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Segment reporting (Tables)

9 Months Ended

Sep. 30, 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 September 30,												Nine months ended September 30,
			2021						2020						2021						2020
Segment revenues:
U.S. dialysis
Dialysis patient service revenues:
External sources			$	2,669,823					$	2,639,761					$	7,874,759					$	7,850,828
Intersegment revenues			22,007						37,049						70,196						104,111
U.S. dialysis patient service revenues			2,691,830						2,676,810						7,944,955						7,954,939
Other revenues:
External sources			6,119						17,141						19,080						29,970
Intersegment revenues			97						268						228						876
Total U.S. dialysis revenues			2,698,046						2,694,219						7,964,263						7,985,785
Other—Ancillary services
Dialysis patient service revenues			168,117						141,889						495,725						402,300
Other external sources			94,260						125,275						285,266						362,184
Intersegment revenues			—						4,079						4,294						12,402
Total ancillary services revenues			262,377						271,243						785,285						776,886
Total net segment revenues			2,960,423						2,965,462						8,749,548						8,762,671
Elimination of intersegment revenues			(22,104)						(41,396)						(74,718)						(117,389)
Consolidated revenues			$	2,938,319					$	2,924,066					$	8,674,830					$	8,645,282
Segment operating income (loss):
U.S. dialysis			$	509,939					$	470,596					$	1,523,625					$	1,484,833
Other—Ancillary services			(6,909)						(7,086)						(36,577)						(49,354)
Total segment operating income			503,030						463,510						1,487,048						1,435,479
Reconciliation of segment operating income to consolidated  income from continuing operations before income taxes:
Corporate administrative support			(28,153)						(25,841)						(79,093)						(122,514)
Consolidated operating income			474,877						437,669						1,407,955						1,312,965
Debt expense			(72,829)						(73,658)						(213,167)						(243,642)
Debt prepayment, refinancing and redemption charges			—						(86,074)						—						(89,022)
Other (loss) income, net			(7,590)						5,395						8,766						10,590
Consolidated income from continuing operations  before income taxes			$	394,458					$	283,332					$	1,203,554					$	990,891

Summary of Depreciation and Amortization Expense by Reportable Segment

Depreciation and amortization expense by reportable segment was as follows:

			Three months ended September 30,												Nine months ended September 30,
			2021						2020						2021						2020
U.S. dialysis			$	161,252					$	148,221					$	477,054					$	442,833
Other—Ancillary services			9,210						8,673						28,798						26,116
			$	170,462					$	156,894					$	505,852					$	468,949

Summary of Expenditures for Property and Equipment by Reportable Segment

Expenditures for property and equipment by reportable segment were as follows:

			Nine months ended September 30,
			2021						2020
U.S. dialysis			$	415,994					$	430,646
Other—Ancillary services			35,915						19,250
			$	451,909					$	449,896

Summary of Assets by Reportable Segment

A summary of assets by reportable segment was as follows:

			September 30, 2021						December 31, 2020
U.S. dialysis			$	15,939,286					$	15,344,647
Other—Ancillary services			1,694,654						1,643,869
Consolidated assets			$	17,633,940					$	16,988,516

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Reconciliation of capital expenditures for property and equipment from segment to consolidated.

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Tabular disclosure of all significant reconciling items in the reconciliation of total assets from reportable segments to the entity's consolidated assets.

+ References

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Tabular disclosure of the reconciliation of profit (loss) from reportable segments to the consolidated income (loss) before income tax expense (benefit) and discontinued operations. Includes, but is not limited to, reconciliation after income tax if income tax is allocated to the reportable segment.

+ References

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Tabular disclosure of each significant reconciling item, other than profit (loss), revenues, or assets, in the reconciliation of totals of such items in reportable segments to the entity's corresponding consolidated amount.

+ References

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