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Goodwill (Tables)
 6 Months Ended
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. dialysisOther — Ancillary servicesConsolidated
Balance at December 31, 2021$6,400,162 $646,079 $7,046,241 
Acquisitions16,750 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