Segment reporting (Tables)

9 Months Ended

Sep. 30, 2023

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 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

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,
	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

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

Summary of Assets by Reportable Segment

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