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Goodwill (Tables)
 3 Months Ended
Mar. 31, 2024
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, 2022$6,416,825 $659,785 $7,076,610 
Acquisitions— 25,723 25,723 
Impairment charges— (26,083)(26,083)
Foreign currency and other adjustments— 36,310 36,310 
Balance at December 31, 2023$6,416,825 $695,735 $7,112,560 
Acquisitions102,082 35,208 137,290 
Divestitures(1,687)— (1,687)
Foreign currency and other adjustments— (18,461)(18,461)
Balance at March 31, 2024$6,517,220 $712,482 $7,229,702 
Balance at March 31, 2024:
Goodwill$6,517,220 $858,977 $7,376,197 
Accumulated impairment charges— (146,495)(146,495)
$6,517,220 $712,482 $7,229,702