AMEDISYS INC, 10-K filed on 2/25/2021
Annual Report
v3.20.4
Document and Entity Information - USD ($)
$ in Billions
 12 Months Ended
Dec. 31, 2020
Feb. 19, 2021
Jun. 30, 2020
Document And Entity Information [Abstract]      
Document Type 10-K    
Document Annual Report true    
Document Period End Date Dec. 31, 2020    
Document Transition Report false    
Entity File Number 0-24260    
Entity Registrant Name AMEDISYS, INC.    
Entity Incorporation, State or Country Code DE    
Entity Tax Identification Number 11-3131700    
Entity Address, Address Line One 3854 American Way, Suite A,    
Entity Address, City or Town Baton Rouge,    
Entity Address, State or Province LA    
Entity Address, Postal Zip Code 70816    
City Area Code 225    
Local Phone Number 292-2031    
Title of 12(b) Security Common Stock, par value $0.001 per share    
Security Exchange Name NASDAQ    
Entity Well-known Seasoned Issuer Yes    
Entity Voluntary Filers No    
Entity Current Reporting Status Yes    
Entity Interactive Data Current Yes    
Entity Filer Category Large Accelerated Filer    
Entity Small Business false    
Entity Emerging Growth Company false    
ICFR Auditor Attestation Flag true    
Entity Shell Company false    
Entity Public Float     $ 5.5
Entity Common Stock, Shares Outstanding   32,848,547  
Amendment Flag false    
Document Fiscal Year Focus 2020    
Document Fiscal Period Focus FY    
Trading Symbol AMED    
Entity Central Index Key 0000896262    
Current Fiscal Year End Date --12-31    
v3.20.4
CONSOLIDATED BALANCE SHEETS - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Current assets:    
Cash and cash equivalents $ 81,808 $ 30,294
Restricted cash 1,549 66,196
Patient accounts receivable 255,145 237,596
Prepaid expenses 10,217 8,243
Other current assets 13,265 8,225
Total current assets 361,984 350,554
Property and equipment, net of accumulated depreciation of $95,024 and $96,137 23,719 28,113
Operating lease right of use assets 93,440 84,791
Goodwill 932,685 658,500
Intangible assets, net of accumulated amortization of $22,973 and $7,044 74,183 64,748
Deferred income taxes 47,987 21,427
Other assets 33,200 54,612
Total assets 1,567,198 1,262,745
Current liabilities:    
Accounts payable 42,674 31,259
Payroll and employee benefits 146,929 120,877
Accrued expenses 166,192 137,111
Provider relief fund advance 60,000 0
Current portion of long-term obligations 10,496 9,927
Current portion of operating lease liabilities 30,046 27,769
Total current liabilities 456,337 326,943
Long-term obligations, less current portion 204,511 232,256
Operating lease liabilities, less current portion 61,987 56,128
Other long-term obligations 33,622 5,905
Total liabilities 756,457 621,232
Commitments and Contingencies
Equity:    
Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding 0 0
Common stock, $0.001 par value, 60,000,000 shares authorized; 37,470,212 and 36,638,021 shares issued; and 32,814,278 and 32,284,051 shares outstanding 38 37
Additional paid-in capital 698,287 645,256
Treasury stock at cost, 4,655,934 and 4,353,970 shares of common stock (319,092) (251,241)
Accumulated other comprehensive income 0 15
Retained earnings 429,991 246,383
Total Amedisys, Inc. stockholders’ equity 809,224 640,450
Noncontrolling interests 1,517 1,063
Total equity 810,741 641,513
Total liabilities and equity $ 1,567,198 $ 1,262,745
v3.20.4
CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Statement of Financial Position [Abstract]    
Property and equipment, accumulated depreciation $ 95,024 $ 96,137
Intangible assets, accumulated amortization $ 22,973 $ 7,044
Preferred stock, par value (usd per share) $ 0.001 $ 0.001
Preferred stock, authorized (shares) 5,000,000 5,000,000
Preferred stock, issued (shares) 0 0
Preferred stock, outstanding (shares) 0 0
Common stock, par value (usd per share) $ 0.001 $ 0.001
Common stock, authorized (shares) 60,000,000 60,000,000
Common stock, issued (shares) 37,470,212 36,638,021
Common stock, outstanding (shares) 32,814,278 32,284,051
Treasury stock at cost (shares) 4,655,934 4,353,970
v3.20.4
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)
shares in Thousands, $ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Income Statement [Abstract]      
Net service revenue $ 2,071,519 $ 1,955,633 $ 1,662,578
Other operating income 34,372 0 0
Cost of service, excluding depreciation and amortization 1,185,369 1,150,337 992,863
General and administrative expenses:      
Salaries and benefits 449,448 394,452 316,522
Non-cash compensation 26,730 25,040 17,887
Other 192,122 188,434 166,897
Depreciation and amortization 28,802 18,428 13,261
Asset impairment charge 4,152 1,470 0
Operating expenses 1,886,623 1,778,161 1,507,430
Operating income 219,268 177,472 155,148
Other income (expense):      
Interest income 292 78 278
Interest expense (11,038) (14,515) (7,370)
Equity in earnings from equity method investments 3,966 5,338 7,692
Miscellaneous, net (1,669) 2,037 3,240
Total other (expense) income, net (8,449) (7,062) 3,840
Income before income taxes 210,819 170,410 158,988
Income tax expense (25,635) (42,503) (38,859)
Net income 185,184 127,907 120,129
Net income attributable to noncontrolling interests (1,576) (1,074) (783)
Net income attributable to Amedisys, Inc. $ 183,608 $ 126,833 $ 119,346
Basic earnings per common share:      
Net income attributable to Amedisys, Inc. common stockholders (usd per share) $ 5.64 $ 3.95 $ 3.64
Weighted average shares outstanding (shares) 32,559 32,142 32,791
Diluted earnings per common share:      
Net income attributable to Amedisys, Inc. common stockholders (usd per share) $ 5.52 $ 3.84 $ 3.55
Weighted average shares outstanding (shares) 33,268 32,990 33,609
v3.20.4
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Statement of Comprehensive Income [Abstract]      
Net income $ 185,184 $ 127,907 $ 120,129
Other comprehensive income 0 0 0
Comprehensive income 185,184 127,907 120,129
Comprehensive income attributable to non-controlling interests (1,576) (1,074) (783)
Comprehensive income attributable to Amedisys, Inc. $ 183,608 $ 126,833 $ 119,346
v3.20.4
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($)
$ in Thousands
Total
Common Stock
Additional Paid-in Capital
Treasury Stock
Accumulated Other Comprehensive Income
Retained Earnings
Noncontrolling Interests
Balance, Stockholders Equity at Dec. 31, 2017 $ 516,426 $ 35 $ 568,780 $ (53,713) $ 15 $ 204 $ 1,105
Balance (in shares) at Dec. 31, 2017   35,747,134          
Increase (Decrease) in Stockholders' Equity [Roll Forward]              
Issuance of stock - employee stock purchase plan 2,429   2,429        
Issuance of stock - employee stock purchase plan (shares)   38,961          
Issuance of stock - 401 (k) plan 9,232   9,232        
Issuance of stock - 401 (k) plan (shares)   129,451          
Issuance/(cancellation) of non-vested stock 0 $ 1 (1)        
Issuance/(cancellation) of non-vested stock (shares)   174,044          
Exercise of stock options 5,953   5,953        
Exercise of stock options (in shares)   162,690          
Non-cash compensation 17,887   17,887        
Surrendered shares (6,570)     (6,570)      
Shares repurchased (181,402)     (181,402)      
Noncontrolling interest distribution (1,090)           (1,090)
Repurchase of noncontrolling interest (361)   (614)       253
Net income 120,129         119,346 783
Balance, Stockholders Equity at Dec. 31, 2018 482,633 $ 36 603,666 (241,685) 15 119,550 1,051
Balance (in shares) at Dec. 31, 2018   36,252,280          
Increase (Decrease) in Stockholders' Equity [Roll Forward]              
Issuance of stock - employee stock purchase plan 3,187   3,187        
Issuance of stock - employee stock purchase plan (shares)   30,483          
Issuance of stock - 401 (k) plan 9,753   9,753        
Issuance of stock - 401 (k) plan (shares)   79,056          
Issuance/(cancellation) of non-vested stock 0 $ 1 (1)        
Issuance/(cancellation) of non-vested stock (shares)   189,134          
Exercise of stock options 3,611   3,611        
Exercise of stock options (in shares)   87,068          
Non-cash compensation 25,040   25,040        
Surrendered shares (9,556)     (9,556)      
Noncontrolling interest distribution (1,062)           (1,062)
Net income 127,907         126,833 1,074
Balance, Stockholders Equity at Dec. 31, 2019 641,513 $ 37 645,256 (251,241) 15 246,383 1,063
Balance (in shares) at Dec. 31, 2019   36,638,021          
Increase (Decrease) in Stockholders' Equity [Roll Forward]              
Issuance of stock - employee stock purchase plan 3,562   3,562        
Issuance of stock - employee stock purchase plan (shares)   21,561          
Issuance of stock - 401 (k) plan 3,057   3,057        
Issuance of stock - 401 (k) plan (shares)   18,312          
Issuance/(cancellation) of non-vested stock 0            
Issuance/(cancellation) of non-vested stock (shares)   169,489          
Exercise of stock options $ 6,325 $ 1 6,324        
Exercise of stock options (in shares) 622,829 622,829          
Non-cash compensation $ 26,730   26,730        
Surrendered shares (54,493)   13,358 (67,851)      
Noncontrolling interest distribution (1,122)           (1,122)
Write-off of other comprehensive income (15)       (15)    
Net income 185,184         183,608 1,576
Balance, Stockholders Equity at Dec. 31, 2020 $ 810,741 $ 38 $ 698,287 $ (319,092) $ 0 $ 429,991 $ 1,517
Balance (in shares) at Dec. 31, 2020   37,470,212          
v3.20.4
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Cash Flows from Operating Activities:      
Net income $ 185,184 $ 127,907 $ 120,129
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 28,802 18,428 13,261
Non-cash compensation 26,730 25,040 17,887
Non-cash 401(k) employer match 0 10,509 8,976
Amortization and impairment of operating lease right of use assets 39,140 35,905 0
(Gain) loss on disposal of property and equipment (30) 141 714
Loss on sale of equity method investment 2,980 0 0
Write-off of other comprehensive income (15) 0 0
Deferred income taxes (26,560) 13,466 20,271
Equity in earnings from equity method investments (3,966) (5,338) (7,692)
Amortization of deferred debt issuance costs/debt discount 869 873 797
Return on equity investment 5,444 4,955 6,158
Asset impairment charge 4,152 1,470 0
Changes in operating assets and liabilities, net of impact of acquisitions:      
Patient accounts receivable 2,114 (24,146) 12,224
Other current assets (7,181) (2,682) 8,679
Other assets 31 832 2,947
Accounts payable 1,941 (11,329) 3,165
Accrued expenses 39,839 42,096 13,524
Other long-term obligations 27,717 (329) 2,443
Operating lease liabilities (34,695) (32,295) 0
Operating lease right of use assets (3,544) (3,503) 0
Net cash provided by operating activities 288,952 202,000 223,483
Cash Flows from Investing Activities:      
Proceeds from sale of deferred compensation plan assets 101 448 715
Proceeds from the sale of property and equipment 80 162 54
Purchases of property and equipment (5,332) (7,888) (6,558)
Investments in equity method investees (875) (210) (7,144)
Proceeds from sale of equity method investment 17,876 0 0
Acquisitions of businesses, net of cash acquired (298,958) (345,460) (9,260)
Net cash used in investing activities (287,108) (352,948) (22,193)
Cash Flows from Financing Activities:      
Proceeds from issuance of stock upon exercise of stock options 6,325 3,611 5,953
Proceeds from issuance of stock to employee stock purchase plan 3,562 3,187 2,429
Shares withheld to pay taxes on non-cash compensation (54,493) (9,556) (6,570)
Non-controlling interest distribution (1,122) (1,062) (1,090)
Proceeds from borrowings under term loan 0 175,000 0
Proceeds from borrowings under revolving line of credit 684,200 262,500 138,000
Repayments of borrowings under revolving line of credit (703,200) (200,000) (130,500)
Principal payments of long-term obligations (10,249) (5,624) (91,450)
Debt issuance costs 0 (847) (2,433)
Provider relief fund advance 60,000 0 0
Purchase of company stock 0 0 (181,402)
Repurchase of noncontrolling interest 0 0 (361)
Net cash (used in) provided by financing activities (14,977) 227,209 (267,424)
Net (decrease) increase in cash, cash equivalents and restricted cash (13,133) 76,261 (66,134)
Cash, cash equivalents and restricted cash at beginning of period 96,490 20,229 86,363
Cash, cash equivalents and restricted cash at end of period 83,357 96,490 20,229
Supplemental Disclosures of Cash Flow Information:      
Cash paid for interest 6,207 9,628 3,522
Cash paid for income taxes, net of refunds received 50,721 29,522 14,278
Supplemental Disclosures of Non-Cash Financing Activity:      
Note payable issued for software licenses $ 0 $ 0 $ 418
v3.20.4
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS
 12 Months Ended
Dec. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS
Amedisys, Inc., a Delaware corporation (together with its consolidated subsidiaries, referred to herein as “Amedisys,” “we,” “us,” or “our”), is a multi-state provider of home health, hospice and personal care services with approximately 75%, 74% and 73% of our revenue derived from Medicare for 2020, 2019 and 2018, respectively. As of December 31, 2020, we owned and operated 320 Medicare-certified home health care centers, 180 Medicare-certified hospice care centers and 14 personal-care care centers in 39 states within the United States and the District of Columbia.
Recently Adopted Accounting Pronouncements
On January 1, 2020, the Company adopted Accounting Standards Update ("ASU") 2016-13, Financial Instruments - Credit Losses (Topic 326), which provides guidance for measuring credit losses on financial instruments. Our adoption of this standard did not have a material effect on our consolidated financial statements.
During the fourth quarter of 2020, the Company adopted ASU 2019-12, Income Taxes (Topic 740) - Simplifying the Accounting for Income Taxes, which eliminates certain exceptions related to the approach for intraperiod tax allocation, the methodology for calculating taxes during the interim periods and the recognition of deferred tax liabilities for outside basis differences. This guidance also simplifies aspects of the accounting for franchise taxes, enacts changes in tax laws or rates and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. The guidance is effective for interim and annual periods beginning after December 15, 2020, with early adoption permitted. Our adoption of this standard on a prospective basis was not material to the Company’s consolidated financial statements.
On January 1, 2019, the Company adopted Accounting Standards Codification ("ASC") 842, Leases, using a modified retrospective transition approach, which requires the new standard to be applied to all leases existing at the date of initial application. Under ASC 842, lessees are required to recognize a lease liability and right-of-use asset ("ROU asset") for all leases with a term greater than twelve months and to disclose key information about leasing arrangements. Additionally, leases are classified as either financing or operating; the classification determines the pattern of expense recognition and classification within the statement of operations. We used the standard's effective date as our date of initial application. Consequently, our financial information was not updated and the disclosures required under the new standard are not provided for dates and periods prior to January 1, 2019. The new standard provides several optional practical expedients that can be adopted at transition. We elected the "package of practical expedients," which allows us to not reassess our prior conclusions regarding lease identification, lease classification and initial direct costs. We did not elect the use-of-hindsight or the practical expedient pertaining to land easements; the latter not being applicable to us. The most significant effects related to this adoption relate to (1) the recognition of new ROU assets and lease liabilities on our balance sheet for our real estate and fleet operating leases; and (2) significant new disclosures about our leasing activities. Upon adoption, we recognized approximately $80 million in operating leases liabilities with corresponding ROU assets of approximately the same amount. The new standard also provides practical expedients for an entity’s ongoing accounting. We have elected the practical expedient that allows us to not separate lease and non-lease components for all of our leases.
On January 1, 2019, the Company adopted ASU 2018-07, Compensation - Stock Compensation (Topic 718): Improvements to Nonemployees Share-Based Payment Accounting, which expands the scope of Topic 718 to include share-based payments issued to nonemployees for goods or services. Our adoption of this standard did not have an effect on our consolidated financial statements.
On January 1, 2018, the Company adopted ASC 606, Revenue from Contracts with Customers, using the full retrospective method. ASC 606 outlines a single comprehensive model to use in accounting for revenue arising from contracts with customers. The standard supersedes existing revenue recognition requirements and eliminates most industry-specific guidance from U.S. Generally Accepted Accounting Principles ("U.S. GAAP"). The core principle of the revenue recognition standard is to require an entity to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which it expects to be entitled in exchange for those goods or services. As a result of the Company's adoption of ASC 606, the revenue and related estimated uncollectible amounts owed to us by non-Medicare payors that were historically classified as provision for doubtful accounts are now considered a revenue adjustment in determining net service revenue. Accordingly, the Company reports estimated uncollectible balances due from third-party payors and uncollectible balances associated with patient responsibility as a reduction of the transaction price and therefore, as a reduction in net service revenue (or as it relates to Hospice room and board, an increase in cost of service, excluding depreciation and amortization) when historically these amounts were classified as provision for doubtful accounts within operating expenses within our consolidated statements of operations. In addition, the adoption of ASC 606 resulted in increased disclosure,
including qualitative and quantitative disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers.
On January 1, 2018, the Company adopted ASU 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business, which provides guidance to assist entities with evaluating whether transactions should be accounted for as an acquisition (or disposal) of assets or a business. We adopted this ASU on a prospective basis. The impact on our consolidated financial statements and related disclosures will depend on the facts and circumstances of any specific future transactions as evaluated under the new framework.

On January 1, 2018, the Company adopted ASU 2017-04, Intangibles - Goodwill and Other (Topic 350) - Simplifying the Test for Goodwill Impairment, which eliminates the requirement to calculate the implied fair value of goodwill to measure a goodwill impairment charge (Step 2 of the goodwill impairment test). Instead, impairment will be measured using the difference between the carrying amount and the fair value of the reporting unit. The ASU is effective for annual and interim periods beginning after December 15, 2019, with early adoption permitted. We adopted this ASU on a prospective basis and will apply this guidance to our future tests of goodwill impairment.
On January 1, 2018, the Company adopted ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments, which provides specific guidance on eight cash flow classification issues not specifically addressed by U.S. GAAP. The ASU is effective for annual and interim periods beginning after December 15, 2017. The standard should be applied using a retrospective transition method unless it is impractical to do so for some of the issues. In such case, the amendments for those issues would be applied prospectively as of the earliest date practicable. Our adoption of this standard using a retrospective transition method for each period presented did not have an effect on our consolidated financial statements.
Recently Issued Accounting Pronouncements
On March 12, 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional expedients and exceptions for applying U.S. GAAP to contract modifications and hedging relationships that reference LIBOR or another reference rate expected to be discontinued, subject to meeting certain criteria. The amendments in this ASU were effective beginning on March 12, 2020 and may generally be applied prospectively through December 31, 2022. This standard will not have an effect on our consolidated financial statements.
Use of Estimates
Our accounting and reporting policies conform with U.S. GAAP. In preparing the consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates.
Principles of Consolidation
These consolidated financial statements include the accounts of Amedisys, Inc. and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying consolidated financial statements, and business combinations accounted for as purchases have been included in our consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain equity investments that are accounted for as set forth below.
Investments
We consolidate investments when the entity is a variable interest entity and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50%. Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our consolidated financial statements. During 2016, we sold a 30% interest in one of our care centers while maintaining a controlling interest in the newly formed joint venture; we repurchased the 30% interest during 2018.
We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a variable interest entity in which we are the primary beneficiary. During 2020, we sold our investment in the Heritage Healthcare Innovation Fund, LP via a secondary transaction for $17.9 million which resulted in a $3.0 million loss which is reflected in miscellaneous, net within our consolidated statement of
operations for the year ended December 31, 2020. The Company's original investment was made in 2010 and no longer fit within our strategic areas of focus. Proceeds from the sale were used to pay down debt and fund operations. During 2018, we made a $7.0 million investment in a healthcare analytics company; this investment is accounted for under the equity method. The book value of investments that we account for under the equity method of accounting totaled $14.2 million and $35.7 million as of December 31, 2020 and 2019, respectively, and is reflected in other assets within our consolidated balance sheets.
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
 12 Months Ended
Dec. 31, 2020
Accounting Policies [Abstract]  
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Revenue Recognition
We account for revenue from contracts with customers in accordance with ASC 606, Revenue from Contracts with Customers, and as such, we recognize revenue in the period in which we satisfy our performance obligations under our contracts by transferring our promised services to our customers in amounts that reflect the consideration to which we expect to be entitled in exchange for providing patient care, which are the transaction prices allocated to the distinct services. The Company's cost of obtaining contracts is not material.
Revenues are recognized as performance obligations are satisfied, which varies based on the nature of the services provided. Our performance obligation is the delivery of patient care services in accordance with the nature and frequency of services outlined in physicians' orders, which are determined by a physician based on a patient's specific goals.
The Company's performance obligations relate to contracts with a duration of less than one year; therefore, the Company has elected to apply the optional exemption provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied as of the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period.
We determine the transaction price based on gross charges for services provided, reduced by estimates for contractual and non-contractual revenue adjustments. Contractual revenue adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third-party payors and others for services provided. Non-contractual revenue adjustments include discounts provided to self-pay, uninsured patients or other payors, adjustments resulting from payment reviews and adjustments arising from our inability to obtain appropriate billing documentation, authorizations or face-to-face documentation. Subsequent changes to the estimate of the transaction price are recorded as adjustments to net service revenue in the period of change.
Non-contractual revenue adjustments are recorded for self-pay, uninsured patients and other payors by major payor class based on our historical collection experience, aged accounts receivable by payor and current economic conditions. The non-contractual revenue adjustments represent the difference between amounts billed and amounts we expect to collect based on our collection history with similar payors. The Company assesses its ability to collect for the healthcare services provided at the time of patient admission based on the Company's verification of the patient's insurance coverage under Medicare, Medicaid, and other commercial or managed care insurance programs. Medicare represents approximately 75% of the Company's consolidated net service revenue.
Amounts due from third-party payors, primarily commercial health insurers and government programs (Medicare and Medicaid), include variable consideration for retroactive revenue adjustments due to settlements of audits and payment reviews. We determine our estimates for non-contractual revenue adjustments related to payment reviews based on our historical experience and success rates in the claim appeals and adjudication process.
We determine our estimates for non-contractual revenue adjustments related to our inability to obtain appropriate billing documentation, authorizations, or face-to-face documentation based on our historical experience which primarily includes a historical collection rate of over 99% on Medicare claims. Revenue is recorded at amounts we estimate to be realizable for services provided.
Revenue by payor class as a percentage of total net service revenue is as follows:
As of December 31,
202020192018
Home Health:
Medicare
41 %44 %50 %
Non-Medicare - Episodic-based
7 %9 %9 %
Non-Medicare - Non-episodic based
13 %12 %12 %
Hospice (1):
Medicare
34 %30 %23 %
Non-Medicare
2 %1 %1 %
Personal Care3 %4 %5 %
100 %100 %100 %
(1) Acquired Compassionate Care Hospice on February 1, 2019, RoseRock Healthcare on April 1, 2019, Asana Hospice on January 1, 2020 and AseraCare Hospice on June 1, 2020.
Home Health Revenue Recognition
Medicare Revenue
Effective January 1, 2020, the Centers for Medicare and Medicaid Services ("CMS") implemented a revised case-mix adjustment methodology, the Patient-Driven Groupings Model ("PDGM"), to better align payment with patient care needs and ensure that clinically complex and ill beneficiaries have adequate access to home health care. PDGM uses 30-day periods of care rather than 60-day episodes of care as the unit of payment, eliminates the use of the number of therapy visits provided in determining payment and relies more heavily on clinical characteristics and other patient information.
Net service revenue is recorded based on the established Federal Medicare home health payment rate for a 30-day period of care. ASC 606 notes that if an entity has a right to consideration from a customer in an amount that corresponds directly with the value of the entity’s performance completed to date, the entity may recognize revenue in the amount to which the entity has a right to invoice. We have elected to apply the "right to invoice" practical expedient and therefore, our revenue recognition is based on the reimbursement we are entitled to for each 30-day payment period. We utilize our historical average length of stay for each 30-day period of care as the measure of progress towards the satisfaction of our performance obligation.
PDGM uses timing, admission source, functional impairment levels and principal and other diagnoses to case-mix adjust payments. The case-mix adjusted payment for a 30-day period of care is subject to additional adjustments based on certain variables including, but not limited to: (a) an outlier payment if our patient’s care was unusually costly (capped at 10% of total reimbursement per provider number); (b) a low utilization payment adjustment (“LUPA”) if the number of visits provided was less than the established threshold, which ranges from two to six visits and varies for every case-mix group under PDGM; (c) a partial payment if a patient transferred to another provider or from another provider before completing the 30-day period of care; and (d) the applicable geographic wage index. Payments for routine and non-routine supplies are now included in the 30-day payment rate.
Medicare can also make various adjustments to payments received if we are unable to produce appropriate billing documentation or acceptable authorizations. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record this estimate during the period in which services are rendered to revenue with a corresponding reduction to patient accounts receivable.
Amounts due from Medicare include variable consideration for retroactive revenue adjustments due to settlements of audits and payment reviews. We determine our estimates for non-contractual revenue adjustments related to payment reviews based on our historical experience and success rates in the claim appeals and adjudication process.
The Medicare home health benefit requires that beneficiaries be homebound (meaning that the beneficiary is unable to leave his/her home without a considerable and taxing effort), require intermittent skilled nursing, physical therapy or speech therapy services, and receive treatment under a plan of care established and periodically reviewed by a physician. In order to provide greater flexibility during the novel coronavirus pandemic ("COVID-19"), CMS has relaxed the definition of homebound status through the duration of the public health emergency. During the pandemic, a beneficiary is considered homebound if they have been instructed by a physician not to leave their home because of a confirmed or suspected COVID-19 diagnosis or if the patient has a condition that makes them more susceptible to contracting COVID-19. Therefore, if a beneficiary is homebound due to COVID-19 and requires skilled services, the services will be covered under the Medicare home health benefit.
All Medicare contracts are required to have a signed plan of care which represents a single performance obligation, comprised of the delivery of a series of distinct services that are substantially similar and have a similar pattern of transfer to the customer. Accordingly, the Company accounts for the series of services ("episode") as a single performance obligation satisfied over time, as the customer simultaneously receives and consumes the benefits of the goods and services provided. An episode starts the first day a billable visit is performed and ends 60 days later or upon discharge, if earlier, with multiple continuous episodes allowed.
A portion of reimbursement from each Medicare episode, referred to as a request for anticipated payment ("RAP"), is billed near the start of each 30-day period of care, and cash is typically received before all services are rendered. Any cash received from Medicare for a RAP for a 30-day period of care that exceeds the associated revenue earned is recorded to accrued expenses within our consolidated balance sheets. CMS reduced the upfront payment for RAPs to 20% for 2020 and has fully eliminated payments associated with RAPs in 2021.
Non-Medicare Revenue
Episodic-based Revenue. We recognize revenue in a similar manner as we recognize Medicare revenue for amounts that are paid by other insurance carriers, including Medicare Advantage programs; however, these amounts can vary based upon the negotiated terms which generally range from 90% to 100% of Medicare rates.
Non-episodic based Revenue. Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates. Contractual revenue adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue. We also make non-contractual revenue adjustments to non-episodic revenue based on our historical experience to reflect the estimated transaction price. We receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment.
Hospice Revenue Recognition
Hospice Medicare Revenue
Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are predetermined daily or hourly rates for each of the four levels of care we deliver. The four levels of care are routine care, general inpatient care, continuous home care and respite care. Routine care accounted for 97% of our total Medicare hospice service revenue for each of 2020, 2019 and 2018, respectively. There are two separate payment rates for routine care: payments for the first 60 days of care and care beyond 60 days. In addition to the two routine rates, we may also receive a service intensity add-on (“SIA”). The SIA is based on visits made in the last seven days of life by a registered nurse or medical social worker for patients in a routine level of care.
The performance obligation is the delivery of hospice services to the patient, as determined by a physician, each day the patient is on hospice care.
We make adjustments to Medicare revenue for non-contractual revenue adjustments, which include our inability to obtain appropriate billing documentation or acceptable authorizations and other reasons unrelated to credit risk. We estimate the impact of these non-contractual revenue adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record it during the period services are rendered.
Additionally, our hospice service revenue is subject to certain limitations on payments from Medicare which are considered variable consideration. We are subject to an inpatient cap limit and an overall Medicare payment cap for each provider number. We monitor these caps on a provider-by-provider basis and estimate amounts due back to Medicare if we estimate a cap has been exceeded. We record these adjustments as a reduction to revenue and an increase in accrued expenses within our consolidated balance sheets. Providers are required to self-report and pay their estimated cap liability by February 28th of the following year. As of December 31, 2020, we have settled our Medicare hospice reimbursements for all fiscal years through October 31, 2013. As of December 31, 2020, we have recorded $9.3 million for estimated amounts due back to Medicare in accrued expenses for the Federal cap years ended October 31, 2014 through September 30, 2021; approximately $2.0 million of this balance was acquired with the AseraCare Hospice ("AseraCare") acquisition. As of December 31, 2019, we had recorded $5.7 million for estimated amounts due back to Medicare in accrued expenses for the Federal cap years ended October 31, 2013 through September 30, 2020.
Hospice Non-Medicare Revenue
Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per day rates, as applicable. Contractual revenue adjustments are recorded for the difference between our standard rates and the contractual rates to be realized from patients, third party payors and others for services provided and are deducted from gross revenue to determine our net service revenue. We also make non-contractual adjustments to non-Medicare revenue based on our historical experience to reflect the estimated transaction price.
Personal Care Revenue Recognition
Personal Care Revenue
We generate net service revenues by providing our services directly to patients based on authorized hours, visits or units determined by the relevant agency, at a rate that is either contractual or fixed by legislation. Net service revenue is recognized at the time services are rendered based on gross charges for the services provided, reduced by estimates for contractual and non-contractual revenue adjustments. We receive payment for providing such services from payors, including state and local governmental agencies, managed care organizations, commercial insurers and private consumers. Payors include the following elder service agencies: Aging Services Access Points ("ASAPs"), Senior Care Options ("SCOs"), Program of All-Inclusive Care for the Elderly ("PACE") and the Veterans Administration ("VA").
Government Grants
In the absence of specific guidance to account for government grants under U.S. GAAP, we have decided to account for government grants in accordance with International Accounting Standard ("IAS") 20, Accounting for Government Grants and Disclosure of Government Assistance, and as such, we recognize grant income on a systematic basis in line with the recognition of expenses or the loss of revenues for which the grants are intended to compensate. We recognize grants once both of the following conditions are met: (1) we are able to comply with the relevant conditions of the grant and (2) the grant will be received. See Note 3 - Novel Coronavirus Pandemic ("COVID-19") for additional information on our accounting for government funds received under the Coronavirus Aid, Relief and Economic Security Act ("CARES Act") and the Mass Home Care ASAP COVID-19 Provider Sustainability Program.
Cash, Cash Equivalents and Restricted Cash
Cash and cash equivalents include certificates of deposit and all highly liquid debt instruments with maturities of three months or less when purchased. Our cash balance as of December 31, 2020 includes approximately $77 million associated with the CARES Act Provider Relief Fund ("PRF"). We separated the PRF funds into their own account and as of December 31, 2020, we have only transferred funds used during the nine-month period ended September 30, 2020 to our operating account. We will transfer funds used during the three-month period ended December 31, 2020 to our operating account in 2021. Restricted cash includes cash that is not available for ordinary business use. As of December 31, 2020, we had $1.5 million of restricted cash that was placed into an escrow account related to the indemnity provisions within the Asana Hospice purchase agreement. As of December 31, 2019, we had $66.2 million of restricted cash that was placed into an escrow account to fund the acquisition of Asana Hospice on January 1, 2020.
The following table summarizes the balances related to our cash, cash equivalents and restricted cash (amounts in millions):
As of December 31,
20202019
Cash and cash equivalents$81.8 $30.3 
Restricted cash1.5 66.2 
Cash, cash equivalents and restricted cash$83.3 $96.5 
Patient Accounts Receivable
We report accounts receivable from services rendered at their estimated transaction price, which includes contractual and non-contractual revenue adjustments based on the amounts expected to be due from payors. Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party payors and patients. The Company's non-Medicare third-party payor base is comprised of a diverse group of payors that are geographically dispersed across the country. As of December 31, 2020, there is no single payor, other than Medicare, that accounts for more than 10% of our total outstanding patient receivables. Thus, we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. We believe the collectibility risk associated with our Medicare accounts, which represent 64% and 58% of our net patient accounts receivable at December 31, 2020 and 2019, respectively, is limited due to our historical collection rate of over 99% from Medicare and the fact that Medicare is a U.S. government payor.
We do not believe there are any significant concentrations of revenues from any payor that would subject us to any significant credit risk in the collection of our accounts receivable.
Medicare Home Health
For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for 20% of our estimated payment for each 30-day period of care. The RAP received for that billing period is then deducted from our final payment. If a final bill is not submitted within the greater of 90 days from the start of the 30-day period of care, or 60 days from the date the RAP was paid, any RAPs received for that billing period will be recouped by Medicare from any other claims in process for that particular provider number. The RAP claim must then be resubmitted. CMS has mandated the full elimination of all upfront payments associated with RAPs in 2021.
Medicare Hospice
For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We bill Medicare on a monthly basis for the services provided to the patient.
Non-Medicare Home Health, Hospice, and Personal Care
For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient’s eligibility for services with the applicable payor. Once the patient has been confirmed for eligibility, we will provide services to the patient and bill the applicable payor. Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular payors or groups of payors with similar characteristics that would subject us to any significant credit risk.
Property and Equipment
Property and equipment is stated at cost and depreciated on a straight-line basis over the estimated useful lives of the assets or life of the lease, if shorter. Additionally, we have internally developed computer software for our own use. Additions and improvements (including interest costs for construction of qualifying long-lived assets) are capitalized. Maintenance and repair expenses are charged to expense as incurred. The cost of property and equipment sold or disposed of and the related accumulated depreciation are eliminated from the property and related accumulated depreciation accounts, and any gain or loss is credited or charged to other general and administrative expenses.
We assess the impairment of a long-lived asset group whenever events or changes in circumstances indicate that the asset’s carrying value may not be recoverable. Factors we consider important that could trigger an impairment review include but are not limited to the following:
•A significant change in the extent or manner in which the long-lived asset group is being used. 
•A significant change in the business climate that could affect the value of the long-lived asset group.
•A significant change in the market value of the assets included in the asset group.
If we determine that the carrying value of long-lived assets may not be recoverable, we compare the carrying value of the asset group to the undiscounted cash flows expected to be generated by the asset group. If the carrying value exceeds the undiscounted cash flows, an impairment charge is indicated. An impairment charge is recognized to the extent that the carrying value of the asset group exceeds its fair value.
We generally provide for depreciation over the following estimated useful service lives.
Years
Building39
Leasehold improvementsLesser of lease term or expected useful life
Equipment and furniture
3 to 7
Vehicles5
Computer software
2 to 7
Finance leases3

