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Goodwill and Other Indefinite-Lived Intangible Assets - Goodwill Rollforward (Details) - USD ($)
3 Months Ended 9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Sep. 30, 2019
Sep. 30, 2018
Goodwill [Roll Forward]        
Balance at beginning of period     $ 80,477,000  
Additions     15,722,000  
Balance at end of period $ 96,199,000   96,199,000  
Goodwill and intangible asset impairment 0 $ 3,653,000 0 $ 3,653,000
Goodwill impairment   $ 3,513,000   $ 3,513,000
Operating Segments | Transitional and Skilled Services        
Goodwill [Roll Forward]        
Balance at beginning of period     45,486,000  
Additions     0  
Balance at end of period 45,486,000   45,486,000  
Operating Segments | Senior Living Services        
Goodwill [Roll Forward]        
Balance at beginning of period     3,958,000  
Additions     0  
Balance at end of period 3,958,000   3,958,000  
Operating Segments | Home Health and Hospice Services        
Goodwill [Roll Forward]        
Balance at beginning of period     27,250,000  
Additions     10,341,000  
Balance at end of period 37,591,000   37,591,000  
All Other        
Goodwill [Roll Forward]        
Balance at beginning of period     3,783,000  
Additions     5,381,000  
Balance at end of period $ 9,164,000   $ 9,164,000