Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2021

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,
	2021		2020		2019
Segment revenues:
U.S. dialysis
Patient service revenues:
External sources	$	10,551,106	$	10,475,273	$	10,399,686
Intersegment revenues	90,512		144,091		131,199
U.S. dialysis patient service revenues	10,641,618		10,619,364		10,530,885
Other revenues
External sources	25,061		39,376		30,895
Intersegment revenues	284		1,195		1,126
Total U.S. dialysis revenues	$	10,666,963	$	10,659,935	$	10,562,906
Other - Ancillary services
Net patient service revenues	662,409		550,978		497,021
Other external sources	380,221		484,977		460,877
Intersegment revenues	4,294		16,743		14,030
Total ancillary services	1,046,924		1,052,698		971,928
Total net segment revenues	11,713,887		11,712,633		11,534,834
Elimination of intersegment revenues	(95,090)		(162,029)		(146,355)
Consolidated revenues	$	11,618,797	$	11,550,604	$	11,388,479
Segment operating margin (loss):
U.S. dialysis	$	1,974,988	$	1,917,604	$	1,924,826
Other - Ancillary services(1)	(66,003)		(76,261)		(189,174)
Total segment margin	1,908,985		1,841,343		1,735,652
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:
Corporate administrative support	(111,615)		(146,707)		(92,335)
Consolidated operating income	1,797,370		1,694,636		1,643,317
Debt expense	(285,254)		(304,111)		(443,824)
Debt prepayment, refinancing and redemption charges	—		(89,022)		(33,402)
Other income, net	6,378		16,759		29,348
Income from continuing operations before income taxes	$	1,518,494	$	1,318,262	$	1,195,439

(1)Includes equity investment income of $3,177, $5,866, and $9,366 in 2021, 2020 and 2019, respectively.

Summary of Depreciation and Amortization Expense by Segment

Depreciation and amortization expense by reportable segment was as follows:


	Year ended December 31,
	2021		2020		2019
U.S. dialysis	$	642,711	$	594,552	$	583,454
Other - Ancillary services	37,904		35,883		31,698
	$	680,615	$	630,435	$	615,152

Summary of Expenditures for Property and Equipment by Segment

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


	Year ended December 31,
	2021		2020		2019
U.S. dialysis	589,662		$	646,870	$	681,339
Other - Ancillary services	51,803		27,671		46,741
DMG - Discontinued operations	—		—		38,466
	$	641,465	$	674,541	$	766,546

Summary of Assets by Segment

Summary of assets by reportable segment was as follows:


	Year ended December 31,
	2021		2020
Segment assets
U.S. dialysis(1)	$	15,375,000	$	15,344,647
Other - Ancillary services(2)	1,746,488		1,643,869
Consolidated assets	$	17,121,488	$	16,988,516

(1)Includes equity method and other investments of $112,500 and $122,974 in 2021 and 2020, respectively.

(2)Includes equity method and other investments of $126,381 and 134,517 in 2021 and 2020, respectively and includes approximately $190,029 and $181,137 in 2021 and 2020, respectively, of net property and equipment related to the Company’s international operations.