The following table summarizes the balances related to our property and equipment for 2020 and 2019 (amounts in millions):
As of December 31,
20202019
Building and leasehold improvements$9.0 $8.7 
Equipment and furniture53.1 55.6 
Finance leases5.9 5.2 
Computer software50.7 54.7 
118.7 124.2 
Less: accumulated depreciation(95.0)(96.1)
$23.7 $28.1 
Depreciation expense for 2020, 2019 and 2018 was $12.1 million, $11.6 million and $10.8 million, respectively.
Business Combinations
We account for acquisitions using the acquisition method of accounting in accordance with ASC 805, Business Combinations. Acquisitions are accounted for as purchases and are included in our consolidated financial statements from their respective acquisition dates. Assets acquired and liabilities assumed, if any, are measured at fair value on the acquisition date using the appropriate valuation method. Goodwill generated from acquisitions is recognized for the excess of the purchase price over tangible and identifiable intangible assets. In determining the fair value of identifiable intangible assets, we use various valuation techniques including discounted cash flow analysis, the income approach, the cost approach and the market approach. These valuation methods require us to make estimates and assumptions surrounding projected revenues and costs, future growth and discount rates.
Goodwill and Other Intangible Assets
Goodwill represents the amount of the purchase price in excess of the fair values assigned to the underlying identifiable net assets of acquired businesses. Goodwill is not amortized, but is subject to an annual impairment test. Tests are performed more frequently if events occur or circumstances change that would more likely than not reduce the fair value of the reporting unit below its carrying amount. These events or circumstances include, but are not limited to, a significant adverse change in the business environment, regulatory environment or legal factors, or a substantial decline in the market capitalization of our stock.
Each of our operating segments described in Note 14 – Segment Information is considered to represent an individual reporting unit for goodwill impairment testing purposes. We consider each of our home health care centers to constitute an individual business for which discrete financial information is available. However, since these care centers have substantially similar operating and economic characteristics and resource allocations and since significant investment decisions concerning these businesses are centralized and the benefits broadly distributed, we have aggregated these care centers and deemed them to constitute a single reporting unit. We have applied this same aggregation principle to our hospice and personal-care care centers and have also deemed each of them to be a single reporting unit.
During 2020, we performed a qualitative assessment to determine if it is more likely than not that the fair value of the reporting units are less than their carrying values by evaluating relevant events and circumstances including financial performance, market conditions and share price. Based on this assessment, we did not record any goodwill impairment charges and none of the goodwill associated with our various reporting units was considered at risk of impairment as of October 31, 2020. Since the date of our last annual goodwill impairment test, there have been no material developments, events, changes in operating performance or other circumstances that would cause management to believe it is more likely than not that the fair value of any of our reporting units would be less than their carrying amounts.
Intangible assets consist of certificates of need, licenses, acquired names and non-compete agreements. We amortize non-compete agreements and acquired names that we do not intend to use indefinitely on a straight-line basis over their estimated useful lives, which are generally two to three years for non-compete agreements and up to three years for acquired names. Our indefinite-lived intangible assets are reviewed for impairment annually or more frequently if events occur or circumstances change that would more likely than not reduce the fair value of the intangible asset below its carrying amount. During 2020, we performed a qualitative assessment of our indefinite-lived intangible assets; as a result of this analysis, we wrote off approximately $4.2 million of acquired names that are no longer in use. During 2019, we also performed a qualitative assessment of our indefinite-lived intangible assets; as a result of this analysis, we wrote off approximately $1.5 million of acquired names. There have been no material developments, events, changes in operating performance or other circumstances that would cause management to believe it is more likely than not that the fair value of any of our remaining intangible assets would be less than their carrying amounts.
Debt Issuance Costs
During 2019, we recorded $0.8 million in deferred debt issuance costs as a reduction to long-term obligations, less current portion in our consolidated balance sheet in connection with our entry into the Amended Credit Agreement (See Note 8 - Long-Term Obligations). As of December 31, 2020 and 2019, we had unamortized debt issuance costs of $2.7 million and $3.5 million, respectively, recorded as a reduction to long-term obligations, less current portion in our accompanying consolidated balance sheets. We amortize deferred debt issuance costs related to our long-term obligations over the term of the obligation through interest expense, unless the debt is extinguished, in which case unamortized balances are immediately expensed. The unamortized debt issuance costs of $2.7 million at December 31, 2020 will be amortized over a weighted-average amortization period of 3.1 years.
Fair Value of Financial Instruments
The following details our financial instruments where the carrying value and the fair value differ (amounts in millions):
 Fair Value at Reporting Date Using
Financial InstrumentCarrying Value as of
December 31, 2020		Quoted Prices in Active
Markets for Identical
Items
(Level 1)		Significant Other
Observable Inputs
(Level 2)		Significant
Unobservable Inputs
(Level 3)
Long-term obligations$215.1 $— $217.7 $— 
The fair value hierarchy is based on three levels of inputs, of which the first two are considered observable and the last unobservable, that may be used to measure fair value. The three levels of inputs are as follows:
•Level 1 – Quoted prices in active markets for identical assets and liabilities. 
•Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
•Level 3 – Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities.
Our deferred compensation plan assets are recorded at fair value and are considered a level 2 measurement. For our other financial instruments, including our cash and cash equivalents, patient accounts receivable, accounts payable, payroll and employee benefits and accrued expenses, we estimate the carrying amounts approximate fair value.
Income Taxes
We use the asset and liability approach for measuring deferred tax assets and liabilities based on temporary differences existing at each balance sheet date using currently enacted tax rates. Our deferred tax calculation requires us to make certain estimates about future operations. Deferred tax assets are reduced by a valuation allowance when we believe it is more likely than not that some portion or all of the deferred tax assets will not be realized. The effect of a change in tax rate is recognized as income or expense in the period that includes the enactment date. As of December 31, 2020 and 2019, our net deferred tax assets were $48.0 million and $21.4 million, respectively.
Management regularly assesses the ability to realize deferred tax assets recorded in the Company’s entities based upon the weight of available evidence, including such factors as the recent earnings history and expected future taxable income. In the event future taxable income is below management’s estimates or is generated in tax jurisdictions different than projected, we could be required to increase the valuation allowance for deferred tax assets. This would result in an increase in our effective tax rate.
Share-Based Compensation
We record all share-based compensation as expense in the financial statements measured at the fair value of the award. We recognize compensation cost on a straight-line basis over the requisite service period for each separately vesting portion of the award. Share-based compensation expense for 2020, 2019 and 2018 was $26.7 million, $25.0 million and $17.9 million, respectively, and the total income tax benefit recognized for these expenses was $4.7 million, $4.6 million and $4.3 million, respectively.
Weighted-Average Shares Outstanding
Net income per share attributable to Amedisys, Inc. common stockholders, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The following table sets forth, for the periods indicated, shares used in our computation of weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands):
For the Years Ended December 31,
202020192018
Weighted average number of shares outstanding – basic32,559 32,142 32,791 
Effect of dilutive securities:
Stock options420 545 502 
Non-vested stock and stock units
289 303 316 
Weighted average number of shares outstanding – diluted33,268 32,990 33,609 
Anti-dilutive securities25 117 50 
Advertising Costs
We expense advertising costs as incurred. Advertising expense for 2020, 2019 and 2018 was $8.0 million, $8.5 million and $7.0 million, respectively.
v3.20.4
NOVEL CORONAVIRUS PANDEMIC ("COVID-19")
 12 Months Ended
Dec. 31, 2020
Unusual or Infrequent Items, or Both [Abstract]  
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") NOVEL CORONAVIRUS PANDEMIC ("COVID-19")
In March 2020, the World Health Organization declared COVID-19 a pandemic. As a healthcare at home company, we have been and will continue to be impacted by the effects of COVID-19; however, we remain committed to carrying out our mission of caring for our patients. We will continue to closely monitor the impact of COVID-19 on all aspects of our business, including the impacts to our employees, patients and suppliers; however, at this time, we are unable to estimate the ultimate impact the pandemic will have on our consolidated financial condition, results of operations or cash flows.
On March 27, 2020, the CARES Act was signed into legislation. The CARES Act provides for $175 billion to healthcare providers, including hospitals on the front lines of the COVID-19 pandemic. Of this total allocated amount, $30 billion was distributed immediately to providers based on their proportionate share of Medicare fee-for-service reimbursements in 2019. Healthcare providers were required to sign an attestation confirming receipt of the Provider Relief Fund ("PRF") funds and agree to the terms and conditions of payment. Our home health and hospice segments received approximately $100 million from the first $30 billion of funds distributed to healthcare providers in April 2020, which is inclusive of $2 million related to our joint venture care centers (equity method investments). We also acquired approximately $6 million of PRF funds in
connection with the acquisition of AseraCare. Under the terms and conditions for receipt of the payment, we are allowed to use the funds to cover lost revenues and health care costs related to COVID-19, and we are required to properly and fully document the use of these funds in reports to the U.S. Department of Health and Human Services ("HHS").
For our wholly-owned subsidiaries, we have decided to only utilize PRF funds to the extent we have qualifying COVID-19 expenses, which totaled $33 million for our home health and hospice segments during the year ended December 31, 2020. Accordingly, for our wholly-owned subsidiaries, we will not be using PRF funds to cover lost revenues resulting from COVID-19. The grant income associated with the COVID-19 expenses incurred to date is reflected in other operating income within our consolidated statement of operations.
HHS issued new guidance in September 2020 noting that PRF funds can be used towards lost revenues or expenses attributable to COVID-19 through June 30, 2021. We do not believe that we will fully utilize the funds received; therefore, we recorded a liability related to the funds that we do not expect to utilize totaling $60 million which is reflected in the Provider Relief Fund Advance account in current liabilities within our consolidated balance sheet. Funds that we intend to use in the future to cover COVID-19 expenses, which we have estimated to be approximately $12 million, have been recorded to a deferred liability account within accrued expenses in our consolidated balance sheet. These estimates may change as our ability to utilize and retain the funds will depend on the magnitude, timing and nature of the impact of the pandemic. In summary, the total funds that we have received from the CARES Act PRF as of December 31, 2020 consist of the following (amounts in millions):
Amount
Funds utilized during the year ended December 31, 2020$33.3 
Estimated funds to be utilized January 2021 through June 202111.6 
Estimated funds to be repaid to the government60.0 
Funds received by unconsolidated joint ventures1.9 
$106.8 
On April 24, 2020, HHS distributed an additional $18 billion in funds to healthcare providers. We did not receive, nor apply, for any additional funds from this second distribution. On October 1, 2020, HHS announced $20 billion in new funding to healthcare providers under the Phase 3 general distribution. We did not apply for any additional funds from this distribution.
The CARES Act also provides for the temporary suspension of the automatic 2% reduction of Medicare claim reimbursements (sequestration) for the period May 1 through December 31, 2020 and the deferral of the employer share of social security tax (6.2%), effective for payments due after the enactment date. Fifty percent of the deferred payroll taxes are due on December 31, 2021 with the remaining amounts due on December 31, 2022. As of December 31, 2020, we have deferred $55 million of social security taxes; approximately $28 million is reflected in each of payroll and employee benefits and other long-term obligations within our consolidated balance sheet.
In December 2020, Congress passed additional COVID-19 relief legislation as part of the Consolidated Appropriations Act, 2021. This legislation extended the suspension of sequestration through March 31, 2021.
Our personal care segment did not receive funds under the CARES Act; however, they did receive funds from the Mass Home Care ASAP COVID-19 Provider Sustainability Program, which are intended to cover costs related to the public health emergency. The grant income associated with the funds received, which totaled $1 million during the year ended December 31, 2020, is reflected in other operating income within our consolidated statement of operations.
v3.20.4
ACQUISITIONS
 12 Months Ended
Dec. 31, 2020
Business Combinations [Abstract]  
ACQUISITIONS ACQUISITIONSWe complete acquisitions from time to time in order to pursue our strategy of increasing our market presence by expanding our service base and enhancing our position in certain geographic areas as a leading provider of home health, hospice and personal care services. The purchase price paid for acquisitions is negotiated through arm’s length transactions, with consideration based on our analysis of, among other things, comparable acquisitions and expected cash flows. Acquisitions are accounted for as purchases and are included in our consolidated financial statements from their respective acquisition dates. Goodwill generated from acquisitions is recognized for the excess of the purchase price over tangible and identifiable intangible assets because of the expected contributions of the acquisitions to our overall corporate strategy. We typically engage outside appraisal firms to assist in the fair value determination of identifiable intangible assets for significant acquisitions. The preliminary purchase price allocation is adjusted, as necessary, up to one year after the acquisition closing date if management obtains more information regarding asset valuation and liabilities assumed.
2020 Acquisitions
Home Health Division
On March 1, 2020, we acquired the regulatory assets of a home health provider in Washington for a purchase price of $3.0 million. The purchase price was paid with cash on hand on the date of the transaction. We recorded goodwill of $2.8 million and other intangibles (certificate of need) of $0.2 million in connection with the acquisition.
On April 18, 2020, we acquired the regulatory assets of a home health provider in Kentucky for a purchase price of $0.7 million. The purchase price was paid with cash on hand on the date of the transaction. We recorded goodwill of $0.5 million and other intangibles (certificate of need) of $0.2 million in connection with the acquisition.
Hospice Division
On January 1, 2020, we acquired Asana Hospice ("Asana"), a hospice provider with eight locations in Pennsylvania, Ohio, Texas, Missouri and Kansas for a purchase price of $66.3 million, net of cash acquired of $0.7 million. Under the purchase agreement, the purchase price was subject to a net working capital adjustment, whereby the purchase price would be adjusted to the extent the actual net working capital of Asana as of the closing differed from the required net working capital under the purchase agreement. The net working capital adjustment, which was finalized during the three-month period ended June 30, 2020, reduced the purchase price by $0.7 million, from $66.3 million to $65.6 million.
The Company has finalized its valuation of the assets acquired and liabilities assumed. The total estimated consideration of $65.6 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions):
Amount
Patient accounts receivable$4.6 
Property and equipment0.2 
Operating lease right of use assets0.9 
Intangible assets5.6 
Total assets acquired
11.3 
Accounts payable(3.2)
Payroll and employee benefits(1.5)
Accrued expenses(0.5)
Operating lease liabilities(0.9)
Total liabilities assumed
(6.1)
Net identifiable assets acquired5.2 
Goodwill60.4 
Total estimated consideration$65.6 
Intangible assets acquired include licenses ($2.0 million), acquired names ($1.3 million) and non-compete agreements ($2.3 million). The acquired names and non-compete agreements will be amortized over a weighted-average period of 2.0 years.
Asana contributed approximately $23.4 million in net service revenue and an operating loss of $3.3 million (inclusive of acquisition and integration costs totaling $2.0 million and intangibles amortization totaling $2.6 million) during the year ended December 31, 2020.
We expect the entire amount of goodwill recorded for this acquisition to be deductible for income tax purposes over approximately 15 years.
On June 1, 2020, we acquired Homecare Preferred Choice, Inc., doing business as AseraCare Hospice ("AseraCare"), a national hospice care provider with 44 locations, for an estimated purchase price of $230.4 million, net of cash acquired and inclusive of a $32 million tax asset. The closing payment for the purchase price included estimates for cash, working capital and various other items. Under the purchase agreement, the purchase price was subject to a closing payment adjustment for any differences between estimated amounts included in the closing payment and actual amounts at close, not to exceed $1.0 million. The
closing payment adjustment, which was finalized in October 2020, reduced the purchase price by $0.8 million, from $230.4 million to $229.6 million.
The Company is in the process of reviewing the fair value of the assets acquired and liabilities assumed. During the year ended December 31, 2020, we recorded measurement period adjustments based on changes to management's estimates and assumptions related to the assets acquired and liabilities assumed. The final valuation of the assets acquired and liabilities assumed was not complete as of December 31, 2020, but will be finalized within the allowable measurement period. Based on the Company's preliminary valuation, the total estimated consideration of $229.6 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions):
Amount
Patient accounts receivable$15.0 
Prepaid expenses0.7 
Property and equipment0.6 
Operating lease right of use assets5.9 
Intangible assets24.3 
Other assets0.1 
Total assets acquired
46.6 
Accounts payable(5.8)
Payroll and employee benefits(5.9)
Accrued expenses(10.4)
Operating lease liabilities(5.4)
Total liabilities assumed
(27.5)
Net identifiable assets acquired19.1 
Goodwill210.5 
Total estimated consideration$229.6 
Intangible assets acquired include licenses ($8.7 million), certificates of need ($0.7 million), acquired names ($5.7 million) and non-compete agreements ($9.2 million). The acquired names will be amortized over a weighted-average period of 2.0 years and the non-compete agreements will be amortized over a weighted-average period of 1.7 years.
AseraCare contributed approximately $64.5 million in net service revenue and an operating loss of $8.2 million (inclusive of acquisition and integration costs totaling $7.6 million and intangibles amortization totaling $6.0 million) during the year ended December 31, 2020.
We expect the entire amount of goodwill recorded for this acquisition to be deductible for income tax purposes over approximately 15 years.
The following table contains unaudited pro forma condensed consolidated statement of operations information for the years ended December 31, 2020 and 2019 assuming that the AseraCare acquisition closed on January 1, 2019 (amounts in millions, except per share data). The pro forma financial information includes various assumptions, including those related to the preliminary purchase price allocation of assets acquired and liabilities assumed. The pro forma financial information may vary in future quarters based on the final valuations and analysis of the fair value of the assets acquired and liabilities assumed.
For the Years Ended
December 31,
20202019
Net service revenue$2,120.1 $2,077.0 
Operating income218.0 167.5 
Net income attributable to Amedisys Inc. 180.6 112.3 
Basic earnings per share5.55 3.49 
Diluted earnings per share5.43 3.40 
The pro forma information presented above includes adjustments for (i) amortization of identifiable intangible assets, (ii) interest on additional debt required to fund the AseraCare acquisition, (iii) non-recurring transaction costs and (iv) income taxes based on the Company's statutory tax rate. This pro forma information is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred. In addition, future results may vary significantly from the results reflected in the pro forma information.
2019 Acquisitions
Hospice Division
On February 1, 2019, we acquired Compassionate Care Hopsice ("CCH"), a national hospice care provider headquartered in New Jersey, for a purchase price of $327.9 million, net of cash acquired of $6.7 million.
The Company has finalized its valuation of the assets acquired and liabilities assumed. The total consideration of $327.9 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions):
Amount
Patient accounts receivable$24.5 
Prepaid expenses0.8 
Other current assets0.1 
Property and equipment0.2 
Intangible assets27.2 
Operating lease right of use assets3.4 
Other assets1.1 
Total assets acquired57.3 
Accounts payable(14.9)
Payroll and employee benefits(11.7)
Accrued expenses(11.7)
Deferred tax liability(0.9)
Operating lease liabilities(3.4)
Total liabilities acquired(42.6)
Net identifiable assets acquired14.7 
Goodwill313.2 
Total estimated consideration$327.9 
Intangible assets acquired include licenses, certificates of need, acquired names and non-compete agreements. The acquired names and non-compete agreements will be amortized over a weighted-average period of 2.0 and 2.3 years, respectively.
CCH contributed approximately $167.4 million in net service revenue and an operating loss of $5.6 million (inclusive of acquisition and integration costs totaling $14.5 million) during the year ended December 31, 2019.
We expect $278.8 million of goodwill recorded for this acquisition to be deductible for income tax purposes over approximately 15 years.
The following table contains unaudited pro forma condensed consolidated statement of operations information for the years ended December 31, 2019 and 2018 assuming that the CCH acquisition closed on January 1, 2018 (amounts in millions, except per share data):
For the Years
Ended December 31,
20192018
Net service revenue$1,971.7 $1,852.8 
Operating income183.8 175.7 
Net income attributable to Amedisys, Inc.130.5 124.6 
Basic earnings per share4.06 3.80 
Diluted earnings per share$3.96 $3.71 
The pro forma information presented above includes adjustments for (i) amortization of identifiable intangible assets, (ii) interest on additional debt required to fund the CCH acquisition, (iii) non-recurring transaction costs and (iv) income taxes based on the Company’s statutory tax rate. This pro forma information is presented for illustrative purposes only and may not be indicative of the results of operations that would have actually occurred. In addition, future results may vary significantly from the results reflected in the pro forma information.
On April 1, 2019, we acquired RoseRock Healthcare ("RoseRock"), an Oklahoma based hospice provider, for a purchase price of $17.5 million. The purchase price was paid with cash on hand on the date of the transaction. We recorded goodwill ($15.8 million) and other intangibles including acquired names ($1.0 million) and non-compete agreements ($0.7 million). The acquired names and non-compete agreements will each be amortized over a weighted-average period of 3.0 years. RoseRock contributed approximately $6.8 million in net service revenue and $0.8 million in operating income for the year ended December 31, 2019. We expect the entire amount of goodwill recorded for this acquisition to be deductible for income tax purposes over approximately 15 years.
v3.20.4
GOODWILL AND OTHER INTANGIBLE ASSETS, NET
 12 Months Ended
Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]  
GOODWILL AND OTHER INTANGIBLE ASSETS, NET GOODWILL AND OTHER INTANGIBLE ASSETS, NET
During 2020, 2019 and 2018, we did not record any goodwill impairment charges as a result of our annual impairment test and none of the goodwill associated with our various reporting units was considered at risk of impairment as of October 31st of each respective year (the date of our annual goodwill impairment test). Since the date of our last annual goodwill impairment test, there have been no material developments, events, changes in operating performance or other circumstances that would cause management to believe it is more likely than not that the fair value of any of our reporting units would be less than their carrying amounts.
The following table summarizes the activity related to our goodwill for 2020 and 2019 (amounts in millions):
Goodwill
Home HealthHospicePersonal CareTotal
Balances at December 31, 2018 (1)$87.1 $199.3 $43.1 $329.5 
Additions— 329.0 — 329.0 
Balances at December 31, 201987.1 528.3 43.1 658.5 
Additions3.3 270.9 — 274.2 
Balances at December 31, 2020$90.4 $799.2 $43.1 $932.7 
(1)Net of prior years' accumulated impairment losses of $733.7 million, which is inclusive of write-offs related to the sale and closure of care centers.
During 2020, we recorded a non-cash other intangible assets impairment charge of $4.2 million related to acquired names which are no longer in use; additionally, we recorded amortization of $2.4 million related to certificates of need and licenses associated with care centers that were closed. During 2019, we recorded a non-cash other intangible assets impairment charge of $1.5 million related to acquired names which are no longer in use or are associated with care centers that were closed.
The following table summarizes the activity related to our other intangible assets, net for 2020 and 2019 (amounts in millions):
Other Intangible Assets, Net
Certificates of Need and LicensesAcquired
Names -Unamortizable		Acquired
Names -Amortizable (4)		Non-Compete
Agreements (4)		Total
Balances at December 31, 2018 (1)$23.9 $19.6 $— $0.6 $44.1 
Additions13.7 — 10.0 5.2 28.9 
Write-off (2)— (1.5)— — (1.5)
Amortization— — (4.4)(2.4)(6.8)
Balances at December 31, 201937.6 18.1 5.6 3.4 64.7 
Additions11.8 — 7.0 11.5 30.3 
Write-off (2)— (4.2)— — (4.2)
Amortization (3)(2.4)— (7.1)(7.1)(16.6)
Balances at December 31, 2020$47.0 $13.9 $5.5 $7.8 $74.2 
(1)Net of prior years' accumulated amortization of $0.7 million for non-compete agreements.
(2)Write-offs are related to our acquired names that are no longer in use or that were associated with care centers that are closed.
(3)Amortization of certificates of need and licenses is related to care centers that were closed during 2020.
(4)The weighted average remaining amortization period of our amortizable acquired names and non-compete agreements is 1.3 years and 1.2 years, respectively.

See Note 4 – Acquisitions for further details on additions to goodwill and other intangible assets, net.
The estimated aggregate amortization expense related to intangible assets for each of the five succeeding years is as follows (amounts in millions):
Intangible Asset Amortization
2021$10.6 
20222.7 
2023— 
2024— 
2025— 
$13.3 
v3.20.4
DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS
 12 Months Ended
Dec. 31, 2020
Details Of Certain Balance Sheet Accounts [Abstract]  
DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS
Additional information regarding certain balance sheet accounts is presented below (amounts in millions):
As of December 31,
20202019
Other current assets:
Payroll tax escrow$6.3 $1.5 
Income tax receivable0.2 2.0 
Due from joint ventures2.3 2.0 
Other4.5 2.7 
$13.3 $8.2 
Other assets:
Workers’ compensation deposits$0.3 $0.2 
Health insurance deposits0.5 0.5 
Other miscellaneous deposits1.2 1.0 
Indemnity receivable13.6 13.6 
Equity method investments14.2 35.7 
Other3.4 3.6 
$33.2 $54.6 
Accrued expenses:
Health insurance$15.1 $15.8 
Workers’ compensation35.8 33.4 
Florida ZPIC audit, gross liability17.4 17.4 
Legal settlements and other audits24.4 19.0 
Income tax payable— 0.5 
Charity care3.6 2.7 
Estimated Medicare cap liability9.3 5.7 
Hospice accruals (room and board, general in-patient and other)29.2 24.4 
Patient liability8.4 9.4 
Deferred operating income (CARES Act)11.6 — 
Other11.4 8.8 
$166.2 $137.1 
Other long-term obligations:
Reserve for uncertain tax positions$3.3 $3.1 
Deferred compensation plan liability1.0 1.0 
Non-current social security taxes (deferred under CARES Act)27.7 — 
Other1.6 1.8 
$33.6 $5.9 
v3.20.4
LEASES
 12 Months Ended
Dec. 31, 2020
Leases [Abstract]  
LEASES LEASES
We determine whether an arrangement is a lease at inception. We have operating leases, primarily for offices and fleet, that expire at various dates over the next eight years. We also have finance leases covering certain office equipment that expire at various dates over the next three years. Our leases do not contain any restrictive covenants.

