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Goodwill (Tables) | 6 Months Ended
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Jun. 30, 2025
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. 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 |

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