<SEC-DOCUMENT>0001193125-24-136175.txt : 20240820
<SEC-HEADER>0001193125-24-136175.hdr.sgml : 20240820
<ACCEPTANCE-DATETIME>20240510161255
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ACCESSION NUMBER:		0001193125-24-136175
CONFORMED SUBMISSION TYPE:	CORRESP
PUBLIC DOCUMENT COUNT:		2
FILED AS OF DATE:		20240510

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			DAVITA INC.
		CENTRAL INDEX KEY:			0000927066
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090]
		ORGANIZATION NAME:           	08 Industrial Applications and Services
		IRS NUMBER:				510354549
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		CORRESP

	BUSINESS ADDRESS:	
		STREET 1:		2000 16TH STREET
		CITY:			DENVER
		STATE:			CO
		ZIP:			80202
		BUSINESS PHONE:		310-536-2668

	MAIL ADDRESS:	
		STREET 1:		2000 16TH STREET
		CITY:			DENVER
		STATE:			CO
		ZIP:			80202

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	DAVITA HEALTHCARE PARTNERS INC.
		DATE OF NAME CHANGE:	20121107

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	DAVITA INC
		DATE OF NAME CHANGE:	20001005

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	TOTAL RENAL CARE HOLDINGS INC
		DATE OF NAME CHANGE:	19950524
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<TYPE>CORRESP
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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. </B>&#167;<B>200.83). This letter requests confidential treatment of the bracketed portions of this letter</B> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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 </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">May&nbsp;10, 2024 </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">FOIA
CONFIDENTIAL TREATMENT REQUESTED BY DAVITA INC. PURSUANT TO 17 C.F.R. &#167;200.83 (&#147;Rule 83&#148;) </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(Contact: Christopher Berry, Chief Accounting
Officer, (253) <FONT STYLE="white-space:nowrap">733-4638)</FONT> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">U.S. Securities and Exchange Commission </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Division of Corporation Finance </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Office of Industrial
Applications and Services </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">100 F Street, NE </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Washington, D.C.
20549 </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="5%" VALIGN="top" ALIGN="left">Attn:</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Michael Fay </P></TD></TR></TABLE>
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<TD WIDTH="5%" VALIGN="top" ALIGN="left">&#8195;</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Kristin Lochhead </P></TD></TR></TABLE> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="5%" VALIGN="top" ALIGN="left"><B>Re:</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>DaVita Inc. </B></P></TD></TR></TABLE>
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<TD WIDTH="5%" VALIGN="top" ALIGN="left"><B>&#8195;</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Form <FONT STYLE="white-space:nowrap">10-K</FONT> For the Fiscal Year Ended December&nbsp;31, 2023
</B></P></TD></TR></TABLE>
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<TD WIDTH="5%" VALIGN="top" ALIGN="left"><B>&#8195;</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Filed February&nbsp;14, 2024 </B></P></TD></TR></TABLE>
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<TD WIDTH="5%" VALIGN="top" ALIGN="left"><B>&#8195;</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>File <FONT STYLE="white-space:nowrap">No.&nbsp;001-14106</FONT> </B></P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Ladies and Gentlemen: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Thank you for your letter dated
April&nbsp;11, 2024, addressed to Christopher Berry, Chief Accounting Officer of DaVita Inc. (&#147;DaVita&#148; or the &#147;Company&#148;), setting forth the comments of the staff of the Division of Corporate Finance (the &#147;Staff&#148;) on the
Company&#146;s Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the fiscal year ended December&nbsp;31, 2023 filed on February&nbsp;14, 2024 (the &#147;2023 <FONT STYLE="white-space:nowrap">10-K&#148;).</FONT> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">This response letter includes a request for confidential treatment of the portions of this letter bracketed below (designated by &#147;[***]&#148;) pursuant
to the Commission&#146;s confidential treatment procedure under Rule 83. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">To facilitate the Staff&#146;s review, we have reproduced the Staff&#146;s
comments in italics below. Our response then follows each of the Staff&#146;s comments. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">1 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Terms and acronyms not defined within the responses below have the meanings assigned to them within the 2023 <FONT
STYLE="white-space:nowrap">10-K.</FONT> </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Staff Comment No.&nbsp;1 </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I><U>Form <FONT STYLE="white-space:nowrap">10-K</FONT> For the Fiscal Year Ended December&nbsp;31, 2023 </U></I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I><U>Management&#146;s Discussion and Analysis, page 58 </U></I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>1. In your response and in future filings, please further explain the IKC adjustment that resulted in $55&nbsp;million in incremental shared savings
revenue. Discuss the circumstances that resulted in the lifting of certain revenue recognition constraints for some of your value-based care contracts with health plans and how you considered ASC 606 in your accounting. </I></P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Response: </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company acknowledges the Staff&#146;s
comment. Our integrated kidney care (&#147;IKC&#148;) revenue is substantially composed of revenue from three primary sources: (i)&nbsp;special needs plans, (ii)&nbsp;our value-based care (&#147;VBC&#148;) contracts with health plans focused
primarily on Medicare Advantage (&#147;MA&#148;) patients, and (iii)&nbsp;the CMS Comprehensive Kidney Care Contracting (&#147;CKCC&#148;) demonstration program for our Medicare
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> patients. The following discussion pertains only to the VBC contract portion of our IKC business. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Our revenue recognition policy and accounting for these IKC arrangements are described in Notes 1 and 2 to the consolidated financial statements included in
our 2023 <FONT STYLE="white-space:nowrap">10-K.</FONT> </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Introductory summary </I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The $55&nbsp;million IKC adjustment referred to in the &#147;Company overview&#148; and &#147;Ancillary services results of operations&#148; sections of the
2023 <FONT STYLE="white-space:nowrap">10-K&#146;s</FONT> Management Discussion and Analysis (MD&amp;A) relates solely to the VBC contract portion of our IKC business. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">This adjustment represents revenue recognized in 2023 for 2023 services at a level incremental to what we would have recognized for 2023 services under prior
constraints as information and measurement limitations driving those recognition constraints were incrementally relieved. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Those limitations are summarily
described in the last paragraph of our &#147;Other revenues&#148; policy in Note 1 to the consolidated financial statements included in our 2023 <FONT STYLE="white-space:nowrap">10-K,</FONT> and changes in those limitations and their effect on the
