Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2020

Commitments And Contingencies Disclosure [Abstract]

Schedule of Changes in General and Professional Liability and Workers Compensation Reserves

Below is a schedule showing the changes in our general and professional liability and workers’ compensation reserves during the three years ended December 31, 2020 (amount in thousands):

	General and
	Professional			Workers’
	Liability			Compensation			Total
Balance at January 1, 2018	$	228,691		$	69,531		$	298,222
Plus: Accrued insurance expense, net of commercial    premiums paid		54,387			38,476			92,863
Less: Payments made in settlement of self-insured claims		(40,027	)		(36,117	)		(76,144	)
Balance at January 1, 2019		243,051			71,890			314,941
Plus: Accrued insurance expense, net of commercial    premiums paid		56,452			49,220			105,672
Less: Payments made in settlement of self-insured claims		(57,683	)		(40,106	)		(97,789	)
Balance at January 1, 2020		241,820			81,004			322,824
Plus: Accrued insurance expense, net of commercial    premiums paid		91,518			67,705			159,223
Less: Payments made in settlement of self-insured claims		(69,559	)		(43,524	)		(113,083	)
Balance at December 31, 2020	$	263,779		$	105,185		$	368,964