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Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2018
Dec. 31, 2017
Income Tax Disclosure [Abstract]    
Allowance for uncollectible accounts $ 194,876 $ 80,056
Reserves and accruals 59,270 45,454
Stock-based compensation 9,201 7,975
Net operating loss carryforward 25,226 28,569
Property and equipment 26 685
Other 1,197 970
Deferred tax assets before valuation allowance 289,796 163,709
Less: Valuation allowance (2,628) (2,615)
Deferred tax assets, net of valuation allowance 287,168 161,094
Gross deferred tax liabilities:    
Amortization (286,552) (258,618)
Accounting method changes (109,418) (4,150)
Accrual to cash adjustment (39) (31,290)
Other (489)  
Total deferred tax liabilities (396,498) (294,058)
Net deferred tax liability $ (109,330) $ (132,964)