Goodwill and Intangibles - Summary of Changes in Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 284,383	$ 284,626
Gross carrying amount, definite-lived intangible assets	28,187	27,929
Accumulated amortization	(15,854)	(15,176)
Net total	12,333	12,753
Gross carrying amount, intangible assets	312,570	312,555
Net total	296,716	297,379
Trade Names
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	10,127	10,127
Accumulated amortization	(9,087)	(8,817)
Net total	1,040	1,310
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	6,238	5,980
Accumulated amortization	(5,846)	(5,729)
Net total	392	251
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	11,822	11,822
Accumulated amortization	(921)	(630)
Net total	10,901	11,192
Trade Names
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	159,632	156,049
Certificates of Need/Licenses
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 124,751	$ 128,577