v2.4.1.9
Summary of Segment Net Revenues, Segment Operating Income Loss and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes (Detail) (USD $)
In Thousands, unless otherwise specified
3 Months Ended 12 Months Ended
Dec. 31, 2014
Sep. 30, 2014
Jun. 30, 2014
Mar. 31, 2014
Dec. 31, 2013
Sep. 30, 2013
Jun. 30, 2013
Mar. 31, 2013
Dec. 31, 2014
Dec. 31, 2013
Dec. 31, 2012
Segment Reporting Information [Line Items]                      
Patient service revenues $ 3,328,017us-gaap_HealthCareOrganizationPatientServiceRevenue $ 3,251,824us-gaap_HealthCareOrganizationPatientServiceRevenue $ 3,172,489us-gaap_HealthCareOrganizationPatientServiceRevenue $ 3,042,776us-gaap_HealthCareOrganizationPatientServiceRevenue $ 3,063,209us-gaap_HealthCareOrganizationPatientServiceRevenue $ 2,999,586us-gaap_HealthCareOrganizationPatientServiceRevenue $ 2,871,673us-gaap_HealthCareOrganizationPatientServiceRevenue $ 2,829,582us-gaap_HealthCareOrganizationPatientServiceRevenue $ 8,868,338us-gaap_HealthCareOrganizationPatientServiceRevenue $ 8,307,195us-gaap_HealthCareOrganizationPatientServiceRevenue $ 7,351,902us-gaap_HealthCareOrganizationPatientServiceRevenue
Net patient service revenues                 8,501,454us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts 8,013,649us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts 7,116,684us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
Other revenues                 1,032,364us-gaap_HealthCareOrganizationOtherRevenue 763,086us-gaap_HealthCareOrganizationOtherRevenue 588,260us-gaap_HealthCareOrganizationOtherRevenue
Total net operating revenues                 12,795,106us-gaap_HealthCareOrganizationRevenue 11,764,050us-gaap_HealthCareOrganizationRevenue 8,186,280us-gaap_HealthCareOrganizationRevenue
Capitated revenues                 3,261,288us-gaap_HealthCareOrganizationCapitationRevenue 2,987,315us-gaap_HealthCareOrganizationCapitationRevenue 481,336us-gaap_HealthCareOrganizationCapitationRevenue
Operating income 452,085us-gaap_OperatingIncomeLoss 437,536us-gaap_OperatingIncomeLoss 484,295us-gaap_OperatingIncomeLoss 441,225us-gaap_OperatingIncomeLoss 484,179us-gaap_OperatingIncomeLoss 377,074us-gaap_OperatingIncomeLoss 522,020us-gaap_OperatingIncomeLoss 166,861us-gaap_OperatingIncomeLoss 1,815,141us-gaap_OperatingIncomeLoss 1,550,134us-gaap_OperatingIncomeLoss 1,297,084us-gaap_OperatingIncomeLoss
Contingent earn-out obligation adjustment                   56,977us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1  
Corporate support costs                 (13,012)dva_SegmentReportingInformationCorporateExpenses [1] (53,699)dva_SegmentReportingInformationCorporateExpenses [1] (46,481)dva_SegmentReportingInformationCorporateExpenses [1]
Transaction expenses                     (30,753)dva_SegmentReportingInformationAcquisitionsRelatedTransactionExpenses
Operating income 452,085us-gaap_OperatingIncomeLoss 437,536us-gaap_OperatingIncomeLoss 484,295us-gaap_OperatingIncomeLoss 441,225us-gaap_OperatingIncomeLoss 484,179us-gaap_OperatingIncomeLoss 377,074us-gaap_OperatingIncomeLoss 522,020us-gaap_OperatingIncomeLoss 166,861us-gaap_OperatingIncomeLoss 1,815,141us-gaap_OperatingIncomeLoss 1,550,134us-gaap_OperatingIncomeLoss 1,297,084us-gaap_OperatingIncomeLoss
Debt expense                 (410,294)us-gaap_InterestAndDebtExpense (429,943)us-gaap_InterestAndDebtExpense (288,554)us-gaap_InterestAndDebtExpense
Debt refinancing charges                 (97,548)dva_DebtRefinancingCharge   (10,963)dva_DebtRefinancingCharge
Other income, net                 2,374us-gaap_OtherNonoperatingIncomeExpense 4,787us-gaap_OtherNonoperatingIncomeExpense 3,737us-gaap_OtherNonoperatingIncomeExpense
Consolidated income from continuing operations before income taxes 354,365us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 336,412us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 282,308us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 336,588us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 380,020us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 270,766us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 412,550us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 61,642us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 1,309,673us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 1,124,978us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 1,001,304us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments
Operating Segments                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 12,852,469us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
11,812,296us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
8,214,547us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
Operating income                 1,828,153us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
[2] 1,546,856us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
[2] 1,374,318us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
[2]
Operating income                 1,828,153us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
[2] 1,546,856us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
[2] 1,374,318us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
[2]
Operating Segments | U.S. dialysis and related lab services                      
Segment Reporting Information [Line Items]                      
Patient service revenues                 8,550,201us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
8,032,772us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
7,316,818us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
Less: Provision for uncollectible accounts                 (353,028)dva_ProvisionForDoubtfulAccountsOnPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
(281,146)dva_ProvisionForDoubtfulAccountsOnPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
(233,580)dva_ProvisionForDoubtfulAccountsOnPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
Net patient service revenues                 8,197,173us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
7,751,626us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
7,083,238us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
Other revenues                 13,498us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[3] 12,600us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[3] 11,447us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[3]
