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Segment reporting | 3 Months Ended
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Mar. 31, 2023
Segment Reporting [Abstract] |
Segment Reporting Disclosure | Segment reporting The Company’s operating divisions are comprised of its U.S. dialysis and related lab services business (its U.S. dialysis business), its U.S. IKC business, its U.S. other ancillary services and its international operations (collectively, its ancillary services), as well as its corporate administrative support. The Company’s separate operating segments include its U.S. dialysis and related lab services business, its U.S. IKC business, its U.S. other ancillary services, its kidney care operations in each foreign sovereign jurisdiction, and its equity method investment in the Asia Pacific joint venture (APAC JV). The U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other operating segments have been combined and disclosed in the other segments category. See Note 25 to the Company's consolidated financial statements included in the 2022 10-K for further description of how the Company determines and measures results for its operating segments. The following is a summary of segment revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:
| Three months ended March 31, |  |
| 2023 |  | 2022 |  |  |  |
Segment revenues: |  |  |  |  |  |  |
U.S. dialysis |  |  |  |  |  |  |
Dialysis patient service revenues: |  |  |  |  |  |  |
External sources | $ | 2,583,933 |  |  | $ | 2,546,961 |  |  |  |  |
Intersegment revenues | 22,047 |  |  | 22,159 |  |  |  |  |
U.S. dialysis patient service revenues | 2,605,980 |  |  | 2,569,120 |  |  |  |  |
Other revenues: |  |  |  |  |  |  |
External sources | 6,180 |  |  | 5,966 |  |  |  |  |
Intersegment revenues | — |  |  | 10 |  |  |  |  |
Total U.S. dialysis revenues | 2,612,160 |  |  | 2,575,096 |  |  |  |  |
Other—Ancillary services |  |  |  |  |  |  |
Dialysis patient service revenues | 176,101 |  |  | 169,320 |  |  |  |  |
Other external sources | 106,485 |  |  | 95,308 |  |  |  |  |
Intersegment revenues | 1,368 |  |  | — |  |  |  |  |
Total ancillary services revenues | 283,954 |  |  | 264,628 |  |  |  |  |
Total net segment revenues | 2,896,114 |  |  | 2,839,724 |  |  |  |  |
Elimination of intersegment revenues | (23,415) |  |  | (22,169) |  |  |  |  |
Consolidated revenues | $ | 2,872,699 |  |  | $ | 2,817,555 |  |  |  |  |
Segment operating margin (loss): |  |  |  |  |  |  |
U.S. dialysis | $ | 361,098 |  |  | $ | 406,440 |  |  |  |  |
Other—Ancillary services | (24,865) |  |  | (32,305) |  |  |  |  |
Total segment operating margin | 336,233 |  |  | 374,135 |  |  |  |  |
Reconciliation of segment operating income to consolidated income before income taxes: |  |  |  |  |  |  |
Corporate administrative support | (24,588) |  |  | (35,827) |  |  |  |  |
Consolidated operating income | 311,645 |  |  | 338,308 |  |  |  |  |
Debt expense | (100,774) |  |  | (73,791) |  |  |  |  |
Other income (loss), net | 3,752 |  |  | (1,786) |  |  |  |  |
Consolidated income before income taxes | $ | 214,623 |  |  | $ | 262,731 |  |  |  |  |
Depreciation and amortization expense by reportable segment was as follows:
| Three months ended March 31, |  |
| 2023 |  | 2022 |  |  |  |
U.S. dialysis | $ | 166,961 |  |  | $ | 162,019 |  |  |  |  |
Other—Ancillary services | 11,110 |  |  | 10,925 |  |  |  |  |
| $ | 178,071 |  |  | $ | 172,944 |  |  |  |  |
Expenditures for property and equipment by reportable segment were as follows:
| Three months ended March 31, |  |
| 2023 |  | 2022 |  |  |  |
U.S. dialysis | $ | 130,966 |  |  | $ | 107,513 |  |  |  |  |
Other—Ancillary services | 16,739 |  |  | 15,595 |  |  |  |  |
| $ | 147,705 |  |  | $ | 123,108 |  |  |  |  |
A summary of assets by reportable segment were as follows:
| March 31, 2023 |  | December 31, 2022
U.S. dialysis | $ | 14,789,095 |  |  | $ | 15,084,454 |
Other—Ancillary services | 1,938,692 |  |  | 1,843,798 |
Consolidated assets | $ | 16,727,787 |  |  | $ | 16,928,252 |

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- Definition The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 31 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8924-108599 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 34 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8981-108599 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 21 -Subparagraph (a) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 40 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9031-108599 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (f) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599 Reference 6: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (e) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599 Reference 7: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 26 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8844-108599 Reference 8: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 41 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9038-108599 Reference 9: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (d) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599 Reference 10: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599 Reference 11: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 42 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9054-108599 Reference 12: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 15 -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8657-108599 Reference 13: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 21 -Subparagraph (b) -URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599 Reference 14: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -URI https://asc.fasb.org/topic&trid=2134510 + Details
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