Goodwill and Intangibles - Summary of Changes in Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 279,316	$ 284,626
Gross carrying amount, definite-lived intangible assets	28,187	27,929
Accumulated amortization	(15,549)	(15,176)
Net total	12,638	12,753
Gross carrying amount, intangible assets	307,503	312,555
Net total	291,954	297,379
Trade Names
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	10,127	10,127
Accumulated amortization	(8,984)	(8,817)
Net total	1,143	1,310
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	6,238	5,980
Accumulated amortization	(5,790)	(5,729)
Net total	448	251
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	11,822	11,822
Accumulated amortization	(775)	(630)
Net total	11,047	11,192
Trade Names
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	156,401	156,049
Certificates of need/licenses
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 122,915	$ 128,577