Equipment and Other Fixed Assets (Details) - USD ($)	Mar. 31, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Equipment and other fixed assets, gross	$ 157,685,556	$ 132,006,461
Less accumulated depreciation	(70,384,632)	(68,447,381)
Equipment and other fixed assets, net	87,300,924	63,559,080
Patient medical equipment
Property, Plant and Equipment [Line Items]
Equipment and other fixed assets, gross	132,311,790	112,070,831
Vehicles
Property, Plant and Equipment [Line Items]
Equipment and other fixed assets, gross	6,916,895	4,461,041
Other
Property, Plant and Equipment [Line Items]
Equipment and other fixed assets, gross	$ 18,456,871	$ 15,474,589