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Goodwill (Tables)
 3 Months Ended
Mar. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]  
Changes in Goodwill by Reportable Segments
Changes in goodwill by reportable segment were as follows:
 
U.S. dialysis and
related lab services
 
Other-ancillary
services and
strategic initiatives
 
Consolidated total
Balance at January 1, 2017
$
5,691,587

 
$
323,788

 
$
6,015,375

Acquisitions
485,434

 
131,598

 
617,032

Divestitures
(32,260
)
 
(126
)
 
(32,386
)
Goodwill impairment charges
—

 
(36,196
)
 
(36,196
)
Foreign currency and other adjustments
—

 
46,454

 
46,454

Balance at December 31, 2017
$
6,144,761

 
$
465,518

 
$
6,610,279

Acquisitions
2,137

 
13,905

 
16,042

Foreign currency and other adjustments
—

 
12,271

 
12,271

Balance at March 31, 2018
$
6,146,898

 
$
491,694

 
$
6,638,592

 
 
 
 
 
 
Balance at March 31, 2018:
 
 
 
 
 
Goodwill
$
6,146,898

 
$
562,214

 
$
6,709,112

Accumulated impairment charges
—

 
(70,520
)
 
(70,520
)
 
$
6,146,898

 
$
491,694

 
$
6,638,592
Schedule of Reporting Units Goodwill Balances
 
 
Goodwill balance
as of
March 31, 2018
 
Carrying
amount
coverage(1)
 
Sensitivities
Reporting unit
 
 
 
Operating
income(2)
 
Discount
rate(3)
Kidney Care Germany
 
$
337,619

 
13.7
%
 
(1.6
)%
 
(11.1
)%
Kidney Care Portugal
 
$
48,066

 
16.9
%
 
(1.9
)%
 
(6.0
)%
Kidney Care Poland
 
$
47,669

 
11.8
%
 
(1.9
)%
 
(6.0
)%
 
(1)
Excess of estimated fair value of the reporting unit over its 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.