0001766400-21-000037 | 10-K | XBRL Viewer

DESCRIPTION OF BUSINESS (Details)	Dec. 31, 2020 agency facility	Oct. 01, 2019
Segment Reporting Information [Line Items]
Spin-off transaction, distribution ratio		0.50
Home Health and Hospice Services
Segment Reporting Information [Line Items]
Number of service providers \| agency	76
Senior Living Services
Segment Reporting Information [Line Items]
Number of properties under lease \| facility	54

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Current assets:
Cash	$ 43	$ 402
Accounts receivable—less allowance for doubtful accounts of $643 and $677, respectively	47,221	32,183
Prepaid expenses and other current assets	12,335	6,098
Total current assets	59,599	38,683
Property and equipment, net	17,884	14,644
Operating lease right-of-use assets	308,650	316,328
Escrow deposits	525	1,400
Deferred tax assets	2,097	0
Restricted and other assets	4,289	2,000
Goodwill	66,444	41,233
Other indefinite-lived intangibles	47,488	33,462
Total assets	506,976	447,750
Current liabilities:
Accounts payable	9,761	8,653
Accrued wages and related liabilities	26,873	16,343
Operating lease liabilities—current	14,106	12,285
Other accrued liabilities	38,275	13,911
Total current liabilities	89,015	51,192
Operating lease liabilities—long-term	296,615	304,044
Other long-term liabilities	11,897	2,877
Long-term debt, net	8,277	18,526
Total liabilities	405,804	376,639
Commitments and contingencies
Equity:
Common stock, $0.001 par value; 100,000 shares authorized; 28,696 and 28,243 shares issued and outstanding at December 31, 2020, respectively, and 28,435 and 27,853 shares issued and outstanding at December 31, 2019, respectively.	28	28
Additional paid-in capital	84,671	74,882
Retained earnings (accumulated deficit)	11,945	(3,799)
Treasury stock, at cost, 3 shares at December 31, 2020	(65)	0
Total Pennant Group, Inc. stockholders' equity	96,579	71,111
Noncontrolling interest	4,593	0
Total equity	101,172	71,111
Total liabilities and equity	$ 506,976	$ 447,750

CONSOLIDATED AND COMBINED STATEMENTS OF STOCKHOLDERS' EQUITY AND NET PARENT INVESTMENT - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Retained Earnings/ (Accumulated Deficit)	Treasury Stock	Net Parent Investment	Non-Controlling Interest
Equity, beginning balance (in shares) at Dec. 31, 2017		0			0
Equity, beginning balance at Dec. 31, 2017	$ 59,916	$ 0	$ 0	$ 0	$ 0	$ 54,996	$ 4,920
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Noncontrolling interest attributable to subsidiary equity plan	1,378					(2,539)	3,917
Net income attributable to noncontrolling interest	595						595
Net transfer from parent	(12,285)					(12,285)
Net income attributable to The Pennant Group, Inc.	15,684					15,684
Equity, ending balance (in shares) at Dec. 31, 2018		0			0
Equity, ending balance at Dec. 31, 2018	65,288	$ 0	0	0	$ 0	55,856	9,432
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Noncontrolling interest attributable to subsidiary equity plan	594					(2,991)	3,585
Share repurchase related to subsidiary equity plan	(394)						(394)
Net income attributable to noncontrolling interest	629						629
Net transfer from parent	11,894					11,894
Net income attributable to The Pennant Group, Inc.	2,546			(3,799)		6,345
Cash Dividend to Parent	(11,600)					(11,600)
Reclassification of Invested Equity	137		72,893			(59,504)	(13,252)
Issuance of common stock after spin-off (in shares)		27,834
Issuance of Common Stock after spin-off	0	$ 28	(28)
Share-based compensation	1,987		1,987
Exercise of stock options, issuance of other awards after spin-off (in shares)		601
Exercise of Stock Options, issuance of other awards after spin-off	30		30
Equity, ending balance (in shares) at Dec. 31, 2019		28,435			0
Equity, ending balance at Dec. 31, 2019	71,111	$ 28	74,882	(3,799)	$ 0	0	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Noncontrolling interests assumed related to acquisitions	4,646						4,646
Sale of noncontrolling interests, net of tax	451		313				138
Net income attributable to noncontrolling interest	(191)						(191)
Net income attributable to The Pennant Group, Inc.	15,744			15,744
Share-based compensation	8,335		8,335
Exercise of stock options, issuance of other awards after spin-off (in shares)		238
Exercise of Stock Options, issuance of other awards after spin-off	1,141		1,141
Issuance/ (cancellation) of restricted stock (in shares)		26
Issuance/ (cancellation) of restricted stock	0
Shares of common stock withheld to satisfy tax withholding obligations (in shares)		3			3
Shares of common stock withheld to satisfy tax withholding obligations	(65)				$ (65)
Equity, ending balance (in shares) at Dec. 31, 2020		28,696			(3)
Equity, ending balance at Dec. 31, 2020	$ 101,172	$ 28	$ 84,671	$ 11,945	$ (65)	$ 0	$ 4,593

PROPERTY AND EQUIPMENT—NET (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 33,590	$ 26,428
Less: accumulated depreciation	(15,706)	(11,784)
Property and equipment, net	17,884	14,644
Depreciation	4,661	3,757	$ 2,863
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	9,984	6,621
Equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	22,420	18,930
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,186	$ 877

COMMITMENTS AND CONTINGENCIES (Details) $ in Thousands	12 Months Ended
COMMITMENTS AND CONTINGENCIES (Details) $ in Thousands	Dec. 31, 2020 USD ($) review	Dec. 31, 2019 USD ($)	Dec. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Number of operating subsidiaries with reviews scheduled \| review	7
Reinsurance receivables \| $	$ 704	$ 0
Revenue \| Customer concentration risk
Concentration Risk [Line Items]
Concentration risk, percent	100.00%	100.00%	100.00%
Subtotal \| Receivables \| Customer concentration risk
Concentration Risk [Line Items]
Concentration risk, percent	75.70%	74.30%
Subtotal \| Revenue \| Customer concentration risk
Concentration Risk [Line Items]
Concentration risk, percent	60.10%	55.60%	53.10%

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

12 Months Ended

Dec. 31, 2020

Accounting Policies [Abstract]

Basis of presentation and summary of significant accounting policies

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Basis of Presentation - The accompanying consolidated and combined financial statements of the Company (the “Financial Statements”) reflect the Company’s financial position, results of operations and cash flows as the business was operated as part of Ensign prior to the Spin-Off, and have been prepared in accordance with accounting principles generally accepted in the United States (“GAAP”) and pursuant to the regulations of the Securities and Exchange Commission (“SEC”). Prior to the Spin-Off, the combined financial statements were prepared on a stand-alone basis and derived from the consolidated financial statements and accounting records of Ensign. Management believes that the Financial Statements reflect, in all material respects, all adjustments which are of a normal and recurring nature necessary to present fairly the Company’s financial position, results of operations, and cash flows for the periods presented in conformity with GAAP applicable to the annual period.

All intercompany transactions and balances between the various legal entities comprising the Company have been eliminated in consolidation. The consolidated and combined statements of income reflect income that is attributable to the Company and the noncontrolling interest.

The Company consists of various limited liability companies and corporations established to operate home health, hospice, home care, and senior living operations. The Financial Statements include the accounts of all entities controlled by the Company through its ownership of a majority voting interest. Revenue was derived from transactional information specific to the Company’s services provided. The costs in the consolidated and combined statements of income reflect direct costs and allocated costs prior to the Spin-Off.

Estimates and Assumptions - The preparation of the Financial Statements in conformity with GAAP requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the Financial Statements and the reported amounts of revenue and expenses during the reporting periods. The most significant estimates in the Financial Statements relate to revenue, cost allocations from prior to the Spin-Off, intangible assets and goodwill, right-of-use assets and lease liabilities for leases greater than 12 months, self-insurance reserves, and income taxes. Actual results could differ from those estimates.

Revenue Recognition - Revenues are recognized when services are provided to the patients at the amount that reflects the consideration to which the Company expects to be entitled from patients and third-party payors, including Medicaid, Medicare and insurers (private and Medicare replacement plans), in exchange for providing patient care. Revenue recognized from healthcare services are adjusted for estimates of variable consideration to arrive at the transaction price. The Company determines the transaction price based on contractually agreed-upon amounts or rate, adjusted for estimates of variable consideration. The Company uses the expected value method in determining the variable component that should be used to arrive at the transaction price, using contractual agreements and historical reimbursement experience within each payor type. The amount of variable consideration which is included in the transaction price may be constrained, and is included in the net revenue only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. If actual amounts of consideration ultimately received differ from the Company’s estimates, the Company adjusts these estimates, which would affect net service revenue in the period such variances become known. See Note 5, Revenue and Accounts Receivable.

CARES Act: The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) was enacted on March 27, 2020 in the United States. During the second quarter of 2020 the Company applied for and received $27,997 in funds under the Accelerated and Advance Payment (“AAP”) Program. The CARES Act allows for deferred payment of the employer-paid portion of social security taxes through the end of 2020, with 50% due on December 31, 2021 and the remainder due on December 31, 2022. For the year ended December 31, 2020, the Company deferred approximately $8,358 of the employer-paid portion of social security taxes, of which $4,179 is included in other long-term liabilities and the current portion of $4,179 in accrued wages and related liabilities. The CARES Act temporarily suspended the automatic 2% reduction of Medicare claim reimbursements for the period of May 1, 2020 through March 31, 2021. The suspension of the Medicare sequestration increased our revenue by approximately $2,765 for the year ended December 31, 2020. The Company will continue to assess the effect of the CARES Act and ongoing other government legislation related to the COVID-19 pandemic that may be issued.

Cash - Cash consists of petty cash and bank term deposits and therefore approximates fair value. The Company places its cash with high credit quality financial institutions. Prior to the Spin-off the Company participated in a cash management program with Ensign where net cash activity was included in the net parent investment.

Accounts Receivable and Allowance for Doubtful Accounts - Accounts receivable consist primarily of amounts due from Medicare and Medicaid programs, other government programs, managed care health plans and private payor sources, net of estimates for variable consideration. Subsequent to our adoption of ASU 2016-13, as noted below, the allowance for doubtful accounts is the Company’s best estimate of current expected credit losses in the accounts receivable balance.

Property and Equipment - Property and equipment are initially recorded at their historical cost. Repairs and maintenance are expensed as incurred. Depreciation is computed using the straight-line method over the estimated useful lives of the depreciable assets (ranging from three to 15 years). Leasehold improvements are amortized on a straight-line basis over the shorter of their estimated useful lives or the remaining lease term.

Impairment of Long-Lived Assets - The Company reviews the carrying value of long-lived assets that are held and used in the independent operating subsidiaries for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of these assets is determined based upon expected undiscounted future net cash flows from the operating subsidiary to which the assets relate, utilizing management’s best estimate, appropriate assumptions, and projections at the time. If the carrying value is determined to be unrecoverable from future operating cash flows, the asset is deemed impaired and an impairment loss would be recognized to the extent the carrying value exceeded the estimated fair value of the asset. The Company estimates the fair value of assets based on the estimated future discounted cash flows of the asset. Management has evaluated its long-lived assets and the Company did not identify any asset impairment during the years ended December 31, 2020, 2019 and 2018.

Intangible Assets and Goodwill - Definite-lived intangible assets consist primarily of patient base and customer relationships. Patient base is amortized over a period of four months to eight months, depending on the classification of the patients and the level of occupancy in a new acquisition when acquired. Customer relationships are amortized between one to seven years depending on the significance of the relationships.

The Company’s indefinite-lived intangible assets consist of trade names and Medicare and Medicaid licenses. The Company tests indefinite-lived intangible assets for impairment on an annual basis or more frequently if events or changes in circumstances indicate that the carrying amount of the intangible asset may not be recoverable. The Company did not identify any asset impairment during the years ended December 31, 2020, 2019 and 2018.

Goodwill represents the excess of the purchase price over the fair value of identifiable net assets acquired in business combinations. Goodwill is subject to annual test for impairment as of the beginning of the fourth quarter or more frequently if events or changes indicate that the Company's goodwill might be impaired. The Company assesses qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount. If the Company determines it is more likely than not that the fair value of a reporting unit is less than its carrying amount, then it is required to perform a quantitative impairment test by comparing the fair value with the carrying amount of the reporting unit. If the carrying amount of a reporting unit exceeds its fair value, then the Company records an impairment of goodwill equal to the amount that the carrying amount of a reporting unit exceeds its fair value.

As of December 31, 2020, we evaluated potential triggering events that might be indicators that our goodwill and indefinite lived intangibles were impaired. No goodwill or intangible asset impairments were recorded during the years ended December 31, 2020, 2019 and 2018. See further discussion at Note 9, Goodwill and Intangible Assets, Net.

Insurance - The Company retains risk for a substantial portion of potential claims for general and professional liability and workers’ compensation. The Company does not retain risk related to its employee health plans.

The Company recognizes 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. As of December 31, 2020 the general and professional liability insurance has a retention limit of $150 per claim with a $500 corridor as an additional out-of-pocket retention we must satisfy for claims within the policy year before the carrier will reimburse losses. The workers’ compensation insurance has a retention limit of $250 per claim, except for policies held in Texas and Washington which are subject to state insurance and possess their own limits.

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. Additionally, the Company has partially indemnified Ensign for general and professional liabilities incurred prior to the Spin-off but not reported until after that date and included that amount in its accrual below.

The following table presents details of the Company's insurance programs, including amounts accrued for the periods indicated in other accrued liabilities and other long-term liabilities in our accompanying balance sheets. The amounts accrued below represent the total estimated liability for individual claims that are less than our noted insurance coverage amounts, which includes outstanding claims and claims incurred but not reported. The amounts are reported gross of reinsurance receivable of $704 and zero included in restricted and other assets for the years ended December 31, 2020 and 2019, respectively.


	Year Ended December 31,
	2020		2019
Type of Insurance
General and professional liability	$	1,063	$	521
Workers’ compensation	2,783		433
Total estimated liability	3,846		954
Less: long-term portion, included in other long-term liabilities	(2,492)		(774)
Current portion of estimated liability, included in other accrued liabilities	$	1,354	$	180

Fair Value of Financial Instruments - The Company’s financial instruments consist principally of cash, accounts receivable, accounts payable and accrued liabilities. The Company believes all of the financial instruments’ recorded values approximate fair values because of their nature or respective short durations. The Company determines fair value measurements are based on a three-tier hierarchy that prioritizes the inputs used to measure fair value. These tiers include: Level 1, defined as observable inputs such as quoted market prices in active markets; Level 2, defined as inputs other than quoted prices included within Level 1 that are observable for the asset or liability, either directly or indirectly; and Level 3, defined as unobservable inputs for which little or no market data exists, therefore requiring an entity to develop its own assumptions.

Income Taxes - Deferred tax assets and liabilities are established for temporary differences between the financial reporting basis and the tax basis of the Company’s assets and liabilities at tax rates in effect when such temporary differences

are expected to reverse. The Company generally expects to fully utilize its deferred tax assets; however, when necessary, the Company records a valuation allowance to reduce its net deferred tax assets to the amount that is more likely than not to be realized.

In determining the need for a valuation allowance or the need for and magnitude of liabilities for uncertain tax positions, the Company makes certain estimates and assumptions. These estimates and assumptions are based on, among other things, knowledge of operations, markets, historical trends and likely future changes and, when appropriate, the opinions of advisors with knowledge and expertise in certain fields. Due to certain risks associated with the Company’s estimates and assumptions, actual results could differ.

Noncontrolling Interest - The noncontrolling interest in a subsidiary is initially recognized at estimated fair value on the acquisition date and is presented within total equity in the Company's consolidated balance sheets. The Company presents the noncontrolling interest and the amount of consolidated net income/ (loss) attributable to The Pennant Group, Inc. in its consolidated and combined statements of income. Net income per share is calculated based on net income/ (loss) attributable to The Pennant Group, Inc.'s stockholders. The carrying amount of the noncontrolling interest is adjusted based on an allocation of subsidiary earnings based on ownership interest.

Share-Based Compensation -The Company measures and recognizes compensation expense for all share-based payment awards, including employee stock options, made to employees and Pennant’s directors based on estimated fair values, ratably over the requisite service period of the award. The Company accounts for forfeitures as they occur. Net income has been reduced as a result of the recognition of the fair value of all stock options and restricted stock awards issued, the amount of which is contingent upon the number of future grants and other variables. The total amount of share-based compensation was $8,335, $3,382, and $2,382 for the years ended December 31, 2020, 2019 and 2018, respectively, of which $7,222, $2,769 and $1,900, respectively, was recorded in general and administrative expense. For further discussion see Note 12, Options and Awards.

Prior to Spin-Off

Cost Allocation - The Financial Statements include allocations of costs for certain shared services provided to the Company by Ensign subsidiaries prior to the Spin-Off on October 1, 2019. Such allocations include, but are not limited to, executive management, accounting, human resources, information technology, compliance, legal, payroll, insurance, tax, treasury, and other general and administrative items. These costs were allocated to the Company on a basis of revenue, location, employee count, or other measures. These cost allocations are reflected within general and administrative expense in the consolidated and combined statements of income, including for share-based compensation expenses disclosed in Note 12, Options and Awards. The amount of general and administrative costs allocated from January 1, 2019 to October 1, 2019, the date of the Spin-Off, inclusive of share-based compensation expense, was $23,710. Management believes the basis on which the expenses were allocated to be a reasonable reflection of the services provided to the Company during the periods.

Insurance - Prior to the Spin-Off Ensign was partially self-insured for healthcare, general and professional liability, and workers’ compensation, and historically allocated premium expense to all subsidiaries of Ensign in its accounting records. To reflect all of the insurance costs, quarterly actuary determined adjustments were allocated to the Company based on the proportional historical premium expense. No self-insurance accruals were allocated to the Company as these accruals represent the obligations of Ensign. In connection with the Spin-Off, the Company purchased insurance through a third-party to replace the coverage provided by Ensign’s self-insured policies.

Debt - Ensign’s external debt and related interest expense were not allocated to the Company for any of the periods presented as no portion of the borrowings were assumed by the Company as part of the Spin-Off. All interest incurred by the Company was subsequent to the Spin-Off.

Income Taxes - Prior to the date of the Spin-off, the Company’s operations have been included in Ensign’s U.S. federal and state income tax returns and all income taxes have been paid by subsidiaries of Ensign. Also prior to the date of the Spin-off, income tax expense and other income tax related information contained in these Financial Statements were presented using a separate tax return approach. Under this approach, the provision for income taxes represents income tax paid or payable for the current year plus the change in deferred taxes during the year calculated as if the Company was a stand-alone taxpayer filing hypothetical income tax returns. Management believes that the assumptions and estimates used to determine these tax amounts are reasonable. However, the Company’s Financial Statements may not necessarily reflect its income tax expense or tax

payments in the future, or what tax amounts would have been if the Company had been a stand-alone company for the entire period presented.

Invested Capital - The net parent investment on the consolidated balance sheets represents Ensign’s historical investment in the Company, the net effect of transactions with, and allocations from, Ensign and the Company’s accumulated earnings. Invested capital was reclassified into additional paid-in-capital at the date of the Spin-Off.

Noncontrolling Interest - Prior to the Spin-Off, the Company presented the noncontrolling interest and the amount of consolidated net income/ (loss) attributable to the Company in its Financial Statements. The carrying amount of the noncontrolling interest was adjusted by an allocation of subsidiary earnings based on ownership interest prior to the Spin-Off. The noncontrolling subsidiary interest included in the Financial Statements was converted into common shares of Pennant concurrent with the distribution to Ensign stockholders at the date of the Spin-Off and thus, will no longer be allocated a portion of earnings.

Share-based compensation - Prior to the Spin-Off, employees of the Company’s subsidiaries participated in Ensign’s equity-based incentive plans (the “Ensign Plans”) and the Cornerstone Subsidiary Equity plan (the “Subsidiary Equity Plan”). Share-based compensation includes the expense attributable to employees of the Company’s subsidiaries who participated in the Ensign Plans, as well as the allocated cost related to Ensign subsidiaries’ employees that participated in the Ensign Plans. Share-based compensation related to Ensign subsidiaries’ employees that participated in the Ensign Plans were allocated on the basis of revenue. All share-based compensation related to the Subsidiary Equity Plan was recognized in the Financial Statements and, therefore, no cost allocation was necessary.

