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Supplemental Data (Tables) | 6 Months Ended
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Jun. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract] |
Condensed Consolidating Statements of Income | Condensed Consolidating Statements of Income
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Three Months Ended June 30, 2017 | DaVita Inc. |  |  |  |
Patient services revenues | $ | — |  |  | $ | 1,681,249 |  |  | $ | 1,055,797 |  |  | $ | (54,579 | ) |  | $ | 2,682,467 |
Less: Provision for uncollectible accounts | — |  |  | (74,413 | ) |  | (41,072 | ) |  | — |  |  | (115,485 | )
Net patient service revenues | — |  |  | 1,606,836 |  |  | 1,014,725 |  |  | (54,579 | ) |  | 2,566,982 |
Capitated revenues | — |  |  | 467,852 |  |  | 555,947 |  |  | (1,721 | ) |  | 1,022,078 |
Other revenues | 193,585 |  |  | 501,861 |  |  | 34,257 |  |  | (441,286 | ) |  | 288,417 |
Total net revenues | 193,585 |  |  | 2,576,549 |  |  | 1,604,929 |  |  | (497,586 | ) |  | 3,877,477 |
Operating expenses and charges | 138,104 |  |  | 2,396,723 |  |  | 1,461,920 |  |  | (497,586 | ) |  | 3,499,161 |
Operating income | 55,481 |  |  | 179,826 |  |  | 143,009 |  |  | — |  |  | 378,316 |
Debt expense | (106,159 | ) |  | (92,346 | ) |  | (14,943 | ) |  | 105,486 |  |  | (107,962 | )
Other income, net | 102,299 |  |  | 2,191 |  |  | 6,249 |  |  | (105,486 | ) |  | 5,253 |
Income tax expense | 22,969 |  |  | 70,927 |  |  | 20,086 |  |  | — |  |  | 113,982 |
Equity earnings in subsidiaries | 98,349 |  |  | 79,605 |  |  | — |  |  | (177,954 | ) |  | — |
Net income | 127,001 |  |  | 98,349 |  |  | 114,229 |  |  | (177,954 | ) |  | 161,625 |
Less: Net income attributable to noncontrolling interests | — |  |  | — |  |  | — |  |  | (34,624 | ) |  | (34,624 | )
Net income attributable to DaVita Inc. | $ | 127,001 |  |  | $ | 98,349 |  |  | $ | 114,229 |  |  | $ | (212,578 | ) |  | $ | 127,001 |
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Three Months Ended June 30, 2016 | DaVita Inc. |  |  |  |
Patient service revenues | $ | — |  |  | $ | 1,664,361 |  |  | $ | 959,946 |  |  | $ | (40,793 | ) |  | $ | 2,583,514 |
Less: Provision for uncollectible accounts | — |  |  | (74,498 | ) |  | (36,930 | ) |  | — |  |  | (111,428 | )
Net patient service revenues | — |  |  | 1,589,863 |  |  | 923,016 |  |  | (40,793 | ) |  | 2,472,086 |
Capitated revenues | — |  |  | 463,732 |  |  | 436,337 |  |  | (84 | ) |  | 899,985 |
Other revenues | 196,910 |  |  | 521,065 |  |  | 31,749 |  |  | (404,144 | ) |  | 345,580 |
Total net revenues | 196,910 |  |  | 2,574,660 |  |  | 1,391,102 |  |  | (445,021 | ) |  | 3,717,651 |
Operating expenses | 134,072 |  |  | 2,510,119 |  |  | 1,189,411 |  |  | (445,021 | ) |  | 3,388,581 |
Operating income | 62,838 |  |  | 64,541 |  |  | 201,691 |  |  | — |  |  | 329,070 |
Debt expense | (102,101 | ) |  | (91,259 | ) |  | (12,998 | ) |  | 103,464 |  |  | (102,894 | )
Other income | 98,654 |  |  | 5,421 |  |  | 2,604 |  |  | (103,464 | ) |  | 3,215 |
