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Debt (Tables)
12 Months Ended
Dec. 31, 2019
Debt Instruments [Abstract]  
Schedule of long-term debt
Long‑term debt consists of the following at December 31
 
2019
    
2018
2017 Credit Agreement - Term B Loan Facility
$
429,000

 
$
433,400

2017 Credit Agreement - Revolving Credit Facility
64,500

 
5,500

Assigned Clinic Loans due to Term Loan Holdings(1)
866

 
5,078

Other Term Loans(2)
92,958

 
113,866

Other Lines of Credit(3)
5,006

 
1,849

Finance Lease Obligations(4)
7,780

 
6,706

Other

 
2,040

 
600,110

 
568,439

Less: discounts and fees, net of accumulated amortization
(12,496
)
 
(8,073
)
Less: current maturities
(38,779
)
 
(42,855
)
 
$
548,835

 
$
517,511

 
 
(1)
See “Note 19—Related Party Transactions.”
(2)
Principal and interest is payable monthly at rates between 3.65% and 6.55% over varying periods through December 2028.
(3)
The interest on the lines of credit is payable monthly at rates between 4.13% and 7.68% and borrowings convert to term loans at various maturity dates through August 2022.
(4)
Finance lease obligations expiring in various years through 2034.
Schedule of maturities of long-term debt
Scheduled maturities of long‑term debt as of December 31, 2019 are as follows:
2020
$
41,903

2021
32,913

2022
89,933

2023
21,927

2024
400,555

Thereafter
12,879

 
$
600,110