v2.4.1.9

Consolidating Statements of Cash Flows (Detail) (USD $) In Thousands, unless otherwise specified | 12 Months Ended
--- | ---
Dec. 31, 2014 | Dec. 31, 2013 | Dec. 31, 2012
Cash flows from operating activities: |  |  |
Net income | $ 863,330us-gaap_ProfitLoss | $ 757,201us-gaap_ProfitLoss | $ 641,237us-gaap_ProfitLoss
Changes in operating assets and liabilities and non cash items included in net income | 596,077us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities | 1,016,140us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities | 459,611us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities
Net cash provided by operating activities | 1,459,407us-gaap_NetCashProvidedByUsedInOperatingActivities | 1,773,341us-gaap_NetCashProvidedByUsedInOperatingActivities | 1,100,848us-gaap_NetCashProvidedByUsedInOperatingActivities
Cash flows from investing activities: |  |  |
Additions of property and equipment, net | (641,330)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment | (617,597)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment | (550,146)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment
Acquisitions | (272,094)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates | (310,394)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates | (4,294,077)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates
Proceeds from asset sales | 8,791us-gaap_ProceedsFromSaleOfProductiveAssets | 62,258us-gaap_ProceedsFromSaleOfProductiveAssets | 3,559us-gaap_ProceedsFromSaleOfProductiveAssets
Purchase of investments and other items | (373,096)dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther | (11,149)dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther | 8,214dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther
Net cash used in investing activities | (1,277,729)us-gaap_NetCashProvidedByUsedInInvestingActivities | (876,882)us-gaap_NetCashProvidedByUsedInInvestingActivities | (4,832,450)us-gaap_NetCashProvidedByUsedInInvestingActivities
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | (7,989)dva_ProceedsFromRepaymentsOfLongTermDebt | (438,007)dva_ProceedsFromRepaymentsOfLongTermDebt | 3,904,893dva_ProceedsFromRepaymentsOfLongTermDebt
Other items | (156,990)us-gaap_ProceedsFromPaymentsForOtherFinancingActivities | (44,984)us-gaap_ProceedsFromPaymentsForOtherFinancingActivities | (32,509)us-gaap_ProceedsFromPaymentsForOtherFinancingActivities
Net cash (used in) provided by financing activities | (164,979)us-gaap_NetCashProvidedByUsedInFinancingActivities | (482,991)us-gaap_NetCashProvidedByUsedInFinancingActivities | 3,872,384us-gaap_NetCashProvidedByUsedInFinancingActivities
Effect of exchange rate changes on cash | 2,293us-gaap_EffectOfExchangeRateOnCashAndCashEquivalents | (967)us-gaap_EffectOfExchangeRateOnCashAndCashEquivalents | (786)us-gaap_EffectOfExchangeRateOnCashAndCashEquivalents
Net increase (decrease) in cash and cash equivalents | 18,992us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease | 412,501us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease | 139,996us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease
Cash and cash equivalents at beginning of the year | 946,249us-gaap_CashAndCashEquivalentsAtCarryingValue | 533,748us-gaap_CashAndCashEquivalentsAtCarryingValue | 393,752us-gaap_CashAndCashEquivalentsAtCarryingValue
Cash and cash equivalents at end of the year | 965,241us-gaap_CashAndCashEquivalentsAtCarryingValue | 946,249us-gaap_CashAndCashEquivalentsAtCarryingValue | 533,748us-gaap_CashAndCashEquivalentsAtCarryingValue
DaVita HealthCare Partners Inc. |  |  |
Cash flows from operating activities: |  |  |
Net income | 723,114us-gaap_ProfitLoss / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 633,446us-gaap_ProfitLoss / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 536,017us-gaap_ProfitLoss / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Changes in operating assets and liabilities and non cash items included in net income | (597,992)us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | (443,071)us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | (383,619)us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Net cash provided by operating activities | 125,122us-gaap_NetCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 190,375us-gaap_NetCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 152,398us-gaap_NetCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Cash flows from investing activities: |  |  |
Additions of property and equipment, net | (51,374)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | (55,252)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | (72,125)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Acquisitions |  |  | (3,645,760)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Proceeds from asset sales |  | 60,650us-gaap_ProceedsFromSaleOfProductiveAssets / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember |
Purchase of investments and other items | (333,803)dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | (4,944)dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 2,841dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Net cash used in investing activities | (385,177)us-gaap_NetCashProvidedByUsedInInvestingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 454us-gaap_NetCashProvidedByUsedInInvestingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | (3,715,044)us-gaap_NetCashProvidedByUsedInInvestingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | 4,513dva_ProceedsFromRepaymentsOfLongTermDebt / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | (421,739)dva_ProceedsFromRepaymentsOfLongTermDebt / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 3,909,760dva_ProceedsFromRepaymentsOfLongTermDebt / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Intercompany borrowing | 410,437us-gaap_ProceedsFromRepaymentsOfRelatedPartyDebt / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 585,441us-gaap_ProceedsFromRepaymentsOfRelatedPartyDebt / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | (586,050)us-gaap_ProceedsFromRepaymentsOfRelatedPartyDebt / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Other items | (58,207)us-gaap_ProceedsFromPaymentsForOtherFinancingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 