Income tax expense | 41,942 |  |  | 89,203 |  |  | 3,743 |  |  | — |  |  | 134,888 |
Equity earnings in subsidiaries | 35,933 |  |  | 146,433 |  |  | — |  |  | (182,366 | ) |  | — |
Net income | 53,382 |  |  | 35,933 |  |  | 187,554 |  |  | (182,366 | ) |  | 94,503 |
Less: Net income attributable to noncontrolling interests | — |  |  | — |  |  | — |  |  | (41,121 | ) |  | (41,121 | )
Net income attributable to DaVita Inc. | $ | 53,382 |  |  | $ | 35,933 |  |  | $ | 187,554 |  |  | $ | (223,487 | ) |  | $ | 53,382 |
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Six Months Ended June 30, 2017 | DaVita Inc. |  |  |  |
Patient services revenues | $ | — |  |  | $ | 3,234,605 |  |  | $ | 2,154,549 |  |  | $ | (105,309 | ) |  | $ | 5,283,845 |
Less: Provision for uncollectible accounts | — |  |  | (136,694 | ) |  | (91,774 | ) |  | — |  |  | (228,468 | )
Net patient service revenues | — |  |  | 3,097,911 |  |  | 2,062,775 |  |  | (105,309 | ) |  | 5,055,377 |
Capitated revenues | — |  |  | 931,479 |  |  | 1,010,901 |  |  | (2,266 | ) |  | 1,940,114 |
Other revenues | 414,971 |  |  | 979,536 |  |  | 69,894 |  |  | (885,132 | ) |  | 579,269 |
Total net revenues | 414,971 |  |  | 5,008,926 |  |  | 3,143,570 |  |  | (992,707 | ) |  | 7,574,760 |
Operating expenses and charges | 270,014 |  |  | 4,276,878 |  |  | 2,754,023 |  |  | (992,707 | ) |  | 6,308,208 |
Operating income | 144,957 |  |  | 732,048 |  |  | 389,547 |  |  | — |  |  | 1,266,552 |
Debt expense | (208,823 | ) |  | (183,747 | ) |  | (28,659 | ) |  | 208,838 |  |  | (212,391 | )
Other income, net | 202,636 |  |  | 5,728 |  |  | 9,970 |  |  | (208,838 | ) |  | 9,496 |
Income tax expense | 57,062 |  |  | 292,348 |  |  | 52,337 |  |  | — |  |  | 401,747 |
Equity earnings in subsidiaries | 492,990 |  |  | 231,309 |  |  | — |  |  | (724,299 | ) |  | — |
Net income | 574,698 |  |  | 492,990 |  |  | 318,521 |  |  | (724,299 | ) |  | 661,910 |
Less: Net income attributable to noncontrolling interests | — |  |  | — |  |  | — |  |  | (87,212 | ) |  | (87,212 | )
Net income attributable to DaVita Inc. | $ | 574,698 |  |  | $ | 492,990 |  |  | $ | 318,521 |  |  | $ | (811,511 | ) |  | $ | 574,698 |
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Six Months Ended June 30, 2016 | DaVita Inc. |  |  |  |
Patient services revenues | $ | — |  |  | $ | 3,317,673 |  |  | $ | 1,827,984 |  |  | $ | (80,209 | ) |  | $ | 5,065,448 |
Less: Provision for uncollectible accounts | — |  |  | (133,311 | ) |  | (87,322 | ) |  | — |  |  | (220,633 | )
Net patient service revenues | — |  |  | 3,184,362 |  |  | 1,740,662 |  |  | (80,209 | ) |  | 4,844,815 |
Capitated revenues | — |  |  | 931,694 |  |  | 856,510 |  |  | (211 | ) |  | 1,787,993 |
Other revenues | 383,885 |  |  | 1,005,420 |  |  | 59,269 |  |  | (782,595 | ) |  | 665,979 |
Total net revenues | 383,885 |  |  | 5,121,476 |  |  | 2,656,441 |  |  | (863,015 | ) |  | 7,298,787 |
Operating expenses and charges | 256,345 |  |  | 4,887,749 |  |  | 2,323,749 |  |  | (863,015 | ) |  | 6,604,828 |
