Document and Entity Information
Document and Entity Information - shares shares in Millions | 6 Months Ended | |
Jun. 30, 2018 | Jul. 31, 2018 | |
Document And Entity Information [Abstract] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Jun. 30, 2018 | |
Document Fiscal Year Focus | 2,018 | |
Document Fiscal Period Focus | Q2 | |
Trading Symbol | DVA | |
Entity Registrant Name | DAVITA INC. | |
Entity Central Index Key | 927,066 | |
Current Fiscal Year End Date | --12-31 | |
Entity Filer Category | Large Accelerated Filer | |
Entity Common Stock, Shares Outstanding | 166.9 |
CONSOLIDATED STATEMENTS OF OPER
CONSOLIDATED STATEMENTS OF OPERATIONS (unaudited) - USD ($) | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Income Statement [Abstract] | ||||
Dialysis and related lab patient service revenues | $ 2,718,403,000 | $ 2,494,609,000 | $ 5,309,477,000 | $ 4,917,395,000 |
Provision for uncollectible accounts | (49,406,000) | (109,600,000) | (23,861,000) | (216,658,000) |
Net dialysis and related lab patient service revenues | 2,668,997,000 | 2,385,009,000 | 5,285,616,000 | 4,700,737,000 |
Other revenues | 217,956,000 | 314,390,000 | 450,781,000 | 629,913,000 |
Total revenues | 2,886,953,000 | 2,699,399,000 | 5,736,397,000 | 5,330,650,000 |
Operating expenses and charges: | ||||
Patient care costs and other costs | 2,069,089,000 | 1,894,664,000 | 4,104,674,000 | 3,746,709,000 |
General and administrative | 264,094,000 | 262,796,000 | 530,623,000 | 525,691,000 |
Depreciation and amortization | 147,079,000 | 140,026,000 | 289,878,000 | 272,910,000 |
Equity investment (income) loss | (9,795,000) | 825,000 | (9,950,000) | 148,000 |
Provision for uncollectible accounts | (2,100,000) | (606,000) | (8,100,000) | 1,304,000 |
Investment and other asset impairments | 11,245,000 | 0 | 11,245,000 | 15,168,000 |
Goodwill impairment charges | 3,106,000 | 10,498,000 | 3,106,000 | 34,696,000 |
Gain on changes in ownership interests, net | (33,957,000) | 0 | (33,957,000) | (6,273,000) |
Gain on settlement, net | 0 | 0 | 0 | (526,827,000) |
Total operating expenses and charges | 2,448,761,000 | 2,308,203,000 | 4,887,519,000 | 4,063,526,000 |
Operating income | 438,192,000 | 391,196,000 | 848,878,000 | 1,267,124,000 |
Debt expense | (119,692,000) | (107,934,000) | (233,208,000) | (212,331,000) |
Other income, net | 1,994,000 | 4,798,000 | 6,576,000 | 8,784,000 |
Income from continuing operations before income taxes | 320,494,000 | 288,060,000 | 622,246,000 | 1,063,577,000 |
Income tax expense | 83,868,000 | 101,915,000 | 154,605,000 | 383,580,000 |
Net income from continuing operations | 236,626,000 | 186,145,000 | 467,641,000 | 679,997,000 |
Net income (loss) from discontinued operations, net of tax | 69,696,000 | (24,520,000) | 63,910,000 | (18,087,000) |
Net income | 306,322,000 | 161,625,000 | 531,551,000 | 661,910,000 |
Less: Net income attributable to noncontrolling interests | (39,046,000) | (34,624,000) | (85,589,000) | (87,212,000) |
Comprehensive Income (Loss), Net of Tax, Attributable to Noncontrolling Interest | 39,046,000 | 34,624,000 | 85,589,000 | 87,210,000 |
Net income attributable to DaVita Inc. | $ 267,276,000 | $ 127,001,000 | $ 445,962,000 | $ 574,698,000 |
Earnings per share: | ||||
Basic net income from continuing operations per share attributable to DaVita Inc. | $ 1.16 | $ 0.79 | $ 2.23 | $ 3.09 |
Basic net income per share attributable to DaVita Inc. | 1.56 | 0.66 | 2.54 | 3 |
Diluted net income from continuing operations per share attributable to DaVita Inc. | 1.15 | 0.78 | 2.19 | 3.04 |
Diluted net income per share attributable to DaVita Inc. | $ 1.53 | $ 0.65 | $ 2.51 | $ 2.95 |
Weighted average shares for earnings per share: | ||||
Basic (in shares) | 171,617,238 | 191,088,216 | 175,267,270 | 191,728,913 |
Diluted (in shares) | 174,105,884 | 193,987,983 | 177,949,934 | 194,630,936 |
Net income from continuing operations | $ 199,603,000 | $ 151,292,000 | $ 390,618,000 | $ 592,197,000 |
Net income (loss) from discontinued operations | 67,673,000 | (24,291,000) | 55,344,000 | (17,499,000) |
Net income attributable to DaVita Inc. | $ 267,276,000 | $ 127,001,000 | $ 445,962,000 | $ 574,698,000 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Statement of Comprehensive Income [Abstract] | ||||
Net income | $ 306,322 | $ 161,625 | $ 531,551 | $ 661,910 |
Unrealized (losses) gains on interest rate cap agreements: | ||||
Unrealized (losses) gains on interest rate cap agreements | (268) | (1,815) | 782 | (5,002) |
Reclassifications of net realized losses on interest rate cap agreements into net income | 1,537 | 1,265 | 3,074 | 2,529 |
Unrealized gains on investments: | ||||
Unrealized gains on investments | 0 | 1,057 | 0 | 2,614 |
Reclassification of net investment realized gains into net income | 0 | (71) | 0 | (211) |
Unrealized (losses) gains on foreign currency translation: | ||||
Foreign currency translation adjustments | (50,529) | 49,142 | (30,648) | 62,403 |
Other comprehensive (loss) income | (49,260) | 49,578 | (26,792) | 62,333 |
Total comprehensive income | 257,062 | 211,203 | 504,759 | 724,243 |
Less: Comprehensive income attributable to noncontrolling interests | (39,046) | (34,624) | (85,589) | (87,210) |
Comprehensive income attributable to DaVita Inc. | $ 218,016 | $ 176,579 | $ 419,170 | $ 637,033 |
CONSOLIDATED BALANCE SHEETS (un
CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
ASSETS | ||
Cash and cash equivalents | $ 389,264 | $ 508,234 |
Restricted cash and equivalents | 90,884 | 10,686 |
Short-term investments | 4,528 | 32,830 |
Accounts receivable, net | 1,842,108 | 1,714,750 |
Inventories | 112,729 | 181,799 |
Other receivables | 471,802 | 372,919 |
Income tax receivable | 23,540 | 49,440 |
Prepaid and other current assets | 97,426 | 112,058 |
Current assets held for sale | 6,053,081 | 5,761,642 |
Total current assets | 9,085,362 | 8,744,358 |
Property and equipment, net of accumulated depreciation of $3,328,176 and $3,103,662 | 3,229,098 | 3,149,213 |
Intangible assets, net of accumulated amortization of $362,054 and $356,774 | 100,255 | 113,827 |
Equity method and other investments | 249,020 | 245,534 |
Long-term investments | 34,200 | 37,695 |
Other long-term assets | 59,070 | 47,287 |
Goodwill | 6,678,559 | 6,610,279 |
Total assets | 19,435,564 | 18,948,193 |
LIABILITIES AND EQUITY | ||
Accounts payable | 542,272 | 509,116 |
Other liabilities | 568,536 | 552,662 |
Accrued compensation and benefits | 633,092 | 616,116 |
Current portion of long-term debt | 1,768,514 | 178,213 |
Current liabilities held for sale | 1,271,364 | 1,185,070 |
Total current liabilities | 4,783,778 | 3,041,177 |
Long-term debt | 8,175,573 | 9,158,018 |
Other long-term liabilities | 418,123 | 365,325 |
Deferred income taxes | 526,425 | 486,247 |
Total liabilities | 13,903,899 | 13,050,767 |
Commitments and contingencies: | ||
Noncontrolling interests subject to put provisions | 1,047,158 | 1,011,360 |
Equity: | ||
Preferred stock ($0.001 par value, 5,000,000 shares authorized; none issued) | ||
Common stock ($0.001 par value, 450,000,000 shares authorized; 182,815,212 and 182,462,278 shares issued and 170,820,196 and 182,462,278 shares outstanding, respectively) | 183 | 182 |
Additional paid-in capital | 1,022,783 | 1,042,899 |
Retained earnings | 4,088,043 | 3,633,713 |
Treasury stock (11,995,016 and zero shares, respectively) | (809,900) | 0 |
Accumulated other comprehensive (loss) income | (21,925) | 13,235 |
Total DaVita Inc. shareholders' equity | 4,279,184 | 4,690,029 |
Noncontrolling interests not subject to put provisions | 205,323 | 196,037 |
Total equity | 4,484,507 | 4,886,066 |
Total liabilities and equity | $ 19,435,564 | $ 18,948,193 |
CONSOLIDATED BALANCE SHEETS (u5
CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Statement of Financial Position [Abstract] | ||
