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Segment reporting (Tables)
 3 Months Ended
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,
 20212020
Segment revenues:  
U.S. dialysis  
Dialysis patient service revenues:  
External sources$2,556,259 $2,579,240 
Intersegment revenues26,944 31,941 
U.S. dialysis patient service revenues2,583,203 2,611,181 
Other revenues(1):
External sources6,616 5,141 
Intersegment revenues59 301 
Total U.S. dialysis revenues2,589,878 2,616,623 
Other—Ancillary services
Dialysis patient service revenues158,328 134,041 
Other external sources98,798 122,815 
Intersegment revenues4,293 4,152 
Total ancillary services revenues261,419 261,008 
Total net segment revenues2,851,297 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 income468,046 488,961 
Reconciliation of segment operating income to consolidated income from continuing
 operations before income taxes:		  
Corporate administrative support(25,444)(23,585)
Consolidated operating income442,602 465,376 
Debt expense(67,014)(88,603)
Debt refinancing charges— (2,948)
Other income (loss), net1,168 (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,
 20212020
U.S. dialysis$155,946 $146,300 
Other—Ancillary services9,755 8,379 
 $165,701 $154,679 
Summary of Assets by Reportable Segment
A summary of assets by reportable segment was as follows:
March 31, 2021December 31, 2020
U.S. dialysis$16,036,940 $15,344,647 
Other—Ancillary services1,610,328 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,
 20212020
U.S. dialysis$133,804 $148,763 
Other—Ancillary services11,109 6,179 
 $144,913 $154,942