constraints during 2023 are described in more detail below. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">For 2022 and prior annual reporting periods, the substantial majority of VBC shared savings
revenue earned in a period was recognized in a subsequent period. This resulted in recognition of amounts earned in prior periods of $94,361, $34,600 and $11,312 during 2023, 2022 and 2021, respectively, as disclosed in Note 2 to the consolidated
financial statements included in our 2023 <FONT STYLE="white-space:nowrap">10-K.</FONT> </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">2 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">However for 2023 and beyond, given both our increased experience and the changes and refinements we have made
with these VBC contracts, we expect that the majority of shared savings revenue earned in a period under these VBC contracts will be recognized in the period earned. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Our fiscal year 2023 therefore represents a transition year, reflecting a general shift in the timing of our revenue recognition for shared savings earned
under our VBC contracts with health plans, as it included a majority of shared savings revenues earned for both 2022 and 2023. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Additional background and
context follow. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>General nature of these VBC arrangements: </I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Under our VBC contracts, we agree to provide certain care monitoring and care coordination services to a cohort of health plan members, typically dialysis
patients with whom we already have a relatively high degree of contact through our dialysis services. The business premise is that if we can provide more proactive, preventative, higher-touch care monitoring and coordination for these patients, we
can help reduce their total medical cost of care. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The health plans that cover these patients therefore agree to compensate us by sharing with us a
portion of any aggregate reduction, or savings (i.e., &#147;shared savings&#148;) in the total medical cost of care that we are able to help drive for these patients. Similarly, many of our VBC contracts require us to bear full or partial shared
losses if aggregate medical costs for these members exceed the applicable shared savings benchmark or target. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Heightened sensitivity to small changes:
</I></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">These VBC contracts result in our earned IKC revenue being highly sensitive to changes in third party medical costs about which we do not generally
have timely or direct visibility, since our entire revenue for these arrangements results from narrow margins on a much larger total cost pool. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">For
example, assume we have a VBC contract with an MA plan under which we agree to share equally in any reduction from $100&nbsp;million of more than 5% in the total actual medical cost of care for health plan members attributed to our VBC contract for
a plan year. If total cost savings come in at 7%, we would earn $1&nbsp;million in revenue (i.e., <FONT STYLE="white-space:nowrap">one-half</FONT> of the total cost savings of $2 million). But if total cost savings come in at exactly 5%, we earn no
revenue at all <I>&#150;</I> such that a 2% adverse change in underlying medical cost outcomes would result in a 100% reduction in our IKC shared savings revenue earned under this example contract. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Revenue recognition policy: </I></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">As summarized in the section
titled &#147;Other revenues&#148; in Note 1 to the consolidated financial statements included in the 2023 <FONT STYLE="white-space:nowrap">10-K,</FONT> our policy is to recognize revenue for these VBC contracts in the period in which our performance
obligation is met, in accordance with ASC Topic 606, subject to the recognition constraint described in ASC <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">606-10-32-11.</FONT></FONT></FONT> That
obligation is a single group performance obligation to stand ready to provide services to health plan members aligned to our contract during the performance period. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">3 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The performance periods for our VBC contracts are typically one year in length (i.e., a &#147;plan
year&#148;), most of them on a calendar <FONT STYLE="white-space:nowrap">year-end,</FONT> and any of our shared savings consideration under the contract remains variable until outcomes for the performance year are finally determined, which typically
takes place through a final reconciliation that is not completed until six to 12 months after the plan year ends. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">ASC <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">606-10-32-11&#146;s</FONT></FONT></FONT> revenue recognition constraint provides that: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">&#147;<I>An entity shall include in the transaction price some or all of an amount of variable consideration</I><I>&#133;</I><I>only to the
extent it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently resolved.</I>&#148; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">As such, it has been our policy to recognize shared savings revenue under these VBC contracts only at such times, and to the extent of amounts, that we
estimate it is <I>probable</I> that we will receive and retain for a particular performance period, whether within the performance period or thereafter as required by the constraint. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Changes in fiscal year 2023: </I></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Prior to 2023, information
and other measurement limitations typically constrained recognition of a majority of our shared savings revenue for these VBC contracts with health plans until a period subsequent to the actual performance period. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">However, as noted above, as the experience of the Company and its health plan partners with these VBC contracts has grown, we have made (or experienced) a
number of changes and refinements in 2023 that management believes have helped to mitigate or alleviate many of these limitations, allowing us to recognize a greater share of expected shared savings revenues for these VBC contracts sooner than we
have in the past. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">These changes and refinements include: </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="5%" VALIGN="top" ALIGN="left"><I>1.</I></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><I>Normalization of medical service utilization post-pandemic</I> &#150; In late 2022 and throughout 2023 as
the peak of the <FONT STYLE="white-space:nowrap">Covid-19</FONT> pandemic subsided, the dramatic disruption in utilization patterns of medical activity for health plan members has also subsided. This includes health plan members&#146; activities of
daily life, including those that lead to acute medical needs or changes in their rate of medical utilization, the incidence rate of medical events, as well as the timing of medical procedures, all of which improves the predictability of aggregate
medical costs for a particular patient population, not to mention the significantly reduced variability in medical costs that previously related to heightened mortality during the pandemic, both from <FONT STYLE="white-space:nowrap">Covid-19</FONT>
itself and from delays in addressing other medical needs, among other factors. </P></TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">4 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>

