Significant Components of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Deferred Tax Assets:
Accrued other and prepaid expenses	$ 2,973	$ 2,823
Allowance for doubtful accounts	1,278	589
Intangible Assets	11,365	13,716
Net operating loss carryforwards	22,662	38,144
Derivative interest	10,144	6,370
Accrued professional liability	2,536	0
Accrued workers’ compensation	3,061	1,356
Share-based compensation	891	959
Depreciation	0	105
Credit carryforwards	797	0
Other	595	822
Gross deferred tax assets	56,302	64,884
Valuation allowance	(55,336)	(63,616)
Deferred tax assets, net	966	1,268
Deferred Tax Liabilities:
Depreciation	(123)	0
Accrued professional liability	0	(92)
Indefinite intangibles	(18,714)	(19,683)
Tax on unrepatriated earnings	(604)	(336)
Other	0	(1,176)
Deferred tax liabilities, gross	(19,441)	(21,287)
Net deferred taxes	$ (18,475)	$ (20,019)