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Segment reporting (Tables)

6 Months Ended

Jun. 30, 2018

Segment Reporting [Abstract]

Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes

The following is a summary of segment net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:

	Three months ended June 30,								Six months ended June 30,
	2018				2017				2018				2017
Segment net revenues:
U.S. dialysis and related lab services
Patient service revenues:
External sources	$	2,612,734			$	2,416,373			$	5,101,899			$	4,777,234
Intersegment revenues	20,096				13,285				38,519				25,084
U.S. dialysis and related lab services patient service revenues	2,632,830				2,429,658				5,140,418				4,802,318
Provision for uncollectible accounts	(49,406		)		(109,292		)		(24,208		)		(216,069		)
Net U.S. dialysis and related lab services patient service revenues	2,583,424				2,320,366				5,116,210				4,586,249
Other revenues(1)	4,919				4,849				10,033				10,159
Total U.S. dialysis and related lab services revenues	2,588,343				2,325,215				5,126,243				4,596,408
Other—Ancillary services and strategic initiatives
Patient service revenues	105,669				77,928				207,925				139,572
Other external sources	213,037				309,541				440,748				619,754
Intersegment revenues	9,189				6,124				19,387				12,493
Total ancillary services and strategic initiatives revenues	327,895				393,593				668,060				771,819
Total net segment revenues	2,916,238				2,718,808				5,794,303				5,368,227
Elimination of intersegment revenues	(29,285		)		(19,409		)		(57,906		)		(37,577		)
Consolidated revenues	$	2,886,953			$	2,699,399			$	5,736,397			$	5,330,650
Segment operating margin:
U.S. dialysis and related lab services	$	449,443			$	450,472			$	882,822			$	1,395,212
Other—Ancillary services and strategic initiatives	2,815				(48,245		)		(4,175		)		(106,466		)
Total segment operating margin	452,258				402,227				878,647				1,288,746
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:
Corporate administrative support	(14,066		)		(11,031		)		(29,769		)		(21,622		)
Consolidated operating income	438,192				391,196				848,878				1,267,124
Debt expense	(119,692		)		(107,934		)		(233,208		)		(212,331		)
Other income, net	1,994				4,798				6,576				8,784
Consolidated income from continuing operations before income taxes	$	320,494			$	288,060			$	622,246			$	1,063,577

(1) Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment.

Summary of Depreciation and Amortization Expense by Reportable Segment

Depreciation and amortization expense by reportable segment was as follows:

	Three months ended June 30,								Six months ended June 30,
	2018				2017				2018				2017
U.S. dialysis and related lab services	$	138,252			$	130,001			$	273,028			$	255,030
Other—Ancillary services and strategic initiatives	8,827				10,025				16,850				17,880
	$	147,079			$	140,026			$	289,878			$	272,910

Summary of Assets by Reportable Segment

Assets by reportable segment were as follows:

	June 30, 2018				December 31, 2017
Segment assets
U.S. dialysis and related lab services (including equity investments of $93,282 and $84,866, respectively)	$	11,989,864			$	11,776,042
Other—Ancillary services and strategic initiatives (including equity investments of $155,738 and $160,668, respectively)	1,392,619				1,410,509
DMG—Held for sale (including equity investments of $5,099 and $10,321, respectively)	6,053,081				5,761,642
Consolidated assets	$	19,435,564			$	18,948,193

Summary of Expenditures for Property and Equipment by Reportable Segment

Expenditures for property and equipment by reportable segment were as follows:

	Three months ended June 30,								Six months ended June 30,
	2018				2017				2018				2017
U.S. dialysis and related lab services	$	194,188			$	152,233			$	383,238			$	325,761
Other—Ancillary services and strategic initiatives	25,047				11,289				37,392				24,508
DMG—Held for sale	22,299				20,883				53,347				48,671
	$	241,534			$	184,405			$	473,977			$	398,940

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