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Commitments and Contingencies (Details) - USD ($)
9 Months Ended
Apr. 03, 2018
Mar. 23, 2018
Sep. 30, 2019
Dec. 31, 2018
Commitments And Contingencies [Line Items]        
General amount of guarantee (as a percent)     2.00%  
Amount outstanding     $ 250,000,000  
Damages sought $ 5,000,000 $ 5,000,000.0    
Standby Letters of Credit        
Commitments And Contingencies [Line Items]        
Amount outstanding     300,000  
Preferred Bank        
Commitments And Contingencies [Line Items]        
Amount outstanding     $ 14,800,000 $ 14,800,000
Standby Letters of Credit | APC        
Commitments And Contingencies [Line Items]        
Term of facility     1 year  
Alpha Care Medical Group, Inc. | Standby Letters of Credit | APC and APC-LSMA        
Commitments And Contingencies [Line Items]        
Term of facility     1 year  
Standby letters of credit assumed     $ 3,800,000