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Investments in Other Entities (Summarized Balance Sheets and Statements of Income) (Detail) - USD ($)
3 Months Ended
Mar. 31, 2018
Mar. 31, 2017
Dec. 31, 2017
LaSalle Medical Associates IPA [Member]      
Equity Method Investment, Summarized Financial Information, Assets [Abstract]      
Equity Method Investment, Summarized Financial Information, Cash and Cash Equivalents $ 22,064,701   $ 21,065,105
Equity Method Investment, Summarized Financial Information, Receivables 3,005,144   2,433,116
Equity Method Investment, Summarized Financial Information, Other current assets 2,173,110   1,565,606
Equity Method Investment, Summarized Financial Information, Loan Receivables 1,250,000   1,250,000
Equity Method Investment, Summarized Financial Information, Restricted Cash 664,612   662,109
Equity Method Investment, Summarized Financial Information, Assets 29,157,567   26,975,936
Equity Method Investment, Summarized Financial Information, Liabilities and Equity [Abstract]      
Equity Method Investment, Summarized Financial Information, Current Liabilities 23,946,133   20,353,337
Equity Method Investment Summarized Financial Information, Stockholders' deficit 5,211,434   6,622,599
Equity Method Investment, Summarized Financial Information, Total liabilities and stockholders' deficit 29,157,567   26,975,936
Equity Method Investment, Summarized Financial Information, Income Statement [Abstract]      
Equity Method Investment, Summarized Financial Information, Revenue 52,983,791 $ 49,753,004  
Equity Method Investment, Summarized Financial Information, Expenses 54,002,458 44,506,050  
Equity Method Investment, Summarized Financial Information, Net (loss) income (1,018,667) 5,246,954  
Universal Care Inc [Member]      
Equity Method Investment, Summarized Financial Information, Assets [Abstract]      
Equity Method Investment, Summarized Financial Information, Cash and Cash Equivalents 22,595,206   21,872,894
Equity Method Investment, Summarized Financial Information, Receivables 23,862,184   18,618,760
Equity Method Investment, Summarized Financial Information, Other current assets 18,870,831   13,021,520
Equity Method Investment, Summarized Financial Information, Other Assets 2,259,507   3,754,470
Equity Method Investment, Summarized Financial Information, Property And Equipment 1,770,157   1,576,621
Equity Method Investment, Summarized Financial Information, Assets 69,357,885   58,844,265
Equity Method Investment, Summarized Financial Information, Liabilities and Equity [Abstract]      
Equity Method Investment, Summarized Financial Information, Current Liabilities 64,984,078   54,421,532
Equity Method Investment, Summarized Financial Information, Other Liabilities 10,044,340   10,051,952
Equity Method Investment Summarized Financial Information, Stockholders' deficit (5,670,533)   (5,629,219)
Equity Method Investment, Summarized Financial Information, Total liabilities and stockholders' deficit 69,357,885   $ 58,844,265
Equity Method Investment, Summarized Financial Information, Income Statement [Abstract]      
Equity Method Investment, Summarized Financial Information, Revenue 72,665,437 46,540,892  
Equity Method Investment, Summarized Financial Information, Expenses 72,154,950 44,757,246  
Equity Method Investment, Summarized Financial Information, Income before provision for income taxes 510,487 1,783,646  
Equity Method Investment, Summarized Financial Information, Provision for income taxes 551,800 713,500  
Equity Method Investment, Summarized Financial Information, Net (loss) income $ (41,313) $ 1,070,146