Property and equipment, accumulated depreciation | $ 3,328,176 | $ 3,103,662 |
Intangible assets, accumulated amortization | $ 362,054 | $ 356,774 |
Preferred stock, par value (usd per share) | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized (in shares) | 5,000,000 | 5,000,000 |
Preferred stock, issued (in shares) | 0 | 0 |
Common stock, par value (usd per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (in shares) | 450,000,000 | 450,000,000 |
Common stock, shares issued (in shares) | 182,815,212 | 182,462,278 |
Common stock, shares outstanding (in shares) | 170,820,196 | 182,462,278 |
Treasury Stock, Common, Shares | 11,995,016 | 0 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2018 | Jun. 30, 2017 | |
Cash flows from operating activities: | ||
Net income | $ 531,551 | $ 661,910 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 289,878 | 390,244 |
Impairment charges | 14,351 | 100,483 |
Stock-based compensation expense | 19,861 | 17,504 |
Deferred income taxes | 56,882 | 40,938 |
Equity investment income, net | (434) | 9,367 |
Gain on sales of business interests, net | (59,053) | (6,273) |
Other non-cash charges, net | 44,337 | 28,611 |
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures: | ||
Accounts receivable | (101,746) | (113,208) |
Inventories | 71,632 | (31,067) |
Other receivables and other current assets | (91,685) | (108,852) |
Other long-term assets | 3,454 | (12,124) |
Accounts payable | 35,228 | (55,897) |
Accrued compensation and benefits | 23,818 | (63,727) |
Other current liabilities | 58,321 | 13,991 |
Income taxes | 24,356 | 123,637 |
Other long-term liabilities | 3,824 | 19,520 |
Net cash provided by operating activities | 924,575 | 1,015,057 |
Cash flows from investing activities: | ||
Additions of property and equipment | (473,977) | (398,940) |
Acquisitions | (89,465) | (619,839) |
Proceeds from asset and business sales | 116,241 | 70,236 |
Purchase of investments available for sale | (4,195) | (6,812) |
Purchase of investments held-to-maturity | (3,726) | (220,591) |
Proceeds from sale of investments available for sale | 5,662 | 5,049 |
Proceeds from investments held-to-maturity | 32,628 | 320,484 |
Purchase of equity investments | (10,241) | (1,194) |
Distributions received on equity investments | 3,009 | 0 |
Net cash used in investing activities | (424,064) | (851,607) |
Cash flows from financing activities: | ||
Borrowings | 28,128,131 | 25,529,555 |
Payments on long-term debt and other financing costs | (27,556,348) | (25,593,587) |
Purchase of treasury stock | (805,179) | (231,674) |
Stock award exercises and other share issuances, net | 3,132 | 8,163 |
Distributions to noncontrolling interests | (94,006) | (116,075) |
Contributions from noncontrolling interests | 31,569 | 39,872 |
Proceeds from sales of additional noncontrolling interests | 15 | 0 |
Purchases of noncontrolling interests | (13,223) | (1,432) |
Net cash used in financing activities | (305,909) | (365,178) |
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (3,473) | 4,192 |
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 191,129 | (197,536) |
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 518,920 | 683,463 |
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 480,148 | 453,207 |
Discontinued Operations | ||
Cash flows from financing activities: | ||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 229,901 | 32,720 |
Continuing Operations | ||
Cash flows from financing activities: | ||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | $ (38,772) | $ (230,256) |
CONSOLIDATED STATEMENTS OF EQUI
CONSOLIDATED STATEMENTS OF EQUITY (unaudited) - USD ($) $ in Thousands | Total | Total | TotalRestricted Stock Units | TotalStock Appreciation Rights | Non- controlling interests subject to put provisions | Common stock | Common stockRestricted Stock Units | Common stockStock Appreciation Rights | Additional paid-in capital | Additional paid-in capitalRestricted Stock Units | Additional paid-in capitalStock Appreciation Rights | Retained earnings | Treasury stock | Accumulated other comprehensive (loss) income | Non- controlling interests not subject to put provisions |
Beginning balance at Dec. 31, 2016 | $ 4,648,047 | $ 973,258 | $ 195 | $ 1,027,182 | $ 3,710,313 | $ 0 | $ (89,643) | $ 201,694 | |||||||
Beginning Balance (in shares) at Dec. 31, 2016 | 194,554,000 | 0 | |||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | $ 574,698 | ||||||||||||||
Other comprehensive income (loss) | 62,333 | ||||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Fair value remeasurements | 0 | ||||||||||||||
Beginning balance at Dec. 31, 2016 | 4,648,047 | 973,258 | $ 195 | 1,027,182 | 3,710,313 | $ 0 | (89,643) | 201,694 | |||||||
Beginning Balance (in shares) at Dec. 31, 2016 | 194,554,000 | 0 | |||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | 663,618 | 103,641 | 663,618 | 63,296 | |||||||||||
Other comprehensive income (loss) | 102,878 | 102,878 | (2) | ||||||||||||
Stock purchase shares issued (in shares) | 360,000 | ||||||||||||||
Stock purchase shares issued | 22,131 | 22,131 | |||||||||||||
Stock unit shares issued (in shares) | 117,000 | 398,000 | |||||||||||||
Stock unit shares issued | $ (101) | $ 0 | $ (101) | $ 0 | |||||||||||
Stock-settled stock-based compensation expense | 34,981 | 34,981 | |||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Distributions | (128,853) | (82,614) | |||||||||||||
Contributions | 52,911 | 21,641 | |||||||||||||
Acquisitions and divestitures | (823) | 43,799 | (823) | (5,770) | |||||||||||
Partial purchases | (2,752) | (397) | (2,752) | (2,208) | |||||||||||
Fair value remeasurements | 32,999 | (32,999) | 32,999 | ||||||||||||
Purchase of treasury stock (in shares) | (12,967,000) | ||||||||||||||
Purchase of treasury stock | (810,949) | $ (810,949) | |||||||||||||
Retirement of treasury stock | (12,967,000) | 12,967,000 | |||||||||||||
Retirement of treasury stock | 0 | $ (13) | (70,718) | (740,218) | $ 810,949 | ||||||||||
Ending balance at Dec. 31, 2017 | $ 4,886,066 | 4,690,029 | 1,011,360 | $ 182 | 1,042,899 | 3,633,713 | $ 0 | 13,235 | 196,037 | ||||||
Ending Balance (in shares) at Dec. 31, 2017 | 182,462,278 | 182,462,000 | 0 | ||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | $ 127,001 | ||||||||||||||
Other comprehensive income (loss) | 49,578 | ||||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Fair value remeasurements | 0 | ||||||||||||||
Cumulative Effect of New Accounting Principle in Period of Adoption | 0 | 8,368 | (8,368) | ||||||||||||
Net income attributable to DaVita Inc. | 445,962 | 445,962 | 52,278 | 445,962 | 33,311 | ||||||||||
Other comprehensive income (loss) | (26,792) | (26,792) | (26,792) | ||||||||||||
Stock unit shares issued (in shares) | 146,000 | 207,000 | |||||||||||||
Stock unit shares issued | $ (448) | $ (4,885) | $ 1 | $ (448) | $ (4,886) | ||||||||||
Stock-settled stock-based compensation expense | 19,832 | 19,832 | |||||||||||||
Distributions | (57,997) | (36,009) | |||||||||||||
Contributions | 19,176 | 12,393 | |||||||||||||
Acquisitions and divestitures | 79 | 665 | 79 | (203) | |||||||||||
Partial purchases | (12,197) | 820 | (12,197) | (206) | |||||||||||
Fair value remeasurements | $ (98) | (22,496) | 22,496 | (22,496) | |||||||||||
Purchase of treasury stock (in shares) | (11,995,000) | (11,995,000) | |||||||||||||
Purchase of treasury stock | $ (809,900) | (809,900) | $ (809,900) | ||||||||||||
Ending balance at Jun. 30, 2018 | $ 4,484,507 | 4,279,184 | 1,047,158 | $ 183 | 1,022,783 | 4,088,043 | $ (809,900) | (21,925) | 205,323 | ||||||
Ending Balance (in shares) at Jun. 30, 2018 | 170,820,196 | 182,815,000 | (11,995,000) | ||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | $ 267,276 | ||||||||||||||
