Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2020

Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes

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


	Year ended December 31,
	2020		2019		2018
Segment revenues:
U.S. dialysis
Patient service revenues:
External sources	$	10,488,731	$	10,421,401	$	10,274,046
Intersegment revenues	144,091		131,199		92,950
U.S. dialysis revenues before provision	10,632,822		10,552,600		10,366,996
Provision for uncollectible accounts	(13,458)		(21,715)		(50,927)
U.S. dialysis patient service revenues	10,619,364		10,530,885		10,316,069
Other revenues(1)
External sources	39,376		30,895		19,880
Intersegment revenues	1,195		1,126		—
Total U.S. dialysis revenues	$	10,659,935	$	10,562,906	$	10,335,949
Other - Ancillary services
Net patient service revenues	550,978		497,021		437,275
Other external sources	484,977		460,877		724,577
Intersegment revenues	16,743		14,030		34,236
Total ancillary services	1,052,698		971,928		1,196,088
Total net segment revenues	11,712,633		11,534,834		11,532,037
Elimination of intersegment revenues	(162,029)		(146,355)		(127,186)
Consolidated revenues	$	11,550,604	$	11,388,479	$	11,404,851
Segment operating margin (loss):
U.S. dialysis	$	1,917,604	$	1,924,826	$	1,709,721
Other - Ancillary services(2)	(76,261)		(189,174)		(93,789)
Total segment margin	1,841,343		1,735,652		1,615,932
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:
Corporate administrative support	(146,707)		(92,335)		(90,108)
Consolidated operating income	1,694,636		1,643,317		1,525,824
Debt expense	(304,111)		(443,824)		(487,435)
Debt prepayment, refinancing and redemption charges	(89,022)		(33,402)		—
Other income	16,759		29,348		10,089
Income from continuing operations before income taxes	$	1,318,262	$	1,195,439	$	1,048,478

(1)Includes management fee revenues from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling interest or which are wholly-owned by third parties.

(2)Includes equity investment income of $5,866, $9,366, and $24,866 in 2020, 2019 and 2018, respectively.

Summary of Depreciation and Amortization Expense by Segment

Depreciation and amortization expense by reportable segment was as follows:


	Year ended December 31,
	2020		2019		2018
U.S. dialysis	$	594,552	$	583,454	$	558,810
Other - Ancillary services	35,883		31,698		32,225
	$	630,435	$	615,152	$	591,035

Summary of Assets by Segment

Summary of assets by reportable segment was as follows:


	Year ended December 31,
	2020		2019
Segment assets
U.S. dialysis(1)	$	15,344,647	$	15,778,880
Other - Ancillary services(2)	1,643,869		1,532,514
Consolidated assets	$	16,988,516	$	17,311,394

(1)Includes equity method and other investments of $122,974 and $124,188 in 2020 and 2019, respectively.

(2)Includes equity method and other investments of $134,517 and 117,795 in 2020 and 2019, respectively and includes approximately $181,137 and $154,572 in 2020 and 2019, respectively, of net property and equipment related to the Company’s international operations.

Summary of Expenditures for Property and Equipment by Segment

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


	Year ended December 31,
	2020		2019		2018
U.S. dialysis	646,870		$	681,339	$	856,108
Other - Ancillary services	27,671		46,741		45,806
DMG - Discontinued operations	—		38,466		85,224
	$	674,541	$	766,546	$	987,138