Organization and Summary of Significant Accounting Policies - Additional Information (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013 Entity	Dec. 31, 2012
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Ownership in joint venture	50.00%
Funds on deposit with a third party recorded in other current assets	$ 176,414	$ 201,572
Number of legal entities that third parties held noncontrolling ownership	300
Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Percentage of management fees included in net operating revenues	1.00%
Term Loan B | Interest rate cap agreements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Interest rate agreements, notional amount	1,250,000
Term Loan B-2 | Interest rate cap agreements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Interest rate agreements, notional amount	1,485,000
Customer relationships | Minimum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period	10 years
Customer relationships | Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period	20 years
Trade names | Minimum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period	2 years
Trade names | Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period	15 years
Provider network and practice management tools | Minimum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period	2 years
Provider network and practice management tools | Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period	15 years
Noncompetition and other agreements | Minimum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period	2 years
Noncompetition and other agreements | Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period	10 years
Alliance and Product Supply Agreement liability
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period	10 years
Buildings | Minimum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Useful lives of the assets	20 years
Buildings | Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Useful lives of the assets	40 years
Equipment and Information Systems | Minimum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Useful lives of the assets	3 years
Equipment and Information Systems | Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Useful lives of the assets	8 years
California Medical Group Insurance
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Equity interest owned	67.00%
Funds on Deposit with Third Party
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Funds on deposit with a third party recorded in other current assets	$ 79,317
Dialysis And Related Lab Services | Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Percentage of risk on revenue	1.00%
UNITED STATES
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of dialysis centers that the company operated or provided administrative services	2,074
Number of states that dialysis centers located	45
Number of patients served	163,000
Outside United States
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of dialysis centers that the company operated or provided administrative services	73