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Commitments and Contingencies (Table) | 12 Months Ended
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Dec. 31, 2018
Commitments And Contingencies Disclosure [Abstract] |
Schedule of Changes in General and Professional Liability and Workers Compensation Reserves | Below is a schedule showing the changes in our general and professional liability and workers’ compensation reserves during the three years ended December 31, 2018 (amount in thousands):
|  | General and |  |  |  |  |  |  |  |  |
|  | Professional |  |  | Workers’ |  |  |  |  |
|  | Liability |  |  | Compensation |  |  | Total |
Balance at January 1, 2016 |  | $ | 203,973 |  |  | $ | 67,503 |  |  | $ | 271,476 |
Liabilities assumed in acquisition |  |  | 0 |  |  |  | 661 |  |  |  | 661 |
Plus: Accrued insurance expense, net of commercial premiums paid |  |  | 54,671 |  |  |  | 29,967 |  |  |  | 84,638 |
Less: Payments made in settlement of self-insured claims |  |  | (51,185 | ) |  |  | (30,775 | ) |  |  | (81,960 | )
Balance at January 1, 2017 |  |  | 207,459 |  |  |  | 67,356 |  |  |  | 274,815 |
Plus: Accrued insurance expense, net of commercial premiums paid |  |  | 65,049 |  |  |  | 37,546 |  |  |  | 102,595 |
Less: Payments made in settlement of self-insured claims |  |  | (43,817 | ) |  |  | (35,371 | ) |  |  | (79,188 | )
Balance at January 1, 2018 |  |  | 228,691 |  |  |  | 69,531 |  |  |  | 298,222 |
Plus: Accrued insurance expense, net of commercial premiums paid |  |  | 54,387 |  |  |  | 38,476 |  |  |  | 92,863 |
Less: Payments made in settlement of self-insured claims |  |  | (40,027 | ) |  |  | (36,117 | ) |  |  | (76,144 | )
Balance at December 31, 2018 |  | $ | 243,051 |  |  | $ | 71,890 |  |  | $ | 314,941 |

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