Revenue Recognition and Receivables - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Disaggregation of Revenue [Line Items]
Total revenues	$ 475,020	$ 476,122	$ 482,811
Total revenues, as a percent	100.00%	100.00%	100.00%
Medicaid
Disaggregation of Revenue [Line Items]
Total revenues	$ 222,560	$ 215,924	$ 249,204
Total revenues, as a percent	46.90%	45.40%	51.60%
Medicare
Disaggregation of Revenue [Line Items]
Total revenues	$ 80,798	$ 84,959	$ 122,043
Total revenues, as a percent	17.00%	17.80%	25.30%
Managed Care
Disaggregation of Revenue [Line Items]
Total revenues	$ 50,323	$ 48,879	$ 39,162
Total revenues, as a percent	10.60%	10.30%	8.10%
Private Pay and other
Disaggregation of Revenue [Line Items]
Total revenues	$ 121,339	$ 126,360	$ 72,402
Total revenues, as a percent	25.50%	26.50%	15.00%