Prior to the Spin-Off, share-based compensation costs associated with the Subsidiary Equity Plan awards was initially measured at fair value at the grant date and was expensed as non-cash compensation over the vesting term. Historically, these awards were granted once per year and the fair value has been determined by an independent valuation of the subsidiary shares. The valuation incorporated a discounted cash flow analysis combined with a market-based approach to determine the fair value of the subsidiary equity.

Earnings Per Share - For the year ended December 31, 2018, the earnings per share included on the accompanying Consolidated and Combined Statements of Income was calculated based on the 27,834 shares of Pennant common stock distributed on October 1, 2019 in conjunction with the Spin-Off, including shares related to the conversion of the noncontrolling interest. Prior to October 1, 2019, Pennant did not have any issued and outstanding common stock. The same number of shares was used to calculate basic and diluted earnings per share since no Pennant employee equity awards were outstanding prior to the Spin-Off. In connection with the Spin-Off, shares of existing equity awards were replaced with shares under the new Pennant awards and are reflected in basic and diluted net income per share for the years ended December 31, 2020 and 2019, respectively. For further discussion see Note 4, Computation of Net Income Per Common Share

Recent Accounting Standards Adopted by the Company

Except for rules and interpretive releases of the SEC under authority of federal securities laws and a limited number of grandfathered standards, the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) is the sole source of authoritative GAAP literature recognized by the FASB and applicable to the Company. For any new pronouncements, the Company considers whether the new pronouncements could alter previous generally accepted accounting principles and determines whether any new or modified principles will have a material impact on the Company’s reported financial position or operations in the near term. The applicability of any standard is subject to the formal review of the Company’s financial management and certain standards are under consideration.

FASB Accounting Standards Update, or ASU, ASU 2020-04 “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting” or ASU 2020-4 - In March 2020, the FASB concluded its reference rate reform project and issued this ASU. The amendments in this ASU provide optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The amendments in this ASU apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. The optional expedients and exceptions are available for all entities as of March 12, 2020, through December 31, 2022. The Company has adopted ASU 2020-04, effective March 12, 2020. The impact of this ASU will be determined based on terms of any future contract modification related to a change in reference rate, including future modifications to the Company’s Revolving Credit Facility described in further detail in Note 11, Debt.

FASB ASU, 2018-15, “Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract” or ASU 2018-15. The update helps entities evaluate the accounting for fees paid by a customer in a cloud computing arrangement (hosting arrangement), by providing guidance in determining when the arrangement includes a software license. It requires entities to account for such costs consistent with the guidance on capitalizing costs associated with developing or obtaining internal-use software. The Company has adopted ASU 2018-15, effective January 1, 2020. There was no material impact to the Company’s Financial Statements or disclosures.

FASB ASU, 2018-13 “Fair Value Measurement (Topic 820): Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement” or ASU 2018-13 - In August 2018, the FASB issued amended guidance to simplify fair value measurement disclosure requirements. The new provisions eliminate the requirements to disclose (1) transfers between Level 1 and Level 2 of the fair value hierarchy, (2) policies related to valuation processes and the timing of transfers between levels of the fair value hierarchy, and (3) net asset value disclosure of estimates of timing of future liquidity events. The FASB also modified disclosure requirements of Level 3 fair value measurements. The Company adopted ASU 2018-13 as of January 1, 2020. There was no material impact to the Company’s Financial Statements or disclosures.

FASB ASU, 2017-04 “Intangibles - Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment” or ASU 2017-04 - In January 2017, the FASB issued amended authoritative guidance to simplify and reduce the cost and complexity of the goodwill impairment test. The new guidance eliminates “Step 2” from the traditional two-step goodwill impairment test and redefines the concept of impairment from a measure of loss when comparing the implied fair value of goodwill to its carrying amount, to a measure comparing the fair value of a reporting unit with its carrying amount. The FASB also eliminated the requirements for any reporting unit with a zero or negative carrying amount to perform a qualitative assessment or “Step 2” of the goodwill impairment test. The new guidance does not amend the optional qualitative assessment of goodwill impairment. The Company adopted ASU 2017-04 as of January 1, 2020. There was no material impact to the Company’s Financial Statements or disclosures.

FASB ASU 2016-13 “Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments” or ASU 2016-13 - In June 2016, the FASB issued ASU 2016-13, which replaced the existing incurred loss impairment model with an expected credit loss model and requires a financial asset measured at amortized cost to be presented at the net amount expected to be collected. The Company adopted ASU 2016-13 as of January 1, 2020. There was no material impact to the Company’s Financial Statements or related disclosures.

LEASES - IMPACT OF NEW LEASES GUIDANCE (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Lease, Cost [Abstract]
Sublease income	$ (143)	$ 0
Variable lease cost	5,330	4,608
Cost of services
Lease, Cost [Abstract]
Operating lease costs	39,191	34,975	$ 31,199
Cost of services \| Facility
Lease, Cost [Abstract]
Operating lease costs	35,562	32,011
Cost of services \| Office
Lease, Cost [Abstract]
Operating lease costs	3,772	2,964
General and administrative expense
Lease, Cost [Abstract]
Operating lease costs	$ 295	$ 162

ACQUISITIONS - NARRATIVE (Details) $ in Thousands	1 Months Ended	2 Months Ended	12 Months Ended
ACQUISITIONS - NARRATIVE (Details) $ in Thousands	Oct. 31, 2020 USD ($)	Feb. 23, 2021 USD ($) agency	Dec. 31, 2020 USD ($) home_health_agency hospice_agency stand-alone_senior_living_operation senior_living_unit	Dec. 31, 2019 USD ($) home_health_agency hospice_agency stand-alone_senior_living_operation senior_living_unit home_care_agency	Dec. 31, 2018 USD ($) home_health_agency hospice_agency stand-alone_senior_living_operation senior_living_unit home_care_agency
Business Acquisition [Line Items]
Non-capitalizable			$ 99
Noncontrolling interest			451
Additional paid in capital			84,671	$ 74,882
Business combination and asset acquisition, purchase price				18,780	$ 5,318
Business combination, acquisition costs			99	665	0
Revenue			17,676
Net income (loss) before taxes			750
Subsequent event
Business Acquisition [Line Items]
Business combination, purchase price		$ 3,625
Scripps Health
Business Acquisition [Line Items]
Acquire interest in joint venture	$ 6,200
Net book value	614
Noncontrolling interest	4,646
Cash from sale of noncontrolling interest	555
Noncontrolling interest to scripps	138
Additional paid in capital	313
Income tax effect	$ 104
Scripps Health \| Home Health Joint Venture
Business Acquisition [Line Items]
Ownership interest	60.00%
Scripps Health \| Hospice Join Venture
Business Acquisition [Line Items]
Ownership interest	80.00%
Series of Individually Immaterial Business Acquisitions
Business Acquisition [Line Items]
Total acquisitions			$ 39,239	18,760	$ 4,725
Business acquisitions 2019
Business Acquisition [Line Items]
Business combination, acquisition costs				$ 611
Home Health Services \| Subsequent event
Business Acquisition [Line Items]
Number of businesses acquired \| agency		2
Hospice Services \| Subsequent event
Business Acquisition [Line Items]
Number of businesses acquired \| agency		2
Home Health and Hospice Services \| Home Health Services
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| home_health_agency			6		4
Home Health and Hospice Services \| Home Health Services \| Business acquisitions 2019
Business Acquisition [Line Items]
Number of businesses acquired \| home_health_agency				2
Home Health and Hospice Services \| Hospice Services
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| hospice_agency			6		2
Home Health and Hospice Services \| Hospice Services \| Business acquisitions 2019
Business Acquisition [Line Items]
Number of businesses acquired \| hospice_agency				5
Home Health and Hospice Services \| Home Care \| Asset acquisitions 2018
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| home_care_agency					2
Home Health and Hospice Services \| Home Care \| Business acquisitions 2019
Business Acquisition [Line Items]
Number of businesses acquired \| home_care_agency				2
Senior Living Services
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| stand-alone_senior_living_operation					7
Number of units (in units) \| senior_living_unit			164	143	386
Senior Living Services \| Asset Acquisitions 2020
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| stand-alone_senior_living_operation			2
Senior Living Services \| Asset acquisitions 2019
Business Acquisition [Line Items]
Number of asset acquisitions \| stand-alone_senior_living_operation				2

GOODWILL AND INTANGIBLE ASSETS - NET

12 Months Ended

Dec. 31, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and intangible assets - net

GOODWILL AND INTANGIBLE ASSETS—NET The Company tests goodwill during the fourth quarter of each year and also if events or changes in circumstances indicate the occurrence of a triggering event which might indicate there may be impairment. The Company performs its goodwill impairment analysis for each reporting unit that constitutes a component for which (1) discrete financial information is available and (2) segment management regularly reviews the operating results of that component, in accordance with the provisions of ASC Topic 350, Intangibles-Goodwill and Other (“ASC 350”).

The Company reviews goodwill for impairment by initially considering qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount, including goodwill, as a basis for determining whether it is necessary to perform a quantitative analysis. If it is determined that it is more likely than not that the fair value of reporting unit is less than its carrying amount, a quantitative analysis is performed to identify goodwill impairment. If it is determined that it is not more likely than not that the fair value of the reporting unit is less than its carrying amount, it is unnecessary to perform a quantitative analysis. The Company may elect to bypass the qualitative assessment and proceed directly to performing a quantitative analysis. Impairment is the condition that exists when the carrying amount of goodwill exceeds its implied fair value. An impairment loss is recognized for the amount that the carrying amount of the reporting unit, including goodwill, exceeds its fair value, limited to the total amount of goodwill allocated to that reporting unit. The Company did not identify any impairment charge during the years ended December 31, 2020, 2019 and 2018.

The following table represents activity in goodwill by segment as of and for the year ended December 31, 2020:


	Home Health and Hospice Services		Senior Living Services		Total
December 31, 2018	$	27,250	$	3,642	$	30,892
Additions	10,341		—		10,341

December 31, 2019	37,591		3,642		41,233
Additions	25,211		—		25,211

December 31, 2020	$	62,802	$	3,642	$	66,444

Other indefinite-lived intangible assets consist of the following:


	Year Ended December 31,
	2020		2019
Trade name	$	1,355	$	355
Medicare and Medicaid licenses	46,133		33,107
Total	$	47,488	$	33,462

OPTIONS AND AWARDS - RESTRICTED STOCK AWARDS ACTIVITY (Details) - The Ensign Plans - Restricted stock awards shares in Thousands	12 Months Ended
	Dec. 31, 2020 $ / shares shares
Non-Vested Restricted Awards
Beginning balance, outstanding (in shares) \| shares	1,793
Granted (in shares) \| shares	29
Vested (in shares) \| shares	(176)
Forfeited (in shares) \| shares	(11)
Ending balance, outstanding (in shares) \| shares	1,635
Weighted Average Grant Date Fair Value
Beginning of period, weighted average exercise price (in dollars per share) \| $ / shares	$ 14.44
Granted (in dollars per share) \| $ / shares	26.84
Vested (in dollars per share) \| $ / shares	13.27
Forfeited (in dollars per share) \| $ / shares	10.92
End of period, weighted average exercise price (in dollars per share) \| $ / shares	$ 14.80

GOODWILL AND INTANGIBLE ASSETS - NET - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Impairment charges	$ 0	$ 0	$ 0

INCOME TAXES - PROVISION FOR INCOME TAXES (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Current:
Federal	$ 5,058	$ 562	$ 3,223
State	1,478	278	915
Current provision for income tax, total	6,536	840	4,138
Deferred:
Federal	(3,348)	1,070	226
State	(838)	175	(12)
Deferred provision for income tax, total	(4,186)	1,245	214
Total income tax expense	$ 2,350	$ 2,085	$ 4,352

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

COMPUTATION OF NET INCOME PER COMMON SHARE (Tables)

12 Months Ended

Dec. 31, 2020

Earnings Per Share [Abstract]

Computation of basic and diluted net income per share

The following table sets forth the computation of basic and diluted net income per share for the periods presented:


	Year Ended December 31,
	2020		2019		2018
Numerator:
Net income	$	15,553	$	3,175	$	16,279
Add: net (loss)/ income attributable to noncontrolling interests	(191)		629		595
Net income attributable to The Pennant Group, Inc.	$	15,744	$	2,546	$	15,684

Denominator:
Weighted average shares outstanding for basic net income per share(a)	28,029		27,838		27,834
Plus: incremental shares from assumed conversion(b)	2,199		1,748		—
Adjusted weighted average common shares outstanding for diluted income per share	30,228		29,586		27,834

Earnings Per Share:
Basic net income per common share(c)	$	0.56	$	0.11	$	0.58
Diluted net income per common share(c)	$	0.52	$	0.11	$	0.58


(a)						Concurrent with the Spin-Off the noncontrolling subsidiary interest converted into 1,160 shares of Pennant. The total number of common shares distributed on October 1, 2019 of 27,834 was utilized in the denominator for the calculation of basic and diluted earnings per share for the year ended December 31, 2018 , as no common stock was outstanding prior to the date of the Spin-Off.
(b)						The calculation of dilutive shares outstanding excludes out-of-the-money stock options (i.e., such options’ exercise prices were greater than the average market price of our common shares for the period) because their inclusion would have been antidilutive. Options outstanding which are anti-dilutive and therefore not factored into the weighted average common shares amount above were 93 and 15 for the years ended December 31, 2020 and 2019, respectively.
(c)						For the years ended December 31, 2019 and 2018 basic and diluted earnings per share were calculated based on net income as the numerator, which included the conversion of the noncontrolling interest in connection with the Spin-Off. For the year ended December 31, 2020, basic and diluted earnings per share was calculated based on net income attributable to The Pennant Group, Inc. as the numerator, . See Note 7, Acquisitions, for further information on our acquisitions for the year ended December 31, 2020.

REVENUE AND ACCOUNTS RECEIVABLE - ALLOWANCE FOR DOUBTFUL ACCOUNTS (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounting Standards Update [Extensible List]	us-gaap:AccountingStandardsUpdate201409Member
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Balance at beginning of period	$ 677	$ 616	$ 5,058
Additions to bad debt expense	560	858	346
Write-offs of uncollectible accounts	(594)	(797)	(198)
Balance at end of period	643	677	616
Revision of Prior Period, Accounting Standards Update, Adjustment
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Balance at beginning of period	$ 0	0	(4,590)
Balance at end of period		$ 0	$ 0

- Definition

Indicates amendment to accounting standards.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (f)(2)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(1)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (f)(2)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=121646688&loc=SL121648383-210437

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (f)(1)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(2)(i)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=121646688&loc=SL121648383-210437

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (h)(2)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (e)(3)
-URI http://asc.fasb.org/extlink&oid=121646688&loc=SL121648383-210437

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (b)(2)
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22499-107794

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (b)(4)
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22499-107794

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (b)(3)
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22499-107794

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(2)(iv)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 20: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(2)(iii)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (h)(1)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 22: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 24: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (c)(2)
-URI http://asc.fasb.org/extlink&oid=109234566&loc=d3e22499-107794

Reference 25: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (e)(4)
-URI http://asc.fasb.org/extlink&oid=121646688&loc=SL121648383-210437

Reference 26: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121646688&loc=SL121648383-210437

Reference 27: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 65
-Paragraph 15
-Subparagraph (g)(2)
-URI http://asc.fasb.org/extlink&oid=121322162&loc=SL121327923-165333

Reference 28: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (f)(1)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 29: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 326
-SubTopic 10
-Section 65
-Paragraph 4
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121646688&loc=SL121648383-210437

Reference 30: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 65
-Paragraph 2
-Subparagraph (g)(2)(ii)
-URI http://asc.fasb.org/extlink&oid=121370832&loc=SL117420844-207641

Reference 31: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 65
-Paragraph 8
-Subparagraph (d)(2)

Reference 32: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 65
-Paragraph 8
-Subparagraph (d)(3)

+ Details

LEASES - NARRATIVE (Details)	Dec. 31, 2020 facility property arrangement
Lessee, Lease, Description [Line Items]
Weighted average remaining lease term	15 years
Weighted average discount rate	8.20%
Senior Living Services
Lessee, Lease, Description [Line Items]
Number of properties under lease	54
Senior Living Services \| Related party
Lessee, Lease, Description [Line Items]
Number of operating facilities \| property	31
Number of properties under lease, master lease agreement	15
Number of separate master lease arrangements \| arrangement	2
Senior Living Services \| Minimum
Lessee, Lease, Description [Line Items]
Lease term	5 years
Senior Living Services \| Minimum \| Related party
Lessee, Lease, Description [Line Items]
Lease term	14 years
Senior Living Services \| Maximum
Lessee, Lease, Description [Line Items]
Lease term	21 years
Senior Living Services \| Maximum \| Related party
Lessee, Lease, Description [Line Items]
Lease term	20 years

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)

12 Months Ended

Dec. 31, 2020

Accounting Policies [Abstract]

Summary of insurance liability


	Year Ended December 31,
	2020		2019
Type of Insurance
General and professional liability	$	1,063	$	521
Workers’ compensation	2,783		433
Total estimated liability	3,846		954
Less: long-term portion, included in other long-term liabilities	(2,492)		(774)
Current portion of estimated liability, included in other accrued liabilities	$	1,354	$	180

ACQUISITIONS - OPERATIONS ACQUIRED (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2020	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill	$ 41,233	$ 66,444	$ 30,892
Total acquisitions	1,400
Series of Individually Immaterial Business Acquisitions
Business Acquisition [Line Items]
Equipment, furniture, and fixtures	91	174	15
Goodwill	10,341	25,211	2,872
Other indefinite-lived intangible assets	8,326	14,026	1,838
Other Assets	2	0	0
Liabilities Assumed	0	(172)	0
Total acquisitions	18,760	39,239	4,725
Less: noncontrolling interest and additional paid in capital	0	(4,646)	0
Additional paid-in capital	$ 18,760	$ 34,593	$ 4,725

GOODWILL AND INTANGIBLE ASSETS - NET - INDEFINITE-LIVED INTANGIBLE ASSETS (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Indefinite-lived Intangible Assets [Line Items]
Other indefinite-lived intangibles	$ 47,488	$ 33,462
Trade name
Indefinite-lived Intangible Assets [Line Items]
Other indefinite-lived intangibles	1,355	355
Medicare and Medicaid licenses
Indefinite-lived Intangible Assets [Line Items]
Other indefinite-lived intangibles	$ 46,133	$ 33,107

OTHER ACCRUED LIABILITIES (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Jun. 30, 2020	Dec. 31, 2019
Other Accrued Liabilities, Current [Abstract]
Refunds payable	$ 2,664		$ 2,152
Deferred revenue	1,271		1,937
Resident deposits	5,647		6,292
Contract Liabilities (CARES Act advance payments)	22,771	$ 27,997	0
Property taxes	982		1,130
Accrued insurance retention - current portion	1,354		0
Other	3,586		2,400
Other accrued liabilities	$ 38,275		$ 13,911

BUSINESS SEGMENTS - FINANCIAL DATA (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Segment Reporting Information [Line Items]
Revenue	$ 390,953	$ 338,531	$ 286,058
Segment Adjusted EBITDAR from Operations	75,048	62,107	57,466
Senior Living Services
Segment Reporting Information [Line Items]
Revenue	137,294	131,907	117,021
Operating segments \| Home Health and Hospice Services
Segment Reporting Information [Line Items]
Revenue	253,659	206,624	169,037
Segment Adjusted EBITDAR from Operations	49,501	33,354	26,427
Operating segments \| Senior Living Services
Segment Reporting Information [Line Items]
Revenue	137,294	131,907	117,021
Segment Adjusted EBITDAR from Operations	48,309	47,344	47,230
All Other
Segment Reporting Information [Line Items]
Revenue	0	0	0
Segment Adjusted EBITDAR from Operations	$ (22,762)	$ (18,591)	$ (16,191)

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8906-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9031-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9038-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130543-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9054-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130545-203045

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 924
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-URI http://asc.fasb.org/extlink&oid=6472922&loc=d3e499488-122856

+ Details

OPTIONS AND AWARDS - OPTIONS GRANTED (Details) - The Ensign Plans - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)	693
2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)	693
Weighted average fair value of options (in dollars per share)	$ 11.05
2020 \| Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average risk-free rate	0.50%
Expected life	6 years 6 months
Weighted average volatility	35.90%
Weighted average dividend yield	0.00%
2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)		667
Weighted average fair value of options (in dollars per share)		$ 5.70
2019 \| Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average risk-free rate		1.60%
Expected life		6 years 6 months
Weighted average volatility		34.60%
Weighted average dividend yield		0.00%

INCOME TAXES - DEFERRED TAX ASSETS AND LIABILITIES (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Deferred tax assets (liabilities):
Accrued expenses	$ 8,181	$ 2,670
Allowance for doubtful accounts	875	869
State taxes	147	27
Lease liabilities	80,979	83,076
Insurance	277	137
Gross deferred tax assets	90,459	86,779
Less: valuation allowance	(15)	0
Net deferred tax assets	90,444	86,779
Depreciation and amortization	(7,512)	(6,107)
Prepaid expenses	(780)	(594)
Right of use asset	(80,055)	(82,181)
Total deferred tax liabilities	(88,347)	(88,882)
Net deferred tax assets	$ 2,097
Net deferred tax liabilities		$ (2,103)

OPTIONS AND AWARDS

12 Months Ended

Dec. 31, 2020

Share-based Payment Arrangement [Abstract]

Options and awards

OPTIONS AND AWARDS

For all periods prior to the Spin-Off, employees of the Company participated in Ensign's share-based compensation plans. The compensation expense recorded by the Company included the expense associated with these employees, as well as an allocation of share-based compensation of certain Ensign employees who provided general and administrative services on our behalf.

