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Commitments and Contingencies (Table)
12 Months Ended
Dec. 31, 2017
Commitments And Contingencies Disclosure [Abstract]  
Schedule of Changes in General and Professional Liability and Workers Compensation Reserves

Below is a schedule showing the changes in our general and professional liability and workers’ compensation reserves during the three years ended December 31, 2017 (amount in thousands):

 

 

 

General and

 

 

 

 

 

 

 

 

 

 

 

Professional

 

 

Workers’

 

 

 

 

 

 

 

Liability

 

 

Compensation

 

 

Total

 

Balance at January 1, 2015

 

$

192,904

 

 

$

66,814

 

 

$

259,718

 

Plus: Accrued insurance expense, net of commercial

   premiums paid

 

 

58,460

 

 

 

32,435

 

 

 

90,895

 

Less: Payments made in settlement of self-insured claims

 

 

(47,391

)

 

 

(31,746

)

 

 

(79,137

)

Balance at January 1, 2016

 

 

203,973

 

 

 

67,503

 

 

 

271,476

 

Liabilities assumed in acquisition

 

 

0

 

 

 

661

 

 

 

661

 

Plus: Accrued insurance expense, net of commercial

   premiums paid

 

 

54,671

 

 

 

29,967

 

 

 

84,638

 

Less: Payments made in settlement of self-insured claims

 

 

(51,185

)

 

 

(30,775

)

 

 

(81,960

)

Balance at January 1, 2017

 

 

207,459

 

 

 

67,356

 

 

 

274,815

 

Plus: Accrued insurance expense, net of commercial

   premiums paid

 

 

65,049

 

 

 

37,546

 

 

 

102,595

 

Less: Payments made in settlement of self-insured claims

 

 

(43,817

)

 

 

(35,371

)

 

 

(79,188

)

Balance at December 31, 2017

 

$

228,691

 

 

$

69,531

 

 

$

298,222