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Property and Equipment (Detail) - USD ($)
$ in Thousands
Dec. 31, 2016
Dec. 31, 2015
Property Plant And Equipment [Abstract]    
Land $ 59,013 $ 42,080
Buildings 491,301 437,283
Leasehold improvements 2,598,471 2,289,425
Equipment and information systems, including internally developed software 2,378,303 2,080,446
New center and capital asset projects in progress 480,439 336,513
Property, Plant and Equipment, Gross, Total 6,007,527 5,185,747
Less accumulated depreciation (2,832,160) (2,397,007)
Property and equipment, net $ 3,175,367 $ 2,788,740