
• | Consolidated revenues of $2.899 billion. |
• | Operating income of $463 million or 16.0% operating margin. |
• | Diluted earnings per share from continuing operations of $1.86. |
• | Operating cash flow from continuing operations of $678 million and free cash flow from continuing operations of $415 million. |
• | Repurchased 8,368,506 shares of our common stock at an average cost of $64.80 per share. |
Three months ended December 31, | Year ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Net income attributable to DaVita Inc.: | (dollars in millions, except per share data) | |||||||||||||||
Net income from continuing operations | $ | 242 | $ | 160 | $ | 707 | $ | 624 | ||||||||
Per share | $ | 1.86 | $ | 0.96 | $ | 4.60 | $ | 3.62 | ||||||||
Adjusted net income from continuing operations(1) | $ | 242 | $ | 149 | $ | 830 | $ | 616 | ||||||||
Per share adjusted(1) | $ | 1.86 | $ | 0.90 | $ | 5.40 | $ | 3.57 | ||||||||
Net income (loss) | $ | 245 | $ | (150 | ) | $ | 811 | $ | 159 | |||||||
Per share | $ | 1.88 | $ | (0.90 | ) | $ | 5.27 | $ | 0.92 | |||||||
Three months ended December 31, | Year ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Operating income: | (dollars in millions) | |||||||||||||||
Operating income | $ | 463 | $ | 388 | $ | 1,643 | $ | 1,526 | ||||||||
Adjusted operating income(1) | $ | 463 | $ | 370 | $ | 1,768 | $ | 1,513 | ||||||||
(1) | For the definitions of non-GAAP financial measures see the note titled “Note on Non-GAAP Financial Measures” and related reconciliations beginning on page 15. |
Three months ended | Quarter change | Year ended | Annual change | ||||||||||||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2019 | December 31, 2018 | ||||||||||||||||||||
Per treatment metrics: | |||||||||||||||||||||||
Revenue | $ | 348.31 | $ | 349.41 | $ | (1.10 | ) | $ | 349.02 | $ | 350.47 | $ | (1.45 | ) | |||||||||
Patient care costs | $ | 237.44 | $ | 236.32 | $ | 1.12 | $ | 239.27 | $ | 247.32 | $ | (8.05 | ) | ||||||||||
General and administrative | $ | 27.27 | $ | 30.63 | $ | (3.36 | ) | $ | 28.41 | $ | 28.40 | $ | 0.01 | ||||||||||
Three months ended December 31, 2019 | Year ended December 31, 2019 | ||||||||||||||||||||
Shares repurchased | Amount paid (in millions) | Paid per share | Shares repurchased | Amount paid (in millions) | Paid per share | ||||||||||||||||
Tender offer(1) | — | $ | — | $ | — | 21,801,975 | $ | 1,234 | $ | 56.60 | |||||||||||
Open market repurchases | 8,368,506 | 542 | 64.80 | 19,218,257 | 1,168 | 60.79 | |||||||||||||||
8,368,506 | $ | 542 | $ | 64.80 | 41,020,232 | $ | 2,402 | $ | 58.57 | ||||||||||||
(1) | The amount paid for shares repurchased associated with our modified "Dutch auction" tender offer during the year ended December 31, 2019 includes the clearing price of $56.50 per share plus related fees and expenses of approximately $2 million. |
Three months ended December 31, | Year ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Cash flow: | (dollars in millions) | |||||||||||||||
Operating cash flow | $ | 681 | $ | 389 | $ | 2,072 | $ | 1,772 | ||||||||
Operating cash flow from continuing operations | $ | 678 | $ | 307 | $ | 1,973 | $ | 1,481 | ||||||||
Free cash flow from continuing operations (new definition)(1) | $ | 415 | $ | 11 | $ | 1,127 | $ | 480 | ||||||||
(1) | For the definitions of non-GAAP financial measures see the note titled “Note on Non-GAAP Financial Measures” and related reconciliations beginning on page 15. |
Three months ended December 31, 2019 | Year ended December 31, 2019 | |||||
Effective income tax rate on: | ||||||
Income from continuing operations | 21.4 | % | 23.4 | % | ||
Income from continuing operations attributable to DaVita Inc. | 25.2 | % | 28.3 | % | ||
Adjusted income from continuing operations attributable to DaVita Inc.(1) | 25.2 | % | 27.5 | % | ||
(1) | For the definitions of non-GAAP financial measures see the note titled “Note on Non-GAAP Financial Measures” and related reconciliations beginning on page 15. |
Current 2020 guidance | Prior 2020 guidance | ||||||||||||||
Low | High | Low | High | ||||||||||||
(dollars in millions, except per share data) | |||||||||||||||
Revenue | $ | 11,500 | $ | 11,700 | — | — | |||||||||
Operating income margin | 13.0 | % | 14.0 | % | — | — | |||||||||
Effective income tax rate on adjusted income from continuing operations attributable to DaVita Inc. | 28.0 | % | 29.5 | % | — | — | |||||||||
Adjusted diluted net income from continuing operations per share attributable to DaVita Inc. | $ | 5.75 | $ | 6.25 | $ | 5.25 | $ | 5.75 | |||||||
Capital expenditures from continuing operations | $ | 700 | $ | 750 | $ | 700 | $ | 750 | |||||||
Free cash flow from continuing operations | $ | 600 | $ | 800 | — | — | |||||||||
• | the concentration of profits generated by higher-paying commercial payor plans for which there is continued downward pressure on average realized payment rates, and a reduction in the number of patients under such plans, including as a result of restrictions or prohibitions on the use and/or availability of charitable premium assistance, which may result in the loss of revenues or patients, or our making incorrect assumptions about how our patients will respond to any change in financial assistance from charitable organizations; |
