Investments in Other Entities (Summarized Balance Sheets and Statements of Income) (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
LaSalle Medical Associates IPA [Member]
Equity Method Investment, Summarized Financial Information, Assets [Abstract]
Equity Method Investment, Summarized Financial Information, Cash and Cash Equivalents	$ 21,065,105	$ 18,441,306
Equity Method Investment, Summarized Financial Information, Receivables	2,433,116	3,142,173
Equity Method Investment, Summarized Financial Information, Other current assets	1,565,606	1,589,606
Equity Method Investment, Summarized Financial Information, Loan Receivables	1,250,000	1,250,000
Equity Method Investment, Summarized Financial Information, Restricted Cash	662,109	657,171
Equity Method Investment, Summarized Financial Information, Assets	26,975,936	25,080,256
Equity Method Investment, Summarized Financial Information, Liabilities and Equity [Abstract]
Equity Method Investment, Summarized Financial Information, Current Liabilities	20,353,337	18,253,224
Equity Method Investment Summarized Financial Information, Stockholders' equity (deficit)	6,622,599	6,827,032
Equity Method Investment, Summarized Financial Information, Total liabilities and stockholders' equity (deficit)	26,975,936	25,080,256
Equity Method Investment, Summarized Financial Information, Income Statement [Abstract]
Equity Method Investment, Summarized Financial Information, Revenue	195,143,984	191,530,251
Equity Method Investment, Summarized Financial Information, Cost of Sales	188,265,085	164,694,297
Equity Method Investment, Summarized Financial Information, (Loss) income before benefit for income taxes	6,878,899	26,835,954
Equity Method Investment, Summarized Financial Information, Income Taxes Benefit	(3,083,333)	(11,406,393)
Equity Method Investment, Summarized Financial Information, Net Income (Loss)	3,795,566	15,429,561
Universal Care Inc [Member]
Equity Method Investment, Summarized Financial Information, Assets [Abstract]
Equity Method Investment, Summarized Financial Information, Cash and Cash Equivalents	21,872,894	23,155,207
Equity Method Investment, Summarized Financial Information, Receivables	18,618,760	17,928,792
Equity Method Investment, Summarized Financial Information, Other current assets	13,021,520	11,319,582
Equity Method Investment, Summarized Financial Information, Other Assets	3,754,470	2,432,338
Equity Method Investment, Summarized Financial Information, Property And Equipment	1,576,621	1,099,766
Equity Method Investment, Summarized Financial Information, Assets	58,844,265	55,935,685
Equity Method Investment, Summarized Financial Information, Liabilities and Equity [Abstract]
Equity Method Investment, Summarized Financial Information, Current Liabilities	54,421,532	46,718,155
Equity Method Investment, Summarized Financial Information, Other Liabilities	10,051,952	8,075,977
Equity Method Investment Summarized Financial Information, Stockholders' equity (deficit)	(5,629,219)	1,141,553
Equity Method Investment, Summarized Financial Information, Total liabilities and stockholders' equity (deficit)	58,844,265	55,935,685
Equity Method Investment, Summarized Financial Information, Income Statement [Abstract]
Equity Method Investment, Summarized Financial Information, Revenue	188,389,384	161,289,612
Equity Method Investment, Summarized Financial Information, Cost of Sales	193,196,938	161,277,959
Equity Method Investment, Summarized Financial Information, (Loss) income before benefit for income taxes	(4,807,554)	11,653
Equity Method Investment, Summarized Financial Information, Income Taxes Benefit	(36,835)	(1,615,678)
Equity Method Investment, Summarized Financial Information, Net Income (Loss)	(4,770,719)	1,734,206
Equity Method Investment, Summarized Financial Information, Other Income Loss From Discontinued Operations	0	106,875
Equity Method Investment, Summarized Financial Information, Other Income	0	106,875
Equity Method Investment, Summarized Financial Information, Income Loss Before Other Income From Discontinued Operations	$ (4,770,719)	$ 1,627,331