52,620us-gaap_ProceedsFromPaymentsForOtherFinancingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 68,697us-gaap_ProceedsFromPaymentsForOtherFinancingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Net cash (used in) provided by financing activities | 356,743us-gaap_NetCashProvidedByUsedInFinancingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 216,322us-gaap_NetCashProvidedByUsedInFinancingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 3,392,407us-gaap_NetCashProvidedByUsedInFinancingActivities / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Net increase (decrease) in cash and cash equivalents | 96,688us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 407,151us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | (170,239)us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Cash and cash equivalents at beginning of the year | 602,188us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 195,037us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 365,276us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Cash and cash equivalents at end of the year | 698,876us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 602,188us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember | 195,037us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = dva_DavitaHealthCarePartnersIncMember
Guarantor Subsidiaries |  |  |
Cash flows from operating activities: |  |  |
Net income | 647,085us-gaap_ProfitLoss / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 522,778us-gaap_ProfitLoss / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 487,077us-gaap_ProfitLoss / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Changes in operating assets and liabilities and non cash items included in net income | 120,772us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 652,374us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 15,693us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Net cash provided by operating activities | 767,857us-gaap_NetCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 1,175,152us-gaap_NetCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 502,770us-gaap_NetCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Cash flows from investing activities: |  |  |
Additions of property and equipment, net | (312,191)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (337,042)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (305,885)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Acquisitions | (228,569)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (156,830)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (564,499)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Proceeds from asset sales | 8,791us-gaap_ProceedsFromSaleOfProductiveAssets / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 1,608us-gaap_ProceedsFromSaleOfProductiveAssets / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 3,559us-gaap_ProceedsFromSaleOfProductiveAssets / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Purchase of investments and other items | (316)dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (3,502)dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (1,761)dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Net cash used in investing activities | (532,285)us-gaap_NetCashProvidedByUsedInInvestingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (495,766)us-gaap_NetCashProvidedByUsedInInvestingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (868,586)us-gaap_NetCashProvidedByUsedInInvestingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | (12,545)dva_ProceedsFromRepaymentsOfLongTermDebt / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (11,061)dva_ProceedsFromRepaymentsOfLongTermDebt / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (23,805)dva_ProceedsFromRepaymentsOfLongTermDebt / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Intercompany borrowing | (306,011)us-gaap_ProceedsFromRepaymentsOfRelatedPartyDebt / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (664,154)us-gaap_ProceedsFromRepaymentsOfRelatedPartyDebt / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 580,825us-gaap_ProceedsFromRepaymentsOfRelatedPartyDebt / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Other items | (14,099)us-gaap_ProceedsFromPaymentsForOtherFinancingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 4,726us-gaap_ProceedsFromPaymentsForOtherFinancingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (25,097)us-gaap_ProceedsFromPaymentsForOtherFinancingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Net cash (used in) provided by financing activities | (332,655)us-gaap_NetCashProvidedByUsedInFinancingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | (670,489)us-gaap_NetCashProvidedByUsedInFinancingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 531,923us-gaap_NetCashProvidedByUsedInFinancingActivities / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Net increase (decrease) in cash and cash equivalents | (97,083)us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 8,897us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 166,107us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Cash and cash equivalents at beginning of the year | 175,004us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 166,107us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember |
Cash and cash equivalents at end of the year | 77,921us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 175,004us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember | 166,107us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_GuarantorSubsidiariesMember
Non-Guarantor Subsidiaries |  |  |
Cash flows from operating activities: |  |  |
Net income | 475,907us-gaap_ProfitLoss / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 397,259us-gaap_ProfitLoss / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 323,195us-gaap_ProfitLoss / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Changes in operating assets and liabilities and non cash items included in net income | 90,521us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 10,555us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 122,485us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Net cash provided by operating activities | 566,428us-gaap_NetCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 407,814us-gaap_NetCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 445,680us-gaap_NetCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Cash flows from investing activities: |  |  |
