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Consolidating Financial Statements (Tables) | 12 Months Ended
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Dec. 31, 2018
Condensed Financial Information Disclosure [Abstract] |
Consolidating Statements of Income | Consolidating Statements of Income
For twelve months ended December 31, 2018 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Dialysis and related lab patient service revenues |  | $ | — |  |  | $ | 7,263,195 |  |  | $ | 3,657,456 |  |  | $ | (210,670 | ) |  | $ | 10,709,981 |
Less: Provision for uncollectible accounts |  | — |  |  | (36,377 | ) |  | (13,210 | ) |  | — |  |  | (49,587 | )
Net dialysis and related lab patient service revenues |  | — |  |  | 7,226,818 |  |  | 3,644,246 |  |  | (210,670 | ) |  | 10,660,394 |
Other revenues |  | 799,230 |  |  | 714,489 |  |  | 189,927 |  |  | (959,189 | ) |  | 744,457 |
Total net revenues |  | 799,230 |  |  | 7,941,307 |  |  | 3,834,173 |  |  | (1,169,859 | ) |  | 11,404,851 |
Operating expenses and charges |  | 646,640 |  |  | 7,100,415 |  |  | 3,301,831 |  |  | (1,169,859 | ) |  | 9,879,027 |
Operating income |  | 152,590 |  |  | 840,892 |  |  | 532,342 |  |  | — |  |  | 1,525,824 |
Debt expense |  | (491,749 | ) |  | (208,484 | ) |  | (36,427 | ) |  | 249,225 |  |  | (487,435 | )
Other income, net |  | 418,839 |  |  | 10,367 |  |  | 22,195 |  |  | (441,312 | ) |  | 10,089 |
Income tax expense |  | 23,482 |  |  | 187,691 |  |  | 47,227 |  |  | — |  |  | 258,400 |
Equity earnings in subsidiaries |  | 103,196 |  |  | 344,025 |  |  | — |  |  | (447,221 | ) |  | — |
Net income from continuing operations |  | 159,394 |  |  | 799,109 |  |  | 470,883 |  |  | (639,308 | ) |  | 790,078 |
Net (loss) income from discontinued operations, net of tax |  | — |  |  | (695,913 | ) |  | 46,788 |  |  | 192,087 |  |  | (457,038 | )
Net income |  | 159,394 |  |  | 103,196 |  |  | 517,671 |  |  | (447,221 | ) |  | 333,040 |
Less: Net income attributable to noncontrolling interests |  | — |  |  | — |  |  | — |  |  | (173,646 | ) |  | (173,646 | )
Net income attributable to DaVita Inc. |  | $ | 159,394 |  |  | $ | 103,196 |  |  | $ | 517,671 |  |  | $ | (620,867 | ) |  | $ | 159,394 |
Consolidating Statements of Income - (continued)
For twelve months ended December 31, 2017 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Dialysis and related lab patient service revenues |  | $ | — |  |  | $ | 6,884,750 |  |  | $ | 3,393,026 |  |  | $ | (184,106 | ) |  | $ | 10,093,670 |
Less: Provision for uncollectible accounts |  | — |  |  | (340,552 | ) |  | (151,982 | ) |  | 7,170 |  |  | (485,364 | )
Net dialysis and related lab patient service revenues |  | — |  |  | 6,544,198 |  |  | 3,241,044 |  |  | (176,936 | ) |  | 9,608,306 |
Other revenues |  | 793,751 |  |  | 1,204,467 |  |  | 68,322 |  |  | (798,212 | ) |  | 1,268,328 |
Total net revenues |  | 793,751 |  |  | 7,748,665 |  |  | 3,309,366 |  |  | (975,148 | ) |  | 10,876,634 |
Operating expenses and charges |  | 527,942 |  |  | 6,475,550 |  |  | 3,035,535 |  |  | (975,148 | ) |  | 9,063,879 |
Operating income |  | 265,809 |  |  | 1,273,115 |  |  | 273,831 |  |  | — |  |  | 1,812,755 |
Debt expense |  | (426,149 | ) |  | (209,612 | ) |  | (34,831 | ) |  | 239,958 |  |  | (430,634 | )
Other income, net |  | 411,731 |  |  | 11,169 |  |  | 18,467 |  |  | (423,702 | ) |  | 17,665 |
Income tax expense |  | 65,965 |  |  | 237,670 |  |  | 20,224 |  |  | — |  |  | 323,859 |
