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Goodwill (Tables) | 12 Months Ended
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Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract] |
Changes in Carrying Value of Goodwill by Reportable Segments | Changes in the carrying value of goodwill by reportable segment 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 |  |  | 105,680 |  |  | 130,057 |
Divestitures | (1,549) |  |  | (6,744) |  |  | (8,293) |
Foreign currency and other adjustments | — |  |  | 9,710 |  |  | 9,710 |
Balance at December 31, 2020 | $ | 6,309,928 |  |  | $ | 609,181 |  |  | $ | 6,919,109 |
Balance at December 31, 2020: |  |  |  |  |
Goodwill | $ | 6,309,928 |  |  | $ | 745,732 |  |  | $ | 7,055,660 |
Accumulated impairment charges | — |  |  | (136,551) |  |  | (136,551) |
| $ | 6,309,928 |  |  | $ | 609,181 |  |  | $ | 6,919,109 |
Schedule of Reporting Units Goodwill Balances |
Reporting unit |  | Goodwill balance |  | Carrying amount coverage(1) |  | Sensitivities
Operating income(2) |  | Discount rate(3)
Germany kidney care |  | $ | 322,736 |  |  | 2.3 | % |  | (1.5) | % |  | (10.1) | %
(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.

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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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