Organization and Summary of Significant Accounting Policies - Additional Information (Details) $ in Thousands		12 Months Ended
	Jan. 01, 2019 USD ($)	Dec. 31, 2019 patient state country clinic entity	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of legal entities that third parties held noncontrolling equity interests | entity		672
Minimum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Lessee, Operating Lease, Term of Contract		5 years
Lessee, Operating Lease, Renewal Term		5 years
Minimum | Noncompetition agreements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period		3 years
Minimum | Buildings
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		25 years
Minimum | Leasehold Improvements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		10 years
Minimum | Equipment and Information Systems
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		3 years
Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Lessee, Operating Lease, Term of Contract		15 years
Lessee, Operating Lease, Renewal Term		10 years
Maximum | Noncompetition agreements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period		10 years
Maximum | Buildings
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		40 years
Maximum | Equipment and Information Systems
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		15 years
Accounting Standards Update 2016-02 | Lease Assets
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification	$ 2,783,784
Accounting Standards Update 2016-02 | Lease Liabilities
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification	3,001,354
Retained earnings
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Cumulative Effect of New Accounting Principle in Period of Adoption			$ 39,876	$ 8,368
Cash Flow Effect | Accounting Standards Update 2016-02
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification	$ 0
United States
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of dialysis centers that the company operated or provided administrative services | clinic		2,753
Number of states where dialysis centers are located | state		46
Number of patients served | patient		206,900
International Operations
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of dialysis centers that the company operated or provided administrative services | clinic		259
Number of patients served | patient		28,700
Number of countries in which dialysis centers located | country		10