Property and Equipment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 35,426		$ 35,426		$ 34,019
Less accumulated depreciation	21,927		21,927		20,564
Total property and equipment, net	13,499		13,499		13,455
Depreciation	1,100	$ 1,100	3,700	$ 3,500
Housekeeping and Dietary equipment
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	22,057		22,057		21,136
Computer hardware and software
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	12,381		12,381		11,750
Other
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 988		$ 988		$ 1,133