Goodwill

3 Months Ended

Mar. 31, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill

Goodwill

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

	U.S. dialysis		Other — Ancillary services		Consolidated
Balance at December 31, 2023	$	6,416,825	$	695,735	$	7,112,560
Acquisitions	102,082		246,987		349,069
Divestitures	(1,687)		(1,506)		(3,193)
Foreign currency and other adjustments	—		(83,220)		(83,220)
Balance at December 31, 2024	6,517,220		857,996		7,375,216
Acquisitions	5,236		(4,838)		398
Foreign currency and other adjustments	—		39,946		39,946
Balance at March 31, 2025	$	6,522,456	$	893,104	$	7,415,560
Balance at March 31, 2025:
Goodwill	$	6,522,456	$	1,039,716	$	7,562,172
Accumulated impairment charges	—		(146,612)		(146,612)
	$	6,522,456	$	893,104	$	7,415,560

The Company did not recognize any goodwill impairment charges during the three months ended March 31, 2025 and 2024.

None of the Company's various reporting units were considered at risk of significant goodwill impairment as of March 31, 2025.