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<TD WIDTH="4%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><I>2.</I></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><I>VBC contracts moving into maturity</I> &#150; Most of our VBC contracts were still in their first or second
plan years in 2021 and 2022, and our two largest VBC plans just reached final reconciliation of their first plan year in 2023. </P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:9%; font-size:10pt; font-family:Times New Roman">Most interpretive or measurement questions under these complex and custom arrangements are resolved between the parties within the first two
plan years. As a result, the Company now has significantly more confidence in its alignment with counterparties on interpretations concerning measurements required under these contracts. This, in turn, provides us higher confidence in our own
estimates of expected shared savings achieved for the plan year made before completion of final reconciliation. </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="4%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">3.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><I>Improved member alignment information</I> &#150; The alignment or attribution of health plan members into
our VBC contracts&#146; accountable cost pools by member month for a plan year can be quite complex and subject to significant time lags, particularly where there are multiple levels of nested attribution mechanics involved. Attribution occurs
primarily by a combination of insurance and clinical criteria, some of which operate prospectively and others retrospectively. </P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:9%; font-size:10pt; font-family:Times New Roman">We have worked with our health plan counterparties to modify elements of our VBC contracts, or to codify protocols or practices related to
these contracts, to provide us with earlier clarity on which of their members are aligned to our contracts. This is a fundamental, first-order data element underlying any reliable cost and expected shared savings estimates, which remains sensitive
to complex member alignment or patient attribution mechanics. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:9%; font-size:10pt; font-family:Times New Roman">While we continue to lack patient-level alignment information until six to
12 months after the plan year ends, our understanding of the expected aggregate impact of the alignment process for these contracts has developed as we have gained multiple plan years of experience with individual health plans as well as increased
our population of other health plan contracts in the same or similar localities, allowing us to compare and contrast information among contracts to better inform our estimates. </P>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="4%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">4.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><I>Obtaining data validation more frequently &#150;</I> Measures of shared savings under our VBC contracts are
also subject to potentially significant adjustment for a number of patient characteristics and clinical quality measures as well as <FONT STYLE="white-space:nowrap">CMS-assigned</FONT> risk adjustment factor (RAF) scores for each patient.
</P></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:9%; font-size:10pt; font-family:Times New Roman">While we continue to lack key patient-level cost, characteristic and clinical quality information until six to 12 months
after the plan year ends, we have modified contracts with our VBC contract counterparties, or established agreed protocols or practices pursuant thereto, to receive more timely and granular data on patient, cost, and other characteristics as well as
summarized interim data validation to ensure that both parties are tracking toward similar financial reconciliation outcomes. This has allowed us to refine our estimates of ultimate shared savings outcomes prior to final determination. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">5 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>

