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Goodwill Goodwill Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016	Dec. 31, 2016	Dec. 31, 2015
Goodwill [Line Items]
Goodwill, Impairment Loss	$ 61,117,000	$ 176,000,000	$ 85,315,000	$ 253,000,000	$ 281,415,000
Goodwill	9,889,791,000		9,889,791,000		9,407,317,000	$ 9,294,479,000
DMG
Goodwill [Line Items]
Goodwill, Impairment Loss			50,619,000		253,000,000
Goodwill	3,373,090,000		3,373,090,000		$ 3,391,942,000	$ 3,398,264,000
Vascular Access Clinic
Goodwill [Line Items]
Goodwill, Impairment Loss	10,498,000
Goodwill	0		0
FLORIDA | DMG
Goodwill [Line Items]
Goodwill, Impairment Loss	49,946,000	97,000,000
Goodwill	397,127,000		397,127,000
NEW MEXICO | DMG
Goodwill [Line Items]
Goodwill, Impairment Loss	673,000
Goodwill	70,253,000		70,253,000
NEVADA | DMG
Goodwill [Line Items]
Goodwill, Impairment Loss		$ 79,000,000
Goodwill	$ 275,914,000		$ 275,914,000

X

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=35741047&loc=d3e13816-109267

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-Publisher FASB
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- Definition

Amount of loss from the write-down of an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 50
-Paragraph 2
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