Commitments and Contingencies Level 4 (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Loss Contingencies [Line Items]
Operating Leases, Rent Expense	$ 27,400	$ 30,500
Agreements, Future Payments, Due in One Year	8,160
Agreements, Future Payments, Due in Two Years	6,188
Agreements, Future Payments, Due in Three Years	4,206
Agreements, Future Payments, Due in Four Years	2,749
Agreements, Future Payments, Due in Five Years	2,039
Agreements, Future Payments, Due in Six Years and Thereafter	4,873
Agreements, Future Payments Due	28,215
Self Insurance Reserve	84,300	$ 80,100
Loss Contingency, Damages Sought, Value	13,600
Employment Agreement [Member]
Loss Contingencies [Line Items]
Agreements, Future Payments, Due in One Year	1,968
Agreements, Future Payments, Due in Two Years	1,296
Agreements, Future Payments, Due in Three Years	399
Agreements, Future Payments, Due in Four Years	123
Agreements, Future Payments, Due in Five Years	8
Agreements, Future Payments, Due in Six Years and Thereafter	0
Agreements, Future Payments Due	3,794
Consulting Agreement [Member]
Loss Contingencies [Line Items]
Agreements, Future Payments, Due in One Year	1,020
Agreements, Future Payments, Due in Two Years	603
Agreements, Future Payments, Due in Three Years	444
Agreements, Future Payments, Due in Four Years	165
Agreements, Future Payments, Due in Five Years	48
Agreements, Future Payments, Due in Six Years and Thereafter	171
Agreements, Future Payments Due	2,451
Noncompete Agreements [Member]
Loss Contingencies [Line Items]
Agreements, Future Payments, Due in One Year	5,172
Agreements, Future Payments, Due in Two Years	4,289
Agreements, Future Payments, Due in Three Years	3,363
Agreements, Future Payments, Due in Four Years	2,461
Agreements, Future Payments, Due in Five Years	1,983
Agreements, Future Payments, Due in Six Years and Thereafter	4,702
Agreements, Future Payments Due	$ 21,970
Minimum [Member]
Loss Contingencies [Line Items]
Management, consulting and non-compete agreement term	5 years
Maximum [Member]
Loss Contingencies [Line Items]
Management, consulting and non-compete agreement term	10 years