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v3.3.1.900

Long-term Debt - Additional Information (Detail) - USD ($) | 1 Months Ended | 12 Months Ended
--- | --- | ---
Oct. 31, 2015 | Apr. 30, 2015 | Jun. 30, 2014 | Dec. 31, 2015 | Dec. 31, 2014 | Dec. 31, 2013
Debt Instrument [Line Items] |  |  |  |  |  |
Payment of total outstanding principal balances under existing Senior Secured Credit Facilities plus accrued interest |  |  |  | $ 53,922,290,000 | $ 60,046,487,000 | $ 66,723,385,000
Debt refinancing charge |  |  |  | 48,072,000 | 97,548,000 |
Senior notes |  |  |  | 4,500,000,000 | 3,775,000,000 |
Maximum additional borrowing capacity |  |  | $ 1,500,000,000 |  |  |
Debt expense recognized |  |  |  | 389,755,000 | 385,750,000 | 401,140,000
Unrealized (losses) gain on interest rate swap and cap agreements |  |  |  | $ (12,241,000) | (10,059,000) | 169,000
Weighted average effective interest rate |  |  |  | 4.39% |  |
Weighted average effective interest rate |  |  |  | 4.42% |  |
Amortization of deferred financing costs |  |  |  | $ 18,625,000 | 24,544,000 | $ 28,803,000
HealthCare Partners (HCP) |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Outstanding letters of credit |  |  |  | 1,286,000 |  |
Letter of Credit |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Outstanding letters of credit |  |  |  | 92,238,000 |  |
Revolving Credit Facility |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Facility, aggregate principal amount |  |  | $ 1,000,000,000 |  |  |
Facility, term |  |  | 5 years |  |  |
Interest rate cap agreements |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Interest rate agreements, notional amount |  |  |  | $ 7,000,000,000 |  |
Derivative, effective date |  |  |  | Jun. 29, 2018 |  |
Interest Rate Cap Agreements Effective September 30, 2016 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Interest rate agreements, notional amount |  |  |  | $ 3,500,000,000 |  |
Derivative, effective date |  |  |  | Sep. 30, 2016 |  |
Derivative, expiration date |  |  |  | Jun. 30, 2018 |  |
Fair value of assets |  |  |  | $ 1,312,000 |  |
Unrealized (losses) gain on interest rate swap and cap agreements |  |  |  | $ (11,029,000) |  |
Amortizing Swap |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Notional amount |  |  | $ 1,137,500,000 |  |  |
Interest rate swap agreements |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Notional amount |  |  | $ 600,000,000 |  |  |
Interest rate swap agreements | Not Designated as Hedging Instrument |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, variable interest rate margin |  |  |  | 1.75% |  |
Notional amount |  |  |  | $ 165,000,000 |  |
Interest Rate Cap Agreements Effective June 29, 2018 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Interest rate agreements, notional amount | $ 3,500,000,000 |  |  |  |  |
Derivative, expiration date | Jun. 30, 2020 |  |  |  |  |
Fair value of assets |  |  |  | 13,815,000 |  |
Unrealized (losses) gain on interest rate swap and cap agreements |  |  |  | (3,492,000) |  |
Maximum |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Senior secured leverage ratio |  |  | 3.50 |  |  |
Minimum |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Senior secured leverage ratio |  |  | 1.00 |  |  |
Term Loan A |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, annual principal payment |  |  |  | $ 50,000,000 | 62,500,000 |
Term Loan A | Interest rate swap agreements |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, variable interest rate margin |  |  |  | 1.75% |  |
Notional amount |  |  |  | $ 760,000,000 |  |
Weighted average effective interest rate |  |  |  | 2.26% |  |
Derivative, expiration date |  |  |  | Sep. 30, 2016 |  |
Debt expense recognized |  |  |  | $ 2,664,000 |  |
Fair value of asset, net |  |  |  | 516,000 |  |
Amount of gains (losses) recognized in OCI on swaps arising during the period net of tax |  |  |  | (3,971,000) |  |
Unrealized pre-tax gains in other comprehensive income |  |  |  | 516,000 |  |
Term Loan B |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, annual principal payment |  |  |  | 35,000,000 | 21,875,000 |
Term Loan B | Interest rate cap agreements |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Interest rate agreements, notional amount |  |  |  | $ 2,735,000,000 |  |
Derivative, expiration date |  |  |  | Sep. 30, 2016 |  |
Debt expense recognized |  |  |  | $ 2,439,000 |  |
Unrealized (losses) gain on interest rate swap and cap agreements |  |  |  | $ (1,593,000) |  |
Term Loan B | Maximum | Interest rate cap agreements |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, variable interest rate margin |  |  |  | 3.50% |  |
LIBOR interest rate for interest cap |  |  |  | 3.50% |  |
Term Loan B | Maximum | Interest rate cap agreements | Derivative Instrument 1 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument Interest rate |  |  |  | 2.50% |  |
Interest rate agreements, notional amount |  |  |  | $ 2,735,000,000 |  |
Remaining outstanding debt |  |  |  | $ 712,500,000 |  |
Derivative, Floor Interest Rate |  |  |  | 0.75% |  |
Term Loan B | Minimum |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument Interest rate |  |  |  | 0.75% |  |
Senior Secured Credit Facilities |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Payment of total outstanding principal balances under existing Senior Secured Credit Facilities plus accrued interest |  |  |  | $ 5,362,400,000 |  |
