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Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 707,998	$ 641,330	$ 617,597
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	584,513	560,610	554,345
HealthCare Partners (HCP)
Segment Reporting Information [Line Items]
Expenditures for property and equipment	66,800	27,885	31,582
Other-Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 56,685	$ 52,835	$ 31,670

X

- Definition

The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Glossary Investing Activities
-URI http://asc.fasb.org/extlink&oid=6516133

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 13
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=56944662&loc=d3e3213-108585

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- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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