v3.26.1
Revenue Recognition Segment Revenue by Payor (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Disaggregation of Revenue [Line Items]      
Other revenues $ 142,751 $ 120,536  
Total revenues 3,415,548 3,223,529  
Contract with Customer, Performance Obligation Satisfied in Previous Period 35,477 28,463  
Contract assets and other receivables 517,653   $ 494,414
IKC and Medicare      
Disaggregation of Revenue [Line Items]      
Contract assets and other receivables 354,329   $ 310,541
Elimination of intersegment revenues      
Disaggregation of Revenue [Line Items]      
Total revenues (23,760) (14,462)  
Medicare and Medicare Advantage      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 1,675,413 1,609,018  
Other revenues 108,506 98,954  
Medicaid and Managed Medicaid      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 212,830 206,509  
Other revenues 0 2  
Other Government Payors      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 341,119 286,493  
Commercial Payors      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 1,063,907 1,012,707  
Other revenues 3,648 2,701  
Other      
Disaggregation of Revenue [Line Items]      
Other revenues 33,885 21,607  
U. S. Dialysis And Related Lab Services      
Disaggregation of Revenue [Line Items]      
Total revenues 2,921,229 2,811,435  
U. S. Dialysis And Related Lab Services | Elimination of intersegment revenues      
Disaggregation of Revenue [Line Items]      
Total revenues (20,472) (11,734)  
U. S. Dialysis And Related Lab Services | Medicare and Medicare Advantage      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 1,675,413 1,609,018  
U. S. Dialysis And Related Lab Services | Medicaid and Managed Medicaid      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 212,830 206,509  
U. S. Dialysis And Related Lab Services | Other Government Payors      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 92,940 76,746  
U. S. Dialysis And Related Lab Services | Commercial Payors      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 954,243 924,888  
U. S. Dialysis And Related Lab Services | Other      
Disaggregation of Revenue [Line Items]      
Other revenues 6,275 6,008  
Other Operating Segment      
Disaggregation of Revenue [Line Items]      
Total revenues 494,319 412,094  
Other Operating Segment | Elimination of intersegment revenues      
Disaggregation of Revenue [Line Items]      
Total revenues (3,288) (2,728)  
Other Operating Segment | Medicare and Medicare Advantage      
Disaggregation of Revenue [Line Items]      
Other revenues 108,506 98,954  
Other Operating Segment | Medicaid and Managed Medicaid      
Disaggregation of Revenue [Line Items]      
Other revenues 0 2  
Other Operating Segment | Other Government Payors      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 248,179 209,747  
Other Operating Segment | Commercial Payors      
Disaggregation of Revenue [Line Items]      
Dialysis patient service revenues 109,664 87,819  
Other revenues 3,648 2,701  
Other Operating Segment | Other      
Disaggregation of Revenue [Line Items]      
Other revenues $ 27,610 $ 15,599