Accounts Receivable - Additional Information (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
Dec. 31, 2017	Dec. 31, 2017	Dec. 31, 2016
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable, less allowance of $218,399 and $238,897	$ 1,714,750	$ 1,714,750	$ 1,503,950
Decrease in allowance for doubtful accounts		$ 20,498	$ 12,837
U.S. dialysis and related lab services
Accounts, Notes, Loans and Financing Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	100.00%	100.00%
Outstanding period in which receivables are reserved 100%		3 months
Health Care Patient Services \| Accounts Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Net accounts receivable, percentage of balances more than six months old	21.00%	21.00%	16.00%
Percentage of accounts receivable due		1.00%
Outstanding period in which receivables are reserved 100%	6 months	1 year
Accounts receivable, less allowance of $218,399 and $238,897	$ 0	$ 0
Government-based Programs, Medicare and Medicaid \| Accounts Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	80.00%	80.00%

Patient accounts receivable months outstanding to be reserved per company policy.

No definition available.

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- Definition

Percentage of Accounts Receivable , 6 months or More Past Due

+ References

No definition available.

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- Definition

Percentage of outstanding patient accounts receivables to be reserved when patient pay amounts due are outstanding for more than four months, as per the Company's policy.

+ References

No definition available.

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- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

No definition available.

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- Definition

Amount due from customers or clients, within one year of the balance sheet date (or the normal operating cycle, whichever is longer), for goods or services (including trade receivables) that have been delivered or sold in the normal course of business, reduced to the estimated net realizable fair value by an allowance established by the entity of the amount it deems uncertain of collection.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(3))
-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

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-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(4))
-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

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- Definition

Amount of increase (decrease) in the allowance for doubtful accounts.

+ References

No definition available.

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- Definition

For an entity that discloses a concentration risk in relation to quantitative amount, which serves as the "benchmark" (or denominator) in the equation, this concept represents the concentration percentage derived from the division.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 275
-SubTopic 10
-Section 50
-Paragraph 18
-URI http://asc.fasb.org/extlink&oid=64851502&loc=d3e6351-108592

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-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 20
-URI http://asc.fasb.org/extlink&oid=73719730&loc=d3e13531-108611

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-Publisher FASB
-Name Accounting Standards Codification
-Topic 275
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-Section 50
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-URI http://asc.fasb.org/extlink&oid=64851502&loc=d3e6404-108592

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