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| UNITED STATES                                                                                                                                                    |
|------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| SECURITIES AND EXCHANGE COMMISSION                                                                                                                               |
| Washington, D.C. 20549                                                                                                                                           |
| _________________________                                                                                                                                        |
| FORM 10-K_________________________                                                                                                                               |
|                                                                                                                                                             |
| x           ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES                               |
| EXCHANGE ACT OF 1934                                                                                                                                             |
| For the fiscal year ended December 31, 2010                                                                                                                      |
| OR                                                                                                                                                               |
| ¨           TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
| For the transition period from ___________to____________                                                                                                         |
| Commission  file number  001-09848                                                                                                           |
| _________________________                                                                                                                                        |
| ALMOST FAMILY, INC.                                                                                                                                              |
| (Exact name of Registrant as specified in its charter)                                                                                                           |
| _________________________                                                                                                                                        |
| Delaware                                                                                                                                                         | 06-1153720 |
| (State or other jurisdiction of incorporation or organization)                                                                                                   | (I.R.S. Employer Identification Number) |
|                                                                                                                                                             |   |
| 9510 Ormsby Station Road, Suite 300, Louisville, Kentucky 40223                                                                                                  |
| (Address of principal executive offices)                                                                                                                         |
|                                                                                                                                                             |
| (502) 891-1000                                                                                                                                                   |
| (Registrant’s telephone number, including area code)                                                                                                       |
|                                                                                                                                                             |
| Not Applicable                                                                                                                                                   |
| (Former name, former address and former fiscal year, if changed since last report)                                                                               |
|                                                                                                                                                             |
| Securities registered pursuant to Section 12(b) of the Act                                                                                                       |

| Title of each class                    | Name of each exchange on which registered |
|----------------------------------------|-------------------------------------------|
| Common Stock, par value $.10 per share | NASDAQ Global Select Market               |

| Securities registered pursuant to Section 12(g) of the Act:  None |
|-----------------------------------------------------------------------------|

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| Large accelerated filer ¨ | Accelerated filer x | Non-accelerated filer ¨ | Smaller reporting company ¨ |
|--------------------------------|---------------------|------------------------------|----------------------------------|

| Class                                  | Outstanding at February 25, 2011 |
|----------------------------------------|----------------------------------|
| Common Stock, $.10 par value per share | 9,346,952 Shares                 |

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TABLE OF CONTENTS

| PART I                   |                                                                                                                                                                                                                                          | 3        |
|--------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------|
| Item 1.                  | Business                                                                                                                                                                                                                                      | 4        |
| Item 1A.                 | Risk Factors                                                                                                                                                                                                                                  | 14       |
| Item 1B.                 | Unresolved Staff Comments                                                                                                                                                                                                                     | 25       |
| Item 2.                  | Properties                                                                                                                                                                                                                                    | 25       |
| Item 3.                  | Legal Proceedings                                                                                                                                                                                                                             | 25       |
| Item 4.                  | (Removed and Reserved)                                                                                                                                                                                                                        | 26       |
| PART II                  |                                                                                                                                                                                                                                          | 26       |
| Item 5                   | Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities                                                                                                                                  | 26       |
| Item 6.                  | Selected Financial Data                                                                                                                                                                                                                       | 28       |
| Item 7.                  | Management's Discussion and Analysis of Financial Condition and Results of Operations                                                                                                                                                         | 29       |
| Item 7A.                 | Quantitative and Qualitative Disclosures about Market Risk                                                                                                                                                                                    | 45       |
| Item 8.                  | Financial Statements and Supplementary Data                                                                                                                                                                                                   | 46       |
| Item 9.                  | Changes in and Disagreements with Accountants on Accounting and Financial Disclosure                                                                                                                                                          | 69       |
| Item 9A.                 | Controls and Procedures                                                                                                                                                                                                                       | 69       |
| Item 9B.                 | Other Information                                                                                                                                                                                                                             | 69       |
| PART III                 |                                                                                                                                                                                                                                          | 70       |
| Item 10.                 | Directors, Executive Officers and Corporate Governance                                                                                                                                                                                        | 70       |
| Items 11, 12, 13 and 14. | Executive Compensation; Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters; Certain Relationships and Related Transactions; and Director Independence; and Principal Accountant Fees and Services |  71 |
| PART IV                  |                                                                                                                                                                                                                                          | 72       |
| Item 15.                 | Exhibits and Financial Statement Schedules                                                                                                                                                                                                    | 72       |

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| ·   | general economic and business conditions; |
|--------------------|-------------------------------------------|

| ·   | demographic changes; |
|--------------------|----------------------|

| ·   | changes in, or failure to comply with, existing governmental regulations; |
|--------------------|---------------------------------------------------------------------------|

| ·   | legislative proposals for healthcare reform; |
|--------------------|----------------------------------------------|

| ·   | changes in Medicare and Medicaid reimbursement levels; |
|--------------------|--------------------------------------------------------|

| ·   | effects of competition in the markets in which the Company operates; |
|--------------------|----------------------------------------------------------------------|

| ·   | liability and other claims asserted against the Company; |
|--------------------|----------------------------------------------------------|

| ·   | potential audits and investigations by government and regulatory agencies, including the impact of any negative publicity or litigation; |
|--------------------|------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | ability to attract and retain qualified personnel; |
|--------------------|----------------------------------------------------|

| ·   | availability and terms of capital; |
|--------------------|------------------------------------|

| ·   | loss of significant contracts or reduction in revenues associated with major payer sources; |
|--------------------|---------------------------------------------------------------------------------------------|

| ·   | ability of customers to pay for services; |
|--------------------|-------------------------------------------|

| ·   | business disruption due to natural disasters or terrorist acts; |
|--------------------|-----------------------------------------------------------------|

| ·   | ability to successfully integrate the operations of acquired businesses and achieve expected synergies and operating efficiencies from the acquisition, in each case within expected time-frames or at all; |
|--------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | significant deterioration in economic conditions and significant market volatility; |
|--------------------|-------------------------------------------------------------------------------------|

| ·   | effect on liquidity of the Company's financing arrangements; and, |
|--------------------|-------------------------------------------------------------------|

| ·   | changes in estimates and judgments associated with critical accounting policies and estimates. |
|--------------------|------------------------------------------------------------------------------------------------|

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PART I

ITEM 1

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| ·   | Generate meaningful same store sales growth through the focused provision of high quality services and attending to the needs of our patients; |
|--------------------|------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Expand the significance of our home health services by selectively acquiring other quality providers, through the startup of new agencies and potentially by providing new services in patients' homes consistent with our Senior Advocacy mission; and |
|--------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Expand our capital base through both earnings performance and by seeking additional capital investments in our Company. |
|--------------------|-------------------------------------------------------------------------------------------------------------------------|

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|   |   |                | Branches       |
|--------|--------|---------------------|----------------|
|   |   | Geographic Clusters | Visiting Nurse | Personal Care |
|   |   | Southeast           |           |   |
|   |   | Florida             |  42       |  7 |
|   |   | Alabama             |  2        |  - |
|   |   |                |           |   |
|   |   | Northeast           |           |   |
|   |   | Connecticut         |  4        |  7 |
|   |   | New Jersey          |  4        |  - |
|   |   | Massachusetts       |  3        |  1 |
|   |   | Pennsylvania        |  1        |  - |
|   |   |                |           |   |
|   |   | Midwest             |           |   |
|   |   | Kentucky            |  17       |  4 |
|   |   | Ohio                |  7        |  4 |
|   |   | Missouri            |  4        |  - |
|   |   | Illinois            |  4        |  - |
|   |   | Indiana             |  2        |  - |
|   |   |                |           |   |
|   |   | Total               |  90       |  23 |

|  Payor Group                      | 2010        |   | 2009        |   | 2008        |
|----------------------------------------|-------------|--------|-------------|--------|-------------|
| Medicare                               | 80.5%  |   | 77.3%  |   | 74.2%  |
| Medicaid and Other Government Programs | 15.0%  |   | 17.0%  |   | 18.4%  |
| Insurance and private pay              | 4.5%        |   | 5.7%        |   | 7.4%        |

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|  Period                              |   | Base episode Payment (1) |
|-------------------------------------------|--------|--------------------------|
| January 1, 2008 through December 31, 2008 |   | $                        | 2,270 |   |
| January 1, 2009 through December 31, 2009 |   | $                        | 2,272 |   |
| January 1, 2010 through December 31, 2010 |   | $                        | 2,313 |   |
| January 1, 2011 through December 31, 2011 |   | $                        | 2,192 |   |

| (1) | The actual episode payment rates vary from those presented in the table, depending on the home health resource groups (“HHRGs”) to which Medicare patients are assigned and the per episode payment is typically reduced or increased by such factors as the patient’s clinical, functional, and services utilization characteristics. |   |
|-----|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------|

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| ·   | Reduces Medicare reimbursement rates for home health care services we provide to our patients.  While implications on rates for years 2011-2013 appear clear, implications on rates are significantly less clear for years 2014-2017 in which the rebasing described below is to occur. |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Imposes new requirements on employer-sponsored health plans including expanding eligibility of employees and dependants, which may increase the cost of providing such benefits. |
|--------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Includes enhanced program integrity provisions, provider billing limitations, provider overpayment notification requirements and overpayment recoupment capabilities for the Centers for Medicare and Medicaid Services (CMS). |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Includes a number of other provisions that could reasonably be expected to have an impact on our business. |
|--------------------|------------------------------------------------------------------------------------------------------------|

| ·   | A “Market Basket Update” reduction of 1% per year in each of 2011, 2012, and 2013 which will reduce our annual cost inflation updates.  CMS market basket updates are to reflect price inflation experienced by health care providers. |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | A 3% “Rural Rate Add-on” effective April 1, 2010 through December 2015.  Approximately 8% of our Medicare patients live in rural areas. |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | A 10% “Outlier Cap” which limits the amount of “outlier” reimbursement a provider may receive to 10% of total reimbursement.  Less than 1% of our revenue would be considered “outlier” reimbursement.  Home health agencies receive additional or “outlier” payments for 60-day home health episodes of care which carry unusually high costs. |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | A “Rebasing” of rates phased in over four years from 2014 through 2017.  These provisions require CMS to recalculate or “rebase” home health reimbursement to more closely align with the costs of providing care.  Any reduction in reimbursement rates resulting from “rebasing” cannot exceed 3.5% per year in each of the four phase-in years.  There are certain requirements for the Medicare Payment Advisory Commission (“MedPac”) and the HHS Secretary to assess and report on the impact of rebasing on access and quality of care.  Home health reimbursement rates have not been “rebased” since the inception of the |
|--------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

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| ·   | prospective payment system in October 1, 2000.  Accordingly, we cannot predict the impact this “rebasing” work may have when it is completed three years from now. |
|--------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Beginning in 2015, an annual “Productivity” adjustment, estimated to result in a 1% per year payment reduction. |
|--------------------|-----------------------------------------------------------------------------------------------------------------------------|

| ·   | A “market basket update” rate increase of 2.4%, less 1.0% from the Legislation, minus the 2.5% “outlier provision”, less a 3.79% “case mix creep” adjustment (for an effective rate cut of approximately 5.2%) |
|--------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Regulations implementing a requirement included in the Legislation for a face-to-face encounter between the patient and the physician ordering home health services |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Regulations intended to address concerns over therapy utilization by requiring additional documentation justifying therapy visits based on specific goals, accepted standards of care, and objective and quantifiable measures of patients’ progress towards those goals |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Revisions to its previously issued “36 Month Rule” which limits the sale or transfer of the Medicare Provider Agreement for any Medicare-certified home health agency that has been in existence for less than 36 months or that has undergone a change of ownership in the last 36 months.  This “36 Month Rule” limitation may reduce the number of home health agencies that otherwise would have been available for acquisition and may limit our ability to successfully pursue our acquisition strategy. |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

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ITEM 1A.

| · | Reduces Medicare reimbursement rates for home health care services we provide to our patients.  While implications on rates for years 2011-2013 appear clear, implications on rates are significantly less clear for years 2014-2017 in which the rebasing described below is to occur. |
|--------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| · | Imposes new requirements on employer-sponsored health plans including expanding eligibility of employees and dependants, which may increase the cost of providing such benefits.                                                                                                                  |
| · | Includes enhanced program integrity provisions, provider billing limitations, provider overpayment notification requirements and overpayment recoupment capabilities for the Centers for Medicare and Medicaid Services (CMS).                                                                    |
| · | Includes a number of other provisions that could reasonably be expected to have an impact on our business.                                                                                                                                                                                        |

| · | A “Market Basket Update” reduction of 1% per year in each of 2011, 2012, and 2013 which will reduce our annual cost inflation updates.  CMS market basket updates are to reflect price inflation experienced by health care providers. |
|--------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| · | A 3% “Rural Rate Add-on” effective April 1, 2010 through December 2015.  Approximately 8% of our Medicare patients live in rural areas.                                                                                                |

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| · | A 10% “Outlier Cap” which limits the amount of “outlier” reimbursement a provider may receive to 10% of total reimbursement.  Less than 1% of our revenue would be considered “outlier” reimbursement.  Home health agencies receive additional or “outlier” payments for 60-day home health episodes of care which carry unusually high costs.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |
|--------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| · | A “Rebasing” of rates phased in over four years from 2014 through 2017.  These provisions require CMS to recalculate or “rebase” home health reimbursement to more closely align with the costs of providing care.  Any reduction in reimbursement rates resulting from “rebasing” cannot exceed 3.5% per year in each of the four phase-in years.  There are certain requirements for the Medicare Payment Advisory Commission (“MedPac”) and the HHS Secretary to assess and report on the impact of rebasing on access and quality of care.  Home health reimbursement rates have not been “rebased” since the inception of the prospective payment system in October 1, 2000.  Accordingly, we cannot predict the impact this “rebasing” work may have when it is completed three years from now. |
| · | Beginning in 2015, an annual “Productivity” adjustment, estimated to result in a 1% per year payment reduction.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |

