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Segment reporting
6 Months Ended
Jun. 30, 2019
Segment Reporting [Abstract]  
Segment Reporting Disclosure
Segment reporting
The Company’s business is comprised of its U.S. dialysis and related lab services business, various ancillary services and strategic initiatives, including its international operations, and its corporate administrative support.
On June 19, 2019, the Company completed the sale of its DMG division to Optum, a subsidiary of UnitedHealth Group Inc. As a result of this transaction, DMG's results of operations have been reported as discontinued operations for all periods presented.
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 APAC JV. 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 net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:
 
Three months ended June 30,
 
Six months ended June 30,
 
2019
 
2018
 
2019
 
2018
Segment revenues:
 
 
 
 
 
 
 
U.S. dialysis and related lab services
 
 
 
 
 
 
 
Patient service revenues:
 
 
 
 
 
 
 
External sources
$
2,612,200

 
$
2,612,734

 
$
5,129,489

 
$
5,101,899

Intersegment revenues
30,042

 
20,096

 
60,462

 
38,519

U.S. dialysis and related lab services patient service
revenues
2,642,242

 
2,632,830

 
5,189,951

 
5,140,418

Provision for uncollectible accounts
(10,249
)
 
(49,406
)
 
(15,712
)
 
(24,208
)
Net U.S. dialysis and related lab services patient
service revenues
2,631,993

 
2,583,424

 
5,174,239

 
5,116,210

Other revenues(1):
 
 
 
 
 
 
 
External sources
5,209

 
4,919

 
9,893

 
10,033

Intersegment revenues
292

 

 
513

 

Total U.S. dialysis and related lab services revenues
$
2,637,494

 
$
2,588,343

 
$
5,184,645

 
$
5,126,243

Other—Ancillary services and strategic initiatives
 
 
 
 
 
 
 
Patient service revenues, net
$
121,865

 
$
105,669

 
$
239,728

 
$
207,925

Other external sources
113,680

 
213,037

 
222,419

 
440,748

Intersegment revenues
3,403

 
9,189

 
6,739

 
19,387

Total ancillary services and strategic initiatives revenues
238,948

 
327,895

 
468,886

 
668,060

Total net segment revenues
2,876,442

 
2,916,238

 
5,653,531

 
5,794,303

Elimination of intersegment revenues
(33,737
)
 
(29,285
)
 
(67,714
)
 
(57,906
)
Consolidated revenues
$
2,842,705

 
$
2,886,953

 
$
5,585,817

 
$
5,736,397

Segment operating margin:
 

 
 

 
 

 
 

U.S. dialysis and related lab services
$
498,957

 
$
449,443

 
$
915,939

 
$
882,822

Other—Ancillary services and strategic initiatives
(15,050
)
 
2,815

 
(72,680
)
 
(4,175
)
Total segment operating margin
483,907

 
452,258

 
843,259

 
878,647

Reconciliation of segment operating margin to consolidated
income from continuing operations before income taxes:
 
 
 
 
 
 
 
Corporate administrative support
(22,021
)
 
(14,066
)
 
(40,866
)
 
(29,769
)
Consolidated operating income
461,886

 
438,192

 
802,393

 
848,878

Debt expense
(131,666
)
 
(119,692
)
 
(263,185
)
 
(233,208
)
Debt prepayment charges
(12,160
)
 

 
(12,160
)
 

Other income, net
5,643

 
1,994

 
12,583

 
6,576

Consolidated income from continuing operations before
income taxes
$
323,703

 
$
320,494

 
$
539,631

 
$
622,246

 
(1)
Includes management fee revenue from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling equity investment or which are wholly-owned by third parties.
A summary of assets by reportable segment was as follows:
 
June 30, 2019
 
December 31, 2018
Segment assets
 

 
 

U.S. dialysis and related lab services (including equity
investments of $101,161 and $95,290, respectively)
$
18,352,683

 
$
12,333,641

Other—Ancillary services and strategic initiatives (including
equity investments of $124,516 and $129,321, respectively)
1,578,277

 
1,387,046

DMG—Held for sale (including equity investments of $0 and
$4,833, respectively)

 
5,389,565

Consolidated assets
$
19,930,960

 
$
19,110,252


Depreciation and amortization expense by reportable segment was as follows:
 
Three months ended June 30,
 
Six months ended June 30,
 
2019
 
2018
 
2019
 
2018
U.S. dialysis and related lab services
$
144,621

 
$
138,252

 
$
285,401

 
$
273,028

OtherAncillary services and strategic initiatives
7,621

 
8,827

 
15,369

 
16,850

 
$
152,242

 
$
147,079

 
$
300,770

 
$
289,878


Expenditures for property and equipment by reportable segment were as follows:
 
Three months ended June 30,
 
Six months ended June 30,
 
2019
 
2018
 
2019
 
2018
U.S. dialysis and related lab services
$
149,264

 
$
197,051

 
$
319,812

 
$
388,458

Other—Ancillary services and strategic initiatives
7,062

 
22,184

 
15,640

 
32,172

DMG—Held for sale
18,714

 
22,299

 
38,466

 
53,347

 
$
175,040

 
$
241,534

 
$
373,918

 
$
473,977