Total net operating revenues                 8,210,671us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
7,764,226us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
7,094,685us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
Operating income                 1,637,626us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[2] 1,200,198us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[2] 1,372,265us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[2]
Operating income                 1,637,626us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[2] 1,200,198us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[2] 1,372,265us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[2]
Operating Segments | U.S. dialysis and related lab services | External Sources                      
Segment Reporting Information [Line Items]                      
Patient service revenues                 8,513,089us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
/ us-gaap_SubsegmentsAxis
= dva_ExternalSourcesMember
7,998,692us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
/ us-gaap_SubsegmentsAxis
= dva_ExternalSourcesMember
7,299,032us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
/ us-gaap_SubsegmentsAxis
= dva_ExternalSourcesMember
Operating Segments | U.S. dialysis and related lab services | Intersegment Revenue                      
Segment Reporting Information [Line Items]                      
Patient service revenues                 37,112us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
34,080us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
17,786us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
Operating Segments | HealthCare Partners (HCP)                      
Segment Reporting Information [Line Items]                      
Net patient service revenues                 219,306us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
220,251us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
34,407us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
Other revenues                 91,374us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[4] 55,723us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[4] 23,552us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[4]
Total net operating revenues                 3,502,299us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
3,196,188us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
477,390us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
Capitated revenues                 3,190,903us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
2,919,964us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
419,431us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
Operating income                 214,983us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[2] 385,253us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[2] 66,930us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[2]
Operating income                 214,983us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[2] 385,253us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[2] 66,930us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[2]
Operating Segments | HealthCare Partners (HCP) | Intersegment Revenue                      
Segment Reporting Information [Line Items]                      
Other revenues                 716us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
250us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
 
Operating Segments | Other-Ancillary services and strategic initiatives                      
Segment Reporting Information [Line Items]                      
Net patient service revenues                 122,087us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
75,852us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
16,824us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
Other revenues                 927,492us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
694,763us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
553,261us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
Total net operating revenues                 1,139,499us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
851,882us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
642,472us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
Capitated revenues                 70,385us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
67,351us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
61,906us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
Operating income                 (24,456)us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
[2] (38,595)us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
[2] (64,877)us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
[2]
Operating income                 (24,456)us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
[2] (38,595)us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
[2] (64,877)us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
[2]
Operating Segments | Other-Ancillary services and strategic initiatives | Intersegment Revenue                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 19,535us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
13,916us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
10,481us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
Intersegment Elimination                      
Segment Reporting Information [Line Items]                      
Total net operating revenues                 $ (57,363)us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_IntersegmentEliminationMember
$ (48,246)us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_IntersegmentEliminationMember
$ (28,267)us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_IntersegmentEliminationMember
[1] Corporate support costs in 2013 also include $7,721 of an adjustment to reduce a tax asset associated with the HCP acquisition escrow provisions.
[2] Certain costs previously reported in the ancillary services and strategic initiatives have been reclassified to U.S. dialysis and related lab services to conform to the current year presentation.
[3] Includes management fees for providing management and administrative services to dialysis centers in which the Company owns a minority equity investment or which are wholly-owned by third parties.
[4] Other revenues primarily relate to providing medical consulting services.