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| ·   | increasing our liability; |
|--------------------|---------------------------|

| ·   | increasing our administrative and other costs; |
|--------------------|------------------------------------------------|

| ·   | increasing or decreasing mandated services; |
|--------------------|---------------------------------------------|

| ·   | forcing us to restructure our relationships with referral sources and providers; or |
|--------------------|-------------------------------------------------------------------------------------|

| ·   | requiring us to implement additional or different programs and systems. |
|--------------------|-------------------------------------------------------------------------|

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| ·   | administrative or legislative changes to the base episode rate; |
|--------------------|-----------------------------------------------------------------|

| ·   | the elimination or reduction of annual rate increases based on medical inflation; |
|--------------------|-----------------------------------------------------------------------------------|

| ·   | the imposition by Medicare of co-payments or other mechanisms shifting responsibility for a portion of payment to beneficiaries; |
|--------------------|----------------------------------------------------------------------------------------------------------------------------------|

| ·   | adjustments to the relative components of the wage index; |
|--------------------|-----------------------------------------------------------|

| ·   | changes to our case mix or therapy thresholds; or   |
|--------------------|---------------------------------------------------------------|

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| ·   | other adverse changes to the way we are paid for delivering our services. |
|--------------------|---------------------------------------------------------------------------|

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| ·   | obtain locations for agencies in markets where need exists; |
|--------------------|-------------------------------------------------------------|

| ·   | identify and hire a sufficient number of sales personnel and appropriately trained home care and other health care professionals; |
|--------------------|-----------------------------------------------------------------------------------------------------------------------------------|

| ·   | obtain adequate financing to fund growth; and |
|--------------------|-----------------------------------------------|

| ·   | operate successfully under applicable government regulations. |
|--------------------|---------------------------------------------------------------|

| ·   | difficulties integrating personnel from acquired entities and other corporate cultures into our business; |
|--------------------|-----------------------------------------------------------------------------------------------------------|

| ·   | difficulties integrating information systems; |
|--------------------|-----------------------------------------------|

| ·   | the potential loss of key employees or referral sources of acquired companies or a reduction in patient referrals by hospitals from which we have acquired home health care agencies; |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | the assumption of liabilities and exposure to undisclosed liabilities of acquired companies; |
|--------------------|----------------------------------------------------------------------------------------------|

| ·   | the acquisition of an agency with undisclosed compliance problems; |
|--------------------|--------------------------------------------------------------------|

| ·   | the diversion of management attention from existing operations; |
|--------------------|-----------------------------------------------------------------|

| ·   | difficulties in recouping partial episode payments and other types of misdirected payments for services from the previous owners; or |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------|

| ·   | an unsuccessful claim for indemnification rights from previous owners for acts or omissions arising prior to the date of acquisition. |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------|

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| ·   | our operating and financial performance; |
|--------------------|------------------------------------------|

| ·   | variances in our quarterly financial results compared to expectations; |
|--------------------|------------------------------------------------------------------------|

| ·   | the depth and liquidity of the market for our common stock; |
|--------------------|-------------------------------------------------------------|

| ·   | future sales of common stock or the perception that sales could occur; |
|--------------------|------------------------------------------------------------------------|

| ·   | investor perception of our business and our prospects; |
|--------------------|--------------------------------------------------------|

| ·   | developments relating to litigation or governmental investigations; |
|--------------------|---------------------------------------------------------------------|

| ·   | changes or proposed changes in health care laws or regulations or enforcement of these laws and regulations, or announcements relating to these matters; or |
|--------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | general economic and stock market conditions |
|--------------------|----------------------------------------------|

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ITEM 1B

ITEM 2

ITEM 3

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ITEM 4

PART II

ITEM 5.

|   | Quarter Ended:     |   | High  |   | Low   |
|--------|--------------------|--------|-------|--------|-------|
|   | March 31, 2009     |   | 47.32 |   | 15.10 |
|   | June 30, 2009      |   | 31.61 |   | 20.40 |
|   | September 30, 2009 |   | 31.82 |   | 23.46 |
|   | December 31, 2009  |   | 41.84 |   | 29.03 |

|   | March 31, 2010     |   | 41.13 |   | 33.86 |
|--------|--------------------|--------|-------|--------|-------|
|   | June 30, 2010      |   | 43.96 |   | 34.84 |
|   | September 30, 2010 |   | 31.08 |   | 24.01 |
|   | December 31, 2010  |   | 38.84 |   | 28.61 |

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| Issuer Purchases of Equity Securities (1)                                                           |   |
|-----------------------------------------------------------------------------------------------------|--------|
| Period                                                                                              |   | (a) Total Number of Shares (or Units) Purchased (1) |   |   | (b) Average Price Paid per Share (or Unit) |   |   | c) Total Number of Shares (or Units) Purchased as Part of Publicly Announced Plans or Programs |   |   | (d) Maximum Number (or Approximate Dollar Value) of Shares (or Units) that May Yet Be Purchased Under the Plans or Programs |   |
|                                                                                                |   |   |   |   |   |   |   |   |   |   |   |   |
| October 1, 2010 - October 31, 2010                                                                  |   |   | - |   |   | $ | - |   |   |   | - |   |   |   | - |   |
| November 1, 2010 -November 30, 2010                                                                 |   |   | - |   |   |   | - |   |   |   | - |   |   |   | - |   |
| December 1, 2010  -   December 31, 2010                                    |   |   | 1,941 |   |   | $ | 35.44 |   |   |   | - |   |   |   | - |   |
| Total                                                                                               |   |   | 1,941 |   |   | $ | 35.44 |   |   |   | - |   |   |   | - |   |
|                                                                                                |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| (1) All shares included herein were submitted by optionees in lieu of cash purchase price that |   |
| would have otherwise been due on option exercise in transactions approved by the Company's          |   |
| Board of Directors.                                                                                 |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |

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ITEM 6

|                                       |   | Year Ended December 31, |    |
|--------------------------------------------|--------|-------------------------|---------|
|  (In thousands except per share data) |   | 2010                    |    |   | 2009 |   |   | 2008 |   |   | 2007 |   |   | 2006 (1) |   |
|  Results of operations data:          |   |                    |    |   |   |   |   |   |   |   |   |   |   |   |   |
|  Net revenues                         |   | $                       | 336,924 |   |   | $ | 297,849 |   |   | $ | 211,517 |   |   | $ | 130,907 |   |   | $ | 88,706 |   |
|  Net income                           |   | $                       | 30,713  |   |   | $ | 24,564 |   |   | $ | 16,293 |   |   | $ | 7,603 |   |   | $ | 4,239 |   |
|                                       |   |                    |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  Per share:                           |   |                    |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  Basic:                               |   |                    |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  Number of shares                     |   |                    | 9,123   |   |   |   | 8,372 |   |   |   | 7,369 |   |   |   | 5,436 |   |   |   | 4,854 |   |
|  Net income                           |   | $                       | 3.37    |   |   | $ | 2.93 |   |   | $ | 2.21 |   |   | $ | 1.40 |   |   | $ | 0.87 |   |
|                                       |   |                    |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  Diluted:                             |   |                    |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  Number of shares                     |   |                    | 9,352   |   |   |   | 8,589 |   |   |   | 7,572 |   |   |   | 5,600 |   |   |   | 5,327 |   |
|  Net income                           |   | $                       | 3.28    |   |   | $ | 2.86 |   |   | $ | 2.16 |   |   | $ | 1.36 |   |   | $ | 0.80 |   |
|                                       |   |                    |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|                                       |   |                    |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|                                       |   |                    |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|                                       |   | Year Ended December 31, |    |
|  Balance sheet data                   |   |                    | 2010    |   |   |   | 2009 |   |   |   | 2008 |   |   |   | 2007 |   |   |   | 2006 |   |
|  Working capital                      |   | $                       | 72,100  |   |   | $ | 39,568 |   |   | $ | 11,082 |   |   | $ | 5,505 |   |   | $ | 7,163 |   |
|  Total assets                         |   |                    | 220,127 |   |   |   | 183,389 |   |   |   | 157,097 |   |   |   | 67,360 |   |   |   | 53,395 |   |
|  Long term liabilities                |   |                    | 10,311  |   |   |   | 9,140 |   |   |   | 29,902 |   |   |   | 17,552 |   |   |   | 13,520 |   |
|  Total liabilities                    |   |                    | 37,959  |   |   |   | 34,412 |   |   |   | 62,314 |   |   |   | 32,518 |   |   |   | 25,656 |   |
|  Shareholders' equity                 |   |                    | 182,168 |   |   |   | 148,977 |   |   |   | 94,783 |   |   |   | 34,842 |   |   |   | 27,740 |   |

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ITEM 7

| ·   | Generate meaningful same store sales growth through the focused provision of high quality services and attending to the needs of our patients; |
|--------------------|------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Expand the significance of our home health services by selectively acquiring other quality providers, through the startup of new agencies and potentially by providing new services in patients' homes consistent with our Senior Advocacy mission; and |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Expand our capital base through both earnings performance and by seeking additional capital investments in our Company. |
|--------------------|-------------------------------------------------------------------------------------------------------------------------|

----

TABLE OF CONTENTS

| ·   | Reduces Medicare reimbursement rates for home health care services we provide to our patients.  While implications on rates for years 2011-2013 appear clear, implications on rates are significantly less clear for years 2014-2017 in which the rebasing described below is to occur. |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Imposes new requirements on employer-sponsored health plans including expanding eligibility of employees and dependants, which may increase the cost of providing such benefits. |
|--------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Includes enhanced program integrity provisions, provider billing limitations, provider overpayment notification requirements and overpayment recoupment capabilities for the Centers for Medicare and Medicaid Services (CMS). |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Includes a number of other provisions that could reasonably be expected to have an impact on our business. |
|--------------------|------------------------------------------------------------------------------------------------------------|

| ·   | A “Market Basket Update” reduction of 1% per year in each of 2011, 2012, and 2013 which will reduce our annual cost inflation updates.  CMS market basket updates are to reflect price inflation experienced by health care providers. |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | A 3% “Rural Rate Add-on” effective April 1, 2010 through December 2015.  Approximately 8% of our Medicare patients live in rural areas. |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | A 10% “Outlier Cap” which limits the amount of “outlier” reimbursement a provider may receive to 10% of total reimbursement.  Less than 1% of our revenue would be considered “outlier” reimbursement.  Home health agencies receive additional or “outlier” payments for 60-day home health episodes of care which carry unusually high costs. |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | A “Rebasing” of rates phased in over four years from 2014 through 2017.  These provisions require CMS to recalculate or “rebase” home health reimbursement to more closely align with the costs of providing care.  Any reduction in reimbursement rates resulting from “rebasing” cannot exceed 3.5% per year in each of the four phase-in years.  There are certain requirements for the Medicare Payment Advisory Commission (“MedPac”) and the HHS Secretary to assess and report on the impact of rebasing on access and quality of care.  Home health reimbursement rates have not been “rebased” since the inception of the prospective payment system in October 1, 2000.  Accordingly, we cannot predict the impact this “rebasing” work may have when it is completed three years from now. |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Beginning in 2015, an annual “Productivity” adjustment, estimated to result in a 1% per year payment reduction. |
|--------------------|-----------------------------------------------------------------------------------------------------------------------------|

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| ·   | A “market basket update” rate increase of 2.1%, less 1.0% from the Legislation, minus the 2.5% “outlier provision”, less a 3.79% “case mix creep” adjustment (for an effective rate cut of approximately 5.2%) |
|--------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Regulations implementing a requirement included in the Legislation for a face-to-face encounter between the patient and the physician ordering home health services |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Regulations intended to address concerns over therapy utilization by requiring additional documentation justifying therapy visits based on specific goals, accepted standards of care, and objective and quantifiable measures of patients’ progress towards those goals |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Revisions to its previously issued “36 Month Rule” which limits the sale or transfer of the Medicare Provider Agreement for any Medicare-certified home health agency that has been in existence for less than 36 months or that has undergone a change of ownership in the last 36 months.  This “36 Month Rule” limitation may reduce the number of home health agencies that otherwise would have been available for acquisition and may limit our ability to successfully pursue our acquisition strategy. |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

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| ·   | Attempting to increase our revenues by: investing more resources in sales and marketing activities, development of diagnosis related specialty programs and increasing our educational programs regarding the value of home health to drive admission growth, establishing startup branch operations to expand our service territories, and acquisitions of underperforming providers with strong referral relationships, |
|--------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Attempting to reduce our costs by: developing a more efficient delivery model, increasing the productivity standards for our staff, optimizing the appropriate use of different levels of professional staff, limiting or eliminating the growth in wage rates, limiting or reducing the size of our work force, closing unprofitable branch operations and accelerating our efforts to evaluate the use of various technological approaches to the delivery of patient care to improve patient outcomes and/or improve the productivity of our workforce, |
|--------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Evaluating the potential implications of health care reform on our employee benefit plans, and possible changes we may need to make to our plans, and |
|--------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------|

| ·   | Potentially other actions we deem appropriate including evaluation of potential additional service offerings in patients' homes consistent with our Senior Advocacy mission or changing the mix of the types of services we provide. |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

