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Acquisitions and divestitures (Tables)
6 Months Ended
Jun. 30, 2020
Business Acquisition [Line Items]  
Schedule of Business Acquisitions by Acquisition, Contingent Consideration
The following is a reconciliation of changes in contingent earn-out obligations for the three and six month periods ended June 30, 2020:
 
Three months ended June 30, 2020
 
Six months ended June 30, 2020
Beginning balance
$
22,386

 
$
24,586

Acquisitions
3,190

 
5,861

Foreign currency translation
(510
)
 
(5,383
)
Fair value remeasurements
(642
)
 
(640
)
Payments or other settlements
(367
)
 
(367
)
Ending balance
$
24,057

 
$
24,057


Dialysis and other businesses  
Business Acquisition [Line Items]  
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]
The following table summarizes the assets acquired and liabilities assumed in these transactions at their estimated acquisition date fair values: 
Current assets
$
9,934

Property and equipment
9,204

Intangible and other long-term assets
7,138

Goodwill
41,584

Deferred income taxes
1,513

Current liabilities
(12,048
)
Noncontrolling interests
(596
)

$
56,729