Document and Entity Information
Document and Entity Information - USD ($) $ in Billions | 12 Months Ended | ||
Dec. 31, 2020 | Feb. 19, 2021 | Jun. 30, 2020 | |
Document And Entity Information [Abstract] | |||
Document Type | 10-K | ||
Document Annual Report | true | ||
Document Period End Date | Dec. 31, 2020 | ||
Document Transition Report | false | ||
Entity File Number | 0-24260 | ||
Entity Registrant Name | AMEDISYS, INC. | ||
Entity Incorporation, State or Country Code | DE | ||
Entity Tax Identification Number | 11-3131700 | ||
Entity Address, Address Line One | 3854 American Way, Suite A, | ||
Entity Address, City or Town | Baton Rouge, | ||
Entity Address, State or Province | LA | ||
Entity Address, Postal Zip Code | 70816 | ||
City Area Code | 225 | ||
Local Phone Number | 292-2031 | ||
Title of 12(b) Security | Common Stock, par value $0.001 per share | ||
Security Exchange Name | NASDAQ | ||
Entity Well-known Seasoned Issuer | Yes | ||
Entity Voluntary Filers | No | ||
Entity Current Reporting Status | Yes | ||
Entity Interactive Data Current | Yes | ||
Entity Filer Category | Large Accelerated Filer | ||
Entity Small Business | false | ||
Entity Emerging Growth Company | false | ||
ICFR Auditor Attestation Flag | true | ||
Entity Shell Company | false | ||
Entity Public Float | $ 5.5 | ||
Entity Common Stock, Shares Outstanding | 32,848,547 | ||
Amendment Flag | false | ||
Document Fiscal Year Focus | 2020 | ||
Document Fiscal Period Focus | FY | ||
Trading Symbol | AMED | ||
Entity Central Index Key | 0000896262 | ||
Current Fiscal Year End Date | --12-31 |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Current assets: | ||
Cash and cash equivalents | $ 81,808 | $ 30,294 |
Restricted cash | 1,549 | 66,196 |
Patient accounts receivable | 255,145 | 237,596 |
Prepaid expenses | 10,217 | 8,243 |
Other current assets | 13,265 | 8,225 |
Total current assets | 361,984 | 350,554 |
Property and equipment, net of accumulated depreciation of $95,024 and $96,137 | 23,719 | 28,113 |
Operating lease right of use assets | 93,440 | 84,791 |
Goodwill | 932,685 | 658,500 |
Intangible assets, net of accumulated amortization of $22,973 and $7,044 | 74,183 | 64,748 |
Deferred income taxes | 47,987 | 21,427 |
Other assets | 33,200 | 54,612 |
Total assets | 1,567,198 | 1,262,745 |
Current liabilities: | ||
Accounts payable | 42,674 | 31,259 |
Payroll and employee benefits | 146,929 | 120,877 |
Accrued expenses | 166,192 | 137,111 |
Provider relief fund advance | 60,000 | 0 |
Current portion of long-term obligations | 10,496 | 9,927 |
Current portion of operating lease liabilities | 30,046 | 27,769 |
Total current liabilities | 456,337 | 326,943 |
Long-term obligations, less current portion | 204,511 | 232,256 |
Operating lease liabilities, less current portion | 61,987 | 56,128 |
Other long-term obligations | 33,622 | 5,905 |
Total liabilities | 756,457 | 621,232 |
Commitments and Contingencies | ||
Equity: | ||
Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding | 0 | 0 |
Common stock, $0.001 par value, 60,000,000 shares authorized; 37,470,212 and 36,638,021 shares issued; and 32,814,278 and 32,284,051 shares outstanding | 38 | 37 |
Additional paid-in capital | 698,287 | 645,256 |
Treasury stock at cost, 4,655,934 and 4,353,970 shares of common stock | (319,092) | (251,241) |
Accumulated other comprehensive income | 0 | 15 |
Retained earnings | 429,991 | 246,383 |
Total Amedisys, Inc. stockholders’ equity | 809,224 | 640,450 |
Noncontrolling interests | 1,517 | 1,063 |
Total equity | 810,741 | 641,513 |
Total liabilities and equity | $ 1,567,198 | $ 1,262,745 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Statement of Financial Position [Abstract] | ||
Property and equipment, accumulated depreciation | $ 95,024 | $ 96,137 |
Intangible assets, accumulated amortization | $ 22,973 | $ 7,044 |
Preferred stock, par value (usd per share) | $ 0.001 | $ 0.001 |
Preferred stock, authorized (shares) | 5,000,000 | 5,000,000 |
Preferred stock, issued (shares) | 0 | 0 |
Preferred stock, outstanding (shares) | 0 | 0 |
Common stock, par value (usd per share) | $ 0.001 | $ 0.001 |
Common stock, authorized (shares) | 60,000,000 | 60,000,000 |
Common stock, issued (shares) | 37,470,212 | 36,638,021 |
Common stock, outstanding (shares) | 32,814,278 | 32,284,051 |
Treasury stock at cost (shares) | 4,655,934 | 4,353,970 |
CONSOLIDATED STATEMENTS OF OPER
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Income Statement [Abstract] | |||
Net service revenue | $ 2,071,519 | $ 1,955,633 | $ 1,662,578 |
Other operating income | 34,372 | 0 | 0 |
Cost of service, excluding depreciation and amortization | 1,185,369 | 1,150,337 | 992,863 |
General and administrative expenses: | |||
Salaries and benefits | 449,448 | 394,452 | 316,522 |
Non-cash compensation | 26,730 | 25,040 | 17,887 |
Other | 192,122 | 188,434 | 166,897 |
Depreciation and amortization | 28,802 | 18,428 | 13,261 |
Asset impairment charge | 4,152 | 1,470 | 0 |
Operating expenses | 1,886,623 | 1,778,161 | 1,507,430 |
Operating income | 219,268 | 177,472 | 155,148 |
Other income (expense): | |||
Interest income | 292 | 78 | 278 |
Interest expense | (11,038) | (14,515) | (7,370) |
Equity in earnings from equity method investments | 3,966 | 5,338 | 7,692 |
Miscellaneous, net | (1,669) | 2,037 | 3,240 |
Total other (expense) income, net | (8,449) | (7,062) | 3,840 |
Income before income taxes | 210,819 | 170,410 | 158,988 |
Income tax expense | (25,635) | (42,503) | (38,859) |
Net income | 185,184 | 127,907 | 120,129 |
Net income attributable to noncontrolling interests | (1,576) | (1,074) | (783) |
Net income attributable to Amedisys, Inc. | $ 183,608 | $ 126,833 | $ 119,346 |
Basic earnings per common share: | |||
Net income attributable to Amedisys, Inc. common stockholders (usd per share) | $ 5.64 | $ 3.95 | $ 3.64 |
Weighted average shares outstanding (shares) | 32,559 | 32,142 | 32,791 |
Diluted earnings per common share: | |||
Net income attributable to Amedisys, Inc. common stockholders (usd per share) | $ 5.52 | $ 3.84 | $ 3.55 |
Weighted average shares outstanding (shares) | 33,268 | 32,990 | 33,609 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Statement of Comprehensive Income [Abstract] | |||
Net income | $ 185,184 | $ 127,907 | $ 120,129 |
Other comprehensive income | 0 | 0 | 0 |
Comprehensive income | 185,184 | 127,907 | 120,129 |
Comprehensive income attributable to non-controlling interests | (1,576) | (1,074) | (783) |
Comprehensive income attributable to Amedisys, Inc. | $ 183,608 | $ 126,833 | $ 119,346 |
CONSOLIDATED STATEMENTS OF STOC
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands | Total | Common Stock | Additional Paid-in Capital | Treasury Stock | Accumulated Other Comprehensive Income | Retained Earnings | Noncontrolling Interests |
Balance, Stockholders Equity at Dec. 31, 2017 | $ 516,426 | $ 35 | $ 568,780 | $ (53,713) | $ 15 | $ 204 | $ 1,105 |
Balance (in shares) at Dec. 31, 2017 | 35,747,134 | ||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Issuance of stock - employee stock purchase plan | 2,429 | 2,429 | |||||
Issuance of stock - employee stock purchase plan (shares) | 38,961 | ||||||
Issuance of stock - 401 (k) plan | 9,232 | 9,232 | |||||
Issuance of stock - 401 (k) plan (shares) | 129,451 | ||||||
Issuance/(cancellation) of non-vested stock | 0 | $ 1 | (1) | ||||
Issuance/(cancellation) of non-vested stock (shares) | 174,044 | ||||||
Exercise of stock options | 5,953 | 5,953 | |||||
Exercise of stock options (in shares) | 162,690 | ||||||
Non-cash compensation | 17,887 | 17,887 | |||||
Surrendered shares | (6,570) | (6,570) | |||||
Shares repurchased | (181,402) | (181,402) | |||||
Noncontrolling interest distribution | (1,090) | (1,090) | |||||
Repurchase of noncontrolling interest | (361) | (614) | 253 | ||||
Net income | 120,129 | 119,346 | 783 | ||||
Balance, Stockholders Equity at Dec. 31, 2018 | 482,633 | $ 36 | 603,666 | (241,685) | 15 | 119,550 | 1,051 |
Balance (in shares) at Dec. 31, 2018 | 36,252,280 | ||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Issuance of stock - employee stock purchase plan | 3,187 | 3,187 | |||||
Issuance of stock - employee stock purchase plan (shares) | 30,483 | ||||||
Issuance of stock - 401 (k) plan | 9,753 | 9,753 | |||||
Issuance of stock - 401 (k) plan (shares) | 79,056 | ||||||
Issuance/(cancellation) of non-vested stock | 0 | $ 1 | (1) | ||||
Issuance/(cancellation) of non-vested stock (shares) | 189,134 | ||||||
Exercise of stock options | 3,611 | 3,611 | |||||
Exercise of stock options (in shares) | 87,068 | ||||||
Non-cash compensation | 25,040 | 25,040 | |||||
Surrendered shares | (9,556) | (9,556) | |||||
Noncontrolling interest distribution | (1,062) | (1,062) | |||||
Net income | 127,907 | 126,833 | 1,074 | ||||
Balance, Stockholders Equity at Dec. 31, 2019 | 641,513 | $ 37 | 645,256 | (251,241) | 15 | 246,383 | 1,063 |
Balance (in shares) at Dec. 31, 2019 | 36,638,021 | ||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Issuance of stock - employee stock purchase plan | 3,562 | 3,562 | |||||
Issuance of stock - employee stock purchase plan (shares) | 21,561 | ||||||
Issuance of stock - 401 (k) plan | 3,057 | 3,057 | |||||
Issuance of stock - 401 (k) plan (shares) | 18,312 | ||||||
Issuance/(cancellation) of non-vested stock | 0 | ||||||
Issuance/(cancellation) of non-vested stock (shares) | 169,489 | ||||||
Exercise of stock options | $ 6,325 | $ 1 | 6,324 | ||||
Exercise of stock options (in shares) | 622,829 | 622,829 | |||||
Non-cash compensation | $ 26,730 | 26,730 | |||||
Surrendered shares | (54,493) | 13,358 | (67,851) | ||||
Noncontrolling interest distribution | (1,122) | (1,122) | |||||
Write-off of other comprehensive income | (15) | (15) | |||||
Net income | 185,184 | 183,608 | 1,576 | ||||
Balance, Stockholders Equity at Dec. 31, 2020 | $ 810,741 | $ 38 | $ 698,287 | $ (319,092) | $ 0 | $ 429,991 | $ 1,517 |
Balance (in shares) at Dec. 31, 2020 | 37,470,212 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Cash Flows from Operating Activities: | |||
Net income | $ 185,184 | $ 127,907 | $ 120,129 |
Adjustments to reconcile net income to net cash provided by operating activities: | |||
Depreciation and amortization | 28,802 | 18,428 | 13,261 |
Non-cash compensation | 26,730 | 25,040 | 17,887 |
Non-cash 401(k) employer match | 0 | 10,509 | 8,976 |
Amortization and impairment of operating lease right of use assets | 39,140 | 35,905 | 0 |
(Gain) loss on disposal of property and equipment | (30) | 141 | 714 |
Loss on sale of equity method investment | 2,980 | 0 | 0 |
Write-off of other comprehensive income | (15) | 0 | 0 |
Deferred income taxes | (26,560) | 13,466 | 20,271 |
Equity in earnings from equity method investments | (3,966) | (5,338) | (7,692) |
Amortization of deferred debt issuance costs/debt discount | 869 | 873 | 797 |
Return on equity investment | 5,444 | 4,955 | 6,158 |
Asset impairment charge | 4,152 | 1,470 | 0 |
Changes in operating assets and liabilities, net of impact of acquisitions: | |||
Patient accounts receivable | 2,114 | (24,146) | 12,224 |
Other current assets | (7,181) | (2,682) | 8,679 |
Other assets | 31 | 832 | 2,947 |
Accounts payable | 1,941 | (11,329) | 3,165 |
Accrued expenses | 39,839 | 42,096 | 13,524 |
Other long-term obligations | 27,717 | (329) | 2,443 |
Operating lease liabilities | (34,695) | (32,295) | 0 |
Operating lease right of use assets | (3,544) | (3,503) | 0 |
Net cash provided by operating activities | 288,952 | 202,000 | 223,483 |
Cash Flows from Investing Activities: | |||
Proceeds from sale of deferred compensation plan assets | 101 | 448 | 715 |
Proceeds from the sale of property and equipment | 80 | 162 | 54 |
Purchases of property and equipment | (5,332) | (7,888) | (6,558) |
Investments in equity method investees | (875) | (210) | (7,144) |
Proceeds from sale of equity method investment | 17,876 | 0 | 0 |
Acquisitions of businesses, net of cash acquired | (298,958) | (345,460) | (9,260) |
Net cash used in investing activities | (287,108) | (352,948) | (22,193) |
Cash Flows from Financing Activities: | |||
Proceeds from issuance of stock upon exercise of stock options | 6,325 | 3,611 | 5,953 |
Proceeds from issuance of stock to employee stock purchase plan | 3,562 | 3,187 | 2,429 |
Shares withheld to pay taxes on non-cash compensation | (54,493) | (9,556) | (6,570) |
Non-controlling interest distribution | (1,122) | (1,062) | (1,090) |
Proceeds from borrowings under term loan | 0 | 175,000 | 0 |
Proceeds from borrowings under revolving line of credit | 684,200 | 262,500 | 138,000 |
Repayments of borrowings under revolving line of credit | (703,200) | (200,000) | (130,500) |
Principal payments of long-term obligations | (10,249) | (5,624) | (91,450) |
Debt issuance costs | 0 | (847) | (2,433) |
Provider relief fund advance | 60,000 | 0 | 0 |
Purchase of company stock | 0 | 0 | (181,402) |
Repurchase of noncontrolling interest | 0 | 0 | (361) |
Net cash (used in) provided by financing activities | (14,977) | 227,209 | (267,424) |
Net (decrease) increase in cash, cash equivalents and restricted cash | (13,133) | 76,261 | (66,134) |
Cash, cash equivalents and restricted cash at beginning of period | 96,490 | 20,229 | 86,363 |
Cash, cash equivalents and restricted cash at end of period | 83,357 | 96,490 | 20,229 |
Supplemental Disclosures of Cash Flow Information: | |||
Cash paid for interest | 6,207 | 9,628 | 3,522 |
Cash paid for income taxes, net of refunds received | 50,721 | 29,522 | 14,278 |
Supplemental Disclosures of Non-Cash Financing Activity: | |||
Note payable issued for software licenses | $ 0 | $ 0 | $ 418 |
NATURE OF OPERATIONS, CONSOLIDA
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS | 12 Months Ended |
Dec. 31, 2020 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS | NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS Amedisys, Inc., a Delaware corporation (together with its consolidated subsidiaries, referred to herein as “Amedisys,” “we,” “us,” or “our”), is a multi-state provider of home health, hospice and personal care services with approximately 75%, 74% and 73% of our revenue derived from Medicare for 2020, 2019 and 2018, respectively. As of December 31, 2020, we owned and operated 320 Medicare-certified home health care centers, 180 Medicare-certified hospice care centers and 14 personal-care care centers in 39 states within the United States and the District of Columbia. Recently Adopted Accounting Pronouncements On January 1, 2020, the Company adopted Accounting Standards Update ("ASU") 2016-13, Financial Instruments - Credit Losses (Topic 326) , which provides guidance for measuring credit losses on financial instruments. Our adoption of this standard did not have a material effect on our consolidated financial statements. During the fourth quarter of 2020, the Company adopted ASU 2019-12, Income Taxes (Topic 740) - Simplifying the Accounting for Income Taxes , which eliminates certain exceptions related to the approach for intraperiod tax allocation, the methodology for calculating taxes during the interim periods and the recognition of deferred tax liabilities for outside basis differences. This guidance also simplifies aspects of the accounting for franchise taxes, enacts changes in tax laws or rates and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. The guidance is effective for interim and annual periods beginning after December 15, 2020, with early adoption permitted. Our adoption of this standard on a prospective basis was not material to the Company’s consolidated financial statements. On January 1, 2019, the Company adopted Accounting Standards Codification ("ASC") 842, Leases, using a modified retrospective transition approach, which requires the new standard to be applied to all leases existing at the date of initial application. Under ASC 842, lessees are required to recognize a lease liability and right-of-use asset ("ROU asset") for all leases with a term greater than twelve months and to disclose key information about leasing arrangements. Additionally, leases are classified as either financing or operating; the classification determines the pattern of expense recognition and classification within the statement of operations. We used the standard's effective date as our date of initial application. Consequently, our financial information was not updated and the disclosures required under the new standard are not provided for dates and periods prior to January 1, 2019. The new standard provides several optional practical expedients that can be adopted at transition. We elected the "package of practical expedients," which allows us to not reassess our prior conclusions regarding lease identification, lease classification and initial direct costs. We did not elect the use-of-hindsight or the practical expedient pertaining to land easements; the latter not being applicable to us. The most significant effects related to this adoption relate to (1) the recognition of new ROU assets and lease liabilities on our balance sheet for our real estate and fleet operating leases; and (2) significant new disclosures about our leasing activities. Upon adoption, we recognized approximately $80 million in operating leases liabilities with corresponding ROU assets of approximately the same amount. The new standard also provides practical expedients for an entity’s ongoing accounting. We have elected the practical expedient that allows us to not separate lease and non-lease components for all of our leases. On January 1, 2019, the Company adopted ASU 2018-07, Compensation - Stock Compensation (Topic 718): Improvements to Nonemployees Share-Based Payment Accounting, which expands the scope of Topic 718 to include share-based payments issued to nonemployees for goods or services. Our adoption of this standard did not have an effect on our consolidated financial statements. On January 1, 2018, the Company adopted ASC 606, Revenue from Contracts with Customers, using the full retrospective method. ASC 606 outlines a single comprehensive model to use in accounting for revenue arising from contracts with customers. The standard supersedes existing revenue recognition requirements and eliminates most industry-specific guidance from U.S. Generally Accepted Accounting Principles ("U.S. GAAP"). The core principle of the revenue recognition standard is to require an entity to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which it expects to be entitled in exchange for those goods or services. As a result of the Company's adoption of ASC 606, the revenue and related estimated uncollectible amounts owed to us by non-Medicare payors that were historically classified as provision for doubtful accounts are now considered a revenue adjustment in determining net service revenue. Accordingly, the Company reports estimated uncollectible balances due from third-party payors and uncollectible balances associated with patient responsibility as a reduction of the transaction price and therefore, as a reduction in net service revenue (or as it relates to Hospice room and board, an increase in cost of service, excluding depreciation and amortization) when historically these amounts were classified as provision for doubtful accounts within operating expenses within our consolidated statements of operations. In addition, the adoption of ASC 606 resulted in increased disclosure, including qualitative and quantitative disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers. On January 1, 2018, the Company adopted ASU 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business , which provides guidance to assist entities with evaluating whether transactions should be accounted for as an acquisition (or disposal) of assets or a business. We adopted this ASU on a prospective basis. The impact on our consolidated financial statements and related disclosures will depend on the facts and circumstances of any specific future transactions as evaluated under the new framework. On January 1, 2018, the Company adopted ASU 2017-04, Intangibles - Goodwill and Other (Topic 350) - Simplifying the Test for Goodwill Impairment , which eliminates the requirement to calculate the implied fair value of goodwill to measure a goodwill impairment charge (Step 2 of the goodwill impairment test). Instead, impairment will be measured using the difference between the carrying amount and the fair value of the reporting unit. The ASU is effective for annual and interim periods beginning after December 15, 2019, with early adoption permitted. We adopted this ASU on a prospective basis and will apply this guidance to our future tests of goodwill impairment. On January 1, 2018, the Company adopted ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments , which provides specific guidance on eight cash flow classification issues not specifically addressed by U.S. GAAP. The ASU is effective for annual and interim periods beginning after December 15, 2017. The standard should be applied using a retrospective transition method unless it is impractical to do so for some of the issues. In such case, the amendments for those issues would be applied prospectively as of the earliest date practicable. Our adoption of this standard using a retrospective transition method for each period presented did not have an effect on our consolidated financial statements. Recently Issued Accounting Pronouncements On March 12, 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting , which provides optional expedients and exceptions for applying U.S. GAAP to contract modifications and hedging relationships that reference LIBOR or another reference rate expected to be discontinued, subject to meeting certain criteria. The amendments in this ASU were effective beginning on March 12, 2020 and may generally be applied prospectively through December 31, 2022. This standard will not have an effect on our consolidated financial statements. Use of Estimates Our accounting and reporting policies conform with U.S. GAAP. In preparing the consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates. Principles of Consolidation These consolidated financial statements include the accounts of Amedisys, Inc. and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying consolidated financial statements, and business combinations accounted for as purchases have been included in our consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain equity investments that are accounted for as set forth below. Investments We consolidate investments when the entity is a variable interest entity and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50%. Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our consolidated financial statements. During 2016, we sold a 30% interest in one of our care centers while maintaining a controlling interest in the newly formed joint venture; we repurchased the 30% interest during 2018. We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a variable interest entity in which we are the primary beneficiary. During 2020, we sold our investment in the Heritage Healthcare Innovation Fund, LP via a secondary transaction for $17.9 million which resulted in a $3.0 million loss which is reflected in miscellaneous, net within our consolidated statement of |
SUMMARY OF SIGNIFICANT ACCOUNTI
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES | 12 Months Ended |
Dec. 31, 2020 | |
Accounting Policies [Abstract] | |
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES | SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Revenue Recognition We account for revenue from contracts with customers in accordance with ASC 606, Revenue from Contracts with Customers , and as such, we recognize revenue in the period in which we satisfy our performance obligations under our contracts by transferring our promised services to our customers in amounts that reflect the consideration to which we expect to be entitled in exchange for providing patient care, which are the transaction prices allocated to the distinct services. The Company's cost of obtaining contracts is not material. Revenues are recognized as performance obligations are satisfied, which varies based on the nature of the services provided. Our performance obligation is the delivery of patient care services in accordance with the nature and frequency of services outlined in physicians' orders, which are determined by a physician based on a patient's specific goals. The Company's performance obligations relate to contracts with a duration of less than one year; therefore, the Company has elected to apply the optional exemption provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied as of the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period. We determine the transaction price based on gross charges for services provided, reduced by estimates for contractual and non-contractual revenue adjustments. Contractual revenue adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third-party payors and others for services provided. Non-contractual revenue adjustments include discounts provided to self-pay, uninsured patients or other payors, adjustments resulting from payment reviews and adjustments arising from our inability to obtain appropriate billing documentation, authorizations or face-to-face documentation. Subsequent changes to the estimate of the transaction price are recorded as adjustments to net service revenue in the period of change. Non-contractual revenue adjustments are recorded for self-pay, uninsured patients and other payors by major payor class based on our historical collection experience, aged accounts receivable by payor and current economic conditions. The non-contractual revenue adjustments represent the difference between amounts billed and amounts we expect to collect based on our collection history with similar payors. The Company assesses its ability to collect for the healthcare services provided at the time of patient admission based on the Company's verification of the patient's insurance coverage under Medicare, Medicaid, and other commercial or managed care insurance programs. Medicare represents approximately 75% of the Company's consolidated net service revenue. Amounts due from third-party payors, primarily commercial health insurers and government programs (Medicare and Medicaid), include variable consideration for retroactive revenue adjustments due to settlements of audits and payment reviews. We determine our estimates for non-contractual revenue adjustments related to payment reviews based on our historical experience and success rates in the claim appeals and adjudication process. We determine our estimates for non-contractual revenue adjustments related to our inability to obtain appropriate billing documentation, authorizations, or face-to-face documentation based on our historical experience which primarily includes a historical collection rate of over 99% on Medicare claims. Revenue is recorded at amounts we estimate to be realizable for services provided. Revenue by payor class as a percentage of total net service revenue is as follows: As of December 31, 2020 2019 2018 Home Health: Medicare 41 % 44 % 50 % Non-Medicare - Episodic-based 7 % 9 % 9 % Non-Medicare - Non-episodic based 13 % 12 % 12 % Hospice (1): Medicare 34 % 30 % 23 % Non-Medicare 2 % 1 % 1 % Personal Care 3 % 4 % 5 % 100 % 100 % 100 % (1) Acquired Compassionate Care Hospice on February 1, 2019, RoseRock Healthcare on April 1, 2019, Asana Hospice on January 1, 2020 and AseraCare Hospice on June 1, 2020. Home Health Revenue Recognition Medicare Revenue Effective January 1, 2020, the Centers for Medicare and Medicaid Services ("CMS") implemented a revised case-mix adjustment methodology, the Patient-Driven Groupings Model ("PDGM"), to better align payment with patient care needs and ensure that clinically complex and ill beneficiaries have adequate access to home health care. PDGM uses 30-day periods of care rather than 60-day episodes of care as the unit of payment, eliminates the use of the number of therapy visits provided in determining payment and relies more heavily on clinical characteristics and other patient information. Net service revenue is recorded based on the established Federal Medicare home health payment rate for a 30-day period of care. ASC 606 notes that if an entity has a right to consideration from a customer in an amount that corresponds directly with the value of the entity’s performance completed to date, the entity may recognize revenue in the amount to which the entity has a right to invoice. We have elected to apply the "right to invoice" practical expedient and therefore, our revenue recognition is based on the reimbursement we are entitled to for each 30-day payment period. We utilize our historical average length of stay for each 30-day period of care as the measure of progress towards the satisfaction of our performance obligation. PDGM uses timing, admission source, functional impairment levels and principal and other diagnoses to case-mix adjust payments. The case-mix adjusted payment for a 30-day period of care is subject to additional adjustments based on certain variables including, but not limited to: (a) an outlier payment if our patient’s care was unusually costly (capped at 10% of total reimbursement per provider number); (b) a low utilization payment adjustment (“LUPA”) if the number of visits provided was less than the established threshold, which ranges from two to six visits and varies for every case-mix group under PDGM; (c) a partial payment if a patient transferred to another provider or from another provider before completing the 30-day period of care; and (d) the applicable geographic wage index. Payments for routine and non-routine supplies are now included in the 30-day payment rate. Medicare can also make various adjustments to payments received if we are unable to produce appropriate billing documentation or acceptable authorizations. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record this estimate during the period in which services are rendered to revenue with a corresponding reduction to patient accounts receivable. Amounts due from Medicare include variable consideration for retroactive revenue adjustments due to settlements of audits and payment reviews. We determine our estimates for non-contractual revenue adjustments related to payment reviews based on our historical experience and success rates in the claim appeals and adjudication process. The Medicare home health benefit requires that beneficiaries be homebound (meaning that the beneficiary is unable to leave his/her home without a considerable and taxing effort), require intermittent skilled nursing, physical therapy or speech therapy services, and receive treatment under a plan of care established and periodically reviewed by a physician. In order to provide greater flexibility during the novel coronavirus pandemic ("COVID-19"), CMS has relaxed the definition of homebound status through the duration of the public health emergency. During the pandemic, a beneficiary is considered homebound if they have been instructed by a physician not to leave their home because of a confirmed or suspected COVID-19 diagnosis or if the patient has a condition that makes them more susceptible to contracting COVID-19. Therefore, if a beneficiary is homebound due to COVID-19 and requires skilled services, the services will be covered under the Medicare home health benefit. All Medicare contracts are required to have a signed plan of care which represents a single performance obligation, comprised of the delivery of a series of distinct services that are substantially similar and have a similar pattern of transfer to the customer. Accordingly, the Company accounts for the series of services ("episode") as a single performance obligation satisfied over time, as the customer simultaneously receives and consumes the benefits of the goods and services provided. An episode starts the first day a billable visit is performed and ends 60 days later or upon discharge, if earlier, with multiple continuous episodes allowed. A portion of reimbursement from each Medicare episode, referred to as a request for anticipated payment ("RAP"), is billed near the start of each 30-day period of care, and cash is typically received before all services are rendered. Any cash received from Medicare for a RAP for a 30-day period of care that exceeds the associated revenue earned is recorded to accrued expenses within our consolidated balance sheets. CMS reduced the upfront payment for RAPs to 20% for 2020 and has fully eliminated payments associated with RAPs in 2021. Non-Medicare Revenue Episodic-based Revenue. We recognize revenue in a similar manner as we recognize Medicare revenue for amounts that are paid by other insurance carriers, including Medicare Advantage programs; however, these amounts can vary based upon the negotiated terms which generally range from 90% to 100% of Medicare rates. Non-episodic based Revenue. Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates. Contractual revenue adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue. We also make non-contractual revenue adjustments to non-episodic revenue based on our historical experience to reflect the estimated transaction price. We receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment. Hospice Revenue Recognition Hospice Medicare Revenue Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are predetermined daily or hourly rates for each of the four levels of care we deliver. The four levels of care are routine care, general inpatient care, continuous home care and respite care. Routine care accounted for 97% of our total Medicare hospice service revenue for each of 2020, 2019 and 2018, respectively. There are two separate payment rates for routine care: payments for the first 60 days of care and care beyond 60 days. In addition to the two routine rates, we may also receive a service intensity add-on (“SIA”). The SIA is based on visits made in the last seven days of life by a registered nurse or medical social worker for patients in a routine level of care. The performance obligation is the delivery of hospice services to the patient, as determined by a physician, each day the patient is on hospice care. We make adjustments to Medicare revenue for non-contractual revenue adjustments, which include our inability to obtain appropriate billing documentation or acceptable authorizations and other reasons unrelated to credit risk. We estimate the impact of these non-contractual revenue adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record it during the period services are rendered. Additionally, our hospice service revenue is subject to certain limitations on payments from Medicare which are considered variable consideration. We are subject to an inpatient cap limit and an overall Medicare payment cap for each provider number. We monitor these caps on a provider-by-provider basis and estimate amounts due back to Medicare if we estimate a cap has been exceeded. We record these adjustments as a reduction to revenue and an increase in accrued expenses within our consolidated balance sheets. Providers are required to self-report and pay their estimated cap liability by February 28th of the following year. As of December 31, 2020, we have settled our Medicare hospice reimbursements for all fiscal years through October 31, 2013. As of December 31, 2020, we have recorded $9.3 million for estimated amounts due back to Medicare in accrued expenses for the Federal cap years ended October 31, 2014 through September 30, 2021; approximately $2.0 million of this balance was acquired with the AseraCare Hospice ("AseraCare") acquisition. As of December 31, 2019, we had recorded $5.7 million for estimated amounts due back to Medicare in accrued expenses for the Federal cap years ended October 31, 2013 through September 30, 2020. Hospice Non-Medicare Revenue Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per day rates, as applicable. Contractual revenue adjustments are recorded for the difference between our standard rates and the contractual rates to be realized from patients, third party payors and others for services provided and are deducted from gross revenue to determine our net service revenue. We also make non-contractual adjustments to non-Medicare revenue based on our historical experience to reflect the estimated transaction price. Personal Care Revenue Recognition Personal Care Revenue We generate net service revenues by providing our services directly to patients based on authorized hours, visits or units determined by the relevant agency, at a rate that is either contractual or fixed by legislation. Net service revenue is recognized at the time services are rendered based on gross charges for the services provided, reduced by estimates for contractual and non-contractual revenue adjustments. We receive payment for providing such services from payors, including state and local governmental agencies, managed care organizations, commercial insurers and private consumers. Payors include the following elder service agencies: Aging Services Access Points ("ASAPs"), Senior Care Options ("SCOs"), Program of All-Inclusive Care for the Elderly ("PACE") and the Veterans Administration ("VA"). Government Grants In the absence of specific guidance to account for government grants under U.S. GAAP, we have decided to account for government grants in accordance with International Accounting Standard ("IAS") 20, Accounting for Government Grants and Disclosure of Government Assistance , and as such, we recognize grant income on a systematic basis in line with the recognition of expenses or the loss of revenues for which the grants are intended to compensate. We recognize grants once both of the following conditions are met: (1) we are able to comply with the relevant conditions of the grant and (2) the grant will be received. See Note 3 - Novel Coronavirus Pandemic ("COVID-19") for additional information on our accounting for government funds received under the Coronavirus Aid, Relief and Economic Security Act ("CARES Act") and the Mass Home Care ASAP COVID-19 Provider Sustainability Program. Cash, Cash Equivalents and Restricted Cash Cash and cash equivalents include certificates of deposit and all highly liquid debt instruments with maturities of three months or less when purchased. Our cash balance as of December 31, 2020 includes approximately $77 million associated with the CARES Act Provider Relief Fund ("PRF"). We separated the PRF funds into their own account and as of December 31, 2020, we have only transferred funds used during the nine-month period ended September 30, 2020 to our operating account. We will transfer funds used during the three-month period ended December 31, 2020 to our operating account in 2021. Restricted cash includes cash that is not available for ordinary business use. As of December 31, 2020, we had $1.5 million of restricted cash that was placed into an escrow account related to the indemnity provisions within the Asana Hospice purchase agreement. As of December 31, 2019, we had $66.2 million of restricted cash that was placed into an escrow account to fund the acquisition of Asana Hospice on January 1, 2020. The following table summarizes the balances related to our cash, cash equivalents and restricted cash (amounts in millions): As of December 31, 2020 2019 Cash and cash equivalents $ 81.8 $ 30.3 Restricted cash 1.5 66.2 Cash, cash equivalents and restricted cash $ 83.3 $ 96.5 Patient Accounts Receivable We report accounts receivable from services rendered at their estimated transaction price, which includes contractual and non-contractual revenue adjustments based on the amounts expected to be due from payors. Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party payors and patients. The Company's non-Medicare third-party payor base is comprised of a diverse group of payors that are geographically dispersed across the country. As of December 31, 2020, there is no single payor, other than Medicare, that accounts for more than 10% of our total outstanding patient receivables. Thus, we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. We believe the collectibility risk associated with our Medicare accounts, which represent 64% and 58% of our net patient accounts receivable at December 31, 2020 and 2019, respectively, is limited due to our historical collection rate of over 99% from Medicare and the fact that Medicare is a U.S. government payor. We do not believe there are any significant concentrations of revenues from any payor that would subject us to any significant credit risk in the collection of our accounts receivable. Medicare Home Health For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for 20% of our estimated payment for each 30-day period of care. The RAP received for that billing period is then deducted from our final payment. If a final bill is not submitted within the greater of 90 days from the start of the 30-day period of care, or 60 days from the date the RAP was paid, any RAPs received for that billing period will be recouped by Medicare from any other claims in process for that particular provider number. The RAP claim must then be resubmitted. CMS has mandated the full elimination of all upfront payments associated with RAPs in 2021. Medicare Hospice For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We bill Medicare on a monthly basis for the services provided to the patient. Non-Medicare Home Health, Hospice, and Personal Care For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient’s eligibility for services with the applicable payor. Once the patient has been confirmed for eligibility, we will provide services to the patient and bill the applicable payor. Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular payors or groups of payors with similar characteristics that would subject us to any significant credit risk. Property and Equipment Property and equipment is stated at cost and depreciated on a straight-line basis over the estimated useful lives of the assets or life of the lease, if shorter. Additionally, we have internally developed computer software for our own use. Additions and improvements (including interest costs for construction of qualifying long-lived assets) are capitalized. Maintenance and repair expenses are charged to expense as incurred. The cost of property and equipment sold or disposed of and the related accumulated depreciation are eliminated from the property and related accumulated depreciation accounts, and any gain or loss is credited or charged to other general and administrative expenses. We assess the impairment of a long-lived asset group whenever events or changes in circumstances indicate that the asset’s carrying value may not be recoverable. Factors we consider important that could trigger an impairment review include but are not limited to the following: • A significant change in the extent or manner in which the long-lived asset group is being used. • A significant change in the business climate that could affect the value of the long-lived asset group. • A significant change in the market value of the assets included in the asset group. If we determine that the carrying value of long-lived assets may not be recoverable, we compare the carrying value of the asset group to the undiscounted cash flows expected to be generated by the asset group. If the carrying value exceeds the undiscounted cash flows, an impairment charge is indicated. An impairment charge is recognized to the extent that the carrying value of the asset group exceeds its fair value. We generally provide for depreciation over the following estimated useful service lives. Years Building 39 Leasehold improvements Lesser of lease term or expected useful life Equipment and furniture 3 to 7 Vehicles 5 Computer software 2 to 7 Finance leases 3 The following table summarizes the balances related to our property and equipment for 2020 and 2019 (amounts in millions): As of December 31, 2020 2019 Building and leasehold improvements $ 9.0 $ 8.7 Equipment and furniture 53.1 55.6 Finance leases 5.9 5.2 Computer software 50.7 54.7 118.7 124.2 Less: accumulated depreciation (95.0) (96.1) $ 23.7 $ 28.1 Depreciation expense for 2020, 2019 and 2018 was $12.1 million, $11.6 million and $10.8 million, respectively. Business Combinations We account for acquisitions using the acquisition method of accounting in accordance with ASC 805, Business Combinations . Acquisitions are accounted for as purchases and are included in our consolidated financial statements from their respective acquisition dates. Assets acquired and liabilities assumed, if any, are measured at fair value on the acquisition date using the appropriate valuation method. Goodwill generated from acquisitions is recognized for the excess of the purchase price over tangible and identifiable intangible assets. In determining the fair value of identifiable intangible assets, we use various valuation techniques including discounted cash flow analysis, the income approach, the cost approach and the market approach. These valuation methods require us to make estimates and assumptions surrounding projected revenues and costs, future growth and discount rates. Goodwill and Other Intangible Assets Goodwill represents the amount of the purchase price in excess of the fair values assigned to the underlying identifiable net assets of acquired businesses. Goodwill is not amortized, but is subject to an annual impairment test. Tests are performed more frequently if events occur or circumstances change that would more likely than not reduce the fair value of the reporting unit below its carrying amount. These events or circumstances include, but are not limited to, a significant adverse change in the business environment, regulatory environment or legal factors, or a substantial decline in the market capitalization of our stock. Each of our operating segments described in Note 14 – Segment Information is considered to represent an individual reporting unit for goodwill impairment testing purposes. We consider each of our home health care centers to constitute an individual business for which discrete financial information is available. However, since these care centers have substantially similar operating and economic characteristics and resource allocations and since significant investment decisions concerning these businesses are centralized and the benefits broadly distributed, we have aggregated these care centers and deemed them to constitute a single reporting unit. We have applied this same aggregation principle to our hospice and personal-care care centers and have also deemed each of them to be a single reporting unit. During 2020, we performed a qualitative assessment to determine if it is more likely than not that the fair value of the reporting units are less than their carrying values by evaluating relevant events and circumstances including financial performance, market conditions and share price. Based on this assessment, we did not record any goodwill impairment charges and none of the goodwill associated with our various reporting units was considered at risk of impairment as of October 31, 2020. Since the date of our last annual goodwill impairment test, there have been no material developments, events, changes in operating performance or other circumstances that would cause management to believe it is more likely than not that the fair value of any of our reporting units would be less than their carrying amounts. Intangible assets consist of certificates of need, licenses, acquired names and non-compete agreements. We amortize non-compete agreements and acquired names that we do not intend to use indefinitely on a straight-line basis over their estimated useful lives, which are generally two Debt Issuance Costs During 2019, we recorded $0.8 million in deferred debt issuance costs as a reduction to long-term obligations, less current portion in our consolidated balance sheet in connection with our entry into the Amended Credit Agreement (See Note 8 - Long-Term Obligations). As of December 31, 2020 and 2019, we had unamortized debt issuance costs of $2.7 million and $3.5 million, respectively, recorded as a reduction to long-term obligations, less current portion in our accompanying consolidated balance sheets. We amortize deferred debt issuance costs related to our long-term obligations over the term of the obligation through interest expense, unless the debt is extinguished, in which case unamortized balances are immediately expensed. The unamortized debt issuance costs of $2.7 million at December 31, 2020 will be amortized over a weighted-average amortization period of 3.1 years. Fair Value of Financial Instruments The following details our financial instruments where the carrying value and the fair value differ (amounts in millions): Fair Value at Reporting Date Using Financial Instrument Carrying Value as of Quoted Prices in Active Significant Other Significant Long-term obligations $ 215.1 $ — $ 217.7 $ — The fair value hierarchy is based on three levels of inputs, of which the first two are considered observable and the last unobservable, that may be used to measure fair value. The three levels of inputs are as follows: • Level 1 – Quoted prices in active markets for identical assets and liabilities. • Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. • Level 3 – Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities. Our deferred compensation plan assets are recorded at fair value and are considered a level 2 measurement. For our other financial instruments, including our cash and cash equivalents, patient accounts receivable, accounts payable, payroll and employee benefits and accrued expenses, we estimate the carrying amounts approximate fair value. Income Taxes We use the asset and liability approach for measuring deferred tax assets and liabilities based on temporary differences existing at each balance sheet date using currently enacted tax rates. Our deferred tax calculation requires us to make certain estimates about future operations. Deferred tax assets are reduced by a valuation allowance when we believe it is more likely than not that some portion or all of the deferred tax assets will not be realized. The effect of a change in tax rate is recognized as income or expense in the period that includes the enactment date. As of December 31, 2020 and 2019, our net deferred tax assets were $48.0 million and $21.4 million, respectively. Management regularly assesses the ability to realize deferred tax assets recorded in the Company’s entities based upon the weight of available evidence, including such factors as the recent earnings history and expected future taxable income. In the event future taxable income is below management’s estimates or is generated in tax jurisdictions different than projected, we could be required to increase the valuation allowance for deferred tax assets. This would result in an increase in our effective tax rate. Share-Based Compensation We record all share-based compensation as expense in the financial statements measured at the fair value of the award. We recognize compensation cost on a straight-line basis over the requisite service period for each separately vesting portion of the award. Share-based compensation expense for 2020, 2019 and 2018 was $26.7 million, $25.0 million and $17.9 million, respectively, and the total income tax benefit recognized for these expenses was $4.7 million, $4.6 million and $4.3 million, respectively. Weighted-Average Shares Outstanding Net income per share attributable to Amedisys, Inc. common stockholders, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The following table sets forth, for the periods indicated, shares used in our computation of weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands): For the Years Ended December 31, 2020 2019 2018 Weighted average number of shares outstanding – basic 32,559 32,142 32,791 Effect of dilutive securities: Stock options 420 545 502 Non-vested stock and stock units 289 303 316 Weighted average number of shares outstanding – diluted 33,268 32,990 33,609 Anti-dilutive securities 25 117 50 Advertising Costs We expense advertising costs as incurred. Advertising expense for 2020, 2019 and 2018 was $8.0 million, $8.5 million and $7.0 million, respectively. |
NOVEL CORONAVIRUS PANDEMIC ("CO
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") | 12 Months Ended |
Dec. 31, 2020 | |
Unusual or Infrequent Items, or Both [Abstract] | |
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") | NOVEL CORONAVIRUS PANDEMIC ("COVID-19") In March 2020, the World Health Organization declared COVID-19 a pandemic. As a healthcare at home company, we have been and will continue to be impacted by the effects of COVID-19; however, we remain committed to carrying out our mission of caring for our patients. We will continue to closely monitor the impact of COVID-19 on all aspects of our business, including the impacts to our employees, patients and suppliers; however, at this time, we are unable to estimate the ultimate impact the pandemic will have on our consolidated financial condition, results of operations or cash flows. On March 27, 2020, the CARES Act was signed into legislation. The CARES Act provides for $175 billion to healthcare providers, including hospitals on the front lines of the COVID-19 pandemic. Of this total allocated amount, $30 billion was distributed immediately to providers based on their proportionate share of Medicare fee-for-service reimbursements in 2019. Healthcare providers were required to sign an attestation confirming receipt of the Provider Relief Fund ("PRF") funds and agree to the terms and conditions of payment. Our home health and hospice segments received approximately $100 million from the first $30 billion of funds distributed to healthcare providers in April 2020, which is inclusive of $2 million related to our joint venture care centers (equity method investments). We also acquired approximately $6 million of PRF funds in connection with the acquisition of AseraCare. Under the terms and conditions for receipt of the payment, we are allowed to use the funds to cover lost revenues and health care costs related to COVID-19, and we are required to properly and fully document the use of these funds in reports to the U.S. Department of Health and Human Services ("HHS"). For our wholly-owned subsidiaries, we have decided to only utilize PRF funds to the extent we have qualifying COVID-19 expenses, which totaled $33 million for our home health and hospice segments during the year ended December 31, 2020. Accordingly, for our wholly-owned subsidiaries, we will not be using PRF funds to cover lost revenues resulting from COVID-19. The grant income associated with the COVID-19 expenses incurred to date is reflected in other operating income within our consolidated statement of operations. HHS issued new guidance in September 2020 noting that PRF funds can be used towards lost revenues or expenses attributable to COVID-19 through June 30, 2021. We do not believe that we will fully utilize the funds received; therefore, we recorded a liability related to the funds that we do not expect to utilize totaling $60 million which is reflected in the Provider Relief Fund Advance account in current liabilities within our consolidated balance sheet. Funds that we intend to use in the future to cover COVID-19 expenses, which we have estimated to be approximately $12 million, have been recorded to a deferred liability account within accrued expenses in our consolidated balance sheet. These estimates may change as our ability to utilize and retain the funds will depend on the magnitude, timing and nature of the impact of the pandemic. In summary, the total funds that we have received from the CARES Act PRF as of December 31, 2020 consist of the following (amounts in millions): Amount Funds utilized during the year ended December 31, 2020 $ 33.3 Estimated funds to be utilized January 2021 through June 2021 11.6 Estimated funds to be repaid to the government 60.0 Funds received by unconsolidated joint ventures 1.9 $ 106.8 On April 24, 2020, HHS distributed an additional $18 billion in funds to healthcare providers. We did not receive, nor apply, for any additional funds from this second distribution. On October 1, 2020, HHS announced $20 billion in new funding to healthcare providers under the Phase 3 general distribution. We did not apply for any additional funds from this distribution. The CARES Act also provides for the temporary suspension of the automatic 2% reduction of Medicare claim reimbursements (sequestration) for the period May 1 through December 31, 2020 and the deferral of the employer share of social security tax (6.2%), effective for payments due after the enactment date. Fifty percent of the deferred payroll taxes are due on December 31, 2021 with the remaining amounts due on December 31, 2022. As of December 31, 2020, we have deferred $55 million of social security taxes; approximately $28 million is reflected in each of payroll and employee benefits and other long-term obligations within our consolidated balance sheet. In December 2020, Congress passed additional COVID-19 relief legislation as part of the Consolidated Appropriations Act, 2021. This legislation extended the suspension of sequestration through March 31, 2021. |
ACQUISITIONS
ACQUISITIONS | 12 Months Ended |
Dec. 31, 2020 | |
Business Combinations [Abstract] | |
ACQUISITIONS | ACQUISITIONSWe complete acquisitions from time to time in order to pursue our strategy of increasing our market presence by expanding our service base and enhancing our position in certain geographic areas as a leading provider of home health, hospice and personal care services. The purchase price paid for acquisitions is negotiated through arm’s length transactions, with consideration based on our analysis of, among other things, comparable acquisitions and expected cash flows. Acquisitions are accounted for as purchases and are included in our consolidated financial statements from their respective acquisition dates. Goodwill generated from acquisitions is recognized for the excess of the purchase price over tangible and identifiable intangible assets because of the expected contributions of the acquisitions to our overall corporate strategy. We typically engage outside appraisal firms to assist in the fair value determination of identifiable intangible assets for significant acquisitions. The preliminary purchase price allocation is adjusted, as necessary, up to one year after the acquisition closing date if management obtains more information regarding asset valuation and liabilities assumed. 2020 Acquisitions Home Health Division On March 1, 2020, we acquired the regulatory assets of a home health provider in Washington for a purchase price of $3.0 million. The purchase price was paid with cash on hand on the date of the transaction. We recorded goodwill of $2.8 million and other intangibles (certificate of need) of $0.2 million in connection with the acquisition. On April 18, 2020, we acquired the regulatory assets of a home health provider in Kentucky for a purchase price of $0.7 million. The purchase price was paid with cash on hand on the date of the transaction. We recorded goodwill of $0.5 million and other intangibles (certificate of need) of $0.2 million in connection with the acquisition. Hospice Division On January 1, 2020, we acquired Asana Hospice ("Asana"), a hospice provider with eight locations in Pennsylvania, Ohio, Texas, Missouri and Kansas for a purchase price of $66.3 million, net of cash acquired of $0.7 million. Under the purchase agreement, the purchase price was subject to a net working capital adjustment, whereby the purchase price would be adjusted to the extent the actual net working capital of Asana as of the closing differed from the required net working capital under the purchase agreement. The net working capital adjustment, which was finalized during the three-month period ended June 30, 2020, reduced the purchase price by $0.7 million, from $66.3 million to $65.6 million. The Company has finalized its valuation of the assets acquired and liabilities assumed. The total estimated consideration of $65.6 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions): Amount Patient accounts receivable $ 4.6 Property and equipment 0.2 Operating lease right of use assets 0.9 Intangible assets 5.6 Total assets acquired 11.3 Accounts payable (3.2) Payroll and employee benefits (1.5) Accrued expenses (0.5) Operating lease liabilities (0.9) Total liabilities assumed (6.1) Net identifiable assets acquired 5.2 Goodwill 60.4 Total estimated consideration $ 65.6 Intangible assets acquired include licenses ($2.0 million), acquired names ($1.3 million) and non-compete agreements ($2.3 million). The acquired names and non-compete agreements will be amortized over a weighted-average period of 2.0 years. Asana contributed approximately $23.4 million in net service revenue and an operating loss of $3.3 million (inclusive of acquisition and integration costs totaling $2.0 million and intangibles amortization totaling $2.6 million) during the year ended December 31, 2020. We expect the entire amount of goodwill recorded for this acquisition to be deductible for income tax purposes over approximately 15 years. On June 1, 2020, we acquired Homecare Preferred Choice, Inc., doing business as AseraCare Hospice ("AseraCare"), a national hospice care provider with 44 locations, for an estimated purchase price of $230.4 million, net of cash acquired and inclusive of a $32 million tax asset. The closing payment for the purchase price included estimates for cash, working capital and various other items. Under the purchase agreement, the purchase price was subject to a closing payment adjustment for any differences between estimated amounts included in the closing payment and actual amounts at close, not to exceed $1.0 million. The closing payment adjustment, which was finalized in October 2020, reduced the purchase price by $0.8 million, from $230.4 million to $229.6 million. The Company is in the process of reviewing the fair value of the assets acquired and liabilities assumed. During the year ended December 31, 2020, we recorded measurement period adjustments based on changes to management's estimates and assumptions related to the assets acquired and liabilities assumed. The final valuation of the assets acquired and liabilities assumed was not complete as of December 31, 2020, but will be finalized within the allowable measurement period. Based on the Company's preliminary valuation, the total estimated consideration of $229.6 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions): Amount Patient accounts receivable $ 15.0 Prepaid expenses 0.7 Property and equipment 0.6 Operating lease right of use assets 5.9 Intangible assets 24.3 Other assets 0.1 Total assets acquired 46.6 Accounts payable (5.8) Payroll and employee benefits (5.9) Accrued expenses (10.4) Operating lease liabilities (5.4) Total liabilities assumed (27.5) Net identifiable assets acquired 19.1 Goodwill 210.5 Total estimated consideration $ 229.6 Intangible assets acquired include licenses ($8.7 million), certificates of need ($0.7 million), acquired names ($5.7 million) and non-compete agreements ($9.2 million). The acquired names will be amortized over a weighted-average period of 2.0 years and the non-compete agreements will be amortized over a weighted-average period of 1.7 years. AseraCare contributed approximately $64.5 million in net service revenue and an operating loss of $8.2 million (inclusive of acquisition and integration costs totaling $7.6 million and intangibles amortization totaling $6.0 million) during the year ended December 31, 2020. We expect the entire amount of goodwill recorded for this acquisition to be deductible for income tax purposes over approximately 15 years. The following table contains unaudited pro forma condensed consolidated statement of operations information for the years ended December 31, 2020 and 2019 assuming that the AseraCare acquisition closed on January 1, 2019 (amounts in millions, except per share data). The pro forma financial information includes various assumptions, including those related to the preliminary purchase price allocation of assets acquired and liabilities assumed. The pro forma financial information may vary in future quarters based on the final valuations and analysis of the fair value of the assets acquired and liabilities assumed. For the Years Ended 2020 2019 Net service revenue $ 2,120.1 $ 2,077.0 Operating income 218.0 167.5 Net income attributable to Amedisys Inc. 180.6 112.3 Basic earnings per share 5.55 3.49 Diluted earnings per share 5.43 3.40 The pro forma information presented above includes adjustments for (i) amortization of identifiable intangible assets, (ii) interest on additional debt required to fund the AseraCare acquisition, (iii) non-recurring transaction costs and (iv) income taxes based on the Company's statutory tax rate. This pro forma information is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred. In addition, future results may vary significantly from the results reflected in the pro forma information. 2019 Acquisitions Hospice Division On February 1, 2019, we acquired Compassionate Care Hopsice ("CCH"), a national hospice care provider headquartered in New Jersey, for a purchase price of $327.9 million, net of cash acquired of $6.7 million. The Company has finalized its valuation of the assets acquired and liabilities assumed. The total consideration of $327.9 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions): Amount Patient accounts receivable $ 24.5 Prepaid expenses 0.8 Other current assets 0.1 Property and equipment 0.2 Intangible assets 27.2 Operating lease right of use assets 3.4 Other assets 1.1 Total assets acquired 57.3 Accounts payable (14.9) Payroll and employee benefits (11.7) Accrued expenses (11.7) Deferred tax liability (0.9) Operating lease liabilities (3.4) Total liabilities acquired (42.6) Net identifiable assets acquired 14.7 Goodwill 313.2 Total estimated consideration $ 327.9 Intangible assets acquired include licenses, certificates of need, acquired names and non-compete agreements. The acquired names and non-compete agreements will be amortized over a weighted-average period of 2.0 and 2.3 years, respectively. CCH contributed approximately $167.4 million in net service revenue and an operating loss of $5.6 million (inclusive of acquisition and integration costs totaling $14.5 million) during the year ended December 31, 2019. We expect $278.8 million of goodwill recorded for this acquisition to be deductible for income tax purposes over approximately 15 years. The following table contains unaudited pro forma condensed consolidated statement of operations information for the years ended December 31, 2019 and 2018 assuming that the CCH acquisition closed on January 1, 2018 (amounts in millions, except per share data): For the Years 2019 2018 Net service revenue $ 1,971.7 $ 1,852.8 Operating income 183.8 175.7 Net income attributable to Amedisys, Inc. 130.5 124.6 Basic earnings per share 4.06 3.80 Diluted earnings per share $ 3.96 $ 3.71 The pro forma information presented above includes adjustments for (i) amortization of identifiable intangible assets, (ii) interest on additional debt required to fund the CCH acquisition, (iii) non-recurring transaction costs and (iv) income taxes based on the Company’s statutory tax rate. This pro forma information is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred. In addition, future results may vary significantly from the results reflected in the pro forma information. On April 1, 2019, we acquired RoseRock Healthcare ("RoseRock"), an Oklahoma based hospice provider, for a purchase price of $17.5 million. The purchase price was paid with cash on hand on the date of the transaction. We recorded goodwill ($15.8 million) and other intangibles including acquired names ($1.0 million) and non-compete agreements ($0.7 million). The acquired names and non-compete agreements will each be amortized over a weighted-average period of 3.0 years. RoseRock contributed approximately $6.8 million in net service revenue and $0.8 million in operating income for the year ended December 31, 2019. We expect the entire amount of goodwill recorded for this acquisition to be deductible for income tax purposes over approximately 15 years. |
