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Segment Reporting
3 Months Ended
Mar. 31, 2024
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting:
Our internal financial reporting and management structure is focused on the major types of services provided by the Company. We manage our operations using two operating segments that are also our reportable segments: (1) home health and (2) hospice. These reportable operating segments are consistent with information used by our Chief Executive Officer, who is our chief operating decision maker, to assess performance and allocate resources. The following is a brief description of our reportable segments:
Home Health - Our home health operations represent the nation’s fourth-largest provider of Medicare-certified skilled home health services, measured by 2022 Medicare revenues. As of March 31, 2024, we operated 255 home health locations in 34 states, with a concentration in the southern half of the United States. We are the sole owner of 244 of these locations. We retain 50.0% to 81.0% ownership in the remaining 11 jointly owned locations. Our home health services include a comprehensive range of Medicare-certified home health nursing services to adult patients in need of care. These services include, among others, skilled nursing, physical, occupational, and speech therapy, medical social work, and home health aide services.
Hospice - Our hospice operations represent one of the nation’s largest providers of Medicare-certified hospice services, measured by 2022 Medicare revenues. As of March 31, 2024, we operated 112 hospice locations in 24 states, with a concentration in the southern half of the United States. We are the sole owner of 108 of these locations. We retain 50.0% to 90.0% ownership in the remaining four jointly owned locations. Hospice care focuses on the quality of life for patients who are experiencing an advanced, life limiting illness while treating the person and symptoms of the disease, rather than the disease itself.
The accounting policies of our reportable segments are the same as those described in Note 1, Summary of Significant Accounting Policies, to the consolidated financial statements included in the Form 10-K. All revenues for our services are generated through external customers. See Note 1, Summary of Significant Accounting Policies—Net Service Revenue, for the disaggregation of our revenues. No corporate overhead is allocated to either of our reportable segments. Our Chief Executive Officer evaluates the performance of our segments and allocates resources to them based on adjusted earnings before interest, taxes, depreciation, and amortization (“Segment Adjusted EBITDA”). Segment assets are not reviewed by our Chief Executive Officer and therefore are not disclosed below.
Selected financial information for our reportable segments is as follows (in millions):
Home HealthHospice
Three Months Ended March 31,Three Months Ended March 31,
2024202320242023
Net service revenue$213.2 $215.8 $49.2 $49.3 
Cost of service, excluding depreciation and amortization109.9 108.2 24.3 24.4 
General and administrative expenses59.5 62.9 15.7 16.3 
Net income attributable to noncontrolling interests0.6 0.4 0.1 0.1 
Segment Adjusted EBITDA$43.2 $44.3 $9.1 $8.5 
Segment reconciliations (in millions):
Three Months Ended March 31,
20242023
Total Segment Adjusted EBITDA$52.3 $52.8 
Non-segment general and administrative expenses(30.5)(29.8)
Interest expense and amortization of debt discounts and fees(11.1)(9.5)
Depreciation and amortization(7.8)(7.8)
Stock-based compensation expense(1.8)(1.5)
Net income attributable to noncontrolling interests0.7 0.5 
Income before income taxes and noncontrolling interests$1.8 $4.7 
Additional detail regarding the revenues of our operating segments by service line follows (in millions):
Three Months Ended March 31,
20242023
Home Health:
Medicare $128.3 $146.0 
Non-Medicare82.6 67.1 
Private duty(1)
2.3 2.7 
Total home health213.2 215.8 
Hospice49.2 49.3 
Total net service revenue$262.4 $265.1 
(1)    Private duty represents long-term comprehensive hourly nursing medical care.