Segment Reporting - Summary of Assets by Segment (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
ASSETS
Consolidated assets	$ 17,311,394	$ 19,110,252
Equity method and other investments	241,983	224,611
Property and equipment, net	3,473,384	3,393,669
U.S. dialysis
ASSETS
Consolidated assets	15,778,880	12,333,641
Equity method and other investments	124,188	95,290
Other - Ancillary services
ASSETS
Consolidated assets	1,532,514	1,387,046
Equity method and other investments	117,795	129,321
DMG - Held for sale
ASSETS
Consolidated assets	0	5,389,565
Equity method and other investments	0	4,833
International | Other - Ancillary services
ASSETS
Property and equipment, net	$ 154,572	$ 136,052