Segment reporting (Tables)

3 Months Ended

Mar. 31, 2020

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,
	2020			2019
Segment revenues:
U.S. dialysis
Dialysis patient service revenues:
External sources	$	2,579,240		$	2,511,826
Intersegment revenues	31,941			30,420
U.S. dialysis patient service revenues	2,611,181			2,542,246
Other revenues(1):
External sources	5,141			4,684
Intersegment revenues	301			221
Total U.S. dialysis revenues	2,616,623			2,547,151
Other—Ancillary services
Dialysis patient service revenues, net	134,041			117,863
Other external sources	122,815			108,739
Intersegment revenues	4,152			3,336
Total ancillary services revenues	261,008			229,938
Total net segment revenues	2,877,631			2,777,089
Elimination of intersegment revenues	(36,394		)	(33,977		)
Consolidated revenues	$	2,841,237		$	2,743,112
Segment operating margin (loss):
U.S. dialysis	$	491,607		$	416,981
Other—Ancillary services	(2,646		)	(57,630		)
Total segment operating margin	488,961			359,351
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:
Corporate administrative support	(23,585		)	(18,844		)
Consolidated operating income	465,376			340,507
Debt expense	(88,603		)	(131,519		)
Debt refinancing charges	(2,948		)	—
Other income, net	(4,350		)	6,940
Consolidated income from continuing operations before income taxes	$	369,475		$	215,928

(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.

Summary of Assets by Reportable Segment

A summary of assets by reportable segment was as follows:

	March 31, 2020		December 31, 2019
U.S. dialysis (including equity investments of $130,144 and $124,188, respectively)	$	16,075,622	$	15,778,880
Other—Ancillary services (including equity investments of $124,355 and $117,795, respectively)	1,520,678		1,532,514
Consolidated assets	$	17,596,300	$	17,311,394

Summary of Depreciation and Amortization Expense by Reportable Segment

Depreciation and amortization expense by reportable segment was as follows:

	Three months ended March 31,
	2020		2019
U.S. dialysis	$	146,300	$	140,780
Other—Ancillary services	8,379		7,748
	$	154,679	$	148,528

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,
	2020		2019
U.S. dialysis	$	148,763	$	170,548
Other—Ancillary services	6,179		8,578
DMG—Discontinued operations	—		19,752
	$	154,942	$	198,878