Outstanding options held by employees of the Company under the Ensign stock plans (collectively the “Ensign Plans”) and outstanding options and restricted stock awards under the Company Subsidiary Equity Plan (together with the Ensign Plans the “Pre-Spin Plans”) were modified and replaced with Pennant awards under the Pennant Plans at the Spin-Off date. Additionally, in connection with the Spin-Off, the Company issued new options and restricted stock awards to Pennant and Ensign employees under the 2019 Omnibus Incentive Plan (the “OIP”) and Long-Term Incentive Plan (the “LTIP”, together referred to as the “Pennant Plans”).

Under the Ensign Plans and the Pennant Plans, share-based payment awards, including employee stock options, restricted stock awards (“RSA”), and restricted stock units (“RSU” and together with RSA, “Restricted Stock”) are issued based on estimated fair value. The following disclosures represent share-based compensation expense relating to the Ensign and Pennant Plans, including awards to employees of the Company’s subsidiaries and an allocation of costs from employees in the Service Center prior to the Spin-Off, and total share-based compensation after the Spin-Off.

Total share-based compensation expense for all of the Plans for the years ended December 31, 2020, 2019 and 2018:


	Year Ended December 31,
	2020		2019		2018
Prior to the Spin-Off:
Total share-based compensation	$	—	$	1,395	$	2,382

Following the Spin-Off:
Share-based compensation expense related to stock options	1,660		315		—
Share-based compensation expense related to Restricted Stock	6,200		1,589		—
Share-based compensation expense related to Restricted Stock to non-employee directors	475		83		—
Total share-based compensation	$	8,335	$	3,382	$	2,382

In future periods, the Company estimates it will recognize the following share-based compensation expense for unvested stock options and unvested Restricted Stock, which were unvested as of December 31, 2020:


	Unrecognized Compensation Expense		Weighted Average Recognition Period (in years)
Unvested stock options	$	10,055	4.3
Unvested Restricted Stock	10,956		1.8
Total unrecognized share-based compensation expense	$	21,011

Stock Options

Under the Pennant Plans, options granted to employees of the subsidiaries of Pennant generally vest over five years at 20% per year on the anniversary of the grant date. Options expire ten years after the date of grant.

The Company uses the Black-Scholes option-pricing model to recognize the value of share-based compensation expense for share-based payment awards under the Plans. Determining the appropriate fair-value model and calculating the fair value of share-based awards at the grant date requires considerable judgment, including estimating stock price volatility and

expected option life. The Company develops estimates based on historical data and market information, which can change significantly over time.

The fair value of each option is estimated on the grant date using a Black-Scholes option-pricing model with the following weighted average assumptions for stock options granted after the Spin-Off:


Grant Year	Options Granted	Risk-Free Interest Rate		Expected Life(a)	Expected Volatility(b)		Dividend Yield		Weighted Average Fair Value of Options
2020	693	0.5	%	6.5	35.9	%	—	%	$	11.05
2019	667	1.6	%	6.5	34.6	%	—	%	$	5.70


(a)						Under the midpoint method, the expected option life is the midpoint between the contractual option life and the average vesting period for the options being granted. This resulted in an expected option life of 6.5 years for the options granted.
(b)						Because the Company’s equity shares have been traded for a relatively short period of time, expected volatility assumption was based on the volatility of related industry stocks.

The following table represents the employee stock option activity during the year ended December 31, 2020:


	Number of Options Outstanding	Weighted Average Exercise Price		Number of Options Vested	Weighted Average Exercise Price of Options Vested




December 31, 2019	1,573	$	9.71	607	$	4.80
Granted	693	$	30.44
Exercised	(239)	$	4.77
Forfeited	(36)	$	14.34
Expired	(9)	$	6.24
December 31, 2020	1,982	$	17.48	615	$	7.52

The aggregate intrinsic value of options outstanding, vested, unvested and exercised as of and for the period ended December 31, 2020 is as follows:


Options	December 31, 2020
Outstanding	$	80,456
Vested	31,077
Unvested	49,379
Exercised	8,002

The intrinsic value is calculated as the difference between the market value of the underlying common stock and the exercise price of the options. There were 1,367 unvested and outstanding options at December 31, 2020. The weighted average contractual life for options outstanding, vested and expected to vest at December 31, 2020 was 7.83 years.

Restricted Stock Awards

Under the Pennant Plans, the Company granted Restricted Stock to Pennant employees, Ensign employees, and to non-employee directors. All awards generally vest between three to five years. A summary of the status of Pennant’s non-vested Restricted Stock, and changes during the period ended December 31, 2020, is presented below:


	Non-Vested Restricted Awards	Weighted Average Grant Date Fair Value
December 31, 2019	1,793	$	14.44
Granted	29	26.84
Vested	(176)	13.27
Forfeited	(11)	10.92
December 31, 2020	1,635	$	14.80

BUSINESS SEGMENTS - INCOME FROM OPERATIONS (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Oct. 01, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020
Revenue, Major Customer [Line Items]
Segment Adjusted EBITDAR from Operations		$ 75,048	$ 62,107	$ 57,466
Less: Depreciation and amortization		4,675	3,810	2,964
Rent—cost of services		39,191	34,975	31,199
Other income		225	0	0
Less: Costs at start-up operations		1,787	483	129
Share-based compensation expense	$ 1,395	8,335	3,382	2,382
Acquisition related costs		99	665	0
Spin-off related transaction costs		0	13,219	756
Transaction services costs		1,181	532	0
Incremental Costs, Direct Medical Supplies, Labor, and Other Expenses		447	0	0
Add: Net income/ (loss) attributable to noncontrolling interest		(191)	629	595
Consolidated and Combined Income from operations		18,917	5,670	$ 20,631
Software expense		446
Interim periods					$ 333	$ 333	$ 333
Direct medical supplies, labor, and other expenses		2,765
Transition Services Agreement \| Related party
Revenue, Major Customer [Line Items]
Expenses from transactions with related party		$ 5,536	$ 2,982

ACQUISITIONS

12 Months Ended

Dec. 31, 2020

Business Combinations [Abstract]

Acquisitions

ACQUISITIONS

The Company’s acquisition focus is to purchase or lease operations that are complementary to the Company’s current businesses, accretive to the Company’s business or otherwise advance the Company’s strategy. The results of all the Company’s independent operating subsidiaries are included in the Financial Statements subsequent to the date of acquisition. Acquisitions are accounted for using the acquisition method of accounting.

2020 Acquisitions

During the year ended December 31, 2020, the Company expanded its operations with the addition of six home health agency, six hospice agencies, and two senior living communities. The aggregate purchase price for these acquisitions was $39,239. In connection with the addition of the senior living communities, the Company entered into a new long-term “triple-net” lease with a subsidiary of Ensign. The addition of these operations added a total of 164 operational senior living units to be operated by the Company’s independent operating subsidiaries. A subsidiary of the Company entered into a separate operations transfer agreement with the prior operator of each acquired operation as part of each transaction. The goodwill was primarily attributable intangible assets that do not qualify for separate recognition and to synergies the Company expects to achieve related to the acquisition and was allocated to the Company's operating segments which are its reporting units. The Company anticipates that the total goodwill recognized will be fully deductible for tax purposes. Acquisition costs related to the business combinations of home health, hospice, and home care acquisitions of $99 were expensed related to the business combinations during the year ended December 31, 2020.

In October 2020, the Company announced it closed on a home health joint venture and hospice joint venture with Scripps Health (“Scripps”), a leading nonprofit integrated health system based in San Diego, California. The closing was effective October 1, 2020. The resulting joint ventures, which combined certain assets and the operations of Scripps’ home health business and the assets and operations of the local Pennant-affiliated home health and hospice agencies, are majority-owned and managed by an independent operating subsidiary of the Company and provide home health and hospice services to patients throughout San Diego County. The fair value of assets contributed by Scripps to the home health joint venture were included in the total value of assets acquired as described above and in the summary table below. The Company paid Scripps $6,200 in cash and contributed assets from the local Pennant-affiliated home health agency with a net book value of $614. The Company acquired 60.0% ownership interest in the joint venture. The contributions of assets by Scripps to the joint venture, resulted in the Company recording a noncontrolling interest with a fair value of $4,646. The fair value of the noncontrolling interest was determined using discounted cash flow models. As part of the transaction with Scripps, the Company contributed the assets of the local Pennant-affiliated hospice agency to another joint venture. The Company sold Scripps a noncontrolling interest in the hospice joint venture for $555 in cash. The company retained an 80.0% ownership interest in the hospice joint venture. The transaction resulted in the Company recognizing a noncontrolling interest of $138 and a contribution to additional paid in capital of $313, net of $104 of the income tax effect.

2019 Acquisitions

During the year ended December 31, 2019, the Company expanded its operations with the addition of two home health agencies, five hospice agencies, two home care agencies and two senior living operations. In connection with the acquisitions of one of the senior living communities, the Company entered into a new long-term “triple-net” lease with a subsidiary of Ensign. The Company did not acquire any material assets or assume any liabilities. A subsidiary of the Company entered into a separate operations transfer agreement with the prior operator of each acquired operation as part of each transaction. The addition of these operations added a total of 143 operational senior living units to be operated by the Company’s independent operating subsidiaries. The aggregate purchase price for these acquisitions was $18,780. Acquisition costs related to the business combinations of home health, hospice, and home care was $611 during the year ended December 31, 2019.

2018 Acquisitions

During the year ended December 31, 2018, the Company expanded its operations with the addition of four home health agencies, two hospice agencies, two home care agencies and seven senior living operations. The Company did not acquire any material assets or assume any liabilities other than the tenant’s post-assumption rights and obligations under the senior living long-term leases. The aggregate purchase price for these acquisitions during the year ended December 31, 2018 was $5,318. The addition of these operations added a total of 386 operational senior living units to be operated by the Company’s independent operating subsidiaries. Typically, subsidiaries of the Company entered into a separate operations transfer agreement with the prior operator as part of each transaction. The Company did not incur acquisition costs related to business combinations during the year ended December 31, 2018.

The fair value of assets for home health and hospice acquisitions was mostly concentrated in goodwill and as such, these transactions were classified as business combinations in accordance with ASC Topic 805, Business Combinations (“ASC 805”). The table below presents the allocation of the purchase price for the operations acquired in business combinations during the years ended December 31, 2020, 2019 and 2018 as noted above:


	Year Ended December 31,
	2020		2019		2018
Equipment, furniture, and fixtures	$	174	$	91	$	15
Goodwill	25,211		10,341		2,872
Other indefinite-lived intangible assets	14,026		8,326		1,838
Other Assets	—		2		—
Liabilities Assumed	(172)		—		—
Total acquisitions	$	39,239	$	18,760	$	4,725
Less: noncontrolling interest and additional paid in capital(a)	(4,646)		—		—
Total cash paid for acquisitions(b)	$	34,593	$	18,760	$	4,725


(a)						Consists of the of noncontrolling interest related to Scripps contribution of assets to the joint venture.
(b)						Total cash paid for acquisitions for the year ended December 31, 2020 includes $1,400 that was recorded as an escrow deposit at December 31, 2019.

Unaudited Pro Forma Financial Information

The Company’s acquisition strategy has been focused on identifying both opportunistic and strategic acquisitions within its target markets that offer strong opportunities for return. The independent operating subsidiaries acquired by the Company are frequently underperforming financially and can have regulatory and clinical challenges to overcome. From time to time, these acquisitions are more strategic in nature that may or may not have positive operational results. Financial information, especially with underperforming independent operating subsidiaries, is often inadequate, inaccurate or unavailable. Consequently, the Company believes that prior operating results are not a meaningful representation of the Company’s current operating results or indicative of the integration potential of its newly acquired independent operating subsidiaries. Revenue and income before tax included in the consolidated and combined statement of income relating to the business combinations was $17,676 and $750, respectively, during the year ended December 31, 2020.

The following tables represent unaudited pro forma results of consolidated and combined operations as if the business combinations in fiscal year 2020 had occurred at the beginning of 2019, after giving effect to certain adjustments. The unaudited pro forma information is not indicative of what the results of operations would have been if the acquisitions had actually occurred at the beginning of the periods presented and is not intended as a projection of future results or trends.

Unaudited Pro Forma Data


	Years Ended December 31,
	2020		2019
Revenue	$	424,805	$	396,468
Net income attributable to The Pennant Group, Inc.(a)	13,784		1,277


(a)						Net income attributable to The Pennant Group, Inc. for the year ended December 31, 2020 and 2019 includes a tax impact of 25.0% and 25.2%, which are the respective statutory tax rates.

The unaudited pro forma financial information has been included for the businesses combinations during the year ended December 31, 2020. The acquisitions during the year ended December 31, 2020 have been included in the December 31, 2020 consolidated balance sheets of the Company, and the operating results have been included in the consolidated and combined statements of income of the Company since the dates the Company gained effective control.

Revenues and operating costs were based on actual results from the prior operator or from regulatory filings where available. If actual results were not available, revenues and operating costs were estimated based on available partial operating results of the prior operator of the operation, or if no information was available, estimates were derived from the Company’s post-acquisition operating results for that particular operation.

The unaudited pro forma information is not indicative of what the results of operations would have been if the business combinations had actually occurred at the beginning of the periods presented and is not intended as a projection of future results or trends.

Subsequent Events

Subsequent to December 31, 2020, the Company acquired two home health agencies and two hospice agencies. The aggregate purchase price for these acquisitions was $3,625. As of the date of this report, the preliminary allocation of the purchase price for the acquisitions acquired subsequent to December 31, 2020 were not completed as necessary valuation information was not yet available. As such, the determination whether these acquisitions should be classified as business combinations or asset acquisitions under ASC 805 will be determined upon completion of the allocation of the purchase price.

COMMITMENTS AND CONTINGENCIES	12 Months Ended
COMMITMENTS AND CONTINGENCIES	Dec. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIESRegulatory Matters - The Company provides services in complex and highly regulated industries. The Company’s compliance with applicable federal, state and local laws and regulations governing these industries may be subject to governmental review and adverse findings may result in significant regulatory action, which could include sanctions, damages, fines, penalties (many of which may not be covered by insurance), and even exclusion from government programs. The Company is a party to various regulatory and other governmental audits and investigations in the ordinary course of business and cannot predict the ultimate outcome of any federal or state regulatory survey, audit or investigation. While governmental audits and investigations are the subject of administrative appeals, the appeals process, even if successful, may take several years to resolve. The Department of Justice, The Centers for Medicare and Medicaid Services (“CMS”), or other federal and state enforcement and regulatory agencies may conduct additional investigations related to the Company's businesses. The Company believes that it is presently in compliance in all material respects with all applicable laws and regulations. Cost-Containment Measures - Government and third party payors have instituted cost-containment measures designed to limit payments made to providers of healthcare services, and there can be no assurance that future measures designed to limit payments made to providers will not adversely affect the Company. Indemnities - From time to time, the Company enters into certain types of contracts that contingently require the Company to indemnify parties against third-party claims. These contracts primarily include (i) certain real estate leases, under which the Company may be required to indemnify property owners or prior operators for post-transfer environmental or other liabilities and other claims arising from the Company’s use of the applicable premises, (ii) operations transfer agreements, in which the Company agrees to indemnify past operators of agencies and communities the Company acquires against certain liabilities arising from the transfer of the operation and/or the operation thereof after the transfer, (iii) certain Ensign lending agreements, and (iv) certain agreements with management, directors and employees, under which the subsidiaries of the Company may be required to indemnify such persons for liabilities arising out of their employment relationships. The terms of such obligations vary by contract and, in most instances, a specific or maximum dollar amount is not explicitly stated therein. Generally, amounts under these contracts cannot be reasonably estimated until a specific claim is asserted. Consequently, because no claims have been asserted, no liabilities have been recorded for these obligations on the Company’s combined balance sheets for any of the periods presented. Litigation - The Company’s businesses involve a significant risk of liability given the age and health of the patients and residents served by its independent operating subsidiaries. The Company, its operating companies, and others in the industry may be subject to a number of claims and lawsuits, including professional liability claims, alleging that services provided have resulted in personal injury, elder abuse, wrongful death or other related claims. Healthcare litigation (including class action litigation) is common and is filed based upon a wide variety of claims and theories, and the Company is routinely subjected to these claims in the ordinary course of business, including potential claims related to patient care and treatment, professional negligence and class actions, as well as employment related claims. If there were a significant increase in the number of these claims or an increase in amounts owing should plaintiffs be successful in their prosecution of these claims, this could materially adversely affect the Company’s business, financial condition, results of operations and cash flows. In addition, the defense of these lawsuits may result in significant legal costs, regardless of the outcome, and can result in large settlement amounts or damage awards. In addition to the potential lawsuits and claims described above, the Company is also subject to potential lawsuits under the False Claims Act (the “FCA”) and comparable state laws alleging submission of fraudulent claims for services to any healthcare program (such as Medicare) or payor. A violation may provide the basis for exclusion from federally funded healthcare programs. Such exclusions could have a correlative negative impact on the Company’s financial performance. Some states, including California, Arizona and Texas, have enacted similar whistleblower and false claims laws and regulations. In addition, the Deficit Reduction Act of 2005 created incentives for states to enact anti-fraud legislation modeled on the FCA. As such, the Company could face increased scrutiny, potential liability and legal expenses and costs based on claims under state false claims acts in markets in which it does conduct business. In May 2009, Congress passed the Fraud Enforcement and Recovery Act ("FERA") which made significant changes to the FCA, expanding the types of activities subject to prosecution and whistleblower liability. Following changes by FERA, healthcare providers face significant penalties for the knowing retention of government overpayments, even if no false claim was involved. Providers can now be liable for knowingly and improperly avoiding or decreasing an obligation to pay money or property to the government, including the retention of any government overpayment. The Patient Protection and Affordable Care Act of 2010 (the “ACA”) supplemented FERA by imposing an affirmative obligation on healthcare providers to return an overpayment to CMS within 60 days of “identification” or the date any corresponding cost report is due, whichever is later. According to CMS’s February 12, 2016, final rule with respect to Medicare Parts A and B, providers have an obligation to proactively exercise “reasonable diligence” to identify overpayments. The 60-day clock begins to run after the reasonable diligence period has concluded, which may take, at most, six months from the receipt of credible information. Retention of any overpayment beyond this period may create liability under the FCA. In addition, FERA extended protections against retaliation for whistleblowers, including protections not only for employees, but also contractors and agents. Thus, there is generally no need for an employment relationship in order to qualify for protection against retaliation for whistleblowing. The Company cannot predict or provide any assurance as to the possible outcome of any litigation. If any litigation were to proceed, and the Company and its operating companies are subjected to, alleged to be liable for, or agree to a settlement of, claims or obligations under federal Medicare statutes, the FCA, or similar state and federal statutes and related regulations, the Company’s business, financial condition and results of operations and cash flows could be materially and adversely affected. Among other things, any settlement or litigation could involve the payment of substantial sums to settle any alleged civil violations, and may also include the assumption of specific procedural and financial obligations by the Company or its independent operating subsidiaries going forward under a corporate integrity agreement and/or other arrangement with the government. Medicare Revenue Recoupments - The Company is subject to probe reviews relating to Medicare services, billings and potential overpayments by Unified Program Integrity Contractors (UPIC), Recovery Audit Contractors (RAC), Zone Program Integrity Contractors (ZPIC), Program Safeguard Contractors (PSC), Supplemental Medical Review Contractors (SMRC) and Medicaid Integrity Contributors (MIC) programs, each of the foregoing collectively referred to as “Reviews.” As of December 31, 2020, seven of the Company’s independent operating subsidiaries had Reviews scheduled, on appeal or in dispute resolution process, both pre- and post-payment. The Company anticipates that these probe reviews will increase in frequency in the future. If an operation fails an initial or subsequent Review, the operation could then be subject to extended Review, suspension of payment, or extrapolation of the identified error rate to all billing in the same time period. As of December 31, 2020, and through the filing of this Annual Report on Form 10-K, the Company’s independent operating subsidiaries have responded to the Reviews that are currently ongoing, on appeal or in dispute resolution process and the Company has no probable or estimable contingencies. Concentrations Credit Risk - The Company has significant accounts receivable balances, the collectability of which is dependent on the availability of funds from certain governmental programs, primarily Medicare and Medicaid. These receivables represent the only significant concentration of credit risk for the Company. The Company does not believe there are significant credit risks associated with these governmental programs. The Company believes that an appropriate allowance has been recorded for the possibility of these receivables proving uncollectible, and continually monitors and adjusts these allowances as necessary. The Company’s gross receivables from the Medicare and Medicaid programs accounted for approximately 75.7% and 74.3% of its total gross accounts receivable as of December 31, 2020 and December 31, 2019, respectively. Revenue from reimbursement under the Medicare and Medicaid programs accounted for 60.1%, 55.6%, and 53.1% of the Company's revenue for the years ended December 31, 2020, 2019 and 2018, respectively.

