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Segment reporting
 6 Months Ended
Jun. 30, 2020
Segment Reporting [Abstract]  
Segment Reporting Disclosure
Segment reporting
The Company’s operations are comprised of its U.S. dialysis and related lab services business, its various ancillary services and strategic initiatives, including its international operations, and its corporate administrative support.
On June 19, 2019, the Company completed the sale of its DMG division to Optum, a subsidiary of UnitedHealth Group Inc. As a result of this transaction, DMG's results of operations have been reported as discontinued operations for all periods presented.
The Company’s separate operating segments include its U.S. dialysis and related lab services business, each of its ancillary services and strategic initiatives, its kidney care operations in each foreign sovereign jurisdiction, its other health operations in each foreign sovereign jurisdiction, and its equity method investment in the APAC JV. The U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other ancillary services and strategic initiatives operating segments, including the international operating segments, have been combined and disclosed in the other segments category. See Note 25 to the Company's consolidated financial statements included in the 10-K for further description of how the Company determines and measures results for its operating segments.
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.
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


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


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