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Goodwill (Tables) | 9 Months Ended
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Sep. 30, 2021
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, 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 |
Acquisitions | 12,423 |  |  | 41,196 |  |  | 53,619 |
Divestitures | (623) |  |  | — |  |  | (623) |
Foreign currency and other adjustments | — |  |  | (31,438) |  |  | (31,438) |
Balance at September 30, 2021 | $ | 6,321,728 |  |  | $ | 618,939 |  |  | $ | 6,940,667 |
Balance at September 30, 2021: |  |  |  |  |
Goodwill | $ | 6,321,728 |  |  | $ | 747,933 |  |  | $ | 7,069,661 |
Accumulated impairment charges | — |  |  | (128,994) |  |  | (128,994) |
| $ | 6,321,728 |  |  | $ | 618,939 |  |  | $ | 6,940,667 |

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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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