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Revenue Recognition and Accounts Receivable - Additional Information (Detail) | 12 Months Ended
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Dec. 31, 2019 USD ($) | Dec. 31, 2018 USD ($)
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] |  |
Accounts receivable, net | $ 1,795,598,000 | $ 1,858,608,000
Medicare bad debt claims |  |
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] |  |
Accounts receivable, net | $ 1,038,248,000 | $ 1,080,561,000
Accounts Receivable |  |
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] |  |
Accounts Receivable Period Outstanding | 1 year |
Patient Services Customer Concentration Risk | Accounts Receivable |  |
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] |  |
Number of concentration risk customers | 0 |
Concentration risk percentage | 10.00% |
Accounts receivable, net | $ 0 |
Percentage Of Accounts Receivable Six Months Or More Past Due | 18.00% |
Accounts Receivable Period Outstanding | 6 months | 6 months
Difference between Revenue Guidance in Effect before and after Topic 606 |  |
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] |  |
Contract with Customer, Performance Obligation Satisfied in Previous Period | $ 37,274,000 | $ 88,495,000
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification |  | 36,000,000
Accounts Receivable |  |
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] |  |
Accounts receivable, allowance | $ 8,328,000 | $ 52,924,000

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