• | the extent to which the ongoing implementation of healthcare reform, or changes in or new legislation, regulations or guidance, enforcement thereof or related litigation; the extent to which such developments result in a reduction in coverage or reimbursement rates for our services, a reduction in the number of patients enrolled in higher-paying commercial plans, or other material impacts to our business; or our making incorrect assumptions about how our patients will respond to any such developments; |
• | a reduction in government payment rates under the Medicare End Stage Renal Disease program or other government-based programs and the impact of the Medicare Advantage benchmark structure; |
• | risks arising from potential and proposed federal and/or state legislation, regulation and ballot, executive action or other initiatives, including such initiatives related to healthcare and/or labor matters; |
• | the impact of the political environment and related developments on the current healthcare marketplace and on our business, including with respect to the future of the Affordable Care Act, the exchanges and many other core aspects of the current health care marketplace; |
• | changes in pharmaceutical practice patterns, reimbursement and payment policies and processes, or pharmaceutical pricing, including with respect to calcimimetics; |
• | legal and compliance risks, such as our continued compliance with complex government regulations; |
• | continued increased competition from dialysis providers and others, and other potential marketplace changes; |
• | our ability to maintain contracts with physician medical directors, changing affiliation models for physicians, and the emergence of new models of care introduced by the government or private sector that may erode our patient base and reimbursement rates, such as accountable care organizations, independent practice associations and integrated delivery systems; |
• | our ability to complete acquisitions, mergers or dispositions that we might announce or be considering, on terms favorable to us or at all, or to integrate and successfully operate any business we may acquire or have acquired, or to successfully expand our operations and services in markets outside the United States, or to businesses outside of dialysis; |
• | uncertainties related to potential payments and/or adjustments under certain provisions of the equity purchase agreement for the sale of our DaVita Medical Group business, such as post-closing adjustments and indemnification obligations; |
• | noncompliance by us or our business associates with any privacy or security laws or any security breach by us or a third party involving the misappropriation, loss or other unauthorized use or disclosure of confidential information; |
• | the variability of our cash flows; the risk that we may not be able to generate sufficient cash in the future to service our indebtedness or to fund our other liquidity needs; and the risk that we may not be able to refinance our indebtedness as it becomes due, on terms favorable to us or at all; |
• | factors that may impact our ability to repurchase stock under our stock repurchase program and the timing of any such stock repurchases, as well as our use of a considerable amount of available funds to repurchase stock; |
• | risks arising from the use of accounting estimates, judgments and interpretations in our financial statements; |
• | impairment of our goodwill, investments or other assets; |
• | uncertainties related to our use of the proceeds from the DaVita Medical Group sale transaction and other available funds, including external financing and cash flow from operations, which may be or have been used in ways that we cannot assure will improve our results of operations or enhance the value of our common stock; and |
• | uncertainties associated with the other risk factors set forth in our Quarterly Report on Form 10-Q for the quarter ended June 30, 2019 as updated by our Quarterly Report on Form 10-Q for the quarter ended September 30, 2019, and the other risks and uncertainties discussed in any subsequent reports that we file or furnish with SEC from time to time. |
Three months ended December 31, | Year ended December 31, | ||||||||||||||
2019 | 2018 | 2019 | 2018 | ||||||||||||
Dialysis patient service revenues | $ | 2,768,035 | $ | 2,729,803 | $ | 10,918,421 | $ | 10,709,981 | |||||||
Provision for uncollectible accounts | (2,026 | ) | (13,749 | ) | (21,715 | ) | (49,587 | ) | |||||||
Net dialysis patient service revenues | 2,766,009 | 2,716,054 | 10,896,706 | 10,660,394 | |||||||||||
Other revenues | 132,575 | 105,070 | 491,773 | 744,457 | |||||||||||
Total revenues | 2,898,584 | 2,821,124 | 11,388,479 | 11,404,851 | |||||||||||
Operating expenses and charges: | |||||||||||||||
Patient care costs | 2,000,625 | 2,027,069 | 7,914,485 | 8,195,513 | |||||||||||
General and administrative | 278,425 | 268,532 | 1,103,312 | 1,135,454 | |||||||||||
Depreciation and amortization | 158,467 | 155,157 | 615,152 | 591,035 | |||||||||||
