2.90%	3.90%
Excess equity compensation deduction	(4.00%)	(2.80%)	(0.00%)
Nondeductible expenses	2.00%	1.50%	0.90%
Other	(0.10%)	0.00%	0.00%
Total	21.30%	36.60%	39.80%

Income Taxes - Schedule of Sign

Income Taxes - Schedule of Significant Components of Provision for Income Taxes for Continuing Operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current [Abstract]
Federal	$ 9,332	$ 7,620	$ 6,502
State	1,564	1,281	1,192
Total current	10,896	8,901	7,694
Deferred [Abstract]
Federal	(5,233)	2,548	5,302
State	369	431	651
Total deferred	(4,864)	2,979	5,953
Total income tax provision	$ 6,032	$ 11,880	$ 13,647

Equity Based Plans (Details)

Equity Based Plans (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Mar. 17, 2016	Mar. 16, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized (in shares)	2,700,000
Number of common shares available for grant (in shares)	489,518
Shares outstanding for which restrictions had not lapsed (in shares)	174,602
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation expense	$ 5,032	$ 4,962	$ 4,491
Compensation not yet recognized	$ 6,600
Amended 2003 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized (in shares)	2,100,000			2,100,000	1,750,000
Number of common shares available for grant (in shares)	481,743
Employees [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted period on the stock granted	4 years
Executive Officer [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted period on the stock granted	4 years
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restrictions will lapse in	2,021
Maximum [Member] | Non Qualified Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized (in shares)	600,000
Maximum [Member] | Amended 2003 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of common shares available for grant (in shares)	2,100,000
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restrictions will lapse in	2,018

Equity Based Plans - Summary of

Equity Based Plans - Summary of Cumulative Summary of Equity Plans (Details) - shares	Dec. 31, 2017	Mar. 17, 2016	Mar. 16, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized (in shares)	2,700,000
Restricted stock issued (in shares)	1,256,359
Outstanding stock options (in shares)	0
Stock options exercised (in shares)	918,091
Stock options exercisable (in shares)	0
Shares available for grant (in shares)	489,518
Amended 1999 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized (in shares)	600,000
Restricted stock issued (in shares)	416,402
Outstanding stock options (in shares)	0
Stock options exercised (in shares)	139,791
Stock options exercisable (in shares)	0
Shares available for grant (in shares)	7,775
Amended 2003 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Authorized (in shares)	2,100,000	2,100,000	1,750,000
Restricted stock issued (in shares)	839,957
Outstanding stock options (in shares)	0
Stock options exercised (in shares)	778,300
Stock options exercisable (in shares)	0
Shares available for grant (in shares)	481,743

Equity Based Plans - Summary 61

Equity Based Plans - Summary of Restricted Stock Granted to Directors, Officers and Employees Pursuant to Its Equity Plans (Details) - Restricted Stock [Member] - $ / shares	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares (in shares)	79,475	101,790	147,928
Weighted average fair value (in dollars per share)	$ 62.19	$ 51.59	$ 41.66

Equity Based Plans, Summary of

Equity Based Plans, Summary of Restricted Stock Cancelled Due to Employee Terminations Prior to Restrictions Lapsing (Details) - Restricted Stock [Member] - $ / shares	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares (in shares)	2,875	4,965	0
Weighted average fair value (in dollars per share)	$ 63.12	$ 35.78	$ 0

Common Stock (Details)

Common Stock (Details) - USD ($)	1 Months Ended	12 Months Ended
	Mar. 31, 2009	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2008
Equity, Class of Treasury Stock [Line Items]
Common stock authorized by the Board of Directors (in shares)	1,200,000			2,250,000
Total purchased shares (in shares)	859,499	0	0
Additional estimated shares (in shares)		207,756
Closing price (in dollars per share)		$ 72.20
Maximum [Member]
Equity, Class of Treasury Stock [Line Items]
Maximum percentage of repurchase of common stock	10.00%
Bank credit agreement to permit share repurchases of common stock	$ 15,000,000

Defined Contribution Plan (Deta

Defined Contribution Plan (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Defined Contribution Plan [Abstract]
Required time period for employees for profit sharing plan	3 months
Maximum employer contribution as a percentage of employee contribution	50.00%
Contribution expense recognized	$ 0	$ 0	$ 0
Employer matching contribution amount	$ 1.5	$ 1.1	$ 0.9