Our office leases generally contain renewal options for periods ranging from one to five years. Because we are not reasonably certain to exercise these renewal options, the options are not considered in determining the lease term, and payments associated with the option years are excluded from lease payments. Our office leases also generally include termination options, which allow for early termination of the lease after the first one to three years. Because we are not reasonably certain to exercise these termination options, the options are not considered in determining the lease term; payments for the full lease term are included in lease payments. Our office leases do not contain any material residual value guarantees.

Our fleet leases include a term of 367 days with monthly renewal options thereafter. Our fleet leases also include terminal rental adjustment clauses (“TRAC”), which provide for a final rental payment adjustment at the end of the lease, typically based on the amount realized from the sale of the vehicle. The TRAC is structured such that it will almost always result in a significant
payment by us to the lessor if the renewal option is not exercised. Based on the significance of the TRAC adjustment at the initial lease expiration, we believe that it is reasonably certain that we will exercise the monthly renewal options; therefore, the renewal options are considered in determining the lease term, and payments associated with the renewal options are included in lease payments.

For our fleet and office equipment leases, we use the implicit rate in the lease as the discount rate. For our office leases, the implicit rate is typically not available, so we use our incremental borrowing rate as the discount rate. Our lease agreements include both lease and non-lease components. We have elected the practical expedient that allows us to not separate lease and non-lease components for all of our leases.

Payments due under our operating and finance leases include fixed payments as well as variable payments. For our office leases, variable payments include amounts for our proportionate share of operating expenses, utilities, property taxes, insurance, common area maintenance and other facility-related expenses. For our vehicle and equipment leases, variable payments consist of sales tax.

The components of lease cost for the years ended December 31, 2020 and 2019 are as follows (amounts in millions):
For the Years Ended December 31,
20202019
Operating lease cost:
Operating lease cost
$38.6 $35.0 
Impairment of operating lease ROU assets
0.5 0.9 
Total operating lease cost
39.1 35.9 
Finance lease cost:
Amortization of ROU assets
2.0 1.7 
Interest on lease liabilities
0.2 0.2 
Total finance lease cost
2.2 1.9 
Variable lease cost
3.0 2.6 
Short-term lease cost
— 0.2 
Total lease cost
$44.3 $40.6 

Amounts reported in the consolidated balance sheets as of December 31, 2020 and 2019 for our operating leases are as follows (amounts in millions):
As of December 31,
20202019
Operating lease ROU assets
$93.4 $84.8 
Current portion of operating lease liabilities
30.0 27.8 
Operating lease liabilities, less current portion
62.0 56.1 
Total operating lease liabilities
$92.0 $83.9 

Amounts reported in the consolidated balance sheets as of December 31, 2020 and 2019 for finance leases are included in the table below. The finance lease ROU assets are recorded within property and equipment, net of accumulated depreciation within our consolidated balance sheets. The finance lease liabilities are recorded within current portion of long-term obligations and long-term obligations, less current portion within our consolidated balance sheets.
As of December 31,
20202019
Finance lease ROU assets
$5.9 $5.2 
Accumulated amortization
(3.3)(1.8)
Finance lease ROU assets, net
$2.6 $3.4 
Current installments of obligations under finance leases
$1.7 $1.7 
Long-term portion of obligations under finance leases
0.9 1.7 
Total finance lease liabilities
$2.6 $3.4 

Supplemental cash flow information and non-cash activity related to our leases are as follows (amounts in millions):
For the Years Ended December 31,
20202019
Cash paid for amounts included in the measurement of lease liabilities and ROU assets:
Operating cash flow from operating leases
$(38.2)$(35.8)
Financing cash flow from finance leases
(2.0)(1.7)
ROU assets obtained in exchange for lease obligations:
Operating leases
38.5 116.0 
Finance leases
1.2 2.9 
Reductions to ROU assets resulting from reductions to lease obligations:
Operating leases
(1.1)(1.7)
Finance leases
— — 

Amounts disclosed for ROU assets obtained in exchange for lease obligations include amounts added to the carrying amount of ROU assets resulting from lease modifications and reassessments.

Weighted average remaining lease terms and discount rates for our leases as of December 31, 2020 and 2019 are as follows:
As of December 31,
20202019
Weighted average remaining lease term (years):
Operating leases
3.73.9
Finance leases
1.72.1
Weighted average discount rate:
Operating leases
3.1 %3.9 %
Finance leases
5.3 %5.3 %
Maturities of lease liabilities as of December 31, 2020 are as follows (amounts in millions):
Operating
Leases		Finance
Leases
2021$32.2 $1.8 
202225.3 0.7 
202317.6 0.2 
202411.7 — 
20256.2 — 
Thereafter4.6 — 
Total undiscounted lease payments
97.6 2.7 
Less: Imputed interest(5.6)(0.1)
Total lease liabilities
$92.0 $2.6 
v3.20.4
LONG-TERM OBLIGATIONS
 12 Months Ended
Dec. 31, 2020
Debt Disclosure [Abstract]  
LONG-TERM OBLIGATIONS LONG-TERM OBLIGATIONS
Long-term debt consists of the following for the periods indicated (amounts in millions):
As of December 31,
20202019
$175.0 million Term Loan; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (1.7% at December 31, 2020); due February 4, 2024
$164.1 $171.7 
$550.0 million Revolving Credit Facility; interest only payments; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (3.8% at December 31, 2020); due February 4, 2024
51.0 70.0 
Promissory notes— 0.6 
Finance leases2.6 3.4 
Principal amount of long-term obligations217.7 245.7 
Deferred debt issuance costs(2.7)(3.5)
215.0 242.2 
Current portion of long-term obligations(10.5)(9.9)
Total$204.5 $232.3 
Maturities of debt as of December 31, 2020 are as follows (amounts in millions):
Long-term
obligations
2021$10.5 
20229.4 
202312.3 
2024185.5 
2025— 
$217.7 
Credit Agreement
On June 29, 2018, we entered into our Amended and Restated Credit Agreement ("Credit Agreement") which provided for a senior secured revolving credit facility in an initial aggregate principal amount of up to $550.0 million (the "Revolving Credit Facility"). The Revolving Credit Facility provided for and included within its $550.0 million limit a $25.0 million swingline facility and commitments for up to $60.0 million in letters of credit. Upon lender approval, we could increase the aggregate loan amount under the Revolving Credit Facility by $125.0 million plus an unlimited amount subject to a leverage limit of 0.5x under the maximum allowable consolidated leverage ratio which was 3.0x per the Credit Agreement.
The final maturity of the Revolving Credit Facility was June 29, 2023 and there was no mandatory amortization on the outstanding principal balances which were payable in full upon maturity. The Revolving Credit Facility was used to provide
ongoing working capital and for general corporate purposes of the Company and our subsidiaries, including permitted acquisitions, as defined in the Credit Agreement.
First Amendment to Amended and Restated Credit Agreement
On February 4, 2019, we entered into the First Amendment to the Credit Agreement (as amended by the First Amendment, the “Amended Credit Agreement”). The Amended Credit Agreement provides for a senior secured credit facility in an initial aggregate principal amount of up to $725.0 million, which includes the $550.0 million Revolving Credit Facility under the Credit Agreement, and a term loan facility with a principal amount of up to $175.0 million (the “Term Loan Facility” and collectively with the Revolving Credit Facility, the “Credit Facility”), which was added by the First Amendment.
We borrowed the entire principal amount of the Term Loan Facility on February 4, 2019 in order to fund a portion of the purchase price of the CCH acquisition, with the remainder of the purchase price and associated transactional fees and expenses funded by proceeds from the Revolving Credit Facility.
The loans issued under the Credit Facility bear interest on a per annum basis, at our election, at either: (i) the Base Rate plus the Applicable Rate or (ii) the Eurodollar Rate plus the Applicable Rate. The “Base Rate” means a fluctuating rate per annum equal to the highest of (a) the federal funds rate plus 0.50% per annum, (b) the prime rate of interest established by the Administrative Agent, and (c) the Eurodollar Rate plus 1% per annum. The “Eurodollar Rate” means the quoted rate per annum equal to the London Interbank Offered Rate ("LIBOR") or a comparable successor rate approved by the Administrative Agent for an interest period of one, two, three or six months (as selected by us). The “Applicable Rate” is based on the consolidated leverage ratio and is presented in the table below. As of December 31, 2020, the Applicable Rate is 0.25% per annum for Base Rate Loans and 1.25% per annum for Eurodollar Rate Loans. We are also subject to a commitment fee and letter of credit fee under the terms of the Amended Credit Agreement, as presented in the table below.
Pricing TierConsolidated Leverage RatioBase Rate LoansEurodollar Rate LoansCommitment
Fee		Letter of
Credit Fee
I
≥ 3.00 to 1.0
1.00 %2.00 %0.35 %1.75 %
II
< 3.00 to 1.0 but ≥ 2.00 to 1.0
0.75 %1.75 %0.30 %1.50 %
III
< 2.00 to 1.0 but ≥ 0.75 to 1.0
0.50 %1.50 %0.25 %1.25 %
IV
< 0.75 to 1.0
0.25 %1.25 %0.20 %1.00 %

The final maturity date of the Credit Facility is February 4, 2024. The Revolving Credit Facility will terminate and be due and payable as of the final maturity date. The Term Loan Facility, however, is subject to quarterly amortization of principal in the amount of (i) 0.625% for the period commencing on February 4, 2019 and ending on March 31, 2020, (ii) 1.250% for the period commencing on April 1, 2020 and ending on March 31, 2023, and (iii) 1.875% for the period commencing on April 1, 2023 and ending on February 4, 2024. The remaining balance of the Term Loan Facility must be paid upon the final maturity date. In addition to the scheduled amortization of the Term Loan Facility, and subject to customary exceptions and reinvestment rights, we are required to prepay the Term Loan Facility, first, and the Revolving Credit Facility, second, with 100% of all net cash proceeds received by any loan party or any subsidiary thereof in connection with (a) any asset sale or disposition where such loan party receives net cash proceeds in excess of $5 million or (b) any debt issuance that is not permitted under the Amended Credit Agreement.
The Amended Credit Agreement requires maintenance of two financial covenants: (i) a consolidated leverage ratio of funded indebtedness to Earnings Before Interest, Taxes, Depreciation and Amortization ("EBITDA"), as defined in the Amended Credit Agreement, and (ii) a consolidated interest coverage ratio of EBITDA to cash interest charges, as defined in the Amended Credit Agreement. Each of these covenants is calculated over rolling four-quarter periods and also is subject to certain exceptions and baskets. The Amended Credit Agreement also contains customary covenants, including, but not limited to, restrictions on: incurrence of liens, incurrence of additional debt, sales of assets and other fundamental corporate changes, investments, and declarations of dividends. These covenants contain customary exclusions and baskets as detailed in the Amended Credit Agreement. In connection with our entry into the Amended Credit Agreement, we recorded $0.8 million in deferred debt issuance costs as long-term obligations, less current portion within our consolidated balance sheet during the year ended December 31, 2019.
The Revolving Credit Facility is guaranteed by substantially all of our wholly-owned direct and indirect subsidiaries. The Amended Credit Agreement requires at all times that we (i) provide guarantees from wholly-owned subsidiaries that in the aggregate represent not less than 95% of our consolidated net revenues and adjusted EBITDA from all wholly-owned subsidiaries and (ii) provide guarantees from subsidiaries that in the aggregate represent not less than 70% of consolidated adjusted EBITDA, subject to certain exceptions.
Our weighted average interest rate for borrowings under our $175.0 million Term Loan Facility was 2.2% for the period ended December 31, 2020 and 3.8% for the period February 4, 2019 to December 31, 2019. Our weighted average interest rate for borrowings under our $550.0 million Revolving Credit Facility was 2.2% for the period ended December 31, 2020 and 4.0% for the period ended December 31, 2019.
As of December 31, 2020, our consolidated leverage ratio was 0.6, our consolidated interest coverage ratio was 25.6 and we are in compliance with our covenants under the Amended Credit Agreement. In the event we are not in compliance with our debt covenants in the future, we would pursue various alternatives in an attempt to successfully resolve the non-compliance, which might include, among other things, seeking debt covenant waivers or amendments.
As of December 31, 2020, our availability under our $550.0 million Revolving Credit Facility was $470.2 million as we have $51.0 million outstanding in borrowings and $28.8 million outstanding in letters of credit.
Joinder Agreement
In connection with the CCH acquisition, we entered into a Joinder Agreement, dated as of February 4, 2019 (the “CCH Joinder”), pursuant to which CCH and its subsidiaries were made parties to, and became subject to the terms and conditions of, the Amended Credit Agreement, the Amended and Restated Security Agreement, dated as of June 29, 2018 (the “Amended and Restated Security Agreement”), and the Amended and Restated Pledge Agreement, dated as of June 29, 2018 (the “Amended and Restated Pledge Agreement”). In connection with the AseraCare acquisition, we entered into a Joinder Agreement, dated as of June 12, 2020, pursuant to which the AseraCare entities were made parties to, and became subject to the terms and conditions of, the Amended Credit Agreement, the Amended and Restated Security Agreement and the Amended and Restated Pledge Agreement (the “AseraCare Joinder,” and together with the CCH Joinder, the “Joinders”). Pursuant to the Joinders, the Amended and Restated Security Agreement and the Amended and Restated Pledge Agreement, CCH and its subsidiaries and the AseraCare entities granted in favor of the Administrative Agent a first lien security interest in substantially all of their personal property assets and pledged to the Administrative Agent each of their respective subsidiaries' issued and outstanding equity interests. CCH and its subsidiaries and the AseraCare entities also guaranteed our obligations, whether now existing or arising after the respective effective dates of the Joinders, under the Amended Credit Agreement pursuant to the terms of the Joinders and the Amended Credit Agreement.
Finance Leases
Our finance leases outstanding of $2.6 million relate to leased equipment and bear interest rates ranging from 5.3% to 5.8%.
v3.20.4
INCOME TAXES
 12 Months Ended
Dec. 31, 2020
Income Tax Disclosure [Abstract]  
INCOME TAXES INCOME TAXES
Income taxes attributable to continuing operations consist of the following (amounts in millions):
For the Years Ended December 31,
202020192018
Current income tax expense/(benefit):
Federal$41.6 $24.2 $16.4 
State and local10.6 4.8 2.1 
52.2 29.0 18.5 
Deferred income tax expense/(benefit):
Federal(22.5)9.5 14.5 
State and local(4.1)4.0 5.8 
(26.6)13.5 20.3 
Income tax expense$25.6 $42.5 $38.8 
Total income tax expense for the years ended December 31, 2020, 2019 and 2018 was allocated as follows (amounts in millions):
For the Years Ended December 31,
202020192018
Income from continuing operations$25.6 $42.5 $38.8 
Interest expense0.2 0.3 0.1 
Goodwill— 0.9 — 
Total$25.8 $43.7 $38.9 
A reconciliation of significant differences between the reported amount of income tax expense and the expected amount of income tax expense that would result from applying the U.S. federal statutory income tax rate of 21% to income before income taxes is as follows:
For the Years Ended December 31,
202020192018
Income tax expense at U.S. federal statutory rate21.0 %21.0 %21.0 %
State and local income taxes, net of federal income tax benefit (1)2.4 4.8 4.8 
Excess tax benefits from share-based compensation (1)(12.7)(2.2)(1.8)
Non-deductible executive compensation2.1 1.6 0.4 
Other items, net (2)(0.6)(0.3)— 
Income tax expense12.2 %24.9 %24.4 %
(1)On August 10, 2020, Paul B. Kusserow, President, Chief Executive Officer and Chairman of the Board of Amedisys, exercised 500,000 stock options previously awarded to him under our 2008 Omnibus Incentive Compensation Plan. We recognize compensation expense for stock option awards on a straight-line basis over the requisite service period for each separately vesting portion of the award in accordance with ASC 718, Compensation: Stock Compensation; however, the income tax deduction related to stock options is not recognized until the stock option exercise date. As a result, for awards that are expected to result in a tax deduction, a deferred tax asset is created as the entity recognizes compensation expense for U.S. GAAP purposes. If the tax deduction exceeds the cumulative U.S. GAAP compensation expense for the award, the tax benefit associated with any excess deduction is recognized as an income tax benefit in the statement of operations, resulting in a reduction of the effective tax rate. Mr. Kusserow's stock option exercise produced a $92.1 million tax deduction in excess of U.S. GAAP compensation expense, resulting in a $19.4 million federal income tax benefit and a $4.6 million state and local income tax benefit for the year ended December 31, 2020.
(2)Includes various items such as non-deductible expenses, non-taxable income, tax credits, valuation allowance, uncertain tax positions and return-to-accrual adjustments.

