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Acquisitions - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended |  |  |
--- | --- | --- | --- | --- | ---
Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017 | Aug. 09, 2018 | May 07, 2018 | Feb. 22, 2018
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Combination, Costs Expensed Not Considered Ongoing |  |  |  |  |  |  |  |  |  |  | $ 15,000 |  |  |
Acquisition related costs |  |  |  |  |  |  |  |  | $ 0 | $ 5,871 | 344 |  |  |
Revenues | $ 198,632 | $ 213,897 | $ 221,666 | $ 213,256 | $ 199,477 | $ 205,683 | $ 197,010 | $ 168,487 |  |  |  |  |  |
Income (loss) from operations |  |  |  |  |  |  |  |  | $ 9,889 | (179,864) | 31,780 |  |  |
Paragon Medical |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Acquisition percentage |  |  |  |  |  |  |  |  |  |  |  |  | 100.00% |
Revenues |  |  |  |  |  |  |  |  |  | 116,998 |  |  |  |
Income (loss) from operations |  |  |  |  |  |  |  |  |  | $ 8,086 | $ 0 |  |  |
Bridgemedica, LLC |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Acquisition percentage |  |  |  |  |  |  |  |  |  |  |  |  |  | 100.00%
Southern California Technical Arts, Inc. |  |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Acquisition percentage |  |  |  |  |  |  |  |  |  |  |  | 100.00% |  |

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