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Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands | 9 Months Ended | 12 Months Ended
--- | --- | ---
Sep. 30, 2023 | Dec. 31, 2022
Goodwill [Roll Forward] |  |
Beginning balance | $ 7,076,610 | $ 7,046,241
Acquisitions | 4,688 | 49,047
Divestitures |  | (3,350)
Foreign currency and other adjustments | 6,925 | (15,328)
Ending balance | 7,088,223 | 7,076,610
Goodwill, before accumulated impairment charges | 7,206,163 |
Accumulated impairment charges | (117,940) |
Ending balance | 7,088,223 | 7,076,610
U.S. dialysis |  |
Goodwill [Roll Forward] |  |
Beginning balance | 6,416,825 | 6,400,162
Acquisitions | 0 | 16,750
Divestitures |  | (87)
Foreign currency and other adjustments | 0 | 0
Ending balance | 6,416,825 | 6,416,825
Goodwill, before accumulated impairment charges | 6,416,825 |
Accumulated impairment charges | 0 |
Ending balance | 6,416,825 | 6,416,825
Other—Ancillary services |  |
Goodwill [Roll Forward] |  |
Beginning balance | 659,785 | 646,079
Acquisitions | 4,688 | 32,297
Divestitures |  | (3,263)
Foreign currency and other adjustments | 6,925 | (15,328)
Ending balance | 671,398 | 659,785
Goodwill, before accumulated impairment charges | 789,338 |
Accumulated impairment charges | (117,940) |
Ending balance | $ 671,398 | $ 659,785

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