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Acquisitions
6 Months Ended
Jun. 30, 2019
Acquisitions [Abstract]  
Acquisitions 17.    Acquisitions

During the first six months of 2019, we did not complete any business combinations within our Roto-Rooter or VITAS segment.

During 2018, we completed four business combinations of former franchisees within the Roto-Rooter segment for $42.2 million in cash to increase our market penetration. The VITAS segment completed one business combination in Florida for $11.0 million to increase our market penetration.

Shown below is movement in Goodwill (in thousands):

VITAS

Roto-Rooter

Total

Balance at December 31, 2018

$

333,331 

$

177,239 

$

510,570 

Foreign currency adjustments

-

57 

57 

Balance at June 30, 2019

$

333,331 

$

177,296 

$

510,627