Operating income | 127,540 |  |  | 233,727 |  |  | 332,692 |  |  | — |  |  | 693,959 |
Debt expense | (203,202 | ) |  | (183,432 | ) |  | (24,512 | ) |  | 205,368 |  |  | (205,778 | )
Other income, net | 197,214 |  |  | 9,757 |  |  | 4,588 |  |  | (205,368 | ) |  | 6,191 |
Income tax expense | 77,088 |  |  | 162,457 |  |  | 22,165 |  |  | — |  |  | 261,710 |
Equity earnings in subsidiaries | 106,352 |  |  | 208,757 |  |  | — |  |  | (315,109 | ) |  | — |
Net income | 150,816 |  |  | 106,352 |  |  | 290,603 |  |  | (315,109 | ) |  | 232,662 |
Less: Net income attributable to noncontrolling interests | — |  |  | — |  |  | — |  |  | (81,846 | ) |  | (81,846 | )
Net income attributable to DaVita Inc. | $ | 150,816 |  |  | $ | 106,352 |  |  | $ | 290,603 |  |  | $ | (396,955 | ) |  | $ | 150,816 |
Condensed Consolidating Statements of Income
| Consolidated Total |  | Physician Groups |  | Unrestricted Subsidiaries |  | Company and Restricted Subsidiaries(1)
For The Six Months Ended June 30, 2017 |  |  |
Patient service operating revenues | $ | 5,283,845 |  |  | $ | 273,017 |  |  | $ | — |  |  | $ | 5,010,828 |
Less: Provision for uncollectible accounts | (228,468 | ) |  | (7,351 | ) |  | — |  |  | (221,117 | )
Net patient service operating revenues | 5,055,377 |  |  | 265,666 |  |  | — |  |  | 4,789,711 |
Capitated revenues | 1,940,114 |  |  | 785,139 |  |  | — |  |  | 1,154,975 |
Other revenues | 579,269 |  |  | 19,596 |  |  | — |  |  | 559,673 |
Total net operating revenues | 7,574,760 |  |  | 1,070,401 |  |  | — |  |  | 6,504,359 |
Operating expenses | 6,308,208 |  |  | 1,032,529 |  |  | (232 | ) |  | 5,275,911 |
Operating income | 1,266,552 |  |  | 37,872 |  |  | 232 |  |  | 1,228,448 |
Debt expense, including refinancing charges | (212,391 | ) |  | (3,323 | ) |  | — |  |  | (209,068 | )
Other income | 9,496 |  |  | 151 |  |  | — |  |  | 9,345 |
Income tax expense | 401,747 |  |  | 32,700 |  |  | 93 |  |  | 368,954 |
Net income | 661,910 |  |  | 2,000 |  |  | 139 |  |  | 659,771 |
Less: Net income attributable to noncontrolling interests | (87,212 | ) |  | — |  |  | — |  |  | (87,212 | )
Net income attributable to DaVita Inc. | $ | 574,698 |  |  | $ | 2,000 |  |  | $ | 139 |  |  | $ | 572,559 |
(1) | After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Comprehensive Income | Condensed Consolidating Statements of Comprehensive Income
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Three Months Ended June 30, 2017 | DaVita Inc. |  |  |  |
Net income | $ | 127,001 |  |  | $ | 98,349 |  |  | $ | 114,229 |  |  | $ | (177,954 | ) |  | $ | 161,625 |
Other comprehensive income | 436 |  |  | — |  |  | 49,142 |  |  | — |  |  | 49,578 |
Total comprehensive income | 127,437 |  |  | 98,349 |  |  | 163,371 |  |  | (177,954 | ) |  | 211,203 |
Less: Comprehensive income attributable to noncontrolling interest | — |  |  | — |  |  | — |  |  | (34,624 | ) |  | (34,624 | )
Comprehensive income attributable to DaVita Inc. | $ | 127,437 |  |  | $ | 98,349 |  |  | $ | 163,371 |  |  | $ | (212,578 | ) |  | $ | 176,579 |
