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Consolidating Financial Statements | 12 Months Ended
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Dec. 31, 2019
Condensed Financial Information Disclosure [Abstract] |
Consolidating Financial Statements | Consolidating financial statements The following information is presented in accordance with Rule 3-10 of Regulation S-X. The operating and investing activities of the separate legal entities included in the Company’s consolidated financial statements are fully interdependent and integrated. Revenues and operating expenses of the separate legal entities include intercompany charges for management and other administrative services. The Company’s senior notes are guaranteed by a substantial majority of its domestic subsidiaries as measured by revenue, income and assets. The subsidiary guarantors have guaranteed the senior notes on a joint and several basis. However, a subsidiary guarantor will be released from its obligations under its guarantee of the senior notes and the indentures governing the senior notes if, in general, there is a sale or other disposition of all or substantially all of the assets of such subsidiary guarantor, including by merger or consolidation, or a sale or other disposition of all of the equity interests in such subsidiary guarantor held by the Company and its restricted subsidiaries, as defined in the indentures; such subsidiary guarantor is designated by the Company as an unrestricted subsidiary, as defined in the indentures, or otherwise ceases to be a restricted subsidiary of the Company, in each case in accordance with the indentures; or such subsidiary guarantor no longer guarantees any other indebtedness, as defined in the indentures, of the Company or any of its restricted subsidiaries, except for guarantees that are contemporaneously released. The senior notes are not guaranteed by certain of the Company's domestic subsidiaries, any of the Company's foreign subsidiaries, or any entities that do not constitute subsidiaries within the meaning of the indentures, such as corporations in which the Company holds capital stock with less than a majority of the voting power, joint ventures and partnerships in which the Company holds less than a majority of the equity or voting interests, non-owned entities and third parties. Contemporaneously with the Company entering into the New Credit Agreement and pursuant to the indentures governing the Company's senior notes, certain subsidiaries of the Company were released from their guarantees of the Company's senior notes such that, after that release, the remaining subsidiary guarantors of the senior notes were the same subsidiaries guaranteeing the New Credit Agreement. The following consolidating statements have been prepared for all periods presented based on the current subsidiary guarantors and non-guarantors stipulated in the Company's New Credit Agreement. Consolidating Statements of Income
For year ended December 31, 2019 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Dialysis patient service revenues |  | $ | — |  |  | $ | 6,961,825 |  |  | $ | 4,226,402 |  |  | $ | (269,806 | ) |  | $ | 10,918,421 |
Less: Provision for uncollectible accounts |  | — |  |  | (15,296 | ) |  | (6,419 | ) |  | — |  |  | (21,715 | )