Additions of property and equipment, net | (277,765)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (225,303)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (172,136)us-gaap_PaymentsToAcquirePropertyPlantAndEquipment / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Acquisitions | (43,525)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (153,564)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (83,818)us-gaap_PaymentsToAcquireBusinessesAndInterestInAffiliates / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Purchase of investments and other items | (38,977)dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (2,703)dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 7,134dva_PaymentsForProceedsFromSaleOfInvestmentsInSecuritiesAndOther / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Net cash used in investing activities | (360,267)us-gaap_NetCashProvidedByUsedInInvestingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (381,570)us-gaap_NetCashProvidedByUsedInInvestingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (248,820)us-gaap_NetCashProvidedByUsedInInvestingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | 43dva_ProceedsFromRepaymentsOfLongTermDebt / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (5,207)dva_ProceedsFromRepaymentsOfLongTermDebt / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 18,938dva_ProceedsFromRepaymentsOfLongTermDebt / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Intercompany borrowing | (104,426)us-gaap_ProceedsFromRepaymentsOfRelatedPartyDebt / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 78,713us-gaap_ProceedsFromRepaymentsOfRelatedPartyDebt / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 5,225us-gaap_ProceedsFromRepaymentsOfRelatedPartyDebt / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Other items | (84,684)us-gaap_ProceedsFromPaymentsForOtherFinancingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (102,330)us-gaap_ProceedsFromPaymentsForOtherFinancingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (76,109)us-gaap_ProceedsFromPaymentsForOtherFinancingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Net cash (used in) provided by financing activities | (189,067)us-gaap_NetCashProvidedByUsedInFinancingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (28,824)us-gaap_NetCashProvidedByUsedInFinancingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (51,946)us-gaap_NetCashProvidedByUsedInFinancingActivities / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Effect of exchange rate changes on cash | 2,293us-gaap_EffectOfExchangeRateOnCashAndCashEquivalents / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (967)us-gaap_EffectOfExchangeRateOnCashAndCashEquivalents / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (786)us-gaap_EffectOfExchangeRateOnCashAndCashEquivalents / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Net increase (decrease) in cash and cash equivalents | 19,387us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | (3,547)us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 144,128us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Cash and cash equivalents at beginning of the year | 169,057us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 172,604us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 28,476us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Cash and cash equivalents at end of the year | 188,444us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 169,057us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember | 172,604us-gaap_CashAndCashEquivalentsAtCarryingValue / dei_LegalEntityAxis = us-gaap_NonGuarantorSubsidiariesMember
Consolidating Adjustments |  |  |
Cash flows from operating activities: |  |  |
Net income | (982,776)us-gaap_ProfitLoss / dei_LegalEntityAxis = dva_ConsolidatingAdjustmentsMember | (796,282)us-gaap_ProfitLoss / dei_LegalEntityAxis = dva_ConsolidatingAdjustmentsMember | (705,052)us-gaap_ProfitLoss / dei_LegalEntityAxis = dva_ConsolidatingAdjustmentsMember
Changes in operating assets and liabilities and non cash items included in net income | $ 982,776us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = dva_ConsolidatingAdjustmentsMember | $ 796,282us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = dva_ConsolidatingAdjustmentsMember | $ 705,052us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivities / dei_LegalEntityAxis = dva_ConsolidatingAdjustmentsMember

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- Definition The sum of adjustments which are added to or deducted from net income or loss, including the portion attributable to noncontrolling interest, to reflect cash provided by or used in operating activities, in accordance with the indirect cash flow method. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -URI http://asc.fasb.org/extlink&oid=31042434&loc=d3e3602-108585 + Details
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- Definition Amount of currency on hand as well as demand deposits with banks or financial institutions. Includes other kinds of accounts that have the general characteristics of demand deposits. Also includes short-term, highly liquid investments that are both readily convertible to known amounts of cash and so near their maturity that they present insignificant risk of changes in value because of changes in interest rates. Excludes cash and cash equivalents within disposal group and discontinued operation. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Cash -URI http://asc.fasb.org/extlink&oid=6506951 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Cash Equivalents -URI http://asc.fasb.org/extlink&oid=6507016 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 02 -Paragraph 1 -Article 5 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02.1) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 Reference 5: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section 45 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=28358313&loc=d3e6676-107765 Reference 6: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=31042434&loc=d3e3044-108585 + Details
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