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GOODWILL AND OTHER INTANGIBLE ASSETS
3 Months Ended
Mar. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Other Intangible Assets GOODWILL AND OTHER INTANGIBLE ASSETS
There was no change in the carrying amount of goodwill for the three months ended March 31, 2021.
Changes in the carrying amount of goodwill consists of the following activity for the three months March 31, 2020 (in thousands):
Balance at December 31, 20191,425,542 
Merger purchase accounting adjustments2,341 
Balance at March 31, 20201,427,883 
The carrying amount and accumulated amortization of intangible assets consists of the following as of March 31, 2021 and December 31, 2020 (in thousands):
March 31, 2021December 31, 2020
Gross intangible assets:
Referral sources$438,121 $438,121 
Trademarks/names44,536 44,536 
Other amortizable intangible assets402 402 
Total gross intangible assets483,059 483,059 
Accumulated amortization:
Referral sources(117,048)(110,498)
Trademarks/names(23,247)(21,146)
Other amortizable intangible assets(385)(363)
Total accumulated amortization(140,680)(132,007)
Total intangible assets, net$342,379 $351,052 
Amortization expense for intangible assets was $8.7 million and $8.8 million for the three months ended March 31, 2021 and 2020, respectively.