Equity earnings in subsidiaries |  | 478,192 |  |  | 74,375 |  |  | — |  |  | (552,567 | ) |  | — |
Net income from continuing operations |  | 663,618 |  |  | 911,377 |  |  | 237,243 |  |  | (736,311 | ) |  | 1,075,927 |
Net (loss) income from discontinued operations, net of tax |  | — |  |  | (433,185 | ) |  | 4,069 |  |  | 183,744 |  |  | (245,372 | )
Net income |  | 663,618 |  |  | 478,192 |  |  | 241,312 |  |  | (552,567 | ) |  | 830,555 |
Less: Net income attributable to noncontrolling interests |  | — |  |  | — |  |  | — |  |  | (166,937 | ) |  | (166,937 | )
Net income attributable to DaVita Inc. |  | $ | 663,618 |  |  | $ | 478,192 |  |  | $ | 241,312 |  |  | $ | (719,504 | ) |  | $ | 663,618 |
For twelve months ended December 31, 2016 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Dialysis and related lab patient service revenues |  | $ | — |  |  | $ | 6,665,601 |  |  | $ | 3,215,085 |  |  | $ | (153,326 | ) |  | $ | 9,727,360 |
Less: Provision for uncollectible accounts |  | — |  |  | (272,426 | ) |  | (158,878 | ) |  | — |  |  | (431,304 | )
Net dialysis and related lab patient service revenues |  | — |  |  | 6,393,175 |  |  | 3,056,207 |  |  | (153,326 | ) |  | 9,296,056 |
Other revenues |  | 767,791 |  |  | 1,378,952 |  |  | 30,184 |  |  | (765,516 | ) |  | 1,411,411 |
Total net revenues |  | 767,791 |  |  | 7,772,127 |  |  | 3,086,391 |  |  | (918,842 | ) |  | 10,707,467 |
Operating expenses and charges |  | 493,175 |  |  | 6,907,469 |  |  | 2,195,955 |  |  | (918,842 | ) |  | 8,677,757 |
Operating income |  | 274,616 |  |  | 864,658 |  |  | 890,436 |  |  | — |  |  | 2,029,710 |
Debt expense |  | (407,925 | ) |  | (191,083 | ) |  | (40,434 | ) |  | 225,326 |  |  | (414,116 | )
Other income, net |  | 396,797 |  |  | 3,726 |  |  | 7,694 |  |  | (400,706 | ) |  | 7,511 |
Income tax expense |  | 77,334 |  |  | 238,446 |  |  | 115,981 |  |  | — |  |  | 431,761 |
Equity earnings in subsidiaries |  | 693,720 |  |  | 667,278 |  |  | — |  |  | (1,360,998 | ) |  | — |
Net income from continuing operations |  | 879,874 |  |  | 1,106,133 |  |  | 741,715 |  |  | (1,536,378 | ) |  | 1,191,344 |
Net (loss) income from discontinued operations, net of tax |  | — |  |  | (412,413 | ) |  | 78,771 |  |  | 175,380 |  |  | (158,262 | )
Net income |  | 879,874 |  |  | 693,720 |  |  | 820,486 |  |  | (1,360,998 | ) |  | 1,033,082 |
Less: Net income attributable to noncontrolling interests |  | — |  |  | — |  |  | — |  |  | (153,208 | ) |  | (153,208 | )
Net income attributable to DaVita Inc. |  | $ | 879,874 |  |  | $ | 693,720 |  |  | $ | 820,486 |  |  | $ | (1,514,206 | ) |  | $ | 879,874 |
Condensed Consolidating Statements of Income
For the year ended December 31, 2018 |  | Consolidated Total |  | Physician Groups |  | Unrestricted Subsidiaries |  | Company and Restricted Subsidiaries(1)
Dialysis and related lab patient service revenues |  | $ | 10,709,981 |  |  | $ | — |  |  | $ | — |  |  | $ | 10,709,981 |
Less: Provision for uncollectible accounts |  | (49,587 | ) |  | — |  |  | — |  |  | (49,587 | )
Net dialysis and related lab patient service revenues |  | 10,660,394 |  |  | — |  |  | — |  |  | 10,660,394 |
Other revenues |  | 744,457 |  |  | — |  |  | — |  |  | 744,457 |
Total net revenues |  | 11,404,851 |  |  | — |  |  | — |  |  | 11,404,851 |
Operating expenses and charges |  | 9,879,027 |  |  | — |  |  | — |  |  | 9,879,027 |
Operating income |  | 1,525,824 |  |  | — |  |  | — |  |  | 1,525,824 |
Debt expense |  | (487,435 | ) |  | — |  |  | — |  |  | (487,435 | )
