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Segment Information - Selected Financial Data (Details) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2018
Mar. 31, 2017
Dec. 31, 2017
Segment information      
Net operating revenues $ 1,252,964 $ 1,091,517  
Adjusted EBITDA 163,232 138,890  
Total assets 5,968,643 5,002,937 $ 5,127,166
Purchases of property and equipment, net 39,617 50,653  
Operating Segments | Long Term Acute Care      
Segment information      
Net operating revenues 464,676 445,123  
Adjusted EBITDA 72,972 72,337  
Total assets 1,862,791 1,978,226  
Purchases of property and equipment, net 10,472 10,943  
Operating Segments | Inpatient Rehabilitation      
Segment information      
Net operating revenues 174,774 144,825  
Adjusted EBITDA 26,776 16,328  
Total assets 877,750 643,994  
Purchases of property and equipment, net 12,917 21,414  
Operating Segments | Outpatient Rehabilitation      
Segment information      
Net operating revenues 257,381 250,371  
Adjusted EBITDA 30,525 31,351  
Total assets 973,122 980,261  
Purchases of property and equipment, net 7,338 6,673  
Operating Segments | Concentra      
Segment information      
Net operating revenues 356,116 250,589  
Adjusted EBITDA 57,797 42,592  
Total assets 2,143,405 1,297,672  
Purchases of property and equipment, net 6,621 8,686  
Other      
Segment information      
Net operating revenues 17 609  
Adjusted EBITDA (24,838) (23,718)  
Total assets 111,575 102,784  
Purchases of property and equipment, net $ 2,269 $ 2,937