Note 15 - Significant Payors

12 Months Ended

Dec. 31, 2025

Notes to Financial Statements

Concentration Risk Disclosure [Text Block]

15. Significant Payors

For 2025, 2024 and 2023, the Company’s revenue by payor type was as follows:

	Personal Care
	For the Years Ended December 31,
	2025					2024					2023
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
State, local and other governmental programs	$	553,475		50.8	%	$	456,885		53.3	%	$	400,753		50.4	%
Managed care organizations		501,528		46.0			376,604		44.0			367,557		46.2
Private pay		27,871		2.6			15,589		1.8			16,268		2.0
Commercial insurance		5,609		0.5			5,593		0.7			6,321		0.8
Other		732		0.1			1,910		0.2			3,819		0.6
Total personal care segment net service revenues	$	1,089,215		100.0	%	$	856,581		100.0	%	$	794,718		100.0	%

	Hospice
	For the Years Ended December 31,
	2025					2024					2023
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	244,344		93.1	%	$	208,099		91.2	%	$	186,317		89.9	%
Commercial insurance		8,558		3.3			11,744		5.2			12,385		6.0
Managed care organizations		8,155		3.1			7,603		3.3			7,037		3.4
Other		1,485		0.5			745		0.3			1,416		0.7
Total hospice segment net service revenues	$	262,542		100.0	%	$	228,191		100.0	%	$	207,155		100.0	%

	Home Health
	For the Years Ended December 31,
	2025					2024					2023
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	47,701		67.4	%	$	48,562		69.5	%	$	41,078		72.3	%
Managed care organizations		17,010		24.0			17,603		25.2			12,613		22.2
State, local and other governmental programs (excluding Medicare)		4,001		5.7			639		1.0			440		0.8
Other		2,061		2.9			3,023		4.3			2,647		4.7
Total home health segment net service revenues	$	70,773		100.0	%	$	69,827		100.0	%	$	56,778		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 2025, 2024 and 2023 were as follows:

	Personal Care
	For the Years Ended December 31,
	2025					2024					2023
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Illinois	$	458,828		42.1	%	$	441,012		51.5	%	$	411,081		51.7	%
Texas		216,712		19.9			17,936		2.0			—		—
New Mexico		118,588		10.9			115,381		13.5			115,986		14.6
New York (1)		—		—			71,763		8.4			92,469		11.6
All other states		295,087		27.1			210,489		24.6			175,182		22.1
Total personal care segment net service revenues	$	1,089,215		100.0	%	$	856,581		100.0	%	$	794,718		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 divested these operations. See Note 5 to the Notes to Consolidated Financial Statements, Divestiture, for additional details regarding our divestiture.

With the Jacksonville Acquisition, the Great Lakes Acquisition, the Helping Hands Acquisition and the Gold Horses Acquisition in 2025, the Company expanded its personal care services to consumers in the state of Florida, Michigan, Pennsylvania and Texas. With the acquisition of Upstate and the Gentiva Acquisition in 2024, the Company expanded its personal care services to consumers in the state of Arizona, Arkansas, California, Missouri, North Carolina, South Carolina and Texas.

	Hospice
	For the Years Ended December 31,
	2025					2024					2023
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Ohio	$	101,833		38.8	%	$	84,811		37.2	%	$	74,871		36.1	%
New Mexico		32,865		12.5			28,532		12.5			30,782		14.9
Illinois		60,427		23.0			52,560		23.0			47,247		22.8
All other states		67,417		25.7			62,288		27.3			54,255		26.2
Total hospice segment net service revenues	$	262,542		100.0	%	$	228,191		100.0	%	$	207,155		100.0	%

With the Helping Hands Acquisition in 2025, the Company entered the hospice market in Pennsylvania, and with the acquisition of Tennessee Quality Care in 2023, the Company expanded its hospice services to patients in the state of Tennessee.

	Home Health
	For the Years Ended December 31,
	2025					2024					2023
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
New Mexico	$	34,724		49.1	%	$	32,766		46.9	%	$	32,949		58.0	%
Tennessee		28,209		39.9			26,497		38.0			10,978		19.4
Illinois		7,171		10.1			10,564		15.1			12,851		22.6
All other states		669		0.9			—		—			—		—
Total home health segment net service revenues	$	70,773		100.0	%	$	69,827		100.0	%	$	56,778		100.0	%

With the Gentiva Acquisition in 2024 and the acquisition of Tennessee Quality Care in 2023 expanded the Company’s home health operations in Tennessee.

A substantial portion of the Company’s revenue and accounts receivable is derived from services performed for state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 37.0%, 43.7% and 44.5% of our net service revenues for the years ended December 31, 2025, 2024 and 2023, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 18.1%, 21.0% and 20.9% of the Company’s net service revenues for 2025, 2024 and 2023, respectively.

The related receivables due from the Illinois Department on Aging represented 25.2% and 21.7% of the Company’s net accounts receivable at December 31, 2025 and 2024, respectively.