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Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2017
Dec. 31, 2016
Income Tax Disclosure [Abstract]    
Allowance for uncollectible accounts $ 80,056 $ 103,525
Reserves and accruals 45,454 62,212
Stock-based compensation 7,975 13,726
Net operating loss carryforward 28,569 49,156
Property and equipment 685 1,621
Other 970 1,610
Deferred tax assets before valuation allowance 163,709 231,850
Less: Valuation allowance (2,615) (4,014)
Deferred tax assets, net of valuation allowance 161,094 227,836
Gross deferred tax liabilities:    
Amortization (258,618) (380,594)
Accrual to cash adjustment (31,290) (53,771)
Other (4,150) (1,023)
Total deferred tax liabilities (294,058) (435,388)
Net deferred tax liability $ (132,964) $ (207,552)