Goodwill and Other Intangibles, Net (Tables)

12 Months Ended

Dec. 31, 2021

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Changes in Goodwill by Segment

The following table summarizes changes in goodwill and other intangibles assets by segment during the twelve months ended December 31, 2021 and 2020 (amounts in thousands):

	Home Health		Hospice		Home and community- based		Facility-based		HCI		Total
Goodwill
Balance as of December 31, 2019	$	867,924	$	128,875	$	166,629	$	15,682	$	40,862	$	1,219,972
Acquisitions	12,025		21,025		134		88		—		33,272
Noncontrolling interest	4,695		2,122		10		—		—		6,827
Adjustments and disposals	(644)		(280)		—		—		—		(924)
Balance as of December 31, 2020	$	884,000	$	151,742	$	166,773	$	15,770	$	40,862	$	1,259,147
Acquisitions	84,377		404,590		254		—		—		489,221

Noncontrolling interest	78		—		—		—		—		78
Adjustments and disposals	(20)		—		—		—		—		(20)
Balance as of December 31, 2021	$	968,435	$	556,332	$	167,027	$	15,770	$	40,862	$	1,748,426
Intangibles Assets
Balance as of December 31, 2019	$	219,872	$	40,590	$	24,096	$	5,317	$	15,681	$	305,556
Acquisitions	7,193		4,212		127		—		—		11,532
Amortization	(556)		(70)		(15)		(6)		(581)		(1,228)
Adjustments and disposals	(505)		—		—		—		—		(505)
Balance as of December 31, 2020	$	226,004	$	44,732	$	24,208	$	5,311	$	15,100	$	315,355
Acquisitions	13,734		73,026		46		614		—		87,420
Amortization	(480)		(418)		(9)		(6)		(581)		(1,494)
Adjustments and disposals	(1,279)		—		—		—		—		(1,279)
Balance as of December 31, 2021	$	237,979	$	117,340	$	24,245	$	5,919	$	14,519	$	400,002

Schedule of Changes in Intangible Assets, Indefinite

The following tables summarize the changes in intangible assets during the twelve months ended December 31, 2021 and 2020 (amounts in thousands):

	2021		2020
Indefinite-lived intangible assets:
Trade names	$	207,780	$	168,700
Certificates of need/licenses	173,955		135,013
Net total	$	381,735	$	303,713
Definite-lived intangible assets:
Trade names
Gross carrying amount	$	11,073	$	10,212
Accumulated amortization	(9,606)		(9,480)

Net total	$	1,467	$	732
Non-compete agreements
Gross carrying amount	$	14,524	$	7,267
Accumulated amortization	(7,172)		(6,387)
Net total	$	7,352	$	880
Customer relationships
Gross carrying amount	$	11,822	$	11,822
Accumulated amortization	(2,374)		(1,792)
Net total	$	9,448	$	10,030
Total definite-lived intangible assets
Gross carrying amount	$	37,419	$	29,301
Accumulated amortization	(19,152)		(17,659)
Net total	$	18,267	$	11,642
Total intangible assets:
Gross carrying amount	$	419,154	$	333,014
Accumulated amortization	(19,152)		(17,659)
Net total	$	400,002	$	315,355

Schedule of Changes in Intangible Assets, Finite

The following tables summarize the changes in intangible assets during the twelve months ended December 31, 2021 and 2020 (amounts in thousands):

	2021		2020
Indefinite-lived intangible assets:
Trade names	$	207,780	$	168,700
Certificates of need/licenses	173,955		135,013
Net total	$	381,735	$	303,713
Definite-lived intangible assets:
Trade names
Gross carrying amount	$	11,073	$	10,212
Accumulated amortization	(9,606)		(9,480)

Net total	$	1,467	$	732
Non-compete agreements
Gross carrying amount	$	14,524	$	7,267
Accumulated amortization	(7,172)		(6,387)
Net total	$	7,352	$	880
Customer relationships
Gross carrying amount	$	11,822	$	11,822
Accumulated amortization	(2,374)		(1,792)
Net total	$	9,448	$	10,030
Total definite-lived intangible assets
Gross carrying amount	$	37,419	$	29,301
Accumulated amortization	(19,152)		(17,659)
Net total	$	18,267	$	11,642
Total intangible assets:
Gross carrying amount	$	419,154	$	333,014
Accumulated amortization	(19,152)		(17,659)
Net total	$	400,002	$	315,355

Schedule of Estimated Intangible Asset Amortization Expense

The estimated intangible asset amortization expense for each of the five years subsequent to December 31, 2021 is as follows (amounts in thousands):

Year	Amortization amount
2022	$	3,696
2023	2,524
2024	2,098
2025	1,790
2026	1,578
Total	$	11,686