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<TD WIDTH="5%" VALIGN="top" ALIGN="left">5.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><I>Improved actuarial data analysis</I> &#150; With the improvements in timing and granularity of data
described above, moderation of the estimate-distorting effects of the <FONT STYLE="white-space:nowrap">Covid-19</FONT> pandemic, as well as continued experience with the unique characteristics of the CKD and ESRD patient populations and these types
of VBC contracts, we have achieved greater confidence in the degree of predictive accuracy of the actuarial models we use to estimate expected shared savings for our VBC contracts. </P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">As a result of these changes and refinements in 2023, and with most of our VBC contracts reaching the end of a performance period (plan year) on
December&nbsp;31, 2023, we were able to recognize a greater share of expected shared savings revenue earned in 2023 as these changes and refinements resulted in a greater portion of that amount becoming <I>probable</I> of ultimately being received
and retained. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">And as a result of these changes and refinements, we now expect that the majority of our ultimate VBC revenues realized will be recognized
in the years in which they were earned for subsequent periods as well. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B></B><B><I>Proposed revision in future filings</I></B><B>: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">As requested by the Staff, the Company proposes to expand its description of this adjustment as follows in its MD&amp;A discussion of Ancillary services
results of operation in future Forms <FONT STYLE="white-space:nowrap">10-Q</FONT> and Forms <FONT STYLE="white-space:nowrap">10-K</FONT> that include the period of this adjustment (with changes marked): </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>&#147;Items impacting operating income </I></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>IKC
adjustment. </I>The increase in IKC revenues for 2023 was primarily due to the lifting of certain revenue recognition constraints for some of our value-based care contracts with health plans, allowing us to recognize approximately $55&nbsp;million
in incremental shared savings revenues <U>compared to what we would have recognized under prior period constraints</U>. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><U>Since we launched our IKC VBC
business, the <FONT STYLE="white-space:nowrap">Covid-19</FONT> pandemic and its distorting effects on medical utilization have subsided, our VBC contracts have continued to mature, we have begun to receive more timely and granular data from our
health plan partners, and we have gained more experience making total medical cost estimates for this population. These changes and refinements have helped to mitigate or alleviate a number of the information and measurement limitations that
constrained our revenue recognition in the past, allowing us to recognize a greater share of expected shared savings revenues for our VBC plans sooner than we had in previous periods. As a result, we recognized a majority of the VBC shared savings
revenues we expected to earn for 2023 in 2023, while in previous years a substantial majority of the shared savings earned for a VBC plan year were recognized in a subsequent year. </U></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><U>Our fiscal year 2023 therefore included a general shift in the timing of our revenue recognition for shared savings under our VBC contracts with health
plans, as it included a majority of shared savings revenues earned for both 2022 and 2023.&#148; </U></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">6 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Staff Comment No.&nbsp;2 </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I><U>Reconciliations of <FONT STYLE="white-space:nowrap">non-GAAP</FONT> measures, page 72 </U></I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>2. In future filings, please include a footnote that describes the composition of the <FONT STYLE="white-space:nowrap">non-GAAP</FONT> adjustments and why
you believe they are not indicative of your ordinary results of operations. As a related matter, explain to us in your response why you believe that the <FONT STYLE="white-space:nowrap">non-GAAP</FONT> adjustment for &#147;closure costs&#148; meets
the requirements of Question 100.01 of the C&amp;DI on <FONT STYLE="white-space:nowrap">Non-GAAP</FONT> Financial Measures. In this regard, we see that you incurred similar costs in FY22 and that you will continue to optimize your U.S. dialysis
center footprint through center mergers and/or closures and expect your center closure levels in the upcoming year to mirror the current year&#146;s elevated closure levels. </I></P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Response: </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Part A of Comment #2 </I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company acknowledges the Staff&#146;s comment. To address the first sentence of the Staff&#146;s comment 2, the Company will revise its disclosures in
future filings to describe the composition of <FONT STYLE="white-space:nowrap">non-GAAP</FONT> adjustments and include expanded discussion of the rationale for the Company&#146;s determination that <FONT STYLE="white-space:nowrap">non-GAAP</FONT>
adjustments are not indicative of ordinary results of operations. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The proposed additional disclosure for future filings is set forth below: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman"><FONT STYLE="white-space:nowrap">Non-GAAP</FONT> adjustments may include, but are not limited to, certain items such as center closure costs
(net losses on retired assets, lease costs, asset impairments and accelerated depreciation and amortization), goodwill impairments, severance and other restructuring costs, significant legal settlement accruals, debt extinguishment and modification