Net dialysis patient service revenues |  | — |  |  | 6,946,529 |  |  | 4,219,983 |  |  | (269,806 | ) |  | 10,896,706 |
Other revenues |  | 804,684 |  |  | 601,394 |  |  | 171,856 |  |  | (1,086,161 | ) |  | 491,773 |
Total revenues |  | 804,684 |  |  | 7,547,923 |  |  | 4,391,839 |  |  | (1,355,967 | ) |  | 11,388,479 |
Operating expenses and charges |  | 642,717 |  |  | 6,631,471 |  |  | 3,826,941 |  |  | (1,355,967 | ) |  | 9,745,162 |
Operating income |  | 161,967 |  |  | 916,452 |  |  | 564,898 |  |  | — |  |  | 1,643,317 |
Debt expense |  | (482,074 | ) |  | (183,272 | ) |  | (53,043 | ) |  | 241,163 |  |  | (477,226 | )
Other income, net |  | 309,623 |  |  | 7,314 |  |  | 46,306 |  |  | (333,895 | ) |  | 29,348 |
Income tax (benefit) expense |  | (2,616 | ) |  | 263,563 |  |  | 18,681 |  |  | — |  |  | 279,628 |
Equity earnings in subsidiaries |  | 818,849 |  |  | 429,628 |  |  | — |  |  | (1,248,477 | ) |  | — |
Net income from continuing operations |  | 810,981 |  |  | 906,559 |  |  | 539,480 |  |  | (1,341,209 | ) |  | 915,811 |
Net income from discontinued operations, net of tax |  | — |  |  | — |  |  | 12,751 |  |  | 92,732 |  |  | 105,483 |
Net income |  | 810,981 |  |  | 906,559 |  |  | 552,231 |  |  | (1,248,477 | ) |  | 1,021,294 |
Less: Net income attributable to noncontrolling interests |  | — |  |  | — |  |  | — |  |  | (210,313 | ) |  | (210,313 | )
Net income attributable to DaVita Inc. |  | $ | 810,981 |  |  | $ | 906,559 |  |  | $ | 552,231 |  |  | $ | (1,458,790 | ) |  | $ | 810,981 |
Consolidating Statements of Income - (continued)
For year ended December 31, 2018 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Dialysis patient service revenues |  | $ | — |  |  | $ | 6,834,865 |  |  | $ | 4,096,666 |  |  | $ | (221,550 | ) |  | $ | 10,709,981 |
Less: Provision for uncollectible accounts |  | — |  |  | (34,977 | ) |  | (14,610 | ) |  | — |  |  | (49,587 | )
Net dialysis patient service revenues |  | — |  |  | 6,799,888 |  |  | 4,082,056 |  |  | (221,550 | ) |  | 10,660,394 |
Other revenues |  | 799,230 |  |  | 488,086 |  |  | 558,079 |  |  | (1,100,938 | ) |  | 744,457 |
Total revenues |  | 799,230 |  |  | 7,287,974 |  |  | 4,640,135 |  |  | (1,322,488 | ) |  | 11,404,851 |
Operating expenses and charges |  | 646,640 |  |  | 6,551,328 |  |  | 4,003,547 |  |  | (1,322,488 | ) |  | 9,879,027 |
Operating income |  | 152,590 |  |  | 736,646 |  |  | 636,588 |  |  | — |  |  | 1,525,824 |
Debt expense |  | (491,749 | ) |  | (201,496 | ) |  | (43,414 | ) |  | 249,224 |  |  | (487,435 | )
Other income, net |  | 418,839 |  |  | 3,430 |  |  | 29,132 |  |  | (441,312 | ) |  | 10,089 |
Income tax expense |  | 23,482 |  |  | 155,372 |  |  | 79,546 |  |  | — |  |  | 258,400 |
Equity earnings in subsidiaries |  | 103,196 |  |  | 388,737 |  |  | — |  |  | (491,933 | ) |  | — |
Net income from continuing operations |  | 159,394 |  |  | 771,945 |  |  | 542,760 |  |  | (684,021 | ) |  | 790,078 |
Net loss from discontinued operations, net of tax |  | — |  |  | — |  |  | (649,126 | ) |  | 192,088 |  |  | (457,038 | )
Net income (loss) |  | 159,394 |  |  | 771,945 |  |  | (106,366 | ) |  | (491,933 | ) |  | 333,040 |
Less: Net income attributable to noncontrolling interests |  | — |  |  | — |  |  | — |  |  | (173,646 | ) |  | (173,646 | )
