Notes Payable and Other Debt - Details of Long-term Debt (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	May 18, 2018	May 10, 2018	Feb. 15, 2018	Dec. 31, 2017	Dec. 31, 2013
Debt Instrument [Line Items]
Debt instrument, maturity date	Aug. 15, 2020
Fixed interest rate (as a percent)		12.50%		10.00%
Debt instrument, outstanding amount	$ 82,740				$ 75,306
Senior debt - guaranteed by HUD
Debt Instrument [Line Items]
Debt instrument, outstanding amount	33,066				33,685
Senior debt - guaranteed by USDA
Debt Instrument [Line Items]
Debt instrument, outstanding amount	13,831				20,320
Senior debt - guaranteed by SBA
Debt Instrument [Line Items]
Debt instrument, outstanding amount	673				2,210
Senior debt Bonds, net of discount
Debt Instrument [Line Items]
Debt instrument, outstanding amount	6,960				7,055
Senior debt-other mortgage indebtedness
Debt Instrument [Line Items]
Debt instrument, outstanding amount	27,398				9,486
Senior Debt Obligations | Senior debt - guaranteed by HUD
Debt Instrument [Line Items]
Debt instrument, outstanding amount	33,066				33,685
Senior Debt Obligations | Senior debt - guaranteed by USDA
Debt Instrument [Line Items]
Debt instrument, outstanding amount	13,831				20,320
Senior Debt Obligations | Senior debt - guaranteed by SBA
Debt Instrument [Line Items]
Debt instrument, outstanding amount	673				2,210
Bonds | Senior debt Bonds, net of discount
Debt Instrument [Line Items]
Debt instrument, outstanding amount	6,960				7,055
Other debt
Debt Instrument [Line Items]
Debt instrument, outstanding amount	$ 812				1,050
Convertible Debt
Debt Instrument [Line Items]
Debt instrument, outstanding amount					1,500
Convertible Debt | Convertible Subordinated Promissory Notes Issued in July 2012
Debt Instrument [Line Items]
Debt instrument, maturity date	Apr. 30, 2018
Fixed interest rate (as a percent)	14.00%
Debt instrument, outstanding amount					1,500
Quail Creek
Debt Instrument [Line Items]
Debt instrument, maturity date	Apr. 30, 2019
Red Mortgage | The Pavilion Care Center | Senior Debt Obligations | Senior debt - guaranteed by HUD
Debt Instrument [Line Items]
Debt instrument, maturity date	Dec. 01, 2027
Fixed interest rate (as a percent)	4.16%
Debt instrument, outstanding amount	$ 1,247				1,329
Red Mortgage | Hearth And Care Of Greenfield | Senior Debt Obligations | Senior debt - guaranteed by HUD
Debt Instrument [Line Items]
Debt instrument, maturity date	Aug. 01, 2038
Fixed interest rate (as a percent)	4.20%
Debt instrument, outstanding amount	$ 2,078				2,127
Midland State Bank | Woodland Manor | Senior Debt Obligations | Senior debt - guaranteed by HUD
Debt Instrument [Line Items]
Debt instrument, maturity date	Oct. 01, 2044
Fixed interest rate (as a percent)	3.75%
Debt instrument, outstanding amount	$ 5,246				5,334
Midland State Bank | Glenvue H&R | Senior Debt Obligations | Senior debt - guaranteed by HUD
Debt Instrument [Line Items]
Debt instrument, maturity date	Oct. 01, 2044
Fixed interest rate (as a percent)	3.75%
Debt instrument, outstanding amount	$ 8,145				8,283
Midland State Bank | Georgetown Health | Senior Debt Obligations | Senior debt - guaranteed by HUD
Debt Instrument [Line Items]
Debt instrument, maturity date	Oct. 01, 2046
Fixed interest rate (as a percent)	2.98%
Debt instrument, outstanding amount	$ 3,584				3,644
KeyBank | Other debt
Debt Instrument [Line Items]
Debt instrument, maturity date	Aug. 02, 2019
Fixed interest rate (as a percent)	0.00%
Debt instrument, outstanding amount	$ 495				495
KeyBank | Autumn Breeze | Senior Debt Obligations | Senior debt - guaranteed by HUD
Debt Instrument [Line Items]
Debt instrument, maturity date	Jan. 01, 2045
Fixed interest rate (as a percent)	3.65%
Debt instrument, outstanding amount	$ 7,081				7,199
KeyBank | Sumter Valley | Senior Debt Obligations | Senior debt - guaranteed by HUD
Debt Instrument [Line Items]
Debt instrument, maturity date	Jan. 01, 2047
Fixed interest rate (as a percent)	3.70%
Debt instrument, outstanding amount	$ 5,685				5,769
Metro City Bank | Attalla Health Care | Senior Debt Obligations | Senior debt - guaranteed by USDA
Debt Instrument [Line Items]
Debt instrument, maturity date	Sep. 30, 2035
Effective interest rate (as a percent)	5.50%
Debt instrument, outstanding amount					6,169
Metro City Bank | Attalla Health Care | Senior Debt Obligations | Senior debt - guaranteed by USDA | Prime Rate
Debt Instrument [Line Items]
Basis spread	1.50%
Metro City Bank | Coosa Valley Health Care | Senior Debt Obligations | Senior debt - guaranteed by USDA
Debt Instrument [Line Items]
Debt instrument, maturity date	Sep. 30, 2035
Effective interest rate (as a percent)	6.75%
Debt instrument, outstanding amount	$ 5,431				5,562
Metro City Bank | Coosa Valley Health Care | Senior Debt Obligations | Senior debt - guaranteed by USDA | Prime Rate
Debt Instrument [Line Items]
Basis spread	1.50%
Community Bank | Mountain Trace Rehab | Senior Debt Obligations | Senior debt - guaranteed by USDA
