Schedule II - Valuation of Qualifying Accounts of Continuing Operations (Schedule of Valuation and Qualifying Accounts) (Details) - USD ($)		12 Months Ended
		Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Allowance for doubtful accounts
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period		$ 14,235,000	$ 10,326,000	$ 8,180,000
Impact of ASC 606 Adoption		(14,235,000)	0	0
Charged to Costs and Expenses		0	8,958,000	7,163,000
Deductions		0	(5,049,000)	(5,017,000)
Balance at End of Period		0	14,235,000	10,326,000
Professional Liability Reserve
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period		20,057	19,977	21,618
Charged to Costs and Expenses		8,865	7,935	6,423
Charged to Other Accounts	[1]	0	0	0
Other		5,475	0	114
Payments	[2]	(7,196)	(7,855)	(8,178)
Balance at End of Period		27,201	20,057	19,977
Workers Compensation Reserve
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period		867	171	227
Charged to Costs and Expenses		(18)	995	372
Charged to Other Accounts	[1]	0	0	0
Other		0	0	0
Payments	[2]	(231)	(299)	(428)
Balance at End of Period		618	867	171
Health Insurance Reserve
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period		1,326	1,019	686
Charged to Costs and Expenses		14,369	13,769	8,896
Charged to Other Accounts	[1]	0	0	0
Other		0	0	(137)
Payments	[2]	(14,299)	(13,462)	(8,426)
Balance at End of Period		$ 1,396	$ 1,326	$ 1,019

[1] The Company has presented the results of certain divestiture and lease termination transactions as discontinued operations. The amounts charged to Other Accounts represent the amounts charged to discontinued operations.

[2] Payments for the Professional Liability Reserve include amounts paid for claims settled during the period as well as payments made under structured arrangements for claims settled in earlier periods.