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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
 3 Months Ended 12 Months Ended
Jun. 30, 2023
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Segment Reporting Information [Line Items]        
Other revenues   $ 565,206 $ 433,430 $ 405,282
Total revenues   12,140,147 11,609,894 11,618,797
Operating Income (Loss)   1,602,784 1,339,062 1,797,370
Corporate administrative support   (163,047) (129,669) (111,615)
Debt expense   (398,551) (357,019) (285,254)
Debt Extinguishment And Modification Costs $ 7,962 7,962 0 0
Other (loss) income, net   (19,177) (15,765) 6,378
Income from continuing operations before income taxes   1,177,094 966,278 1,518,494
Segment Reporting Information footnote:        
Equity investment income (loss) from equity method investments in nonconsolidated dialysis partnerships.   27,864 26,520 26,937
Property and equipment, net of accumulated depreciation   3,073,533 3,256,397  
U.S. dialysis        
Segment Reporting Information [Line Items]        
Total revenues   10,848,776 10,512,774 10,576,167
Other - Ancillary services        
Segment Reporting Information [Line Items]        
Total revenues   1,291,371 1,097,120 1,042,630
Operating Segments        
Segment Reporting Information [Line Items]        
Total revenues   12,236,221 11,701,135 11,713,887
Operating Income (Loss)   1,765,831 1,468,731 1,908,985
Operating Segments | U.S. dialysis        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues before provision   10,911,747 10,575,372 10,641,618
Total revenues   10,936,998 10,599,809 10,666,963
Operating Income (Loss)   1,774,578 1,565,310 1,974,988
Operating Segments | U.S. dialysis | External Sources        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues before provision   10,823,525 10,488,327 10,551,106
Other revenues   25,251 24,447 25,061
Operating Segments | U.S. dialysis | Intersubsegment Eliminations        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues before provision   88,222 87,045 90,512
Other revenues   0 (10) 284
Operating Segments | Other - Ancillary services        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues before provision   751,416 688,137 662,409
Other revenues   539,955 408,983 380,221
Total revenues   1,299,223 1,101,326 1,046,924
Operating Income (Loss)   (8,747) (96,579) (66,003)
Segment Reporting Information footnote:        
Equity investment income (loss) from equity method investments in nonconsolidated dialysis partnerships.   (2,103) (1,898) (3,177)
Operating Segments | Other - Ancillary services | Intersubsegment Eliminations        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues before provision   7,852 4,206 4,294
Intersegment Elimination        
Segment Reporting Information [Line Items]        
Total revenues   (96,074) (91,241) (95,090)
Intersegment Elimination | U.S. dialysis        
Segment Reporting Information [Line Items]        
Total revenues   (88,222) (87,035) (90,796)
Intersegment Elimination | Other - Ancillary services        
Segment Reporting Information [Line Items]        
Total revenues   $ (7,852) $ (4,206) $ (4,294)