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Organization, Nature of Operations and Basis of Presentation (Details) $ in Thousands | 12 Months Ended
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Dec. 31, 2017 USD ($) Clinic State Facility | Dec. 31, 2016 USD ($) Clinic | Dec. 31, 2015 USD ($)
Organization, Nature of Operations and Basis of Presentation [Abstract] |  |  |
Number of clinics operated | 578 |  |
Number of states where clinics are operated | State | 41 |  |
Number of third party facilities | Facility | 32 |  |
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] |  |  |
Percentage of general partnership interest owned | 1.00% |  |
Percentage of interest acquired | 35.00% |  |
Percentage of interest acquired in a single clinic |  |  | 60.00%
Number of clinic practices acquired | 2 | 2 |
Number of clinics consolidated with an existing clinic | 1 |  |
Number of clinics that operate as a satellite clinic with existing partnerships | 1 |  |
Mandatorily redeemable non-controlling interests | $ | $ 327 | $ 69,190 | $ 45,974
Minimum [Member] |  |  |
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] |  |  |
Percentage of limited partnership interest owned | 49.00% |  |
Percentage of interest acquired |  | 2.00% | 5.00%
Maximum [Member] |  |  |
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] |  |  |
Percentage of limited partnership interest owned | 99.00% |  |
Percentage of interest acquired |  | 35.00% | 35.00%
March 2017 Acquisition [Member] |  |  |
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] |  |  |
Percentage of interest acquired | 55.00% |  |

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