GOODWILL AND OTHER INTANGIBLE A
GOODWILL AND OTHER INTANGIBLE ASSETS, NET | 12 Months Ended |
Dec. 31, 2020 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
GOODWILL AND OTHER INTANGIBLE ASSETS, NET | GOODWILL AND OTHER INTANGIBLE ASSETS, NET During 2020, 2019 and 2018, we did not record any goodwill impairment charges as a result of our annual impairment test and none of the goodwill associated with our various reporting units was considered at risk of impairment as of October 31st of each respective year (the date of our annual goodwill impairment test). Since the date of our last annual goodwill impairment test, there have been no material developments, events, changes in operating performance or other circumstances that would cause management to believe it is more likely than not that the fair value of any of our reporting units would be less than their carrying amounts. The following table summarizes the activity related to our goodwill for 2020 and 2019 (amounts in millions): Goodwill Home Health Hospice Personal Care Total Balances at December 31, 2018 (1) $ 87.1 $ 199.3 $ 43.1 $ 329.5 Additions — 329.0 — 329.0 Balances at December 31, 2019 87.1 528.3 43.1 658.5 Additions 3.3 270.9 — 274.2 Balances at December 31, 2020 $ 90.4 $ 799.2 $ 43.1 $ 932.7 (1) Net of prior years' accumulated impairment losses of $733.7 million, which is inclusive of write-offs related to the sale and closure of care centers. During 2020, we recorded a non-cash other intangible assets impairment charge of $4.2 million related to acquired names which are no longer in use; additionally, we recorded amortization of $2.4 million related to certificates of need and licenses associated with care centers that were closed. During 2019, we recorded a non-cash other intangible assets impairment charge of $1.5 million related to acquired names which are no longer in use or are associated with care centers that were closed. The following table summarizes the activity related to our other intangible assets, net for 2020 and 2019 (amounts in millions): Other Intangible Assets, Net Certificates of Need and Licenses Acquired Acquired Non-Compete Total Balances at December 31, 2018 (1) $ 23.9 $ 19.6 $ — $ 0.6 $ 44.1 Additions 13.7 — 10.0 5.2 28.9 Write-off (2) — (1.5) — — (1.5) Amortization — — (4.4) (2.4) (6.8) Balances at December 31, 2019 37.6 18.1 5.6 3.4 64.7 Additions 11.8 — 7.0 11.5 30.3 Write-off (2) — (4.2) — — (4.2) Amortization (3) (2.4) — (7.1) (7.1) (16.6) Balances at December 31, 2020 $ 47.0 $ 13.9 $ 5.5 $ 7.8 $ 74.2 (1) Net of prior years' accumulated amortization of $0.7 million for non-compete agreements. (2) Write-offs are related to our acquired names that are no longer in use or that were associated with care centers that are closed. (3) Amortization of certificates of need and licenses is related to care centers that were closed during 2020. (4) The weighted average remaining amortization period of our amortizable acquired names and non-compete agreements is 1.3 years and 1.2 years, respectively. See Note 4 – Acquisitions for further details on additions to goodwill and other intangible assets, net. The estimated aggregate amortization expense related to intangible assets for each of the five succeeding years is as follows (amounts in millions): Intangible Asset Amortization 2021 $ 10.6 2022 2.7 2023 — 2024 — 2025 — $ 13.3 |
DETAILS OF CERTAIN BALANCE SHEE
DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS | 12 Months Ended |
Dec. 31, 2020 | |
Details Of Certain Balance Sheet Accounts [Abstract] | |
DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS | DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS Additional information regarding certain balance sheet accounts is presented below (amounts in millions): As of December 31, 2020 2019 Other current assets: Payroll tax escrow $ 6.3 $ 1.5 Income tax receivable 0.2 2.0 Due from joint ventures 2.3 2.0 Other 4.5 2.7 $ 13.3 $ 8.2 Other assets: Workers’ compensation deposits $ 0.3 $ 0.2 Health insurance deposits 0.5 0.5 Other miscellaneous deposits 1.2 1.0 Indemnity receivable 13.6 13.6 Equity method investments 14.2 35.7 Other 3.4 3.6 $ 33.2 $ 54.6 Accrued expenses: Health insurance $ 15.1 $ 15.8 Workers’ compensation 35.8 33.4 Florida ZPIC audit, gross liability 17.4 17.4 Legal settlements and other audits 24.4 19.0 Income tax payable — 0.5 Charity care 3.6 2.7 Estimated Medicare cap liability 9.3 5.7 Hospice accruals (room and board, general in-patient and other) 29.2 24.4 Patient liability 8.4 9.4 Deferred operating income (CARES Act) 11.6 — Other 11.4 8.8 $ 166.2 $ 137.1 Other long-term obligations: Reserve for uncertain tax positions $ 3.3 $ 3.1 Deferred compensation plan liability 1.0 1.0 Non-current social security taxes (deferred under CARES Act) 27.7 — Other 1.6 1.8 $ 33.6 $ 5.9 |
LEASES
LEASES | 12 Months Ended |
Dec. 31, 2020 | |
Leases [Abstract] | |
LEASES | LEASES We determine whether an arrangement is a lease at inception. We have operating leases, primarily for offices and fleet, that expire at various dates over the next eight years. We also have finance leases covering certain office equipment that expire at various dates over the next three years. Our leases do not contain any restrictive covenants. Our office leases generally contain renewal options for periods ranging from one Our fleet leases include a term of 367 days with monthly renewal options thereafter. Our fleet leases also include terminal rental adjustment clauses (“TRAC”), which provide for a final rental payment adjustment at the end of the lease, typically based on the amount realized from the sale of the vehicle. The TRAC is structured such that it will almost always result in a significant payment by us to the lessor if the renewal option is not exercised. Based on the significance of the TRAC adjustment at the initial lease expiration, we believe that it is reasonably certain that we will exercise the monthly renewal options; therefore, the renewal options are considered in determining the lease term, and payments associated with the renewal options are included in lease payments. For our fleet and office equipment leases, we use the implicit rate in the lease as the discount rate. For our office leases, the implicit rate is typically not available, so we use our incremental borrowing rate as the discount rate. Our lease agreements include both lease and non-lease components. We have elected the practical expedient that allows us to not separate lease and non-lease components for all of our leases. Payments due under our operating and finance leases include fixed payments as well as variable payments. For our office leases, variable payments include amounts for our proportionate share of operating expenses, utilities, property taxes, insurance, common area maintenance and other facility-related expenses. For our vehicle and equipment leases, variable payments consist of sales tax. The components of lease cost for the years ended December 31, 2020 and 2019 are as follows (amounts in millions): For the Years Ended December 31, 2020 2019 Operating lease cost: Operating lease cost $ 38.6 $ 35.0 Impairment of operating lease ROU assets 0.5 0.9 Total operating lease cost 39.1 35.9 Finance lease cost: Amortization of ROU assets 2.0 1.7 Interest on lease liabilities 0.2 0.2 Total finance lease cost 2.2 1.9 Variable lease cost 3.0 2.6 Short-term lease cost — 0.2 Total lease cost $ 44.3 $ 40.6 Amounts reported in the consolidated balance sheets as of December 31, 2020 and 2019 for our operating leases are as follows (amounts in millions): As of December 31, 2020 2019 Operating lease ROU assets $ 93.4 $ 84.8 Current portion of operating lease liabilities 30.0 27.8 Operating lease liabilities, less current portion 62.0 56.1 Total operating lease liabilities $ 92.0 $ 83.9 Amounts reported in the consolidated balance sheets as of December 31, 2020 and 2019 for finance leases are included in the table below. The finance lease ROU assets are recorded within property and equipment, net of accumulated depreciation within our consolidated balance sheets. The finance lease liabilities are recorded within current portion of long-term obligations and long-term obligations, less current portion within our consolidated balance sheets. As of December 31, 2020 2019 Finance lease ROU assets $ 5.9 $ 5.2 Accumulated amortization (3.3) (1.8) Finance lease ROU assets, net $ 2.6 $ 3.4 Current installments of obligations under finance leases $ 1.7 $ 1.7 Long-term portion of obligations under finance leases 0.9 1.7 Total finance lease liabilities $ 2.6 $ 3.4 Supplemental cash flow information and non-cash activity related to our leases are as follows (amounts in millions): For the Years Ended December 31, 2020 2019 Cash paid for amounts included in the measurement of lease liabilities and ROU assets: Operating cash flow from operating leases $ (38.2) $ (35.8) Financing cash flow from finance leases (2.0) (1.7) ROU assets obtained in exchange for lease obligations: Operating leases 38.5 116.0 Finance leases 1.2 2.9 Reductions to ROU assets resulting from reductions to lease obligations: Operating leases (1.1) (1.7) Finance leases — — Amounts disclosed for ROU assets obtained in exchange for lease obligations include amounts added to the carrying amount of ROU assets resulting from lease modifications and reassessments. Weighted average remaining lease terms and discount rates for our leases as of December 31, 2020 and 2019 are as follows: As of December 31, 2020 2019 Weighted average remaining lease term (years): Operating leases 3.7 3.9 Finance leases 1.7 2.1 Weighted average discount rate: Operating leases 3.1 % 3.9 % Finance leases 5.3 % 5.3 % Maturities of lease liabilities as of December 31, 2020 are as follows (amounts in millions): Operating Finance 2021 $ 32.2 $ 1.8 2022 25.3 0.7 2023 17.6 0.2 2024 11.7 — 2025 6.2 — Thereafter 4.6 — Total undiscounted lease payments 97.6 2.7 Less: Imputed interest (5.6) (0.1) Total lease liabilities $ 92.0 $ 2.6 |
LONG-TERM OBLIGATIONS
LONG-TERM OBLIGATIONS | 12 Months Ended |
Dec. 31, 2020 | |
Debt Disclosure [Abstract] | |
LONG-TERM OBLIGATIONS | LONG-TERM OBLIGATIONS Long-term debt consists of the following for the periods indicated (amounts in millions): As of December 31, 2020 2019 $175.0 million Term Loan; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (1.7% at December 31, 2020); due February 4, 2024 $ 164.1 $ 171.7 $550.0 million Revolving Credit Facility; interest only payments; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (3.8% at December 31, 2020); due February 4, 2024 51.0 70.0 Promissory notes — 0.6 Finance leases 2.6 3.4 Principal amount of long-term obligations 217.7 245.7 Deferred debt issuance costs (2.7) (3.5) 215.0 242.2 Current portion of long-term obligations (10.5) (9.9) Total $ 204.5 $ 232.3 Maturities of debt as of December 31, 2020 are as follows (amounts in millions): Long-term 2021 $ 10.5 2022 9.4 2023 12.3 2024 185.5 2025 — $ 217.7 Credit Agreement On June 29, 2018, we entered into our Amended and Restated Credit Agreement ("Credit Agreement") which provided for a senior secured revolving credit facility in an initial aggregate principal amount of up to $550.0 million (the "Revolving Credit Facility"). The Revolving Credit Facility provided for and included within its $550.0 million limit a $25.0 million swingline facility and commitments for up to $60.0 million in letters of credit. Upon lender approval, we could increase the aggregate loan amount under the Revolving Credit Facility by $125.0 million plus an unlimited amount subject to a leverage limit of 0.5x under the maximum allowable consolidated leverage ratio which was 3.0x per the Credit Agreement. The final maturity of the Revolving Credit Facility was June 29, 2023 and there was no mandatory amortization on the outstanding principal balances which were payable in full upon maturity. The Revolving Credit Facility was used to provide ongoing working capital and for general corporate purposes of the Company and our subsidiaries, including permitted acquisitions, as defined in the Credit Agreement. First Amendment to Amended and Restated Credit Agreement On February 4, 2019, we entered into the First Amendment to the Credit Agreement (as amended by the First Amendment, the “Amended Credit Agreement”). The Amended Credit Agreement provides for a senior secured credit facility in an initial aggregate principal amount of up to $725.0 million, which includes the $550.0 million Revolving Credit Facility under the Credit Agreement, and a term loan facility with a principal amount of up to $175.0 million (the “Term Loan Facility” and collectively with the Revolving Credit Facility, the “Credit Facility”), which was added by the First Amendment. We borrowed the entire principal amount of the Term Loan Facility on February 4, 2019 in order to fund a portion of the purchase price of the CCH acquisition, with the remainder of the purchase price and associated transactional fees and expenses funded by proceeds from the Revolving Credit Facility. The loans issued under the Credit Facility bear interest on a per annum basis, at our election, at either: (i) the Base Rate plus the Applicable Rate or (ii) the Eurodollar Rate plus the Applicable Rate. The “Base Rate” means a fluctuating rate per annum equal to the highest of (a) the federal funds rate plus 0.50% per annum, (b) the prime rate of interest established by the Administrative Agent, and (c) the Eurodollar Rate plus 1% per annum. The “Eurodollar Rate” means the quoted rate per annum equal to the London Interbank Offered Rate ("LIBOR") or a comparable successor rate approved by the Administrative Agent for an interest period of one, two, three or six months (as selected by us). The “Applicable Rate” is based on the consolidated leverage ratio and is presented in the table below. As of December 31, 2020, the Applicable Rate is 0.25% per annum for Base Rate Loans and 1.25% per annum for Eurodollar Rate Loans. We are also subject to a commitment fee and letter of credit fee under the terms of the Amended Credit Agreement, as presented in the table below. Pricing Tier Consolidated Leverage Ratio Base Rate Loans Eurodollar Rate Loans Commitment Letter of I ≥ 3.00 to 1.0 1.00 % 2.00 % 0.35 % 1.75 % II < 3.00 to 1.0 but ≥ 2.00 to 1.0 0.75 % 1.75 % 0.30 % 1.50 % III < 2.00 to 1.0 but ≥ 0.75 to 1.0 0.50 % 1.50 % 0.25 % 1.25 % IV < 0.75 to 1.0 0.25 % 1.25 % 0.20 % 1.00 % The final maturity date of the Credit Facility is February 4, 2024. The Revolving Credit Facility will terminate and be due and payable as of the final maturity date. The Term Loan Facility, however, is subject to quarterly amortization of principal in the amount of (i) 0.625% for the period commencing on February 4, 2019 and ending on March 31, 2020, (ii) 1.250% for the period commencing on April 1, 2020 and ending on March 31, 2023, and (iii) 1.875% for the period commencing on April 1, 2023 and ending on February 4, 2024. The remaining balance of the Term Loan Facility must be paid upon the final maturity date. In addition to the scheduled amortization of the Term Loan Facility, and subject to customary exceptions and reinvestment rights, we are required to prepay the Term Loan Facility, first, and the Revolving Credit Facility, second, with 100% of all net cash proceeds received by any loan party or any subsidiary thereof in connection with (a) any asset sale or disposition where such loan party receives net cash proceeds in excess of $5 million or (b) any debt issuance that is not permitted under the Amended Credit Agreement. The Amended Credit Agreement requires maintenance of two financial covenants: (i) a consolidated leverage ratio of funded indebtedness to Earnings Before Interest, Taxes, Depreciation and Amortization ("EBITDA"), as defined in the Amended Credit Agreement, and (ii) a consolidated interest coverage ratio of EBITDA to cash interest charges, as defined in the Amended Credit Agreement. Each of these covenants is calculated over rolling four-quarter periods and also is subject to certain exceptions and baskets. The Amended Credit Agreement also contains customary covenants, including, but not limited to, restrictions on: incurrence of liens, incurrence of additional debt, sales of assets and other fundamental corporate changes, investments, and declarations of dividends. These covenants contain customary exclusions and baskets as detailed in the Amended Credit Agreement. In connection with our entry into the Amended Credit Agreement, we recorded $0.8 million in deferred debt issuance costs as long-term obligations, less current portion within our consolidated balance sheet during the year ended December 31, 2019. The Revolving Credit Facility is guaranteed by substantially all of our wholly-owned direct and indirect subsidiaries. The Amended Credit Agreement requires at all times that we (i) provide guarantees from wholly-owned subsidiaries that in the aggregate represent not less than 95% of our consolidated net revenues and adjusted EBITDA from all wholly-owned subsidiaries and (ii) provide guarantees from subsidiaries that in the aggregate represent not less than 70% of consolidated adjusted EBITDA, subject to certain exceptions. Our weighted average interest rate for borrowings under our $175.0 million Term Loan Facility was 2.2% for the period ended December 31, 2020 and 3.8% for the period February 4, 2019 to December 31, 2019. Our weighted average interest rate for borrowings under our $550.0 million Revolving Credit Facility was 2.2% for the period ended December 31, 2020 and 4.0% for the period ended December 31, 2019. As of December 31, 2020, our consolidated leverage ratio was 0.6, our consolidated interest coverage ratio was 25.6 and we are in compliance with our covenants under the Amended Credit Agreement. In the event we are not in compliance with our debt covenants in the future, we would pursue various alternatives in an attempt to successfully resolve the non-compliance, which might include, among other things, seeking debt covenant waivers or amendments. As of December 31, 2020, our availability under our $550.0 million Revolving Credit Facility was $470.2 million as we have $51.0 million outstanding in borrowings and $28.8 million outstanding in letters of credit. Joinder Agreement In connection with the CCH acquisition, we entered into a Joinder Agreement, dated as of February 4, 2019 (the “CCH Joinder”), pursuant to which CCH and its subsidiaries were made parties to, and became subject to the terms and conditions of, the Amended Credit Agreement, the Amended and Restated Security Agreement, dated as of June 29, 2018 (the “Amended and Restated Security Agreement”), and the Amended and Restated Pledge Agreement, dated as of June 29, 2018 (the “Amended and Restated Pledge Agreement”). In connection with the AseraCare acquisition, we entered into a Joinder Agreement, dated as of June 12, 2020, pursuant to which the AseraCare entities were made parties to, and became subject to the terms and conditions of, the Amended Credit Agreement, the Amended and Restated Security Agreement and the Amended and Restated Pledge Agreement (the “AseraCare Joinder,” and together with the CCH Joinder, the “Joinders”). Pursuant to the Joinders, the Amended and Restated Security Agreement and the Amended and Restated Pledge Agreement, CCH and its subsidiaries and the AseraCare entities granted in favor of the Administrative Agent a first lien security interest in substantially all of their personal property assets and pledged to the Administrative Agent each of their respective subsidiaries' issued and outstanding equity interests. CCH and its subsidiaries and the AseraCare entities also guaranteed our obligations, whether now existing or arising after the respective effective dates of the Joinders, under the Amended Credit Agreement pursuant to the terms of the Joinders and the Amended Credit Agreement. Finance Leases Our finance leases outstanding of $2.6 million relate to leased equipment and bear interest rates ranging from 5.3% to 5.8%. |
INCOME TAXES
INCOME TAXES | 12 Months Ended |
Dec. 31, 2020 | |
Income Tax Disclosure [Abstract] | |
INCOME TAXES | INCOME TAXES Income taxes attributable to continuing operations consist of the following (amounts in millions): For the Years Ended December 31, 2020 2019 2018 Current income tax expense/(benefit): Federal $ 41.6 $ 24.2 $ 16.4 State and local 10.6 4.8 2.1 52.2 29.0 18.5 Deferred income tax expense/(benefit): Federal (22.5) 9.5 14.5 State and local (4.1) 4.0 5.8 (26.6) 13.5 20.3 Income tax expense $ 25.6 $ 42.5 $ 38.8 Total income tax expense for the years ended December 31, 2020, 2019 and 2018 was allocated as follows (amounts in millions): For the Years Ended December 31, 2020 2019 2018 Income from continuing operations $ 25.6 $ 42.5 $ 38.8 Interest expense 0.2 0.3 0.1 Goodwill — 0.9 — Total $ 25.8 $ 43.7 $ 38.9 A reconciliation of significant differences between the reported amount of income tax expense and the expected amount of income tax expense that would result from applying the U.S. federal statutory income tax rate of 21% to income before income taxes is as follows: For the Years Ended December 31, 2020 2019 2018 Income tax expense at U.S. federal statutory rate 21.0 % 21.0 % 21.0 % State and local income taxes, net of federal income tax benefit (1) 2.4 4.8 4.8 Excess tax benefits from share-based compensation (1) (12.7) (2.2) (1.8) Non-deductible executive compensation 2.1 1.6 0.4 Other items, net (2) (0.6) (0.3) — Income tax expense 12.2 % 24.9 % 24.4 % (1) On August 10, 2020, Paul B. Kusserow, President, Chief Executive Officer and Chairman of the Board of Amedisys, exercised 500,000 stock options previously awarded to him under our 2008 Omnibus Incentive Compensation Plan. We recognize compensation expense for stock option awards on a straight-line basis over the requisite service period for each separately vesting portion of the award in accordance with ASC 718, Compensation: Stock Compensation ; however, the income tax deduction related to stock options is not recognized until the stock option exercise date. As a result, for awards that are expected to result in a tax deduction, a deferred tax asset is created as the entity recognizes compensation expense for U.S. GAAP purposes. If the tax deduction exceeds the cumulative U.S. GAAP compensation expense for the award, the tax benefit associated with any excess deduction is recognized as an income tax benefit in the statement of operations, resulting in a reduction of the effective tax rate. Mr. Kusserow's stock option exercise produced a $92.1 million tax deduction in excess of U.S. GAAP compensation expense, resulting in a $19.4 million federal income tax benefit and a $4.6 million state and local income tax benefit for the year ended December 31, 2020. (2) Includes various items such as non-deductible expenses, non-taxable income, tax credits, valuation allowance, uncertain tax positions and return-to-accrual adjustments. As of December 31, 2020 and 2019, the Company had income taxes receivable of $0.2 million and $2.0 million, respectively, included in other current assets within our consolidated balance sheets. Deferred tax assets (liabilities) consist of the following components (amounts in millions): As of December 31, 2020 2019 Deferred tax assets: Accrued payroll & employee benefits $ 15.9 $ 15.1 Workers’ compensation 9.6 9.0 Share-based compensation 5.1 7.9 Legal & compliance matters 7.0 4.8 Lease liability 25.2 23.1 Provider relief fund advance (1) 15.6 — Deferred social security taxes (2) 14.3 — Net operating loss carryforwards 2.4 3.7 Tax credit carryforwards 2.9 3.1 Other 0.6 0.5 Gross deferred tax assets 98.6 67.2 Less: valuation allowance (0.1) (0.4) Net deferred tax assets 98.5 66.8 Deferred tax liabilities: Property and equipment (3.8) (4.3) Amortization of intangible assets (11.8) (0.3) Deferred revenue (9.0) (13.5) Investment in partnerships — (3.3) Right-of-use asset (24.9) (22.8) Other liabilities (1.0) (1.2) Gross deferred tax liabilities (50.5) (45.4) Deferred income taxes $ 48.0 $ 21.4 (1) In April 2020, approximately $100 million was provided to the Company through the healthcare Provider Relief Fund established under the CARES Act. As of December 31, 2020, the Company recorded a liability related to the funds that we do not expect to utilize totaling $60 million, which is reflected in the Provider Relief Fund Advance account in current liabilities within our consolidated balance sheet. For income tax purposes, the Company recognized the $60 million as income upon receipt, resulting in a deferred tax asset as of December 31, 2020. The company will recognize an income tax deduction when the liability is paid during the year ended December 31, 2021. (2) The CARES Act provides for the deferral of the employer share of social security tax (6.2%), effective for payments due after the enactment date through December 31, 2020. Fifty percent of the deferred payroll taxes are due on December 31, 2021 with the remaining amounts due on December 31, 2022. As of December 31, 2020, the Company has deferred $55.4 million of social security tax payments; $27.7 million of this amount is reflected in each payroll and employee benefits and other long-term obligations within our consolidated balance sheet. For income tax purposes, the deferred social security taxes will be deductible when paid on December 31, 2021 and December, 31, 2022, resulting in a deferred tax asset at December 31, 2020. As of December 31, 2020, we have state net operating loss ("NOL") carryforwards of $47.5 million that are available to reduce future taxable income and $3.7 million of various state tax credits available to reduce future state income taxes. The state NOL and tax credit carryforwards expire at various times. As of December 31, 2020 and 2019, the valuation allowance for deferred tax assets, which is primarily related to certain state NOLs and state tax credit carryforwards, was $0.1 million and $0.4 million, respectively. The net change in the total valuation allowance for the years ended December 31, 2020 and 2019 was a decrease of $0.3 million. In assessing the realizability of deferred tax assets, management considers whether 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 in those jurisdictions during the periods in which those temporary differences become deductible. Management considers the scheduled reversal of deferred tax liabilities (including the impact of available carryback and carryforward periods), projected future taxable income, and tax-planning strategies in making this assessment. In order to fully realize the deferred tax assets, the Company will need to generate future taxable income before the expiration of the carryforwards governed by the tax code. Based on the current level of pretax earnings, the Company will generate the minimum amount of future taxable income needed to support the realization of the deferred tax assets. As a result, as of December 31, 2020, management believes that it is more likely than not that we will realize the benefits of these deferred tax assets, net of the existing valuation allowances. The amount of the deferred tax asset considered realizable, however, could be reduced in the near term if estimates of future taxable income during the carryforward period are reduced. Uncertain Tax Positions We account for uncertain tax positions in accordance with the authoritative guidance for uncertain tax positions. A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (amounts in millions): For the Years Ended December 31, 2020 2019 2018 Balance at beginning of period $ 2.7 $ 2.7 $ 2.7 Additions for tax positions related to current year — — — Additions for tax positions related to prior year — — — Reductions for tax positions related to prior years — — — Lapse of statute of limitations — — — Settlements — — — Balance at end of period $ 2.7 $ 2.7 $ 2.7 As of December 31, 2020 and 2019, there is $2.7 million of unrecognized tax benefits recorded in other long-term obligations within the consolidated balance sheets that, if recognized in future periods, would impact our effective tax rate. We recognized $0.2 million, $0.3 million and $0.1 million of interest as components of interest expense in connection with our reserve for uncertain tax positions during the years ended December 31, 2020, 2019 and 2018, respectively. Interest related to uncertain tax positions included in the consolidated balance sheets at December 31, 2020 and 2019 was $0.6 million and $0.4 million, respectively. We are subject to income taxes in the U.S. and in many individual states, with significant operations in Louisiana, South Carolina, Alabama, Georgia, Massachusetts and Tennessee. We are open to examination in the U.S. and in various individual states for tax years ended December 31, 2014 through December 31, 2020. We are also open to examination in various states for the years ended 2007 through 2020 resulting from NOLs generated and available for carryforward from those years. |
CAPITAL STOCK AND SHARE-BASED C
CAPITAL STOCK AND SHARE-BASED COMPENSATION | 12 Months Ended |
Dec. 31, 2020 | |
Share-based Payment Arrangement [Abstract] | |
