Property and Equipment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 36,004	$ 34,019
Less accumulated depreciation	22,495	20,564
Total property and equipment, net	13,509	13,455
Depreciation	5,000	4,800	$ 4,400
Housekeeping and Dietary equipment
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	22,349	21,136
Computer hardware and software
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	12,665	11,750
Other
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 990	$ 1,133