As of December 31, 2020 and 2019, the Company had income taxes receivable of $0.2 million and $2.0 million, respectively, included in other current assets within our consolidated balance sheets.
Deferred tax assets (liabilities) consist of the following components (amounts in millions):
As of December 31,
20202019
Deferred tax assets:
Accrued payroll & employee benefits$15.9 $15.1 
Workers’ compensation9.6 9.0 
Share-based compensation5.1 7.9 
Legal & compliance matters7.0 4.8 
Lease liability25.2 23.1 
Provider relief fund advance (1)15.6 — 
Deferred social security taxes (2)14.3 — 
Net operating loss carryforwards2.4 3.7 
Tax credit carryforwards2.9 3.1 
Other0.6 0.5 
Gross deferred tax assets98.6 67.2 
Less: valuation allowance(0.1)(0.4)
Net deferred tax assets98.5 66.8 
Deferred tax liabilities:
Property and equipment(3.8)(4.3)
Amortization of intangible assets(11.8)(0.3)
Deferred revenue(9.0)(13.5)
Investment in partnerships— (3.3)
Right-of-use asset(24.9)(22.8)
Other liabilities(1.0)(1.2)
Gross deferred tax liabilities(50.5)(45.4)
Deferred income taxes$48.0 $21.4 
(1)In April 2020, approximately $100 million was provided to the Company through the healthcare Provider Relief Fund established under the CARES Act. As of December 31, 2020, the Company recorded a liability related to the funds that we do not expect to utilize totaling $60 million, which is reflected in the Provider Relief Fund Advance account in current liabilities within our consolidated balance sheet. For income tax purposes, the Company recognized the $60 million as income upon receipt, resulting in a deferred tax asset as of December 31, 2020. The company will recognize an income tax deduction when the liability is paid during the year ended December 31, 2021.
(2)The CARES Act provides for the deferral of the employer share of social security tax (6.2%), effective for payments due after the enactment date through December 31, 2020. Fifty percent of the deferred payroll taxes are due on December 31, 2021 with the remaining amounts due on December 31, 2022. As of December 31, 2020, the Company has deferred $55.4 million of social security tax payments; $27.7 million of this amount is reflected in each payroll and employee benefits and other long-term obligations within our consolidated balance sheet. For income tax purposes, the deferred social security taxes will be deductible when paid on December 31, 2021 and December, 31, 2022, resulting in a deferred tax asset at December 31, 2020.
As of December 31, 2020, we have state net operating loss ("NOL") carryforwards of $47.5 million that are available to reduce future taxable income and $3.7 million of various state tax credits available to reduce future state income taxes. The state NOL and tax credit carryforwards expire at various times.
As of December 31, 2020 and 2019, the valuation allowance for deferred tax assets, which is primarily related to certain state NOLs and state tax credit carryforwards, was $0.1 million and $0.4 million, respectively. The net change in the total valuation allowance for the years ended December 31, 2020 and 2019 was a decrease of $0.3 million.
In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income in those jurisdictions during the periods in which those temporary differences become deductible. Management considers the scheduled reversal of deferred tax liabilities (including the impact of available carryback and carryforward periods), projected future taxable income, and tax-planning strategies in making this assessment. In order to fully realize the deferred tax assets, the Company will need to generate future taxable income before the expiration of the
carryforwards governed by the tax code. Based on the current level of pretax earnings, the Company will generate the minimum amount of future taxable income needed to support the realization of the deferred tax assets. As a result, as of December 31, 2020, management believes that it is more likely than not that we will realize the benefits of these deferred tax assets, net of the existing valuation allowances. The amount of the deferred tax asset considered realizable, however, could be reduced in the near term if estimates of future taxable income during the carryforward period are reduced.
Uncertain Tax Positions
We account for uncertain tax positions in accordance with the authoritative guidance for uncertain tax positions. A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (amounts in millions):
For the Years Ended December 31,
202020192018
Balance at beginning of period$2.7 $2.7 $2.7 
Additions for tax positions related to current year— — — 
Additions for tax positions related to prior year— — — 
Reductions for tax positions related to prior years— — — 
Lapse of statute of limitations— — — 
Settlements— — — 
Balance at end of period$2.7 $2.7 $2.7 
As of December 31, 2020 and 2019, there is $2.7 million of unrecognized tax benefits recorded in other long-term obligations within the consolidated balance sheets that, if recognized in future periods, would impact our effective tax rate.
We recognized $0.2 million, $0.3 million and $0.1 million of interest as components of interest expense in connection with our reserve for uncertain tax positions during the years ended December 31, 2020, 2019 and 2018, respectively. Interest related to uncertain tax positions included in the consolidated balance sheets at December 31, 2020 and 2019 was $0.6 million and $0.4 million, respectively.
We are subject to income taxes in the U.S. and in many individual states, with significant operations in Louisiana, South Carolina, Alabama, Georgia, Massachusetts and Tennessee. We are open to examination in the U.S. and in various individual states for tax years ended December 31, 2014 through December 31, 2020. We are also open to examination in various states for the years ended 2007 through 2020 resulting from NOLs generated and available for carryforward from those years.
v3.20.4
CAPITAL STOCK AND SHARE-BASED COMPENSATION
 12 Months Ended
Dec. 31, 2020
Share-based Payment Arrangement [Abstract]  
CAPITAL SOCK AND SHARE-BASED COMPENSATION CAPITAL STOCK AND SHARE-BASED COMPENSATIONWe are authorized by our Certificate of Incorporation to issue 60,000,000 shares of common stock, $0.001 par value and 5,000,000 shares of preferred stock, $0.001 par value. As of December 31, 2020, there were 37,470,212 and 32,814,278 shares of common stock issued and outstanding, respectively, and no shares of preferred stock issued or outstanding. Our Board of Directors is authorized to fix the dividend rights and terms, conversion and voting rights, redemption rights and other privileges and restrictions applicable to our preferred stock.
Share-Based Awards
On March 29, 2018, our Board of Directors and the Compensation Committee approved, subject to stockholder approval, the Amedisys, Inc. 2018 Omnibus Incentive Compensation Plan (the “2018 Plan”). On June 6, 2018, our stockholders approved the 2018 Plan at the Company's annual meeting of stockholders. The 2018 Plan replaces our 2008 Omnibus Incentive Compensation Plan (the “2008 Plan”), which terminated on June 6, 2018 when the stockholders approved the 2018 Plan. The 2018 Plan authorizes the grant of various types of equity-based awards, such as stock awards, restricted stock units, stock appreciation rights and stock options to eligible participants, which include all of our employees and all employees of our 50% or more owned subsidiaries, our non-employee directors and certain consultants. The vesting terms of the awards may be tied to continued employment (or, for our non-employee directors, continued service on the Board of Directors) and/or achievement of certain pre-determined performance goals. We refer to stock awards subject to service-based vesting conditions as “non-vested stock” and restricted stock units subject to service-based or a combination of service-based and performance-based vesting conditions as “non-vested stock units.” The 2018 Plan is administered by the Compensation Committee of our Board of Directors, which determines, within the provisions of the 2018 Plan, those eligible participants to whom, and the times at which, awards shall be granted. The Compensation Committee, in its discretion, may delegate its authority and duties under the 2018 Plan to specified officers; however, only the Compensation Committee may approve the terms of awards to our executive officers.
Equity-based awards may be granted for a number of shares not to exceed, in the aggregate, approximately 2.5 million shares of common stock. We had approximately 2.0 million shares available at December 31, 2020. The price per share for stock options shall be no less than the greater of (a) 100% of the fair value of a share of common stock on the date the option is granted or (b) the aggregate par value of the shares of our common stock on the date the option is granted. If a stock option is granted to any owner of 10% or more of the total combined voting power of us and our subsidiaries, the price is to be at least 110% of the fair value of a share of our common stock on the date the award is granted. Each equity-based award vests ratably over a one year to four year period, with the exception of those issued under contractual arrangements that specify otherwise, and may be exercised during a period as determined by our Compensation Committee or as otherwise approved by our Compensation Committee. The contractual terms of stock options exercised shall not exceed ten years from the date such option is granted. The Company analyzes historical data of forfeited awards to develop an estimated forfeiture rate that is applied to the Company's non-cash compensation expense; however, all non-cash compensation expense is adjusted to reflect actual vestings and forfeitures.
Employee Stock Purchase Plan (“ESPP”)
We have a plan whereby our eligible employees may purchase our common stock at 85% of the market price at the time of purchase. On June 7, 2012, our stockholders ratified an amendment adopted by our Board of Directors to increase the total number of shares of our common stock authorized for issuance under our ESPP from 2,500,000 shares to 4,500,000 shares, and as of December 31, 2020, there were 1,328,627 shares available for future issuance. The following is a detail of the purchases that were made under the plan:
Employee Stock Purchase Plan PeriodShares IssuedPrice
2018 and Prior3,122,983 $15.92 
January 1, 2019 to March 31, 20197,181 104.77 
April 1, 2019 to June 30, 20198,230 103.20 
July 1, 2019 to September 30, 20197,216 111.36 
October 1, 2019 to December 31, 20196,063 141.88 
January 1, 2020 to March 31, 20205,295 156.01 
April 1, 2020 to June 30, 20205,414 168.76 
July 1, 2020 to September 30, 20204,789 200.97 
October 1, 2020 to December 31, 20204,202 249.33 
3,171,373 
ESPP expense included in general and administrative expense in our accompanying consolidated statements of operations was $0.6 million, $0.6 million and $0.5 million for 2020, 2019 and 2018, respectively.
Stock Options
On August 10, 2020, Paul B. Kusserow, President, Chief Executive Officer and Chairman of the Board of Amedisys, exercised 500,000 stock options previously awarded to him under the 2008 Plan. In connection with the exercise, Mr. Kusserow surrendered 231,683 shares of common stock to us to satisfy tax withholding and strike price obligations and elected to hold the net 268,317 shares issued to him. The surrendered shares are classified as treasury shares. This transaction resulted in a cash outflow of $40.4 million, reflected within financing activities in our consolidated statement of cashflows, related to the remittance of tax withholding obligations. In addition, Mr. Kusserow's stock option exercise resulted in a $24.0 million income tax benefit that was recorded in our consolidated statement of operations during the year ended December 31, 2020. We recognize compensation expense for stock option awards on a straight-line basis over the requisite service period for each separately vesting portion of the award in accordance with ASC 718, Compensation: Stock Compensation; however, the income tax deduction related to stock options is not recognized until the stock option exercise date. As a result, for awards that are expected to result in a tax deduction, a deferred tax asset is created as the entity recognizes compensation expense for U.S. GAAP purposes. If the tax deduction exceeds the cumulative U.S. GAAP compensation expense for the award, the tax benefit associated with any excess deduction is recognized as an income tax benefit in the statement of operations.
We use the Black-Scholes option pricing model to estimate the fair value of our stock options. There were 43,249, 142,122 and 163,666 options granted during 2020, 2019 and 2018, respectively. Stock option compensation expense included in general and administrative expense in our accompanying consolidated statements of operations was $4.3 million, $6.2 million and $5.7 million for 2020, 2019 and 2018, respectively.
The fair values of the awards were estimated using the following assumptions for 2020, 2019 and 2018:
For the Years Ended December 31,
202020192018
Risk Free Rate
0.38% - 1.51%
1.44% - 2.53%
2.56% - 3.04%
Expected Volatility
40.15% - 42.80%
42.46% - 43.83%
42.00% - 45.32%
Expected Term6.25 years
6.00 - 6.25 years
4.12 - 6.25 years
Weighted Average Fair Value$86.72$54.42$42.48
Dividend Yield—%—%—%
We used the simplified method to estimate the expected term for the stock options granted during 2020, 2019 and 2018 as adequate historical experience is not available to provide a reasonable estimate.
The following table presents our stock option activity for 2020:
Number of
Shares		Weighted
Average Exercise
Price		Weighted
Average Contractual
Life (Years)
Outstanding options at January 1, 2020875,974 $49.62 6.26
Granted43,249 209.41 
Exercised(622,829)31.60 
Canceled, forfeited or expired(18,353)103.89 
Outstanding options at December 31, 2020278,041 $111.27 7.68
Exercisable options at December 31, 202089,429 $76.40 6.75
The aggregate intrinsic value of our outstanding options and exercisable options at December 31, 2020 was $50.6 million and $19.4 million, respectively. Total intrinsic value of options exercised was $121.1 million, $7.3 million and $9.7 million for 2020, 2019 and 2018, respectively. The tax benefit from stock options exercised during the period amounted to $27.9 million, $1.3 million and $1.6 million for 2020, 2019 and 2018, respectively.
The following table presents our non-vested stock option activity for 2020:
Number of
Shares		Weighted Average
Grant Date Fair Value
Non-vested stock options at January 1, 2020305,750 $41.66 
Granted43,249 86.72 
Vested(142,233)34.84 
Forfeited(18,154)47.66 
Non-vested stock options at December 31, 2020188,612 $56.55 
At December 31, 2020, there was $4.8 million of unrecognized compensation cost related to stock options that we expect to be recognized over a weighted-average period of 1.9 years.
Non-Vested Stock
We issue shares of non-vested stock with a vesting term of one year. The compensation expense is determined based on the market price of our common stock at the date of grant applied to the total number of shares that are anticipated to fully vest. Non-vested stock compensation expense included in general and administrative expenses in our accompanying consolidated statements of operations was $0.8 million, $1.2 million and $1.4 million for 2020, 2019 and 2018, respectively.
The following table presents our non-vested stock activity for 2020:
Number of
Shares		Weighted Average
Grant Date Fair
Value
Non-vested stock at January 1, 20209,859 $119.12 
Granted1,560 158.72 
Vested(11,419)124.53 
Canceled, forfeited or expired— — 
Non-vested stock at December 31, 2020— $— 
The weighted average grant date fair value of non-vested stock granted was $158.72, $119.12 and $80.54 in 2020, 2019 and 2018, respectively.
At December 31, 2020, there was no unrecognized compensation cost related to non-vested stock awards; we currently do not have any outstanding awards.
Non-Vested Stock Units
We issue non-vested stock unit awards that are service-based, performance-based or a combination of both with vesting terms ranging from one to four years. Based on the terms and conditions of these awards, we determine if the awards should be recorded as either equity or liability instruments. The compensation expense is determined based on the market price of our common stock at the date of grant, applied to the total number of units that are anticipated to vest, unless the award specifies differently. We account for such awards similar to our non-vested stock awards; however, no shares of stock are issued to the recipient until the stock unit awards have vested and after the pre-determined delivery date has occurred.
Non-Vested Stock Units – Service-Based
Service-based non-vested stock unit compensation expense included in general and administrative expenses in our accompanying consolidated statements of operations was $7.5 million, $8.7 million and $4.5 million for 2020, 2019 and 2018, respectively.
The following table presents our service-based non-vested stock units activity for 2020:
Number of 
Shares		Weighted Average
Grant Date Fair
Value
Non-vested stock units at January 1, 2020231,418 $91.87 
Granted34,429 206.10 
Vested(89,074)78.15 
Canceled, forfeited or expired(19,227)97.36 
Non-vested stock units at December 31, 2020157,546 $123.92 
The weighted average grant date fair value of service-based non-vested stock units granted was $206.10, $123.70 and $95.14 in 2020, 2019 and 2018, respectively.
At December 31, 2020, there was $9.3 million of unrecognized compensation cost related to our service-based non-vested stock units that we expect to be recognized over a weighted average period of 1.8 years.
Non-Vested Stock Units – Service-Based and Performance-Based Awards
During 2020, we awarded performance-based awards to certain employees. The target level established by the award, which is based on the Company’s 2020 adjusted earnings before interest, taxes, depreciation and amortization (“Adjusted EBITDA”), provided for the recipients to receive an aggregate of 81,183 non-vested stock units if the target was achieved. For a select group of employees, if the target objective is surpassed to the point of achieving the projected maximum payout, the recipients will receive an additional aggregate of 11,633 non-vested stock units during the three-month period ending March 31, 2021. The target number of shares to be potentially awarded has been reduced by forfeitures as indicated in the table below. Performance-based non-vested stock units compensation expense included in general and administrative expenses in our consolidated statements of operations was $13.5 million, $8.4 million and $5.8 million for 2020, 2019 and 2018, respectively.
The following table presents our performance-based non-vested stock units activity for 2020:
Number of 
Shares		Weighted Average
Grant Date Fair
Value
Non-vested stock units at January 1, 2020207,424 $97.55 
Granted85,727 201.90 
Vested(78,856)83.12 
Canceled, forfeited or expired(18,008)101.40 
Non-vested stock units at December 31, 2020196,287 $148.16 
The weighted average grant date fair value of performance-based non-vested stock units granted was $201.90, $128.89 and $79.59 in 2020, 2019 and 2018, respectively.
At December 31, 2020, there was $17.3 million in unrecognized compensation costs related to our performance-based non-vested stock units that we expect to be recognized over a weighted average period of 1.8 years.
v3.20.4
COMMITMENTS AND CONTINGENCIES
 12 Months Ended
Dec. 31, 2020
Commitments and Contingencies Disclosure [Abstract]  
COMMITMENTS AND CONTINGENCIES COMMITMENTS AND CONTINGENCIES
Legal Proceedings – Ongoing
We are involved in the following legal actions:
Subpoena Duces Tecum and Civil Investigative Demands Issued by the U.S. Department of Justice
On May 21, 2015, we received a Subpoena Duces Tecum (“Subpoena”) issued by the U.S. Department of Justice. The Subpoena requests the delivery of information regarding 53 identified hospice patients to the United States Attorney’s Office for the District of Massachusetts. It also requests the delivery of documents relating to our hospice clinical and business operations and related compliance activities. The Subpoena generally covers the period from January 1, 2011 through May 21, 2015. We are fully cooperating with the U.S. Department of Justice with respect to this investigation.
On November 3, 2015, we received a civil investigative demand (“CID”) issued by the U.S. Department of Justice pursuant to the federal False Claims Act relating to claims submitted to Medicare and/or Medicaid for hospice services provided through designated facilities in the Morgantown, West Virginia area. The CID requests the delivery of information to the United States
Attorney’s Office for the Northern District of West Virginia regarding 66 identified hospice patients, as well as documents relating to our hospice clinical and business operations in the Morgantown area. The CID generally covers the period from January 1, 2009 through August 31, 2015. We are fully cooperating with the U.S. Department of Justice with respect to this investigation.
On June 27, 2016, we received a CID issued by the U.S. Department of Justice pursuant to the federal False Claims Act relating to claims submitted to Medicare and/or Medicaid for hospice services provided through designated facilities in the Parkersburg, West Virginia area. The CID requests the delivery of information to the United States Attorney’s Office for the Southern District of West Virginia regarding 68 identified hospice patients, as well as documents relating to our hospice clinical and business operations in the Parkersburg area. The CID generally covers the period from January 1, 2011 through June 20, 2016. We are fully cooperating with the U.S. Department of Justice with respect to this investigation.
Based on our analysis of sample claims data in connection with preliminary settlement discussions with the U.S. Department of Justice regarding the above matters, we have recorded a total of $6.5 million to accrued expenses in our consolidated balance sheets related to this matter. Due to the ongoing nature of the investigations and current stage of the settlement discussions, we are unable to estimate a range of potential loss at this time, and we cannot predict the timing or outcome of these investigations.
In addition to the matters referenced in this note, we are involved in legal actions in the normal course of business, some of which seek monetary damages, including claims for punitive damages. Based on information available to us as of the date of this filing, we do not believe that these normal course actions, when finally concluded and determined, will have a material impact on our consolidated financial condition, results of operations or cash flows.
Legal fees related to all legal matters are expensed as incurred.
Other Investigative Matters – Completed
Corporate Integrity Agreement
On May 5, 2020, the Company received notice from the Office of Inspector General-HHS ("OIG") that the Company's five-year corporate integrity agreement ("CIA") with the OIG has been completed. On April 23, 2014, with no admissions of liability on our part, we entered into a settlement agreement with the U.S. Department of Justice relating to certain of our clinical and business operations. Concurrently with our entry into this agreement, we entered into a CIA with the OIG. The CIA formalized various aspects of our already existing ethics and compliance programs and contained other requirements designed to help ensure our ongoing compliance with federal health care program requirements. Among other things, the CIA required us to maintain our existing compliance program, executive compliance committee and compliance committee of the Board of Directors; provide certain compliance training; continue screening new and current employees to ensure they are eligible to participate in federal health care programs; engage an independent review organization ("IRO") to perform certain audits and reviews and prepare certain reports regarding our compliance with federal health care programs, our billing submissions to federal health care programs and our compliance and risk mitigation programs; and provide certain reports and management certifications to the OIG. Additionally, the CIA specifically required that we report substantial overpayments that we discovered we had received from federal health care programs, as well as probable violations of federal health care laws. The corporate integrity agreement had a term of five years that ended on April 21, 2019. We filed our final annual report on July 19, 2019.
Compassionate Care Hospice Corporate Integrity Agreement
On January 8, 2021, the Company received notice from the OIG that the Company's five-year CIA with the OIG has been completed. On January 30, 2015, CCH entered into a CIA with the OIG. The CIA required that CCH provide annual on-site compliance training; develop and implement policies to ensure compliance with federal health care program requirements; screen new and current employees to ensure that they are eligible to participate in federal health care programs; establish a compliance committee that contains both a Compliance Officer and a Chief Quality Officer; retain a Governing Authority expert who will periodically complete a compliance program review; and retain an IRO to complete claims review for hospice services rendered in New York. The OIG waived the claims review for the final year of the CCH CIA based on the closure of the New York operations. Additionally, the CIA required that CCH report substantial overpayments that CCH discovered it received from federal health care programs, as well as probable violations of federal criminal, civil or administrative health care laws. Upon breach of the CIA, CCH could have become liable for payment of certain stipulated penalties, or could have been excluded from participation in federal health care programs. The CIA had a term of five years that ended on January 30, 2020. We filed our final annual report on March 25, 2020.
Third Party Audits – Ongoing
From time to time, in the ordinary course of business, we are subject to audits under various governmental programs in which third party firms engaged by CMS, including Recovery Audit Contractors (“RACs”), Zone Program Integrity Contractors (“ZPICs”), Uniform Program Integrity Contractors (“UPICs”), Program Safeguard Contractors (“PSCs”), Medicaid Integrity Contractors (“MICs”) and Supplemental Medical Review Contractors (“SMRCs”), conduct extensive reviews of claims data to identify potential improper payments. We cannot predict the ultimate outcome of any regulatory reviews or other governmental audits and investigations.
In July 2010, our subsidiary that provides hospice services in Florence, South Carolina received from a ZPIC a request for records regarding a sample of 30 beneficiaries who received services from the subsidiary during the period of January 1, 2008 through March 31, 2010 (the “Review Period”) to determine whether the underlying services met pertinent Medicare payment requirements. We acquired the hospice operations subject to this review on August 1, 2009; the Review Period covers time periods both before and after our ownership of these hospice operations. Based on the ZPIC’s findings for 16 beneficiaries, which were extrapolated to all claims for hospice services provided by the Florence subsidiary billed during the Review Period, on June 6, 2011, the Medicare Administrative Contractor ("MAC") for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment. We dispute these findings, and our Florence subsidiary has filed appeals through the Original Medicare Standard Appeals Process, in which we are seeking to have those findings overturned. An administrative law judge ("ALJ") hearing was held in early January 2015. On January 18, 2016, we received a letter dated January 6, 2016 referencing the ALJ hearing decision for the overpayment issued on June 6, 2011. The decision was partially favorable with a new overpayment amount of $3.7 million with a balance owed of $5.6 million including interest based on 9 disputed claims (originally 16). We filed an appeal to the Medicare Appeals Council on the remaining 9 disputed claims and also argued that the statistical method used to select the sample was not valid. No assurances can be given as to the timing or outcome of the Medicare Appeals Council decision. As of December 31, 2020, Medicare has withheld payments of $5.7 million (including additional interest) as part of their standard procedures once this level of the appeal process has been reached. In the event we are not able to recoup this alleged overpayment, we are entitled to be indemnified by the prior owners of the hospice operations for amounts relating to the period prior to August 1, 2009. On January 10, 2019, an arbitration panel from the American Health Lawyers Association determined that the prior owners' liability for their indemnification obligation was $2.8 million. This amount is recorded as an indemnity receivable within other assets in our consolidated balance sheets.
In July 2016, the Company received a request for medical records from SafeGuard Services, L.L.C (“SafeGuard”), a ZPIC, related to services provided by some of the care centers that the Company acquired from Infinity Home Care, L.L.C. The review period covers time periods both before and after our ownership of the care centers, which were acquired on December 31, 2015. In August 2017, the Company received Requests for Repayment from Palmetto GBA, LLC (“Palmetto”) regarding Infinity Home Care of Lakeland, LLC, (“Lakeland Care Centers”) and Infinity Home Care of Pinellas, LLC, (“Clearwater Care Center”). The Palmetto letters are based on a statistical extrapolation performed by SafeGuard which alleged an overpayment of $34.0 million for the Lakeland Care Centers on a universe of 72 Medicare claims totaling $0.2 million in actual claims payments using a 100% error rate and an overpayment of $4.8 million for the Clearwater Care Center on a universe of 70 Medicare claims totaling $0.2 million in actual claims payments using a 100% error rate.
The Lakeland Request for Repayment covers claims between January 2, 2014 and September 13, 2016. The Clearwater Request for Repayment covers claims between January 2, 2015 and December 9, 2016. As a result of partially successful Level I and Level II Administrative Appeals, the alleged overpayment for the Lakeland Care Centers has been reduced to $26.0 million and the alleged overpayment for the Clearwater Care Center has been reduced to $3.3 million. The Company has now filed Level III Administrative Appeals, and will continue to vigorously pursue its appeal rights, which include contesting the methodology used by the ZPIC contractor to perform statistical extrapolation. The Company is contractually entitled to indemnification by the prior owners for all claims prior to December 31, 2015, for up to $12.6 million.
At this stage of the review, based on the information currently available to the Company, the Company cannot predict the timing or outcome of this review. The Company estimates a low-end potential range of loss related to this review of $6.5 million (assuming the Company is successful in seeking indemnity from the prior owners and unsuccessful in demonstrating that the extrapolation method used by SafeGuard was erroneous). The Company has reduced its high-end potential range of loss from $38.8 million (the maximum amount Palmetto claims has been overpaid for both the Lakeland Care Centers and the Clearwater Care Center, of which $12.6 million is subject to indemnification by the prior owners) to $29.3 million based on the partial success achieved by the Company in prosecuting its Level I and II Administrative Appeals.

As of December 31, 2020, we have an accrued liability of approximately $17.4 million related to this matter. We expect to be indemnified by the prior owners for approximately $10.9 million of the total $12.6 million available indemnification related to this matter and have recorded this amount within other assets in our consolidated balance sheets. The net of these two amounts,
$6.5 million, was recorded as a reduction in revenue in our consolidated statements of operations during 2017. As of December 31, 2020, $1.5 million of net receivables have been impacted by this payment suspension.
Insurance
We are obligated for certain costs associated with our insurance programs, including employee health, workers’ compensation and professional liability. While we maintain various insurance programs to cover these risks, we are self-insured for a substantial portion of our potential claims. We recognize our obligations associated with these costs, up to specified deductible limits in the period in which a claim is incurred, including with respect to both reported claims and claims incurred but not reported. These costs have generally been estimated based on historical data of our claims experience. Such estimates, and the resulting reserves, are reviewed and updated by us on a quarterly basis.
The following table presents details of our insurance programs, including amounts accrued for the periods indicated (amounts in millions) in accrued expenses in our consolidated balance sheets. The amounts accrued below represent our total estimated liability for individual claims that are less than our noted insurance coverage amounts, which can include outstanding claims and claims incurred but not reported.
As of December 31,
Type of Insurance20202019
Health insurance$15.1 $15.8 
Workers’ compensation35.8 33.4 
Professional liability4.9 5.1 
55.8 54.3 
Less: long-term portion(1.2)(1.3)
$54.6 $53.0 
Our health insurance has an exposure limit of $1.3 million for any individual covered life. Our workers compensation insurance has a retention limit of $1.0 million per incident and our professional liability insurance has a retention limit of $0.3 million per incident.
Severance
We have commitments related to our severance plans applicable to a number of our senior executives and senior management, as well as the employment agreement entered into with our Chief Executive Officer, all of which generally commit us to pay severance benefits under certain circumstances.
Other
We are subject to various other types of claims and disputes arising in the ordinary course of our business. While the resolution of such issues is not presently determinable, we believe that the ultimate resolution of such matters will not have a significant effect on our consolidated financial condition, results of operations and cash flows.
v3.20.4
EMPLOYEE BENEFIT PLANS
 12 Months Ended
Dec. 31, 2020
Retirement Benefits [Abstract]  
EMPLOYEE BENEFIT PLANS EMPLOYEE BENEFIT PLANS
401(k) Benefit Plan
We maintain a plan qualified under Section 401(k) of the Internal Revenue Code for all employees who have reached 21 years of age, effective the first month after their hire date. Under the plan, eligible employees may elect to defer a portion of their compensation, subject to Internal Revenue Service limits.
Our match of contributions to be made to each eligible employee contribution is $0.44 for every $1.00 contributed up to the first 6% of their salary. The match is discretionary and thus is subject to change at the discretion of management. Effective January 1, 2020, our match of contributions is made in the form of cash. During 2019 and 2018, matching contributions were made in the form of our common stock, valued based upon the fair value of the stock as of the end of each calendar quarter end. We expensed approximately $12.9 million, $10.5 million and $9.0 million related to our 401(k) benefit plan for 2020, 2019 and 2018, respectively.
Deferred Compensation Plan
We had a Deferred Compensation Plan for additional tax-deferred savings for a select group of management or highly compensated employees. Amounts credited under the Deferred Compensation Plan were funded into a rabbi trust, which is managed by a trustee. The trustee has the discretion to manage the assets of the Deferred Compensation Plan as deemed fit, thus, the assets are not necessarily reflective of the same investment choices that would have been made by the participants.
Effective January 1, 2015, all prospective salary deferrals ceased. Participants will be allowed to make transactions with any remaining account balances as they wish per plan guidelines.
v3.20.4
SHARE REPURCHASE
 12 Months Ended
Dec. 31, 2020
Equity [Abstract]  
SHARE REPURCHASE SHARE REPURCHASES
2021 Stock Repurchase Program
On December 23, 2020, we announced that our Board of Directors authorized a stock repurchase program, under which we may repurchase up to $100 million of our outstanding common stock through December 31, 2021.
Under the terms of the program, we are allowed to repurchase shares from time to time through open market purchases, unsolicited or solicited privately negotiated transactions, an accelerated stock repurchase program, and/or a trading plan in compliance with Exchange Act Rule 10b5-1. The timing and the amount of the repurchases will be determined by management based on a number of factors, including but not limited to share price, trading volume and general market conditions, as well as on working capital requirements, general business conditions and other factors.
We did not repurchase any shares pursuant to this stock repurchase program during the year ended December 31, 2020.
2019 Stock Repurchase Program
On February 25, 2019, we announced that our Board of Directors authorized a stock repurchase program, under which we could have repurchased up to $100 million of our outstanding common stock through March 1, 2020. We did not repurchase any shares pursuant to this stock repurchase program during 2019 or 2020. The stock repurchase program expired on March 1, 2020.
2018 Share Repurchase
On June 4, 2018, we purchased 2,418,304 of our common shares from affiliates of KKR Credit Advisors (US) LLC ("KKR"), representing one-half of KKR's then current holdings in the Company and 7.1% of the aggregate outstanding shares of the Company's common stock for a total purchase price of $181.4 million including related direct costs. The Company repurchased the shares at $73.96 which represents 96% of the closing stock price of the Company's common stock on June 4, 2018. The repurchased shares are classified as treasury shares.
v3.20.4
SEGMENT INFORMATION
 12 Months Ended
Dec. 31, 2020
Segment Reporting [Abstract]  
SEGMENT INFORMATION SEGMENT INFORMATION
Our operations involve servicing patients through our three reportable business segments: home health, hospice and personal care. Our home health segment delivers a wide range of services in the homes of individuals who may be recovering from surgery, have a chronic disability or terminal illness or need assistance with completing important tasks. Our hospice segment provides palliative care and comfort to terminally ill patients and their families. Our personal care segment provides patients with assistance with the essential activities of daily living. The “other” column in the following tables consists of costs relating to executive management and administrative support functions, primarily information services, accounting, finance, billing and collections, legal, compliance, risk management, procurement, marketing, clinical administration, training, human resources and administration.
Management evaluates performance and allocates resources based on the operating income of the reportable segments, which includes an allocation of corporate expenses attributable to the specific segment and includes revenues and all other costs directly attributable to the specific segment. Segment assets are not reviewed by the company’s chief operating decision maker and therefore are not disclosed below (amounts in millions).
For the Year Ended December 31, 2020
Home HealthHospicePersonal CareOtherTotal
Net service revenue$1,249.2 $750.1 $72.2 $— $2,071.5 
Other operating income20.2 13.1 1.1 — 34.4 
Cost of service, excluding depreciation and amortization729.9 400.6 54.9 — 1,185.4 
General and administrative expenses307.2 175.4 12.4 173.2 668.2 
Depreciation and amortization3.9 2.2 0.2 22.5 28.8 
Asset impairment charge3.4 0.8 — — 4.2 
Operating expenses1,044.4 579.0 67.5 195.7 1,886.6 
Operating income (loss)$225.0 $184.2 $5.8 $(195.7)$219.3 
For the Year Ended December 31, 2019
Home HealthHospicePersonal CareOtherTotal
Net service revenue$1,256.4 $617.2 $82.0 $— $1,955.6 
Cost of service, excluding depreciation and amortization754.1 335.1 61.1 — 1,150.3 
General and administrative expenses297.2 137.5 12.3 160.9 607.9 
Depreciation and amortization4.2 1.6 0.2 12.4 18.4 
Asset impairment charge1.5 — — — 1.5 
Operating expenses1,057.0 474.2 73.6 173.3 1,778.1 
Operating income (loss)$199.4 $143.0 $8.4 $(173.3)$177.5 
For the Year Ended December 31, 2018
Home HealthHospicePersonal CareOtherTotal
Net service revenue$1,174.5 $410.9 $77.2 $— $1,662.6 
Cost of service, excluding depreciation and amortization722.1 212.0 58.8 — 992.9 
General and administrative expenses276.3 84.6 12.8 127.6 501.3 
Depreciation and amortization3.5 1.1 0.3 8.4 13.3 
Operating expenses1,001.9 297.7 71.9 136.0 1,507.5 
Operating income (loss)$172.6 $113.2 $5.3 $(136.0)$155.1 
v3.20.4
UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION
 12 Months Ended
Dec. 31, 2020
Quarterly Financial Information Disclosure [Abstract]  
UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION
Net Income
Attributable to
Amedisys, Inc.
Common
Stockholders (1)
Net Service RevenueNet Income
Attributable to
Amedisys, Inc.		BasicDiluted
2020
1st Quarter$491.7 $31.8 $0.98 $0.96 
2nd Quarter485.0 34.7 1.07 1.04 
3rd Quarter544.1 72.0 2.20 2.16 
4th Quarter550.7 45.1 1.38 1.36 
$2,071.5 $183.6 $5.64 $5.52 
2019
1st Quarter$467.3 $31.3 $0.98 $0.95 
2nd Quarter493.0 33.7 1.05 1.02 
3rd Quarter494.6 34.1 1.06 1.03 
4th Quarter500.7 27.7 0.86 0.83 
$1,955.6 $126.8 $3.95 $3.84 
(1)Because of the method used in calculating per share data, the quarterly per share data may not necessarily total to the per share data as computed for the entire year.
v3.20.4
RELATED PARTY TRANSACTIONS
 12 Months Ended
Dec. 31, 2020
Related Party Transactions [Abstract]  
RELATED PARTY TRANSACTIONS RELATED PARTY TRANSACTIONS
During 2018, we made a $7.0 million investment in Medalogix, a healthcare predictive data and analytics company; this investment is accounted for under the equity method. During the years ended December 31, 2020 and 2019, we incurred costs of approximately $3.9 million and $0.5 million, respectively, in connection with the usage of Medalogix's analytics platforms. We believe that the terms of these transactions are consistent with those negotiated at arm’s length.
On June 4, 2018, we purchased 2,418,304 of our common shares from affiliates of KKR, representing one-half of KKR's holdings in the Company and 7.1% of the aggregate outstanding shares of the Company's common stock for a total purchase price of $181.4 million including related direct costs. The Company repurchased the shares at $73.96 which represents 96% of the closing stock price of the Company's common stock on June 4, 2018. At the time of the transaction, KKR held approximately 14.2% of the Company's outstanding shares of common stock.
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)
 12 Months Ended
Dec. 31, 2020
Accounting Policies [Abstract]  
Recently Adopted Accounting Pronouncements
Recently Adopted Accounting Pronouncements
On January 1, 2020, the Company adopted Accounting Standards Update ("ASU") 2016-13, Financial Instruments - Credit Losses (Topic 326), which provides guidance for measuring credit losses on financial instruments. Our adoption of this standard did not have a material effect on our consolidated financial statements.
During the fourth quarter of 2020, the Company adopted ASU 2019-12, Income Taxes (Topic 740) - Simplifying the Accounting for Income Taxes, which eliminates certain exceptions related to the approach for intraperiod tax allocation, the methodology for calculating taxes during the interim periods and the recognition of deferred tax liabilities for outside basis differences. This guidance also simplifies aspects of the accounting for franchise taxes, enacts changes in tax laws or rates and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. The guidance is effective for interim and annual periods beginning after December 15, 2020, with early adoption permitted. Our adoption of this standard on a prospective basis was not material to the Company’s consolidated financial statements.
On January 1, 2019, the Company adopted Accounting Standards Codification ("ASC") 842, Leases, using a modified retrospective transition approach, which requires the new standard to be applied to all leases existing at the date of initial application. Under ASC 842, lessees are required to recognize a lease liability and right-of-use asset ("ROU asset") for all leases with a term greater than twelve months and to disclose key information about leasing arrangements. Additionally, leases are classified as either financing or operating; the classification determines the pattern of expense recognition and classification within the statement of operations. We used the standard's effective date as our date of initial application. Consequently, our financial information was not updated and the disclosures required under the new standard are not provided for dates and periods prior to January 1, 2019. The new standard provides several optional practical expedients that can be adopted at transition. We elected the "package of practical expedients," which allows us to not reassess our prior conclusions regarding lease identification, lease classification and initial direct costs. We did not elect the use-of-hindsight or the practical expedient pertaining to land easements; the latter not being applicable to us. The most significant effects related to this adoption relate to (1) the recognition of new ROU assets and lease liabilities on our balance sheet for our real estate and fleet operating leases; and (2) significant new disclosures about our leasing activities. Upon adoption, we recognized approximately $80 million in operating leases liabilities with corresponding ROU assets of approximately the same amount. The new standard also provides practical expedients for an entity’s ongoing accounting. We have elected the practical expedient that allows us to not separate lease and non-lease components for all of our leases.
On January 1, 2019, the Company adopted ASU 2018-07, Compensation - Stock Compensation (Topic 718): Improvements to Nonemployees Share-Based Payment Accounting, which expands the scope of Topic 718 to include share-based payments issued to nonemployees for goods or services. Our adoption of this standard did not have an effect on our consolidated financial statements.
On January 1, 2018, the Company adopted ASC 606, Revenue from Contracts with Customers, using the full retrospective method. ASC 606 outlines a single comprehensive model to use in accounting for revenue arising from contracts with customers. The standard supersedes existing revenue recognition requirements and eliminates most industry-specific guidance from U.S. Generally Accepted Accounting Principles ("U.S. GAAP"). The core principle of the revenue recognition standard is to require an entity to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which it expects to be entitled in exchange for those goods or services. As a result of the Company's adoption of ASC 606, the revenue and related estimated uncollectible amounts owed to us by non-Medicare payors that were historically classified as provision for doubtful accounts are now considered a revenue adjustment in determining net service revenue. Accordingly, the Company reports estimated uncollectible balances due from third-party payors and uncollectible balances associated with patient responsibility as a reduction of the transaction price and therefore, as a reduction in net service revenue (or as it relates to Hospice room and board, an increase in cost of service, excluding depreciation and amortization) when historically these amounts were classified as provision for doubtful accounts within operating expenses within our consolidated statements of operations. In addition, the adoption of ASC 606 resulted in increased disclosure,
including qualitative and quantitative disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers.
On January 1, 2018, the Company adopted ASU 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business, which provides guidance to assist entities with evaluating whether transactions should be accounted for as an acquisition (or disposal) of assets or a business. We adopted this ASU on a prospective basis. The impact on our consolidated financial statements and related disclosures will depend on the facts and circumstances of any specific future transactions as evaluated under the new framework.

