Segment Reporting - Summary of Expenditures for Property and Equipment by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 674,541	$ 766,546	$ 987,138
U.S. dialysis
Segment Reporting Information [Line Items]
Expenditures for property and equipment	646,870	681,339	856,108
Other - Ancillary services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	27,671	46,741	45,806
DMG - discontinued operations
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 0	$ 38,466	$ 85,224