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Three Months Ended June 30, 2016 | DaVita Inc. |  |  |  |
Net income | $ | 53,382 |  |  | $ | 35,933 |  |  | $ | 187,554 |  |  | $ | (182,366 | ) |  | $ | 94,503 |
Other comprehensive loss | (1,530 | ) |  | — |  |  | (4,844 | ) |  | — |  |  | (6,374 | )
Total comprehensive income | 51,852 |  |  | 35,933 |  |  | 182,710 |  |  | (182,366 | ) |  | 88,129 |
Less: Comprehensive income attributable to the noncontrolling interests | — |  |  | — |  |  | — |  |  | (41,270 | ) |  | (41,270 | )
Comprehensive income attributable to DaVita Inc. | $ | 51,852 |  |  | $ | 35,933 |  |  | $ | 182,710 |  |  | $ | (223,636 | ) |  | $ | 46,859 |
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Six Months Ended June 30, 2017 | DaVita Inc. |  |  |  |
Net income | $ | 574,698 |  |  | $ | 492,990 |  |  | $ | 318,521 |  |  | $ | (724,299 | ) |  | $ | 661,910 |
Other comprehensive (loss) income | (70 | ) |  | — |  |  | 62,403 |  |  | — |  |  | 62,333 |
Total comprehensive income | 574,628 |  |  | 492,990 |  |  | 380,924 |  |  | (724,299 | ) |  | 724,243 |
Less: Comprehensive income attributable to noncontrolling interest | — |  |  | — |  |  | — |  |  | (87,210 | ) |  | (87,210 | )
Comprehensive income attributable to DaVita Inc. | $ | 574,628 |  |  | $ | 492,990 |  |  | $ | 380,924 |  |  | $ | (811,509 | ) |  | $ | 637,033 |
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Six Months Ended June 30, 2016 | DaVita Inc. |  |  |  |
Net income | $ | 150,816 |  |  | $ | 106,352 |  |  | $ | 290,603 |  |  | $ | (315,109 | ) |  | $ | 232,662 |
Other comprehensive (loss) income | (6,398 | ) |  | — |  |  | 6,337 |  |  | — |  |  | (61 | )
Total comprehensive income | 144,418 |  |  | 106,352 |  |  | 296,940 |  |  | (315,109 | ) |  | 232,601 |
Less: Comprehensive income attributable to the noncontrolling interests | — |  |  | — |  |  | — |  |  | (81,995 | ) |  | (81,995 | )
Comprehensive income attributable to DaVita Inc. | $ | 144,418 |  |  | $ | 106,352 |  |  | $ | 296,940 |  |  | $ | (397,104 | ) |  | $ | 150,606 |
Condensed Consolidating Statements of Comprehensive Income
| Consolidated Total |  | Physician Groups |  | Unrestricted Subsidiaries |  | Company and Restricted Subsidiaries(1)
For The Six Months Ended June 30, 2017 |  |  |
Net income | $ | 661,910 |  |  | $ | 2,000 |  |  | $ | 139 |  |  | $ | 659,771 |
Other comprehensive income | 62,333 |  |  | — |  |  | — |  |  | 62,333 |
Total comprehensive income | 724,243 |  |  | 2,000 |  |  | 139 |  |  | 722,104 |
Less: Comprehensive income attributable to the noncontrolling interests | (87,210 | ) |  | — |  |  | — |  |  | (87,210 | )
Comprehensive income attributable to DaVita Inc. | $ | 637,033 |  |  | $ | 2,000 |  |  | $ | 139 |  |  | $ | 634,894 |
(1) | After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Balance Sheets | Condensed Consolidating Balance Sheets
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
As of June 30, 2017 | DaVita Inc. |  |  |  |
