Goodwill and Other Intangible Assets - Goodwill (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2019	Dec. 31, 2018
Goodwill
Measurement period adjustments related to acquisitions		$ 2,100	$ 300
Goodwill allocated
Goodwill, Net as of beginning of the year	$ 232,244
Goodwill, Net as of end of the year	271,701	232,244
Patient Care
Goodwill allocated
Goodwill, Gross as of beginning of the year	660,912	627,410
Goodwill, Accumulated Impairment	(428,668)	(428,668)	(428,668)
Goodwill, Net as of beginning of the year	232,244	198,742
Additions from acquisitions	39,386	35,926
Measurement period adjustments	71	(2,424)
Goodwill, Gross as of end of the year	700,369	660,912	627,410
Goodwill, Net as of end of the year	271,701	232,244	198,742
Products & Services
Goodwill allocated
Goodwill, Gross as of beginning of the year	139,299	139,299
Goodwill, Accumulated Impairment	(139,299)	(139,299)	(139,299)
Goodwill, Gross as of end of the year	139,299	139,299	139,299
Consolidated
Goodwill allocated
Goodwill, Gross as of beginning of the year	800,211	766,709
Goodwill, Accumulated Impairment	(567,967)	(567,967)	(567,967)
Goodwill, Net as of beginning of the year	232,244	198,742
Additions from acquisitions	39,386	35,926
Measurement period adjustments	71	(2,424)
Goodwill, Gross as of end of the year	839,668	800,211	766,709
Goodwill, Net as of end of the year	$ 271,701	$ 232,244	$ 198,742