v2.4.0.8
Summary of Segment Net Revenues, Segment Operating Income Loss and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes (Detail) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended 12 Months Ended
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
Segment Reporting Information [Line Items]                      
Patient service operating 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
Less: Provision for uncollectible accounts                 (293,546) (235,218) (190,234)
Total net operating revenues                 11,764,050 8,186,280 6,731,806
Net patient service revenues                 8,013,649 7,116,684 6,280,306
Other revenues                 763,086 588,260 406,367
Contingent earn-out obligation adjustment                 56,977    
Corporate support costs                 (65,041) [1] (52,457) [1] (47,051) [1]
Transaction expenses                   (30,753)  
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
Debt expense                 (429,943) (288,554) (241,090)
Debt refinancing and redemption charges                   (10,963)  
Other income                 4,787 3,737 2,982
Consolidated income from continuing operations before income taxes 380,020 270,766 412,550 61,642 282,162 271,210 187,392 260,540 1,124,978 1,001,304 916,605
U.S. dialysis and related lab services
                      
Segment Reporting Information [Line Items]                      
Patient service operating revenues                 8,032,772 7,316,818 6,473,952
Less: Provision for uncollectible accounts                 (281,146) (233,580) (190,234)
Net patient service revenues                 7,751,626 7,083,238 6,283,718
Other revenues                 12,600 [2] 11,447 [2] 11,019 [2]
HealthCare Partners (HCP)
                      
Segment Reporting Information [Line Items]                      
Patient service operating revenues                 2,920,214 419,431  
Net patient service revenues                 220,251 34,407  
Other revenues                 55,723 23,552  
Other-ancillary services and strategic initiatives
                      
Segment Reporting Information [Line Items]                      
Patient service operating revenues                 67,351 61,906 45,133
Net patient service revenues                 75,852 16,824 7,730
Other revenues                 694,763 553,261 395,347
Operating Segments
                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 11,812,296 8,214,547 6,748,743
Operating income                 1,558,198 [3] 1,380,294 [3] 1,201,764 [3]
Operating Segments | U.S. dialysis and related lab services
                      
Segment Reporting Information [Line Items]                      
Patient service operating revenues                 7,998,692 7,299,032 6,462,811
Total net operating revenues                 7,764,226 7,094,685 6,294,737
Operating income                 1,211,540 [3] 1,378,241 [3] 1,235,869 [3]
Operating Segments | HealthCare Partners (HCP)
                      
Segment Reporting Information [Line Items]                      
Patient service operating revenues                 2,919,964 419,431  
Total net operating revenues                 3,196,188 477,390  
Operating income                 385,253 [3] 66,930 [3]  
Operating Segments | Other-ancillary services and strategic initiatives
                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 851,882 642,472 454,006
Operating income                 (38,595) [3] (64,877) [3] (34,105) [3]
Intersegment Elimination
                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 (48,246) (28,267) (16,937)
Intersegment Elimination | U.S. dialysis and related lab services
                      
Segment Reporting Information [Line Items]                      
Patient service operating revenues                 (34,080) (17,786) (11,141)
Intersegment Elimination | HealthCare Partners (HCP)
                      
Segment Reporting Information [Line Items]                      
Patient service operating revenues                 250    
Intersegment Elimination | Other-ancillary services and strategic initiatives
                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 $ (13,916) $ (10,481) $ (5,796)
[1] Corporate support costs also include $7,721 of an adjustment to reduce a tax asset associated with the HCP acquisition escrow provisions
[2] Includes management fees for providing management and administrative services to dialysis centers in which the Company owns a minority equity investment or which are wholly-owned by third parties.
[3] Certain costs previously reported in the ancillary services and strategic initiatives have been reclassified to U.S. dialysis and related lab services to conform to the current year presentation.