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Goodwill - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Line Items]
Goodwill impairment charges	$ 0	$ 0	$ 3,106	$ 34,696	$ 36,196
Goodwill	6,702,659		6,702,659		$ 6,610,279	$ 6,015,375
Vascular Access Clinic
Goodwill [Line Items]
Goodwill impairment charges				$ 34,696
Goodwill	$ 0		0
GERMANY
Goodwill [Line Items]
Goodwill impairment charges			$ 3,106

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

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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

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