Annual report pursuant to Section 13 and 15(d)

Acquisitions and Joint Venture Activities - Price Allocation (Details)

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Acquisitions and Joint Venture Activities - Price Allocation (Details) - USD ($)
12 Months Ended
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Business Acquisition [Line Items]      
Goodwill $ 1,219,972,000 $ 1,161,717,000 $ 392,601,000
Home Health Agencies and Hospice Agency      
Business Acquisition [Line Items]      
Cash 57,930,000 8,800,000  
Other assets and (liabilities), net (2,835,000)    
Total identifiable assets 12,566,000    
Noncontrolling interest 10,478,000    
Goodwill 55,842,000 11,000,000.0  
Goodwill, Noncontrolling interest portion 7,390    
Trade Names | Home Health Agencies and Hospice Agency      
Business Acquisition [Line Items]      
Indefinite-lived intangible assets 7,403,000 1,500,000  
Certificates of need/licenses | Home Health Agencies and Hospice Agency      
Business Acquisition [Line Items]      
Indefinite-lived intangible assets $ 7,998,000 $ 1,400,000