CAPITAL SOCK AND SHARE-BASED COMPENSATION | CAPITAL STOCK AND SHARE-BASED COMPENSATIONWe are authorized by our Certificate of Incorporation to issue 60,000,000 shares of common stock, $0.001 par value and 5,000,000 shares of preferred stock, $0.001 par value. As of December 31, 2020, there were 37,470,212 and 32,814,278 shares of common stock issued and outstanding, respectively, and no shares of preferred stock issued or outstanding. Our Board of Directors is authorized to fix the dividend rights and terms, conversion and voting rights, redemption rights and other privileges and restrictions applicable to our preferred stock. Share-Based Awards On March 29, 2018, our Board of Directors and the Compensation Committee approved, subject to stockholder approval, the Amedisys, Inc. 2018 Omnibus Incentive Compensation Plan (the “2018 Plan”). On June 6, 2018, our stockholders approved the 2018 Plan at the Company's annual meeting of stockholders. The 2018 Plan replaces our 2008 Omnibus Incentive Compensation Plan (the “2008 Plan”), which terminated on June 6, 2018 when the stockholders approved the 2018 Plan. The 2018 Plan authorizes the grant of various types of equity-based awards, such as stock awards, restricted stock units, stock appreciation rights and stock options to eligible participants, which include all of our employees and all employees of our 50% or more owned subsidiaries, our non-employee directors and certain consultants. The vesting terms of the awards may be tied to continued employment (or, for our non-employee directors, continued service on the Board of Directors) and/or achievement of certain pre-determined performance goals. We refer to stock awards subject to service-based vesting conditions as “non-vested stock” and restricted stock units subject to service-based or a combination of service-based and performance-based vesting conditions as “non-vested stock units.” The 2018 Plan is administered by the Compensation Committee of our Board of Directors, which determines, within the provisions of the 2018 Plan, those eligible participants to whom, and the times at which, awards shall be granted. The Compensation Committee, in its discretion, may delegate its authority and duties under the 2018 Plan to specified officers; however, only the Compensation Committee may approve the terms of awards to our executive officers. Equity-based awards may be granted for a number of shares not to exceed, in the aggregate, approximately 2.5 million shares of common stock. We had approximately 2.0 million shares available at December 31, 2020. The price per share for stock options shall be no less than the greater of (a) 100% of the fair value of a share of common stock on the date the option is granted or (b) the aggregate par value of the shares of our common stock on the date the option is granted. If a stock option is granted to any owner of 10% or more of the total combined voting power of us and our subsidiaries, the price is to be at least 110% of the fair value of a share of our common stock on the date the award is granted. Each equity-based award vests ratably over a one year to four Employee Stock Purchase Plan (“ESPP”) We have a plan whereby our eligible employees may purchase our common stock at 85% of the market price at the time of purchase. On June 7, 2012, our stockholders ratified an amendment adopted by our Board of Directors to increase the total number of shares of our common stock authorized for issuance under our ESPP from 2,500,000 shares to 4,500,000 shares, and as of December 31, 2020, there were 1,328,627 shares available for future issuance. The following is a detail of the purchases that were made under the plan: Employee Stock Purchase Plan Period Shares Issued Price 2018 and Prior 3,122,983 $ 15.92 January 1, 2019 to March 31, 2019 7,181 104.77 April 1, 2019 to June 30, 2019 8,230 103.20 July 1, 2019 to September 30, 2019 7,216 111.36 October 1, 2019 to December 31, 2019 6,063 141.88 January 1, 2020 to March 31, 2020 5,295 156.01 April 1, 2020 to June 30, 2020 5,414 168.76 July 1, 2020 to September 30, 2020 4,789 200.97 October 1, 2020 to December 31, 2020 4,202 249.33 3,171,373 ESPP expense included in general and administrative expense in our accompanying consolidated statements of operations was $0.6 million, $0.6 million and $0.5 million for 2020, 2019 and 2018, respectively. Stock Options On August 10, 2020, Paul B. Kusserow, President, Chief Executive Officer and Chairman of the Board of Amedisys, exercised 500,000 stock options previously awarded to him under the 2008 Plan. In connection with the exercise, Mr. Kusserow surrendered 231,683 shares of common stock to us to satisfy tax withholding and strike price obligations and elected to hold the net 268,317 shares issued to him. The surrendered shares are classified as treasury shares. This transaction resulted in a cash outflow of $40.4 million, reflected within financing activities in our consolidated statement of cashflows, related to the remittance of tax withholding obligations. In addition, Mr. Kusserow's stock option exercise resulted in a $24.0 million income tax benefit that was recorded in our consolidated statement of operations during the year ended December 31, 2020. We recognize compensation expense for stock option awards on a straight-line basis over the requisite service period for each separately vesting portion of the award in accordance with ASC 718, Compensation: Stock Compensation ; however, the income tax deduction related to stock options is not recognized until the stock option exercise date. As a result, for awards that are expected to result in a tax deduction, a deferred tax asset is created as the entity recognizes compensation expense for U.S. GAAP purposes. If the tax deduction exceeds the cumulative U.S. GAAP compensation expense for the award, the tax benefit associated with any excess deduction is recognized as an income tax benefit in the statement of operations. We use the Black-Scholes option pricing model to estimate the fair value of our stock options. There were 43,249, 142,122 and 163,666 options granted during 2020, 2019 and 2018, respectively. Stock option compensation expense included in general and administrative expense in our accompanying consolidated statements of operations was $4.3 million, $6.2 million and $5.7 million for 2020, 2019 and 2018, respectively. The fair values of the awards were estimated using the following assumptions for 2020, 2019 and 2018: For the Years Ended December 31, 2020 2019 2018 Risk Free Rate 0.38% - 1.51% 1.44% - 2.53% 2.56% - 3.04% Expected Volatility 40.15% - 42.80% 42.46% - 43.83% 42.00% - 45.32% Expected Term 6.25 years 6.00 - 6.25 years 4.12 - 6.25 years Weighted Average Fair Value $86.72 $54.42 $42.48 Dividend Yield —% —% —% We used the simplified method to estimate the expected term for the stock options granted during 2020, 2019 and 2018 as adequate historical experience is not available to provide a reasonable estimate. The following table presents our stock option activity for 2020: Number of Weighted Weighted Outstanding options at January 1, 2020 875,974 $ 49.62 6.26 Granted 43,249 209.41 Exercised (622,829) 31.60 Canceled, forfeited or expired (18,353) 103.89 Outstanding options at December 31, 2020 278,041 $ 111.27 7.68 Exercisable options at December 31, 2020 89,429 $ 76.40 6.75 The aggregate intrinsic value of our outstanding options and exercisable options at December 31, 2020 was $50.6 million and $19.4 million, respectively. Total intrinsic value of options exercised was $121.1 million, $7.3 million and $9.7 million for 2020, 2019 and 2018, respectively. The tax benefit from stock options exercised during the period amounted to $27.9 million, $1.3 million and $1.6 million for 2020, 2019 and 2018, respectively. The following table presents our non-vested stock option activity for 2020: Number of Weighted Average Non-vested stock options at January 1, 2020 305,750 $ 41.66 Granted 43,249 86.72 Vested (142,233) 34.84 Forfeited (18,154) 47.66 Non-vested stock options at December 31, 2020 188,612 $ 56.55 At December 31, 2020, there was $4.8 million of unrecognized compensation cost related to stock options that we expect to be recognized over a weighted-average period of 1.9 years. Non-Vested Stock We issue shares of non-vested stock with a vesting term of one year. The compensation expense is determined based on the market price of our common stock at the date of grant applied to the total number of shares that are anticipated to fully vest. Non-vested stock compensation expense included in general and administrative expenses in our accompanying consolidated statements of operations was $0.8 million, $1.2 million and $1.4 million for 2020, 2019 and 2018, respectively. The following table presents our non-vested stock activity for 2020: Number of Weighted Average Non-vested stock at January 1, 2020 9,859 $ 119.12 Granted 1,560 158.72 Vested (11,419) 124.53 Canceled, forfeited or expired — — Non-vested stock at December 31, 2020 — $ — The weighted average grant date fair value of non-vested stock granted was $158.72, $119.12 and $80.54 in 2020, 2019 and 2018, respectively. At December 31, 2020, there was no unrecognized compensation cost related to non-vested stock awards; we currently do not have any outstanding awards. Non-Vested Stock Units We issue non-vested stock unit awards that are service-based, performance-based or a combination of both with vesting terms ranging from one four Non-Vested Stock Units – Service-Based Service-based non-vested stock unit compensation expense included in general and administrative expenses in our accompanying consolidated statements of operations was $7.5 million, $8.7 million and $4.5 million for 2020, 2019 and 2018, respectively. The following table presents our service-based non-vested stock units activity for 2020: Number of Weighted Average Non-vested stock units at January 1, 2020 231,418 $ 91.87 Granted 34,429 206.10 Vested (89,074) 78.15 Canceled, forfeited or expired (19,227) 97.36 Non-vested stock units at December 31, 2020 157,546 $ 123.92 The weighted average grant date fair value of service-based non-vested stock units granted was $206.10, $123.70 and $95.14 in 2020, 2019 and 2018, respectively. At December 31, 2020, there was $9.3 million of unrecognized compensation cost related to our service-based non-vested stock units that we expect to be recognized over a weighted average period of 1.8 years. Non-Vested Stock Units – Service-Based and Performance-Based Awards During 2020, we awarded performance-based awards to certain employees. The target level established by the award, which is based on the Company’s 2020 adjusted earnings before interest, taxes, depreciation and amortization (“Adjusted EBITDA”), provided for the recipients to receive an aggregate of 81,183 non-vested stock units if the target was achieved. For a select group of employees, if the target objective is surpassed to the point of achieving the projected maximum payout, the recipients will receive an additional aggregate of 11,633 non-vested stock units during the three-month period ending March 31, 2021. The target number of shares to be potentially awarded has been reduced by forfeitures as indicated in the table below. Performance-based non-vested stock units compensation expense included in general and administrative expenses in our consolidated statements of operations was $13.5 million, $8.4 million and $5.8 million for 2020, 2019 and 2018, respectively. The following table presents our performance-based non-vested stock units activity for 2020: Number of Weighted Average Non-vested stock units at January 1, 2020 207,424 $ 97.55 Granted 85,727 201.90 Vested (78,856) 83.12 Canceled, forfeited or expired (18,008) 101.40 Non-vested stock units at December 31, 2020 196,287 $ 148.16 The weighted average grant date fair value of performance-based non-vested stock units granted was $201.90, $128.89 and $79.59 in 2020, 2019 and 2018, respectively. At December 31, 2020, there was $17.3 million in unrecognized compensation costs related to our performance-based non-vested stock units that we expect to be recognized over a weighted average period of 1.8 years. |
COMMITMENTS AND CONTINGENCIES
COMMITMENTS AND CONTINGENCIES | 12 Months Ended |
Dec. 31, 2020 | |
Commitments and Contingencies Disclosure [Abstract] | |
COMMITMENTS AND CONTINGENCIES | COMMITMENTS AND CONTINGENCIES Legal Proceedings – Ongoing We are involved in the following legal actions: Subpoena Duces Tecum and Civil Investigative Demands Issued by the U.S. Department of Justice On May 21, 2015, we received a Subpoena Duces Tecum (“Subpoena”) issued by the U.S. Department of Justice. The Subpoena requests the delivery of information regarding 53 identified hospice patients to the United States Attorney’s Office for the District of Massachusetts. It also requests the delivery of documents relating to our hospice clinical and business operations and related compliance activities. The Subpoena generally covers the period from January 1, 2011 through May 21, 2015. We are fully cooperating with the U.S. Department of Justice with respect to this investigation. On November 3, 2015, we received a civil investigative demand (“CID”) issued by the U.S. Department of Justice pursuant to the federal False Claims Act relating to claims submitted to Medicare and/or Medicaid for hospice services provided through designated facilities in the Morgantown, West Virginia area. The CID requests the delivery of information to the United States Attorney’s Office for the Northern District of West Virginia regarding 66 identified hospice patients, as well as documents relating to our hospice clinical and business operations in the Morgantown area. The CID generally covers the period from January 1, 2009 through August 31, 2015. We are fully cooperating with the U.S. Department of Justice with respect to this investigation. On June 27, 2016, we received a CID issued by the U.S. Department of Justice pursuant to the federal False Claims Act relating to claims submitted to Medicare and/or Medicaid for hospice services provided through designated facilities in the Parkersburg, West Virginia area. The CID requests the delivery of information to the United States Attorney’s Office for the Southern District of West Virginia regarding 68 identified hospice patients, as well as documents relating to our hospice clinical and business operations in the Parkersburg area. The CID generally covers the period from January 1, 2011 through June 20, 2016. We are fully cooperating with the U.S. Department of Justice with respect to this investigation. Based on our analysis of sample claims data in connection with preliminary settlement discussions with the U.S. Department of Justice regarding the above matters, we have recorded a total of $6.5 million to accrued expenses in our consolidated balance sheets related to this matter. Due to the ongoing nature of the investigations and current stage of the settlement discussions, we are unable to estimate a range of potential loss at this time, and we cannot predict the timing or outcome of these investigations. In addition to the matters referenced in this note, we are involved in legal actions in the normal course of business, some of which seek monetary damages, including claims for punitive damages. Based on information available to us as of the date of this filing, we do not believe that these normal course actions, when finally concluded and determined, will have a material impact on our consolidated financial condition, results of operations or cash flows. Legal fees related to all legal matters are expensed as incurred. Other Investigative Matters – Completed Corporate Integrity Agreement On May 5, 2020, the Company received notice from the Office of Inspector General-HHS ("OIG") that the Company's five-year corporate integrity agreement ("CIA") with the OIG has been completed. On April 23, 2014, with no admissions of liability on our part, we entered into a settlement agreement with the U.S. Department of Justice relating to certain of our clinical and business operations. Concurrently with our entry into this agreement, we entered into a CIA with the OIG. The CIA formalized various aspects of our already existing ethics and compliance programs and contained other requirements designed to help ensure our ongoing compliance with federal health care program requirements. Among other things, the CIA required us to maintain our existing compliance program, executive compliance committee and compliance committee of the Board of Directors; provide certain compliance training; continue screening new and current employees to ensure they are eligible to participate in federal health care programs; engage an independent review organization ("IRO") to perform certain audits and reviews and prepare certain reports regarding our compliance with federal health care programs, our billing submissions to federal health care programs and our compliance and risk mitigation programs; and provide certain reports and management certifications to the OIG. Additionally, the CIA specifically required that we report substantial overpayments that we discovered we had received from federal health care programs, as well as probable violations of federal health care laws. The corporate integrity agreement had a term of five years that ended on April 21, 2019. We filed our final annual report on July 19, 2019. Compassionate Care Hospice Corporate Integrity Agreement On January 8, 2021, the Company received notice from the OIG that the Company's five-year CIA with the OIG has been completed. On January 30, 2015, CCH entered into a CIA with the OIG. The CIA required that CCH provide annual on-site compliance training; develop and implement policies to ensure compliance with federal health care program requirements; screen new and current employees to ensure that they are eligible to participate in federal health care programs; establish a compliance committee that contains both a Compliance Officer and a Chief Quality Officer; retain a Governing Authority expert who will periodically complete a compliance program review; and retain an IRO to complete claims review for hospice services rendered in New York. The OIG waived the claims review for the final year of the CCH CIA based on the closure of the New York operations. Additionally, the CIA required that CCH report substantial overpayments that CCH discovered it received from federal health care programs, as well as probable violations of federal criminal, civil or administrative health care laws. Upon breach of the CIA, CCH could have become liable for payment of certain stipulated penalties, or could have been excluded from participation in federal health care programs. The CIA had a term of five years that ended on January 30, 2020. We filed our final annual report on March 25, 2020. Third Party Audits – Ongoing From time to time, in the ordinary course of business, we are subject to audits under various governmental programs in which third party firms engaged by CMS, including Recovery Audit Contractors (“RACs”), Zone Program Integrity Contractors (“ZPICs”), Uniform Program Integrity Contractors (“UPICs”), Program Safeguard Contractors (“PSCs”), Medicaid Integrity Contractors (“MICs”) and Supplemental Medical Review Contractors (“SMRCs”), conduct extensive reviews of claims data to identify potential improper payments. We cannot predict the ultimate outcome of any regulatory reviews or other governmental audits and investigations. In July 2010, our subsidiary that provides hospice services in Florence, South Carolina received from a ZPIC a request for records regarding a sample of 30 beneficiaries who received services from the subsidiary during the period of January 1, 2008 through March 31, 2010 (the “Review Period”) to determine whether the underlying services met pertinent Medicare payment requirements. We acquired the hospice operations subject to this review on August 1, 2009; the Review Period covers time periods both before and after our ownership of these hospice operations. Based on the ZPIC’s findings for 16 beneficiaries, which were extrapolated to all claims for hospice services provided by the Florence subsidiary billed during the Review Period, on June 6, 2011, the Medicare Administrative Contractor ("MAC") for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment. We dispute these findings, and our Florence subsidiary has filed appeals through the Original Medicare Standard Appeals Process, in which we are seeking to have those findings overturned. An administrative law judge ("ALJ") hearing was held in early January 2015. On January 18, 2016, we received a letter dated January 6, 2016 referencing the ALJ hearing decision for the overpayment issued on June 6, 2011. The decision was partially favorable with a new overpayment amount of $3.7 million with a balance owed of $5.6 million including interest based on 9 disputed claims (originally 16). We filed an appeal to the Medicare Appeals Council on the remaining 9 disputed claims and also argued that the statistical method used to select the sample was not valid. No assurances can be given as to the timing or outcome of the Medicare Appeals Council decision. As of December 31, 2020, Medicare has withheld payments of $5.7 million (including additional interest) as part of their standard procedures once this level of the appeal process has been reached. In the event we are not able to recoup this alleged overpayment, we are entitled to be indemnified by the prior owners of the hospice operations for amounts relating to the period prior to August 1, 2009. On January 10, 2019, an arbitration panel from the American Health Lawyers Association determined that the prior owners' liability for their indemnification obligation was $2.8 million. This amount is recorded as an indemnity receivable within other assets in our consolidated balance sheets. In July 2016, the Company received a request for medical records from SafeGuard Services, L.L.C (“SafeGuard”), a ZPIC, related to services provided by some of the care centers that the Company acquired from Infinity Home Care, L.L.C. The review period covers time periods both before and after our ownership of the care centers, which were acquired on December 31, 2015. In August 2017, the Company received Requests for Repayment from Palmetto GBA, LLC (“Palmetto”) regarding Infinity Home Care of Lakeland, LLC, (“Lakeland Care Centers”) and Infinity Home Care of Pinellas, LLC, (“Clearwater Care Center”). The Palmetto letters are based on a statistical extrapolation performed by SafeGuard which alleged an overpayment of $34.0 million for the Lakeland Care Centers on a universe of 72 Medicare claims totaling $0.2 million in actual claims payments using a 100% error rate and an overpayment of $4.8 million for the Clearwater Care Center on a universe of 70 Medicare claims totaling $0.2 million in actual claims payments using a 100% error rate. The Lakeland Request for Repayment covers claims between January 2, 2014 and September 13, 2016. The Clearwater Request for Repayment covers claims between January 2, 2015 and December 9, 2016. As a result of partially successful Level I and Level II Administrative Appeals, the alleged overpayment for the Lakeland Care Centers has been reduced to $26.0 million and the alleged overpayment for the Clearwater Care Center has been reduced to $3.3 million. The Company has now filed Level III Administrative Appeals, and will continue to vigorously pursue its appeal rights, which include contesting the methodology used by the ZPIC contractor to perform statistical extrapolation. The Company is contractually entitled to indemnification by the prior owners for all claims prior to December 31, 2015, for up to $12.6 million. At this stage of the review, based on the information currently available to the Company, the Company cannot predict the timing or outcome of this review. The Company estimates a low-end potential range of loss related to this review of $6.5 million (assuming the Company is successful in seeking indemnity from the prior owners and unsuccessful in demonstrating that the extrapolation method used by SafeGuard was erroneous). The Company has reduced its high-end potential range of loss from $38.8 million (the maximum amount Palmetto claims has been overpaid for both the Lakeland Care Centers and the Clearwater Care Center, of which $12.6 million is subject to indemnification by the prior owners) to $29.3 million based on the partial success achieved by the Company in prosecuting its Level I and II Administrative Appeals. As of December 31, 2020, we have an accrued liability of approximately $17.4 million related to this matter. We expect to be indemnified by the prior owners for approximately $10.9 million of the total $12.6 million available indemnification related to this matter and have recorded this amount within other assets in our consolidated balance sheets. The net of these two amounts, $6.5 million, was recorded as a reduction in revenue in our consolidated statements of operations during 2017. As of December 31, 2020, $1.5 million of net receivables have been impacted by this payment suspension. Insurance We are obligated for certain costs associated with our insurance programs, including employee health, workers’ compensation and professional liability. While we maintain various insurance programs to cover these risks, we are self-insured for a substantial portion of our potential claims. We recognize our obligations associated with these costs, up to specified deductible limits in the period in which a claim is incurred, including with respect to both reported claims and claims incurred but not reported. These costs have generally been estimated based on historical data of our claims experience. Such estimates, and the resulting reserves, are reviewed and updated by us on a quarterly basis. The following table presents details of our insurance programs, including amounts accrued for the periods indicated (amounts in millions) in accrued expenses in our consolidated balance sheets. The amounts accrued below represent our total estimated liability for individual claims that are less than our noted insurance coverage amounts, which can include outstanding claims and claims incurred but not reported. As of December 31, Type of Insurance 2020 2019 Health insurance $ 15.1 $ 15.8 Workers’ compensation 35.8 33.4 Professional liability 4.9 5.1 55.8 54.3 Less: long-term portion (1.2) (1.3) $ 54.6 $ 53.0 Our health insurance has an exposure limit of $1.3 million for any individual covered life. Our workers compensation insurance has a retention limit of $1.0 million per incident and our professional liability insurance has a retention limit of $0.3 million per incident. Severance We have commitments related to our severance plans applicable to a number of our senior executives and senior management, as well as the employment agreement entered into with our Chief Executive Officer, all of which generally commit us to pay severance benefits under certain circumstances. Other We are subject to various other types of claims and disputes arising in the ordinary course of our business. While the resolution of such issues is not presently determinable, we believe that the ultimate resolution of such matters will not have a significant effect on our consolidated financial condition, results of operations and cash flows. |
EMPLOYEE BENEFIT PLANS
EMPLOYEE BENEFIT PLANS | 12 Months Ended |
Dec. 31, 2020 | |
Retirement Benefits [Abstract] | |
EMPLOYEE BENEFIT PLANS | EMPLOYEE BENEFIT PLANS 401(k) Benefit Plan We maintain a plan qualified under Section 401(k) of the Internal Revenue Code for all employees who have reached 21 years of age, effective the first month after their hire date. Under the plan, eligible employees may elect to defer a portion of their compensation, subject to Internal Revenue Service limits. Our match of contributions to be made to each eligible employee contribution is $0.44 for every $1.00 contributed up to the first 6% of their salary. The match is discretionary and thus is subject to change at the discretion of management. Effective January 1, 2020, our match of contributions is made in the form of cash. During 2019 and 2018, matching contributions were made in the form of our common stock, valued based upon the fair value of the stock as of the end of each calendar quarter end. We expensed approximately $12.9 million, $10.5 million and $9.0 million related to our 401(k) benefit plan for 2020, 2019 and 2018, respectively. Deferred Compensation Plan We had a Deferred Compensation Plan for additional tax-deferred savings for a select group of management or highly compensated employees. Amounts credited under the Deferred Compensation Plan were funded into a rabbi trust, which is managed by a trustee. The trustee has the discretion to manage the assets of the Deferred Compensation Plan as deemed fit, thus, the assets are not necessarily reflective of the same investment choices that would have been made by the participants. Effective January 1, 2015, all prospective salary deferrals ceased. Participants will be allowed to make transactions with any remaining account balances as they wish per plan guidelines. |
SHARE REPURCHASE
SHARE REPURCHASE | 12 Months Ended |
Dec. 31, 2020 | |
Equity [Abstract] | |
SHARE REPURCHASE | SHARE REPURCHASES 2021 Stock Repurchase Program On December 23, 2020, we announced that our Board of Directors authorized a stock repurchase program, under which we may repurchase up to $100 million of our outstanding common stock through December 31, 2021. Under the terms of the program, we are allowed to repurchase shares from time to time through open market purchases, unsolicited or solicited privately negotiated transactions, an accelerated stock repurchase program, and/or a trading plan in compliance with Exchange Act Rule 10b5-1. The timing and the amount of the repurchases will be determined by management based on a number of factors, including but not limited to share price, trading volume and general market conditions, as well as on working capital requirements, general business conditions and other factors. We did not repurchase any shares pursuant to this stock repurchase program during the year ended December 31, 2020. 2019 Stock Repurchase Program On February 25, 2019, we announced that our Board of Directors authorized a stock repurchase program, under which we could have repurchased up to $100 million of our outstanding common stock through March 1, 2020. We did not repurchase any shares pursuant to this stock repurchase program during 2019 or 2020. The stock repurchase program expired on March 1, 2020. 2018 Share Repurchase On June 4, 2018, we purchased 2,418,304 of our common shares from affiliates of KKR Credit Advisors (US) LLC ("KKR"), representing one-half of KKR's then current holdings in the Company and 7.1% of the aggregate outstanding shares of the Company's common stock for a total purchase price of $181.4 million including related direct costs. The Company repurchased the shares at $73.96 which represents 96% of the closing stock price of the Company's common stock on June 4, 2018. The repurchased shares are classified as treasury shares. |
SEGMENT INFORMATION
SEGMENT INFORMATION | 12 Months Ended |
Dec. 31, 2020 | |
Segment Reporting [Abstract] | |
SEGMENT INFORMATION | SEGMENT INFORMATION Our operations involve servicing patients through our three reportable business segments: home health, hospice and personal care. Our home health segment delivers a wide range of services in the homes of individuals who may be recovering from surgery, have a chronic disability or terminal illness or need assistance with completing important tasks. Our hospice segment provides palliative care and comfort to terminally ill patients and their families. Our personal care segment provides patients with assistance with the essential activities of daily living. The “other” column in the following tables consists of costs relating to executive management and administrative support functions, primarily information services, accounting, finance, billing and collections, legal, compliance, risk management, procurement, marketing, clinical administration, training, human resources and administration. Management evaluates performance and allocates resources based on the operating income of the reportable segments, which includes an allocation of corporate expenses attributable to the specific segment and includes revenues and all other costs directly attributable to the specific segment. Segment assets are not reviewed by the company’s chief operating decision maker and therefore are not disclosed below (amounts in millions). For the Year Ended December 31, 2020 Home Health Hospice Personal Care Other Total Net service revenue $ 1,249.2 $ 750.1 $ 72.2 $ — $ 2,071.5 Other operating income 20.2 13.1 1.1 — 34.4 Cost of service, excluding depreciation and amortization 729.9 400.6 54.9 — 1,185.4 General and administrative expenses 307.2 175.4 12.4 173.2 668.2 Depreciation and amortization 3.9 2.2 0.2 22.5 28.8 Asset impairment charge 3.4 0.8 — — 4.2 Operating expenses 1,044.4 579.0 67.5 195.7 1,886.6 Operating income (loss) $ 225.0 $ 184.2 $ 5.8 $ (195.7) $ 219.3 For the Year Ended December 31, 2019 Home Health Hospice Personal Care Other Total Net service revenue $ 1,256.4 $ 617.2 $ 82.0 $ — $ 1,955.6 Cost of service, excluding depreciation and amortization 754.1 335.1 61.1 — 1,150.3 General and administrative expenses 297.2 137.5 12.3 160.9 607.9 Depreciation and amortization 4.2 1.6 0.2 12.4 18.4 Asset impairment charge 1.5 — — — 1.5 Operating expenses 1,057.0 474.2 73.6 173.3 1,778.1 Operating income (loss) $ 199.4 $ 143.0 $ 8.4 $ (173.3) $ 177.5 For the Year Ended December 31, 2018 Home Health Hospice Personal Care Other Total Net service revenue $ 1,174.5 $ 410.9 $ 77.2 $ — $ 1,662.6 Cost of service, excluding depreciation and amortization 722.1 212.0 58.8 — 992.9 General and administrative expenses 276.3 84.6 12.8 127.6 501.3 Depreciation and amortization 3.5 1.1 0.3 8.4 13.3 Operating expenses 1,001.9 297.7 71.9 136.0 1,507.5 Operating income (loss) $ 172.6 $ 113.2 $ 5.3 $ (136.0) $ 155.1 |
UNAUDITED SUMMARIZED QUARTERLY
UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION | 12 Months Ended |
Dec. 31, 2020 | |
Quarterly Financial Information Disclosure [Abstract] | |
UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION | UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION Net Income Net Service Revenue Net Income Basic Diluted 2020 1st Quarter $ 491.7 $ 31.8 $ 0.98 $ 0.96 2nd Quarter 485.0 34.7 1.07 1.04 3rd Quarter 544.1 72.0 2.20 2.16 4th Quarter 550.7 45.1 1.38 1.36 $ 2,071.5 $ 183.6 $ 5.64 $ 5.52 2019 1st Quarter $ 467.3 $ 31.3 $ 0.98 $ 0.95 2nd Quarter 493.0 33.7 1.05 1.02 3rd Quarter 494.6 34.1 1.06 1.03 4th Quarter 500.7 27.7 0.86 0.83 $ 1,955.6 $ 126.8 $ 3.95 $ 3.84 (1) Because of the method used in calculating per share data, the quarterly per share data may not necessarily total to the per share data as computed for the entire year. |
RELATED PARTY TRANSACTIONS
RELATED PARTY TRANSACTIONS | 12 Months Ended |
Dec. 31, 2020 | |
Related Party Transactions [Abstract] | |
RELATED PARTY TRANSACTIONS | RELATED PARTY TRANSACTIONS During 2018, we made a $7.0 million investment in Medalogix, a healthcare predictive data and analytics company; this investment is accounted for under the equity method. During the years ended December 31, 2020 and 2019, we incurred costs of approximately $3.9 million and $0.5 million, respectively, in connection with the usage of Medalogix's analytics platforms. We believe that the terms of these transactions are consistent with those negotiated at arm’s length. On June 4, 2018, we purchased 2,418,304 of our common shares from affiliates of KKR, representing one-half of KKR's holdings in the Company and 7.1% of the aggregate outstanding shares of the Company's common stock for a total purchase price of $181.4 million including related direct costs. The Company repurchased the shares at $73.96 which represents 96% of the closing stock price of the Company's common stock on June 4, 2018. At the time of the transaction, KKR held approximately 14.2% of the Company's outstanding shares of common stock. |
SUMMARY OF SIGNIFICANT ACCOUN_2
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies) | 12 Months Ended |
Dec. 31, 2020 | |
Accounting Policies [Abstract] | |
