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Goodwill | 12 Months Ended
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Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract] |
Goodwill | (9) Goodwill The following table reflects the changes in the carrying amount of goodwill by reporting unit for the year ended December 31, 2023:
| Year Ended December 31, 2023
| Healthcare |  | Industrial |  | Consolidated
(in thousands) | Gross Goodwill |  | Impairments |  | Net Goodwill |  | Gross Goodwill |  | Impairments |  | Net Goodwill |  | Gross Goodwill |  | Impairments |  | Net Goodwill
Balance at beginning of year | $ | 143,431 |  |  | $ | (32,055) |  |  | $ | 111,376 |  |  | $ | 316,265 |  |  | $ | (42,329) |  |  | $ | 273,936 |  |  | $ | 459,696 |  |  | $ | (74,384) |  |  | $ | 385,312 |
Acquisitions | 1,005 |  |  | — |  |  | 1,005 |  |  | 7,386 |  |  | — |  |  | 7,386 |  |  | 8,391 |  |  | — |  |  | 8,391 |
Impairments | — |  |  | — |  |  | — |  |  | — |  |  | (279,808) |  |  | (279,808) |  |  | — |  |  | (279,808) |  |  | (279,808) |
Foreign currency translation adjustments | 3,701 |  |  | — |  |  | 3,701 |  |  | (1,514) |  |  | — |  |  | (1,514) |  |  | 2,187 |  |  | — |  |  | 2,187 |
Balance at end of year | $ | 148,137 |  |  | $ | (32,055) |  |  | $ | 116,082 |  |  | $ | 322,137 |  |  | $ | (322,137) |  |  | $ | — |  |  | $ | 470,274 |  |  | $ | (354,192) |  |  | $ | 116,082 |
The effect of foreign currency exchange in the table above reflects the impact on goodwill of amounts recorded in currencies other than the U.S. dollar on the financial statements of foreign subsidiaries and the resulting effect of foreign currency translation between the applicable functional currency and the U.S. dollar. Goodwill Impairment For purposes of our annual goodwill impairment test, our reporting units are Healthcare Solutions and Industrial Solutions. For the years ended December 31, 2023 and December 31, 2022, we completed the required annual goodwill impairment tests for each of our reporting units as of November 1, 2023 and November 30, 2022, respectively, as further discussed in Note 2. The goodwill impairment tests performed as of each testing date compared the fair value of each of our reporting units to its carrying value. We estimated the fair value of each reporting unit based upon projections of future revenues, expenses, and cash flows discounted to their present value. The use of forecasted cash flows for purposes of the annual goodwill impairment test represents the application of Level 3 fair value measurement inputs, as defined in Note 24. As a result of our goodwill impairment test performed as of November 1, 2023, we determined that the carrying value of our Industrial Solutions reporting unit exceeded its fair value by an amount that was in excess of the goodwill assigned to the Industrial Solutions reporting unit. This result of our impairment test is primarily attributable to (1) the significant and sustained decline in the trading price of our common stock and our market capitalization leading up to and as of November 1, 2023 and (2) the significantly higher carrying value (including the goodwill balance) of the Industrial Solutions reporting unit, as compared to the Healthcare Solutions reporting unit. Consistent with the result of our annual goodwill impairment test, we recognized a goodwill impairment charge of $279,808 to write off the entire goodwill balance assigned to the Industrial Solutions reporting unit. This goodwill charge is reported within impairments of goodwill and intangible assets on our consolidated statement of operations for the year ended December 31, 2023. The estimated fair value of our Healthcare Solutions reporting unit was in excess of its carrying value as of November 1, 2023 and November 30, 2022, and the estimated fair value of our Industrial Solutions reporting unit was in excess of its carrying value as of November 30, 2022.

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