Provision for uncollectible accounts | — | — | — | (7,300 | ) | ||||||||||
Equity investment (income) loss | (1,521 | ) | 10,610 | (12,679 | ) | 4,484 | |||||||||
Investment and other asset impairments | — | — | — | 17,338 | |||||||||||
Goodwill impairment charges | — | — | 124,892 | 3,106 | |||||||||||
Gain on changes in ownership interest, net | — | (28,152 | ) | — | (60,603 | ) | |||||||||
Total operating expenses and charges | 2,435,996 | 2,433,216 | 9,745,162 | 9,879,027 | |||||||||||
Operating income | 462,588 | 387,908 | 1,643,317 | 1,525,824 | |||||||||||
Debt expense | (92,050 | ) | (128,300 | ) | (443,824 | ) | (487,435 | ) | |||||||
Debt prepayment, refinancing and redemption charges | — | — | (33,402 | ) | — | ||||||||||
Other income (loss), net | 11,485 | (494 | ) | 29,348 | 10,089 | ||||||||||
Income from continuing operations before income taxes | 382,023 | 259,114 | 1,195,439 | 1,048,478 | |||||||||||
Income tax expense | 81,690 | 51,748 | 279,628 | 258,400 | |||||||||||
Net income from continuing operations | 300,333 | 207,366 | 915,811 | 790,078 | |||||||||||
Net income (loss) from discontinued operations, net of tax | 2,629 | (309,209 | ) | 105,483 | (457,038 | ) | |||||||||
Net income (loss) | 302,962 | (101,843 | ) | 1,021,294 | 333,040 | ||||||||||
Less: Net income attributable to noncontrolling interests | (58,091 | ) | (47,929 | ) | (210,313 | ) | (173,646 | ) | |||||||
Net income (loss) attributable to DaVita Inc. | $ | 244,871 | $ | (149,772 | ) | $ | 810,981 | $ | 159,394 | ||||||
Earnings per share attributable to DaVita Inc.: | |||||||||||||||
Basic net income from continuing operations per share | $ | 1.87 | $ | 0.97 | $ | 4.61 | $ | 3.66 | |||||||
Basic net income (loss) per share | $ | 1.89 | $ | (0.90 | ) | $ | 5.29 | $ | 0.93 | ||||||
Diluted net income from continuing operations per share | $ | 1.86 | $ | 0.96 | $ | 4.60 | $ | 3.62 | |||||||
Diluted net income (loss) per share | $ | 1.88 | $ | (0.90 | ) | $ | 5.27 | $ | 0.92 | ||||||
Weighted average shares for earnings per share: | |||||||||||||||
Basic | 129,446,558 | 165,984,925 | 153,180,908 | 170,785,999 | |||||||||||
Diluted | 130,504,514 | 166,477,914 | 153,812,064 | 172,364,581 | |||||||||||
Amounts attributable to DaVita Inc.: | |||||||||||||||
Net income from continuing operations | $ | 242,242 | $ | 160,332 | $ | 706,832 | $ | 624,321 | |||||||
Net income (loss) from discontinued operations | 2,629 | (310,104 | ) | 104,149 | (464,927 | ) | |||||||||
Net income (loss) attributable to DaVita Inc. | $ | 244,871 | $ | (149,772 | ) | $ | 810,981 | $ | 159,394 | ||||||
Three months ended December 31, | Year ended December 31, | ||||||||||||||
2019 | 2018 | 2019 | 2018 | ||||||||||||
Net income (loss) | $ | 302,962 | $ | (101,843 | ) | $ | 1,021,294 | $ | 333,040 | ||||||
Other comprehensive income (loss), net of tax: | |||||||||||||||
Unrealized gains (losses) on interest rate cap agreements: | |||||||||||||||
Unrealized gains (losses) | 2,822 | (953 | ) | 1,151 | (133 | ) | |||||||||
Reclassifications into net income (loss) | 1,595 | 1,606 | 6,377 | 6,286 | |||||||||||
Unrealized gains (losses) on foreign currency translation: | |||||||||||||||
Foreign currency translation adjustments | 25,688 | (6,469 | ) | (20,102 | ) | (45,944 | ) | ||||||||
Other comprehensive income (loss) | 30,105 | (5,816 | ) | (12,574 | ) | (39,791 | ) | ||||||||
Total comprehensive income (loss) | 333,067 | (107,659 | ) | 1,008,720 | 293,249 | ||||||||||
Less: Comprehensive income attributable to noncontrolling interests | (58,091 | ) | (47,929 | ) | (210,313 | ) | (173,646 | ) | |||||||
Comprehensive income (loss) attributable to DaVita Inc. | $ | 274,976 | $ | (155,588 | ) | $ | 798,407 | $ | 119,603 | ||||||
Year ended December 31, | |||||||
2019 | 2018 | ||||||
Cash flows from operating activities: | |||||||
Net income | $ | 1,021,294 | $ | 333,040 | |||
Adjustments to reconcile net income to net cash provided by operating activities: | |||||||
Depreciation and amortization | 615,152 | 591,035 | |||||
Impairment charges | 124,892 | 61,981 | |||||
Valuation adjustment on disposal group | — | 316,840 | |||||
Debt prepayment, refinancing and redemption charges | 33,402 | — | |||||
Stock-based compensation expense | 67,850 | 73,061 | |||||
Deferred income taxes | 41,723 | 273,660 | |||||
Equity investment income, net | 8,582 | 26,449 | |||||
Gain (loss) on sales of business interests, net | 23,022 | (85,699 | ) | ||||
Other non-cash charges, net | 49,579 | 82,374 | |||||
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures: | |||||||
Accounts receivable | (79,957 | ) | (81,176 | ) | |||
Inventories | 10,158 | 73,505 | |||||
Other receivables and other current assets | 2,790 | 236,995 | |||||
Other long-term assets | 6,965 | 3,497 | |||||
Accounts payable | (84,539 | ) | (35,959 | ) | |||
Accrued compensation and benefits | (14,697 | ) | 84,165 | ||||
Other current liabilities | 181,940 | (157,462 | ) | ||||
Income taxes | 95,645 | (23,635 | ) | ||||
Other long-term liabilities | (31,446 | ) | (1,031 | ) | |||
Net cash provided by operating activities | 2,072,355 | 1,771,640 | |||||
