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Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2015 | Dec. 31, 2014 | Dec. 31, 2013
Cash flows from operating activities: |  |  |
Net income | $ 427,410 | $ 863,330 | $ 757,201
Changes in operating assets and liabilities and non-cash items included in net income | 1,129,790 | 596,077 | 1,016,140
Net cash provided by operating activities | 1,557,200 | 1,459,407 | 1,773,341
Cash flows from investing activities: |  |  |
Additions of property and equipment | (707,998) | (641,330) | (617,597)
Acquisitions | (96,469) | (272,094) | (310,394)
Proceeds from asset sales | 19,715 | 8,791 | 62,258
(Purchases) proceeds from investment sales and other items | (97,032) | (373,096) | (11,149)
Net cash used in investing activities | (881,784) | (1,277,729) | (876,882)
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | 619,698 | (7,989) | (438,007)
Other items | (758,668) | (156,990) | (44,984)
Net cash used in financing activities | (138,970) | (164,979) | (482,991)
Effect of exchange rate changes on cash | (2,571) | 2,293 | (967)
Net increase in cash and cash equivalents | 533,875 | 18,992 | 412,501
Cash and cash equivalents at beginning of the year | 965,241 | 946,249 | 533,748
Cash and cash equivalents at end of the year | 1,499,116 | 965,241 | 946,249
Consolidation, Eliminations |  |  |
Cash flows from operating activities: |  |  |
Net income | (514,183) | (982,776) | (796,282)
Changes in operating assets and liabilities and non-cash items included in net income | 514,183 | 982,776 | 796,282
DaVita HealthCare Partners Inc. | Reportable Legal Entities |  |  |
Cash flows from operating activities: |  |  |
Net income | 269,732 | 723,114 | 633,446
Changes in operating assets and liabilities and non-cash items included in net income | (146,531) | (597,992) | (443,071)
Net cash provided by operating activities | 123,201 | 125,122 | 190,375
Cash flows from investing activities: |  |  |
Additions of property and equipment | (115,269) | (51,374) | (55,252)
Proceeds from asset sales |  |  | 60,650
(Purchases) proceeds from investment sales and other items | (74,474) | (333,803) | (4,944)
Net cash used in investing activities | (189,743) | (385,177) | 454
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | 640,009 | 4,513 | (421,739)
Intercompany borrowing | 486,588 | 410,437 | 585,441
Other items | (572,295) | (58,207) | 52,620
Net cash used in financing activities | 554,302 | 356,743 | 216,322
Net increase in cash and cash equivalents | 487,760 | 96,688 | 407,151
Cash and cash equivalents at beginning of the year | 698,876 | 602,188 | 195,037
Cash and cash equivalents at end of the year | 1,186,636 | 698,876 | 602,188
Guarantor Subsidiaries | Reportable Legal Entities |  |  |
Cash flows from operating activities: |  |  |
Net income | 195,507 | 647,085 | 522,778
Changes in operating assets and liabilities and non-cash items included in net income | 688,106 | 120,772 | 523,440
Net cash provided by operating activities | 883,613 | 767,857 | 1,046,218
Cash flows from investing activities: |  |  |
Additions of property and equipment | (319,695) | (312,191) | (337,919)
Acquisitions | (76,983) | (228,569) | (156,830)
Proceeds from asset sales | 19,715 | 8,791 | 1,608
(Purchases) proceeds from investment sales and other items | (2,144) | (316) | (3,502)
Net cash used in investing activities | (379,107) | (532,285) | (496,643)
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | (11,953) | (12,545) | (11,061)
Intercompany borrowing | (394,735) | (282,461) | (557,893)
Other items | (66,382) | (14,099) | 4,726
Net cash used in financing activities | (473,070) | (309,105) | (564,228)
Net increase in cash and cash equivalents | 31,436 | (73,533) | (14,653)
Cash and cash equivalents at beginning of the year | 77,921 | 151,454 | 166,107
Cash and cash equivalents at end of the year | 109,357 | 77,921 | 151,454
Non-Guarantor Subsidiaries | Reportable Legal Entities |  |  |
Cash flows from operating activities: |  |  |
Net income | 476,354 | 475,907 | 397,259
Changes in operating assets and liabilities and non-cash items included in net income | 74,032 | 90,521 | 139,489
Net cash provided by operating activities | 550,386 | 566,428 | 536,748
Cash flows from investing activities: |  |  |
Additions of property and equipment | (273,034) | (277,765) | (224,426)
Acquisitions | (19,486) | (43,525) | (153,564)
(Purchases) proceeds from investment sales and other items | (20,414) | (38,977) | (2,703)
Net cash used in investing activities | (312,934) | (360,267) | (380,693)
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | (8,358) | 43 | (5,207)
Intercompany borrowing | (91,853) | (127,976) | (27,548)
Other items | (119,991) | (84,684) | (102,330)
Net cash used in financing activities | (220,202) | (212,617) | (135,085)
Effect of exchange rate changes on cash | (2,571) | 2,293 | (967)
Net increase in cash and cash equivalents | 14,679 | (4,163) | 20,003
Cash and cash equivalents at beginning of the year | 188,444 | 192,607 | 172,604
Cash and cash equivalents at end of the year | $ 203,123 | $ 188,444 | $ 192,607

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