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Goodwill (Tables) | 12 Months Ended
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Dec. 31, 2022
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, 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 | 16,750 |  |  | 32,297 |  |  | 49,047 |
Divestitures | (87) |  |  | (3,263) |  |  | (3,350) |
Foreign currency and other adjustments | — |  |  | (15,328) |  |  | (15,328) |
Balance at December 31, 2022 | $ | 6,416,825 |  |  | $ | 659,785 |  |  | $ | 7,076,610 |
Balance at December 31, 2022: |  |  |  |  |
Goodwill | $ | 6,416,825 |  |  | $ | 778,774 |  |  | $ | 7,195,599 |
Accumulated impairment charges | — |  |  | (118,989) |  |  | (118,989) |
| $ | 6,416,825 |  |  | $ | 659,785 |  |  | $ | 7,076,610 |
Schedule of Reporting Units Goodwill Balances |
Reporting unit |  | Goodwill balance |  | Carrying amount coverage(1) |  | Sensitivities
Operating income(2) |  | Discount rate(3)
Germany kidney care |  | $ | 281,781 |  |  | 18.9 | % |  | (2.0) | % |  | (9.2) | %
(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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