Debt Instrument [Line Items]
Debt instrument, maturity date	Jan. 24, 2036
Effective interest rate (as a percent)	7.00%
Debt instrument, outstanding amount	$ 4,166				4,260
Community Bank | Mountain Trace Rehab | Senior Debt Obligations | Senior debt - guaranteed by USDA | Prime Rate
Debt Instrument [Line Items]
Basis spread	1.75%
Bank of Atlanta | Southland Healthcare | Senior Debt Obligations | Senior debt - guaranteed by USDA
Debt Instrument [Line Items]
Debt instrument, maturity date	Jul. 27, 2036
Effective interest rate (as a percent)	6.75%
Debt instrument, outstanding amount	$ 4,234				4,329
Bank of Atlanta | Southland Healthcare | Senior Debt Obligations | Senior debt - guaranteed by USDA | Prime Rate
Debt Instrument [Line Items]
Basis spread	1.50%
Bank of Atlanta | Southland Healthcare | Senior Debt Obligations | Senior debt - guaranteed by SBA
Debt Instrument [Line Items]
Debt instrument, maturity date	Jul. 27, 2036
Effective interest rate (as a percent)	7.50%
Debt instrument, outstanding amount	$ 673				687
Bank of Atlanta | Southland Healthcare | Senior Debt Obligations | Senior debt - guaranteed by SBA | Prime Rate
Debt Instrument [Line Items]
Basis spread	2.25%
CDC [Member] | College Park | Senior Debt Obligations | Senior debt - guaranteed by SBA
Debt Instrument [Line Items]
Debt instrument, maturity date	Oct. 01, 2031
Fixed interest rate (as a percent)	2.81%
Debt instrument, outstanding amount					1,523
City of Springfield | Eaglewood Care Center | Bonds | Bonds Series A
Debt Instrument [Line Items]
Debt instrument, maturity date	May 01, 2042
Fixed interest rate (as a percent)	7.65%
Debt instrument, outstanding amount	$ 6,610				6,610
City of Springfield | Eaglewood Care Center | Bonds | Bonds Series B
Debt Instrument [Line Items]
Debt instrument, maturity date	May 01, 2021
Fixed interest rate (as a percent)	8.50%
Debt instrument, outstanding amount	$ 350				445
Congressional Bank | Quail Creek
Debt Instrument [Line Items]
Debt instrument, maturity date	Apr. 30, 2019
Effective interest rate (as a percent)	5.75%
Congressional Bank | Quail Creek | Senior debt-other mortgage indebtedness
Debt Instrument [Line Items]
Debt instrument, outstanding amount	$ 4,136				4,314
First Commercial Bank | Northwest
Debt Instrument [Line Items]
Debt instrument, maturity date	Jul. 31, 2020
Effective interest rate (as a percent)	5.00%
First Commercial Bank | Northwest | Senior debt-other mortgage indebtedness
Debt Instrument [Line Items]
Debt instrument, outstanding amount					1,122
Exchange Bank of Alabama | Meadowood
Debt Instrument [Line Items]
Debt instrument, maturity date	May 01, 2022
Effective interest rate (as a percent)	4.50%
Exchange Bank of Alabama | Meadowood | Senior debt-other mortgage indebtedness
Debt Instrument [Line Items]
Debt instrument, outstanding amount	$ 3,951				4,050
Pinecone
Debt Instrument [Line Items]
Fixed interest rate (as a percent)			12.50%
Pinecone | Attalla Health Care
Debt Instrument [Line Items]
Debt instrument, maturity date	Aug. 15, 2020
Effective interest rate (as a percent)	13.50%
Pinecone | Attalla Health Care | Senior debt-other mortgage indebtedness
Debt Instrument [Line Items]
Debt instrument, outstanding amount	$ 8,705
Pinecone | College Park
Debt Instrument [Line Items]
Debt instrument, maturity date	Aug. 15, 2020
Effective interest rate (as a percent)	13.50%
Pinecone | College Park | Senior debt-other mortgage indebtedness
Debt Instrument [Line Items]
Debt instrument, outstanding amount	$ 2,727
Pinecone | Northwest
Debt Instrument [Line Items]
Debt instrument, maturity date	Aug. 15, 2020
Effective interest rate (as a percent)	13.50%
Pinecone | Northwest | Senior debt-other mortgage indebtedness
Debt Instrument [Line Items]
Debt instrument, outstanding amount	$ 2,685
Pinecone | AdCare Property Holdings, LLC
Debt Instrument [Line Items]
Debt instrument, maturity date	Aug. 15, 2020
Effective interest rate (as a percent)	13.50%
Pinecone | AdCare Property Holdings, LLC | Senior debt-other mortgage indebtedness
Debt Instrument [Line Items]
Debt instrument, outstanding amount	$ 5,194
First Insurance Funding | Other debt
Debt Instrument [Line Items]
Debt instrument, maturity date	Mar. 01, 2019
Fixed interest rate (as a percent)	4.24%
Debt instrument, outstanding amount	$ 81				20
Mc Bride | Other debt
Debt Instrument [Line Items]
Debt instrument, maturity date	Sep. 30, 2019
Fixed interest rate (as a percent)	4.00%
Debt instrument, outstanding amount	$ 153				264
Pharmacy Care of Arkansas | Other debt
Debt Instrument [Line Items]
Debt instrument, maturity date	Feb. 08, 2018
Fixed interest rate (as a percent)	2.00%
Debt instrument, outstanding amount					42
South Carolina Department of Health & Human Services | Other debt
Debt Instrument [Line Items]
Debt instrument, maturity date	Feb. 24, 2019
Fixed interest rate (as a percent)	5.75%
Debt instrument, outstanding amount	$ 83				$ 229	$ 400