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Segment reporting (Tables)
9 Months Ended
Sep. 30, 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 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.
Summary of Assets by Reportable Segment
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


Summary of Depreciation and Amortization Expense by Reportable Segment
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


Summary of Expenditures for Property and Equipment by Reportable Segment
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