Net income (loss) attributable to DaVita Inc. |  | $ | 159,394 |  |  | $ | 771,945 |  |  | $ | (106,366 | ) |  | $ | (665,579 | ) |  | $ | 159,394 |
For year ended December 31, 2017 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Dialysis patient service revenues |  | $ | — |  |  | $ | 6,417,574 |  |  | $ | 3,848,172 |  |  | $ | (172,076 | ) |  | $ | 10,093,670 |
Less: Provision for uncollectible accounts |  | — |  |  | (322,085 | ) |  | (170,447 | ) |  | 7,168 |  |  | (485,364 | )
Net dialysis patient service revenues |  | — |  |  | 6,095,489 |  |  | 3,677,725 |  |  | (164,908 | ) |  | 9,608,306 |
Other revenues |  | 793,751 |  |  | 408,460 |  |  | 1,080,832 |  |  | (1,014,715 | ) |  | 1,268,328 |
Total net revenues |  | 793,751 |  |  | 6,503,949 |  |  | 4,758,557 |  |  | (1,179,623 | ) |  | 10,876,634 |
Operating expenses and charges |  | 527,942 |  |  | 5,331,545 |  |  | 4,384,015 |  |  | (1,179,623 | ) |  | 9,063,879 |
Operating income |  | 265,809 |  |  | 1,172,404 |  |  | 374,542 |  |  | — |  |  | 1,812,755 |
Debt expense |  | (426,149 | ) |  | (200,953 | ) |  | (43,490 | ) |  | 239,958 |  |  | (430,634 | )
Other income, net |  | 411,731 |  |  | 5,979 |  |  | 23,657 |  |  | (423,702 | ) |  | 17,665 |
Income tax expense |  | 65,965 |  |  | 210,068 |  |  | 47,826 |  |  | — |  |  | 323,859 |
Equity earnings in subsidiaries |  | 478,192 |  |  | 460,261 |  |  | — |  |  | (938,453 | ) |  | — |
Net income from continuing operations |  | 663,618 |  |  | 1,227,623 |  |  | 306,883 |  |  | (1,122,197 | ) |  | 1,075,927 |
Net loss from discontinued operations, net of tax |  | — |  |  | — |  |  | (429,116 | ) |  | 183,744 |  |  | (245,372 | )
Net income (loss) |  | 663,618 |  |  | 1,227,623 |  |  | (122,233 | ) |  | (938,453 | ) |  | 830,555 |
Less: Net income attributable to noncontrolling interests |  | — |  |  | — |  |  | — |  |  | (166,937 | ) |  | (166,937 | )
Net income (loss) attributable to DaVita Inc. |  | $ | 663,618 |  |  | $ | 1,227,623 |  |  | $ | (122,233 | ) |  | $ | (1,105,390 | ) |  | $ | 663,618 |
Consolidating Statements of Comprehensive Income
For the year ended December 31, 2019 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Net income |  | $ | 810,981 |  |  | $ | 906,559 |  |  | $ | 552,231 |  |  | $ | (1,248,477 | ) |  | $ | 1,021,294 |
Other comprehensive income (loss) |  | 7,528 |  |  | — |  |  | (20,102 | ) |  | — |  |  | (12,574 | )
Total comprehensive income |  | 818,509 |  |  | 906,559 |  |  | 532,129 |  |  | (1,248,477 | ) |  | 1,008,720 |
Less: Comprehensive income attributable to noncontrolling interest |  | — |  |  | — |  |  | — |  |  | (210,313 | ) |  | (210,313 | )
Comprehensive income attributable to DaVita Inc. |  | $ | 818,509 |  |  | $ | 906,559 |  |  | $ | 532,129 |  |  | $ | (1,458,790 | ) |  | $ | 798,407 |
For the year ended December 31, 2018 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income (loss) |  | $ | 159,394 |  |  | $ | 771,945 |  |  | $ | (106,366 | ) |  | $ | (491,933 | ) |  | $ | 333,040 |
Other comprehensive income (loss) |  | 6,153 |  |  | — |  |  | (45,944 | ) |  | — |  |  | (39,791 | )
Total comprehensive income (loss) |  | 165,547 |  |  | 771,945 |  |  | (152,310 | ) |  | (491,933 | ) |  | 293,249 |
Less: Comprehensive income attributable to noncontrolling interest |  | — |  |  | — |  |  | — |  |  | (173,646 | ) |  | (173,646 | )
