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Property and Equipment (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2018
Mar. 31, 2017
Dec. 31, 2017
Property, Plant and Equipment [Line Items]      
Total property and equipment, at cost $ 36,310   $ 36,004
Less accumulated depreciation 22,823   22,495
Total property and equipment, net 13,487   13,509
Depreciation 1,300 $ 1,300  
Housekeeping and Dietary equipment      
Property, Plant and Equipment [Line Items]      
Total property and equipment, at cost 22,518   22,349
Computer hardware and software      
Property, Plant and Equipment [Line Items]      
Total property and equipment, at cost 12,803   12,665
Other      
Property, Plant and Equipment [Line Items]      
Total property and equipment, at cost $ 989   $ 990