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Goodwill (Tables) | 9 Months Ended
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Sep. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract] |
Changes in Goodwill by Reportable Segments [Text Block] | Changes in goodwill by reportable segments were as follows:
| U.S. dialysis |  | Other - Ancillary services |  | Consolidated
Balance at December 31, 2018 | $ | 6,275,004 |  |  | $ | 566,956 |  |  | $ | 6,841,960 |
Acquisitions | 18,089 |  |  | 72,137 |  |  | 90,226 |
Impairment charges | — |  |  | (124,892 | ) |  | (124,892 | )
Foreign currency and other adjustments | (5,993 | ) |  | (13,666 | ) |  | (19,659 | )
Balance at December 31, 2019 | $ | 6,287,100 |  |  | $ | 500,535 |  |  | $ | 6,787,635 |
Acquisitions | 24,377 |  |  | 85,871 |  |  | 110,248 |
Divestitures | (1,549 | ) |  | (6,744 | ) |  | (8,293 | )
Foreign currency and other adjustments | — |  |  | (21,213 | ) |  | (21,213 | )
Balance at September 30, 2020 | $ | 6,309,928 |  |  | $ | 558,449 |  |  | $ | 6,868,377 |
Balance at September 30, 2020 |  |  |  |  |
Goodwill | $ | 6,309,928 |  |  | $ | 688,881 |  |  | $ | 6,998,809 |
Accumulated impairment charges | — |  |  | (130,432 | ) |  | (130,432 | )
| $ | 6,309,928 |  |  | $ | 558,449 |  |  | $ | 6,868,377 |

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- Definition Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=121556970&loc=d3e13816-109267 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=121556970&loc=d3e13854-109267 + Details
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