Segment and Related Information - Financial Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Segment and Related Information
Net revenues	$ 256,637	$ 279,638	$ 723,810	$ 797,155
Material costs	81,462	92,034	228,675	261,810
Personnel expenses	89,727	94,594	252,734	272,795
Depreciation & amortization	8,803	9,373	26,513	26,906
Segment income from operations	13,075	17,403	42,763	38,527
Purchase of property, plant and equipment			19,352	20,262
Patient Care
Segment and Related Information
Net revenues	212,664	230,931	598,706	652,700
Material costs	63,938	71,339	178,851	199,626
Personnel expenses	76,989	81,274	216,910	233,402
Other expenses	34,713	37,245	86,462	112,014
Depreciation & amortization	4,786	4,943	14,089	13,997
Segment income from operations	32,238	36,130	102,394	93,661
Patient Care | Operating segments
Segment and Related Information
Net revenues	212,664	230,931	598,706	652,700
Material costs	56,599	65,055	160,212	181,358
Patient Care | Intersegments
Segment and Related Information
Material costs	7,339	6,284	18,639	18,268
Products & Services
Segment and Related Information
Net revenues	93,984	102,377	264,003	294,700
Material costs	67,535	74,365	188,723	212,429
Personnel expenses	12,738	13,320	35,824	39,393
Other expenses	5,957	6,858	18,614	20,883
Depreciation & amortization	2,633	2,723	7,883	7,862
Segment income from operations	5,121	5,111	12,959	14,133
Products & Services | Operating segments
Segment and Related Information
Net revenues	43,973	48,707	125,104	144,455
Material costs	24,863	26,979	68,463	80,452
Products & Services | Intersegments
Segment and Related Information
Net revenues	50,011	53,670	138,899	150,245
Material costs	$ 42,672	$ 47,386	$ 120,260	$ 131,977