Segment reporting

9 Months Ended

Sep. 30, 2020

Segment Reporting [Abstract]

Segment Reporting Disclosure

Segment reporting

The Company’s operations are comprised of its U.S. dialysis and related lab services business (its U.S. dialysis business), its various ancillary services and strategic initiatives including its international operations (collectively, its ancillary services), 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. See Note 25 to the Company's consolidated financial statements included in the 10-K for further description of how the Company determines and measures results for its operating segments.

The following is a summary of segment net revenues, segment operating income (loss), and a reconciliation of segment operating income (loss) to consolidated income before income taxes:

	Three months ended September 30,						Nine months ended September 30,
	2020			2019			2020			2019
Segment revenues:
U.S. dialysis
Dialysis patient service revenues:
External sources	$	2,639,761		$	2,648,969		$	7,850,828		$	7,762,746
Intersegment revenues	37,049			32,150			104,111			92,611
U.S. dialysis patient service revenues	2,676,810			2,681,119			7,954,939			7,855,357
Other revenues(1):
External sources	17,141			10,096			29,970			19,989
Intersegment revenues	268			212			876			726
Total U.S. dialysis revenues	2,694,219			2,691,427			7,985,785			7,876,072
Other—Ancillary services
Dialysis patient service revenues	141,889			128,223			402,300			367,951
Other external sources	125,275			116,790			362,184			339,209
Intersegment revenues	4,079			3,483			12,402			10,222
Total ancillary services revenues	271,243			248,496			776,886			717,382
Total net segment revenues	2,965,462			2,939,923			8,762,671			8,593,454
Elimination of intersegment revenues	(41,396		)	(35,845		)	(117,389		)	(103,559		)
Consolidated revenues	$	2,924,066		$	2,904,078		$	8,645,282		$	8,489,895
Segment operating income (loss):
U.S. dialysis	$	470,596		$	500,742		$	1,484,833		$	1,416,680
Other—Ancillary services	(7,086		)	(97,725		)	(49,354		)	(170,405		)
Total segment operating income	463,510			403,017			1,435,479			1,246,275
Reconciliation of segment operating income to consolidated income from continuing operations before income taxes:
Corporate administrative support	(25,841		)	(24,681		)	(122,514		)	(65,546		)
Consolidated operating income	437,669			378,336			1,312,965			1,180,729
Debt expense	(73,658		)	(88,589		)	(243,642		)	(351,774		)
Debt prepayment, refinancing and redemption charges	(86,074		)	(21,242		)	(89,022		)	(33,402		)
Other income, net	5,395			5,280			10,590			17,863
Consolidated income from continuing operations before income taxes	$	283,332		$	273,785		$	990,891		$	813,416

(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:

	September 30, 2020		December 31, 2019
U.S. dialysis (including equity investments of $125,525  and $124,188, respectively)	$	15,549,310	$	15,778,880
Other—Ancillary services (including equity investments of $126,958 and $117,795, respectively)	1,497,362		1,532,514
Consolidated assets	$	17,046,672	$	17,311,394

Depreciation and amortization expense by reportable segment was as follows:

	Three months ended September 30,				Nine months ended September 30,
	2020		2019		2020		2019
U.S. dialysis	$	148,221	$	147,607	$	442,833	$	433,008
Other—Ancillary services	8,673		8,308		26,116		23,677
	$	156,894	$	155,915	$	468,949	$	456,685

Expenditures for property and equipment by reportable segment were as follows:

	Nine months ended September 30,
	2020		2019
U.S. dialysis	$	430,646	$	477,533
Other—Ancillary services	19,250		31,184
DMG—Discontinued operations	—		38,466
	$	449,896	$	547,183