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Goodwill (Tables) | 6 Months Ended
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Jun. 30, 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 |  |
Acquisitions | — |  |  | 690 |  |  | 690 |  |
Foreign currency and other adjustments | — |  |  | 28,942 |  |  | 28,942 |  |
Balance at June 30, 2023 | $ | 6,416,825 |  |  | $ | 689,417 |  |  | $ | 7,106,242 |  |
Balance at June 30, 2023: |  |  |  |  |  |
Goodwill | $ | 6,416,825 |  |  | $ | 810,632 |  |  | $ | 7,227,457 |  |
Accumulated impairment charges | — |  |  | (121,215) |  |  | (121,215) |  |
| $ | 6,416,825 |  |  | $ | 689,417 |  |  | $ | 7,106,242 |  |

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