Almost Family Merger - Pro Forma Schedule (Details) - Almost Family - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Net service revenue	$ 2,002,420	$ 1,845,041
Net income attributable to the Company	$ 79,434	$ 70,526
Diluted earnings per share	$ 2.55	$ 2.26