costs, and significant adjustments to recognized shared savings earnings in our IKC business. Management believes that these adjustments are for costs and expenses that are not required to maintain ongoing operations and may impact certain operating
income or other trends that management believes would not be indicative of the underlying ordinary results of operations. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Part B of Comment #2
</I></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Several external forces in 2021 and 2022 had a significant impact on our business. In particular, our business was uniquely impacted by <FONT
STYLE="white-space:nowrap">Covid-19.</FONT> Our patient population was particularly vulnerable to <FONT STYLE="white-space:nowrap">Covid-19</FONT> given their multiple comorbidities and, as a result, the mortality rates of our patients increased
[***]. This excess mortality was noted particularly during each <FONT STYLE="white-space:nowrap">Covid-19</FONT> surge and resulted in a compounding impact on treatment volumes that persisted even after each surge subsided. Our treatment volumes
grew an average of approximately 3.5% annually over the three years prior to the pandemic, turned flat in 2020 and actually experienced a reduction of nearly 5% from the end of 2020 through the end of 2023. The result was a significant and negative
long-term impact on our revenue and capacity needs across our clinic footprint. In addition, we have seen continuing growth in the percentage of our patients who have elected to dialyze at home in recent years, which has further reduced the capacity
needs of our domestic <FONT STYLE="white-space:nowrap">in-center</FONT> dialysis footprint. This growth in the percentage of our patients electing home dialysis further reduced the capacity needs of our domestic clinic footprint. This period of time
also saw a rise in other inter-related external forces that put pressure on our cost structure, including, among other things, inflation, rising interest rates, and increasing labor and supply costs. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">7 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Recognizing the cumulative impact of these unique events, we completed a special strategic review of our
outpatient clinic capacity requirements and utilization in the third quarter of 2022 and began to execute on the recommendations of this review shortly thereafter. However, from the time <FONT STYLE="white-space:nowrap">Covid-19</FONT> emerged, we
had disclosed that there was a significant amount of uncertainty regarding the severity, duration and ultimate impact of the pandemic on our patient population and business, and this level of uncertainty was particularly acute during the surges
throughout 2021 and into 2022. As a result, even as we executed on the 2022 review, the pandemic&#146;s continuing impact on our patient population prompted us to initiate a secondary special review in 2023. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">As a result of these special reviews, which included an assessment of potential external forces on our business, the Company implemented a special program
that was internally referred to as &#147;Footprint of the Future.&#148; This program was intended to reduce our clinical footprint in the United States through clinic closures that were separate and apart from normal course operations and involved
closures at a level and pace significantly higher than historical experience prior to <FONT STYLE="white-space:nowrap">Covid-19.</FONT> These closures resulted in significant elevated associated costs when compared to prior years. For reference,
prior to the impact of the pandemic, in 2018, 2019 and 2020, respectively, the Company sold or closed 11, 32 and 26 clinics in the U.S., and experienced a net increase in the number of centers we operated. By contrast, the Company sold or closed 65,
134, and 72 clinics in the U.S. in 2021, 2022, and 2023, respectively, and experienced a net decrease in the number of centers we operated. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Because we
prioritize continuity of care for our patients and maintaining a culture of compliance and integrity with regulatory authorities and our joint venture partners, our process to close these clinics can vary in complexity and may require an extended
time to close as we ensure each patient finds an alternative location to receive this life-sustaining care. As a result, the costs of closing these clinics may be realized over the course of several quarters once the decision has been made on which
clinics to exit. In certain cases, we may be able to close clinics on an expedited time frame, but those closures generally result in an elevated level of costs as compared to our ordinary course clinic closures. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Management believes that the elevated costs of these center closures is not indicative of current or future normal operations as the high level of closures
were part of a unique and special program that we initiated to address the wide-ranging impacts of <FONT STYLE="white-space:nowrap">Covid-19</FONT> on our business. Due to both the protracted impact of the pandemic and the extended period of time
required to close certain clinics, we have incurred these elevated costs over several quarters. However, with the pandemic subsiding, we are nearing the end of this unique and special program and we anticipate that center closures will return to a
normalized level over the next several quarters. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">8 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Management does not believe the exclusion of center closure costs from adjusted <FONT
STYLE="white-space:nowrap">non-GAAP</FONT> operating income during this period of elevated closures is misleading to investors and believes the exclusion is appropriate under Rule 100(b) of Regulation G, as these elevated costs do not exclude
normal, recurring costs necessary to operate the existing business. In evaluating this <FONT STYLE="white-space:nowrap">non-GAAP</FONT> adjustment, management considered that some clinic turnover was normal to historical operations; however,
