Property and Equipment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 55,171		$ 35,630
Operating lease - right-of-use assets	18,137
Less accumulated depreciation	25,094		22,730
Total property and equipment, net	30,077		12,900
Depreciation	2,400	$ 1,300
Operating lease cost	1,214
Housekeeping and Dietary equipment
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	23,251		22,596
Computer hardware and software
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	12,413		12,114
Other
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 1,370		$ 920