Goodwill and Intangibles - Schedule of Changes in Recorded Goodwill by Reporting Unit (Details) - USD ($) $ in Thousands	6 Months Ended	9 Months Ended
Jun. 30, 2019	Sep. 30, 2019
Goodwill [Roll Forward]
Balance as of December 31, 2018	$ 1,161,717	$ 1,161,717
Acquisitions		45,731
Noncontrolling interests		6,367
Adjustments and disposals		2,412
Balance as of September 30, 2019		1,216,227
Intangible assets
Balance as of December 31, 2018	297,379	297,379
Acquisitions		15,002
Adjustments and disposals		(6,913)
Amortization		(951)
Balance as of September 30, 2019		304,517
Home health reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2018	822,602	822,602
Acquisitions		38,471
Noncontrolling interests		4,248
Adjustments and disposals		595
Balance as of September 30, 2019		865,916
Intangible assets
Balance as of December 31, 2018	215,382	215,382
Acquisitions		11,863
Adjustments and disposals		(7,612)
Amortization		(363)
Balance as of September 30, 2019		219,270
Hospice reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2018	118,583	118,583
Acquisitions		5,771
Noncontrolling interests		1,569
Adjustments and disposals		1,215
Balance as of September 30, 2019		127,138
Intangible assets
Balance as of December 31, 2018	37,010	37,010
Acquisitions		1,783
Adjustments and disposals		1,283
Amortization		(72)
Balance as of September 30, 2019		40,004
Home and community-based services reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2018	165,583	165,583
Acquisitions		551
Noncontrolling interests		0
Adjustments and disposals		495
Balance as of September 30, 2019		166,629
Intangible assets
Balance as of December 31, 2018	23,948	23,948
Acquisitions		154
Adjustments and disposals		(1)
Amortization		(3)
Balance as of September 30, 2019		24,098
Facility-based reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2018	14,194	14,194
Acquisitions		938
Noncontrolling interests		550
Adjustments and disposals		0
Balance as of September 30, 2019		15,682
Intangible assets
Balance as of December 31, 2018	4,147	4,147
Acquisitions		1,202
Adjustments and disposals		(1)
Amortization		(29)
Balance as of September 30, 2019		5,319
HCI reporting unit
Goodwill [Roll Forward]
Balance as of December 31, 2018	40,755	40,755
Acquisitions		0
Noncontrolling interests		0
Adjustments and disposals		107
Balance as of September 30, 2019		40,862
Intangible assets
Balance as of December 31, 2018	16,892	16,892
Acquisitions	$ 0
Adjustments and disposals		(582)
Amortization		(484)
Balance as of September 30, 2019		$ 15,826

Intangible Assets [Roll Forward]

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Amount of increase (decrease) from adjustments after acquisition date under purchase accounting of an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized, net of deferred tax adjustments.

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The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets. As a noncash expense, this element is added back to net income when calculating cash provided by or used in operations using the indirect method.

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Amount of increase (decrease) in carrying value of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.

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Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Sum of the carrying amounts of all intangible assets, excluding goodwill, as of the balance sheet date, net of accumulated amortization and impairment charges.

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Net Increase or Decrease in balance of noncontrolling interest in the subsidiary during the reporting period.

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