Other comprehensive income (loss) | (49,260) | ||||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Fair value remeasurements | (98) | ||||||||||||||
Ending balance at Jun. 30, 2018 | $ 4,484,507 | $ 4,279,184 | $ 1,047,158 | $ 183 | $ 1,022,783 | $ 4,088,043 | $ (809,900) | $ (21,925) | $ 205,323 | ||||||
Ending Balance (in shares) at Jun. 30, 2018 | 170,820,196 | 182,815,000 | (11,995,000) |
Condensed consolidated interim
Condensed consolidated interim financial statements Condensed consolidated interim financial statements | 6 Months Ended |
Jun. 30, 2018 | |
Text Block [Abstract] | |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block] | Condensed consolidated interim financial statements The condensed consolidated interim financial statements included in this report are prepared by the Company without audit. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these condensed consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and investments, accounting for income taxes, long-term variable compensation accruals, consolidation of variable interest entities and certain fair value estimates. The results of operations for the six months ended June 30, 2018 are not necessarily indicative of the operating results for the full year. The condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 . Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these condensed consolidated financial statements were issued and has included all necessary adjustments and disclosures. |
Revenue Recognition Revenue Rec
Revenue Recognition Revenue Recognition | 6 Months Ended |
Jun. 30, 2018 | |
Text Block [Abstract] | |
Revenue Recognition [Text Block] | Revenue recognition On January 1, 2018, the Company adopted Financial Accounting Standards Board (FASB) Accounting Standards Codification Topic 606 Revenue from Contracts with Customers (Topic 606) using the cumulative effect method for those contracts that were not substantially completed as of January 1, 2018. Results for reporting periods beginning on and after January 1, 2018 are presented under Topic 606, while prior period amounts continue to be presented in accordance with the Company's historical accounting under Revenue Recognition (Topic 605). The adoption of this new standard primarily changed the Company’s presentation of revenues, provision for uncollectible accounts and allowance for doubtful accounts. Topic 606 requires revenue to be recognized based on the Company’s estimate of the transaction price the Company expects to collect as a result of satisfying its performance obligations. Accordingly, for performance obligations satisfied after the adoption of Topic 606, the Company no longer separately presents a provision for uncollectible accounts on the consolidated income statement and no longer presents the related allowance for doubtful accounts on the consolidated balance sheet. However, as a result of the Company’s election to apply Topic 606 only to contracts not substantially completed as of January 1, 2018, the Company continues to maintain an allowance for doubtful accounts related to performance obligations satisfied prior to the adoption of Topic 606. Net collections or write-offs of accounts receivable generated prior to January 1, 2018, beyond amounts previously reserved thereon, are presented in the provision for uncollectible accounts on the consolidated income statement in accordance with Topic 605. The Company’s allowance for doubtful accounts related to performance obligations satisfied prior to the adoption of Topic 606 was $110,962 and $218,399 as of June 30, 2018 and December 31, 2017, respectively. There are significant risks associated with estimating revenue, which generally take several years to resolve. These estimates are subject to ongoing insurance coverage changes, geographic coverage differences, differing interpretations of contract coverage and other payor issues, as well as patient issues including determining applicable primary and secondary coverage, changes in patient coverage and coordination of benefits. As these estimates are refined over time, both positive and negative adjustments to revenue are recognized in the current period. As a result of changes in these estimates, additional revenue was recognized during the three and six months ended June 30, 2018 associated with performance obligations satisfied in years prior to the adoption of Topic 606 of $8,817 and $76,227 , respectively, which includes a benefit of $12,000 and $36,000 for those respective periods from electing to apply Topic 606 only to contracts not substantially completed as of January 1, 2018. The following table summarizes the Company's segment revenues by primary payor source: For the three months ended June 30, 2018 June 30, 2017 (1) U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated Patient service revenues: Medicare and Medicare Advantage $ 1,526,066 $ $ 1,526,066 $ 1,313,504 $ $ 1,313,504 Medicaid and Managed Medicaid 150,288 150,288 151,286 151,286 Other government 110,338 86,530 196,868 90,712 62,604 153,316 Commercial 796,732 19,139 815,871 764,864 15,324 780,188 Other revenues: Medicare and Medicare Advantage 154,028 154,028 225,511 225,511 Medicaid and Managed Medicaid 16,158 16,158 19,020 19,020 Commercial 17,006 17,006 26,812 26,812 Other (2) 4,919 35,034 39,953 4,849 44,322 49,171 Eliminations of intersegment revenues (20,096 ) (9,189 ) (29,285 ) (13,285 ) (6,124 ) (19,409 ) Total $ 2,568,247 $ 318,706 $ 2,886,953 $ 2,311,930 $ 387,469 $ 2,699,399 (1) As noted above, prior period amounts have not been adjusted under the cumulative effect method. The Company's dialysis and related lab services revenues for the three months ended June 30, 2017 has been presented net of the provision for uncollectible accounts of $109,600 in this table to conform to the current period presentation. (2) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives. For the six months ended June 30, 2018 June 30, 2017 (1) U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated Patient service revenues: Medicare and Medicare Advantage $ 3,011,258 $ $ 3,011,258 $ 2,586,100 $ $ 2,586,100 Medicaid and Managed Medicaid 307,783 307,783 295,871 295,871 Other government 217,458 169,068 386,526 182,704 110,366 293,070 Commercial 1,579,711 38,857 1,618,568 1,521,574 29,206 1,550,780 Other revenues: Medicare and Medicare Advantage 296,786 296,786 450,713 450,713 Medicaid and Managed Medicaid 31,949 31,949 37,615 37,615 Commercial 57,427 57,427 52,020 52,020 Other (2) 10,033 73,973 84,006 10,159 91,899 102,058 Eliminations of intersegment revenues (38,519 ) (19,387 ) (57,906 ) (25,084 ) (12,493 ) (37,577 ) Total $ 5,087,724 $ 648,673 $ 5,736,397 $ 4,571,324 $ 759,326 $ 5,330,650 (1) As noted above, prior period amounts have not been adjusted under the cumulative effect method. The Company's dialysis and related lab services revenues for the six months ended June 30, 2017 has been presented net of the provision for uncollectible accounts of $216,658 in this table to conform to the current period presentation. (2) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives. Dialysis and related lab patient service revenues Dialysis and related lab services patient service revenues are recognized in the period services are provided. Revenues consist primarily of payments from Medicare, Medicaid and commercial health plans for dialysis and related lab services provided to patients. A usual and customary fee schedule is maintained for the Company’s dialysis treatments and related lab patient services; however, actual collectible revenue is normally recognized at a discount from the fee schedule. Revenues associated with Medicare and Medicaid programs are estimated based on: (a) the payment rates that are established by statute or regulation for the portion of payment rates paid by the government payor (e.g., 80% for Medicare