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Note 13 - Significant Payors | 9 Months Ended
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Sep. 30, 2025
Notes to Financial Statements |
Concentration Risk Disclosure [Text Block] | 13. 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, |
|  | 2025 |  |  | 2024 |  |  | 2025 |  |  | 2024 |
|  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |
|  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |
|  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |
State, local and other governmental programs |  | $ | 139,383 |  |  |  | 50.5 | % |  | $ | 116,702 |  |  |  | 54.2 | % |  | $ | 410,781 |  |  |  | 51.1 | % |  | $ | 337,458 |  |  |  | 53.0 | %
Managed care organizations |  |  | 127,293 |  |  |  | 46.2 |  |  |  | 93,321 |  |  |  | 43.3 |  |  |  | 366,210 |  |  |  | 45.6 |  |  |  | 281,732 |  |  |  | 44.3 |
Private pay |  |  | 7,064 |  |  |  | 2.5 |  |  |  | 3,599 |  |  |  | 1.7 |  |  |  | 21,331 |  |  |  | 2.7 |  |  |  | 11,194 |  |  |  | 1.8 |
Commercial insurance |  |  | 1,860 |  |  |  | 0.7 |  |  |  | 1,415 |  |  |  | 0.7 |  |  |  | 4,356 |  |  |  | 0.5 |  |  |  | 4,368 |  |  |  | 0.7 |
Other |  |  | 170 |  |  |  | 0.1 |  |  |  | 396 |  |  |  | 0.1 |  |  |  | 560 |  |  |  | 0.1 |  |  |  | 1,501 |  |  |  | 0.2 |
Total personal care segment net service revenues |  | $ | 275,770 |  |  |  | 100.0 | % |  | $ | 215,433 |  |  |  | 100.0 | % |  | $ | 803,238 |  |  |  | 100.0 | % |  | $ | 636,253 |  |  |  | 100.0 | %
Hospice Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
|  | 2025 |  |  | 2024 |  |  | 2025 |  |  | 2024 |
|  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |
|  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |
|  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |
Medicare |  | $ | 64,148 |  |  |  | 93.1 | % |  | $ | 52,413 |  |  |  | 91.5 | % |  | $ | 178,784 |  |  |  | 92.9 | % |  | $ | 154,187 |  |  |  | 91.1 | %
Commercial insurance |  |  | 2,140 |  |  |  | 3.1 |  |  |  | 2,892 |  |  |  | 5.0 |  |  |  | 6,518 |  |  |  | 3.4 |  |  |  | 8,870 |  |  |  | 5.2 |
Managed care organizations |  |  | 2,216 |  |  |  | 3.2 |  |  |  | 1,821 |  |  |  | 3.2 |  |  |  | 6,245 |  |  |  | 3.2 |  |  |  | 5,518 |  |  |  | 3.3 |
Other |  |  | 387 |  |  |  | 0.6 |  |  |  | 183 |  |  |  | 0.3 |  |  |  | 993 |  |  |  | 0.5 |  |  |  | 627 |  |  |  | 0.4 |
Total hospice segment net service revenues |  | $ | 68,891 |  |  |  | 100.0 | % |  | $ | 57,309 |  |  |  | 100.0 | % |  | $ | 192,540 |  |  |  | 100.0 | % |  | $ | 169,202 |  |  |  | 100.0 | %
Home Health Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
|  | 2025 |  |  | 2024 |  |  | 2025 |  |  | 2024 |
|  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |
|  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |
|  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |
Medicare |  | $ | 11,617 |  |  |  | 65.9 | % |  | $ | 12,036 |  |  |  | 70.6 | % |  | $ | 36,711 |  |  |  | 68.4 | % |  | $ | 36,216 |  |  |  | 69.6 | %
Managed care organizations |  |  | 4,492 |  |  |  | 25.5 |  |  |  | 4,215 |  |  |  | 24.7 |  |  |  | 12,564 |  |  |  | 23.4 |  |  |  | 13,291 |  |  |  | 25.6 |
State, local and other governmental programs (excluding Medicare) |  |  | 993 |  |  |  | 5.6 |  |  |  | (17 | ) |  |  | — |  |  |  | 2,878 |  |  |  | 5.3 |  |  |  | — |  |  |  | — |
Other |  |  | 538 |  |  |  | 3.0 |  |  |  | 811 |  |  |  | 4.7 |  |  |  | 1,521 |  |  |  | 2.9 |  |  |  | 2,493 |  |  |  | 4.8 |
Total home health segment net service revenues |  | $ | 17,640 |  |  |  | 100.0 | % |  | $ | 17,045 |  |  |  | 100.0 | % |  | $ | 53,674 |  |  |  | 100.0 | % |  | $ | 52,000 |  |  |  | 100.0 | %
The Company derives a significant amount of its revenue from its operations in Illinois, New Mexico, Ohio, Tennessee, and Texas. The percentages of segment revenue for each of these significant states and New York for the three and nine months ended September 30, 2025 and 2024, respectively, were as follows:
Personal Care Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
|  | 2025 |  |  | 2024 |  |  | 2025 |  |  | 2024 |
|  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |
|  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |
|  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |
Illinois |  | $ | 115,989 |  |  |  | 42.1 | % |  | $ | 111,916 |  |  |  | 51.9 | % |  | $ | 342,629 |  |  |  | 42.7 | % |  | $ | 330,265 |  |  |  | 51.9 | %
New Mexico |  |  | 30,029 |  |  |  | 10.9 |  |  |  | 28,962 |  |  |  | 13.4 |  |  |  | 87,320 |  |  |  | 10.9 |  |  |  | 86,573 |  |  |  | 13.6 |
New York(1) |  |  | (318 | ) |  |  | — |  |  |  | 21,406 |  |  |  | 9.9 |  |  |  | (104 | ) |  |  | — |  |  |  | 68,239 |  |  |  | 10.7 |
Texas |  |  | 53,449 |  |  |  | 19.4 |  |  |  | — |  |  |  | — |  |  |  | 155,773 |  |  |  | 19.4 |  |  |  | — |  |  |  | — |
All other states |  |  | 76,621 |  |  |  | 27.6 |  |  |  | 53,149 |  |  |  | 24.8 |  |  |  | 217,620 |  |  |  | 27.0 |  |  |  | 151,176 |  |  |  | 23.8 |
Total personal care segment net service revenues |  | $ | 275,770 |  |  |  | 100.0 | % |  | $ | 215,433 |  |  |  | 100.0 | % |  | $ | 803,238 |  |  |  | 100.0 | % |  | $ | 636,253 |  |  |  | 100.0 | %
| (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.