Other income, net |  | 10,089 |  |  | — |  |  | — |  |  | 10,089 |
Income tax expense |  | 258,400 |  |  | — |  |  | — |  |  | 258,400 |
Net income from continuing operations |  | 790,078 |  |  | — |  |  | — |  |  | 790,078 |
Net (loss) income from discontinued operations, net of tax |  | (457,038 | ) |  | 37,373 |  |  | 92 |  |  | (494,503 | )
Net income |  | 333,040 |  |  | 37,373 |  |  | 92 |  |  | 295,575 |
Less: Net income attributable to noncontrolling interests |  | (173,646 | ) |  | (7,841 | ) |  | — |  |  | (165,805 | )
Net income attributable to DaVita Inc. |  | $ | 159,394 |  |  | $ | 29,532 |  |  | $ | 92 |  |  | $ | 129,770 |
Consolidating Statements of Comprehensive Income | Consolidating Statements of Comprehensive Income
For the year ended December 31, 2018 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Net income |  | $ | 159,394 |  |  | $ | 103,196 |  |  | $ | 517,671 |  |  | $ | (447,221 | ) |  | $ | 333,040 |
Other comprehensive income (loss) |  | 6,153 |  |  | — |  |  | (45,944 | ) |  | — |  |  | (39,791 | )
Total comprehensive income |  | 165,547 |  |  | 103,196 |  |  | 471,727 |  |  | (447,221 | ) |  | 293,249 |
Less: Comprehensive income attributable to noncontrolling interest |  | — |  |  | — |  |  | — |  |  | (173,646 | ) |  | (173,646 | )
Comprehensive income attributable to DaVita Inc. |  | $ | 165,547 |  |  | $ | 103,196 |  |  | $ | 471,727 |  |  | $ | (620,867 | ) |  | $ | 119,603 |
For the year ended December 31, 2017 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income |  | $ | 663,618 |  |  | $ | 478,192 |  |  | $ | 241,312 |  |  | $ | (552,567 | ) |  | $ | 830,555 |
Other comprehensive income |  | 3,106 |  |  | — |  |  | 99,770 |  |  | — |  |  | 102,876 |
Total comprehensive income |  | 666,724 |  |  | 478,192 |  |  | 341,082 |  |  | (552,567 | ) |  | 933,431 |
Less: Comprehensive income attributable to noncontrolling interest |  | — |  |  | — |  |  | — |  |  | (166,935 | ) |  | (166,935 | )
Comprehensive income attributable to DaVita Inc. |  | $ | 666,724 |  |  | $ | 478,192 |  |  | $ | 341,082 |  |  | $ | (719,502 | ) |  | $ | 766,496 |
For the year ended December 31, 2016 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income |  | $ | 879,874 |  |  | $ | 693,720 |  |  | $ | 820,486 |  |  | $ | (1,360,998 | ) |  | $ | 1,033,082 |
Other comprehensive loss |  | (290 | ) |  | — |  |  | (29,337 | ) |  | — |  |  | (29,627 | )
Total comprehensive income |  | 879,584 |  |  | 693,720 |  |  | 791,149 |  |  | (1,360,998 | ) |  | 1,003,455 |
Less: Comprehensive income attributable to noncontrolling interest |  | — |  |  | — |  |  | — |  |  | (153,398 | ) |  | (153,398 | )
Comprehensive income attributable to DaVita Inc. |  | $ | 879,584 |  |  | $ | 693,720 |  |  | $ | 791,149 |  |  | $ | (1,514,396 | ) |  | $ | 850,057 |
Condensed Consolidating Statements of Comprehensive Income
For the year ended December 31, 2018 |  | Consolidated Total |  | Physician Groups |  | Unrestricted Subsidiaries |  | Company and Restricted Subsidiaries(1)
Net income |  | $ | 333,040 |  |  | $ | 37,373 |  |  | $ | 92 |  |  | $ | 295,575 |
Other comprehensive loss |  | (39,791 | ) |  | — |  |  | — |  |  | (39,791 | )
Total comprehensive income |  | 293,249 |  |  | 37,373 |  |  | 92 |  |  | 255,784 |
Less: Comprehensive income attributable to noncontrolling interest |  | (173,646 | ) |  | (7,841 | ) |  | — |  |  | (165,805 | )
Comprehensive income attributable to DaVita Inc. |  | $ | 119,603 |  |  | $ | 29,532 |  |  | $ | 92 |  |  | $ | 89,979 |
