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Goodwill - Schedule of Reporting Units Goodwill Balances (Details) - USD ($) $ in Thousands | 12 Months Ended |  |
--- | --- | --- | ---
Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017
Goodwill [Line Items] |  |  |
Goodwill | $ 6,787,635 | $ 6,841,960 | $ 6,610,279
Percentage change in operating income used to evaluate fair value of reporting unit for goodwill assessment | 3.00% |  |
Percentage change in discount rate used to evaluate fair value of reporting unit for goodwill assessment | 1.00% |  |
Kidney Care | GERMANY |  |  |
Goodwill [Line Items] |  |  |
Goodwill | $ 295,151 |  |
Carrying amount coverage | 0.00% |  |
Sensitivities, Operating Income | (1.30%) |  |
Sensitivities, Discount rate | (11.00%) |  |
Kidney Care | BRAZIL |  |  |
Goodwill [Line Items] |  |  |
Goodwill | $ 88,551 |  |
Carrying amount coverage | 4.40% |  |
Sensitivities, Operating Income | (2.80%) |  |
Sensitivities, Discount rate | (7.00%) |  |

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