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Commitments and Contingencies - Additional Information (Detail) £ in Millions | 3 Months Ended | 9 Months Ended | 12 Months Ended |  |  |  |  |  |  |
--- | --- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Sep. 30, 2020 USD ($) | Mar. 31, 2020 USD ($) | Sep. 30, 2020 USD ($) | Sep. 30, 2020 GBP (£) | Dec. 31, 2015 USD ($) | Dec. 31, 2014 USD ($) | Dec. 31, 2013 USD ($) | Dec. 31, 2012 USD ($) | Dec. 31, 2011 USD ($) | Sep. 30, 2020 GBP (£) | Jun. 01, 2020 USD ($) | Jan. 31, 2020 USD ($) | Dec. 31, 2019 USD ($) | Dec. 31, 2018 USD ($) | Dec. 31, 2017 USD ($) | Dec. 31, 2016 USD ($)
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability, current | $ 50,000,000 |  | $ 50,000,000 |  |  |  |  |  |  |  |  |  | $ 42,000,000 |  |  |
Compensation liability claims | 90,000,000 |  | 90,000,000 |  |  |  |  |  |  |  |  |  | 81,000,000 |  |  |
Compensation and related benefits | 46,000,000 |  | 46,000,000 |  |  |  |  |  |  |  |  |  | 40,000,000 |  |  |
Department of Human Services |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Aggregate payment made |  |  |  |  | $ 4,000,000 | $ 4,000,000 | $ 4,000,000 | $ 4,000,000 | $ 4,000,000 |  |  |  |  |  |  |
Amount claimed from over payments of legal settlements |  |  |  |  | 7,000,000 | 8,000,000 | 7,000,000 | $ 4,000,000 |  |  |  |  |  |  |  |
Amount claimed from over payments of legal settlements due to change in calculations |  |  |  |  | 3,000,000 | 2,000,000 | 2,000,000 |  |  |  |  |  |  |  |  |
Per Occurrence/Per Location Deductible | Wind Storms |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses |  |  |  |  |  |  |  |  |  |  | $ 2,500,000 |  |  |  |  |
Cygnet Health Care Limited |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Property insurance | £ |  |  |  | £ 1,500 |  |  |  |  |  |  |  |  |  |  |  |
Maximum | Wind Storms |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | $ 1,000,000,000 |  | $ 1,000,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Percentage of insurance deductible | 5.00% |  | 5.00% |  |  |  |  |  |  | 5.00% |  |  |  |  |  |
Maximum | Flood |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | $ 100,000,000 |  | $ 100,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Maximum | LAS VEGAS, NEVADA | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 500,000,000 |  | 500,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Maximum | CALIFORNIA | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 130,000,000 |  | 130,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Maximum | Faulty Zones of UNITED STATES | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 100,000,000 |  | 100,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Maximum | PUERTO RICO | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 40,000,000 |  | 40,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Maximum | PUERTO RICO | Flood |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 1,000,000 |  | 1,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Maximum | OTHER STATES | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 250,000,000 |  | 250,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Maximum | Texas | Flood |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | $ 10,000,000 |  | $ 10,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Minimum | Wind Storms |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Percentage of insurance deductible | 3.00% |  | 3.00% |  |  |  |  |  |  | 3.00% |  |  |  |  |  |
General And Professional Liability Insurance Policies |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability | $ 5,000,000 | $ 20,000,000 | $ 25,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
General and Professional Liability |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability | $ 262,000,000 |  | $ 262,000,000 |  |  |  |  |  |  |  |  |  | 242,000,000 |  |  |
Subsidiaries | Professional Liability |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability |  |  |  |  |  |  |  |  |  |  |  |  | 5,000,000 | $ 5,000,000 | $ 5,000,000 |
Purchased several excess policies through commercial insurance carriers per occurrence |  |  |  |  |  |  |  |  |  |  |  | $ 2,500,000 |  |  |  |
Purchased several excess policies through commercial insurance carriers per occurrence excess claim amount |  |  |  |  |  |  |  |  |  |  |  | 10,000,000 |  |  |  |
Subsidiaries | Professional Liability | Cygnet Health Care Limited |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability | £ |  |  |  |  |  |  |  |  |  | £ 10 |  |  |  |  |  |
Subsidiaries | Professional Liability | Maximum |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability |  |  |  |  |  |  |  |  |  |  |  | 10,000,000 |  |  |  | $ 10,000,000
Subsidiaries | General Liability |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability |  |  |  |  |  |  |  |  |  |  |  |  | $ 3,000,000 | $ 3,000,000 | $ 3,000,000 |
Subsidiaries | General Liability | Cygnet Health Care Limited |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability | £ |  |  |  |  |  |  |  |  |  | £ 25 |  |  |  |  |  |
Subsidiaries | General Liability | Maximum |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability |  |  |  |  |  |  |  |  |  |  |  | $ 3,000,000 |  |  |  | $ 3,000,000
Subsidiaries | General And Professional Liability Insurance Policies |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Percentage of liability for claims paid under commercially insured coverage | 10.00% |  | 10.00% |  |  |  |  |  |  | 10.00% |  |  |  |  |  |
Subsidiaries | General And Professional Liability Insurance Policies | Maximum |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Purchased several excess policies through commercial insurance carriers per occurrence |  |  |  |  | $ 250,000,000 | $ 250,000,000 | $ 200,000,000 |  |  |  |  |  |  |  |  |
Liability for claims paid under commercially insured coverage | $ 5,000,000 |  | $ 5,000,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Subsidiaries | General And Professional Liability Insurance Policies | Maximum | Located in U.K. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Liability for claims paid under commercially insured coverage | $ 8,500,000 |  | $ 8,500,000 |  |  |  |  |  |  |  |  |  |  |  |  |

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