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Goodwill (Tables)
 12 Months Ended
Dec. 31, 2016
Goodwill And Intangible Assets Disclosure [Abstract]  
Changes in Carrying Value of Goodwill by Reportable Segments

Changes in the carrying value of goodwill by reportable segments were as follows:

 

 

 

U.S. dialysis and

related lab services

 

 

DMG

 

 

Other ancillary

services and

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

 

 

75,295

 

 

 

248,901

 

 

 

123,632

 

 

$

447,828

 

Divestitures

 

 

(12,891

)

 

 

(2,223

)

 

 

(29,645

)

 

$

(44,759

)

Goodwill impairment charges

 

 

—

 

 

 

(253,000

)

 

 

(28,415

)

 

$

(281,415

)

Foreign currency and other adjustments

 

 

—

 

 

 

—

 

 

 

(8,816

)

 

$

(8,816

)

Balance at December 31, 2016

 

$

5,691,587

 

 

$

3,391,942

 

 

$

323,788

 

 

$

9,407,317

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Balance at December 31, 2016:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Goodwill

 

$

5,691,587

 

 

$

3,833,711

 

 

$

358,112

 

 

$

9,883,410

 

Accumulated impairment charges

 

 

—

 

 

 

(441,769

)

 

 

(34,324

)

 

$

(476,093

)

 

 

$

5,691,587

 

 

$

3,391,942

 

 

$

323,788

 

 

$

9,407,317

 

 
Schedule of Goodwill and Indefinite-Lived Intangible Asset Impairment Charges

As a result of the assessments described above, the Company has recognized the goodwill impairment charges below:

 

 

 

Year ended December 31,

 

Reporting unit

 

2016

 

 

2015

 

 

2014

 

DMG Nevada

 

$

161,800

 

 

$

181,253

 

 

$

—

 

DMG Florida

 

 

91,200

 

 

 

5,800

 

 

 

—

 

DMG Arizona

 

 

—

 

 

 

1,716

 

 

 

—

 

Vascular access

 

 

28,415

 

 

 

—

 

 

 

—

 

International operations

 

 

—

 

 

 

4,065

 

 

 

1,000

 

Total

 

$

281,415

 

 

$

192,834

 

 

$

1,000

 

 
Schedule of Reporting Units Goodwill Balances

Further reductions in reimbursement rates, increases in medical cost or utilization trends, or other significant adverse changes in expected future cash flows or valuation assumptions could result in goodwill impairment charges in the future for the following reporting units, which remain at risk of goodwill impairment:

 

 

 

Goodwill balance

 

 

Carrying

 

 

Sensitivities

 

Reporting unit

 

as of

December 31, 2016

 

 

amount

coverage(1)

 

 

Operating

income(2)

 

 

Discount

rate(3)

 

DMG Nevada

 

$

261,204

 

 

 

11.4%

 

 

 

-2.2%

 

 

 

-3.9%

 

DMG Florida

 

$

442,835

 

 

 

7.1%

 

 

 

-1.7%

 

 

 

-3.2%

 

DMG New Mexico

 

$

70,926

 

 

 

2.6%

 

 

 

-1.5%

 

 

 

-2.2%

 

DMG Washington

 

$

244,502

 

 

 

3.7%

 

 

 

-1.8%

 

 

 

-3.4%

 

Vascular access

 

$

34,696

 

 

 

4.3%

 

 

 

-2.7%

 

 

 

-5.3%

 

 

 

(1)

Excess of estimated fair value of the reporting unit over carrying amount as of the latest assessment date.

 

(2)

Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date.

 

(3)

Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date.