Overview and significant Accounting Policies (Details 2) $ in Thousands	12 Months Ended
	Dec. 31, 2019 USD ($) facility	Dec. 31, 2018 USD ($)
Geographic concentrations
Number of facilities to provide services | facility	21
Total revenue	$ 217,577	$ 284,628
Total property, plant and equipment	8,323	13,592
United States
Geographic concentrations
Total revenue	182,034	243,298
Total property, plant and equipment	$ 6,836	11,647
Other countries
Geographic concentrations
Number of facilities to provide services | facility	4
Total revenue	$ 35,543	41,330
Total property, plant and equipment	$ 1,102	$ 1,945