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Significant Payors | 12 Months Ended
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Dec. 31, 2022
Significant Payors [Abstract] |
Significant Payors | 13. Significant Payors For 2022, 2021 and 2020, the Company’s revenue by payor type was as follows:
|  | Personal Care |  |
|  | For the Years Ended December 31, |  |
|  | 2022 |  |  |  | 2021 |  |  |  | 2020 |  |
|  | 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 |  | $ | 348,234 |  |  |  | 49.3 |  | % |  | $ | 338,325 |  |  |  | 49.3 |  | % |  | $ | 324,670 |  |  |  | 50.2 |  | %
Managed care organizations |  |  | 326,778 |  |  |  | 46.3 |  |  |  |  | 311,801 |  |  |  | 45.5 |  |  |  |  | 287,032 |  |  |  | 44.3 |  |
Private pay |  |  | 18,301 |  |  |  | 2.6 |  |  |  |  | 19,991 |  |  |  | 2.9 |  |  |  |  | 20,398 |  |  |  | 3.2 |  |
Commercial insurance |  |  | 7,689 |  |  |  | 1.1 |  |  |  |  | 9,820 |  |  |  | 1.4 |  |  |  |  | 9,991 |  |  |  | 1.5 |  |
Other |  |  | 5,505 |  |  |  | 0.7 |  |  |  |  | 5,917 |  |  |  | 0.9 |  |  |  |  | 5,142 |  |  |  | 0.8 |  |
Total personal care segment net service revenues |  | $ | 706,507 |  |  |  | 100.0 |  | % |  | $ | 685,854 |  |  |  | 100.0 |  | % |  | $ | 647,233 |  |  |  | 100.0 |  | %
|  | Hospice |  |
|  | For the Years Ended December 31, |  |
|  | 2022 |  |  |  | 2021 |  |  |  | 2020 |  |
|  | 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 |  | $ | 183,407 |  |  |  | 90.9 |  | % |  | $ | 142,086 |  |  |  | 93.3 |  | % |  | $ | 94,068 |  |  |  | 92.9 |  | %
Managed care organizations |  |  | 7,353 |  |  |  | 3.6 |  |  |  |  | 5,664 |  |  |  | 3.7 |  |  |  |  | 4,931 |  |  |  | 4.9 |  |
Other |  |  | 11,012 |  |  |  | 5.5 |  |  |  |  | 4,503 |  |  |  | 3.0 |  |  |  |  | 2,298 |  |  |  | 2.2 |  |
Total hospice segment net service revenues |  | $ | 201,772 |  |  |  | 100.0 |  | % |  | $ | 152,253 |  |  |  | 100.0 |  | % |  | $ | 101,297 |  |  |  | 100.0 |  | %
|  | Home Health |  |
|  | For the Years Ended December 31, |  |
|  | 2022 |  |  |  | 2021 |  |  |  | 2020 |  |
|  | 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 |  | $ | 31,505 |  |  |  | 73.5 |  | % |  | $ | 20,700 |  |  |  | 78.4 |  | % |  | $ | 12,765 |  |  |  | 78.6 |  | %
Managed care organizations |  |  | 8,698 |  |  |  | 20.3 |  |  |  |  | 4,457 |  |  |  | 16.9 |  |  |  |  | 3,188 |  |  |  | 19.6 |  |
Other |  |  | 2,638 |  |  |  | 6.2 |  |  |  |  | 1,235 |  |  |  | 4.7 |  |  |  |  | 292 |  |  |  | 1.8 |  |
Total home health segment net service revenues |  | $ | 42,841 |  |  |  | 100.0 |  | % |  | $ | 26,392 |  |  |  | 100.0 |  | % |  | $ | 16,245 |  |  |  | 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 for 2022, 2021 and 2020 were as follows:
|  | Personal Care |  |
|  | For the Years Ended December 31, |  |
|  | 2022 |  |  |  | 2021 |  |  |  | 2020 |  |
|  | 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 |  | $ | 360,778 |  |  |  | 51.1 |  | % |  | $ | 328,619 |  |  |  | 47.9 |  | % |  | $ | 288,326 |  |  |  | 44.6 |  | %
New York |  |  | 86,592 |  |  |  | 12.3 |  |  |  |  | 99,732 |  |  |  | 14.5 |  |  |  |  | 115,510 |  |  |  | 17.8 |  |
New Mexico |  |  | 105,315 |  |  |  | 14.9 |  |  |  |  | 97,784 |  |  |  | 14.3 |  |  |  |  | 86,618 |  |  |  | 13.4 |  |
All other states |  |  | 153,822 |  |  |  | 21.7 |  |  |  |  | 159,719 |  |  |  | 23.3 |  |  |  |  | 156,779 |  |  |  | 24.2 |  |
Total personal care segment net service revenues |  | $ | 706,507 |  |  |  | 100.0 |  | % |  | $ | 685,854 |  |  |  | 100.0 |  | % |  | $ | 647,233 |  |  |  | 100.0 |  | %
