Goodwill and Other Intangibles, Net (Tables)

12 Months Ended

Dec. 31, 2022

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, 2022 and 2021 (amounts in thousands):

	Home Health		Hospice		Home and community- based		Facility-based		HCI		Total
Goodwill
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
Acquisitions	19,917		—		—		—		—		19,917
Noncontrolling interest	1,266		—		—		—		—		1,266
Adjustments and disposals	(2,491)		(20)		(1,320)		—		—		(3,831)
Balance as of December 31, 2022	$	987,127	$	556,312	$	165,707	$	15,770	$	40,862	$	1,765,778
Intangibles Assets
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
Acquisitions	5,483		—		—		—		—		5,483
Amortization	(1,937)		(1,679)		(9)		(368)		(581)		(4,574)

Adjustments and disposals	(3,805)		(1,267)		(511)		—		—		(5,583)
Balance as of December 31, 2022	$	237,720	$	114,394	$	23,725	$	5,551	$	13,938	$	395,328

Schedule of Changes in Intangible Assets, Indefinite

The following tables summarize the changes in intangible assets during the twelve months ended December 31, 2022 and 2021 (amounts in thousands):

	2022		2021
Indefinite-lived intangible assets:
Trade names	$	210,373	$	207,780
Certificates of need/licenses	170,808		173,955
Net total	$	381,181	$	381,735
Definite-lived intangible assets:
Trade names
Gross carrying amount	$	11,273	$	11,073
Accumulated amortization	(10,615)		(9,606)
Net total	$	658	$	1,467
Non-compete agreements
Gross carrying amount	$	14,778	$	14,524
Accumulated amortization	(10,155)		(7,172)
Net total	$	4,623	$	7,352
Customer relationships
Gross carrying amount	$	11,822	$	11,822
Accumulated amortization	(2,956)		(2,374)
Net total	$	8,866	$	9,448
Total definite-lived intangible assets
Gross carrying amount	$	37,873	$	37,419
Accumulated amortization	(23,726)		(19,152)
Net total	$	14,147	$	18,267

Total intangible assets:
Gross carrying amount	$	419,054	$	419,154
Accumulated amortization	(23,726)		(19,152)
Net total	$	395,328	$	400,002

Schedule of Changes in Intangible Assets, Finite

The following tables summarize the changes in intangible assets during the twelve months ended December 31, 2022 and 2021 (amounts in thousands):

	2022		2021
Indefinite-lived intangible assets:
Trade names	$	210,373	$	207,780
Certificates of need/licenses	170,808		173,955
Net total	$	381,181	$	381,735
Definite-lived intangible assets:
Trade names
Gross carrying amount	$	11,273	$	11,073
Accumulated amortization	(10,615)		(9,606)
Net total	$	658	$	1,467
Non-compete agreements
Gross carrying amount	$	14,778	$	14,524
Accumulated amortization	(10,155)		(7,172)
Net total	$	4,623	$	7,352
Customer relationships
Gross carrying amount	$	11,822	$	11,822
Accumulated amortization	(2,956)		(2,374)
Net total	$	8,866	$	9,448
Total definite-lived intangible assets
Gross carrying amount	$	37,873	$	37,419
Accumulated amortization	(23,726)		(19,152)
Net total	$	14,147	$	18,267

Total intangible assets:
Gross carrying amount	$	419,054	$	419,154
Accumulated amortization	(23,726)		(19,152)
Net total	$	395,328	$	400,002

Schedule of Estimated Intangible Asset Amortization Expense

The estimated intangible asset amortization expense for each of the five years subsequent to December 31, 2022 is as follows (amounts in thousands):

Year	Amortization amount
2023	$	2,708
2024	2,224
2025	1,860
2026	1,579
2027	656
Total	$	9,027