Recently Adopted Accounting Pronouncements | Recently Adopted Accounting Pronouncements On January 1, 2020, the Company adopted Accounting Standards Update ("ASU") 2016-13, Financial Instruments - Credit Losses (Topic 326) , which provides guidance for measuring credit losses on financial instruments. Our adoption of this standard did not have a material effect on our consolidated financial statements. During the fourth quarter of 2020, the Company adopted ASU 2019-12, Income Taxes (Topic 740) - Simplifying the Accounting for Income Taxes , which eliminates certain exceptions related to the approach for intraperiod tax allocation, the methodology for calculating taxes during the interim periods and the recognition of deferred tax liabilities for outside basis differences. This guidance also simplifies aspects of the accounting for franchise taxes, enacts changes in tax laws or rates and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. The guidance is effective for interim and annual periods beginning after December 15, 2020, with early adoption permitted. Our adoption of this standard on a prospective basis was not material to the Company’s consolidated financial statements. On January 1, 2019, the Company adopted Accounting Standards Codification ("ASC") 842, Leases, using a modified retrospective transition approach, which requires the new standard to be applied to all leases existing at the date of initial application. Under ASC 842, lessees are required to recognize a lease liability and right-of-use asset ("ROU asset") for all leases with a term greater than twelve months and to disclose key information about leasing arrangements. Additionally, leases are classified as either financing or operating; the classification determines the pattern of expense recognition and classification within the statement of operations. We used the standard's effective date as our date of initial application. Consequently, our financial information was not updated and the disclosures required under the new standard are not provided for dates and periods prior to January 1, 2019. The new standard provides several optional practical expedients that can be adopted at transition. We elected the "package of practical expedients," which allows us to not reassess our prior conclusions regarding lease identification, lease classification and initial direct costs. We did not elect the use-of-hindsight or the practical expedient pertaining to land easements; the latter not being applicable to us. The most significant effects related to this adoption relate to (1) the recognition of new ROU assets and lease liabilities on our balance sheet for our real estate and fleet operating leases; and (2) significant new disclosures about our leasing activities. Upon adoption, we recognized approximately $80 million in operating leases liabilities with corresponding ROU assets of approximately the same amount. The new standard also provides practical expedients for an entity’s ongoing accounting. We have elected the practical expedient that allows us to not separate lease and non-lease components for all of our leases. On January 1, 2019, the Company adopted ASU 2018-07, Compensation - Stock Compensation (Topic 718): Improvements to Nonemployees Share-Based Payment Accounting, which expands the scope of Topic 718 to include share-based payments issued to nonemployees for goods or services. Our adoption of this standard did not have an effect on our consolidated financial statements. On January 1, 2018, the Company adopted ASC 606, Revenue from Contracts with Customers, using the full retrospective method. ASC 606 outlines a single comprehensive model to use in accounting for revenue arising from contracts with customers. The standard supersedes existing revenue recognition requirements and eliminates most industry-specific guidance from U.S. Generally Accepted Accounting Principles ("U.S. GAAP"). The core principle of the revenue recognition standard is to require an entity to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which it expects to be entitled in exchange for those goods or services. As a result of the Company's adoption of ASC 606, the revenue and related estimated uncollectible amounts owed to us by non-Medicare payors that were historically classified as provision for doubtful accounts are now considered a revenue adjustment in determining net service revenue. Accordingly, the Company reports estimated uncollectible balances due from third-party payors and uncollectible balances associated with patient responsibility as a reduction of the transaction price and therefore, as a reduction in net service revenue (or as it relates to Hospice room and board, an increase in cost of service, excluding depreciation and amortization) when historically these amounts were classified as provision for doubtful accounts within operating expenses within our consolidated statements of operations. In addition, the adoption of ASC 606 resulted in increased disclosure, including qualitative and quantitative disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers. On January 1, 2018, the Company adopted ASU 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business , which provides guidance to assist entities with evaluating whether transactions should be accounted for as an acquisition (or disposal) of assets or a business. We adopted this ASU on a prospective basis. The impact on our consolidated financial statements and related disclosures will depend on the facts and circumstances of any specific future transactions as evaluated under the new framework. On January 1, 2018, the Company adopted ASU 2017-04, Intangibles - Goodwill and Other (Topic 350) - Simplifying the Test for Goodwill Impairment , which eliminates the requirement to calculate the implied fair value of goodwill to measure a goodwill impairment charge (Step 2 of the goodwill impairment test). Instead, impairment will be measured using the difference between the carrying amount and the fair value of the reporting unit. The ASU is effective for annual and interim periods beginning after December 15, 2019, with early adoption permitted. We adopted this ASU on a prospective basis and will apply this guidance to our future tests of goodwill impairment. On January 1, 2018, the Company adopted ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments , which provides specific guidance on eight cash flow classification issues not specifically addressed by U.S. GAAP. The ASU is effective for annual and interim periods beginning after December 15, 2017. The standard should be applied using a retrospective transition method unless it is impractical to do so for some of the issues. In such case, the amendments for those issues would be applied prospectively as of the earliest date practicable. Our adoption of this standard using a retrospective transition method for each period presented did not have an effect on our consolidated financial statements. Recently Issued Accounting Pronouncements On March 12, 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting |
Use of Estimates | Use of Estimates Our accounting and reporting policies conform with U.S. GAAP. In preparing the consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates. |
Principles of Consolidation | Principles of Consolidation These consolidated financial statements include the accounts of Amedisys, Inc. and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying consolidated financial statements, and business combinations accounted for as purchases have been included in our consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain equity investments that are accounted for as set forth below. |
Investments | Investments We consolidate investments when the entity is a variable interest entity and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50%. Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our consolidated financial statements. During 2016, we sold a 30% interest in one of our care centers while maintaining a controlling interest in the newly formed joint venture; we repurchased the 30% interest during 2018. We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a variable interest entity in which we are the primary beneficiary. During 2020, we sold our investment in the Heritage Healthcare Innovation Fund, LP via a secondary transaction for $17.9 million which resulted in a $3.0 million loss which is reflected in miscellaneous, net within our consolidated statement of |
Revenue Recognition | Revenue Recognition We account for revenue from contracts with customers in accordance with ASC 606, Revenue from Contracts with Customers , and as such, we recognize revenue in the period in which we satisfy our performance obligations under our contracts by transferring our promised services to our customers in amounts that reflect the consideration to which we expect to be entitled in exchange for providing patient care, which are the transaction prices allocated to the distinct services. The Company's cost of obtaining contracts is not material. Revenues are recognized as performance obligations are satisfied, which varies based on the nature of the services provided. Our performance obligation is the delivery of patient care services in accordance with the nature and frequency of services outlined in physicians' orders, which are determined by a physician based on a patient's specific goals. The Company's performance obligations relate to contracts with a duration of less than one year; therefore, the Company has elected to apply the optional exemption provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied as of the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period. We determine the transaction price based on gross charges for services provided, reduced by estimates for contractual and non-contractual revenue adjustments. Contractual revenue adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third-party payors and others for services provided. Non-contractual revenue adjustments include discounts provided to self-pay, uninsured patients or other payors, adjustments resulting from payment reviews and adjustments arising from our inability to obtain appropriate billing documentation, authorizations or face-to-face documentation. Subsequent changes to the estimate of the transaction price are recorded as adjustments to net service revenue in the period of change. Non-contractual revenue adjustments are recorded for self-pay, uninsured patients and other payors by major payor class based on our historical collection experience, aged accounts receivable by payor and current economic conditions. The non-contractual revenue adjustments represent the difference between amounts billed and amounts we expect to collect based on our collection history with similar payors. The Company assesses its ability to collect for the healthcare services provided at the time of patient admission based on the Company's verification of the patient's insurance coverage under Medicare, Medicaid, and other commercial or managed care insurance programs. Medicare represents approximately 75% of the Company's consolidated net service revenue. Amounts due from third-party payors, primarily commercial health insurers and government programs (Medicare and Medicaid), include variable consideration for retroactive revenue adjustments due to settlements of audits and payment reviews. We determine our estimates for non-contractual revenue adjustments related to payment reviews based on our historical experience and success rates in the claim appeals and adjudication process. We determine our estimates for non-contractual revenue adjustments related to our inability to obtain appropriate billing documentation, authorizations, or face-to-face documentation based on our historical experience which primarily includes a historical collection rate of over 99% on Medicare claims. Revenue is recorded at amounts we estimate to be realizable for services provided. Revenue by payor class as a percentage of total net service revenue is as follows: As of December 31, 2020 2019 2018 Home Health: Medicare 41 % 44 % 50 % Non-Medicare - Episodic-based 7 % 9 % 9 % Non-Medicare - Non-episodic based 13 % 12 % 12 % Hospice (1): Medicare 34 % 30 % 23 % Non-Medicare 2 % 1 % 1 % Personal Care 3 % 4 % 5 % 100 % 100 % 100 % (1) Acquired Compassionate Care Hospice on February 1, 2019, RoseRock Healthcare on April 1, 2019, Asana Hospice on January 1, 2020 and AseraCare Hospice on June 1, 2020. Home Health Revenue Recognition Medicare Revenue Effective January 1, 2020, the Centers for Medicare and Medicaid Services ("CMS") implemented a revised case-mix adjustment methodology, the Patient-Driven Groupings Model ("PDGM"), to better align payment with patient care needs and ensure that clinically complex and ill beneficiaries have adequate access to home health care. PDGM uses 30-day periods of care rather than 60-day episodes of care as the unit of payment, eliminates the use of the number of therapy visits provided in determining payment and relies more heavily on clinical characteristics and other patient information. Net service revenue is recorded based on the established Federal Medicare home health payment rate for a 30-day period of care. ASC 606 notes that if an entity has a right to consideration from a customer in an amount that corresponds directly with the value of the entity’s performance completed to date, the entity may recognize revenue in the amount to which the entity has a right to invoice. We have elected to apply the "right to invoice" practical expedient and therefore, our revenue recognition is based on the reimbursement we are entitled to for each 30-day payment period. We utilize our historical average length of stay for each 30-day period of care as the measure of progress towards the satisfaction of our performance obligation. PDGM uses timing, admission source, functional impairment levels and principal and other diagnoses to case-mix adjust payments. The case-mix adjusted payment for a 30-day period of care is subject to additional adjustments based on certain variables including, but not limited to: (a) an outlier payment if our patient’s care was unusually costly (capped at 10% of total reimbursement per provider number); (b) a low utilization payment adjustment (“LUPA”) if the number of visits provided was less than the established threshold, which ranges from two to six visits and varies for every case-mix group under PDGM; (c) a partial payment if a patient transferred to another provider or from another provider before completing the 30-day period of care; and (d) the applicable geographic wage index. Payments for routine and non-routine supplies are now included in the 30-day payment rate. Medicare can also make various adjustments to payments received if we are unable to produce appropriate billing documentation or acceptable authorizations. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record this estimate during the period in which services are rendered to revenue with a corresponding reduction to patient accounts receivable. Amounts due from Medicare include variable consideration for retroactive revenue adjustments due to settlements of audits and payment reviews. We determine our estimates for non-contractual revenue adjustments related to payment reviews based on our historical experience and success rates in the claim appeals and adjudication process. The Medicare home health benefit requires that beneficiaries be homebound (meaning that the beneficiary is unable to leave his/her home without a considerable and taxing effort), require intermittent skilled nursing, physical therapy or speech therapy services, and receive treatment under a plan of care established and periodically reviewed by a physician. In order to provide greater flexibility during the novel coronavirus pandemic ("COVID-19"), CMS has relaxed the definition of homebound status through the duration of the public health emergency. During the pandemic, a beneficiary is considered homebound if they have been instructed by a physician not to leave their home because of a confirmed or suspected COVID-19 diagnosis or if the patient has a condition that makes them more susceptible to contracting COVID-19. Therefore, if a beneficiary is homebound due to COVID-19 and requires skilled services, the services will be covered under the Medicare home health benefit. All Medicare contracts are required to have a signed plan of care which represents a single performance obligation, comprised of the delivery of a series of distinct services that are substantially similar and have a similar pattern of transfer to the customer. Accordingly, the Company accounts for the series of services ("episode") as a single performance obligation satisfied over time, as the customer simultaneously receives and consumes the benefits of the goods and services provided. An episode starts the first day a billable visit is performed and ends 60 days later or upon discharge, if earlier, with multiple continuous episodes allowed. A portion of reimbursement from each Medicare episode, referred to as a request for anticipated payment ("RAP"), is billed near the start of each 30-day period of care, and cash is typically received before all services are rendered. Any cash received from Medicare for a RAP for a 30-day period of care that exceeds the associated revenue earned is recorded to accrued expenses within our consolidated balance sheets. CMS reduced the upfront payment for RAPs to 20% for 2020 and has fully eliminated payments associated with RAPs in 2021. Non-Medicare Revenue Episodic-based Revenue. We recognize revenue in a similar manner as we recognize Medicare revenue for amounts that are paid by other insurance carriers, including Medicare Advantage programs; however, these amounts can vary based upon the negotiated terms which generally range from 90% to 100% of Medicare rates. Non-episodic based Revenue. Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates. Contractual revenue adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue. We also make non-contractual revenue adjustments to non-episodic revenue based on our historical experience to reflect the estimated transaction price. We receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment. Hospice Revenue Recognition Hospice Medicare Revenue Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are predetermined daily or hourly rates for each of the four levels of care we deliver. The four levels of care are routine care, general inpatient care, continuous home care and respite care. Routine care accounted for 97% of our total Medicare hospice service revenue for each of 2020, 2019 and 2018, respectively. There are two separate payment rates for routine care: payments for the first 60 days of care and care beyond 60 days. In addition to the two routine rates, we may also receive a service intensity add-on (“SIA”). The SIA is based on visits made in the last seven days of life by a registered nurse or medical social worker for patients in a routine level of care. The performance obligation is the delivery of hospice services to the patient, as determined by a physician, each day the patient is on hospice care. We make adjustments to Medicare revenue for non-contractual revenue adjustments, which include our inability to obtain appropriate billing documentation or acceptable authorizations and other reasons unrelated to credit risk. We estimate the impact of these non-contractual revenue adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record it during the period services are rendered. Additionally, our hospice service revenue is subject to certain limitations on payments from Medicare which are considered variable consideration. We are subject to an inpatient cap limit and an overall Medicare payment cap for each provider number. We monitor these caps on a provider-by-provider basis and estimate amounts due back to Medicare if we estimate a cap has been exceeded. We record these adjustments as a reduction to revenue and an increase in accrued expenses within our consolidated balance sheets. Providers are required to self-report and pay their estimated cap liability by February 28th of the following year. As of December 31, 2020, we have settled our Medicare hospice reimbursements for all fiscal years through October 31, 2013. As of December 31, 2020, we have recorded $9.3 million for estimated amounts due back to Medicare in accrued expenses for the Federal cap years ended October 31, 2014 through September 30, 2021; approximately $2.0 million of this balance was acquired with the AseraCare Hospice ("AseraCare") acquisition. As of December 31, 2019, we had recorded $5.7 million for estimated amounts due back to Medicare in accrued expenses for the Federal cap years ended October 31, 2013 through September 30, 2020. Hospice Non-Medicare Revenue Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per day rates, as applicable. Contractual revenue adjustments are recorded for the difference between our standard rates and the contractual rates to be realized from patients, third party payors and others for services provided and are deducted from gross revenue to determine our net service revenue. We also make non-contractual adjustments to non-Medicare revenue based on our historical experience to reflect the estimated transaction price. Personal Care Revenue Recognition Personal Care Revenue |
Government Grants | Government Grants In the absence of specific guidance to account for government grants under U.S. GAAP, we have decided to account for government grants in accordance with International Accounting Standard ("IAS") 20, Accounting for Government Grants and Disclosure of Government Assistance , and as such, we recognize grant income on a systematic basis in line with the recognition of expenses or the loss of revenues for which the grants are intended to compensate. We recognize grants once both of the following conditions are met: (1) we are able to comply with the relevant conditions of the grant and (2) the grant will be received. See Note 3 - Novel Coronavirus Pandemic ("COVID-19") for additional information on our accounting for government funds received under the Coronavirus Aid, Relief and Economic Security Act ("CARES Act") and the Mass Home Care ASAP COVID-19 Provider Sustainability Program. |
Cash, Cash Equivalents and Restricted Cash | Cash, Cash Equivalents and Restricted CashCash and cash equivalents include certificates of deposit and all highly liquid debt instruments with maturities of three months or less when purchased. |
Patient Accounts Receivable | Patient Accounts Receivable We report accounts receivable from services rendered at their estimated transaction price, which includes contractual and non-contractual revenue adjustments based on the amounts expected to be due from payors. Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party payors and patients. The Company's non-Medicare third-party payor base is comprised of a diverse group of payors that are geographically dispersed across the country. As of December 31, 2020, there is no single payor, other than Medicare, that accounts for more than 10% of our total outstanding patient receivables. Thus, we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. We believe the collectibility risk associated with our Medicare accounts, which represent 64% and 58% of our net patient accounts receivable at December 31, 2020 and 2019, respectively, is limited due to our historical collection rate of over 99% from Medicare and the fact that Medicare is a U.S. government payor. We do not believe there are any significant concentrations of revenues from any payor that would subject us to any significant credit risk in the collection of our accounts receivable. Medicare Home Health For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for 20% of our estimated payment for each 30-day period of care. The RAP received for that billing period is then deducted from our final payment. If a final bill is not submitted within the greater of 90 days from the start of the 30-day period of care, or 60 days from the date the RAP was paid, any RAPs received for that billing period will be recouped by Medicare from any other claims in process for that particular provider number. The RAP claim must then be resubmitted. CMS has mandated the full elimination of all upfront payments associated with RAPs in 2021. Medicare Hospice For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We bill Medicare on a monthly basis for the services provided to the patient. Non-Medicare Home Health, Hospice, and Personal Care |
Property and Equipment | Property and Equipment Property and equipment is stated at cost and depreciated on a straight-line basis over the estimated useful lives of the assets or life of the lease, if shorter. Additionally, we have internally developed computer software for our own use. Additions and improvements (including interest costs for construction of qualifying long-lived assets) are capitalized. Maintenance and repair expenses are charged to expense as incurred. The cost of property and equipment sold or disposed of and the related accumulated depreciation are eliminated from the property and related accumulated depreciation accounts, and any gain or loss is credited or charged to other general and administrative expenses. We assess the impairment of a long-lived asset group whenever events or changes in circumstances indicate that the asset’s carrying value may not be recoverable. Factors we consider important that could trigger an impairment review include but are not limited to the following: • A significant change in the extent or manner in which the long-lived asset group is being used. • A significant change in the business climate that could affect the value of the long-lived asset group. • A significant change in the market value of the assets included in the asset group. If we determine that the carrying value of long-lived assets may not be recoverable, we compare the carrying value of the asset group to the undiscounted cash flows expected to be generated by the asset group. If the carrying value exceeds the undiscounted cash flows, an impairment charge is indicated. An impairment charge is recognized to the extent that the carrying value of the asset group exceeds its fair value. We generally provide for depreciation over the following estimated useful service lives. Years Building 39 Leasehold improvements Lesser of lease term or expected useful life Equipment and furniture 3 to 7 Vehicles 5 Computer software 2 to 7 Finance leases 3 The following table summarizes the balances related to our property and equipment for 2020 and 2019 (amounts in millions): As of December 31, 2020 2019 Building and leasehold improvements $ 9.0 $ 8.7 Equipment and furniture 53.1 55.6 Finance leases 5.9 5.2 Computer software 50.7 54.7 118.7 124.2 Less: accumulated depreciation (95.0) (96.1) $ 23.7 $ 28.1 Depreciation expense for 2020, 2019 and 2018 was $12.1 million, $11.6 million and $10.8 million, respectively. |
Business Combinations | Business Combinations We account for acquisitions using the acquisition method of accounting in accordance with ASC 805, Business Combinations . Acquisitions are accounted for as purchases and are included in our consolidated financial statements from their respective acquisition dates. Assets acquired and liabilities assumed, if any, are measured at fair value on the acquisition date using the appropriate valuation method. Goodwill generated from acquisitions is recognized for the excess of the purchase price over tangible and identifiable intangible assets. In determining the fair value of identifiable intangible assets, we use various valuation techniques including discounted cash flow analysis, the income approach, the cost approach and the market approach. These valuation methods require us to make estimates and assumptions surrounding projected revenues and costs, future growth and discount rates. |
Goodwill and Other Intangible Assets | Goodwill and Other Intangible Assets Goodwill represents the amount of the purchase price in excess of the fair values assigned to the underlying identifiable net assets of acquired businesses. Goodwill is not amortized, but is subject to an annual impairment test. Tests are performed more frequently if events occur or circumstances change that would more likely than not reduce the fair value of the reporting unit below its carrying amount. These events or circumstances include, but are not limited to, a significant adverse change in the business environment, regulatory environment or legal factors, or a substantial decline in the market capitalization of our stock. Each of our operating segments described in Note 14 – Segment Information is considered to represent an individual reporting unit for goodwill impairment testing purposes. We consider each of our home health care centers to constitute an individual business for which discrete financial information is available. However, since these care centers have substantially similar operating and economic characteristics and resource allocations and since significant investment decisions concerning these businesses are centralized and the benefits broadly distributed, we have aggregated these care centers and deemed them to constitute a single reporting unit. We have applied this same aggregation principle to our hospice and personal-care care centers and have also deemed each of them to be a single reporting unit. two |
Debt Issuance Costs | Debt Issuance CostsDuring 2019, we recorded $0.8 million in deferred debt issuance costs as a reduction to long-term obligations, less current portion in our consolidated balance sheet in connection with our entry into the Amended Credit Agreement (See Note 8 - Long-Term Obligations). As of December 31, 2020 and 2019, we had unamortized debt issuance costs of $2.7 million and $3.5 million, respectively, recorded as a reduction to long-term obligations, less current portion in our accompanying consolidated balance sheets. We amortize deferred debt issuance costs related to our long-term obligations over the term of the obligation through interest expense, unless the debt is extinguished, in which case unamortized balances are immediately expensed. |
Fair Value of Financial Instruments | Fair Value of Financial Instruments The following details our financial instruments where the carrying value and the fair value differ (amounts in millions): Fair Value at Reporting Date Using Financial Instrument Carrying Value as of Quoted Prices in Active Significant Other Significant Long-term obligations $ 215.1 $ — $ 217.7 $ — The fair value hierarchy is based on three levels of inputs, of which the first two are considered observable and the last unobservable, that may be used to measure fair value. The three levels of inputs are as follows: • Level 1 – Quoted prices in active markets for identical assets and liabilities. • Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. • Level 3 – Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities. |
Income Taxes | Income Taxes We use the asset and liability approach for measuring deferred tax assets and liabilities based on temporary differences existing at each balance sheet date using currently enacted tax rates. Our deferred tax calculation requires us to make certain estimates about future operations. Deferred tax assets are reduced by a valuation allowance when we believe it is more likely than not that some portion or all of the deferred tax assets will not be realized. The effect of a change in tax rate is recognized as income or expense in the period that includes the enactment date. As of December 31, 2020 and 2019, our net deferred tax assets were $48.0 million and $21.4 million, respectively. Management regularly assesses the ability to realize deferred tax assets recorded in the Company’s entities based upon the weight of available evidence, including such factors as the recent earnings history and expected future taxable income. In the event future taxable income is below management’s estimates or is generated in tax jurisdictions different than projected, we could be required to increase the valuation allowance for deferred tax assets. This would result in an increase in our effective tax rate. |
Share-Based Compensation | Share-Based CompensationWe record all share-based compensation as expense in the financial statements measured at the fair value of the award. We recognize compensation cost on a straight-line basis over the requisite service period for each separately vesting portion of the award. |
Weighted-Average Shares Outstanding | Weighted-Average Shares OutstandingNet income per share attributable to Amedisys, Inc. common stockholders, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. |
Advertising Costs | Advertising CostsWe expense advertising costs as incurred. |
SUMMARY OF SIGNIFICANT ACCOUN_3
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Accounting Policies [Abstract] | |
Schedule of Revenue by Payor Class | Revenue by payor class as a percentage of total net service revenue is as follows: As of December 31, 2020 2019 2018 Home Health: Medicare 41 % 44 % 50 % Non-Medicare - Episodic-based 7 % 9 % 9 % Non-Medicare - Non-episodic based 13 % 12 % 12 % Hospice (1): Medicare 34 % 30 % 23 % Non-Medicare 2 % 1 % 1 % Personal Care 3 % 4 % 5 % 100 % 100 % 100 % (1) Acquired Compassionate Care Hospice on February 1, 2019, RoseRock Healthcare on April 1, 2019, Asana Hospice on January 1, 2020 and AseraCare Hospice on June 1, 2020. |
Schedule of Cash Cash Equivalents and Restricted Cash | The following table summarizes the balances related to our cash, cash equivalents and restricted cash (amounts in millions): As of December 31, 2020 2019 Cash and cash equivalents $ 81.8 $ 30.3 Restricted cash 1.5 66.2 Cash, cash equivalents and restricted cash $ 83.3 $ 96.5 |
Schedule of Estimated Useful Lives of Property and Equipment | We generally provide for depreciation over the following estimated useful service lives. Years Building 39 Leasehold improvements Lesser of lease term or expected useful life Equipment and furniture 3 to 7 Vehicles 5 Computer software 2 to 7 Finance leases 3 |
Schedule of Property and Equipment | The following table summarizes the balances related to our property and equipment for 2020 and 2019 (amounts in millions): As of December 31, 2020 2019 Building and leasehold improvements $ 9.0 $ 8.7 Equipment and furniture 53.1 55.6 Finance leases 5.9 5.2 Computer software 50.7 54.7 118.7 124.2 Less: accumulated depreciation (95.0) (96.1) $ 23.7 $ 28.1 |
Schedule of Fair Value of Financial Instruments | The following details our financial instruments where the carrying value and the fair value differ (amounts in millions): Fair Value at Reporting Date Using Financial Instrument Carrying Value as of Quoted Prices in Active Significant Other Significant Long-term obligations $ 215.1 $ — $ 217.7 $ — |
Schedule of Weighted-Average Shares Outstanding | The following table sets forth, for the periods indicated, shares used in our computation of weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands): For the Years Ended December 31, 2020 2019 2018 Weighted average number of shares outstanding – basic 32,559 32,142 32,791 Effect of dilutive securities: Stock options 420 545 502 Non-vested stock and stock units 289 303 316 Weighted average number of shares outstanding – diluted 33,268 32,990 33,609 Anti-dilutive securities 25 117 50 |
NOVEL CORONAVIRUS PANDEMIC ("_2
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Unusual or Infrequent Items, or Both [Abstract] | |
Schedule Of Cares Act Provider Relief Funds | In summary, the total funds that we have received from the CARES Act PRF as of December 31, 2020 consist of the following (amounts in millions): Amount Funds utilized during the year ended December 31, 2020 $ 33.3 Estimated funds to be utilized January 2021 through June 2021 11.6 Estimated funds to be repaid to the government 60.0 Funds received by unconsolidated joint ventures 1.9 $ 106.8 |
ACQUISITIONS (Tables)
ACQUISITIONS (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Business Combinations [Abstract] | |
