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Concentrations - Additional Information (Detail)
$ in Thousands
12 Months Ended
Dec. 31, 2015
USD ($)
Dec. 31, 2014
USD ($)
Project
Dec. 31, 2013
Concentration Risk [Line Items]      
Concentration risk, customer There is no single commercial payor that accounted for more than 10% of total consolidated accounts receivable at December 31, 2015 and 2014.    
Accounts Receivable | Government-based Programs, Medicare and Medicaid      
Concentration Risk [Line Items]      
Concentration Risk, Percentage 80.00%    
Accounts Receivable | Product Concentration Risk | Minimum      
Concentration Risk [Line Items]      
Concentration Risk, Percentage 10.00% 10.00%  
U.S. dialysis and related lab services | Sales Revenue Services Net | Government-based Programs, Medicare and Medicaid      
Concentration Risk [Line Items]      
Concentration Risk, Percentage 66.00% 67.00% 66.00%
Accounts receivable, and other receivables, from Medicare and Medicaid-assigned plans | $ $ 827,258 $ 705,532  
HealthCare Partners (HCP)      
Concentration Risk [Line Items]      
Number of health plans | Project   3  
HealthCare Partners (HCP) | Sales Revenue Services Net | Government-based Programs, Medicare and Medicaid      
Concentration Risk [Line Items]      
Concentration Risk, Percentage 70.00% 71.00% 69.00%
HealthCare Partners (HCP) | Sales Revenue Services Net | Product Concentration Risk      
Concentration Risk [Line Items]      
Concentration Risk, Percentage 61.00% 64.00% 67.00%
HealthCare Partners (HCP) | Accounts Receivable | Customer Concentration Risk      
Concentration Risk [Line Items]      
Concentration Risk, Percentage 71.00% 73.00%