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, 2019
Dec. 31, 2018
Dec. 31, 2017
Indefinite-lived intangible assets:      
Indefinite-lived intangible assets $ 293,188 $ 284,626  
Definite-lived intangible assets:      
Gross carrying amount 28,799 27,929  
Accumulated amortization (16,431) (15,176)  
Net total 12,368 12,753  
Total intangible assets, Gross carrying amount 321,987 312,555  
Total intangible assets, Net total 305,556 297,379 $ 134,611
Trade name      
Indefinite-lived intangible assets:      
Indefinite-lived intangible assets 163,499 156,049  
Certificates of Need/ Licenses      
Indefinite-lived intangible assets:      
Indefinite-lived intangible assets 129,689 128,577  
Trade name      
Definite-lived intangible assets:      
Gross carrying amount 10,182 10,127  
Accumulated amortization (9,229) (8,817)  
Net total 953 1,310  
Non-compete      
Definite-lived intangible assets:      
Gross carrying amount 6,795 5,980  
Accumulated amortization (5,991) (5,729)  
Net total 804 251  
Customer Relationships      
Definite-lived intangible assets:      
Gross carrying amount 11,822 11,822  
Accumulated amortization (1,211) (630)  
Net total $ 10,611 $ 11,192