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v3.23.3

Segment reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended
--- | --- | ---
Sep. 30, 2023 | Jun. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022
Segment Reporting Information [Line Items] |  |  |  |  |
Other revenues | $ 169,382 |  | $ 102,200 | $ 391,731 | $ 320,132
Total revenues | 3,121,332 |  | 2,948,694 | 8,994,400 | 8,693,006
Operating income (loss) | 495,939 |  | 311,787 | 1,212,875 | 1,082,810
Corporate administrative support | (41,294) |  | (24,417) | (99,745) | (91,217)
Debt expense | (98,080) |  | (99,680) | (302,361) | (256,057)
Debt extinguishment and modification costs | 0 | $ (7,962) | 0 | (7,962) | 0
Other loss, net | (19,650) |  | (4,898) | (14,525) | (7,968)
Income before income taxes | 378,209 |  | 207,209 | 888,027 | 818,785
U.S. dialysis |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Total revenues | 2,761,017 |  | 2,680,296 | 8,061,383 | 7,877,073
Other—Ancillary services |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Total revenues | 360,315 |  | 268,398 | 933,017 | 815,933
Operating Segments |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Total revenues | 3,147,853 |  | 2,971,651 | 9,066,105 | 8,757,522
Operating income (loss) | 537,233 |  | 336,203 | 1,312,620 | 1,174,026
Operating Segments | U.S. dialysis |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Dialysis patient service revenues | 2,779,067 |  | 2,697,197 | 8,109,259 | 7,923,465
Total revenues | 2,785,306 |  | 2,703,253 | 8,128,081 | 7,941,589
Operating income (loss) | 509,135 |  | 351,474 | 1,330,992 | 1,230,715
Operating Segments | U.S. dialysis | External Sources |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Dialysis patient service revenues | 2,754,778 |  | 2,674,240 | 8,042,561 | 7,858,939
Other revenues | 6,239 |  | 6,056 | 18,822 | 18,134
Operating Segments | U.S. dialysis | Intersubsegment Eliminations |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Dialysis patient service revenues | 24,289 |  | 22,957 | 66,698 | 64,526
Other revenues | 0 |  | 0 | 0 | (10)
Operating Segments | Other—Ancillary services |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Dialysis patient service revenues | 197,172 |  | 172,254 | 560,108 | 513,935
Other revenues | 163,143 |  | 96,144 | 372,909 | 301,998
Total revenues | 362,547 |  | 268,398 | 938,024 | 815,933
Operating income (loss) | 28,098 |  | (15,271) | (18,372) | (56,689)
Operating Segments | Other—Ancillary services | Intersubsegment Eliminations |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Dialysis patient service revenues | 2,232 |  | 0 | 5,007 | 0
Intersegment Elimination |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Total revenues | (26,521) |  | (22,957) | (71,705) | (64,516)
Intersegment Elimination | U.S. dialysis |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Total revenues | (24,289) |  | $ (22,957) | (66,698) | $ (64,516)
Intersegment Elimination | Other—Ancillary services |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |
Total revenues | $ (2,232) |  |  | $ (5,007) |

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