Comprehensive income (loss) attributable to DaVita Inc. |  | $ | 165,547 |  |  | $ | 771,945 |  |  | $ | (152,310 | ) |  | $ | (665,579 | ) |  | $ | 119,603 |
For the year ended December 31, 2017 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income (loss) |  | $ | 663,618 |  |  | $ | 1,227,623 |  |  | $ | (122,233 | ) |  | $ | (938,453 | ) |  | $ | 830,555 |
Other comprehensive income (loss) |  | 3,106 |  |  | — |  |  | 99,770 |  |  | — |  |  | 102,876 |
Total comprehensive income (loss) |  | 666,724 |  |  | 1,227,623 |  |  | (22,463 | ) |  | (938,453 | ) |  | 933,431 |
Less: Comprehensive income attributable to noncontrolling interest |  | — |  |  | — |  |  | — |  |  | (166,935 | ) |  | (166,935 | )
Comprehensive income (loss) attributable to DaVita Inc. |  | $ | 666,724 |  |  | $ | 1,227,623 |  |  | $ | (22,463 | ) |  | $ | (1,105,388 | ) |  | $ | 766,496 |
Consolidating Balance Sheets
As of December 31, 2019 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Cash and cash equivalents |  | $ | 758,241 |  |  | $ | 532 |  |  | $ | 343,599 |  |  | $ | — |  |  | $ | 1,102,372 |
Restricted cash and equivalents |  | 14,499 |  |  | — |  |  | 91,847 |  |  | — |  |  | 106,346 |
Accounts receivable, net |  | — |  |  | 1,189,301 |  |  | 606,297 |  |  | — |  |  | 1,795,598 |
Other current assets |  | 76,787 |  |  | 548,553 |  |  | 102,410 |  |  | (41,896 | ) |  | 685,854 |
Total current assets |  | 849,527 |  |  | 1,738,386 |  |  | 1,144,153 |  |  | (41,896 | ) |  | 3,690,170 |
Property and equipment, net |  | 543,932 |  |  | 1,589,417 |  |  | 1,344,543 |  |  | (4,508 | ) |  | 3,473,384 |
Operating lease right-of-use assets |  | 109,415 |  |  | 1,656,145 |  |  | 1,084,552 |  |  | (20,065 | ) |  | 2,830,047 |
Intangible assets, net |  | 362 |  |  | 31,569 |  |  | 103,753 |  |  | — |  |  | 135,684 |
Investments in and advances to affiliates, net |  | 10,813,991 |  |  | 7,611,402 |  |  | 3,051,208 |  |  | (21,476,601 | ) |  | — |
Other long-term assets and investments |  | 102,779 |  |  | 133,698 |  |  | 176,315 |  |  | (18,318 | ) |  | 394,474 |
Goodwill |  | — |  |  | 4,812,972 |  |  | 1,974,663 |  |  | — |  |  | 6,787,635 |
Total assets |  | $ | 12,420,006 |  |  | $ | 17,573,589 |  |  | $ | 8,879,187 |  |  | $ | (21,561,388 | ) |  | $ | 17,311,394 |
Current liabilities |  | $ | 379,286 |  |  | $ | 1,327,378 |  |  | $ | 666,470 |  |  | $ | (1,036 | ) |  | $ | 2,372,098 |
Intercompany payables |  | 1,381,863 |  |  | 3,051,208 |  |  | 2,615,151 |  |  | (7,048,222 | ) |  | — |
Long-term operating lease liabilities |  | 136,123 |  |  | 1,567,776 |  |  | 1,039,145 |  |  | (19,244 | ) |  | 2,723,800 |
Long-term debt and other long-term liabilities |  | 7,741,725 |  |  | 674,558 |  |  | 364,102 |  |  | (64,507 | ) |  | 8,715,878 |
Noncontrolling interests subject to put provisions |  | 647,600 |  |  | — |  |  | — |  |  | 532,776 |  |  | 1,180,376 |
Total DaVita Inc. shareholders' equity |  | 2,133,409 |  |  | 10,952,669 |  |  | 3,475,710 |  |  | (14,428,379 | ) |  | 2,133,409 |
Noncontrolling interests not subject to put provisions |  | — |  |  | — |  |  | 718,609 |  |  | (532,776 | ) |  | 185,833 |
Total equity |  | 2,133,409 |  |  | 10,952,669 |  |  | 4,194,319 |  |  | (14,961,155 | ) |  | 2,319,242 |
