0001766400-23-000026 | 10-K | XBRL Viewer

GOODWILL AND INTANGIBLE ASSETS—NET

12 Months Ended

Dec. 31, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

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, 2022, 2021 and 2020.

The following table represents activity in goodwill by segment as of and for the year ended December 31, 2022:


	Home Health and Hospice Services		Senior Living Services		Total
December 31, 2020	$	62,802	$	3,642	$	66,444
Additions	7,821		—		7,821

December 31, 2021	70,623		3,642		74,265
Additions	5,232		—		5,232

December 31, 2022	$	75,855	$	3,642	$	79,497

Other indefinite-lived intangible assets consist of the following:


	December 31,
	2022		2021
Trade name	$	1,385	$	1,355
Medicare and Medicaid licenses	57,232		52,375
Total	$	58,617	$	53,730

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

12 Months Ended

Dec. 31, 2022

Accounting Policies [Abstract]

Summary of insurance liability

The following table presents details of the Company's general and professional liability and worker’s compensation, 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 $1,561 and $927 included in restricted and other assets for the years ended December 31, 2022 and 2021, respectively and $188 included in prepaid expenses and other current assets for the year ended December 31, 2022.


	December 31, 2022
	2022		2021
Type of Insurance
General and professional liability	$	3,690	$	2,007
Workers’ compensation	3,810		4,899
Total estimated liability	7,500		6,906
Less: long-term portion, included in other long-term liabilities	(5,748)		(5,293)
Current portion of estimated liability, included in other accrued liabilities	$	1,752	$	1,613

PROPERTY AND EQUIPMENT—NET

12 Months Ended

Dec. 31, 2022

Property, Plant and Equipment [Abstract]

PROPERTY AND EQUIPMENT—NET

Property and equipment, net consist of the following:


	December 31, 2021
	2022		2021
Land	$	96	$	—
Building	1,890		—
Leasehold improvements	18,759		11,660
Equipment	25,532		22,415
Furniture and fixtures	1,151		1,199
	47,428		35,274
Less: accumulated depreciation	(20,807)		(18,486)
Property and equipment, net	$	26,621	$	16,788

Depreciation expense was $4,856, $4,751 and $4,661 for the years ended December 31, 2022, 2021 and 2020, respectively.

The Company acquired one building and related assets during the year ended December 31, 2022 associated with an existing senior living community operation. The total acquisition price of the land, building and related equipment was $2,007.

Asset Impairment.

The Company measures certain assets at fair value on a non-recurring basis, including long-lived assets, which are evaluated for impairment. Long-lived assets include assets such as property and equipment, operating lease assets and certain intangible assets. The inputs used to determine the fair value of long-lived assets and a reporting unit are considered Level 3 measurements due to their subjective nature. Management has evaluated its long-lived assets and determined there were $218 and $2,835 for the years ended December 31, 2022 and 2021, respectively, in loss on asset dispositions and impairment, net in the consolidated statements of income.

COMPUTATION OF NET INCOME PER COMMON SHARE

12 Months Ended

Dec. 31, 2022

Earnings Per Share [Abstract]

COMPUTATION OF NET INCOME PER COMMON SHARE

COMPUTATION OF NET INCOME PER COMMON SHAREBasic net income per share is computed by dividing net income attributable to stockholders of the Company by the weighted average number of outstanding common shares for the period. The computation of diluted net income per share is similar to the computation of basic net income per share except that the denominator is increased to include the number of additional common shares that would have been outstanding if the dilutive potential common shares had been issued.

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


	Year Ended December 31,
	2022		2021		2020
Numerator:
Net income	$	7,243	$	2,148	$	15,553
Less: net income (loss) attributable to noncontrolling interests	600		(548)		(191)
Net income attributable to The Pennant Group, Inc.	$	6,643	$	2,696	$	15,744

Denominator:
Weighted average shares outstanding for basic net income per share	29,064		28,406		28,029
Plus: incremental shares from assumed conversion(a)	1,095		2,236		2,199
Adjusted weighted average common shares outstanding for diluted income per share	30,159		30,642		30,228

Earnings Per Share:
Basic net income per common share	$	0.23	$	0.09	$	0.56
Diluted net income per common share	$	0.22	$	0.09	$	0.52


(a)						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 1,860, 478, and 93 for the years ended December 31, 2022, 2021 and 2020, respectively.

LEASES - NARRATIVE (Details) $ in Thousands	12 Months Ended
LEASES - NARRATIVE (Details) $ in Thousands	Dec. 31, 2022 USD ($) agency property facility arrangement	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Apr. 01, 2022 lease
Lessee, Lease, Description [Line Items]
Non-cash adjustment to right-of-use assets and lease liabilities from lease modifications	$ 6,270	$ 4,674	$ 1,939
Weighted average remaining lease term	12 years 8 months 12 days
Weighted average discount rate	7.60%
Related party
Lessee, Lease, Description [Line Items]
Non-cash adjustment to right-of-use assets and lease liabilities from lease terminations and assignments	$ 42,506
Non-cash adjustment to right-of-use assets and lease liabilities from lease modifications	6,161
Related party \| Operating lease, rent expense
Lessee, Lease, Description [Line Items]
Fees incurred	$ 13,595	$ 12,773	$ 12,536
Senior Living Services
Lessee, Lease, Description [Line Items]
Number of properties under lease \| agency	49
Senior Living Services \| Related party
Lessee, Lease, Description [Line Items]
Number of operating facilities \| property	29
Number of properties under lease, master lease agreement \| facility	12
Number of separate master lease arrangements \| arrangement	2
Number of terminated leases under master lease agreement \| lease				4
Senior Living Services \| Minimum
Lessee, Lease, Description [Line Items]
Lease term	14 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	25 years
Senior Living Services \| Maximum \| Related party
Lessee, Lease, Description [Line Items]
Lease term	20 years
Home Health and Hospice Services
Lessee, Lease, Description [Line Items]
Number of service providers \| agency	95
Home Health and Hospice Services \| Minimum
Lessee, Lease, Description [Line Items]
Lease term	1 year
Home Health and Hospice Services \| Maximum
Lessee, Lease, Description [Line Items]
Lease term	11 years

BUSINESS SEGMENTS

12 Months Ended

Dec. 31, 2022

Segment Reporting [Abstract]

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, 2022, the Company provided services through 95 affiliated home health, hospice and home care agencies, and 49 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.

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 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 and credit allowances, (4) redundant and nonrecurring costs associated with the Transition Services Agreement, (5) loss related to senior living operations transferred to Ensign, (6) unusual or non-recurring charges, and (7) net income (loss) attributable to noncontrolling interest. 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.

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”.


	Home Health and Hospice Services		Senior Living Services		All Other		Total
Year Ended December 31, 2022
Revenue	$	342,249	$	130,992	$	—	$	473,241
Segment Adjusted EBITDAR from Operations	$	61,827	$	37,563	$	(31,435)	$	67,955
Year Ended December 31, 2021
Revenue	$	309,570	$	130,124	$	—	$	439,694
Segment Adjusted EBITDAR from Operations	$	55,565	$	37,517	$	(26,208)	$	66,874
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

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


	Year Ended December 31,
	2022		2021		2020
Segment Adjusted EBITDAR from Operations	$	67,955	$	66,874	$	75,048
Less: Depreciation and amortization	4,900		4,784		4,675
Rent—cost of services	38,018		40,863		39,191
Other income	(31)		(24)		225
Adjustments to Segment EBITDAR from Operations:
Less: Costs at start-up operations(a)	1,435		1,045		1,787
Share-based compensation expense(b)	3,363		10,040		8,335
Acquisition related costs and credit allowances(c)	731		80		99

Transition services costs(d)	77		2,008		1,181
COVID-19 Related costs and supplies(e)	—		—		447

Loss related to senior living operations transferred to Ensign(f)	6,103		2,835		—
Unusual or non-recurring charges (g)	1,220		—		—
Add: Net income (loss) attributable to noncontrolling interest	600		(548)		(191)
Consolidated Income from operations	$	12,739	$	4,695	$	18,917


(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 and related payroll taxes incurred, including the impact of the modification of certain restricted stock units described below in Note 12, Options and Awards, to the Consolidated Financial Statements. Share-based compensation expense and related payroll taxes are included in cost of services and general and administrative expense.
(c)						Non-capitalizable costs associated with acquisitions and credit allowances for amounts in dispute with the prior owners of certain acquired operations.

(d)						Costs identified as redundant or non-recurring incurred by the Company as a result of the Spin-off. The 2021 amounts represents part of the costs incurred under the Transition Services Agreement. All amounts are included in general and administrative expense. Fees incurred under the Transition Services Agreement were $1,561, $3,124, and $5,536 for the year ended December 31, 2022, 2021 and 2020, respectively.
(e)						Beginning in the first quarter of fiscal year 2021, we updated our definition of Segment Adjusted EBITDAR to no longer include an adjustment for COVID-19 expenses offset by the amount of sequestration relief. COVID-19 expenses continue to be part of daily operations for which less specific identification is visible. Furthermore, the sequestration relief was extended through December 31, 2021. Sequestration relief was $3,555 for the year ended December 31, 2021. The 2020 amount 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.

(f)						On January 27, 2022, affiliates of the Company, entered into certain operations transfer agreements (collectively, the “Transfer Agreements”) with affiliates of Ensign, providing for the transfer of the operations of certain senior living communities (the “Transaction”) from affiliates of the Company to affiliates of Ensign. The closing of the Transaction was completed in two phases with the transfer of two operations on March 1, 2022 and the remainder transferred on April 1, 2022. The amount includes $6,500 for the year ended December 31, 2022 to cover post-closing capital expenditures and operating losses related to one of the communities transferred on April 1, 2022. The amount above also includes an offset of $397 for the year ended December 31, 2022, for the related net impact on revenue and cost of service attributable to the transferred entities. This amount excludes rent and depreciation and amortization expense related to such operations. During year ended December 31, 2021, the Company impaired certain leasehold improvements included in property and equipment totaling $2,835 primarily related to the operations included in the transaction with Ensign.
(g)						Represents unusual or non-recurring charges for legal services, implementation costs, integration costs, and consulting fees including $958 in general and administrative expenses and $262 in cost of services for the year ended December 31, 2022.

- 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.

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+ Details

DEBT - NARRATIVE (Details) - USD ($)	Feb. 23, 2021	Dec. 31, 2022
Revolving credit facility
Debt Instrument [Line Items]
Borrowing capacity	$ 150,000,000
Revolving credit facility \| Line of credit
Debt Instrument [Line Items]
Weighted average interest rate		7.00%
Borrowing availability		$ 81,314,000
Revolving credit facility \| Minimum
Debt Instrument [Line Items]
Margin	0.35%
Revolving credit facility \| Minimum \| LIBOR
Debt Instrument [Line Items]
Margin	2.30%
Revolving credit facility \| Minimum \| Base Rate
Debt Instrument [Line Items]
Margin	1.30%
Revolving credit facility \| Maximum
Debt Instrument [Line Items]
Margin	0.50%
Revolving credit facility \| Maximum \| LIBOR
Debt Instrument [Line Items]
Margin	3.30%
Revolving credit facility \| Maximum \| Base Rate
Debt Instrument [Line Items]
Margin	2.30%
Letters of credit \| Line of credit
Debt Instrument [Line Items]
Letters of credit outstanding		$ 4,186,000

COMPUTATION OF NET INCOME PER COMMON SHARE (Tables)

12 Months Ended

Dec. 31, 2022

Earnings Per Share [Abstract]

Schedule 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,
	2022		2021		2020
Numerator:
Net income	$	7,243	$	2,148	$	15,553
Less: net income (loss) attributable to noncontrolling interests	600		(548)		(191)
Net income attributable to The Pennant Group, Inc.	$	6,643	$	2,696	$	15,744

Denominator:
Weighted average shares outstanding for basic net income per share	29,064		28,406		28,029
Plus: incremental shares from assumed conversion(a)	1,095		2,236		2,199
Adjusted weighted average common shares outstanding for diluted income per share	30,159		30,642		30,228

Earnings Per Share:
Basic net income per common share	$	0.23	$	0.09	$	0.56
Diluted net income per common share	$	0.22	$	0.09	$	0.52


(a)						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 1,860, 478, and 93 for the years ended December 31, 2022, 2021 and 2020, respectively.

