Segment reporting

9 Months Ended

Sep. 30, 2023

Segment Reporting [Abstract]

Segment Reporting Disclosure

Segment reporting

The Company’s operating divisions comprises its U.S. dialysis and related lab services business (its U.S. dialysis business), its U.S. IKC business, its U.S. other ancillary services and its international operations (collectively, its ancillary services), as well as its corporate administrative support.

The Company’s separate operating segments include its U.S. dialysis and related lab services business, its U.S. IKC business, its U.S. other ancillary services, its kidney care operations in each foreign sovereign jurisdiction, and its equity method investments in each of the Asia Pacific joint venture (APAC JV) and Mozarc. The U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other 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 2022 10-K for further description of how the Company determines and measures results for its operating segments.

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

	Three months ended September 30,				Nine months ended September 30,
	2023		2022		2023		2022
Segment revenues:
U.S. dialysis
Dialysis patient service revenues:
External sources	$	2,754,778	$	2,674,240	$	8,042,561	$	7,858,939
Intersegment revenues	24,289		22,957		66,698		64,526
U.S. dialysis patient service revenues	2,779,067		2,697,197		8,109,259		7,923,465
Other revenues:
External sources	6,239		6,056		18,822		18,134
Intersegment revenues	—		—		—		(10)
Total U.S. dialysis revenues	2,785,306		2,703,253		8,128,081		7,941,589
Other—Ancillary services
Dialysis patient service revenues	197,172		172,254		560,108		513,935
Other external sources	163,143		96,144		372,909		301,998
Intersegment revenues	2,232		—		5,007		—
Total ancillary services revenues	362,547		268,398		938,024		815,933
Total net segment revenues	3,147,853		2,971,651		9,066,105		8,757,522
Elimination of intersegment revenues	(26,521)		(22,957)		(71,705)		(64,516)
Consolidated revenues	$	3,121,332	$	2,948,694	$	8,994,400	$	8,693,006
Segment operating margin (loss):
U.S. dialysis	$	509,135	$	351,474	$	1,330,992	$	1,230,715
Other—Ancillary services	28,098		(15,271)		(18,372)		(56,689)
Total segment operating margin	537,233		336,203		1,312,620		1,174,026
Reconciliation of segment operating income to  consolidated income before income taxes:
Corporate administrative support	(41,294)		(24,417)		(99,745)		(91,217)
Consolidated operating income	495,939		311,787		1,212,875		1,082,810
Debt expense	(98,080)		(99,680)		(302,361)		(256,057)
Debt extinguishment and modification costs	—		—		(7,962)		—
Other loss, net	(19,650)		(4,898)		(14,525)		(7,968)
Consolidated income before income taxes	$	378,209	$	207,209	$	888,027	$	818,785

Depreciation and amortization expense by reportable segment was as follows:

	Three months ended September 30,				Nine months ended September 30,
	2023		2022		2023		2022
U.S. dialysis	$	175,908	$	184,688	$	514,710	$	507,320
Other—Ancillary services	12,515		9,726		35,456		31,214
	$	188,423	$	194,414	$	550,166	$	538,534

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

	Nine months ended September 30,
	2023		2022
U.S. dialysis	$	363,895	$	363,046
Other—Ancillary services	45,116		46,345
	$	409,011	$	409,391

 

A summary of assets by reportable segment were as follows:

	September 30, 2023		December 31, 2022
U.S. dialysis	$	14,574,707	$	15,084,454
Other—Ancillary services	2,354,033		1,843,798
Consolidated assets	$	16,928,740	$	16,928,252