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Goodwill
 12 Months Ended
Dec. 31, 2015
Goodwill [Abstract]  
Goodwill

7. Goodwill

The changes in the carrying amount of goodwill as of December 31, 2015 and 2014 consisted of the following (in thousands):

Year Ended
December 31, 2015
Year Ended
December 31, 2014
Beginning balance
$
147,914
 
$
143,955
 
Goodwill acquired during the year
 
23,428
 
 
12,974
 
Goodwill allocated to specific assets for businesses acquired in 2013
 
—
 
 
(9,760
)
Goodwill adjustments for purchase price allocation of businesses acquired
 
385
 
 
880
 
Goodwill written-off - closed clinics
 
(180
)
 
(135
)
Ending balance
$
171,547
 
$
147,914