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Organization and Summary of Significant Accounting Policies - Additional Information (Details) $ in Thousands | 12 Months Ended |
--- | --- | ---
Dec. 31, 2018 segment patient state country clinic entity | Jan. 01, 2019 USD ($)
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Operating divisions | segment | 2 |
Number of legal entities that third parties held noncontrolling equity interests | entity | 653 |
Minimum | Noncompetition and other agreements |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Amortization period | 2 years |
Minimum | Buildings |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Property, and equipment useful lives | 20 years |
Minimum | Leasehold Improvements |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Property, and equipment useful lives | 10 years |
Minimum | Equipment and Information Systems |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Property, and equipment useful lives | 3 years |
Maximum | Noncompetition and other agreements |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Amortization period | 10 years |
Maximum | Buildings |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Property, and equipment useful lives | 40 years |
Maximum | Equipment and Information Systems |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Property, and equipment useful lives | 15 years |
United States |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Number of dialysis centers that the company operated or provided administrative services | clinic | 2,664 |
Number of states where dialysis centers are located | state | 46 |
Number of patients served | patient | 202,700 |
International Operations |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Number of dialysis centers that the company operated or provided administrative services | clinic | 241 |
Number of patients served | patient | 25,000 |
Number of countries in which dialysis centers located | country | 9 |
Continuing Operations |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Number of legal entities that third parties held noncontrolling equity interests | entity | 650 |
Adjustments for New Accounting Pronouncement [Member] | Scenario, Forecast |  |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items] |  |
Net lease liabilities | $ |  | $ 3,000,000

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