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Goodwill - Changes in Carrying Value of Goodwill by Reportable Segments (Details) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2022 | Dec. 31, 2021
Goodwill [Roll Forward] |  |
Beginning balance | $ 7,046,241 | $ 6,919,109
Acquisitions | 49,047 | 173,244
Divestitures | (3,350) | (1,745)
Foreign currency and other adjustments | (15,328) | (44,367)
Ending balance | 7,076,610 | 7,046,241
Goodwill | 7,195,599 |
Accumulated impairment charges | (118,989) |
U.S. dialysis |  |
Goodwill [Roll Forward] |  |
Beginning balance | 6,400,162 | 6,309,928
Acquisitions | 16,750 | 91,979
Divestitures | (87) | (1,745)
Foreign currency and other adjustments | 0 | 0
Ending balance | 6,416,825 | 6,400,162
Goodwill | 6,416,825 |
Accumulated impairment charges | 0 |
Other - Ancillary services |  |
Goodwill [Roll Forward] |  |
Beginning balance | 646,079 | 609,181
Acquisitions | 32,297 | 81,265
Divestitures | (3,263) | 0
Foreign currency and other adjustments | (15,328) | (44,367)
Ending balance | 659,785 | $ 646,079
Goodwill | 778,774 |
Accumulated impairment charges | $ (118,989) |

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