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Acquisitions and divestitures - Additional Information (Detail) $ in Thousands | 3 Months Ended | 9 Months Ended
--- | --- | ---
Sep. 30, 2021 USD ($) | Sep. 30, 2020 USD ($) | Sep. 30, 2021 USD ($) clinic | Sep. 30, 2020 USD ($)
Business Acquisition [Line Items] |  |  |  |
Cash paid to acquire businesses |  |  | $ 45,143 | $ 112,597
Goodwill deductible for tax purposes associated with acquisitions | $ 49,501 |  | 49,501 |
Additional tax benefits recognized under the Coronavirus Aid, Relied, and Economic Security Act | 0 | $ 0 | 0 | $ 9,980
Other current liabilities |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Contingent earn-out obligations | 7,420 |  | 7,420 |
Other long-term liabilities |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Contingent earn-out obligations | 15,337 |  | 15,337 |
Other companies |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Contingent earn-out obligations | $ 22,757 |  | $ 22,757 |
Minimum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Earn-out consideration payment period |  |  | 1 year |
Maximum |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Contingent earn-out obligations and liabilities assumed associated with acquisitions |  |  | $ 35,941 |
Maximum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Earn-out consideration payment period |  |  | 5 years |
Dialysis and other businesses |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Cash paid to acquire businesses |  |  | $ 45,143 |
Contingent earn-out obligations and liabilities assumed associated with acquisitions |  |  | 3,181 |
Deferred purchase price obligations |  |  | $ 8,626 |
U.S. dialysis | Dialysis and other businesses |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Number of businesses acquired | clinic |  |  | 2 |
Foreign Dialysis Centers | Dialysis and other businesses |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Number of businesses acquired | clinic |  |  | 10 |

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