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Significant Payors | 9 Months Ended
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Sep. 30, 2022
Significant Payors [Abstract] |
Significant Payors | 12. Significant Payors The Company’s revenue by payor type was as follows:
Personal Care Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
| 2022 |  |  | 2021 |  |  | 2022 |  |  | 2021 |
| Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
State, local and other governmental programs | $ | 88,448 |  | 49.4 | % | $ | 83,821 |  | 49.5 | % | $ | 257,817 |  | 49.4 | % | $ | 253,052 |  | 49.5 | %
Managed care organizations |  | 83,199 |  | 46.4 |  |  | 76,890 |  | 45.3 |  |  | 241,164 |  | 46.1 |  |  | 231,211 |  | 45.3 |
Private pay |  | 4,521 |  | 2.6 |  |  | 4,934 |  | 2.9 |  |  | 13,758 |  | 2.6 |  |  | 14,883 |  | 2.9 |
Commercial insurance |  | 1,870 |  | 1.0 |  |  | 2,459 |  | 1.4 |  |  | 5,988 |  | 1.1 |  |  | 7,481 |  | 1.5 |
Other |  | 1,142 |  | 0.6 |  |  | 1,505 |  | 0.9 |  |  | 4,415 |  | 0.8 |  |  | 4,117 |  | 0.8 |
Total personal care segment net service revenues | $ | 179,180 |  | 100.0 | % | $ | 169,609 |  | 100.0 | % | $ | 523,142 |  | 100.0 | % | $ | 510,744 |  | 100.0 | %
Hospice Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
| 2022 |  |  | 2021 |  |  | 2022 |  |  | 2021 |
| Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
Medicare | $ | 46,537 |  | 90.6 | % | $ | 36,280 |  | 92.7 | % | $ | 137,174 |  | 90.8 | % | $ | 104,715 |  | 93.4 | %
Commercial insurance |  | 2,772 |  | 5.4 |  |  | 1,154 |  | 3.0 |  |  | 7,742 |  | 5.1 |  |  | 2,648 |  | 2.4 |
Managed care organizations |  | 1,815 |  | 3.5 |  |  | 1,514 |  | 3.9 |  |  | 5,498 |  | 3.6 |  |  | 4,396 |  | 3.9 |
Other |  | 235 |  | 0.5 |  |  | 147 |  | 0.4 |  |  | 746 |  | 0.5 |  |  | 339 |  | 0.3 |
Total hospice segment net service revenues | $ | 51,359 |  | 100.0 | % | $ | 39,095 |  | 100.0 | % | $ | 151,160 |  | 100.0 | % | $ | 112,098 |  | 100.0 | %
Home Health Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
| 2022 |  |  | 2021 |  |  | 2022 |  |  | 2021 |
| Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
Medicare | $ | 7,320 |  | 73.5 | % | $ | 6,372 |  | 80.1 | % | $ | 21,727 |  | 73.0 | % | $ | 13,699 |  | 80.5 | %
Managed care organizations |  | 1,998 |  | 20.1 |  |  | 1,218 |  | 15.3 |  |  | 6,160 |  | 20.7 |  |  | 2,838 |  | 16.7 |
Other |  | 638 |  | 6.4 |  |  | 368 |  | 4.6 |  |  | 1,881 |  | 6.3 |  |  | 478 |  | 2.8 |
Total home health segment net service revenues | $ | 9,956 |  | 100.0 | % | $ | 7,958 |  | 100.0 | % | $ | 29,768 |  | 100.0 | % | $ | 17,015 |  | 100.0 | %
The Company derives a significant amount of its revenue from its operations in Illinois, New Mexico and New York. The percentages of segment revenue for each of these significant states were as follows:
Personal Care Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
|  | 2022 |  |  | 2021 |  |  | 2022 |  |  | 2021 |
| Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
Illinois | $ | 92,804 |  | 51.8 | % | $ | 81,959 |  | 48.3 | % | $ | 266,284 |  | 50.9 | % | $ | 240,131 |  | 47.0 | %
New Mexico |  | 26,912 |  | 15.0 |  |  | 24,214 |  | 14.3 |  |  | 78,825 |  | 15.1 |  |  | 73,291 |  | 14.3 |
New York (1) |  | 20,997 |  | 11.7 |  |  | 24,127 |  | 14.2 |  |  | 63,510 |  | 12.1 |  |  | 77,237 |  | 15.1 |
All other states |  | 38,467 |  | 21.5 |  |  | 39,309 |  | 23.2 |  |  | 114,523 |  | 21.9 |  |  | 120,085 |  | 23.6 |
Total personal care segment net service revenues | $ | 179,180 |  | 100.0 | % | $ | 169,609 |  | 100.0 | % | $ | 523,142 |  | 100.0 | % | $ | 510,744 |  | 100.0 | %
