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Segment reporting (Tables) | 6 Months Ended
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Jun. 30, 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 June 30, |  | Six months ended June 30,
| 2019 |  | 2018 |  | 2019 |  | 2018
Segment revenues: |  |  |  |  |  |  |
U.S. dialysis and related lab services |  |  |  |  |  |  |
Patient service revenues: |  |  |  |  |  |  |
External sources | $ | 2,612,200 |  |  | $ | 2,612,734 |  |  | $ | 5,129,489 |  |  | $ | 5,101,899 |
Intersegment revenues | 30,042 |  |  | 20,096 |  |  | 60,462 |  |  | 38,519 |
U.S. dialysis and related lab services patient service revenues | 2,642,242 |  |  | 2,632,830 |  |  | 5,189,951 |  |  | 5,140,418 |
Provision for uncollectible accounts | (10,249 | ) |  | (49,406 | ) |  | (15,712 | ) |  | (24,208 | )
Net U.S. dialysis and related lab services patient service revenues | 2,631,993 |  |  | 2,583,424 |  |  | 5,174,239 |  |  | 5,116,210 |
Other revenues(1): |  |  |  |  |  |  |
External sources | 5,209 |  |  | 4,919 |  |  | 9,893 |  |  | 10,033 |
Intersegment revenues | 292 |  |  | — |  |  | 513 |  |  | — |
Total U.S. dialysis and related lab services revenues | $ | 2,637,494 |  |  | $ | 2,588,343 |  |  | $ | 5,184,645 |  |  | $ | 5,126,243 |
Other—Ancillary services and strategic initiatives |  |  |  |  |  |  |
Patient service revenues, net | $ | 121,865 |  |  | $ | 105,669 |  |  | $ | 239,728 |  |  | $ | 207,925 |
Other external sources | 113,680 |  |  | 213,037 |  |  | 222,419 |  |  | 440,748 |
Intersegment revenues | 3,403 |  |  | 9,189 |  |  | 6,739 |  |  | 19,387 |
Total ancillary services and strategic initiatives revenues | 238,948 |  |  | 327,895 |  |  | 468,886 |  |  | 668,060 |
Total net segment revenues | 2,876,442 |  |  | 2,916,238 |  |  | 5,653,531 |  |  | 5,794,303 |
Elimination of intersegment revenues | (33,737 | ) |  | (29,285 | ) |  | (67,714 | ) |  | (57,906 | )
Consolidated revenues | $ | 2,842,705 |  |  | $ | 2,886,953 |  |  | $ | 5,585,817 |  |  | $ | 5,736,397 |
Segment operating margin: |  |  |  |  |  |  |  |  |  |  |
U.S. dialysis and related lab services | $ | 498,957 |  |  | $ | 449,443 |  |  | $ | 915,939 |  |  | $ | 882,822 |
Other—Ancillary services and strategic initiatives | (15,050 | ) |  | 2,815 |  |  | (72,680 | ) |  | (4,175 | )
Total segment operating margin | 483,907 |  |  | 452,258 |  |  | 843,259 |  |  | 878,647 |
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: |  |  |  |  |  |  |
Corporate administrative support | (22,021 | ) |  | (14,066 | ) |  | (40,866 | ) |  | (29,769 | )
Consolidated operating income | 461,886 |  |  | 438,192 |  |  | 802,393 |  |  | 848,878 |
Debt expense | (131,666 | ) |  | (119,692 | ) |  | (263,185 | ) |  | (233,208 | )
Debt prepayment charges | (12,160 | ) |  | — |  |  | (12,160 | ) |  | — |
Other income, net | 5,643 |  |  | 1,994 |  |  | 12,583 |  |  | 6,576 |
Consolidated income from continuing operations before income taxes | $ | 323,703 |  |  | $ | 320,494 |  |  | $ | 539,631 |  |  | $ | 622,246 |
(1) Includes management fee revenue from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling equity investment or which are wholly-owned by third parties.
Summary of Assets by Reportable Segment | A summary of assets by reportable segment was as follows:
| June 30, 2019 |  | December 31, 2018
Segment assets |  |  |  |  |
U.S. dialysis and related lab services (including equity investments of $101,161 and $95,290, respectively) | $ | 18,352,683 |  |  | $ | 12,333,641 |
Other—Ancillary services and strategic initiatives (including equity investments of $124,516 and $129,321, respectively) | 1,578,277 |  |  | 1,387,046 |
DMG—Held for sale (including equity investments of $0 and $4,833, respectively) | — |  |  | 5,389,565 |
Consolidated assets | $ | 19,930,960 |  |  | $ | 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 June 30, |  | Six months ended June 30,
| 2019 |  | 2018 |  | 2019 |  | 2018
U.S. dialysis and related lab services | $ | 144,621 |  |  | $ | 138,252 |  |  | $ | 285,401 |  |  | $ | 273,028 |
Other—Ancillary services and strategic initiatives | 7,621 |  |  | 8,827 |  |  | 15,369 |  |  | 16,850 |
| $ | 152,242 |  |  | $ | 147,079 |  |  | $ | 300,770 |  |  | $ | 289,878 |
Summary of Expenditures for Property and Equipment by Reportable Segment |
| Three months ended June 30, |  | Six months ended June 30,
| 2019 |  | 2018 |  | 2019 |  | 2018
U.S. dialysis and related lab services | $ | 144,621 |  |  | $ | 138,252 |  |  | $ | 285,401 |  |  | $ | 273,028 |
Other—Ancillary services and strategic initiatives | 7,621 |  |  | 8,827 |  |  | 15,369 |  |  | 16,850 |
| $ | 152,242 |  |  | $ | 147,079 |  |  | $ | 300,770 |  |  | $ | 289,878 |
Expenditures for property and equipment by reportable segment were as follows:

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