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)

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.

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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.

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Amount of foreign currency translation gain (loss) which increases (decreases) an asset representing future economic benefits from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount of accumulated impairment loss for an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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A roll forward is a reconciliation of a concept from the beginning of a period to the end of a period.

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Amount of divestiture of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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