Property and Equipment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 35,081		$ 35,081		$ 36,004
Less accumulated depreciation	22,014		22,014		22,495
Total property and equipment, net	13,067		13,067		13,509
Depreciation	1,100	$ 1,100	3,700	$ 3,700
Housekeeping and Dietary equipment
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	22,177		22,177		22,349
Computer hardware and software
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	11,955		11,955		12,665
Other
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 949		$ 949		$ 990