Goodwill - Narrative (Details) - USD ($)	3 Months Ended	12 Months Ended
Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Goodwill [Line Items]
Goodwill impairment charges	$ 0	$ 24,198,000	$ 36,196,000
Vascular Access Clinic
Goodwill [Line Items]
Goodwill impairment charges		$ 24,198,000

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.

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 50
-Paragraph 2
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=35741047&loc=d3e13854-109267

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 45
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=6388280&loc=d3e13777-109266

Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 28
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3602-108585

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=35741047&loc=d3e13816-109267

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