Goodwill and Other Intangible Assets - Intangible Assets (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Dec. 31, 2017
Schedule of Finite and Indefinite-Lived Intangible Assets [Line Items]
Accumulated Amortization	$ (150,084)	$ (132,779)
Net Carrying Amount	192,747
Gross carrying amount	388,031	388,118
Total acquired intangible assets	237,947	255,339
Trade names
Schedule of Finite and Indefinite-Lived Intangible Assets [Line Items]
Trade name (Indefinite lived)	$ 45,200	45,200
Facility management contracts
Schedule of Finite and Indefinite-Lived Intangible Assets [Line Items]
Weighted Average Useful Life	16 years 3 months
Gross Carrying Amount	$ 308,431	308,518
Accumulated Amortization	(122,309)	(106,724)
Net Carrying Amount	$ 186,122	201,794
Covenants not to compete
Schedule of Finite and Indefinite-Lived Intangible Assets [Line Items]
Weighted Average Useful Life	1 year
Gross Carrying Amount	$ 700	700
Accumulated Amortization	(700)	(517)
Net Carrying Amount	$ 0	183
Technology
Schedule of Finite and Indefinite-Lived Intangible Assets [Line Items]
Weighted Average Useful Life	7 years 3 months
Gross Carrying Amount	$ 33,700	33,700
Accumulated Amortization	(27,075)	(25,538)
Net Carrying Amount	$ 6,625	$ 8,162