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TABLE OF CONTENTS

| Consolidated                                |   | 2010   |    |   | 2009   |   |   | Change |   |
|---------------------------------------------|--------|--------|---------|--------|--------|--------|--------|--------|--------|
|                                        |   | Amount |    |   | % Rev  |   |   | Amount |   |   | % Rev |   |   | Amount |   |   | % |   |
|  Net service revenues:                 |   |   |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  Visiting Nurse                        |   | $      | 294,915 |   |   |   | 87.5   | %      |   | $ | 256,060 |   |   |   | 86.0 | % |   | $ | 38,855 |   |   |   | 15.2 | % |
|  Personal Care                         |   |   | 42,009  |   |   |   | 12.5   | %      |   |   | 41,789 |   |   |   | 14.0 | % |   |   | 220 |   |   |   | 0.5 | % |
|                                        |   |   | 336,924 |   |   |   | 100.0  | %      |   |   | 297,849 |   |   |   | 100.0 | % |   |   | 39,075 |   |   |   | 13.1 | % |
| Operating income before corporate expenses: |   |   |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  Visiting Nurse                        |   |   | 66,333  |   |   |   | 22.5   | %      |   |   | 53,955 |   |   |   | 21.1 | % |   |   | 12,378 |   |   |   | 22.9 | % |
|  Personal Care                         |   |   | 5,715   |   |   |   | 13.6   | %      |   |   | 5,166 |   |   |   | 12.4 | % |   |   | 549 |   |   |   | 10.6 | % |
|                                        |   |   | 72,048  |   |   |   | 21.4   | %      |   |   | 59,121 |   |   |   | 19.8 | % |   |   | 12,927 |   |   |   | 21.9 | % |
|  Corporate expenses                    |   |   | 20,391  |   |   |   | 6.1    | %      |   |   | 17,252 |   |   |   | 5.8 | % |   |   | 3,139 |   |   |   | 18.2 | % |
|  Operating income                      |   |   | 51,657  |   |   |   | 15.3   | %      |   |   | 41,869 |   |   |   | 14.1 | % |   |   | 9,788 |   |   |   | 23.4 | % |
|  Interest expense, net                 |   |   | 266     |   |   |   | 0.1    | %      |   |   | 803 |   |   |   | 0.3 | % |   |   | (537 | ) |   |   | -66.9 | % |
|  Income tax expense                    |   |   | 20,678  |   |   |   | 6.1    | %      |   |   | 16,502 |   |   |   | 5.5 | % |   |   | 4,176 |   |   |   | 25.3 | % |
| Net income                                  |   | $      | 30,713  |   |   |   | 9.1    | %      |   | $ | 24,564 |   |   |   | 8.2 | % |   | $ | 6,149 |   |   |   | 25.0 | % |
|                                        |   |   |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  EBITDA (1)                            |   | $      | 56,075  |   |   |   | 16.6   | %      |   | $ | 45,625 |   |   |   | 15.3 | % |   | $ | 10,450 |   |   |   | 22.9 | % |

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TABLE OF CONTENTS

|                                                                    |   | 2010   |      |   | 2009   |   |   | Change |   |
|-------------------------------------------------------------------------|--------|--------|-----------|--------|--------|--------|--------|--------|--------|
|                                                                    |   | Amount |      |   | % Rev  |   |   | Amount |   |   | % Rev |   |   | Amount |   |   | % |   |
| Net service revenues                                                    |   | $      | 294,915   |   |   |   | 100.0  | %      |   | $ | 256,060 |   |   |   | 100.0 | % |   | $ | 38,855 |   |   |   | 15.2 | % |
| Cost of service revenues                                                |   |   | 126,122   |   |   |   | 42.8   | %      |   |   | 110,661 |   |   |   | 43.2 | % |   |   | 15,461 |   |   |   | 14.0 | % |
| Gross margin                                                            |   |   | 168,793   |   |   |   | 57.2   | %      |   |   | 145,399 |   |   |   | 56.8 | % |   |   | 23,394 |   |   |   | 16.1 | % |
| General and administrative      expenses: |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Salaries and benefits                                                   |   |   | 76,320    |   |   |   | 25.9   | %      |   |   | 66,930 |   |   |   | 26.1 | % |   |   | 9,390 |   |   |   | 14.0 | % |
| Other                                                                   |   |   | 26,140    |   |   |   | 8.9    | %      |   |   | 24,514 |   |   |   | 9.6 | % |   |   | 1,626 |   |   |   | 6.6 | % |
| Total general and administrativeexpenses                                |   |   | 102,460   |   |   |   | 34.7   | %      |   |   | 91,444 |   |   |   | 35.7 | % |   |   | 11,016 |   |   |   | 12.0 | % |
| Operating income before corporate expenses                              |   | $      | 66,333    |   |   |   | 22.5   | %      |   | $ | 53,955 |   |   |   | 21.1 | % |   | $ | 12,378 |   |   |   | 22.9 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Average number of locations                                             |   |   | 86        |   |   |   |   |   |   |   | 78 |   |   |   |   |   |   |   | 8 |   |   |   | 10.3 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| All payors:                                                             |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Patients Months                                                         |   |   | 205,681   |   |   |   |   |   |   |   | 185,959 |   |   |   |   |   |   |   | 19,722 |   |   |   | 10.6 | % |
| Admissions                                                              |   |   | 58,291    |   |   |   |   |   |   |   | 52,029 |   |   |   |   |   |   |   | 6,262 |   |   |   | 12.0 | % |
| Billable Visits                                                         |   |   | 1,886,287 |   |   |   |   |   |   |   | 1,712,480 |   |   |   |   |   |   |   | 173,807 |   |   |   | 10.1 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Medicare Statistics:                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Revenue (in thousands)                                                  |   | $      | 271,248   |   |   |   | 92.0   | %      |   | $ | 230,383 |   |   |   | 90.0 | % |   | $ | 40,865 |   |   |   | 17.7 | % |
| Billable visits                                                         |   |   | 1,581,360 |   |   |   |   |   |   |   | 1,395,001 |   |   |   |   |   |   |   | 186,359 |   |   |   | 13.4 | % |
| Admissions                                                              |   |   | 52,757    |   |   |   |   |   |   |   | 47,110 |   |   |   |   |   |   |   | 5,647 |   |   |   | 12.0 | % |
| Episodes                                                                |   |   | 85,901    |   |   |   |   |   |   |   | 76,436 |   |   |   |   |   |   |   | 9,465 |   |   |   | 12.4 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Revenue per completed episode                                           |   | $      | 3,140     |   |   |   |   |   |   | $ | 2,974 |   |   |   |   |   |   | $ | 166 |   |   |   | 5.6 | % |
| Visits per episode                                                      |   |   | 18.2      |   |   |   |   |   |   |   | 17.7 |   |   |   |   |   |   |   | 0.5 |   |   |   | 2.8 | % |

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|                                                                    |   | 2010   |      |   | 2009   |   |   | Change |   |
|-------------------------------------------------------------------------|--------|--------|-----------|--------|--------|--------|--------|--------|--------|
|                                                                    |   | Amount |      |   | % Rev  |   |   | Amount |   |   | % Rev |   |   | Amount |   |   | % |   |
| Net service revenues                                                    |   | $      | 42,009    |   |   |   | 100.0  | %      |   | $ | 41,789 |   |   |   | 100.0 | % |   | $ | 220 |   |   |   | 0.5 | % |
| Cost of service revenues                                                |   |   | 27,638    |   |   |   | 65.8   | %      |   |   | 28,066 |   |   |   | 67.2 | % |   |   | (428 | ) |   |   | -1.5 | % |
| Gross margin                                                            |   |   | 14,371    |   |   |   | 34.2   | %      |   |   | 13,723 |   |   |   | 32.8 | % |   |   | 648 |   |   |   | 4.7 | % |
| General and administrative      expenses: |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Salaries and benefits                                                   |   |   | 5,370     |   |   |   | 12.8   | %      |   |   | 5,305 |   |   |   | 12.7 | % |   |   | 65 |   |   |   | 1.2 | % |
| Other                                                                   |   |   | 3,286     |   |   |   | 7.8    | %      |   |   | 3,252 |   |   |   | 7.8 | % |   |   | 34 |   |   |   | 1.0 | % |
| Total general and administrativeexpenses                                |   |   | 8,656     |   |   |   | 20.6   | %      |   |   | 8,557 |   |   |   | 20.5 | % |   |   | 99 |   |   |   | 1.2 | % |
| Operating income before corporate expenses                              |   | $      | 5,715     |   |   |   | 13.6   | %      |   | $ | 5,166 |   |   |   | 12.4 | % |   | $ | 549 |   |   |   | 10.6 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Average number of locations                                             |   |   | 23        |   |   |   |   |   |   |   | 22 |   |   |   |   |   |   |   | 1 |   |   |   | 4.5 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Admissions                                                              |   |   | 2,953     |   |   |   |   |   |   |   | 3,135 |   |   |   |   |   |   |   | (182 | ) |   |   | -5.8 | % |
| Patient months of care                                                  |   |   | 46,562    |   |   |   |   |   |   |   | 47,154 |   |   |   |   |   |   |   | (592 | ) |   |   | -1.3 | % |
| Patient days of care                                                    |   |   | 604,388   |   |   |   |   |   |   |   | 600,447 |   |   |   |   |   |   |   | 3,941 |   |   |   | 0.7 | % |
| Billable hours                                                          |   |   | 2,312,444 |   |   |   |   |   |   |   | 2,339,080 |   |   |   |   |   |   |   | (26,636 | ) |   |   | -1.1 | % |
| Revenue per billable hour                                               |   | $      | 18.17     |   |   |   |   |   |   | $ | 17.87 |   |   |   |   |   |   | $ | 0.30 |   |   |   | 1.7 | % |

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TABLE OF CONTENTS

| Consolidated                                |   | 2009   |    |   | 2008   |   |   | Change |   |
|---------------------------------------------|--------|--------|---------|--------|--------|--------|--------|--------|--------|
|                                        |   | Amount |    |   | % Rev  |   |   | Amount |   |   | % Rev |   |   | Amount |   |   | % |   |
|  Net service revenues:                 |   |   |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  Visiting Nurse                        |   | $      | 256,060 |   |   |   | 86.0   | %      |   | $ | 172,977 |   |   |   | 81.8 | % |   | $ | 83,083 |   |   |   | 48.0 | % |
|  Personal Care                         |   |   | 41,789  |   |   |   | 14.0   | %      |   |   | 38,540 |   |   |   | 18.2 | % |   |   | 3,249 |   |   |   | 8.4 | % |
|                                        |   |   | 297,849 |   |   |   | 100.0  | %      |   |   | 211,517 |   |   |   | 100.0 | % |   |   | 86,332 |   |   |   | 40.8 | % |
| Operating income before corporate expenses: |   |   |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  Visiting Nurse                        |   |   | 53,955  |   |   |   | 21.1   | %      |   |   | 37,030 |   |   |   | 21.4 | % |   |   | 16,925 |   |   |   | 45.7 | % |
|  Personal Care                         |   |   | 5,166   |   |   |   | 12.4   | %      |   |   | 3,770 |   |   |   | 9.8 | % |   |   | 1,396 |   |   |   | 37.0 | % |
|                                        |   |   | 59,121  |   |   |   | 19.8   | %      |   |   | 40,800 |   |   |   | 19.3 | % |   |   | 18,321 |   |   |   | 44.9 | % |
|  Corporate expenses                    |   |   | 17,252  |   |   |   | 5.8    | %      |   |   | 12,775 |   |   |   | 6.0 | % |   |   | 4,477 |   |   |   | 35.0 | % |
|  Operating income                      |   |   | 41,869  |   |   |   | 14.1   | %      |   |   | 28,025 |   |   |   | 13.2 | % |   |   | 13,844 |   |   |   | 49.4 | % |
|  Interest expense, net                 |   |   | 803     |   |   |   | 0.3    | %      |   |   | 1,147 |   |   |   | 0.5 | % |   |   | (344 | ) |   |   | -30.0 | % |
|  Income tax expense                    |   |   | 16,502  |   |   |   | 5.5    | %      |   |   | 10,585 |   |   |   | 5.0 | % |   |   | 5,917 |   |   |   | 55.9 | % |
| Net income                                  |   | $      | 24,564  |   |   |   | 8.2    | %      |   | $ | 16,293 |   |   |   | 7.7 | % |   | $ | 8,271 |   |   |   | 50.8 | % |
|                                        |   |   |    |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
|  EBITDA (1)                            |   | $      | 45,625  |   |   |   | 15.3   | %      |   | $ | 30,043 |   |   |   | 14.2 | % |   | $ | 15,582 |   |   |   | 51.9 | % |

