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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, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Mar. 31, 2016 | Dec. 31, 2015 | Sep. 30, 2015 | Jun. 30, 2015 | Mar. 31, 2015 | Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Patient service revenues |  | $ 3,715,742 | $ 3,730,576 | $ 3,717,651 | $ 3,581,136 | $ 3,533,589 | $ 3,525,665 | $ 3,434,618 | $ 3,287,965 | $ 10,354,161 | $ 9,480,279 | $ 8,868,338
Less: Provision for uncollectible accounts |  |  |  |  |  |  |  |  |  | (451,353) | (427,860) | (366,884)
Net patient service revenues |  |  |  |  |  |  |  |  |  | 9,902,808 | 9,052,419 | 8,501,454
Other revenues |  |  |  |  |  |  |  |  |  | 1,323,618 | 1,220,323 | 1,032,364
Total net operating revenues |  |  |  |  |  |  |  |  |  | 14,745,105 | 13,781,837 | 12,795,106
Capitated revenues |  |  |  |  |  |  |  |  |  | 3,518,679 | 3,509,095 | 3,261,288
Operating income (loss) |  | 381,428 | 819,156 | 329,070 | 364,889 | 244,935 | 509,368 | 480,548 | (64,156) | 1,894,543 | 1,170,695 | 1,815,141
Corporate administrative support | [1] |  |  |  |  |  |  |  |  | (44,561) | (18,965) | (13,012)
Debt expense |  |  |  |  |  |  |  |  |  | (414,382) | (408,380) | (410,294)
Debt refinancing and redemption charges |  |  |  |  |  |  |  |  |  |  | (48,072) | (97,548)
Other income |  |  |  |  |  |  |  |  |  | 8,734 | 8,893 | 2,374
Income before income taxes |  | $ 278,072 | $ 716,451 | $ 229,391 | $ 264,981 | $ 146,307 | $ 408,371 | $ 330,539 | $ (162,081) | 1,488,895 | 723,136 | 1,309,673
Operating Segments |  |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Total net operating revenues |  |  |  |  |  |  |  |  |  | 14,872,975 | 13,861,123 | 12,852,469
Operating income (loss) |  |  |  |  |  |  |  |  |  | 1,939,104 | 1,189,660 | 1,828,153
Operating Segments | U.S. Dialysis And Related Lab Services |  |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Patient service revenues |  |  |  |  |  |  |  |  |  | 9,551,422 | 9,033,991 | 8,550,201
Less: Provision for uncollectible accounts |  |  |  |  |  |  |  |  |  | (429,882) | (406,530) | (353,028)
Net patient service revenues |  |  |  |  |  |  |  |  |  | 9,121,540 | 8,627,461 | 8,197,173
Other revenues | [2] |  |  |  |  |  |  |  |  | 16,649 | 13,971 | 13,498
Total net operating revenues |  |  |  |  |  |  |  |  |  | 9,138,189 | 8,641,432 | 8,210,671
Operating income (loss) |  |  |  |  |  |  |  |  |  | 1,777,014 | 1,259,632 | 1,637,626
Operating Segments | U.S. Dialysis And Related Lab Services | External Sources |  |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Patient service revenues |  |  |  |  |  |  |  |  |  | 9,482,648 | 8,980,515 | 8,513,089
Operating Segments | U.S. Dialysis And Related Lab Services | Intersubsegment Eliminations |  |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Patient service revenues |  |  |  |  |  |  |  |  |  | 68,774 | 53,476 | 37,112
Operating Segments | DaVita Medical Group (DMG) |  |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net patient service revenues |  |  |  |  |  |  |  |  |  | 621,583 | 317,950 | 219,306
Other revenues | [3] |  |  |  |  |  |  |  |  | 61,040 | 82,470 | 91,374
Total net operating revenues |  |  |  |  |  |  |  |  |  | 4,113,414 | 3,837,261 | 3,502,299
Capitated revenues |  |  |  |  |  |  |  |  |  | 3,430,576 | 3,436,705 | 3,190,903
Operating income (loss) |  |  |  |  |  |  |  |  |  | (104,233) | 33,929 | 214,983
Operating Segments | DaVita Medical Group (DMG) | Intersubsegment Eliminations |  |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Other revenues |  |  |  |  |  |  |  |  |  | 215 | 136 | 716
Operating Segments | Other-Ancillary services and strategic initiatives |  |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net patient service revenues |  |  |  |  |  |  |  |  |  | 228,459 | 160,484 | 122,087
Other revenues |  |  |  |  |  |  |  |  |  | 1,245,929 | 1,123,882 | 927,492
Total net operating revenues |  |  |  |  |  |  |  |  |  | 1,621,372 | 1,382,430 | 1,139,499
Capitated revenues |  |  |  |  |  |  |  |  |  | 88,103 | 72,390 | 70,385
Operating income (loss) |  |  |  |  |  |  |  |  |  | 266,323 | (103,901) | (24,456)
Operating Segments | Other-Ancillary services and strategic initiatives | Intersubsegment Eliminations |  |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Total net operating revenues |  |  |  |  |  |  |  |  |  | 58,881 | 25,674 | 19,535
Intersegment Elimination |  |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Total net operating revenues |  |  |  |  |  |  |  |  |  | $ (127,870) | $ (79,286) | $ (57,363)
[1] | Corporate administrative support costs in 2016 also include $30,934 of an adjustment to reduce a tax asset associated with the DMG acquisition escrow provisions.
[2] | Includes management fees for providing management and administrative services to dialysis centers in which the Company owns a noncontrolling interest or which are wholly-owned by third parties.
[3] | Includes medical consulting service fees and management fees for providing management and administrative services to unconsolidated joint ventures, as well as revenue related to the maintenance of existing physician networks

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