Undrawn revolving credit facilities |  |  |  | $ 1,000,000,000 |  |
Weighted average effective interest rate |  |  |  | 3.46% |  |
Term Loan A Term Loan B |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Interest rate description |  |  |  | At December 31, 2015, the overall weighted average interest rate for the Term Loan A was determined based upon the LIBOR interest rates in effect for all of the individual tranches plus the interest rate margin. |  |
Term Loan A Term Loan B | Maximum |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Term Loan A and Term Loan B maturity date range |  |  |  | 12 months |  |
Term Loan A Term Loan B | Minimum |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Term Loan A and Term Loan B maturity date range |  |  |  | 1 month |  |
Senior Notes 5.125 Percent Due 2024 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Senior note, interest rate |  |  | 5.125% | 5.125% |  |
Senior note, due date |  |  |  | 2024 |  |
Debt Instrument, frequency of periodic payment |  |  |  | The 5 1/8% Senior Notes pay interest on January 15 and July 15 |  |
Senior notes |  |  |  | $ 1,750,000,000 |  |
Senior Notes 6.375 Percent Due 2018 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Senior notes, principal balance |  |  |  | $ 775,000,000 |  |
Term Loan A-3 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, annual principal payment |  |  |  |  | 16,875,000 |
Term Loan B-2 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, annual principal payment |  |  |  |  | $ 4,125,000 |
Senior Notes 5.0 Percent Due 2025 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Senior note, interest rate |  | 5.00% |  | 5.00% |  |
Senior note, due date |  | 2025 |  | 2025 |  |
Debt Instrument, frequency of periodic payment |  |  |  | The 5.0% Senior Notes pay interest on May 1 and November 1 |  |
Senior notes, principal balance |  | $ 1,500,000,000 |  |  |  |
Senior notes |  |  |  | $ 1,500,000,000 |  |
Senior notes interest payment, first required payment date |  | Nov. 01, 2015 |  |  |  |
Debt instrument, redemption description |  |  |  | The Company may redeem up to 35% of the 5.0% Senior Notes at any time prior to May 1, 2018 at a certain specified price from the proceeds of one or more equity offerings. In addition, the Company may redeem some or all of the 5.0% Senior Notes at any time prior to May 1, 2020 at make whole redemption rates and on or after such date at certain specified redemption prices. |  |
Senior Notes 5.0 Percent Due 2025 | Senior Notes Redemption Period One |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
End date of debt instrument redemption period |  | May 01, 2018 |  |  |  |
Senior Notes 5.0 Percent Due 2025 | Senior Notes Redemption Period Two |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
End date of debt instrument redemption period |  | May 01, 2020 |  |  |  |
Senior Notes 5.0 Percent Due 2025 | Maximum |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt Instrument, redemption price percentage |  | 35.00% |  |  |  |
Senior Notes 5.75 Percent Due 2022 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Senior note, interest rate |  |  |  | 5.75% |  |
Senior note, due date |  |  |  | 2022 |  |
Senior notes |  |  |  | $ 1,250,000,000 |  |
Senior Notes 6.625 Percent Due 2020 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Senior note, interest rate |  | 6.625% |  |  |  |
Senior note, due date |  |  |  | 2020 |  |
Senior notes, principal balance |  | $ 775,000,000 |  |  |  |
Debt redemption and refinance charges |  |  |  | $ 48,072,000 |  |
New Term Loan A |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Facility, aggregate principal amount |  |  | $ 1,000,000,000 |  |  |
Facility, term |  |  | 5 years |  |  |
New Term Loan B |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Facility, aggregate principal amount |  |  | $ 3,500,000,000 |  |  |
Facility, term |  |  | 7 years |  |  |
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective September 30, 2016 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
LIBOR cap rate |  |  |  | 3.50% |  |
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective June 29, 2018 |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
LIBOR cap rate | 3.50% |  |  |  |  |
London Interbank Offered Rate (LIBOR) | Term Loan A |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, variable interest rate margin |  |  |  | 1.75% |  |
London Interbank Offered Rate (LIBOR) | Term Loan A | Interest rate swap agreements |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Fixed interest rate, lower limit |  |  |  | 0.49% |  |
Fixed interest rate, upper limit |  |  |  | 0.52% |  |
London Interbank Offered Rate (LIBOR) | Term Loan B |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, variable interest rate margin |  |  |  | 2.75% |  |
LIBOR cap rate |  |  |  | 2.50% |  |
London Interbank Offered Rate (LIBOR) | Term Loan B | Maximum |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, variable interest rate margin |  |  |  |  | 2.75% |
London Interbank Offered Rate (LIBOR) | Term Loan B | Minimum |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |
Debt instrument, variable interest rate margin |  |  |  | 2.75% |  |

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