BUSINESS SEGMENTS - FINANCIAL DATA (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Segment Reporting Information [Line Items]
Revenue	$ 473,241	$ 439,694	$ 390,953
Segment Adjusted EBITDAR from Operations	67,955	66,874	75,048
Senior Living Services
Segment Reporting Information [Line Items]
Revenue	130,992	130,124	137,294
Operating segments \| Home Health and Hospice Services
Segment Reporting Information [Line Items]
Revenue	342,249	309,570	253,659
Segment Adjusted EBITDAR from Operations	61,827	55,565	49,501
Operating segments \| Senior Living Services
Segment Reporting Information [Line Items]
Revenue	130,992	130,124	137,294
Segment Adjusted EBITDAR from Operations	37,563	37,517	48,309
All Other
Segment Reporting Information [Line Items]
Revenue	0	0	0
Segment Adjusted EBITDAR from Operations	$ (31,435)	$ (26,208)	$ (22,762)

- 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.

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+ Details

INCOME TAXES

12 Months Ended

Dec. 31, 2022

Income Tax Disclosure [Abstract]

INCOME TAXES

The provision for income tax expense for the years ended December 31, 2022, 2021 and 2020 is summarized as follows:


	Year Ended December 31,
	2022		2021		2020
Current:
Federal	$	(193)	$	1,768	$	5,058
State	146		566		1,478
Total current	(47)		2,334		6,536
Deferred:
Federal	1,334		(1,360)		(3,348)
State	362		(392)		(838)
Total deferred	1,696		(1,752)		(4,186)

Total income tax expense	$	1,649	$	582	$	2,350

A reconciliation of the federal statutory rate to the effective tax rate for income from continuing operations for the years ended December 31, 2022, 2021 and 2020, respectively, is comprised as follows:


	Year Ended December 31,
	2022		2021		2020
Income tax expense at statutory rate	21.0	%	21.0	%	21.0	%
State income taxes - net of federal benefit	4.7		3.9		2.7
Non-deductible meals and entertainment	0.6		1.8		0.3
Non-deductible equity compensation(a)	(6.1)		19.4		—
Section 162(m) limitation	0.6		2.1		—
Non-deductible accrued bonus	—		2.7		—
Other non-deductible expenses	0.2		0.7		0.1


Deductible equity compensation(b)	(0.8)		(34.1)		(10.8)
Noncontrolling interest	(1.7)		5.0		0.3
Other adjustments	—		(1.2)		(0.5)
Total income tax provision	18.5	%	21.3	%	13.1	%


(a)						During the year ended December 31, 2022, as a result of award modifications, approximately $2,567 of the share-based compensation expense related to restricted stock that originally did not result in a deferred tax asset because it would be subject to future limitation under IRC Section 162(m) resulted in a deferred tax asset.
(b)						During the year ended December 31, 2022, employees exercised stock options representing approximately 125 shares. During the year ended December 31, 2021, employees exercised stock options representing approximately 115 shares. During the year ended December 31, 2020, employees exercised stock options representing approximately 239 shares. These exercises and vestings resulted in tax benefits that reduced the Company's effective tax rate significantly in the years ended December 31, 2021 and December 31, 2020.

The Company’s deferred tax assets and liabilities for the years ended December 31, 2022 and 2021 are summarized below.


	Year Ended December 31,
	2022		2021
Deferred tax assets (liabilities):
Accrued compensation	$	7,681	$	6,402
Allowance for doubtful accounts	1,088		1,728
Net operating losses	2,537		—
Lease liabilities	68,676		79,575
Insurance	961		953
Other	1,564		3,427
Gross deferred tax assets	82,507		92,085
Less: valuation allowance	(29)		(25)
Net deferred tax assets	82,478		92,060
Depreciation and amortization	(11,618)		(8,432)
Prepaid expenses	(781)		(907)
Right of use asset	(67,765)		(78,656)
State taxes	(165)		(217)
Total deferred tax liabilities	(80,329)		(88,212)
Net deferred tax assets (liabilities)	$	2,149	$	3,848

As of December 31, 2022, the Company has federal and state net operating loss carryforwards available to offset future taxable income of $9,865 and $9,211, respectively. The federal net operating loss carryfoward does not expire, but is limited to 80% of taxable income in any given year. The state NOL carryforwards, if not utilized, will expire in years ending between December 31, 2027 and December 31, 2042. The Company believes that it is more likely than not that the benefit from

the state NOL carryforwards in certain jurisdictions where we do not file a consolidated return will not be realized. In recognition of this risk, as of December 31, 2022, the Company has provided a valuation allowance of $29 on the deferred tax assets related to these states for the tax effect of the NOL carryforwards that will not be realized.

A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows:


	Year Ended December 31,
	2022		2021		2020
Balance at January 1	$	65	$	—	$	—
Additions for tax positions of prior years	—		188		—
Reductions for tax positions related to the current year	(65)		(123)		—
Balance at December 31	$	—	$	65	$	—

None of unrecognized tax benefits net of their state benefits would affect the Company’s effective tax rate for the years ended December 31, 2022 and 2021. 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.

As of December 31, 2022, the Company is no longer subject to federal tax examinations for the fiscal years prior to 2019, and in most states, is no longer subject to state income tax examinations for fiscal years before 2018. The lapses for the years ended December 31, 2022 and 2021 had no impact on the Company’s unrecognized tax benefits.

On December 29, 2022, the Consolidated Appropriations Act, 2023 was enacted. Among other things, the Consolidated Appropriations Act, 2023 introduced certain retirement plan changes and some limited income tax changes. The Company does not anticipate the Consolidated Appropriations Act, 2023 will have any impact on the Company’s income taxes.

- 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

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Retained Earnings/ (Accumulated Deficit)	Treasury Stock	Non-Controlling Interest
Equity, beginning balance (in shares) at Dec. 31, 2019		28,435
Equity, beginning balance at Dec. 31, 2019	$ 71,111	$ 28	$ 74,882	$ (3,799)	$ 0	$ 0
Equity, beginning balance (in shares) at Dec. 31, 2019					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 (loss) attributable to Non-Controlling interests	(191)					(191)
Net income attributable to The Pennant Group, Inc.	15,744			15,744
Share-based compensation	8,335		8,335
Issuance of common stock from the exercise of stock options (in shares)		238
Issuance of common stock from the exercise of stock options	1,141		1,141
Net issuance of restricted stock (in shares)		26
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
Equity, ending balance at Dec. 31, 2020	101,172	$ 28	84,671	11,945	$ (65)	4,593
Equity, ending balance (in shares) at Dec. 31, 2020					3
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to Non-Controlling interests	(548)					(548)
Net income attributable to The Pennant Group, Inc.	2,696			2,696
Share-based compensation	10,040		10,040
Issuance of common stock from the exercise of stock options (in shares)		115
Issuance of common stock from the exercise of stock options	$ 884		884
Net issuance of restricted stock (in shares)		15
Equity, ending balance (in shares) at Dec. 31, 2021	28,499	28,826
Equity, ending balance at Dec. 31, 2021	$ 114,244	$ 28	95,595	14,641	$ (65)	4,045
Equity, ending balance (in shares) at Dec. 31, 2021	3				3
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss) attributable to Non-Controlling interests	$ 600					600
Net income attributable to The Pennant Group, Inc.	6,643			6,643
Share-based compensation	3,086		3,086
Issuance of common stock from the exercise of stock options (in shares)		125
Issuance of common stock from the exercise of stock options	$ 1,084	$ 1	1,083
Net issuance of restricted stock (in shares)		1,198
Equity, ending balance (in shares) at Dec. 31, 2022	29,692	30,149
Equity, ending balance at Dec. 31, 2022	$ 125,657	$ 29	$ 99,764	$ 21,284	$ (65)	$ 4,645
Equity, ending balance (in shares) at Dec. 31, 2022	3				3

COMMON STOCK REPURCHASE PROGRAM	12 Months Ended
COMMON STOCK REPURCHASE PROGRAM	Dec. 31, 2022
Equity [Abstract]
COMMON STOCK REPURCHASE PROGRAM	COMMON STOCK REPURCHASE PROGRAMOn December 12, 2022, the Board of the Directors of the Company approved a share repurchase program under which the Company may repurchase up to $1,000 of its common stock. Under the share repurchase program, the Company may repurchase shares from time to time through open market purchases, including through the use of trading plans intended to comply with Rule 10b5-1 under the Securities Exchange Act of 1934. The timing and total amount of stock repurchases will depend upon business, economic and market conditions, corporate and regulatory requirements, prevailing stock prices, and other considerations. The authorization expires on December 12, 2023, and may be suspended or discontinued at any time and does not obligate the company to acquire any amount of common stock. No shares were repurchased during the year ended December 31, 2022.

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

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+ Details

BUSINESS SEGMENTS - NARRATIVE (Details)	Dec. 31, 2022 agency
Home Health and Hospice Services
Segment Reporting Information [Line Items]
Number of service providers	95
Senior Living Services
Segment Reporting Information [Line Items]
Number of properties under lease	49

INCOME TAXES - TAX RATE RECONCILIATION (Details) - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Contingency [Line Items]
Income tax expense at statutory rate	21.00%	21.00%	21.00%
State income taxes - net of federal benefit	4.70%	3.90%	2.70%
Non-deductible meals and entertainment	0.60%	1.80%	0.30%
Non-deductible equity compensation	(6.10%)	19.40%	0.00%
Section 162(m) limitation	0.60%	2.10%	0.00%
Non-deductible accrued bonus	0.00%	2.70%	0.00%
Other non-deductible expenses	0.20%	0.70%	0.10%
Deductible equity compensation	(0.80%)	(34.10%)	(10.80%)
Noncontrolling interest	(1.70%)	5.00%	0.30%
Other adjustments	0.00%	(1.20%)	(0.50%)
Total income tax provision	18.50%	21.30%	13.10%
Share-based compensation	$ (3,086)	$ (10,040)	$ (8,335)
The Ensign Plans
Income Tax Contingency [Line Items]
Exercised (in shares)	125	115	239
Restricted stock awards
Income Tax Contingency [Line Items]
Share-based compensation	$ (2,567)

DEBT (Tables)

12 Months Ended

Dec. 31, 2022

Debt Disclosure [Abstract]

Schedule of long-term debt

Long-term debt, net consists of the following:


	December 31, 2022
	2022		2021
Revolving credit facility	$	64,500	$	53,500
Less: unamortized debt issuance costs(a)	(1,608)		(2,128)
Long-term debt, net	$	62,892	$	51,372


(a)						Amortization expense for debt issuance costs was $520, $488, and $330 for the years ended December 31, 2022, 2021 and 2020, respectively, and is recorded in interest expense, net on the consolidated statements of income.

- 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.