Total liabilities and equity |  | $ | 12,420,006 |  |  | $ | 17,573,589 |  |  | $ | 8,879,187 |  |  | $ | (21,561,388 | ) |  | $ | 17,311,394 |
Consolidating Balance Sheets - (continued)
As of December 31, 2018 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non- Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Cash and cash equivalents |  | $ | 60,653 |  |  | $ | 1,232 |  |  | $ | 261,153 |  |  | $ | — |  |  | $ | 323,038 |
Restricted cash and equivalents |  | 1,005 |  |  | 12,048 |  |  | 79,329 |  |  | — |  |  | 92,382 |
Accounts receivable, net |  | — |  |  | 1,204,122 |  |  | 654,486 |  |  | — |  |  | 1,858,608 |
Other current assets |  | 37,185 |  |  | 565,974 |  |  | 157,407 |  |  | — |  |  | 760,566 |
Current assets held for sale |  | — |  |  | — |  |  | 5,389,565 |  |  | — |  |  | 5,389,565 |
Total current assets |  | 98,843 |  |  | 1,783,376 |  |  | 6,541,940 |  |  | — |  |  | 8,424,159 |
Property and equipment, net |  | 491,462 |  |  | 1,584,321 |  |  | 1,317,886 |  |  | — |  |  | 3,393,669 |
Intangible assets, net |  | 153 |  |  | 42,896 |  |  | 75,797 |  |  | — |  |  | 118,846 |
Investments in and advances to affiliates, net |  | 13,522,198 |  |  | 6,196,801 |  |  | 2,498,545 |  |  | (22,217,544 | ) |  | — |
Other long-term assets and investments |  | 53,385 |  |  | 90,037 |  |  | 188,196 |  |  | — |  |  | 331,618 |
Goodwill |  | — |  |  | 4,806,939 |  |  | 2,035,021 |  |  | — |  |  | 6,841,960 |
Total assets |  | $ | 14,166,041 |  |  | $ | 14,504,370 |  |  | $ | 12,657,385 |  |  | $ | (22,217,544 | ) |  | $ | 19,110,252 |
Current liabilities |  | $ | 1,945,943 |  |  | $ | 1,217,526 |  |  | $ | 483,933 |  |  | $ | — |  |  | $ | 3,647,402 |
Current liabilities held for sale |  | — |  |  | — |  |  | 1,243,759 |  |  | — |  |  | 1,243,759 |
Total current liabilities |  | 1,945,943 |  |  | 1,217,526 |  |  | 1,727,692 |  |  | — |  |  | 4,891,161 |
Intercompany payables |  | — |  |  | 2,498,545 |  |  | 6,161,292 |  |  | (8,659,837 | ) |  | — |
Long-term debt and other long-term liabilities |  | 7,918,581 |  |  | 687,443 |  |  | 580,028 |  |  | — |  |  | 9,186,052 |
Noncontrolling interests subject to put provisions |  | 598,075 |  |  | — |  |  | — |  |  | 526,566 |  |  | 1,124,641 |
Total DaVita Inc. shareholders' equity |  | 3,703,442 |  |  | 10,100,856 |  |  | 3,456,851 |  |  | (13,557,707 | ) |  | 3,703,442 |
Noncontrolling interests not subject to put provisions |  | — |  |  | — |  |  | 731,522 |  |  | (526,566 | ) |  | 204,956 |
Total equity |  | 3,703,442 |  |  | 10,100,856 |  |  | 4,188,373 |  |  | (14,084,273 | ) |  | 3,908,398 |
Total liabilities and equity |  | $ | 14,166,041 |  |  | $ | 14,504,370 |  |  | $ | 12,657,385 |  |  | $ | (22,217,544 | ) |  | $ | 19,110,252 |
Consolidating Statements of Cash Flow
For the year ended December 31, 2019 |  | DaVita Inc. |  | Guarantor Subsidiaries |  | Non-Guarantor Subsidiaries |  | Consolidating Adjustments |  | Consolidated Total
Cash flows from operating activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income |  | $ | 810,981 |  |  | $ | 906,559 |  |  | $ | 552,231 |  |  | $ | (1,248,477 | ) |  | $ | 1,021,294 |
Changes in operating assets and liabilities and non-cash items included in net income |  | (602,288 | ) |  | (73,356 | ) |  | 478,228 |  |  | 1,248,477 |  |  | 1,051,061 |