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TABLE OF CONTENTS

|                                                                    |   | 2009   |      |   | 2008   |   |   | Change |   |
|-------------------------------------------------------------------------|--------|--------|-----------|--------|--------|--------|--------|--------|--------|
|                                                                    |   | Amount |      |   | % Rev  |   |   | Amount |   |   | % Rev |   |   | Amount |   |   | % |   |
| Net service revenues                                                    |   | $      | 256,060   |   |   |   | 100.0  | %      |   | $ | 172,977 |   |   |   | 100.0 | % |   | $ | 83,083 |   |   |   | 48.0 | % |
| Cost of service revenues                                                |   |   | 110,661   |   |   |   | 43.2   | %      |   |   | 71,900 |   |   |   | 41.6 | % |   |   | 38,761 |   |   |   | 53.9 | % |
| Gross margin                                                            |   |   | 145,399   |   |   |   | 56.8   | %      |   |   | 101,077 |   |   |   | 58.4 | % |   |   | 44,322 |   |   |   | 43.8 | % |
| General and administrative      expenses: |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Salaries and benefits                                                   |   |   | 66,930    |   |   |   | 26.1   | %      |   |   | 45,290 |   |   |   | 26.2 | % |   |   | 21,640 |   |   |   | 47.8 | % |
| Other                                                                   |   |   | 24,514    |   |   |   | 9.6    | %      |   |   | 18,757 |   |   |   | 10.8 | % |   |   | 5,757 |   |   |   | 30.7 | % |
| Total general and administrativeexpenses                                |   |   | 91,444    |   |   |   | 35.7   | %      |   |   | 64,047 |   |   |   | 37.0 | % |   |   | 27,397 |   |   |   | 42.8 | % |
| Operating income before corporate expenses                              |   | $      | 53,955    |   |   |   | 21.1   | %      |   | $ | 37,030 |   |   |   | 21.4 | % |   | $ | 16,925 |   |   |   | 45.7 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Average number of locations                                             |   |   | 78        |   |   |   |   |   |   |   | 62 |   |   |   |   |   |   |   | 16 |   |   |   | 25.8 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| All payors:                                                             |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Patients Months                                                         |   |   | 185,959   |   |   |   |   |   |   |   | 131,027 |   |   |   |   |   |   |   | 54,932 |   |   |   | 41.9 | % |
| Admissions                                                              |   |   | 52,029    |   |   |   |   |   |   |   | 39,691 |   |   |   |   |   |   |   | 12,338 |   |   |   | 31.1 | % |
| Billable Visits                                                         |   |   | 1,712,480 |   |   |   |   |   |   |   | 1,088,339 |   |   |   |   |   |   |   | 624,141 |   |   |   | 57.3 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Medicare Statistics:                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Revenue (in thousands)                                                  |   | $      | 230,383   |   |   |   | 90.0   | %      |   | $ | 156,892 |   |   |   | 90.7 | % |   | $ | 73,491 |   |   |   | 46.8 | % |
| Billable visits                                                         |   |   | 1,395,001 |   |   |   |   |   |   |   | 952,191 |   |   |   |   |   |   |   | 442,810 |   |   |   | 46.5 | % |
| Admissions                                                              |   |   | 47,110    |   |   |   |   |   |   |   | 36,200 |   |   |   |   |   |   |   | 10,910 |   |   |   | 30.1 | % |
| Episodes                                                                |   |   | 76,436    |   |   |   |   |   |   |   | 53,692 |   |   |   |   |   |   |   | 22,744 |   |   |   | 42.4 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Revenue per completed episode                                           |   | $      | 2,974     |   |   |   |   |   |   | $ | 2,855 |   |   |   |   |   |   | $ | 119 |   |   |   | 4.2 | % |
| Visits per episode                                                      |   |   | 17.7      |   |   |   |   |   |   |   | 17.3 |   |   |   |   |   |   |   | 0.4 |   |   |   | 2.3 | % |

----

TABLE OF CONTENTS

|                                                                    |   | 2009   |      |   | 2008   |   |   | Change |   |
|-------------------------------------------------------------------------|--------|--------|-----------|--------|--------|--------|--------|--------|--------|
|                                                                    |   | Amount |      |   | % Rev  |   |   | Amount |   |   | % Rev |   |   | Amount |   |   | % |   |
| Net service revenues                                                    |   | $      | 41,789    |   |   |   | 100.0  | %      |   | $ | 38,540 |   |   |   | 100.0 | % |   | $ | 3,249 |   |   |   | 8.4 | % |
| Cost of service revenues                                                |   |   | 28,066    |   |   |   | 67.2   | %      |   |   | 26,347 |   |   |   | 68.4 | % |   |   | 1,719 |   |   |   | 6.5 | % |
| Gross margin                                                            |   |   | 13,723    |   |   |   | 32.8   | %      |   |   | 12,193 |   |   |   | 31.6 | % |   |   | 1,530 |   |   |   | 12.5 | % |
| General and administrative      expenses: |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Salaries and benefits                                                   |   |   | 5,305     |   |   |   | 12.7   | %      |   |   | 5,229 |   |   |   | 13.6 | % |   |   | 76 |   |   |   | 1.5 | % |
| Other                                                                   |   |   | 3,252     |   |   |   | 7.8    | %      |   |   | 3,194 |   |   |   | 8.3 | % |   |   | 58 |   |   |   | 1.8 | % |
| Total general and administrativeexpenses                                |   |   | 8,557     |   |   |   | 20.5   | %      |   |   | 8,423 |   |   |   | 21.9 | % |   |   | 134 |   |   |   | 1.6 | % |
| Operating income before corporate expenses                              |   | $      | 5,166     |   |   |   | 12.4   | %      |   | $ | 3,770 |   |   |   | 9.8 | % |   | $ | 1,396 |   |   |   | 37.0 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Average number of locations                                             |   |   | 22        |   |   |   |   |   |   |   | 22 |   |   |   |   |   |   |   | - |   |   |   | 0.0 | % |
|                                                                    |   |   |      |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Admissions                                                              |   |   | 3,135     |   |   |   |   |   |   |   | 3,457 |   |   |   |   |   |   |   | (322 | ) |   |   | -9.3 | % |
| Patient months of care                                                  |   |   | 47,154    |   |   |   |   |   |   |   | 43,378 |   |   |   |   |   |   |   | 3,776 |   |   |   | 8.7 | % |
| Patient days of care                                                    |   |   | 600,447   |   |   |   |   |   |   |   | 550,208 |   |   |   |   |   |   |   | 50,239 |   |   |   | 9.1 | % |
| Billable hours                                                          |   |   | 2,339,080 |   |   |   |   |   |   |   | 2,074,229 |   |   |   |   |   |   |   | 264,851 |   |   |   | 12.8 | % |
| Revenue per billable hour                                               |   | $      | 17.87     |   |   |   |   |   |   | $ | 18.58 |   |   |   |   |   |   | $ | (0.71 | ) |   |   | -3.8 | % |

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| Net Change in Cash and Cash Equivalents   |   | 2010   |   |   | 2009   |   |   | 2008   |   |
|-------------------------------------------|--------|--------|--------|--------|--------|--------|--------|--------|--------|
| Provided by (used in):                    |   |   |   |   |   |   |   |   |   |
| Operating activities                      |   | $      | 34,769 |   |   | $      | 27,100 |   |   | $ | 9,355 |   |
| Investing activities                      |   |   | (5,407 | )      |   |   | (8,644 | )      |   |   | (61,273 | ) |
| Financing activities                      |   |   | (808   | )      |   |   | (249   | )      |   |   | 52,627 |   |
| Net increase in cash and cash equivalents |   | $      | 28,554 |   |   | $      | 18,207 |   |   | $ | 709 |   |

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|                      |   | 2011   |   |   | 2012   |   |   | 2013   |   |   | 2014  |   |   | 2015   |   |   | Total  |   |
|---------------------------|--------|--------|--------|--------|--------|--------|--------|--------|--------|--------|-------|--------|--------|--------|--------|--------|--------|--------|
| Revolving credit facility |   | $      | -      |   |   | $      | -      |   |   | $      | -     |   |   | $      | -      |   |   | $      | - |   |   | $ | - |   |
| Capital lease obligations |   |   | 95     |   |   |   | -      |   |   |   | -     |   |   |   | -      |   |   |   | - |   |   |   | 95 |   |
| Notes payable             |   |   | 1,600  |   |   |   | 1,200  |   |   |   | 125   |   |   |   | -      |   |   |   | - |   |   |   | 2,925 |   |
| Operating leases          |   |   | 4,523  |   |   |   | 3,344  |   |   |   | 1,900 |   |   |   | 857    |   |   |   | 845 |   |   |   | 11,469 |   |
| Total                     |   | $      | 6,218  |   |   | $      | 4,544  |   |   | $      | 2,025 |   |   | $      | 857    |   |   | $      | 845 |   |   | $ | 14,489 |   |

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|                                                                                                        |   |   |   |   |   |   |   |   |   |
|-------------------------------------------------------------------------------------------------------------|--------|--------|--------|--------|--------|--------|--------|--------|--------|
|                                                                                                        |   | 2010   |   |   | 2009   |   |   | 2008   |   |
|  Net income                                                                                            |   | $      | 30,713 |   |   | $      | 24,564 |   |   | $ | 16,293 |   |
|  Add back:                                                                                             |   |   |   |   |   |   |   |   |   |   |   |   |
|  Interest expense                                                                                      |   |   | 266    |   |   |   | 803    |   |   |   | 1,147 |   |
|  Income tax expense                                                                                    |   |   | 20,678 |   |   |   | 16,502 |   |   |   | 10,585 |   |
|  Depreciation and amortization                                                                         |   |   | 2,913  |   |   |   | 2,385  |   |   |   | 1,330 |   |
|  Amortization of stock-based compensation                                                              |   |   | 1,505  |   |   |   | 1,371  |   |   |   | 688 |   |
|  Earnings before interest, income taxes, depreciation    and amortization (EBITDA) |   | $      | 56,075 |   |   | $      | 45,625 |   |   | $ | 30,043 |   |

ITEM 7A.

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ITEM 8

|                                                                     |   | Year Ended December 31, |    |
|--------------------------------------------------------------------------|--------|-------------------------|---------|
|                                                                     |   | 2010                    |    |   | 2009 |   |   | 2008 |   |
|  Net service revenues                                               |   | $                       | 336,924 |   |   | $ | 297,849 |   |   | $ | 211,517 |   |
|  Cost of service revenues (excluding depreciation and amortization) |   |                    | 153,763 |   |   |   | 138,565 |   |   |   | 98,246 |   |
|  Gross margin                                                       |   |                    | 183,161 |   |   |   | 159,284 |   |   |   | 113,271 |   |
|  General and administrative expenses:                               |   |                    |    |   |   |   |   |   |   |   |   |   |
|  Salaries and benefits                                              |   |                    | 91,455  |   |   |   | 81,589 |   |   |   | 57,996 |   |
|  Other                                                              |   |                    | 40,049  |   |   |   | 35,826 |   |   |   | 27,250 |   |
|  Total general and administrative expenses                          |   |                    | 131,504 |   |   |   | 117,415 |   |   |   | 85,246 |   |
|  Operating income                                                   |   |                    | 51,657  |   |   |   | 41,869 |   |   |   | 28,025 |   |
|  Interest expense, net                                              |   |                    | (266    | ) |   |   | (803 | ) |   |   | (1,147 | ) |
|  Income before income taxes                                         |   |                    | 51,391  |   |   |   | 41,066 |   |   |   | 26,878 |   |
|  Income tax expense                                                 |   |                    | (20,678 | ) |   |   | (16,502 | ) |   |   | (10,585 | ) |
|  Net income                                                         |   | $                       | 30,713  |   |   | $ | 24,564 |   |   | $ | 16,293 |   |
|                                                                     |   |                    |    |   |   |   |   |   |   |   |   |   |
|                                                                     |   |                    |    |   |   |   |   |   |   |   |   |   |
|  Per share amounts-basic:                                           |   |                    |    |   |   |   |   |   |   |   |   |   |
|  Average shares outstanding                                         |   |                    | 9,123   |   |   |   | 8,372 |   |   |   | 7,369 |   |
|                                                                     |   |                    |    |   |   |   |   |   |   |   |   |   |
|  Net income                                                         |   | $                       | 3.37    |   |   | $ | 2.93 |   |   | $ | 2.21 |   |
|                                                                     |   |                    |    |   |   |   |   |   |   |   |   |   |
|  Per share amounts-diluted:                                         |   |                    |    |   |   |   |   |   |   |   |   |   |
|  Average shares outstanding                                         |   |                    | 9,352   |   |   |   | 8,589 |   |   |   | 7,572 |   |
|                                                                     |   |                    |    |   |   |   |   |   |   |   |   |   |
|  Net income                                                         |   | $                       | 3.28    |   |   | $ | 2.86 |   |   | $ | 2.16 |   |

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|                                                     |   | As of December 31, |    |
|----------------------------------------------------------|--------|--------------------|---------|
|  ASSETS                                             |   | 2010               |    |   | 2009 |   |
|  CURRENT ASSETS:                                    |   |               |    |   |   |   |
|  Cash and cash equivalents                          |   | $                  | 47,943  |   |   | $ | 19,389 |   |
|  Accounts receivable - net                          |   |               | 39,772  |   |   |   | 35,121 |   |
|  Prepaid expenses and other current assets          |   |               | 3,513   |   |   |   | 2,544 |   |
|  Deferred tax assets                                |   |               | 8,521   |   |   |   | 7,786 |   |
|  TOTAL CURRENT ASSETS                               |   |               | 99,749  |   |   |   | 64,840 |   |
|                                                     |   |               |    |   |   |   |   |   |
|  PROPERTY AND EQUIPMENT - NET                       |   |               | 4,514   |   |   |   | 4,291 |   |
|                                                     |   |               |    |   |   |   |   |   |
|  GOODWILL                                           |   |               | 101,060 |   |   |   | 99,333 |   |
|                                                     |   |               |    |   |   |   |   |   |
|  OTHER INTANGIBLE ASSETS                            |   |               | 14,285  |   |   |   | 14,338 |   |
|                                                     |   |               |    |   |   |   |   |   |
|  OTHER ASSETS                                       |   |               | 519     |   |   |   | 587 |   |
|                                                     |   | $                  | 220,127 |   |   | $ | 183,389 |   |
|                                                     |   |               |    |   |   |   |   |   |
|  LIABILITIES AND STOCKHOLDERS' EQUITY               |   |               |    |   |   |   |   |   |
|  CURRENT LIABILITIES:                               |   |               |    |   |   |   |   |   |
|  Accounts payable                                   |   | $                  | 5,424   |   |   | $ | 3,360 |   |
|  Accrued other liabilities                          |   |               | 20,529  |   |   |   | 20,076 |   |
|  Current portion - capital leases and notes payable |   |               | 1,695   |   |   |   | 1,836 |   |
|  TOTAL CURRENT LIABILITIES                          |   |               | 27,648  |   |   |   | 25,272 |   |
|                                                     |   |               |    |   |   |   |   |   |
|  LONG-TERM LIABILITIES:                             |   |               |    |   |   |   |   |   |
|  Revolving credit facility                          |   |               | -       |   |   |   | - |   |
|  Notes payable                                      |   |               | 1,325   |   |   |   | 2,800 |   |
|  Deferred tax liabilities                           |   |               | 8,763   |   |   |   | 5,258 |   |
|  Other liabilities                                  |   |               | 223     |   |   |   | 1,082 |   |
|  TOTAL LONG-TERM LIABILITIES                        |   |               | 10,311  |   |   |   | 9,140 |   |
|  TOTAL LIABILITIES                                  |   |               | 37,959  |   |   |   | 34,412 |   |
|                                                     |   |               |    |   |   |   |   |   |
|  STOCKHOLDERS' EQUITY:                              |   |               |    |   |   |   |   |   |
|  Preferred stock, par value $0.05; authorized       |   |               |    |   |   |   |   |   |
|  2,000 shares; none issued or outstanding           |   |               | -       |   |   |   | - |   |
|  Common stock, par value $0.10; authorized          |   |               |    |   |   |   |   |   |
|  25,000; 9,239 and 9,151                            |   |               |    |   |   |   |   |   |
|  issued and outstanding                             |   |               | 924     |   |   |   | 915 |   |
|  Treasury stock, at cost, 4 and zero shares         |   |               | (139    | ) |   |   | - |   |
|  Additional paid-in capital                         |   |               | 97,073  |   |   |   | 94,465 |   |
|  Retained earnings                                  |   |               | 84,310  |   |   |   | 53,597 |   |
|  TOTAL STOCKHOLDERS' EQUITY                         |   |               | 182,168 |   |   |   | 148,977 |   |
|                                                     |   | $                  | 220,127 |   |   | $ | 183,389 |   |

