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Segment reporting (Tables) | 6 Months Ended
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Jun. 30, 2020
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 income (loss), and a reconciliation of segment operating income (loss) to consolidated income before income taxes:
| Three months ended June 30, |  | Six months ended June 30,
| 2020 |  | 2019 |  | 2020 |  | 2019
Segment revenues: |  |  |  |  |  |  |
U.S. dialysis |  |  |  |  |  |  |
Dialysis patient service revenues: |  |  |  |  |  |  |
External sources | $ | 2,631,827 |  |  | $ | 2,601,951 |  |  | $ | 5,211,067 |  |  | $ | 5,113,777 |
Intersegment revenues | 35,122 |  |  | 30,042 |  |  | 67,062 |  |  | 60,462 |
U.S. dialysis patient service revenues | 2,666,949 |  |  | 2,631,993 |  |  | 5,278,129 |  |  | 5,174,239 |
Other revenues(1): |  |  |  |  |  |  |
External sources | 7,688 |  |  | 5,209 |  |  | 12,830 |  |  | 9,893 |
Intersegment revenues | 307 |  |  | 292 |  |  | 608 |  |  | 513 |
Total U.S. dialysis revenues | 2,674,944 |  |  | 2,637,494 |  |  | 5,291,567 |  |  | 5,184,645 |
Other—Ancillary services |  |  |  |  |  |  |
Dialysis patient service revenues, net | 126,370 |  |  | 121,865 |  |  | 260,411 |  |  | 239,728 |
Other external sources | 114,094 |  |  | 113,680 |  |  | 236,908 |  |  | 222,419 |
Intersegment revenues | 4,171 |  |  | 3,403 |  |  | 8,324 |  |  | 6,739 |
Total ancillary services revenues | 244,635 |  |  | 238,948 |  |  | 505,643 |  |  | 468,886 |
Total net segment revenues | 2,919,579 |  |  | 2,876,442 |  |  | 5,797,210 |  |  | 5,653,531 |
Elimination of intersegment revenues | (39,600 | ) |  | (33,737 | ) |  | (75,994 | ) |  | (67,714 | )
Consolidated revenues | $ | 2,879,979 |  |  | $ | 2,842,705 |  |  | $ | 5,721,216 |  |  | $ | 5,585,817 |
Segment operating income (loss): |  |  |  |  |  |  |  |  |  |  |
U.S. dialysis | $ | 522,630 |  |  | $ | 498,957 |  |  | $ | 1,014,236 |  |  | $ | 915,939 |
Other—Ancillary services | (39,622 | ) |  | (15,050 | ) |  | (42,268 | ) |  | (72,680 | )
Total segment operating income | 483,008 |  |  | 483,907 |  |  | 971,968 |  |  | 843,259 |
Reconciliation of segment operating income to consolidated income from continuing operations before income taxes: |  |  |  |  |  |  |
Corporate administrative support | (73,088 | ) |  | (22,021 | ) |  | (96,672 | ) |  | (40,866 | )
Consolidated operating income | 409,920 |  |  | 461,886 |  |  | 875,296 |  |  | 802,393 |
Debt expense | (81,381 | ) |  | (131,666 | ) |  | (169,984 | ) |  | (263,185 | )
Debt prepayment and refinancing charges | — |  |  | (12,160 | ) |  | (2,948 | ) |  | (12,160 | )
Other income, net | 9,545 |  |  | 5,643 |  |  | 5,195 |  |  | 12,583 |
Consolidated income from continuing operations before income taxes | $ | 338,084 |  |  | $ | 323,703 |  |  | $ | 707,559 |  |  | $ | 539,631 |
(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, 2020 |  | December 31, 2019
U.S. dialysis (including equity investments of $130,732 and $124,188, respectively) | $ | 17,896,917 |  |  | $ | 15,778,880 |
Other—Ancillary services (including equity investments of $124,757 and $117,795, respectively) | 1,408,174 |  |  | 1,532,514 |
Consolidated assets | $ | 19,305,091 |  |  | $ | 17,311,394 |
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,
| 2020 |  | 2019 |  | 2020 |  | 2019
U.S. dialysis | $ | 148,312 |  |  | $ | 144,621 |  |  | $ | 294,612 |  |  | $ | 285,401 |
Other—Ancillary services | 9,064 |  |  | 7,621 |  |  | 17,443 |  |  | 15,369 |
| $ | 157,376 |  |  | $ | 152,242 |  |  | $ | 312,055 |  |  | $ | 300,770 |
Summary of Expenditures for Property and Equipment by Reportable Segment | Expenditures for property and equipment by reportable segment were as follows:
| Six months ended June 30,
| 2020 |  | 2019
U.S. dialysis | $ | 280,801 |  |  | $ | 319,812 |
Other—Ancillary services | 10,866 |  |  | 15,640 |
DMG—Discontinued operations | — |  |  | 38,466 |
| $ | 291,667 |  |  | $ | 373,918 |

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