Summary of Significant Accounting Policies - Components of Property, Building and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Other Long Term Assets [Line Items]
Property, building and equipment, gross	$ 78,477	$ 77,003
Less accumulated depreciation	35,226	38,907
Property, Plant and Equipment, Net	43,251	38,096
Land [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	2,033	2,033
Building and improvements [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	11,363	10,026
Transportation equipment [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	11,220	6,912
Fixed equipment [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	1,090	3,373
Office furniture and medical equipment [Member]
Other Long Term Assets [Line Items]
Property, building and equipment, gross	$ 52,771	$ 54,659