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Accrued Professional Liabilities - Schedule of Accrued Professional Liability (Detail) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Payables and Accruals [Abstract] |  |  |
Balance at beginning of year | $ 250,187 | $ 202,052 | $ 202,527
Assumed liabilities through acquisition | 1,276 | 20,716 |
Provision (adjustment) for losses related to Current year | 34,483 | 41,291 | 38,129
Provision (adjustment) for losses related to Prior years | 10,299 | 9,983 | (25,428)
Total provision for losses | 44,782 | 51,274 | 12,701
Claim payments related to Current year | (555) | (712) | (766)
Claim payments related to Prior years | (51,699) | (23,143) | (12,410)
Total payments | (52,254) | (23,855) | (13,176)
Balance at end of year | $ 243,991 | $ 250,187 | $ 202,052

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- Definition Malpractice loss contingency provision for losses. + References No definition available. + Details
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- Definition Amount of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability) at the end of the accounting period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=82911808&loc=d3e14326-108349 + Details
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- Definition Amount of loss recognized for asserted and unasserted malpractice claims. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=82911808&loc=d3e14326-108349 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 954 -SubTopic 450 -Section 30 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=68049836&loc=d3e5870-115623 + Details
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- Definition Amount of increase in asserted and unasserted malpractice claims that were originally recognized in a prior period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=82911808&loc=d3e14326-108349 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 954 -SubTopic 450 -Section 30 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=68049836&loc=d3e5870-115623 + Details
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- Definition Amount of costs associated with malpractice claims and insurance premiums incurred during an accounting period, less insurance recoveries and returns of previously paid premiums. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=82911808&loc=d3e14326-108349 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 954 -SubTopic 450 -Section 30 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=68049836&loc=d3e5870-115623 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 954 -SubTopic 720 -Section 25 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=68060100&loc=d3e8578-115644 + Details
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