On January 1, 2018, the Company adopted ASU 2017-04, Intangibles - Goodwill and Other (Topic 350) - Simplifying the Test for Goodwill Impairment, which eliminates the requirement to calculate the implied fair value of goodwill to measure a goodwill impairment charge (Step 2 of the goodwill impairment test). Instead, impairment will be measured using the difference between the carrying amount and the fair value of the reporting unit. The ASU is effective for annual and interim periods beginning after December 15, 2019, with early adoption permitted. We adopted this ASU on a prospective basis and will apply this guidance to our future tests of goodwill impairment.
On January 1, 2018, the Company adopted ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments, which provides specific guidance on eight cash flow classification issues not specifically addressed by U.S. GAAP. The ASU is effective for annual and interim periods beginning after December 15, 2017. The standard should be applied using a retrospective transition method unless it is impractical to do so for some of the issues. In such case, the amendments for those issues would be applied prospectively as of the earliest date practicable. Our adoption of this standard using a retrospective transition method for each period presented did not have an effect on our consolidated financial statements.
Recently Issued Accounting Pronouncements
On March 12, 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional expedients and exceptions for applying U.S. GAAP to contract modifications and hedging relationships that reference LIBOR or another reference rate expected to be discontinued, subject to meeting certain criteria. The amendments in this ASU were effective beginning on March 12, 2020 and may generally be applied prospectively through December 31, 2022. This standard will not have an effect on our consolidated financial statements.
Use of Estimates
Use of Estimates
Our accounting and reporting policies conform with U.S. GAAP. In preparing the consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates.
Principles of Consolidation
Principles of Consolidation
These consolidated financial statements include the accounts of Amedisys, Inc. and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying consolidated financial statements, and business combinations accounted for as purchases have been included in our consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain equity investments that are accounted for as set forth below.
Investments
Investments
We consolidate investments when the entity is a variable interest entity and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50%. Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our consolidated financial statements. During 2016, we sold a 30% interest in one of our care centers while maintaining a controlling interest in the newly formed joint venture; we repurchased the 30% interest during 2018.
We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a variable interest entity in which we are the primary beneficiary. During 2020, we sold our investment in the Heritage Healthcare Innovation Fund, LP via a secondary transaction for $17.9 million which resulted in a $3.0 million loss which is reflected in miscellaneous, net within our consolidated statement of
operations for the year ended December 31, 2020. The Company's original investment was made in 2010 and no longer fit within our strategic areas of focus. Proceeds from the sale were used to pay down debt and fund operations. During 2018, we made a $7.0 million investment in a healthcare analytics company; this investment is accounted for under the equity method. The book value of investments that we account for under the equity method of accounting totaled $14.2 million and $35.7 million as of December 31, 2020 and 2019, respectively, and is reflected in other assets within our consolidated balance sheets.
Revenue Recognition
Revenue Recognition
We account for revenue from contracts with customers in accordance with ASC 606, Revenue from Contracts with Customers, and as such, we recognize revenue in the period in which we satisfy our performance obligations under our contracts by transferring our promised services to our customers in amounts that reflect the consideration to which we expect to be entitled in exchange for providing patient care, which are the transaction prices allocated to the distinct services. The Company's cost of obtaining contracts is not material.
Revenues are recognized as performance obligations are satisfied, which varies based on the nature of the services provided. Our performance obligation is the delivery of patient care services in accordance with the nature and frequency of services outlined in physicians' orders, which are determined by a physician based on a patient's specific goals.
The Company's performance obligations relate to contracts with a duration of less than one year; therefore, the Company has elected to apply the optional exemption provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied as of the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period.
We determine the transaction price based on gross charges for services provided, reduced by estimates for contractual and non-contractual revenue adjustments. Contractual revenue adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third-party payors and others for services provided. Non-contractual revenue adjustments include discounts provided to self-pay, uninsured patients or other payors, adjustments resulting from payment reviews and adjustments arising from our inability to obtain appropriate billing documentation, authorizations or face-to-face documentation. Subsequent changes to the estimate of the transaction price are recorded as adjustments to net service revenue in the period of change.
Non-contractual revenue adjustments are recorded for self-pay, uninsured patients and other payors by major payor class based on our historical collection experience, aged accounts receivable by payor and current economic conditions. The non-contractual revenue adjustments represent the difference between amounts billed and amounts we expect to collect based on our collection history with similar payors. The Company assesses its ability to collect for the healthcare services provided at the time of patient admission based on the Company's verification of the patient's insurance coverage under Medicare, Medicaid, and other commercial or managed care insurance programs. Medicare represents approximately 75% of the Company's consolidated net service revenue.
Amounts due from third-party payors, primarily commercial health insurers and government programs (Medicare and Medicaid), include variable consideration for retroactive revenue adjustments due to settlements of audits and payment reviews. We determine our estimates for non-contractual revenue adjustments related to payment reviews based on our historical experience and success rates in the claim appeals and adjudication process.
We determine our estimates for non-contractual revenue adjustments related to our inability to obtain appropriate billing documentation, authorizations, or face-to-face documentation based on our historical experience which primarily includes a historical collection rate of over 99% on Medicare claims. Revenue is recorded at amounts we estimate to be realizable for services provided.
Revenue by payor class as a percentage of total net service revenue is as follows:
As of December 31,
202020192018
Home Health:
Medicare
41 %44 %50 %
Non-Medicare - Episodic-based
7 %9 %9 %
Non-Medicare - Non-episodic based
13 %12 %12 %
Hospice (1):
Medicare
34 %30 %23 %
Non-Medicare
2 %1 %1 %
Personal Care3 %4 %5 %
100 %100 %100 %
(1) Acquired Compassionate Care Hospice on February 1, 2019, RoseRock Healthcare on April 1, 2019, Asana Hospice on January 1, 2020 and AseraCare Hospice on June 1, 2020.
Home Health Revenue Recognition
Medicare Revenue
Effective January 1, 2020, the Centers for Medicare and Medicaid Services ("CMS") implemented a revised case-mix adjustment methodology, the Patient-Driven Groupings Model ("PDGM"), to better align payment with patient care needs and ensure that clinically complex and ill beneficiaries have adequate access to home health care. PDGM uses 30-day periods of care rather than 60-day episodes of care as the unit of payment, eliminates the use of the number of therapy visits provided in determining payment and relies more heavily on clinical characteristics and other patient information.
Net service revenue is recorded based on the established Federal Medicare home health payment rate for a 30-day period of care. ASC 606 notes that if an entity has a right to consideration from a customer in an amount that corresponds directly with the value of the entity’s performance completed to date, the entity may recognize revenue in the amount to which the entity has a right to invoice. We have elected to apply the "right to invoice" practical expedient and therefore, our revenue recognition is based on the reimbursement we are entitled to for each 30-day payment period. We utilize our historical average length of stay for each 30-day period of care as the measure of progress towards the satisfaction of our performance obligation.
PDGM uses timing, admission source, functional impairment levels and principal and other diagnoses to case-mix adjust payments. The case-mix adjusted payment for a 30-day period of care is subject to additional adjustments based on certain variables including, but not limited to: (a) an outlier payment if our patient’s care was unusually costly (capped at 10% of total reimbursement per provider number); (b) a low utilization payment adjustment (“LUPA”) if the number of visits provided was less than the established threshold, which ranges from two to six visits and varies for every case-mix group under PDGM; (c) a partial payment if a patient transferred to another provider or from another provider before completing the 30-day period of care; and (d) the applicable geographic wage index. Payments for routine and non-routine supplies are now included in the 30-day payment rate.
Medicare can also make various adjustments to payments received if we are unable to produce appropriate billing documentation or acceptable authorizations. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record this estimate during the period in which services are rendered to revenue with a corresponding reduction to patient accounts receivable.
Amounts due from Medicare include variable consideration for retroactive revenue adjustments due to settlements of audits and payment reviews. We determine our estimates for non-contractual revenue adjustments related to payment reviews based on our historical experience and success rates in the claim appeals and adjudication process.
The Medicare home health benefit requires that beneficiaries be homebound (meaning that the beneficiary is unable to leave his/her home without a considerable and taxing effort), require intermittent skilled nursing, physical therapy or speech therapy services, and receive treatment under a plan of care established and periodically reviewed by a physician. In order to provide greater flexibility during the novel coronavirus pandemic ("COVID-19"), CMS has relaxed the definition of homebound status through the duration of the public health emergency. During the pandemic, a beneficiary is considered homebound if they have been instructed by a physician not to leave their home because of a confirmed or suspected COVID-19 diagnosis or if the patient has a condition that makes them more susceptible to contracting COVID-19. Therefore, if a beneficiary is homebound due to COVID-19 and requires skilled services, the services will be covered under the Medicare home health benefit.
All Medicare contracts are required to have a signed plan of care which represents a single performance obligation, comprised of the delivery of a series of distinct services that are substantially similar and have a similar pattern of transfer to the customer. Accordingly, the Company accounts for the series of services ("episode") as a single performance obligation satisfied over time, as the customer simultaneously receives and consumes the benefits of the goods and services provided. An episode starts the first day a billable visit is performed and ends 60 days later or upon discharge, if earlier, with multiple continuous episodes allowed.
A portion of reimbursement from each Medicare episode, referred to as a request for anticipated payment ("RAP"), is billed near the start of each 30-day period of care, and cash is typically received before all services are rendered. Any cash received from Medicare for a RAP for a 30-day period of care that exceeds the associated revenue earned is recorded to accrued expenses within our consolidated balance sheets. CMS reduced the upfront payment for RAPs to 20% for 2020 and has fully eliminated payments associated with RAPs in 2021.
Non-Medicare Revenue
Episodic-based Revenue. We recognize revenue in a similar manner as we recognize Medicare revenue for amounts that are paid by other insurance carriers, including Medicare Advantage programs; however, these amounts can vary based upon the negotiated terms which generally range from 90% to 100% of Medicare rates.
Non-episodic based Revenue. Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates. Contractual revenue adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue. We also make non-contractual revenue adjustments to non-episodic revenue based on our historical experience to reflect the estimated transaction price. We receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment.
Hospice Revenue Recognition
Hospice Medicare Revenue
Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are predetermined daily or hourly rates for each of the four levels of care we deliver. The four levels of care are routine care, general inpatient care, continuous home care and respite care. Routine care accounted for 97% of our total Medicare hospice service revenue for each of 2020, 2019 and 2018, respectively. There are two separate payment rates for routine care: payments for the first 60 days of care and care beyond 60 days. In addition to the two routine rates, we may also receive a service intensity add-on (“SIA”). The SIA is based on visits made in the last seven days of life by a registered nurse or medical social worker for patients in a routine level of care.
The performance obligation is the delivery of hospice services to the patient, as determined by a physician, each day the patient is on hospice care.
We make adjustments to Medicare revenue for non-contractual revenue adjustments, which include our inability to obtain appropriate billing documentation or acceptable authorizations and other reasons unrelated to credit risk. We estimate the impact of these non-contractual revenue adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record it during the period services are rendered.
Additionally, our hospice service revenue is subject to certain limitations on payments from Medicare which are considered variable consideration. We are subject to an inpatient cap limit and an overall Medicare payment cap for each provider number. We monitor these caps on a provider-by-provider basis and estimate amounts due back to Medicare if we estimate a cap has been exceeded. We record these adjustments as a reduction to revenue and an increase in accrued expenses within our consolidated balance sheets. Providers are required to self-report and pay their estimated cap liability by February 28th of the following year. As of December 31, 2020, we have settled our Medicare hospice reimbursements for all fiscal years through October 31, 2013. As of December 31, 2020, we have recorded $9.3 million for estimated amounts due back to Medicare in accrued expenses for the Federal cap years ended October 31, 2014 through September 30, 2021; approximately $2.0 million of this balance was acquired with the AseraCare Hospice ("AseraCare") acquisition. As of December 31, 2019, we had recorded $5.7 million for estimated amounts due back to Medicare in accrued expenses for the Federal cap years ended October 31, 2013 through September 30, 2020.
Hospice Non-Medicare Revenue
Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per day rates, as applicable. Contractual revenue adjustments are recorded for the difference between our standard rates and the contractual rates to be realized from patients, third party payors and others for services provided and are deducted from gross revenue to determine our net service revenue. We also make non-contractual adjustments to non-Medicare revenue based on our historical experience to reflect the estimated transaction price.
Personal Care Revenue Recognition
Personal Care Revenue
We generate net service revenues by providing our services directly to patients based on authorized hours, visits or units determined by the relevant agency, at a rate that is either contractual or fixed by legislation. Net service revenue is recognized at the time services are rendered based on gross charges for the services provided, reduced by estimates for contractual and non-contractual revenue adjustments. We receive payment for providing such services from payors, including state and local governmental agencies, managed care organizations, commercial insurers and private consumers. Payors include the following elder service agencies: Aging Services Access Points ("ASAPs"), Senior Care Options ("SCOs"), Program of All-Inclusive Care for the Elderly ("PACE") and the Veterans Administration ("VA").
Government Grants
Government Grants
In the absence of specific guidance to account for government grants under U.S. GAAP, we have decided to account for government grants in accordance with International Accounting Standard ("IAS") 20, Accounting for Government Grants and Disclosure of Government Assistance, and as such, we recognize grant income on a systematic basis in line with the recognition of expenses or the loss of revenues for which the grants are intended to compensate. We recognize grants once both of the following conditions are met: (1) we are able to comply with the relevant conditions of the grant and (2) the grant will be received. See Note 3 - Novel Coronavirus Pandemic ("COVID-19") for additional information on our accounting for government funds received under the Coronavirus Aid, Relief and Economic Security Act ("CARES Act") and the Mass Home Care ASAP COVID-19 Provider Sustainability Program.
Cash, Cash Equivalents and Restricted Cash Cash, Cash Equivalents and Restricted CashCash and cash equivalents include certificates of deposit and all highly liquid debt instruments with maturities of three months or less when purchased.
Patient Accounts Receivable
Patient Accounts Receivable
We report accounts receivable from services rendered at their estimated transaction price, which includes contractual and non-contractual revenue adjustments based on the amounts expected to be due from payors. Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party payors and patients. The Company's non-Medicare third-party payor base is comprised of a diverse group of payors that are geographically dispersed across the country. As of December 31, 2020, there is no single payor, other than Medicare, that accounts for more than 10% of our total outstanding patient receivables. Thus, we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. We believe the collectibility risk associated with our Medicare accounts, which represent 64% and 58% of our net patient accounts receivable at December 31, 2020 and 2019, respectively, is limited due to our historical collection rate of over 99% from Medicare and the fact that Medicare is a U.S. government payor.
We do not believe there are any significant concentrations of revenues from any payor that would subject us to any significant credit risk in the collection of our accounts receivable.
Medicare Home Health
For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for 20% of our estimated payment for each 30-day period of care. The RAP received for that billing period is then deducted from our final payment. If a final bill is not submitted within the greater of 90 days from the start of the 30-day period of care, or 60 days from the date the RAP was paid, any RAPs received for that billing period will be recouped by Medicare from any other claims in process for that particular provider number. The RAP claim must then be resubmitted. CMS has mandated the full elimination of all upfront payments associated with RAPs in 2021.
Medicare Hospice
For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We bill Medicare on a monthly basis for the services provided to the patient.
Non-Medicare Home Health, Hospice, and Personal Care
For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient’s eligibility for services with the applicable payor. Once the patient has been confirmed for eligibility, we will provide services to the patient and bill the applicable payor. Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular payors or groups of payors with similar characteristics that would subject us to any significant credit risk.
Property and Equipment
Property and Equipment
Property and equipment is stated at cost and depreciated on a straight-line basis over the estimated useful lives of the assets or life of the lease, if shorter. Additionally, we have internally developed computer software for our own use. Additions and improvements (including interest costs for construction of qualifying long-lived assets) are capitalized. Maintenance and repair expenses are charged to expense as incurred. The cost of property and equipment sold or disposed of and the related accumulated depreciation are eliminated from the property and related accumulated depreciation accounts, and any gain or loss is credited or charged to other general and administrative expenses.
We assess the impairment of a long-lived asset group whenever events or changes in circumstances indicate that the asset’s carrying value may not be recoverable. Factors we consider important that could trigger an impairment review include but are not limited to the following:
•A significant change in the extent or manner in which the long-lived asset group is being used. 
•A significant change in the business climate that could affect the value of the long-lived asset group.
•A significant change in the market value of the assets included in the asset group.
If we determine that the carrying value of long-lived assets may not be recoverable, we compare the carrying value of the asset group to the undiscounted cash flows expected to be generated by the asset group. If the carrying value exceeds the undiscounted cash flows, an impairment charge is indicated. An impairment charge is recognized to the extent that the carrying value of the asset group exceeds its fair value.
We generally provide for depreciation over the following estimated useful service lives.
Years
Building39
Leasehold improvementsLesser of lease term or expected useful life
Equipment and furniture
3 to 7
Vehicles5
Computer software
2 to 7
Finance leases3