|  | Hospice |  |
|  | For the Years Ended December 31, |  |
|  | 2022 |  |  |  | 2021 |  |  |  | 2020 |  |
|  | 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 |  | $ | 70,503 |  |  |  | 35.0 |  | % |  | $ | 61,415 |  |  |  | 40.3 |  | % |  | $ | — |  |  |  | — |  | %
New Mexico |  |  | 30,722 |  |  |  | 15.2 |  |  |  |  | 36,063 |  |  |  | 23.7 |  |  |  |  | 42,648 |  |  |  | 42.1 |  |
Illinois |  |  | 47,181 |  |  |  | 23.4 |  |  |  |  | — |  |  |  | — |  |  |  |  | — |  |  |  | — |  |
All other states |  |  | 53,366 |  |  |  | 26.4 |  |  |  |  | 54,775 |  |  |  | 36.0 |  |  |  |  | 58,649 |  |  |  | 57.9 |  |
Total hospice segment net service revenues |  | $ | 201,772 |  |  |  | 100.0 |  | % |  | $ | 152,253 |  |  |  | 100.0 |  | % |  | $ | 101,297 |  |  |  | 100.0 |  | %
With the acquisition of Queen City Hospice in late 2020, the Company expanded its hospice services in the state of Ohio, and with the JourneyCare acquisition in 2022, the Company also expanded its hospice services in the state of Illinois.
|  | Home Health |  |
|  | For the Years Ended December 31, |  |
|  | 2022 |  |  |  | 2021 |  |  |  | 2020 |  |
|  | 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 |  | $ | 34,111 |  |  |  | 79.6 |  | % |  | $ | 24,735 |  |  |  | 93.7 |  | % |  | $ | 16,245 |  |  |  | 100.0 |  | %
Illinois |  |  | 8,730 |  |  |  | 20.4 |  |  |  |  | 1,657 |  |  |  | 6.3 |  |  |  |  | — |  |  |  | — |  |
Total home health segment net service revenues |  | $ | 42,841 |  |  |  | 100.0 |  | % |  | $ | 26,392 |  |  |  | 100.0 |  | % |  | $ | 16,245 |  |  |  | 100.0 |  | %
With the acquisition of Summit in 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 state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 43.8%, 38.2% and 37.7% of our net service revenues for the years ended December 31, 2022, 2021 and 2020, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.7%, 21.4% and 23.0% of the Company’s net service revenues for 2022, 2021 and 2020, respectively. The related receivables due from the Illinois Department on Aging represented 18.0% and 16.1% of the Company’s net accounts receivable at December 31, 2022 and 2021, respectively. 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. 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. The Company submitted an attestation on November 22, 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 April 1, 2023. The Company continues to assess the future of its participation in this program. Given the current profitability of the program, the Company has suspended materially all of its new fee-for-service patient admissions through County Social Service Departments in the CDPAP program. The Company recognized approximat ely $39.2 million from the program for the year ended December 31, 2022.

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- Definition The entire disclosure for any concentrations existing at the date of the financial statements that make an entity vulnerable to a reasonably possible, near-term, severe impact. This disclosure informs financial statement users about the general nature of the risk associated with the concentration, and may indicate the percentage of concentration risk as of the balance sheet date. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -URI https://asc.fasb.org/topic&trid=2134479 + Details
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