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Goodwill - Changes in Carrying Value of Goodwill by Reportable Segments (Details) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2021 | Dec. 31, 2020
Goodwill [Roll Forward] |  |
Beginning balance | $ 6,919,109 | $ 6,787,635
Acquisitions | 173,244 | 130,057
Divestitures | (1,745) | (8,293)
Foreign currency and other adjustments | (44,367) | 9,710
Ending balance | 7,046,241 | 6,919,109
Goodwill | 7,172,448 |
Accumulated impairment charges | (126,207) |
U.S. dialysis |  |
Goodwill [Roll Forward] |  |
Beginning balance | 6,309,928 | 6,287,100
Acquisitions | 91,979 | 24,377
Divestitures | (1,745) | (1,549)
Foreign currency and other adjustments | 0 | 0
Ending balance | 6,400,162 | 6,309,928
Goodwill | 6,400,162 |
Accumulated impairment charges | 0 |
Other - Ancillary services |  |
Goodwill [Roll Forward] |  |
Beginning balance | 609,181 | 500,535
Acquisitions | 81,265 | 105,680
Divestitures | 0 | (6,744)
Foreign currency and other adjustments | (44,367) | 9,710
Ending balance | 646,079 | $ 609,181
Goodwill | 772,286 |
Accumulated impairment charges | $ (126,207) |

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- Definition Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 942 -SubTopic 210 -Section S99 -Paragraph 1 -Subparagraph (SX 210.9-03(10)(1)) -URI http://asc.fasb.org/extlink&oid=120398452&loc=d3e534808-122878 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 45 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=120320667&loc=SL49117168-202975 Reference 3: http://www.xbrl.org/2003/role/exampleRef -Publisher FASB -Name Accounting Standards Codification -Topic 852 -SubTopic 10 -Section 55 -Paragraph 10 -URI http://asc.fasb.org/extlink&oid=84165509&loc=d3e56426-112766 Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 45 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=99380562&loc=d3e13770-109266 + Details
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- Definition Amount of increase in asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized resulting from a business combination. + 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 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=121556970&loc=d3e13816-109267 + Details
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