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Accounts and Notes Receivable | 6 Months Ended
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Jun. 30, 2019
Receivables [Abstract] |
Accounts and Notes Receivable | Note 3—Accounts and Notes Receivable The Company’s accounts and notes receivable balances consisted of the following as of June 30, 2019 and December 31, 2018:
| June 30, 2019 |  | December 31, 2018
| (in thousands) |  |
Short-term |  |  |
Accounts and notes receivable | $ | 390,184 |  | $ | 389,047
Allowance for doubtful accounts | (43,419) |  | (47,209)
Total net short-term accounts and notes receivable | $ | 346,765 |  | $ | 341,838
Long-term |  |  |
Notes receivable | $ | 51,956 |  | $ | 53,043
Allowance for doubtful accounts | (10,000) |  | (10,000)
Total net long-term notes receivable | $ | 41,956 |  | $ | 43,043
Total net accounts and notes receivable | $ | 388,721 |  | $ | 384,881
The Company makes credit decisions on a case-by-case basis after reviewing a number of qualitative and quantitative factors related to the specific client as well as current industry variables that may impact that client. There are a variety of factors that impact a client’s ability to pay in accordance with the Company’s service agreements. These factors include, but are not limited to, fluctuating census numbers, litigation costs and the client’s participation in programs funded by federal and state governmental agencies. Deviations in the timing or amounts of reimbursements under those programs can impact the client’s cash flows and their ability to make timely payments. However, the client's obligation to pay the Company in accordance with the service agreements are not contingent upon the client’s cash flows. Notwithstanding the Company’s efforts to minimize its credit risk exposure, the aforementioned factors, as well as other factors that impact client cash flows or ability to make timely payments, could have an indirect, yet material adverse effect on the Company’s results of operations and financial condition. The Company’s net current accounts and notes receivable balance increased from December 31, 2018. Fluctuations in net accounts and notes receivable are generally attributable to a variety of factors including, but not limited to, the timing of cash receipts from customers and the inception, transition or termination of client relationships. The Company deploys significant resources and has invested in tools and processes to optimize Management’s credit and collections efforts. When appropriate, the Company utilizes interest-bearing promissory notes as an alternative to accounts receivable to enhance the collectability of amounts due, by instituting definitive repayment plans and providing a means by which to further evidence the amounts owed. As of June 30, 2019 and December 31, 2018, the Company's promissory notes outstanding were $57.6 million and $63.3 million, respectively, net of reserves of $15.9 million and $13.5 million, respectively. In addition, the Company may assist clients who are adjusting to changes in their cash flows by amending the Company’s agreements from full-service to management-only arrangements, or by modifying contractual payment terms to accommodate clients who have in good faith established clearly-defined plans for addressing cash flow issues. These efforts are intended to minimize the Company’s collections risk.

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- Definition The entire disclosure for claims held for amounts due a entity, excluding financing receivables. Examples include, but are not limited to, trade accounts receivables, notes receivables, loans receivables. Includes disclosure for allowance for credit losses. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 310 -SubTopic 10 -URI http://asc.fasb.org/subtopic&trid=2196772 + Details
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