(1) After the elimination of the unrestricted subsidiaries and the physician groups
Consolidating Balance Sheets | Consolidating Balance Sheets
As of December 31, 2018 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Cash and cash equivalents |  | $ | 60,653 |  |  | $ | — |  |  | $ | 262,385 |  |  | $ | — |  |  | $ | 323,038 |
Restricted cash and equivalents |  | 1,005 |  |  | 12,048 |  |  | 79,329 |  |  | — |  |  | 92,382 |
Accounts receivable, net |  | — |  |  | 1,264,290 |  |  | 594,318 |  |  | — |  |  | 1,858,608 |
Other current assets |  | 37,185 |  |  | 601,318 |  |  | 122,063 |  |  | — |  |  | 760,566 |
Current assets held for sale |  | — |  |  | 4,440,953 |  |  | 948,612 |  |  | — |  |  | 5,389,565 |
Total current assets |  | 98,843 |  |  | 6,318,609 |  |  | 2,006,707 |  |  | — |  |  | 8,424,159 |
Property and equipment, net |  | 491,462 |  |  | 1,624,835 |  |  | 1,277,372 |  |  | — |  |  | 3,393,669 |
Intangible assets, net |  | 153 |  |  | 42,933 |  |  | 75,760 |  |  | — |  |  | 118,846 |
Investments in subsidiaries |  | 10,102,750 |  |  | 3,239,862 |  |  | — |  |  | (13,342,612 | ) |  | — |
Intercompany receivables |  | 3,419,448 |  |  | — |  |  | 1,471,203 |  |  | (4,890,651 | ) |  | — |
Other long-term assets and investments |  | 53,385 |  |  | 80,537 |  |  | 197,696 |  |  | — |  |  | 331,618 |
Goodwill |  | — |  |  | 4,812,365 |  |  | 2,029,595 |  |  | — |  |  | 6,841,960 |
Total assets |  | $ | 14,166,041 |  |  | $ | 16,119,141 |  |  | $ | 7,058,333 |  |  | $ | (18,233,263 | ) |  | $ | 19,110,252 |
Current liabilities |  | $ | 1,945,943 |  |  | $ | 1,251,534 |  |  | $ | 449,925 |  |  | $ | — |  |  | $ | 3,647,402 |
Current liabilities held for sale |  | — |  |  | 722,766 |  |  | 520,993 |  |  | — |  |  | 1,243,759 |
Total current liabilities |  | 1,945,943 |  |  | 1,974,300 |  |  | 970,918 |  |  | — |  |  | 4,891,161 |
Intercompany payables |  | — |  |  | 3,327,026 |  |  | 1,563,625 |  |  | (4,890,651 | ) |  | — |
Long-term debt and other long-term liabilities |  | 7,918,581 |  |  | 715,065 |  |  | 552,406 |  |  | — |  |  | 9,186,052 |
Noncontrolling interests subject to put provisions |  | 598,075 |  |  | — |  |  | — |  |  | 526,566 |  |  | 1,124,641 |
Total DaVita Inc. shareholders' equity |  | 3,703,442 |  |  | 10,102,750 |  |  | 3,239,862 |  |  | (13,342,612 | ) |  | 3,703,442 |
Noncontrolling interests not subject to put provisions |  | — |  |  | — |  |  | 731,522 |  |  | (526,566 | ) |  | 204,956 |
Total equity |  | 3,703,442 |  |  | 10,102,750 |  |  | 3,971,384 |  |  | (13,869,178 | ) |  | 3,908,398 |
Total liabilities and equity |  | $ | 14,166,041 |  |  | $ | 16,119,141 |  |  | $ | 7,058,333 |  |  | $ | (18,233,263 | ) |  | $ | 19,110,252 |
Consolidating Balance Sheets - (continued)
As of December 31, 2017 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Cash and cash equivalents |  | $ | 149,305 |  |  | $ | — |  |  | $ | 358,929 |  |  | $ | — |  |  | $ | 508,234 |
Restricted cash and equivalents |  | 1,002 |  |  | 9,384 |  |  | 300 |  |  | — |  |  | 10,686 |
Accounts receivable, net |  | — |  |  | 1,208,715 |  |  | 506,035 |  |  | — |  |  | 1,714,750 |
Other current assets |  | 67,025 |  |  | 621,409 |  |  | 86,955 |  |  | — |  |  | 775,389 |
Current assets held for sale |  | — |  |  | 4,992,067 |  |  | 769,575 |  |  | — |  |  | 5,761,642 |
Total current assets |  | 217,332 |  |  | 6,831,575 |  |  | 1,721,794 |  |  | — |  |  | 8,770,701 |
