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v3.19.2

Held for Sale and Discontinued Operations Additional Information (Details) $ in Thousands |  |  | 3 Months Ended | 6 Months Ended
--- | --- | --- | --- | ---
Jun. 19, 2019 USD ($) | Dec. 05, 2017 | Jun. 30, 2019 USD ($) | Jun. 30, 2018 USD ($) | Jun. 30, 2019 USD ($) | Jun. 18, 2019 USD ($) clinic | Jun. 30, 2018 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |  |  |  |  |  |
Proceeds from Divestiture of Businesses | $ 4,465,476 |  |  |  |  |  |
Proceeds from Divestiture of Businesses, Net of Cash Divested | $ 3,824,509 |  |  |  |  |  |
Payments to Acquire Businesses, Gross |  |  |  |  | $ 65,970 |  | $ 89,465
Series of Individually Immaterial Business Acquisitions |  |  |  |  |  |  |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |  |  |  |  |  |
Payments to Acquire Businesses, Gross |  |  |  |  | 63,945 |  |
DMG held for sale | Series of Individually Immaterial Business Acquisitions |  |  |  |  |  |  |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |  |  |  |  |  |
Number of businesses acquired | clinic |  |  |  |  |  | 2 |
Payments to Acquire Businesses, Gross |  |  |  |  |  | $ 2,025 |
Business Combination, Consideration Transferred, Other |  |  |  |  |  | $ 212 |
Discontinued Operations, Held-for-sale | DMG held for sale |  |  |  |  |  |  |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |  |  |  |  |  |
Business acquisition, Effective date of acquisition | Jun. 19, 2019 |  |  |  |  |  |
Purchase and Sale Agreement, Aggregate purchase price | $ 4,340,000 |  |  |  |  |  |
Business Acquisition, Date of Acquisition Agreement |  | Dec. 05, 2017 |  |  |  |  |
Loss on sale of discontinued operations before taxes |  |  | $ (23,022) | $ 0 | $ (23,022) |  | $ 0

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