Net cash provided by operating activities |  | 208,693 |  |  | 833,203 |  |  | 1,030,459 |  |  | — |  |  | 2,072,355 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment, net |  | (145,378 | ) |  | (310,032 | ) |  | (311,136 | ) |  | — |  |  | (766,546 | )
Acquisitions |  | — |  |  | (11,851 | ) |  | (89,010 | ) |  | — |  |  | (100,861 | )
Proceeds from asset sales, net of cash divested |  | 3,824,516 |  |  | 1,777 |  |  | 51,099 |  |  | — |  |  | 3,877,392 |
Investments and other items |  | (4,606 | ) |  | (6,676 | ) |  | (3,363 | ) |  | — |  |  | (14,645 | )
Net cash provided by (used in) investing activities |  | 3,674,532 |  |  | (326,782 | ) |  | (352,410 | ) |  | — |  |  | 2,995,340 |
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-term debt and related financing costs, net |  | (2,052,197 | ) |  | (10,481 | ) |  | (17,513 | ) |  | — |  |  | (2,080,191 | )
Intercompany borrowing |  | 1,267,138 |  |  | (455,405 | ) |  | (811,733 | ) |  | — |  |  | — |
Other items |  | (2,387,084 | ) |  | (53,283 | ) |  | (175,892 | ) |  | — |  |  | (2,616,259 | )
Net cash used in financing activities |  | (3,172,143 | ) |  | (519,169 | ) |  | (1,005,138 | ) |  | — |  |  | (4,696,450 | )
Effect of exchange rate changes on cash |  | — |  |  | — |  |  | (1,760 | ) |  | — |  |  | (1,760 | )
Net increase (decrease) in cash, cash equivalents and restricted cash |  | 711,082 |  |  | (12,748 | ) |  | (328,849 | ) |  | — |  |  | 369,485 |
Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations |  | — |  |  | — |  |  | (423,813 | ) |  | — |  |  | (423,813 | )
Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations |  | 711,082 |  |  | (12,748 | ) |  | 94,964 |  |  | — |  |  | 793,298 |
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year |  | 61,658 |  |  | 13,280 |  |  | 340,482 |  |  | — |  |  | 415,420 |
Cash, cash equivalents and restricted cash of continuing operations at end of the year |  | $ | 772,740 |  |  | $ | 532 |  |  | $ | 435,446 |  |  | $ | — |  |  | $ | 1,208,718 |
Consolidating Statements of Cash Flow - (continued)
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 |  |  | $ | 771,945 |  |  | $ | (106,366 | ) |  | $ | (491,933 | ) |  | $ | 333,040 |
Changes in operating assets and liabilities and non-cash items included in net income |  | (86,070 | ) |  | (150,976 | ) |  | 1,183,713 |  |  | 491,933 |  |  | 1,438,600 |
Net cash provided by operating activities |  | 73,324 |  |  | 620,969 |  |  | 1,077,347 |  |  | — |  |  | 1,771,640 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment, net |  | (175,787 | ) |  | (425,008 | ) |  | (386,343 | ) |  | — |  |  | (987,138 | )
Acquisitions |  | — |  |  | (42,987 | ) |  | (140,169 | ) |  | — |  |  | (183,156 | )
Proceeds from asset and business sales, net of cash divested |  | — |  |  | 55,184 |  |  | 95,021 |  |  | — |  |  | 150,205 |
Investments and other items |  | 30,962 |  |  | (8,286 | ) |  | (8,230 | ) |  | — |  |  | 14,446 |
Net cash used in investing activities |  | (144,825 | ) |  | (421,097 | ) |  | (439,721 | ) |  | — |  |  | (1,005,643 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-term debt and related financing costs, net |  | 725,889 |  |  | (8,874 | ) |  | (22,238 | ) |  | — |  |  | 694,777 |
Intercompany borrowing |  | 404,897 |  |  | (168,224 | ) |  | (236,673 | ) |  | — |  |  | — |
