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Note 12 - Significant Payors - Revenue from External Customers by Products and Services (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended
--- | --- | ---
Jun. 30, 2025 | Jun. 30, 2024 | Jun. 30, 2025 | Jun. 30, 2024
Net service revenues |  | $ 349,443 | $ 286,922 | $ 687,151 | $ 567,668
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] |  |  |  |  |
Net service revenues |  | $ 62,212 | $ 56,030 | $ 123,649 | $ 111,893
Concentration Risk, Percentage |  | 100.00% | 100.00% | 100.00% | 100.00%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | Medicare [Member] |  |  |  |  |
Net service revenues |  | $ 57,846 | $ 51,122 | $ 114,638 | $ 101,774
Concentration Risk, Percentage |  | 93.00% | 91.20% | 92.70% | 91.00%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | Commercial Insurance [Member] |  |  |  |  |
Net service revenues |  | $ 1,997 | $ 2,844 | $ 4,375 | $ 5,978
Concentration Risk, Percentage |  | 3.20% | 5.10% | 3.50% | 5.30%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | Managed Care Organizations [Member] |  |  |  |  |
Net service revenues |  | $ 2,001 | $ 1,880 | $ 4,029 | $ 3,697
Concentration Risk, Percentage |  | 3.20% | 3.40% | 3.30% | 3.30%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | Other [Member] |  |  |  |  |
Net service revenues |  | $ 368 | $ 184 | $ 607 | $ 444
Concentration Risk, Percentage |  | 0.60% | 0.30% | 0.50% | 0.40%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] |  |  |  |  |
Net service revenues |  | $ 18,048 | $ 18,075 | $ 36,033 | $ 34,955
Concentration Risk, Percentage |  | 100.00% | 100.00% | 100.00% | 100.00%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | Medicare [Member] |  |  |  |  |
Net service revenues |  | $ 12,517 | $ 12,517 | $ 25,094 | $ 24,180
Concentration Risk, Percentage |  | 69.40% | 69.30% | 69.70% | 69.20%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | Managed Care Organizations [Member] |  |  |  |  |
Net service revenues |  | $ 4,264 | $ 4,676 | $ 8,072 | $ 9,076
Concentration Risk, Percentage |  | 23.60% | 25.90% | 22.40% | 26.00%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | State, Local, and Other Governmental Programs (Excluding Medicare) [Member] |  |  |  |  |
Net service revenues |  | $ 796 | $ 44 | $ 1,884 | $ 70
Concentration Risk, Percentage |  | 4.40% | 0.20% | 5.20% | 0.20%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | Other [Member] |  |  |  |  |
Net service revenues |  | $ 471 | $ 838 | $ 983 | $ 1,629
Concentration Risk, Percentage |  | 2.60% | 4.60% | 2.70% | 4.60%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] |  |  |  |  |
Net service revenues |  | $ 269,183 | $ 212,817 | $ 527,469 | $ 420,820
Concentration Risk, Percentage |  | 100.00% | 100.00% | 100.00% | 100.00%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | State, Local, and Other Governmental Programs [Member] |  |  |  |  |
Net service revenues |  | $ 138,506 | $ 113,002 | $ 271,410 | $ 220,756
Concentration Risk, Percentage |  | 51.40% | 53.10% | 51.40% | 52.50%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | Commercial Insurance [Member] |  |  |  |  |
Net service revenues |  | $ 1,334 | $ 1,467 | $ 2,494 | $ 2,953
Concentration Risk, Percentage |  | 0.50% | 0.70% | 0.50% | 0.70%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | Managed Care Organizations [Member] |  |  |  |  |
Net service revenues |  | $ 121,900 | $ 94,135 | $ 238,907 | $ 188,411
Concentration Risk, Percentage |  | 45.30% | 44.20% | 45.30% | 44.80%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | Private Pay [Member] |  |  |  |  |
Net service revenues |  | $ 7,292 | $ 3,689 | $ 14,268 | $ 7,595
Concentration Risk, Percentage |  | 2.70% | 1.70% | 2.70% | 1.80%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | Other [Member] |  |  |  |  |
