Segment reporting (Tables)

3 Months Ended

Mar. 31, 2019

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 net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:

	Three months ended March 31,
	2019			2018
Segment revenues:
U.S. dialysis and related lab services
Patient service revenues:
External sources	$	2,517,289		$	2,489,165
Intersegment revenues	30,420			18,422
U.S. dialysis and related lab services patient service revenues	2,547,709			2,507,587
Provision for uncollectible accounts	(5,463		)	25,199
Net U.S. dialysis and related lab services patient service revenues	2,542,246			2,532,786
Other revenues(1):
External sources	4,684			5,114
Intersegment revenues	221			—
Total U.S. dialysis and related lab services revenues	$	2,547,151		$	2,537,900
Other—Ancillary services and strategic initiatives
Patient service revenues, net	$	117,863		$	102,255
Other external sources	108,739			227,711
Intersegment revenues	3,336			10,199
Total ancillary services and strategic initiatives revenues	229,938			340,165
Total net segment revenues	2,777,089			2,878,065
Elimination of intersegment revenues	(33,977		)	(28,621		)
Consolidated revenues	$	2,743,112		$	2,849,444
Segment operating margin:
U.S. dialysis and related lab services	$	416,981		$	433,380
Other—Ancillary services and strategic initiatives	(57,630		)	(6,990		)
Total segment operating margin	359,351			426,390
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:
Corporate administrative support	(18,844		)	(15,704		)
Consolidated operating income	340,507			410,686
Debt expense	(131,519		)	(113,516		)
Other income, net	6,940			4,582
Consolidated income from continuing operations before income taxes	$	215,928		$	301,752

(1)

Includes management fee revenue from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling equity investment

Summary of Assets by Reportable Segment

A summary of assets by reportable segment was as follows:

	March 31, 2019		December 31, 2018
Segment assets
U.S. dialysis and related lab services (including equity investments of $101,173 and $95,290, respectively)	$	15,095,326	$	12,333,641
Other—Ancillary services and strategic initiatives (including equity investments of $125,136 and $129,321, respectively)	1,505,670		1,387,046
DMG—Held for sale (including equity investments of $5,282 and $4,833, respectively)	6,004,948		5,389,565
Consolidated assets	$	22,605,944	$	19,110,252

Summary of Depreciation and Amortization Expense by Reportable Segment

Depreciation and amortization expense by reportable segment was as follows:

	Three months ended March 31,
	2019		2018
U.S. dialysis and related lab services	$	140,780	$	134,776
Other—Ancillary services and strategic initiatives	7,748		8,023
	$	148,528	$	142,799

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,
	2019		2018
U.S. dialysis and related lab services	$	170,548	$	191,406
Other—Ancillary services and strategic initiatives	8,578		9,988
DMG—Held for sale	19,752		31,049
	$	198,878	$	232,443