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Mandatorily Redeemable Non-Controlling Interest (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2017
Jun. 30, 2017
Dec. 31, 2016
Changes in Carrying Amount of Redeemable Non-Controlling Interest [Roll Forward]          
Beginning balance $ 69,190 $ 45,974      
Operating results allocated to mandatorily redeemable non-controlling interest partners 6,055 4,057      
Distributions to mandatorily redeemable non-controlling interest partners (7,336) (4,628)      
Changes in the redemption value of mandatorily redeemable non-controlling interest 12,894 6,169      
Payments for settlement of mandatorily redeemable non-controlling interest (2,361) (1,262)      
Purchases of businesses - initial liability related to mandatorily redeemable non-controlling interest 10,282 18,880      
Other 119 0      
Extinguishment of mandatorily redeemable non-controlling interest (88,516) 0      
Ending balance 327 69,190      
Carrying Amount of Redeemable Non-Controlling Interest [Abstract]          
Contractual time period has lapsed but holder's employment has not been terminated     $ 327   $ 24,700
Contractual time period has not lapsed and holder's employment has not been terminated     0   46,949
Holder's employment has terminated and contractual time period has expired     0   0
Holder's employment has terminated and contractual time period has not expired     0   0
Redemption value prior to excess distributed earnings     327   71,649
Excess distributions over earnings and losses     0   (2,459)
Redeemable non-controlling interests $ 69,190 $ 69,190 $ 327   $ 69,190
Therapy Practice [Member] | Minimum [Member]          
Business Acquisition [Line Items]          
Business acquisition, percentage of limited partnership acquired       50.00%  
Therapy Practice [Member] | Maximum [Member]          
Business Acquisition [Line Items]          
Business acquisition, percentage of limited partnership acquired       90.00%  
Therapy Practice [Member] | NewCo. [Member]          
Business Acquisition [Line Items]          
Percentage of equity interest of subsidiary contributed for acquisition       100.00%  
Business acquisition, percentage of general partnership interest acquired       100.00%  
Business acquisition, consideration payable, term of note 2 years        
Employment agreement renewal term 1 year        
Non-Compete agreement term under condition of termination of employment of employed selling shareholder 2 years        
Therapy Practice [Member] | NewCo. [Member] | Minimum [Member]          
Business Acquisition [Line Items]          
Employment agreement term 3 years        
Non-Compete agreement term regardless of whether the selling shareholder is employed 5 years        
Required redemption term, under condition of termination of employment of employed selling shareholders 3 years        
Therapy Practice [Member] | NewCo. [Member] | Maximum [Member]          
Business Acquisition [Line Items]          
Employment agreement term 5 years        
Non-Compete agreement term regardless of whether the selling shareholder is employed 6 years        
Required redemption term, under condition of termination of employment of employed selling shareholders 5 years