PROPERTY AND EQUIPMENT—NET

12 Months Ended

Dec. 31, 2020

Property, Plant and Equipment [Abstract]

Property and equipment - net

PROPERTY AND EQUIPMENT—NET

Property and equipment, net consist of the following:


	Year Ended December 31,
	2020		2019
Leasehold improvements	$	9,984	$	6,621
Equipment	22,420		18,930
Furniture and fixtures	1,186		877
	33,590		26,428
Less: accumulated depreciation	(15,706)		(11,784)
Property and equipment, net	$	17,884	$	14,644

Depreciation expense was $4,661, $3,757 and $2,863 for the years ended December 31, 2020, 2019 and 2018, respectively.

GOODWILL AND INTANGIBLE ASSETS - NET - ACTIVITY IN GOODWILL (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 41,233	$ 30,892
Additions	25,211	10,341
Goodwill, ending balance	66,444	41,233
Home Health and Hospice Services
Goodwill [Roll Forward]
Goodwill, beginning balance	37,591	27,250
Additions	25,211	10,341
Goodwill, ending balance	62,802	37,591
Senior Living Services
Goodwill [Roll Forward]
Goodwill, beginning balance	3,642	3,642
Additions	0	0
Goodwill, ending balance	$ 3,642	$ 3,642

COMPUTATION OF NET INCOME PER COMMON SHARE - RECONCILIATION (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Net Income (Loss) Available to Common Stockholders, Diluted [Abstract]
Net income	$ 15,553	$ 3,175	$ 16,279
Add: Net income/ (loss) attributable to noncontrolling interest	(191)	629	595
Net income attributable to The Pennant Group, Inc.	$ 15,744	$ 2,546	$ 15,684
Weighted Average Number of Shares Outstanding Reconciliation [Abstract]
Weighted average shares outstanding for basic net income per share (in shares)	28,029	27,838	27,834
Plus: incremental shares from assumed conversion	2,199	1,748	0
Adjusted weighted average common shares outstanding for diluted income per share (in share)	30,228	29,586	27,834
Earnings Per Share, Basic and Diluted [Abstract]
Basic net income per share (in dollars per share)	$ 0.56	$ 0.11	$ 0.58
Diluted net income per share (in dollars per share)	$ 0.52	$ 0.11	$ 0.58

INCOME TAXES (Tables)

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

Provision for income taxes on continuing operations

The provision for income taxes for the years ended December 31, 2020, 2019 and 2018 is summarized as follows:


	Year Ended December 31,
	2020		2019		2018
Current:
Federal	$	5,058	$	562	$	3,223
State	1,478		278		915
Total current	6,536		840		4,138
Deferred:
Federal	(3,348)		1,070		226
State	(838)		175		(12)
Total deferred	(4,186)		1,245		214

Total income tax expense	$	2,350	$	2,085	$	4,352

Reconciliation of federal statutory rate to effective tax rate

A reconciliation of the federal statutory rate to the effective tax rate for income from continuing operations for the years ended December 31, 2020, 2019 and 2018, respectively, is comprised as follows:


	Year Ended December 31,
	2020		2019		2018
Income tax expense at statutory rate	21.0	%	21.0	%	21.0	%
State income taxes - net of federal benefit	2.7		6.8		3.5
Non-deductible expenses	0.4		2.6		0.4
Transaction costs(a)	—		41.2		—
Tax credits	—		(1.6)		—
Equity compensation(b)	(10.8)		(30.0)		(2.9)
Revaluation of deferred	—		—		(0.2)
Other adjustments	(0.2)		(0.4)		(0.7)
Total income tax provision	13.1	%	39.6	%	21.1	%


(a)						The Company's completion of the Spin-Off in the year ended December 31, 2019 resulted in the Company not being able to deduct approximately $10,300 of the related transaction costs, which increased the effective tax rate significantly and affected all items that were impacted by this exclusion.
(b)						During the year ended December 31, 2020, employees exercised stock options representing approximately 239 shares. During the year ended December 31, 2019, employees exercised stock options representing approximately 100 shares and had restricted stock awards vest representing 960 shares. These exercises and vestings resulted in tax benefits that reduced the Company's effective tax rate significantly in both years.

Deferred tax assets and liabilities

The Company’s deferred tax assets and liabilities for the years ended December 31, 2020 and 2019 are summarized below.


	Year Ended December 31,
	2020		2019
Deferred tax assets (liabilities):
Accrued expenses	$	8,181	$	2,670
Allowance for doubtful accounts	875		869
State taxes	147		27
Lease liabilities	80,979		83,076
Insurance	277		137
Gross deferred tax assets	90,459		86,779
Less: valuation allowance	(15)		—
Net deferred tax assets	90,444		86,779
Depreciation and amortization	(7,512)		(6,107)
Prepaid expenses	(780)		(594)
Right of use asset	(80,055)		(82,181)

Total deferred tax liabilities	(88,347)		(88,882)
Net deferred tax assets (liabilities)	$	2,097	$	(2,103)

For the

REVENUE AND ACCOUNTS RECEIVABLE - NARRATIVE (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Jun. 30, 2020
Disaggregation of Revenue [Line Items]
Contract Liabilities (CARES Act advance payments)	$ 22,771	$ 0		$ 27,997
Senior Living Services
Disaggregation of Revenue [Line Items]
Payment terms	Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For residents under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered.
Customer concentration risk \| Revenue
Disaggregation of Revenue [Line Items]
Revenue %	100.00%	100.00%	100.00%
Customer concentration risk \| Revenue \| Subtotal
Disaggregation of Revenue [Line Items]
Revenue %	60.10%	55.60%	53.10%

Cover Page - USD ($) $ in Thousands	12 Months Ended
Cover Page - USD ($) $ in Thousands	Dec. 31, 2020	Feb. 24, 2021	Jun. 30, 2020
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2020
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-38900
Entity Registrant Name	THE PENNANT GROUP, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	83-3349931
Entity Address, Address Line One	1675 East Riverside Drive
Entity Address, Address Line Two	Suite 150
Entity Address, City or Town	Eagle
Entity Address, State or Province	ID
Entity Address, Postal Zip Code	83616
City Area Code	(208)
Local Phone Number	506-6100
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	PNTG
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	true
ICFR Auditor Attestation Flag	false
Entity Ex Transition Period	true
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		28,262,407
Entity Public Float			$ 603,746
Entity Central Index Key	0001766400
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	FY
Amendment Flag	false
Documents Incorporated by Reference	Part III of this Form 10-K incorporates information by reference from the Registrant's definitive proxy statement on Schedule 14A for the Registrant's 2021 Annual Meeting of Stockholders to be filed within 120 days after the close of the fiscal year covered by this annual report.

DEBT (Tables)

12 Months Ended

Dec. 31, 2020

Debt Disclosure [Abstract]

Schedule of long-term debt

Long-term debt, net consists of the following:


	Year Ended December 31,
	2020		2019
Revolving Credit Facility	$	9,500	$	20,000
Less: unamortized debt issuance costs	(1,223)		(1,474)
Long-term debt, net	$	8,277	$	18,526

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI http://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 1A
-URI http://asc.fasb.org/extlink&oid=119993939&loc=d3e28541-108399

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 6
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21506-112644

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08.(e),(f))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=119993939&loc=d3e28551-108399

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21521-112644

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21538-112644

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 470
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=75038535&loc=d3e64711-112823

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 55
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=114775985&loc=d3e28878-108400

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21475-112644

+ Details

INCOME TAXES

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

Income taxes

INCOME TAXES

The provision for income taxes for the years ended December 31, 2020, 2019 and 2018 is summarized as follows:


	Year Ended December 31,
	2020		2019		2018
Current:
Federal	$	5,058	$	562	$	3,223
State	1,478		278		915
Total current	6,536		840		4,138
Deferred:
Federal	(3,348)		1,070		226
State	(838)		175		(12)
Total deferred	(4,186)		1,245		214

Total income tax expense	$	2,350	$	2,085	$	4,352


	Year Ended December 31,
	2020		2019		2018
Income tax expense at statutory rate	21.0	%	21.0	%	21.0	%
State income taxes - net of federal benefit	2.7		6.8		3.5
Non-deductible expenses	0.4		2.6		0.4
Transaction costs(a)	—		41.2		—
Tax credits	—		(1.6)		—
Equity compensation(b)	(10.8)		(30.0)		(2.9)
Revaluation of deferred	—		—		(0.2)
Other adjustments	(0.2)		(0.4)		(0.7)
Total income tax provision	13.1	%	39.6	%	21.1	%


(a)						The Company's completion of the Spin-Off in the year ended December 31, 2019 resulted in the Company not being able to deduct approximately $10,300 of the related transaction costs, which increased the effective tax rate significantly and affected all items that were impacted by this exclusion.
(b)						During the year ended December 31, 2020, employees exercised stock options representing approximately 239 shares. During the year ended December 31, 2019, employees exercised stock options representing approximately 100 shares and had restricted stock awards vest representing 960 shares. These exercises and vestings resulted in tax benefits that reduced the Company's effective tax rate significantly in both years.

Prior to the date of the Spin-Off, the Company's operations were included in Ensign’s U.S. federal and state income tax returns and all income taxes were paid by subsidiaries of Ensign. Additionally, prior to the date of the Spin-Off, income tax expense and other income tax related information contained in these Consolidated and Combined Financial Statements were presented on a separate tax return approach. Under this approach, the provision for income taxes represents income tax paid or payable for the current year plus the change in deferred taxes during the year calculated as if the Company were a stand-alone taxpayer filing hypothetical income tax returns. Management believes that the assumptions and estimates used to determine these tax amounts were reasonable. However, the Company's Consolidated and Combined Financial Statements may not necessarily reflect the Company’s income tax expense or tax payments in the future, or what its tax amounts would have been if the Company had been a stand-alone company during the periods presented.

Effective January 1, 2018, the Tax Cuts and Jobs Act of 2017 (“Tax Act”) reduced the corporate rate from 35.0% to 21.0%. The Company adopted ASU 2018-05, Taxes (Topic 740): Amendments to SEC Paragraph Pursuant to SEC Staff Accounting Bulletin No. 118. As of December 31, 2018, the Company had completed its accounting for the tax effects of the enactment of the Tax Act.

The Company recorded prepaid expenses for income taxes for the year ended December 31, 2020 and for the income tax returns the Company filed for the three month period from October 1, 2019 through December 31, 2019.

The Company’s deferred tax assets and liabilities for the years ended December 31, 2020 and 2019 are summarized below.


	Year Ended December 31,
	2020		2019
Deferred tax assets (liabilities):
Accrued expenses	$	8,181	$	2,670
Allowance for doubtful accounts	875		869
State taxes	147		27
Lease liabilities	80,979		83,076
Insurance	277		137
Gross deferred tax assets	90,459		86,779
Less: valuation allowance	(15)		—
Net deferred tax assets	90,444		86,779
Depreciation and amortization	(7,512)		(6,107)
Prepaid expenses	(780)		(594)
Right of use asset	(80,055)		(82,181)

Total deferred tax liabilities	(88,347)		(88,882)
Net deferred tax assets (liabilities)	$	2,097	$	(2,103)

For the year ended December 31, 2019, the Company included the net deferred tax liability in other long-term liabilities on it Consolidated Balance Sheets.

During the year ended December 31, 2020, the Company utilized all of its net operating loss ("NOL") carryforwards for federal income tax purposes. As of December 31, 2020, the Company has $500 of NOL carryforwards in various states, which are available to reduce future state taxable income, if any. Some of the state NOL carryforwards do not expire while others, if not utilized, will expire in the year ending December 31, 2039.

The Company believes that it is more likely than not that the benefit from certain state NOL carryforwards will not be realized. In recognition of this risk, as of December 31, 2020, the Company has provided a valuation allowance of $15 on the deferred tax assets related to these state NOL carryforwards.

The federal statutes of limitations on the Company’s 2016, 2015, and 2014 income tax years lapsed during the third quarter of 2020, 2019, and 2018, respectively. During the fourth quarter of each year, various state statutes of limitations also lapsed. The lapses for the years ended December 31, 2020 and 2019 had no impact on the Company’s unrecognized tax benefits.

For the years ended December 31, 2020 and 2019, the Company did not have any unrecognized tax benefits, net of their state benefits that would affect the Company’s effective tax rate. The Company classifies interest and/or penalties on income tax liabilities or refunds as additional income tax expense or income. Such amounts are not material.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References + Details

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 643	$ 677
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	28,696,000	28,435,000
Common stock, shares outstanding (in shares)	28,243,000	27,853,000
Treasury stock, at cost (in shares)	3,000

DESCRIPTION OF BUSINESS	12 Months Ended
DESCRIPTION OF BUSINESS	Dec. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of business	DESCRIPTION OF BUSINESS The Pennant Group, Inc. (herein referred to as “Pennant,” the “Company,” “it,” or “its”), is a holding company with no direct operating assets, employees or revenue. The Company, through its independent operating subsidiaries, provides healthcare services across the post-acute care continuum. As of December 31, 2020, the Company’s subsidiaries operated 76 home health, hospice and home care agencies and 54 senior living communities located in Arizona, California, Colorado, Idaho, Iowa, Montana, Nevada, Oklahoma, Oregon, Texas, Utah, Washington, Wisconsin and Wyoming. On October 1, 2019, The Ensign Group, Inc. (NASDAQ: ENSG) (“Ensign” or the “Parent”) completed the separation of Pennant from Ensign through a tax-free distribution (except as to cash received in lieu of fractional shares) of substantially all of Pennant’s issued and outstanding common stock to the stockholders of Ensign (the “Spin-Off”). To accomplish the Spin-Off, Ensign contributed the Company’s assets and liabilities into Pennant and each Ensign stockholder received a distribution of one share of Pennant common stock for every two shares of Ensign’s common stock, plus cash in lieu of fractional shares. Additionally, the noncontrolling interest was converted into shares of Pennant at the established conversion ratio. As a result of the Spin-Off on October 1, 2019, Pennant began trading as an independent company on the NASDAQ under the symbol “PNTG.” Certain of the Company’s subsidiaries, collectively referred to as the Service Center, provide accounting, payroll, human resources, information technology, legal, risk management, and other services to the operations through contractual relationships. Each of the Company’s affiliated operations are operated by separate, independent subsidiaries that have their own management, employees and assets. References herein to the consolidated “Company” and “its” assets and activities is not meant to imply, nor should it be construed as meaning, that Pennant has direct operating assets, employees or revenue, or that any of the subsidiaries, are operated by Pennant.

RELATED PARTY TRANSACTIONS AND NET PARENT INVESTMENT (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2020 USD ($) property	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)
Recognition of tax benefits related to Tax Matters Agreement
Related Party Transaction [Line Items]
Amounts of related party transaction	$ 578	$ 291
Senior Living Services \| Minimum
Related Party Transaction [Line Items]
Lease term	5 years
Senior Living Services \| Maximum
Related Party Transaction [Line Items]
Lease term	21 years
Related party
Related Party Transaction [Line Items]
Cost of services	$ 4,205	3,166	$ 2,996
Related party \| Operating lease, rent expense
Related Party Transaction [Line Items]
Expenses from transactions with related party	12,536	11,292	$ 10,363
Related party \| Transition Services Agreement
Related Party Transaction [Line Items]
Expenses from transactions with related party	$ 5,536	$ 2,982
Related party \| Senior Living Services
Related Party Transaction [Line Items]
Number of operating facilities \| property	31
Related party \| Senior Living Services \| Minimum
Related Party Transaction [Line Items]
Lease term	14 years
Related party \| Senior Living Services \| Maximum
Related Party Transaction [Line Items]
Lease term	20 years

REVENUE AND ACCOUNTS RECEIVABLE (Tables)

12 Months Ended

Dec. 31, 2020

Revenue from Contract with Customer [Abstract]

Revenue by major payor source

Revenue by payor for the years ended December 31, 2020, 2019 and 2018, is summarized in the following tables:


	Year Ended December 31, 2020
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	58,399	$	119,873	$	—	$	178,272	45.6	%
Medicaid	7,645		12,462		36,780		56,887		14.5
Subtotal	66,044		132,335		36,780		235,159		60.1
Managed care	31,572		1,546		—		33,118		8.5
Private and other(a)	21,968		194		100,514		122,676		31.4
Total revenue	$	119,584	$	134,075	$	137,294	$	390,953	100.0	%


(a)						Private and other payors in our home health and hospice services segment includes revenue from all payors generated in our home care operations.


	Year Ended December 31, 2019
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	47,819	$	93,933	$	—	$	141,752	41.9	%
Medicaid	6,575		10,061		29,819		46,455		13.7
Subtotal	54,394		103,994		29,819		188,207		55.6
Managed care	27,711		1,536		—		29,247		8.6
Private and other(a)	18,837		152		102,088		121,077		35.8
Total revenue	$	100,942	$	105,682	$	131,907	$	338,531	100.0	%


(a)						Private and other payors in our home health and hospice services segment includes revenue from all payors generated in our home care operations.


	Year Ended December 31, 2018
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	42,091	$	73,906	$	—	$	115,997	40.5	%
Medicaid	4,680		7,729		23,624		36,033		12.6
Subtotal	46,771		81,635		23,624		152,030		53.1
Managed care	23,541		918		—		24,459		8.6
Private and other(a)	16,067		105		93,397		109,569		38.3
Total revenue	$	86,379	$	82,658	$	117,021	$	286,058	100.0	%


(a)						Private and other payors in our home health and hospice services segment includes revenue from all payors generated in our home care operations.

Schedule of accounts receivable

Accounts receivable as of December 31, 2020 and December 31, 2019 is summarized in the following table:


	December 31, 2020		December 31, 2019
Medicare	$	28,569	$	17,822
Medicaid	7,669		6,579
Managed care	7,590		4,380
Private and other	4,036		4,079
Accounts receivable, gross	47,864		32,860
Less: allowance for doubtful accounts	(643)		(677)
Accounts receivable, net	$	47,221	$	32,183

Allowance for doubtful accounts

The following table summarizes the activity for our allowance for doubtful accounts for the years ended years ended December 31, 2020, 2019 and 2018:


	Year Ended December 31,
	2020		2019		2018
Balance at beginning of period	$	677	$	616	$	5,058
Impact of ASC 606 Adoption(a)	—		—		(4,590)
Additions to bad debt expense	560		858		346
Write-offs of uncollectible accounts	(594)		(797)		(198)
Balance at end of period	$	643	$	677	$	616


(a)						Subsequent to the adoption of ASC 606, the majority of what was previously presented as allowance for doubtful accounts related to bad debt expense has been incorporated as an implicit price concession factored into net revenue and accounts receivable. Allowance for doubtful accounts as of December 31, 2020 represents the Company’s best estimate of probable losses inherent in the accounts receivable balance based on known troubled accounts and other currently available evidence.

