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Segment reporting (Tables) | 3 Months Ended
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Mar. 31, 2019
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 March 31,
| 2019 |  | 2018
Segment revenues: |  |  |
U.S. dialysis and related lab services |  |  |
Patient service revenues: |  |  |
External sources | $ | 2,517,289 |  |  | $ | 2,489,165 |
Intersegment revenues | 30,420 |  |  | 18,422 |
U.S. dialysis and related lab services patient service revenues | 2,547,709 |  |  | 2,507,587 |
Provision for uncollectible accounts | (5,463 | ) |  | 25,199 |
Net U.S. dialysis and related lab services patient service revenues | 2,542,246 |  |  | 2,532,786 |
Other revenues(1): |  |  |
External sources | 4,684 |  |  | 5,114 |
Intersegment revenues | 221 |  |  | — |
Total U.S. dialysis and related lab services revenues | $ | 2,547,151 |  |  | $ | 2,537,900 |
Other—Ancillary services and strategic initiatives |  |  |
Patient service revenues, net | $ | 117,863 |  |  | $ | 102,255 |
Other external sources | 108,739 |  |  | 227,711 |
Intersegment revenues | 3,336 |  |  | 10,199 |
Total ancillary services and strategic initiatives revenues | 229,938 |  |  | 340,165 |
Total net segment revenues | 2,777,089 |  |  | 2,878,065 |
Elimination of intersegment revenues | (33,977 | ) |  | (28,621 | )
Consolidated revenues | $ | 2,743,112 |  |  | $ | 2,849,444 |
Segment operating margin: |  |  |  |  |
U.S. dialysis and related lab services | $ | 416,981 |  |  | $ | 433,380 |
Other—Ancillary services and strategic initiatives | (57,630 | ) |  | (6,990 | )
Total segment operating margin | 359,351 |  |  | 426,390 |
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: |  |  |
Corporate administrative support | (18,844 | ) |  | (15,704 | )
Consolidated operating income | 340,507 |  |  | 410,686 |
Debt expense | (131,519 | ) |  | (113,516 | )
Other income, net | 6,940 |  |  | 4,582 |
Consolidated income from continuing operations before income taxes | $ | 215,928 |  |  | $ | 301,752 |
(1) Includes management fee revenue from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling equity investment
Summary of Assets by Reportable Segment | A summary of assets by reportable segment was as follows:
| March 31, 2019 |  | December 31, 2018
Segment assets |  |  |  |  |
U.S. dialysis and related lab services (including equity investments of $101,173 and $95,290, respectively) | $ | 15,095,326 |  |  | $ | 12,333,641 |
Other—Ancillary services and strategic initiatives (including equity investments of $125,136 and $129,321, respectively) | 1,505,670 |  |  | 1,387,046 |
DMG—Held for sale (including equity investments of $5,282 and $4,833, respectively) | 6,004,948 |  |  | 5,389,565 |
Consolidated assets | $ | 22,605,944 |  |  | $ | 19,110,252 |
Summary of Depreciation and Amortization Expense by Reportable Segment | Depreciation and amortization expense by reportable segment was as follows:
| Three months ended March 31,
| 2019 |  | 2018
U.S. dialysis and related lab services | $ | 140,780 |  |  | $ | 134,776 |
Other—Ancillary services and strategic initiatives | 7,748 |  |  | 8,023 |
| $ | 148,528 |  |  | $ | 142,799 |
Summary of Expenditures for Property and Equipment by Reportable Segment | Expenditures for property and equipment by reportable segment were as follows:
| Three months ended March 31,
| 2019 |  | 2018
U.S. dialysis and related lab services | $ | 170,548 |  |  | $ | 191,406 |
Other—Ancillary services and strategic initiatives | 8,578 |  |  | 9,988 |
DMG—Held for sale | 19,752 |  |  | 31,049 |
| $ | 198,878 |  |  | $ | 232,443 |

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