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Segment Reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Segment Reporting Information [Line Items]      
Other revenues $ 433,430 $ 405,282 $ 524,353
Total revenues 11,609,894 11,618,797 11,550,604
Operating Income (Loss) 1,339,062 1,797,370 1,694,636
Corporate administrative support (129,669) (111,615) (146,707)
Debt expense (357,019) (285,254) (304,111)
Debt prepayment, refinancing and redemption charges 0 0 (89,022)
Other (loss) income, net (15,765) 6,378 16,759
Income (Loss) from Continuing Operations before Equity Method Investments, Income Taxes, Noncontrolling Interest, Total 966,278 1,518,494 1,318,262
Segment Reporting Information footnote:      
Equity investment income (loss) from equity method investments in nonconsolidated dialysis partnerships. 26,520 26,937 26,916
U.S. dialysis      
Segment Reporting Information [Line Items]      
Total revenues 10,512,774 10,576,167 10,514,649
Other - Ancillary services      
Segment Reporting Information [Line Items]      
Total revenues 1,097,120 1,042,630 1,035,955
Operating Segments      
Segment Reporting Information [Line Items]      
Total revenues 11,701,135 11,713,887 11,712,633
Operating Income (Loss) 1,468,731 1,908,985 1,841,343
Operating Segments | U.S. dialysis      
Segment Reporting Information [Line Items]      
Dialysis patient service revenues before provision 10,575,372 10,641,618 10,619,364
Total revenues 10,599,809 10,666,963 10,659,935
Operating Income (Loss) 1,565,310 1,974,988 1,917,604
Operating Segments | U.S. dialysis | External Sources      
Segment Reporting Information [Line Items]      
Dialysis patient service revenues before provision 10,488,327 10,551,106 10,475,273
Other revenues 24,447 25,061 39,376
Operating Segments | U.S. dialysis | Intersubsegment Eliminations      
Segment Reporting Information [Line Items]      
Dialysis patient service revenues before provision 87,045 90,512 144,091
Other revenues (10) 284 1,195
Operating Segments | Other - Ancillary services      
Segment Reporting Information [Line Items]      
Dialysis patient service revenues before provision 688,137 662,409 550,978
Other revenues 408,983 380,221 484,977
Total revenues 1,101,326 1,046,924 1,052,698
Operating Income (Loss) (96,579) (66,003) (76,261)
Segment Reporting Information footnote:      
Equity investment income (loss) from equity method investments in nonconsolidated dialysis partnerships. 1,898 3,177 5,866
Operating Segments | Other - Ancillary services | Intersubsegment Eliminations      
Segment Reporting Information [Line Items]      
Dialysis patient service revenues before provision 4,206 4,294 16,743
Intersegment Elimination      
Segment Reporting Information [Line Items]      
Total revenues (91,241) (95,090) (162,029)
Intersegment Elimination | U.S. dialysis      
Segment Reporting Information [Line Items]      
Total revenues (87,035) (90,796) (145,286)
Intersegment Elimination | Other - Ancillary services      
Segment Reporting Information [Line Items]      
Total revenues $ (4,206) $ (4,294) $ (16,743)