Noncontrolling Interests Subject to Put Provisions and Other Commitments - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2019 USD ($)
Commitments And Contingencies Disclosure [Line Items]
Purchase Obligation, Due in Next Twelve Months	$ 399,042
Purchase Obligation, Due in Second Year	312,119
Purchase Obligation, Due in Third Year	$ 312,101
EPO
Commitments And Contingencies Disclosure [Line Items]
Long term purchase commitment, expiration date	Dec. 31, 2022
Dialysis Equipment, Parts and Supplies
Commitments And Contingencies Disclosure [Line Items]
Long term purchase commitment, expiration date	Dec. 31, 2020
Hemodialysis Supplies
Commitments And Contingencies Disclosure [Line Items]
Long term purchase commitment, expiration date	Dec. 31, 2022
Minimum
Commitments And Contingencies Disclosure [Line Items]
Scheduled dissolution term of joint ventures	10 years
Minimum | EPO
Commitments And Contingencies Disclosure [Line Items]
Long-term purchase commitment, percentage of quantity required to be purchased	90.00%
Maximum
Commitments And Contingencies Disclosure [Line Items]
Scheduled dissolution term of joint ventures	50 years
Commitments to Provide Operating Capital
Commitments And Contingencies Disclosure [Line Items]
Other potential commitments to provide operating capital to several dialysis centers	$ 9,669