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|                                                                 |   | Common Stock Shares                                            Amount |   |   | Treasury Stock Shares                                     Amount |   |   | Additional Paid-in Capital |   |   | Retained Earnings |   |   | Total Stockholders' Equity |   |
|----------------------------------------------------------------------|--------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------|--------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------|--------|----------------------------|--------|--------|-------------------|--------|--------|----------------------------|--------|
| Balance, December 31, 2007                                           |   |                                                                                                                                                                                                                                                                                              | 7,808  |   |                                                                                                                                                                                                                                                 | $      | 781    |                       |   |   | (2,297            | )      |   | $                          | (8,879 | ) |   | $ | 30,199 |   |   | $ | 12,740 |   |   | $ | 34,842 |   |
| Options exercised, net of shares  surrendered or withheld  |   |                                                                                                                                                                                                                                                                                              | 11     |   |                                                                                                                                                                                                                                                 |   | 1      |                       |   |   | -                 |   |   |                       | -      |   |   |   | 52 |   |   |   | - |   |   |   | 53 |   |
| Restricted stock awards and  stock-based compensation      |   |                                                                                                                                                                                                                                                                                              | 34     |   |                                                                                                                                                                                                                                                 |   | 3      |                       |   |   | -                 |   |   |                       | -      |   |   |   | 685 |   |   |   | - |   |   |   | 688 |   |
| Stock provided in acquisitions                                       |   |                                                                                                                                                                                                                                                                                              | 48     |   |                                                                                                                                                                                                                                                 |   | 5      |                       |   |   | -                 |   |   |                       | -      |   |   |   | 995 |   |   |   | - |   |   |   | 1,000 |   |
| Tax benefit from exercise of non-  qualified stock options |   |                                                                                                                                                                                                                                                                                              | -      |   |                                                                                                                                                                                                                                                 |   | -      |                       |   |   | -                 |   |   |                       | -      |   |   |   | 86 |   |   |   | - |   |   |   | 86 |   |
| Stock offering                                                       |   |                                                                                                                                                                                                                                                                                              | 2,512  |   |                                                                                                                                                                                                                                                 |   | 251    |                       |   |   | -                 |   |   |                       | -      |   |   |   | 41,570 |   |   |   | - |   |   |   | 41,821 |   |
| Retirement of Treasury Stock                                         |   |                                                                                                                                                                                                                                                                                              | (2,297 | )      |                                                                                                                                                                                                                                                 |   | (230   | )                          |   |   | 2,297             |   |   |                       | 8,879  |   |   |   | (8,649 | ) |   |   | - |   |   |   | - |   |
| Net income                                                           |   |                                                                                                                                                                                                                                                                                              | -      |   |                                                                                                                                                                                                                                                 |   | -      |                       |   |   | -                 |   |   |                       | -      |   |   |   | - |   |   |   | 16,293 |   |   |   | 16,293 |   |
| Balance, December 31, 2008                                           |   |                                                                                                                                                                                                                                                                                              | 8,116  |   |                                                                                                                                                                                                                                                 | $      | 811    |                       |   |   | -                 |   |   | $                          | -      |   |   | $ | 64,938 |   |   | $ | 29,033 |   |   | $ | 94,783 |   |
| Options exercised, net of shares  surrendered or withheld  |   |                                                                                                                                                                                                                                                                                              | 20     |   |                                                                                                                                                                                                                                                 |   | 2      |                       |   |   | -                 |   |   |                       | -      |   |   |   | 98 |   |   |   | - |   |   |   | 100 |   |
| Restricted stock awards and  stock-based compensation      |   |                                                                                                                                                                                                                                                                                              | 47     |   |                                                                                                                                                                                                                                                 |   | 5      |                       |   |   | -                 |   |   |                       | -      |   |   |   | 1,366 |   |   |   | - |   |   |   | 1,371 |   |
| Tax benefit from exercise of non-  qualified stock options |   |                                                                                                                                                                                                                                                                                              | -      |   |                                                                                                                                                                                                                                                 |   | -      |                       |   |   | -                 |   |   |                       | -      |   |   |   | 203 |   |   |   | - |   |   |   | 203 |   |
| Stock offering                                                       |   |                                                                                                                                                                                                                                                                                              | 968    |   |                                                                                                                                                                                                                                                 |   | 97     |                       |   |   | -                 |   |   |                       | -      |   |   |   | 27,860 |   |   |   | - |   |   |   | 27,957 |   |
| Net income                                                           |   |                                                                                                                                                                                                                                                                                              | -      |   |                                                                                                                                                                                                                                                 |   | -      |                       |   |   | -                 |   |   |                       | -      |   |   |   | - |   |   |   | 24,564 |   |   |   | 24,564 |   |
| Balance, December 31, 2009                                           |   |                                                                                                                                                                                                                                                                                              | 9,151  |   |                                                                                                                                                                                                                                                 | $      | 915    |                       |   |   | -                 |   |   | $                          | -      |   |   | $ | 94,465 |   |   | $ | 53,597 |   |   | $ | 148,977 |   |
| Options exercised, net of shares  surrendered or withheld  |   |                                                                                                                                                                                                                                                                                              | 80     |   |                                                                                                                                                                                                                                                 |   | 8      |                       |   |   | (4                | )      |   |                       | (139   | ) |   |   | (129 | ) |   |   | - |   |   |   | (260 | ) |
| Restricted stock awards and  stock-based compensation      |   |                                                                                                                                                                                                                                                                                              | 12     |   |                                                                                                                                                                                                                                                 |   | 1      |                       |   |   | -                 |   |   |                       | -      |   |   |   | 1,504 |   |   |   | - |   |   |   | 1,505 |   |
| Tax benefit from exercise of non-  qualified stock options |   |                                                                                                                                                                                                                                                                                              | -      |   |                                                                                                                                                                                                                                                 |   | -      |                       |   |   | -                 |   |   |                       | -      |   |   |   | 1,233 |   |   |   | - |   |   |   | 1,233 |   |
| Net income                                                           |   |                                                                                                                                                                                                                                                                                              | -      |   |                                                                                                                                                                                                                                                 |   | -      |                       |   |   | -                 |   |   |                       | -      |   |   |   | - |   |   |   | 30,713 |   |   |   | 30,713 |   |
| Balance, December 31, 2010                                           |   |                                                                                                                                                                                                                                                                                              | 9,243  |   |                                                                                                                                                                                                                                                 | $      | 924    |                       |   |   | (4                | )      |   | $                          | (139   | ) |   | $ | 97,073 |   |   | $ | 84,310 |   |   | $ | 182,168 |   |

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|                                                                                                                                                                  (In thousands) |   | Year Ended December 31, |   |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------|-------------------------|--------|
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |   | 2010                    |   |   | 2009 |   |   | 2008 |   |
|  Cash flows from operating activities:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |   |                    |   |   |   |   |   |   |   |
|  Net income                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |   | $                       | 30,713 |   |   | $ | 24,564 |   |   | $ | 16,293 |   |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Adjustments to reconcile income to net cash                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |   |                    |   |   |   |   |   |   |   |   |   |   |
|   provided by operating activities:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Depreciation and amortization                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |   |                    | 2,913  |   |   |   | 2,385 |   |   |   | 1,330 |   |
|  Provision for uncollectible accounts                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |   |                    | 3,675  |   |   |   | 3,762 |   |   |   | 2,963 |   |
|  Stock-based compensation                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  |   |                    | 1,505  |   |   |   | 1,371 |   |   |   | 688 |   |
|  Deferred income taxes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |   |                    | 2,770  |   |   |   | 695 |   |   |   | 1,364 |   |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |   |                    | 41,576 |   |   |   | 32,777 |   |   |   | 22,638 |   |
|  Change in certain net assets and liabilities, net of the effects of acquisitions:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |                    |   |   |   |   |   |   |   |   |   |   |
|  (Increase) decrease in:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Accounts receivable                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |   |                    | (8,239 | ) |   |   | (3,958 | ) |   |   | (14,282 | ) |
|  Prepaid expenses and other current assets                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |   |                    | (1,184 | ) |   |   | 570 |   |   |   | (993 | ) |
|  Other assets                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              |   |                    | 68     |   |   |   | (69 | ) |   |   | (34 | ) |
|  Increase (decrease) in:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Accounts payable and accrued expenses                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |   |                    | 2,548  |   |   |   | (2,220 | ) |   |   | 2,026 |   |
|  Net cash provided by operating activities                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |   |                    | 34,769 |   |   |   | 27,100 |   |   |   | 9,355 |   |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Cash flows from investing activities:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Capital expenditures                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |   |                    | (2,607 | ) |   |   | (2,134 | ) |   |   | (1,476 | ) |
|  Acquisitions, net of cash acquired                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |   |                    | (2,800 | ) |   |   | (6,510 | ) |   |   | (59,797 | ) |
|  Net cash used in investing activities                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |   |                    | (5,407 | ) |   |   | (8,644 | ) |   |   | (61,273 | ) |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Cash flows from financing activities:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |   |                    |   |   |   |   |   |   |   |   |   |   |
|     Net revolving credit facility (repayments) borrowings                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |   |                    | -      |   |   |   | (23,998 | ) |   |   | 11,611 |   |
|  Proceeds from stock option exercises                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |   |                    | 380    |   |   |   | 113 |   |   |   | 53 |   |
|  Purchase of common stock in connection with stock options                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |   |                    | (640   | ) |   |   | (14 | ) |   |   | - |   |
|  Tax benefit from non-qualified stock option exercises                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |   |                    | 1,233  |   |   |   | 203 |   |   |   | 86 |   |
|  Proceeds from stock offering, net                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |   |                    | -      |   |   |   | 27,957 |   |   |   | 41,821 |   |
|  Principal payments on capital leases and notes payable                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |   |                    | (1,781 | ) |   |   | (4,510 | ) |   |   | (944 | ) |
|  Net cash (used in) provided by financing activities                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |   |                    | (808   | ) |   |   | (249 | ) |   |   | 52,627 |   |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Net increase in cash and cash equivalents                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |   |                    | 28,554 |   |   |   | 18,207 |   |   |   | 709 |   |
|  Cash and cash equivalents at beginning of period                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          |   |                    | 19,389 |   |   |   | 1,182 |   |   |   | 473 |   |
|  Cash and cash equivalents at end of period                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |   | $                       | 47,943 |   |   | $ | 19,389 |   |   | $ | 1,182 |   |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Supplemental disclosures of cash flow information:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Cash payment of interest, net of amounts capitalized                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |   | $                       | 266    |   |   | $ | 1,133 |   |   | $ | 871 |   |
|  Cash payment of taxes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |   | $                       | 17,954 |   |   | $ | 14,175 |   |   | $ | 9,308 |   |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Summary of non-cash investing and financing activities:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |   |                    |   |   |   |   |   |   |   |   |   |   |
|  Capital expenditures financed under capital leases                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |   | $                       | -      |   |   | $ | - |   |   | $ | 967 |   |
|  Acquisitions funded by notes payable                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |   | $                       | 125    |   |   | $ | 1,200 |   |   | $ | 3,100 |   |
|  Acquisitions funded by stock                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              |   | $                       | -      |   |   | $ | - |   |   | $ | 1,000 |   |

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|                 |   |     |    |   | Other Intangible Assets           |   |
|----------------------|--------|----------|---------|--------|-----------------------------------|--------|
|                 |   | Goodwill |    |   | Certificates of Need and Licenses |   |   | Trade Name |   |   | Non-compete Agreements |   |   | Total |   |
| Balances at 12-31-08 |   | $        | 92,170  |   |                              | $      | 7,390 |   |   | $ | 8,651 |   |   | $ | 674 |   |   | $ | 16,715 |   |
| Additions            |   |     | 5,409   |   |                              |   | 300 |   |   |   | - |   |   |   | - |   |   |   | 300 |   |
| Reclassifications *  |   |     | 1,754   |   |                              |   | (1,099 | ) |   |   | (1,270 | ) |   |   | (10 | ) |   |   | (2,379 | ) |
| Amortization         |   |     | -       |   |                              |   | - |   |   |   | - |   |   |   | (298 | ) |   |   | (298 | ) |
| Balances at 12-31-09 |   | $        | 99,333  |   |                              | $      | 6,591 |   |   | $ | 7,381 |   |   | $ | 366 |   |   | $ | 14,338 |   |
| Additions            |   |     | 1,727   |   |                              |   | 250 |   |   |   | - |   |   |   | - |   |   |   | 250 |   |
| Amortization         |   |     | -       |   |                              |   | - |   |   |   | - |   |   |   | (303 | ) |   |   | (303 | ) |
| Balances at 12-31-10 |   | $        | 101,060 |   |                              | $      | 6,841 |   |   | $ | 7,381 |   |   | $ | 63 |   |   | $ | 14,285 |   |

