Annual report pursuant to Section 13 and 15(d)

Goodwill and Other Intangibles, Net - Schedule of Changes in Intangible Assets (Details)

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Goodwill and Other Intangibles, Net - Schedule of Changes in Intangible Assets (Details) - USD ($)
$ in Thousands
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Indefinite-lived intangible assets:      
Indefinite-lived intangible assets $ 303,713 $ 293,188  
Definite-lived intangible assets:      
Gross carrying amount 29,301 28,799  
Accumulated amortization (17,659) (16,431)  
Net total 11,642 12,368  
Total intangible assets, Gross carrying amount 333,014 321,987  
Total intangible assets, Net total 315,355 305,556 $ 297,379
Trade name      
Indefinite-lived intangible assets:      
Indefinite-lived intangible assets 168,700 163,499  
Certificates of Need/ Licenses      
Indefinite-lived intangible assets:      
Indefinite-lived intangible assets 135,013 129,689  
Trade name      
Definite-lived intangible assets:      
Gross carrying amount 10,212 10,182  
Accumulated amortization (9,480) (9,229)  
Net total 732 953  
Non-compete      
Definite-lived intangible assets:      
Gross carrying amount 7,267 6,795  
Accumulated amortization (6,387) (5,991)  
Net total 880 804  
Customer Relationships      
Definite-lived intangible assets:      
Gross carrying amount 11,822 11,822  
Accumulated amortization (1,792) (1,211)  
Net total $ 10,030 $ 10,611