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Goodwill - Additional Information (Details) $ in Thousands	3 Months Ended		12 Months Ended
Goodwill - Additional Information (Details) $ in Thousands	Sep. 30, 2019 USD ($)	Mar. 31, 2019 USD ($)	Dec. 31, 2019 USD ($) segment	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)
Goodwill [Line Items]
Goodwill impairment charges			$ 124,892	$ 3,106	$ 36,196
Goodwill			6,787,635	6,841,960	6,610,279
Goodwill, Subsequent Recognition of Deferred Tax Asset			26,634
Goodwill, Impairment Loss, Net of Tax			$ 98,258
Other reporting units
Goodwill [Line Items]
Number of Operating Segments \| segment			0
Other - Ancillary services
Goodwill [Line Items]
Goodwill impairment charges	$ 83,855		$ 124,892	3,106
Goodwill			500,535	566,956	465,518
Vascular access
Goodwill [Line Items]
Goodwill impairment charges					34,696
Goodwill					0
International Operations
Goodwill [Line Items]
Goodwill impairment charges					$ 1,500
GERMANY \| Other reporting units
Goodwill [Line Items]
Goodwill impairment charges			5,416	$ 3,106
Goodwill, Subsequent Recognition of Deferred Tax Asset			1,013
GERMANY \| Kidney Care
Goodwill [Line Items]
Goodwill impairment charges	$ 78,439	$ 41,037
Goodwill			295,151
Goodwill, Subsequent Recognition of Deferred Tax Asset			$ 25,621