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Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended
--- | --- | ---
Mar. 31, 2021 | Dec. 31, 2020
Goodwill [Roll Forward] |  |
Beginning balance | $ 6,919,109 | $ 6,787,635
Acquisitions | 5,456 | 130,057
Divestitures |  | 8,293
Foreign currency and other adjustments | (33,356) | 9,710
Ending balance | 6,891,209 | 6,919,109
Goodwill, before accumulated impairment charges | 7,021,782 |
Accumulated impairment charges | (130,573) |
Ending balance | 6,891,209 | 6,919,109
U.S. dialysis |  |
Goodwill [Roll Forward] |  |
Beginning balance | 6,309,928 | 6,287,100
Acquisitions | 0 | 24,377
Divestitures |  | 1,549
Foreign currency and other adjustments | 0 | 0
Ending balance | 6,309,928 | 6,309,928
Goodwill, before accumulated impairment charges | 6,309,928 |
Accumulated impairment charges | 0 |
Ending balance | 6,309,928 | 6,309,928
Other—Ancillary services |  |
Goodwill [Roll Forward] |  |
Beginning balance | 609,181 | 500,535
Acquisitions | 5,456 | 105,680
Divestitures |  | 6,744
Foreign currency and other adjustments | (33,356) | 9,710
Ending balance | 581,281 | 609,181
Goodwill, before accumulated impairment charges | 711,854 |
Accumulated impairment charges | (130,573) |
Ending balance | $ 581,281 | $ 609,181

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