Goodwill and Intangible Assets
 12 Months Ended
Dec. 31, 2016
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Intangible Assets
Goodwill and Intangible Assets
A summary of activity related to goodwill for the year ended December 31, 2016 follows (in thousands):
Balance at December 31, 2014
 
$
1,298,753

Acquisitions
 
113,812

Divestitures
 
(8,399
)
Purchase price adjustments
 
3,761

Balance at December 31, 2015
 
$
1,407,927

Acquisitions
 
147,895

Divestitures
 
(552
)
Purchase price adjustments
 
(66
)
Balance at December 31, 2016
 
$
1,555,204


Additions to goodwill include new acquisitions and incremental ownership acquired in the Company's subsidiaries. A summary of the Company's acquisitions for the years ended December 31, 2016 and 2015 is included in Note 3, Acquisitions and Developments.
The Company tests its goodwill and indefinite-lived intangible assets for impairment annually, as of October 1, or more frequently if certain indicators arise.  The Company reviews goodwill at the reporting unit level, which is defined as one level below an operating segment. The Company has determined that it has five reporting units, which include the following: 1) Surgical Facilities 2) Ancillary Services, 3) Midwest Labs, 4) The Alliance, including Optical Synergies and 5) Family Vision Care.  When reviewing goodwill, the Company compares the carrying value of the net assets of the reporting unit to the estimated fair value of the reporting unit. If the carrying value exceeds the net present value of the estimated discounted future cash flows, an impairment indicator exists and an estimate of the possible impairment loss is calculated. The fair value calculation includes multiple assumptions and estimates, including the projected cash flows and discount rates applied.
The Company performed its annual goodwill impairment assessment by developing a fair value estimate of the business enterprise as of October 1, 2016 using a discounted cash flows approach.  The results of the Company's fair value estimate were corroborated using a market-based approach.  The result of the Company's annual goodwill impairment test at October 1, 2016 indicated no impairment. There were also no impairment charges recorded during the years ended December 31, 2015 and 2014.
A summary of the activity related to intangible assets as of December 31, 2016 follows (in thousands):
 
 
Physician Income Guarantees
 
Management Rights
 
Non-Compete Agreements
 
Certificates of Need
 
Customer Relationships
 
Other
 
Total Intangible Assets
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Balance at December 31, 2014
 
$
973

 
$
24,757

 
$
16,590

 
$
3,711

 
$
6,274

 
$
2,583

 
$
54,888

Additions
 
1,052

 
—

 
7,532

 
—

 
—

 
—

 
8,584

Recruitment expense
 
(813
)
 
—

 
—

 
—

 
—

 
—

 
(813
)
Amortization
 
—

 
(1,731
)
 
(5,551
)
 
—

 
(1,338
)
 
(471
)
 
(9,091
)
Balance at December 31, 2015
 
$
1,212

 
$
23,026

 
$
18,571

 
$
3,711

 
$
4,936

 
$
2,112

 
$
53,568

Additions
 
210

 
—

 
4,025

 
69

 
—

 
450

 
4,754

Disposals
 
—

 
—

 
—

 
—

 
(22
)
 
(113
)
 
(135
)
Recruitment expense
 
(609
)
 
—

 
—

 
—

 
—

 
—

 
(609
)
Amortization
 
—

 
(1,736
)
 
(6,139
)
 
—

 
(1,210
)
 
(470
)
 
(9,555
)
Balance at December 31, 2016
 
$
813

 
$
21,290

 
$
16,457

 
$
3,780

 
$
3,704

 
$
1,979

 
$
48,023

During the years ended December 31, 2016, 2015 and 2014, the Company had amortization expense of $9.6 million, $9.1 million and $5.2 million, respectively.
A summary of the scheduled amortization related to the Company's finite-lived intangible assets as of December 31, 2016 follows (in thousands):
    
 
 
Amortization of Finite-Lived Intangible Assets
 
 
 
2016
 
$
9,042

2017
 
6,923

2018
 
6,393

2019
 
4,023

2020
 
2,960

Thereafter
 
14,660

Total
 
$
44,001