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Goodwill (Tables) | 6 Months Ended
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Jun. 30, 2022
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, 2020 | $ | 6,309,928 |  |  | $ | 609,181 |  |  | $ | 6,919,109 |
Acquisitions | 91,979 |  |  | 81,265 |  |  | 173,244 |
Divestitures | (1,745) |  |  | — |  |  | (1,745) |
Foreign currency and other adjustments | — |  |  | (44,367) |  |  | (44,367) |
Balance at December 31, 2021 | $ | 6,400,162 |  |  | $ | 646,079 |  |  | $ | 7,046,241 |
Acquisitions | — |  |  | (1,145) |  |  | (1,145) |
Divestitures | (87) |  |  | (3,126) |  |  | (3,213) |
Foreign currency and other adjustments | — |  |  | (22,105) |  |  | (22,105) |
Balance at June 30, 2022 | $ | 6,400,075 |  |  | $ | 619,703 |  |  | $ | 7,019,778 |
Balance at June 30, 2022: |  |  |  |  |
Goodwill | $ | 6,400,075 |  |  | $ | 736,265 |  |  | $ | 7,136,340 |
Accumulated impairment charges | — |  |  | (116,562) |  |  | (116,562) |
| $ | 6,400,075 |  |  | $ | 619,703 |  |  | $ | 7,019,778 |

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