LEASES (Tables)

12 Months Ended

Dec. 31, 2020

Leases [Abstract]

Components of operating lease cot

The components of operating lease cost, are as follows:


	Year Ended December 31,
	2020		2019
Operating Lease Costs:
Facility Rent—cost of services	$	35,562	$	32,011
Office Rent—cost of services	3,772		2,964
Sublease income	(143)		—
Rent—cost of services	$	39,191	$	34,975

General and administrative expense	$	295	$	162
Variable lease cost(a)	$	5,330	$	4,608


(a)						Represents variable lease cost for operating leases, which costs include property taxes and insurance, common area maintenance, and consumer price index increases, incurred as part of our triple net lease, and which is included in cost of services for the years ended December 31, 2020 and 2019.

Rent expense for operating leases classified under Topic 840 for the year ended December 31, 2018 was $31,199.

Future minimum lease payments

The following table shows the lease maturity analysis for all leases as of December 31, 2020:


Year	Amount
2021	$	38,393
2022	37,730
2023	37,038
2024	36,230
2025	35,349
Thereafter	356,838
Total lease payments	541,578
Less: present value adjustments	(230,857)
Present value of total lease liabilities	310,721
Less: current lease liabilities	(14,106)
Long-term operating lease liabilities	$	296,615

DEBT

12 Months Ended

Dec. 31, 2020

Debt Disclosure [Abstract]

DEBT

Long-term debt, net consists of the following:


	Year Ended December 31,
	2020		2019
Revolving Credit Facility	$	9,500	$	20,000
Less: unamortized debt issuance costs	(1,223)		(1,474)
Long-term debt, net	$	8,277	$	18,526

On October 1, 2019, Pennant entered into a credit agreement (the “Credit Agreement”), which provided for a revolving credit facility (the “2019 Revolving Credit Facility”) with a syndicate of banks with a borrowing capacity of $75,000. The interest rates applicable to loans under the 2019 Revolving Credit Facility were, at the Company’s election, either (i) Adjusted LIBOR (as defined in the Credit Agreement) plus a margin ranging from 2.5% to 3.5% per annum or (ii) Base Rate plus a margin ranging from 1.5% to 2.5% per annum, in each case based on the ratio of Consolidated Total Net Debt to Consolidated EBITDA (each, as defined in the Credit Agreement). In addition, Pennant paid a commitment fee on the undrawn portion of the commitments under the 2019 Revolving Credit Facility that of approximately 0.6% per annum. The Company is not required to repay any loans under the Credit Agreement prior to maturity in 2024, other than to the extent the outstanding borrowings exceed the aggregate commitments under the Credit Agreement. As of December 31, 2020, the Company’s weighted average interest rate on its outstanding debt was 4.75%. As of December 31, 2020, we had availability on the 2019 Revolving Credit Facility of $62,164, which is net of outstanding letters of credit of $3,336.

The fair value of the 2019 Revolving Credit Facility approximates carrying value, due to the short-term nature and variable interest rates. The fair value of this debt is categorized within Level 2 of the fair value hierarchy based on the observable market borrowing rates.

The Credit Agreement is guaranteed, jointly and severally, by certain of the Company’s wholly owned subsidiaries, and is secured by a pledge of stock of the Company's material independent operating subsidiaries as well as a first lien on substantially all of each material operating subsidiary's personal property. The Credit Agreement contains customary covenants that, among other things, restrict, subject to certain exceptions, the ability of the Company and its independent operating subsidiaries to grant liens on their assets, incur indebtedness, sell assets, make investments, engage in acquisitions, mergers or consolidations, amend certain material agreements and pay certain dividends and other restricted payments. Financial covenants require compliance with certain levels of leverage ratios that impact the amount of interest. As of December 31, 2020, the Company was compliant with all covenants.

Subsequent Events

On February 23, 2021, Pennant entered into an amendment to the Credit Agreement (the “Amended Credit Agreement”), which provides for a revolving credit facility (the “2021 Revolving Credit Facility”) with a syndicate of banks with a borrowing capacity of $150,000. The interest rates applicable to loans under the 2021 Revolving Credit Facility are, at the Company’s election, either (i) Adjusted LIBOR (as defined in the Amended Credit Agreement) plus a margin ranging from 2.3% to 3.3% per annum or (ii) Base Rate plus a margin ranging from 1.3% to 2.3% per annum, in each case based on the ratio of Consolidated Total Net Debt to Consolidated EBITDA (each, as defined in the Amended Credit Agreement). In addition, Pennant will pay a commitment fee on the undrawn portion of the commitments under the Revolving Credit Facility that will range from 0.35% to 0.50% per annum, depending on the Consolidated Total Net Debt to Consolidated EBITDA ratio of the Company and its subsidiaries. The Company is not required to repay any loans under the Amended Credit Agreement prior to maturity in 2026.

BUSINESS SEGMENTS (Tables)

12 Months Ended

Dec. 31, 2020

Segment Reporting [Abstract]

Financial data combined by business segment

The following table presents certain financial information regarding our reportable segments, general and administrative expenses are not allocated to the reportable segments and are included in “All Other” for the years ended December 31, 2020, 2019 and 2018:


	Home Health and Hospice Services		Senior Living Services		All Other		Total
Year Ended December 31, 2020
Revenue	$	253,659	$	137,294	$	—	$	390,953
Segment Adjusted EBITDAR from Operations	$	49,501	$	48,309	$	(22,762)	$	75,048
Year Ended December 31, 2019
Revenue	$	206,624	$	131,907	$	—	$	338,531
Segment Adjusted EBITDAR from Operations	$	33,354	$	47,344	$	(18,591)	$	62,107
Year Ended December 31, 2018
Revenue	$	169,037	$	117,021	$	—	$	286,058
Segment Adjusted EBITDAR from Operations	$	26,427	$	47,230	$	(16,191)	$	57,466

Reconciliation of total Combined Adjusted EBITDAR from Operations for our reportable segments to Combined Income from Operations


	Year Ended December 31,
	2020		2019		2018
Segment Adjusted EBITDAR from Operations	$	75,048	$	62,107	$	57,466
Less: Depreciation and amortization	4,675		3,810		2,964
Rent—cost of services	39,191		34,975		31,199
Other income	225		—		—
Adjustments to Segment EBITDAR from Operations:
Less: Costs at start-up operations(a)	1,787		483		129
Share-based compensation expense(b)	8,335		3,382		2,382
Acquisition related costs(c)	99		665		—
Spin-off related transaction costs(d)	—		13,219		756
Transition services costs(e)	1,181		532		—
COVID-19 Related costs and supplies(f)	447		—		—
Add: Net income/ (loss) attributable to noncontrolling interest	(191)		629		595
Consolidated and Combined Income from operations	$	18,917	$	5,670	$	20,631


(a)						Represents results related to start-up operations. This amount excludes rent and depreciation and amortization expense related to such operations.
(b)						Share-based compensation expense incurred which is included in cost of services and general and administrative expense.
(c)						Acquisition related costs that are not capitalizable.


(d)						Costs incurred related to the Spin-Off are included in general and administrative expense.
(e)						A portion of the costs incurred under the Transition Services Agreement (as defined in Note 3, Related Party Transactions and Net Parent Investment) identified as redundant or nonrecurring that are included in general and administrative expense. Transition service costs includes $446 of duplicative software expense for the year ended December 31, 2020, of which $333 pertains to the first three quarters of the fiscal year and were not included as adjustments in previous interim periods. Fees incurred under the Transition Services agreement, net of the Company’s payroll reimbursement, were $5,536, $2,982, and zero for the years ended December 31, 2020, 2019 and 2018, respectively.
(f)						Represents incremental costs incurred as part of the Company's response to COVID-19 including direct medical supplies, labor, and other expenses, net of $2,765 in increased revenue related to the 2% payment increase in Medicare reimbursements for sequestration relief for the year ended December 31, 2020.

OTHER ACCRUED LIABILITIES

12 Months Ended

Dec. 31, 2020

Payables and Accruals [Abstract]

OTHER ACCRUED LIABILITIES

Other accrued liabilities consist of the following:


	December 31, 2020		December 31, 2019

Refunds payable	$	2,664	$	2,152
Deferred revenue	1,271		1,937
Resident deposits	5,647		6,292
Contract Liabilities (CARES Act advance payments)	22,771		—
Property taxes	982		1,130
Accrued insurance retention - current portion	1,354		—
Other	3,586		2,400
Other accrued liabilities	$	38,275	$	13,911

Refunds payable includes payables related to overpayments, duplicate payments and credit balances from various payor sources. Deferred revenue occurs when the Company receives payments in advance of services provided. Resident deposits include refundable deposits to residents and a small portion consists of non-refundable deposits recognized into revenue over a period of time. The CARES Act also expanded the Centers for Medicare & Medicaid Services’ (“CMS”) ability to provide accelerated/advance payments intended to increase the cash flow of healthcare providers and suppliers impacted by COVID-19. During the second quarter the Company applied for and received $27,997 in funds under the AAP Program. On October 1, 2020, the Continuing Appropriations Act, 2021 and Other Extensions Act (the “CA Act”) was signed into law.

Among other things, the CA Act significantly changed the repayment terms for AAP. These funds are subject to automatic recoupment through offsets to new claims beginning one year after funds were issued beginning in April 2021, at which time, Medicare will automatically recoup 25 percent of Medicare payments for 11 months. At the end of the 11 months and assuming full repayment has not occurred, recoupment will increase to 50 percent for another six months. Any balance outstanding after these two recoupment periods will be subject to repayment at a four percent interest rate. The Company anticipates completing repayment of the AAP within the allotted recoupment periods. As a result of the recoupment guidance, the Company reclassified $5,226 of the AAP to other long-term liabilities.