Cash flows from investing activities: | |||||||
Additions of property and equipment | (766,546 | ) | (987,138 | ) | |||
Acquisitions | (100,861 | ) | (183,156 | ) | |||
Proceeds from asset and business sales | 3,877,392 | 150,205 | |||||
Purchase of other debt and equity investments | (5,458 | ) | (8,448 | ) | |||
Purchase of investments held-to-maturity | (101,462 | ) | (5,963 | ) | |||
Proceeds from sale of other debt and equity investments | 3,676 | 9,526 | |||||
Proceeds from investments held-to-maturity | 95,376 | 34,862 | |||||
Purchase of equity investments | (9,366 | ) | (19,177 | ) | |||
Distributions received on equity investments | 2,589 | 3,646 | |||||
Net cash provided by (used in) investing activities | 2,995,340 | (1,005,643 | ) | ||||
Cash flows from financing activities: | |||||||
Borrowings | 38,525,850 | 59,934,750 | |||||
Payments on long-term debt and other financing costs | (40,606,041 | ) | (59,239,973 | ) | |||
Purchase of treasury stock | (2,383,816 | ) | (1,161,511 | ) | |||
Distributions to noncontrolling interests | (233,123 | ) | (196,441 | ) | |||
Stock award exercises and other share issuances, net | 11,382 | 13,577 | |||||
Contributions from noncontrolling interests | 57,317 | 52,311 | |||||
Proceeds from sales of additional noncontrolling interest | — | 15 | |||||
Purchases of noncontrolling interests | (68,019 | ) | (28,082 | ) | |||
Net cash used in financing activities | (4,696,450 | ) | (625,354 | ) | |||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (1,760 | ) | (3,350 | ) | |||
Net increase in cash, cash equivalents and restricted cash | 369,485 | 137,293 | |||||
Less: Net (decrease) increase in cash, cash equivalents and restricted cash from discontinued operations | (423,813 | ) | 240,793 | ||||
Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations | 793,298 | (103,500 | ) | ||||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 415,420 | 518,920 | |||||
Cash, cash equivalents and restricted cash of continuing operations at end of the year | $ | 1,208,718 | $ | 415,420 | |||
December 31, 2019 | December 31, 2018 | ||||||
ASSETS | |||||||
Cash and cash equivalents | $ | 1,102,372 | $ | 323,038 | |||
Restricted cash and equivalents | 106,346 | 92,382 | |||||
Short-term investments | 11,572 | 2,935 | |||||
Accounts receivable, net | 1,795,598 | 1,858,608 | |||||
Inventories | 97,949 | 107,381 | |||||
Other receivables | 489,695 | 469,796 | |||||
Prepaid and other current assets | 66,866 | 111,840 | |||||
Income tax receivable | 19,772 | 68,614 | |||||
Current assets held for sale, net | — | 5,389,565 | |||||
Total current assets | 3,690,170 | 8,424,159 | |||||
Property and equipment, net | 3,473,384 | 3,393,669 | |||||
Operating lease right-of-use assets | 2,830,047 | — | |||||
Intangible assets, net | 135,684 | 118,846 | |||||
Equity method and other investments | 241,983 | 224,611 | |||||
Long-term investments | 36,519 | 35,424 | |||||
Other long-term assets | 115,972 | 71,583 | |||||
Goodwill | 6,787,635 | 6,841,960 | |||||
$ | 17,311,394 | $ | 19,110,252 | ||||
LIABILITIES AND EQUITY | |||||||
Accounts payable | $ | 403,840 | $ | 463,270 | |||
Other liabilities | 756,174 | 595,850 | |||||
Accrued compensation and benefits | 695,052 | 658,913 | |||||
Current portion of operating lease liabilities | 343,912 | — | |||||
Current portion of long-term debt | 130,708 | 1,929,369 | |||||
Income tax payable | 42,412 | — | |||||
Current liabilities held for sale | — | 1,243,759 | |||||
Total current liabilities | 2,372,098 | 4,891,161 | |||||
Long-term operating lease liabilities | 2,723,800 | — | |||||
Long-term debt | 7,977,526 | 8,172,847 | |||||
Other long-term liabilities | 160,809 | 450,669 | |||||
Deferred income taxes | 577,543 | 562,536 | |||||
Total liabilities | 13,811,776 | 14,077,213 | |||||
Commitments and contingencies | |||||||
Noncontrolling interests subject to put provisions | 1,180,376 | 1,124,641 | |||||
Equity: | |||||||
Preferred stock ($0.001 par value, 5,000,000 shares authorized; none issued) | — | — | |||||
Common stock ($0.001 par value, 450,000,000 shares authorized; 125,842,853 and 166,387,307 shares issued and outstanding, respectively) | 126 | 166 | |||||
Additional paid-in capital | 749,043 | 995,006 | |||||
Retained earnings | 1,431,738 | 2,743,194 | |||||
Accumulated other comprehensive loss | (47,498 | ) | (34,924 | ) | |||
Total DaVita Inc. shareholders' equity | 2,133,409 | 3,703,442 | |||||
Noncontrolling interests not subject to put provisions | 185,833 | 204,956 | |||||
Total equity | 2,319,242 | 3,908,398 | |||||
$ | 17,311,394 | $ | 19,110,252 | ||||
Three months ended | Year ended December 31, 2019 | ||||||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||||||
1. Consolidated business metrics: | |||||||||||||||
Operating income margin | 16.0 | % | 13.0 | % | 13.8 | % | 14.4 | % | |||||||
Adjusted operating income margin excluding certain items(1)(5) | 16.0 | % | 15.9 | % | 13.1 | % | 15.5 | % | |||||||
General and administrative expenses as a percent of consolidated revenues(2) | 9.6 | % | 10.3 | % | 9.5 | % | 9.7 | % | |||||||
Effective income tax rate on income from continuing operations | 21.4 | % | 23.8 | % | 20.0 | % | 23.4 | % | |||||||
