Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
Sep. 30, 2021	Dec. 31, 2020
Goodwill [Roll Forward]
Beginning balance	$ 6,919,109	$ 6,787,635
Acquisitions	53,619	130,057
Divestitures	(623)	(8,293)
Foreign currency and other adjustments	(31,438)	9,710
Ending balance	6,940,667	6,919,109
Goodwill, before accumulated impairment charges	7,069,661
Accumulated impairment charges	(128,994)
Ending balance	6,940,667	6,919,109
U.S. dialysis
Goodwill [Roll Forward]
Beginning balance	6,309,928	6,287,100
Acquisitions	12,423	24,377
Divestitures	(623)	(1,549)
Foreign currency and other adjustments	0	0
Ending balance	6,321,728	6,309,928
Goodwill, before accumulated impairment charges	6,321,728
Accumulated impairment charges	0
Ending balance	6,321,728	6,309,928
Other—Ancillary services
Goodwill [Roll Forward]
Beginning balance	609,181	500,535
Acquisitions	41,196	105,680
Divestitures	0	(6,744)
Foreign currency and other adjustments	(31,438)	9,710
Ending balance	618,939	609,181
Goodwill, before accumulated impairment charges	747,933
Accumulated impairment charges	(128,994)
Ending balance	$ 618,939	$ 609,181

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount of increase in asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized resulting from a business combination.

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Amount of foreign currency translation gain (loss) which increases (decreases) an asset representing future economic benefits from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount before accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount of accumulated impairment loss for an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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A roll forward is a reconciliation of a concept from the beginning of a period to the end of a period.

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Amount of divestiture of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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