Restructuring - Cost (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended	9 Months Ended
	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2019	Jun. 30, 2020	Sep. 30, 2020	Sep. 30, 2019
Restructuring Cost and Reserve [Line Items]
Restructuring and impairment						$ 4,880	$ 0
Lease impairment loss						4,880
Loss on termination of lease						882
Operation Simplification and Optimization Program
Restructuring Cost and Reserve [Line Items]
Restructuring and impairment	$ 1,833	$ 7,614	$ 7,754
Restructuring charges	1,833			$ 0		22,109	0
DRG Acquisition Integration Program
Restructuring Cost and Reserve [Line Items]
Restructuring and impairment	1,359				$ 3,324	4,683
Severance and Related Benefit Costs | Operation Simplification and Optimization Program
Restructuring Cost and Reserve [Line Items]
Restructuring and impairment	472	4,865	6,574
Restructuring charges	472			0		11,911	0
Severance and Related Benefit Costs | DRG Acquisition Integration Program
Restructuring Cost and Reserve [Line Items]
Restructuring and impairment	1,210				3,312	4,522
Exit and Disposal Costs | Operation Simplification and Optimization Program
Restructuring Cost and Reserve [Line Items]
Restructuring and impairment	1,361	$ 2,749	$ 1,180
Restructuring charges	506			0		4,435	0
Exit and Disposal Costs | DRG Acquisition Integration Program
Restructuring Cost and Reserve [Line Items]
Restructuring and impairment	149				$ 12	161
Lease Exist Cost Including Impairment | Operation Simplification and Optimization Program
Restructuring Cost and Reserve [Line Items]
Restructuring charges	$ 855			$ 0		$ 5,763	$ 0