Effective income tax rate on income from continuing operations attributable to DaVita Inc.(1) | 25.2 | % | 30.3 | % | 24.3 | % | 28.3 | % | |||||||
Effective income tax rate on adjusted income from continuing operations attributable to DaVita Inc.(1) | 25.2 | % | 27.6 | % | 23.1 | % | 27.5 | % | |||||||
2. Summary of financial results: | |||||||||||||||
Revenues: | |||||||||||||||
U.S. net dialysis patient services and other | $ | 2,687 | $ | 2,691 | $ | 2,633 | $ | 10,563 | |||||||
Other—Ancillary services | |||||||||||||||
U.S. other | 122 | 118 | 100 | 464 | |||||||||||
International net dialysis patient service and other | 132 | 131 | 124 | 508 | |||||||||||
255 | 248 | 224 | 972 | ||||||||||||
Eliminations | (43 | ) | (36 | ) | (35 | ) | (146 | ) | |||||||
Total consolidated revenues | $ | 2,899 | $ | 2,904 | $ | 2,821 | $ | 11,388 | |||||||
Operating income (loss): | |||||||||||||||
U.S. dialysis | $ | 508 | $ | 501 | $ | 437 | $ | 1,925 | |||||||
Other—Ancillary services | |||||||||||||||
U.S. | (21 | ) | (15 | ) | (19 | ) | (66 | ) | |||||||
International | 2 | (83 | ) | (10 | ) | (123 | ) | ||||||||
(19 | ) | (98 | ) | (29 | ) | (189 | ) | ||||||||
Corporate administrative support expenses | (27 | ) | (25 | ) | (20 | ) | (92 | ) | |||||||
Total consolidated operating income | $ | 463 | $ | 378 | $ | 388 | $ | 1,643 | |||||||
Three months ended | Year ended December 31, 2019 | ||||||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||||||
3. Summary of reportable segment financial results: | |||||||||||||||
U.S. dialysis | |||||||||||||||
Revenue: | |||||||||||||||
Net dialysis patient service revenues | $ | 2,676 | $ | 2,681 | $ | 2,628 | $ | 10,531 | |||||||
Other revenues | 11 | 10 | 5 | 32 | |||||||||||
Total operating revenues | 2,687 | 2,691 | 2,633 | 10,563 | |||||||||||
Operating expenses: | |||||||||||||||
Patient care costs | 1,824 | 1,813 | 1,872 | 7,219 | |||||||||||
General and administrative | 209 | 235 | 210 | 857 | |||||||||||
Depreciation and amortization | 150 | 148 | 147 | 583 | |||||||||||
Equity investment income | (5 | ) | (5 | ) | (5 | ) | (22 | ) | |||||||
Gain on changes in ownership interests, net | — | — | (28 | ) | — | ||||||||||
Total operating expenses | 2,179 | 2,191 | 2,196 | 8,638 | |||||||||||
Segment operating income | $ | 508 | $ | 501 | $ | 437 | $ | 1,925 | |||||||
Reconciliation for non-GAAP measure: | |||||||||||||||
Gain on changes in ownership interests, net | — | — | (28 | ) | — | ||||||||||
Adjusted segment operating income(1) | $ | 508 | $ | 501 | $ | 409 | $ | 1,925 | |||||||
4. U.S. dialysis business metrics: | |||||||||||||||
Volume: | |||||||||||||||
Treatments | 7,681,462 | 7,673,191 | 7,552,412 | 30,172,699 | |||||||||||
Number of treatment days | 79.4 | 79.0 | 79.4 | 313.0 | |||||||||||
Average treatments per day | 96,744 | 97,129 | 95,119 | 96,398 | |||||||||||
Per day year over year increase | 1.7 | % | 2.7 | % | 3.1 | % | 2.5 | % | |||||||
Normalized non-acquired treatment growth year over year | 2.1 | % | 2.2 | % | 2.6 | % | |||||||||
Operating net revenues: | |||||||||||||||
U.S. dialysis services net revenue per treatment | $ | 348.31 | $ | 349.41 | $ | 347.97 | $ | 349.02 | |||||||
Expenses: | |||||||||||||||
Patient care costs per treatment | $ | 237.44 | $ | 236.32 | $ | 247.81 | $ | 239.27 | |||||||
General and administrative expenses per treatment | $ | 27.27 | $ | 30.63 | $ | 27.86 | $ | 28.41 | |||||||
Accounts receivable: | |||||||||||||||
Net receivables | $ | 1,671 | $ | 1,719 | $ | 1,703 | |||||||||
DSO | 58 | 60 | 60 | ||||||||||||
5. Discontinued operations | |||||||||||||||
Operating results: | |||||||||||||||
Net revenues | $ | — | $ | — | $ | 1,231 | $ | 2,713 | |||||||
Expenses | 2 | 2 | 1,282 | 2,544 | |||||||||||
Valuation adjustment | — | — | 219 | — | |||||||||||
Goodwill impairment charges | — | — | 42 | — | |||||||||||
(Loss) income from discontinued operations before taxes | (2 | ) | (2 | ) | (313 | ) | 169 | ||||||||
Loss on sale of discontinued operations, before taxes | — | — | — | (23 | ) | ||||||||||
Income tax (benefit) expense | (5 | ) | 5 | (3 | ) | 41 | |||||||||
Net income (loss) from discontinued operations, net of tax | $ | 3 | $ | (7 | ) | $ | (309 | ) | $ | 105 | |||||
Three months ended | Year ended December 31, 2019 | ||||||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||||||
6. Cash flow: | |||||||||||||||
Operating cash flow | $ | 681 | $ | 641 | $ | 389 | $ | 2,072 | |||||||
Operating cash flow from continuing operations | $ | 678 | $ | 648 | $ | 307 | $ | 1,973 | |||||||
Operating cash flow from continuing operations, last twelve months | $ | 1,973 | $ | 1,602 | $ | 1,481 | |||||||||
Free cash flow from continuing operations (new definition)(1) | $ | 415 | $ | 437 | $ | 11 | $ | 1,127 | |||||||
Free cash flow from continuing operations, last twelve months (new definition)(1) | $ | 1,127 | $ | 722 | $ | 480 | |||||||||
Capital expenditures from continuing operations: | |||||||||||||||
Routine maintenance/IT/other | $ | 130 | $ | 84 | $ | 139 | $ | 355 | |||||||
Development and relocations | $ | 89 | $ | 90 | $ | 123 | $ | 373 | |||||||
