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Goodwill (Tables) | 9 Months Ended
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Sep. 30, 2016
Goodwill And Intangible Assets Disclosure [Abstract] |
Changes in Goodwill by Reportable Segments | Changes in goodwill by reportable segments were as follows:
|  |  |  |  |  |  |  |  |  | Other-ancillary |  |  |  |  |
|  | U.S. dialysis and |  |  |  |  |  |  | services and |  |  |  |  |
|  | related lab services |  |  | DMG |  |  | strategic initiatives |  |  | Consolidated total |
Balance at January 1, 2015 |  | $ | 5,610,643 |  |  | $ | 3,562,534 |  |  | $ | 242,118 |  |  | $ | 9,415,295 |
Acquisitions |  |  | 21,910 |  |  |  | 29,910 |  |  |  | 45,273 |  |  |  | 97,093 |
Divestitures |  |  | (3,370 | ) |  |  | (5,411 | ) |  |  | — |  |  |  | (8,781 | )
Goodwill impairment charges |  |  | — |  |  |  | (188,769 | ) |  |  | (4,065 | ) |  |  | (192,834 | )
Foreign currency and other adjustments |  |  | — |  |  |  | — |  |  |  | (16,294 | ) |  |  | (16,294 | )
Balance at December 31, 2015 |  | $ | 5,629,183 |  |  | $ | 3,398,264 |  |  | $ | 267,032 |  |  | $ | 9,294,479 |
Acquisitions |  |  | 52,792 |  |  |  | 248,901 |  |  |  | 70,116 |  |  |  | 371,809 |
Divestitures |  |  | (4,222 | ) |  |  | (2,223 | ) |  |  | (29,374 | ) |  |  | (35,819 | )
Goodwill impairment charges |  |  | — |  |  |  | (253,000 | ) |  |  | — |  |  |  | (253,000 | )
Foreign currency and other adjustments |  |  | — |  |  |  | — |  |  |  | 5,527 |  |  |  | 5,527 |
Balance at September 30, 2016 |  | $ | 5,677,753 |  |  | $ | 3,391,942 |  |  | $ | 313,301 |  |  | $ | 9,382,996 |

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- Definition Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=35741047&loc=d3e13816-109267 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=35741047&loc=d3e13854-109267 + Details
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