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Goodwill | 6 Months Ended
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Jun. 30, 2025
Goodwill and Intangible Assets Disclosure [Abstract] |
Goodwill | Goodwill Changes in the carrying value of goodwill by reportable segment were as follows:
| U.S. dialysis |  | Other — Ancillary services |  | Consolidated
Balance at December 31, 2023 | $ | 6,416,825 |  |  | $ | 695,735 |  |  | $ | 7,112,560 |
Acquisitions | 102,082 |  |  | 246,987 |  |  | 349,069 |
Divestitures | (1,687) |  |  | (1,506) |  |  | (3,193) |
Foreign currency and other adjustments | — |  |  | (83,220) |  |  | (83,220) |
Balance at December 31, 2024 | 6,517,220 |  |  | 857,996 |  |  | 7,375,216 |
Acquisitions | 5,384 |  |  | (4,715) |  |  | 669 |
Foreign currency and other adjustments | — |  |  | 89,884 |  |  | 89,884 |
Balance at June 30, 2025 | $ | 6,522,604 |  |  | $ | 943,165 |  |  | $ | 7,465,769 |
Balance at June 30, 2025: |  |  |  |  |
Goodwill | $ | 6,522,604 |  |  | $ | 1,099,747 |  |  | $ | 7,622,351 |
Accumulated impairment charges | — |  |  | (156,582) |  |  | (156,582) |
| $ | 6,522,604 |  |  | $ | 943,165 |  |  | $ | 7,465,769 |
The Company did not recognize any goodwill impairment charges during the six months ended June 30, 2025 and 2024. The Company performed various annual impairment assessments during the six months ended June 30, 2025, with no impairment indicated. None of the Company's various reporting units were considered at risk of significant goodwill impairment as of June 30, 2025.

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