management did not want to introduce judgment into the Company&#146;s presentation and determined instead to present all comparable periods, per Question 100.02 of the C&amp;DI on <FONT STYLE="white-space:nowrap">Non-GAAP</FONT> Financial Measures,
to allow investors to evaluate &#147;normal&#148; pre-Covid level costs themselves<I>. </I>As a result, in the third quarter of 2022, which was the first time this <FONT STYLE="white-space:nowrap">non-GAAP</FONT> presentation appeared, the Company
presented all periods reported on a comparable basis, which presentation included recasting prior periods that reflected historical closure levels. Management anticipates the adjustment for center closure costs will cease by the end of 2024 as the
number of center closures returns to levels observed in years prior to the <FONT STYLE="white-space:nowrap">Covid-19</FONT> pandemic. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Staff Comment
Nos. 3 and 4 </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I><U>Consolidated Financial Statements </U></I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I><U>Property and equipment, page <FONT STYLE="white-space:nowrap">F-13</FONT> </U></I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>3. We note the disclosure here that maintenance and repairs are charged to expense as incurred and a reference on page 65, for example, that routine repairs
and maintenance are included within patient care costs. The disclosures on page 70 and 72, however, appear to indicate that certain routine maintenance is accounted for as a capital expenditure. Please describe for us the specific routine
maintenance costs that are accounted for as a capital expenditure and quantify the large expenditures or groups of similar expenditures. In addition, please provide us an analysis of how you determined the accounting for these separate costs or
groups of costs is appropriate. </I></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company acknowledges the Staff&#146;s comment. Please see our response to comment number 4 below which addresses
both comments 3 and 4. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>4. Please identify, describe and quantify for us the specific costs included within developments and relocations, as disclosed
on page 70. In addition, please fully describe for us how you determined capital expenditure accounting is appropriate for the separate costs or groups of similar costs. </I></P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Response: </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company acknowledges the Staff&#146;s
comment. As used in the tabular cash flow summary on page 70 at the beginning of the &#147;Liquidity and capital resources&#148; section of the 2023 <FONT STYLE="white-space:nowrap">10-K,</FONT> the term &#147;Routine maintenance&#148; was intended
to refer only to maintenance capital expenditures, (following the &#147;Capital expenditures&#148; header), not all expenditures for maintenance. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">For
clarity, the Company capitalizes expenditures for the purchase of property and equipment, improvements thereon, leasehold improvements, and qualifying software costs, as well as costs to replace, extend the life of or increase the functionality of
existing capital assets, where such purchases and costs have an expected benefit period of more than one year. All other expenditures related to capital assets are expensed as incurred (i.e., as repairs and maintenance expense). </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">9 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">By breaking out <FONT STYLE="white-space:nowrap">non-acquisition</FONT> capital expenditures into two lines
within the investing activities section of that tabular cash flow summary, the Company intended to assist the reader by distinguishing between the following two types of capital expenditures: </P>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="3%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><I>Maintenance capital expenditures</I> &#150; those capital expenditures considered necessary or useful to
maintain the current productive capacity of the business. For the Company, this generally includes those capital expenditures made to replace, extend the life of, or improve the functionality of the Company&#146;s existing capital assets and
includes costs to renovate the Company&#146;s dialysis centers and business offices, replace equipment such as dialysis machines, furniture and other equipment, and invest in and upgrade the various information technology systems that support the
Company&#146;s business on an ongoing basis. </P></TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="3%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><I>Development capital expenditures</I> &#150; capital expenditures incurred to expand the productive capacity of
the business (that is, exclusive of business acquisitions, which are presented separately on the following &#147;Acquisition expenditures&#148; row in the tabular cash flow summary on page 70 of the 2023
<FONT STYLE="white-space:nowrap">10-K).</FONT> For the Company, this generally includes those capital expenditures made to expand the Company&#146;s business, principally though development of new (de novo) dialysis centers, expansions of existing
centers, for center relocations that also expand the Company&#146;s unit capacity in a particular market, and new or expanded dialysis operations at hospitals the Company serves. </P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">As requested in the Staff&#146;s comment 3, the following table summarizes the principal components of the Company&#146;s maintenance capital expenditures, as
described above, which were previously labelled &#147;Routine maintenance/IT/other&#148; in the table on page 70 of the 2023 <FONT STYLE="white-space:nowrap">10-K:</FONT> </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:8pt" ALIGN="center">


