Segment Reporting - Summary of Expenditures for Property and Equipment by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 766,546	$ 987,138	$ 905,250
U.S. dialysis
Segment Reporting Information [Line Items]
Expenditures for property and equipment	681,339	856,108	769,732
Other - Ancillary services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	46,741	45,806	40,377
DMG - Held for sale
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 38,466	$ 85,224	$ 95,141