| Changes in Goodwill by Reportable Segments [Text Block] |
Changes in the carrying value of goodwill by reportable segment were as follows: | | | | | | | | | | | | | | | | | | | U.S. dialysis | | Other — Ancillary services | | Consolidated | | Balance at December 31, 2024 | $ | 6,517,220 | | | $ | 857,996 | | | $ | 7,375,216 | | | Acquisitions | 10,396 | | | 61,288 | | | 71,684 | | | | | | | | | | | | | | | Foreign currency and other adjustments | — | | | 98,195 | | | 98,195 | | | Balance at December 31, 2025 | 6,527,616 | | | 1,017,479 | | | 7,545,095 | | | Acquisitions | 25,903 | | | 24,106 | | | 50,009 | | | | | | | | | Impairment charges | — | | | (57,104) | | | (57,104) | | | Foreign currency and other adjustments | — | | | 10,042 | | | 10,042 | | | Balance at September 30, 2026 | $ | 6,553,519 | | | $ | 994,523 | | | $ | 7,548,042 | | | | | | | | | Balance at September 30, 2026: | | | | | | | Goodwill | $ | 6,553,519 | | | $ | 1,204,478 | | | $ | 7,757,997 | | | Accumulated impairment charges | — | | | (209,955) | | | (209,955) | | | $ | 6,553,519 | | | $ | 994,523 | | | $ | 7,548,042 | |
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