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Note 13 - Significant Payors - Revenue from External Customers by Products and Services (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended
--- | --- | ---
Sep. 30, 2025 | Sep. 30, 2024 | Sep. 30, 2025 | Sep. 30, 2024
Net service revenues |  | $ 362,301 | $ 289,787 | $ 1,049,452 | $ 857,455
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] |  |  |  |  |
Net service revenues |  | $ 275,770 | $ 215,433 | $ 803,238 | $ 636,253
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 |  | $ 139,383 | $ 116,702 | $ 410,781 | $ 337,458
Concentration Risk, Percentage |  | 50.50% | 54.20% | 51.10% | 53.00%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | Managed Care Organizations [Member] |  |  |  |  |
Net service revenues |  | $ 127,293 | $ 93,321 | $ 366,210 | $ 281,732
Concentration Risk, Percentage |  | 46.20% | 43.30% | 45.60% | 44.30%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | Commercial Insurance [Member] |  |  |  |  |
Net service revenues |  | $ 1,860 | $ 1,415 | $ 4,356 | $ 4,368
Concentration Risk, Percentage |  | 0.70% | 0.70% | 0.50% | 0.70%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | Private Pay [Member] |  |  |  |  |
Net service revenues |  | $ 7,064 | $ 3,599 | $ 21,331 | $ 11,194
Concentration Risk, Percentage |  | 2.50% | 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 |  | $ 170 | $ 396 | $ 560 | $ 1,501
Concentration Risk, Percentage |  | 0.10% | 0.10% | 0.10% | 0.20%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] |  |  |  |  |
Net service revenues |  | $ 68,891 | $ 57,309 | $ 192,540 | $ 169,202
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 |  | $ 64,148 | $ 52,413 | $ 178,784 | $ 154,187
Concentration Risk, Percentage |  | 93.10% | 91.50% | 92.90% | 91.10%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | Managed Care Organizations [Member] |  |  |  |  |
Net service revenues |  | $ 2,216 | $ 1,821 | $ 6,245 | $ 5,518
Concentration Risk, Percentage |  | 3.20% | 3.20% | 3.20% | 3.30%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | Commercial Insurance [Member] |  |  |  |  |
Net service revenues |  | $ 2,140 | $ 2,892 | $ 6,518 | $ 8,870
Concentration Risk, Percentage |  | 3.10% | 5.00% | 3.40% | 5.20%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | Other [Member] |  |  |  |  |
Net service revenues |  | $ 387 | $ 183 | $ 993 | $ 627
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 |  | $ 17,640 | $ 17,045 | $ 53,674 | $ 52,000
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 |  | $ 11,617 | $ 12,036 | $ 36,711 | $ 36,216
Concentration Risk, Percentage |  | 65.90% | 70.60% | 68.40% | 69.60%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | Managed Care Organizations [Member] |  |  |  |  |
Net service revenues |  | $ 4,492 | $ 4,215 | $ 12,564 | $ 13,291
Concentration Risk, Percentage |  | 25.50% | 24.70% | 23.40% | 25.60%
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 |  | $ 993 | $ (17) | $ 2,878 | $ 0
Concentration Risk, Percentage |  | 5.60% | 0.00% | 5.30% | 0.00%
Customer Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | Other [Member] |  |  |  |  |
Net service revenues |  | $ 538 | $ 811 | $ 1,521 | $ 2,493
Concentration Risk, Percentage |  | 3.00% | 4.70% | 2.90% | 4.80%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] |  |  |  |  |
Net service revenues |  | $ 275,770 | $ 215,433 | $ 803,238 | $ 636,253
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 |  | $ 115,989 | $ 111,916 | $ 342,629 | $ 330,265
Concentration Risk, Percentage |  | 42.10% | 51.90% | 42.70% | 51.90%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | NEW MEXICO |  |  |  |  |
Net service revenues |  | $ 30,029 | $ 28,962 | $ 87,320 | $ 86,573
Concentration Risk, Percentage |  | 10.90% | 13.40% | 10.90% | 13.60%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | NEW YORK |  |  |  |  |
Net service revenues | [1] | $ (318) | $ 21,406 | $ (104) | $ 68,239
Concentration Risk, Percentage | [1] | 0.00% | 9.90% | 0.00% | 10.70%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Personal Care Segment [Member] | TEXAS |  |  |  |  |
Net service revenues |  | $ 53,449 | $ 0 | $ 155,773 | $ 0
Concentration Risk, Percentage |  | 19.40% | 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 |  | $ 76,621 | $ 53,149 | $ 217,620 | $ 151,176
Concentration Risk, Percentage |  | 27.60% | 24.80% | 27.00% | 23.80%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] |  |  |  |  |
Net service revenues |  | $ 68,891 | $ 57,309 | $ 192,540 | $ 169,202
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 |  | $ 15,532 | $ 13,289 | $ 44,516 | $ 38,544
Concentration Risk, Percentage |  | 22.50% | 23.20% | 23.10% | 22.80%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | OHIO |  |  |  |  |
Net service revenues |  | $ 26,913 | $ 21,531 | $ 73,304 | $ 62,400
Concentration Risk, Percentage |  | 39.10% | 37.60% | 38.10% | 36.90%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | NEW MEXICO |  |  |  |  |
Net service revenues |  | $ 8,769 | $ 6,951 | $ 24,865 | $ 21,361
Concentration Risk, Percentage |  | 12.70% | 12.10% | 12.90% | 12.60%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Hospice Segment [Member] | All Other States [Member] |  |  |  |  |
Net service revenues |  | $ 17,677 | $ 15,538 | $ 49,855 | $ 46,897
Concentration Risk, Percentage |  | 25.70% | 27.10% | 25.90% | 27.70%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] |  |  |  |  |
Net service revenues |  | $ 17,640 | $ 17,045 | $ 53,674 | $ 52,000
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 |  | $ 1,759 | $ 2,413 | $ 5,680 | $ 8,397
Concentration Risk, Percentage |  | 10.00% | 14.20% | 10.60% | 16.10%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | NEW MEXICO |  |  |  |  |
Net service revenues |  | $ 8,644 | $ 8,090 | $ 25,937 | $ 24,166
Concentration Risk, Percentage |  | 49.00% | 47.40% | 48.30% | 46.50%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | TENNESSEE |  |  |  |  |
Net service revenues |  | $ 6,852 | $ 6,542 | $ 21,672 | $ 19,437
Concentration Risk, Percentage |  | 38.80% | 38.40% | 40.40% | 37.40%
Geographic Concentration Risk [Member] | Revenue from Contract with Customer, Segment Benchmark [Member] | Home Health Segment [Member] | All Other States [Member] |  |  |  |  |
Net service revenues |  | $ 385 | $ 0 | $ 385 | $ 0
Concentration Risk, Percentage |  | 2.20% | 0.00% | 0.70% | 0.00%
[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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