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Investments in Other Entities (Summarized Balance Sheets and Statements of Income) (Detail) - USD ($) | 12 Months Ended
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Dec. 31, 2017 | Dec. 31, 2016
LaSalle Medical Associates IPA [Member] |  |
Equity Method Investment, Summarized Financial Information, Assets [Abstract] |  |
Equity Method Investment, Summarized Financial Information, Cash and Cash Equivalents | $ 21,065,105 | $ 18,441,306
Equity Method Investment, Summarized Financial Information, Receivables | 2,433,116 | 3,142,173
Equity Method Investment, Summarized Financial Information, Other current assets | 1,565,606 | 1,589,606
Equity Method Investment, Summarized Financial Information, Loan Receivables | 1,250,000 | 1,250,000
Equity Method Investment, Summarized Financial Information, Restricted Cash | 662,109 | 657,171
Equity Method Investment, Summarized Financial Information, Assets | 26,975,936 | 25,080,256
Equity Method Investment, Summarized Financial Information, Liabilities and Equity [Abstract] |  |
Equity Method Investment, Summarized Financial Information, Current Liabilities | 20,353,337 | 18,253,224
Equity Method Investment Summarized Financial Information, Stockholders' equity (deficit) | 6,622,599 | 6,827,032
Equity Method Investment, Summarized Financial Information, Total liabilities and stockholders' equity (deficit) | 26,975,936 | 25,080,256
Equity Method Investment, Summarized Financial Information, Income Statement [Abstract] |  |
Equity Method Investment, Summarized Financial Information, Revenue | 195,143,984 | 191,530,251
Equity Method Investment, Summarized Financial Information, Cost of Sales | 188,265,085 | 164,694,297
Equity Method Investment, Summarized Financial Information, (Loss) income before benefit for income taxes | 6,878,899 | 26,835,954
Equity Method Investment, Summarized Financial Information, Income Taxes Benefit | (3,083,333) | (11,406,393)
Equity Method Investment, Summarized Financial Information, Net Income (Loss) | 3,795,566 | 15,429,561
Universal Care Inc [Member] |  |
Equity Method Investment, Summarized Financial Information, Assets [Abstract] |  |
Equity Method Investment, Summarized Financial Information, Cash and Cash Equivalents | 21,872,894 | 23,155,207
Equity Method Investment, Summarized Financial Information, Receivables | 18,618,760 | 17,928,792
Equity Method Investment, Summarized Financial Information, Other current assets | 13,021,520 | 11,319,582
Equity Method Investment, Summarized Financial Information, Other Assets | 3,754,470 | 2,432,338
Equity Method Investment, Summarized Financial Information, Property And Equipment | 1,576,621 | 1,099,766
Equity Method Investment, Summarized Financial Information, Assets | 58,844,265 | 55,935,685
Equity Method Investment, Summarized Financial Information, Liabilities and Equity [Abstract] |  |
Equity Method Investment, Summarized Financial Information, Current Liabilities | 54,421,532 | 46,718,155
Equity Method Investment, Summarized Financial Information, Other Liabilities | 10,051,952 | 8,075,977
Equity Method Investment Summarized Financial Information, Stockholders' equity (deficit) | (5,629,219) | 1,141,553
Equity Method Investment, Summarized Financial Information, Total liabilities and stockholders' equity (deficit) | 58,844,265 | 55,935,685
Equity Method Investment, Summarized Financial Information, Income Statement [Abstract] |  |
Equity Method Investment, Summarized Financial Information, Revenue | 188,389,384 | 161,289,612
Equity Method Investment, Summarized Financial Information, Cost of Sales | 193,196,938 | 161,277,959
Equity Method Investment, Summarized Financial Information, (Loss) income before benefit for income taxes | (4,807,554) | 11,653
Equity Method Investment, Summarized Financial Information, Income Taxes Benefit | (36,835) | (1,615,678)
Equity Method Investment, Summarized Financial Information, Net Income (Loss) | (4,770,719) | 1,734,206
Equity Method Investment, Summarized Financial Information, Other Income Loss From Discontinued Operations | 0 | 106,875
Equity Method Investment, Summarized Financial Information, Other Income | 0 | 106,875
Equity Method Investment, Summarized Financial Information, Income Loss Before Other Income From Discontinued Operations | $ (4,770,719) | $ 1,627,331

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