Schedule Of Business Acquisitions, Asana Hospice | The Company has finalized its valuation of the assets acquired and liabilities assumed. The total estimated consideration of $65.6 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions): Amount Patient accounts receivable $ 4.6 Property and equipment 0.2 Operating lease right of use assets 0.9 Intangible assets 5.6 Total assets acquired 11.3 Accounts payable (3.2) Payroll and employee benefits (1.5) Accrued expenses (0.5) Operating lease liabilities (0.9) Total liabilities assumed (6.1) Net identifiable assets acquired 5.2 Goodwill 60.4 Total estimated consideration $ 65.6 |
Schedule Of Business Acquisitions, AseraCare Hospice | The Company is in the process of reviewing the fair value of the assets acquired and liabilities assumed. During the year ended December 31, 2020, we recorded measurement period adjustments based on changes to management's estimates and assumptions related to the assets acquired and liabilities assumed. The final valuation of the assets acquired and liabilities assumed was not complete as of December 31, 2020, but will be finalized within the allowable measurement period. Based on the Company's preliminary valuation, the total estimated consideration of $229.6 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions): Amount Patient accounts receivable $ 15.0 Prepaid expenses 0.7 Property and equipment 0.6 Operating lease right of use assets 5.9 Intangible assets 24.3 Other assets 0.1 Total assets acquired 46.6 Accounts payable (5.8) Payroll and employee benefits (5.9) Accrued expenses (10.4) Operating lease liabilities (5.4) Total liabilities assumed (27.5) Net identifiable assets acquired 19.1 Goodwill 210.5 Total estimated consideration $ 229.6 |
Schedule of Pro Forma Financial Information, AseraCare | The following table contains unaudited pro forma condensed consolidated statement of operations information for the years ended December 31, 2020 and 2019 assuming that the AseraCare acquisition closed on January 1, 2019 (amounts in millions, except per share data). The pro forma financial information includes various assumptions, including those related to the preliminary purchase price allocation of assets acquired and liabilities assumed. The pro forma financial information may vary in future quarters based on the final valuations and analysis of the fair value of the assets acquired and liabilities assumed. For the Years Ended 2020 2019 Net service revenue $ 2,120.1 $ 2,077.0 Operating income 218.0 167.5 Net income attributable to Amedisys Inc. 180.6 112.3 Basic earnings per share 5.55 3.49 Diluted earnings per share 5.43 3.40 |
Schedule Of Business Acquisitions Compassionate Care Hospice | The Company has finalized its valuation of the assets acquired and liabilities assumed. The total consideration of $327.9 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions): Amount Patient accounts receivable $ 24.5 Prepaid expenses 0.8 Other current assets 0.1 Property and equipment 0.2 Intangible assets 27.2 Operating lease right of use assets 3.4 Other assets 1.1 Total assets acquired 57.3 Accounts payable (14.9) Payroll and employee benefits (11.7) Accrued expenses (11.7) Deferred tax liability (0.9) Operating lease liabilities (3.4) Total liabilities acquired (42.6) Net identifiable assets acquired 14.7 Goodwill 313.2 Total estimated consideration $ 327.9 |
Schedule of Pro Forma Financial Information, Compassionate Care Hospice | The following table contains unaudited pro forma condensed consolidated statement of operations information for the years ended December 31, 2019 and 2018 assuming that the CCH acquisition closed on January 1, 2018 (amounts in millions, except per share data): For the Years 2019 2018 Net service revenue $ 1,971.7 $ 1,852.8 Operating income 183.8 175.7 Net income attributable to Amedisys, Inc. 130.5 124.6 Basic earnings per share 4.06 3.80 Diluted earnings per share $ 3.96 $ 3.71 |
GOODWILL AND OTHER INTANGIBLE_2
GOODWILL AND OTHER INTANGIBLE ASSETS, NET (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Summary of Activity Related to Goodwill and Other Intangible Assets Net | The following table summarizes the activity related to our goodwill for 2020 and 2019 (amounts in millions): Goodwill Home Health Hospice Personal Care Total Balances at December 31, 2018 (1) $ 87.1 $ 199.3 $ 43.1 $ 329.5 Additions — 329.0 — 329.0 Balances at December 31, 2019 87.1 528.3 43.1 658.5 Additions 3.3 270.9 — 274.2 Balances at December 31, 2020 $ 90.4 $ 799.2 $ 43.1 $ 932.7 (1) Net of prior years' accumulated impairment losses of $733.7 million, which is inclusive of write-offs related to the sale and closure of care centers. During 2020, we recorded a non-cash other intangible assets impairment charge of $4.2 million related to acquired names which are no longer in use; additionally, we recorded amortization of $2.4 million related to certificates of need and licenses associated with care centers that were closed. During 2019, we recorded a non-cash other intangible assets impairment charge of $1.5 million related to acquired names which are no longer in use or are associated with care centers that were closed. The following table summarizes the activity related to our other intangible assets, net for 2020 and 2019 (amounts in millions): Other Intangible Assets, Net Certificates of Need and Licenses Acquired Acquired Non-Compete Total Balances at December 31, 2018 (1) $ 23.9 $ 19.6 $ — $ 0.6 $ 44.1 Additions 13.7 — 10.0 5.2 28.9 Write-off (2) — (1.5) — — (1.5) Amortization — — (4.4) (2.4) (6.8) Balances at December 31, 2019 37.6 18.1 5.6 3.4 64.7 Additions 11.8 — 7.0 11.5 30.3 Write-off (2) — (4.2) — — (4.2) Amortization (3) (2.4) — (7.1) (7.1) (16.6) Balances at December 31, 2020 $ 47.0 $ 13.9 $ 5.5 $ 7.8 $ 74.2 (1) Net of prior years' accumulated amortization of $0.7 million for non-compete agreements. (2) Write-offs are related to our acquired names that are no longer in use or that were associated with care centers that are closed. (3) Amortization of certificates of need and licenses is related to care centers that were closed during 2020. (4) The weighted average remaining amortization period of our amortizable acquired names and non-compete agreements is 1.3 years and 1.2 years, respectively. |
Schedule of Estimated Aggregate Future Amortization Expense | The estimated aggregate amortization expense related to intangible assets for each of the five succeeding years is as follows (amounts in millions): Intangible Asset Amortization 2021 $ 10.6 2022 2.7 2023 — 2024 — 2025 — $ 13.3 |
DETAILS OF CERTAIN BALANCE SH_2
DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Details Of Certain Balance Sheet Accounts [Abstract] | |
Schedule of Other Current Assets | Additional information regarding certain balance sheet accounts is presented below (amounts in millions): As of December 31, 2020 2019 Other current assets: Payroll tax escrow $ 6.3 $ 1.5 Income tax receivable 0.2 2.0 Due from joint ventures 2.3 2.0 Other 4.5 2.7 $ 13.3 $ 8.2 Other assets: Workers’ compensation deposits $ 0.3 $ 0.2 Health insurance deposits 0.5 0.5 Other miscellaneous deposits 1.2 1.0 Indemnity receivable 13.6 13.6 Equity method investments 14.2 35.7 Other 3.4 3.6 $ 33.2 $ 54.6 Accrued expenses: Health insurance $ 15.1 $ 15.8 Workers’ compensation 35.8 33.4 Florida ZPIC audit, gross liability 17.4 17.4 Legal settlements and other audits 24.4 19.0 Income tax payable — 0.5 Charity care 3.6 2.7 Estimated Medicare cap liability 9.3 5.7 Hospice accruals (room and board, general in-patient and other) 29.2 24.4 Patient liability 8.4 9.4 Deferred operating income (CARES Act) 11.6 — Other 11.4 8.8 $ 166.2 $ 137.1 Other long-term obligations: Reserve for uncertain tax positions $ 3.3 $ 3.1 Deferred compensation plan liability 1.0 1.0 Non-current social security taxes (deferred under CARES Act) 27.7 — Other 1.6 1.8 $ 33.6 $ 5.9 |
Schedule of Other Assets | Additional information regarding certain balance sheet accounts is presented below (amounts in millions): As of December 31, 2020 2019 Other current assets: Payroll tax escrow $ 6.3 $ 1.5 Income tax receivable 0.2 2.0 Due from joint ventures 2.3 2.0 Other 4.5 2.7 $ 13.3 $ 8.2 Other assets: Workers’ compensation deposits $ 0.3 $ 0.2 Health insurance deposits 0.5 0.5 Other miscellaneous deposits 1.2 1.0 Indemnity receivable 13.6 13.6 Equity method investments 14.2 35.7 Other 3.4 3.6 $ 33.2 $ 54.6 Accrued expenses: Health insurance $ 15.1 $ 15.8 Workers’ compensation 35.8 33.4 Florida ZPIC audit, gross liability 17.4 17.4 Legal settlements and other audits 24.4 19.0 Income tax payable — 0.5 Charity care 3.6 2.7 Estimated Medicare cap liability 9.3 5.7 Hospice accruals (room and board, general in-patient and other) 29.2 24.4 Patient liability 8.4 9.4 Deferred operating income (CARES Act) 11.6 — Other 11.4 8.8 $ 166.2 $ 137.1 Other long-term obligations: Reserve for uncertain tax positions $ 3.3 $ 3.1 Deferred compensation plan liability 1.0 1.0 Non-current social security taxes (deferred under CARES Act) 27.7 — Other 1.6 1.8 $ 33.6 $ 5.9 |
Schedule of Accrued Expenses | Additional information regarding certain balance sheet accounts is presented below (amounts in millions): As of December 31, 2020 2019 Other current assets: Payroll tax escrow $ 6.3 $ 1.5 Income tax receivable 0.2 2.0 Due from joint ventures 2.3 2.0 Other 4.5 2.7 $ 13.3 $ 8.2 Other assets: Workers’ compensation deposits $ 0.3 $ 0.2 Health insurance deposits 0.5 0.5 Other miscellaneous deposits 1.2 1.0 Indemnity receivable 13.6 13.6 Equity method investments 14.2 35.7 Other 3.4 3.6 $ 33.2 $ 54.6 Accrued expenses: Health insurance $ 15.1 $ 15.8 Workers’ compensation 35.8 33.4 Florida ZPIC audit, gross liability 17.4 17.4 Legal settlements and other audits 24.4 19.0 Income tax payable — 0.5 Charity care 3.6 2.7 Estimated Medicare cap liability 9.3 5.7 Hospice accruals (room and board, general in-patient and other) 29.2 24.4 Patient liability 8.4 9.4 Deferred operating income (CARES Act) 11.6 — Other 11.4 8.8 $ 166.2 $ 137.1 Other long-term obligations: Reserve for uncertain tax positions $ 3.3 $ 3.1 Deferred compensation plan liability 1.0 1.0 Non-current social security taxes (deferred under CARES Act) 27.7 — Other 1.6 1.8 $ 33.6 $ 5.9 |
Schedule of Other Long-Term Obligations | Additional information regarding certain balance sheet accounts is presented below (amounts in millions): As of December 31, 2020 2019 Other current assets: Payroll tax escrow $ 6.3 $ 1.5 Income tax receivable 0.2 2.0 Due from joint ventures 2.3 2.0 Other 4.5 2.7 $ 13.3 $ 8.2 Other assets: Workers’ compensation deposits $ 0.3 $ 0.2 Health insurance deposits 0.5 0.5 Other miscellaneous deposits 1.2 1.0 Indemnity receivable 13.6 13.6 Equity method investments 14.2 35.7 Other 3.4 3.6 $ 33.2 $ 54.6 Accrued expenses: Health insurance $ 15.1 $ 15.8 Workers’ compensation 35.8 33.4 Florida ZPIC audit, gross liability 17.4 17.4 Legal settlements and other audits 24.4 19.0 Income tax payable — 0.5 Charity care 3.6 2.7 Estimated Medicare cap liability 9.3 5.7 Hospice accruals (room and board, general in-patient and other) 29.2 24.4 Patient liability 8.4 9.4 Deferred operating income (CARES Act) 11.6 — Other 11.4 8.8 $ 166.2 $ 137.1 Other long-term obligations: Reserve for uncertain tax positions $ 3.3 $ 3.1 Deferred compensation plan liability 1.0 1.0 Non-current social security taxes (deferred under CARES Act) 27.7 — Other 1.6 1.8 $ 33.6 $ 5.9 |
LEASES (Tables)
LEASES (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Leases [Abstract] | |
Schedule of Lease Cost | The components of lease cost for the years ended December 31, 2020 and 2019 are as follows (amounts in millions): For the Years Ended December 31, 2020 2019 Operating lease cost: Operating lease cost $ 38.6 $ 35.0 Impairment of operating lease ROU assets 0.5 0.9 Total operating lease cost 39.1 35.9 Finance lease cost: Amortization of ROU assets 2.0 1.7 Interest on lease liabilities 0.2 0.2 Total finance lease cost 2.2 1.9 Variable lease cost 3.0 2.6 Short-term lease cost — 0.2 Total lease cost $ 44.3 $ 40.6 |
Schedule of Operating Leases | Amounts reported in the consolidated balance sheets as of December 31, 2020 and 2019 for our operating leases are as follows (amounts in millions): As of December 31, 2020 2019 Operating lease ROU assets $ 93.4 $ 84.8 Current portion of operating lease liabilities 30.0 27.8 Operating lease liabilities, less current portion 62.0 56.1 Total operating lease liabilities $ 92.0 $ 83.9 |
Schedule of Finance Leases | Amounts reported in the consolidated balance sheets as of December 31, 2020 and 2019 for finance leases are included in the table below. The finance lease ROU assets are recorded within property and equipment, net of accumulated depreciation within our consolidated balance sheets. The finance lease liabilities are recorded within current portion of long-term obligations and long-term obligations, less current portion within our consolidated balance sheets. As of December 31, 2020 2019 Finance lease ROU assets $ 5.9 $ 5.2 Accumulated amortization (3.3) (1.8) Finance lease ROU assets, net $ 2.6 $ 3.4 Current installments of obligations under finance leases $ 1.7 $ 1.7 Long-term portion of obligations under finance leases 0.9 1.7 Total finance lease liabilities $ 2.6 $ 3.4 |
Schedule of Supplemental CashFlow Information and NonCash Activity for Leases | Supplemental cash flow information and non-cash activity related to our leases are as follows (amounts in millions): For the Years Ended December 31, 2020 2019 Cash paid for amounts included in the measurement of lease liabilities and ROU assets: Operating cash flow from operating leases $ (38.2) $ (35.8) Financing cash flow from finance leases (2.0) (1.7) ROU assets obtained in exchange for lease obligations: Operating leases 38.5 116.0 Finance leases 1.2 2.9 Reductions to ROU assets resulting from reductions to lease obligations: Operating leases (1.1) (1.7) Finance leases — — |
Schedule of Weighted Average Remaining Lease Term and Discount Rate | Weighted average remaining lease terms and discount rates for our leases as of December 31, 2020 and 2019 are as follows: As of December 31, 2020 2019 Weighted average remaining lease term (years): Operating leases 3.7 3.9 Finance leases 1.7 2.1 Weighted average discount rate: Operating leases 3.1 % 3.9 % Finance leases 5.3 % 5.3 % |
Schedule of Lease Liability Maturity | Maturities of lease liabilities as of December 31, 2020 are as follows (amounts in millions): Operating Finance 2021 $ 32.2 $ 1.8 2022 25.3 0.7 2023 17.6 0.2 2024 11.7 — 2025 6.2 — Thereafter 4.6 — Total undiscounted lease payments 97.6 2.7 Less: Imputed interest (5.6) (0.1) Total lease liabilities $ 92.0 $ 2.6 |
LONG-TERM OBLIGATIONS (Tables)
LONG-TERM OBLIGATIONS (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Debt Disclosure [Abstract] | |
Schedule of Long-Term Debt | Long-term debt consists of the following for the periods indicated (amounts in millions): As of December 31, 2020 2019 $175.0 million Term Loan; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (1.7% at December 31, 2020); due February 4, 2024 $ 164.1 $ 171.7 $550.0 million Revolving Credit Facility; interest only payments; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (3.8% at December 31, 2020); due February 4, 2024 51.0 70.0 Promissory notes — 0.6 Finance leases 2.6 3.4 Principal amount of long-term obligations 217.7 245.7 Deferred debt issuance costs (2.7) (3.5) 215.0 242.2 Current portion of long-term obligations (10.5) (9.9) Total $ 204.5 $ 232.3 |
Schedule of Maturities of Long-Term Debt | Maturities of debt as of December 31, 2020 are as follows (amounts in millions): Long-term 2021 $ 10.5 2022 9.4 2023 12.3 2024 185.5 2025 — $ 217.7 |
Schedule of Commitment Fee Under Credit Facilities | The “Applicable Rate” is based on the consolidated leverage ratio and is presented in the table below. As of December 31, 2020, the Applicable Rate is 0.25% per annum for Base Rate Loans and 1.25% per annum for Eurodollar Rate Loans. We are also subject to a commitment fee and letter of credit fee under the terms of the Amended Credit Agreement, as presented in the table below. Pricing Tier Consolidated Leverage Ratio Base Rate Loans Eurodollar Rate Loans Commitment Letter of I ≥ 3.00 to 1.0 1.00 % 2.00 % 0.35 % 1.75 % II < 3.00 to 1.0 but ≥ 2.00 to 1.0 0.75 % 1.75 % 0.30 % 1.50 % III < 2.00 to 1.0 but ≥ 0.75 to 1.0 0.50 % 1.50 % 0.25 % 1.25 % IV < 0.75 to 1.0 0.25 % 1.25 % 0.20 % 1.00 % |
INCOME TAXES (Tables)
INCOME TAXES (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Income Tax Disclosure [Abstract] | |
Schedule of Income Tax Provision | Income taxes attributable to continuing operations consist of the following (amounts in millions): For the Years Ended December 31, 2020 2019 2018 Current income tax expense/(benefit): Federal $ 41.6 $ 24.2 $ 16.4 State and local 10.6 4.8 2.1 52.2 29.0 18.5 Deferred income tax expense/(benefit): Federal (22.5) 9.5 14.5 State and local (4.1) 4.0 5.8 (26.6) 13.5 20.3 Income tax expense $ 25.6 $ 42.5 $ 38.8 Total income tax expense for the years ended December 31, 2020, 2019 and 2018 was allocated as follows (amounts in millions): For the Years Ended December 31, 2020 2019 2018 Income from continuing operations $ 25.6 $ 42.5 $ 38.8 Interest expense 0.2 0.3 0.1 Goodwill — 0.9 — Total $ 25.8 $ 43.7 $ 38.9 |
Schedule of Sources of Tax Effects | A reconciliation of significant differences between the reported amount of income tax expense and the expected amount of income tax expense that would result from applying the U.S. federal statutory income tax rate of 21% to income before income taxes is as follows: For the Years Ended December 31, 2020 2019 2018 Income tax expense at U.S. federal statutory rate 21.0 % 21.0 % 21.0 % State and local income taxes, net of federal income tax benefit (1) 2.4 4.8 4.8 Excess tax benefits from share-based compensation (1) (12.7) (2.2) (1.8) Non-deductible executive compensation 2.1 1.6 0.4 Other items, net (2) (0.6) (0.3) — Income tax expense 12.2 % 24.9 % 24.4 % (1) On August 10, 2020, Paul B. Kusserow, President, Chief Executive Officer and Chairman of the Board of Amedisys, exercised 500,000 stock options previously awarded to him under our 2008 Omnibus Incentive Compensation Plan. We recognize compensation expense for stock option awards on a straight-line basis over the requisite service period for each separately vesting portion of the award in accordance with ASC 718, Compensation: Stock Compensation ; however, the income tax deduction related to stock options is not recognized until the stock option exercise date. As a result, for awards that are expected to result in a tax deduction, a deferred tax asset is created as the entity recognizes compensation expense for U.S. GAAP purposes. If the tax deduction exceeds the cumulative U.S. GAAP compensation expense for the award, the tax benefit associated with any excess deduction is recognized as an income tax benefit in the statement of operations, resulting in a reduction of the effective tax rate. Mr. Kusserow's stock option exercise produced a $92.1 million tax deduction in excess of U.S. GAAP compensation expense, resulting in a $19.4 million federal income tax benefit and a $4.6 million state and local income tax benefit for the year ended December 31, 2020. (2) Includes various items such as non-deductible expenses, non-taxable income, tax credits, valuation allowance, uncertain tax positions and return-to-accrual adjustments. |
Schedule of Net Deferred Tax Assets | Deferred tax assets (liabilities) consist of the following components (amounts in millions): As of December 31, 2020 2019 Deferred tax assets: Accrued payroll & employee benefits $ 15.9 $ 15.1 Workers’ compensation 9.6 9.0 Share-based compensation 5.1 7.9 Legal & compliance matters 7.0 4.8 Lease liability 25.2 23.1 Provider relief fund advance (1) 15.6 — Deferred social security taxes (2) 14.3 — Net operating loss carryforwards 2.4 3.7 Tax credit carryforwards 2.9 3.1 Other 0.6 0.5 Gross deferred tax assets 98.6 67.2 Less: valuation allowance (0.1) (0.4) Net deferred tax assets 98.5 66.8 Deferred tax liabilities: Property and equipment (3.8) (4.3) Amortization of intangible assets (11.8) (0.3) Deferred revenue (9.0) (13.5) Investment in partnerships — (3.3) Right-of-use asset (24.9) (22.8) Other liabilities (1.0) (1.2) Gross deferred tax liabilities (50.5) (45.4) Deferred income taxes $ 48.0 $ 21.4 (1) In April 2020, approximately $100 million was provided to the Company through the healthcare Provider Relief Fund established under the CARES Act. As of December 31, 2020, the Company recorded a liability related to the funds that we do not expect to utilize totaling $60 million, which is reflected in the Provider Relief Fund Advance account in current liabilities within our consolidated balance sheet. For income tax purposes, the Company recognized the $60 million as income upon receipt, resulting in a deferred tax asset as of December 31, 2020. The company will recognize an income tax deduction when the liability is paid during the year ended December 31, 2021. |
Schedule of Uncertain Tax Positions | A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (amounts in millions): For the Years Ended December 31, 2020 2019 2018 Balance at beginning of period $ 2.7 $ 2.7 $ 2.7 Additions for tax positions related to current year — — — Additions for tax positions related to prior year — — — Reductions for tax positions related to prior years — — — Lapse of statute of limitations — — — Settlements — — — Balance at end of period $ 2.7 $ 2.7 $ 2.7 |
CAPITAL STOCK AND SHARE-BASED_2
CAPITAL STOCK AND SHARE-BASED COMPENSATION (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Share-based Payment Arrangement [Abstract] | |
Schedule of Employee Stock Purchase Plan Activity | The following is a detail of the purchases that were made under the plan: Employee Stock Purchase Plan Period Shares Issued Price 2018 and Prior 3,122,983 $ 15.92 January 1, 2019 to March 31, 2019 7,181 104.77 April 1, 2019 to June 30, 2019 8,230 103.20 July 1, 2019 to September 30, 2019 7,216 111.36 October 1, 2019 to December 31, 2019 6,063 141.88 January 1, 2020 to March 31, 2020 5,295 156.01 April 1, 2020 to June 30, 2020 5,414 168.76 July 1, 2020 to September 30, 2020 4,789 200.97 October 1, 2020 to December 31, 2020 4,202 249.33 3,171,373 |
Schedule of Share-based Payment Award Valuation Assumptions | The fair values of the awards were estimated using the following assumptions for 2020, 2019 and 2018: For the Years Ended December 31, 2020 2019 2018 Risk Free Rate 0.38% - 1.51% 1.44% - 2.53% 2.56% - 3.04% Expected Volatility 40.15% - 42.80% 42.46% - 43.83% 42.00% - 45.32% Expected Term 6.25 years 6.00 - 6.25 years 4.12 - 6.25 years Weighted Average Fair Value $86.72 $54.42 $42.48 Dividend Yield —% —% —% |
Schedule of Stock Options Activity | The following table presents our stock option activity for 2020: Number of Weighted Weighted Outstanding options at January 1, 2020 875,974 $ 49.62 6.26 Granted 43,249 209.41 Exercised (622,829) 31.60 Canceled, forfeited or expired (18,353) 103.89 Outstanding options at December 31, 2020 278,041 $ 111.27 7.68 Exercisable options at December 31, 2020 89,429 $ 76.40 6.75 The following table presents our non-vested stock option activity for 2020: Number of Weighted Average Non-vested stock options at January 1, 2020 305,750 $ 41.66 Granted 43,249 86.72 Vested (142,233) 34.84 Forfeited (18,154) 47.66 Non-vested stock options at December 31, 2020 188,612 $ 56.55 |
Schedule of Non-Vested Stock Activity | The following table presents our non-vested stock activity for 2020: Number of Weighted Average Non-vested stock at January 1, 2020 9,859 $ 119.12 Granted 1,560 158.72 Vested (11,419) 124.53 Canceled, forfeited or expired — — Non-vested stock at December 31, 2020 — $ — |
Schedule of Non-Vested Stock Unit Activity | The following table presents our service-based non-vested stock units activity for 2020: Number of Weighted Average Non-vested stock units at January 1, 2020 231,418 $ 91.87 Granted 34,429 206.10 Vested (89,074) 78.15 Canceled, forfeited or expired (19,227) 97.36 Non-vested stock units at December 31, 2020 157,546 $ 123.92 |
Schedule of Non-Vested Performance-based Units Activity | The following table presents our performance-based non-vested stock units activity for 2020: Number of Weighted Average Non-vested stock units at January 1, 2020 207,424 $ 97.55 Granted 85,727 201.90 Vested (78,856) 83.12 Canceled, forfeited or expired (18,008) 101.40 Non-vested stock units at December 31, 2020 196,287 $ 148.16 |
COMMITMENTS AND CONTINGENCIES (
COMMITMENTS AND CONTINGENCIES (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Commitments and Contingencies Disclosure [Abstract] | |
Schedule of Insurance Programs | The following table presents details of our insurance programs, including amounts accrued for the periods indicated (amounts in millions) in accrued expenses in our consolidated balance sheets. The amounts accrued below represent our total estimated liability for individual claims that are less than our noted insurance coverage amounts, which can include outstanding claims and claims incurred but not reported. As of December 31, Type of Insurance 2020 2019 Health insurance $ 15.1 $ 15.8 Workers’ compensation 35.8 33.4 Professional liability 4.9 5.1 55.8 54.3 Less: long-term portion (1.2) (1.3) $ 54.6 $ 53.0 |
SEGMENT INFORMATION (Tables)
SEGMENT INFORMATION (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Segment Reporting [Abstract] | |
Schedule of Operating Income of Reportable Segments | Management evaluates performance and allocates resources based on the operating income of the reportable segments, which includes an allocation of corporate expenses attributable to the specific segment and includes revenues and all other costs directly attributable to the specific segment. Segment assets are not reviewed by the company’s chief operating decision maker and therefore are not disclosed below (amounts in millions). For the Year Ended December 31, 2020 Home Health Hospice Personal Care Other Total Net service revenue $ 1,249.2 $ 750.1 $ 72.2 $ — $ 2,071.5 Other operating income 20.2 13.1 1.1 — 34.4 Cost of service, excluding depreciation and amortization 729.9 400.6 54.9 — 1,185.4 General and administrative expenses 307.2 175.4 12.4 173.2 668.2 Depreciation and amortization 3.9 2.2 0.2 22.5 28.8 Asset impairment charge 3.4 0.8 — — 4.2 Operating expenses 1,044.4 579.0 67.5 195.7 1,886.6 Operating income (loss) $ 225.0 $ 184.2 $ 5.8 $ (195.7) $ 219.3 For the Year Ended December 31, 2019 Home Health Hospice Personal Care Other Total Net service revenue $ 1,256.4 $ 617.2 $ 82.0 $ — $ 1,955.6 Cost of service, excluding depreciation and amortization 754.1 335.1 61.1 — 1,150.3 General and administrative expenses 297.2 137.5 12.3 160.9 607.9 Depreciation and amortization 4.2 1.6 0.2 12.4 18.4 Asset impairment charge 1.5 — — — 1.5 Operating expenses 1,057.0 474.2 73.6 173.3 1,778.1 Operating income (loss) $ 199.4 $ 143.0 $ 8.4 $ (173.3) $ 177.5 For the Year Ended December 31, 2018 Home Health Hospice Personal Care Other Total Net service revenue $ 1,174.5 $ 410.9 $ 77.2 $ — $ 1,662.6 Cost of service, excluding depreciation and amortization 722.1 212.0 58.8 — 992.9 General and administrative expenses 276.3 84.6 12.8 127.6 501.3 Depreciation and amortization 3.5 1.1 0.3 8.4 13.3 Operating expenses 1,001.9 297.7 71.9 136.0 1,507.5 Operating income (loss) $ 172.6 $ 113.2 $ 5.3 $ (136.0) $ 155.1 |
UNAUDITED SUMMARIZED QUARTERL_2
UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Quarterly Financial Information Disclosure [Abstract] | |
Schedule of Unaudited Summarized Quarterly Financial Information | Net Income Net Service Revenue Net Income Basic Diluted 2020 1st Quarter $ 491.7 $ 31.8 $ 0.98 $ 0.96 2nd Quarter 485.0 34.7 1.07 1.04 3rd Quarter 544.1 72.0 2.20 2.16 4th Quarter 550.7 45.1 1.38 1.36 $ 2,071.5 $ 183.6 $ 5.64 $ 5.52 2019 1st Quarter $ 467.3 $ 31.3 $ 0.98 $ 0.95 2nd Quarter 493.0 33.7 1.05 1.02 3rd Quarter 494.6 34.1 1.06 1.03 4th Quarter 500.7 27.7 0.86 0.83 $ 1,955.6 $ 126.8 $ 3.95 $ 3.84 (1) Because of the method used in calculating per share data, the quarterly per share data may not necessarily total to the per share data as computed for the entire year. |
NATURE OF OPERATIONS, CONSOLI_2
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS - Narrative (Details) $ in Thousands | 12 Months Ended | |||
Dec. 31, 2020USD ($)care_centerstate | Dec. 31, 2019USD ($) | Dec. 31, 2018USD ($) | Dec. 31, 2016 | |
Organization And Nature Of Operations [Line Items] | ||||
Number of states with facilities | state | 39 | |||
Minimum percent ownership for controlling interest (percent) | 50.00% | |||
Noncontrolling Interest Repurchased | 30.00% | |||
Maximum ownership percentage for equity method investment (percent) | 50.00% | |||
Payments to Acquire Equity Investments | $ 875 | $ 210 | $ 7,144 | |
Equity method investment, aggregate cost | 14,200 | 35,700 | ||
Proceeds from sale of equity method investment | 17,876 | 0 | 0 | |
Loss on sale of equity method investment | $ (2,980) | $ 0 | $ 0 | |
Noncontrolling interest sold [Member] | ||||
Organization And Nature Of Operations [Line Items] | ||||
Noncontrolling interest, ownership percentage by noncontrolling owners (percent) | 30.00% | |||
Revenue from Contract with Customer Benchmark [Member] | Medicare Revenue [Member] | ||||
Organization And Nature Of Operations [Line Items] | ||||
Percent of net services revenue provided by Medicare | 75.00% | 74.00% | 73.00% | |
Home Health [Member] | ||||
Organization And Nature Of Operations [Line Items] | ||||
Number of owned and operated care centers | care_center | 320 | |||
Hospice [Member] | ||||
Organization And Nature Of Operations [Line Items] | ||||
Number of owned and operated care centers | care_center | 180 | |||
Personal Care [Member] | ||||
Organization And Nature Of Operations [Line Items] | ||||
Number of owned and operated care centers | care_center | 14 | |||
Healthcare analytics company [Member] | ||||
Organization And Nature Of Operations [Line Items] | ||||
Payments to Acquire Equity Investments | $ 7,000 | |||
Heritage Healthcare Innovation Fund LP [Member] | ||||
Organization And Nature Of Operations [Line Items] | ||||
Proceeds from sale of equity method investment | $ 17,900 | |||
Loss on sale of equity method investment | $ (3,000) |
NATURE OF OPERATIONS, CONSOLI_3
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS - Recently Issued Accounting Pronouncements (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 | Jan. 01, 2019 |
New Accounting Pronouncements or Change in Accounting Principle [Line Items] | |||
Operating lease liabilities | $ 92,000 | $ 83,900 | |
Operating lease right of use assets | $ 93,440 | $ 84,791 | |
ASU 2016-02 [Member] | |||
New Accounting Pronouncements or Change in Accounting Principle [Line Items] | |||
Operating lease liabilities | $ 80,000 | ||
Operating lease right of use assets | $ 80,000 |
SUMMARY OF SIGNIFICANT ACCOUN_4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Revenue Recognition Narrative (Details) $ in Millions | 12 Months Ended | ||
Dec. 31, 2020USD ($)Number_of_Visits | Dec. 31, 2019USD ($) | Dec. 31, 2018 | |
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Net service revenue episode payment rate | 60 days | ||
Percentage of total reimbursement of outlier payment | 10.00% | ||
Historical collection rate from Medicare | 99.00% | ||
Hospice Medicare revenue rate accounted for routine care | 97.00% | 97.00% | 97.00% |
Rate of request for anticipated payment submitted for the initial period of care | 20.00% | ||
Net Service Revenue Period Of Care Payment Rate Duration | 30 days | ||
Revenue from Contract with Customer Benchmark [Member] | Medicare Revenue [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Percent of net services revenue provided by Medicare | 75.00% | 74.00% | 73.00% |
Home Health [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Historical collection rate from Medicare | 99.00% | ||
Hospice [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Historical collection rate from Medicare | 99.00% | ||
Minimum [Member] | Home Health [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Low utilization payment adjustment, maximum number of visits | Number_of_Visits | 2 | ||
Non-medicare revenue term rates | 90.00% | ||
Maximum [Member] | Home Health [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Low utilization payment adjustment, maximum number of visits | Number_of_Visits | 6 | ||
Non-medicare revenue term rates | 100.00% | ||
Cap Year 2014 Through 2021 [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Estimated amounts due back to Medicare | $ 9.3 | ||
Cap Year 2014 Through 2021 [Member] | AseraCare Hospice [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Estimated amounts due back to Medicare | $ 2 | ||
Cap Year 2013 Through 2020 [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Estimated amounts due back to Medicare | $ 5.7 |
SUMMARY OF SIGNIFICANT ACCOUN_5
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Revenue Recognition by Payor Class (Details) | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Revenue by payor class as a percentage of total net service revenue | 100.00% | 100.00% | 100.00% |
Home Health Medicare [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Revenue by payor class as a percentage of total net service revenue | 41.00% | 44.00% | 50.00% |
Home Health Non-Medicare - Episodic Based [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Revenue by payor class as a percentage of total net service revenue | 7.00% | 9.00% | 9.00% |
Home Health Non-Medicare - Non-Episodic Based [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Revenue by payor class as a percentage of total net service revenue | 13.00% | 12.00% | 12.00% |
Hospice Medicare [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Revenue by payor class as a percentage of total net service revenue | 34.00% | 30.00% | 23.00% |
Hospice Non-Medicare [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Revenue by payor class as a percentage of total net service revenue | 2.00% | 1.00% | 1.00% |
Personal Care [Member] | |||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||
Revenue by payor class as a percentage of total net service revenue | 3.00% | 4.00% | 5.00% |
SUMMARY OF SIGNIFICANT ACCOUN_6
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017 |
