Accrued Professional Liabilities - Rollforward of Reserves (Details) $ in Thousands	9 Months Ended
Sep. 30, 2015 USD ($)
Self Insurance Reserve [Roll Forward]
Balance at December 31, 2014	$ 53,785
Assumed liabilities through acquisitions	4,957
Provision related to current period reserves	14,591
Payments for current period reserves	(2,567)
Benefit related to changes in prior period reserves	(902)
Payments for prior period reserves	(7,780)
Balance at September 30, 2015	$ 62,084

Carrying amount (including both current and noncurrent portions) of accrued known and estimated losses incurred as of the balance sheet date for which no insurance coverage exists, and for which a claim has been made or is probable of being asserted, typically arising from workmen's compensation-type of incidents and personal injury to nonemployees from accidents on the entity's property.

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 210

-SubTopic 10

-Section S99

-Paragraph 1

-Subparagraph (SX 210.5-02.24)

-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Name:	us-gaap_SelfInsuranceReserve
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	instant