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Commitments and Contingencies (Tables) | 12 Months Ended
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Dec. 31, 2020
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, 2020 (amount in thousands):
|  | General and |  |  |  |  |  |  |  |  |
|  | Professional |  |  | Workers’ |  |  |  |  |
|  | Liability |  |  | Compensation |  |  | Total |
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 January 1, 2019 |  |  | 243,051 |  |  |  | 71,890 |  |  |  | 314,941 |
Plus: Accrued insurance expense, net of commercial premiums paid |  |  | 56,452 |  |  |  | 49,220 |  |  |  | 105,672 |
Less: Payments made in settlement of self-insured claims |  |  | (57,683 | ) |  |  | (40,106 | ) |  |  | (97,789 | )
Balance at January 1, 2020 |  |  | 241,820 |  |  |  | 81,004 |  |  |  | 322,824 |
Plus: Accrued insurance expense, net of commercial premiums paid |  |  | 91,518 |  |  |  | 67,705 |  |  |  | 159,223 |
Less: Payments made in settlement of self-insured claims |  |  | (69,559 | ) |  |  | (43,524 | ) |  |  | (113,083 | )
Balance at December 31, 2020 |  | $ | 263,779 |  |  | $ | 105,185 |  |  | $ | 368,964 |

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