Goodwill (Tables)

12 Months Ended

Dec. 31, 2021

Goodwill and Intangible Assets Disclosure [Abstract]

Changes in Carrying Value of Goodwill by Reportable Segments

Changes in the carrying value of goodwill by reportable segment were as follows:

	U.S. dialysis		Other - Ancillary services		Consolidated
Balance at December 31, 2019	$	6,287,100	$	500,535	$	6,787,635
Acquisitions	24,377		105,680		130,057
Divestitures	(1,549)		(6,744)		(8,293)
Foreign currency and other adjustments	—		9,710		9,710
Balance at December 31, 2020	$	6,309,928	$	609,181	$	6,919,109
Acquisitions	91,979		81,265		173,244
Divestitures	(1,745)		—		(1,745)
Foreign currency and other adjustments	—		(44,367)		(44,367)
Balance at December 31, 2021	$	6,400,162	$	646,079	$	7,046,241
Balance at December 31, 2021:
Goodwill	$	6,400,162	$	772,286	$	7,172,448
Accumulated impairment charges	—		(126,207)		(126,207)
	$	6,400,162	$	646,079	$	7,046,241

Schedule of Reporting Units Goodwill Balances

Reporting unit	Goodwill balance		Carrying amount coverage(1)		Sensitivities
					Operating income(2)		Discount rate(3)
Germany kidney care	$	298,499	6.6	%	(1.7)	%	(9.4)	%

(1)Excess of estimated fair value of the reporting unit over its carrying amount as of the latest assessment date.

(2)Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date.

(3)Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date.