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Acquisitions - Additional Information (Detail)
$ in Thousands
 1 Months Ended 3 Months Ended
Mar. 01, 2016
USD ($)
Aug. 17, 2015
USD ($)
Clinic
State
Patient
Dec. 31, 2012
Entity
Mar. 31, 2016
USD ($)
Entity
Mar. 31, 2015
USD ($)
Business Acquisition [Line Items]          
Cash paid to acquire business       $ 405,154 $ 40,650
Goodwill deductible for tax purposes associated with acquisitions       6,851  
Other Accrued Liabilities          
Business Acquisition [Line Items]          
Fair value of contingent earn-out consideration       28,029  
Other long-term liabilities          
Business Acquisition [Line Items]          
Fair value of contingent earn-out consideration       4,874  
Other companies          
Business Acquisition [Line Items]          
Additional cash consideration in the form of earn-out payments       128,603  
Fair value of contingent earn-out consideration       $ 32,903  
Minimum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins          
Business Acquisition [Line Items]          
Earn out consideration payment period       1 year  
Maximum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins          
Business Acquisition [Line Items]          
Earn out consideration payment period       2 years  
Noncompetition agreements          
Business Acquisition [Line Items]          
Amortizable intangible assets acquired, weighted-average estimated useful lives       7 years  
Other Segments | Asia-Pacific dialysis business | Khazanah Nasional Berhad and Mitsui and Co., LTD          
Business Acquisition [Line Items]          
Ownership interest percentage       40.00%  
Subscribed investment amount       $ 300,000  
Investment period       3 years  
The Everett Clinic Medical Group (TEC)          
Business Acquisition [Line Items]          
Date of acquisition agreement       Nov. 23, 2015  
Effective date of acquisition       Mar. 01, 2016  
Cash paid to acquire business $ 398,093        
Assumptions of certain liabilities $ 7,287        
Ownership interest percentage 100.00%        
Amortizable intangible assets acquired, weighted-average estimated useful lives       6 years  
Goodwill deductible for tax purposes associated with acquisitions       $ 267  
Dialysis businesses and other businesses          
Business Acquisition [Line Items]          
Cash paid to acquire business       7,061  
Number of businesses acquired | Entity     2    
Deferred purchase price obligations       $ 100  
Dialysis businesses and other businesses | Other Segments | Foreign Dialysis And Other Medical Businesses          
Business Acquisition [Line Items]          
Number of businesses acquired | Entity       1  
Renal Ventures Limited, LLC          
Business Acquisition [Line Items]          
Cash paid to acquire business   $ 415,000      
Ownership interest percentage   100.00%      
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