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Details of Certain Balance Sheet Accounts | 12 Months Ended
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Dec. 31, 2020
Details Of Certain Balance Sheet Accounts [Abstract] |
Details of Certain Balance Sheet Accounts | 7. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consist of the following:
|  | December 31, |
|  | 2020 |  |  | 2019 |
|  | (Amounts in Thousands) |
Prepaid workers’ compensation and liability insurance |  | $ | 2,838 |  |  | $ | 2,040 |
Workers’ compensation insurance receivable |  |  | 1,860 |  |  |  | 1,989 |
Health insurance receivable |  |  | 528 |  |  |  | 1,567 |
Other |  |  | 4,743 |  |  |  | 2,397 |
Total prepaid expenses and other current assets |  | $ | 9,969 |  |  | $ | 7,993 |
Accrued expenses consisted of the following:
|  | December 31, |
|  | 2020 |  |  | 2019 |
|  | (Amounts in Thousands) |
Current portion of operating lease liabilities |  | $ | 9,283 |  |  | $ | 7,234 |
Accrued health insurance |  |  | 5,607 |  |  |  | 4,140 |
Accrued professional fees |  |  | 4,220 |  |  |  | 2,517 |
Payor advances (1) |  |  | 4,206 |  |  |  | — |
Accrued payroll taxes |  |  | 4,543 |  |  |  | 1,843 |
Other |  |  | 9,705 |  |  |  | 6,695 |
Total accrued expenses |  | $ | 37,564 |  |  | $ | 22,429 |
| (1) | The Company deferred the recognition of $4.2 million of payments received from payors for COVID-19 reimbursements which will be recognized if we incur specific expenses such as additional personal protective equipment or will be returned as stipulated if COVID-19 expenses are not incurred.
Government stimulus advances consisted of the following:
|  | December 31, |
|  | 2020 |  |  | 2019 |
|  | (Amounts in Thousands) |
Provider Relief Fund |  |  | 12,252 |  |  | $ | — |
CMS advanced payment program - Queen City Hospice |  |  | 10,801 |  |  |  | — |
Payroll tax deferral |  |  | 7,141 |  |  |  | — |
Provider Relief Fund - Queen City Hospice |  |  | 1,893 |  |  |  | — |
Total government stimulus advances |  | $ | 32,087 |  |  | $ | — |
In recognition of the significant threat to the liquidity of financial markets posed by the COVID-19 pandemic, the Federal Reserve and Congress have taken dramatic actions to provide liquidity to businesses and the banking system in the United States. One of the primary sources of relief for healthcare providers is the CARES Act, which was expanded by the PPPHCE Act, and the CAA. See Note 12 for additional information regarding government actions to mitigate COVID-19’s impact. Provider Relief Funds In April 2020, the Company received grants in an aggregate principal amount of $6.9 million, for which it did not apply, from the Provider Relief Fund as part of the automatic general distributions by HHS. The Company returned these funds in June 2020. In November 2020, the Company received grants in an aggregate principal amount of $13.7 million from the Provider Relief Fund, for which we applied. The Company utilized $1.4 million of these funds for healthcare related expenses attributable to COVID-19 that were unreimbursed by other sources in the period ended December 31, 2020 and, in accordance with the current guidance issued by HHS, expects to utilize additional funds through June 30, 2021, at which point any unused funds will be returned. We are required to properly and fully document the use of such funds in reports to HHS. The Company’s ability to utilize and retain some or all of such funds will depend on the magnitude, timing and nature of the impact of the COVID-19 pandemic, as well as the terms and conditions of the funds received. In April 2020, Queen City Hospice received grants in an aggregate principal amount of approximately $2.5 million, for which it did not apply, from the Provider Relief Fund as part of the automatic general distributions by HHS. Queen City Hospice utilized approximately $0.6 million for healthcare related expenses attributable to COVID-19 that were unreimbursed by other sources. Queen City Hospice intends to repay $1.9 million, which represents the remainder of the grants received but not utilized, in 2021. Commercial organizations that receive annual total awards of $750,000 or more in federal funding, including payments received through the Provider Relief Fund, are subject to federal audit requirements. Medicare Accelerated and Advance Payment Program – Queen City Hospice In addition, the CARES Act expands the Medicare Accelerated and Advance Payment Program to increase cash flow to providers impacted by the COVID-19 pandemic. Hospice and home health providers were able to request an advance or accelerated payment of up to 100% of the Medicare payment amount for a three-month period (not including Medicare Advantage payments). The Medicare Accelerated and Advance Payment Program payments are a loan that providers must pay back. Recoupment of these payments was due to begin in August, but CMS has delayed the recoupment process for these payments, based on amended repayment terms imposed by the CAA, enacted October 1, 2020, until one year after payment was issued. In April 2020, Queen City Hospice received an amount equal to $10.8 million pursuant to the Medicare Accelerated and Advance Payment Program. Queen City Hospice did not repay the funds prior to the completion of our acquisition of Queen City Hospice, however, Queen City Hospice intends to repay such funds in March 2021, prior to any CMS recoupment and before any interest accrues. Payroll tax deferral The CARES Act also provides for certain federal income and other tax changes, including the deferral of the employer portion of Social Security payroll taxes. The Company received a cash benefit of approximately $7.1 million related to the deferral of employer payroll taxes for 2020 under the CARES Act, for the period April 2, 2020 through June 30, 2020. Effective July 1, 2020, the Company began paying its deferred portion of employer Social Security payroll taxes and expects to repay the $7.1 million in 2021.

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