17. Acquisitions

During the first three 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		-		28		28
Balance at March 31, 2019	$	333,331	$	177,267	$	510,598