Cash and Cash Equivalents [Line Items] | ||||
Cash and cash equivalents | $ 81,808 | $ 30,294 | ||
Restricted cash | 1,549 | 66,196 | ||
Cash, Cash Equivalents and Restricted Cash | 83,357 | 96,490 | $ 20,229 | $ 86,363 |
Cash Balance Associated With Provider Relief Fund | 77,000 | |||
Asana Hospice Acquisition [Member] | ||||
Cash and Cash Equivalents [Line Items] | ||||
Restricted cash | $ 1,500 | $ 66,200 |
SUMMARY OF SIGNIFICANT ACCOUN_7
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Patient Accounts Receivable Narrative (Details) - day | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Accounting Policies [Abstract] | ||
Percentage of patient receivables outstanding | 10.00% | |
Historical collection rate from Medicare | 99.00% | |
Portion of accounts receivable derived from Medicare | 64.00% | 58.00% |
Rate of request for anticipated payment submitted for the initial period of care | 20.00% | |
Maximum days to submit final bill from the start of period of care | 90 | |
Maximum days to submit final bill from the date the request for anticipated payment was paid | 60 |
SUMMARY OF SIGNIFICANT ACCOUN_8
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Additional Information Narrative (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Accounting Policies [Abstract] | |||
Payments of Financing Costs | $ 0 | $ 847 | $ 2,433 |
Asset impairment charge | 4,152 | 1,470 | 0 |
Depreciation | 12,100 | 11,600 | 10,800 |
Unamortized debt issuance costs | $ 2,700 | 3,500 | |
Unamortized debt issuance costs, weighted average amortization period, years | 3 years 1 month 6 days | ||
Deferred tax assets | $ 47,987 | 21,427 | |
Non-cash compensation | 26,730 | 25,040 | 17,887 |
Share-based compensation, tax benefit recognized | 4,700 | 4,600 | 4,300 |
Advertising expense | 8,000 | 8,500 | $ 7,000 |
Finite-Lived Intangible Assets [Line Items] | |||
Non-cash impairment charge for write-off of intangible assets | 4,200 | 1,500 | |
Acquired Names [Member] | |||
Finite-Lived Intangible Assets [Line Items] | |||
Non-cash impairment charge for write-off of intangible assets | 4,200 | 1,500 | |
Noncompete Agreements [Member] | |||
Finite-Lived Intangible Assets [Line Items] | |||
Non-cash impairment charge for write-off of intangible assets | $ 0 | $ 0 | |
Noncompete Agreements [Member] | Minimum [Member] | |||
Finite-Lived Intangible Assets [Line Items] | |||
Estimated useful life of intangible assets | 2 years | ||
Noncompete Agreements [Member] | Maximum [Member] | |||
Finite-Lived Intangible Assets [Line Items] | |||
Estimated useful life of intangible assets | 3 years | ||
Acquired Names [Member] | |||
Finite-Lived Intangible Assets [Line Items] | |||
Estimated useful life of intangible assets | 3 years |
SUMMARY OF SIGNIFICANT ACCOUN_9
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Estimated Useful Lives of Property and Equipment (Details) | 12 Months Ended |
Dec. 31, 2020 | |
Building [Member] | |
Property, Plant and Equipment [Line Items] | |
Useful Life | 39 years |
Leasehold Improvements [Member] | |
Property, Plant and Equipment [Line Items] | |
Estimated Useful Life | Lesser of lease term or expected useful life |
Equipment and Furniture [Member] | Minimum [Member] | |
Property, Plant and Equipment [Line Items] | |
Useful Life | 3 years |
Equipment and Furniture [Member] | Maximum [Member] | |
Property, Plant and Equipment [Line Items] | |
Useful Life | 7 years |
Vehicles [Member] | |
Property, Plant and Equipment [Line Items] | |
Useful Life | 5 years |
Computer Software [Member] | Minimum [Member] | |
Property, Plant and Equipment [Line Items] | |
Useful Life | 2 years |
Computer Software [Member] | Maximum [Member] | |
Property, Plant and Equipment [Line Items] | |
Useful Life | 7 years |
Finance Leases [Member] | |
Property, Plant and Equipment [Line Items] | |
Useful Life | 3 years |
SUMMARY OF SIGNIFICANT ACCOU_10
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Balances Related to Property and Equipment (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | $ 118,700 | $ 124,200 |
Less accumulated depreciation | (95,024) | (96,137) |
Property and equipment, net | 23,719 | 28,113 |
Building and Leasehold Improvements [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | 9,000 | 8,700 |
Equipment and Furniture [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | 53,100 | 55,600 |
Finance Leases [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | 5,900 | 5,200 |
Computer Software [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | $ 50,700 | $ 54,700 |
SUMMARY OF SIGNIFICANT ACCOU_11
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Financial Instruments Where Carrying Value and Fair Value Differ (Details) $ in Millions | Dec. 31, 2020USD ($) |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
Debt Instrument Carrying Amount Excluding Finance Leases | $ 215.1 |
Fair Value, Inputs, Level 1 [Member] | |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
Long-term obligations, fair value | 0 |
Fair Value, Inputs, Level 2 [Member] | |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
Long-term obligations, fair value | 217.7 |
Fair Value, Inputs, Level 3 [Member] | |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |
Long-term obligations, fair value | $ 0 |
SUMMARY OF SIGNIFICANT ACCOU_12
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Weighted Average Shares Outstanding (Details) - shares shares in Thousands | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Accounting Policies [Abstract] | |||
Weighted average number of shares outstanding – basic | 32,559 | 32,142 | 32,791 |
Effect of dilutive securities: | |||
Stock options | 420 | 545 | 502 |
Non-vested stock and stock units | 289 | 303 | 316 |
Weighted average number of shares outstanding – diluted | 33,268 | 32,990 | 33,609 |
Anti-dilutive securities | 25 | 117 | 50 |
NOVEL CORONAVIRUS PANDEMIC ("_3
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") (Details) - USD ($) $ in Thousands | 1 Months Ended | 12 Months Ended | |||||
Apr. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | Oct. 01, 2020 | Apr. 24, 2020 | Mar. 27, 2020 | |
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items] | |||||||
Funding For Healthcare Providers Including Hospitals | $ 175,000,000 | ||||||
Funding Immediately Distributed To Healthcare Providers Based On Their 2019 Medicare Fee For Service Reimbursements | $ 30,000,000 | ||||||
Funding Received From CARES Act | $ 100,000 | ||||||
CARES Act Deferral Of Employer Share Social Security Tax | $ 55,400 | ||||||
Payroll and employee benefits | 146,929 | $ 120,877 | |||||
Other long-term obligations | 33,622 | 5,905 | |||||
Additional Funding Distributed To Healthcare Providers | $ 20,000,000 | $ 18,000,000 | |||||
CARES Act Provider Relief Funds Utilized | 33,300 | ||||||
Estimated CARES Act Provider Relief Funds Expected To Be Utilized | 11,600 | ||||||
Estimated CARES Act Provider Relief Fund Amounts to be Repaid | 60,000 | ||||||
CARES Act Provider Relief Funds Received by Unconsolidated Joint Ventures | 1,900 | ||||||
Total CARES Act Provider Relief Funds Received | 106,800 | ||||||
Provider relief fund advance | 60,000 | 0 | |||||
Estimated Future COVID19 Related Expenses | 12,000 | ||||||
Other operating income | 34,372 | $ 0 | $ 0 | ||||
COVID-19 Deferral of Social Security Taxes [Member] | |||||||
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items] | |||||||
CARES Act Deferral Of Employer Share Social Security Tax | 55,000 | ||||||
Payroll and employee benefits | 28,000 | ||||||
Other long-term obligations | 28,000 | ||||||
Home Health And Hospice [Member] | |||||||
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items] | |||||||
COVID19 Expenses Incurred | 33,000 | ||||||
Personal Care [Member] | |||||||
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items] | |||||||
Funding Received From Mass HomeCare ASAP COVID19 Provider Sustainability Program | 1,000 | ||||||
Other operating income | $ 1,000 | ||||||
AseraCare Hospice [Member] | |||||||
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items] | |||||||
Funding Received From CARES Act | 6,000 | ||||||
Equity Method Investments [Member] | |||||||
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items] | |||||||
Funding Received From CARES Act | $ 2,000 |
ACQUISITIONS - Narrative (Detai
ACQUISITIONS - Narrative (Details) $ in Thousands | Oct. 01, 2020USD ($) | Jun. 01, 2020USD ($)care_center | Apr. 18, 2020USD ($) | Mar. 01, 2020USD ($) | Jan. 01, 2020USD ($)care_center | Apr. 01, 2019USD ($) | Feb. 01, 2019USD ($) | Dec. 31, 2020USD ($) | Sep. 30, 2020USD ($) | Jun. 30, 2020USD ($) | Mar. 31, 2020USD ($) | Dec. 31, 2019USD ($) | Sep. 30, 2019USD ($) | Jun. 30, 2019USD ($) | Mar. 31, 2019USD ($) | Dec. 31, 2020USD ($) | Dec. 31, 2019USD ($) | Dec. 31, 2018USD ($) |
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Goodwill recorded during period | $ 274,200 | $ 329,000 | ||||||||||||||||
Net service revenue | $ 550,700 | $ 544,100 | $ 485,000 | $ 491,700 | $ 500,700 | $ 494,600 | $ 493,000 | $ 467,300 | 2,071,519 | 1,955,633 | $ 1,662,578 | |||||||
Operating income (loss) | 219,268 | 177,472 | 155,148 | |||||||||||||||
Depreciation and amortization | $ 28,802 | 18,428 | $ 13,261 | |||||||||||||||
Noncompete Agreements [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Weighted-average amortization period | 1 year 2 months 12 days | |||||||||||||||||
Home Health [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Goodwill recorded during period | $ 3,300 | 0 | ||||||||||||||||
Home Health [Member] | WASHINGTON | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Payments to Acquire Businesses, Gross | $ 3,000 | |||||||||||||||||
Goodwill recorded during period | 2,800 | |||||||||||||||||
Home Health [Member] | WASHINGTON | Certificate of Need [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 200 | 200 | ||||||||||||||||
Home Health [Member] | KENTUCKY | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Payments to Acquire Businesses, Gross | $ 700 | |||||||||||||||||
Goodwill recorded during period | 500 | |||||||||||||||||
Home Health [Member] | KENTUCKY | Certificate of Need [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 200 | 200 | ||||||||||||||||
Hospice [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Goodwill recorded during period | 270,900 | 329,000 | ||||||||||||||||
Personal Care [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Goodwill recorded during period | 0 | 0 | ||||||||||||||||
Asana Hospice [Member] | Hospice [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, number of care centers acquired | care_center | 8 | |||||||||||||||||
Payments to Acquire Businesses, Gross | $ 66,300 | |||||||||||||||||
Cash Acquired from Acquisition | $ 700 | |||||||||||||||||
Business Acquisition Working Capital Adjustment | $ 700 | |||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Receivables | 4,600 | 4,600 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment | 200 | 200 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Right of Use Assets | 900 | 900 | ||||||||||||||||
Acquisition, other intangibles recorded | 5,600 | 5,600 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Assets | 11,300 | 11,300 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accounts Payable | (3,200) | (3,200) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Payroll and Employee Benefits | (1,500) | (1,500) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accrued Expenses | (500) | (500) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Liabilities | (900) | (900) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities | (6,100) | (6,100) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net | 5,200 | 5,200 | ||||||||||||||||
Goodwill recorded during period | 60,400 | |||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net | 65,600 | 65,600 | ||||||||||||||||
Period of time goodwill is expected to be deductible for income tax purposes | 15 years | |||||||||||||||||
Net service revenue | 23,400 | |||||||||||||||||
Operating income (loss) | (3,300) | |||||||||||||||||
Business Combination, Integration Related Costs | 2,000 | |||||||||||||||||
Depreciation and amortization | 2,600 | |||||||||||||||||
Asana Hospice [Member] | Hospice [Member] | Noncompete Agreements [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 2,300 | 2,300 | ||||||||||||||||
Weighted-average amortization period | 2 years | |||||||||||||||||
Asana Hospice [Member] | Hospice [Member] | Medicare Licenses [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 2,000 | 2,000 | ||||||||||||||||
Asana Hospice [Member] | Hospice [Member] | Acquired Names [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 1,300 | 1,300 | ||||||||||||||||
Weighted-average amortization period | 2 years | |||||||||||||||||
AseraCare Hospice [Member] | Hospice [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, number of care centers acquired | care_center | 44 | |||||||||||||||||
Payments to Acquire Businesses, Gross | $ 230,400 | |||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Receivables | 15,000 | 15,000 | ||||||||||||||||
Business Combination Recognized Identifiable Assets Acquired and Liabilities Assumed Current Assets Prepaid Expense | 700 | 700 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment | 600 | 600 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Right of Use Assets | 5,900 | 5,900 | ||||||||||||||||
Acquisition, other intangibles recorded | 24,300 | 24,300 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets | 100 | 100 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Assets | 46,600 | 46,600 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accounts Payable | (5,800) | (5,800) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Payroll and Employee Benefits | (5,900) | (5,900) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accrued Expenses | (10,400) | (10,400) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Liabilities | (5,400) | (5,400) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities | (27,500) | (27,500) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net | 19,100 | 19,100 | ||||||||||||||||
Goodwill recorded during period | 210,500 | |||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net | 229,600 | 229,600 | ||||||||||||||||
Period of time goodwill is expected to be deductible for income tax purposes | 15 years | |||||||||||||||||
Payments related to tax asset | $ 32,000 | |||||||||||||||||
Business Acquisition Closing Payment Adjustment | $ 800 | |||||||||||||||||
Net service revenue | 64,500 | |||||||||||||||||
Operating income (loss) | (8,200) | |||||||||||||||||
Business Combination, Integration Related Costs | 7,600 | |||||||||||||||||
Depreciation and amortization | 6,000 | |||||||||||||||||
AseraCare Hospice [Member] | Hospice [Member] | Maximum [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Business Acquisition Closing Payment Adjustment | $ 1,000 | |||||||||||||||||
AseraCare Hospice [Member] | Hospice [Member] | Certificates Of Need [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 700 | 700 | ||||||||||||||||
AseraCare Hospice [Member] | Hospice [Member] | Noncompete Agreements [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 9,200 | 9,200 | ||||||||||||||||
Weighted-average amortization period | 1 year 8 months 12 days | |||||||||||||||||
AseraCare Hospice [Member] | Hospice [Member] | Medicare Licenses [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 8,700 | 8,700 | ||||||||||||||||
AseraCare Hospice [Member] | Hospice [Member] | Acquired Names [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | $ 5,700 | $ 5,700 | ||||||||||||||||
Weighted-average amortization period | 2 years | |||||||||||||||||
RoseRock Healthcare [Member] | Hospice [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Payments to Acquire Businesses, Gross | $ 17,500 | |||||||||||||||||
Goodwill recorded during period | 15,800 | |||||||||||||||||
Period of time goodwill is expected to be deductible for income tax purposes | 15 years | |||||||||||||||||
Net service revenue | 6,800 | |||||||||||||||||
Operating income (loss) | 800 | |||||||||||||||||
RoseRock Healthcare [Member] | Hospice [Member] | Noncompete Agreements [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 700 | 700 | ||||||||||||||||
Weighted-average amortization period | 3 years | |||||||||||||||||
RoseRock Healthcare [Member] | Hospice [Member] | Acquired Names [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Acquisition, other intangibles recorded | 1,000 | 1,000 | ||||||||||||||||
Weighted-average amortization period | 3 years | |||||||||||||||||
Compassionate Care Hospice [Member] | Hospice [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Payments to Acquire Businesses, Gross | $ 327,900 | |||||||||||||||||
Cash Acquired from Acquisition | $ 6,700 | |||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Receivables | 24,500 | 24,500 | ||||||||||||||||
Business Combination Recognized Identifiable Assets Acquired and Liabilities Assumed Current Assets Prepaid Expense | 800 | 800 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired And Liabilities Assumed, Other Current Asset | 100 | 100 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment | 200 | 200 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Right of Use Assets | 3,400 | 3,400 | ||||||||||||||||
Acquisition, other intangibles recorded | 27,200 | 27,200 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets | 1,100 | 1,100 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Assets | 57,300 | 57,300 | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accounts Payable | (14,900) | (14,900) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Payroll and Employee Benefits | (11,700) | (11,700) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accrued Expenses | (11,700) | (11,700) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Deferred Tax Liabilities | (900) | (900) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Liabilities | (3,400) | (3,400) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities | (42,600) | (42,600) | ||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net | 14,700 | 14,700 | ||||||||||||||||
Goodwill recorded during period | 313,200 | |||||||||||||||||
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net | 327,900 | 327,900 | ||||||||||||||||
Goodwill deductible for income tax purposes | $ 278,800 | 278,800 | ||||||||||||||||
Period of time goodwill is expected to be deductible for income tax purposes | 15 years | |||||||||||||||||
Net service revenue | 167,400 | |||||||||||||||||
Operating income (loss) | (5,600) | |||||||||||||||||
Business Combination, Integration Related Costs | $ 14,500 | |||||||||||||||||
Compassionate Care Hospice [Member] | Hospice [Member] | Noncompete Agreements [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Weighted-average amortization period | 2 years 3 months 18 days | |||||||||||||||||
Compassionate Care Hospice [Member] | Hospice [Member] | Acquired Names [Member] | ||||||||||||||||||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | ||||||||||||||||||
Weighted-average amortization period | 2 years |
ACQUISITIONS - Pro Forma Conden
ACQUISITIONS - Pro Forma Condensed Consolidated Statement of Income (Details) - Hospice [Member] - USD ($) $ / shares in Units, $ in Millions | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
AseraCare Hospice [Member] | |||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | |||
Net service revenue | $ 2,120.1 | $ 2,077 | |
Operating income | 218 | 167.5 | |
Net income attributable to Amedisys Inc. | $ 180.6 | $ 112.3 | |
Basic earnings per share | $ 5.55 | $ 3.49 | |
Diluted earnings per share | $ 5.43 | $ 3.40 | |
Compassionate Care Hospice [Member] | |||
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items] | |||
Net service revenue | $ 1,971.7 | $ 1,852.8 | |
Operating income | 183.8 | 175.7 | |
Net income attributable to Amedisys Inc. | $ 130.5 | $ 124.6 | |
Basic earnings per share | $ 4.06 | $ 3.80 | |
Diluted earnings per share | $ 3.96 | $ 3.71 |
GOODWILL AND OTHER INTANGIBLE_3
GOODWILL AND OTHER INTANGIBLE ASSETS, NET - Activity Related to Goodwill (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Goodwill [Line Items] | ||
Goodwill, Impaired, Accumulated Impairment Loss | $ 733,700 | |
Goodwill [Roll Forward] | ||
Beginning balance | 658,500 | $ 329,500 |
Additions | 274,200 | 329,000 |
Ending balance | 932,685 | 658,500 |
Home Health [Member] | ||
Goodwill [Roll Forward] | ||
Beginning balance | 87,100 | 87,100 |
Additions | 3,300 | 0 |
Ending balance | 90,400 | 87,100 |
Hospice [Member] | ||
Goodwill [Roll Forward] | ||
Beginning balance | 528,300 | 199,300 |
Additions | 270,900 | 329,000 |
Ending balance | 799,200 | 528,300 |
Personal Care [Member] | ||
Goodwill [Roll Forward] | ||
Beginning balance | 43,100 | 43,100 |
Additions | 0 | 0 |
Ending balance | $ 43,100 | $ 43,100 |
GOODWILL AND OTHER INTANGIBLE_4
GOODWILL AND OTHER INTANGIBLE ASSETS, NET - Goodwill and Intangibles (Details) - USD ($) $ in Millions | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Intangible Assets [Line Items] | ||
Non-cash impairment charge for write-off of intangible assets | $ 4.2 | $ 1.5 |
Amortization of Intangible Assets | 16.6 | 6.8 |
Acquired Names [Member] | ||
Intangible Assets [Line Items] | ||
Non-cash impairment charge for write-off of intangible assets | 4.2 | 1.5 |
Certificates of Need and Licenses [Member] | ||
Intangible Assets [Line Items] | ||
Non-cash impairment charge for write-off of intangible assets | 0 | 0 |
Amortization of Intangible Assets | $ 2.4 | $ 0 |
GOODWILL AND OTHER INTANGIBLE_5
GOODWILL AND OTHER INTANGIBLE ASSETS, NET - Activity Related to Other Intangible Assets, Net (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Intangible Assets [Line Items] | ||
Non-cash impairment charge for write-off of intangible assets | $ 4,200 | $ 1,500 |
Intangible assets, accumulated amortization | 22,973 | 7,044 |
Intangible Assets [Roll Forward] | ||
Beginning balance | 64,748 | 44,100 |
Additions | 30,300 | 28,900 |
Write-off | (4,200) | (1,500) |
Amortization | (16,600) | (6,800) |
Ending balance | 74,183 | 64,748 |
Amortizable acquired names [Member] | ||
Intangible Assets [Line Items] | ||
Non-cash impairment charge for write-off of intangible assets | $ 0 | 0 |
Weighted-average amortization period | 1 year 3 months 18 days | |
Intangible Assets [Roll Forward] | ||
Beginning balance | $ 5,600 | 0 |
Additions | 7,000 | 10,000 |
Write-off | 0 | 0 |
Amortization | (7,100) | (4,400) |
Ending balance | 5,500 | 5,600 |
Noncompete Agreements [Member] | ||
Intangible Assets [Line Items] | ||
Non-cash impairment charge for write-off of intangible assets | 0 | 0 |
Intangible assets, accumulated amortization | $ 700 | |
Weighted-average amortization period | 1 year 2 months 12 days | |
Intangible Assets [Roll Forward] | ||
Beginning balance | $ 3,400 | 600 |
Additions | 11,500 | 5,200 |
Write-off | 0 | 0 |
Amortization | (7,100) | (2,400) |
Ending balance | 7,800 | 3,400 |
Certificates of Need and Licenses [Member] | ||
Intangible Assets [Line Items] | ||
Non-cash impairment charge for write-off of intangible assets | 0 | 0 |
Intangible Assets [Roll Forward] | ||
Beginning balance | 37,600 | 23,900 |
Additions | 11,800 | 13,700 |
Write-off | 0 | 0 |
Amortization | (2,400) | 0 |
Ending balance | 47,000 | 37,600 |
Unamortizable acquired names [Member] | ||
Intangible Assets [Line Items] | ||
Non-cash impairment charge for write-off of intangible assets | 4,200 | 1,500 |
Intangible Assets [Roll Forward] | ||
Beginning balance | 18,100 | 19,600 |
Additions | 0 | 0 |
Write-off | (4,200) | (1,500) |
Amortization | 0 | 0 |
Ending balance | $ 13,900 | $ 18,100 |
GOODWILL AND OTHER INTANGIBLE_6
GOODWILL AND OTHER INTANGIBLE ASSETS, NET - Estimated Future Amortization Expense (Details) $ in Millions | Dec. 31, 2020USD ($) |
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract] | |
2021 | $ 10.6 |
2022 | 2.7 |
2023 | 0 |
2024 | 0 |
2025 | 0 |
Total | $ 13.3 |
DETAILS OF CERTAIN BALANCE SH_3
DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS - Balances (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Other current assets: | ||
Payroll tax escrow | $ 6,300 | $ 1,500 |
Income tax receivable | 200 | 2,000 |
Due from joint ventures | 2,300 | 2,000 |
Other | 4,500 | 2,700 |
Other current assets | 13,265 | 8,225 |
Other assets: | ||
Workers’ compensation deposits | 300 | 200 |
Health insurance deposits | 500 | 500 |
Other miscellaneous deposits | 1,200 | 1,000 |
Indemnity receivable | 13,600 | 13,600 |
Equity method investments | 14,200 | 35,700 |
Other | 3,400 | 3,600 |
Other assets | 33,200 | 54,612 |
Accrued expenses: | ||
Health insurance | 15,100 | 15,800 |
Workers’ compensation | 35,800 | 33,400 |
Florida ZPIC audit, gross liability | 17,400 | 17,400 |
Legal settlements and other audits | 24,400 | 19,000 |
Income tax payable | 0 | 500 |
Charity care | 3,600 | 2,700 |
Estimated Medicare cap liability | 9,300 | 5,700 |
Hospice accruals (room and board, general in-patient and other) | 29,200 | 24,400 |
Patient liability | 8,400 | 9,400 |
Deferred operating income (CARES Act) | 11,600 | 0 |
Other | 11,400 | 8,800 |
Accrued expenses | 166,192 | 137,111 |
Other long-term obligations: | ||
Reserve for uncertain tax positions | 3,300 | 3,100 |
Deferred compensation plan liability | 1,000 | 1,000 |
Non-current social security taxes (deferred under CARES Act) | 27,700 | 0 |
Other | 1,600 | 1,800 |
Other long-term obligations | $ 33,622 | $ 5,905 |
LEASES (Details)
LEASES (Details) | 12 Months Ended |
Dec. 31, 2020 | |
Lessee, Lease, Description [Line Items] | |
Lessee, Operating Lease, Term of Contract | 8 years |
Lessee, Finance Lease, Term of Contract | 3 years |
Fleet Lease [Member] | |
Lessee, Lease, Description [Line Items] | |
Lessee, Operating Lease, Term of Contract | 367 days |
Minimum [Member] | |
Lessee, Lease, Description [Line Items] | |
Lessee, Operating Lease, Option to Terminate | Option for early termination of lease after one year |
Lessee, Operating Lease, Renewal Term | 1 year |
Maximum [Member] | |
Lessee, Lease, Description [Line Items] | |
Lessee, Operating Lease, Option to Terminate | Option for early termination of lease after three years |
Lessee, Operating Lease, Renewal Term | 5 years |
LEASES - Lease Cost (Details)
LEASES - Lease Cost (Details) - USD ($) $ in Millions | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Leases [Abstract] | ||
Operating lease cost | $ 38.6 | $ 35 |
Impairment of operating lease ROU assets | 0.5 | 0.9 |
Total operating lease cost | 39.1 | 35.9 |
Amortization of ROU assets | 2 | 1.7 |
Finance Lease, Interest Expense | 0.2 | 0.2 |
Finance Lease Cost | 2.2 | 1.9 |
Variable lease cost | 3 | 2.6 |
Short-term lease cost | 0 | 0.2 |
Total lease cost | $ 44.3 | $ 40.6 |
LEASES - Operating Lease (Detai
LEASES - Operating Lease (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Leases [Abstract] | ||
Operating lease ROU assets | $ 93,440 | $ 84,791 |
Current portion of operating lease liabilities | 30,046 | 27,769 |
Operating lease liabilities, less current portion | 61,987 | 56,128 |
Operating lease liabilities | $ 92,000 | $ 83,900 |
LEASES - Finance Leases (Detail
LEASES - Finance Leases (Details) - USD ($) $ in Millions | Dec. 31, 2020 | Dec. 31, 2019 |
Leases [Abstract] | ||
Finance lease ROU assets | $ 5.9 | $ 5.2 |
Finance Lease, ROU Asset, Accumulated Amortization | (3.3) | (1.8) |
Finance lease ROU assets, net | 2.6 | 3.4 |
Current installments of obligations under finance leases | 1.7 | 1.7 |
Long-term portion of obligations under finance leases | 0.9 | 1.7 |
Total finance lease liabilities | $ 2.6 | $ 3.4 |
LEASES - Supplemental Cashflow
LEASES - Supplemental Cashflow Information (Details) - USD ($) $ in Millions | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Leases [Abstract] | ||
Operating cash flow from operating leases | $ (38.2) | $ (35.8) |
Financing cash flow from finance leases | (2) | (1.7) |
Right-of-Use Asset Obtained in Exchange for Operating Lease Liability | 38.5 | 116 |
Right-of-Use Asset Obtained in Exchange for Finance Lease Liability | 1.2 | 2.9 |
Lessee Operating lease Reductions to ROU assets resulting from reductions to lease obligations | (1.1) | (1.7) |
Lessee Finance lease Reduction to ROU assets resulting from reductions to lease obligations | $ 0 | $ 0 |
LEASES- Weighted Average Remain
LEASES- Weighted Average Remaining Term and Discount Rate (Details) | Dec. 31, 2020 | Dec. 31, 2019 |
Leases [Abstract] | ||
Operating Lease, Weighted Average Remaining Lease Term | 3 years 8 months 12 days | 3 years 10 months 24 days |
Finance Lease, Weighted Average Remaining Lease Term | 1 year 8 months 12 days | 2 years 1 month 6 days |
Operating Lease, Weighted Average Discount Rate, Percent | 3.10% | 3.90% |
Finance Lease, Weighted Average Discount Rate, Percent | 5.30% | 5.30% |
LEASES - Maturities (Details)
LEASES - Maturities (Details) - USD ($) $ in Millions | Dec. 31, 2020 | Dec. 31, 2019 |
Leases [Abstract] | ||
Operating Lease - 2021 | $ 32.2 | |
Operating Lease - 2022 | 25.3 | |
Operating Lease - 2023 | 17.6 | |
Operating Lease - 2024 | 11.7 | |
Operating Lease - 2025 | 6.2 | |
Operating Lease - Thereafter | 4.6 | |
Operating Lease - Total undiscounted lease payments | 97.6 | |
Operating Lease - Less: Imputed Interest | (5.6) | |
Operating lease liabilities | 92 | $ 83.9 |
Finance Lease - 2021 | 1.8 | |
Finance Lease - 2022 | 0.7 | |
Finance Lease - 2023 | 0.2 | |
Finance Lease - 2024 | 0 | |
Finance Lease - 2025 | 0 | |
Finance Lease - Thereafter | 0 | |
Finance Lease - Total undiscounted lease payments | 2.7 | |
Finance Lease - Less: Imputed Interest | (0.1) | |
Total finance lease liabilities | $ 2.6 | $ 3.4 |
LONG-TERM OBLIGATIONS - Summary
LONG-TERM OBLIGATIONS - Summary of Long-Term Debt (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | ||
Principal amount | $ 217,700 | $ 245,700 |
Deferred debt issuance costs | (2,700) | (3,500) |
Long-term obligations, including current portion | 215,000 | 242,200 |
Current portion of long-term obligations | (10,496) | (9,927) |
Long-term obligations, less current portion | 204,511 | 232,256 |
Term Loan [Member] | One Hundred Seventy Five Million Term Loan Facility [Member] | ||
Debt Instrument [Line Items] | ||
Principal amount | 164,100 | 171,700 |
Revolving Credit Facility [Member] | Five Hundred Fifty Million Revolving Credit Facility [Member] | ||
Debt Instrument [Line Items] | ||
Principal amount | 51,000 | 70,000 |
Promissory Notes [Member] | ||
Debt Instrument [Line Items] | ||
Principal amount | 0 | 600 |
Finance Leases [Member] | ||
Debt Instrument [Line Items] | ||
Principal amount | $ 2,600 | $ 3,400 |
LONG-TERM OBLIGATIONS - Summa_2
LONG-TERM OBLIGATIONS - Summary of Long-Term Debt Additional Information (Details) $ in Thousands | 12 Months Ended |
Dec. 31, 2020USD ($) | |
Term Loan [Member] | One Hundred Seventy Five Million Term Loan Facility [Member] | |
Debt Instrument [Line Items] | |
Debt Instrument, face amount | $ 175,000 |
Maturity date | Feb. 4, 2024 |
Term Loan [Member] | One Hundred Seventy Five Million Term Loan Facility [Member] | Eurodollar [Member] | |
Debt Instrument [Line Items] | |
Debt Instrument Interest Rate at Period End | 1.70% |
Revolving Credit Facility [Member] | Five Hundred Fifty Million Revolving Credit Facility [Member] | |
Debt Instrument [Line Items] | |
Debt Instrument, face amount | $ 550,000 |
Maturity date | Feb. 4, 2024 |
Revolving Credit Facility [Member] | Five Hundred Fifty Million Revolving Credit Facility [Member] | Eurodollar [Member] | |
Debt Instrument [Line Items] | |
Debt Instrument Interest Rate at Period End | 3.80% |
LONG-TERM OBLIGATIONS - Maturit
LONG-TERM OBLIGATIONS - Maturities of Debt (Details) - USD ($) $ in Millions | Dec. 31, 2020 | Dec. 31, 2019 |
Long-Term Obligations, Fiscal Year Maturity | ||
2021 | $ 10.5 | |
2022 | 9.4 | |
2023 | 12.3 | |
2024 | 185.5 | |
2025 | 0 | |
Total | $ 217.7 | $ 245.7 |
LONG-TERM OBLIGATIONS - Fees an
LONG-TERM OBLIGATIONS - Fees and Rates Under Credit Facilities (Details) | 12 Months Ended |
Dec. 31, 2020 | |
Consolidated Leverage Ratio: Greater Than Equal to 3.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Commitment Fee | 0.35% |
Letter of Credit Fee | 1.75% |
Consolidated Leverage Ratio: Greater Than Equal to 3.00 to 1.0 | Minimum [Member] | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 3 |
Consolidated Leverage Ratio: Greater Than Equal to 3.00 to 1.0 | Base Rate [Member] | |
Line of Credit Facility [Line Items] | |
Margin on Loans | 1.00% |
Consolidated Leverage Ratio: Greater Than Equal to 3.00 to 1.0 | Eurodollar [Member] | |
Line of Credit Facility [Line Items] | |
Margin on Loans | 2.00% |
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Commitment Fee | 0.30% |
Letter of Credit Fee | 1.50% |
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0 | Maximum [Member] | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 3 |
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0 | Minimum [Member] | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 2 |
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0 | Base Rate [Member] | |
Line of Credit Facility [Line Items] | |
Margin on Loans | 0.75% |
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0 | Eurodollar [Member] | |
Line of Credit Facility [Line Items] | |
Margin on Loans | 1.75% |
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0 | |
Line of Credit Facility [Line Items] | |
Commitment Fee | 0.25% |
Letter of Credit Fee | 1.25% |
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0 | Maximum [Member] | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 2 |
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0 | Minimum [Member] | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 0.75 |
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0 | Base Rate [Member] | |
Line of Credit Facility [Line Items] | |
Margin on Loans | 0.50% |
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0 | Eurodollar [Member] | |
Line of Credit Facility [Line Items] | |
Margin on Loans | 1.50% |
