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Revenue - Schedule of U.K. Revenue and Percentage Generated by Each Payor Type (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 777,251	$ 760,916	$ 2,327,230	$ 2,268,895
U.K. Facilities [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 267,868	$ 272,290	$ 820,074	$ 836,394
Revenue, Percentage	100.00%	100.00%	100.00%	100.00%
U.K. Facilities [Member] | U.K. Public Funded Sources [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 242,747	$ 245,919	$ 740,492	$ 756,094
Revenue, Percentage	90.60%	90.30%	90.30%	90.40%
U.K. Facilities [Member] | Self-Pay [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 24,430	$ 26,159	$ 77,895	$ 78,499
Revenue, Percentage	9.10%	9.60%	9.50%	9.40%
U.K. Facilities [Member] | Other [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue	$ 691	$ 212	$ 1,687	$ 1,801
Revenue, Percentage	0.30%	0.10%	0.20%	0.20%

X

- Definition

Percentage of healthcare organization revenue before allowance for doubtful accounts.

+ References

No definition available.

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- Definition

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+ References

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- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=118956577&loc=SL49130543-203045

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=118956577&loc=SL49130545-203045

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