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Goodwill - Changes in Carrying Value of Goodwill by Reportable Segments (Details) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2023 | Dec. 31, 2022 | Dec. 31, 2021
Goodwill [Roll Forward] |  |  |
Beginning balance | $ 7,076,610 | $ 7,046,241 |
Acquisitions | 25,723 | 49,047 |
Divestitures |  | (3,350) |
Impairment charges | (26,083) | 0 | $ 0
Foreign currency and other adjustments | 36,310 | (15,328) |
Ending balance | 7,112,560 | 7,076,610 | 7,046,241
Goodwill | 7,261,661 |  |
Accumulated impairment charges | (149,101) |  |
Transplant Software Reporting Unit |  |  |
Goodwill [Roll Forward] |  |  |
Impairment charges | (26,083) |  |
Ending balance | 14,424 |  |
U.S. dialysis |  |  |
Goodwill [Roll Forward] |  |  |
Beginning balance | 6,416,825 | 6,400,162 |
Acquisitions | 0 | 16,750 |
Divestitures |  | (87) |
Impairment charges | 0 |  |
Foreign currency and other adjustments | 0 | 0 |
Ending balance | 6,416,825 | 6,416,825 | 6,400,162
Goodwill | 6,416,825 |  |
Accumulated impairment charges | 0 |  |
Other - Ancillary services |  |  |
Goodwill [Roll Forward] |  |  |
Beginning balance | 659,785 | 646,079 |
Acquisitions | 25,723 | 32,297 |
Divestitures |  | (3,263) |
Impairment charges | (26,083) |  |
Foreign currency and other adjustments | 36,310 | (15,328) |
Ending balance | 695,735 | $ 659,785 | $ 646,079
Goodwill | 844,836 |  |
Accumulated impairment charges | $ (149,101) |  |

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