Property and equipment, net |  | 408,010 |  |  | 1,560,390 |  |  | 1,180,813 |  |  | — |  |  | 3,149,213 |
Intangible assets, net |  | 250 |  |  | 50,971 |  |  | 62,606 |  |  | — |  |  | 113,827 |
Investments in subsidiaries |  | 10,009,874 |  |  | 3,085,722 |  |  | — |  |  | (13,095,596 | ) |  | — |
Intercompany receivables |  | 3,677,947 |  |  | — |  |  | 1,313,213 |  |  | (4,991,160 | ) |  | — |
Other long-term assets and investments |  | 47,297 |  |  | 68,344 |  |  | 214,875 |  |  | — |  |  | 330,516 |
Goodwill |  | — |  |  | 4,732,320 |  |  | 1,877,959 |  |  | — |  |  | 6,610,279 |
Total assets |  | $ | 14,360,710 |  |  | $ | 16,329,322 |  |  | $ | 6,371,260 |  |  | $ | (18,086,756 | ) |  | $ | 18,974,536 |
Current liabilities |  | $ | 238,706 |  |  | $ | 1,207,482 |  |  | $ | 436,262 |  |  | $ | — |  |  | $ | 1,882,450 |
Current liabilities held for sale |  | — |  |  | 739,294 |  |  | 445,776 |  |  | — |  |  | 1,185,070 |
Total current liabilities |  | 238,706 |  |  | 1,946,776 |  |  | 882,038 |  |  | — |  |  | 3,067,520 |
Intercompany payables |  | — |  |  | 3,690,042 |  |  | 1,301,118 |  |  | (4,991,160 | ) |  | — |
Long-term debt and other long-term liabilities |  | 8,857,373 |  |  | 682,630 |  |  | 469,587 |  |  | — |  |  | 10,009,590 |
Noncontrolling interests subject to put provisions |  | 574,602 |  |  | — |  |  | — |  |  | 436,758 |  |  | 1,011,360 |
Total DaVita Inc. shareholders' equity |  | 4,690,029 |  |  | 10,009,874 |  |  | 3,085,722 |  |  | (13,095,596 | ) |  | 4,690,029 |
Noncontrolling interests not subject to put provisions |  | — |  |  | — |  |  | 632,795 |  |  | (436,758 | ) |  | 196,037 |
Total equity |  | 4,690,029 |  |  | 10,009,874 |  |  | 3,718,517 |  |  | (13,532,354 | ) |  | 4,886,066 |
Total liabilities and equity |  | $ | 14,360,710 |  |  | $ | 16,329,322 |  |  | $ | 6,371,260 |  |  | $ | (18,086,756 | ) |  | $ | 18,974,536 |
Condensed Consolidating Balance Sheets
As of December 31, 2018 |  | Consolidated Total |  | Physician Groups |  | Unrestricted Subsidiaries |  | Company and Restricted Subsidiaries(1)
Cash and cash equivalents |  | $ | 323,038 |  |  | $ | — |  |  | $ | — |  |  | $ | 323,038 |
Restricted cash and equivalents |  | 92,382 |  |  | — |  |  | — |  |  | 92,382 |
Accounts receivable, net |  | 1,858,608 |  |  | — |  |  | — |  |  | 1,858,608 |
Other current assets |  | 760,566 |  |  | — |  |  | — |  |  | 760,566 |
Other current assets held for sale |  | 5,389,565 |  |  | 532,050 |  |  | 2,825 |  |  | 4,854,690 |
Total current assets |  | 8,424,159 |  |  | 532,050 |  |  | 2,825 |  |  | 7,889,284 |
Property and equipment, net |  | 3,393,669 |  |  | — |  |  | — |  |  | 3,393,669 |
Amortizable intangibles, net |  | 118,846 |  |  | — |  |  | — |  |  | 118,846 |
Other long-term assets |  | 331,618 |  |  | — |  |  | — |  |  | 331,618 |
Goodwill |  | 6,841,960 |  |  | — |  |  | — |  |  | 6,841,960 |
Total assets |  | $ | 19,110,252 |  |  | $ | 532,050 |  |  | $ | 2,825 |  |  | $ | 18,575,377 |
Current liabilities |  | $ | 3,647,402 |  |  | $ | — |  |  | $ | — |  |  | $ | 3,647,402 |
Current liabilities held for sale |  | 1,243,759 |  |  | 351,925 |  |  | — |  |  | 891,834 |
Total current liabilities |  | 4,891,161 |  |  | 351,925 |  |  | — |  |  | 4,539,236 |
Payables to parent |  | — |  |  | 25,456 |  |  | 2,825 |  |  | (28,281 | )
Long-term debt and other long-term liabilities |  | 9,186,052 |  |  | — |  |  | — |  |  | 9,186,052 |
Noncontrolling interests subject to put provisions |  | 1,124,641 |  |  | — |  |  | — |  |  | 1,124,641 |
