2.0.0.10 false Consolidated Statements of Income (USD $) 00020 - Statement - Consolidated Statements of Income true false In Thousands false false 1 usd $ false false USD Standard http://www.xbrl.org/2003/iso4217 USD iso4217 0 false 2 usd $ false false USD Standard http://www.xbrl.org/2003/iso4217 USD iso4217 0 3 Net revenue: 1 us-gaap_HealthCareOrganizationRevenueAbstract us-gaap true na duration string No definition available. false false false false false true false false false false false false 1 false false false false 0 0 false false false 2 false false false false 0 0 false false false No definition available. false 4 Dialysis Care Revenue 2 us-gaap_HealthCareOrganizationPatientServiceRevenue us-gaap true credit duration monetary No definition available. false false false false false false false false false false false false 1 true true false false 2170784000 2170784 false false false 2 true true false false 1923321000 1923321 false false false Amount of revenue recognized during the period for providing services to patients, primarily on an inpatient or outpatient basis and from office visits. For financial reporting purposes, patient service revenue is reflected net of provisions for contractual allowances (the amount needed to reduce the entity's gross billing rates to agreed-upon rates in contracts with third-party payers) and other adjustments. Significant revenue earned under capitation arrangements is reported separately. Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher AICPA -Name Audit and Accounting Guide (AAG) -Number AAG-HCO -Chapter 8 -Paragraph 10 -IssueDate 2006-05-01 false 5 Dialysis Products Revenue 2 us-gaap_HealthCareOrganizationOtherRevenue us-gaap true credit duration monetary No definition available. false false false false false false false false false false false false 1 false true false false 711345000 711345 false false false 2 false true false false 636489000 636489 false false false Revenues recognized during the period that were not otherwise reflected in the entity's income statement. No authoritative reference available. false 6 Net revenue 1 us-gaap_HealthCareOrganizationRevenue us-gaap true credit duration monetary No definition available. false false false false false false false false false false false totallabel false 1 false true false false 2882129000 2882129 false false false 2 false true false false 2559810000 2559810 false false false The sum of revenues recognized during the period by the entity from providing services to in-patients, outpatients, residents in facilities owned or operated by the entity, from insurance premiums, or from goods provided or services performed. No authoritative reference available. true 7 Costs of revenue: 1 us-gaap_CostOfRevenueAbstract us-gaap true na duration string No definition available. false false false false false true false false false false false false 1 false false false false 0 0 false false false 2 false false false false 0 0 false false false No definition available. false 8 Dialysis Care Cost of Revenue 2 us-gaap_CostOfServices us-gaap true debit duration monetary No definition available. false false false false false false false false false false false false 1 false true false false 1541681000 1541681 false false false 2 false true false false 1396807000 1396807 false false false Total costs related to services rendered by an entity during the reporting period. 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Indirect selling expenses are expenses that cannot be directly linked to the sale of specific products, for example telephone expenses, Internet, and postal charges. General and administrative expenses include salaries of non-sales personnel, rent, utilities, communication, etc. Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 03 -Paragraph 4 -Article 5 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher AICPA -Name Accounting Research Bulletin (ARB) -Number 43 -Chapter 4 -Paragraph 5A false 14 Research and development 2 us-gaap_ResearchAndDevelopmentExpense us-gaap true debit duration monetary No definition available. false false false false false false false false false false false false 1 false true false false 23089000 23089 false false false 2 false true false false 22896000 22896 false false false The aggregate costs incurred (1) in a planned search or critical investigation aimed at discovery of new knowledge with the hope that such knowledge will be useful in developing a new product or service, a new process or technique, or in bringing about a significant improvement to an existing product or process; or (2) to translate research findings or other knowledge into a plan or design for a new product or process or for a significant improvement to an existing product or process whether intended for sale or the entity's use, during the reporting period charged to research and development projects, including the costs of developing computer software up to the point in time of achieving technological feasibility, and costs allocated in accounting for a business combination to in-process projects deemed to have no alternative future use. 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If the entity does not present consolidated financial statements, the amount of profit or loss for the period, net of income taxes. 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