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|                                      | 2010   |   | 2009   |   | 2008   |
|-------------------------------------------|--------|--------|--------|--------|--------|
| Medicare                                  | 80.5%  |   | 77.3%  |   | 74.2%  |
| Medicaid & other government programs: |   |   |   |   |   |
| Connecticut                               | 6.0%   |   | 7.5%   |   | 6.4%   |
| Ohio                                      | 4.1%   |   | 4.4%   |   | 5.1%   |
| Kentucky                                  | 3.1%   |   | 3.1%   |   | 4.4%   |
| Florida                                   | 0.7%   |   | 0.6%   |   | 0.8%   |
| Massachusetts                             | 0.5%   |   | 0.7%   |   | 1.2%   |
| Others                                    | 0.6%   |   | 0.7%   |   | 0.5%   |
| Subtotal                                  | 15.0%  |   | 17.0%  |   | 18.4%  |
| All other payors                          | 4.5%   |   | 5.7%   |   | 7.4%   |
| Total                                     | 100.0% |   | 100.0% |   | 100.0% |

|                                      |   | 2010   |   |   | 2009    |   |
|-------------------------------------------|--------|--------|--------|--------|---------|--------|
|                                      |   | Amount |   |   | Percent |   |   | Amount |   |   | Percent |   |
| Medicare                                  |   | $      | 33,480 |   |    |   | 65.2 | % |   | $ | 28,306 |   |   |   | 64.4 | % |
| Medicaid & other government programs: |   |   |   |   |    |   |   |   |   |   |   |   |   |   |   |   |
| Connecticut                               |   |   | 5,327  |   |    |   | 10.4 | % |   |   | 5,431 |   |   |   | 12.3 | % |
| Kentucky                                  |   |   | 4,503  |   |    |   | 8.8 | % |   |   | 1,799 |   |   |   | 4.1 | % |
| Ohio                                      |   |   | 1,853  |   |    |   | 3.6 | % |   |   | 1,493 |   |   |   | 3.4 | % |
| Others                                    |   |   | 1,383  |   |    |   | 2.7 | % |   |   | 2,429 |   |   |   | 5.5 | % |
| Subtotal                                  |   |   | 13,066 |   |    |   | 25.4 | % |   |   | 11,152 |   |   |   | 25.4 | % |
| All other payors                          |   |   | 4,824  |   |    |   | 9.4 | % |   |   | 4,521 |   |   |   | 10.3 | % |
| Subtotal                                  |   |   | 51,370 |   |    |   | 100.0 | % |   |   | 43,979 |   |   |   | 100.0 | % |
| Third party payable                       |   |   | (4,073 | )      |    |   |   |   |   |   | (2,324 | ) |   |   |   |   |
| Allowance for uncollectible accounts      |   |   | (7,525 | )      |    |   |   |   |   |   | (6,534 | ) |   |   |   |   |
| Total                                     |   | $      | 39,772 |   |    |   |   |   |   | $ | 35,121 |   |   |   |   |   |

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|                      |   | 2010   |
|---------------------------|--------|--------|
| Payor                     |   | 0-90   |   | 91-180 |   | 181-365 |   | >1 yr. |   | Total |
| Medicare                  |   | 46%    |   | 12% |   | 3% |   | 4% |   | 65% |
| Medicaid & Government |   | 13%    |   | 4% |   | 6% |   | 3% |   | 26% |
| Self Pay                  |   | 1%     |   | 0% |   | 0% |   | 1% |   | 2% |
| Insurance                 |   | 4%     |   | 1% |   | 1% |   | 1% |   | 7% |
| Total                     |   | 64%    |   | 17% |   | 10% |   | 9% |   | 100% |
|                      |   |   |   |   |   |   |   |   |   |   |
|                      |   |   |   |   |   |   |   |   |   |   |
|                      |   | 2009   |
| Payor                     |   | 0-90   |   | 91-180 |   | 181-365 |   | >1 yr. |   | Total |
| Medicare                  |   | 50%    |   | 8% |   | 3% |   | 3% |   | 64% |
| Medicaid & Government |   | 17%    |   | 3% |   | 3% |   | 3% |   | 26% |
| Self Pay                  |   | 1%     |   | 0% |   | 0% |   | 1% |   | 2% |
| Insurance                 |   | 3%     |   | 1% |   | 2% |   | 2% |   | 8% |
| Total                     |   | 71%    |   | 12% |   | 8% |   | 9% |   | 100% |

|                      |   | 2010   |
|---------------------------|--------|--------|
| Payor                     |   | 0-90   |   | 91-180 |   | 181-365 |   | >1 yr. |   | >2 yrs. |
| Medicare                  |   | 3%     |   | 9% |   | 32% |   | 100% |   | 100% |
| Medicaid & Government |   | 2%     |   | 8% |   | 24% |   | 83% |   | 100% |
| Self Pay                  |   | 1%     |   | 7% |   | 50% |   | 81% |   | 100% |
| Insurance                 |   | 3%     |   | 9% |   | 47% |   | 98% |   | 100% |
| Total                     |   | 3%     |   | 9% |   | 30% |   | 93% |   | 100% |
|                      |   |   |   |   |   |   |   |   |   |   |
|                      |   |   |   |   |   |   |   |   |   |   |
|                      |   | 2009   |
| Payor                     |   | 0-90   |   | 91-180 |   | 181-365 |   | >1 yr. |   | >2 yrs. |
| Medicare                  |   | 3%     |   | 10% |   | 59% |   | 100% |   | 100% |
| Medicaid & Government |   | 2%     |   | 6% |   | 27% |   | 82% |   | 100% |
| Self Pay                  |   | 1%     |   | 6% |   | 25% |   | 78% |   | 100% |
| Insurance                 |   | 4%     |   | 9% |   | 51% |   | 98% |   | 100% |
| Total                     |   | 2%     |   | 9% |   | 43% |   | 93% |   | 100% |

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|                                               |        |   |        |   |        |
|----------------------------------------------------|-------------|--------|-------------|--------|-------------|
|                                               | 2010        |   | 2009        |   | 2008        |
| Basic weighted average outstanding shares          |  9,123 |   |  8,372 |   |  7,369 |
| Dilutive effect of outstanding compensation awards |  229   |   |  217   |   |  203   |
| Diluted weighted average outstanding shares        |  9,352 |   |  8,589 |   |  7,572 |

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|                                  |   |   |   |   |   |   |
|---------------------------------------|--------|--------|--------|--------|--------|--------|
|                                  |   | 2010   |   |   | 2009   |   |
| Wages and employee benefits           |   | $      | 10,554 |   |   | $      | 9,381 |   |
| Insurance accruals                    |   |   | 5,850  |   |   |   | 5,612 |   |
| Accrued taxes                         |   |   | 183    |   |   |   | 1,503 |   |
| Accrued professional fees and other   |   |   | 3,942  |   |   |   | 2,730 |   |
| Acquisition contingent considerations |   |   | -      |   |   |   | 850 |   |
|                                  |   | $      | 20,529 |   |   | $      | 20,076 |   |

|                            |   |   |   |   |   |   |
|---------------------------------|--------|--------|--------|--------|--------|--------|
|                            |   | 2010   |   |   | 2009   |   |
| Leasehold improvements          |   | $      | 725    |   |   | $      | 590 |   |
| Medical equipment               |   |   | 556    |   |   |   | 579 |   |
| Computer equipment and software |   |   | 10,427 |   |   |   | 8,662 |   |
| Office and other equipment      |   |   | 2,594  |   |   |   | 2,375 |   |
|                            |   |   | 14,302 |   |   |   | 12,206 |   |
| Less accumulated depreciation   |   |   | (9,788 | )      |   |   | (7,915 | ) |
|                            |   | $      | 4,514  |   |   | $      | 4,291 |   |

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|                      |   |   |   |
|---------------------------|--------|--------|--------|
|                      |   | 2010   |   |   | 2009 |   |   | 2008 |   |
| Federal - current         |   | $      | 14,970 |   |   | $ | 13,208 |   |   | $ | 7,304 |   |
| State and local - current |   |   | 2,938  |   |   |   | 2,570 |   |   |   | 1,316 |   |
| Deferred                  |   |   | 2,770  |   |   |   | 724 |   |   |   | 1,965 |   |
|                      |   | $      | 20,678 |   |   | $ | 16,502 |   |   | $ | 10,585 |   |

|                                          |   |
|-----------------------------------------------|--------|
|                                          | 2010   |   | 2009 |   | 2008 |
| Tax provision using statutory rate            | 35.0%  |   | 35.0% |   | 35.0% |
| State and local taxes, net of Federal benefit | 4.3%   |   | 7.3% |   | 4.0% |
| Valuation allowance                           | 0.3%   |   | -4.2% |   | 0.0% |
| Other, net                                    | 0.6%   |   | 2.1% |   | 0.4% |
| Tax provision for continuing operations       | 40.2%  |   | 40.2% |   | 39.4% |

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|                                                                                  |   |   |   |   |   |   |
|---------------------------------------------------------------------------------------|--------|--------|--------|--------|--------|--------|
|                                                                                  |   | 2010   |   |   | 2009   |   |
| Deferred tax assets                                                                   |   |   |   |   |   |   |
| Non-deductible reserves and allowances                                                |   | $      | 6,647  |   |   | $      | 5,861 |   |
| Insurance accruals                                                                    |   |   | 2,113  |   |   |   | 2,107 |   |
| Net operating loss carryforwards                                                      |   |   | 1,812  |   |   |   | 2,741 |   |
|                                                                                  |   |   | 10,572 |   |   |   | 10,709 |   |
| Valuation allowance                                                                   |   |   | (1,113 | )      |   |   | (942 | ) |
| Deferred tax assets                                                                   |   |   | 9,459  |   |   |   | 9,767 |   |
|                                                                                  |   |   |   |   |   |   |   |   |
| Deferred tax liabilities                                                              |   |   |   |   |   |   |   |   |
| Intangibles                                                                           |   |   | (8,707 | )      |   |   | (6,469 | ) |
| Accelerated depreciation                                                              |   |   | (994   | )      |   |   | (770 | ) |
| Deferred tax liabilities                                                              |   |   | (9,701 | )      |   |   | (7,239 | ) |
| Net deferred tax (liabilities) assets                                                 |   | $      | (242   | )      |   | $      | 2,528 |   |
|                                                                                  |   |   |   |   |   |   |   |   |
| Deferred tax (liabilities) assets are reflected in the accompanying balance sheet as: |   |   |   |   |   |   |   |   |
| Current assets                                                                        |   |   | 8,521  |   |   |   | 7,786 |   |
| Long-term liabilities                                                                 |   |   | (8,763 | )      |   |   | (5,258 | ) |
| Net deferred tax (liabilities) assets                                                 |   | $      | (242   | )      |   | $      | 2,528 |   |

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|              |   | Shares |   |   | Wtd. Avg. Ex. Price |   |
|-------------------|--------|--------|--------|--------|---------------------|--------|
| December 31, 2007 |   |   | 317    |   |                | $      | 11.87 |   |
|              |   |   |   |   |                |   |   |   |
| Granted           |   |   | 90     |   |                |   | 23.43 |   |
| Exercised         |   |   | (11    | )      |                |   | 5.50 |   |
| Forfeited         |   |   | (22    | )      |                |   | 20.82 |   |
| December 31, 2008 |   |   | 374    |   |                | $      | 14.24 |   |
|              |   |   |   |   |                |   |   |   |
| Granted           |   |   | 85     |   |                |   | 35.14 |   |
| Exercised         |   |   | (20    | )      |                |   | 5.59 |   |
| Forfeited         |   |   | (9     | )      |                |   | (20.05 | ) |
| December 31, 2009 |   |   | 430    |   |                | $      | 18.87 |   |
|              |   |   |   |   |                |   |   |   |
| Granted           |   |   | 2      |   |                |   | 31.91 |   |
| Exercised         |   |   | (95    | )      |                |   | 5.44 |   |
| Forfeited         |   |   | (25    | )      |                |   | (26.92 | ) |
| December 31, 2010 |   |   | 312    |   |                | $      | 22.41 |   |

|                               |   |   |   |   |   |   |   |   |   |
|------------------------------------|--------|--------|--------|--------|--------|--------|--------|--------|--------|
|                               |   | 2010   |   |   | 2009   |   |   | 2008   |   |
| Exercisable at end of year         |   |   | 199    |   |   |   | 210    |   |   |   | 173 |   |
| Weighted average price             |   | $      | 19.59  |   |   | $      | 10.50  |   |   | $ | 6.39 |   |
|                               |   |   |   |   |   |   |   |   |   |   |   |   |
| Weighted average fair value        |   |   |   |   |   |   |   |   |   |   |   |   |
| of options granted during the year |   | $      | 11.08  |   |   | $      | 17.16  |   |   | $ | 9.89 |   |

