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Property And Equipment (Details) - USD ($)
$ in Thousands
3 Months Ended 12 Months Ended
Sep. 30, 2014
Jun. 30, 2014
Dec. 31, 2014
Dec. 31, 2013
Dec. 31, 2012
Mar. 31, 2014
Sep. 30, 2013
Jun. 30, 2013
Mar. 31, 2013
Property and equipment                  
Property and equipment, gross     $ 504,063 $ 414,657          
Less accumulated depreciation     (241,697) (180,830)          
Property and equipment before construction in progress and foreign currency translation     262,366 233,827          
Construction-in-progress     13,373 9,120          
Foreign currency translation     (6,169) (3,710)          
Property and equipment, net $ 273,330 $ 274,054 269,570 [1] 239,237 [1]   $ 273,991 $ 216,369 $ 223,341 $ 216,602
Impairment charges $ 47,526 $ 182,000 229,526 [1] [1] $ 81,021 [1]        
Land                  
Property and equipment                  
Property and equipment, gross     1,795 1,795          
Buildings and leasehold improvements                  
Property and equipment                  
Property and equipment, gross     85,653 70,709          
Office, computer, and telephone equipment                  
Property and equipment                  
Property and equipment, gross     114,669 87,332          
Medical and medical testing equipment                  
Property and equipment                  
Property and equipment, gross     300,511 253,347          
Automobiles and vans                  
Property and equipment                  
Property and equipment, gross     $ 1,435 $ 1,474          
Leasehold improvements and other fixed assets                  
Property and equipment                  
Impairment charges         $ 300        
[1] As Restated