Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount of loss from the write-down of an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015	Dec. 31, 2015
Goodwill [Line Items]
Beginning balance			$ 9,294,479	$ 9,415,295	$ 9,415,295
Acquisitions			321,012		97,093
Divestitures			(4,980)		(8,781)
Goodwill impairment charges	$ (176,000)	$ (4,065)	(253,000)	(4,065)	(192,834)
Foreign currency and other adjustments			3,446		(16,294)
Ending balance	9,360,957		9,360,957		9,294,479
U.S. Dialysis And Related Lab Services
Goodwill [Line Items]
Beginning balance			5,629,183	5,610,643	5,610,643
Acquisitions			52,792		21,910
Divestitures			(4,222)		(3,370)
Ending balance	5,677,753		5,677,753		5,629,183
HealthCare Partners (HCP)
Goodwill [Line Items]
Beginning balance			3,398,264	3,562,534	3,562,534
Acquisitions			248,622		29,910
Divestitures			(758)		(5,411)
Goodwill impairment charges			(253,000)		(188,769)
Ending balance	3,393,128		3,393,128		3,398,264
Other Segments
Goodwill [Line Items]
Beginning balance			267,032	$ 242,118	242,118
Acquisitions			19,598		45,273
Goodwill impairment charges					(4,065)
Foreign currency and other adjustments			3,446		(16,294)
Ending balance	$ 290,076		$ 290,076		$ 267,032