Noncontrolling Interests Subject to Put Provisions and Other Commitments - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2020 USD ($)
Commitments And Contingencies Disclosure [Line Items]
Purchase Obligation, Due in Next Twelve Months	$ 542,061
Purchase Obligation, Due in Second Year	540,715
Purchase Obligation, Due in Third Year	179,869
Purchase Obligation, to be Paid, Year Four	92,075
Off -Balance Sheet Financing Arrangements	$ 0
EPO
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	$ 8,663