v2.4.0.8

Acquisitions and Discontinued Operations - Additional Information (Detail) (USD $) In Thousands, except Share data, unless otherwise specified | 1 Months Ended | 3 Months Ended | 12 Months Ended |  |  |  | 12 Months Ended | 1 Months Ended | 12 Months Ended | 1 Months Ended | 12 Months Ended | 1 Months Ended | 12 Months Ended
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Sep. 02, 2011 Entity | Dec. 31, 2013 | Sep. 30, 2013 | Jun. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2012 | Jun. 30, 2012 | Mar. 31, 2012 | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | Oct. 31, 2011 Entity | Sep. 30, 2011 Entity | Dec. 31, 2013 Other Accrued Liabilities | Dec. 31, 2013 Other long-term liabilities | Dec. 31, 2013 Other companies | Dec. 31, 2013 Other companies Scenario 1 | Dec. 31, 2013 Other companies Earn-out obligations | Dec. 31, 2013 U.S. dialysis and related lab services | Dec. 31, 2012 U.S. dialysis and related lab services | Dec. 31, 2011 U.S. dialysis and related lab services | Dec. 31, 2012 HomeChoice Partners | Dec. 31, 2013 HomeChoice Partners | Dec. 31, 2012 HomeChoice Partners Minimum | Apr. 30, 2013 HealthCare Partners (HCP) | Nov. 01, 2012 HealthCare Partners (HCP) | Dec. 31, 2013 HealthCare Partners (HCP) | Nov. 01, 2012 HealthCare Partners (HCP) Customer relationships | Nov. 01, 2012 HealthCare Partners (HCP) Trade names | Nov. 01, 2012 HealthCare Partners (HCP) Noncompetition and other agreements | Nov. 01, 2012 HealthCare Partners (HCP) Provider network and practice management tools | Dec. 31, 2013 CDSI I Holding Company, Inc | Dec. 31, 2012 CDSI I Holding Company, Inc | Dec. 31, 2011 CDSI I Holding Company, Inc Person Entity Location | Dec. 31, 2013 Other dialysis acquisitions | Dec. 31, 2012 Other dialysis acquisitions | Dec. 31, 2011 Other dialysis acquisitions | Dec. 31, 2013 Other dialysis acquisitions U.S. dialysis and related lab services Entity | Dec. 31, 2012 Other dialysis acquisitions U.S. dialysis and related lab services Entity | Dec. 31, 2011 Other dialysis acquisitions U.S. dialysis and related lab services Entity | Dec. 31, 2013 Other dialysis acquisitions Foreign Entity | Dec. 31, 2012 Other dialysis acquisitions Foreign Entity | Dec. 31, 2011 Other dialysis acquisitions Foreign Entity | Dec. 31, 2011 Other dialysis acquisitions Vascular Access Centers Entity
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of businesses acquired |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 113 |  |  |  | 26 | 93 | 57 | 38 | 13 | 8 |
Number of centers |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 1
Cash paid to acquire business |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | $ 3,645,759 |  |  |  |  |  |  |  | $ 723,012 | $ 310,394 | $ 648,318 | $ 354,430 |  |  |  |  |  |  |
Deferred purchase price obligations |  |  |  |  |  |  |  |  |  | 209 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 6,541 | 24,683 | 6,101 | 12,469 |  |  |  |  |  |  |
Number of patients |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 8,000 |  |  |  |  |  |  |  |  |  |
Number of states |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 23 |  |  |  |  |  |  |  |  |  |
Additional transaction and integration costs incurred in association with the acquisition |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 21,700 |  |  |  |  |  |  |  |  |  |
Amortizable intangible assets acquired, weighted-average estimated useful lives |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 17 years 2 months 12 days |  | 20 years | 10 years 7 months 6 days | 5 years 8 months 12 days | 7 years | 14 years | 15 years | 9 years |  |  |  |  |  |  |  |  |  |
Goodwill deductible for tax purposes associated with acquisitions |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 2,426,986 |  |  |  |  |  | 221,454 | 491,457 | 560,000 |  |  |  |  |  |  |  |  |  |
Revenues |  | 3,063,209 | 2,999,586 | 2,871,673 | 2,829,582 | 2,477,853 | 1,945,888 | 1,913,006 | 1,849,533 | 8,307,195 | 7,351,902 | 6,470,540 |  |  |  |  |  |  |  | 8,032,772 | 7,316,818 | 6,473,952 |  |  |  |  |  | 3,200,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Operating income |  | 484,179 | 377,074 | 522,020 | 166,861 | 388,056 | 340,885 | 247,261 | 320,882 | 1,550,134 | 1,297,084 | 1,154,713 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 385,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Total consideration paid |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 4,701,231 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Common stock share issued to acquire business |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 18,760,624 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Approximate value of common stock share issued |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 1,055,472 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Cash paid for post-closing working capital adjustment |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 5,251 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additional cash consideration in the form of earn-out payments |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 275,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Amortizable intangible assets |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 1,882,818 |  | 1,453,410 | 170,494 | 74,650 | 184,686 |  |  |  |  |  |  |  |  |  |  |  |  |
Goodwill deductible period for tax purpose |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 15 years |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Contingent consideration payment |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 136,954 |  | 68,750 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Contingent earn-out obligation adjustment |  |  |  |  |  |  |  |  |  | (56,977) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 56,977 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additional cash consideration in the form of earn-out payments |  | 6,577 |  |  |  | 142,244 |  |  |  | 6,577 | 142,244 |  |  |  |  |  | 118,600 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Earn out consideration payment period |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 3 years | 5 years |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Fair value of contingent earn-out consideration |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 28,058 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Contingent earn-out obligations |  | 28,058 |  |  |  | 292,042 |  |  |  | 28,058 | 292,042 |  |  |  | 6,736 | 21,322 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Proceeds from sale of discontinued operations |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 70,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additional consideration if certain performance amounts exceed certain thresholds over the next two years |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 20,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Performance amounts thresholds measurement period |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 2 years |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Contingent receivable |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Gain recorded on account of divestitures |  |  |  |  |  |  |  |  |  | 13,375 |  | (4,756) |  |  |  |  |  |  |  |  |  |  |  | 13,375 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of outpatient dialysis centers to be divested | 30 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of outpatient dialysis centers divested |  |  |  |  |  |  |  |  |  |  |  |  | 2 | 28 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Proceeds from sale of discontinued operations |  |  |  |  |  |  |  |  |  |  |  | 84,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Loss recorded on account of divestitures |  |  |  |  |  |  |  |  |  |  |  | $ (4,756) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

