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Description of Business and Significant Accounting Policies (Details) | 1 Months Ended | 3 Months Ended | 12 Months Ended |
--- | --- | --- | --- | ---
Jan. 31, 2013 | Jul. 31, 2011 | Sep. 30, 2015 | Dec. 31, 2015 USD ($) financial_institution segment | Dec. 31, 2014 USD ($) | Dec. 31, 2013 USD ($) | Sep. 30, 2014 USD ($)
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Number of financial institutions holding cash and cash equivalents and marketable securities | financial_institution |  |  |  | 1 |  |  |
Service agreement term |  |  |  | 1 year |  |  |
Number of reportable segments | segment |  |  |  | 2 |  |  |
Notes receivable |  |  |  | $ 6,472,000 | $ 10,208,000 |  |
Discounted notes receivable |  |  |  | 6,460,000 | 10,196,000 |  |
Marketable securities |  |  |  | 69,496,000 |  |  |
Unrealized gains from marketable securities |  |  |  | $ 543,000 |  |  |
Amortization period of inventories and supplies |  |  |  | 24 months |  |  |
Depreciation |  |  |  | $ 4,419,000 | 3,946,000 | $ 3,373,000 |
Impairment loss on goodwill and intangible assets |  |  |  | $ 0 | $ 0 | $ 0 |
Percentage of reduction of Medicare payments to nursing centers |  | 11.10% |  |  |  |  |
Percentage of reduction of Medicare payments to plans and providers (up to) | 2.00% |  |  |  |  |  |
Change in Self-Insurance Reserve |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Self-insurance claims reserve adjustment |  |  |  |  |  |  | $ 37,416,000
Autos And Trucks |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Useful life |  |  |  | 3 years |  |  |
Minimum |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Days to notify cancellation of service |  |  |  | 30 days |  |  |
Initial period of service term |  |  |  | 60 days |  |  |
Property and equipment payment terms |  |  |  | 24 months |  |  |
Percentage of revenue from a major client |  |  |  | 3.00% |  |  |
Minimum | Change in Self-Insurance Reserve |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Estimated self-insurance claim close-out period |  |  | 15 years |  |  |  |
Minimum | Laundry And Linen Equipment Installations |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Useful life |  |  |  | 3 years |  |  |
Minimum | Housekeeping, And Office Furniture And Equipment |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Useful life |  |  |  | 3 years |  |  |
Maximum |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Days to notify cancellation of service |  |  |  | 90 days |  |  |
Initial period of service term |  |  |  | 120 days |  |  |
Property and equipment payment terms |  |  |  | 60 months |  |  |
Percentage of revenue from a major client |  |  |  | 9.00% |  |  |
Maximum | Change in Self-Insurance Reserve |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Estimated self-insurance claim close-out period |  |  | 17 years |  |  |  |
Maximum | Laundry And Linen Equipment Installations |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Useful life |  |  |  | 7 years |  |  |
Maximum | Housekeeping, And Office Furniture And Equipment |  |  |  |  |  |  |
Property, Plant and Equipment [Line Items] |  |  |  |  |  |  |
Useful life |  |  |  | 7 years |  |  |

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