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Segment reporting (Tables)

6 Months Ended

Jun. 30, 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, and a reconciliation of segment operating margin to consolidated income before income taxes:

			Three months ended June 30,												Six months ended June 30,
			2025						2024						2025						2024
Segment revenues:
U.S. dialysis
Patient service revenues:
External sources			$	2,890,709					$	2,822,187					$	5,696,136					$	5,547,761
Intersegment revenues			16,716						12,925						28,450						37,389
U.S. dialysis patient service revenues			2,907,425						2,835,112						5,724,586						5,585,150
Other revenues
External sources			5,966						5,898						11,974						12,021
Total U.S. dialysis revenues			2,913,391						2,841,010						5,736,560						5,597,171
Other—Ancillary services
Patient service revenues			316,162						238,915						613,728						454,873
Other external sources			166,689						119,722						281,217						242,622
Intersegment revenues			2,836						3,823						5,565						6,570
Total ancillary services			485,687						362,460						900,510						704,065
Total net segment revenues			3,399,078						3,203,470						6,637,070						6,301,236
Elimination of intersegment revenues			(19,552)						(16,748)						(34,015)						(43,959)
Consolidated revenues			$	3,379,526					$	3,186,722					$	6,603,055					$	6,257,277
Significant segment expenses:
U.S. dialysis
Patient care costs			$	1,928,462					$	1,854,541					$	3,841,890					$	3,679,120
General and administrative			312,089						281,795						594,768						556,357
Depreciation and amortization			156,782						160,410						313,681						333,262
Other segment items(1)			(6,786)						(5,922)						(12,396)						(47,491)
U.S. dialysis segment expenses			2,390,547						2,290,824						4,737,943						4,521,248
Other - Ancillary services expenses			428,973						381,052						846,604						734,159
Segment operating margin:
U.S. dialysis			522,844						550,186						998,617						1,075,923
Other—Ancillary services(2)			56,714						(18,592)						53,906						(30,094)
Total segment operating margin			579,558						531,594						1,052,523						1,045,829
Reconciliation of segment operating income to consolidated  income before income taxes:
Corporate administrative support			(41,717)						(25,196)						(75,745)						(55,586)
Consolidated operating income			537,841						506,398						976,778						990,243
Debt expense			(146,062)						(97,747)						(281,117)						(197,165)
Debt prepayment, extinguishment and modification costs			—						(9,732)						—						(9,732)
Other loss, net			(22,851)						(27,479)						(40,400)						(40,120)
Income from continuing operations before income  taxes			$	368,928					$	371,440					$	655,261					$	743,226

Summary of Expenditures for Property and Equipment by Reportable Segment

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

									Six months ended June 30,
															2025						2024
U.S. dialysis															$	216,902					$	211,171
Other—Ancillary services															47,447						34,569
															$	264,349					$	245,740

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- Definition

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

+ References

No definition available.

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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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