GOODWILL AND OTHER INTANGIBLE ASSETS

3 Months Ended

Mar. 31, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Other Intangible Assets

GOODWILL AND OTHER INTANGIBLE ASSETS

Changes in the carrying amount of goodwill consists of the following activity for the three months ended March 31, 2020 (in thousands):

Balance at December 31, 2019	$	1,425,542
Purchase accounting adjustments	2,341
Balance at March 31, 2020	$	1,427,883

There was no change in the carrying amount of goodwill for the three months ended March 31, 2019.

The carrying amount and accumulated amortization of intangible assets consists of the following as of March 31, 2020 and December 31, 2019 (in thousands):

	March 31, 2020			December 31, 2019
Gross intangible assets:
Referral sources	$	438,121		$	438,121
Trademarks/names	44,536			44,536
Other amortizable intangible assets	402			402
Total gross intangible assets	483,059			483,059
Accumulated amortization:
Referral sources	(90,846		)	(84,295		)
Trademarks/names	(14,845		)	(12,748		)
Other amortizable intangible assets	(172		)	(106		)
Total accumulated amortization	(105,863		)	(97,149		)
Total intangible assets, net	$	377,196		$	385,910

Amortization expense for intangible assets was $8.8 million and $4.9 million for the three months ended March 31, 2020 and 2019, respectively.