GOODWILL AND OTHER INTANGIBLE ASSETS

9 Months Ended

Sep. 30, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

GOODWILL AND OTHER INTANGIBLE ASSETS

GOODWILL AND OTHER INTANGIBLE ASSETS

Changes in the carrying amount of goodwill consists of the following activity for the three and nine months ended September 30, 2022 (in thousands):

Balance at December 31, 2021	$	1,477,564
Purchase accounting adjustments	936
Balance at March 31, 2022	1,478,500
Acquisitions	33,746
Balance at June 30, 2022	$	1,512,246
Acquisitions	$	20,797
Balance at September 30, 2022	$	1,533,043

There were no changes in the carrying amount of goodwill for the three or nine months ended September 30, 2021.

The carrying amount and accumulated amortization of intangible assets consist of the following as of September 30, 2022 and December 31, 2021 (in thousands):

	September 30, 2022		December 31, 2021
Gross intangible assets:
Referral sources	$	509,646	$	482,200
Trademarks/names	38,508		47,718
Other amortizable intangible assets	912		1,037
Total gross intangible assets	549,066		530,955
Accumulated amortization:
Referral sources	(160,159)		(137,613)
Trademarks/names	(16,254)		(26,936)
Other amortizable intangible assets	(100)		(386)
Total accumulated amortization	(176,513)		(164,935)
Total intangible assets, net	$	372,553	$	366,020

Amortization expense for intangible assets was $8.4 million and $24.6 million for the three and nine months ended September 30, 2022, respectively. Amortization expense for intangible assets was $7.9 million and $25.5 million for the three and nine months ended September 30, 2021, respectively.