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Segment reporting (Tables)

9 Months Ended

Sep. 30, 2024

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 revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:

			Three months ended September 30,												Nine months ended September 30,
			2024						2023						2024						2023
Segment revenues:
U.S. dialysis
Dialysis patient service revenues:
External sources			$	2,883,656					$	2,754,778					$	8,431,418					$	8,042,561
Intersegment revenues			16,140						24,289						53,528						66,698
U.S. dialysis patient service revenues			2,899,796						2,779,067						8,484,946						8,109,259
Other revenues:
External sources			6,204						6,239						18,224						18,822
Total U.S. dialysis revenues			2,906,000						2,785,306						8,503,170						8,128,081
Other—Ancillary services
Dialysis patient service revenues			254,905						197,172						709,777						560,108
Other external sources			118,825						163,143						361,448						372,909
Intersegment revenues			2,598						2,232						9,168						5,007
Total ancillary services revenues			376,328						362,547						1,080,393						938,024
Total net segment revenues			3,282,328						3,147,853						9,583,563						9,066,105
Elimination of intersegment revenues			(18,738)						(26,521)						(62,696)						(71,705)
Consolidated revenues			$	3,263,590					$	3,121,332					$	9,520,867					$	8,994,400
Segment operating margin (loss):
U.S. dialysis			$	549,476					$	509,135					$	1,625,399					$	1,330,992
Other—Ancillary services			13,906						28,098						(16,188)						(18,372)
Total segment operating margin			563,382						537,233						1,609,211						1,312,620
Reconciliation of segment operating income to consolidated  income before income taxes:
Corporate administrative support			(28,504)						(41,294)						(84,090)						(99,745)
Consolidated operating income			534,878						495,939						1,525,121						1,212,875
Debt expense			(134,583)						(98,080)						(331,748)						(302,361)
Debt prepayment, extinguishment and modification costs			(10,081)						—						(19,813)						(7,962)
Other loss, net			(16,780)						(19,650)						(56,900)						(14,525)
Consolidated income before income taxes			$	373,434					$	378,209					$	1,116,660					$	888,027

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,
			2024						2023						2024						2023
U.S. dialysis			$	170,543					$	175,908					$	503,805					$	514,710
Other—Ancillary services			16,471						12,515						45,953						35,456
			$	187,014					$	188,423					$	549,758					$	550,166

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,
															2024						2023
U.S. dialysis															$	331,031					$	363,895
Other—Ancillary services															53,755						45,116
															$	384,786					$	409,011

X

- Definition

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

+ References

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- Definition

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

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-30

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- Definition

Tabular disclosure of reconciliation of other items from reportable segments to their consolidated amount. Excludes reconciliation of revenue, profit (loss), and assets.

+ 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

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-30

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