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+ Details

DESCRIPTION OF BUSINESS (Details)	Dec. 31, 2022 agency
Home Health and Hospice Services
Segment Reporting Information [Line Items]
Number of service providers	95
Senior Living Services
Segment Reporting Information [Line Items]
Number of properties under lease	49

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - SUMMARY OF INSURANCE LIABILITY (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
General and professional liability	$ 3,690	$ 2,007
Workers’ compensation	3,810	4,899
Total estimated liability	7,500	6,906
Less: long-term portion, included in other long-term liabilities	(5,748)	(5,293)
Current portion of estimated liability, included in other accrued liabilities	$ 1,752	$ 1,613

DEBT

12 Months Ended

Dec. 31, 2022

Debt Disclosure [Abstract]

DEBT

Long-term debt, net consists of the following:


	December 31, 2022
	2022		2021
Revolving credit facility	$	64,500	$	53,500
Less: unamortized debt issuance costs(a)	(1,608)		(2,128)
Long-term debt, net	$	62,892	$	51,372


(a)						Amortization expense for debt issuance costs was $520, $488, and $330 for the years ended December 31, 2022, 2021 and 2020, respectively, and is recorded in interest expense, net on the consolidated statements of income.

On February 23, 2021, Pennant entered into an amendment to its existing credit agreement (as amended, the “Credit Agreement”), which provides for an increased revolving credit facility with a syndicate of banks with a borrowing capacity of $150,000 (the “Revolving Credit Facility”). The interest rates applicable to loans under the Revolving Credit Facility are, at the Company’s election, either (i) Adjusted LIBOR (as defined in the 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 Credit Agreement). In addition, Pennant pays a commitment fee on the undrawn portion of the commitments under the Revolving Credit Facility which ranges 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 Credit Agreement prior to maturity in 2026, other than to the extent the outstanding borrowings exceed the aggregate commitments under the Credit Agreement. As of December 31, 2022, the Company’s weighted average interest rate on its outstanding debt was 7.0%. As of December 31, 2022, the Company had available borrowing on the Revolving Credit Facility of $81,314, which is net of outstanding letters of credit of $4,186.

The fair value of the 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 independent operating 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, 2022, the Company was compliant with all such financial covenants.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-URI https://asc.fasb.org/topic&trid=2208564

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (h)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (c)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1I
-Subparagraph (d)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 6: 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(c))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (g)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1C
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Paragraph 1C
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-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495334-112611

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
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-Section 50
-Paragraph 1I
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495371-112611

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 20
-Section 50
-Paragraph 1B
-Subparagraph (i)
-URI https://asc.fasb.org/extlink&oid=123466505&loc=SL123495323-112611

+ Details

TRANSACTIONS WITH ENSIGN	12 Months Ended
TRANSACTIONS WITH ENSIGN	Dec. 31, 2022
Related Party Transactions [Abstract]
TRANSACTIONS WITH ENSIGN	TRANSACTIONS WITH ENSIGN On October 1, 2019, The Ensign Group, Inc. (“Ensign”) completed the separation of Pennant (the “Spin-Off”). 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 to govern the relationship of the parties following the Spin-Off. The Transitions Services Agreement with Ensign (the “Transition Services Agreement”) primarily provided Pennant with administrative support. The Transitions Services Agreement expired two years after the Spin-Off date. The Company has incurred $1,561, $3,124, and $5,536 in costs related to the Transitions Services Agreement for the years ended December 31, 2022, 2021 and 2020, respectively that related primarily to shared administrative support and other services at proximate operations. Services included in cost of services were $3,211, $3,084, and $4,205 for the years ended December 31, 2022, 2021 and 2020, respectively. that related primarily to room and board charges at skilled nursing facilities for hospice patients. Additionally, the Company’s independent operating subsidiaries leased 29 of its senior living communities from subsidiaries of Ensign under a master lease arrangement as of year ended December 31, 2022. See further discussion below at Note 13., Leases. On January 27, 2022, affiliates of the Company, entered into certain operations transfer agreements (collectively, the “Transfer Agreements”) with affiliates of Ensign, providing for the transfer of the operations of five senior living communities (the “Transaction”). The Transfer Agreements require one of the transferors to place $6,500 in escrow to cover post-closing capital expenditures and operating losses related to one of the communities, and such escrow was funded by an initial payment by the transferor at closing followed by eight equal monthly installments. The Transaction closed in April 2022. As of December 31, 2022 all payments to the escrow account were completed and the $6,500 was included in loss on asset dispositions and impairment, net.

OTHER ACCRUED LIABILITIES

12 Months Ended

Dec. 31, 2022

Payables and Accruals [Abstract]

OTHER ACCRUED LIABILITIES

Other accrued liabilities consist of the following:


	December 31, 2022		December 31, 2021
Refunds payable	$	2,244	$	3,095
Deferred revenue	1,592		1,456
Resident deposits	4,315		5,111
Contract liabilities (CARES Act advance payments)	—		6,211
Property taxes	1,027		1,102
Deferred state relief funds	1,479		—
Accrued self-insurance liabilities	3,546		1,613
Other	2,481		2,896
Other accrued liabilities	$	16,684	$	21,484

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. Deferred state relief funds are relief funds we have received from various states that we will offset against future related expenses.

OPTIONS AND AWARDS - OPTIONS GRANTED (Details) - The Ensign Plans - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)	448
2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)	448
Weighted average fair value of options (in dollars per share)	$ 6.35
2022 \| Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-Free Interest Rate	2.70%
Expected life	6 years 6 months
Expected volatility	39.80%
Dividend Yield	0.00%
2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)		454
Weighted average fair value of options (in dollars per share)		$ 13.84
2021 \| Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-Free Interest Rate		1.10%
Expected life		6 years 6 months
Expected volatility		38.40%
Dividend Yield		0.00%
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]
Risk-Free Interest Rate			0.50%
Expected life			6 years 6 months
Expected volatility			35.90%
Dividend Yield			0.00%

OPTIONS AND AWARDS (Tables)

12 Months Ended

Dec. 31, 2022

Share-Based Payment Arrangement [Abstract]

Schedule of total share-based compensation expense

Total share-based compensation expense for all of the Plans for the years ended December 31, 2022, 2021 and 2020:


	Year Ended December 31,
	2022		2021		2020
Share-based compensation expense related to stock options	3,266		3,093		1,660
Share-based compensation expense related to Restricted Stock	(467)		6,141		6,200
Share-based compensation expense related to Restricted Stock to non-employee directors	287		806		475
Total share-based compensation	$	3,086	$	10,040	$	8,335

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, 2022:


	Unrecognized Compensation Expense		Weighted Average Recognition Period (in years)
Unvested stock options	$	10,005	3.3
Unvested Restricted Stock	3,126		4.5
Total unrecognized share-based compensation expense	$	13,131

Schedule of 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
2022	448	2.7	%	6.5	39.8	%	—	%	$	6.35
2021	454	1.1	%	6.5	38.4	%	—	%	$	13.84
2020	693	0.5	%	6.5	35.9	%	—	%	$	11.05


(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.

Schedule of employee stock option activity

The following table represents the employee stock option activity during the year ended December 31, 2022:


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




December 31, 2021	2,242	$	21.38	840	$	12.28
Granted	448	$	14.39
Exercised	(125)	$	8.69
Forfeited	(245)	$	23.54
Expired	(101)	$	14.03
December 31, 2022	2,219	$	20.76	973	$	16.90

Schedule of 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, 2022 is as follows:


Options	December 31, 2022
Outstanding	$	2,049
Vested	1,971
Unvested	78
Exercised	902

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, 2022, is presented below:


	Non-Vested Restricted Awards	Weighted Average Grant Date Fair Value
December 31, 2021	1,493	$	15.00
Granted	281	13.55
Vested	(1,079)	14.92
Forfeited	(277)	14.93
December 31, 2022	418	$	14.26

INCOME TAXES (Tables)

12 Months Ended

Dec. 31, 2022

Income Tax Disclosure [Abstract]

Schedule of provision for income taxes on continuing operations

The provision for income tax expense for the years ended December 31, 2022, 2021 and 2020 is summarized as follows:


	Year Ended December 31,
	2022		2021		2020
Current:
Federal	$	(193)	$	1,768	$	5,058
State	146		566		1,478
Total current	(47)		2,334		6,536
Deferred:
Federal	1,334		(1,360)		(3,348)
State	362		(392)		(838)
Total deferred	1,696		(1,752)		(4,186)

Total income tax expense	$	1,649	$	582	$	2,350

Reconciliation of federal statutory rate to effective tax rate


	Year Ended December 31,
	2022		2021		2020
Income tax expense at statutory rate	21.0	%	21.0	%	21.0	%
State income taxes - net of federal benefit	4.7		3.9		2.7
Non-deductible meals and entertainment	0.6		1.8		0.3
Non-deductible equity compensation(a)	(6.1)		19.4		—
Section 162(m) limitation	0.6		2.1		—
Non-deductible accrued bonus	—		2.7		—
Other non-deductible expenses	0.2		0.7		0.1


Deductible equity compensation(b)	(0.8)		(34.1)		(10.8)
Noncontrolling interest	(1.7)		5.0		0.3
Other adjustments	—		(1.2)		(0.5)
Total income tax provision	18.5	%	21.3	%	13.1	%


(a)						During the year ended December 31, 2022, as a result of award modifications, approximately $2,567 of the share-based compensation expense related to restricted stock that originally did not result in a deferred tax asset because it would be subject to future limitation under IRC Section 162(m) resulted in a deferred tax asset.
(b)						During the year ended December 31, 2022, employees exercised stock options representing approximately 125 shares. During the year ended December 31, 2021, employees exercised stock options representing approximately 115 shares. During the year ended December 31, 2020, employees exercised stock options representing approximately 239 shares. These exercises and vestings resulted in tax benefits that reduced the Company's effective tax rate significantly in the years ended December 31, 2021 and December 31, 2020.

Schedule of deferred tax assets and liabilities

The Company’s deferred tax assets and liabilities for the years ended December 31, 2022 and 2021 are summarized below.


	Year Ended December 31,
	2022		2021
Deferred tax assets (liabilities):
Accrued compensation	$	7,681	$	6,402
Allowance for doubtful accounts	1,088		1,728
Net operating losses	2,537		—
Lease liabilities	68,676		79,575
Insurance	961		953
Other	1,564		3,427
Gross deferred tax assets	82,507		92,085
Less: valuation allowance	(29)		(25)
Net deferred tax assets	82,478		92,060
Depreciation and amortization	(11,618)		(8,432)
Prepaid expenses	(781)		(907)
Right of use asset	(67,765)		(78,656)
State taxes	(165)		(217)
Total deferred tax liabilities	(80,329)		(88,212)
Net deferred tax assets (liabilities)	$	2,149	$	3,848

Schedule of unrecognized tax benefits

A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows:


	Year Ended December 31,
	2022		2021		2020
Balance at January 1	$	65	$	—	$	—
Additions for tax positions of prior years	—		188		—
Reductions for tax positions related to the current year	(65)		(123)		—
Balance at December 31	$	—	$	65	$	—

COMMITMENTS AND CONTINGENCIES (Details) $ in Thousands		1 Months Ended	12 Months Ended
COMMITMENTS AND CONTINGENCIES (Details) $ in Thousands	May 02, 2022 agency	May 31, 2022 USD ($)	Dec. 31, 2022 USD ($) review
Concentration Risk [Line Items]
Number of operating subsidiaries with reviews scheduled \| review			8
Sampled and extrapolated overpayments		$ 5,134	$ 5,134
Number of patient records under review \| agency	107
Period of review	10 months
General and professional liability, retention limit			150
Out-of-pocket retention			500
Workers' compensation, retention limit			250
Maximum
Concentration Risk [Line Items]
Self insurance, individual coverage limit			$ 325

COMMON STOCK REPURCHASE PROGRAM (Details) - Stock Repurchase Program - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 12, 2022
Equity, Class of Treasury Stock [Line Items]
Stock repurchased (in shares)	0
Common stock
Equity, Class of Treasury Stock [Line Items]
Stock repurchased authorize amount		$ 1,000,000

PROPERTY AND EQUIPMENT—NET (Tables)

12 Months Ended

Dec. 31, 2022

Property, Plant and Equipment [Abstract]

Schedule of property and equipment, net

Property and equipment, net consist of the following:


	December 31, 2021
	2022		2021
Land	$	96	$	—
Building	1,890		—
Leasehold improvements	18,759		11,660
Equipment	25,532		22,415
Furniture and fixtures	1,151		1,199
	47,428		35,274
Less: accumulated depreciation	(20,807)		(18,486)
Property and equipment, net	$	26,621	$	16,788

GOODWILL AND INTANGIBLE ASSETS—NET - INDEFINITE-LIVED INTANGIBLE ASSETS (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Indefinite-lived Intangible Assets [Line Items]
Other indefinite-lived intangibles	$ 58,617	$ 53,730
Trade name
Indefinite-lived Intangible Assets [Line Items]
Other indefinite-lived intangibles	1,385	1,355
Medicare and Medicaid licenses
Indefinite-lived Intangible Assets [Line Items]
Other indefinite-lived intangibles	$ 57,232	$ 52,375

REVENUE AND ACCOUNTS RECEIVABLE

12 Months Ended

Dec. 31, 2022

Revenue from Contract with Customer [Abstract]

REVENUE AND ACCOUNTS RECEIVABLE

Revenue is 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 managed care programs (Commercial, Medicare Advantage and Managed Medicaid plans), in exchange for providing patient care. 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 62.3%, 62.6%, and 60.1% of the Company’s revenue for the years ended December 31, 2022, 2021 and 2020, 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 below.

