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Goodwill (Tables) | 3 Months Ended
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Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract] |
Changes in Goodwill by Reportable Segments [Text Block] | Changes in the carrying value of goodwill by reportable segment were as follows:
| U.S. dialysis |  | Other — Ancillary services |  | Consolidated
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 |
Foreign currency and other adjustments | — |  |  | 13,701 |  |  | 13,701 |
Balance at March 31, 2023 | $ | 6,416,825 |  |  | $ | 673,486 |  |  | $ | 7,090,311 |
Balance at March 31, 2023: |  |  |  |  |
Goodwill | $ | 6,416,825 |  |  | $ | 794,391 |  |  | $ | 7,211,216 |
Accumulated impairment charges | — |  |  | (120,905) |  |  | (120,905) |
| $ | 6,416,825 |  |  | $ | 673,486 |  |  | $ | 7,090,311 |

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