Acquisition expenditures | $ | 24 | $ | 11 | $ | 65 | $ | 99 | |||||||
Proceeds from sale of self-developed properties | $ | 19 | $ | 12 | $ | 13 | $ | 58 | |||||||
7. Debt and capital structure: | |||||||||||||||
Total debt(3)(4) | $ | 8,181 | $ | 8,212 | $ | 10,154 | |||||||||
Net debt, net of cash and cash equivalents(3)(4) | $ | 7,079 | $ | 6,959 | $ | 9,831 | |||||||||
Leverage ratio (see calculation on page 14) | 3.08x | 3.21x | 4.52x | ||||||||||||
Weighted average effective interest rate: | |||||||||||||||
During the quarter | 4.55 | % | 5.09 | % | 5.07 | % | |||||||||
At end of the quarter | 4.46 | % | 4.66 | % | 5.19 | % | |||||||||
On the senior secured credit facilities at end of the quarter | 3.93 | % | 4.30 | % | 5.11 | % | |||||||||
Debt with fixed and capped rates as a percentage of total debt: | |||||||||||||||
Debt with rates fixed by its terms | 44 | % | 44 | % | 48 | % | |||||||||
Debt with rates capped by cap agreements | 87 | % | 86 | % | 82 | % | |||||||||
Amount spent on share repurchases | $ | 542 | $ | 1,748 | $ | — | $ | 2,402 | |||||||
Number of shares repurchased | 8,368,506 | 30,591,750 | — | 41,020,232 | |||||||||||
(1) | These are non-GAAP financial measures. For a reconciliation of these non-GAAP financial measures to their most comparable measure calculated and presented in accordance with GAAP, and for a definition of adjusted amounts, see attached reconciliation schedules. |
(2) | General and administrative expenses includes certain corporate support, long-term incentive compensation and advocacy costs. |
(3) | The reported balance sheet amounts at December 31, 2019, September 30, 2019 and December 31, 2018, exclude approximately $72.8, $76.0 and $52.0, respectively, of debt discount associated with the Term Loan B and other deferred financing costs related to our senior secured credit facilities and senior notes in effect at that time. The reported balance sheet amounts exclude DMG debt which was classified as held for sale liabilities as of December 31, 2018. |
(4) | The reported total debt and net debt, net of cash and cash equivalents, excludes DMG cash and debt classified as held for sale assets and liabilities, respectively, as of December 31, 2018. |
(5) | Adjusted operating income margin is a calculation of adjusted operating income divided by consolidated revenues. |
Rolling twelve months ended | |||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||
Net income(1) | $ | 706,832 | $ | 624,922 | $ | 159,394 | |||||
Income taxes | 279,628 | 249,686 | 358,168 | ||||||||
Interest expense | 397,934 | 437,513 | 451,251 | ||||||||
Depreciation and amortization | 615,151 | 611,841 | 591,035 | ||||||||
Impairment charges | 124,892 | 124,892 | 61,981 | ||||||||
Noncontrolling interests and equity investment income, net | 223,175 | 210,641 | 183,855 | ||||||||
Stock-settled stock-based compensation | 63,404 | 56,784 | 73,081 | ||||||||
Debt prepayment, refinancing and redemption charges | 33,402 | 33,402 | — | ||||||||
Gain on changes in ownership interest, net | — | (28,152 | ) | (85,699 | ) | ||||||
Valuation adjustment | — | — | 316,840 | ||||||||
Other | (12,025 | ) | 24,088 | 41,084 | |||||||
“Consolidated EBITDA” | $ | 2,432,393 | $ | 2,345,617 | $ | 2,150,990 | |||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||
Total debt, excluding debt discount and other deferred financing costs(2) | $ | 8,181,074 | $ | 8,211,895 | $ | 10,190,763 | |||||
Letters of credit issued | 72,759 | 72,777 | 36,987 | ||||||||
8,253,833 | 8,284,672 | 10,227,750 | |||||||||
Less: Cash and cash equivalents including short-term investments(3) | (750,000 | ) | (750,000 | ) | (501,695 | ) | |||||
Consolidated net debt | $ | 7,503,833 | $ | 7,534,672 | $ | 9,726,055 | |||||
Last twelve months “Consolidated EBITDA” | $ | 2,432,393 | $ | 2,345,617 | $ | 2,150,990 | |||||
Leverage ratio | 3.08x | 3.21x | 4.52x | ||||||||
Maximum leverage ratio permitted under New and Prior Credit Agreement | 5.00x | 5.00x | 5.00x | ||||||||
(1) | The reported net income for December 31, 2019 and September 30, 2019 is our reported net income from continuing operations attributable to DaVita Inc. as the New Credit Agreement requires divestitures to be reflected on a proforma basis, as such DMG is excluded from our leverage ratio calculation. The reported net income for December 31, 2018 is our reported net income attributable to DaVita Inc. |
(2) | The reported total debt amounts at December 31, 2019, September 30, 2019 and December 31, 2018, exclude $72,840, $75,979 and $52,000, respectively, of debt discount associated with the Term Loan B and other deferred financing costs. |
(3) | Excluding DMG’s-physician owned entities' cash for the twelve months ended December 31, 2018 and amounts not readily convertible to cash related to the Company's non-qualified deferred compensation plans for all periods presented. The Company's New Credit Agreement limits the amount deducted for cash and cash equivalents to the lesser of all unrestricted cash and cash equivalents of the Company or $750,000. |
Note 2: | Adjusted net income from continuing operations and adjusted diluted net income from continuing operations per share attributable to DaVita Inc. |