patients) and (b) for the portion not paid by the primary government payor, estimates of the amounts ultimately collectible from other government programs paying secondary coverage (e.g., Medicaid secondary coverage), the patient’s commercial health plan secondary coverage, or the patient. The Company’s reimbursements from Medicare are subject to certain variations under Medicare’s single bundled payment rate system, whereby reimbursements can be adjusted for certain patient characteristics and other factors. The Company’s revenue recognition is estimated based on its judgment regarding its ability to collect, which depends upon its ability to effectively capture, document and bill for Medicare’s base payment rate as well as these other variable factors. Under Medicare’s bundled payment rate system, services covered by Medicare are subject to estimating risk, whereby reimbursements from Medicare can vary significantly depending upon certain patient characteristics and other variable factors. Even with the bundled payment rate system, Medicare payments for bad debt claims as established by cost reports require evidence of collection efforts. As a result, billing and collection of Medicare bad debt claims can be delayed significantly and final payment is subject to audit. Medicaid payments, when Medicaid coverage is secondary, can also be difficult to estimate. For many states, Medicaid payment terms and methods differ from Medicare, and may prevent accurate estimation of individual payment amounts prior to billing. Revenues associated with commercial health plans are estimated based on contractual terms for the patients under healthcare plans with which the Company has formal agreements, non-contracted health plan coverage terms if known, estimated secondary collections, historical collection experience, historical trends of refunds and payor payment adjustments (retractions), inefficiencies in the Company’s billing and collection processes that can result in denied claims for payments, and regulatory compliance matters. Commercial revenue recognition also involves significant estimating risks. With many larger, commercial insurers the Company has several different contracts and payment arrangements, and these contracts often include only a subset of the Company’s centers. In certain circumstances, it may not be possible to determine which contract, if any, should be applied prior to billing. In addition, for services provided by non-contracted centers, final collection may require specific negotiation of a payment amount, typically at a significant discount from the Company’s usual and customary rates. Other revenues Other revenues consist of the revenues associated with the ancillary services and strategic initiatives, management and administrative support services that are provided to outpatient dialysis centers that the Company does not own or in which the Company owns a noncontrolling interest, and administrative and management support services to certain other non-dialysis joint ventures in which the Company owns a noncontrolling interest. Revenues associated with pharmacy services are estimated as prescriptions are filled and shipped to patients. Revenues associated with dialysis management services, disease management services, medical consulting services, clinical research programs, physician services, end stage renal disease (ESRD) seamless care organizations, and comprehensive care are estimated in the period services are provided. Revenues associated with direct primary care are estimated over the membership period. |
Earnings per share
Earnings per share | 6 Months Ended |
Jun. 30, 2018 | |
Earnings Per Share [Abstract] | |
Earnings per share | Earnings per share Basic earnings per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interest redemption rights in excess of fair value, by the weighted average number of common shares, net of shares held in escrow that under certain circumstances may be returned to the Company. Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights (SSARs) and unvested stock units (under the treasury stock method) as well as shares held in escrow that the Company expects will remain outstanding. The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows: Three months ended June 30, Six months ended June 30, 2018 2017 2018 2017 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 199,603 $ 151,292 $ 390,618 $ 592,197 Change in noncontrolling interest redemption rights in excess of fair value (98 ) — (98 ) — Net income from continuing operations for basic earnings per share 199,505 151,292 390,520 592,197 Net income (loss) from discontinued operations attributable to DaVita Inc. 67,673 (24,291 ) 55,344 (17,499 ) Net income attributable to DaVita Inc. for basic earnings per share $ 267,178 $ 127,001 $ 445,864 $ 574,698 Basic: Weighted average shares outstanding during the period 173,811 193,282 177,461 193,923 Contingently returnable shares held in escrow for the DaVita HealthCare (2,194 ) (2,194 ) (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 171,617 191,088 175,267 191,729 Basic net income from continuing operations per share attributable to $ 1.16 $ 0.79 $ 2.23 $ 3.09 Basic net income (loss) from discontinued operations per share 0.40 (0.13 ) 0.31 (0.09 ) Basic net income per share attributable to DaVita Inc. $ 1.56 $ 0.66 $ 2.54 $ 3.00 Diluted: Weighted average shares outstanding during the period 173,811 193,282 177,461 193,923 Assumed incremental shares from stock plans 295 706 489 708 Weighted average shares for diluted earnings per share calculation 174,106 193,988 177,950 194,631 Diluted net income from continuing operations per share attributable to $ 1.15 $ 0.78 $ 2.19 $ 3.04 Diluted net income (loss) from discontinued operations per share 0.38 (0.13 ) 0.32 (0.09 ) Diluted net income per share attributable to DaVita Inc. $ 1.53 $ 0.65 $ 2.51 $ 2.95 Anti-dilutive stock-settled awards excluded from calculation (1) 6,227 3,780 4,840 3,603 (1) Shares associated with stock-settled stock appreciation rights excluded from the diluted denominator calculation because they are antidilutive under the treasury stock method. |
Restricted Cash Restricted Cash
Restricted Cash Restricted Cash | 6 Months Ended |
Jun. 30, 2018 | |
Restricted Cash [Abstract] | |
Cash and Cash Equivalents Disclosure [Text Block] | Restricted cash and equivalents The Company had restricted cash and cash equivalents of $90,884 and $10,686 at June 30, 2018 and December 31, 2017, respectively. Approximately $78,513 of the balance at June 30, 2018 represents restricted cash equivalents held in trust to satisfy insurer and state regulatory requirements related to the Company's self-insurance for professional and general liability and workers' compensation risks administered by wholly-owned captive insurance entities. Prior to the first quarter of 2018, these requirements were satisfied by a letter of credit rather than restricted cash held in trust. The remaining restricted cash and equivalents held at June 30, 2018 and December 31, 2017 primarily represent cash pledged to third parties in connection with two of the Company's ancillary and strategic initiatives businesses. |
Investments in debt and equity
Investments in debt and equity securities | 6 Months Ended |
Jun. 30, 2018 | |
Investments, Debt and Equity Securities [Abstract] | |