<TR>

<TD WIDTH="78%"></TD>

<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>

<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Year-ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2023</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2022</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">[***]</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"> [***]</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"> [***]</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Maintenance capital expenditures</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">406,056</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">431,293</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">As requested in the Staff&#146;s comment 4, the following table summarizes the principal components of the Company&#146;s
development capital expenditures, as described above, which were previously labeled &#147;Developments and relocations&#148; in the table on page 70 of the 2023 <FONT STYLE="white-space:nowrap">10-K:</FONT> </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:8pt" ALIGN="center">


<TR>

<TD WIDTH="78%"></TD>

<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>

<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Year-ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2023</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2022</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">[***]</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"> [***]</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"> [***]</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Development capital expenditures</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">161,927</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">172,137</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">10 </P>

</DIV></Center>


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<Center><DIV STYLE="width:8.5in" align="left">

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B></B><B><I>Proposed revision in future filings</I></B><B>: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">In future quarterly and annual filings, within the cash flow summary at the beginning of our liquidity discussion in MD&amp;A, we propose to rename these lines
as &#147;Maintenance capital expenditures&#148; and &#147;Development capital expenditures&#148; with the following explanatory footnotes to the table, respectively: </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">1.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><U>Maintenance capital expenditures represent capital expenditures to maintain the productive capacity of the
business and include those made for investments in information technology, dialysis center renovations, capital asset replacements, and any other capital expenditures that are not development or acquisition expenditures</U>. </P></TD></TR></TABLE>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">2.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><U>Development capital expenditures represent capital expenditures (other than acquisition expenditures) made
to expand the productive capacity of the business and include those for new U.S. and international dialysis center developments, dialysis center expansions, and new or expanded contracted hospital operations</U>. </P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">For ease of reference, this proposed change has been reflected in the cash flow summary table at the beginning of our liquidity discussion in MD&amp;A, on
pages 34 and 35, within our Quarterly Report on Form <FONT STYLE="white-space:nowrap">10-Q</FONT> for the quarter ended March&nbsp;31, 2024 filed with the SEC on May&nbsp;2, 2024. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company will also expand the description of its accounting policy for property and equipment in Note 1 to the consolidated financial statements included
in its Annual Report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the year ending December&nbsp;31, 2024 (the &#147;2024 <FONT STYLE="white-space:nowrap">10-K&#148;)</FONT> as follows (with added text compared to the 2023 <FONT
STYLE="white-space:nowrap">10-K</FONT> underlined): </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Property and equipment </I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U>The Company capitalizes expenditures to purchase property and equipment, improvements thereon, leasehold improvements, and qualifying
software costs, as well as costs to replace, extend the life of or increase the functionality of existing capital assets, where such purchases and costs have an expected benefit period of more than one year. All other expenditures related to capital
assets are expensed as incurred (i.e., as repairs and maintenance expense)</U>. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Property and equipment is stated at cost less accumulated
depreciation and amortization and is further reduced by any impairments. Maintenance and repairs are charged to expense as incurred. Property and equipment assets are reviewed for possible impairment whenever significant events or changes in
circumstances indicate that an impairment may have occurred. Property and equipment impairment assessments are performed at a location or market level, as applicable, based on the specific cash flows they support or protect. If the Company commits
to a plan to dispose of a long-lived asset before the end of its previously estimated useful life, cash flow estimates are revised accordingly, and the Company records an asset impairment, if applicable, or accelerates depreciation over the revised
estimated useful life. Upon sale or retirement of long-lived assets, the cost and related accumulated depreciation or amortization are removed from the balance sheet and any resulting gain or loss is included in current operating expenses. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">11 </P>

</DIV></Center>


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<HR SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">


<Center><DIV STYLE="width:8.5in" align="left">

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Staff Comment No.&nbsp;5 </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I><U>9. Goodwill, page <FONT STYLE="white-space:nowrap">F-22</FONT> </U></I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>5. You disclose, in part, that &#147;since the dates of the Company&#146;s last annual goodwill impairment assessments, there have been certain
developments, events, changes in operating performance and other changes in key circumstances that have affected the Company&#146;s businesses.&#148; Please revise your disclosure in future filings to identify the dates of your annual goodwill
impairment assessment, whether you performed an interim impairment analysis, and to include specific facts regarding any developments, events, etc. that could impact your impairment analysis. In addition, please update your accounting policy to
address your application of ASC <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">350-20-35-3</FONT></FONT></FONT> through <FONT STYLE="white-space:nowrap">35-13.</FONT> </I></P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Response: </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company acknowledges the Staff&#146;s
comment. The Company would like to clarify that its disclosure quoted in the Staff&#146;s comment was intended to confirm that since the last annual assessment performed for each reporting unit, normal business operations continued. It was not meant
to imply that any specific event or circumstance, such as those described under ASC <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">350-20-35-3C,</FONT></FONT></FONT> had occurred that would cause
us to question whether the fair value of a reporting unit is less than its carrying amount. We propose to remove this disclosure in future filings. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The
Company sets its annual impairment assessments at various dates during the year. In most cases the dates are set to generally align with the quarter in which the Company originally entered the underlying business or geographic region associated with
a reporting unit. As of December&nbsp;31, 2023, our formal annual goodwill impairment assessment dates by reporting unit were as follows: </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:8pt" ALIGN="center">


<TR>

<TD WIDTH="82%"></TD>

<TD VALIGN="bottom" WIDTH="12%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom" NOWRAP> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-bottom:1.00pt solid #000000; display:table-cell; font-size:8pt; font-family:Times New Roman; "><B>Reporting unit (RU)</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Assessment&nbsp;date</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">[***]</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">[***]</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">In order to address the concerns raised by the Staff in comment 5, the Company proposes to revise its accounting policy and
disclosures related to goodwill in future filings and include an accompanying description of how we apply ASC <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">350-20-35-3</FONT></FONT></FONT> through
<FONT STYLE="white-space:nowrap">35-13.</FONT> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">These proposed changes to future filings are shown below (where new or changed content compared to prior
filings is underlined and with brackets around assertions that remain dependent upon future events), which we believe fulfills the requirements of U.S. GAAP, including ASC <FONT STYLE="white-space:nowrap">350-20,</FONT> and applicable SEC
regulations. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B></B><B><I>Proposed revisions in future filings</I></B><B>: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Annual Report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the fiscal year ended December&nbsp;31, 2024 </I></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">12 </P>

</DIV></Center>


<p style="margin-top:1em; margin-bottom:0em; page-break-before:always"> </p>
<HR SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">