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

Home Health Revenue

Medicare Revenue

Net service revenue is recognized in accordance with the Patient Driven Groupings Model (“PDGM”). 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 low utilization payment adjustment 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.

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 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 Medicare 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, 2022, 2021 and 2020, is summarized in the following tables:


	Year Ended December 31, 2022
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	91,415	$	140,338	$	—	$	231,753	49.0	%
Medicaid	9,749		15,568		37,617		62,934		13.3
Subtotal	101,164		155,906		37,617		294,687		62.3
Managed care	57,824		4,277		—		62,101		13.1
Private and other(a)	22,741		337		93,375		116,453		24.6
Total revenue	$	181,729	$	160,520	$	130,992	$	473,241	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, 2021
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	80,849	$	135,939	$	—	$	216,788	49.3	%
Medicaid	8,935		12,103		37,317		58,355		13.3
Subtotal	89,784		148,042		37,317		275,143		62.6
Managed care	46,167		3,196		—		49,363		11.2
Private and other(a)	22,007		374		92,807		115,188		26.2
Total revenue	$	157,958	$	151,612	$	130,124	$	439,694	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, 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.

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.

Accounts receivable as of December 31, 2022 and December 31, 2021 is summarized in the following table:


	December 31, 2022		December 31, 2021
Medicare	$	31,321	$	31,327
Medicaid	10,700		11,793
Managed care	9,370		7,901
Private and other	2,621		3,821
Accounts receivable, gross	54,012		54,842
Less: allowance for doubtful accounts	(592)		(902)
Accounts receivable, net	$	53,420	$	53,940

The following table summarizes the activity for our allowance for doubtful accounts for the years ended December 31, 2022, 2021 and 2020:


	Year Ended December 31,
	2022		2021		2020
Balance at beginning of period	$	902	$	643	$	677
Additions to bad debt expense	881		616		560
Write-offs of uncollectible accounts	(1,191)		(357)		(594)
Balance at end of period	$	592	$	902	$	643

Concentrations- Credit Risk

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 77.8% and 78.6% of its total gross accounts receivable as of December 31, 2022 and December 31, 2021, respectively. Revenue from reimbursement under the Medicare and Medicaid programs accounted for 62.3%, 62.6%, and 60.1% of the Company's revenue for the years ended December 31, 2022, 2021 and 2020, respectively.

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities:
Net income	$ 7,243	$ 2,148	$ 15,553
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Depreciation and amortization	4,900	4,784	4,675
Amortization of deferred financing fees	520	488	330
Provision for doubtful accounts	881	616	560
Share-based compensation	3,086	10,040	8,335
Deferred income taxes	1,700	(1,752)	(2,201)
Impairment of long-lived assets	218	2,835	0
Change in operating assets and liabilities:
Accounts receivable	(361)	(7,335)	(15,712)
Prepaid expenses and other assets	(7,426)	(4,624)	(7,435)
Operating lease obligations	(67)	803	2,068
Accounts payable	2,368	562	993
Accrued wages and related liabilities	(197)	(3,864)	10,538
Other accrued liabilities	1,856	2,570	2,427
Advance payments	(6,211)	(21,786)	27,997
Other long-term liabilities	534	(3,708)	2,076
Net cash provided by (used in) operating activities	9,044	(18,223)	50,204
Cash flows from investing activities:
Purchase of property and equipment	(14,170)	(6,303)	(7,253)
Cash payments for business acquisitions	(10,130)	(13,550)	(33,193)
Escrow deposits	(49)	0	(525)
Restricted and other assets	110	(267)	(645)
Net cash used in investing activities	(24,239)	(20,120)	(41,616)
Cash flows from financing activities:
Sale of noncontrolling interest	0	0	555
Proceeds from revolver agreement	129,500	125,500	52,700
Payments on revolver agreement	(118,500)	(81,500)	(63,200)
Repurchase of shares of common stock to satisfy tax withholding obligations	0	0	(65)
Payments for deferred financing costs	0	(1,394)	(78)
Issuance of common stock upon the exercise of options	1,084	884	1,141
Net cash provided by (used in) financing activities	12,084	43,490	(8,947)
Net increase (decrease) in cash	(3,111)	5,147	(359)
Cash beginning of period	5,190	43	402
Cash end of period	2,079	5,190	43
Cash paid during the period for:
Interest	3,027	1,448	1,116
Income taxes	99	2,616	7,865
Operating lease liabilities	35,994	39,151	35,853
Right-of-use assets obtained in exchange for new operating lease obligations	12,645	3,230	5,451
Non-cash adjustment to right-of-use assets and lease liabilities from lease modifications	6,270	4,674	1,939
Non-cash adjustment to right-of-use assets and lease liabilities from lease terminations and assignments	(43,136)	0	0
Non-cash investing activity:
Capital expenditures in accounts payable	$ 1,280	$ 730	$ 560

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - NARRATIVE (Details)	12 Months Ended
	Dec. 31, 2022 USD ($) community	Dec. 31, 2021 USD ($) community	Dec. 31, 2020 USD ($)
Unusual or Infrequent Item, or Both [Line Items]
Impairment of long-lived assets	$ 218,000	$ 2,835,000	$ 0
Number of communities impaired \| community	6	6
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
Reinsurance receivables	1,561,000	927,000
Individual stop-loss insurance coverage	325,000
Medical benefits liability	1,794,000
Share-based compensation	3,086,000	10,040,000	8,335,000
General and administrative expense
Unusual or Infrequent Item, or Both [Line Items]
Share-based compensation	647,000	$ 7,964,000	7,222,000
Prepaid Expenses and Other Current Assets
Unusual or Infrequent Item, or Both [Line Items]
Reinsurance receivables	$ 188,000
Minimum
Unusual or Infrequent Item, or Both [Line Items]
Property and equipment estimated useful lives	3 years
Maximum
Unusual or Infrequent Item, or Both [Line Items]
Property and equipment estimated useful lives	40 years
CARES Act
Unusual or Infrequent Item, or Both [Line Items]
Accrued payroll taxes employer portion	$ 7,836,000
The coronavirus aid, relief, and economic security act, advance payments received			$ 27,997,000

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Current assets:
Cash	$ 2,079	$ 5,190
Accounts receivable—less allowance for doubtful accounts of $592 and $902, respectively	53,420	53,940
Prepaid expenses and other current assets	18,323	16,711
Total current assets	73,822	75,841
Property and equipment, net	26,621	16,788
Right-of-use assets	260,868	300,997
Deferred tax assets, net	2,149	3,848
Restricted and other assets	10,545	4,828
Goodwill	79,497	74,265
Other indefinite-lived intangibles	58,617	53,730
Total assets	512,119	530,297
Current liabilities:
Accounts payable	13,647	10,553
Accrued wages and related liabilities	23,283	23,480
Operating lease liabilities—current	16,633	16,118
Other accrued liabilities	16,684	21,484
Total current liabilities	70,247	71,635
Long-term operating lease liabilities—less current portion	247,042	287,753
Other long-term liabilities	6,281	5,293
Long-term debt, net	62,892	51,372
Total liabilities	386,462	416,053
Commitments and contingencies
Equity:
Common stock, $0.001 par value; 100,000 shares authorized; 30,149 and 29,692 shares issued and outstanding at December 31, 2022, respectively, and 28,826 and 28,499 shares issued and outstanding at December 31, 2021, respectively	29	28
Additional paid-in capital	99,764	95,595
Retained earnings	21,284	14,641
Treasury stock, at cost, 3 shares at December 31, 2022 and 2021	(65)	(65)
Total Pennant Group, Inc. stockholders' equity	121,012	110,199
Noncontrolling interest	4,645	4,045
Total equity	125,657	114,244
Total liabilities and equity	$ 512,119	$ 530,297

COMMITMENTS AND CONTINGENCIES	12 Months Ended
COMMITMENTS AND CONTINGENCIES	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES Regulatory Matters - The Company provides services in complex and highly regulated industries. The Company’s compliance with applicable U.S. 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 and penalties subject to appeal may remain in place during such appeals. The Department of Justice, 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, may propose future cost-containment measures, 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 consolidated 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, and professional negligence, 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 may 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, for which 18 states have qualified, including California and Texas, where we conduct business. 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 conducts business. Under the Fraud Enforcement and Recovery Act (“FERA”) and its associated rules, healthcare providers face significant penalties for the knowing retention of government overpayments, even if no false claim was involved. Providers have an obligation to proactively exercise “reasonable diligence” to identify overpayments and return those overpayments to CMS within 60 days of “identification” or the date any corresponding cost report is due, whichever is later. Retention of overpayments beyond this period may create liability under the FCA. In addition, FERA protects whistleblowers (including employees, contractors, and agents) from retaliation. 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, 2022, eight of the Company’s independent operating subsidiaries had Reviews scheduled, on appeal or in dispute resolution process, both pre- and post-payment. 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. The Company, from time to time, receives record requests in Reviews which have resulted in claim denials on paid claims. The Company has appealed substantially all denials arising from these Reviews using the applicable appeals process. As of December 31, 2022, 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. The Company cannot predict the ultimate outcome of any regulatory and other governmental Reviews. While such reviews are the subject of administrative appeals, the appeals process, even if successful, may take several years to resolve. The costs to respond to and defend such Reviews may be significant and an adverse determination in such reviews may subject the Company to sanctions, damages, extrapolation of damage findings, additional recoupments, fines, other penalties (some of which may not be covered by insurance), and termination from Medicare programs which may, either individually or in the aggregate, have a material adverse effect on the Company's business and financial condition. From June 2021 to May 2022, one hospice provider number was subject to a Medicare payment suspension imposed by a UPIC. As of December 31, 2022, the total amount due from the government payor impacted by the suspension was $5,134 and was recorded in long-term other assets. In May 2022, the Company received communication that the Medicare payment suspension was terminated and the UPIC’s review was complete. The UPIC reviewed 107 patient records covering a 10-month period to determine whether, in its view, a Medicare overpayment was made. Based on the results of the review, the UPIC has alleged sampled and extrapolated overpayments of $5,134, and has withheld that amount through recoupment of Medicare payments. The Company is pursuing its appeal rights through the administrative appeals process, including contesting the methodology used by the UPIC to perform statistical extrapolation. At this stage of the review, based on the information currently available to the Company, the Company cannot predict the timing or the ultimate outcome of this review. As of December 31, 2022, we have an accrued liability that is immaterial for this Review which was recorded as an offset to revenue. Insurance - The Company retains risk for a substantial portion of potential claims for general and professional liability, workers’ compensation and automobile liability. 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. 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, Washington and Wyoming which are subject to state insurance and possess their own limits. Effective January 1, 2022, the Company is self-insured for claims related to employee health, dental, and vision care. To protect itself against loss exposure, the Company has purchased individual stop-loss insurance coverage that insures individual health claims that exceed $325 for each covered person for fiscal year 2022.

