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Segment Reporting - Summary of Expenditures for Property and Equipment by Segment (Details) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Segment Reporting Information [Line Items] |  |  |
Expenditures for property and equipment | $ 987,138 | $ 905,250 | $ 829,095
U.S. dialysis and related lab services |  |  |
Segment Reporting Information [Line Items] |  |  |
Expenditures for property and equipment | 856,108 | 769,732 | 675,994
Other ancillary services and strategic initiatives |  |  |
Segment Reporting Information [Line Items] |  |  |
Expenditures for property and equipment | 45,806 | 40,377 | 68,702
DMG - Held for sale |  |  |
Segment Reporting Information [Line Items] |  |  |
Expenditures for property and equipment | $ 85,224 | $ 95,141 | $ 84,399

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- Definition The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3213-108585 + Details
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- Definition Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table. + References No definition available. + Details
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- Details
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