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Commitments and Contingencies Level 4 (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Loss Contingencies [Line Items]    
Agreements, Future Payments, Due in One Year $ 7,189  
Agreements, Future Payments, Due in Two Years 5,161  
Agreements, Future Payments, Due in Three Years 3,496  
Agreements, Future Payments, Due in Four Years 2,585  
Agreements, Future Payments, Due in Five Years 2,165  
Agreements, Future Payments, Due in Six Years and Thereafter 3,900  
Agreements, Future Payments Due 24,496  
Self Insurance Reserve 92,800 $ 84,300
Loss Contingency, Damages Sought, Value 13,600  
Employment Agreement [Member]    
Loss Contingencies [Line Items]    
Agreements, Future Payments, Due in One Year 1,941  
Agreements, Future Payments, Due in Two Years 1,017  
Agreements, Future Payments, Due in Three Years 585  
Agreements, Future Payments, Due in Four Years 299  
Agreements, Future Payments, Due in Five Years 148  
Agreements, Future Payments, Due in Six Years and Thereafter 49  
Agreements, Future Payments Due 4,039  
Consulting Agreement [Member]    
Loss Contingencies [Line Items]    
Agreements, Future Payments, Due in One Year 716  
Agreements, Future Payments, Due in Two Years 562  
Agreements, Future Payments, Due in Three Years 255  
Agreements, Future Payments, Due in Four Years 138  
Agreements, Future Payments, Due in Five Years 132  
Agreements, Future Payments, Due in Six Years and Thereafter 129  
Agreements, Future Payments Due 1,932  
Noncompete Agreements [Member]    
Loss Contingencies [Line Items]    
Agreements, Future Payments, Due in One Year 4,532  
Agreements, Future Payments, Due in Two Years 3,582  
Agreements, Future Payments, Due in Three Years 2,656  
Agreements, Future Payments, Due in Four Years 2,148  
Agreements, Future Payments, Due in Five Years 1,885  
Agreements, Future Payments, Due in Six Years and Thereafter 3,722  
Agreements, Future Payments Due $ 18,525  
Minimum [Member]    
Loss Contingencies [Line Items]    
Management, consulting and non-compete agreement term five years  
Maximum [Member]    
Loss Contingencies [Line Items]    
Management, consulting and non-compete agreement term ten years