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Details of Certain Balance Sheet Accounts | 3 Months Ended
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Mar. 31, 2021
Details Of Certain Balance Sheet Accounts [Abstract] |
Details of Certain Balance Sheet Accounts | 6. Details of Certain Balance Sheet Accounts Prepaid expenses and other current assets consisted of the following:
|  | March 31, 2021 |  |  | December 31, 2020 |
|  | (Amounts in Thousands) |
Workers' compensation insurance receivable |  | $ | 1,924 |  |  | $ | 1,860 |
Prepaid workers' compensation and liability insurance |  |  | 1,875 |  |  |  | 2,838 |
Health insurance receivable |  |  | 1,379 |  |  |  | 528 |
Other |  |  | 5,609 |  |  |  | 4,743 |
Total prepaid expenses and other current assets |  | $ | 10,787 |  |  | $ | 9,969 |
Accrued expenses consisted of the following:
|  | March 31, 2021 |  |  | December 31, 2020 |
|  | (Amounts in Thousands) |
Current portion of operating lease liabilities |  | $ | 9,498 |  |  | $ | 9,283 |
Accrued health insurance |  |  | 5,063 |  |  |  | 5,607 |
Accrued payroll taxes |  |  | 6,978 |  |  |  | 4,543 |
Accrued professional fees |  |  | 2,935 |  |  |  | 4,220 |
Payor advances (1) |  |  | 5,052 |  |  |  | 4,206 |
Other |  |  | 9,128 |  |  |  | 9,705 |
Total accrued expenses |  | $ | 38,654 |  |  | $ | 37,564 |
| (1) | Represents the deferred portion of payments received from payors for COVID-19 reimbursements which will be recognized as we incur specific COVID-19 related expenses (including expenses related to securing and maintaining adequate personnel) or will be returned if such related expenses are not incurred.
Government stimulus advances consisted of the following:
|  | March 31, 2021 |  |  | December 31, 2020 |
|  | (Amounts in Thousands) |
Provider Relief Fund |  | $ | 11,334 |  |  | $ | 12,252 |
CMS advanced payment program — Queen City Hospice |  |  | — |  |  |  | 10,801 |
Payroll tax deferral |  |  | 7,141 |  |  |  | 7,141 |
Provider Relief Fund — Queen City Hospice |  |  | 1,893 |  |  |  | 1,893 |
Total government stimulus advances |  | $ | 20,368 |  |  | $ | 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. The American Rescue Plan Act of 2021 (“ARPA”), another relief package with numerous provisions that affect healthcare providers, was signed into law in March 2021. See Note 9 for additional information regarding government actions to mitigate COVID-19’s impact. Provider Relief Fund In total, the CARES Act and other relief legislation include over $178 billion in funding to be distributed through the Provider Relief Fund to eligible providers, including public entities and Medicare- and/or Medicaid-enrolled providers. In November 2020, the Company received grants in an aggregate principal amount of $13.7 million from the Provider Relief Fund, for which we had previously applied. The Company utilized $0.9 million of these funds for healthcare related expenses attributable to COVID-19 that were unreimbursed by other sources in the three months ended March 31, 2021 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. Queen City Hospice intends to administer retention payments of $1.9 million to caregivers in the second quarter of 2021, which we believe to be necessary to secure and maintain adequate personnel. Commercial organizations that receive and expend 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 The CARES Act expanded 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 repay. 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 repaid such funds following such acquisition in March 2021, prior to any CMS recoupment and before any interest accrual. Payroll tax deferral The CARES Act also provides for certain federal income and other tax changes, including allowing for the deferral of the employer portion of Social Security payroll taxes through December 31, 2020. 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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