(1) In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure CDPAP fiscal intermediaries. The Company was not selected in the initial RFO process. We submitted a formal protest in response to the selection process, which was filed and accepted in March 2021, but we have not received a response to the formal protest. The Company continues to consider other arrangements and to pursue our protest of the award. The New York fiscal year 2023 state budget, passed in April 2022, amends the current Fiscal Intermediary RFO process to authorize all fiscal intermediaries that submitted an RFO application and served at least 200 clients in New York City or 50 clients in other counties between January 1, 2020 and March 31, 2020 to contract with the New York State Department of Health and continue to operate in all counties contained in their application, if the fiscal intermediary submits an attestation and supporting information to the New York State Department of Health no later than November 29, 2022. Under this provision, the Company is allowed to continue to contract with all of its current payors for CDPAP services, as of the contract award date, which is anticipated to be January 15, 2023. The Company continues to assess the future of its participation in this program. Given the status of the program, the Company has suspended materially all of its new patient admissions under the New York CDPAP program.
Hospice Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
| 2022 |  |  | 2021 |  |  | 2022 |  |  | 2021 |
| Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
Ohio | $ | 18,139 |  | 35.3 | % | $ | 15,868 |  | 40.6 | % | $ | 51,714 |  | 34.2 | % | $ | 44,676 |  | 39.8 | %
Illinois (2) |  | 12,188 |  | 23.7 |  |  | — |  | — |  |  | 35,290 |  | 23.3 |  |  | — |  | — |
New Mexico |  | 7,789 |  | 15.2 |  |  | 9,268 |  | 23.7 |  |  | 23,867 |  | 15.8 |  |  | 27,216 |  | 24.3 |
All other states |  | 13,243 |  | 25.8 |  |  | 13,959 |  | 35.7 |  |  | 40,289 |  | 26.7 |  |  | 40,206 |  | 35.9 |
Total hospice segment net service revenues | $ | 51,359 |  | 100.0 | % | $ | 39,095 |  | 100.0 | % | $ | 151,160 |  | 100.0 | % | $ | 112,098 |  | 100.0 | %
(2) With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois.
Home Health Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
| 2022 |  |  | 2021 |  |  | 2022 |  |  | 2021 |
| Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
New Mexico | $ | 8,375 |  | 84.1 | % | $ | 7,958 |  | 100.0 | % | $ | 24,954 |  | 83.8 | % | $ | 17,015 |  | 100.0 | %
Illinois (3) |  | 1,581 |  | 15.9 |  |  | — |  | — |  |  | 4,814 |  | 16.2 |  |  | — |  | — |
Total home health segment net service revenues | $ | 9,956 |  | 100.0 | % | $ | 7,958 |  | 100.0 | % | $ | 29,768 |  | 100.0 | % | $ | 17,015 |  | 100.0 | %
(3) With the acquisition of Summit Home Health, LLC (“Summit”) on October 1, 2021, the Company expanded its home health services in the state of Illinois. A substantial portion of the Company’s revenue and accounts receivable are derived from services performed for federal, state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 44.3%, and 37.8% of our net service revenues for the three months ended September 30, 2022, and 2021, respectively, and accounted for 43.5% and 37.5% of our net service revenues for the nine months ended September 30, 2022 and 2021, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 21.0% and 21.3% of the Company’s net service revenues for the three months ended September 30, 2022 and 2021, respectively, and accounted for 20.8% and 21.4% of the Company’s net service revenues for the nine months ended September 30, 2022 and 2021, respectively. The related receivables due from the Illinois Department on Aging represented 15.3% and 16.1% of the Company’s net accounts receivable at September 30, 2022 and December 31, 2021, respectively.

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