Provision for Loss for Insurance Risks (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Professional Malpractice Liability Insurance
Malpractice Insurance [Line Items]
Continuing operations	$ 70,695	$ 59,190	$ 53,564
Discontinued operations	(4,053)	8,073	31,061
Workers compensation
Malpractice Insurance [Line Items]
Continuing operations	51,191	36,152	37,369
Discontinued operations	$ (3,695)	$ 2,110	$ 11,976