The following table summarizes the balances related to our property and equipment for 2020 and 2019 (amounts in millions):
As of December 31,
20202019
Building and leasehold improvements$9.0 $8.7 
Equipment and furniture53.1 55.6 
Finance leases5.9 5.2 
Computer software50.7 54.7 
118.7 124.2 
Less: accumulated depreciation(95.0)(96.1)
$23.7 $28.1 
Depreciation expense for 2020, 2019 and 2018 was $12.1 million, $11.6 million and $10.8 million, respectively.
Business Combinations
Business Combinations
We account for acquisitions using the acquisition method of accounting in accordance with ASC 805, Business Combinations. Acquisitions are accounted for as purchases and are included in our consolidated financial statements from their respective acquisition dates. Assets acquired and liabilities assumed, if any, are measured at fair value on the acquisition date using the appropriate valuation method. Goodwill generated from acquisitions is recognized for the excess of the purchase price over tangible and identifiable intangible assets. In determining the fair value of identifiable intangible assets, we use various valuation techniques including discounted cash flow analysis, the income approach, the cost approach and the market approach. These valuation methods require us to make estimates and assumptions surrounding projected revenues and costs, future growth and discount rates.
Goodwill and Other Intangible Assets
Goodwill and Other Intangible Assets
Goodwill represents the amount of the purchase price in excess of the fair values assigned to the underlying identifiable net assets of acquired businesses. Goodwill is not amortized, but is subject to an annual impairment test. Tests are performed more frequently if events occur or circumstances change that would more likely than not reduce the fair value of the reporting unit below its carrying amount. These events or circumstances include, but are not limited to, a significant adverse change in the business environment, regulatory environment or legal factors, or a substantial decline in the market capitalization of our stock.
Each of our operating segments described in Note 14 – Segment Information is considered to represent an individual reporting unit for goodwill impairment testing purposes. We consider each of our home health care centers to constitute an individual business for which discrete financial information is available. However, since these care centers have substantially similar operating and economic characteristics and resource allocations and since significant investment decisions concerning these businesses are centralized and the benefits broadly distributed, we have aggregated these care centers and deemed them to constitute a single reporting unit. We have applied this same aggregation principle to our hospice and personal-care care centers and have also deemed each of them to be a single reporting unit.
During 2020, we performed a qualitative assessment to determine if it is more likely than not that the fair value of the reporting units are less than their carrying values by evaluating relevant events and circumstances including financial performance, market conditions and share price. Based on this assessment, we did not record any goodwill impairment charges and none of the goodwill associated with our various reporting units was considered at risk of impairment as of October 31, 2020. Since the date of our last annual goodwill impairment test, there have been no material developments, events, changes in operating performance or other circumstances that would cause management to believe it is more likely than not that the fair value of any of our reporting units would be less than their carrying amounts.Intangible assets consist of certificates of need, licenses, acquired names and non-compete agreements. We amortize non-compete agreements and acquired names that we do not intend to use indefinitely on a straight-line basis over their estimated useful lives, which are generally two to three years for non-compete agreements and up to three years for acquired names. Our indefinite-lived intangible assets are reviewed for impairment annually or more frequently if events occur or circumstances change that would more likely than not reduce the fair value of the intangible asset below its carrying amount.
Debt Issuance Costs Debt Issuance CostsDuring 2019, we recorded $0.8 million in deferred debt issuance costs as a reduction to long-term obligations, less current portion in our consolidated balance sheet in connection with our entry into the Amended Credit Agreement (See Note 8 - Long-Term Obligations). As of December 31, 2020 and 2019, we had unamortized debt issuance costs of $2.7 million and $3.5 million, respectively, recorded as a reduction to long-term obligations, less current portion in our accompanying consolidated balance sheets. We amortize deferred debt issuance costs related to our long-term obligations over the term of the obligation through interest expense, unless the debt is extinguished, in which case unamortized balances are immediately expensed.
Fair Value of Financial Instruments
Fair Value of Financial Instruments
The following details our financial instruments where the carrying value and the fair value differ (amounts in millions):
 Fair Value at Reporting Date Using
Financial InstrumentCarrying Value as of
December 31, 2020		Quoted Prices in Active
Markets for Identical
Items
(Level 1)		Significant Other
Observable Inputs
(Level 2)		Significant
Unobservable Inputs
(Level 3)
Long-term obligations$215.1 $— $217.7 $— 
The fair value hierarchy is based on three levels of inputs, of which the first two are considered observable and the last unobservable, that may be used to measure fair value. The three levels of inputs are as follows:
•Level 1 – Quoted prices in active markets for identical assets and liabilities. 
•Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
•Level 3 – Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities.
Our deferred compensation plan assets are recorded at fair value and are considered a level 2 measurement. For our other financial instruments, including our cash and cash equivalents, patient accounts receivable, accounts payable, payroll and employee benefits and accrued expenses, we estimate the carrying amounts approximate fair value.
Income Taxes
Income Taxes
We use the asset and liability approach for measuring deferred tax assets and liabilities based on temporary differences existing at each balance sheet date using currently enacted tax rates. Our deferred tax calculation requires us to make certain estimates about future operations. Deferred tax assets are reduced by a valuation allowance when we believe it is more likely than not that some portion or all of the deferred tax assets will not be realized. The effect of a change in tax rate is recognized as income or expense in the period that includes the enactment date. As of December 31, 2020 and 2019, our net deferred tax assets were $48.0 million and $21.4 million, respectively.
Management regularly assesses the ability to realize deferred tax assets recorded in the Company’s entities based upon the weight of available evidence, including such factors as the recent earnings history and expected future taxable income. In the event future taxable income is below management’s estimates or is generated in tax jurisdictions different than projected, we could be required to increase the valuation allowance for deferred tax assets. This would result in an increase in our effective tax rate.
Share-Based Compensation Share-Based CompensationWe record all share-based compensation as expense in the financial statements measured at the fair value of the award. We recognize compensation cost on a straight-line basis over the requisite service period for each separately vesting portion of the award.
Weighted-Average Shares Outstanding Weighted-Average Shares OutstandingNet income per share attributable to Amedisys, Inc. common stockholders, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period.
Advertising Costs Advertising CostsWe expense advertising costs as incurred.
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)
 12 Months Ended
Dec. 31, 2020
Accounting Policies [Abstract]  
Schedule of Revenue by Payor Class
Revenue by payor class as a percentage of total net service revenue is as follows:
As of December 31,
202020192018
Home Health:
Medicare
41 %44 %50 %
Non-Medicare - Episodic-based
7 %9 %9 %
Non-Medicare - Non-episodic based
13 %12 %12 %
Hospice (1):
Medicare
34 %30 %23 %
Non-Medicare
2 %1 %1 %
Personal Care3 %4 %5 %
100 %100 %100 %
(1) Acquired Compassionate Care Hospice on February 1, 2019, RoseRock Healthcare on April 1, 2019, Asana Hospice on January 1, 2020 and AseraCare Hospice on June 1, 2020.
Schedule of Cash Cash Equivalents and Restricted Cash
The following table summarizes the balances related to our cash, cash equivalents and restricted cash (amounts in millions):
As of December 31,
20202019
Cash and cash equivalents$81.8 $30.3 
Restricted cash1.5 66.2 
Cash, cash equivalents and restricted cash$83.3 $96.5 
Schedule of Estimated Useful Lives of Property and Equipment
We generally provide for depreciation over the following estimated useful service lives.
Years
Building39
Leasehold improvementsLesser of lease term or expected useful life
Equipment and furniture
3 to 7
Vehicles5
Computer software
2 to 7
Finance leases3
Schedule of Property and Equipment
The following table summarizes the balances related to our property and equipment for 2020 and 2019 (amounts in millions):
As of December 31,
20202019
Building and leasehold improvements$9.0 $8.7 
Equipment and furniture53.1 55.6 
Finance leases5.9 5.2 
Computer software50.7 54.7 
118.7 124.2 
Less: accumulated depreciation(95.0)(96.1)
$23.7 $28.1 
Schedule of Fair Value of Financial Instruments
The following details our financial instruments where the carrying value and the fair value differ (amounts in millions):
 Fair Value at Reporting Date Using
Financial InstrumentCarrying Value as of
December 31, 2020		Quoted Prices in Active
Markets for Identical
Items
(Level 1)		Significant Other
Observable Inputs
(Level 2)		Significant
Unobservable Inputs
(Level 3)
Long-term obligations$215.1 $— $217.7 $— 
Schedule of Weighted-Average Shares Outstanding The following table sets forth, for the periods indicated, shares used in our computation of weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands):
For the Years Ended December 31,
202020192018
Weighted average number of shares outstanding – basic32,559 32,142 32,791 
Effect of dilutive securities:
Stock options420 545 502 
Non-vested stock and stock units
289 303 316 
Weighted average number of shares outstanding – diluted33,268 32,990 33,609 
Anti-dilutive securities25 117 50 
v3.20.4
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") (Tables)
 12 Months Ended
Dec. 31, 2020
Unusual or Infrequent Items, or Both [Abstract]  
Schedule Of Cares Act Provider Relief Funds In summary, the total funds that we have received from the CARES Act PRF as of December 31, 2020 consist of the following (amounts in millions):
Amount
Funds utilized during the year ended December 31, 2020$33.3 
Estimated funds to be utilized January 2021 through June 202111.6 
Estimated funds to be repaid to the government60.0 
Funds received by unconsolidated joint ventures1.9 
$106.8 
v3.20.4
ACQUISITIONS (Tables)
 12 Months Ended
Dec. 31, 2020
Business Combinations [Abstract]  
Schedule Of Business Acquisitions, Asana Hospice
The Company has finalized its valuation of the assets acquired and liabilities assumed. The total estimated consideration of $65.6 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions):
Amount
Patient accounts receivable$4.6 
Property and equipment0.2 
Operating lease right of use assets0.9 
Intangible assets5.6 
Total assets acquired
11.3 
Accounts payable(3.2)
Payroll and employee benefits(1.5)
Accrued expenses(0.5)
Operating lease liabilities(0.9)
Total liabilities assumed
(6.1)
Net identifiable assets acquired5.2 
Goodwill60.4 
Total estimated consideration$65.6 
Schedule Of Business Acquisitions, AseraCare Hospice
The Company is in the process of reviewing the fair value of the assets acquired and liabilities assumed. During the year ended December 31, 2020, we recorded measurement period adjustments based on changes to management's estimates and assumptions related to the assets acquired and liabilities assumed. The final valuation of the assets acquired and liabilities assumed was not complete as of December 31, 2020, but will be finalized within the allowable measurement period. Based on the Company's preliminary valuation, the total estimated consideration of $229.6 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions):
Amount
Patient accounts receivable$15.0 
Prepaid expenses0.7 
Property and equipment0.6 
Operating lease right of use assets5.9 
Intangible assets24.3 
Other assets0.1 
Total assets acquired
46.6 
Accounts payable(5.8)
Payroll and employee benefits(5.9)
Accrued expenses(10.4)
Operating lease liabilities(5.4)
Total liabilities assumed
(27.5)
Net identifiable assets acquired19.1 
Goodwill210.5 
Total estimated consideration$229.6 
Schedule of Pro Forma Financial Information, AseraCare
The following table contains unaudited pro forma condensed consolidated statement of operations information for the years ended December 31, 2020 and 2019 assuming that the AseraCare acquisition closed on January 1, 2019 (amounts in millions, except per share data). The pro forma financial information includes various assumptions, including those related to the preliminary purchase price allocation of assets acquired and liabilities assumed. The pro forma financial information may vary in future quarters based on the final valuations and analysis of the fair value of the assets acquired and liabilities assumed.
For the Years Ended
December 31,
20202019
Net service revenue$2,120.1 $2,077.0 
Operating income218.0 167.5 
Net income attributable to Amedisys Inc. 180.6 112.3 
Basic earnings per share5.55 3.49 
Diluted earnings per share5.43 3.40 
Schedule Of Business Acquisitions Compassionate Care Hospice
The Company has finalized its valuation of the assets acquired and liabilities assumed. The total consideration of $327.9 million has been allocated to assets acquired and liabilities assumed as of the acquisition date as follows (amounts in millions):
Amount
Patient accounts receivable$24.5 
Prepaid expenses0.8 
Other current assets0.1 
Property and equipment0.2 
Intangible assets27.2 
Operating lease right of use assets3.4 
Other assets1.1 
Total assets acquired57.3 
Accounts payable(14.9)
Payroll and employee benefits(11.7)
Accrued expenses(11.7)
Deferred tax liability(0.9)
Operating lease liabilities(3.4)
Total liabilities acquired(42.6)
Net identifiable assets acquired14.7 
Goodwill313.2 
Total estimated consideration$327.9 
Schedule of Pro Forma Financial Information, Compassionate Care Hospice The following table contains unaudited pro forma condensed consolidated statement of operations information for the years ended December 31, 2019 and 2018 assuming that the CCH acquisition closed on January 1, 2018 (amounts in millions, except per share data):
For the Years
Ended December 31,
20192018
Net service revenue$1,971.7 $1,852.8 
Operating income183.8 175.7 
Net income attributable to Amedisys, Inc.130.5 124.6 
Basic earnings per share4.06 3.80 
Diluted earnings per share$3.96 $3.71 
v3.20.4
GOODWILL AND OTHER INTANGIBLE ASSETS, NET (Tables)
 12 Months Ended
Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]  
Summary of Activity Related to Goodwill and Other Intangible Assets Net
The following table summarizes the activity related to our goodwill for 2020 and 2019 (amounts in millions):
Goodwill
Home HealthHospicePersonal CareTotal
Balances at December 31, 2018 (1)$87.1 $199.3 $43.1 $329.5 
Additions— 329.0 — 329.0 
Balances at December 31, 201987.1 528.3 43.1 658.5 
Additions3.3 270.9 — 274.2 
Balances at December 31, 2020$90.4 $799.2 $43.1 $932.7 
(1)Net of prior years' accumulated impairment losses of $733.7 million, which is inclusive of write-offs related to the sale and closure of care centers.
During 2020, we recorded a non-cash other intangible assets impairment charge of $4.2 million related to acquired names which are no longer in use; additionally, we recorded amortization of $2.4 million related to certificates of need and licenses associated with care centers that were closed. During 2019, we recorded a non-cash other intangible assets impairment charge of $1.5 million related to acquired names which are no longer in use or are associated with care centers that were closed.
The following table summarizes the activity related to our other intangible assets, net for 2020 and 2019 (amounts in millions):
Other Intangible Assets, Net
Certificates of Need and LicensesAcquired
Names -Unamortizable		Acquired
Names -Amortizable (4)		Non-Compete
Agreements (4)		Total
Balances at December 31, 2018 (1)$23.9 $19.6 $— $0.6 $44.1 
Additions13.7 — 10.0 5.2 28.9 
Write-off (2)— (1.5)— — (1.5)
Amortization— — (4.4)(2.4)(6.8)
Balances at December 31, 201937.6 18.1 5.6 3.4 64.7 
Additions11.8 — 7.0 11.5 30.3 
Write-off (2)— (4.2)— — (4.2)
Amortization (3)(2.4)— (7.1)(7.1)(16.6)
Balances at December 31, 2020$47.0 $13.9 $5.5 $7.8 $74.2 
(1)Net of prior years' accumulated amortization of $0.7 million for non-compete agreements.
(2)Write-offs are related to our acquired names that are no longer in use or that were associated with care centers that are closed.
(3)Amortization of certificates of need and licenses is related to care centers that were closed during 2020.
(4)The weighted average remaining amortization period of our amortizable acquired names and non-compete agreements is 1.3 years and 1.2 years, respectively.
Schedule of Estimated Aggregate Future Amortization Expense
The estimated aggregate amortization expense related to intangible assets for each of the five succeeding years is as follows (amounts in millions):
Intangible Asset Amortization
2021$10.6 
20222.7 
2023— 
2024— 
2025— 
$13.3 
v3.20.4
DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS (Tables)
 12 Months Ended
Dec. 31, 2020
Details Of Certain Balance Sheet Accounts [Abstract]  
Schedule of Other Current Assets
Additional information regarding certain balance sheet accounts is presented below (amounts in millions):
As of December 31,
20202019
Other current assets:
Payroll tax escrow$6.3 $1.5 
Income tax receivable0.2 2.0 
Due from joint ventures2.3 2.0 
Other4.5 2.7 
$13.3 $8.2 
Other assets:
Workers’ compensation deposits$0.3 $0.2 
Health insurance deposits0.5 0.5 
Other miscellaneous deposits1.2 1.0 
Indemnity receivable13.6 13.6 
Equity method investments14.2 35.7 
Other3.4 3.6 
$33.2 $54.6 
Accrued expenses:
Health insurance$15.1 $15.8 
Workers’ compensation35.8 33.4 
Florida ZPIC audit, gross liability17.4 17.4 
Legal settlements and other audits24.4 19.0 
Income tax payable— 0.5 
Charity care3.6 2.7 
Estimated Medicare cap liability9.3 5.7 
Hospice accruals (room and board, general in-patient and other)29.2 24.4 
Patient liability8.4 9.4 
Deferred operating income (CARES Act)11.6 — 
Other11.4 8.8 
$166.2 $137.1 
Other long-term obligations:
Reserve for uncertain tax positions$3.3 $3.1 
Deferred compensation plan liability1.0 1.0 
Non-current social security taxes (deferred under CARES Act)27.7 — 
Other1.6 1.8 
$33.6 $5.9 
Schedule of Other Assets
Additional information regarding certain balance sheet accounts is presented below (amounts in millions):
As of December 31,
20202019
Other current assets:
Payroll tax escrow$6.3 $1.5 
Income tax receivable0.2 2.0 
Due from joint ventures2.3 2.0 
Other4.5 2.7 
$13.3 $8.2 
Other assets:
Workers’ compensation deposits$0.3 $0.2 
Health insurance deposits0.5 0.5 
Other miscellaneous deposits1.2 1.0 
Indemnity receivable13.6 13.6 
Equity method investments14.2 35.7 
Other3.4 3.6 
$33.2 $54.6 
Accrued expenses:
Health insurance$15.1 $15.8 
Workers’ compensation35.8 33.4 
Florida ZPIC audit, gross liability17.4 17.4 
Legal settlements and other audits24.4 19.0 
Income tax payable— 0.5 
Charity care3.6 2.7 
Estimated Medicare cap liability9.3 5.7 
Hospice accruals (room and board, general in-patient and other)29.2 24.4 
Patient liability8.4 9.4 
Deferred operating income (CARES Act)11.6 — 
Other11.4 8.8 
$166.2 $137.1 
Other long-term obligations:
Reserve for uncertain tax positions$3.3 $3.1 
Deferred compensation plan liability1.0 1.0 
Non-current social security taxes (deferred under CARES Act)27.7 — 
Other1.6 1.8 
$33.6 $5.9 
Schedule of Accrued Expenses
Additional information regarding certain balance sheet accounts is presented below (amounts in millions):
As of December 31,
20202019
Other current assets:
Payroll tax escrow$6.3 $1.5 
Income tax receivable0.2 2.0 
Due from joint ventures2.3 2.0 
Other4.5 2.7 
$13.3 $8.2 
Other assets:
Workers’ compensation deposits$0.3 $0.2 
Health insurance deposits0.5 0.5 
Other miscellaneous deposits1.2 1.0 
Indemnity receivable13.6 13.6 
Equity method investments14.2 35.7 
Other3.4 3.6 
$33.2 $54.6 
Accrued expenses:
Health insurance$15.1 $15.8 
Workers’ compensation35.8 33.4 
Florida ZPIC audit, gross liability17.4 17.4 
Legal settlements and other audits24.4 19.0 
Income tax payable— 0.5 
Charity care3.6 2.7 
Estimated Medicare cap liability9.3 5.7 
Hospice accruals (room and board, general in-patient and other)29.2 24.4 
Patient liability8.4 9.4 
Deferred operating income (CARES Act)11.6 — 
Other11.4 8.8 
$166.2 $137.1 
Other long-term obligations:
Reserve for uncertain tax positions$3.3 $3.1 
Deferred compensation plan liability1.0 1.0 
Non-current social security taxes (deferred under CARES Act)27.7 — 
Other1.6 1.8 
$33.6 $5.9 
Schedule of Other Long-Term Obligations
Additional information regarding certain balance sheet accounts is presented below (amounts in millions):
As of December 31,
20202019
Other current assets:
Payroll tax escrow$6.3 $1.5 
Income tax receivable0.2 2.0 
Due from joint ventures2.3 2.0 
Other4.5 2.7 
$13.3 $8.2 
Other assets:
Workers’ compensation deposits$0.3 $0.2 
Health insurance deposits0.5 0.5 
Other miscellaneous deposits1.2 1.0 
Indemnity receivable13.6 13.6 
Equity method investments14.2 35.7 
Other3.4 3.6 
$33.2 $54.6 
Accrued expenses:
Health insurance$15.1 $15.8 
Workers’ compensation35.8 33.4 
Florida ZPIC audit, gross liability17.4 17.4 
Legal settlements and other audits24.4 19.0 
Income tax payable— 0.5 
Charity care3.6 2.7 
Estimated Medicare cap liability9.3 5.7 
Hospice accruals (room and board, general in-patient and other)29.2 24.4 
Patient liability8.4 9.4 
Deferred operating income (CARES Act)11.6 — 
Other11.4 8.8 
$166.2 $137.1 
Other long-term obligations:
Reserve for uncertain tax positions$3.3 $3.1 
Deferred compensation plan liability1.0 1.0 
Non-current social security taxes (deferred under CARES Act)27.7 — 
Other1.6 1.8 
$33.6 $5.9 
v3.20.4
LEASES (Tables)
 12 Months Ended
Dec. 31, 2020
Leases [Abstract]  
Schedule of Lease Cost
The components of lease cost for the years ended December 31, 2020 and 2019 are as follows (amounts in millions):
For the Years Ended December 31,
20202019
Operating lease cost:
Operating lease cost
$38.6 $35.0 
Impairment of operating lease ROU assets
0.5 0.9 
Total operating lease cost
39.1 35.9 
Finance lease cost:
Amortization of ROU assets
2.0 1.7 
Interest on lease liabilities
0.2 0.2 
Total finance lease cost
2.2 1.9 
Variable lease cost
3.0 2.6 
Short-term lease cost
— 0.2 
Total lease cost
$44.3 $40.6 
Schedule of Operating Leases
Amounts reported in the consolidated balance sheets as of December 31, 2020 and 2019 for our operating leases are as follows (amounts in millions):
As of December 31,
20202019
Operating lease ROU assets
$93.4 $84.8 
Current portion of operating lease liabilities
30.0 27.8 
Operating lease liabilities, less current portion
62.0 56.1 
Total operating lease liabilities
$92.0 $83.9 
Schedule of Finance Leases Amounts reported in the consolidated balance sheets as of December 31, 2020 and 2019 for finance leases are included in the table below. The finance lease ROU assets are recorded within property and equipment, net of accumulated depreciation within our consolidated balance sheets. The finance lease liabilities are recorded within current portion of long-term obligations and long-term obligations, less current portion within our consolidated balance sheets.
As of December 31,
20202019
Finance lease ROU assets
$5.9 $5.2 
Accumulated amortization
(3.3)(1.8)
Finance lease ROU assets, net
$2.6 $3.4 
Current installments of obligations under finance leases
$1.7 $1.7 
Long-term portion of obligations under finance leases
0.9 1.7 
Total finance lease liabilities
$2.6 $3.4 
Schedule of Supplemental CashFlow Information and NonCash Activity for Leases
Supplemental cash flow information and non-cash activity related to our leases are as follows (amounts in millions):
For the Years Ended December 31,
20202019
Cash paid for amounts included in the measurement of lease liabilities and ROU assets:
Operating cash flow from operating leases
$(38.2)$(35.8)
Financing cash flow from finance leases
(2.0)(1.7)
ROU assets obtained in exchange for lease obligations:
Operating leases
38.5 116.0 
Finance leases
1.2 2.9 
Reductions to ROU assets resulting from reductions to lease obligations:
Operating leases
(1.1)(1.7)
Finance leases
— — 
Schedule of Weighted Average Remaining Lease Term and Discount Rate
Weighted average remaining lease terms and discount rates for our leases as of December 31, 2020 and 2019 are as follows:
As of December 31,
20202019
Weighted average remaining lease term (years):
Operating leases
3.73.9
Finance leases
1.72.1
Weighted average discount rate:
Operating leases
3.1 %3.9 %
Finance leases
5.3 %5.3 %
Schedule of Lease Liability Maturity
Maturities of lease liabilities as of December 31, 2020 are as follows (amounts in millions):
Operating
Leases		Finance
Leases
2021$32.2 $1.8 
202225.3 0.7 
202317.6 0.2 
202411.7 — 
20256.2 — 
Thereafter4.6 — 
Total undiscounted lease payments
97.6 2.7 
Less: Imputed interest(5.6)(0.1)
Total lease liabilities
$92.0 $2.6 
v3.20.4
LONG-TERM OBLIGATIONS (Tables)
 12 Months Ended
Dec. 31, 2020
Debt Disclosure [Abstract]  
Schedule of Long-Term Debt
Long-term debt consists of the following for the periods indicated (amounts in millions):
As of December 31,
20202019
$175.0 million Term Loan; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (1.7% at December 31, 2020); due February 4, 2024
$164.1 $171.7 
$550.0 million Revolving Credit Facility; interest only payments; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (3.8% at December 31, 2020); due February 4, 2024
51.0 70.0 
Promissory notes— 0.6 
Finance leases2.6 3.4 
Principal amount of long-term obligations217.7 245.7 
Deferred debt issuance costs(2.7)(3.5)
215.0 242.2 
Current portion of long-term obligations(10.5)(9.9)
Total$204.5 $232.3 
Schedule of Maturities of Long-Term Debt
Maturities of debt as of December 31, 2020 are as follows (amounts in millions):
Long-term
obligations
2021$10.5 
20229.4 
202312.3 
2024185.5 
2025— 
$217.7 
Schedule of Commitment Fee Under Credit Facilities The “Applicable Rate” is based on the consolidated leverage ratio and is presented in the table below. As of December 31, 2020, the Applicable Rate is 0.25% per annum for Base Rate Loans and 1.25% per annum for Eurodollar Rate Loans. We are also subject to a commitment fee and letter of credit fee under the terms of the Amended Credit Agreement, as presented in the table below.
Pricing TierConsolidated Leverage RatioBase Rate LoansEurodollar Rate LoansCommitment
Fee		Letter of
Credit Fee
I
≥ 3.00 to 1.0
1.00 %2.00 %0.35 %1.75 %
II
< 3.00 to 1.0 but ≥ 2.00 to 1.0
0.75 %1.75 %0.30 %1.50 %
III
< 2.00 to 1.0 but ≥ 0.75 to 1.0
0.50 %1.50 %0.25 %1.25 %
IV
< 0.75 to 1.0
0.25 %1.25 %0.20 %1.00 %
v3.20.4
INCOME TAXES (Tables)
 12 Months Ended
Dec. 31, 2020
Income Tax Disclosure [Abstract]  
Schedule of Income Tax Provision
Income taxes attributable to continuing operations consist of the following (amounts in millions):
For the Years Ended December 31,
202020192018
Current income tax expense/(benefit):
Federal$41.6 $24.2 $16.4 
State and local10.6 4.8 2.1 
52.2 29.0 18.5 
Deferred income tax expense/(benefit):
Federal(22.5)9.5 14.5 
State and local(4.1)4.0 5.8 
(26.6)13.5 20.3 
Income tax expense$25.6 $42.5 $38.8 
Total income tax expense for the years ended December 31, 2020, 2019 and 2018 was allocated as follows (amounts in millions):
For the Years Ended December 31,
202020192018
Income from continuing operations$25.6 $42.5 $38.8 
Interest expense0.2 0.3 0.1 
Goodwill— 0.9 — 
Total$25.8 $43.7 $38.9 
Schedule of Sources of Tax Effects
A reconciliation of significant differences between the reported amount of income tax expense and the expected amount of income tax expense that would result from applying the U.S. federal statutory income tax rate of 21% to income before income taxes is as follows:
For the Years Ended December 31,
202020192018
Income tax expense at U.S. federal statutory rate21.0 %21.0 %21.0 %
State and local income taxes, net of federal income tax benefit (1)2.4 4.8 4.8 
Excess tax benefits from share-based compensation (1)(12.7)(2.2)(1.8)
Non-deductible executive compensation2.1 1.6 0.4 
Other items, net (2)(0.6)(0.3)— 
Income tax expense12.2 %24.9 %24.4 %
(1)On August 10, 2020, Paul B. Kusserow, President, Chief Executive Officer and Chairman of the Board of Amedisys, exercised 500,000 stock options previously awarded to him under our 2008 Omnibus Incentive Compensation Plan. We recognize compensation expense for stock option awards on a straight-line basis over the requisite service period for each separately vesting portion of the award in accordance with ASC 718, Compensation: Stock Compensation; however, the income tax deduction related to stock options is not recognized until the stock option exercise date. As a result, for awards that are expected to result in a tax deduction, a deferred tax asset is created as the entity recognizes compensation expense for U.S. GAAP purposes. If the tax deduction exceeds the cumulative U.S. GAAP compensation expense for the award, the tax benefit associated with any excess deduction is recognized as an income tax benefit in the statement of operations, resulting in a reduction of the effective tax rate. Mr. Kusserow's stock option exercise produced a $92.1 million tax deduction in excess of U.S. GAAP compensation expense, resulting in a $19.4 million federal income tax benefit and a $4.6 million state and local income tax benefit for the year ended December 31, 2020.
(2)Includes various items such as non-deductible expenses, non-taxable income, tax credits, valuation allowance, uncertain tax positions and return-to-accrual adjustments.
Schedule of Net Deferred Tax Assets
Deferred tax assets (liabilities) consist of the following components (amounts in millions):
As of December 31,
20202019
Deferred tax assets:
Accrued payroll & employee benefits$15.9 $15.1 
Workers’ compensation9.6 9.0 
Share-based compensation5.1 7.9 
Legal & compliance matters7.0 4.8 
Lease liability25.2 23.1 
Provider relief fund advance (1)15.6 — 
Deferred social security taxes (2)14.3 — 
Net operating loss carryforwards2.4 3.7 
Tax credit carryforwards2.9 3.1 
Other0.6 0.5 
Gross deferred tax assets98.6 67.2 
Less: valuation allowance(0.1)(0.4)
Net deferred tax assets98.5 66.8 
Deferred tax liabilities:
Property and equipment(3.8)(4.3)
Amortization of intangible assets(11.8)(0.3)
Deferred revenue(9.0)(13.5)
Investment in partnerships— (3.3)
Right-of-use asset(24.9)(22.8)
Other liabilities(1.0)(1.2)
Gross deferred tax liabilities(50.5)(45.4)
Deferred income taxes$48.0 $21.4 
(1)In April 2020, approximately $100 million was provided to the Company through the healthcare Provider Relief Fund established under the CARES Act. As of December 31, 2020, the Company recorded a liability related to the funds that we do not expect to utilize totaling $60 million, which is reflected in the Provider Relief Fund Advance account in current liabilities within our consolidated balance sheet. For income tax purposes, the Company recognized the $60 million as income upon receipt, resulting in a deferred tax asset as of December 31, 2020. The company will recognize an income tax deduction when the liability is paid during the year ended December 31, 2021.
(2)The CARES Act provides for the deferral of the employer share of social security tax (6.2%), effective for payments due after the enactment date through December 31, 2020. Fifty percent of the deferred payroll taxes are due on December 31, 2021 with the remaining amounts due on December 31, 2022. As of December 31, 2020, the Company has deferred $55.4 million of social security tax payments; $27.7 million of this amount is reflected in each payroll and employee benefits and other long-term obligations within our consolidated balance sheet. For income tax purposes, the deferred social security taxes will be deductible when paid on December 31, 2021 and December, 31, 2022, resulting in a deferred tax asset at December 31, 2020.
Schedule of Uncertain Tax Positions A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (amounts in millions):
For the Years Ended December 31,
202020192018
Balance at beginning of period$2.7 $2.7 $2.7 
Additions for tax positions related to current year— — — 
Additions for tax positions related to prior year— — — 
Reductions for tax positions related to prior years— — — 
Lapse of statute of limitations— — — 
Settlements— — — 
Balance at end of period$2.7 $2.7 $2.7 
v3.20.4
CAPITAL STOCK AND SHARE-BASED COMPENSATION (Tables)
 12 Months Ended
Dec. 31, 2020
Share-based Payment Arrangement [Abstract]  
Schedule of Employee Stock Purchase Plan Activity The following is a detail of the purchases that were made under the plan:
Employee Stock Purchase Plan PeriodShares IssuedPrice
2018 and Prior3,122,983 $15.92 
January 1, 2019 to March 31, 20197,181 104.77 
April 1, 2019 to June 30, 20198,230 103.20 
July 1, 2019 to September 30, 20197,216 111.36 
October 1, 2019 to December 31, 20196,063 141.88 
January 1, 2020 to March 31, 20205,295 156.01 
April 1, 2020 to June 30, 20205,414 168.76 
July 1, 2020 to September 30, 20204,789 200.97 
October 1, 2020 to December 31, 20204,202 249.33 
3,171,373 
Schedule of Share-based Payment Award Valuation Assumptions
The fair values of the awards were estimated using the following assumptions for 2020, 2019 and 2018:
For the Years Ended December 31,
202020192018
Risk Free Rate
0.38% - 1.51%
1.44% - 2.53%
2.56% - 3.04%
Expected Volatility
40.15% - 42.80%
42.46% - 43.83%
42.00% - 45.32%
Expected Term6.25 years
6.00 - 6.25 years
4.12 - 6.25 years
Weighted Average Fair Value$86.72$54.42$42.48
Dividend Yield—%—%—%
Schedule of Stock Options Activity
The following table presents our stock option activity for 2020:
Number of
Shares		Weighted
Average Exercise
Price		Weighted
Average Contractual
Life (Years)
Outstanding options at January 1, 2020875,974 $49.62 6.26
Granted43,249 209.41 
Exercised(622,829)31.60 
Canceled, forfeited or expired(18,353)103.89 
Outstanding options at December 31, 2020278,041 $111.27 7.68
Exercisable options at December 31, 202089,429 $76.40 6.75
The following table presents our non-vested stock option activity for 2020:
Number of
Shares		Weighted Average
Grant Date Fair Value
Non-vested stock options at January 1, 2020305,750 $41.66 
Granted43,249 86.72 
Vested(142,233)34.84 
Forfeited(18,154)47.66 
Non-vested stock options at December 31, 2020188,612 $56.55 
Schedule of Non-Vested Stock Activity
The following table presents our non-vested stock activity for 2020:
Number of
Shares		Weighted Average
Grant Date Fair
Value
Non-vested stock at January 1, 20209,859 $119.12 
Granted1,560 158.72 
Vested(11,419)124.53 
Canceled, forfeited or expired— — 
Non-vested stock at December 31, 2020— $— 
Schedule of Non-Vested Stock Unit Activity
The following table presents our service-based non-vested stock units activity for 2020:
Number of 
Shares		Weighted Average
Grant Date Fair
Value
Non-vested stock units at January 1, 2020231,418 $91.87 
Granted34,429 206.10 
Vested(89,074)78.15 
Canceled, forfeited or expired(19,227)97.36 
Non-vested stock units at December 31, 2020157,546 $123.92 
Schedule of Non-Vested Performance-based Units Activity
The following table presents our performance-based non-vested stock units activity for 2020:
Number of 
Shares		Weighted Average
Grant Date Fair
Value
Non-vested stock units at January 1, 2020207,424 $97.55 
Granted85,727 201.90 
Vested(78,856)83.12 
Canceled, forfeited or expired(18,008)101.40 
Non-vested stock units at December 31, 2020196,287 $148.16 
v3.20.4
COMMITMENTS AND CONTINGENCIES (Tables)
 12 Months Ended
Dec. 31, 2020
Commitments and Contingencies Disclosure [Abstract]  
Schedule of Insurance Programs
The following table presents details of our insurance programs, including amounts accrued for the periods indicated (amounts in millions) in accrued expenses in our consolidated balance sheets. The amounts accrued below represent our total estimated liability for individual claims that are less than our noted insurance coverage amounts, which can include outstanding claims and claims incurred but not reported.
As of December 31,
Type of Insurance20202019
Health insurance$15.1 $15.8 
Workers’ compensation35.8 33.4 
Professional liability4.9 5.1 
55.8 54.3 
Less: long-term portion(1.2)(1.3)
$54.6 $53.0 
v3.20.4
SEGMENT INFORMATION (Tables)
 12 Months Ended
Dec. 31, 2020
Segment Reporting [Abstract]  
Schedule of Operating Income of Reportable Segments Management evaluates performance and allocates resources based on the operating income of the reportable segments, which includes an allocation of corporate expenses attributable to the specific segment and includes revenues and all other costs directly attributable to the specific segment. Segment assets are not reviewed by the company’s chief operating decision maker and therefore are not disclosed below (amounts in millions).
For the Year Ended December 31, 2020
Home HealthHospicePersonal CareOtherTotal
Net service revenue$1,249.2 $750.1 $72.2 $— $2,071.5 
Other operating income20.2 13.1 1.1 — 34.4 
Cost of service, excluding depreciation and amortization729.9 400.6 54.9 — 1,185.4 
General and administrative expenses307.2 175.4 12.4 173.2 668.2 
