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Segment Reporting
12 Months Ended
Dec. 31, 2018
Segment Reporting [Abstract]  
Segment Reporting Segment reporting
The Company consists of two major divisions, DaVita Kidney Care (Kidney Care) and DaVita Medical Group (DMG). The Kidney Care division is comprised of the Company’s U.S. dialysis and related lab services business, various ancillary services and strategic initiatives, including its international operations, and the Company’s corporate administrative support. See Note 1 "Organization" for a summary description of the Company's businesses.
The Company’s operating segments have been defined based on the separate financial information that is regularly produced and reviewed by the Company’s chief operating decision maker in making decisions about allocating resources to and assessing the financial performance of the Company’s various operating lines of business. The chief operating decision maker for the Company is its Chief Executive Officer.
The Company’s separate operating segments include its U.S. dialysis and related lab services business, each of its ancillary services and strategic initiatives, its kidney care operations in each foreign sovereign jurisdiction, its other health operations in each foreign sovereign jurisdiction, and its equity method investment in the Asia Pacific joint venture. The U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other ancillary services and strategic initiatives operating segments, including the international operating segments, have been combined and disclosed in the other segments category.
The Company’s operating segment financial information included in this report is prepared on the internal management reporting basis that the chief operating decision maker uses to allocate resources and assess the financial performance of the Company's operating segments. For internal management reporting, segment operations include direct segment operating expenses but generally exclude corporate administrative support costs, which consist primarily of indirect labor, benefits and long-term incentive-based compensation expenses of certain departments which provide support to all of the Company’s various operating lines of business, except to the extent that such costs are charged to and borne by certain ancillary services and strategic initiatives via internal management fees. These corporate administrative support costs are reduced by internal management fees received from the Company’s ancillary lines of business.
The following is a summary of segment revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:
 
Year ended December 31,
 
2018
 
2017
 
2016
Segment revenues:(1)
 

 
 

 
 

U.S. dialysis and related lab services
 

 
 

 
 

Patient service revenues:
 

 
 

 
 

External sources
$
10,274,046

 
$
9,767,123

 
$
9,524,067

Intersegment revenues
92,950

 
55,176

 
27,355

Total U.S. dialysis and related lab services revenues
10,366,996

 
9,822,299

 
9,551,422

Provision for uncollectible accounts
(50,927
)
 
(481,973
)
 
(429,878
)
Net U.S. dialysis and related lab services patient service revenues
10,316,069

 
9,340,326

 
9,121,544

Other revenues(2)
19,880

 
19,739

 
16,645

Total net U.S. dialysis and related lab services revenues
10,335,949

 
9,360,065

 
9,138,189

Other - Ancillary services and strategic initiatives
 

 
 

 
 

Net patient service revenues
437,275

 
323,156

 
201,867

Other external sources
724,577

 
1,248,589

 
1,394,766

Intersegment revenues
34,236

 
24,603

 
24,739

Total ancillary services and strategic initiatives revenues
1,196,088

 
1,596,348

 
1,621,372

Total net segment revenues
11,532,037

 
10,956,413

 
10,759,561

Elimination of intersegment revenues
(127,186
)
 
(79,779
)
 
(52,094
)
Consolidated net revenues
$
11,404,851

 
$
10,876,634

 
$
10,707,467

Segment operating margin (loss):
 

 
 

 
 

U.S. dialysis and related lab services
$
1,709,721

 
$
2,297,198

 
$
1,777,014

Other—Ancillary services and strategic initiatives
(93,789
)
 
(439,477
)
 
266,324

Total segment margin
1,615,932

 
1,857,721

 
2,043,338

Reconciliation of segment operating margin to consolidated income from
continuing operations before income taxes:
 

 
 

 
 

Corporate administrative support
(90,108
)
 
(44,966
)
 
(13,628
)
Consolidated operating income
1,525,824

 
1,812,755

 
2,029,710

Debt expense
(487,435
)
 
(430,634
)
 
(414,116
)
Other income
10,089

 
17,665

 
7,511

Income from continuing operations before income taxes
$
1,048,478

 
$
1,399,786

 
$
1,623,105

 
 
(1)
On January 1, 2018, the Company adopted Revenue from Contracts with Customers (Topic 606) using the cumulative effect method for those contracts that were not substantially completed as of January 1, 2018. Results related to performance obligations satisfied beginning on and after January 1, 2018 are presented under Topic 606, while results related to the satisfaction of performance obligations in prior periods continue to be reported in accordance with the Company's historical accounting under Revenue Recognition (Topic 605). See Notes 1 and 2 of these consolidated financial statements for further discussion of the Company's adoption of Topic 606.
(2)
Includes management fee revenues from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling interest or which are wholly-owned by third parties.
Depreciation and amortization expense by reportable segment is as follows: 
 
Year ended December 31,
 
2018
 
2017
 
2016
U.S. dialysis and related lab services
$
558,810

 
$
520,965

 
$
482,768

Other - Ancillary services and strategic initiatives
32,225

 
38,946

 
26,729

 
$
591,035

 
$
559,911

 
$
509,497


Summary of assets by reportable segment is as follows:
 
Year ended December 31,
 
2018
 
2017
Segment assets
 

 
 

U.S. dialysis and related lab services (including equity investments of
$95,290 and $84,866, respectively)
$
12,333,641

 
$
11,802,131

Other - Ancillary services and strategic initiatives(1) (including equity
investments of $129,321 and $160,668, respectively)
1,387,046

 
1,410,763

DMG - Held for sale (including equity investments of $4,833 and
$10,321, respectively)
5,389,565

 
5,761,642

Consolidated assets
$
19,110,252

 
$
18,974,536

 
(1)
Includes approximately $136,052 and $125,932 in 2018 and 2017, respectively, of net property and equipment related to the Company’s international operations.
Expenditures for property and equipment by reportable segment is as follows: 
 
Year ended December 31,
 
2018
 
2017
 
2016
 
 
 
 
 
 
U.S. dialysis and related lab services
$
856,108

 
$
769,732

 
$
675,994

Other - Ancillary services and strategic initiatives
45,806

 
40,377

 
68,702

DMG - Held for sale
85,224

 
95,141

 
84,399

 
$
987,138

 
$
905,250

 
$
829,095