Goodwill and Other Intangible Assets - Intangible Assets (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Dec. 31, 2018
Schedule of Finite and Indefinite-Lived Intangible Assets [Line Items]
Accumulated Amortization	$ (166,193)	$ (155,659)
Net Carrying Amount	176,022
Gross carrying amount	387,415	388,019
Total acquired intangible assets	221,222	232,360
Trade names
Schedule of Finite and Indefinite-Lived Intangible Assets [Line Items]
Trade names (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 18 days
Gross Carrying Amount	$ 308,515	308,419
Accumulated Amortization	(137,909)	(127,481)
Net Carrying Amount	$ 170,606	180,938
Covenants not to compete
Schedule of Finite and Indefinite-Lived Intangible Assets [Line Items]
Weighted Average Useful Life	1 year
Gross Carrying Amount	$ 0	700
Accumulated Amortization	0	(700)
Net Carrying Amount	$ 0	0
Technology
Schedule of Finite and Indefinite-Lived Intangible Assets [Line Items]
Weighted Average Useful Life	7 years 3 months 18 days
Gross Carrying Amount	$ 33,700	33,700
Accumulated Amortization	(28,284)	(27,478)
Net Carrying Amount	$ 5,416	$ 6,222