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|              |   | Shares |   |   | Wtd. Avg. Ex. Price |   |
|-------------------|--------|--------|--------|--------|---------------------|--------|
| December 31, 2009 |   |   | 221    |   |                | $      | 26.83 |   |
| Vested            |   |   | 89     |   |                |   | 26.02 |   |
| Granted           |   |   | 2      |   |                |   | 31.91 |   |
| Forfeited         |   |   | 21     |   |                |   | 27.64 |   |
| December 31, 2010 |   |   | 113    |   |                | $      | 27.40 |   |

|                    |       |   | Options Outstanding |   |   | Options Exercisable                  |   |
|-------------------------|------------|--------|---------------------|--------|--------|--------------------------------------|--------|
| Range of Exercise Price |       |   | Shares              |   |   | Wtd. Avg. Remaining Contractual Life |   |   | Wtd. Avg. Exercise Price |   |   | Shares |   |   | Wtd. Avg. Exercise Price |   |
| $                       | 2.13-3.00  |   |                |   | 20     |                                 |   |   | 0.05 |   |   | $ | 2.13 |   |   |   | 20 |   |   | $ | 2.13 |   |
| $                       | 3.01-25.00 |   |                |   | 209    |                                 |   |   | 6.13 |   |   | $ | 19.03 |   |   |   | 144 |   |   | $ | 18.22 |   |
| Over $25.00             |       |   |                | 83     |   |                                 |   | 8.24 |   |   | $ | 35.89 |   |   |   | 35 |   |   | $ | 35.22 |   |
| $                       | 2.13-25.00 |   |                |   | 312    |                                 |   |   | 6.30 |   |   | $ | 22.41 |   |   |   | 199 |   |   | $ | 19.59 |   |

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| 2011  |   | $      | 4,523  |   |
|-------|--------|--------|--------|--------|
| 2012  |   |   | 3,344  |   |
| 2013  |   |   | 1,900  |   |
| 2014  |   |   | 857    |   |
| 2015  |   |   | 845    |   |
| Total |   | $      | 11,469 |   |

|                                              |   | Capital Leases |   |   | Acquisition Notes Payable |   |   | Total  |   |
|---------------------------------------------------|--------|----------------|--------|--------|---------------------------|--------|--------|--------|--------|
| 2011                                              |   | $              | 105    |   |                      | $      | 1,600  |   |   | $ | 1,705 |   |
| 2012                                              |   |           | -      |   |                      |   | 1,200  |   |   |   | 1,200 |   |
| 2013                                              |   |           | -      |   |                      |   | 125    |   |   |   | 125 |   |
| 2014                                              |   |           | -      |   |                      |   | -      |   |   |   | - |   |
| 2015                                              |   |           | -      |   |                      |   | -      |   |   |   | - |   |
|                                              |   |           | 105    |   |                      |   | 2,925  |   |   |   | 3,030 |   |
| Less: amount representing interest                |   |           | (10    | )      |                      |   | -      |   |   |   | (10 | ) |
| Present value of minimum lease/principal payments |   |           | 95     |   |                      |   | 2,925  |   |   |   | 3,020 |   |
| Less: current portion                             |   |           | 95     |   |                      |   | 1,600  |   |   |   | 1,695 |   |
|                                              |   | $              | -      |   |                      | $      | 1,325  |   |   | $ | 1,325 |   |

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|                          |   | Year Ended December 31, |    |
|-------------------------------|--------|-------------------------|---------|
|                          |   | 2010                    |    |   | 2009 |   |   | 2008 |   |
| Net revenues                  |   |                    |    |   |   |   |   |   |   |
| Visiting Nurses               |   | $                       | 294,915 |   |   | $ | 256,060 |   |   | $ | 172,977 |   |
| Personal Care                 |   |                    | 42,009  |   |   |   | 41,789 |   |   |   | 38,540 |   |
|                          |   | $                       | 336,924 |   |   | $ | 297,849 |   |   | $ | 211,517 |   |
|                          |   |                    |    |   |   |   |   |   |   |   |   |   |
| Operating income              |   |                    |    |   |   |   |   |   |   |   |   |   |
| Visiting Nurses               |   | $                       | 66,333  |   |   | $ | 53,755 |   |   | $ | 36,645 |   |
| Personal Care                 |   |                    | 5,715   |   |   |   | 5,166 |   |   |   | 3,770 |   |
| Unallocated                   |   |                    | (20,391 | ) |   |   | (17,252 | ) |   |   | (12,775 | ) |
|                          |   | $                       | 51,657  |   |   | $ | 41,669 |   |   | $ | 27,640 |   |
|                          |   |                    |    |   |   |   |   |   |   |   |   |   |
| Identifiable assets           |   |                    |    |   |   |   |   |   |   |   |   |   |
| Visiting Nurses               |   | $                       | 147,041 |   |   | $ | 142,364 |   |   | $ | 134,877 |   |
| Personal Care                 |   |                    | 15,521  |   |   |   | 14,897 |   |   |   | 15,563 |   |
| Unallocated                   |   |                    | 57,565  |   |   |   | 26,128 |   |   |   | 6,657 |   |
|                          |   | $                       | 220,127 |   |   | $ | 183,389 |   |   | $ | 157,097 |   |
|                          |   |                    |    |   |   |   |   |   |   |   |   |   |
| Identifiable liabilities      |   |                    |    |   |   |   |   |   |   |   |   |   |
| Visiting Nurses               |   | $                       | 10,458  |   |   | $ | 12,048 |   |   | $ | 15,237 |   |
| Personal Care                 |   |                    | 2,834   |   |   |   | 3,375 |   |   |   | 2,106 |   |
| Unallocated                   |   |                    | 24,667  |   |   |   | 18,989 |   |   |   | 44,971 |   |
|                          |   | $                       | 37,959  |   |   | $ | 34,412 |   |   | $ | 62,314 |   |
|                          |   |                    |    |   |   |   |   |   |   |   |   |   |
| Capital expenditures          |   |                    |    |   |   |   |   |   |   |   |   |   |
| Visiting Nurses               |   | $                       | 1,815   |   |   | $ | 884 |   |   | $ | 597 |   |
| Personal Care                 |   |                    | 69      |   |   |   | 52 |   |   |   | 52 |   |
| Unallocated                   |   |                    | 723     |   |   |   | 1,198 |   |   |   | 827 |   |
|                          |   | $                       | 2,607   |   |   | $ | 2,134 |   |   | $ | 1,476 |   |
|                          |   |                    |    |   |   |   |   |   |   |   |   |   |
| Depreciation and amortization |   |                    |    |   |   |   |   |   |   |   |   |   |
| Visiting Nurses               |   | $                       | 1,379   |   |   | $ | 1,076 |   |   | $ | 671 |   |
| Personal Care                 |   |                    | 44      |   |   |   | 30 |   |   |   | 22 |   |
| Unallocated                   |   |                    | 1,490   |   |   |   | 1,279 |   |   |   | 637 |   |
|                          |   | $                       | 2,913   |   |   | $ | 2,385 |   |   | $ | 1,330 |   |

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|                       |   | Year Ended December 31, 2010 |   |   | Year Ended December 31, 2009 |   |
|----------------------------|--------|------------------------------|--------|--------|------------------------------|--------|
|                       |   | Dec. 31                      |   |   | Sept. 30                     |   |   | Jun. 30 |   |   | Mar. 31 |   |   | Dec. 31 |   |   | Sept. 30 |   |   | Jun. 30 |   |   | Mar. 31 |   |
| Net service revenues       |   | $                            | 84,643 |   |                         | $      | 84,897 |   |   | $ | 85,606 |   |   | $ | 81,778 |   |   | $ | 78,021 |   |   | $ | 76,294 |   |   | $ | 74,593 |   |   | $ | 68,941 |   |
| Gross margin               |   |                         | 46,226 |   |                         |   | 45,766 |   |   |   | 46,977 |   |   |   | 44,192 |   |   |   | 41,948 |   |   |   | 40,515 |   |   |   | 40,096 |   |   |   | 36,725 |   |
| Net income                 |   | $                            | 6,987  |   |                         | $      | 7,941 |   |   | $ | 8,342 |   |   | $ | 7,443 |   |   | $ | 6,809 |   |   | $ | 6,166 |   |   | $ | 5,994 |   |   | $ | 5,595 |   |
|                       |   |                         |   |   |                         |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Average shares outstanding |   |                         |   |   |                         |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Basic                      |   |                         | 9,149  |   |                         |   | 9,143 |   |   |   | 9,110 |   |   |   | 9,071 |   |   |   | 9,058 |   |   |   | 8,281 |   |   |   | 8,176 |   |   |   | 8,152 |   |
| Diluted                    |   |                         | 9,363  |   |                         |   | 9,343 |   |   |   | 9,366 |   |   |   | 9,326 |   |   |   | 9,308 |   |   |   | 8,448 |   |   |   | 8,389 |   |   |   | 8,281 |   |
|                       |   |                         |   |   |                         |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Net income per share       |   |                         |   |   |                         |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |
| Basic                      |   | $                            | 0.76   |   |                         | $      | 0.87 |   |   | $ | 0.92 |   |   | $ | 0.82 |   |   | $ | 0.75 |   |   | $ | 0.74 |   |   | $ | 0.73 |   |   | $ | 0.69 |   |
| Diluted                    |   | $                            | 0.75   |   |                         | $      | 0.85 |   |   | $ | 0.89 |   |   | $ | 0.80 |   |   | $ | 0.73 |   |   | $ | 0.73 |   |   | $ | 0.71 |   |   | $ | 0.68 |   |

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| /s/ William B. Yarmuth                               |   | /s/ C. Steven Guenthner                                  |
|------------------------------------------------------|--------|----------------------------------------------------------|
| William B. Yarmuth                                   |   | C. Steven Guenthner                                      |
| Chairman, President and Chief Executive Officer |   | Senior Vice President & Chief Financial Officer |
| Date: February 28, 2011                              |   | February 28, 2011                                        |

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ITEM 9

ITEM 9A.

ITEM 9B

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PART III

ITEM 10.

| Name                     |   | Age |   | Position with the Company                                    |
|--------------------------|--------|-----|--------|--------------------------------------------------------------|
| William B. Yarmuth (1)   |   | 58  |   | Chairman of the Board, President and Chief Executive Officer |
| C. Steven Guenthner (2)  |   | 50  |   | Senior Vice President and Chief Financial Officer            |
| P. Todd Lyles (3)        |   | 49  |   | Senior Vice President – Administration                 |
| Anne T. Liechty (4)      |   | 58  |   | Senior Vice President - Operations                           |
| Phyllis D. Montville (5) |   | 62  |   | Senior Vice President – Operations                     |
| Carla J. Hengst (6)      |   | 55  |   | Vice President – PC Operations                         |

| (1) | William B. Yarmuth has been a director of the Company since 1991, when the Company acquired National Health Industries (“National”), where Mr. Yarmuth was Chairman, President and Chief Executive Officer.  After the acquisition, Mr. Yarmuth became the President and Chief Operating Officer of the Company.  Mr. Yarmuth became Chairman and CEO in 1992.  He was Chairman of the Board, President and Chief Executive Officer of National from 1981 to 1991. |
|-----|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| (2) | C. Steven Guenthner has been Senior Vice President and Chief Financial Officer of the Company since 1992.  From 1983 through 1992 Mr. Guenthner was employed as a C.P.A. with Arthur Andersen LLP.  Prior to joining the Company he served as a Senior Manager in the firm’s Accounting and Audit division specializing in mergers and acquisitions, public companies and the healthcare industry. |
|-----|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| (3) | P. Todd Lyles joined the Company as Senior Vice President Planning and Development in October 1997 and now serves as Senior Vice President – Administration.  Prior to joining the Company Mr. Lyles was Vice President Development for the Kentucky Division of Columbia/HCA, a position he had held since 1993.  Mr. Lyles experience also includes 8 years with Humana Inc. in various financial and hospital management positions. |
|-----|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| (4) | Anne T. Liechty became Senior Vice President – VN Operations in 2001.  Ms. Liechty has been employed by the Company since 1986 in various capacities including Vice President of Operations for the Company’s VN segment and its Product segment. |
|-----|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| (5) | Phyllis Montville became Senior Vice President – Operations in 2007.  Ms. Montville came to the company in 2006 as Vice President of VN Operations in Florida.  She has 23 years experience in home care management, most of which is in the Florida market.  Ms. Montville owned and operated her own franchise for 10 years.  She started in the home care field as a branch manager and home care nurse. |
|-----|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

| (6) | Carla J. Hengst joined the Company in June of 2008 as Vice President and now serves as the Vice President of Personal Care Operations.  Prior to joining the Company, Ms. Hengst was a Vice President of Operations for US Medical Management for two years.  Ms. Hengst’s experience also includes 17 years with Gentiva Health Services in various management positions. |
|-----|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

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|   | Code of Ethics |
|--------|----------------|

ITEMS 11, 12, 13 and 14.

| Plan Category                      |   | Shares to be Issued Upon Exercise |   |   | Weighted Average Option Exercise Price |   |   | Shares Available for Future Grants |   |
|------------------------------------|--------|-----------------------------------|--------|--------|----------------------------------------|--------|--------|------------------------------------|--------|
|                               |   |                              |   |   |                                   |   |   |                               |   |
| Plans approved by shareholders     |   |                              | 312    |   |                                   | $      | 22.41  |                               |   |   | 220 |   |
| Plans not approved by shareholders |   |                              | -      |   |                                   |   | -      |                               |   |   | - |   |
| Total                              |   |                              | 312    |   |                                   | $      | 22.41  |                               |   |   | 220 |   |

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PART IV

ITEM 15.

| (a)   | The following items are filed as part of this report: |
|-----------------|-------------------------------------------------------|

| 1.   | Index to Consolidated Financial Statements |
|----------------|--------------------------------------------|

|   | Consolidated Statements of Income for the years ended December 31, 2010, 2009 and 2008                          | 46     |
|--------|-----------------------------------------------------------------------------------------------------------------|--------|
|   | Consolidated Balance Sheets as of December 31, 2010 and 2009                                                    | 47     |
|   | Consolidated Statements of Stockholders’ Equity for the years ended December 31, 2010, 2009 and 2008 | 48     |
|   | Consolidated Statements of Cash Flows for the years ended December 31, 2010, 2009 and 2008                      | 49     |
|   | Notes to Consolidated Financial Statements                                                                      | 50     |
|   | Report of Independent Registered Public Accounting Firm                                                         | 66     |
|   |                                                                                                            |   |
| 2. .   |  Index to Financial Statement Schedule                                                                |   |
|   | Schedule II – Valuation and Qualifying Accounts                                                           | 77     |