REVENUE AND ACCOUNTS RECEIVABLE - NARRATIVE (Details)	12 Months Ended
REVENUE AND ACCOUNTS RECEIVABLE - NARRATIVE (Details)	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
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 \| Medicare And Medicaid
Disaggregation of Revenue [Line Items]
Revenue %	62.30%	62.60%	60.10%
Customer concentration risk \| Receivables \| Medicare And Medicaid
Disaggregation of Revenue [Line Items]
Revenue %	77.80%	78.60%

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

12 Months Ended

Dec. 31, 2022

Accounting Policies [Abstract]

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Basis of Presentation - The accompanying consolidated financial statements of the Company (the “Financial Statements”) reflect the Company’s financial position for the years ended December 31, 2022 and 2021, and the Company’s results of operations and cash flows for the years ended December 31, 2022, 2021 and 2020 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”). The Company presents noncontrolling interests within the equity section of its consolidated balance sheets and the amount of consolidated net income (loss) that is attributable to The Pennant Group, Inc. and the noncontrolling interest in its consolidated statements of income.

All intercompany transactions and balances between the various legal entities comprising the Company have been eliminated in consolidation. The consolidated 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 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 self-insurance reserves, revenue, intangible assets and goodwill, right-of-use assets and lease liabilities for leases greater than 12 months, 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 effect net service revenue in the period such variances become known.

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. 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. The CARES Act allowed 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. The Company deferred approximately $7,836 of employer-paid portion of social security tax, all of which was repaid as of December 31, 2022. 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 2020, the Company applied for and received $27,997 in funds under the Accelerated and Advance Payment (“AAP”) Program, all of which was recouped as of June 23, 2022.

Cash - Cash consists of petty cash and bank deposits and therefore approximates fair value. The Company places its cash with high credit quality financial institutions.

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. 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 40 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 evaluated its long-lived assets and the Company identified $218 and $2,835 in long-lived asset impairments related to six senior living communities for the years ended December 31, 2022 and 2021, respectively. Management did not identify any asset impairment during the year ended December 31, 2020. See further discussion at Note 8, Property and Equipment, Net.

Intangible Assets and Goodwill - 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 indefinite-lived intangible asset impairment during the years ended December 31, 2022, 2021 and 2020.

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, 2022, we evaluated potential triggering events that might be indicators that our goodwill and indefinite lived intangibles were impaired. As a result of our evaluation, no goodwill or indefinite intangible asset impairments were recorded during the years ended December 31, 2022, 2021 and 2020. See further discussion at Note 9, Goodwill and Intangible Assets, Net.

Self-Insurance Reserve - The Company retains risk for a substantial portion of potential claims for general and professional liability and workers’ compensation. 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. The Company evaluates the adequacy of the self insurance reserves in conjunction with an independent actuarial assessment. As of December 31, 2022 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, Washington, and Wyoming 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.


	December 31, 2022
	2022		2021
Type of Insurance
General and professional liability	$	3,690	$	2,007
Workers’ compensation	3,810		4,899
Total estimated liability	7,500		6,906
Less: long-term portion, included in other long-term liabilities	(5,748)		(5,293)
Current portion of estimated liability, included in other accrued liabilities	$	1,752	$	1,613

Beginning on January 1, 2022 the Company transitioned its employee health plans to a self insurance model. Prior to that date the Company did not retain risk related to its employee health plans. The Company self-funds medical, including prescription drugs, dental healthcare, and vision benefits for its employees. The Company is fully liable for all financial and legal aspects of these benefit plans. To protect itself against loss exposure with this policy,the Company has purchased individual stop-loss insurance coverage that insures individual claims that exceed $325 for each covered person for fiscal 2022. As of December 31, 2022 our medical benefits liability was $1,794 recorded as a component of other accrued liabilities.

Fair Value of Financial Instruments - The Company’s financial instruments consist principally of cash, accounts receivable, accounts payable, accrued liabilities, and debt. 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 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 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 and restricted stock, 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 $3,086, $10,040, and $8,335 for the years ended December 31, 2022, 2021 and 2020, respectively, of which $647, $7,964 and $7,222, respectively, was recorded in general and administrative expense, with the difference being recorded in cost of services. For further discussion see Note 12, Options and Awards.

PROPERTY AND EQUIPMENT—NET (Details) $ in Thousands	12 Months Ended
PROPERTY AND EQUIPMENT—NET (Details) $ in Thousands	Dec. 31, 2022 USD ($) building	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 47,428	$ 35,274
Less: accumulated depreciation	(20,807)	(18,486)
Property and equipment, net	26,621	16,788
Depreciation	$ 4,856	4,751	$ 4,661
Number of building acquired \| building	1
Real estate and personal property acquired	$ 2,007
Impairment of long-lived assets	218	2,835	$ 0
Land
Property, Plant and Equipment [Line Items]
Property and equipment, gross	96	0
Building
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,890	0
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	18,759	11,660
Equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	25,532	22,415
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,151	$ 1,199

COVER - USD ($)	12 Months Ended
COVER - USD ($)	Dec. 31, 2022	Feb. 22, 2023	Jun. 30, 2022
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2022
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	false
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		29,705,640
Entity Public Float			$ 361,547,000
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 2023 Annual Meeting of Stockholders to be filed within 120 days after the close of the fiscal year covered by this annual report.
Entity Central Index Key	0001766400
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	FY
Amendment Flag	false

DEBT - SCHEDULE OF LONG-TERM DEBT (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Less: unamortized debt issuance costs	$ (1,608)	$ (2,128)
Long-term debt, net	62,892	51,372
Amortization of deferred financing fees	520	488	$ 330
Revolving credit facility \| Line of credit
Debt Instrument [Line Items]
Revolving credit facility	$ 64,500	$ 53,500

- Definition

Amount, excluding unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Statement [Abstract]
Revenue	$ 473,241	$ 439,694	$ 390,953
Expense:
Cost of services	376,638	350,236	296,874
Rent—cost of services	38,018	40,863	39,191
General and administrative expense	33,981	36,259	31,296
Depreciation and amortization	4,900	4,784	4,675
Loss on asset dispositions and impairment, net	6,965	2,857	0
Total expenses	460,502	434,999	372,036
Income from operations	12,739	4,695	18,917
Other (expense) income:
Other (expense) income	(31)	(24)	225
Interest expense, net	(3,816)	(1,941)	(1,239)
Other expense, net	(3,847)	(1,965)	(1,014)
Income before provision for income taxes	8,892	2,730	17,903
Provision for income taxes	1,649	582	2,350
Net income	7,243	2,148	15,553
Less: net income (loss) attributable to noncontrolling interest	600	(548)	(191)
Net income and other comprehensive income attributable to The Pennant Group, Inc.	$ 6,643	$ 2,696	$ 15,744
Earnings per share:
Basic (in dollars per share)	$ 0.23	$ 0.09	$ 0.56
Diluted (in dollars per share)	$ 0.22	$ 0.09	$ 0.52
Weighted average common shares outstanding:
Basic (in shares)	29,064	28,406	28,029
Diluted (in shares)	30,159	30,642	30,228

REVENUE AND ACCOUNTS RECEIVABLE - ALLOWANCE FOR DOUBTFUL ACCOUNTS (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Balance at beginning of period	$ 902	$ 643	$ 677
Additions to bad debt expense	881	616	560
Write-offs of uncollectible accounts	(1,191)	(357)	(594)
Balance at end of period	$ 592	$ 902	$ 643

BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Basis of Presentation	The accompanying consolidated financial statements of the Company (the “Financial Statements”) reflect the Company’s financial position for the years ended December 31, 2022 and 2021, and the Company’s results of operations and cash flows for the years ended December 31, 2022, 2021 and 2020 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”). The Company presents noncontrolling interests within the equity section of its consolidated balance sheets and the amount of consolidated net income (loss) that is attributable to The Pennant Group, Inc. and the noncontrolling interest in its consolidated statements of income.
Consolidation	All intercompany transactions and balances between the various legal entities comprising the Company have been eliminated in consolidation. The consolidated 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 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 self-insurance reserves, revenue, intangible assets and goodwill, right-of-use assets and lease liabilities for leases greater than 12 months, 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 effect net service revenue in the period such variances become known. Revenue is 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 managed care programs (Commercial, Medicare Advantage and Managed Medicaid plans), in exchange for providing patient care. 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. Medicare Revenue Net service revenue is recognized in accordance with the Patient Driven Groupings Model (“PDGM”). 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 low utilization payment adjustment 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. 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 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 Medicare 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.
Cash	Cash consists of petty cash and bank deposits and therefore approximates fair value. The Company places its cash with high credit quality financial institutions.
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. 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 40 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.
Intangible Assets and Goodwill	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 indefinite-lived intangible asset impairment during the years ended December 31, 2022, 2021 and 2020.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, 2022, we evaluated potential triggering events that might be indicators that our goodwill and indefinite lived intangibles were impaired. As a result of our evaluation, no goodwill or indefinite intangible asset impairments were recorded during the years ended December 31, 2022, 2021 and 2020. See further discussion at Note 9, Goodwill and Intangible Assets, Net.
Fair Value of Financial Instruments	The Company’s financial instruments consist principally of cash, accounts receivable, accounts payable, accrued liabilities, and debt. 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 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 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 and restricted stock, 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.

OTHER ACCRUED LIABILITIES (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Other Accrued Liabilities, Current [Abstract]
Refunds payable	$ 2,244	$ 3,095
Deferred revenue	1,592	1,456
Resident deposits	4,315	5,111
Contract liabilities (CARES Act advance payments)	0	6,211
Property taxes	1,027	1,102
Deferred state relief funds	1,479	0
Accrued self-insurance liabilities	3,546	1,613
Other	2,481	2,896
Other accrued liabilities	$ 16,684	$ 21,484

INCOME TAXES - DEFERRED TAX ASSETS AND LIABILITIES (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Deferred Tax Assets, Net [Abstract]
Accrued compensation	$ 7,681	$ 6,402
Allowance for doubtful accounts	1,088	1,728
Net operating losses	2,537	0
Lease liabilities	68,676	79,575
Insurance	961	953
Other	1,564	3,427
Gross deferred tax assets	82,507	92,085
Less: valuation allowance	(29)	(25)
Net deferred tax assets	82,478	92,060
Depreciation and amortization	(11,618)	(8,432)
Prepaid expenses	(781)	(907)
Right of use asset	(67,765)	(78,656)
State taxes	(165)	(217)
Total deferred tax liabilities	(80,329)	(88,212)
Net deferred tax assets (liabilities)	$ 2,149	$ 3,848

OPTIONS AND AWARDS - SHARE-BASED COMPENSATION EXPENSE AND NARRATIVE (Details) - USD ($) $ in Thousands		12 Months Ended
	Jul. 25, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation		$ 3,086	$ 10,040	$ 8,335
Weighted average contractual life for options outstanding, vested and expected to vest		6 years 11 months 12 days
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation		$ 3,266	3,093	1,660
Restricted stock awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation		$ (467)	$ 6,141	$ 6,200
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		$ 13,131
Share-based compensation	$ 3,812
Options, unvested and outstanding (in shares)		1,246,000
The Ensign Plans \| Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested stock options		$ 10,005
Weighted Average Recognition Period (in years)		3 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		$ 3,126
Weighted Average Recognition Period (in years)		4 years 6 months
Vesting period		5 years
The Ensign Plans \| RSU
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Forfeited (in shares)	250,000
Vested (in shares)	942,842