Investments in debt and equity securities | Short-term and long-term investments Effective January 1, 2018, the Company adopted ASU No. 2016-01, Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities. The amendments in this ASU revise accounting related to (i) the classification and measurement of investments in equity securities and (ii) the presentation of certain fair value changes for financial liabilities at fair value. The Company also adopted ASU 2018-03 which provides related technical corrections and improvements. The principal effect of these ASUs on the Company's consolidated financial statements is that, prior to adoption of ASU 2016-01, changes in the fair values of investments in equity securities with readily determinable fair values or redemption values were recognized in other comprehensive income until realized, while under ASU 2016-01 all changes in the fair values of these equity securities are recognized in current earnings. The adoption of these ASUs did not have a material impact on these condensed consolidated financial statements. Effective January 1, 2018, the Company recognized a cumulative effect of change in accounting principle upon adoption of ASUs 2016-01 and 2018-03, in conjunction with ASU 2018-02, the effect of which was to decrease accumulated other comprehensive income, and to increase retained earnings, by $5,662 in after-tax unrealized gains accumulated in other comprehensive income through December 31, 2017 from equity securities classified as available-for-sale investments prior to adoption of ASU 2016-01. From January 1, 2018, equity securities that have readily determinable fair values or redemption values are recorded at estimated fair value with changes in their value recognized in current earnings. The Company classifies its debt securities as held-to-maturity and records them at amortized cost based on its intentions and strategy concerning those investments. The Company classifies these debt and equity investments as "Short-term investments" or "Long-term investments" on its consolidated balance sheet, as applicable, based on the characteristics of the financial instrument or the Company's intentions or expectations for the investment. The Company’s investments in these short-term and long-term debt and equity investments consist of the following: June 30, 2018 December 31, 2017 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 2,228 $ — $ 2,228 $ 31,630 $ — $ 31,630 Investments in mutual funds and common stock — 36,500 36,500 — 38,895 38,895 $ 2,228 $ 36,500 $ 38,728 $ 31,630 $ 38,895 $ 70,525 Short-term investments $ 2,228 $ 2,300 $ 4,528 $ 31,630 $ 1,200 $ 32,830 Long-term investments — 34,200 34,200 — 37,695 37,695 $ 2,228 $ 36,500 $ 38,728 $ 31,630 $ 38,895 $ 70,525 Debt securities: The Company's short-term debt investments are principally bank certificates of deposit with contractual maturities longer than three months but shorter than one year. These debt securities are accounted for as held to maturity and recorded at amortized cost, which approximates their fair values at June 30, 2018 and December 31, 2017 . Equity securities: The Company's equity investments in mutual funds and common stock are held within a trust to fund existing obligations associated with several of the Company’s non-qualified deferred compensation plans. During the six months ended June 30, 2018 , the Company recognized pre-tax net gains of $619 in the income statement associated with changes in the fair value of these equity securities, comprised of pre-tax realized gains of $3,904 and a net decrease in unrealized gains of $3,285 . During the six months ended June 30, 2017 , the Company recognized pre-tax realized gains on the sale or redemption of equity securities of $346 , or $211 after-tax, which was previously recorded in other comprehensive income. |
Equity method and other investm
Equity method and other investments | 6 Months Ended |
Jun. 30, 2018 | |
Equity Method Investments and Joint Ventures [Abstract] | |
Equity method and other investments | Equity method and other investments Equity investments in nonconsolidated investees over which the Company maintains significant influence, but which do not have readily determinable fair values, are carried on the equity method. As described in Note 5 to these condensed consolidated financial statements, effective January 1, 2018, the Company adopted ASU 2016-01 and related ASU 2018-03 concerning recognition and measurement of financial assets and financial liabilities. In adopting this new guidance, the Company has made an accounting policy election to adopt an adjusted cost method measurement alternative for investments in equity securities without readily determinable fair values. Specifically, under this measurement alternative, unless elected otherwise for a particular investment, the Company initially records equity investments that qualify for the measurement alternative at cost but remeasures them to fair value through earnings when there is an observable transaction involving the same or a similar investment with the same issuer or upon an impairment. The Company maintains equity method and minor adjusted cost method investments in the private securities of certain other healthcare and healthcare-related businesses. The Company classifies these investments as "Equity method and other investments" on its consolidated balance sheet. The total carrying amount of equity investments carried under the adjusted cost method measurement alternative at June 30, 2018 was $12,386 . Through June 30, 2018 , there have been no meaningful impairments or other downward or upward valuation adjustments recognized on these investments. Total equity method and other investments in nonconsolidated businesses were $249,020 and $245,534 at June 30, 2018 and December 31, 2017, respectively. During the six months ended June 30, 2018 and 2017, the Company recognized equity investment income of $9,950 and loss of $148 , respectively, from equity method investments in nonconsolidated businesses. The Company's largest equity method investment is its ownership interest in DaVita Care Pte. Ltd. (the APAC JV), which was carried at $155,802 and $160,481 at June 30, 2018 and December 31, 2017, respectively. The Company recognized a non-cash other-than-temporary impairment on this investment of $280,066 in the fourth quarter of 2017. As of June 30, 2018 and December 31, 2017, the Company holds a 60% voting interest and a 73.3% current economic interest in the APAC JV. Based on the governance structure and voting rights established for the APAC JV at its formation on August 1, 2016, certain key decisions affecting the joint venture’s operations are not subject to the unilateral discretion of the Company, but rather are shared with the other noncontrolling investors. These other noncontrolling investors currently collectively hold a 40% voting interest and a 26.7% economic interest in the APAC JV, and their economic interests are expected to increase to match their voting interests in the joint venture as they make additional subscribed capital contributions through August 1, 2019. |
Goodwill
Goodwill | 6 Months Ended |