Depreciation and amortization3.9 2.2 0.2 22.5 28.8 
Asset impairment charge3.4 0.8 — — 4.2 
Operating expenses1,044.4 579.0 67.5 195.7 1,886.6 
Operating income (loss)$225.0 $184.2 $5.8 $(195.7)$219.3 
For the Year Ended December 31, 2019
Home HealthHospicePersonal CareOtherTotal
Net service revenue$1,256.4 $617.2 $82.0 $— $1,955.6 
Cost of service, excluding depreciation and amortization754.1 335.1 61.1 — 1,150.3 
General and administrative expenses297.2 137.5 12.3 160.9 607.9 
Depreciation and amortization4.2 1.6 0.2 12.4 18.4 
Asset impairment charge1.5 — — — 1.5 
Operating expenses1,057.0 474.2 73.6 173.3 1,778.1 
Operating income (loss)$199.4 $143.0 $8.4 $(173.3)$177.5 
For the Year Ended December 31, 2018
Home HealthHospicePersonal CareOtherTotal
Net service revenue$1,174.5 $410.9 $77.2 $— $1,662.6 
Cost of service, excluding depreciation and amortization722.1 212.0 58.8 — 992.9 
General and administrative expenses276.3 84.6 12.8 127.6 501.3 
Depreciation and amortization3.5 1.1 0.3 8.4 13.3 
Operating expenses1,001.9 297.7 71.9 136.0 1,507.5 
Operating income (loss)$172.6 $113.2 $5.3 $(136.0)$155.1 
v3.20.4
UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION (Tables)
 12 Months Ended
Dec. 31, 2020
Quarterly Financial Information Disclosure [Abstract]  
Schedule of Unaudited Summarized Quarterly Financial Information
Net Income
Attributable to
Amedisys, Inc.
Common
Stockholders (1)
Net Service RevenueNet Income
Attributable to
Amedisys, Inc.		BasicDiluted
2020
1st Quarter$491.7 $31.8 $0.98 $0.96 
2nd Quarter485.0 34.7 1.07 1.04 
3rd Quarter544.1 72.0 2.20 2.16 
4th Quarter550.7 45.1 1.38 1.36 
$2,071.5 $183.6 $5.64 $5.52 
2019
1st Quarter$467.3 $31.3 $0.98 $0.95 
2nd Quarter493.0 33.7 1.05 1.02 
3rd Quarter494.6 34.1 1.06 1.03 
4th Quarter500.7 27.7 0.86 0.83 
$1,955.6 $126.8 $3.95 $3.84 
(1)Because of the method used in calculating per share data, the quarterly per share data may not necessarily total to the per share data as computed for the entire year.
v3.20.4
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS - Narrative (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
USD ($)
care_center
state
Dec. 31, 2019
USD ($)
Dec. 31, 2018
USD ($)
Dec. 31, 2016
Organization And Nature Of Operations [Line Items]        
Number of states with facilities | state 39      
Minimum percent ownership for controlling interest (percent) 50.00%      
Noncontrolling Interest Repurchased     30.00%  
Maximum ownership percentage for equity method investment (percent) 50.00%      
Payments to Acquire Equity Investments $ 875 $ 210 $ 7,144  
Equity method investment, aggregate cost 14,200 35,700    
Proceeds from sale of equity method investment 17,876 0 0  
Loss on sale of equity method investment $ (2,980) $ 0 $ 0  
Noncontrolling interest sold [Member]        
Organization And Nature Of Operations [Line Items]        
Noncontrolling interest, ownership percentage by noncontrolling owners (percent)       30.00%
Revenue from Contract with Customer Benchmark [Member] | Medicare Revenue [Member]        
Organization And Nature Of Operations [Line Items]        
Percent of net services revenue provided by Medicare 75.00% 74.00% 73.00%  
Home Health [Member]        
Organization And Nature Of Operations [Line Items]        
Number of owned and operated care centers | care_center 320      
Hospice [Member]        
Organization And Nature Of Operations [Line Items]        
Number of owned and operated care centers | care_center 180      
Personal Care [Member]        
Organization And Nature Of Operations [Line Items]        
Number of owned and operated care centers | care_center 14      
Healthcare analytics company [Member]        
Organization And Nature Of Operations [Line Items]        
Payments to Acquire Equity Investments     $ 7,000  
Heritage Healthcare Innovation Fund LP [Member]        
Organization And Nature Of Operations [Line Items]        
Proceeds from sale of equity method investment $ 17,900      
Loss on sale of equity method investment $ (3,000)      
v3.20.4
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS - Recently Issued Accounting Pronouncements (Details) - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Jan. 01, 2019
New Accounting Pronouncements or Change in Accounting Principle [Line Items]      
Operating lease liabilities $ 92,000 $ 83,900  
Operating lease right of use assets $ 93,440 $ 84,791  
ASU 2016-02 [Member]      
New Accounting Pronouncements or Change in Accounting Principle [Line Items]      
Operating lease liabilities     $ 80,000
Operating lease right of use assets     $ 80,000
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Revenue Recognition Narrative (Details)
$ in Millions
 12 Months Ended
Dec. 31, 2020
USD ($)
Number_of_Visits
Dec. 31, 2019
USD ($)
Dec. 31, 2018
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Net service revenue episode payment rate 60 days    
Percentage of total reimbursement of outlier payment 10.00%    
Historical collection rate from Medicare 99.00%    
Hospice Medicare revenue rate accounted for routine care 97.00% 97.00% 97.00%
Rate of request for anticipated payment submitted for the initial period of care 20.00%    
Net Service Revenue Period Of Care Payment Rate Duration 30 days    
Revenue from Contract with Customer Benchmark [Member] | Medicare Revenue [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Percent of net services revenue provided by Medicare 75.00% 74.00% 73.00%
Home Health [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Historical collection rate from Medicare 99.00%    
Hospice [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Historical collection rate from Medicare 99.00%    
Minimum [Member] | Home Health [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Low utilization payment adjustment, maximum number of visits | Number_of_Visits 2    
Non-medicare revenue term rates 90.00%    
Maximum [Member] | Home Health [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Low utilization payment adjustment, maximum number of visits | Number_of_Visits 6    
Non-medicare revenue term rates 100.00%    
Cap Year 2014 Through 2021 [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Estimated amounts due back to Medicare $ 9.3    
Cap Year 2014 Through 2021 [Member] | AseraCare Hospice [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Estimated amounts due back to Medicare $ 2.0    
Cap Year 2013 Through 2020 [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Estimated amounts due back to Medicare   $ 5.7  
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Revenue Recognition by Payor Class (Details)
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Revenue by payor class as a percentage of total net service revenue 100.00% 100.00% 100.00%
Home Health Medicare [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Revenue by payor class as a percentage of total net service revenue 41.00% 44.00% 50.00%
Home Health Non-Medicare - Episodic Based [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Revenue by payor class as a percentage of total net service revenue 7.00% 9.00% 9.00%
Home Health Non-Medicare - Non-Episodic Based [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Revenue by payor class as a percentage of total net service revenue 13.00% 12.00% 12.00%
Hospice Medicare [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Revenue by payor class as a percentage of total net service revenue 34.00% 30.00% 23.00%
Hospice Non-Medicare [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Revenue by payor class as a percentage of total net service revenue 2.00% 1.00% 1.00%
Personal Care [Member]      
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]      
Revenue by payor class as a percentage of total net service revenue 3.00% 4.00% 5.00%
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Cash, Cash Equivalents and Restricted Cash (Details) - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Cash and Cash Equivalents [Line Items]        
Cash and cash equivalents $ 81,808 $ 30,294    
Restricted cash 1,549 66,196    
Cash, Cash Equivalents and Restricted Cash 83,357 96,490 $ 20,229 $ 86,363
Cash Balance Associated With Provider Relief Fund 77,000      
Asana Hospice Acquisition [Member]        
Cash and Cash Equivalents [Line Items]        
Restricted cash $ 1,500 $ 66,200    
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Patient Accounts Receivable Narrative (Details) - day
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Accounting Policies [Abstract]    
Percentage of patient receivables outstanding 10.00%  
Historical collection rate from Medicare 99.00%  
Portion of accounts receivable derived from Medicare 64.00% 58.00%
Rate of request for anticipated payment submitted for the initial period of care 20.00%  
Maximum days to submit final bill from the start of period of care 90  
Maximum days to submit final bill from the date the request for anticipated payment was paid 60  
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Additional Information Narrative (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Accounting Policies [Abstract]      
Payments of Financing Costs $ 0 $ 847 $ 2,433
Asset impairment charge 4,152 1,470 0
Depreciation 12,100 11,600 10,800
Unamortized debt issuance costs $ 2,700 3,500  
Unamortized debt issuance costs, weighted average amortization period, years 3 years 1 month 6 days    
Deferred tax assets $ 47,987 21,427  
Non-cash compensation 26,730 25,040 17,887
Share-based compensation, tax benefit recognized 4,700 4,600 4,300
Advertising expense 8,000 8,500 $ 7,000
Finite-Lived Intangible Assets [Line Items]      
Non-cash impairment charge for write-off of intangible assets 4,200 1,500  
Acquired Names [Member]      
Finite-Lived Intangible Assets [Line Items]      
Non-cash impairment charge for write-off of intangible assets 4,200 1,500  
Noncompete Agreements [Member]      
Finite-Lived Intangible Assets [Line Items]      
Non-cash impairment charge for write-off of intangible assets $ 0 $ 0  
Noncompete Agreements [Member] | Minimum [Member]      
Finite-Lived Intangible Assets [Line Items]      
Estimated useful life of intangible assets 2 years    
Noncompete Agreements [Member] | Maximum [Member]      
Finite-Lived Intangible Assets [Line Items]      
Estimated useful life of intangible assets 3 years    
Acquired Names [Member]      
Finite-Lived Intangible Assets [Line Items]      
Estimated useful life of intangible assets 3 years    
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Estimated Useful Lives of Property and Equipment (Details)
 12 Months Ended
Dec. 31, 2020
Building [Member]  
Property, Plant and Equipment [Line Items]  
Useful Life 39 years
Leasehold Improvements [Member]  
Property, Plant and Equipment [Line Items]  
Estimated Useful Life Lesser of lease term or expected useful life
Equipment and Furniture [Member] | Minimum [Member]  
Property, Plant and Equipment [Line Items]  
Useful Life 3 years
Equipment and Furniture [Member] | Maximum [Member]  
Property, Plant and Equipment [Line Items]  
Useful Life 7 years
Vehicles [Member]  
Property, Plant and Equipment [Line Items]  
Useful Life 5 years
Computer Software [Member] | Minimum [Member]  
Property, Plant and Equipment [Line Items]  
Useful Life 2 years
Computer Software [Member] | Maximum [Member]  
Property, Plant and Equipment [Line Items]  
Useful Life 7 years
Finance Leases [Member]  
Property, Plant and Equipment [Line Items]  
Useful Life 3 years
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Balances Related to Property and Equipment (Details) - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Property, Plant and Equipment [Line Items]    
Property and equipment, gross $ 118,700 $ 124,200
Less accumulated depreciation (95,024) (96,137)
Property and equipment, net 23,719 28,113
Building and Leasehold Improvements [Member]    
Property, Plant and Equipment [Line Items]    
Property and equipment, gross 9,000 8,700
Equipment and Furniture [Member]    
Property, Plant and Equipment [Line Items]    
Property and equipment, gross 53,100 55,600
Finance Leases [Member]    
Property, Plant and Equipment [Line Items]    
Property and equipment, gross 5,900 5,200
Computer Software [Member]    
Property, Plant and Equipment [Line Items]    
Property and equipment, gross $ 50,700 $ 54,700
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Financial Instruments Where Carrying Value and Fair Value Differ (Details)
$ in Millions
Dec. 31, 2020
USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]  
Debt Instrument Carrying Amount Excluding Finance Leases $ 215.1
Fair Value, Inputs, Level 1 [Member]  
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]  
Long-term obligations, fair value 0.0
Fair Value, Inputs, Level 2 [Member]  
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]  
Long-term obligations, fair value 217.7
Fair Value, Inputs, Level 3 [Member]  
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]  
Long-term obligations, fair value $ 0.0
v3.20.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Weighted Average Shares Outstanding (Details) - shares
shares in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Accounting Policies [Abstract]      
Weighted average number of shares outstanding – basic 32,559 32,142 32,791
Effect of dilutive securities:      
Stock options 420 545 502
Non-vested stock and stock units 289 303 316
Weighted average number of shares outstanding – diluted 33,268 32,990 33,609
Anti-dilutive securities 25 117 50
v3.20.4
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") (Details) - USD ($)
$ in Thousands
 1 Months Ended 12 Months Ended
Apr. 30, 2020
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Oct. 01, 2020
Apr. 24, 2020
Mar. 27, 2020
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items]              
Funding For Healthcare Providers Including Hospitals             $ 175,000,000
Funding Immediately Distributed To Healthcare Providers Based On Their 2019 Medicare Fee For Service Reimbursements             $ 30,000,000
Funding Received From CARES Act $ 100,000            
CARES Act Deferral Of Employer Share Social Security Tax   $ 55,400          
Payroll and employee benefits   146,929 $ 120,877        
Other long-term obligations   33,622 5,905        
Additional Funding Distributed To Healthcare Providers         $ 20,000,000 $ 18,000,000  
CARES Act Provider Relief Funds Utilized   33,300          
Estimated CARES Act Provider Relief Funds Expected To Be Utilized   11,600          
Estimated CARES Act Provider Relief Fund Amounts to be Repaid   60,000          
CARES Act Provider Relief Funds Received by Unconsolidated Joint Ventures   1,900          
Total CARES Act Provider Relief Funds Received   106,800          
Provider relief fund advance   60,000 0        
Estimated Future COVID19 Related Expenses   12,000          
Other operating income   34,372 $ 0 $ 0      
COVID-19 Deferral of Social Security Taxes [Member]              
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items]              
CARES Act Deferral Of Employer Share Social Security Tax   55,000          
Payroll and employee benefits   28,000          
Other long-term obligations   28,000          
Home Health And Hospice [Member]              
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items]              
COVID19 Expenses Incurred   33,000          
Personal Care [Member]              
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items]              
Funding Received From Mass HomeCare ASAP COVID19 Provider Sustainability Program   1,000          
Other operating income   $ 1,000          
AseraCare Hospice [Member]              
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items]              
Funding Received From CARES Act 6,000            
Equity Method Investments [Member]              
NOVEL CORONAVIRUS PANDEMIC ("COVID-19") [Line Items]              
Funding Received From CARES Act $ 2,000            
v3.20.4
ACQUISITIONS - Narrative (Details)
$ in Thousands
 3 Months Ended 12 Months Ended
Oct. 01, 2020
USD ($)
Jun. 01, 2020
USD ($)
care_center
Apr. 18, 2020
USD ($)
Mar. 01, 2020
USD ($)
Jan. 01, 2020
USD ($)
care_center
Apr. 01, 2019
USD ($)
Feb. 01, 2019
USD ($)
Dec. 31, 2020
USD ($)
Sep. 30, 2020
USD ($)
Jun. 30, 2020
USD ($)
Mar. 31, 2020
USD ($)
Dec. 31, 2019
USD ($)
Sep. 30, 2019
USD ($)
Jun. 30, 2019
USD ($)
Mar. 31, 2019
USD ($)
Dec. 31, 2020
USD ($)
Dec. 31, 2019
USD ($)
Dec. 31, 2018
USD ($)
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Goodwill recorded during period                               $ 274,200 $ 329,000  
Net service revenue               $ 550,700 $ 544,100 $ 485,000 $ 491,700 $ 500,700 $ 494,600 $ 493,000 $ 467,300 2,071,519 1,955,633 $ 1,662,578
Operating income (loss)                               219,268 177,472 155,148
Depreciation and amortization                               $ 28,802 18,428 $ 13,261
Noncompete Agreements [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Weighted-average amortization period                               1 year 2 months 12 days    
Home Health [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Goodwill recorded during period                               $ 3,300 0  
Home Health [Member] | WASHINGTON                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Payments to Acquire Businesses, Gross       $ 3,000                            
Goodwill recorded during period                               2,800    
Home Health [Member] | WASHINGTON | Certificate of Need [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded               200               200    
Home Health [Member] | KENTUCKY                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Payments to Acquire Businesses, Gross     $ 700                              
Goodwill recorded during period                               500    
Home Health [Member] | KENTUCKY | Certificate of Need [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded               200               200    
Hospice [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Goodwill recorded during period                               270,900 329,000  
Personal Care [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Goodwill recorded during period                               0 0  
Asana Hospice [Member] | Hospice [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, number of care centers acquired | care_center         8                          
Payments to Acquire Businesses, Gross         $ 66,300                          
Cash Acquired from Acquisition         $ 700                          
Business Acquisition Working Capital Adjustment                   $ 700                
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Receivables               4,600               4,600    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment               200               200    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Right of Use Assets               900               900    
Acquisition, other intangibles recorded               5,600               5,600    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Assets               11,300               11,300    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accounts Payable               (3,200)               (3,200)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Payroll and Employee Benefits               (1,500)               (1,500)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accrued Expenses               (500)               (500)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Liabilities               (900)               (900)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities               (6,100)               (6,100)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net               5,200               5,200    
Goodwill recorded during period                               60,400    
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net               65,600               65,600    
Period of time goodwill is expected to be deductible for income tax purposes         15 years                          
Net service revenue                               23,400    
Operating income (loss)                               (3,300)    
Business Combination, Integration Related Costs                               2,000    
Depreciation and amortization                               2,600    
Asana Hospice [Member] | Hospice [Member] | Noncompete Agreements [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded               2,300               2,300    
Weighted-average amortization period         2 years                          
Asana Hospice [Member] | Hospice [Member] | Medicare Licenses [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded               2,000               2,000    
Asana Hospice [Member] | Hospice [Member] | Acquired Names [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded               1,300               1,300    
Weighted-average amortization period         2 years                          
AseraCare Hospice [Member] | Hospice [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, number of care centers acquired | care_center   44                                
Payments to Acquire Businesses, Gross   $ 230,400                                
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Receivables               15,000               15,000    
Business Combination Recognized Identifiable Assets Acquired and Liabilities Assumed Current Assets Prepaid Expense               700               700    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment               600               600    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Right of Use Assets               5,900               5,900    
Acquisition, other intangibles recorded               24,300               24,300    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets               100               100    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Assets               46,600               46,600    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accounts Payable               (5,800)               (5,800)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Payroll and Employee Benefits               (5,900)               (5,900)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accrued Expenses               (10,400)               (10,400)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Liabilities               (5,400)               (5,400)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities               (27,500)               (27,500)    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net               19,100               19,100    
Goodwill recorded during period                               210,500    
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net               229,600               229,600    
Period of time goodwill is expected to be deductible for income tax purposes   15 years                                
Payments related to tax asset   $ 32,000                                
Business Acquisition Closing Payment Adjustment $ 800                                  
Net service revenue                               64,500    
Operating income (loss)                               (8,200)    
Business Combination, Integration Related Costs                               7,600    
Depreciation and amortization                               6,000    
AseraCare Hospice [Member] | Hospice [Member] | Maximum [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Business Acquisition Closing Payment Adjustment   $ 1,000                                
AseraCare Hospice [Member] | Hospice [Member] | Certificates Of Need [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded               700               700    
AseraCare Hospice [Member] | Hospice [Member] | Noncompete Agreements [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded               9,200               9,200    
Weighted-average amortization period   1 year 8 months 12 days                                
AseraCare Hospice [Member] | Hospice [Member] | Medicare Licenses [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded               8,700               8,700    
AseraCare Hospice [Member] | Hospice [Member] | Acquired Names [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded               $ 5,700               $ 5,700    
Weighted-average amortization period   2 years                                
RoseRock Healthcare [Member] | Hospice [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Payments to Acquire Businesses, Gross           $ 17,500                        
Goodwill recorded during period                                 15,800  
Period of time goodwill is expected to be deductible for income tax purposes           15 years                        
Net service revenue                                 6,800  
Operating income (loss)                                 800  
RoseRock Healthcare [Member] | Hospice [Member] | Noncompete Agreements [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded                       700         700  
Weighted-average amortization period           3 years                        
RoseRock Healthcare [Member] | Hospice [Member] | Acquired Names [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Acquisition, other intangibles recorded                       1,000         1,000  
Weighted-average amortization period           3 years                        
Compassionate Care Hospice [Member] | Hospice [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Payments to Acquire Businesses, Gross             $ 327,900                      
Cash Acquired from Acquisition             $ 6,700                      
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Receivables                       24,500         24,500  
Business Combination Recognized Identifiable Assets Acquired and Liabilities Assumed Current Assets Prepaid Expense                       800         800  
Business Combination, Recognized Identifiable Assets Acquired And Liabilities Assumed, Other Current Asset                       100         100  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment                       200         200  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Right of Use Assets                       3,400         3,400  
Acquisition, other intangibles recorded                       27,200         27,200  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets                       1,100         1,100  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Assets                       57,300         57,300  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accounts Payable                       (14,900)         (14,900)  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Payroll and Employee Benefits                       (11,700)         (11,700)  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accrued Expenses                       (11,700)         (11,700)  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Deferred Tax Liabilities                       (900)         (900)  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Operating Lease Liabilities                       (3,400)         (3,400)  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities                       (42,600)         (42,600)  
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net                       14,700         14,700  
Goodwill recorded during period                                 313,200  
Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net                       327,900         327,900  
Goodwill deductible for income tax purposes                       $ 278,800         278,800  
Period of time goodwill is expected to be deductible for income tax purposes             15 years                      
Net service revenue                                 167,400  
Operating income (loss)                                 (5,600)  
Business Combination, Integration Related Costs                                 $ 14,500  
Compassionate Care Hospice [Member] | Hospice [Member] | Noncompete Agreements [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Weighted-average amortization period             2 years 3 months 18 days                      
Compassionate Care Hospice [Member] | Hospice [Member] | Acquired Names [Member]                                    
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]                                    
Weighted-average amortization period             2 years                      
v3.20.4
ACQUISITIONS - Pro Forma Condensed Consolidated Statement of Income (Details) - Hospice [Member] - USD ($)
$ / shares in Units, $ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
AseraCare Hospice [Member]      
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]      
Net service revenue $ 2,120.1 $ 2,077.0  
Operating income 218.0 167.5  
Net income attributable to Amedisys Inc. $ 180.6 $ 112.3  
Basic earnings per share $ 5.55 $ 3.49  
Diluted earnings per share $ 5.43 $ 3.40  
Compassionate Care Hospice [Member]      
Schedule of Business Acquisitions, Purchase Price Allocation [Line Items]      
Net service revenue   $ 1,971.7 $ 1,852.8
Operating income   183.8 175.7
Net income attributable to Amedisys Inc.   $ 130.5 $ 124.6
Basic earnings per share   $ 4.06 $ 3.80
Diluted earnings per share   $ 3.96 $ 3.71
v3.20.4
GOODWILL AND OTHER INTANGIBLE ASSETS, NET - Activity Related to Goodwill (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Goodwill [Line Items]    
Goodwill, Impaired, Accumulated Impairment Loss $ 733,700  
Goodwill [Roll Forward]    
Beginning balance 658,500 $ 329,500
Additions 274,200 329,000
Ending balance 932,685 658,500
Home Health [Member]    
Goodwill [Roll Forward]    
Beginning balance 87,100 87,100
Additions 3,300 0
Ending balance 90,400 87,100
Hospice [Member]    
Goodwill [Roll Forward]    
Beginning balance 528,300 199,300
Additions 270,900 329,000
Ending balance 799,200 528,300
Personal Care [Member]    
Goodwill [Roll Forward]    
Beginning balance 43,100 43,100
Additions 0 0
Ending balance $ 43,100 $ 43,100
v3.20.4
GOODWILL AND OTHER INTANGIBLE ASSETS, NET - Goodwill and Intangibles (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Intangible Assets [Line Items]    
Non-cash impairment charge for write-off of intangible assets $ 4.2 $ 1.5
Amortization of Intangible Assets 16.6 6.8
Acquired Names [Member]    
Intangible Assets [Line Items]    
Non-cash impairment charge for write-off of intangible assets 4.2 1.5
Certificates of Need and Licenses [Member]    
Intangible Assets [Line Items]    
Non-cash impairment charge for write-off of intangible assets 0.0 0.0
Amortization of Intangible Assets $ 2.4 $ 0.0
v3.20.4
GOODWILL AND OTHER INTANGIBLE ASSETS, NET - Activity Related to Other Intangible Assets, Net (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Intangible Assets [Line Items]    
Non-cash impairment charge for write-off of intangible assets $ 4,200 $ 1,500
Intangible assets, accumulated amortization 22,973 7,044
Intangible Assets [Roll Forward]    
Beginning balance 64,748 44,100
Additions 30,300 28,900
Write-off (4,200) (1,500)
Amortization (16,600) (6,800)
Ending balance 74,183 64,748
Amortizable acquired names [Member]    
Intangible Assets [Line Items]    
Non-cash impairment charge for write-off of intangible assets $ 0 0
Weighted-average amortization period 1 year 3 months 18 days  
Intangible Assets [Roll Forward]    
Beginning balance $ 5,600 0
Additions 7,000 10,000
Write-off 0 0
Amortization (7,100) (4,400)
Ending balance 5,500 5,600
Noncompete Agreements [Member]    
Intangible Assets [Line Items]    
Non-cash impairment charge for write-off of intangible assets 0 0
Intangible assets, accumulated amortization $ 700  
Weighted-average amortization period 1 year 2 months 12 days  
Intangible Assets [Roll Forward]    
Beginning balance $ 3,400 600
Additions 11,500 5,200
Write-off 0 0
Amortization (7,100) (2,400)
Ending balance 7,800 3,400
Certificates of Need and Licenses [Member]    
Intangible Assets [Line Items]    
Non-cash impairment charge for write-off of intangible assets 0 0
Intangible Assets [Roll Forward]    
Beginning balance 37,600 23,900
Additions 11,800 13,700
Write-off 0 0
Amortization (2,400) 0
Ending balance 47,000 37,600
Unamortizable acquired names [Member]    
Intangible Assets [Line Items]    
Non-cash impairment charge for write-off of intangible assets 4,200 1,500
Intangible Assets [Roll Forward]    
Beginning balance 18,100 19,600
Additions 0 0
Write-off (4,200) (1,500)
Amortization 0 0
Ending balance $ 13,900 $ 18,100
v3.20.4
GOODWILL AND OTHER INTANGIBLE ASSETS, NET - Estimated Future Amortization Expense (Details)
$ in Millions
Dec. 31, 2020
USD ($)
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]  
2021 $ 10.6
2022 2.7
2023 0.0
2024 0.0
2025 0.0
Total $ 13.3
v3.20.4
DETAILS OF CERTAIN BALANCE SHEET ACCOUNTS - Balances (Details) - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Other current assets:    
Payroll tax escrow $ 6,300 $ 1,500
Income tax receivable 200 2,000
Due from joint ventures 2,300 2,000
Other 4,500 2,700
Other current assets 13,265 8,225
Other assets:    
Workers’ compensation deposits 300 200
Health insurance deposits 500 500
Other miscellaneous deposits 1,200 1,000
Indemnity receivable 13,600 13,600
Equity method investments 14,200 35,700
Other 3,400 3,600
Other assets 33,200 54,612
Accrued expenses:    
Health insurance 15,100 15,800
Workers’ compensation 35,800 33,400
Florida ZPIC audit, gross liability 17,400 17,400
Legal settlements and other audits 24,400 19,000
Income tax payable 0 500
Charity care 3,600 2,700
Estimated Medicare cap liability 9,300 5,700
Hospice accruals (room and board, general in-patient and other) 29,200 24,400
Patient liability 8,400 9,400
Deferred operating income (CARES Act) 11,600 0
Other 11,400 8,800
Accrued expenses 166,192 137,111
Other long-term obligations:    
Reserve for uncertain tax positions 3,300 3,100
Deferred compensation plan liability 1,000 1,000
Non-current social security taxes (deferred under CARES Act) 27,700 0
Other 1,600 1,800
Other long-term obligations $ 33,622 $ 5,905
v3.20.4
LEASES (Details)
 12 Months Ended
Dec. 31, 2020
Lessee, Lease, Description [Line Items]  
Lessee, Operating Lease, Term of Contract 8 years
Lessee, Finance Lease, Term of Contract 3 years
Fleet Lease [Member]  
Lessee, Lease, Description [Line Items]  
Lessee, Operating Lease, Term of Contract 367 days
Minimum [Member]  
Lessee, Lease, Description [Line Items]  
Lessee, Operating Lease, Option to Terminate Option for early termination of lease after one year
Lessee, Operating Lease, Renewal Term 1 year
Maximum [Member]  
Lessee, Lease, Description [Line Items]  
Lessee, Operating Lease, Option to Terminate Option for early termination of lease after three years
Lessee, Operating Lease, Renewal Term 5 years
v3.20.4
LEASES - Lease Cost (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Leases [Abstract]    
Operating lease cost $ 38.6 $ 35.0
Impairment of operating lease ROU assets 0.5 0.9
Total operating lease cost 39.1 35.9
Amortization of ROU assets 2.0 1.7
Finance Lease, Interest Expense 0.2 0.2
Finance Lease Cost 2.2 1.9
Variable lease cost 3.0 2.6
Short-term lease cost 0.0 0.2
Total lease cost $ 44.3 $ 40.6
v3.20.4
LEASES - Operating Lease (Details) - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Leases [Abstract]    
Operating lease ROU assets $ 93,440 $ 84,791
Current portion of operating lease liabilities 30,046 27,769
Operating lease liabilities, less current portion 61,987 56,128
Operating lease liabilities $ 92,000 $ 83,900
v3.20.4
LEASES - Finance Leases (Details) - USD ($)
$ in Millions
Dec. 31, 2020
Dec. 31, 2019
Leases [Abstract]    
Finance lease ROU assets $ 5.9 $ 5.2
Finance Lease, ROU Asset, Accumulated Amortization (3.3) (1.8)
Finance lease ROU assets, net 2.6 3.4
Current installments of obligations under finance leases 1.7 1.7
Long-term portion of obligations under finance leases 0.9 1.7
Total finance lease liabilities $ 2.6 $ 3.4
v3.20.4
LEASES - Supplemental Cashflow Information (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Leases [Abstract]    
Operating cash flow from operating leases $ (38.2) $ (35.8)
Financing cash flow from finance leases (2.0) (1.7)
Right-of-Use Asset Obtained in Exchange for Operating Lease Liability 38.5 116.0
Right-of-Use Asset Obtained in Exchange for Finance Lease Liability 1.2 2.9
Lessee Operating lease Reductions to ROU assets resulting from reductions to lease obligations (1.1) (1.7)
Lessee Finance lease Reduction to ROU assets resulting from reductions to lease obligations $ 0.0 $ 0.0
v3.20.4
LEASES- Weighted Average Remaining Term and Discount Rate (Details)
Dec. 31, 2020
Dec. 31, 2019
Leases [Abstract]    
Operating Lease, Weighted Average Remaining Lease Term 3 years 8 months 12 days 3 years 10 months 24 days
Finance Lease, Weighted Average Remaining Lease Term 1 year 8 months 12 days 2 years 1 month 6 days
Operating Lease, Weighted Average Discount Rate, Percent 3.10% 3.90%
Finance Lease, Weighted Average Discount Rate, Percent 5.30% 5.30%
v3.20.4
LEASES - Maturities (Details) - USD ($)
$ in Millions
Dec. 31, 2020
Dec. 31, 2019
Leases [Abstract]    
Operating Lease - 2021 $ 32.2  
Operating Lease - 2022 25.3  
Operating Lease - 2023 17.6  
Operating Lease - 2024 11.7  
Operating Lease - 2025 6.2  
Operating Lease - Thereafter 4.6  
Operating Lease - Total undiscounted lease payments 97.6  
Operating Lease - Less: Imputed Interest (5.6)  
Operating lease liabilities 92.0 $ 83.9
Finance Lease - 2021 1.8  
Finance Lease - 2022 0.7  
Finance Lease - 2023 0.2  
Finance Lease - 2024 0.0  
Finance Lease - 2025 0.0  
Finance Lease - Thereafter 0.0  
Finance Lease - Total undiscounted lease payments 2.7  
Finance Lease - Less: Imputed Interest (0.1)  
Total finance lease liabilities $ 2.6 $ 3.4
v3.20.4
LONG-TERM OBLIGATIONS - Summary of Long-Term Debt (Details) - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Debt Instrument [Line Items]    
Principal amount $ 217,700 $ 245,700
Deferred debt issuance costs (2,700) (3,500)
Long-term obligations, including current portion 215,000 242,200
Current portion of long-term obligations (10,496) (9,927)
Long-term obligations, less current portion 204,511 232,256
