Income Taxes - Significant Components of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Deferred Tax Assets:
Accrued other and prepaid expenses	$ 3,494	$ 2,973
Allowance for doubtful accounts	704	1,278
Intangible Assets	10,725	11,365
Net operating loss carryforwards	17,228	22,662
Derivative interest	7,940	10,144
Accrued professional liability	2,632	2,536
Accrued workers’ compensation	3,439	3,061
Share-based compensation	0	891
Credit carryforwards	1,055	797
Other	584	595
Gross deferred tax assets	47,801	56,302
Valuation allowance	(46,454)	(55,336)
Deferred tax assets, net	1,347	966
Deferred Tax Liabilities:
Depreciation	(70)	(123)
Indefinite intangibles	(13,971)	(18,714)
Tax on unrepatriated earnings	(263)	(604)
Share-based compensation	(197)	0
Deferred tax liabilities, gross	(14,501)	(19,441)
Net deferred taxes	$ (13,154)	$ (18,475)