Jun. 30, 2018 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Goodwill | Goodwill Changes in goodwill by reportable segment were as follows: U.S. dialysis and related lab services Other-ancillary services and strategic initiatives Consolidated total Balance at January 1, 2017 $ 5,691,587 $ 323,788 $ 6,015,375 Acquisitions 485,434 131,598 617,032 Divestitures (32,260 ) (126 ) (32,386 ) Goodwill impairment charges — (36,196 ) (36,196 ) Foreign currency and other adjustments — 46,454 46,454 Balance at December 31, 2017 $ 6,144,761 $ 465,518 $ 6,610,279 Acquisitions 6,357 99,863 106,220 Divestitures (218 ) (15,166 ) (15,384 ) Goodwill impairment charges — (3,106 ) (3,106 ) Foreign currency and other adjustments — (19,450 ) (19,450 ) Balance at June 30, 2018 $ 6,150,900 $ 527,659 $ 6,678,559 Balance at June 30, 2018: Goodwill $ 6,150,900 $ 561,937 $ 6,712,837 Accumulated impairment charges — (34,278 ) (34,278 ) $ 6,150,900 $ 527,659 $ 6,678,559 The Company elected to early adopt ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment, effective January 1, 2017. Each of the Company’s operating segments described in Note 19 to these condensed consolidated financial statements represents an individual reporting unit for goodwill impairment testing purposes, except that each sovereign jurisdiction within the Company’s international operating segments is considered a separate reporting unit. Within the U.S. dialysis and related lab services operating segment, the Company considers each of its dialysis centers to constitute an individual business for which discrete financial information is available. However, since these dialysis centers have similar operating and economic characteristics, and the allocation of resources and significant investment decisions concerning these businesses are highly centralized and the benefits broadly distributed, the Company has aggregated these centers and deemed them to constitute a single reporting unit. The Company has applied a similar aggregation to the vascular access service centers in its vascular access reporting unit, to the physician practices in its physician services and direct primary care reporting units, and to the dialysis centers within each international reporting unit. For the Company’s other operating segments, discrete business components below the operating segment level constitute individual reporting units. During the three and six months ended June 30, 2018 , the Company performed scheduled annual and other reporting unit goodwill impairment assessments, including for the Company’s Brazil dialysis and German integrated healthcare businesses. As a result, the Company recognized a goodwill impairment charge of $3,106 at its German integrated healthcare business. During the three and six months ended June 30, 2017 , the Company recognized goodwill impairment charges of $10,498 and $34,696 , respectively, at the Company’s vascular access reporting unit. These charges resulted primarily from continuing changes in the Company's outlook for this business as the Company's partners and operators continued to evaluate potential changes in operations, including termination of their management services agreements and center closures, as a result of recent changes in Medicare reimbursement. There is no goodwill remaining at the Company's vascular access reporting unit. As of June 30, 2018 , the Company’s Brazil dialysis business had a goodwill balance of $54,940 with an excess of estimated fair value over its carrying amount as of the latest assessment date of 9.8% . Future reductions in reimbursement rates, changes in actual or expected growth rates, or other significant adverse changes in expected future cash flows or valuation assumptions could result in goodwill impairment charges in the future for this Brazil dialysis business. As of the latest assessment date, the potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income was (2.5)% and the potential impact on estimated fair value of an increase in discount rates of 100 basis points was (7.3)% . Except as described above and in the Company’s annual report on Form 10-K for the year ended December 31, 2017, none of the Company's various other reporting units were considered at risk of significant goodwill impairment as of June 30, 2018 . Since the dates of the Company's last annual goodwill impairment assessments, there have been certain developments, events, changes in operating performance and other changes in key circumstances that have affected the Company's businesses. However, these changes did not cause management to believe it is more likely than not that the fair value of any of the Company's reporting units would be less than their respective carrying amounts as of June 30, 2018 . |
Income taxes
Income taxes | 6 Months Ended |
Jun. 30, 2018 | |
Income Tax Disclosure [Abstract] | |
Income taxes | Income taxes As of June 30, 2018 , the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold was $39,966 , of which $37,123 would impact the Company's effective tax rate if recognized. The total balance increased $7,190 from the December 31, 2017 balance of $32,776 . The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. At June 30, 2018 and December 31, 2017 , the Company had approximately $6,642 and $4,195 , respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefits. The Company performed a provisional analysis of the Tax Cuts and Jobs Act of 2017 (2017 Tax Act) and recorded a reasonable estimate at December 31, 2017. The Company is in the process of completing its analysis with regards to the 2017 Tax Act and will record any adjustments to its estimate on or before December 22, 2018, with any adjustments to be recorded to income tax expense in the period when the adjustments are determined. As of June 30, 2018, the Company has not made any material adjustments to the December 31, 2017 estimates. |
Long-term debt
Long-term debt | 6 Months Ended |
Jun. 30, 2018 | |
Debt Disclosure [Abstract] | |
Long-term debt | Long-term debt Long-term debt was comprised of the following: June 30, 2018 December 31, 2017 Senior secured credit facilities: Term Loan A $ 725,000 $ 775,000 Term Loan A-2 952,000 — Term Loan B 3,360,000 3,377,500 Revolver — 300,000 Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 172,692 150,512 Capital lease obligations 292,296 297,170 Total debt principal outstanding 10,001,988 9,400,182 Discount and deferred financing costs (57,901 ) (63,951 ) 9,944,087 9,336,231 Less current portion (1,768,514 ) (178,213 ) $ 8,175,573 $ 9,158,018 Scheduled maturities of long-term debt at June 30, 2018 were as follows: 2018 (remainder of the year) 95,011 2019 1,712,246 2020 74,792 2021 3,311,046 2022 1,287,741 2023 162,580 Thereafter 3,358,572 On March 29, 2018, the Company entered into an Increase Joinder No. 1 (Increase Joinder Agreement) under its existing senior secured credit facilities. Pursuant to this Increase Joinder Agreement, the Company entered into an additional $995,000 Term Loan A-2. The new Term Loan A-2 bears interest at LIBOR plus an interest rate margin of 1.00% . As of June 30, 2018 , the Company had drawn $952,000 of the Term Loan A-2. The remaining amount of $43,000 on Term Loan A-2 was drawn subsequent to June 30, 2018 . During the first six months of 2018 , the Company made mandatory principal payments under its senior secured credit facilities totaling $50,000 on Term Loan A and $17,500 on Term Loan B. As of June 30, 2018 , the Company maintains several active and forward interest rate cap agreements that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt, as described below. The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the terms of the cap agreements. The cap agreements do not contain credit-risk contingent features. On June 30, 2018 , the Company's interest rate cap agreements that were entered into in November 2014 with notional amounts totaling $3,500,000 expired. These cap agreements became effective September 30, 2016 and had the economic effect of capping the LIBOR variable component of the Company’s interest rate at a maximum of 3.50% on an equivalent amount of the Company’s debt. During the six months ended June 30, 2018 , the Company recognized debt expense of $4,140 from these cap agreements and recorded an immaterial loss in other comprehensive income due to a decrease in unrealized fair value of these cap agreements. As of June 30, 2018 , the Company maintains several currently effective interest rate cap agreements that were entered into in October 2015 with notional amounts totaling $3,500,000 . These cap agreements became effective June 29, 2018 and have the economic effect of capping the LIBOR variable component of the Company’s interest rate at a maximum of 3.50% on an equivalent amount of its debt. These cap agreements expire on June 30, 2020 . As of June 30, 2018 , the total fair value of these cap agreements was