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Business Acqusition Business Acquisition (Details) - USD ($) $ in Thousands			3 Months Ended								12 Months Ended
	Feb. 11, 2019	Jan. 04, 2016	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Revenues			$ 242,444	$ 202,307	$ 212,820	$ 202,064	$ 222,555	$ 190,117	$ 197,154	$ 186,567	$ 859,634	$ 796,392	$ 763,520
SurgiQuestInc [Member]
Business Acquisition [Line Items]
Business combination, consideration transferred		$ 257,700
Payments to acquire business		$ 265,000
Revenues													68,400
Pro Forma Information [Abstract]
Business Acquisition, Pro Forma Revenue													763,520
Business Acquisition, Pro Forma Net Income (Loss)													$ 29,153
Subsequent Event [Member] | Buffalo Filter LLC [Member]
Business Acquisition [Line Items]
Payments to acquire business	$ 365,000

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The pro forma net Income or Loss for the period as if the business combination or combinations had been completed at the beginning of a period.

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Amount of consideration transferred, consisting of acquisition-date fair value of assets transferred by the acquirer, liabilities incurred by the acquirer, and equity interest issued by the acquirer.

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