Goodwill and Other Intangibles, Net - Schedule of Changes in Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Indefinite-lived intangible assets:
Indefinite-lived intangible assets	$ 284,626	$ 131,792
Definite-lived intangible assets:
Gross carrying amount	27,929	15,859
Accumulated amortization	(15,176)	(13,041)
Net total	12,753	2,818
Total intangible assets, Gross carrying amount	312,555	147,651
Total intangible assets, Net total	297,379	134,610
Trade name
Indefinite-lived intangible assets:
Indefinite-lived intangible assets	156,049	78,299
Certificates of Need/ Licenses
Indefinite-lived intangible assets:
Indefinite-lived intangible assets	128,577	53,493
Trade name
Definite-lived intangible assets:
Gross carrying amount	10,127	10,127
Accumulated amortization	(8,817)	(7,547)
Net total	1,310	2,580
Non-compete
Definite-lived intangible assets:
Gross carrying amount	5,980	5,732
Accumulated amortization	(5,729)	(5,494)
Net total	251	238
Customer Relationships
Definite-lived intangible assets:
Gross carrying amount	11,822	0
Accumulated amortization	(630)	0
Net total	$ 11,192	$ 0