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Goodwill (Tables) | 12 Months Ended
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Dec. 31, 2018
Goodwill [Abstract] |
Changes in Carrying Amount of Goodwill | The changes in the carrying amount of goodwill as of December 31, 2018 and 2017 consisted of the following (in thousands):
|  | Year Ended December 31, 2018 |  |  | Year Ended December 31, 2017 |
Beginning balance |  | $ | 271,338 |  |  | $ | 226,806 |
Goodwill acquired during the year |  |  | 19,778 |  |  |  | 44,292 |
Goodwill adjustments for purchase price allocation of businesses acquired in prior year |  |  | 2,409 |  |  |  | 706 |
Goodwill written-off - closed clinic |  |  | - |  |  |  | (466 | )
Ending balance |  | $ | 293,525 |  |  | $ | 271,338 |

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- Definition Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=108376223&loc=d3e13816-109267 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=108376223&loc=d3e13854-109267 + Details
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