Significant Components of Deferred Tax Assets and Liabilities (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
Current deferred tax assets (liabilities):
Accrued other and prepaid expenses	$ 2,591,944	$ 2,302,277
Accrued settlement charge	283,534	0
Allowance for doubtful accounts	649,790	808,466
Assets held for sale	0	2,826,663
Other	468,082	597,237
Gross deferred tax assets	3,993,350	6,534,643
Valuation allowance	(4,528,177)	(551,160)
Deferred tax assets (liabilities)	(534,827)	5,983,483
Non-current deferred tax (liabilities) and assets:
Amortization	(1,313,863)	4,377,573
Depreciation	(383,895)	(1,631,495)
Identifiable intangibles	(2,237,409)	(2,409,238)
Net operating loss carryforwards	32,531,221	23,616,558
Accrued professional liability	(117,842)	293,815
Accrued workers' compensation	675,201	768,617
Tax on unrepatriated earnings	(453,298)	(1,860,656)
Share-based compensation	1,610,346	2,120,269
Other	313,898	966,361
Gross deferred tax assets	30,624,359	26,241,804
Valuation allowance	(47,473,410)	(3,481,752)
Deferred tax (liabilities) assets	(16,849,051)	22,760,052
Net deferred taxes	$ (17,383,878)	$ 28,743,535