Consolidated Leverage Ratio: Less Than 0.75 to 1.0 | |
Line of Credit Facility [Line Items] | |
Commitment Fee | 0.20% |
Letter of Credit Fee | 1.00% |
Consolidated Leverage Ratio: Less Than 0.75 to 1.0 | Maximum [Member] | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 0.75 |
Consolidated Leverage Ratio: Less Than 0.75 to 1.0 | Base Rate [Member] | |
Line of Credit Facility [Line Items] | |
Margin on Loans | 0.25% |
Consolidated Leverage Ratio: Less Than 0.75 to 1.0 | Eurodollar [Member] | |
Line of Credit Facility [Line Items] | |
Margin on Loans | 1.25% |
LONG-TERM OBLIGATIONS - Narrati
LONG-TERM OBLIGATIONS - Narrative (Details) $ in Thousands | Feb. 04, 2019USD ($) | Jun. 29, 2018USD ($) | Feb. 04, 2024 | Dec. 31, 2019USD ($) | Dec. 31, 2020USD ($) | Dec. 31, 2019USD ($) | Dec. 31, 2018USD ($) | Mar. 31, 2020 | Mar. 31, 2023 |
Debt Instrument [Line Items] | |||||||||
Principal payments of long-term obligations | $ 10,249 | $ 5,624 | $ 91,450 | ||||||
Consolidated leverage ratio | 0.6 | ||||||||
Consolidated interest coverage ratio | 25.6 | ||||||||
Principal amount | $ 245,700 | $ 217,700 | 245,700 | ||||||
Payments of Financing Costs | 0 | 847 | $ 2,433 | ||||||
Credit Agreement [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Swing Line Facility | $ 25,000 | ||||||||
Letters of Credit, maximum commitment | 60,000 | ||||||||
Finance Leases [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Principal amount | 3,400 | $ 2,600 | 3,400 | ||||||
Finance Leases [Member] | Minimum [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Interest rate (percent) | 5.30% | ||||||||
Finance Leases [Member] | Maximum [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Interest rate (percent) | 5.80% | ||||||||
Amended Credit Agreement [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Maturity date | Feb. 4, 2024 | ||||||||
Additional interest rate above Federal Fund rate (percent) | 0.50% | ||||||||
Additional interest rate above Eurodollar Rate (percent) | 1.00% | ||||||||
Percentage of consolidated revenue and adjusted EBITDA that guarantor wholly-owned subsidiaries represent | 95.00% | ||||||||
Percentage of adjusted EBITDA that guarantor subsidiaries represent | 70.00% | ||||||||
Payments of Financing Costs | $ 800 | ||||||||
Amended Credit Agreement [Member] | Minimum [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Proceeds Received From Loan Party Of Subsidiary | $ 5,000 | ||||||||
Amended Credit Agreement [Member] | Base Rate [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Description of variable rate basis | Fluctuating rate per annum equal to the highest of (a) the federal funds rate plus 0.50% per annum, (b) the prime rate of interest established by the Administrative Agent, and (c) the Eurodollar Rate for an interest period of one month plus 1% per annum. | ||||||||
Basis spread on variable rate (percent) | 0.25% | ||||||||
Amended Credit Agreement [Member] | Eurodollar [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Description of variable rate basis | Rate at which Eurodollar deposits in the London interbank market for an interest period of one, two, three or six months | ||||||||
Basis spread on variable rate (percent) | 1.25% | ||||||||
Five Hundred Fifty Million Revolving Credit Facility [Member] | Revolving Credit Facility [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Debt Instrument, face amount | $ 550,000 | ||||||||
Weighted Average Interest Rate | 2.20% | 4.00% | |||||||
Maturity date | Feb. 4, 2024 | ||||||||
Remaining availability under the revolving credit facility | $ 470,200 | ||||||||
Principal amount | $ 70,000 | 51,000 | $ 70,000 | ||||||
Five Hundred Fifty Million Revolving Credit Facility [Member] | Letter of Credit [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Outstanding letters of credit | 28,800 | ||||||||
Five Hundred Fifty Million Revolving Credit Facility [Member] | Credit Agreement [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Debt Instrument, face amount | 550,000 | ||||||||
Credit facility, maximum additional borrowing capacity | $ 125,000 | ||||||||
Credit facility, maximum allowable consolidated leverage ratio multiple | 0.5 | ||||||||
Credit facility maximum allowable consolidated leverage ratio | 3 | ||||||||
Maturity date | Jun. 29, 2023 | ||||||||
Five Hundred Fifty Million Revolving Credit Facility [Member] | Amended Credit Agreement [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Credit facility, maximum borrowing capacity | 725,000 | ||||||||
Debt Instrument, face amount | 550,000 | ||||||||
One Hundred Seventy Five Million Term Loan Facility [Member] | Term Loan [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Debt Instrument, face amount | $ 175,000 | ||||||||
Weighted Average Interest Rate | 3.80% | 2.20% | |||||||
Maturity date | Feb. 4, 2024 | ||||||||
Principal amount | $ 171,700 | $ 164,100 | $ 171,700 | ||||||
One Hundred Seventy Five Million Term Loan Facility [Member] | Amended Credit Agreement [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Debt Instrument, face amount | $ 175,000 | ||||||||
Debt Instrument Periodic Payment Percentage | 0.625% | ||||||||
One Hundred Seventy Five Million Term Loan Facility [Member] | Amended Credit Agreement [Member] | Subsequent Event [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Debt Instrument Periodic Payment Percentage | 1.875% | 1.25% |
INCOME TAXES - Narrative (Detai
INCOME TAXES - Narrative (Details) - USD ($) $ in Thousands | Aug. 10, 2020 | Apr. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017 |
Income Tax Disclosure [Line Items] | ||||||
Income tax receivable | $ 200 | $ 2,000 | ||||
Uncertain tax benefits accrued | 2,700 | 2,700 | $ 2,700 | $ 2,700 | ||
Valuation allowance | 100 | 400 | ||||
Net change in total valuation allowance | 300 | 300 | ||||
Unrecognized Tax Benefits, Income Tax Penalties and Interest Expense | 200 | 300 | 100 | |||
Interest and penalties accrued related to uncertain income tax positions | 600 | 400 | ||||
CARES Act Deferral Of Employer Share Social Security Tax | 55,400 | |||||
Other long-term obligations | 33,622 | 5,905 | ||||
Payroll and employee benefits | 146,929 | 120,877 | ||||
Funding Received From CARES Act | $ 100,000 | |||||
Provider relief fund advance | 60,000 | 0 | ||||
Income Tax Expense (Benefit) | $ 25,635 | $ 42,503 | $ 38,859 | |||
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period | 622,829 | |||||
Social Security Tax [Member] | ||||||
Income Tax Disclosure [Line Items] | ||||||
Other long-term obligations | $ 27,700 | |||||
Payroll and employee benefits | 27,700 | |||||
Executive Stock Option Exercise [Member] | ||||||
Income Tax Disclosure [Line Items] | ||||||
Recognized share-based compensation tax benefit | 92,100 | |||||
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period | 500,000 | |||||
COVID-19 Deferral of Social Security Taxes [Member] | ||||||
Income Tax Disclosure [Line Items] | ||||||
CARES Act Deferral Of Employer Share Social Security Tax | 55,000 | |||||
Other long-term obligations | 28,000 | |||||
Payroll and employee benefits | $ 28,000 | |||||
Minimum [Member] | ||||||
Income Tax Disclosure [Line Items] | ||||||
Tax years open to examination | 2007 | |||||
Maximum [Member] | ||||||
Income Tax Disclosure [Line Items] | ||||||
Tax years open to examination | 2020 | |||||
State Tax Credit [Member] | ||||||
Income Tax Disclosure [Line Items] | ||||||
Tax credits | $ 3,700 | |||||
Federal [Member] | Executive Stock Option Exercise [Member] | ||||||
Income Tax Disclosure [Line Items] | ||||||
Recognized share-based compensation tax benefit | 19,400 | |||||
State and Local Jurisdiction [Member] | Executive Stock Option Exercise [Member] | ||||||
Income Tax Disclosure [Line Items] | ||||||
Recognized share-based compensation tax benefit | 4,600 | |||||
State and Local Jurisdiction [Member] | Net Operating Loss [Member] | ||||||
Income Tax Disclosure [Line Items] | ||||||
Net operating loss carryforwards | $ 47,500 |
INCOME TAXES - Components of Ta
INCOME TAXES - Components of Tax Provision by Jurisdiction (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Current income tax expense/(benefit): | |||
Federal | $ 41,600 | $ 24,200 | $ 16,400 |
State and local | 10,600 | 4,800 | 2,100 |
Current income tax expense (benefit) | 52,200 | 29,000 | 18,500 |
Deferred income tax expense/(benefit): | |||
Federal | (22,500) | 9,500 | 14,500 |
State and local | (4,100) | 4,000 | 5,800 |
Deferred income tax expense (benefit) | (26,560) | 13,466 | 20,271 |
Income tax expense | $ 25,635 | $ 42,503 | $ 38,859 |
INCOME TAXES - Income Tax Expen
INCOME TAXES - Income Tax Expense Allocation (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Income Tax Disclosure [Abstract] | |||
Income from continuing operations | $ 25,635 | $ 42,503 | $ 38,859 |
Interest expense | 200 | 300 | 100 |
Goodwill | 0 | 900 | 0 |
Total income tax expense allocation | $ 25,800 | $ 43,700 | $ 38,900 |
INCOME TAXES - Reconciliation o
INCOME TAXES - Reconciliation of Effective Tax Rate (Details) | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Income Tax Disclosure [Abstract] | |||
Income tax expense at U.S. federal statutory rate | 21.00% | 21.00% | 21.00% |
State and local income taxes, net of federal income tax benefit (1) | 2.40% | 4.80% | 4.80% |
Excess tax benefits from share-based compensation (1) | (12.70%) | (2.20%) | (1.80%) |
Non-deductible executive compensation | 2.10% | 1.60% | 0.40% |
Other items, net (2) | (0.60%) | (0.30%) | 0.00% |
Income tax expense | 12.20% | 24.90% | 24.40% |
INCOME TAXES - Components of De
INCOME TAXES - Components of Deferred Tax Assets (Liabilities) (Details) - USD ($) $ in Millions | Dec. 31, 2020 | Dec. 31, 2019 |
Deferred tax assets: | ||
Accrued payroll & employee benefits | $ 15.9 | $ 15.1 |
Workers’ compensation | 9.6 | 9 |
Share-based compensation | 5.1 | 7.9 |
Legal & compliance matters | 7 | 4.8 |
Lease liability | 25.2 | 23.1 |
Provider relief fund advance (1) | 15.6 | 0 |
Deferred social security taxes (2) | 14.3 | 0 |
Net operating loss carryforwards | 2.4 | 3.7 |
Tax credit carryforwards | 2.9 | 3.1 |
Other | 0.6 | 0.5 |
Gross deferred tax assets | 98.6 | 67.2 |
Less: valuation allowance | (0.1) | (0.4) |
Net deferred tax assets | 98.5 | 66.8 |
Deferred tax liabilities: | ||
Property and equipment | (3.8) | (4.3) |
Amortization of intangible assets | (11.8) | (0.3) |
Deferred revenue | (9) | (13.5) |
Investment in partnerships | 0 | (3.3) |
Right-of-use asset | (24.9) | (22.8) |
Other liabilities | (1) | (1.2) |
Gross deferred tax liabilities | (50.5) | (45.4) |
Net deferred tax assets (liabilities) | $ 48 | $ 21.4 |
INCOME TAXES - Reconciliation_2
INCOME TAXES - Reconciliation of Unrecognized Tax Benefits (Details) - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward] | |||
Uncertain tax benefits, beginning balance | $ 2.7 | $ 2.7 | $ 2.7 |
Additions for tax positions related to current year | 0 | 0 | 0 |
Additions for tax positions related to prior year | 0 | 0 | 0 |
Reductions for tax positions related to prior years | 0 | 0 | 0 |
Lapse of statute of limitations | 0 | 0 | 0 |
Settlements | 0 | 0 | 0 |
Uncertain tax benefits, ending balance | $ 2.7 | $ 2.7 | $ 2.7 |
CAPITAL STOCK AND SHARE-BASED_3
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Narrative (Details) - USD ($) $ / shares in Units, $ in Millions | 12 Months Ended | ||||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | Jun. 07, 2012 | Jun. 06, 2012 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Common stock, authorized (shares) | 60,000,000 | 60,000,000 | |||
Common stock, par value (usd per share) | $ 0.001 | $ 0.001 | |||
Preferred stock, authorized (shares) | 5,000,000 | 5,000,000 | |||
Preferred stock, par value (usd per share) | $ 0.001 | $ 0.001 | |||
Common stock, issued (shares) | 37,470,212 | 36,638,021 | |||
Common stock, outstanding (shares) | 32,814,278 | 32,284,051 | |||
Preferred stock, issued (shares) | 0 | 0 | |||
Percentage of ownership in subsidiaries | 50.00% | ||||
Equity-based awards, number of shares authorized (shares) | 2,500,000 | ||||
Equity-based awards, shares available for grant (shares) | 2,000,000 | ||||
Percentage of total combined voting power of the Company and subsidiaries | 10.00% | ||||
Percentage of market value for purchases under Employee Stock Purchase Program (percent) | 85.00% | ||||
Common stock authorized for issuance under Employee Stock Purchase Plan (shares) | 1,328,627 | ||||
Employee Stock Purchase Plan expense | $ 0.6 | $ 0.6 | $ 0.5 | ||
Options granted (shares) | 43,249 | ||||
Maximum [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Contractual term of share-based award | ten years | ||||
Common stock authorized for issuance under Employee Stock Purchase Plan (shares) | 4,500,000 | 2,500,000 | |||
Vesting period of equity-based awards | 4 years | ||||
Minimum [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Vesting period of equity-based awards | 12 months | ||||
Share-Based Awards [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Fair value of share of common stock (percent) | 100.00% | ||||
Share Based Awards to More Than Ten Percent Owner [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Fair value of share of common stock (percent) | 110.00% | ||||
Stock Option [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Options granted (shares) | 43,249 | 142,122 | 163,666 | ||
Stock compensation expense | $ 4.3 | $ 6.2 | $ 5.7 | ||
Tax benefit from stock option exercise | 27.9 | 1.3 | 1.6 | ||
Intrinsic value of options outstanding | 50.6 | ||||
Intrinsic value of options exerciseable | 19.4 | ||||
Intrinsic value of options exercised during the period | 121.1 | 7.3 | 9.7 | ||
Unrecognized compensation expense | $ 4.8 | ||||
Unrecognized compensation expense weighted-average period for recognitions (years) | 1 year 10 months 24 days | ||||
Non-Vested Stock [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Stock compensation expense | $ 0.8 | $ 1.2 | $ 1.4 | ||
Non-vested stock granted, weighted average grant date fair value (usd per share) | $ 158.72 | $ 119.12 | $ 80.54 | ||
Vesting period of equity-based awards | 1 year | ||||
Non-Vested Stock Units [Member] | Maximum [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Vesting period of equity-based awards | 4 years | ||||
Non-Vested Stock Units [Member] | Minimum [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Vesting period of equity-based awards | 1 year | ||||
Non-Vested Stock Units - Service-Based [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Stock compensation expense | $ 7.5 | $ 8.7 | $ 4.5 | ||
Unrecognized compensation expense | $ 9.3 | ||||
Unrecognized compensation expense weighted-average period for recognitions (years) | 1 year 9 months 18 days | ||||
Non-vested stock granted, weighted average grant date fair value (usd per share) | $ 206.10 | $ 123.70 | $ 95.14 | ||
Non-Vested Stock Units - Service-Based and Performance-Based [Member] | |||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||||
Stock compensation expense | $ 13.5 | $ 8.4 | $ 5.8 | ||
Unrecognized compensation expense | $ 17.3 | ||||
Unrecognized compensation expense weighted-average period for recognitions (years) | 1 year 9 months 18 days | ||||
Non-vested stock granted, weighted average grant date fair value (usd per share) | $ 201.90 | $ 128.89 | $ 79.59 | ||
Performance-based award, target number of units to be received (shares) | 81,183 |
CAPITAL STOCK AND SHARE-BASED_4
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Employee Stock Purchase Plan Purchases (Details) - $ / shares | 3 Months Ended | 79 Months Ended | 103 Months Ended | |||||||
Dec. 31, 2020 | Sep. 30, 2020 | Jun. 30, 2020 | Mar. 31, 2020 | Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2020 | |
Share-based Payment Arrangement [Abstract] | ||||||||||
Employee Stock Purchase Plan shares issued (shares) | 4,202 | 4,789 | 5,414 | 5,295 | 6,063 | 7,216 | 8,230 | 7,181 | 3,122,983 | 3,171,373 |
Price per Employee Stock Purchase Plan share issued (usd per share) | $ 249.33 | $ 200.97 | $ 168.76 | $ 156.01 | $ 141.88 | $ 111.36 | $ 103.20 | $ 104.77 | $ 15.92 | $ 249.33 |
CAPITAL STOCK AND SHARE-BASED_5
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Stock Option Valuation Assumptions (Details) - Stock Option [Member] - $ / shares | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Risk Free Rate, minimum | 0.38% | 1.44% | 2.56% |
Risk Free Rate, maximum | 1.51% | 2.53% | 3.04% |
Expected Volatility, minimum | 40.15% | 42.46% | 42.00% |
Expected Volatility, maximum | 42.80% | 43.83% | 45.32% |
Expected Term | 6 years 3 months | ||
Weighted Average Fair Value | $ 86.72 | $ 54.42 | $ 42.48 |
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Dividend Rate | 0.00% | 0.00% | 0.00% |
Minimum [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Expected Term | 6 years | 4 years 1 month 13 days | |
Maximum [Member] | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |||
Expected Term | 6 years 3 months | 6 years 3 months |
CAPITAL STOCK AND SHARE-BASED_6
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands | Aug. 10, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 |
Number of Shares | ||||
Outstanding, beginning balance (shares) | 875,974 | |||
Granted (shares) | 43,249 | |||
Exercise of stock options (in shares) | 622,829 | |||
Canceled, forfeited or expired (shares) | (18,353) | |||
Outstanding, ending balance (shares) | 278,041 | 875,974 | ||
Exercisable (shares) | 89,429 | |||
Weighted Average Exercise Price | ||||
Outstanding, beginning balance (usd per share) | $ 49.62 | |||
Granted (usd per share) | 209.41 | |||
Exercised (usd per share) | 31.60 | |||
Canceled, forfeited or expired (usd per share) | 103.89 | |||
Outstanding, ending balance (usd per share) | 111.27 | $ 49.62 | ||
Exercisable (usd per share) | $ 76.40 | |||
Weighted Average Contractual Life (Years) | ||||
Outstanding, weighted average contractual life (years) | 7 years 8 months 4 days | 6 years 3 months 3 days | ||
Exercisable, weighted average contractual life (years) | 6 years 9 months | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Exercise of stock options (in shares) | 622,829 | |||
Payments Related to Tax Withholding for Share-based Compensation | $ 54,493 | $ 9,556 | $ 6,570 | |
Executive Stock Option Exercise [Member] | ||||
Number of Shares | ||||
Exercise of stock options (in shares) | 500,000 | |||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Issuance/(cancellation) of non-vested stock (shares) | 268,317 | |||
Surrendered Shares In Shares | 231,683 | |||
Exercise of stock options (in shares) | 500,000 | |||
Tax benefit from stock option exercise | 24,000 | |||
Payments Related to Tax Withholding for Share-based Compensation | $ 40,400 |
CAPITAL STOCK AND SHARE-BASED_7
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Non-Vested Stock Option Activity (Details) | 12 Months Ended |
Dec. 31, 2020$ / sharesshares | |
Number of Shares | |
Non-vested stock options beginning balance (shares) | shares | 305,750 |
Granted (shares) | shares | 43,249 |
Vested (shares) | shares | (142,233) |
Forfeited (shares) | shares | (18,154) |
Non-vested stock options ending balance (shares) | shares | 188,612 |
Weighted Average Grant Date Fair Value | |
Non-vested stock options beginning balance (usd per share) | $ / shares | $ 41.66 |
Granted (usd per share) | $ / shares | 86.72 |
Vested (usd per share) | $ / shares | 34.84 |
Forfeited (usd per share) | $ / shares | 47.66 |
Non-vested stock options ending balance (usd per share) | $ / shares | $ 56.55 |
CAPITAL STOCK AND SHARE-BASED_8
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Non-Vested Stock Activity (Details) - Non-Vested Stock [Member] - $ / shares | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Number of Shares | |||
Non-vested, beginning balance (shares) | 9,859 | ||
Granted (shares) | 1,560 | ||
Vested (shares) | (11,419) | ||
Canceled, forfeited or expired (shares) | 0 | ||
Non-vested, ending balance (shares) | 0 | 9,859 | |
Weighted Average Grant Date Fair Value | |||
Non-vested, beginning balance (usd per share) | $ 119.12 | ||
Granted (usd per share) | 158.72 | $ 119.12 | $ 80.54 |
Vested (usd per share) | 124.53 | ||
Canceled, forfeited or expired (usd per share) | 0 | ||
Non-vested, ending balance (usd per share) | $ 0 | $ 119.12 |
CAPITAL STOCK AND SHARE-BASED_9
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Non-Vested Stock Units Activity (Details) - $ / shares | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Non-Vested Stock Units - Service-Based [Member] | |||
Number of Shares | |||
Non-vested, beginning balance (shares) | 231,418 | ||
Granted (shares) | 34,429 | ||
Vested (shares) | (89,074) | ||
Canceled, forfeited or expired (shares) | (19,227) | ||
Non-vested, ending balance (shares) | 157,546 | 231,418 | |
Weighted Average Grant Date Fair Value | |||
Non-vested, beginning balance (usd per share) | $ 91.87 | ||
Granted (usd per share) | 206.10 | $ 123.70 | $ 95.14 |
Vested (usd per share) | 78.15 | ||
Canceled, forfeited or expired (usd per share) | 97.36 | ||
Non-vested, ending balance (usd per share) | $ 123.92 | $ 91.87 | |
Non-Vested Stock Units - Service-Based and Performance-Based [Member] | |||
Number of Shares | |||
Non-vested, beginning balance (shares) | 207,424 | ||
Granted (shares) | 85,727 | ||
Vested (shares) | (78,856) | ||
Canceled, forfeited or expired (shares) | (18,008) | ||
Non-vested, ending balance (shares) | 196,287 | 207,424 | |
Weighted Average Grant Date Fair Value | |||
Non-vested, beginning balance (usd per share) | $ 97.55 | ||
Granted (usd per share) | 201.90 | $ 128.89 | $ 79.59 |
Vested (usd per share) | 83.12 | ||
Canceled, forfeited or expired (usd per share) | 101.40 | ||
Non-vested, ending balance (usd per share) | $ 148.16 | $ 97.55 | |
Additional Performance Based Award Target share Amount | 11,633 |
COMMITMENTS AND CONTINGENCIES -
COMMITMENTS AND CONTINGENCIES - Narrative (Details) $ in Thousands | Jun. 27, 2016patient | Jan. 18, 2016USD ($)claim | Nov. 03, 2015patient | May 21, 2015patient | Jan. 30, 2015 | Apr. 23, 2014 | Jun. 06, 2011beneficiary | Aug. 31, 2017USD ($)claim | Dec. 31, 2020USD ($) | Dec. 31, 2019USD ($) | Dec. 31, 2018USD ($) | Dec. 31, 2017USD ($) | Mar. 31, 2010beneficiary | Jan. 10, 2019USD ($) |
Loss Contingencies [Line Items] | ||||||||||||||
Indemnity receivable | $ 13,600 | $ 13,600 | ||||||||||||
Other General and Administrative Expense | 192,122 | 188,434 | $ 166,897 | |||||||||||
Patient accounts receivable | 255,145 | $ 237,596 | ||||||||||||
Health insurance retention limit | 1,300 | |||||||||||||
Workers' compensation insurance retention limit | 1,000 | |||||||||||||
Professional liability insurance retention limit | 300 | |||||||||||||
South Carolina [Member] | Hospice [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of beneficiaries | beneficiary | 30 | |||||||||||||
Indemnity receivable | 2,800 | |||||||||||||
Indemnification amount | $ 2,800 | |||||||||||||
South Carolina [Member] | Hospice [Member] | Extrapolated [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of beneficiaries | beneficiary | 16 | |||||||||||||
South Carolina [Member] | Hospice [Member] | Unfavorable [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of the overpayment made to the subsidiary | $ 3,700 | |||||||||||||
Recovery amount of overpayment made to subsidiary including interest | $ 5,600 | |||||||||||||
Number of claims submitted by subsidiary | claim | 9 | |||||||||||||
Recovery amount of over payment made to subsidiary including interest withheld | 5,700 | |||||||||||||
US Department of Justice [Member] | Hospice [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Loss contingency accrual | 6,500 | |||||||||||||
US Department of Justice [Member] | Massachusetts [Member] | Hospice [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of patients | patient | 53 | |||||||||||||
US Department of Justice [Member] | Morgantown, West Virginia [Member] | Hospice [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of patients | patient | 66 | |||||||||||||
US Department of Justice [Member] | Parkersburg, West Virginia [Member] | Hospice [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of patients | patient | 68 | |||||||||||||
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Loss contingency accrual | 17,400 | |||||||||||||
Indemnity receivable | 10,900 | |||||||||||||
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Infinity HomeCare [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Indemnification amount | $ 12,600 | |||||||||||||
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Home Health [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Florida Zpic revenue reduction | $ 6,500 | |||||||||||||
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Home Health [Member] | Minimum [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of the overpayment made to the subsidiary | 6,500 | |||||||||||||
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Home Health [Member] | Maximum [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of the overpayment made to the subsidiary | 38,800 | 29,300 | ||||||||||||
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Home Health [Member] | Infinity HomeCare [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Patient accounts receivable | 1,500 | |||||||||||||
Safeguard Zone Program Integrity Contractor [Member] | Lakeland, Florida [Member] | Home Health [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of the overpayment made to the subsidiary | $ 34,000 | 26,000 | ||||||||||||
Number of claims submitted by subsidiary | claim | 72 | |||||||||||||
Actual claims payment | $ 200 | |||||||||||||
Error rate (percent) | 100.00% | |||||||||||||
Safeguard Zone Program Integrity Contractor [Member] | Clearwater, Florida [Member] | Home Health [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of the overpayment made to the subsidiary | $ 4,800 | $ 3,300 | ||||||||||||
Number of claims submitted by subsidiary | claim | 70 | |||||||||||||
Actual claims payment | $ 200 | |||||||||||||
Error rate (percent) | 100.00% | |||||||||||||
Amedisys CIA [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Corporate integrity agreement term (years) | 5 years | |||||||||||||
Compassionate Care Hospice CIA [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Corporate integrity agreement term (years) | 5 years |
COMMITMENTS AND CONTINGENCIES_2
COMMITMENTS AND CONTINGENCIES - Insurance Programs (Details) - USD ($) $ in Millions | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Commitments and Contingencies Disclosure [Abstract] | ||
Health insurance | $ 15.1 | $ 15.8 |
Workers’ compensation | 35.8 | 33.4 |
Professional liability | 4.9 | 5.1 |
Estimated Insurance Total | 55.8 | 54.3 |
Less: long-term portion | (1.2) | (1.3) |
Estimated Insurance Excluding Long Term Portion | $ 54.6 | $ 53 |
EMPLOYEE BENEFIT PLANS - Narrat
EMPLOYEE BENEFIT PLANS - Narrative (Details) - USD ($) | 12 Months Ended | ||
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Retirement Benefits [Abstract] | |||
Employer match amount | $ 0.44 | ||
Employee contribution amount | $ 1 | ||
Maximum percentage of employee salary eligible for employer match (percent) | 6.00% | ||
401(k) expense recognized | $ 12,900,000 | $ 10,500,000 | $ 9,000,000 |
SHARE REPURCHASE - Narrative (D
SHARE REPURCHASE - Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands | Dec. 23, 2020 | Feb. 25, 2019 | Jun. 04, 2018 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 |
Share Repurchase [Line Items] | ||||||
Purchase of company stock | $ 0 | $ 0 | $ 181,402 | |||
2021 Stock Repurchase Program [Member] | ||||||
Share Repurchase [Line Items] | ||||||
Stock repurchase program, authorized amount | $ 100,000 | |||||
Stock repurchase program, expiration date | Dec. 31, 2021 | |||||
2019 Stock Repurchase Program [Member] | ||||||
Share Repurchase [Line Items] | ||||||
Stock repurchase program, authorized amount | $ 100,000 | |||||
Stock repurchase program, expiration date | Mar. 1, 2020 | |||||
KKR Share Repurchase [Member] | ||||||
Share Repurchase [Line Items] | ||||||
Percentage of Shares Outstanding | 7.10% | |||||
Purchase of company stock | $ 181,400 | |||||
Discounted Closing Stock Price | $ 73.96 | |||||
Percentage of Closing Stock Price | 96.00% | |||||
Shares repurchased (shares) | 2,418,304 |
SEGMENT INFORMATION - Narrative
SEGMENT INFORMATION - Narrative (Details) | 12 Months Ended |
Dec. 31, 2020segment | |
Segment Reporting [Abstract] | |
Number of reportable business segments | 3 |
SEGMENT INFORMATION - Operating
SEGMENT INFORMATION - Operating Income of Reportable Segments (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2020 | Sep. 30, 2020 | Jun. 30, 2020 | Mar. 31, 2020 | Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Segment Reporting Information [Line Items] | |||||||||||
Net service revenue | $ 550,700 | $ 544,100 | $ 485,000 | $ 491,700 | $ 500,700 | $ 494,600 | $ 493,000 | $ 467,300 | $ 2,071,519 | $ 1,955,633 | $ 1,662,578 |
Other operating income | 34,372 | 0 | 0 | ||||||||
Cost of service, excluding depreciation and amortization | 1,185,369 | 1,150,337 | 992,863 | ||||||||
General and administrative expenses | 668,200 | 607,900 | 501,300 | ||||||||
Depreciation and amortization | 28,802 | 18,428 | 13,261 | ||||||||
Asset impairment charge | 4,152 | 1,470 | 0 | ||||||||
Operating expenses | 1,886,623 | 1,778,161 | 1,507,430 | ||||||||
Operating income (loss) | 219,268 | 177,472 | 155,148 | ||||||||
Home Health [Member] | Reportable Business Segments [Member] | |||||||||||
Segment Reporting Information [Line Items] | |||||||||||
Net service revenue | 1,249,200 | 1,256,400 | 1,174,500 | ||||||||
Other operating income | 20,200 | ||||||||||
Cost of service, excluding depreciation and amortization | 729,900 | 754,100 | 722,100 | ||||||||
General and administrative expenses | 307,200 | 297,200 | 276,300 | ||||||||
Depreciation and amortization | 3,900 | 4,200 | 3,500 | ||||||||
Asset impairment charge | 3,400 | 1,500 | |||||||||
Operating expenses | 1,044,400 | 1,057,000 | 1,001,900 | ||||||||
Operating income (loss) | 225,000 | 199,400 | 172,600 | ||||||||
Hospice [Member] | Reportable Business Segments [Member] | |||||||||||
Segment Reporting Information [Line Items] | |||||||||||
Net service revenue | 750,100 | 617,200 | 410,900 | ||||||||
Other operating income | 13,100 | ||||||||||
Cost of service, excluding depreciation and amortization | 400,600 | 335,100 | 212,000 | ||||||||
General and administrative expenses | 175,400 | 137,500 | 84,600 | ||||||||
Depreciation and amortization | 2,200 | 1,600 | 1,100 | ||||||||
Asset impairment charge | 800 | 0 | |||||||||
Operating expenses | 579,000 | 474,200 | 297,700 | ||||||||
Operating income (loss) | 184,200 | 143,000 | 113,200 | ||||||||
Personal Care [Member] | |||||||||||
Segment Reporting Information [Line Items] | |||||||||||
Other operating income | 1,000 | ||||||||||
Personal Care [Member] | Reportable Business Segments [Member] | |||||||||||
Segment Reporting Information [Line Items] | |||||||||||
Net service revenue | 72,200 | 82,000 | 77,200 | ||||||||
Other operating income | 1,100 | ||||||||||
Cost of service, excluding depreciation and amortization | 54,900 | 61,100 | 58,800 | ||||||||
General and administrative expenses | 12,400 | 12,300 | 12,800 | ||||||||
Depreciation and amortization | 200 | 200 | 300 | ||||||||
Asset impairment charge | 0 | 0 | |||||||||
Operating expenses | 67,500 | 73,600 | 71,900 | ||||||||
Operating income (loss) | 5,800 | 8,400 | 5,300 | ||||||||
Other [Member] | Other Segment [Member] | |||||||||||
Segment Reporting Information [Line Items] | |||||||||||
Net service revenue | 0 | 0 | 0 | ||||||||
Other operating income | 0 | ||||||||||
Cost of service, excluding depreciation and amortization | 0 | 0 | 0 | ||||||||
General and administrative expenses | 173,200 | 160,900 | 127,600 | ||||||||
Depreciation and amortization | 22,500 | 12,400 | 8,400 | ||||||||
Asset impairment charge | 0 | 0 | |||||||||
Operating expenses | 195,700 | 173,300 | 136,000 | ||||||||
Operating income (loss) | $ (195,700) | $ (173,300) | $ (136,000) |
UNAUDITED SUMMARIZED QUARTERL_3
UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION Operating Activity (Details) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2020 | Sep. 30, 2020 | Jun. 30, 2020 | Mar. 31, 2020 | Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Quarterly Financial Information Disclosure [Abstract] | |||||||||||
Net service revenue | $ 550,700 | $ 544,100 | $ 485,000 | $ 491,700 | $ 500,700 | $ 494,600 | $ 493,000 | $ 467,300 | $ 2,071,519 | $ 1,955,633 | $ 1,662,578 |
Net income attributable to Amedisys, Inc. | $ 45,100 | $ 72,000 | $ 34,700 | $ 31,800 | $ 27,700 | $ 34,100 | $ 33,700 | $ 31,300 | $ 183,608 | $ 126,833 | $ 119,346 |
Net income attributable to Amedisys, Inc. common stockholders - basic (usd per share) | $ 1.38 | $ 2.20 | $ 1.07 | $ 0.98 | $ 0.86 | $ 1.06 | $ 1.05 | $ 0.98 | $ 5.64 | $ 3.95 | $ 3.64 |
Net income attributable to Amedisys, Inc. common stockholders - diluted (usd per share) | $ 1.36 | $ 2.16 | $ 1.04 | $ 0.96 | $ 0.83 | $ 1.03 | $ 1.02 | $ 0.95 | $ 5.52 | $ 3.84 | $ 3.55 |
RELATED PARTY TRANSACTIONS - Na
RELATED PARTY TRANSACTIONS - Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands | Jun. 04, 2018 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 |
Related Party Transaction [Line Items] | ||||
Payments to Acquire Equity Investments | $ 875 | $ 210 | $ 7,144 | |
Purchase of company stock | 0 | 0 | 181,402 | |
Medalogix | ||||
Related Party Transaction [Line Items] | ||||
Payments to Acquire Equity Investments | $ 7,000 | |||
Related party transaction, amount of transaction | $ 3,900 | $ 500 | ||
KKR Share Repurchase [Member] | ||||
Related Party Transaction [Line Items] | ||||
Shares repurchased (shares) | 2,418,304 | |||
Percentage of Shares Outstanding | 7.10% | |||
Purchase of company stock | $ 181,400 | |||
Discounted Closing Stock Price | $ 73.96 | |||
Percentage of Closing Stock Price | 96.00% | |||
KKR Share Repurchase [Member] | KKR Consulting [Member] | ||||
Related Party Transaction [Line Items] | ||||
Percentage of Shares Outstanding | 14.20% |