Total DaVita Inc. shareholders' equity |  | 3,703,442 |  |  | 154,669 |  |  | — |  |  | 3,548,773 |
Noncontrolling interests not subject to put provisions |  | 204,956 |  |  | — |  |  | — |  |  | 204,956 |
Shareholders' equity |  | 3,908,398 |  |  | 154,669 |  |  | — |  |  | 3,753,729 |
Total liabilities and shareholders' equity |  | $ | 19,110,252 |  |  | $ | 532,050 |  |  | $ | 2,825 |  |  | $ | 18,575,377 |
Consolidating Statements of Cash Flows | Consolidating Statements of Cash Flow
For the year ended December 31, 2018 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non-Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Cash flows from operating activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income |  | $ | 159,394 |  |  | $ | 103,196 |  |  | $ | 517,671 |  |  | $ | (447,221 | ) |  | $ | 333,040 |
Changes in operating assets and liabilities and non-cash items included in net income |  | (86,070 | ) |  | 818,027 |  |  | 259,422 |  |  | 447,221 |  |  | 1,438,600 |
Net cash provided by operating activities |  | 73,324 |  |  | 921,223 |  |  | 777,093 |  |  | — |  |  | 1,771,640 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment, net |  | (175,787 | ) |  | (534,278 | ) |  | (277,073 | ) |  | — |  |  | (987,138 | )
Acquisitions |  | — |  |  | (73,046 | ) |  | (110,110 | ) |  | — |  |  | (183,156 | )
Proceeds from asset sales, net of cash divested |  | — |  |  | 61,962 |  |  | 88,243 |  |  | — |  |  | 150,205 |
Investments and other items |  | 30,962 |  |  | (16,362 | ) |  | (154 | ) |  | — |  |  | 14,446 |
Net cash used in investing activities |  | (144,825 | ) |  | (561,724 | ) |  | (299,094 | ) |  | — |  |  | (1,005,643 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-term debt and related financing costs, net |  | 725,889 |  |  | (11,437 | ) |  | (19,675 | ) |  | — |  |  | 694,777 |
Intercompany borrowing |  | 404,897 |  |  | (311,778 | ) |  | (93,119 | ) |  | — |  |  | — |
Other items |  | (1,147,934 | ) |  | (28,067 | ) |  | (144,130 | ) |  | — |  |  | (1,320,131 | )
Net cash used in financing activities |  | (17,148 | ) |  | (351,282 | ) |  | (256,924 | ) |  | — |  |  | (625,354 | )
Effect of exchange rate changes on cash |  | — |  |  | — |  |  | (3,350 | ) |  | — |  |  | (3,350 | )
Net (decrease) increase in cash, cash equivalents and restricted cash |  | (88,649 | ) |  | 8,217 |  |  | 217,725 |  |  | — |  |  | 137,293 |
Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations |  | — |  |  | 5,553 |  |  | 235,240 |  |  | — |  |  | 240,793 |
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations |  | (88,649 | ) |  | 2,664 |  |  | (17,515 | ) |  | — |  |  | (103,500 | )
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year |  | 150,307 |  |  | 9,384 |  |  | 359,229 |  |  | — |  |  | 518,920 |
Cash, cash equivalents and restricted cash of continuing operations at end of the year |  | $ | 61,658 |  |  | $ | 12,048 |  |  | $ | 341,714 |  |  | $ | — |  |  | $ | 415,420 |
Consolidating Statements of Cash Flow - (continued)
For the year ended December 31, 2017 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non-Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Cash flows from operating activities: |  |  |  |  |  |  |  |  |  |
Net income |  | $ | 663,618 |  |  | $ | 478,192 |  |  | $ | 241,312 |  |  | $ | (552,567 | ) |  | $ | 830,555 |
Changes in operating assets and liabilities and non-cash items included in net income |  | (533,300 | ) |  | 368,135 |  |  | 695,209 |  |  | 552,567 |  |  | 1,082,611 |