Three months ended | |||||||||||||||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||||||||||||||
Dollars | Per share | Dollars | Per share | Dollars | Per share | ||||||||||||||||||
Net income from continuing operations attributable to DaVita Inc. | $ | 242,242 | $ | 1.86 | $ | 150,113 | $ | 0.99 | $ | 160,332 | $ | 0.96 | |||||||||||
Operating charges: | |||||||||||||||||||||||
Goodwill impairment charges | — | — | 83,855 | 0.55 | — | — | |||||||||||||||||
Gain on changes in ownership interests, net | — | — | — | — | (28,152 | ) | (0.17 | ) | |||||||||||||||
Equity investment: | |||||||||||||||||||||||
Loss due to business sale in APAC JV | — | — | — | — | 8,715 | 0.05 | |||||||||||||||||
Loss due to impairments in the APAC JV | — | — | — | — | 1,530 | 0.01 | |||||||||||||||||
Debt prepayment, refinancing and redemption charges | — | — | 21,242 | 0.14 | — | — | |||||||||||||||||
Related income tax | — | — | (23,236 | ) | (0.15 | ) | 6,719 | 0.04 | |||||||||||||||
Adjusted net income from continuing operations attributable to DaVita Inc. | $ | 242,242 | $ | 1.86 | $ | 231,974 | $ | 1.53 | $ | 149,144 | $ | 0.90 | |||||||||||
Year ended | |||||||||||||||
December 31, 2019 | December 31, 2018 | ||||||||||||||
Dollars | Per share | Dollars | Per share | ||||||||||||
Net income from continuing operations attributable to DaVita Inc. | $ | 706,832 | $ | 4.60 | $ | 624,321 | $ | 3.62 | |||||||
Operating charges: | |||||||||||||||
Goodwill impairment charges | 124,892 | 0.81 | 3,106 | 0.02 | |||||||||||
Impairment of other assets | — | — | 17,338 | 0.10 | |||||||||||
Gain on changes in ownership interests, net | — | — | (60,603 | ) | (0.35 | ) | |||||||||
Equity investment: | |||||||||||||||
Loss due to business sale in APAC JV | — | — | 8,715 | 0.05 | |||||||||||
Loss due to impairments in the APAC JV | — | — | 7,525 | 0.04 | |||||||||||
General and administrative: | |||||||||||||||
Restructuring charges | — | — | 11,366 | 0.07 | |||||||||||
Debt prepayment, refinancing and redemption charges | 33,402 | 0.22 | — | — | |||||||||||
Related income tax | (35,231 | ) | (0.23 | ) | 4,181 | 0.02 | |||||||||
Adjusted net income from continuing operations attributable to DaVita Inc. | $ | 829,895 | $ | 5.40 | $ | 615,949 | $ | 3.57 | |||||||
Three months ended | Year ended | ||||||||||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | December 31, 2019 | December 31, 2018 | |||||||||||||||
Consolidated: | |||||||||||||||||||
Operating income | $ | 462,588 | $ | 378,336 | $ | 387,908 | $ | 1,643,317 | $ | 1,525,824 | |||||||||
Operating charges: | |||||||||||||||||||
Goodwill impairment charges | — | 83,855 | — | 124,892 | 3,106 | ||||||||||||||
Impairment of other assets | — | — | — | — | 17,338 | ||||||||||||||
Gain on changes in ownership interests, net | — | — | (28,152 | ) | — | (60,603 | ) | ||||||||||||
Equity investment: | |||||||||||||||||||
Loss due to business sale in APAC JV | — | — | 8,715 | — | 8,715 | ||||||||||||||
Loss due to impairments in the APAC JV | — | — | 1,530 | — | 7,525 | ||||||||||||||
General and administrative: | |||||||||||||||||||
Restructuring charges | — | — | — | — | 11,366 | ||||||||||||||
Adjusted operating income | $ | 462,588 | $ | 462,191 | $ | 370,001 | $ | 1,768,209 | $ | 1,513,271 | |||||||||
Three months ended | Year ended | ||||||||||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | December 31, 2019 | December 31, 2018 | |||||||||||||||
Consolidated: | |||||||||||||||||||
U.S. dialysis: | |||||||||||||||||||
Segment operating income | $ | 508,146 | $ | 500,742 | $ | 436,893 | $ | 1,924,826 | $ | 1,709,721 | |||||||||
Gain on changes in ownership interests, net | — | — | (28,152 | ) | — | (28,152 | ) | ||||||||||||
Adjusted U.S. dialysis operating income | $ | 508,146 | $ | 500,742 | $ | 408,742 | $ | 1,924,826 | $ | 1,681,570 | |||||||||
Other - Ancillary services: | |||||||||||||||||||
U.S. | |||||||||||||||||||
Segment operating loss | $ | (20,878 | ) | $ | (14,928 | ) | $ | (18,993 | ) | $ | (66,377 | ) | $ | (70,396 | ) | ||||
Impairment of other assets | — | — | — | — | 17,338 | ||||||||||||||
Restructuring charges | — | — | — | — | 11,366 | ||||||||||||||
Gain on changes in ownership interests | — | — | — | — | (33,699 | ) | |||||||||||||
Adjusted operating loss | $ | (20,878 | ) | $ | (14,928 | ) | $ | (18,993 | ) | $ | (66,377 | ) | $ | (75,390 | ) | ||||
International | |||||||||||||||||||
Segment operating income (loss) | $ | 2,109 | $ | (82,797 | ) | $ | (10,489 | ) | $ | (122,797 | ) | $ | (23,394 | ) | |||||
Goodwill impairment charges | — | 83,855 | — | 124,892 | 3,106 | ||||||||||||||
Loss on changes in ownership interests | — | — | — | — | 1,248 | ||||||||||||||
Equity investment: | |||||||||||||||||||
Loss due to business sale in the APAC JV | — | — | 8,715 | — | 8,715 | ||||||||||||||
Loss due to impairments in the APAC JV | — | — | 1,530 | — | 7,525 | ||||||||||||||
Adjusted operating income (loss) | $ | 2,109 | $ | 1,058 | $ | (245 | ) | $ | 2,095 | $ | (2,800 | ) | |||||||
Adjusted Other - Ancillary services operating loss | $ | (18,770 | ) | $ | (13,870 | ) | $ | (19,238 | ) | $ | (64,282 | ) | $ | (78,190 | ) | ||||