Cash and cash equivalents | $ | 374,973 |  |  | $ | 40,508 |  |  | $ | 296,516 |  |  | $ | — |  |  | $ | 711,997 |
Accounts receivable, net | — |  |  | 1,278,053 |  |  | 775,759 |  |  | — |  |  | 2,053,812 |
Other current assets | 254,108 |  |  | 891,208 |  |  | 112,643 |  |  | — |  |  | 1,257,959 |
Total current assets | 629,081 |  |  | 2,209,769 |  |  | 1,184,918 |  |  | — |  |  | 4,023,768 |
Property and equipment, net | 345,667 |  |  | 1,669,583 |  |  | 1,232,780 |  |  | — |  |  | 3,248,030 |
Intangible assets, net | 355 |  |  | 1,405,712 |  |  | 56,827 |  |  | — |  |  | 1,462,894 |
Investments in subsidiaries | 10,368,953 |  |  | 2,375,421 |  |  | — |  |  | (12,744,374 | ) |  | — |
Intercompany receivables | 3,266,741 |  |  | — |  |  | 1,035,735 |  |  | (4,302,476 | ) |  | — |
Other long-term assets and investments | 45,228 |  |  | 92,891 |  |  | 579,182 |  |  | — |  |  | 717,301 |
Goodwill | — |  |  | 7,850,917 |  |  | 2,038,874 |  |  | — |  |  | 9,889,791 |
Total assets | $ | 14,656,025 |  |  | $ | 15,604,293 |  |  | $ | 6,128,316 |  |  | $ | (17,046,850 | ) |  | $ | 19,341,784 |
Current liabilities | $ | 399,436 |  |  | $ | 1,807,277 |  |  | $ | 566,612 |  |  | $ | — |  |  | $ | 2,773,325 |
Intercompany payables | — |  |  | 2,181,952 |  |  | 2,120,524 |  |  | (4,302,476 | ) |  | — |
Long-term debt and other long-term liabilities | 8,578,628 |  |  | 1,246,111 |  |  | 462,120 |  |  | — |  |  | 10,286,859 |
Noncontrolling interests subject to put provisions | 593,647 |  |  | — |  |  | — |  |  | 416,057 |  |  | 1,009,704 |
Total DaVita Inc. shareholder's equity | 5,084,314 |  |  | 10,368,953 |  |  | 2,375,421 |  |  | (12,744,374 | ) |  | 5,084,314 |
Noncontrolling interests not subject to put provisions | — |  |  | — |  |  | 603,639 |  |  | (416,057 | ) |  | 187,582 |
Total equity | 5,084,314 |  |  | 10,368,953 |  |  | 2,979,060 |  |  | (13,160,431 | ) |  | 5,271,896 |
Total liabilities and equity | $ | 14,656,025 |  |  | $ | 15,604,293 |  |  | $ | 6,128,316 |  |  | $ | (17,046,850 | ) |  | $ | 19,341,784 |
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
As of December 31, 2016 | DaVita Inc. |  |  |  |
Cash and cash equivalents | $ | 549,921 |  |  | $ | 59,192 |  |  | $ | 304,074 |  |  | $ | — |  |  | $ | 913,187 |
Accounts receivable, net | — |  |  | 1,215,232 |  |  | 702,070 |  |  | — |  |  | 1,917,302 |
Other current assets | 277,911 |  |  | 736,727 |  |  | 135,101 |  |  | — |  |  | 1,149,739 |
Total current assets | 827,832 |  |  | 2,011,151 |  |  | 1,141,245 |  |  | — |  |  | 3,980,228 |
Property and equipment, net | 337,200 |  |  | 1,689,798 |  |  | 1,148,369 |  |  | — |  |  | 3,175,367 |
Intangible assets, net | 487 |  |  | 1,491,057 |  |  | 36,223 |  |  | — |  |  | 1,527,767 |
Investments in subsidiaries | 9,717,728 |  |  | 2,002,660 |  |  | — |  |  | (11,720,388 | ) |  | — |
Intercompany receivables | 3,250,692 |  |  | — |  |  | 866,955 |  |  | (4,117,647 | ) |  | — |
Other long-term assets and investments | 39,994 |  |  | 86,710 |  |  | 523,874 |  |  | — |  |  | 650,578 |
