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Consolidating Financial Statements - Consolidating Statements of Cash Flows (Details) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Cash flows from operating activities: |  |  |
Net income | $ 333,040 | $ 830,555 | $ 1,033,082
Changes in operating assets and liabilities and non-cash items included in net income | 1,438,600 | 1,082,611 | 939,044
Net cash provided by operating activities | 1,771,640 | 1,913,166 | 1,972,126
Cash flows from investing activities: |  |  |
Additions of property and equipment | (987,138) | (905,250) | (829,095)
Acquisitions | (183,156) | (803,879) | (563,856)
Proceeds from asset and business sales | 150,205 | 92,336 | 64,725
Investments and other items | 14,446 | 252,061 | 126,558
Net cash used in investing activities | (1,005,643) | (1,364,732) | (1,201,668)
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | 694,777 | 154,848 | (124,442)
Intercompany borrowing | 0 | 0 | 0
Other items | (1,320,131) | (921,105) | (1,227,539)
Net cash used in financing activities | (625,354) | (766,257) | (1,351,981)
Effect of Exchange Rate on Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Including Disposal Group and Discontinued Operations | (3,350) | 254 | 4,276
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 137,293 | (217,569) | (577,247)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 518,920 | 683,463 | 1,244,917
Cash, cash equivalents and restricted cash of continuing operations at end of the year | 415,420 | 518,920 | 683,463
Reportable Legal Entites | DaVita Inc. |  |  |
Cash flows from operating activities: |  |  |
Net income | 159,394 | 663,618 | 879,874
Changes in operating assets and liabilities and non-cash items included in net income | (86,070) | (533,300) | (612,706)
Net cash provided by operating activities | 73,324 | 130,318 | 267,168
Cash flows from investing activities: |  |  |
Additions of property and equipment | (175,787) | (155,972) | (139,303)
Acquisitions | 0 | 0 | 0
Proceeds from asset and business sales | 0 | 0 | 0
Investments and other items | 30,962 | 211,619 | 153,031
Net cash used in investing activities | (144,825) | 55,647 | 13,728
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | 725,889 | 173,529 | (92,460)
Intercompany borrowing | 404,897 | 22,589 | 236,052
Other items | (1,147,934) | (781,697) | (1,061,203)
Net cash used in financing activities | (17,148) | (585,579) | (917,611)
Effect of Exchange Rate on Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Including Disposal Group and Discontinued Operations | 0 | 0 | 0
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | (88,649) | (399,614) | (636,715)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 150,307 | 549,921 | 1,186,636
Cash, cash equivalents and restricted cash of continuing operations at end of the year | 61,658 | 150,307 | 549,921
Reportable Legal Entites | Guarantor Subsidiaries |  |  |
Cash flows from operating activities: |  |  |
Net income | 103,196 | 478,192 | 693,720
Changes in operating assets and liabilities and non-cash items included in net income | 818,027 | 368,135 | 359,366
Net cash provided by operating activities | 921,223 | 846,327 | 1,053,086
Cash flows from investing activities: |  |  |
Additions of property and equipment | (534,278) | (490,800) | (382,305)
Acquisitions | (73,046) | (693,522) | (472,413)
Proceeds from asset and business sales | 61,962 | 90,340 | 70,342
Investments and other items | (16,362) | (7,004) | (29,038)
Net cash used in investing activities | (561,724) | (1,100,986) | (813,414)
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | (11,437) | (12,662) | (27,830)
Intercompany borrowing | (311,778) | 218,980 | (231,800)
Other items | (28,067) | (2,493) | (21,525)
Net cash used in financing activities | (351,282) | 203,825 | (281,155)
Effect of Exchange Rate on Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Including Disposal Group and Discontinued Operations | 0 | 0 | 0
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 8,217 | (50,834) | (41,483)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 9,384 | 8,687 | 0
Cash, cash equivalents and restricted cash of continuing operations at end of the year | 12,048 | 9,384 | 8,687
Reportable Legal Entites | Non- Guarantor Subsidiaries |  |  |
Cash flows from operating activities: |  |  |
Net income | 517,671 | 241,312 | 820,486
Changes in operating assets and liabilities and non-cash items included in net income | 259,422 | 695,209 | (168,614)
Net cash provided by operating activities | 777,093 | 936,521 | 651,872
Cash flows from investing activities: |  |  |
Additions of property and equipment | (277,073) | (258,478) | (307,487)
Acquisitions | (110,110) | (110,357) | (91,443)
Proceeds from asset and business sales | 88,243 | 1,996 | (5,617)
Investments and other items | (154) | 47,446 | 2,565
Net cash used in investing activities | (299,094) | (319,393) | (401,982)
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | (19,675) | (6,019) | (4,152)
Intercompany borrowing | (93,119) | (241,569) | (4,252)
Other items | (144,130) | (136,915) | (144,811)
Net cash used in financing activities | (256,924) | (384,503) | (153,215)
Effect of Exchange Rate on Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Including Disposal Group and Discontinued Operations | (3,350) | 254 | 4,276
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 217,725 | 232,879 | 100,951
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 359,229 | 124,855 | 58,281
Cash, cash equivalents and restricted cash of continuing operations at end of the year | 341,714 | 359,229 | 124,855
Consolidating Adjustments |  |  |
Cash flows from operating activities: |  |  |
Net income | (447,221) | (552,567) | (1,360,998)
Changes in operating assets and liabilities and non-cash items included in net income | 447,221 | 552,567 | 1,360,998
Net cash provided by operating activities | 0 | 0 | 0
Cash flows from investing activities: |  |  |
Additions of property and equipment | 0 | 0 | 0
Acquisitions | 0 | 0 | 0
Proceeds from asset and business sales | 0 | 0 | 0
Investments and other items | 0 | 0 | 0
Net cash used in investing activities | 0 | 0 | 0
Cash flows from financing activities: |  |  |
Long-term debt and related financing costs, net | 0 | 0 | 0
Intercompany borrowing | 0 | 0 | 0
Other items | 0 | 0 | 0
Net cash used in financing activities | 0 | 0 | 0
Effect of Exchange Rate on Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Including Disposal Group and Discontinued Operations | 0 | 0 | 0
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 0 | 0 | 0
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 0 | 0 | 0
Cash, cash equivalents and restricted cash of continuing operations at end of the year | 0 | 0 | 0
Discontinued Operations |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 240,793 | (53,026) | (15,793)
Discontinued Operations | Reportable Legal Entites | DaVita Inc. |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 0 | 0 | 0
Discontinued Operations | Reportable Legal Entites | Guarantor Subsidiaries |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 5,553 | (51,531) | (50,170)
Discontinued Operations | Reportable Legal Entites | Non- Guarantor Subsidiaries |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 235,240 | (1,495) | 34,377
Discontinued Operations | Consolidating Adjustments |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 0 | 0 | 0
Continuing Operations |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | (103,500) | (164,543) | (561,454)
Continuing Operations | Reportable Legal Entites | DaVita Inc. |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | (88,649) | (399,614) | (636,715)
Continuing Operations | Reportable Legal Entites | Guarantor Subsidiaries |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | 2,664 | 697 | 8,687
Continuing Operations | Reportable Legal Entites | Non- Guarantor Subsidiaries |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | (17,515) | 234,374 | 66,574
Continuing Operations | Consolidating Adjustments |  |  |
Cash flows from financing activities: |  |  |
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations | $ 0 | $ 0 | $ 0

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