RECENT AND SUBSEQUENT EVENTS	3 Months Ended
RECENT AND SUBSEQUENT EVENTS	Mar. 31, 2020
Subsequent Events [Abstract]
RECENT AND SUBSEQUENT EVENTS	RECENT AND SUBSEQUENT EVENTS COVID-19 Pandemic In December 2019, there was an outbreak of a new strain of coronavirus (“COVID-19”). In March 2020, the World Health Organization declared the outbreak of COVID-19 a pandemic. As a provider of essential healthcare services, the Company is significantly exposed to the health and economic effects of COVID-19 and has seen a significant impact on its employees, patients and business operations. The COVID-19 pandemic did not significantly impact the Company's financial results for the three months ended March 31, 2020. The Company believes that the economic disruptions and unprecedented market volatilities and uncertainties resulting from the COVID-19 outbreak represent indicators of impairment for its indefinite-life and long-lived assets, including its tradename. As a result, the Company performed interim impairment tests of its indefinite-life and long-lived assets as of March 31, 2020, which resulted in no impairment. The Company is carefully monitoring the impact of the COVID-19 pandemic on its operating and financial performance. The amounts and types of revenue, expense, and cash flow impacts will be dependent on numerous factors, including the nature of the COVID-19 pandemic, such as its rate of spread, duration, and geographic coverage; the legal, regulatory, and administrative developments related to the pandemic at federal, state, and local levels; and the Company’s infectious disease prevention and control efforts. The Company began to experience increased expenses and a reduction in treatment volume in connection with the pandemic beginning in March, as discussed below. The Company expects to see a more significant impact on its operating and financial performance due to the COVID-19 pandemic in the second quarter, which may also continue into the third quarter and beyond. The Company has undertaken measures designed to mitigate this impact, but these measures may not be sufficient to fully offset the pandemic’s operating and financial effects on its business. These effects will likely continue for the duration of the pandemic and may increase further in the event the severity or geographic coverage of the pandemic increase. We cannot at this time accurately predict the ultimate impact that COVID-19 will have on our operating and financial performance, but the adverse impact could be material. Treatment Volume Patients suffering from end-stage renal disease generally have co-morbidities that often place them at increased risk with COVID-19, which may result in increased patient hospitalizations, missed treatments and higher mortality. Through March 31, 2020, the Company experienced an immaterial reduction in treatment volume as a result of patients contracting COVID-19, but this impact increased subsequent to March 31, 2020 and could become material in the event of a prolonged or increasingly severe pandemic. Further, broad economic factors resulting from the pandemic, including increasing unemployment rates, may lead to increases in uninsured patients and patients with lower-paying government insurance programs. The impact of this may be delayed or mitigated as a result of patients accessing COBRA and exchange plans but could have a material impact on the Company's longer term earnings. A significant reduction in treatment volume or in the number of patients with commercial insurance would have a material adverse effect on the Company's revenues, earnings and cash flows. Expense Management In light of its increased expenses and the potential impact to revenue from the COVID-19 pandemic, as well as the Company's first quarter 2020 performance, the Company has and will continue to implement cost saving initiatives, including temporary reductions in executive compensation, reducing discretionary spending, including travel, increased management of existing corporate headcount and other temporary corporate expense initiatives. The Company does not expect any of these cost savings initiatives to directly impact clinic staff or regional operations teams that are providing on-site support to its clinics during the pandemic. The Company also expects that, with the pandemic, it will re-prioritize its capital expenditures and continue its slower pace of de novo clinic development. Balance Sheet, Cash Flow and Liquidity During the first quarter of 2020, the Company did not experience any significant issues in billing or cash collections directly associated with the COVID-19 pandemic; however, it may experience delays in the future due to lower claims operations staffing levels and longer call waiting times at certain of the Company's commercial payors. The CARES Act is a relief package intended to assist many aspects of the American economy, and includes provisions to expand existing and introduce new programs to provide additional sources of liquidity to healthcare providers. Medicare Accelerated and Advance Payment Program In March 2020, in an action unrelated to the CARES Act, CMS expanded its existing Accelerated and Advance Payment Program to a broader group of Medicare providers and suppliers for the duration of the COVID-19 public health emergency. Payments under this program are intended to provide necessary funds when there is a disruption in Medicare claims submission and/or claims processing. The Company's facilities can request up to 100% of the Medicare fee-for-service payment amount for a three-month period. CMS has instructed its Medicare Administrative Contractors to review and issue advance payments within seven calendar days of receiving an advance payment request. Repayment of advance payments will commence 120 days after the date the payment is issued and will be effectuated via an automatic 100% offset against future claims payments. The Company's facilities that use this program will have 210 days to repay the advance payment. In April 2020, the Company's facilities applied for and received an aggregate of $82,666 in advanced payments under this program. CARES Act Provider Relief Fund On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) was enacted in response to the COVID-19 pandemic. The CARES Act includes $100 billion in funds to be provided to hospitals and other healthcare providers to support healthcare-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured individuals are able to obtain testing and treatment for COVID-19. On April 10, 2020, CMS began distribution of $30 billion of the funds to providers based on the provider’s share of total Medicare fee-for-service reimbursements in 2019. As part of this distribution, the Company's facilities received approximately $26,595 in the aggregate during April 2020. HHS requires providers, within 30 days of receipt of these funds, to submit an attestation accepting certain terms and condition. If a provider does not wish to comply with these terms and conditions, the provider must remit the full payment to HHS. Several of the terms and conditions originally published by HHS are unclear and pose interpretative questions that remain subject to clarification, including specifics on the allowable uses for the relief funds. Accordingly, the Company has determined to leave these funds segregated in special accounts and not spend or otherwise disperse these funds while it is assessing the terms and conditions that HHS will require. The Company's ability to utilize and retain some or all of the provider relief grant funds will depend on the magnitude, timing and nature of the impact of COVID-19, as well as the guidelines and rules of the program, which will ultimately determine how these funds can be used to offset lost revenue and increased expenses associated with the COVID-19 pandemic. Temporary suspension of the automatic 2% reduction of Medicare program payments, known as “sequestration” The CARES Act suspended for the period from May 2020 through December 2020 the 2% Medicare reimbursement reduction that has been in place since April 1, 2013. As a result, the Company currently expects to receive an increase in patient service operating revenues of approximately $5,000 for the period from May 2020 through December 2020 from this suspension. Social Security Payroll Match The CARES Act provides for the deferral of the social security payroll tax match of 6.2% through the end of 2020. The Company expects that this will allow it to delay funding approximately $12,000 to $13,000 of payroll taxes. Half of this amount (approximately $6,000 to $6,500) will be payable in December 2021 and the other half in December 2022. While this expense will continue to be recorded in the Consolidated Statement of Operations and accrued on the Consolidated Balance Sheet during 2020, the deferral of the payment will provide the Company additional liquidity during the deferral period. See “Note 10 — Income Taxes” for discussion of the impacts of the CARES Act on the Company's income taxes for the three months ended March 31, 2020.