10.

Goodwill

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


	Year ended December 31, 2013
	U.S. dialysis and related lab services			HCP			Other ancillary services and strategic initiatives			Consolidated total
Balance at January 1, 2013	$	5,309,152		$	3,506,571		$	137,027		$	8,952,750
Acquisitions		163,037			17,833			90,397			271,267
Divestitures		(2,728	)		—			—			(2,728	)
Other adjustments		12			(8,242	)		(85	)		(8,315	)

Balance at December 31, 2013	$	5,469,473		$	3,516,162		$	227,339		$	9,212,974


	Year ended December 31, 2012
	U.S. dialysis and related lab services			HCP			Other ancillary services and strategic initiatives			Consolidated total
Balance at January 1, 2012	$	4,865,864		$	—		$	81,112		$	4,946,976
Acquisitions		443,997			3,518,790			88,611			4,051,398
Divestitures		(709	)		—			—			(709	)
Held for sale		—			—			(31,853	)		(31,853	)
Other adjustments		—			—			(843	)		(843	)

Balance at December 31, 2012 as previously reported	$	5,309,152		$	3,518,790		$	137,027		$	8,964,969
HCP purchase accounting adjustments		—			(12,219	)		—			(12,219	)

Balance at December 31, 2012 as adjusted	$	5,309,152		$	3,506,571		$	137,027		$	8,952,750

Each of the Company’s operating segments described in Note 25 to these consolidated financial statements represents an individual reporting unit for goodwill impairment testing purposes, except that each sovereign jurisdiction within our international operating segments is considered a separate reporting unit.

Within the U.S. dialysis and related lab services operating segment, the Company considers each of its dialysis centers to constitute an individual business for which discrete financial information is available. However, since these dialysis centers have similar operating and economic characteristics, and the allocation of resources and significant investment decisions concerning these businesses are highly centralized and the benefits broadly distributed, the Company has aggregated these centers and deemed them to constitute a single reporting unit.

The Company has applied a similar aggregation to the HCP operations in each region, to the vascular access service centers in its vascular access services reporting unit, to the physician practices in its physician services reporting unit, and to the dialysis centers in each sovereign international jurisdiction. For the Company’s additional operating segments, no component below the operating segment level is considered a discrete business and therefore these operating segments directly constitute individual reporting units.

During 2013 and 2012, the Company did not record any goodwill impairment charges. As of December 31, 2013, none of the goodwill associated with the Company’s various reporting units was considered at risk of impairment. Since the dates of the Company’s last annual goodwill impairment tests, there have been certain developments, events, changes in operating performance and other changes in circumstances that have affected the Company’s businesses, however these did not cause management to believe it is more likely than not that the fair value of any of its reporting units would be less than its carrying amount.

In 2011, the Company estimated that the carrying amount of goodwill related to HomeChoice exceeded its implied fair value by $24,000, resulting in a pre-tax goodwill impairment charge of that amount. This amount is included as a component of losses from operations of discontinued operations as a result of the divestiture of HomeChoice on February 1, 2013. See Note 21 to the consolidated financial statements for further details.