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Goodwill - Narrative (Details) $ in Thousands | 3 Months Ended | 6 Months Ended | 12 Months Ended
--- | --- | --- | ---
Jun. 30, 2019 USD ($) | Jun. 30, 2018 USD ($) | Jun. 30, 2019 USD ($) segment | Jun. 30, 2018 USD ($) | Dec. 31, 2018 USD ($)
Goodwill [Line Items] |  |  |  |  |
Goodwill impairment charges | $ 0 | $ 3,106 | $ 41,037 | $ 3,106 | $ 3,106
Other Reporting Units |  |  |  |  |
Goodwill [Line Items] |  |  |  |  |
Goodwill impairment charges | $ 0 |  |  |  |
Number of Reportable Segments | segment |  |  | 0 |  |
GERMANY | Other Reporting Units |  |  |  |  |
Goodwill [Line Items] |  |  |  |  |
Goodwill impairment charges |  |  |  | $ 3,106 |
GERMANY | Kidney Care |  |  |  |  |
Goodwill [Line Items] |  |  |  |  |
Goodwill impairment charges |  |  | $ 41,037 |  |
Goodwill, Subsequent Recognition of Deferred Tax Asset |  |  | 8,865 |  |
Goodwill, Impairment Loss, Net of Tax |  |  | $ 32,172 |  |

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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://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 2 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=108376223&loc=d3e13854-109267 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3602-108585 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 1 -Subparagraph (e) -URI http://asc.fasb.org/extlink&oid=108376223&loc=d3e13816-109267 Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 45 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=99380562&loc=d3e13777-109266 + Details
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- Definition Number of operating segments. An operating segment is a component of an enterprise: (a) that engages in business activities from which it may earn revenues and incur expenses (including revenues and expenses relating to transactions with other components of the same enterprise), (b) whose operating results are regularly reviewed by the enterprise's chief operating decision maker to make decisions about resources to be allocated to the segment and assess its performance, and (c) for which discrete financial information is available. An operating segment may engage in business activities for which it has yet to earn revenues, for example, start-up operations may be operating segments before earning revenues. + References No definition available. + Details
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