Term Loan [Member] | One Hundred Seventy Five Million Term Loan Facility [Member]    
Debt Instrument [Line Items]    
Principal amount 164,100 171,700
Revolving Credit Facility [Member] | Five Hundred Fifty Million Revolving Credit Facility [Member]    
Debt Instrument [Line Items]    
Principal amount 51,000 70,000
Promissory Notes [Member]    
Debt Instrument [Line Items]    
Principal amount 0 600
Finance Leases [Member]    
Debt Instrument [Line Items]    
Principal amount $ 2,600 $ 3,400
v3.20.4
LONG-TERM OBLIGATIONS - Summary of Long-Term Debt Additional Information (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
USD ($)
Term Loan [Member] | One Hundred Seventy Five Million Term Loan Facility [Member]  
Debt Instrument [Line Items]  
Debt Instrument, face amount $ 175,000
Maturity date Feb. 04, 2024
Term Loan [Member] | One Hundred Seventy Five Million Term Loan Facility [Member] | Eurodollar [Member]  
Debt Instrument [Line Items]  
Debt Instrument Interest Rate at Period End 1.70%
Revolving Credit Facility [Member] | Five Hundred Fifty Million Revolving Credit Facility [Member]  
Debt Instrument [Line Items]  
Debt Instrument, face amount $ 550,000
Maturity date Feb. 04, 2024
Revolving Credit Facility [Member] | Five Hundred Fifty Million Revolving Credit Facility [Member] | Eurodollar [Member]  
Debt Instrument [Line Items]  
Debt Instrument Interest Rate at Period End 3.80%
v3.20.4
LONG-TERM OBLIGATIONS - Maturities of Debt (Details) - USD ($)
$ in Millions
Dec. 31, 2020
Dec. 31, 2019
Long-Term Obligations, Fiscal Year Maturity    
2021 $ 10.5  
2022 9.4  
2023 12.3  
2024 185.5  
2025 0.0  
Total $ 217.7 $ 245.7
v3.20.4
LONG-TERM OBLIGATIONS - Fees and Rates Under Credit Facilities (Details)
 12 Months Ended
Dec. 31, 2020
Consolidated Leverage Ratio: Greater Than Equal to 3.00 to 1.0  
Line of Credit Facility [Line Items]  
Commitment Fee 0.35%
Letter of Credit Fee 1.75%
Consolidated Leverage Ratio: Greater Than Equal to 3.00 to 1.0 | Minimum [Member]  
Line of Credit Facility [Line Items]  
Consolidated Leverage Ratio 3.00
Consolidated Leverage Ratio: Greater Than Equal to 3.00 to 1.0 | Base Rate [Member]  
Line of Credit Facility [Line Items]  
Margin on Loans 1.00%
Consolidated Leverage Ratio: Greater Than Equal to 3.00 to 1.0 | Eurodollar [Member]  
Line of Credit Facility [Line Items]  
Margin on Loans 2.00%
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0  
Line of Credit Facility [Line Items]  
Commitment Fee 0.30%
Letter of Credit Fee 1.50%
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0 | Maximum [Member]  
Line of Credit Facility [Line Items]  
Consolidated Leverage Ratio 3.00
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0 | Minimum [Member]  
Line of Credit Facility [Line Items]  
Consolidated Leverage Ratio 2.00
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0 | Base Rate [Member]  
Line of Credit Facility [Line Items]  
Margin on Loans 0.75%
Consolidated Leverage Ratio: Less Than 3.00 to 1.0 but Greater Than Equal To 2.00 to 1.0 | Eurodollar [Member]  
Line of Credit Facility [Line Items]  
Margin on Loans 1.75%
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0  
Line of Credit Facility [Line Items]  
Commitment Fee 0.25%
Letter of Credit Fee 1.25%
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0 | Maximum [Member]  
Line of Credit Facility [Line Items]  
Consolidated Leverage Ratio 2.00
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0 | Minimum [Member]  
Line of Credit Facility [Line Items]  
Consolidated Leverage Ratio 0.75
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0 | Base Rate [Member]  
Line of Credit Facility [Line Items]  
Margin on Loans 0.50%
Consolidated Leverage Ratio: Less Than 2.00 to 1.0 but Greater Than Equal To 0.75 to 1.0 | Eurodollar [Member]  
Line of Credit Facility [Line Items]  
Margin on Loans 1.50%
Consolidated Leverage Ratio: Less Than 0.75 to 1.0  
Line of Credit Facility [Line Items]  
Commitment Fee 0.20%
Letter of Credit Fee 1.00%
Consolidated Leverage Ratio: Less Than 0.75 to 1.0 | Maximum [Member]  
Line of Credit Facility [Line Items]  
Consolidated Leverage Ratio 0.75
Consolidated Leverage Ratio: Less Than 0.75 to 1.0 | Base Rate [Member]  
Line of Credit Facility [Line Items]  
Margin on Loans 0.25%
Consolidated Leverage Ratio: Less Than 0.75 to 1.0 | Eurodollar [Member]  
Line of Credit Facility [Line Items]  
Margin on Loans 1.25%
v3.20.4
LONG-TERM OBLIGATIONS - Narrative (Details)
$ in Thousands
 10 Months Ended 11 Months Ended 12 Months Ended 14 Months Ended 36 Months Ended
Feb. 04, 2019
USD ($)
Jun. 29, 2018
USD ($)
Feb. 04, 2024
Dec. 31, 2019
USD ($)
Dec. 31, 2020
USD ($)
Dec. 31, 2019
USD ($)
Dec. 31, 2018
USD ($)
Mar. 31, 2020
Mar. 31, 2023
Debt Instrument [Line Items]                  
Principal payments of long-term obligations         $ 10,249 $ 5,624 $ 91,450    
Consolidated leverage ratio         0.6        
Consolidated interest coverage ratio         25.6        
Principal amount       $ 245,700 $ 217,700 245,700      
Payments of Financing Costs         0 847 $ 2,433    
Credit Agreement [Member]                  
Debt Instrument [Line Items]                  
Swing Line Facility   $ 25,000              
Letters of Credit, maximum commitment   60,000              
Finance Leases [Member]                  
Debt Instrument [Line Items]                  
Principal amount       3,400 $ 2,600 3,400      
Finance Leases [Member] | Minimum [Member]                  
Debt Instrument [Line Items]                  
Interest rate (percent)         5.30%        
Finance Leases [Member] | Maximum [Member]                  
Debt Instrument [Line Items]                  
Interest rate (percent)         5.80%        
Amended Credit Agreement [Member]                  
Debt Instrument [Line Items]                  
Maturity date Feb. 04, 2024                
Additional interest rate above Federal Fund rate (percent) 0.50%                
Additional interest rate above Eurodollar Rate (percent) 1.00%                
Percentage of consolidated revenue and adjusted EBITDA that guarantor wholly-owned subsidiaries represent 95.00%                
Percentage of adjusted EBITDA that guarantor subsidiaries represent 70.00%                
Payments of Financing Costs           $ 800      
Amended Credit Agreement [Member] | Minimum [Member]                  
Debt Instrument [Line Items]                  
Proceeds Received From Loan Party Of Subsidiary $ 5,000                
Amended Credit Agreement [Member] | Base Rate [Member]                  
Debt Instrument [Line Items]                  
Description of variable rate basis         Fluctuating rate per annum equal to the highest of (a) the federal funds rate plus 0.50% per annum, (b) the prime rate of interest established by the Administrative Agent, and (c) the Eurodollar Rate for an interest period of one month plus 1% per annum.        
Basis spread on variable rate (percent)         0.25%        
Amended Credit Agreement [Member] | Eurodollar [Member]                  
Debt Instrument [Line Items]                  
Description of variable rate basis         Rate at which Eurodollar deposits in the London interbank market for an interest period of one, two, three or six months        
Basis spread on variable rate (percent)         1.25%        
Five Hundred Fifty Million Revolving Credit Facility [Member] | Revolving Credit Facility [Member]                  
Debt Instrument [Line Items]                  
Debt Instrument, face amount         $ 550,000        
Weighted Average Interest Rate         2.20% 4.00%      
Maturity date         Feb. 04, 2024        
Remaining availability under the revolving credit facility         $ 470,200        
Principal amount       $ 70,000 51,000 $ 70,000      
Five Hundred Fifty Million Revolving Credit Facility [Member] | Letter of Credit [Member]                  
Debt Instrument [Line Items]                  
Outstanding letters of credit         28,800        
Five Hundred Fifty Million Revolving Credit Facility [Member] | Credit Agreement [Member]                  
Debt Instrument [Line Items]                  
Debt Instrument, face amount   550,000              
Credit facility, maximum additional borrowing capacity   $ 125,000              
Credit facility, maximum allowable consolidated leverage ratio multiple   0.5              
Credit facility maximum allowable consolidated leverage ratio   3.0              
Maturity date   Jun. 29, 2023              
Five Hundred Fifty Million Revolving Credit Facility [Member] | Amended Credit Agreement [Member]                  
Debt Instrument [Line Items]                  
Credit facility, maximum borrowing capacity 725,000                
Debt Instrument, face amount 550,000                
One Hundred Seventy Five Million Term Loan Facility [Member] | Term Loan [Member]                  
Debt Instrument [Line Items]                  
Debt Instrument, face amount         $ 175,000        
Weighted Average Interest Rate       3.80% 2.20%        
Maturity date         Feb. 04, 2024        
Principal amount       $ 171,700 $ 164,100 $ 171,700      
One Hundred Seventy Five Million Term Loan Facility [Member] | Amended Credit Agreement [Member]                  
Debt Instrument [Line Items]                  
Debt Instrument, face amount $ 175,000                
Debt Instrument Periodic Payment Percentage               0.625%  
One Hundred Seventy Five Million Term Loan Facility [Member] | Amended Credit Agreement [Member] | Subsequent Event [Member]                  
Debt Instrument [Line Items]                  
Debt Instrument Periodic Payment Percentage     1.875%           1.25%
v3.20.4
INCOME TAXES - Narrative (Details) - USD ($)
$ in Thousands
 1 Months Ended 12 Months Ended
Aug. 10, 2020
Apr. 30, 2020
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Income Tax Disclosure [Line Items]            
Income tax receivable     $ 200 $ 2,000    
Uncertain tax benefits accrued     2,700 2,700 $ 2,700 $ 2,700
Valuation allowance     100 400    
Net change in total valuation allowance     300 300    
Unrecognized Tax Benefits, Income Tax Penalties and Interest Expense     200 300 100  
Interest and penalties accrued related to uncertain income tax positions     600 400    
CARES Act Deferral Of Employer Share Social Security Tax     55,400      
Other long-term obligations     33,622 5,905    
Payroll and employee benefits     146,929 120,877    
Funding Received From CARES Act   $ 100,000        
Provider relief fund advance     60,000 0    
Income Tax Expense (Benefit)     $ 25,635 $ 42,503 $ 38,859  
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period     622,829      
Social Security Tax [Member]            
Income Tax Disclosure [Line Items]            
Other long-term obligations     $ 27,700      
Payroll and employee benefits     27,700      
Executive Stock Option Exercise [Member]            
Income Tax Disclosure [Line Items]            
Recognized share-based compensation tax benefit     92,100      
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period 500,000          
COVID-19 Deferral of Social Security Taxes [Member]            
Income Tax Disclosure [Line Items]            
CARES Act Deferral Of Employer Share Social Security Tax     55,000      
Other long-term obligations     28,000      
Payroll and employee benefits     $ 28,000      
Minimum [Member]            
Income Tax Disclosure [Line Items]            
Tax years open to examination     2007      
Maximum [Member]            
Income Tax Disclosure [Line Items]            
Tax years open to examination     2020      
State Tax Credit [Member]            
Income Tax Disclosure [Line Items]            
Tax credits     $ 3,700      
Federal [Member] | Executive Stock Option Exercise [Member]            
Income Tax Disclosure [Line Items]            
Recognized share-based compensation tax benefit     19,400      
State and Local Jurisdiction [Member] | Executive Stock Option Exercise [Member]            
Income Tax Disclosure [Line Items]            
Recognized share-based compensation tax benefit     4,600      
State and Local Jurisdiction [Member] | Net Operating Loss [Member]            
Income Tax Disclosure [Line Items]            
Net operating loss carryforwards     $ 47,500      
v3.20.4
INCOME TAXES - Components of Tax Provision by Jurisdiction (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Current income tax expense/(benefit):      
Federal $ 41,600 $ 24,200 $ 16,400
State and local 10,600 4,800 2,100
Current income tax expense (benefit) 52,200 29,000 18,500
Deferred income tax expense/(benefit):      
Federal (22,500) 9,500 14,500
State and local (4,100) 4,000 5,800
Deferred income tax expense (benefit) (26,560) 13,466 20,271
Income tax expense $ 25,635 $ 42,503 $ 38,859
v3.20.4
INCOME TAXES - Income Tax Expense Allocation (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Income Tax Disclosure [Abstract]      
Income from continuing operations $ 25,635 $ 42,503 $ 38,859
Interest expense 200 300 100
Goodwill 0 900 0
Total income tax expense allocation $ 25,800 $ 43,700 $ 38,900
v3.20.4
INCOME TAXES - Reconciliation of Effective Tax Rate (Details)
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Income Tax Disclosure [Abstract]      
Income tax expense at U.S. federal statutory rate 21.00% 21.00% 21.00%
State and local income taxes, net of federal income tax benefit (1) 2.40% 4.80% 4.80%
Excess tax benefits from share-based compensation (1) (12.70%) (2.20%) (1.80%)
Non-deductible executive compensation 2.10% 1.60% 0.40%
Other items, net (2) (0.60%) (0.30%) 0.00%
Income tax expense 12.20% 24.90% 24.40%
v3.20.4
INCOME TAXES - Components of Deferred Tax Assets (Liabilities) (Details) - USD ($)
$ in Millions
Dec. 31, 2020
Dec. 31, 2019
Deferred tax assets:    
Accrued payroll & employee benefits $ 15.9 $ 15.1
Workers’ compensation 9.6 9.0
Share-based compensation 5.1 7.9
Legal & compliance matters 7.0 4.8
Lease liability 25.2 23.1
Provider relief fund advance (1) 15.6 0.0
Deferred social security taxes (2) 14.3 0.0
Net operating loss carryforwards 2.4 3.7
Tax credit carryforwards 2.9 3.1
Other 0.6 0.5
Gross deferred tax assets 98.6 67.2
Less: valuation allowance (0.1) (0.4)
Net deferred tax assets 98.5 66.8
Deferred tax liabilities:    
Property and equipment (3.8) (4.3)
Amortization of intangible assets (11.8) (0.3)
Deferred revenue (9.0) (13.5)
Investment in partnerships 0.0 (3.3)
Right-of-use asset (24.9) (22.8)
Other liabilities (1.0) (1.2)
Gross deferred tax liabilities (50.5) (45.4)
Net deferred tax assets (liabilities) $ 48.0 $ 21.4
v3.20.4
INCOME TAXES - Reconciliation of Unrecognized Tax Benefits (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]      
Uncertain tax benefits, beginning balance $ 2.7 $ 2.7 $ 2.7
Additions for tax positions related to current year 0.0 0.0 0.0
Additions for tax positions related to prior year 0.0 0.0 0.0
Reductions for tax positions related to prior years 0.0 0.0 0.0
Lapse of statute of limitations 0.0 0.0 0.0
Settlements 0.0 0.0 0.0
Uncertain tax benefits, ending balance $ 2.7 $ 2.7 $ 2.7
v3.20.4
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Narrative (Details) - USD ($)
$ / shares in Units, $ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Jun. 07, 2012
Jun. 06, 2012
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Common stock, authorized (shares) 60,000,000 60,000,000      
Common stock, par value (usd per share) $ 0.001 $ 0.001      
Preferred stock, authorized (shares) 5,000,000 5,000,000      
Preferred stock, par value (usd per share) $ 0.001 $ 0.001      
Common stock, issued (shares) 37,470,212 36,638,021      
Common stock, outstanding (shares) 32,814,278 32,284,051      
Preferred stock, issued (shares) 0 0      
Percentage of ownership in subsidiaries 50.00%        
Equity-based awards, number of shares authorized (shares) 2,500,000        
Equity-based awards, shares available for grant (shares) 2,000,000.0        
Percentage of total combined voting power of the Company and subsidiaries 10.00%        
Percentage of market value for purchases under Employee Stock Purchase Program (percent) 85.00%        
Common stock authorized for issuance under Employee Stock Purchase Plan (shares) 1,328,627        
Employee Stock Purchase Plan expense $ 0.6 $ 0.6 $ 0.5    
Options granted (shares) 43,249        
Maximum [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Contractual term of share-based award ten years        
Common stock authorized for issuance under Employee Stock Purchase Plan (shares)       4,500,000 2,500,000
Vesting period of equity-based awards 4 years        
Minimum [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Vesting period of equity-based awards 12 months        
Share-Based Awards [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Fair value of share of common stock (percent) 100.00%        
Share Based Awards to More Than Ten Percent Owner [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Fair value of share of common stock (percent) 110.00%        
Stock Option [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Options granted (shares) 43,249 142,122 163,666    
Stock compensation expense $ 4.3 $ 6.2 $ 5.7    
Tax benefit from stock option exercise 27.9 1.3 1.6    
Intrinsic value of options outstanding 50.6        
Intrinsic value of options exerciseable 19.4        
Intrinsic value of options exercised during the period 121.1 7.3 9.7    
Unrecognized compensation expense $ 4.8        
Unrecognized compensation expense weighted-average period for recognitions (years) 1 year 10 months 24 days        
Non-Vested Stock [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Stock compensation expense $ 0.8 $ 1.2 $ 1.4    
Non-vested stock granted, weighted average grant date fair value (usd per share) $ 158.72 $ 119.12 $ 80.54    
Vesting period of equity-based awards 1 year        
Non-Vested Stock Units [Member] | Maximum [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Vesting period of equity-based awards 4 years        
Non-Vested Stock Units [Member] | Minimum [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Vesting period of equity-based awards 1 year        
Non-Vested Stock Units - Service-Based [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Stock compensation expense $ 7.5 $ 8.7 $ 4.5    
Unrecognized compensation expense $ 9.3        
Unrecognized compensation expense weighted-average period for recognitions (years) 1 year 9 months 18 days        
Non-vested stock granted, weighted average grant date fair value (usd per share) $ 206.10 $ 123.70 $ 95.14    
Non-Vested Stock Units - Service-Based and Performance-Based [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Stock compensation expense $ 13.5 $ 8.4 $ 5.8    
Unrecognized compensation expense $ 17.3        
Unrecognized compensation expense weighted-average period for recognitions (years) 1 year 9 months 18 days        
Non-vested stock granted, weighted average grant date fair value (usd per share) $ 201.90 $ 128.89 $ 79.59    
Performance-based award, target number of units to be received (shares) 81,183        
v3.20.4
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Employee Stock Purchase Plan Purchases (Details) - $ / shares
 3 Months Ended 79 Months Ended 103 Months Ended
Dec. 31, 2020
Sep. 30, 2020
Jun. 30, 2020
Mar. 31, 2020
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2018
Dec. 31, 2020
Share-based Payment Arrangement [Abstract]                    
Employee Stock Purchase Plan shares issued (shares) 4,202 4,789 5,414 5,295 6,063 7,216 8,230 7,181 3,122,983 3,171,373
Price per Employee Stock Purchase Plan share issued (usd per share) $ 249.33 $ 200.97 $ 168.76 $ 156.01 $ 141.88 $ 111.36 $ 103.20 $ 104.77 $ 15.92 $ 249.33
v3.20.4
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Stock Option Valuation Assumptions (Details) - Stock Option [Member] - $ / shares
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Risk Free Rate, minimum 0.38% 1.44% 2.56%
Risk Free Rate, maximum 1.51% 2.53% 3.04%
Expected Volatility, minimum 40.15% 42.46% 42.00%
Expected Volatility, maximum 42.80% 43.83% 45.32%
Expected Term 6 years 3 months    
Weighted Average Fair Value $ 86.72 $ 54.42 $ 42.48
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Dividend Rate 0.00% 0.00% 0.00%
Minimum [Member]      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Expected Term   6 years 4 years 1 month 13 days
Maximum [Member]      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Expected Term   6 years 3 months 6 years 3 months
v3.20.4
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Stock Option Activity (Details) - USD ($)
$ / shares in Units, $ in Thousands
 12 Months Ended
Aug. 10, 2020
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Number of Shares        
Outstanding, beginning balance (shares)   875,974    
Granted (shares)   43,249    
Exercise of stock options (in shares)   622,829    
Canceled, forfeited or expired (shares)   (18,353)    
Outstanding, ending balance (shares)   278,041 875,974  
Exercisable (shares)   89,429    
Weighted Average Exercise Price        
Outstanding, beginning balance (usd per share)   $ 49.62    
Granted (usd per share)   209.41    
Exercised (usd per share)   31.60    
Canceled, forfeited or expired (usd per share)   103.89    
Outstanding, ending balance (usd per share)   111.27 $ 49.62  
Exercisable (usd per share)   $ 76.40    
Weighted Average Contractual Life (Years)        
Outstanding, weighted average contractual life (years)   7 years 8 months 4 days 6 years 3 months 3 days  
Exercisable, weighted average contractual life (years)   6 years 9 months    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Exercise of stock options (in shares)   622,829    
Payments Related to Tax Withholding for Share-based Compensation   $ 54,493 $ 9,556 $ 6,570
Executive Stock Option Exercise [Member]        
Number of Shares        
Exercise of stock options (in shares) 500,000      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Issuance/(cancellation) of non-vested stock (shares) 268,317      
Surrendered Shares In Shares 231,683      
Exercise of stock options (in shares) 500,000      
Tax benefit from stock option exercise   24,000    
Payments Related to Tax Withholding for Share-based Compensation   $ 40,400    
v3.20.4
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Non-Vested Stock Option Activity (Details)
 12 Months Ended
Dec. 31, 2020
$ / shares
shares
Number of Shares  
Non-vested stock options beginning balance (shares) | shares 305,750
Granted (shares) | shares 43,249
Vested (shares) | shares (142,233)
Forfeited (shares) | shares (18,154)
Non-vested stock options ending balance (shares) | shares 188,612
Weighted Average Grant Date Fair Value  
Non-vested stock options beginning balance (usd per share) | $ / shares $ 41.66
Granted (usd per share) | $ / shares 86.72
Vested (usd per share) | $ / shares 34.84
Forfeited (usd per share) | $ / shares 47.66
Non-vested stock options ending balance (usd per share) | $ / shares $ 56.55
v3.20.4
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Non-Vested Stock Activity (Details) - Non-Vested Stock [Member] - $ / shares
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Number of Shares      
Non-vested, beginning balance (shares) 9,859    
Granted (shares) 1,560    
Vested (shares) (11,419)    
Canceled, forfeited or expired (shares) 0    
Non-vested, ending balance (shares) 0 9,859  
Weighted Average Grant Date Fair Value      
Non-vested, beginning balance (usd per share) $ 119.12    
Granted (usd per share) 158.72 $ 119.12 $ 80.54
Vested (usd per share) 124.53    
Canceled, forfeited or expired (usd per share) 0    
Non-vested, ending balance (usd per share) $ 0 $ 119.12  
v3.20.4
CAPITAL STOCK AND SHARE-BASED COMPENSATION - Non-Vested Stock Units Activity (Details) - $ / shares
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Non-Vested Stock Units - Service-Based [Member]      
Number of Shares      
Non-vested, beginning balance (shares) 231,418    
Granted (shares) 34,429    
Vested (shares) (89,074)    
Canceled, forfeited or expired (shares) (19,227)    
Non-vested, ending balance (shares) 157,546 231,418  
Weighted Average Grant Date Fair Value      
Non-vested, beginning balance (usd per share) $ 91.87    
Granted (usd per share) 206.10 $ 123.70 $ 95.14
Vested (usd per share) 78.15    
Canceled, forfeited or expired (usd per share) 97.36    
Non-vested, ending balance (usd per share) $ 123.92 $ 91.87  
Non-Vested Stock Units - Service-Based and Performance-Based [Member]      
Number of Shares      
Non-vested, beginning balance (shares) 207,424    
Granted (shares) 85,727    
Vested (shares) (78,856)    
Canceled, forfeited or expired (shares) (18,008)    
Non-vested, ending balance (shares) 196,287 207,424  
Weighted Average Grant Date Fair Value      
Non-vested, beginning balance (usd per share) $ 97.55    
Granted (usd per share) 201.90 $ 128.89 $ 79.59
Vested (usd per share) 83.12    
Canceled, forfeited or expired (usd per share) 101.40    
Non-vested, ending balance (usd per share) $ 148.16 $ 97.55  
Additional Performance Based Award Target share Amount 11,633    
v3.20.4
COMMITMENTS AND CONTINGENCIES - Narrative (Details)
$ in Thousands
 1 Months Ended 12 Months Ended 27 Months Ended
Jun. 27, 2016
patient
Jan. 18, 2016
USD ($)
claim
Nov. 03, 2015
patient
May 21, 2015
patient
Jan. 30, 2015
Apr. 23, 2014
Jun. 06, 2011
beneficiary
Aug. 31, 2017
USD ($)
claim
Dec. 31, 2020
USD ($)
Dec. 31, 2019
USD ($)
Dec. 31, 2018
USD ($)
Dec. 31, 2017
USD ($)
Mar. 31, 2010
beneficiary
Jan. 10, 2019
USD ($)
Loss Contingencies [Line Items]                            
Indemnity receivable                 $ 13,600 $ 13,600        
Other General and Administrative Expense                 192,122 188,434 $ 166,897      
Patient accounts receivable                 255,145 $ 237,596        
Health insurance retention limit                 1,300          
Workers' compensation insurance retention limit                 1,000          
Professional liability insurance retention limit                 300          
South Carolina [Member] | Hospice [Member]                            
Loss Contingencies [Line Items]                            
Number of beneficiaries | beneficiary                         30  
Indemnity receivable                 2,800          
Indemnification amount                           $ 2,800
South Carolina [Member] | Hospice [Member] | Extrapolated [Member]                            
Loss Contingencies [Line Items]                            
Number of beneficiaries | beneficiary             16              
South Carolina [Member] | Hospice [Member] | Unfavorable [Member]                            
Loss Contingencies [Line Items]                            
Recovery amount of the overpayment made to the subsidiary   $ 3,700                        
Recovery amount of overpayment made to subsidiary including interest   $ 5,600                        
Number of claims submitted by subsidiary | claim   9                        
Recovery amount of over payment made to subsidiary including interest withheld                 5,700          
US Department of Justice [Member] | Hospice [Member]                            
Loss Contingencies [Line Items]                            
Loss contingency accrual                 6,500          
US Department of Justice [Member] | Massachusetts [Member] | Hospice [Member]                            
Loss Contingencies [Line Items]                            
Number of patients | patient       53                    
US Department of Justice [Member] | Morgantown, West Virginia [Member] | Hospice [Member]                            
Loss Contingencies [Line Items]                            
Number of patients | patient     66                      
US Department of Justice [Member] | Parkersburg, West Virginia [Member] | Hospice [Member]                            
Loss Contingencies [Line Items]                            
Number of patients | patient 68                          
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member]                            
Loss Contingencies [Line Items]                            
Loss contingency accrual                 17,400          
Indemnity receivable                 10,900          
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Infinity HomeCare [Member]                            
Loss Contingencies [Line Items]                            
Indemnification amount               $ 12,600            
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Home Health [Member]                            
Loss Contingencies [Line Items]                            
Florida Zpic revenue reduction                       $ 6,500    
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Home Health [Member] | Minimum [Member]                            
Loss Contingencies [Line Items]                            
Recovery amount of the overpayment made to the subsidiary               6,500            
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Home Health [Member] | Maximum [Member]                            
Loss Contingencies [Line Items]                            
Recovery amount of the overpayment made to the subsidiary               38,800 29,300          
Safeguard Zone Program Integrity Contractor [Member] | Florida [Member] | Home Health [Member] | Infinity HomeCare [Member]                            
Loss Contingencies [Line Items]                            
Patient accounts receivable                 1,500          
Safeguard Zone Program Integrity Contractor [Member] | Lakeland, Florida [Member] | Home Health [Member]                            
Loss Contingencies [Line Items]                            
Recovery amount of the overpayment made to the subsidiary               $ 34,000 26,000          
Number of claims submitted by subsidiary | claim               72            
Actual claims payment               $ 200            
Error rate (percent)               100.00%            
Safeguard Zone Program Integrity Contractor [Member] | Clearwater, Florida [Member] | Home Health [Member]                            
Loss Contingencies [Line Items]                            
Recovery amount of the overpayment made to the subsidiary               $ 4,800 $ 3,300          
Number of claims submitted by subsidiary | claim               70            
Actual claims payment               $ 200            
Error rate (percent)               100.00%            
Amedisys CIA [Member]                            
Loss Contingencies [Line Items]                            
Corporate integrity agreement term (years)           5 years                
Compassionate Care Hospice CIA [Member]                            
Loss Contingencies [Line Items]                            
Corporate integrity agreement term (years)         5 years                  
v3.20.4
COMMITMENTS AND CONTINGENCIES - Insurance Programs (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Commitments and Contingencies Disclosure [Abstract]    
Health insurance $ 15.1 $ 15.8
Workers’ compensation 35.8 33.4
Professional liability 4.9 5.1
Estimated Insurance Total 55.8 54.3
Less: long-term portion (1.2) (1.3)
Estimated Insurance Excluding Long Term Portion $ 54.6 $ 53.0
v3.20.4
EMPLOYEE BENEFIT PLANS - Narrative (Details) - USD ($)
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Retirement Benefits [Abstract]      
Employer match amount $ 0.44    
Employee contribution amount $ 1.00    
Maximum percentage of employee salary eligible for employer match (percent) 6.00%    
401(k) expense recognized $ 12,900,000 $ 10,500,000 $ 9,000,000.0
v3.20.4
SHARE REPURCHASE - Narrative (Details) - USD ($)
$ / shares in Units, $ in Thousands
 12 Months Ended
Dec. 23, 2020
Feb. 25, 2019
Jun. 04, 2018
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Share Repurchase [Line Items]            
Purchase of company stock       $ 0 $ 0 $ 181,402
2021 Stock Repurchase Program [Member]            
Share Repurchase [Line Items]            
Stock repurchase program, authorized amount $ 100,000          
Stock repurchase program, expiration date Dec. 31, 2021          
2019 Stock Repurchase Program [Member]            
Share Repurchase [Line Items]            
Stock repurchase program, authorized amount   $ 100,000        
Stock repurchase program, expiration date   Mar. 01, 2020        
KKR Share Repurchase [Member]            
Share Repurchase [Line Items]            
Percentage of Shares Outstanding     7.10%      
Purchase of company stock     $ 181,400      
Discounted Closing Stock Price     $ 73.96      
Percentage of Closing Stock Price     96.00%      
Shares repurchased (shares)     2,418,304      
v3.20.4
SEGMENT INFORMATION - Narrative (Details)
 12 Months Ended
Dec. 31, 2020
segment
Segment Reporting [Abstract]  
Number of reportable business segments 3
v3.20.4
SEGMENT INFORMATION - Operating Income of Reportable Segments (Details) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2020
Sep. 30, 2020
Jun. 30, 2020
Mar. 31, 2020
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Segment Reporting Information [Line Items]                      
Net service revenue $ 550,700 $ 544,100 $ 485,000 $ 491,700 $ 500,700 $ 494,600 $ 493,000 $ 467,300 $ 2,071,519 $ 1,955,633 $ 1,662,578
Other operating income                 34,372 0 0
Cost of service, excluding depreciation and amortization                 1,185,369 1,150,337 992,863
General and administrative expenses                 668,200 607,900 501,300
Depreciation and amortization                 28,802 18,428 13,261
Asset impairment charge                 4,152 1,470 0
Operating expenses                 1,886,623 1,778,161 1,507,430
Operating income (loss)                 219,268 177,472 155,148
Home Health [Member] | Reportable Business Segments [Member]                      
Segment Reporting Information [Line Items]                      
Net service revenue                 1,249,200 1,256,400 1,174,500
Other operating income                 20,200    
Cost of service, excluding depreciation and amortization                 729,900 754,100 722,100
General and administrative expenses                 307,200 297,200 276,300
Depreciation and amortization                 3,900 4,200 3,500
Asset impairment charge                 3,400 1,500  
Operating expenses                 1,044,400 1,057,000 1,001,900
Operating income (loss)                 225,000 199,400 172,600
Hospice [Member] | Reportable Business Segments [Member]                      
Segment Reporting Information [Line Items]                      
Net service revenue                 750,100 617,200 410,900
Other operating income                 13,100    
Cost of service, excluding depreciation and amortization                 400,600 335,100 212,000
General and administrative expenses                 175,400 137,500 84,600
Depreciation and amortization                 2,200 1,600 1,100
Asset impairment charge                 800 0  
Operating expenses                 579,000 474,200 297,700
Operating income (loss)                 184,200 143,000 113,200
Personal Care [Member]                      
Segment Reporting Information [Line Items]                      
Other operating income                 1,000    
Personal Care [Member] | Reportable Business Segments [Member]                      
Segment Reporting Information [Line Items]                      
Net service revenue                 72,200 82,000 77,200
Other operating income                 1,100    
Cost of service, excluding depreciation and amortization                 54,900 61,100 58,800
General and administrative expenses                 12,400 12,300 12,800
Depreciation and amortization                 200 200 300
Asset impairment charge                 0 0  
Operating expenses                 67,500 73,600 71,900
Operating income (loss)                 5,800 8,400 5,300
Other [Member] | Other Segment [Member]                      
Segment Reporting Information [Line Items]                      
Net service revenue                 0 0 0
Other operating income                 0    
Cost of service, excluding depreciation and amortization                 0 0 0
General and administrative expenses                 173,200 160,900 127,600
Depreciation and amortization                 22,500 12,400 8,400
Asset impairment charge                 0 0  
Operating expenses                 195,700 173,300 136,000
Operating income (loss)                 $ (195,700) $ (173,300) $ (136,000)
v3.20.4
UNAUDITED SUMMARIZED QUARTERLY FINANCIAL INFORMATION Operating Activity (Details) - USD ($)
$ / shares in Units, $ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2020
Sep. 30, 2020
Jun. 30, 2020
Mar. 31, 2020
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]                      
Net service revenue $ 550,700 $ 544,100 $ 485,000 $ 491,700 $ 500,700 $ 494,600 $ 493,000 $ 467,300 $ 2,071,519 $ 1,955,633 $ 1,662,578
Net income attributable to Amedisys, Inc. $ 45,100 $ 72,000 $ 34,700 $ 31,800 $ 27,700 $ 34,100 $ 33,700 $ 31,300 $ 183,608 $ 126,833 $ 119,346
Net income attributable to Amedisys, Inc. common stockholders - basic (usd per share) $ 1.38 $ 2.20 $ 1.07 $ 0.98 $ 0.86 $ 1.06 $ 1.05 $ 0.98 $ 5.64 $ 3.95 $ 3.64
Net income attributable to Amedisys, Inc. common stockholders - diluted (usd per share) $ 1.36 $ 2.16 $ 1.04 $ 0.96 $ 0.83 $ 1.03 $ 1.02 $ 0.95 $ 5.52 $ 3.84 $ 3.55
v3.20.4
RELATED PARTY TRANSACTIONS - Narrative (Details) - USD ($)
$ / shares in Units, $ in Thousands
 12 Months Ended
Jun. 04, 2018
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Related Party Transaction [Line Items]        
Payments to Acquire Equity Investments   $ 875 $ 210 $ 7,144
Purchase of company stock   0 0 181,402
Medalogix        
Related Party Transaction [Line Items]        
Payments to Acquire Equity Investments       $ 7,000
Related party transaction, amount of transaction   $ 3,900 $ 500  
KKR Share Repurchase [Member]        
Related Party Transaction [Line Items]        
Shares repurchased (shares) 2,418,304      
Percentage of Shares Outstanding 7.10%      
Purchase of company stock $ 181,400      
Discounted Closing Stock Price $ 73.96      
Percentage of Closing Stock Price 96.00%      
KKR Share Repurchase [Member] | KKR Consulting [Member]        
Related Party Transaction [Line Items]        
Percentage of Shares Outstanding 14.20%