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
Mar. 31, 2015
Mar. 31, 2014
Segment Reporting Information [Line Items]    
Patient service revenues $ 2,271,815us-gaap_HealthCareOrganizationPatientServiceRevenue $ 2,114,098us-gaap_HealthCareOrganizationPatientServiceRevenue
Less: Provision for uncollectible accounts (99,164)us-gaap_HealthCareOrganizationPatientServiceRevenueProvisionforBadDebts (83,197)us-gaap_HealthCareOrganizationPatientServiceRevenueProvisionforBadDebts
Net patient service revenues 2,172,651us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts 2,030,901us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
Other revenues 264,799us-gaap_HealthCareOrganizationOtherRevenue 224,310us-gaap_HealthCareOrganizationOtherRevenue
Total net operating revenues 3,287,965us-gaap_HealthCareOrganizationRevenue 3,042,776us-gaap_HealthCareOrganizationRevenue
Capitated revenues 850,515us-gaap_HealthCareOrganizationCapitationRevenue 787,565us-gaap_HealthCareOrganizationCapitationRevenue
Other external sources (64,156)us-gaap_OperatingIncomeLoss 441,225us-gaap_OperatingIncomeLoss
Corporate support costs (6,133)dva_SegmentReportingInformationCorporateExpenses (1,106)dva_SegmentReportingInformationCorporateExpenses
Debt expense (97,392)us-gaap_InterestAndDebtExpense (106,335)us-gaap_InterestAndDebtExpense
Other (loss) income (533)us-gaap_OtherNonoperatingIncomeExpense 1,698us-gaap_OtherNonoperatingIncomeExpense
Consolidated (loss) income from continuing operations before income taxes (162,081)us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments 336,588us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments
Operating Segments    
Segment Reporting Information [Line Items]    
Total net operating revenues 3,304,800us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
3,055,579us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
Other external sources (58,023)us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
442,331us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
Operating Segments | U.S. dialysis and related lab services    
Segment Reporting Information [Line Items]    
Patient service revenues 2,166,150us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
2,036,575us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
Less: Provision for uncollectible accounts (97,477)us-gaap_HealthCareOrganizationPatientServiceRevenueProvisionforBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
(81,463)us-gaap_HealthCareOrganizationPatientServiceRevenueProvisionforBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
Net patient service revenues 2,068,673us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
1,955,112us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
Other revenues 3,184us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[1] 3,154us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
[1]
Total net operating revenues 2,071,857us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
1,958,266us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
Other external sources (104,489)us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
386,700us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
Operating Segments | U.S. dialysis and related lab services | External Sources    
Segment Reporting Information [Line Items]    
Patient service revenues 2,154,294us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
/ us-gaap_SubsegmentsAxis
= dva_ExternalSourcesMember
2,028,743us-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 11,856us-gaap_HealthCareOrganizationPatientServiceRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_USDialysisAndRelatedLabServicesMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
7,832us-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 80,210us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
56,222us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
Other revenues 15,053us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[2] 12,523us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
[2]
Total net operating revenues 927,772us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
840,439us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
Capitated revenues 832,472us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
771,542us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
Other external sources 60,294us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
53,953us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
Operating Segments | HealthCare Partners (HCP) | Intersegment Revenue    
Segment Reporting Information [Line Items]    
Other revenues 37us-gaap_HealthCareOrganizationOtherRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= dva_HealthcarePartnersMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
152us-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 35,624us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
27,399us-gaap_HealthCareOrganizationPatientServiceRevenueLessProvisionForBadDebts
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
Total net operating revenues 305,171us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
256,874us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
Capitated revenues 18,043us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
16,023us-gaap_HealthCareOrganizationCapitationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
Other external sources (13,828)us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
1,678us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
Operating Segments | Other-Ancillary services and strategic initiatives | External Sources    
Segment Reporting Information [Line Items]    
Other external sources 246,562us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
/ us-gaap_SubsegmentsAxis
= dva_ExternalSourcesMember
208,633us-gaap_OperatingIncomeLoss
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
/ us-gaap_SubsegmentsAxis
= dva_ExternalSourcesMember
Operating Segments | Other-Ancillary services and strategic initiatives | Intersegment Revenue    
Segment Reporting Information [Line Items]    
Total net operating revenues 4,942us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_OperatingSegmentsMember
/ us-gaap_StatementBusinessSegmentsAxis
= us-gaap_AllOtherSegmentsMember
/ us-gaap_SubsegmentsAxis
= dva_IntersegmentRevenueMember
4,819us-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 $ (16,835)us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_IntersegmentEliminationMember
$ (12,803)us-gaap_HealthCareOrganizationRevenue
/ us-gaap_ConsolidationItemsAxis
= us-gaap_IntersegmentEliminationMember
[1] Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties or centers in which the Company owns a minority equity investment.
[2] Includes payments received for medical consulting services and management fees for providing management and administrative services to an unconsolidated joint venture that provides medical services in which the Company owns a 50% interest, as well as revenue related to the maintenance of existing physician networks.