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Significant Payors

3 Months Ended

Mar. 31, 2022

12. Significant Payors

For the three months ended March 31, 2022 and 2021, the Company’s revenue by payor type was as follows:


Personal Care Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
State, local and other governmental programs	$	83,908		49.5	%	$	80,849		49.0	%
Managed care organizations		77,390		45.6			75,456		45.8
Private pay		4,626		2.7			4,903		3.0
Commercial insurance		2,024		1.2			2,346		1.4
Other		1,684		1.0			1,314		0.8
Total personal care segment net service revenues	$	169,632		100.0	%	$	164,868		100.0	%


Hospice Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	43,485		91.1	%	$	33,985		94.2	%
Commercial insurance		2,244		4.7			533		1.5
Managed care organizations		1,715		3.6			1,487		4.1
Other		283		0.6			89		0.2
Total hospice segment net service revenues	$	47,727		100.0	%	$	36,094		100.0	%


Home Health Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	6,812		73.4	%	$	3,502		80.7	%
Managed care organizations		1,904		20.5			798		18.4
Other		559		6.1			40		0.9
Total home health segment net service revenues	$	9,275		100.0	%	$	4,340		100.0	%

The Company derives a significant amount of its revenue from its operations in Illinois, New Mexico and New York. The percentages of segment revenue for each of these significant states for the three months ended March 31, 2022 and 2021 were as follows:


Personal Care Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Illinois	$	84,693		49.9	%	$	73,385		44.5	%
New Mexico		25,440		15.0			23,593		14.3
New York ⁽¹⁾		21,385		12.6			27,575		16.7
All other states		38,114		22.5			40,315		24.5
Total personal care segment net service revenues	$	169,632		100.0	%	$	164,868		100.0	%

(1)

In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure CDPAP fiscal intermediaries. The Company was not selected in the initial RFO process. We submitted a formal protest in response to the selection process, which was filed and accepted in March 2021, but we have not yet received a response to the formal protest. The Company continues to consider other arrangements and to pursue our protest of the award. The New York fiscal year 2023 state budget, passed in April 2022, amends the current Fiscal Intermediary RFO process to authorize all fiscal intermediaries that submitted an RFO application and served at least 200 clients in New York City or 50 clients in other counties between January 1, 2020 and March 31, 2020 to contract with the New York State Department of Health and continue to operate in all counties contained in their application. Under this provision, the Company would be allowed to continue to contract with all of its current payors for CDPAP services. The Company is currently assessing the future of its participation in this program. Given the status of the program, the Company has suspended materially all of its new patient admissions under the New York CDPAP program.


Hospice Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Ohio	$	16,328		34.2	%	$	14,114		39.1	%
Illinois ⁽²⁾		9,541		20.0			—		—
New Mexico		8,233		17.3			9,230		25.6
All other states		13,625		28.5			12,750		35.3
Total hospice segment net service revenues	$	47,727		100.0	%	$	36,094		100.0	%

(2)

With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois.


Home Health Segment	For the Three Months Ended March 31,
	2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
New Mexico	$	7,509		81.0	%	$	4,340		100.0	%
Illinois ⁽³⁾		1,766		19.0			—		—
Total home health segment net service revenues	$	9,275		100.0	%	$	4,340		100.0	%

(3)

With the acquisition of Summit Home Health, LLC (“Summit”) on October 1, 2021, the Company expanded its home health services in the state of Illinois.

A substantial portion of the Company’s revenue and accounts receivable are derived from services performed for federal, state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 42.4%, and 35.8% of our net service revenues for the three months ended March 31, 2022, and 2021, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.7% and 20.4% of the Company’s net service revenues for the three months ended March 31, 2022 and 2021, respectively.

The related receivables due from the Illinois Department on Aging represented 16.1% of the Company’s net accounts receivable at both March 31, 2022 and December 31, 2021.