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Segment reporting (Tables) | 6 Months Ended
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Jun. 30, 2022
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 margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:
| Three months ended June 30, |  | Six months ended June 30,
| 2022 |  | 2021 |  | 2022 |  | 2021
Segment revenues: |  |  |  |  |  |  |
U.S. dialysis |  |  |  |  |  |  |
Dialysis patient service revenues: |  |  |  |  |  |  |
External sources | $ | 2,637,738 |  |  | $ | 2,648,676 |  |  | $ | 5,184,700 |  |  | $ | 5,204,936 |
Intersegment revenues | 19,410 |  |  | 21,247 |  |  | 41,568 |  |  | 48,190 |
U.S. dialysis patient service revenues | 2,657,148 |  |  | 2,669,923 |  |  | 5,226,268 |  |  | 5,253,126 |
Other revenues: |  |  |  |  |  |  |
External sources | 6,113 |  |  | 6,345 |  |  | 12,078 |  |  | 12,961 |
Intersegment revenues | (21) |  |  | 70 |  |  | (10) |  |  | 130 |
Total U.S. dialysis revenues | 2,663,240 |  |  | 2,676,338 |  |  | 5,238,336 |  |  | 5,266,217 |
Other—Ancillary services |  |  |  |  |  |  |
Dialysis patient service revenues | 172,361 |  |  | 169,281 |  |  | 341,680 |  |  | 327,608 |
Other external sources | 110,545 |  |  | 92,208 |  |  | 205,854 |  |  | 191,006 |
Intersegment revenues | — |  |  | — |  |  | — |  |  | 4,294 |
Total ancillary services revenues | 282,906 |  |  | 261,489 |  |  | 547,534 |  |  | 522,908 |
Total net segment revenues | 2,946,146 |  |  | 2,937,827 |  |  | 5,785,870 |  |  | 5,789,125 |
Elimination of intersegment revenues | (19,389) |  |  | (21,317) |  |  | (41,558) |  |  | (52,614) |
Consolidated revenues | $ | 2,926,757 |  |  | $ | 2,916,510 |  |  | $ | 5,744,312 |  |  | $ | 5,736,511 |
Segment operating margin (loss): |  |  |  |  |  |  |
U.S. dialysis | $ | 472,801 |  |  | $ | 533,779 |  |  | $ | 879,241 |  |  | $ | 1,013,686 |
Other—Ancillary services | (9,113) |  |  | (17,808) |  |  | (41,418) |  |  | (29,668) |
Total segment operating margin | 463,688 |  |  | 515,971 |  |  | 837,823 |  |  | 984,018 |
Reconciliation of segment operating income to consolidated income before income taxes: |  |  |  |  |  |  |
Corporate administrative support | (30,973) |  |  | (25,495) |  |  | (66,800) |  |  | (50,940) |
Consolidated operating income | 432,715 |  |  | 490,476 |  |  | 771,023 |  |  | 933,078 |
Debt expense | (82,586) |  |  | (73,324) |  |  | (156,377) |  |  | (140,338) |
Other (loss) income, net | (1,284) |  |  | 15,188 |  |  | (3,070) |  |  | 16,356 |
Consolidated income before income taxes | $ | 348,845 |  |  | $ | 432,340 |  |  | $ | 611,576 |  |  | $ | 809,096 |
Summary of Depreciation and Amortization Expense by Reportable Segment | Depreciation and amortization expense by reportable segment was as follows:
| Three months ended June 30, |  | Six months ended June 30,
| 2022 |  | 2021 |  | 2022 |  | 2021
U.S. dialysis | $ | 160,612 |  |  | $ | 159,856 |  |  | $ | 322,632 |  |  | $ | 315,802 |
Other—Ancillary services | 10,564 |  |  | 9,833 |  |  | 21,488 |  |  | 19,588 |
| $ | 171,176 |  |  | $ | 169,689 |  |  | $ | 344,120 |  |  | $ | 335,390 |
Summary of Expenditures for Property and Equipment by Reportable Segment | Expenditures for property and equipment by reportable segment were as follows:
|  |  | Six months ended June 30,
|  |  |  |  | 2022 |  | 2021
U.S. dialysis |  |  |  |  | $ | 237,686 |  |  | $ | 271,884 |
Other—Ancillary services |  |  |  |  | 27,775 |  |  | 22,554 |
|  |  |  |  | $ | 265,461 |  |  | $ | 294,438 |
Summary of Assets by Reportable Segment | A summary of assets by reportable segment were as follows:
| June 30, 2022 |  | December 31, 2021
U.S. dialysis | $ | 15,325,222 |  |  | $ | 15,375,000 |
Other—Ancillary services | 1,775,353 |  |  | 1,746,488 |
Consolidated assets | $ | 17,100,575 |  |  | $ | 17,121,488 |

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