Annual report pursuant to Section 13 and 15(d)

Summary of Significant Accounting Policies - Schedule of Net Accounts Receivable Balance Concentrations by Major Category (Details)

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Summary of Significant Accounting Policies - Schedule of Net Accounts Receivable Balance Concentrations by Major Category (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Accounts Notes And Loans Receivable [Line Items]    
Net accounts receivable $ 31,444 $ 30,828
Net accounts receivable, percentage 100.00% 100.00%
Medicare    
Accounts Notes And Loans Receivable [Line Items]    
Net accounts receivable $ 1,501 $ 7,208
Net accounts receivable, percentage 4.70% 23.40%
Medicaid Or Other Government    
Accounts Notes And Loans Receivable [Line Items]    
Net accounts receivable $ 244 $ 410
Net accounts receivable, percentage 0.80% 1.30%
Private Insurance    
Accounts Notes And Loans Receivable [Line Items]    
Net accounts receivable $ 1,249 $ 1,832
Net accounts receivable, percentage 4.00% 6.00%
Patient Responsibility    
Accounts Notes And Loans Receivable [Line Items]    
Net accounts receivable $ 1,218 $ 2,538
Net accounts receivable, percentage 3.90% 8.20%
Business To Business And Other Receivables    
Accounts Notes And Loans Receivable [Line Items]    
Net accounts receivable $ 27,232 $ 18,840
Net accounts receivable, percentage 86.60% 61.10%