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- Definition Business Acquisition Contingent Consideration Revenue Earnout Period + References No definition available. + Details
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- Definition Fair values as of the balance sheet date of contingent earn-out considerations if certain performance targets are met. + References No definition available. + Details
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- Definition Business Acquisition, Purchase Price Allocation, Goodwill and Intangible Assets, Expected Tax Deductible Term + References No definition available. + Details
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- Definition Business Acquisitions Additional Potential Earn Out Cash Payments + References No definition available. + Details
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- Definition Contingent Receivable from Sale of Discontinued Operation + References No definition available. + Details
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- Definition Disposal Group Including Discontinued Operations Contingent Consideration Potential Cash Proceeds + References No definition available. + Details
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- Definition The number of centers acquired during the period. + References No definition available. + Details
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- Definition This represents the number of outpatient dialysis centers that are required to be divested. + References No definition available. + Details
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- Definition Number of customers + References No definition available. + Details
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- Definition Weighted average amortization period of finite-lived intangible assets acquired either individually or as part of a group of assets, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (a)(3) -URI http://asc.fasb.org/extlink&oid=26713463&loc=d3e16265-109275 + Details
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- Definition Number of shares of equity interests issued or issuable to acquire entity. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (b)(4) -URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e6927-128479 + Details
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- Definition The amount of goodwill arising from a business combination that is expected to be deductible for tax purposes. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (d) -URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e6927-128479 + Details
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- Definition This element represents acquisition-related costs incurred to effect a business combination which costs have been expensed during the period. Such costs include finder's fees; advisory, legal, accounting, valuation, and other professional or consulting fees; general administrative costs, including the costs of maintaining an internal acquisitions department; and may include costs of registering and issuing debt and equity securities. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 10 -Section 25 -Paragraph 23 -URI http://asc.fasb.org/extlink&oid=21917927&loc=d3e1043-128460 + Details
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- Definition 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. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 30 -Paragraph 7 -URI http://asc.fasb.org/extlink&oid=6911251&loc=d3e6578-128477 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 30 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6911251&loc=d3e6613-128477 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e6927-128479 + Details
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- Definition Amount of liabilities incurred by the acquirer as part of consideration transferred in a business combination. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 25 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=6911189&loc=d3e6405-128476 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 30 -Paragraph 7 -URI http://asc.fasb.org/extlink&oid=6911251&loc=d3e6578-128477 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 30 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6911251&loc=d3e6613-128477 + Details
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- Definition Amount of (increase) decrease in the value of a contingent consideration liability, including, but not limited to, differences arising upon settlement. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 50 -Paragraph 4 -Subparagraph (a)(1) -URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e7008-128479 + Details
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- Definition For contingent consideration arrangements recognized in connection with a business combination, this element represents an estimate of the high-end of the potential range (undiscounted) of the consideration which may be paid. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (c)(3) -URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e6927-128479 + Details
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- Definition Amount of liability recognized arising from contingent consideration in a business combination. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 35 -Paragraph 1 -Subparagraph b -URI http://asc.fasb.org/extlink&oid=6911338&loc=d3e6819-128478 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 25 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=6911189&loc=d3e6408-128476 + Details
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- Definition The amount of identifiable intangible assets recognized as of the acquisition date. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 20 -Section 50 -Paragraph 1 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=6910749&loc=d3e4845-128472 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 10 -Section 55 -Paragraph 37 -URI http://asc.fasb.org/extlink&oid=25498275&loc=d3e2207-128464 + Details
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- Definition Amount of gain (loss), after tax expense or benefit and not previously recognized, resulting from the sale of a business component. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 205 -SubTopic 20 -Section 45 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=6892542&loc=d3e957-107759 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 205 -SubTopic 20 -Section 50 -Paragraph 1 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=6360339&loc=d3e1361-107760 + Details
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