Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2019

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, 2019 (amount in thousands):

	General and
	Professional			Workers’
	Liability			Compensation			Total
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 January 1, 2018		228,691			69,531			298,222
Plus: Accrued insurance expense, net of commercial    premiums paid		54,387			38,476			92,863
Less: Payments made in settlement of self-insured claims		(40,027	)		(36,117	)		(76,144	)
Balance at January 1, 2019		243,051			71,890			314,941
Plus: Accrued insurance expense, net of commercial    premiums paid		56,452			49,220			105,672
Less: Payments made in settlement of self-insured claims		(57,683	)		(40,106	)		(97,789	)
Balance at December 31, 2019	$	241,820		$	81,004		$	322,824