Net cash provided by operating activities |  | 130,318 |  |  | 846,327 |  |  | 936,521 |  |  | — |  |  | 1,913,166 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment, net |  | (155,972 | ) |  | (490,800 | ) |  | (258,478 | ) |  | — |  |  | (905,250 | )
Acquisitions |  | — |  |  | (693,522 | ) |  | (110,357 | ) |  | — |  |  | (803,879 | )
Proceeds from asset and business sales, net of cash divested |  | — |  |  | 90,340 |  |  | 1,996 |  |  | — |  |  | 92,336 |
Investments and other items |  | 211,619 |  |  | (7,004 | ) |  | 47,446 |  |  | — |  |  | 252,061 |
Net cash provided by (used in) investing activities |  | 55,647 |  |  | (1,100,986 | ) |  | (319,393 | ) |  | — |  |  | (1,364,732 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-term debt and related financing costs, net |  | 173,529 |  |  | (12,662 | ) |  | (6,019 | ) |  | — |  |  | 154,848 |
Intercompany borrowing |  | 22,589 |  |  | 218,980 |  |  | (241,569 | ) |  | — |  |  | — |
Other items |  | (781,697 | ) |  | (2,493 | ) |  | (136,915 | ) |  | — |  |  | (921,105 | )
Net cash (used in) provided by financing activities |  | (585,579 | ) |  | 203,825 |  |  | (384,503 | ) |  | — |  |  | (766,257 | )
Effect of exchange rate changes on cash |  | — |  |  | — |  |  | 254 |  |  | — |  |  | 254 |
Net (decrease) increase in cash, cash equivalents and restricted cash |  | (399,614 | ) |  | (50,834 | ) |  | 232,879 |  |  | — |  |  | (217,569 | )
Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations |  | — |  |  | (51,531 | ) |  | (1,495 | ) |  | — |  |  | (53,026 | )
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations |  | (399,614 | ) |  | 697 |  |  | 234,374 |  |  | — |  |  | (164,543 | )
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year |  | 549,921 |  |  | 8,687 |  |  | 124,855 |  |  | — |  |  | 683,463 |
Cash, cash equivalents and restricted cash of continuing operations at end of the year |  | $ | 150,307 |  |  | $ | 9,384 |  |  | $ | 359,229 |  |  | $ | — |  |  | $ | 518,920 |
Consolidating Statements of Cash Flow - (continued)
For the year ended December 31, 2016 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non-Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Cash flows from operating activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income |  | $ | 879,874 |  |  | $ | 693,720 |  |  | $ | 820,486 |  |  | $ | (1,360,998 | ) |  | $ | 1,033,082 |
Changes in operating assets and liabilities and non-cash items included in net income |  | (612,706 | ) |  | 359,366 |  |  | (168,614 | ) |  | 1,360,998 |  |  | 939,044 |
Net cash provided by operating activities |  | 267,168 |  |  | 1,053,086 |  |  | 651,872 |  |  | — |  |  | 1,972,126 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment, net |  | (139,303 | ) |  | (382,305 | ) |  | (307,487 | ) |  | — |  |  | (829,095 | )
Acquisitions |  | — |  |  | (472,413 | ) |  | (91,443 | ) |  | — |  |  | (563,856 | )
Proceeds from asset sales |  | — |  |  | 70,342 |  |  | (5,617 | ) |  | — |  |  | 64,725 |
Investments and other items |  | 153,031 |  |  | (29,038 | ) |  | 2,565 |  |  | — |  |  | 126,558 |
Net cash provided by (used in) investing activities |  | 13,728 |  |  | (813,414 | ) |  | (401,982 | ) |  | — |  |  | (1,201,668 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-term debt and related financing costs, net |  | (92,460 | ) |  | (27,830 | ) |  | (4,152 | ) |  | — |  |  | (124,442 | )
Intercompany borrowing |  | 236,052 |  |  | (231,800 | ) |  | (4,252 | ) |  | — |  |  | — |