OPTIONS AND AWARDS - AGGREGATE INTRINSIC VALUE OF OPTIONS (Details) - The Ensign Plans $ in Thousands	Dec. 31, 2022 USD ($)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding	$ 2,049
Vested	1,971
Unvested	78
Exercised	$ 902

OPTIONS AND AWARDS - SHARE-BASED COMPENSATION (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation	$ 3,086	$ 10,040	$ 8,335
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation	3,266	3,093	1,660
Restricted stock awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation	(467)	6,141	6,200
Restricted stock awards \| Non-employee director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation	$ 287	$ 806	$ 475

REVENUE AND ACCOUNTS RECEIVABLE - ACCOUNTS RECEIVABLE (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Accounts Receivable [Abstract]
Accounts receivable, gross	$ 54,012	$ 54,842
Less: allowance for doubtful accounts	(592)	(902)
Accounts receivable, net	53,420	53,940
Medicare
Accounts Receivable [Abstract]
Accounts receivable, gross	31,321	31,327
Medicaid
Accounts Receivable [Abstract]
Accounts receivable, gross	10,700	11,793
Managed care
Accounts Receivable [Abstract]
Accounts receivable, gross	9,370	7,901
Private and other
Accounts Receivable [Abstract]
Accounts receivable, gross	$ 2,621	$ 3,821

LEASES (Tables)

12 Months Ended

Dec. 31, 2022

Leases [Abstract]

Schedule of operating lease cost

The components of operating lease cost, are as follows:


	Year Ended December 31,
	2022		2021		2020
Operating lease costs:
Facility rent—cost of services	$	32,958	$	35,958	$	35,562
Office rent—cost of services	5,060		4,905		3,772
Sublease income	—		—		(143)
Rent—cost of services	$	38,018	$	40,863	$	39,191

General and administrative expense	$	370	$	276	295
Variable lease cost(a)	$	6,281	$	6,248	5,330


(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, 2022, 2021 and 2020.

Schedule of future minimum lease payments

The following table shows the lease maturity analysis for all leases as of December 31, 2022:


Year	Amount
2023	$	35,553
2024	34,773
2025	33,358
2026	32,315
2027	31,732
Thereafter	245,181
Total lease payments	412,912
Less: present value adjustments	(149,237)
Present value of total lease liabilities	263,675
Less: current lease liabilities	(16,633)
Long-term operating lease liabilities	$	247,042

ACQUISITIONS

12 Months Ended

Dec. 31, 2022

Business Combination and Asset Acquisition [Abstract]

ACQUISITIONS

ACQUISITIONSThe 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.

2022 Acquisitions

During the year ended December 31, 2022, the Company expanded its operations with the addition of three home health and four hospice agencies as well as one senior living community. 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 fair value of assets for the Company’s home health and hospice acquisitions was mostly concentrated in goodwill and intangible assets and as such, these transactions were classified as a business combination in accordance with ASC Topic 805, Business Combinations (“ASC 805”). The purchase price for the business combinations was $10,130, which consisted of equipment and other assets of $188, goodwill of $5,232, and indefinite-lived intangible assets of $4,887 related to Medicare and Medicaid licenses, other intangible assets of $10, and less assumed liabilities of $187. The acquisitions contributed $3,242 in revenue and operating loss of $50 during the year ended December 31, 2022. The Company anticipates that the total goodwill recognized will be fully deductible for tax purposes. There were no material acquisition costs that were expensed related to the business combination during the year ended December 31, 2022.

2021 Acquisitions

During the year ended December 31, 2021, the Company expanded its operations with the addition of five home health agencies, four hospice agencies, and two home care agencies. The aggregate purchase price for these acquisitions was $14,135. 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 to 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 $80 were expensed related to the business combinations during the year ended December 31, 2021.

Two of the hospice agencies were acquired Medicare licenses and are considered asset acquisitions. The fair value of assets for the hospice licenses acquired totaled $585 and was allocated to indefinite-lived intangible assets.

2020 Acquisitions

During the year ended December 31, 2020, the Company expanded its operations with the addition of six home health agencies, six hospice agencies, and two senior living operations. The aggregate purchase price for these acquisitions was $39,239. In connection with the acquisition 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.

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 acquisitions during the years ended December 31, 2022, 2021 and 2020 as noted above:


	December 31, 2021
	2022		2021		2020
Equipment, furniture, and fixtures	$	188	$	62	$	174
Goodwill	5,232		7,821		25,211
Other indefinite-lived intangible assets	4,887		6,242		14,026
Intangible Assets	10		—		—
Other assets	—		10		—
Liabilities assumed	(187)		—		(172)
Total acquisitions	$	10,130	$	14,135	$	39,239
Less: noncontrolling interest and additional paid in capital(a)	—		—		(4,646)
Less: cash paid in prior year (held in escrow)(b)	—		(585)		(1,400)
Total cash paid for acquisitions	$	10,130	$	13,550	$	33,193


(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, 2021 and the year ended December 31, 2020 includes $585 and $1,400 as an escrow deposit that was paid in the prior year.

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 and 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. The assets added during the year ended December 31, 2022 and through the issuance of the Financial Statements were not material operations to the Company individually or in the aggregate. Accordingly, pro forma financial information is not presented. These additions have been included in the December 31, 2022 consolidated balance sheets of the Company, and the operating results have been included in the consolidated statements of operations of the Company since the date the Company gained effective control.

OPTIONS AND AWARDS - EMPLOYEE STOCK OPTION ACTIVITY (Details) - The Ensign Plans - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Number of Options Outstanding
Beginning balance, outstanding (in shares)	2,242
Granted (in shares)	448
Exercised (in shares)	(125)	(115)	(239)
Forfeited (in shares)	(245)
Expired (in shares)	(101)
Ending balance, outstanding (in shares)	2,219	2,242
Weighted Average Exercise Price
Beginning of period, weighted average exercise price (in dollars per share)	$ 21.38
Granted (in dollars per share)	14.39
Exercised (in dollars per share)	8.69
Forfeited (in dollars per share)	23.54
Expired (in dollars per share)	14.03
End of period, weighted average exercise price (in dollars per share)	$ 20.76	$ 21.38
Number of options vested (in shares)	973	840
Weighted average exercise price of options vested (in dollars per share)	$ 16.90	$ 12.28

INCOME TAXES - UNRECOGNIZED TAX BENEFITS (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Balance at January 1	$ 65	$ 0	$ 0
Additions for tax positions of prior years	0	188	0
Reductions for tax positions related to the current year	(65)	(123)	0
Balance at December 31	$ 0	$ 65	$ 0

ACQUISITIONS (Tables)

12 Months Ended

Dec. 31, 2022

Business Combination and Asset Acquisition [Abstract]

Schedule of operations acquired in business combinations

The table below presents the allocation of the purchase price for the operations acquired in acquisitions during the years ended December 31, 2022, 2021 and 2020 as noted above:


	December 31, 2021
	2022		2021		2020
Equipment, furniture, and fixtures	$	188	$	62	$	174
Goodwill	5,232		7,821		25,211
Other indefinite-lived intangible assets	4,887		6,242		14,026
Intangible Assets	10		—		—
Other assets	—		10		—
Liabilities assumed	(187)		—		(172)
Total acquisitions	$	10,130	$	14,135	$	39,239
Less: noncontrolling interest and additional paid in capital(a)	—		—		(4,646)
Less: cash paid in prior year (held in escrow)(b)	—		(585)		(1,400)
Total cash paid for acquisitions	$	10,130	$	13,550	$	33,193


(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, 2021 and the year ended December 31, 2020 includes $585 and $1,400 as an escrow deposit that was paid in the prior year.

TRANSACTIONS WITH ENSIGN (Details) $ in Thousands		12 Months Ended
TRANSACTIONS WITH ENSIGN (Details) $ in Thousands	Jan. 01, 2022	Dec. 31, 2022 USD ($) property	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Jan. 27, 2022 USD ($)
Affiliates Of Ensign
Related Party Transaction [Line Items]
Escrow deposits		$ 6,500			$ 6,500
Related party
Related Party Transaction [Line Items]
Cost of services		$ 3,211	$ 3,084	$ 4,205
Related party \| Senior Living Services
Related Party Transaction [Line Items]
Number of operating facilities \| property		29
Related party \| Transition Services Agreement
Related Party Transaction [Line Items]
Expiration period	2 years
Expenses from transactions with related party		$ 1,561	$ 3,124	$ 5,536

GOODWILL AND INTANGIBLE ASSETS—NET - ACTIVITY IN GOODWILL (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 74,265	$ 66,444
Additions	5,232	7,821
Goodwill, ending balance	79,497	74,265
Home Health and Hospice Services
Goodwill [Roll Forward]
Goodwill, beginning balance	70,623	62,802
Additions	5,232	7,821
Goodwill, ending balance	75,855	70,623
Senior Living Services
Goodwill [Roll Forward]
Goodwill, beginning balance	3,642	3,642
Additions	0	0
Goodwill, ending balance	$ 3,642	$ 3,642

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

DESCRIPTION OF BUSINESS	12 Months Ended
DESCRIPTION OF BUSINESS	Dec. 31, 2022
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, 2022, the Company’s subsidiaries operated 95 home health, hospice and home care agencies and 49 senior living communities located in Arizona, California, Colorado, Idaho, Iowa, Montana, Nevada, Oklahoma, Oregon, Texas, Utah, Washington, Wisconsin and Wyoming. 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.

INCOME TAXES - NARRATIVE (Details) $ in Thousands	Dec. 31, 2022 USD ($)
Federal tax authority
Income Tax Contingency [Line Items]
Operating loss carryforwards	$ 9,865
State and Local Jurisdiction
Income Tax Contingency [Line Items]
Operating loss carryforwards	9,211
Operating loss carryforwards, valuation allowance	$ 29

BUSINESS SEGMENTS (Tables)

12 Months Ended

Dec. 31, 2022

Segment Reporting [Abstract]

Schedule of financial data combined by business segment


	Home Health and Hospice Services		Senior Living Services		All Other		Total
Year Ended December 31, 2022
Revenue	$	342,249	$	130,992	$	—	$	473,241
Segment Adjusted EBITDAR from Operations	$	61,827	$	37,563	$	(31,435)	$	67,955
Year Ended December 31, 2021
Revenue	$	309,570	$	130,124	$	—	$	439,694
Segment Adjusted EBITDAR from Operations	$	55,565	$	37,517	$	(26,208)	$	66,874
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

Schedule of reconciliation of total combined adjusted EBITDAR from operations for our reportable segments to combined income from operations

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


	Year Ended December 31,
	2022		2021		2020
Segment Adjusted EBITDAR from Operations	$	67,955	$	66,874	$	75,048
Less: Depreciation and amortization	4,900		4,784		4,675
Rent—cost of services	38,018		40,863		39,191
Other income	(31)		(24)		225
Adjustments to Segment EBITDAR from Operations:
Less: Costs at start-up operations(a)	1,435		1,045		1,787
Share-based compensation expense(b)	3,363		10,040		8,335
Acquisition related costs and credit allowances(c)	731		80		99

Transition services costs(d)	77		2,008		1,181
COVID-19 Related costs and supplies(e)	—		—		447

Loss related to senior living operations transferred to Ensign(f)	6,103		2,835		—
Unusual or non-recurring charges (g)	1,220		—		—
Add: Net income (loss) attributable to noncontrolling interest	600		(548)		(191)
Consolidated Income from operations	$	12,739	$	4,695	$	18,917


(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 and related payroll taxes incurred, including the impact of the modification of certain restricted stock units described below in Note 12, Options and Awards, to the Consolidated Financial Statements. Share-based compensation expense and related payroll taxes are included in cost of services and general and administrative expense.
(c)						Non-capitalizable costs associated with acquisitions and credit allowances for amounts in dispute with the prior owners of certain acquired operations.

