Property and Equipment (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 57,044		$ 57,044		$ 35,630
Operating lease - right-of-use assets	19,016		19,016
Less accumulated depreciation	27,441		27,441		22,730
Total property and equipment, net	29,603		29,603		12,900
Depreciation	2,300	$ 1,300	4,800	$ 2,600
Depreciation of operating lease - right-of-use assets	1,016		2,230
Housekeeping and Dietary equipment
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	23,865		23,865		22,596
Computer hardware and software
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	12,484		12,484		12,114
Other
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 1,679		$ 1,679		$ 920