Summary of Significant Accounting Policies - Components of Property, Building and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Other Long Term Assets [Line Items]
Property, building and equipment, gross	$ 77,003	$ 79,470
Less accumulated depreciation	38,907	44,683
Property, Plant and Equipment, Net	38,096	34,787
Land [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	2,033	543
Building and improvements [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	10,026	9,238
Transportation equipment [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	6,912	6,191
Fixed equipment [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	3,373	3,661
Office furniture and medical equipment [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	$ 54,659	$ 59,837