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GOODWILL AND OTHER INTANGIBLE ASSETS
6 Months Ended
Jun. 30, 2022
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 and six months June 30, 2022 (in thousands):
Balance at December 31, 2021$1,477,564 
Purchase accounting adjustments936 
Balance at March 31, 20221,478,500 
Acquisitions33,746 
Balance at June 30, 2022$1,512,246 
There were no changes in the carrying amount of goodwill for the three or six months ended June 30, 2021.
The carrying amount and accumulated amortization of intangible assets consists of the following as of June 30, 2022 and December 31, 2021 (in thousands):
June 30, 2022December 31, 2021
Gross intangible assets:
Referral sources$504,812 $482,200 
Trademarks/names38,172 47,718 
Other amortizable intangible assets634 1,037 
Total gross intangible assets543,618 530,955 
Accumulated amortization:
Referral sources(152,444)(137,613)
Trademarks/names(15,611)(26,936)
Other amortizable intangible assets(34)(386)
Total accumulated amortization(168,089)(164,935)
Total intangible assets, net$375,529 $366,020 
Amortization expense for intangible assets was $8.7 million and $16.2 million for the three and six months ended June 30, 2022, respectively. Amortization expense for intangible assets was $9.0 million and $17.6 million for the three and six months ended June 30, 2021, respectively.