Commitments and Contingencies65

Commitments and Contingencies (Details) $ in Millions	12 Months Ended
	Dec. 31, 2017USD ($)Officer	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)
Operating Leased Assets [Line Items]
Rent expense	$ 34.8	$ 30.3	$ 28.3
Renewal period of employment agreements	2 years
Expiration date	Dec. 31, 2018
Future compensation - 2018	$ 30.1
Future compensation - 2019 through 2022	$ 15.6
Executive Officer [Member]
Operating Leased Assets [Line Items]
Number of officers with the company had employee agreement | Officer	3
Minimum [Member]
Operating Leased Assets [Line Items]
Operating leases renewal period	1 year
Maximum [Member]
Operating Leased Assets [Line Items]
Operating leases renewal period	5 years

Commitments and Contingencies -

Commitments and Contingencies - Future Minimum Operating Lease Commitments (Details) $ in Thousands	Dec. 31, 2017USD ($)
Commitments and Contingencies [Abstract]
2,018	$ 33,357
2,019	25,551
2,020	21,777
2,021	10,919
2,022	6,144
Thereafter	5,009
Total	$ 102,757

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Earnings Per Share [Abstract]
Net income attributable to USPh shareholders									$ 22,256	$ 20,551	$ 20,615
Charges to additional paid-in capital Revaluation of redeemable non-controlling interests									(206)	0	0
Tax effect at statutory rate (federal and state) of 39.25%									80	0	0
Net income attributable to common shareholders									$ 22,130	$ 20,551	$ 20,615
Basic and diluted net income per share attributable to USPH shareholders (in dollars per share)	$ 0.57	$ 0.41	$ 0.39	$ 0.38	$ 0.42	$ 0.38	$ 0.48	$ 0.36	$ 1.76	$ 1.64	$ 1.66
Shares used in computation [Abstract]
Basic and diluted earnings per share - weighted-average shares (in shares)	12,593	12,581	12,579	12,528	12,519	12,520	12,511	12,448	12,570	12,500	12,392
Federal and state statutory income tax rate									39.25%

Selected Quarterly Financial 68

Selected Quarterly Financial Data (Unaudited) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Selected Quarterly Financial Data (Unaudited) [Abstract]
Net patient revenues	$ 101,642	$ 96,273	$ 97,657	$ 93,654	$ 88,946	$ 86,411	$ 88,433	$ 85,049	$ 389,226	$ 348,839	$ 324,293
Net revenues	109,203	103,032	104,251	97,565	90,864	88,344	90,430	86,908	414,051	356,546	331,302
Operating income	13,962	12,888	15,678	12,200	10,954	12,055	15,033	11,491	$ 54,728	$ 49,533	$ 47,294
Net income	8,706	6,594	6,390	6,034	6,510	6,134	7,671	5,953
Net income attributable to USPH shareholders	$ 7,349	$ 5,150	$ 4,941	$ 4,816	$ 5,247	$ 4,804	$ 6,012	$ 4,488
Basic and diluted earnings per share attributable to common shareholders (in dollars per share)	$ 0.57	$ 0.41	$ 0.39	$ 0.38	$ 0.42	$ 0.38	$ 0.48	$ 0.36	$ 1.76	$ 1.64	$ 1.66
Shares used in computation - basic and diluted (in shares)	12,593	12,581	12,579	12,528	12,519	12,520	12,511	12,448	12,570	12,500	12,392

SCHEDULE II - VALUATION AND Q69

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS (Details) - Allowance for Doubtful Accounts [Member] - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2017	[1]	Dec. 31, 2016		Dec. 31, 2015
Movement in Valuation Allowances and Reserves [Roll Forward]
Beginning Balance		$ 1,792		$ 1,642		$ 1,867
Additions Charged to Cost and Expenses		3,672		3,906		4,170
Additions Charged to Other Accounts		0		0		0
Deductions	[2]	3,191		3,756		4,395
Ending Balance		$ 2,273		$ 1,792	[1]	$ 1,642
[1]	Related to patient accounts receivable and accounts receivable-other.
[2]	Uncollectible accounts written off, net of recoveries.