The Company has identified three business segments, North America, International, and Asia Pacific, which were determined based upon how the Company manages its businesses. All segments are primarily engaged in providing dialysis care services and the distribution of products and equipment for the treatment of ESRD. In the U.S., the Company is also engaged in performing clinical laboratory testing and providing vascular access services and providing inpatient dialysis services and other services under contract to hospitals. The Company has aggregated the International and Asia Pacific operating segments as “International.” The segments are aggregated due to their similar economic characteristics. These characteristics include the same services provided and products sold, the same type patient population, similar methods of distribution of products and services and similar economic environments.

Management evaluates each segment using a measure that reflects all of the segment's controllable revenues and expenses. Management believes that the most appropriate measure in this regard is operating income which measures the Company's source of earnings. Financing is a corporate function, which the Company's segments do not control. Therefore, the Company does not include interest expense relating to financing as a segment measure. Similarly, the Company does not allocate “corporate costs,” which relate primarily to certain headquarters overhead charges, including accounting and finance, professional services, etc., because the Company believes that these costs are also not within the control of the individual segments. As of January 1, 2011, production of products, production asset management, quality management and procurement is centrally managed in Corporate by Global Manufacturing Operations with products being transferred to the regions at cost. This is a change from prior periods, when these services were managed within the regions. The business segment information has been adjusted accordingly with the exception of segment assets in the prior period. In addition, certain acquisitions and intangible assets are not allocated to a segment but are accounted for as “corporate.” The Company also regards income taxes to be outside the segment's control.

Information pertaining to the Company's business segments for the three- and six-month periods ended June 30, 2011 and 2010 is set forth below.

				North America		International		Segment Total		Corporate		Total
Three months ended June 30, 2011

	Net revenue external customers		$	2,027,419	$	1,162,448	$	3,189,867	$	4,185	$	3,194,052
	Inter - segment revenue			1,815		-		1,815		(1,815)		-
	Revenue			2,029,234		1,162,448		3,191,682		2,370		3,194,052
	Depreciation and amortization			(66,555)		(42,822)		(109,377)		(26,912)		(136,289)
	Operating income			348,457		203,144		551,601		(42,057)		509,544
	Income (loss) from equity method investees			8,849		31		8,880		-		8,880
	Capital expenditures, acquisitions and investments			74,555		797,637		872,192		32,692		904,884

Three months ended June 30, 2010

	Net revenue external customers		$	2,026,582	$	919,524	$	2,946,106	$	93	$	2,946,199
	Inter - segment revenue			1,263		-		1,263		(1,263)		-
	Revenue			2,027,845		919,524		2,947,369		(1,170)		2,946,199
	Depreciation and amortization			(63,004)		(33,508)		(96,512)		(24,395)		(120,907)
	Operating income			332,097		173,095		505,192		(38,627)		466,565
	Income (loss) from equity method investees			1,887		27		1,914		-		1,914
	Capital expenditures, acquisitions and investments			71,316		93,608		164,924		163,478		328,402

Six months ended June 30, 2011

	Net revenue external customers		$	4,004,707	$	2,217,681	$	6,222,388	$	8,052	$	6,230,440
	Inter - segment revenue			3,509		-		3,509		(3,509)		-
	Total net revenue			4,008,216		2,217,681		6,225,897		4,543		6,230,440
	Depreciation and amortization			(134,782)		(83,171)		(217,953)		(54,320)		(272,273)
	Operating Income			660,563		374,154		1,034,717		(80,089)		954,628
	Income (loss) from equity method investees			16,367		95		16,462		-		16,462
	Segment assets⁽¹⁾			11,415,424		5,541,670		16,957,094		2,095,540		19,052,634
		thereof investments in equity method investees		339,230		5,756		344,986		-		344,986
	Capital expenditures, acquisitions and investments⁽²⁾			462,425		838,413		1,300,838		60,004		1,360,842

Six months ended June 30, 2010

	Net revenue external customers		$	3,986,270	$	1,841,747	$	5,828,017	$	311	$	5,828,328
	Inter - segment revenue			1,828		-		1,828		(1,828)		-
	Total net revenue			3,988,098		1,841,747		5,829,845		(1,517)		5,828,328
	Depreciation and amortization			(126,715)		(70,067)		(196,782)		(48,583)		(245,365)
	Operating Income			640,003		324,025		964,028		(72,284)		891,744
	Income (loss) from equity method investees			3,577		50		3,627		-		3,627
	Segment assets			11,281,830		3,948,045		15,229,875		769,689		15,999,564
		thereof investments in equity method investees		16,543		3,478		20,021		-		20,021
	Capital expenditures, acquisitions and investments⁽³⁾			144,883		178,858		323,741		194,141		517,882

	(1) If production was still managed within the segments, as it was in 2010, segment assets would have been $12,403,823 in North America, $6,153,751 in International and $495,060 in Corporate in 2011.
	(2) North America and International acquisitions exclude $6,000 and $1,731, respectively, of non-cash acquisitions for 2011.
	(3) International and Corporate acquisitions exclude $8,884 and $2,125 of non-cash acquisitions for 2010.