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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
 3 Months Ended 12 Months Ended
Dec. 31, 2015
Sep. 30, 2015
Jun. 30, 2015
Mar. 31, 2015
Dec. 31, 2014
Sep. 30, 2014
Jun. 30, 2014
Mar. 31, 2014
Dec. 31, 2015
Dec. 31, 2014
Dec. 31, 2013
Segment Reporting Information [Line Items]                      
Patient service revenues $ 3,533,589 $ 3,525,665 $ 3,434,618 $ 3,287,965 $ 3,328,017 $ 3,251,824 $ 3,172,489 $ 3,042,776 $ 9,480,279 $ 8,868,338 $ 8,307,195
Less: Provision for uncollectible accounts                 (427,860) (366,884) (293,546)
Net patient service revenues                 9,052,419 8,501,454 8,013,649
Other revenues                 1,220,323 1,032,364 763,086
Total net operating revenues                 13,781,837 12,795,106 11,764,050
Capitated revenues                 3,509,095 3,261,288 2,987,315
Operating income (loss) 244,935 509,368 480,548 (64,156) 452,085 437,536 484,295 441,225 1,170,695 1,815,141 1,550,134
Contingent earn-out obligation adjustment                     56,977
Corporate administrative support [1]                 (18,965) (13,012) (53,699)
Debt expense                 (408,380) (410,294) (429,943)
Debt refinancing charges                 (48,072) (97,548)  
Other income                 8,893 2,374 4,787
Income from continuing operations before income taxes $ 146,307 $ 408,371 $ 330,539 $ (162,081) $ 354,365 $ 336,412 $ 282,308 $ 336,588 723,136 1,309,673 1,124,978
Operating Segments                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 13,861,123 12,852,469 11,812,296
Operating income (loss) [2]                 1,189,660 1,828,153 1,546,856
Operating Segments | U.S. dialysis and related lab services                      
Segment Reporting Information [Line Items]                      
Patient service revenues                 9,033,991 8,550,201 8,032,772
Less: Provision for uncollectible accounts                 (406,530) (353,028) (281,146)
Net patient service revenues                 8,627,461 8,197,173 7,751,626
Other revenues [3]                 13,971 13,498 12,600
Total net operating revenues                 8,641,432 8,210,671 7,764,226
Operating income (loss) [2]                 1,259,632 1,637,626 1,200,198
Operating Segments | U.S. dialysis and related lab services | External Sources                      
Segment Reporting Information [Line Items]                      
Patient service revenues                 8,980,515 8,513,089 7,998,692
Operating Segments | U.S. dialysis and related lab services | Intersegment Revenue                      
Segment Reporting Information [Line Items]                      
Patient service revenues                 53,476 37,112 34,080
Operating Segments | HealthCare Partners (HCP)                      
Segment Reporting Information [Line Items]                      
Net patient service revenues                 317,950 219,306 220,251
Other revenues [4]                 82,470 91,374 55,723
Total net operating revenues                 3,837,261 3,502,299 3,196,188
Capitated revenues                 3,436,705 3,190,903 2,919,964
Operating income (loss) [2]                 33,929 214,983 385,253
Operating Segments | HealthCare Partners (HCP) | Intersegment Revenue                      
Segment Reporting Information [Line Items]                      
Other revenues                 136 716 250
Operating Segments | Other-Ancillary services and strategic initiatives                      
Segment Reporting Information [Line Items]                      
Net patient service revenues                 160,484 122,087 75,852
Other revenues                 1,123,882 927,492 694,763
Total net operating revenues                 1,382,430 1,139,499 851,882
Capitated revenues                 72,390 70,385 67,351
Operating income (loss) [2]                 (103,901) (24,456) (38,595)
Operating Segments | Other-Ancillary services and strategic initiatives | Intersegment Revenue                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 25,674 19,535 13,916
Intersegment Elimination                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 $ (79,286) $ (57,363) $ (48,246)
[1] Corporate administrative support costs in 2013 also include $7,721 of an adjustment to reduce a tax asset associated with the HCP acquisition escrow provisions.
[2] 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.
[3] 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.
[4] Other revenues primarily relate to providing medical consulting services.