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Contingencies - Additional Information (Detail) $ in Thousands | 1 Months Ended | 12 Months Ended
--- | --- | ---
Jan. 31, 2017 USD ($) | Mar. 31, 2016 USD ($) | Jun. 30, 2015 USD ($) | Dec. 31, 2012 Entity | Dec. 31, 2016 USD ($)
Dialysis businesses and other businesses |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |
Number of businesses acquired | Entity |  |  |  | 2 |
Vainer Private Civil Suit |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |
Litigation settlement amount |  |  | $ 450,000 |  |
Legal fees |  |  | $ 45,000 |  |
2016 U.S. Attorney Prescription Drug Investigation |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |
Estimated accruals for potential damages and liabilities |  |  |  |  | $ 38,330
Solari Post-Acquisition Matter |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |
Estimated accruals for potential damages and liabilities |  | $ 16,000 |  |  |
U.S. Department of Veterans Affairs (VA) | Subsequent Event |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |
Litigation settlement amount | $ 538,000 |  |  |  |

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- Definition Amount charged against operating income increasing loss contingency liability, after adjustments to reduce previously estimated charges. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=25496072&loc=d3e14326-108349 + Details
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