v3.26.1
Segment reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes (Detail) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Segment Reporting Information [Line Items]    
Other revenues $ 142,751 $ 120,536
Total revenues 3,415,548 3,223,529
Operating income (loss) 481,892 438,937
Corporate administrative support (29,907) (34,026)
Debt expense (145,131) (135,055)
Other income (loss), net 4,473 (17,549)
Income before income taxes 341,234 286,333
Patient care costs 2,342,257 2,239,660
General and administrative 421,914 374,090
Depreciation and amortization 177,829 176,451
Operating expenses 2,933,656 2,784,592
U. S. Dialysis And Related Lab Services    
Segment Reporting Information [Line Items]    
Total revenues 2,921,229 2,811,435
Depreciation and amortization 155,170 156,899
Other Operating Segment    
Segment Reporting Information [Line Items]    
Total revenues 494,319 412,094
Depreciation and amortization 22,659 19,552
Operating Segments    
Segment Reporting Information [Line Items]    
Total revenues 3,439,308 3,237,991
Operating income (loss) 511,799 472,963
Operating Segments | U. S. Dialysis And Related Lab Services    
Segment Reporting Information [Line Items]    
Operating income (loss) 505,967 475,772
Patient care costs 1,969,056 1,913,428
General and administrative 319,772 282,679
Segment Reporting, Other Segment Item, Amount (8,264) (5,609)
Operating expenses 2,435,734 2,347,397
Operating Segments | Other Operating Segment    
Segment Reporting Information [Line Items]    
Operating income (loss) 5,832 (2,809)
Operating Segments | U S Dialysis And Related Lab Services with Intersegment    
Segment Reporting Information [Line Items]    
Dialysis patient service revenues 2,935,426 2,817,161
Total revenues 2,941,701 2,823,169
Operating Segments | U S Dialysis And Related Lab Services with Intersegment | External Sources    
Segment Reporting Information [Line Items]    
Dialysis patient service revenues 2,914,954 2,805,427
Other revenues 6,275 6,008
Operating Segments | U S Dialysis And Related Lab Services with Intersegment | Intersubsegment Eliminations    
Segment Reporting Information [Line Items]    
Dialysis patient service revenues 20,472 11,734
Operating Segments | Other Operating Segments with Intersegment    
Segment Reporting Information [Line Items]    
Dialysis patient service revenues 357,843 297,566
Other revenues 136,476 114,528
Total revenues 497,607 414,822
Operating Segments | Other Operating Segments with Intersegment | Intersubsegment Eliminations    
Segment Reporting Information [Line Items]    
Other revenues 3,288 2,728
Intersegment Elimination    
Segment Reporting Information [Line Items]    
Total revenues (23,760) (14,462)
Intersegment Elimination | U. S. Dialysis And Related Lab Services    
Segment Reporting Information [Line Items]    
Total revenues (20,472) (11,734)
Intersegment Elimination | Other Operating Segment    
Segment Reporting Information [Line Items]    
Total revenues $ (3,288) $ (2,728)