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Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | 12 Months Ended |
--- | --- | --- | --- | ---
Jun. 30, 2017 | Jun. 30, 2016 | Jun. 30, 2017 | Jun. 30, 2016 | Dec. 31, 2016 | Jun. 30, 2017
Goodwill [Roll Forward] |  |  |  |  |  |
Beginning balance |  |  | $ 9,407,317 | $ 9,294,479 | $ 9,294,479 |
Acquisitions |  |  | 572,764 |  | 447,828 |
Divestitures |  |  | (32,343) |  | (44,759) |
Goodwill impairment charges | $ (61,117) | $ (176,000) | (85,315) | (253,000) | (281,415) |
Foreign currency and other adjustments |  |  | 27,368 |  | (8,816) |
Ending balance | 9,889,791 |  | 9,889,791 |  | 9,407,317 |
Goodwill |  |  |  |  |  | $ 10,451,199
Accumulated impairment charges |  |  |  |  |  | (561,408)
Goodwill, net | 9,889,791 |  | 9,407,317 | 9,294,479 | 9,294,479 | 9,889,791
U.S. dialysis and related lab services |  |  |  |  |  |
Goodwill [Roll Forward] |  |  |  |  |  |
Beginning balance |  |  | 5,691,587 | 5,629,183 | 5,629,183 |
Acquisitions |  |  | 427,299 |  | 75,295 |
Divestitures |  |  | (32,260) |  | (12,891) |
Ending balance | 6,086,626 |  | 6,086,626 |  | 5,691,587 |
Goodwill |  |  |  |  |  | 6,086,626
Accumulated impairment charges |  |  |  |  |  | 0
Goodwill, net | 6,086,626 |  | 5,691,587 | 5,629,183 | 5,629,183 | 6,086,626
DMG |  |  |  |  |  |
Goodwill [Roll Forward] |  |  |  |  |  |
Beginning balance |  |  | 3,391,942 | 3,398,264 | 3,398,264 |
Acquisitions |  |  | 31,796 |  | 248,901 |
Divestitures |  |  | (29) |  | (2,223) |
Goodwill impairment charges |  |  | (50,619) |  | (253,000) |
Ending balance | 3,373,090 |  | 3,373,090 |  | 3,391,942 |
Goodwill |  |  |  |  |  | 3,865,478
Accumulated impairment charges |  |  |  |  |  | (492,388)
Goodwill, net | 3,373,090 |  | 3,391,942 | 3,398,264 | 3,398,264 | 3,373,090
Ancillary services and strategic initiatives |  |  |  |  |  |
Goodwill [Roll Forward] |  |  |  |  |  |
Beginning balance |  |  | 323,788 | 267,032 | 267,032 |
Acquisitions |  |  | 113,669 |  | 123,632 |
Divestitures |  |  | (54) |  | (29,645) |
Goodwill impairment charges |  |  | (34,696) |  | (28,415) |
Foreign currency and other adjustments |  |  | 27,368 |  | (8,816) |
Ending balance | 430,075 |  | 430,075 |  | 323,788 |
Goodwill |  |  |  |  |  | 499,095
Accumulated impairment charges |  |  |  |  |  | (69,020)
Goodwill, net | $ 430,075 |  | $ 323,788 | $ 267,032 | $ 267,032 | $ 430,075

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