<Center><DIV STYLE="width:8.5in" align="left">

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Notes to Consolidated Financial Statements </I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Note 1. Organization and summary of significant accounting policies </I></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Goodwill </I></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Goodwill represents the difference between the
fair value of businesses acquired and the fair value of the identifiable tangible and intangible net assets acquired. Goodwill is not amortized, but is assessed by individual reporting unit for impairment as circumstances warrant and at least
annually. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company operates multiple reporting units. <U>The Company&#146;s annual impairment assessment is performed in the third quarter for its
U.S. dialysis reporting unit and at various points throughout the year for its other reporting units. In addition to these annual impairment assessments, the Company also performs impairment assessments at intervening periods</U><B><U>
</U></B><U>when a reporting unit is considered <FONT STYLE="white-space:nowrap">at-risk</FONT> of significant goodwill impairment. </U> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><U>In performing
these assessments, the Company may first assess goodwill for impairment qualitatively as determined appropriate. If goodwill is more likely than not impaired, the Company is required to perform a quantitative assessment. When performing quantitative
goodwill impairment assessments, the Company estimates fair value using either appraisals developed with an independent third party valuation firm, which consider both discounted cash flow estimates for the subject business and observed market
multiples for similar businesses, or recent good-faith offer prices received for the subject business that would be acceptable to the Company</U>. An impairment charge is recognized when and to the extent a reporting unit&#146;s carrying amount is
determined to exceed its fair value after taking into account the effect of deferred taxes arising from the impairment. See Note [9] for further details. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Note [9.] Goodwill </I></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>.... </I></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Each of the Company&#146;s operating segments described in Note [24] to these consolidated financial statements represents an individual reporting unit for
goodwill impairment assessment purposes. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Within the U.S. dialysis operating segment, the Company considers each of its dialysis centers to constitute an
individual business for which discrete financial information is available. However, since these dialysis centers have similar operating and economic characteristics, and the allocation of resources and significant investment decisions concerning
these businesses are highly centralized and the benefits broadly distributed, the Company has aggregated these centers and deemed them to constitute a single reporting unit. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company has applied a similar aggregation to the physician practices in its physician services reporting units and to the dialysis centers within each
international reporting unit. For the Company&#146;s other operating segments, discrete business components below the operating segment level constitute individual reporting units. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">13 </P>

</DIV></Center>


<p style="margin-top:1em; margin-bottom:0em; page-break-before:always"> </p>
<HR SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">


<Center><DIV STYLE="width:8.5in" align="left">

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOIA Confidential Treatment Request by DaVita Inc. Pursuant to Rule 83 (17 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>C.F.R. &#167;200.83). This letter requests confidential treatment of the bracketed portions of this letter </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(designated by &#147;[***]&#148;). </B></P> <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P>
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><U>[The Company performed various other interim and annual impairment assessments during the year ended
December</U><U></U><U>&nbsp;31, 2024, with no impairment indicated</U>. None&nbsp;of the Company&#146;s reporting units were considered at risk of significant goodwill impairment as of December&nbsp;31, 2024.] </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">During the year ended December&nbsp;31, 2023, the Company <U>performed its annual impairment assessment of its transplant software reporting unit and</U>
recognized a goodwill impairment charge of $26,083<U> in that reporting unit</U>, or $19,575 net of tax. This charge resulted from a reduction in estimated fair value for the business driven primarily from the business not achieving its revenue
targets, with reduced revenue expectations for future years, as well as an increase in the risk-free rate. After this impairment charge, the transplant software reporting unit had a goodwill balance of $14,424 remaining. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Quarterly Report on Form <FONT STYLE="white-space:nowrap">10-Q</FONT> for the quarter ended June&nbsp;30, 2024 </I></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Notes to Consolidated Financial Statements </I></P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>Note [5].
Goodwill </I></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><I>.... </I></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">[The Company did not recognize
any goodwill impairment charges during the six months ended June&nbsp;30, 2024. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><U>The Company performed various annual impairment assessments during the
six months ended June</U><U></U><U>&nbsp;30, 2024, with no impairment indicated</U>. None of the Company&#146;s various reporting units were considered at risk of significant goodwill impairment as of June&nbsp;30, 2024.] </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">*&#8195;&#8195;&#8195;&#8195; *&#8195;&#8195;&#8195;&#8195; * </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">We believe the foregoing is responsive to your comments. We understand that you will be reviewing our responses and may have additional comments. We are
available to discuss any of our responses above at your convenience. Please do not hesitate to contact the undersigned at (206) <FONT STYLE="white-space:nowrap">419-2019.</FONT> </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TR>

<TD WIDTH="100%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">Sincerely,</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Christopher Berry</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">Christopher Berry</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">Chief Accounting Officer</TD></TR>
</TABLE> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%" VALIGN="top" ALIGN="left">cc:</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Javier J. Rodriguez, Chief Executive Officer, DaVita Inc. </P></TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%" VALIGN="top" ALIGN="left">&#8195;</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Joel Ackerman, Chief Financial Officer and Treasurer, DaVita Inc. </P></TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%" VALIGN="top" ALIGN="left">&#8195;</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Kathleen A. Waters, Chief Legal and Public Affairs Officer, DaVita Inc. </P></TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%" VALIGN="top" ALIGN="left">&#8195;</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Sharon Flanagan and Sonia Barros, Sidley Austin LLP </P></TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">14 </P>

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