(d)						Costs identified as redundant or non-recurring incurred by the Company as a result of the Spin-off. The 2021 amounts represents part of the costs incurred under the Transition Services Agreement. All amounts are included in general and administrative expense. Fees incurred under the Transition Services Agreement were $1,561, $3,124, and $5,536 for the year ended December 31, 2022, 2021 and 2020, respectively.
(e)						Beginning in the first quarter of fiscal year 2021, we updated our definition of Segment Adjusted EBITDAR to no longer include an adjustment for COVID-19 expenses offset by the amount of sequestration relief. COVID-19 expenses continue to be part of daily operations for which less specific identification is visible. Furthermore, the sequestration relief was extended through December 31, 2021. Sequestration relief was $3,555 for the year ended December 31, 2021. The 2020 amount 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.

(f)						On January 27, 2022, affiliates of the Company, entered into certain operations transfer agreements (collectively, the “Transfer Agreements”) with affiliates of Ensign, providing for the transfer of the operations of certain senior living communities (the “Transaction”) from affiliates of the Company to affiliates of Ensign. The closing of the Transaction was completed in two phases with the transfer of two operations on March 1, 2022 and the remainder transferred on April 1, 2022. The amount includes $6,500 for the year ended December 31, 2022 to cover post-closing capital expenditures and operating losses related to one of the communities transferred on April 1, 2022. The amount above also includes an offset of $397 for the year ended December 31, 2022, for the related net impact on revenue and cost of service attributable to the transferred entities. This amount excludes rent and depreciation and amortization expense related to such operations. During year ended December 31, 2021, the Company impaired certain leasehold improvements included in property and equipment totaling $2,835 primarily related to the operations included in the transaction with Ensign.
(g)						Represents unusual or non-recurring charges for legal services, implementation costs, integration costs, and consulting fees including $958 in general and administrative expenses and $262 in cost of services for the year ended December 31, 2022.

ACQUISITIONS - NARRATIVE (Details) $ in Thousands	1 Months Ended	12 Months Ended
ACQUISITIONS - NARRATIVE (Details) $ in Thousands	Oct. 31, 2020 USD ($)	Dec. 31, 2022 USD ($) agency	Dec. 31, 2021 USD ($) agency	Dec. 31, 2020 USD ($) agency
Business Acquisition [Line Items]
Goodwill		$ 79,497	$ 74,265	$ 66,444
Operating loss		12,739	4,695	18,917
Acquire interest in joint venture	$ 6,200
Net book value	614
Sale of noncontrolling interests, net of tax				451
Additional paid-in capital		99,764	95,595
Scripps Health
Business Acquisition [Line Items]
Sale of noncontrolling interests, net of tax	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]
Business combination, purchase price		10,130	14,135	39,239
Equipment and other assets		188
Goodwill		5,232	7,821	25,211
Other indefinite-lived intangible assets		4,887	6,242	14,026
Other intangible assets		10	0	0
Liabilities assumed		187	0	172
Revenues		3,242
Operating loss		(50)
Acquisition costs		0	80	$ 99
Number of units (in units) \| agency				164
Hospice Services \| Series of Individually Immaterial Business Acquisitions
Business Acquisition [Line Items]
Other indefinite-lived intangible assets			585
Home Health and Hospice Services
Business Acquisition [Line Items]
Goodwill		$ 75,855	$ 70,623	$ 62,802
Home Health and Hospice Services \| Home Health Services
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| agency		3	5	6
Home Health and Hospice Services \| Hospice Services
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| agency		4	4	6
Home Health and Hospice Services \| Hospice Services \| Series of Individually Immaterial Business Acquisitions
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| agency			2
Home Health and Hospice Services \| Home Care Agencies
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| agency			2
Senior Living Services
Business Acquisition [Line Items]
Number of businesses acquired and assets acquisitions \| agency		1		2
Goodwill		$ 3,642	$ 3,642	$ 3,642

OTHER ACCRUED LIABILITIES (Tables)

12 Months Ended

Dec. 31, 2022

Payables and Accruals [Abstract]

Schedule of other accrued liabilities

Other accrued liabilities consist of the following:


	December 31, 2022		December 31, 2021
Refunds payable	$	2,244	$	3,095
Deferred revenue	1,592		1,456
Resident deposits	4,315		5,111
Contract liabilities (CARES Act advance payments)	—		6,211
Property taxes	1,027		1,102
Deferred state relief funds	1,479		—
Accrued self-insurance liabilities	3,546		1,613
Other	2,481		2,896
Other accrued liabilities	$	16,684	$	21,484

INCOME TAXES - PROVISION FOR INCOME TAXES (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Current:
Federal	$ (193)	$ 1,768	$ 5,058
State	146	566	1,478
Total current	(47)	2,334	6,536
Deferred:
Federal	1,334	(1,360)	(3,348)
State	362	(392)	(838)
Total deferred	1,696	(1,752)	(4,186)
Total income tax expense	$ 1,649	$ 582	$ 2,350

- Definition

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

+ References + Details

OPTIONS AND AWARDS

12 Months Ended

Dec. 31, 2022

Share-Based Payment Arrangement [Abstract]

OPTIONS AND AWARDS

Outstanding options and restricted stock awards of the Company were granted under the 2019 Omnibus Incentive Plan (the “OIP”) and Long-Term Incentive Plan (the “LTIP”), together referred to as the “Pennant Plans”).

Under the Pennant Plans, stock-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 employees of the Company’s subsidiaries and non-employee directors who have awards under the Pennant Plans.

Share-Based Compensation

The following disclosures represent share-based compensation expense relating to the Pennant Plans, including awards to employees of the Company’s subsidiaries.

Total share-based compensation expense for all of the Plans for the years ended December 31, 2022, 2021 and 2020:


	Year Ended December 31,
	2022		2021		2020
Share-based compensation expense related to stock options	3,266		3,093		1,660
Share-based compensation expense related to Restricted Stock	(467)		6,141		6,200
Share-based compensation expense related to Restricted Stock to non-employee directors	287		806		475
Total share-based compensation	$	3,086	$	10,040	$	8,335


	Unrecognized Compensation Expense		Weighted Average Recognition Period (in years)
Unvested stock options	$	10,005	3.3
Unvested Restricted Stock	3,126		4.5
Total unrecognized share-based compensation expense	$	13,131

On July 25, 2022 the Company modified certain outstanding RSUs granted to the former chief executive officer in connection with the Spin-off. All the RSUs had an original vesting date of October 1, 2022. The modification resulted in the forfeiture of 250,000 outstanding RSUs and accelerated the vesting on the remaining 942,842 RSUs from October 1, 2022 to July 31, 2022. The modification of the award resulted in a net reduction of share-based compensation expense related to the awards of $3,812 recorded in general and administrative expense during the year.

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
2022	448	2.7	%	6.5	39.8	%	—	%	$	6.35
2021	454	1.1	%	6.5	38.4	%	—	%	$	13.84
2020	693	0.5	%	6.5	35.9	%	—	%	$	11.05


(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, 2022:


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




December 31, 2021	2,242	$	21.38	840	$	12.28
Granted	448	$	14.39
Exercised	(125)	$	8.69
Forfeited	(245)	$	23.54
Expired	(101)	$	14.03
December 31, 2022	2,219	$	20.76	973	$	16.90

The aggregate intrinsic value of options outstanding, vested, unvested and exercised as of and for the period ended December 31, 2022 is as follows:


Options	December 31, 2022
Outstanding	$	2,049
Vested	1,971
Unvested	78
Exercised	902

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 1,246 unvested and outstanding options at December 31, 2022. The weighted average contractual life for options outstanding, vested and expected to vest at December 31, 2022 was 6.95 years.

Restricted Stock

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, 2022, is presented below:


	Non-Vested Restricted Awards	Weighted Average Grant Date Fair Value
December 31, 2021	1,493	$	15.00
Granted	281	13.55
Vested	(1,079)	14.92
Forfeited	(277)	14.93
December 31, 2022	418	$	14.26

AUDIT INFORMATION	12 Months Ended
AUDIT INFORMATION	Dec. 31, 2022
Audit Information [Abstract]
Auditor Firm ID	34
Auditor Name	DELOITTE & TOUCHE LLP
Auditor Location	Boise, ID

LEASES - IMPACT OF NEW LEASES GUIDANCE (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Lease, Cost [Abstract]
Sublease income	$ 0	$ 0	$ (143)
Variable lease cost	6,281	6,248	5,330
Cost of services
Lease, Cost [Abstract]
Operating lease costs	38,018	40,863	39,191
Cost of services \| Facility
Lease, Cost [Abstract]
Operating lease costs	32,958	35,958	35,562
Cost of services \| Office
Lease, Cost [Abstract]
Operating lease costs	5,060	4,905	3,772
General and administrative expense
Lease, Cost [Abstract]
Operating lease costs	$ 370	$ 276	$ 295

GOODWILL AND INTANGIBLE ASSETS—NET (Tables)

12 Months Ended

Dec. 31, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of activity in goodwill by segment

The following table represents activity in goodwill by segment as of and for the year ended December 31, 2022:


	Home Health and Hospice Services		Senior Living Services		Total
December 31, 2020	$	62,802	$	3,642	$	66,444
Additions	7,821		—		7,821

December 31, 2021	70,623		3,642		74,265
Additions	5,232		—		5,232

December 31, 2022	$	75,855	$	3,642	$	79,497

Schedule of other indefinite-lived intangible assets

Other indefinite-lived intangible assets consist of the following:


	December 31,
	2022		2021
Trade name	$	1,385	$	1,355
Medicare and Medicaid licenses	57,232		52,375
Total	$	58,617	$	53,730

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (h)
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-Publisher FASB
-Name Accounting Standards Codification
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
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-Section 50
-Paragraph 1
-Subparagraph (g)
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Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
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-URI https://asc.fasb.org/extlink&oid=121556970&loc=d3e13816-109267

+ Details

OPTIONS AND AWARDS - RESTRICTED STOCK (Details) - The Ensign Plans - Restricted stock awards shares in Thousands	12 Months Ended
	Dec. 31, 2022 $ / shares shares
Non-Vested Restricted Awards
Beginning balance, outstanding (in shares) \| shares	1,493
Granted (in shares) \| shares	281
Vested (in shares) \| shares	(1,079)
Forfeited (in shares) \| shares	(277)
Ending balance, outstanding (in shares) \| shares	418
Weighted Average Grant Date Fair Value
Beginning of period, weighted average exercise price (in dollars per share) \| $ / shares	$ 15.00
Granted (in dollars per share) \| $ / shares	13.55
Vested (in dollars per share) \| $ / shares	14.92
Forfeited (in dollars per share) \| $ / shares	14.93
End of period, weighted average exercise price (in dollars per share) \| $ / shares	$ 14.26

