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Description of Business and Significant Accounting Policies (Details) | 12 Months Ended
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Dec. 31, 2020 USD ($) segment financial_institution | Dec. 31, 2019 USD ($) financial_institution | Dec. 31, 2018 USD ($)
Schedule of Accounting Policies [Line Items] |  |  |
Renewal term | 1 year |  |
Number of reportable segments | segment | 2 |  |
Marketable securities | $ 125,012,000 | $ 90,711,000 |
Unrealized gains (losses) from marketable securities | $ 2,600,000 | 2,800,000 | $ (800,000)
Amortization period of inventories and supplies | 24 months |  |
Depreciation | $ 10,100,000 | 9,700,000 | 4,900,000
Advertising expense | 0 | 0 | 0
Goodwill and intangible asset impairment | $ 0 | $ 0 | 0
Number of financial institutions holding cash and cash equivalents and marketable securities | financial_institution | 1 | 1 |
Revenues | $ 1,760,303,000 | $ 1,840,778,000 | 2,002,601,000
Genesis |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Accounts receivable | 22,500,000 |  |
Notes receivable | 21,300,000 |  |
Customer Concentration Risk | Revenue from Contract with Customer Benchmark | Genesis |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Revenues | $ 258,700,000 | $ 287,800,000 | $ 386,700,000
Concentration risk, percentage | 14.70% | 15.60% | 19.30%
Minimum |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Cancellation notice period | 30 days |  |
Initial period preceding cancellation notice | 60 days |  |
Typical maturity | 1 year |  |
Minimum | Housekeeping and Dietary equipment |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Property plant and equipment, useful life | 5 years |  |
Minimum | Computer hardware and software |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Property plant and equipment, useful life | 3 years |  |
Minimum | Vehicles |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Property plant and equipment, useful life | 5 years |  |
Maximum |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Cancellation notice period | 90 days |  |
Initial period preceding cancellation notice | 120 days |  |
Typical maturity | 3 years |  |
Maximum | Housekeeping and Dietary equipment |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Property plant and equipment, useful life | 7 years |  |
Maximum | Computer hardware and software |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Property plant and equipment, useful life | 7 years |  |
Maximum | Vehicles |  |  |
Schedule of Accounting Policies [Line Items] |  |  |
Property plant and equipment, useful life | 10 years |  |

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