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Schedule II - Valuation and Qualifying Accounts (Details) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015
Allowance for Doubtful Accounts and Bilinig Adjustments |  |  |  |
Movement in Valuation Allowances and Reserves [Roll Forward] |  |  |  |
Balance at beginning of year |  | $ 8,093 | $ 6,682 | $ 4,404
Provisions |  | 5,251 | 2,881 | 2,196
Valuation Allowances and Reserves, Additions for Charges to Other Accounts | [1] | 6,799 | 7,907 | 8,290
Deductions | [2] | (10,234) | (9,377) | (8,208)
Balance at end of year |  | 9,909 | 8,093 | 6,682
Allowance for Workers' Compensation and Medical Malpractice Loss Reserves |  |  |  |
Movement in Valuation Allowances and Reserves [Roll Forward] |  |  |  |
Balance at beginning of year |  | 15,784 | 15,020 | 15,564
Provisions |  | 2,908 | 2,693 | 2,117
Valuation Allowances and Reserves, Additions for Charges to Other Accounts | [1] | 0 | 0 | 0
Deductions | [2] | (3,915) | (1,929) | (2,661)
Balance at end of year |  | $ 14,777 | $ 15,784 | $ 15,020
[1] | Charges to other accounts include the provision for permanent placement fallouts and billing adjustments that have been deducted from revenues in the accompanying consolidated statements of operations and comprehensive income.
[2] | Deductions from the allowance for doubtful accounts and billing adjustments include write-offs of uncollectible accounts receivable and permanent placements fallouts that have been charged against the allowance for doubtful accounts and billing adjustments. Deductions from workers’ compensation loss reserves include payments of claims and changes related to anticipated insurance and indemnification recoveries which have corresponding changes in the workers' compensation receivable balance in the accompanying consolidated balance sheets.

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- Definition A roll forward is a reconciliation of a concept from the beginning of a period to the end of a period. + References No definition available. + Details
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- Definition Total of allowances and reserves, the valuation and qualifying accounts that are either netted against the cost of an asset (in order to value it at its carrying value) or that reflect a liability established to represent expected future costs. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 4 -Subparagraph (SX 210.12-09) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 + Details
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- Definition Amount of increase in the allowances and reserves, which consist of the valuation and qualifying accounts that are either netted against the cost of an asset or that reflect a liability established to represent expected future costs, from charges to costs and expenses. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 4 -Subparagraph (SX 210.12-09) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 + Details
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- Definition Amount of increase in the allowances and reserves, which consist of the valuation and qualifying accounts that are either netted against the cost of an asset or that reflect a liability established to represent expected future costs, from charges to accounts other than costs and expenses. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 4 -Subparagraph (SX 210.12-09) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 + Details
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- Definition Total of the deductions in a given period to allowances and reserves, the valuation and qualifying accounts that are either netted against the cost of an asset (in order to value it at its carrying value) or that reflect a liability established to represent expected future costs, representing receivables written off as uncollectible and portions of the reserves utilized, respectively. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 4 -Subparagraph (SX 210.12-09) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 + Details
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