BUSINESS SEGMENTS - INCOME FROM OPERATIONS (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Revenue, Major Customer [Line Items]
Segment Adjusted EBITDAR from Operations	$ 67,955	$ 66,874	$ 75,048
Less: Depreciation and amortization	4,900	4,784	4,675
Rent—cost of services	38,018	40,863	39,191
Other income	(31)	(24)	225
Less: Costs at start-up operations	1,435	1,045	1,787
Share-based compensation expense	3,363	10,040	8,335
Acquisition related costs and credit allowances	731	80	99
Transaction services costs	77	2,008	1,181
COVID-19 Related costs and supplies	0	0	447
Loss related to senior living operations transferred to Ensign	6,103	2,835	0
Unusual or non-recurring charges	1,220	0	0
Add: Net income (loss) attributable to noncontrolling interest	600	(548)	(191)
Consolidated Income from operations	12,739	4,695	18,917
Sequestration relief		3,555
Direct medical supplies, labor, and other expenses			2,765
General and administrative expense
Revenue, Major Customer [Line Items]
Unusual or non-recurring charges	958
Cost of services
Revenue, Major Customer [Line Items]
Unusual or non-recurring charges	262
Transition Services Agreement \| Related party
Revenue, Major Customer [Line Items]
Fees incurred	1,561	$ 3,124	$ 5,536
Transfer Agreements \| Related party \| Affiliates Of Ensign
Revenue, Major Customer [Line Items]
Post-closing capital expenditures and operating losses	6,500
Impact on revenue and service cost	$ (397)

LEASES

12 Months Ended

Dec. 31, 2022

Leases [Abstract]

LEASES

LEASESThe Company’s independent operating subsidiaries lease 49 senior living communities and its administrative offices under non-cancelable operating leases, most of which have initial lease terms ranging from 14 to 25 years. The Company’s independent operating subsidiaries also lease the administrative offices of 95 home health and hospice agencies which generally range from one to 11 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, 2022, the Company’s independent operating subsidiaries leased 29 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. The total amount of rent expense included in Rent - cost of services paid to subsidiaries of Ensign was $13,595, $12,773, and 12,536, for the years ended December 31, 2022, 2021 and 2020, respectively. 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.

Twelve 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.

On January 27, 2022, affiliates of the Company, entered into Transfer Agreements with affiliates of Ensign, providing for the transfer of the operations of senior living communities. The closing of the Transaction was completed in two phases with the transfer of two operations on March 1, 2022 and the remainder transferred on April 1, 2022. As a result of the lease terminations, the Company reduced both the right of use assets and the lease liabilities by $42,506. Four of the terminated leases were part of master lease agreements. As a result of the transferred leases being removed from master lease arrangements, the remaining lease components under the master lease arrangements were modified which resulted in a net increase to the lease liability and ROU asset balance of $6,161 for the year ended December 31, 2022.

The components of operating lease cost, are as follows:


	Year Ended December 31,
	2022		2021		2020
Operating lease costs:
Facility rent—cost of services	$	32,958	$	35,958	$	35,562
Office rent—cost of services	5,060		4,905		3,772
Sublease income	—		—		(143)
Rent—cost of services	$	38,018	$	40,863	$	39,191

General and administrative expense	$	370	$	276	295
Variable lease cost(a)	$	6,281	$	6,248	5,330


(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, 2022, 2021 and 2020.

The following table shows the lease maturity analysis for all leases as of December 31, 2022:


Year	Amount
2023	$	35,553
2024	34,773
2025	33,358
2026	32,315
2027	31,732
Thereafter	245,181
Total lease payments	412,912
Less: present value adjustments	(149,237)
Present value of total lease liabilities	263,675
Less: current lease liabilities	(16,633)
Long-term operating lease liabilities	$	247,042

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, 2022, the weighted average remaining lease term is 12.7 years and the weighted average discount rate is 7.6%.

REVENUE AND ACCOUNTS RECEIVABLE - REVENUE BY MAJOR PAYOR (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Disaggregation of Revenue [Line Items]
Revenue	$ 473,241	$ 439,694	$ 390,953
Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	100.00%	100.00%	100.00%
Medicare
Disaggregation of Revenue [Line Items]
Revenue	$ 231,753	$ 216,788	$ 178,272
Medicare \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	49.00%	49.30%	45.60%
Medicaid
Disaggregation of Revenue [Line Items]
Revenue	$ 62,934	$ 58,355	$ 56,887
Medicaid \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	13.30%	13.30%	14.50%
Subtotal
Disaggregation of Revenue [Line Items]
Revenue	$ 294,687	$ 275,143	$ 235,159
Subtotal \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	62.30%	62.60%	60.10%
Managed care
Disaggregation of Revenue [Line Items]
Revenue	$ 62,101	$ 49,363	$ 33,118
Managed care \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	13.10%	11.20%	8.50%
Private and other
Disaggregation of Revenue [Line Items]
Revenue	$ 116,453	$ 115,188	$ 122,676
Private and other \| Revenue \| Customer concentration risk
Disaggregation of Revenue [Line Items]
Revenue %	24.60%	26.20%	31.40%
Home Health and Hospice Services \| Home Health Services
Disaggregation of Revenue [Line Items]
Revenue	$ 181,729	$ 157,958	$ 119,584
Home Health and Hospice Services \| Home Health Services \| Medicare
Disaggregation of Revenue [Line Items]
Revenue	91,415	80,849	58,399
Home Health and Hospice Services \| Home Health Services \| Medicaid
Disaggregation of Revenue [Line Items]
Revenue	9,749	8,935	7,645
Home Health and Hospice Services \| Home Health Services \| Subtotal
Disaggregation of Revenue [Line Items]
Revenue	101,164	89,784	66,044
Home Health and Hospice Services \| Home Health Services \| Managed care
Disaggregation of Revenue [Line Items]
Revenue	57,824	46,167	31,572
Home Health and Hospice Services \| Home Health Services \| Private and other
Disaggregation of Revenue [Line Items]
Revenue	22,741	22,007	21,968
Home Health and Hospice Services \| Hospice Services
Disaggregation of Revenue [Line Items]
Revenue	160,520	151,612	134,075
Home Health and Hospice Services \| Hospice Services \| Medicare
Disaggregation of Revenue [Line Items]
Revenue	140,338	135,939	119,873
Home Health and Hospice Services \| Hospice Services \| Medicaid
Disaggregation of Revenue [Line Items]
Revenue	15,568	12,103	12,462
Home Health and Hospice Services \| Hospice Services \| Subtotal
Disaggregation of Revenue [Line Items]
Revenue	155,906	148,042	132,335
Home Health and Hospice Services \| Hospice Services \| Managed care
Disaggregation of Revenue [Line Items]
Revenue	4,277	3,196	1,546
Home Health and Hospice Services \| Hospice Services \| Private and other
Disaggregation of Revenue [Line Items]
Revenue	337	374	194
Senior Living Services
Disaggregation of Revenue [Line Items]
Revenue	130,992	130,124	137,294
Senior Living Services \| Medicare
Disaggregation of Revenue [Line Items]
Revenue	0	0	0
Senior Living Services \| Medicaid
Disaggregation of Revenue [Line Items]
Revenue	37,617	37,317	36,780
Senior Living Services \| Subtotal
Disaggregation of Revenue [Line Items]
Revenue	37,617	37,317	36,780
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	$ 93,375	$ 92,807	$ 100,514

REVENUE AND ACCOUNTS RECEIVABLE (Tables)

12 Months Ended

Dec. 31, 2022

Revenue from Contract with Customer [Abstract]

Schedule of revenue by major payor source

Revenue by payor for the years ended December 31, 2022, 2021 and 2020, is summarized in the following tables:


	Year Ended December 31, 2022
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	91,415	$	140,338	$	—	$	231,753	49.0	%
Medicaid	9,749		15,568		37,617		62,934		13.3
Subtotal	101,164		155,906		37,617		294,687		62.3
Managed care	57,824		4,277		—		62,101		13.1
Private and other(a)	22,741		337		93,375		116,453		24.6
Total revenue	$	181,729	$	160,520	$	130,992	$	473,241	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, 2021
	Home Health and Hospice Services
	Home Health Services		Hospice Services		Senior Living Services		Total Revenue		Revenue %
Medicare	$	80,849	$	135,939	$	—	$	216,788	49.3	%
Medicaid	8,935		12,103		37,317		58,355		13.3
Subtotal	89,784		148,042		37,317		275,143		62.6
Managed care	46,167		3,196		—		49,363		11.2
Private and other(a)	22,007		374		92,807		115,188		26.2
Total revenue	$	157,958	$	151,612	$	130,124	$	439,694	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, 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.

Schedule of accounts receivable

Accounts receivable as of December 31, 2022 and December 31, 2021 is summarized in the following table:


	December 31, 2022		December 31, 2021
Medicare	$	31,321	$	31,327
Medicaid	10,700		11,793
Managed care	9,370		7,901
Private and other	2,621		3,821
Accounts receivable, gross	54,012		54,842
Less: allowance for doubtful accounts	(592)		(902)
Accounts receivable, net	$	53,420	$	53,940

Allowance for doubtful accounts

The following table summarizes the activity for our allowance for doubtful accounts for the years ended December 31, 2022, 2021 and 2020:


	Year Ended December 31,
	2022		2021		2020
Balance at beginning of period	$	902	$	643	$	677
Additions to bad debt expense	881		616		560
Write-offs of uncollectible accounts	(1,191)		(357)		(594)
Balance at end of period	$	592	$	902	$	643

Concentrations- Credit Risk

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 592	$ 902
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)	30,149,000	28,826,000
Common stock, shares outstanding (in shares)	29,692,000	28,499,000
Treasury stock, at cost (in shares)	3,000	3,000

LEASES - FUTURE MINIMUM LEASE PAYMENTS (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Leases, Under Adoption of ASC 842 [Abstract]
2023	$ 35,553
2024	34,773
2025	33,358
2026	32,315
2027	31,732
Thereafter	245,181
Total lease payments	412,912
Less: present value adjustments	(149,237)
Present value of total lease liabilities	263,675
Less: current lease liabilities	(16,633)	$ (16,118)
Long-term operating lease liabilities	$ 247,042	$ 287,753

ACQUISITIONS - SCHEDULE OF OPERATIONS ACQUIRED IN BUSINESS COMBINATIONS (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Goodwill	$ 79,497	$ 74,265	$ 66,444
Series of Individually Immaterial Business Acquisitions
Business Acquisition [Line Items]
Equipment, furniture, and fixtures	188	62	174
Goodwill	5,232	7,821	25,211
Other indefinite-lived intangible assets	4,887	6,242	14,026
Intangible Assets	10	0	0
Other assets	0	10	0
Liabilities assumed	(187)	0	(172)
Total acquisitions	10,130	14,135	39,239
Less: noncontrolling interest and additional paid in capital	0	0	(4,646)
Less: cash paid in prior year (held in escrow)	0	(585)	(1,400)
Total cash paid for acquisitions	$ 10,130	$ 13,550	$ 33,193

COMPUTATION OF NET INCOME PER COMMON SHARE - RECONCILIATION (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Numerator:
Net income	$ 7,243	$ 2,148	$ 15,553
Less: net income (loss) attributable to noncontrolling interest	600	(548)	(191)
Net income and other comprehensive income attributable to The Pennant Group, Inc.	$ 6,643	$ 2,696	$ 15,744
Denominator:
Weighted average shares outstanding for basic net income per share (in shares)	29,064	28,406	28,029
Plus: incremental shares from assumed conversion (in shares)	1,095	2,236	2,199
Adjusted weighted average common shares outstanding for diluted income per share (in share)	30,159	30,642	30,228
Earnings Per Share:
Basic net income per common share (in dollars per share)	$ 0.23	$ 0.09	$ 0.56
Diluted net income per common share (in dollars per share)	$ 0.22	$ 0.09	$ 0.52
Anti-dilutive effect of common equivalent shares outstanding (in shares)	1,860	478	93

GOODWILL AND INTANGIBLE ASSETS—NET - NARRATIVE (Details) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Impairment charges	$ 0	$ 0	$ 0