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Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2023

Segment Reporting [Abstract]

Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes

The following is a summary of segment revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:

			Year ended December 31,
			2023						2022						2021
Segment revenues:
U.S. dialysis
Patient service revenues:
External sources			$	10,823,525					$	10,488,327					$	10,551,106
Intersegment revenues			88,222						87,045						90,512
U.S. dialysis patient service revenues			10,911,747						10,575,372						10,641,618
Other revenues
External sources			25,251						24,447						25,061
Intersegment revenues			—						(10)						284
Total U.S. dialysis revenues			10,936,998						10,599,809						10,666,963
Other - Ancillary services
Patient service revenues			751,416						688,137						662,409
Other external sources			539,955						408,983						380,221
Intersegment revenues			7,852						4,206						4,294
Total ancillary services			1,299,223						1,101,326						1,046,924
Total net segment revenues			12,236,221						11,701,135						11,713,887
Elimination of intersegment revenues			(96,074)						(91,241)						(95,090)
Consolidated revenues			$	12,140,147					$	11,609,894					$	11,618,797
Segment operating margin (loss):
U.S. dialysis			$	1,774,578					$	1,565,310					$	1,974,988
Other - Ancillary services(1)			(8,747)						(96,579)						(66,003)
Total segment margin			1,765,831						1,468,731						1,908,985
Reconciliation of segment operating margin to consolidated income from  continuing operations before income taxes:
Corporate administrative support			(163,047)						(129,669)						(111,615)
Consolidated operating income			1,602,784						1,339,062						1,797,370
Debt expense			(398,551)						(357,019)						(285,254)
Debt extinguishment and modification costs			(7,962)						—						—
Other (loss) income, net			(19,177)						(15,765)						6,378
Income from continuing operations before income taxes			$	1,177,094					$	966,278					$	1,518,494

 

(1)Segment operating loss for Other - Ancillary services includes equity investment loss of $2,103, $1,898 and $3,177 in 2023, 2022 and 2021, respectively.

Summary of Depreciation and Amortization Expense by Segment

Depreciation and amortization expense by reportable segment was as follows:

			Year ended December 31,
			2023						2022						2021
U.S. dialysis			$	695,674					$	690,949					$	642,711
Other - Ancillary services			49,769						41,653						37,904
			$	745,443					$	732,602					$	680,615

Summary of Expenditures for Property and Equipment by Segment

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

			Year ended December 31,
			2023						2022						2021
U.S. dialysis			$	501,149					$	533,600					$	589,662
Other - Ancillary services			66,836						69,829						51,803
			$	567,985					$	603,429					$	641,465

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

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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

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-31

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-Name Accounting Standards Codification
-Topic 280
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-Publisher FASB
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Tabular disclosure of reconciliation of other items from reportable segments to their consolidated amount. Excludes reconciliation of revenue, profit (loss), and assets.

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-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-31

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