XML 73 R55.htm IDEA: XBRL DOCUMENT v3.8.0.1
Accrued Professional Liabilities - Additional Information (Detail) - USD ($)
$ in Thousands
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Dec. 31, 2014
Payables and Accruals [Abstract]        
Total accrued professional liability $ 250,187 $ 202,052 $ 202,527 $ 168,369
Accrued professional liability incurred but loss reserves not reported for claims 138,500 128,100    
Accrued professional liability incurred and loss reserves reported for claims 111,700 74,000    
Accrued professional liabilities 37,912 $ 28,972    
Insurance receivables $ 18,900