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Segment Reporting - Summary of Depreciation and Amortization Expense 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] |  |  |
Depreciation and amortization | $ 591,035 | $ 559,911 | $ 509,497
U.S. dialysis and related lab services |  |  |
Segment Reporting Information [Line Items] |  |  |
Depreciation and amortization | 558,810 | 520,965 | 482,768
Other ancillary services and strategic initiatives |  |  |
Segment Reporting Information [Line Items] |  |  |
Depreciation and amortization | $ 32,225 | $ 38,946 | $ 26,729

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- Definition The current period expense charged against earnings on long-lived, physical assets not used in production, and which are not intended for resale, to allocate or recognize the cost of such assets over their useful lives; or to record the reduction in book value of an intangible asset over the benefit period of such asset; or to reflect consumption during the period of an asset that is not used in production. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 360 -SubTopic 10 -Section 50 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=6391035&loc=d3e2868-110229 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585 + 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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