Goodwill and Intangibles - Summary of Changes in Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 291,901	$ 284,626
Gross carrying amount, definite-lived intangible assets	28,743	27,929
Accumulated amortization	(16,127)	(15,176)
Net total	12,616	12,753
Gross carrying amount, intangible assets	320,644	312,555
Net total	304,517	297,379
Trade Names
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	10,182	10,127
Accumulated amortization	(9,157)	(8,817)
Net total	1,025	1,310
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	6,739	5,980
Accumulated amortization	(5,904)	(5,729)
Net total	835	251
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount, definite-lived intangible assets	11,822	11,822
Accumulated amortization	(1,066)	(630)
Net total	10,756	11,192
Trade Names
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	162,780	156,049
Certificates of Need/Licenses
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	$ 129,121	$ 128,577