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Segment reporting (Tables) | 3 Months Ended
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Mar. 31, 2021
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 March 31, |  |
| 2021 |  | 2020 |  |  |  |
Segment revenues: |  |  |  |  |  |  |
U.S. dialysis |  |  |  |  |  |  |
Dialysis patient service revenues: |  |  |  |  |  |  |
External sources | $ | 2,556,259 |  |  | $ | 2,579,240 |  |  |  |  |
Intersegment revenues | 26,944 |  |  | 31,941 |  |  |  |  |
U.S. dialysis patient service revenues | 2,583,203 |  |  | 2,611,181 |  |  |  |  |
Other revenues(1): |  |  |  |  |  |  |
External sources | 6,616 |  |  | 5,141 |  |  |  |  |
Intersegment revenues | 59 |  |  | 301 |  |  |  |  |
Total U.S. dialysis revenues | 2,589,878 |  |  | 2,616,623 |  |  |  |  |
Other—Ancillary services |  |  |  |  |  |  |
Dialysis patient service revenues | 158,328 |  |  | 134,041 |  |  |  |  |
Other external sources | 98,798 |  |  | 122,815 |  |  |  |  |
Intersegment revenues | 4,293 |  |  | 4,152 |  |  |  |  |
Total ancillary services revenues | 261,419 |  |  | 261,008 |  |  |  |  |
Total net segment revenues | 2,851,297 |  |  | 2,877,631 |  |  |  |  |
Elimination of intersegment revenues | (31,296) |  |  | (36,394) |  |  |  |  |
Consolidated revenues | $ | 2,820,001 |  |  | $ | 2,841,237 |  |  |  |  |
Segment operating income (loss): |  |  |  |  |  |  |
U.S. dialysis | $ | 479,906 |  |  | $ | 491,607 |  |  |  |  |
Other—Ancillary services | (11,860) |  |  | (2,646) |  |  |  |  |
Total segment operating income | 468,046 |  |  | 488,961 |  |  |  |  |
Reconciliation of segment operating income to consolidated income from continuing operations before income taxes: |  |  |  |  |  |  |
Corporate administrative support | (25,444) |  |  | (23,585) |  |  |  |  |
Consolidated operating income | 442,602 |  |  | 465,376 |  |  |  |  |
Debt expense | (67,014) |  |  | (88,603) |  |  |  |  |
Debt refinancing charges | — |  |  | (2,948) |  |  |  |  |
Other income (loss), net | 1,168 |  |  | (4,350) |  |  |  |  |
Consolidated income from continuing operations before income taxes | $ | 376,756 |  |  | $ | 369,475 |  |  |  |  |
(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 Depreciation and Amortization Expense by Reportable Segment | Depreciation and amortization expense by reportable segment was as follows:
| Three months ended March 31, |
| 2021 |  | 2020 |
U.S. dialysis | $ | 155,946 |  |  | $ | 146,300 |  |
Other—Ancillary services | 9,755 |  |  | 8,379 |  |
| $ | 165,701 |  |  | $ | 154,679 |  |
Summary of Assets by Reportable Segment | A summary of assets by reportable segment was as follows:
| March 31, 2021 |  | December 31, 2020
U.S. dialysis | $ | 16,036,940 |  |  | $ | 15,344,647 |
Other—Ancillary services | 1,610,328 |  |  | 1,643,869 |
Consolidated assets | $ | 17,647,268 |  |  | $ | 16,988,516 |
Summary of Expenditures for Property and Equipment by Reportable Segment | Expenditures for property and equipment by reportable segment were as follows:
| Three months ended March 31,
| 2021 |  | 2020
U.S. dialysis | $ | 133,804 |  |  | $ | 148,763 |
Other—Ancillary services | 11,109 |  |  | 6,179 |
| $ | 144,913 |  |  | $ | 154,942 |

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