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	12 Months Ended
	Dec. 31, 2020
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation - The accompanying consolidated and combined financial statements of the Company (the “Financial Statements”) reflect the Company’s financial position, results of operations and cash flows as the business was operated as part of Ensign prior to the Spin-Off, and have been prepared in accordance with accounting principles generally accepted in the United States (“GAAP”) and pursuant to the regulations of the Securities and Exchange Commission (“SEC”). Prior to the Spin-Off, the combined financial statements were prepared on a stand-alone basis and derived from the consolidated financial statements and accounting records of Ensign. Management believes that the Financial Statements reflect, in all material respects, all adjustments which are of a normal and recurring nature necessary to present fairly the Company’s financial position, results of operations, and cash flows for the periods presented in conformity with GAAP applicable to the annual period.
Consolidation	All intercompany transactions and balances between the various legal entities comprising the Company have been eliminated in consolidation. The consolidated and combined statements of income reflect income that is attributable to the Company and the noncontrolling interest. The Company consists of various limited liability companies and corporations established to operate home health, hospice, home care, and senior living operations. The Financial Statements include the accounts of all entities controlled by the Company through its ownership of a majority voting interest. Revenue was derived from transactional information specific to the Company’s services provided. The costs in the consolidated and combined statements of income reflect direct costs and allocated costs prior to the Spin-Off.
Estimates and Assumptions	Estimates and Assumptions - The preparation of the Financial Statements in conformity with GAAP requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the Financial Statements and the reported amounts of revenue and expenses during the reporting periods. The most significant estimates in the Financial Statements relate to revenue, cost allocations from prior to the Spin-Off, intangible assets and goodwill, right-of-use assets and lease liabilities for leases greater than 12 months, self-insurance reserves, and income taxes. Actual results could differ from those estimates.
Revenue Recognition	Revenue Recognition - Revenues are recognized when services are provided to the patients at the amount that reflects the consideration to which the Company expects to be entitled from patients and third-party payors, including Medicaid, Medicare and insurers (private and Medicare replacement plans), in exchange for providing patient care. Revenue recognized from healthcare services are adjusted for estimates of variable consideration to arrive at the transaction price. The Company determines the transaction price based on contractually agreed-upon amounts or rate, adjusted for estimates of variable consideration. The Company uses the expected value method in determining the variable component that should be used to arrive at the transaction price, using contractual agreements and historical reimbursement experience within each payor type. The amount of variable consideration which is included in the transaction price may be constrained, and is included in the net revenue only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. If actual amounts of consideration ultimately received differ from the Company’s estimates, the Company adjusts these estimates, which would affect net service revenue in the period such variances become known.Revenues are recognized when services are provided to the patients or residents at the amount that reflects the consideration to which the Company expects to be entitled from patients, residents and third-party payors, including Medicaid, Medicare and insurers (private and Medicare replacement plans), in exchange for providing patient care or senior living residence. The healthcare services in home health and hospice patient contracts include routine services in exchange for a contractual agreed-upon amount or rate. Routine services are treated as a single performance obligation satisfied over time as services are rendered. As such, patient care services represent a bundle of services that are not capable of being distinct within the context of the contract. Additionally, there may be ancillary services which are not included in the rates for routine services, but instead are treated as separate performance obligations satisfied at a point in time, if and when those services are rendered. Revenue recognized from healthcare services are adjusted for estimates of variable consideration to arrive at the transaction price. The Company determines the transaction price based on contractually agreed-upon amounts or rate, adjusted for estimates of variable consideration. The Company uses the expected value method in determining the variable component that should be used to arrive at the transaction price, using contractual agreements and historical reimbursement experience within each payor type. The amount of variable consideration which is included in the transaction price may be constrained, and is included in the net revenue only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. If actual amounts of consideration ultimately received differ from the Company’s estimates, the Company adjusts these estimates, which would affect net service revenue in the period such variances become known. Revenue from the Medicare and Medicaid programs accounted for 60.1%, 55.6%, and 53.1% of the Company’s revenue for the years ended December 31, 2020, 2019 and 2018, respectively. The Company records revenue from these governmental and managed care programs as services are performed at their expected net realizable amounts under these programs. The Company’s revenue from governmental and managed care programs is subject to audit and retroactive adjustment by governmental and third-party agencies. Consistent with healthcare industry accounting practices, any changes to these governmental revenue estimates are recorded in the period the change or adjustment becomes known based on final settlement. Disaggregation of Revenue The Company disaggregates revenue from contracts with its patients or residents by reportable operating segments and payors. The Company has determined that disaggregating revenue into these categories achieves the disclosure objectives to depict how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors. A reconciliation of disaggregated revenue to segment revenue as well as revenue by payor is provided in below. The Company’s service specific revenue recognition policies are as follows: Home Health Revenue Medicare Revenue For Medicare episodes that began after January 1, 2020, net service revenue is recognized in accordance with the Patient Driven Groupings Model (“PDGM”). This new reimbursement structure involves case mix calculation methodology refinements, changes to low-utilization payment adjustment (“LUPA”) thresholds, the elimination of therapy thresholds, a change to the unit of payment from a 60-day episode to a 30-day payment period, and reduction of requests for anticipated payments (“RAPs”) to 20% of the estimated payment for a patient’s initial or subsequent period of care up-front (after the initial assessment is completed and upon initial billing). The RAPs will be completely phased out effective January 1, 2021. Under PDGM, Medicare provides agencies with payments for each 30-day payment period provided to beneficiaries. If a beneficiary is still eligible for care after the end of the first 30-day payment period, a second 30-day payment period can begin. There are no limits to the number of periods of care a beneficiary who remains eligible for the home health benefit can receive. While payment for each 30-day payment period is adjusted to reflect the beneficiary’s health condition and needs, a special outlier provision exists to ensure appropriate payment for those beneficiaries that have the most expensive care needs. The payment under the Medicare program is also adjusted for certain variables including, but not limited to: (a) a LUPA if the number of visits is below an established threshold that varies based on the diagnosis of a beneficiary; (b) a partial payment if the patient transferred to another provider or the Company received a patient from another provider before completing the period of care; (c) adjustment to the admission source of claim if it is determined that the patient had a qualifying stay in a post-acute care setting within 14 days prior to the start of a 30-day payment period; (d) the timing of the 30-day payment period provided to a patient in relation to the admission date, regardless of whether the same home health provider provided care for the entire series of episodes; (e) changes to the acuity of the patient during the previous 30-day payment period; (f) changes in the base payments established by the Medicare program; (g) adjustments to the base payments for case mix and geographic wages; and (h) recoveries of overpayments. For all episodes that began prior to January 1, 2020, net service revenue was recorded under the Medicare prospective payment system based on a 60-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a) an outlier payment if the patient’s care was unusually costly; (b) a LUPA if the number of visits was fewer than five; (c) a partial payment if the patient transferred to another provider or transferred from another provider before completing the episode; (d) a payment adjustment based upon the level of covered therapy services; (e) the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (f) changes in the base episode payments established by the Medicare program; (g) adjustments to the base episode payments for case mix and geographic wages; and (h) recoveries of overpayments. The Company adjusts Medicare revenue on completed episodes to reflect differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation and other reasons unrelated to credit risk. Therefore, the Company believes that its reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered. In addition to revenue recognized on completed episodes and periods, the Company also recognizes a portion of revenue associated with episodes and periods in progress. Episodes in progress are 30-day payment periods, if the episode started after January 1, 2020, or 60-day episodes of care, if the episode started prior to January 1, 2020, that begin during the reporting period but were not completed as of the end of the period. As such, the Company estimates revenue and recognizes it on a daily basis. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per period of care or episode of care and the Company’s estimate of the average percentage complete based on the scheduled end of period and end of episode dates. Non-Medicare Revenue Episodic Based Revenue - The Company recognizes revenue in a similar manner as it recognizes Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms. Non-episodic Based Revenue - Revenue is recognized on an accrual basis based upon the date of service at amounts equal to its established or estimated per visit rates, as applicable. Hospice Revenue Revenue is recognized on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are calculated as daily rates for each of the levels of care the Company delivers. Revenue is adjusted for an inability to obtain appropriate billing documentation or authorizations acceptable to the payor and other reasons unrelated to credit risk. Additionally, as Medicare hospice revenue is subject to an inpatient cap and an overall payment cap, the Company monitors its provider numbers and estimates amounts due back to Medicare if a cap has been exceeded. The Company regularly evaluates and records these adjustments as a reduction to revenue and an increase to other accrued liabilities. Senior Living Revenue The Company has elected the lessor practical expedient within ASC Topic 842, Leases (“ASC 842”) and therefore recognizes, measures, presents, and discloses the revenue for services rendered under the Company’s senior living residency agreements based upon the predominant component, either the lease or non-lease component, of the contracts. The Company has determined that the services included under the Company’s senior living residency agreements each have the same timing and pattern of transfer. The Company recognizes revenue under ASC Topic 606, Revenue from Contracts with Customers for its senior residency agreements, for which it has determined that the non-lease components of such residency agreements are the predominant component of each such contract. The Company’s senior living revenue consists of fees for basic housing and assisted living care. Accordingly, we record revenue when services are rendered on the date services are provided at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For residents under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered. Practical Expedients and Exemptions As the Company’s contracts have an original duration of one year or less, the Company uses the practical expedient applicable to its contracts and does not consider the time value of money. Further, because of the short duration of these contracts, the Company has not disclosed the transaction price for the remaining performance obligations as of the end of each reporting period or when the Company expects to recognize this revenue. In addition, the Company has applied the practical expedient provided by ASC 340, Other Assets and Deferred Costs (“ASC 340”), and all incremental customer contract acquisition costs are expensed as they are incurred because the amortization period would have been one year or less.
Cash and Cash Equivalents	Cash - Cash consists of petty cash and bank term deposits and therefore approximates fair value. The Company places its cash with high credit quality financial institutions. Prior to the Spin-off the Company participated in a cash management program with Ensign where net cash activity was included in the net parent investment.
Accounts Receivable and Allowance for Doubtful Accounts	Accounts Receivable and Allowance for Doubtful Accounts - Accounts receivable consist primarily of amounts due from Medicare and Medicaid programs, other government programs, managed care health plans and private payor sources, net of estimates for variable consideration. Subsequent to our adoption of ASU 2016-13, as noted below, the allowance for doubtful accounts is the Company’s best estimate of current expected credit losses in the accounts receivable balance.
Property and Equipment	Property and Equipment - Property and equipment are initially recorded at their historical cost. Repairs and maintenance are expensed as incurred. Depreciation is computed using the straight-line method over the estimated useful lives of the depreciable assets (ranging from three to 15 years). Leasehold improvements are amortized on a straight-line basis over the shorter of their estimated useful lives or the remaining lease term.
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets - The Company reviews the carrying value of long-lived assets that are held and used in the independent operating subsidiaries for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of these assets is determined based upon expected undiscounted future net cash flows from the operating subsidiary to which the assets relate, utilizing management’s best estimate, appropriate assumptions, and projections at the time. If the carrying value is determined to be unrecoverable from future operating cash flows, the asset is deemed impaired and an impairment loss would be recognized to the extent the carrying value exceeded the estimated fair value of the asset. The Company estimates the fair value of assets based on the estimated future discounted cash flows of the asset.
Goodwill and Intangible Assets	Intangible Assets and Goodwill - Definite-lived intangible assets consist primarily of patient base and customer relationships. Patient base is amortized over a period of four months to eight months, depending on the classification of the patients and the level of occupancy in a new acquisition when acquired. Customer relationships are amortized between one to seven years depending on the significance of the relationships. The Company’s indefinite-lived intangible assets consist of trade names and Medicare and Medicaid licenses. The Company tests indefinite-lived intangible assets for impairment on an annual basis or more frequently if events or changes in circumstances indicate that the carrying amount of the intangible asset may not be recoverable. The Company did not identify any asset impairment during the years ended December 31, 2020, 2019 and 2018. Goodwill represents the excess of the purchase price over the fair value of identifiable net assets acquired in business combinations. Goodwill is subject to annual test for impairment as of the beginning of the fourth quarter or more frequently if events or changes indicate that the Company's goodwill might be impaired. The Company assesses qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount. If the Company determines it is more likely than not that the fair value of a reporting unit is less than its carrying amount, then it is required to perform a quantitative impairment test by comparing the fair value with the carrying amount of the reporting unit. If the carrying amount of a reporting unit exceeds its fair value, then the Company records an impairment of goodwill equal to the amount that the carrying amount of a reporting unit exceeds its fair value. As of December 31, 2020, we evaluated potential triggering events that might be indicators that our goodwill and indefinite lived intangibles were impaired. No goodwill or intangible asset impairments were recorded during the years ended December 31, 2020, 2019 and 2018. See further discussion at Note 9, Goodwill and Intangible Assets, Net.
Fair Value of Financial Instruments	Fair Value of Financial Instruments - The Company’s financial instruments consist principally of cash, accounts receivable, accounts payable and accrued liabilities. The Company believes all of the financial instruments’ recorded values approximate fair values because of their nature or respective short durations. The Company determines fair value measurements are based on a three-tier hierarchy that prioritizes the inputs used to measure fair value. These tiers include: Level 1, defined as observable inputs such as quoted market prices in active markets; Level 2, defined as inputs other than quoted prices included within Level 1 that are observable for the asset or liability, either directly or indirectly; and Level 3, defined as unobservable inputs for which little or no market data exists, therefore requiring an entity to develop its own assumptions.
Income Taxes	Income Taxes - Deferred tax assets and liabilities are established for temporary differences between the financial reporting basis and the tax basis of the Company’s assets and liabilities at tax rates in effect when such temporary differences are expected to reverse. The Company generally expects to fully utilize its deferred tax assets; however, when necessary, the Company records a valuation allowance to reduce its net deferred tax assets to the amount that is more likely than not to be realized. In determining the need for a valuation allowance or the need for and magnitude of liabilities for uncertain tax positions, the Company makes certain estimates and assumptions. These estimates and assumptions are based on, among other things, knowledge of operations, markets, historical trends and likely future changes and, when appropriate, the opinions of advisors with knowledge and expertise in certain fields. Due to certain risks associated with the Company’s estimates and assumptions, actual results could differ.
Noncontrolling Interest	Noncontrolling Interest - The noncontrolling interest in a subsidiary is initially recognized at estimated fair value on the acquisition date and is presented within total equity in the Company's consolidated balance sheets. The Company presents the noncontrolling interest and the amount of consolidated net income/ (loss) attributable to The Pennant Group, Inc. in its consolidated and combined statements of income. Net income per share is calculated based on net income/ (loss) attributable to The Pennant Group, Inc.'s stockholders. The carrying amount of the noncontrolling interest is adjusted based on an allocation of subsidiary earnings based on ownership interest.
Share-Based Compensation	Share-Based Compensation -The Company measures and recognizes compensation expense for all share-based payment awards, including employee stock options, made to employees and Pennant’s directors based on estimated fair values, ratably over the requisite service period of the award. The Company accounts for forfeitures as they occur. Net income has been reduced as a result of the recognition of the fair value of all stock options and restricted stock awards issued, the amount of which is contingent upon the number of future grants and other variables.
Recent Accounting Pronouncements	Prior to Spin-Off Cost Allocation - The Financial Statements include allocations of costs for certain shared services provided to the Company by Ensign subsidiaries prior to the Spin-Off on October 1, 2019. Such allocations include, but are not limited to, executive management, accounting, human resources, information technology, compliance, legal, payroll, insurance, tax, treasury, and other general and administrative items. These costs were allocated to the Company on a basis of revenue, location, employee count, or other measures. These cost allocations are reflected within general and administrative expense in the consolidated and combined statements of income, including for share-based compensation expenses disclosed in Note 12, Options and Awards. The amount of general and administrative costs allocated from January 1, 2019 to October 1, 2019, the date of the Spin-Off, inclusive of share-based compensation expense, was $23,710. Management believes the basis on which the expenses were allocated to be a reasonable reflection of the services provided to the Company during the periods. Insurance - Prior to the Spin-Off Ensign was partially self-insured for healthcare, general and professional liability, and workers’ compensation, and historically allocated premium expense to all subsidiaries of Ensign in its accounting records. To reflect all of the insurance costs, quarterly actuary determined adjustments were allocated to the Company based on the proportional historical premium expense. No self-insurance accruals were allocated to the Company as these accruals represent the obligations of Ensign. In connection with the Spin-Off, the Company purchased insurance through a third-party to replace the coverage provided by Ensign’s self-insured policies. Debt - Ensign’s external debt and related interest expense were not allocated to the Company for any of the periods presented as no portion of the borrowings were assumed by the Company as part of the Spin-Off. All interest incurred by the Company was subsequent to the Spin-Off. Income Taxes - Prior to the date of the Spin-off, the Company’s operations have been included in Ensign’s U.S. federal and state income tax returns and all income taxes have been paid by subsidiaries of Ensign. Also prior to the date of the Spin-off, income tax expense and other income tax related information contained in these Financial Statements were presented using a separate tax return approach. Under this approach, the provision for income taxes represents income tax paid or payable for the current year plus the change in deferred taxes during the year calculated as if the Company was a stand-alone taxpayer filing hypothetical income tax returns. Management believes that the assumptions and estimates used to determine these tax amounts are reasonable. However, the Company’s Financial Statements may not necessarily reflect its income tax expense or tax payments in the future, or what tax amounts would have been if the Company had been a stand-alone company for the entire period presented. Invested Capital - The net parent investment on the consolidated balance sheets represents Ensign’s historical investment in the Company, the net effect of transactions with, and allocations from, Ensign and the Company’s accumulated earnings. Invested capital was reclassified into additional paid-in-capital at the date of the Spin-Off. Noncontrolling Interest - Prior to the Spin-Off, the Company presented the noncontrolling interest and the amount of consolidated net income/ (loss) attributable to the Company in its Financial Statements. The carrying amount of the noncontrolling interest was adjusted by an allocation of subsidiary earnings based on ownership interest prior to the Spin-Off. The noncontrolling subsidiary interest included in the Financial Statements was converted into common shares of Pennant concurrent with the distribution to Ensign stockholders at the date of the Spin-Off and thus, will no longer be allocated a portion of earnings. Share-based compensation - Prior to the Spin-Off, employees of the Company’s subsidiaries participated in Ensign’s equity-based incentive plans (the “Ensign Plans”) and the Cornerstone Subsidiary Equity plan (the “Subsidiary Equity Plan”). Share-based compensation includes the expense attributable to employees of the Company’s subsidiaries who participated in the Ensign Plans, as well as the allocated cost related to Ensign subsidiaries’ employees that participated in the Ensign Plans. Share-based compensation related to Ensign subsidiaries’ employees that participated in the Ensign Plans were allocated on the basis of revenue. All share-based compensation related to the Subsidiary Equity Plan was recognized in the Financial Statements and, therefore, no cost allocation was necessary. Prior to the Spin-Off, share-based compensation costs associated with the Subsidiary Equity Plan awards was initially measured at fair value at the grant date and was expensed as non-cash compensation over the vesting term. Historically, these awards were granted once per year and the fair value has been determined by an independent valuation of the subsidiary shares. The valuation incorporated a discounted cash flow analysis combined with a market-based approach to determine the fair value of the subsidiary equity. Earnings Per Share - For the year ended December 31, 2018, the earnings per share included on the accompanying Consolidated and Combined Statements of Income was calculated based on the 27,834 shares of Pennant common stock distributed on October 1, 2019 in conjunction with the Spin-Off, including shares related to the conversion of the noncontrolling interest. Prior to October 1, 2019, Pennant did not have any issued and outstanding common stock. The same number of shares was used to calculate basic and diluted earnings per share since no Pennant employee equity awards were outstanding prior to the Spin-Off. In connection with the Spin-Off, shares of existing equity awards were replaced with shares under the new Pennant awards and are reflected in basic and diluted net income per share for the years ended December 31, 2020 and 2019, respectively. For further discussion see Note 4, Computation of Net Income Per Common Share Recent Accounting Standards Adopted by the Company Except for rules and interpretive releases of the SEC under authority of federal securities laws and a limited number of grandfathered standards, the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) is the sole source of authoritative GAAP literature recognized by the FASB and applicable to the Company. For any new pronouncements, the Company considers whether the new pronouncements could alter previous generally accepted accounting principles and determines whether any new or modified principles will have a material impact on the Company’s reported financial position or operations in the near term. The applicability of any standard is subject to the formal review of the Company’s financial management and certain standards are under consideration. FASB Accounting Standards Update, or ASU, ASU 2020-04 “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting” or ASU 2020-4 - In March 2020, the FASB concluded its reference rate reform project and issued this ASU. The amendments in this ASU provide optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The amendments in this ASU apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. The optional expedients and exceptions are available for all entities as of March 12, 2020, through December 31, 2022. The Company has adopted ASU 2020-04, effective March 12, 2020. The impact of this ASU will be determined based on terms of any future contract modification related to a change in reference rate, including future modifications to the Company’s Revolving Credit Facility described in further detail in Note 11, Debt. FASB ASU, 2018-15, “Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract” or ASU 2018-15. The update helps entities evaluate the accounting for fees paid by a customer in a cloud computing arrangement (hosting arrangement), by providing guidance in determining when the arrangement includes a software license. It requires entities to account for such costs consistent with the guidance on capitalizing costs associated with developing or obtaining internal-use software. The Company has adopted ASU 2018-15, effective January 1, 2020. There was no material impact to the Company’s Financial Statements or disclosures. FASB ASU, 2018-13 “Fair Value Measurement (Topic 820): Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement” or ASU 2018-13 - In August 2018, the FASB issued amended guidance to simplify fair value measurement disclosure requirements. The new provisions eliminate the requirements to disclose (1) transfers between Level 1 and Level 2 of the fair value hierarchy, (2) policies related to valuation processes and the timing of transfers between levels of the fair value hierarchy, and (3) net asset value disclosure of estimates of timing of future liquidity events. The FASB also modified disclosure requirements of Level 3 fair value measurements. The Company adopted ASU 2018-13 as of January 1, 2020. There was no material impact to the Company’s Financial Statements or disclosures. FASB ASU, 2017-04 “Intangibles - Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment” or ASU 2017-04 - In January 2017, the FASB issued amended authoritative guidance to simplify and reduce the cost and complexity of the goodwill impairment test. The new guidance eliminates “Step 2” from the traditional two-step goodwill impairment test and redefines the concept of impairment from a measure of loss when comparing the implied fair value of goodwill to its carrying amount, to a measure comparing the fair value of a reporting unit with its carrying amount. The FASB also eliminated the requirements for any reporting unit with a zero or negative carrying amount to perform a qualitative assessment or “Step 2” of the goodwill impairment test. The new guidance does not amend the optional qualitative assessment of goodwill impairment. The Company adopted ASU 2017-04 as of January 1, 2020. There was no material impact to the Company’s Financial Statements or disclosures. FASB ASU 2016-13 “Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments” or ASU 2016-13 - In June 2016, the FASB issued ASU 2016-13, which replaced the existing incurred loss impairment model with an expected credit loss model and requires a financial asset measured at amortized cost to be presented at the net amount expected to be collected. The Company adopted ASU 2016-13 as of January 1, 2020. There was no material impact to the Company’s Financial Statements or related disclosures.
Invested Capital	Invested Capital - The net parent investment on the consolidated balance sheets represents Ensign’s historical investment in the Company, the net effect of transactions with, and allocations from, Ensign and the Company’s accumulated earnings. Invested capital was reclassified into additional paid-in-capital at the date of the Spin-Off.
Earnings Per Share	Basic and diluted net income per share are computed by dividing net income by the weighted average number of outstanding common shares during the period. In the basic and diluted earnings per share calculations, net income is equal to net income attributable to The Pennant Group, Inc. Prior to Spin-Off Net income attributable to the noncontrolling interest has been included in the numerator for the years ended December 31, 2019 and 2018, respectively, as the non-controlling subsidiary interest that existed prior to the Spin-Off was converted into common shares of Pennant concurrent with the distribution to Ensign stockholders at the date of the Spin-Off.

CONSOLIDATED AND COMBINED STATEMENTS OF INCOME - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Statement [Abstract]
Revenue	$ 390,953	$ 338,531	$ 286,058
Expense:
Cost of services	296,874	258,941	212,421
Rent—cost of services	39,191	34,975	31,199
General and administrative expense	31,296	35,135	18,843
Depreciation and amortization	4,675	3,810	2,964
Total expenses	372,036	332,861	265,427
Consolidated and Combined Income from operations	18,917	5,670	20,631
Other income (expense):
Other income	225	0	0
Interest expense, net	(1,239)	(410)	0
Other income (expense), net	(1,014)	(410)	0
Income before provision for income taxes	17,903	5,260	20,631
Provision for income taxes	2,350	2,085	4,352
Net income	15,553	3,175	16,279
Less: net (loss)/ income attributable to noncontrolling interest	(191)	629	595
Net income and other comprehensive income attributable to The Pennant Group, Inc.	$ 15,744	$ 2,546	$ 15,684
Earnings per share (Note 4):
Basic (in dollars per share)	$ 0.56	$ 0.11	$ 0.58
Diluted (in dollars per share)	$ 0.52	$ 0.11	$ 0.58
Weighted average common shares outstanding:
Basic (in shares)	28,029	27,838	27,834
Diluted (in shares)	30,228	29,586	27,834

DEBT - SCHEDULE OF LONG-TERM DEBT (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Less: unamortized debt issuance costs	$ (1,223)	$ (1,474)
Long-term debt, net	8,277	18,526
Revolving credit facility \| Line of credit
Debt Instrument [Line Items]
Revolving Credit Facility	$ 9,500	$ 20,000

INCOME TAXES - TAX RATE RECONCILIATION (Details)	12 Months Ended
INCOME TAXES - TAX RATE RECONCILIATION (Details)	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Effective Income Tax Rate Reconciliation, Percent [Abstract]
Income tax expense at statutory rate	21.00%	21.00%	21.00%
State income taxes - net of federal benefit	2.70%	6.80%	3.50%
Non-deductible expenses	0.40%	2.60%	0.40%
Transaction costs(a)	0.00%	41.20%	0.00%
Tax credits	0.00%	(1.60%)	0.00%
Equity compensation(b)	(10.80%)	(30.00%)	(2.90%)
Revaluation of deferred	0.00%	0.00%	(0.20%)
Other adjustments	(0.20%)	(0.40%)	(0.70%)
Total income tax provision	13.10%	39.60%	21.10%

LEASES

12 Months Ended

Dec. 31, 2020

Leases [Abstract]

Leases

LEASES

The Company’s independent operating subsidiaries lease 54 senior living communities and its administrative offices under non-cancelable operating leases, most of which have initial lease terms ranging from five to 21 years. Most of these leases contain renewal options, most involve rent increases and none contain purchase options. The lease term excludes lease renewals because the renewal rents are not at a bargain, there are no economic penalties for the Company to renew the lease, and it is not reasonably certain that the Company will exercise the extension options. As of December 31, 2020, the Company’s independent operating subsidiaries leased 31 communities from subsidiaries of Ensign (“Ensign Leases”) under a master lease arrangement. The existing leases with subsidiaries of Ensign are for initial terms of between 14 to 20 years. In addition to rent, each of the operating companies are required to pay the following: (1) all impositions and taxes levied on or with respect to the leased properties (other than taxes on the income of the lessor); (2) all utilities and other services necessary or appropriate for the leased properties and the business conducted on the leased properties; (3) all insurance required in connection with the leased properties and the business conducted on the leased properties; (4) all community maintenance and repair costs; and (5) all fees in connection with any licenses or authorizations necessary or appropriate for the leased properties and the business conducted on the leased properties.

Fifteen of the Company’s affiliated senior living communities, excluding the communities that are operated under the Ensign Leases (as defined herein), are operated under two separate master lease arrangements. Under these master leases, a breach at a single community could subject one or more of the other communities covered by the same master lease to the same default risk. Failure to comply with Medicare and Medicaid provider requirements is a default under several of the Company’s leases and master leases. With an indivisible lease, it is difficult to restructure the composition of the portfolio or economic terms of the master lease without the consent of the landlord.

The components of operating lease cost, are as follows:


	Year Ended December 31,
	2020		2019
Operating Lease Costs:
Facility Rent—cost of services	$	35,562	$	32,011
Office Rent—cost of services	3,772		2,964
Sublease income	(143)		—
Rent—cost of services	$	39,191	$	34,975

General and administrative expense	$	295	$	162
Variable lease cost(a)	$	5,330	$	4,608


(a)						Represents variable lease cost for operating leases, which costs include property taxes and insurance, common area maintenance, and consumer price index increases, incurred as part of our triple net lease, and which is included in cost of services for the years ended December 31, 2020 and 2019.

Rent expense for operating leases classified under Topic 840 for the year ended December 31, 2018 was $31,199.

The following table shows the lease maturity analysis for all leases as of December 31, 2020:


Year	Amount
2021	$	38,393
2022	37,730
2023	37,038
2024	36,230
2025	35,349
Thereafter	356,838
Total lease payments	541,578
Less: present value adjustments	(230,857)
Present value of total lease liabilities	310,721
Less: current lease liabilities	(14,106)
Long-term operating lease liabilities	$	296,615

Operating lease liabilities are based on the net present value of the remaining lease payments over the remaining lease term. In determining the present value of lease payments, the Company used its incremental borrowing rate based on the information available at each lease’s commencement date to determine each lease's operating lease liability. As of December 31, 2020, the weighted average remaining lease term is 15.0 years and the weighted average discount rate is 8.2%.

OPTIONS AND AWARDS - SHARE-BASED COMPENSATION (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Oct. 01, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation	$ 1,395	$ 8,335	$ 3,382	$ 2,382
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation		1,660	315	0
Restricted stock awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation		6,200	1,589	0
Restricted stock awards \| Non-employee director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation		$ 475	$ 83	$ 0

PROPERTY AND EQUIPMENT—NET (Tables)

12 Months Ended

Dec. 31, 2020

Property, Plant and Equipment [Abstract]

Schedule of property and equipment, net

Property and equipment, net consist of the following:


	Year Ended December 31,
	2020		2019
Leasehold improvements	$	9,984	$	6,621
Equipment	22,420		18,930
Furniture and fixtures	1,186		877
	33,590		26,428
Less: accumulated depreciation	(15,706)		(11,784)
Property and equipment, net	$	17,884	$	14,644

RELATED PARTY TRANSACTIONS AND NET PARENT INVESTMENT	12 Months Ended
RELATED PARTY TRANSACTIONS AND NET PARENT INVESTMENT	Dec. 31, 2020
Related Party Transactions [Abstract]
Related party transactions and net parent investment	RELATED PARTY TRANSACTIONS AND NET PARENT INVESTMENT The Financial Statements include a combination of stand-alone and combined business functions between Ensign and the Company’s subsidiaries prior to the Spin-Off. The Company leases 31 of its senior living communities from subsidiaries of Ensign, each of the leases have a term of between 14 and 20 years from the lease commencement date. The total amount of rent expense included in Rent - cost of services paid to subsidiaries of Ensign was $12,536, $11,292, and $10,363 for the years ended December 31, 2020, 2019 and 2018, respectively. Certain related party activity occurred as the Company’s subsidiaries received services from Ensign’s subsidiaries. Services included in cost of services were $4,205, $3,166, and $2,996 for the years ended December 31, 2020, 2019 and 2018, respectively. The consolidated balance sheets of the Company include Ensign assets and liabilities that are specifically identifiable or otherwise attributable to the Company and were transferred to the Company in connection with the Spin-Off. Transactions that have occurred between subsidiaries of the Company and subsidiaries of Ensign are considered to be effectively settled at the time the transaction is recorded. The net effect of these transactions, including the cash management, is included in the consolidated and combined statements of cash flows as “Net investment from/(to) Parent”. Other related party activity with Ensign On October 1, 2019, in connection with the Spin-Off, Pennant entered into several agreements with Ensign that set forth the principal actions taken or to be taken in connection with the Spin-Off and govern the relationship of the parties following the Spin-Off. The Company has incurred $5,536 and $2,982 in costs related to the Transitions Services Agreement for the years ended December 31, 2020 and 2019, respectively. Additionally, the Company has recognized $578 and $291 in tax benefits related to the Tax Matters Agreement for the years ended December 31, 2020 and 2019, respectively, and has recorded a payable to Ensign in connection with any unpaid portion of these amounts. See “Certain Relationships and Related Party Transactions—Agreements with Ensign Related to the Spin-Off,” contained within the Information Statement as well as the Form 8-K filed with the SEC on October 3, 2019 for further discussion of the agreements entered into in connection with the Spin-Off.

