Segment Reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Segment Reporting Information [Line Items]
Other revenues	$ 405,282	$ 524,353	$ 491,773
Total revenues	11,618,797	11,550,604	11,388,479
Operating Income (Loss)	1,797,370	1,694,636	1,643,317
Corporate administrative support	(111,615)	(146,707)	(92,335)
Debt expense	(285,254)	(304,111)	(443,824)
Debt prepayment, refinancing and redemption charges	0	(89,022)	(33,402)
Other income	6,378	16,759	29,348
Income (Loss) from Continuing Operations before Equity Method Investments, Income Taxes, Noncontrolling Interest, Total	1,518,494	1,318,262	1,195,439
Segment Reporting Information footnote:
Equity investment income (loss)	26,937	26,916	12,679
U.S. dialysis
Segment Reporting Information [Line Items]
Total revenues	10,576,167	10,514,649	10,430,581
Other - Ancillary services
Segment Reporting Information [Line Items]
Total revenues	1,042,630	1,035,955	957,898
Operating Segments
Segment Reporting Information [Line Items]
Total revenues	11,713,887	11,712,633	11,534,834
Operating Income (Loss)	1,908,985	1,841,343	1,735,652
Operating Segments | U.S. dialysis
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision	10,641,618	10,619,364	10,530,885
Total revenues	10,666,963	10,659,935	10,562,906
Operating Income (Loss)	1,974,988	1,917,604	1,924,826
Operating Segments | U.S. dialysis | External Sources
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision	10,551,106	10,475,273	10,399,686
Other revenues	25,061	39,376	30,895
Operating Segments | U.S. dialysis | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision	90,512	144,091	131,199
Other revenues	284	1,195	1,126
Operating Segments | Other - Ancillary services
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision	662,409	550,978	497,021
Other revenues	380,221	484,977	460,877
Total revenues	1,046,924	1,052,698	971,928
Operating Income (Loss)	(66,003)	(76,261)	(189,174)
Segment Reporting Information footnote:
Equity investment income (loss)	3,177	5,866	9,366
Operating Segments | Other - Ancillary services | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision	4,294	16,743	14,030
Intersegment Elimination
Segment Reporting Information [Line Items]
Total revenues	(95,090)	(162,029)	(146,355)
Intersegment Elimination | U.S. dialysis
Segment Reporting Information [Line Items]
Total revenues	(90,796)	(145,286)	(132,325)
Intersegment Elimination | Other - Ancillary services
Segment Reporting Information [Line Items]
Total revenues	$ (4,294)	$ (16,743)	$ (14,030)