XML 59 R46.htm IDEA: XBRL DOCUMENT
v3.10.0.1

Revenue Recognition Segment Revenue by Payor (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended
--- | --- | ---
Sep. 30, 2018 | Sep. 30, 2017 | Sep. 30, 2018 | Sep. 30, 2017
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | $ 2,670,701 | $ 2,561,543 | $ 7,980,178 | $ 7,478,938
Other revenues | 188,606 | 322,849 | 639,387 | 952,762
Total revenues | 2,847,330 | 2,765,071 | 8,583,727 | 8,095,721
Intersegment Elimination |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Total revenues | (33,785) | (19,471) | (91,691) | (57,047)
Medicare and Medicare Advantage |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 1,513,191 | 1,338,155 | 4,524,449 | 3,924,255
Other revenues | 130,746 | 232,251 | 427,532 | 682,964
Medicaid and Managed Medicaid |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 159,165 | 155,113 | 466,948 | 450,984
Other revenues | 12,042 | 17,142 | 43,991 | 54,757
Other Government Payors |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 193,958 | 161,924 | 580,548 | 454,997
Commercial Payors |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 817,834 | 800,505 | 2,436,338 | 2,351,282
Other revenues | 20,205 | 27,222 | 77,633 | 79,241
Other |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Other revenues | 33,974 | 52,230 | 117,979 | 154,288
U.S. dialysis and related lab services |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Total revenues | 2,551,377 | 2,356,999 | 7,639,101 | 6,928,323
U.S. dialysis and related lab services | Intersegment Elimination |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Total revenues | (25,424) | (13,475) | (63,943) | (38,559)
U.S. dialysis and related lab services | Medicare and Medicare Advantage |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 1,513,191 | 1,338,155 | 4,524,449 | 3,924,255
U.S. dialysis and related lab services | Medicaid and Managed Medicaid |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 159,165 | 155,113 | 466,948 | 450,984
U.S. dialysis and related lab services | Other Government Payors |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 113,043 | 89,243 | 330,500 | 271,947
U.S. dialysis and related lab services | Commercial Payors |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 786,470 | 783,171 | 2,366,182 | 2,304,745
U.S. dialysis and related lab services | Other |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Other revenues | 4,932 | 4,792 | 14,965 | 14,951
Other—Ancillary services and strategic initiatives |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Total revenues | 295,953 | 408,072 | 944,626 | 1,167,398
Other—Ancillary services and strategic initiatives | Intersegment Elimination |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Total revenues | (8,361) | (5,996) | (27,748) | (18,488)
Other—Ancillary services and strategic initiatives | Medicare and Medicare Advantage |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Other revenues | 130,746 | 232,251 | 427,532 | 682,964
Other—Ancillary services and strategic initiatives | Medicaid and Managed Medicaid |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Other revenues | 12,042 | 17,142 | 43,991 | 54,757
Other—Ancillary services and strategic initiatives | Other Government Payors |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 80,915 | 72,681 | 250,048 | 183,050
Other—Ancillary services and strategic initiatives | Commercial Payors |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Patient service revenues | 31,364 | 17,334 | 70,156 | 46,537
Other revenues | 20,205 | 27,222 | 77,633 | 79,241
Other—Ancillary services and strategic initiatives | Other |  |  |  |
Disaggregation of Revenue [Line Items] |  |  |  |
Other revenues | $ 29,042 | $ 47,438 | $ 103,014 | $ 139,337

X
- Definition Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table. + References No definition available. + Details
Name: | us-gaap_DisaggregationOfRevenueLineItems
Namespace Prefix: | us-gaap_
Data Type: | xbrli:stringItemType
Balance Type: | na
Period Type: | duration

X
- Definition Amount of revenue and income classified as other. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 944 -SubTopic 220 -Section S99 -Paragraph 1 -Subparagraph (SX 210.7-04.4) -URI http://asc.fasb.org/extlink&oid=114873790&loc=SL114874131-224263 + Details
Name: | us-gaap_OtherIncome
Namespace Prefix: | us-gaap_
Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | duration

X
- Definition Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130539-203045 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130545-203045 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 4 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130543-203045 + Details
Name: | us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax
Namespace Prefix: | us-gaap_
Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | duration

X
- Definition Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss). + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8736-108599 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 220 -SubTopic 10 -Section S99 -Paragraph 2 -Subparagraph (SX 210.5-03.1) -URI http://asc.fasb.org/extlink&oid=115205541&loc=SL114868664-224227 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8933-108599 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8736-108599 + Details
Name: | us-gaap_Revenues
Namespace Prefix: | us-gaap_
Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | duration

X
- Details
Name: | srt_ConsolidationItemsAxis=us-gaap_IntersegmentEliminationMember
Namespace Prefix: |
Data Type: | na
Balance Type: |
Period Type: |

X
- Details
Name: | us-gaap_HealthCareOrganizationRevenueSourcesAxis=dva_MedicareandMedicareAdvantageMember
Namespace Prefix: |
Data Type: | na
Balance Type: |
Period Type: |

X
- Details
Name: | us-gaap_HealthCareOrganizationRevenueSourcesAxis=dva_MedicaidandManagedMedicaidMember
Namespace Prefix: |
Data Type: | na
Balance Type: |
Period Type: |

X
- Details
Name: | us-gaap_HealthCareOrganizationRevenueSourcesAxis=dva_OtherGovernmentPayorsMember
Namespace Prefix: |
Data Type: | na
Balance Type: |
Period Type: |

X
- Details
Name: | us-gaap_HealthCareOrganizationRevenueSourcesAxis=dva_CommercialPayorsMember
Namespace Prefix: |
Data Type: | na
Balance Type: |
Period Type: |

X
- Details
Name: | us-gaap_HealthCareOrganizationRevenueSourcesAxis=dva_OtherSourcesofRevenueMember
Namespace Prefix: |
Data Type: | na
Balance Type: |
Period Type: |

X
- Details
Name: | us-gaap_StatementBusinessSegmentsAxis=dva_USDialysisAndRelatedLabServicesMember
Namespace Prefix: |
Data Type: | na
Balance Type: |
Period Type: |

X
- Details
Name: | us-gaap_StatementBusinessSegmentsAxis=us-gaap_AllOtherSegmentsMember
Namespace Prefix: |
Data Type: | na
Balance Type: |
Period Type: |