REVENUE AND ACCOUNTS RECEIVABLE

12 Months Ended

Dec. 31, 2020

Revenue from Contract with Customer [Abstract]

Revenue and accounts receivable

REVENUE AND ACCOUNTS RECEIVABLERevenues are recognized when services are provided to the patients or residents at the amount that reflects the consideration to which the Company expects to be entitled from patients, residents and third-party payors, including Medicaid, Medicare and insurers (private and Medicare replacement plans), in exchange for providing patient care or senior living residence. The healthcare services in home health and hospice patient contracts include routine services in exchange for a contractual agreed-upon amount or rate. Routine services are treated as a single performance obligation satisfied over time as

services are rendered. As such, patient care services represent a bundle of services that are not capable of being distinct within the context of the contract. Additionally, there may be ancillary services which are not included in the rates for routine services, but instead are treated as separate performance obligations satisfied at a point in time, if and when those services are rendered.

Revenue recognized from healthcare services are adjusted for estimates of variable consideration to arrive at the transaction price. The Company determines the transaction price based on contractually agreed-upon amounts or rate, adjusted for estimates of variable consideration. The Company uses the expected value method in determining the variable component that should be used to arrive at the transaction price, using contractual agreements and historical reimbursement experience within each payor type. The amount of variable consideration which is included in the transaction price may be constrained, and is included in the net revenue only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. If actual amounts of consideration ultimately received differ from the Company’s estimates, the Company adjusts these estimates, which would affect net service revenue in the period such variances become known.

Revenue from the Medicare and Medicaid programs accounted for 60.1%, 55.6%, and 53.1% of the Company’s revenue for the years ended December 31, 2020, 2019 and 2018, respectively. The Company records revenue from these governmental and managed care programs as services are performed at their expected net realizable amounts under these programs. The Company’s revenue from governmental and managed care programs is subject to audit and retroactive adjustment by governmental and third-party agencies. Consistent with healthcare industry accounting practices, any changes to these governmental revenue estimates are recorded in the period the change or adjustment becomes known based on final settlement.

Disaggregation of Revenue

The Company disaggregates revenue from contracts with its patients or residents by reportable operating segments and payors. The Company has determined that disaggregating revenue into these categories achieves the disclosure objectives to depict how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors. A reconciliation of disaggregated revenue to segment revenue as well as revenue by payor is provided in below.

The Company’s service specific revenue recognition policies are as follows:

Home Health Revenue

Medicare Revenue

For Medicare episodes that began after January 1, 2020, net service revenue is recognized in accordance with the Patient Driven Groupings Model (“PDGM”). This new reimbursement structure involves case mix calculation methodology refinements, changes to low-utilization payment adjustment (“LUPA”) thresholds, the elimination of therapy thresholds, a change to the unit of payment from a 60-day episode to a 30-day payment period, and reduction of requests for anticipated payments (“RAPs”) to 20% of the estimated payment for a patient’s initial or subsequent period of care up-front (after the initial assessment is completed and upon initial billing). The RAPs will be completely phased out effective January 1, 2021. Under PDGM, Medicare provides agencies with payments for each 30-day payment period provided to beneficiaries. If a beneficiary is still eligible for care after the end of the first 30-day payment period, a second 30-day payment period can begin. There are no limits to the number of periods of care a beneficiary who remains eligible for the home health benefit can receive. While payment for each 30-day payment period is adjusted to reflect the beneficiary’s health condition and needs, a special outlier provision exists to ensure appropriate payment for those beneficiaries that have the most expensive care needs. The payment under the Medicare program is also adjusted for certain variables including, but not limited to: (a) a LUPA if the number of visits is below an established threshold that varies based on the diagnosis of a beneficiary; (b) a partial payment if the patient transferred to another provider or the Company received a patient from another provider before completing the period of care; (c) adjustment to the admission source of claim if it is determined that the patient had a qualifying stay in a post-acute care setting within 14 days prior to the start of a 30-day payment period; (d) the timing of the 30-day payment period provided to a patient in relation to the admission date, regardless of whether the same home health provider provided care for the entire series of episodes; (e) changes to the acuity of the patient during the previous 30-day payment period; (f) changes in the base payments established by the Medicare program; (g) adjustments to the base payments for case mix and geographic wages; and (h) recoveries of overpayments.

For all episodes that began prior to January 1, 2020, net service revenue was recorded under the Medicare prospective payment system based on a 60-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a) an outlier payment if the patient’s care was unusually costly; (b) a LUPA if the number of visits was fewer than five; (c) a partial payment if the patient transferred to another provider or transferred from another provider before completing the episode; (d) a payment adjustment based upon the level of covered therapy services; (e) the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (f) changes in the base episode payments established by the Medicare program; (g) adjustments to the base episode payments for case mix and geographic wages; and (h) recoveries of overpayments.

The Company adjusts Medicare revenue on completed episodes to reflect differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation and other reasons unrelated to credit risk. Therefore, the Company believes that its reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered.

In addition to revenue recognized on completed episodes and periods, the Company also recognizes a portion of revenue associated with episodes and periods in progress. Episodes in progress are 30-day payment periods, if the episode started after January 1, 2020, or 60-day episodes of care, if the episode started prior to January 1, 2020, that begin during the reporting period but were not completed as of the end of the period. As such, the Company estimates revenue and recognizes it on a daily basis. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per period of care or episode of care and the Company’s estimate of the average percentage complete based on the scheduled end of period and end of episode dates.

Non-Medicare Revenue

Episodic Based Revenue - The Company recognizes revenue in a similar manner as it recognizes Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms.

Non-episodic Based Revenue - Revenue is recognized on an accrual basis based upon the date of service at amounts equal to its established or estimated per visit rates, as applicable.

Hospice Revenue

Revenue is recognized on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are calculated as daily rates for each of the levels of care the Company delivers. Revenue is adjusted for an inability to obtain appropriate billing documentation or authorizations acceptable to the payor and other reasons unrelated to credit risk. Additionally, as Medicare hospice revenue is subject to an inpatient cap and an overall payment cap, the Company monitors its provider numbers and estimates amounts due back to Medicare if a cap has been exceeded. The Company regularly evaluates and records these adjustments as a reduction to revenue and an increase to other accrued liabilities.

Senior Living Revenue

The Company has elected the lessor practical expedient within ASC Topic 842, Leases (“ASC 842”) and therefore recognizes, measures, presents, and discloses the revenue for services rendered under the Company’s senior living residency agreements based upon the predominant component, either the lease or non-lease component, of the contracts. The Company has determined that the services included under the Company’s senior living residency agreements each have the same timing and pattern of transfer. The Company recognizes revenue under ASC Topic 606, Revenue from Contracts with Customers for its senior residency agreements, for which it has determined that the non-lease components of such residency agreements are the predominant component of each such contract.

The Company’s senior living revenue consists of fees for basic housing and assisted living care. Accordingly, we record revenue when services are rendered on the date services are provided at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For residents under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered.

Revenue by payor for the years ended December 31, 2020, 2019 and 2018, is summarized in the following tables:


	Year Ended December 31, 2020
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	58,399	$	119,873	$	—	$	178,272	45.6	%
Medicaid	7,645		12,462		36,780		56,887		14.5
Subtotal	66,044		132,335		36,780		235,159		60.1
Managed care	31,572		1,546		—		33,118		8.5
Private and other(a)	21,968		194		100,514		122,676		31.4
Total revenue	$	119,584	$	134,075	$	137,294	$	390,953	100.0	%


(a)						Private and other payors in our home health and hospice services segment includes revenue from all payors generated in our home care operations.


	Year Ended December 31, 2019
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	47,819	$	93,933	$	—	$	141,752	41.9	%
Medicaid	6,575		10,061		29,819		46,455		13.7
Subtotal	54,394		103,994		29,819		188,207		55.6
Managed care	27,711		1,536		—		29,247		8.6
Private and other(a)	18,837		152		102,088		121,077		35.8
Total revenue	$	100,942	$	105,682	$	131,907	$	338,531	100.0	%


(a)						Private and other payors in our home health and hospice services segment includes revenue from all payors generated in our home care operations.


	Year Ended December 31, 2018
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	42,091	$	73,906	$	—	$	115,997	40.5	%
Medicaid	4,680		7,729		23,624		36,033		12.6
Subtotal	46,771		81,635		23,624		152,030		53.1
Managed care	23,541		918		—		24,459		8.6
Private and other(a)	16,067		105		93,397		109,569		38.3
Total revenue	$	86,379	$	82,658	$	117,021	$	286,058	100.0	%


(a)						Private and other payors in our home health and hospice services segment includes revenue from all payors generated in our home care operations.

Balance Sheet Impact

Included in the Company’s consolidated balance sheets are contract assets, comprised of billed accounts receivable and unbilled receivables, which are the result of the timing of revenue recognition, billings and cash collections, as well as, contract liabilities, which primarily represent payments the Company receives in advance of services provided. As of December 31, 2020, the Company had contract liabilities in the amount of $27,997 related to Advance Payments received in connection with the CARES Act. As further discussed in Note 10, Other Accrued Liabilities, the repayment terms for Medicare advance payments were modified through the passage of the Continuing Appropriations Act, 2021 and Other Extensions Act on October 1, 2020.

Accounts receivable as of December 31, 2020 and December 31, 2019 is summarized in the following table:


	December 31, 2020		December 31, 2019
Medicare	$	28,569	$	17,822
Medicaid	7,669		6,579
Managed care	7,590		4,380
Private and other	4,036		4,079
Accounts receivable, gross	47,864		32,860
Less: allowance for doubtful accounts	(643)		(677)
Accounts receivable, net	$	47,221	$	32,183

The following table summarizes the activity for our allowance for doubtful accounts for the years ended years ended December 31, 2020, 2019 and 2018:


	Year Ended December 31,
	2020		2019		2018
Balance at beginning of period	$	677	$	616	$	5,058
Impact of ASC 606 Adoption(a)	—		—		(4,590)
Additions to bad debt expense	560		858		346
Write-offs of uncollectible accounts	(594)		(797)		(198)
Balance at end of period	$	643	$	677	$	616


(a)						Subsequent to the adoption of ASC 606, the majority of what was previously presented as allowance for doubtful accounts related to bad debt expense has been incorporated as an implicit price concession factored into net revenue and accounts receivable. Allowance for doubtful accounts as of December 31, 2020 represents the Company’s best estimate of probable losses inherent in the accounts receivable balance based on known troubled accounts and other currently available evidence.

Practical Expedients and Exemptions

As the Company’s contracts have an original duration of one year or less, the Company uses the practical expedient applicable to its contracts and does not consider the time value of money. Further, because of the short duration of these contracts, the Company has not disclosed the transaction price for the remaining performance obligations as of the end of each reporting period or when the Company expects to recognize this revenue. In addition, the Company has applied the practical expedient provided by ASC 340, Other Assets and Deferred Costs (“ASC 340”), and all incremental customer contract acquisition costs are expensed as they are incurred because the amortization period would have been one year or less.

DEBT - NARRATIVE (Details) - USD ($)			9 Months Ended
DEBT - NARRATIVE (Details) - USD ($)	Feb. 23, 2021	Oct. 01, 2019	Oct. 01, 2019	Dec. 31, 2020
Subsequent event
Debt Instrument [Line Items]
Borrowing capacity	$ 150,000,000
Minimum \| LIBOR
Debt Instrument [Line Items]
Margin		2.50%
Minimum \| LIBOR \| Subsequent event
Debt Instrument [Line Items]
Margin	2.30%
Minimum \| Base Rate
Debt Instrument [Line Items]
Margin		1.50%
Minimum \| Base Rate \| Subsequent event
Debt Instrument [Line Items]
Margin	1.30%
Maximum \| LIBOR
Debt Instrument [Line Items]
Margin		3.50%
Maximum \| LIBOR \| Subsequent event
Debt Instrument [Line Items]
Margin	3.30%
Maximum \| Base Rate
Debt Instrument [Line Items]
Margin		2.50%
Maximum \| Base Rate \| Subsequent event
Debt Instrument [Line Items]
Margin	2.30%
Revolving credit facility \| Line of credit
Debt Instrument [Line Items]
Borrowing capacity		$ 75,000,000	$ 75,000,000
Commitment fee on undrawn portion			0.60%
Weighted average interest rate				4.75%
Borrowing availability				$ 62,164,000
Letters of credit \| Line of credit
Debt Instrument [Line Items]
Letters of credit outstanding				$ 3,336,000

BUSINESS SEGMENTS - NARRATIVE (Details)	Dec. 31, 2020 agency facility
Home Health and Hospice Services
Segment Reporting Information [Line Items]
Number of service providers \| agency	76
Senior Living Services
Segment Reporting Information [Line Items]
Number of properties under lease \| facility	54

GOODWILL AND INTANGIBLE ASSETS - NET (Tables)

12 Months Ended

Dec. 31, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Activity in goodwill by segment

The following table represents activity in goodwill by segment as of and for the year ended December 31, 2020:


	Home Health and Hospice Services		Senior Living Services		Total
December 31, 2018	$	27,250	$	3,642	$	30,892
Additions	10,341		—		10,341

December 31, 2019	37,591		3,642		41,233
Additions	25,211		—		25,211

December 31, 2020	$	62,802	$	3,642	$	66,444

Other indefinite-lived intangible assets

Other indefinite-lived intangible assets consist of the following:


	Year Ended December 31,
	2020		2019
Trade name	$	1,355	$	355
Medicare and Medicaid licenses	46,133		33,107
Total	$	47,488	$	33,462

OTHER ACCRUED LIABILITIES - NARRATIVE (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Oct. 31, 2020	Jun. 30, 2020	Dec. 31, 2019
Payables and Accruals [Line Items]
Contract Liabilities (CARES Act advance payments)	$ 22,771		$ 27,997	$ 0
Revision of Prior Period, Adjustment
Payables and Accruals [Line Items]
AAP amount reclassified		$ 5,226
Long-term liabilities		$ 5,226

- Definition

Amount of obligation due after one year or beyond the normal operating cycle, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 201.5-02(25))
-URI http://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(23))
-URI http://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(22))
-URI http://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 201.5-02(26))
-URI http://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=75031198&loc=d3e14064-108612

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (bb)
-URI http://asc.fasb.org/extlink&oid=121559654&loc=d3e5710-111685

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 201.5-02(24))
-URI http://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=121559654&loc=d3e5710-111685

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 810
-SubTopic 10
-Section 45
-Paragraph 25
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=116870748&loc=SL6758485-165988

+ Details

ACQUISITIONS (Tables)

12 Months Ended

Dec. 31, 2020

Business Combinations [Abstract]

Schedule of operations acquired in business combinations

The table below presents the allocation of the purchase price for the operations acquired in business combinations during the years ended December 31, 2020, 2019 and 2018 as noted above:


	Year Ended December 31,
	2020		2019		2018
Equipment, furniture, and fixtures	$	174	$	91	$	15
Goodwill	25,211		10,341		2,872
Other indefinite-lived intangible assets	14,026		8,326		1,838
Other Assets	—		2		—
Liabilities Assumed	(172)		—		—
Total acquisitions	$	39,239	$	18,760	$	4,725
Less: noncontrolling interest and additional paid in capital(a)	(4,646)		—		—
Total cash paid for acquisitions(b)	$	34,593	$	18,760	$	4,725


(a)						Consists of the of noncontrolling interest related to Scripps contribution of assets to the joint venture.
(b)						Total cash paid for acquisitions for the year ended December 31, 2020 includes $1,400 that was recorded as an escrow deposit at December 31, 2019.

Unaudited pro forma results of condensed combined operations


	Years Ended December 31,
	2020		2019
Revenue	$	424,805	$	396,468
Net income attributable to The Pennant Group, Inc.(a)	13,784		1,277


(a)						Net income attributable to The Pennant Group, Inc. for the year ended December 31, 2020 and 2019 includes a tax impact of 25.0% and 25.2%, which are the respective statutory tax rates.

CONSOLIDATED AND COMBINED 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	$ 15,553	$ 3,175	$ 16,279
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	4,675	3,810	2,964
Amortization of deferred financing fees	330	78	0
Provision for doubtful accounts	560	858	346
Share-based compensation	8,335	3,382	2,382
Deferred income taxes	(2,201)	79	0
Change in operating assets and liabilities:
Accounts receivable	(15,712)	(8,571)	(2,569)
Prepaid expenses and other assets	(7,435)	(2,746)	(210)
Operating lease obligations	2,068	(1,861)	0
Accounts payable	993	4,069	1,373
Accrued wages and related liabilities	10,538	3,376	1,583
Other accrued liabilities	2,427	1,720	398
Advance payments	27,997	0	0
Other long-term liabilities	2,076	2,185	729
Net cash provided by operating activities	50,204	9,554	23,275
Cash flows from investing activities:
Purchase of property and equipment	(7,253)	(6,714)	(3,603)
Cash payments for business acquisitions	(33,193)	(18,760)	(4,725)
Cash payments for asset acquisitions	0	(20)	(593)
Escrow deposits	(525)	(1,400)	0
Restricted and other assets	(645)	429	(556)
Net cash used in investing activities	(41,616)	(26,465)	(9,477)
Cash flows from financing activities:
Proceeds from sale of subsidiary shares	0	2,293	1,972
Repurchase of subsidiary shares	0	(2,687)	(1,972)
Net investment from/(to) parent	0	10,788	(13,793)
Cash distribution to parent in connection with Spin-Off	0	(11,600)	0
Sale of noncontrolling interest	555	0	0
Proceeds from revolver agreement	52,700	42,500	0
Payments on revolver agreement	(63,200)	(22,500)	0
Repurchase of shares of common stock to satisfy tax withholding obligations	(65)	0	0
Payments for deferred financing costs	(78)	(1,552)	0
Issuance of common stock upon the exercise of options	1,141	30	0
Net cash provided by/(used in) financing activities	(8,947)	17,272	(13,793)
Net (decrease)/ increase in cash	(359)	361	5
Cash beginning of period	402	41	36
Cash end of period	43	402	41
Cash paid during the period for:
Interest	1,116	156	0
Income taxes	7,865	120	0
Operating lease liabilities	35,853	37,088	0
Right-of-use assets obtained in exchange for new operating lease obligations	5,451	9,059	0
Net non-cash adjustment to right-of-use assets and lease liabilities from lease modifications	1,939	77,462	0
Non-cash investing activity:
Capital expenditures	$ 560	$ 946	$ 717

COMPUTATION OF NET INCOME PER COMMON SHARE - NARRATIVE (Details) - shares		12 Months Ended
	Oct. 01, 2019	Dec. 31, 2020	Dec. 31, 2019
Earnings Per Share, Diluted, by Common Class, Including Two Class Method [Line Items]
Options which are anti-dilutive and not factored into the weighted average common shares amount (in shares)		93,000	15,000
Common stock
Earnings Per Share, Diluted, by Common Class, Including Two Class Method [Line Items]
Shares issued (in shares)	27,834,000		27,834,000
Noncontrolling Interest Holders \| Common stock
Earnings Per Share, Diluted, by Common Class, Including Two Class Method [Line Items]
Shares issued (in shares)	1,160,000

OPTIONS AND AWARDS (Tables)

12 Months Ended

Dec. 31, 2020

Share-based Payment Arrangement [Abstract]

Total share-based compensation expense

Total share-based compensation expense for all of the Plans for the years ended December 31, 2020, 2019 and 2018:


	Year Ended December 31,
	2020		2019		2018
Prior to the Spin-Off:
Total share-based compensation	$	—	$	1,395	$	2,382

Following the Spin-Off:
Share-based compensation expense related to stock options	1,660		315		—
Share-based compensation expense related to Restricted Stock	6,200		1,589		—
Share-based compensation expense related to Restricted Stock to non-employee directors	475		83		—
Total share-based compensation	$	8,335	$	3,382	$	2,382


	Unrecognized Compensation Expense		Weighted Average Recognition Period (in years)
Unvested stock options	$	10,055	4.3
Unvested Restricted Stock	10,956		1.8
Total unrecognized share-based compensation expense	$	21,011

Stock options granted fair value assumptions

The fair value of each option is estimated on the grant date using a Black-Scholes option-pricing model with the following weighted average assumptions for stock options granted after the Spin-Off:


Grant Year	Options Granted	Risk-Free Interest Rate		Expected Life(a)	Expected Volatility(b)		Dividend Yield		Weighted Average Fair Value of Options
2020	693	0.5	%	6.5	35.9	%	—	%	$	11.05
2019	667	1.6	%	6.5	34.6	%	—	%	$	5.70


(a)						Under the midpoint method, the expected option life is the midpoint between the contractual option life and the average vesting period for the options being granted. This resulted in an expected option life of 6.5 years for the options granted.
(b)						Because the Company’s equity shares have been traded for a relatively short period of time, expected volatility assumption was based on the volatility of related industry stocks.