Goodwill | — |  |  | 7,838,984 |  |  | 1,568,333 |  |  | — |  |  | 9,407,317 |
Total assets | $ | 14,173,933 |  |  | $ | 15,120,360 |  |  | $ | 5,284,999 |  |  | $ | (15,838,035 | ) |  | $ | 18,741,257 |
Current liabilities | $ | 303,840 |  |  | $ | 1,865,193 |  |  | $ | 527,412 |  |  | $ | — |  |  | $ | 2,696,445 |
Intercompany payables | — |  |  | 2,322,124 |  |  | 1,795,523 |  |  | (4,117,647 | ) |  | — |
Long-term debt and other long-term liabilities | 8,614,445 |  |  | 1,215,315 |  |  | 392,053 |  |  | — |  |  | 10,221,813 |
Noncontrolling interests subject to put provisions | 607,601 |  |  | — |  |  | — |  |  | 365,657 |  |  | 973,258 |
Total DaVita Inc. shareholder's equity | 4,648,047 |  |  | 9,717,728 |  |  | 2,002,660 |  |  | (11,720,388 | ) |  | 4,648,047 |
Noncontrolling interests not subject to put provisions | — |  |  | — |  |  | 567,351 |  |  | (365,657 | ) |  | 201,694 |
Total equity | 4,648,047 |  |  | 9,717,728 |  |  | 2,570,011 |  |  | (12,086,045 | ) |  | 4,849,741 |
Total liabilities and equity | $ | 14,173,933 |  |  | $ | 15,120,360 |  |  | $ | 5,284,999 |  |  | $ | (15,838,035 | ) |  | $ | 18,741,257 |
Condensed Consolidating Balance Sheets
| Consolidated Total |  | Physician Groups |  | Unrestricted Subsidiaries |  | Company and Restricted Subsidiaries(1)
As of June 30, 2017 |  |  |
Cash and cash equivalents | $ | 711,997 |  |  | $ | 107,232 |  |  | $ | — |  |  | $ | 604,765 |
Accounts receivable, net | 2,053,812 |  |  | 213,804 |  |  | — |  |  | 1,840,008 |
Other current assets | 1,257,959 |  |  | 13,679 |  |  | — |  |  | 1,244,280 |
Total current assets | 4,023,768 |  |  | 334,715 |  |  | — |  |  | 3,689,053 |
Property and equipment, net | 3,248,030 |  |  | 3,368 |  |  | — |  |  | 3,244,662 |
Amortizable intangibles, net | 1,462,894 |  |  | 4,553 |  |  | — |  |  | 1,458,341 |
Other long-term assets | 717,301 |  |  | 82,477 |  |  | 2,946 |  |  | 631,878 |
Goodwill | 9,889,791 |  |  | 29,865 |  |  | — |  |  | 9,859,926 |
Total assets | $ | 19,341,784 |  |  | $ | 454,978 |  |  | $ | 2,946 |  |  | $ | 18,883,860 |
Current liabilities | $ | 2,773,325 |  |  | $ | 178,259 |  |  | $ | — |  |  | $ | 2,595,066 |
Payables to parent | — |  |  | 114,038 |  |  | 2,946 |  |  | (116,984 | )
Long-term debt and other long-term liabilities | 10,286,859 |  |  | 55,870 |  |  | — |  |  | 10,230,989 |
Noncontrolling interests subject to put provisions | 1,009,704 |  |  | — |  |  | — |  |  | 1,009,704 |
Total DaVita Inc. shareholders’ equity | 5,084,314 |  |  | 106,811 |  |  | — |  |  | 4,977,503 |
Noncontrolling interests not subject to put provisions | 187,582 |  |  | — |  |  | — |  |  | 187,582 |
Shareholders’ equity | 5,271,896 |  |  | 106,811 |  |  | — |  |  | 5,165,085 |
Total liabilities and shareholder’s equity | $ | 19,341,784 |  |  | $ | 454,978 |  |  | $ | 2,946 |  |  | $ | 18,883,860 |
(1) | After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Cash Flows | Condensed Consolidating Statements of Cash Flows
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Six Months Ended June 30, 2017 | DaVita Inc. |  |  |  |