an asset of approximately $2,085 . During the six months ended June 30, 2018 , the Company recorded a gain of $1,053 in other comprehensive income due to an increase in the unrealized fair value of these cap agreements. The following table summarizes the Company’s derivative instruments outstanding as of June 30, 2018 and December 31, 2017 : June 30, 2018 December 31, 2017 Derivatives designated as hedging instruments Balance sheet location Fair value Balance sheet location Fair value Interest rate cap agreements Other long-term assets $ 2,085 Other long-term assets $ 1,032 The following table summarizes the effects of the Company’s interest rate cap agreements for the three and six months ended June 30, 2018 and 2017 : Amount of unrecognized gains (losses) in OCI on interest rate cap agreements Location of losses reclassified from accumulated OCI into income Amount of losses reclassified from accumulated OCI into income Three months ended Six months ended Three months ended Six months ended Derivatives designated as cash flow hedges 2018 2017 2018 2017 2018 2017 2018 2017 Interest rate cap $ (361 ) $ (2,969 ) $ 1,053 $ (8,186 ) Debt expense $ 2,070 $ 2,070 $ 4,140 $ 4,139 Tax benefit 93 1,154 (271 ) 3,184 Tax expense (533 ) (805 ) (1,066 ) (1,610 ) Total $ (268 ) $ (1,815 ) $ 782 $ (5,002 ) $ 1,537 $ 1,265 $ 3,074 $ 2,529 As of June 30, 2018 , the Company’s Term Loan B debt bears interest at LIBOR plus an interest rate margin of 2.75% . Term Loan B is subject to interest rate caps if LIBOR should rise above 3.50% . Term Loan A bears interest at LIBOR plus an interest rate margin of 2.00% . The capped portion of Term Loan A is $140,000 if LIBOR should rise above 3.50% . In addition, the uncapped portion of Term Loan A, which is subject to the variability of LIBOR, is $585,000 . Term Loan A-2 is subject to the variability of LIBOR plus an interest rate margin of 1.00% . Interest rates on the Company’s senior notes are fixed by their terms. The Company’s weighted average effective interest rate on the senior secured credit facilities at the end of the second quarter was 4.72% , based on the current margins in effect of 2.00% for Term Loan A, 1.00% for Term Loan A-2, and 2.75% for Term Loan B, as of June 30, 2018 . The Company’s overall weighted average effective interest rate during the quarter ended June 30, 2018 was 4.91% and as of June 30, 2018 was 4.99% . As of June 30, 2018 , the Company’s interest rates are fixed on approximately 48.8% of its total debt. As of June 30, 2018 , the Company had undrawn revolving credit facilities totaling $1,000,000 , of which approximately $14,355 was committed for outstanding letters of credit. The remaining amount is unencumbered. The Company also has approximately $22,351 of additional outstanding letters of credit related to its Kidney Care business and $211 of committed outstanding letters of credit related to DaVita Medical Group (DMG), which is backed by a certificate of deposit. |
Contingencies
Contingencies | 6 Months Ended |
Jun. 30, 2018 | |
Commitments and Contingencies Disclosure [Abstract] | |
Contingencies | Contingencies The majority of the Company’s revenues are from government programs and may be subject to adjustment as a result of: (i) examination by government agencies or contractors, for which the resolution of any matters raised may take extended periods of time to finalize; (ii) differing interpretations of government regulations by different Medicare contractors or regulatory authorities; (iii) differing opinions regarding a patient’s medical diagnosis or the medical necessity of services provided; and (iv) retroactive applications or interpretations of governmental requirements. In addition, the Company’s revenues from commercial payors may be subject to adjustment as a result of potential claims for refunds, as a result of government actions or as a result of other claims by commercial payors. The Company operates in a highly regulated industry and is a party to various lawsuits, claims, qui tam suits, governmental investigations and audits (including investigations resulting from its obligation to self-report suspected violations of law) and other legal proceedings. The Company records accruals for certain legal proceedings and regulatory matters to the extent that the Company determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. As of June 30, 2018 and December 31, 2017, the Company’s total recorded accruals, including DMG, with respect to legal proceedings and regulatory matters, net of anticipated third party recoveries, were immaterial. While these accruals reflect the Company’s best estimate of the probable loss for those matters as of the dates of those accruals, the recorded amounts may differ materially from the actual amount of the losses for those matters, and any anticipated third party recoveries for any such losses may not ultimately be recoverable. Additionally, in some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal proceedings and regulatory matters, which also may be impacted by various factors, including that they may involve indeterminate claims for monetary damages or may involve fines, penalties or non-monetary remedies; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; are in the early stages of the proceedings; or result in a change of business practices. Further, there may be various levels of judicial review available to the Company in connection with any such proceeding. The following is a description of certain lawsuits, claims, governmental investigations and audits and other legal proceedings to which the Company is subject. Inquiries by the Federal Government and Certain Related Civil Proceedings 2015 U.S. Office of Inspector General (OIG) Medicare Advantage Civil Investigation : In March 2015, JSA HealthCare Corporation (JSA), a subsidiary of DMG, received a subpoena from the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) requesting documents and information for the period from January 1, 2008 through December 31, 2013, for certain MA plans for which JSA provided services. It also requests information regarding JSA’s communications about patient diagnoses as they relate to certain MA plans generally, and more specifically as related to two Florida physicians with whom JSA previously contracted. The Company is producing the requested information and is cooperating with the government’s investigation. In addition to the subpoena described above, in June 2015, the Company received a civil subpoena from the OIG covering the period from January 1, 2008 through the present and seeking production of a wide range of documents relating to the Company’s and its subsidiaries’ (including DMG’s and its subsidiary JSA’s) provision of services to MA plans and related patient diagnosis coding and risk adjustment submissions and payments. The Company believes that the request is part of a broader industry investigation into MA patient diagnosis coding and risk adjustment practices and potential overpayments by the government. The information requested includes information relating to patient diagnosis coding practices for a number of conditions, including potentially improper historical DMG coding for a particular condition. With respect to that condition, the guidance related to that coding issue was discontinued following the Company’s November 1, 2012 acquisition of HealthCare Partners (now known as the Company's DMG business), and the Company notified Centers for Medicare and Medicaid Services (CMS) in April 2015 of the coding practice and potential overpayments. In that regard, the Company has identified certain additional coding practices which may have been problematic, some of which were the subject of the previously disclosed and dismissed Swoben Private Civil Suit, and is in discussions with the DOJ relating to those practices. The Company is cooperating with the government. In connection with the Company's acquisition of DMG in 2012, the Company has certain indemnification rights against the sellers and an escrow was established as security for the indemnification. The Company has submitted an indemnification claim against the sellers secured by the escrow for any and all liabilities incurred relating to these matters and intends to pursue recovery from the escrow. However, the Company can make no assurances that the indemnification and escrow will cover the full amount of the Company’s potential losses related to these matters. 