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| 3.1    | Certificate of Incorporation, as amended, of the Registrant (incorporated by reference to Exhibit No. 3.1 of the Registrant’s Annual Report on Form 10-K for the year ended March 31, 1997 and Exhibit 3.1 of the Registrant’s Quarterly Report Form 10-Q for the quarter ended September 30, 2008)                                                                                |
|--------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 3.2    | Amended and Restated Bylaws of the Registrant (incorporated by reference to Exhibit 3 of the Registrant’s Current Report on Form 8-K dated November 12, 2007)                                                                                                                                                                                                                            |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 4.1    | Other Debt Instruments – copies of other debt instruments for which the total debt is less than 10% of assets will be furnished to the Commission upon request.                                                                                                                                                                                                                          |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.1+  | Nonqualified Stock Option Plan, as amended (incorporated by reference to the Registrant’s Registration Statement on Form S-8 Reg. No. 33-20815).                                                                                                                                                                                                                                         |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.2+  | Supplemental Nonqualified Stock Option Plan (incorporated by reference to Exhibit 19.4 to the Registrant’s Report on Form 10-Q for the Quarter Ended November 30, 1987 Commission File No. 15342).                                                                                                                                                                                       |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.3+  | Incentive Stock Option Plan, as amended (incorporated by reference to the Registrant’s Registration Statement on Form S-8 Reg. No. 33-20815).                                                                                                                                                                                                                                            |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.4+  | Amendment to the Senior Service Corporation 1987 Nonqualified Stock Option Plan (incorporated by reference to Exhibit 19.3 to the Registrant’s Report on Form 10-Q for the quarter ended November 30, 1989).                                                                                                                                                                             |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.5+  | 1991 Long-Term Incentive Plan (incorporated by references to the Registrant’s Registration Statement on Form S-8 Reg. No. 33-81124).                                                                                                                                                                                                                                                     |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.6+  | Employment Agreement, dated January 1, 1996, between the Company and William B. Yarmuth (incorporated by reference to the Registrant’s report on Form 10-K for the year ended March 31, 1996).                                                                                                                                                                                           |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.7   | Loan Agreement between the Company and Bank One, KY (incorporated by reference to the Registrant’s report on Form 10-K for the year ended March 31, 2001).                                                                                                                                                                                                                               |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.8   | Third Amendment to Loan Agreement between the Company and Bank One, NA, dated March 23, 2004 (incorporated by reference to the Registrant’s report on Form 10-K for the year ended December 31, 2003)                                                                                                                                                                                    |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.9   | Fourth Amendment to Loan Documents dated as of August 11, 2005, by and between (i) Almost Family, Inc., (ii) each of the subsidiaries of AFI that is party to the Agreement, and (iii) JP Morgan Chase Bank, N.A. (successor  by merger to Bank One N.A.).  (incorporated by reference to the Registrant’s report on Form 10-Q for the quarter ended June 30, 2005). |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.10  | Fifth Amendment to Loan Documents dated as of December 4, 2007, by and between (i) Almost Family, Inc., (ii) each of the subsidiaries of Almost Family, Inc. that is party to the Amendment, and (iii) JP Morgan Chase Bank, N.A. (successor  by merger to Bank One N.A).                                                                                                            |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.11+ | 2007 Stock and Incentive Compensation Plan (incorporated by reference to Appendix A of the Definitive Proxy Statement on Schedule 14A as filed on June 25, 2007).                                                                                                                                                                                                                              |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |
| 10.12+ | 2000 Stock Option Plan (incorporated by reference to the Registrant’s Registration Statement on Form S-8 Reg. No. 333-88744).                                                                                                                                                                                                                                                            |
|   |                                                                                                                                                                                                                                                                                                                                                                                           |

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| 10.13+ | Amended and Restated Non-Employee Directors Deferred Compensation Plan                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|--------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| 10.14+ | 1993 Non-Employee Directors Stock Option Plan (incorporated by reference to the Registrant’s Registration Statement on Form S-8 Reg. No. 333-881100).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| 10.15+ | Forms of Stock Option Agreements and Restricted Stock Award Agreement pursuant to 2007 Stock and Incentive Plan (incorporated by reference to the Registrant’s report on Form 10-K for the year ended December 31, 2008).                                                                                                                                                                                                                                                                                                                                                                                                                        |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| 10.16  | Stock Purchase Agreement dated as of June 18, 2008 among (i) the Registrant, (ii) PCI Holding Corp. and (iii) National Home Care, Inc. (solely in its capacity as the Seller Representative), including executed copies of the following exhibits: (incorporated by reference to Exhibit 10.1 of the Registrant’s Quarterly Report on form 10-Q for the quarter ended June 30, 2008) (listed omitted attachments and schedules will be furnished supplementally to the SEC upon request):                                                                                                                                                        |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| (A)    | Assumption and Indemnification Agreement dated as of June 18, 2008, by and among (i) PCI Holding Corp., (ii) Patient Care, Inc., (iii) National Home Care, Inc., (iv) Patient Care, Inc. – Illinois, (v) Patient Care Medical Services, Inc. – Ohio, (vi) Georgia Nursing Services, Inc., (vii) Patient Care Massachusetts, Inc., (viii) E.C. Solutions, Inc., (ix) Patient Care Florida, Inc., (x) Patient Care Medical Services, Inc., (xi) Priority Care, Inc., (xii) Patient Care Pennsylvania, Inc., (xiii) Patient Care New Jersey, Inc., and (xiv) the Registrant; |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| (B-1)  | Consulting Agreement dated as of June 18, 2008 among (i) the Registrant, (ii) Robert Nixon, and (iii) Nixco, LLC (omitted);                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| (B-2)  | Nonsolicitation and Noncompetition Agreement dated June 18, 2008 among (i) the Registrant and Patient Care and (ii) Robert Nixon and Nixco LLC (omitted),                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| (C)    | Release Agreements dated as of June 18, 2008 by and between (i) Robert Nixon, Elias Nemnom, and Raymond Rasa, respectively, and (ii) Patient Care, Patient Care Medical Services, Inc., Priority Care, Inc., Patient Care Pennsylvania, Inc., Patient Care New Jersey, Inc.;                                                                                                                                                                                                                                                                                                                                                                           |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| (D)    | Escrow Agreement dated June 18, 2008 among the Registrant, PCI Holding Corp., National Home Care, Inc., and JPMorgan Chase Bank, National Association;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| (E)    | Form of Seller Counsel Opinion Letter; and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| (F)    | Form of Buyer Counsel Opinion Letter.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| 10.17  | Credit Agreement, dated as of July 15, 2008 among Almost Family, Inc., the lenders party thereto, JPMorgan Chase Bank, N.A. as Administrative Agent and Fifth Third Bank as Syndication Agent.  (Except for Schedule 5.09, schedules have been omitted.  Almost Family undertakes to furnish supplemental copies of any of the omitted schedules upon request by the Securities and Exchange Commission.) (Incorporated by reference to Exhibit 10.1 of the Registrant's Current Report on Form 8-K dated July 15, 2008.)                                                                                                          |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |
| 10.18+ | Amendment dated January 1, 2009  to  Employment Agreement  effective January 1,  1996, between the Registrant and William B. Yarmuth (incorporated by reference to the Registrant’s report on Form 10-K for the year ended December 31, 2008).                                                                                                                                                                                                                                                                                                                                                           |
|   |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |

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| 10.19+    | Amendment to Amended and Restated 2000 Stock Option Plan dated January 1, 2009 (incorporated by reference to the Registrant’s report on Form 10-K for the year ended December 31, 2008).                                                                                                                                   |
|-----------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
|      |                                                                                                                                                                                                                                                                                                                             |
| 10.20     | Almost Family, Inc. 2009 Employee Stock Purchase Plan (incorporated by reference to Appendix A of the Definitive Proxy Statement on Schedule 14A as filed on July 1, 2009).                                                                                                                                                      |
|      |                                                                                                                                                                                                                                                                                                                             |
| 10.21     | Credit Agreement, dated as of December 2, 2010 among Almost Family, Inc., the lenders party thereto, JPMorgan Chase Bank, N.A. as Administrative Agent and Bank of America, N.A., as Syndication Agent.  (Incorporated by reference to Exhibit 10.1 of the Registrant's Current Report on Form 8-K dated December 2, 2010). |
|  21* |  List of Subsidiaries of Almost Family, Inc.                                                                                                                                                                                                                                                                                |
|      |                                                                                                                                                                                                                                                                                                                             |
| 23.1*     | Consent of Ernst & Young LLP                                                                                                                                                                                                                                                                                                 |
|      |                                                                                                                                                                                                                                                                                                                             |
| 31.1*     | Certification of Chief Executive Officer pursuant to Rule 13a-14(a) and Rule 15d-14(a) of the Securities Exchange Act, as amended.                                                                                                                                                                                               |
|      |                                                                                                                                                                                                                                                                                                                             |
| 31.2*     | Certification of Chief Financial Officer pursuant to Rule 13a-14(a) and Rule 15d-14(a) of the Securities Exchange Act, as amended.                                                                                                                                                                                               |
|      |                                                                                                                                                                                                                                                                                                                             |
| 32.1*     | Certification of Chief Executive Officer  pursuant to 18 U.S.C 1350, as adopted pursuant tosection 906 of the Sarbanes Oxley Act of 2002.                                                                                                                                                                              |
|      |                                                                                                                                                                                                                                                                                                                             |
| 32.2*     | Certification of Chief Financial Officer  pursuant to 18 U.S.C 1350, as adopted pursuant to section 906 of the Sarbanes Oxley Act of 2002.                                                                                                                                                                             |

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| Signature |                     | Title  |                                                           | Date                                              |
|-----------|--------------------------|--------|----------------------------------------------------------------|---------------------------------------------------|
|      |                     |   |                                                           |                                              |
| By:       | /s/ William B. Yarmuth   |   |                                                           | Director, Chief Executive Officer and President   |   | February 28, 2011 |
|      | William B. Yarmuth       |   | (principal executive officer)                                  |                                              |   |
|      |                     |   |                                                           |                                              |   |
| By:       | /s/ C. Steven Guenthner  |   |                                                           | Senior Vice President and Chief Financial Officer |   | February 28, 2011 |
|      | C. Steven Guenthner      |   | (principal financial officer and principal accounting officer) |                                              |   |
|      |                     |   |                                                           |                                              |   |
| By:       | /s/ Steven B. Bing       |   |                                                           | Director                                          |   | February 28, 2011 |
|      | Steven B. Bing           |   |                                                           |                                              |   |
|      |                     |   |                                                           |                                              |   |
| By:       | /s/ Donald G. McClinton  |   |                                                           | Director                                          |   | February 28, 2011 |
|      | Donald G. McClinton      |   |                                                           |                                              |   |
|      |                     |   |                                                           |                                              |   |
| By:       | /s/ Tyree G. Wilburn     |   |                                                           | Director                                          |   | February 28, 2011 |
|      | Tyree G. Wilburn         |   |                                                           |                                              |   |
|      |                     |   |                                                           |                                              |   |
| By:       | /s/ Jonathan D. Goldberg |   |                                                           | Director                                          |   | February 28, 2011 |
|      | Jonathan D. Goldberg     |   |                                                           |                                              |   |
|      |                     |   |                                                           |                                              |   |
| By:       | /s/ W. Earl Reed, III    |   |                                                           | Director                                          |   | February 28, 2011 |
|      | W. Earl Reed, III        |   |                                                           |                                              |   |
|      |                     |   |                                                           |                                              |   |
| By:       | /s/ Henry M. Altman, Jr. |   |                                                           | Director                                          |   | February 28, 2011 |
|      | Henry M. Altman, Jr.     |   |                                                           |                                              |   |

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|                                  |   | Col. A                         |   |   | Col. B                           |   |   | Col. C                       |   |   | Col. D         |   |   | Col. E                   |   |
|---------------------------------------|--------|--------------------------------|--------|--------|----------------------------------|--------|--------|------------------------------|--------|--------|----------------|--------|--------|--------------------------|--------|
|                                  |   |                           |   |   |                             |   |   |                         |   |   |           |   |   |                     |   |
|                                  |   |                           |   |   | Additions/(Deductions)           |   |   |                         |   |   |           |   |
| Description                           |   | Balance at Beginning of Period |   |   | (1)Charged to Costs and Expenses |   |   | (2)Charged to Other Accounts |   |   | (3) Deductions |   |   | Balance at End of Period |   |
|                                  |   |                           |   |   |                             |   |   |                         |   |   |           |   |   |                     |   |
| Allowance for uncollectible accounts: |   |                           |   |   |                             |   |   |                         |   |   |           |   |   |                     |   |
| Year Ended December 31, 2010          |   | $                              | 6,534  |   |                             | $      | 3,675  |                         |   | $      | (451           | )      |   | $                        | (2,233 | ) |   | $ | 7,525 |   |
|                                  |   |                           |   |   |                             |   |   |                         |   |   |           |   |   |                     |   |   |   |   |   |   |
| Year Ended December 31, 2009          |   |                           | 4,418  |   |                             |   | 3,762  |                         |   |   | 155            |   |   |                     | (1,801 | ) |   |   | 6,534 |   |
|                                  |   |                           |   |   |                             |   |   |                         |   |   |           |   |   |                     |   |   |   |   |   |   |
| Year Ended December 31, 2008          |   |                           | 3,006  |   |                             |   | 2,963  |                         |   |   | 392            |   |   |                     | (1,943 | ) |   |   | 4,418 |   |

| (1)   | Charged to bad debt expense. |
|-----------------|------------------------------|

| (2)   | Acquired uncollectible accounts reserves. |
|-----------------|-------------------------------------------|

| (3)   | Write-off of accounts. |
|-----------------|------------------------|

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