Annual report pursuant to Section 13 and 15(d)

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

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Summary of Significant Accounting Policies - Schedule of Gross 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]    
Gross accounts receivable $ 34,710 $ 39,360
Gross accounts receivable, percentage 100.00% 100.00%
Medicare    
Accounts Notes And Loans Receivable [Line Items]    
Gross accounts receivable $ 2,247 $ 12,500
Gross accounts receivable, percentage 6.50% 31.80%
Medicaid Or Other Government    
Accounts Notes And Loans Receivable [Line Items]    
Gross accounts receivable $ 295 $ 617
Gross accounts receivable, percentage 0.80% 1.60%
Private Insurance    
Accounts Notes And Loans Receivable [Line Items]    
Gross accounts receivable $ 1,411 $ 3,475
Gross accounts receivable, percentage 4.10% 8.80%
Patient Responsibility    
Accounts Notes And Loans Receivable [Line Items]    
Gross accounts receivable $ 2,283 $ 3,227
Gross accounts receivable, percentage 6.60% 8.20%
Business To Business And Other Receivables    
Accounts Notes And Loans Receivable [Line Items]    
Gross accounts receivable $ 28,474 $ 19,541
Gross accounts receivable, percentage 82.00% 49.60%