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Aggregate Purchase Cost Allocations for Acquisitions (Detail) - USD ($)
$ in Thousands
Dec. 31, 2016
Dec. 31, 2015
Dec. 31, 2014
Business Acquisition [Line Items]      
Goodwill $ 9,407,317 $ 9,294,479 $ 9,415,295
Dialysis businesses and other businesses      
Business Acquisition [Line Items]      
Current assets 3,996 3,843 915
Property and equipment 9,407 12,436 5,999
Amortizable intangible and other long-term assets 986 4,345 4,193
Goodwill 203,326 97,093 221,514
Long-term deferred income taxes, assets 597    
Long-term deferred income taxes, liabilities   (1,467)  
Noncontrolling interests assumed (30,337) (18,905) (25,963)
Liabilities assumed (3,317) (1,440) (1,883)
Aggregate purchase cost 190,053 104,864 295,875
Dialysis businesses and other businesses | Customer relationships      
Business Acquisition [Line Items]      
Intangible assets, other than goodwill     74,515
Dialysis businesses and other businesses | Noncompetition agreements      
Business Acquisition [Line Items]      
Intangible assets, other than goodwill $ 5,395 $ 8,959 $ 16,585