Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

Reference 1: http://www.xbrl.org/2003/role/presentationRef
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Amount of increase in asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized resulting from a business combination.

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Amount of foreign currency translation gain (loss) which increases (decreases) an asset representing future economic benefits from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount before accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount of accumulated impairment loss for an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount of loss from the write-down of an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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A roll forward is a reconciliation of a concept from the beginning of a period to the end of a period.

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Amount of divestiture of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016	Sep. 30, 2017
Goodwill [Roll Forward]
Beginning balance			$ 9,407,317	$ 9,294,479	$ 9,294,479
Acquisitions			687,875		447,828
Divestitures			(32,343)		(44,759)
Goodwill impairment charges	$ (601,040)	$ 0	(686,355)	(253,000)	(281,415)
Foreign currency and other adjustments			39,383		(8,816)
Ending balance	9,415,877		9,415,877		9,407,317
Goodwill						$ 10,578,325
Accumulated impairment charges						(1,162,448)
Total goodwill by reportable segments	9,415,877		9,407,317	9,294,479	9,294,479	9,415,877
U.S. dialysis and related lab services
Goodwill [Roll Forward]
Beginning balance			5,691,587	5,629,183	5,629,183
Acquisitions			441,486		75,295
Divestitures			(32,260)		(12,891)
Goodwill impairment charges			0		0
Foreign currency and other adjustments			0		0
Ending balance	6,100,813		6,100,813		5,691,587
Goodwill						6,100,813
Accumulated impairment charges						0
Total goodwill by reportable segments	6,100,813		5,691,587	5,629,183	5,629,183	6,100,813
DMG
Goodwill [Roll Forward]
Beginning balance			3,391,942	3,398,264	3,398,264
Acquisitions			132,778		248,901
Divestitures			(29)		(2,223)
Goodwill impairment charges			(651,659)		(253,000)
Foreign currency and other adjustments			0		0
Ending balance	2,873,032		2,873,032		3,391,942
Goodwill						3,966,460
Accumulated impairment charges						(1,093,428)
Total goodwill by reportable segments	2,873,032		3,391,942	3,398,264	3,398,264	2,873,032
Ancillary services and strategic initiatives
Goodwill [Roll Forward]
Beginning balance			323,788	267,032	267,032
Acquisitions			113,611		123,632
Divestitures			(54)		(29,645)
Goodwill impairment charges			(34,696)		(28,415)
Foreign currency and other adjustments			39,383		(8,816)
Ending balance	442,032		442,032		323,788
Goodwill						511,052
Accumulated impairment charges						(69,020)
Total goodwill by reportable segments	$ 442,032		$ 323,788	$ 267,032	$ 267,032	$ 442,032