Other items |  | (1,147,934 | ) |  | (29,457 | ) |  | (142,740 | ) |  | — |  |  | (1,320,131 | )
Net cash used in financing activities |  | (17,148 | ) |  | (206,555 | ) |  | (401,651 | ) |  | — |  |  | (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 | ) |  | (6,683 | ) |  | 232,625 |  |  | — |  |  | 137,293 |
Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations |  | — |  |  | — |  |  | 240,793 |  |  | — |  |  | 240,793 |
Net decrease in cash, cash equivalents and restricted cash from continuing operations |  | (88,649 | ) |  | (6,683 | ) |  | (8,168 | ) |  | — |  |  | (103,500 | )
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year |  | 150,307 |  |  | 19,963 |  |  | 348,650 |  |  | — |  |  | 518,920 |
Cash, cash equivalents and restricted cash of continuing operations at end of the year |  | $ | 61,658 |  |  | $ | 13,280 |  |  | $ | 340,482 |  |  | $ | — |  |  | $ | 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 |  |  | $ | 1,227,623 |  |  | $ | (122,233 | ) |  | $ | (938,453 | ) |  | $ | 830,555 |
Changes in operating assets and liabilities and non-cash items included in net income |  | (533,300 | ) |  | (739,023 | ) |  | 1,416,481 |  |  | 938,453 |  |  | 1,082,611 |
Net cash provided by operating activities |  | 130,318 |  |  | 488,600 |  |  | 1,294,248 |  |  | — |  |  | 1,913,166 |
Cash flows from investing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Additions of property and equipment, net |  | (155,972 | ) |  | (348,292 | ) |  | (400,986 | ) |  | — |  |  | (905,250 | )
Acquisitions |  | — |  |  | (528,588 | ) |  | (275,291 | ) |  | — |  |  | (803,879 | )
Proceeds from asset sales |  | — |  |  | 25,989 |  |  | 66,347 |  |  | — |  |  | 92,336 |
Investments and other items |  | 211,619 |  |  | (3,526 | ) |  | 43,968 |  |  | — |  |  | 252,061 |
Net cash provided by (used in) investing activities |  | 55,647 |  |  | (854,417 | ) |  | (565,962 | ) |  | — |  |  | (1,364,732 | )
Cash flows from financing activities: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Long-term debt and related financing costs, net |  | 173,529 |  |  | (8,186 | ) |  | (10,495 | ) |  | — |  |  | 154,848 |
Intercompany borrowing |  | 22,589 |  |  | 382,452 |  |  | (405,041 | ) |  | — |  |  | — |
Other items |  | (781,697 | ) |  | (2,205 | ) |  | (137,203 | ) |  | — |  |  | (921,105 | )
Net cash (used in) provided by financing activities |  | (585,579 | ) |  | 372,061 |  |  | (552,739 | ) |  | — |  |  | (766,257 | )
Effect of exchange rate changes on cash |  | — |  |  | — |  |  | 254 |  |  | — |  |  | 254 |
Net (decrease) increase in cash, cash equivalents and restricted cash |  | (399,614 | ) |  | 6,244 |  |  | 175,801 |  |  | — |  |  | (217,569 | )
Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations |  | — |  |  | — |  |  | (53,026 | ) |  | — |  |  | (53,026 | )
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations |  | (399,614 | ) |  | 6,244 |  |  | 228,827 |  |  | — |  |  | (164,543 | )
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year |  | 549,921 |  |  | 13,719 |  |  | 119,823 |  |  | — |  |  | 683,463 |
Cash, cash equivalents and restricted cash of continuing operations at end of the year |  | $ | 150,307 |  |  | $ | 19,963 |  |  | $ | 348,650 |  |  | $ | — |  |  | $ | 518,920 |

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