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Other Contingencies (Details)
1 Months Ended 12 Months Ended
Jan. 31, 2013
Jul. 31, 2011
Dec. 31, 2015
USD ($)
financial_covenant
state
Jan. 01, 2016
USD ($)
Short-term Debt [Line Items]        
Bank line of credit     $ 200,000,000  
Borrowings under line of credit     0  
Change in bank line of credit     $ 78,259,000  
Number of financial covenants | financial_covenant     1  
Pledge percentage of current assets (less than)     6.00%  
Pledge percentage of total assets (less than)     5.00%  
Number of states in which entity operates | state     48  
Percentage of reduction to Medicare payments to nursing centers   11.10%    
Percentage of reduction of Medicare payments to plans and providers (up to) 2.00%      
Standby Letter of Credit        
Short-term Debt [Line Items]        
Irrevocable standby letter of credit, outstanding     $ 78,259,000  
Standby Letter of Credit | Subsequent Event        
Short-term Debt [Line Items]        
Irrevocable standby letter of credit, outstanding       $ 68,778,000