Assets Held for Sale - Narrative (Details) - USD ($)	1 Months Ended	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Goodwill impaired										$ 0	$ 0
Current assets held for sale	$ 50,099,000	$ 50,099,000				$ 577,000				50,099,000	577,000
Current liabilities held for sale	5,767,000	5,767,000				0				5,767,000	0
Patient service operating revenues		206,079,000	$ 211,429,000	$ 213,252,000	$ 191,762,000	207,806,000	$ 205,719,000	$ 205,952,000	$ 186,299,000	822,522,000	805,776,000
Depreciation, amortization and impairment										43,765,000	39,802,000	$ 37,634,000
Certain Clinics in Pennsylvania, Ohio, and New Jersey and Other Property and Equipment | Disposal Group, Held-for-sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Goodwill impaired										3,289,000
Valuation allowance on disposal group	1,023,000	1,023,000								1,023,000
Current assets held for sale	50,099,000	50,099,000								50,099,000
Current liabilities held for sale	5,767,000	$ 5,767,000								5,767,000
Impairment of assets to be disposed of										1,881,000
Certain Clinics In Pennsylvania, Ohio, and New Jersey | Disposal Group, Held-for-sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Patient service operating revenues										$ 28,621,000
Long Lived Assets Held-For-Sale | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Depreciation, amortization and impairment	$ 858,000
Certain Clinics In Maryland | Disposal Group, Held-for-sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Valuation allowance on disposal group						0					0
Current assets held for sale						577,000					577,000
Current liabilities held for sale						$ 0					0
Impairment of assets to be disposed of											$ 0