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Acquisitions and Divestitures - Additional Information (Detail) $ in Thousands |  |  |  | 1 Months Ended | 3 Months Ended | 6 Months Ended
--- | --- | --- | --- | --- | --- | ---
Jun. 01, 2016 USD ($) | Mar. 01, 2016 USD ($) | Aug. 17, 2015 USD ($) Clinic State Patient | Dec. 31, 2012 Entity | Jun. 30, 2016 USD ($) | Jun. 30, 2016 USD ($) Entity | Jun. 30, 2015 USD ($)
Business Acquisition [Line Items] |  |  |  |  |  |  |
Gain (loss) on sales of business interests |  |  |  |  | $ 29,791 | $ 29,791 |
Cash paid to acquire business |  |  |  |  |  | $ 473,314 | $ 45,059
Amortizable intangible assets acquired, weighted-average estimated useful lives |  |  |  |  |  | 8 years |
Goodwill deductible for tax purposes associated with acquisitions |  |  |  |  | 72,190 | $ 72,190 |
Other Accrued Liabilities |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Fair value of contingent earn-out consideration |  |  |  |  | 18,148 | 18,148 |
Other long-term liabilities |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Fair value of contingent earn-out consideration |  |  |  |  | 1,486 | 1,486 |
Other companies |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Additional cash consideration in the form of earn-out payments |  |  |  |  | 98,600 | 98,600 |
Fair value of contingent earn-out consideration |  |  |  |  | 19,634 | $ 19,634 |
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 |
HealthCare Partners (HCP) | Arizona |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Gain (loss) on sales of business interests | $ 10,489 |  |  |  |  |  |
HealthCare Partners (HCP) | Tandigm Health |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Ownership interest, before sale |  |  |  |  |  | 50.00% |
Ownership interest, after sale |  |  |  |  |  | 19.00% |
Gain (loss) on sales of business interests |  |  |  |  |  | $ 40,280 |
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 |  | $ 398,094 |  |  |  |  |
Assumptions of certain liabilities |  | $ 7,284 |  |  |  |  |
Ownership interest percentage |  | 100.00% |  |  |  |  |
Amortizable intangible assets acquired, weighted-average estimated useful lives |  |  |  |  |  | 6 years |
Goodwill deductible for tax purposes associated with acquisitions |  |  |  |  | $ 0 | $ 0 |
Dialysis businesses and other businesses |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Cash paid to acquire business |  |  |  |  |  | 75,220 |
Number of businesses acquired | Entity |  |  |  | 2 |  |  |
Deferred purchase price obligations |  |  |  |  |  | $ 3,387 |
Dialysis businesses and other businesses | U.S. Dialysis And Related Lab Services |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Number of businesses acquired | Entity |  |  |  |  |  | 4 |
Dialysis businesses and other businesses | Other Segments | Foreign Dialysis Centers |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Number of businesses acquired | Entity |  |  |  |  |  | 3 |
Dialysis businesses and other businesses | Other Segments | Other Medical Businesses |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Number of businesses acquired | Entity |  |  |  |  |  | 3 |
Renal Ventures Limited, LLC |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |
Cash paid to acquire business |  |  | $ 415,000 |  |  |  |
Ownership interest percentage |  |  | 100.00% |  |  |  |
Number of dialysis clinics venture operations | Clinic |  |  | 36 |  |  |  |
Number of dialysis clinics venture operations states | State |  |  | 6 |  |  |  |
Number of dialysis clinic patients | Patient |  |  | 2,400 |  |  |  |

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