Other items |  | (1,061,203 | ) |  | (21,525 | ) |  | (144,811 | ) |  | — |  |  | (1,227,539 | )
Net cash used in financing activities |  | (917,611 | ) |  | (281,155 | ) |  | (153,215 | ) |  | — |  |  | (1,351,981 | )
Effect of exchange rate changes on cash |  | — |  |  | — |  |  | 4,276 |  |  | — |  |  | 4,276 |
Net (decrease) increase in cash, cash equivalents and restricted cash |  | (636,715 | ) |  | (41,483 | ) |  | 100,951 |  |  | — |  |  | (577,247 | )
Less: Net (decrease) increase in cash, cash equivalents and restricted cash from discontinued operations |  | — |  |  | (50,170 | ) |  | 34,377 |  |  | — |  |  | (15,793 | )
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations |  | (636,715 | ) |  | 8,687 |  |  | 66,574 |  |  | — |  |  | (561,454 | )
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year |  | 1,186,636 |  |  | — |  |  | 58,281 |  |  | — |  |  | 1,244,917 |
Cash, cash equivalents and restricted cash of continuing operations at end of the year |  | $ | 549,921 |  |  | $ | 8,687 |  |  | $ | 124,855 |  |  | $ | — |  |  | $ | 683,463 |
Condensed Consolidating Statements of Cash Flow
For the year ended December 31, 2018 |  | Consolidated Total |  | Physician Groups |  | Unrestricted Subsidiaries |  | Company and Restricted Subsidiaries(1)
Cash flows from operating activities: |  |  |  |  |  |  |  |  |  |  |  |
Net income |  | $ | 333,040 |  |  | $ | 37,373 |  |  | $ | 92 |  |  | $ | 295,575 |
Changes in operating and intercompany assets and liabilities and non-cash items included in net income |  | 1,438,600 |  |  | 81,722 |  |  | (92 | ) |  | 1,356,970 |
Net cash provided by operating activities |  | 1,771,640 |  |  | 119,095 |  |  | — |  |  | 1,652,545 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment |  | (987,138 | ) |  | (2,746 | ) |  | — |  |  | (984,392 | )
Acquisitions and divestitures, net |  | (183,156 | ) |  | — |  |  | — |  |  | (183,156 | )
Proceeds from asset sales |  | 150,205 |  |  | — |  |  | — |  |  | 150,205 |
Investments and other items, net |  | 14,446 |  |  | (154 | ) |  | — |  |  | 14,600 |
Net cash used in investing activities |  | (1,005,643 | ) |  | (2,900 | ) |  | — |  |  | (1,002,743 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |
Long-term debt and related financing costs, net |  | 694,777 |  |  | — |  |  | — |  |  | 694,777 |
Intercompany |  | — |  |  | 25,296 |  |  | — |  |  | (25,296 | )
Other items |  | (1,320,131 | ) |  | — |  |  | — |  |  | (1,320,131 | )
Net cash (used in) provided by financing activities |  | (625,354 | ) |  | 25,296 |  |  | — |  |  | (650,650 | )
Effect of exchange rate changes on cash |  | (3,350 | ) |  | — |  |  | — |  |  | (3,350 | )
Net increase (decrease) in cash, cash equivalents and restricted cash |  | 137,293 |  |  | 141,491 |  |  | — |  |  | (4,198 | )
Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations |  | 240,793 |  |  | 141,491 |  |  | — |  |  | 99,302 |
Net decrease in cash, cash equivalents and restricted cash from continuing operations |  | (103,500 | ) |  | — |  |  | — |  |  | (103,500 | )
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year |  | 518,920 |  |  | — |  |  | — |  |  | 518,920 |
Cash, cash equivalents and restricted cash of continuing operations at end of the year |  | $ | 415,420 |  |  | $ | — |  |  | $ | — |  |  | $ | 415,420 |
(1) After the elimination of the unrestricted subsidiaries and the physician groups

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