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Segment reporting (Tables) | 3 Months Ended
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Mar. 31, 2025
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 (loss) to consolidated income before income taxes:
| Three months ended March 31, |  |
| 2025 |  | 2024 |  |  |  |
Segment revenues: |  |  |  |  |  |  |
U.S. dialysis |  |  |  |  |  |  |
Patient service revenues: |  |  |  |  |  |  |
External sources | $ | 2,805,427 |  |  | $ | 2,725,575 |  |  |  |  |
Intersegment revenues | 11,734 |  |  | 24,463 |  |  |  |  |
U.S. dialysis patient service revenues | 2,817,161 |  |  | 2,750,038 |  |  |  |  |
Other revenues |  |  |  |  |  |  |
External sources | 6,008 |  |  | 6,122 |  |  |  |  |
Total U.S. dialysis revenues | 2,823,169 |  |  | 2,756,160 |  |  |  |  |
Other—Ancillary services |  |  |  |  |  |  |
Patient service revenues | 297,566 |  |  | 215,957 |  |  |  |  |
Other external sources | 114,528 |  |  | 122,901 |  |  |  |  |
Intersegment revenues | 2,728 |  |  | 2,747 |  |  |  |  |
Total ancillary services | 414,822 |  |  | 341,605 |  |  |  |  |
Total net segment revenues | 3,237,991 |  |  | 3,097,765 |  |  |  |  |
Elimination of intersegment revenues | (14,462) |  |  | (27,210) |  |  |  |  |
Consolidated revenues | $ | 3,223,529 |  |  | $ | 3,070,555 |  |  |  |  |
Significant segment expenses: |  |  |  |  |  |  |
U.S. dialysis |  |  |  |  |  |  |
Patient care costs | $ | 1,913,428 |  |  | $ | 1,824,579 |  |  |  |  |
General and administrative | 282,679 |  |  | 274,562 |  |  |  |  |
Depreciation and amortization | 156,899 |  |  | 172,852 |  |  |  |  |
Other segment items(1) | (5,609) |  |  | (41,570) |  |  |  |  |
U.S. dialysis segment expenses | 2,347,397 |  |  | 2,230,423 |  |  |  |  |
Other - Ancillary services expenses | 417,631 |  |  | 353,107 |  |  |  |  |
Segment operating margin (loss): |  |  |  |  |  |  |
U.S. dialysis | 475,772 |  |  | 525,737 |  |  |  |  |
Other—Ancillary services(2) | (2,809) |  |  | (11,502) |  |  |  |  |
Total segment operating margin (loss) | 472,963 |  |  | 514,235 |  |  |  |  |
Reconciliation of segment operating income to consolidated income before income taxes: |  |  |  |  |  |  |
Corporate administrative support | (34,026) |  |  | (30,390) |  |  |  |  |
Consolidated operating income | 438,937 |  |  | 483,845 |  |  |  |  |
Debt expense | (135,055) |  |  | (99,418) |  |  |  |  |
Other loss, net | (17,549) |  |  | (12,641) |  |  |  |  |
Income from continuing operations before income taxes | $ | 286,333 |  |  | $ | 371,786 |  |  |  |  |
Summary of Expenditures for Property and Equipment by Reportable Segment | Expenditures for property and equipment by reportable segment were as follows:
|  |  | Three months ended March 31,
|  |  |  |  | 2025 |  | 2024
U.S. dialysis |  |  |  |  | $ | 113,591 |  |  | $ | 104,953 |
Other—Ancillary services |  |  |  |  | 29,667 |  |  | 16,062 |
|  |  |  |  | $ | 143,258 |  |  | $ | 121,015 |

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