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v3.19.3.a.u2

Acquisitions and Divestitures - Additional Information (Details) $ in Thousands |  |  | 12 Months Ended
--- | --- | --- | ---
Jun. 19, 2019 USD ($) | May 01, 2017 USD ($) patient state clinic outpatient_dialysis_center | Dec. 31, 2019 USD ($) clinic | Dec. 31, 2018 USD ($) clinic | Dec. 31, 2017 USD ($) clinic
Business Acquisition [Line Items] |  |  |  |  |
Cash paid to acquire business |  |  | $ 100,861 | $ 183,156 | $ 803,879
Contingent earn-out obligations associated with acquisitions |  |  | 23,536 | 1,246 |
Non-cash gain on acquiring additional ownership in business acquisition |  |  |  | 28,152 |
Proceeds from divestiture of business | $ 4,465,476 |  |  |  |
Contingent earn-out obligations |  |  | 33,889 |  |
Fair value of contingent earn-out consideration |  |  | 24,586 | 2,608 | 6,388
Other accrued liabilities |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Fair value of contingent earn-out consideration |  |  | 6,712 |  |
Other long-term liabilities |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Fair value of contingent earn-out consideration |  |  | 17,874 |  |
Other companies |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Fair value of contingent earn-out consideration |  |  | $ 24,586 |  |
Minimum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Earn-out consideration payment period |  |  | 1 year |  |
Maximum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Earn-out consideration payment period |  |  | 5 years |  |
Series of individually immaterial business acquisitions |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Cash paid to acquire business |  |  | $ 98,836 | 176,161 | 308,550
Contingent earn-out obligations associated with acquisitions |  |  | 23,536 | 1,246 | 2,692
Deferred Purchase price and liabilities assumed |  |  | $ 4,326 | $ 34,394 | $ 23,748
Amortizable intangible assets acquired, weighted-average estimated useful lives |  |  | 6 years | 6 years | 7 years
Goodwill deductible for tax purposes associated with acquisitions |  |  | $ 88,517 | $ 165,013 | $ 237,363
Renal Ventures Limited, LLC |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Cash paid to acquire business |  | $ 359,913 |  |  |
Amortizable intangible assets acquired, weighted-average estimated useful lives |  |  | 5 years |  |
Goodwill deductible for tax purposes associated with acquisitions |  |  | $ 298,200 |  |
Ownership interest percentage |  | 100.00% |  |  |
Number of dialysis clinic patients | patient |  | 2,600 |  |  |
Number of states where dialysis centers are located | state |  | 6 |  |  |
Proceeds from divestiture of business |  | $ 21,219 |  |  |
Business acquisition, transaction costs |  |  |  |  | $ 11,950
Operating Dialysis Center |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Number of businesses divested | outpatient_dialysis_center |  | 3 |  |  |
Operating Dialysis Center | Renal Ventures Limited, LLC |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Number of businesses acquired | clinic |  | 36 |  |  |
Number of businesses divested | outpatient_dialysis_center |  | 3 |  |  |
New Center Under Construction | Renal Ventures Limited, LLC |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Number of businesses acquired | clinic |  | 1 |  |  |
Number of businesses divested | outpatient_dialysis_center |  | 1 |  |  |
Home Dialysis Clinic | Renal Ventures Limited, LLC |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Number of businesses acquired | clinic |  | 1 |  |  |
U S Dialysis And Related Lab Services | Series of individually immaterial business acquisitions |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Number of businesses acquired | clinic |  |  | 7 | 18 | 30
Foreign Dialysis Centers | Series of individually immaterial business acquisitions |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Number of businesses acquired | clinic |  |  | 16 | 28 | 68

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