Cash flows from operating activities: |  |  |  |  |  |  |  |  |
Net income | $ | 574,698 |  |  | $ | 492,990 |  |  | $ | 318,521 |  |  | $ | (724,299 | ) |  | $ | 661,910 |
Changes in operating assets and liabilities and non-cash items included in net income | (431,980 | ) |  | 52,218 |  |  | 4,997 |  |  | 724,299 |  |  | 349,534 |
Net cash provided by operating activities | 142,718 |  |  | 545,208 |  |  | 323,518 |  |  | — |  |  | 1,011,444 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment, net | (50,966 | ) |  | (182,494 | ) |  | (165,480 | ) |  | — |  |  | (398,940 | )
Acquisitions | — |  |  | (538,450 | ) |  | (81,389 | ) |  | — |  |  | (619,839 | )
Proceeds from asset and business sales | — |  |  | 70,127 |  |  | 109 |  |  | — |  |  | 70,236 |
Proceeds (purchases) from investment sales and other items, net | 49,036 |  |  | (2,974 | ) |  | 50,833 |  |  | — |  |  | 96,895 |
Net cash used in investing activities | (1,930 | ) |  | (653,791 | ) |  | (195,927 | ) |  | — |  |  | (851,648 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-term debt and related financing costs, net | (54,992 | ) |  | (6,893 | ) |  | (2,147 | ) |  | — |  |  | (64,032 | )
Intercompany (payments) borrowing | (37,233 | ) |  | 98,224 |  |  | (60,991 | ) |  | — |  |  | — |
Other items | (223,511 | ) |  | (1,432 | ) |  | (76,203 | ) |  | — |  |  | (301,146 | )
Net cash (used in) provided by financing activities | (315,736 | ) |  | 89,899 |  |  | (139,341 | ) |  | — |  |  | (365,178 | )
Effect of exchange rate changes on cash | — |  |  | — |  |  | 4,192 |  |  | — |  |  | 4,192 |
Net decrease in cash and cash equivalents | (174,948 | ) |  | (18,684 | ) |  | (7,558 | ) |  | — |  |  | (201,190 | )
Cash and cash equivalents at beginning of period | 549,921 |  |  | 59,192 |  |  | 304,074 |  |  | — |  |  | 913,187 |
Cash and cash equivalents at end of period | $ | 374,973 |  |  | $ | 40,508 |  |  | $ | 296,516 |  |  | $ | — |  |  | $ | 711,997 |
|  |  | Guarantor subsidiaries |  | Non- Guarantor subsidiaries |  | Consolidating adjustments |  | Consolidated total
For The Six Months Ended June 30, 2016 | DaVita Inc. |  |  |  |
Cash flows from operating activities: |  |  |  |  |  |  |  |  |
Net income | $ | 150,816 |  |  | $ | 106,352 |  |  | $ | 290,603 |  |  | $ | (315,109 | ) |  | $ | 232,662 |
Changes in operating assets and liabilities and non-cash items included in net income | (1,505 | ) |  | 219,697 |  |  | 179,676 |  |  | 315,109 |  |  | 712,977 |
Net cash provided by operating activities | 149,311 |  |  | 326,049 |  |  | 470,279 |  |  | — |  |  | 945,639 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment, net | (42,266 | ) |  | (171,164 | ) |  | (145,197 | ) |  | — |  |  | (358,627 | )
Acquisitions | — |  |  | (462,592 | ) |  | (10,722 | ) |  | — |  |  | (473,314 | )
Proceeds from asset and business sales | — |  |  | 17,393 |  |  | — |  |  | — |  |  | 17,393 |
Proceeds (purchases) from investment sales and other items, net | 21,230 |  |  | (10,869 | ) |  | 45,958 |  |  | — |  |  | 56,319 |
