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Acquisitions - Additional Information (Detail) $ in Thousands |  |  | 1 Months Ended | 12 Months Ended
--- | --- | --- | --- | ---
Nov. 23, 2015 USD ($) Clinic Provider | Aug. 17, 2015 USD ($) Clinic State Patient | Dec. 31, 2012 Entity | Dec. 31, 2015 USD ($) Entity | Dec. 31, 2014 USD ($) Entity | Dec. 31, 2013 USD ($) Entity
Business Acquisition [Line Items] |  |  |  |  |  |
Cash paid to acquire business |  |  |  | $ 96,469 | $ 272,094 | $ 310,394
Deferred purchase price obligations |  |  |  |  | $ 136 | $ 209
Amortizable intangible assets acquired, weighted-average estimated useful lives |  |  |  | 8 years | 10 years | 14 years
Goodwill deductible for tax purposes associated with acquisitions |  |  |  | $ 73,733 | $ 175,247 | $ 221,454
Additional cash consideration in the form of earn-out payments |  |  |  | 29,050 | $ 15,614 |
Other Accrued Liabilities |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Fair value of contingent earn-out consideration |  |  |  | 29,050 |  |
Other long-term liabilities |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Fair value of contingent earn-out consideration |  |  |  | 5,085 |  |
Other companies |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Additional cash consideration in the form of earn-out payments |  |  |  | 129,626 |  |
Fair value of contingent earn-out consideration |  |  |  | $ 34,135 |  |
Customer relationships |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Amortizable intangible assets acquired, weighted-average estimated useful lives |  |  |  |  | 10 years | 17 years
Noncompetition agreements |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Amortizable intangible assets acquired, weighted-average estimated useful lives |  |  |  | 8 years | 8 years | 9 years
Minimum | Other companies | EBITDA operating income performance targets or quality margins |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Earn out consideration payment period |  |  |  | 1 year |  |
Maximum | Other companies | EBITDA operating income performance targets or quality margins |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Earn out consideration payment period |  |  |  | 2 years |  |
Renal Ventures Limited, LLC |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Renal ventures interest percentage in dialysis centers |  | 100.00% |  |  |  |
Cash paid to acquire business |  | $ 415,000 |  |  |  |
Number of dialysis clinics ventures operations | Clinic |  | 36 |  |  |  |
Number Of dialysis clinics venture operations states | State |  | 6 |  |  |  |
Number of dialysis clinic patients | Patient |  | 2,400 |  |  |  |
The Everett Clinic Medical Group (TEC) |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Cash paid to acquire business | $ 385,000 |  |  |  |  |
Number of providers in primary and specialty | Provider | 500 |  |  |  |  |
The Everett Clinic Medical Group (TEC) | Minimum |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Number of dialysis clinic patients | Clinic | 315,000 |  |  |  |  |
Other dialysis acquisitions |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Cash paid to acquire business |  |  |  | $ 96,469 | $ 272,094 | $ 310,394
Number of businesses acquired | Entity |  |  | 2 |  |  |
Other dialysis acquisitions | U.S. dialysis and related lab services |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Number of businesses acquired | Entity |  |  |  | 6 | 18 | 26
Other dialysis acquisitions | Foreign Dialysis And Other Medical Businesses |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Number of businesses acquired | Entity |  |  |  | 21 | 7 | 38
Other dialysis acquisitions | Vascular access centers |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Number of businesses acquired | Entity |  |  |  | 3 |  |
Other dialysis acquisitions | Maximum | HomeChoice Partners |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |
Deferred purchase price obligations |  |  |  | $ 8,395 | $ 23,781 | $ 24,683

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