Income Taxes - Significant Components of Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Deferred Tax Assets:
Accrued other and prepaid expenses	$ 1,600	$ 1,557
Allowance for doubtful accounts	909	624
Intangible assets	27,036	28,889
Net operating loss carryforwards	20,536	19,796
Accrued professional liability claims	1,525	1,794
Accrued workers’ compensation claims	3,015	2,839
Share-based compensation	721	381
Operating lease liabilities	4,871	6,108
Credit carryforwards	188	188
Other	0	128
Gross deferred tax assets	60,401	62,304
Valuation allowance	(37,472)	(37,345)	$ (1,200)
Deferred tax assets	22,929	24,959
Deferred Tax Liabilities:
Depreciation	(1,077)	(224)
Indefinite-lived intangibles	(25,546)	(27,609)
Operating lease right-of-use assets	(2,499)	(4,312)
Tax on unrepatriated earnings	(361)	(337)
Other	(38)	0
Deferred tax liabilities	(29,521)	(32,482)
Net deferred taxes	$ (6,592)	$ (7,523)