Net cash used in investing activities | (21,036 | ) |  | (627,232 | ) |  | (109,961 | ) |  | — |  |  | (758,229 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-term debt and related financing costs, net | (42,493 | ) |  | (13,917 | ) |  | (4,823 | ) |  | — |  |  | (61,233 | )
Intercompany borrowing (payments) | 11,208 |  |  | 247,765 |  |  | (258,973 | ) |  | — |  |  | — |
Other items | (255,032 | ) |  | (6,253 | ) |  | (81,036 | ) |  | — |  |  | (342,321 | )
Net cash (used in) provided by financing activities | (286,317 | ) |  | 227,595 |  |  | (344,832 | ) |  | — |  |  | (403,554 | )
Effect of exchange rate changes on cash | — |  |  | — |  |  | 444 |  |  | — |  |  | 444 |
Net (decrease) increase in cash and cash equivalents | (158,042 | ) |  | (73,588 | ) |  | 15,930 |  |  | — |  |  | (215,700 | )
Cash and cash equivalents at beginning of period | 1,186,636 |  |  | 109,357 |  |  | 203,123 |  |  | — |  |  | 1,499,116 |
Cash and cash equivalents at end of period | $ | 1,028,594 |  |  | $ | 35,769 |  |  | $ | 219,053 |  |  | $ | — |  |  | $ | 1,283,416 |
Condensed Consolidating Statements of Cash Flows
| Consolidated Total |  | Physician Groups |  | Unrestricted Subsidiaries |  | Company and Restricted Subsidiaries(1)
For The Six Months Ended June 30, 2017 |  |  |
Cash flows from operating activities: |  |  |  |  |  |  |
Net income | $ | 661,910 |  |  | $ | 2,000 |  |  | $ | 139 |  |  | $ | 659,771 |
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | 349,534 |  |  | (37,812 | ) |  | (139 | ) |  | 387,485 |
Net cash provided by (used in) operating activities | 1,011,444 |  |  | (35,812 | ) |  | — |  |  | 1,047,256 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment | (398,940 | ) |  | (5,603 | ) |  | — |  |  | (393,337 | )
Acquisitions and divestitures, net | (619,839 | ) |  | — |  |  | — |  |  | (619,839 | )
Proceeds from discontinued operations | 70,236 |  |  | — |  |  | — |  |  | 70,236 |
Investments and other items | 96,895 |  |  | (1,386 | ) |  | — |  |  | 98,281 |
Net cash used in investing activities | (851,648 | ) |  | (6,989 | ) |  | — |  |  | (844,659 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |
Long-term debt | (64,032 | ) |  | — |  |  | — |  |  | (64,032 | )
Intercompany | — |  |  | 45,342 |  |  | — |  |  | (45,342 | )
Other items | (301,146 | ) |  | — |  |  | — |  |  | (301,146 | )
Net cash (used in) provided by financing activities | (365,178 | ) |  | 45,342 |  |  | — |  |  | (410,520 | )
Effect of exchange rate changes on cash | 4,192 |  |  | — |  |  | — |  |  | 4,192 |
Net (decrease) increase in cash | (201,190 | ) |  | 2,541 |  |  | — |  |  | (203,731 | )
Cash and cash equivalents at beginning of period | 913,187 |  |  | 104,691 |  |  | — |  |  | 808,496 |
Cash and cash equivalents at end of period | $ | 711,997 |  |  | $ | 107,232 |  |  | $ | — |  |  | $ | 604,765 |
(1) | After elimination of the unrestricted subsidiaries and the physician groups.

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