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Goodwill (Tables)
 6 Months Ended
Jun. 30, 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, 20236,416,825 695,735 7,112,560 
Acquisitions102,082 35,735 137,817 
Divestitures(1,687)— (1,687)
Foreign currency and other adjustments— (47,291)(47,291)
Balance at June 30, 2024$6,517,220 $684,179 $7,201,399 
Balance at June 30, 2024:
Goodwill$6,517,220 $829,684 $7,346,904 
Accumulated impairment charges— (145,505)(145,505)
$6,517,220 $684,179 $7,201,399