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Contingencies - Additional Information (Detail) $ in Thousands | 1 Months Ended | 3 Months Ended | 6 Months Ended |
--- | --- | --- | --- | ---
Jun. 30, 2015 USD ($) | Dec. 31, 2012 Clinic | Jun. 30, 2017 USD ($) | Mar. 31, 2017 USD ($) | Jun. 30, 2016 USD ($) | Jun. 30, 2017 USD ($) | Jun. 30, 2016 USD ($) | Dec. 31, 2016 USD ($)
Other Commitments [Line Items] |  |  |  |  |  |  |  |
Loss contingency liability |  |  | $ 62,000 |  |  | $ 62,000 |  | $ 69,000
Gain on litigation settlement |  |  | $ 0 |  | $ 0 | $ 526,827 | $ 0 |
Dialysis and other businesses |  |  |  |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |  |  |  |
Number of businesses acquired | Clinic |  | 2 |  |  |  |  |  |
Vainer Private Civil Suit |  |  |  |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |  |  |  |
Litigation settlement amount | $ (450,000) |  |  |  |  |  |  |
Legal fees | $ 45,000 |  |  |  |  |  |  |
US Department Of Veterans Affairs Suit |  |  |  |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |  |  |  |
Litigation settlement amount |  |  |  | $ 538,000 |  |  |  |
Gain on litigation settlement |  |  |  | 527,000 |  |  |  |
Noncontrolling Interest | US Department Of Veterans Affairs Suit |  |  |  |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |  |  |  |
Gain on litigation settlement |  |  |  | 9,000 |  |  |  |
Operating Income (Loss) | US Department Of Veterans Affairs Suit |  |  |  |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |  |  |  |
Gain on litigation settlement |  |  |  | 530,000 |  |  |  |
Equity Method Investments | Noncontrolling Interest | US Department Of Veterans Affairs Suit |  |  |  |  |  |  |  |
Other Commitments [Line Items] |  |  |  |  |  |  |  |
Gain on litigation settlement |  |  |  | $ 3,000 |  |  |  |

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