Hospice Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
|  | 2025 |  |  | 2024 |  |  | 2025 |  |  | 2024 |
|  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |
|  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |
|  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |
Ohio |  | $ | 26,913 |  |  |  | 39.1 | % |  | $ | 21,531 |  |  |  | 37.6 | % |  | $ | 73,304 |  |  |  | 38.1 | % |  | $ | 62,400 |  |  |  | 36.9 | %
Illinois |  |  | 15,532 |  |  |  | 22.5 |  |  |  | 13,289 |  |  |  | 23.2 |  |  |  | 44,516 |  |  |  | 23.1 |  |  |  | 38,544 |  |  |  | 22.8 |
New Mexico |  |  | 8,769 |  |  |  | 12.7 |  |  |  | 6,951 |  |  |  | 12.1 |  |  |  | 24,865 |  |  |  | 12.9 |  |  |  | 21,361 |  |  |  | 12.6 |
All other states |  |  | 17,677 |  |  |  | 25.7 |  |  |  | 15,538 |  |  |  | 27.1 |  |  |  | 49,855 |  |  |  | 25.9 |  |  |  | 46,897 |  |  |  | 27.7 |
Total hospice segment net service revenues |  | $ | 68,891 |  |  |  | 100.0 | % |  | $ | 57,309 |  |  |  | 100.0 | % |  | $ | 192,540 |  |  |  | 100.0 | % |  | $ | 169,202 |  |  |  | 100.0 | %
Home Health Segment |  | For the Three Months Ended September 30, |  |  | For the Nine Months Ended September 30, |
|  | 2025 |  |  | 2024 |  |  | 2025 |  |  | 2024 |
|  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |  |  |  |  |  |  | % of Segment |
|  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |  |  | Amount |  |  | Net Service |
|  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |  |  | (in Thousands) |  |  | Revenues |
New Mexico |  | $ | 8,644 |  |  |  | 49.0 | % |  | $ | 8,090 |  |  |  | 47.4 | % |  | $ | 25,937 |  |  |  | 48.3 | % |  | $ | 24,166 |  |  |  | 46.5 | %
Tennessee |  |  | 6,852 |  |  |  | 38.8 |  |  |  | 6,542 |  |  |  | 38.4 |  |  |  | 21,672 |  |  |  | 40.4 |  |  |  | 19,437 |  |  |  | 37.4 |
Illinois |  |  | 1,759 |  |  |  | 10.0 |  |  |  | 2,413 |  |  |  | 14.2 |  |  |  | 5,680 |  |  |  | 10.6 |  |  |  | 8,397 |  |  |  | 16.1 |
All other states |  |  | 385 |  |  |  | 2.2 |  |  |  | — |  |  |  | — |  |  |  | 385 |  |  |  | 0.7 |  |  |  | — |  |  |  | — |
Total home health segment net service revenues |  | $ | 17,640 |  |  |  | 100.0 | % |  | $ | 17,045 |  |  |  | 100.0 | % |  | $ | 53,674 |  |  |  | 100.0 | % |  | $ | 52,000 |  |  |  | 100.0 | %
A substantial portion of the Company’s revenue and accounts receivable are derived from services performed for federal, state, and local governmental agencies. The personal care segment derives a significant amount of its net service revenues in Illinois, which represented 32.0% and 38.6% of our net service revenues for the three months ended September 30, 2025 and 2024, respectively, and accounted for 32.6% and 38.5% of our net service revenues for the nine months ended September 30, 2025 and 2024, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 18.1% and 21.4% of the Company’s net service revenues for the three months ended September 30, 2025 and 2024, respectively, and accounted for 18.4% and 21.1% of the Company’s net service revenues for the nine months ended September 30, 2025 and 2024, respectively. The related receivables due from the Illinois Department on Aging represented 16.6% and 21.7% of the Company’s net accounts receivable at September 30, 2025 and December 31, 2024, respectively.

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