Net service revenues |  | $ 151 | $ 524 | $ 390 | $ 1,105
Concentration Risk, Percentage |  | 0.10% | 0.30% | 0.10% | 0.20%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] |  |  |  |  |
Net service revenues |  | $ 62,212 | $ 56,030 | $ 123,649 | $ 111,893
Concentration Risk, Percentage |  | 100.00% | 100.00% | 100.00% | 100.00%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | ILLINOIS |  |  |  |  |
Net service revenues |  | $ 14,419 | $ 13,003 | $ 28,983 | $ 25,255
Concentration Risk, Percentage |  | 23.20% | 23.20% | 23.40% | 22.60%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | NEW MEXICO |  |  |  |  |
Net service revenues |  | $ 8,184 | $ 6,895 | $ 16,097 | $ 14,410
Concentration Risk, Percentage |  | 13.20% | 12.30% | 13.00% | 12.90%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | OHIO |  |  |  |  |
Net service revenues |  | $ 23,204 | $ 20,633 | $ 46,391 | $ 40,869
Concentration Risk, Percentage |  | 37.30% | 36.80% | 37.50% | 36.50%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | All Other States [Member] |  |  |  |  |
Net service revenues |  | $ 16,405 | $ 15,499 | $ 32,178 | $ 31,359
Concentration Risk, Percentage |  | 26.30% | 27.70% | 26.10% | 28.00%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] |  |  |  |  |
Net service revenues |  | $ 18,048 | $ 18,075 | $ 36,033 | $ 34,955
Concentration Risk, Percentage |  | 100.00% | 100.00% | 100.00% | 100.00%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | ILLINOIS |  |  |  |  |
Net service revenues |  | $ 1,989 | $ 3,042 | $ 3,921 | $ 5,984
Concentration Risk, Percentage |  | 11.00% | 16.80% | 10.90% | 17.10%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | NEW MEXICO |  |  |  |  |
Net service revenues |  | $ 8,737 | $ 8,300 | $ 17,292 | $ 16,077
Concentration Risk, Percentage |  | 48.40% | 45.90% | 48.00% | 46.00%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | TENNESSEE |  |  |  |  |
Net service revenues |  | $ 7,322 | $ 6,733 | $ 14,820 | $ 12,894
Concentration Risk, Percentage |  | 40.60% | 37.30% | 41.10% | 36.90%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] |  |  |  |  |
Net service revenues |  | $ 269,183 | $ 212,817 | $ 527,469 | $ 420,820
Concentration Risk, Percentage |  | 100.00% | 100.00% | 100.00% | 100.00%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | ILLINOIS |  |  |  |  |
Net service revenues |  | $ 115,226 | $ 110,774 | $ 226,640 | $ 218,349
Concentration Risk, Percentage |  | 42.80% | 52.10% | 43.00% | 51.90%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | NEW MEXICO |  |  |  |  |
Net service revenues |  | $ 28,987 | $ 28,644 | $ 57,292 | $ 57,611
Concentration Risk, Percentage |  | 10.80% | 13.50% | 10.90% | 13.70%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | NEW YORK |  |  |  |  |
Net service revenues | [1] | $ (59) | $ 23,299 | $ 214 |
Concentration Risk, Percentage | [1] | 0.00% | 10.90% | 0.00% |
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | TEXAS |  |  |  |  |
Net service revenues |  | $ 52,464 | $ 0 | $ 102,324 | $ 0
Concentration Risk, Percentage |  | 19.50% | 0.00% | 19.40% | 0.00%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | All Other States [Member] |  |  |  |  |
Net service revenues |  | $ 72,565 | $ 50,100 | $ 140,999 | $ 98,027
Concentration Risk, Percentage |  | 26.90% | 23.50% | 26.70% | 23.30%
[1] | As a result of changes and uncertainty in New York regarding the CDPAP, the Company determined that its New York personal care operations no longer fit its growth strategy and is divesting these operations. See Note 3 to the Notes to Unaudited Condensed Consolidated Financial Statements, Divestiture, for additional details regarding our divestiture.

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