Corporate administrative support expenses | $ | (26,788 | ) | $ | (24,681 | ) | $ | (19,502 | ) | $ | (92,335 | ) | $ | (90,108 | ) | ||||
Adjusted operating income | $ | 462,588 | $ | 462,191 | $ | 370,001 | $ | 1,768,209 | $ | 1,513,271 | |||||||||
Three months ended | Year ended December 31, 2019 | ||||||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||||||
Income from continuing operations before income taxes | $ | 382,023 | $ | 273,785 | $ | 259,114 | $ | 1,195,439 | |||||||
Less: Noncontrolling owners’ income primarily attributable to non-tax paying entities | (58,118 | ) | (58,502 | ) | (47,203 | ) | (209,544 | ) | |||||||
Income from continuing operations before income taxes attributable to DaVita Inc. | $ | 323,905 | $ | 215,283 | $ | 211,911 | $ | 985,895 | |||||||
Income tax expense for continuing operations | $ | 81,690 | $ | 65,254 | $ | 51,748 | $ | 279,628 | |||||||
Less: Income tax attributable to noncontrolling interests | (27 | ) | (84 | ) | (169 | ) | (565 | ) | |||||||
Income tax expense from continuing operations attributable to DaVita Inc. | $ | 81,663 | $ | 65,170 | $ | 51,579 | $ | 279,063 | |||||||
Effective income tax rate on income from continuing operations attributable to DaVita Inc. | 25.2 | % | 30.3 | % | 24.3 | % | 28.3 | % | |||||||
Three months ended | Year ended December 31, 2019 | ||||||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||||||
Income from continuing operations before income taxes | $ | 382,023 | $ | 273,785 | $ | 259,114 | $ | 1,195,439 | |||||||
Operating charges: | |||||||||||||||
Goodwill impairment charges | — | 83,855 | — | 124,892 | |||||||||||
Gain on changes in ownership interests, net | — | — | (28,152 | ) | — | ||||||||||
Equity investment: | |||||||||||||||
Loss due to business sale in APAC JV | — | — | 8,715 | — | |||||||||||
Loss due to impairments in the APAC JV | — | — | 1,530 | — | |||||||||||
Debt prepayment, refinancing and redemption charges | — | 21,242 | — | 33,402 | |||||||||||
Noncontrolling owners’ income primarily attributable to non-tax paying entities | (58,118 | ) | (58,502 | ) | (47,203 | ) | (209,544 | ) | |||||||
Adjusted income from continuing operations before income taxes attributable to DaVita Inc. | $ | 323,905 | $ | 320,380 | $ | 194,004 | $ | 1,144,189 | |||||||
Income tax expense | $ | 81,690 | $ | 65,254 | $ | 51,748 | $ | 279,628 | |||||||
Add income tax related to: | |||||||||||||||
Operating charges: | |||||||||||||||
Goodwill impairment charges | — | 17,768 | — | 26,633 | |||||||||||
Gain on changes in ownership interests, net | — | — | (7,247 | ) | — | ||||||||||
Equity investment: | |||||||||||||||
Loss due to business sale in APAC JV | — | — | 449 | — | |||||||||||
Loss due to impairments in the APAC JV | — | — | 79 | — | |||||||||||
Debt prepayment, refinancing and redemption charges | — | 5,468 | — | 8,598 | |||||||||||
Less income tax related to: | |||||||||||||||
Noncontrolling interests | (27 | ) | (84 | ) | (169 | ) | (565 | ) | |||||||
Income tax on adjusted income from continuing operations attributable to DaVita Inc. | $ | 81,663 | $ | 88,406 | $ | 44,860 | $ | 314,294 | |||||||
Effective income tax rate on adjusted income from continuing operations attributable to DaVita Inc. | 25.2 | % | 27.6 | % | 23.1 | % | 27.5 | % | |||||||
Three months ended | |||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||
Net cash provided by continuing operating activities | $ | 677,901 | $ | 647,553 | $ | 307,278 | |||||
Less: Distributions to noncontrolling interests | (75,953 | ) | (61,456 | ) | (56,768 | ) | |||||
Plus: Contributions to noncontrolling interests | 13,222 | 12,814 | 9,132 | ||||||||
Cash provided by continuing operating activities attributable to DaVita Inc. | 615,170 | 598,911 | 259,642 | ||||||||
Less: Expenditures for routine maintenance and information technology | (130,243 | ) | (83,513 | ) | (138,745 | ) | |||||
Less: Expenditures for development | (89,120 | ) | (89,752 | ) | (122,793 | ) | |||||
Plus: Proceeds from sale of self-developed properties | 19,365 | 11,616 | 12,606 | ||||||||
Free cash flow from continuing operations (new definition) | $ | 415,172 | $ | 437,262 | $ | 10,710 | |||||
Rolling twelve months ended | |||||||||||
December 31, 2019 | September 30, 2019 | December 31, 2018 | |||||||||
Net cash provided by continuing operating activities | $ | 1,972,721 | $ | 1,602,098 | $ | 1,480,956 | |||||
Less: Distributions to noncontrolling interests | (233,123 | ) | (213,938 | ) | (196,441 | ) | |||||
Plus: Contributions to noncontrolling interests | 57,317 | 53,227 | 52,311 | ||||||||
Cash provided by continuing operating activities attributable to DaVita Inc. | 1,796,915 | 1,441,387 | 1,336,826 | ||||||||
Less: Expenditures for routine maintenance and information technology | (355,444 | ) | (363,946 | ) | (415,038 | ) | |||||
Less: Expenditures for development | (372,636 | ) | (406,309 | ) | (486,877 | ) | |||||
Plus: Proceeds from sale of self-developed properties | 57,817 | 51,058 | 45,314 | ||||||||
Free cash flow from continuing operations (new definition) | $ | 1,126,652 | $ | 722,190 | $ | 480,225 | |||||