Employee stock option activity

The following table represents the employee stock option activity during the year ended December 31, 2020:


	Number of Options Outstanding	Weighted Average Exercise Price		Number of Options Vested	Weighted Average Exercise Price of Options Vested




December 31, 2019	1,573	$	9.71	607	$	4.80
Granted	693	$	30.44
Exercised	(239)	$	4.77
Forfeited	(36)	$	14.34
Expired	(9)	$	6.24
December 31, 2020	1,982	$	17.48	615	$	7.52

Aggregate intrinsic value of options outstanding, vested, expected to vest and exercisable

The aggregate intrinsic value of options outstanding, vested, unvested and exercised as of and for the period ended December 31, 2020 is as follows:


Options	December 31, 2020
Outstanding	$	80,456
Vested	31,077
Unvested	49,379
Exercised	8,002

Summary of non-vested restricted stock awards

A summary of the status of Pennant’s non-vested Restricted Stock, and changes during the period ended December 31, 2020, is presented below:


	Non-Vested Restricted Awards	Weighted Average Grant Date Fair Value
December 31, 2019	1,793	$	14.44
Granted	29	26.84
Vested	(176)	13.27
Forfeited	(11)	10.92
December 31, 2020	1,635	$	14.80

REVENUE AND ACCOUNTS RECEIVABLE - REVENUE BY MAJOR PAYOR (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Disaggregation of Revenue [Line Items]
Revenue	$ 390,953	$ 338,531	$ 286,058
Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	100.00%	100.00%	100.00%
Medicare
Disaggregation of Revenue [Line Items]
Revenue	$ 178,272	$ 141,752	$ 115,997
Medicare \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	45.60%	41.90%	40.50%
Medicaid
Disaggregation of Revenue [Line Items]
Revenue	$ 56,887	$ 46,455	$ 36,033
Medicaid \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	14.50%	13.70%	12.60%
Subtotal
Disaggregation of Revenue [Line Items]
Revenue	$ 235,159	$ 188,207	$ 152,030
Subtotal \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	60.10%	55.60%	53.10%
Managed care
Disaggregation of Revenue [Line Items]
Revenue	$ 33,118	$ 29,247	$ 24,459
Managed care \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	8.50%	8.60%	8.60%
Private and other
Disaggregation of Revenue [Line Items]
Revenue	$ 122,676	$ 121,077	$ 109,569
Private and other \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	31.40%	35.80%	38.30%
Home Health and Hospice Services \| Home Health Services
Disaggregation of Revenue [Line Items]
Revenue	$ 119,584	$ 100,942	$ 86,379
Home Health and Hospice Services \| Home Health Services \| Medicare
Disaggregation of Revenue [Line Items]
Revenue	58,399	47,819	42,091
Home Health and Hospice Services \| Home Health Services \| Medicaid
Disaggregation of Revenue [Line Items]
Revenue	7,645	6,575	4,680
Home Health and Hospice Services \| Home Health Services \| Subtotal
Disaggregation of Revenue [Line Items]
Revenue	66,044	54,394	46,771
Home Health and Hospice Services \| Home Health Services \| Managed care
Disaggregation of Revenue [Line Items]
Revenue	31,572	27,711	23,541
Home Health and Hospice Services \| Home Health Services \| Private and other
Disaggregation of Revenue [Line Items]
Revenue	21,968	18,837	16,067
Home Health and Hospice Services \| Hospice Services
Disaggregation of Revenue [Line Items]
Revenue	134,075	105,682	82,658
Home Health and Hospice Services \| Hospice Services \| Medicare
Disaggregation of Revenue [Line Items]
Revenue	119,873	93,933	73,906
Home Health and Hospice Services \| Hospice Services \| Medicaid
Disaggregation of Revenue [Line Items]
Revenue	12,462	10,061	7,729
Home Health and Hospice Services \| Hospice Services \| Subtotal
Disaggregation of Revenue [Line Items]
Revenue	132,335	103,994	81,635
Home Health and Hospice Services \| Hospice Services \| Managed care
Disaggregation of Revenue [Line Items]
Revenue	1,546	1,536	918
Home Health and Hospice Services \| Hospice Services \| Private and other
Disaggregation of Revenue [Line Items]
Revenue	194	152	105
Senior Living Services
Disaggregation of Revenue [Line Items]
Revenue	137,294	131,907	117,021
Senior Living Services \| Medicare
Disaggregation of Revenue [Line Items]
Revenue	0	0	0
Senior Living Services \| Medicaid
Disaggregation of Revenue [Line Items]
Revenue	36,780	29,819	23,624
Senior Living Services \| Subtotal
Disaggregation of Revenue [Line Items]
Revenue	36,780	29,819	23,624
Senior Living Services \| Managed care
Disaggregation of Revenue [Line Items]
Revenue	0	0	0
Senior Living Services \| Private and other
Disaggregation of Revenue [Line Items]
Revenue	$ 100,514	$ 102,088	$ 93,397

OPTIONS AND AWARDS - AGGREGATE INTRINSIC VALUE OF OPTIONS (Details) - The Ensign Plans $ in Thousands	Dec. 31, 2020 USD ($)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding	$ 80,456
Vested	31,077
Unvested	49,379
Exercised	$ 8,002

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details) - USD ($) shares in Thousands		9 Months Ended	12 Months Ended
	Oct. 01, 2019	Oct. 01, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Jun. 30, 2020
Property, Plant and Equipment [Line Items]
Contract Liabilities (CARES Act advance payments)			$ 22,771,000	$ 0		$ 27,997,000
Accrued payroll taxes employer portion			8,358,000
Direct medical supplies, labor, and other expenses			2,765,000
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Intangible asset impairments			0	0	$ 0
General and professional liability, retention limit			150,000
Out-of-pocket retention			500,000
Workers' compensation, retention limit			250,000
Share-based compensation		$ 1,395,000	8,335,000	3,382,000	2,382,000
General and administrative expense		$ 23,710,000	$ 31,296,000	35,135,000	18,843,000
Minimum
Property, Plant and Equipment [Line Items]
Property and equipment estimated useful lives			3 years
Maximum
Property, Plant and Equipment [Line Items]
Property and equipment estimated useful lives			15 years
General and administrative expense
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share-based compensation			$ 7,222,000	$ 2,769,000	$ 1,900,000
Customer Contracts \| Minimum
Finite-Lived Intangible Assets [Line Items]
Amortization period			4 months
Customer Contracts \| Maximum
Finite-Lived Intangible Assets [Line Items]
Amortization period			8 months
Customer Relationships \| Minimum
Finite-Lived Intangible Assets [Line Items]
Amortization period			1 year
Customer Relationships \| Maximum
Finite-Lived Intangible Assets [Line Items]
Amortization period			7 years
Common stock
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Shares issued (in shares)	27,834			27,834
Other long-term liabilities
Property, Plant and Equipment [Line Items]
Accrued payroll taxes employer portion			$ 4,179,000

ACQUISITIONS - UNAUDITED PRO FORMA (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Business Acquisition, Pro Forma Information [Abstract]
Revenue	$ 424,805	$ 396,468
Net income attributable to The Pennant Group, Inc	$ 13,784	$ 1,277
Statutory tax rate	25.00%	25.20%

OPTIONS AND AWARDS - NARRATIVE (Details) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020 USD ($) shares
Restricted stock awards \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years
Restricted stock awards \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	5 years
The Ensign Plans
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total unrecognized share-based compensation expense	$ 21,011
Options, unvested and outstanding (in shares) \| shares	1,367
Weighted average contractual life for options outstanding, vested and expected to vest	7 years 9 months 29 days
The Ensign Plans \| Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested stock options	$ 10,055
Unvested options and stock awards, cost net yet recognized, period for recognition	4 years 3 months 18 days
Options, vesting percent per year	20.00%
Options, expiration period	10 years
The Ensign Plans \| Restricted stock awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested Restricted Stock	$ 10,956
Unvested options and stock awards, cost net yet recognized, period for recognition	1 year 9 months 18 days
Vesting period	5 years

COMPUTATION OF NET INCOME PER COMMON SHARE

12 Months Ended

Dec. 31, 2020

Earnings Per Share [Abstract]

Computation of net income per common share

COMPUTATION OF NET INCOME PER COMMON SHARE

Basic and diluted net income per share are computed by dividing net income by the weighted average number of outstanding common shares during the period. In the basic and diluted earnings per share calculations, net income is equal to net income attributable to The Pennant Group, Inc.

Prior to Spin-Off

Net income attributable to the noncontrolling interest has been included in the numerator for the years ended December 31, 2019 and 2018, respectively, as the non-controlling subsidiary interest that existed prior to the Spin-Off was converted into common shares of Pennant concurrent with the distribution to Ensign stockholders at the date of the Spin-Off.

The following table sets forth the computation of basic and diluted net income per share for the periods presented:


	Year Ended December 31,
	2020		2019		2018
Numerator:
Net income	$	15,553	$	3,175	$	16,279
Add: net (loss)/ income attributable to noncontrolling interests	(191)		629		595
Net income attributable to The Pennant Group, Inc.	$	15,744	$	2,546	$	15,684

Denominator:
Weighted average shares outstanding for basic net income per share(a)	28,029		27,838		27,834
Plus: incremental shares from assumed conversion(b)	2,199		1,748		—
Adjusted weighted average common shares outstanding for diluted income per share	30,228		29,586		27,834

Earnings Per Share:
Basic net income per common share(c)	$	0.56	$	0.11	$	0.58
Diluted net income per common share(c)	$	0.52	$	0.11	$	0.58


(a)						Concurrent with the Spin-Off the noncontrolling subsidiary interest converted into 1,160 shares of Pennant. The total number of common shares distributed on October 1, 2019 of 27,834 was utilized in the denominator for the calculation of basic and diluted earnings per share for the year ended December 31, 2018 , as no common stock was outstanding prior to the date of the Spin-Off.
(b)						The calculation of dilutive shares outstanding excludes out-of-the-money stock options (i.e., such options’ exercise prices were greater than the average market price of our common shares for the period) because their inclusion would have been antidilutive. Options outstanding which are anti-dilutive and therefore not factored into the weighted average common shares amount above were 93 and 15 for the years ended December 31, 2020 and 2019, respectively.
(c)						For the years ended December 31, 2019 and 2018 basic and diluted earnings per share were calculated based on net income as the numerator, which included the conversion of the noncontrolling interest in connection with the Spin-Off. For the year ended December 31, 2020, basic and diluted earnings per share was calculated based on net income attributable to The Pennant Group, Inc. as the numerator, . See Note 7, Acquisitions, for further information on our acquisitions for the year ended December 31, 2020.

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - SUMMARY OF INSURANCE LIABILITY (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Reinsurance receivables	$ 704	$ 0
General and professional liability	1,063	521
Workers’ compensation	2,783	433
Total estimated liability	3,846	954
Less: long-term portion, included in other long-term liabilities	(2,492)	(774)
Current portion of estimated liability, included in other accrued liabilities	$ 1,354	$ 180

LEASES - FUTURE MINIMUM LEASE PAYMENTS (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Leases, Under Adoption of ASC 842 [Abstract]
2021	$ 38,393
2022	37,730
2023	37,038
2024	36,230
2025	35,349
Thereafter	356,838
Total lease payments	541,578
Less: present value adjustments	(230,857)
Present value of total lease liabilities	310,721
Less: current lease liabilities	(14,106)	$ (12,285)
Long-term operating lease liabilities	$ 296,615	$ 304,044

OPTIONS AND AWARDS - EMPLOYEE STOCK OPTION ACTIVITY (Details) - The Ensign Plans - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Number of Options Outstanding
Beginning balance, outstanding (in shares)	1,573
Granted (in shares)	693
Exercised (in shares)	(239)
Forfeited (in shares)	(36)
Expired (in shares)	(9)
Ending balance, outstanding (in shares)	1,982	1,573
Weighted Average Exercise Price
Beginning of period, weighted average exercise price (in dollars per share)	$ 9.71
Granted (in dollars per share)	30.44
Exercised (in dollars per share)	4.77
Forfeited (in dollars per share)	14.34
Expired (in dollars per share)	6.24
End of period, weighted average exercise price (in dollars per share)	$ 17.48	$ 9.71
Number of options vested (in shares)	615	607
Weighted average exercise price of options vested (in dollars per share)	$ 7.52	$ 4.80

OTHER ACCRUED LIABILITIES (Tables)

12 Months Ended

Dec. 31, 2020

Payables and Accruals [Abstract]

Schedule of other accrued liabilities

Other accrued liabilities consist of the following:


	December 31, 2020		December 31, 2019

Refunds payable	$	2,664	$	2,152
Deferred revenue	1,271		1,937
Resident deposits	5,647		6,292
Contract Liabilities (CARES Act advance payments)	22,771		—
Property taxes	982		1,130
Accrued insurance retention - current portion	1,354		—
Other	3,586		2,400
Other accrued liabilities	$	38,275	$	13,911

BUSINESS SEGMENTS

12 Months Ended

Dec. 31, 2020

Segment Reporting [Abstract]

Business segments

BUSINESS SEGMENTS

The Company classifies its operations into the following reportable operating segments: (1) home health and hospice services, which includes the Company’s home health, hospice and home care businesses; and (2) senior living services, which includes the operation of assisted living, independent living and memory care communities. The reporting segments are business units that offer different services and are managed separately to provide greater visibility into those operations. Our Chief Executive Officer and President, who is our Chief Operating Decision Maker “CODM”, reviews financial information at the operating segment level. We also report an “all other” category that includes general and administrative expense from our Service Center.

As of December 31, 2020, the Company provided services through 76 affiliated home health, hospice and home care agencies, and 54 affiliated senior living operations. The Company evaluates performance and allocates capital resources to each segment based on an operating model that is designed to maximize the quality of care provided and profitability. The Company’s Service Center provides various services to all lines of business. The Company does not review assets by segment and therefore assets by segment are not disclosed below.

Beginning in the third quarter of 2019, in anticipation of the Spin-Off, the GAAP segment measure of profit and loss was changed from Segment Income (Loss) Before Provision for Income Taxes to Adjusted Segment EBITDAR from Operations. Prior period presentation has been revised to reflect the new measurement.

The CODM uses Segment Adjusted EBITDAR from Operations as the primary measure of profit and loss for the Company's reportable segments and to compare the performance of its operations with those of its competitors. Segment Adjusted EBITDAR from Operations is net income/ (loss) attributable to the Company's reportable segments excluding interest expense, provision for income taxes, depreciation and amortization expense, rent, and, in order to view the operations performance on a comparable basis from period to period, certain adjustments including: (1) costs at start-up operations, (2) share-based compensation, (3) acquisition related costs, (4) Spin-Off transaction costs, (5) redundant and nonrecurring costs associated with the transition services agreement, (6) net income/ (loss) attributable to noncontrolling interest, and (7) net COVID-19 related costs. General and administrative expenses are not allocated to the reportable segments, and are included as “All Other”, accordingly the segment earnings measure reported is before allocation of corporate general and administrative expenses. The Company's segment measures may be different from the calculation methods used by other companies and, therefore, comparability may be limited.


	Home Health and Hospice Services		Senior Living Services		All Other		Total
Year Ended December 31, 2020
Revenue	$	253,659	$	137,294	$	—	$	390,953
Segment Adjusted EBITDAR from Operations	$	49,501	$	48,309	$	(22,762)	$	75,048
Year Ended December 31, 2019
Revenue	$	206,624	$	131,907	$	—	$	338,531
Segment Adjusted EBITDAR from Operations	$	33,354	$	47,344	$	(18,591)	$	62,107
Year Ended December 31, 2018
Revenue	$	169,037	$	117,021	$	—	$	286,058
Segment Adjusted EBITDAR from Operations	$	26,427	$	47,230	$	(16,191)	$	57,466

The table below provides a reconciliation of Segment Adjusted EBITDAR from Operations above to income from operations:


	Year Ended December 31,
	2020		2019		2018
Segment Adjusted EBITDAR from Operations	$	75,048	$	62,107	$	57,466
Less: Depreciation and amortization	4,675		3,810		2,964
Rent—cost of services	39,191		34,975		31,199
Other income	225		—		—
Adjustments to Segment EBITDAR from Operations:
Less: Costs at start-up operations(a)	1,787		483		129
Share-based compensation expense(b)	8,335		3,382		2,382
Acquisition related costs(c)	99		665		—
Spin-off related transaction costs(d)	—		13,219		756
Transition services costs(e)	1,181		532		—
COVID-19 Related costs and supplies(f)	447		—		—
Add: Net income/ (loss) attributable to noncontrolling interest	(191)		629		595
Consolidated and Combined Income from operations	$	18,917	$	5,670	$	20,631


(a)						Represents results related to start-up operations. This amount excludes rent and depreciation and amortization expense related to such operations.
(b)						Share-based compensation expense incurred which is included in cost of services and general and administrative expense.
(c)						Acquisition related costs that are not capitalizable.


(d)						Costs incurred related to the Spin-Off are included in general and administrative expense.
(e)						A portion of the costs incurred under the Transition Services Agreement (as defined in Note 3, Related Party Transactions and Net Parent Investment) identified as redundant or nonrecurring that are included in general and administrative expense. Transition service costs includes $446 of duplicative software expense for the year ended December 31, 2020, of which $333 pertains to the first three quarters of the fiscal year and were not included as adjustments in previous interim periods. Fees incurred under the Transition Services agreement, net of the Company’s payroll reimbursement, were $5,536, $2,982, and zero for the years ended December 31, 2020, 2019 and 2018, respectively.
(f)						Represents incremental costs incurred as part of the Company's response to COVID-19 including direct medical supplies, labor, and other expenses, net of $2,765 in increased revenue related to the 2% payment increase in Medicare reimbursements for sequestration relief for the year ended December 31, 2020.

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8924-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 34
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8981-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 21
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8721-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9031-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 26
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8844-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9038-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9054-108599

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 15
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8657-108599

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 21
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8721-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-URI http://asc.fasb.org/topic&trid=2134510

+ Details

REVENUE AND ACCOUNTS RECEIVABLE - ACCOUNTS RECEIVABLE (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Accounts Receivable [Abstract]
Accounts receivable, gross	$ 47,864	$ 32,860
Less: allowance for doubtful accounts	(643)	(677)
Accounts receivable, net	47,221	32,183
Medicare
Accounts Receivable [Abstract]
Accounts receivable, gross	28,569	17,822
Medicaid
Accounts Receivable [Abstract]
Accounts receivable, gross	7,669	6,579
Managed care
Accounts Receivable [Abstract]
Accounts receivable, gross	7,590	4,380
Private and other
Accounts Receivable [Abstract]
Accounts receivable, gross	$ 4,036	$ 4,079

INCOME TAXES - NARRATIVE (Details) - USD ($) shares in Thousands		12 Months Ended
	Oct. 01, 2019	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Nondeductible transaction costs	$ 10,300,000
The Ensign Plans
Operating Loss Carryforwards [Line Items]
Exercised (in shares)		(239)
Federal tax authority
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards		$ 500,000
Less: valuation allowance		$ 15