2016 U.S. Attorney Texas Investigation : In early February 2016, the Company announced that its pharmacy services wholly-owned subsidiary, DaVita Rx, LLC, (DaVita Rx) received a Civil Investigative Demand (CID) from the U.S. Attorney’s Office for the Northern District of Texas. The government is conducting a federal False Claims Act (FCA) investigation concerning allegations that DaVita Rx presented or caused to be presented false claims for payment to the government for prescription medications, as well as into the Company’s relationship with pharmaceutical manufacturers. The CID covers the period from January 1, 2006 through the present. In the spring of 2015, the Company initiated an internal compliance review of DaVita Rx during which it identified potential billing and operational issues, including potential write-offs and discounts of patient co-payment obligations, and credits to payors for returns of prescription drugs related to DaVita Rx. The Company notified the government in September 2015 that it was conducting this review of DaVita Rx and began providing regular updates of its review. Upon completion of its review, the Company filed a self-disclosure with the OIG in February 2016 and has been working to address and update the practices it identified in the self-disclosure, some of which overlap with information requested by the U.S. Attorney’s Office. The OIG informed the Company in February 2016 that its submission was not accepted. They indicated that the OIG is not expressing an opinion regarding the conduct disclosed or the Company’s legal positions. In connection with the Company’s ongoing efforts working with the government the Company learned that a qui tam complaint had been filed covering some of the issues in the CID and the Company’s self-disclosure. In December 2017, the Company finalized and executed a settlement agreement with the government and relators in the qui tam matter and that included total monetary consideration of $63,700 , as previously announced, of which $41,500 was an incremental cash payment and $22,200 was for amounts previously refunded, and all of which was previously accrued. The government’s investigation into certain of the Company's relationships with pharmaceutical manufacturers is ongoing, and in July 2018 the government served an HHS-OIG subpoena seeking additional documents and information relating to those relationships. The Company is continuing to cooperate with the government in this investigation. 2017 U.S. Attorney Massachusetts Investigation : In January 2017, the Company was served with an administrative subpoena for records by the U.S. Attorney’s Office, District of Massachusetts, relating to an investigation into possible federal health care offenses. The subpoena covers the period from January 1, 2007 through the present, and seeks documents relevant to charitable patient assistance organizations, particularly the American Kidney Fund, including documents related to efforts to provide patients with information concerning the availability of charitable assistance. The Company is cooperating with the government. 2017 U.S. Attorney Colorado Investigation : In November 2017, the U.S. Attorney’s Office, District of Colorado informed the Company of an investigation it was conducting into possible federal health care offenses involving DaVita Kidney Care, as well as several of the Company's wholly-owned subsidiaries, including DMG, DaVita Rx, DaVita Laboratory Services, Inc. (DaVita Labs), and RMS Lifeline Inc. (Lifeline). There is overlap between the Colorado investigation and the other reported investigations concerning DMG and DaVita Rx. The Company is cooperating with the government. 2017 U.S. Attorney Florida Investigation : In November 2017, the U.S. Attorney’s Office, Southern District of Florida informed the Company of an investigation it was conducting into possible federal healthcare offenses involving the Company's wholly-owned subsidiary, Lifeline. The Company is cooperating with the government. 2018 U.S. Attorney Florida Investigation : In March 2018, DaVita Labs, received two CIDs from the U.S. Attorney’s Office, Middle District of Florida that were identical in nature but directed to the two different labs. According to the face of the CIDs, the U.S. Attorney’s Office is conducting an investigation as to whether the Company's subsidiary submitted claims for blood, urine, and fecal testing, where there were insufficient test validation or stability studies to ensure accurate results, in violation of the False Claims Act. The Company is cooperating with the government. * * * Although the Company cannot predict whether or when proceedings might be initiated or when these matters may be resolved (other than as described above), it is not unusual for inquiries such as these to continue for a considerable period of time through the various phases of document and witness requests and on-going discussions with regulators and to develop over the course of time. In addition to the inquiries and proceedings specifically identified above, the Company frequently is subject to other inquiries by state or federal government agencies and/or private civil qui tam complaints filed by relators. Negative findings or terms and conditions that the Company might agree to accept as part of a negotiated resolution of pending or future government inquiries or relator proceedings could result in, among other things, substantial financial penalties or awards against the Company, substantial payments made by the Company, harm to the Company’s reputation, required changes to the Company’s business practices, exclusion from future participation in the Medicare, Medicaid and other federal health care programs and, if criminal proceedings were initiated against the Company, possible criminal penalties, any of which could have a material adverse effect on the Company. Shareholder and Derivative Claims Peace Officers’ Annuity and Benefit Fund of Georgia Securities Class Action Civil Suit : On February 1, 2017, the Peace Officers’ Annuity and Benefit Fund of Georgia filed a putative federal securities class action complaint in the U.S. District Court for the District of Colorado against the Company and certain executives. The complaint covers the time period of August 2015 to October 2016 and alleges, generally, that the Company and its executives violated federal securities laws concerning the Company’s financial results and revenue derived from patients who received charitable premium assistance from an industry-funded non-profit organization. The complaint further alleges that the process by which patients obtained commercial insurance and received charitable premium assistance was improper and "created a false impression of DaVita’s business and operational status and future growth prospects." In November 2017, the court appointed the lead plaintiff and an amended complaint was filed on January 12, 2018. On March 27, 2018, the Company and various individual defendants filed a motion to dismiss. The plaintiffs filed an opposition to the motion to dismiss on June 6, 2018. The Company filed a reply in support of the motion on July 19, 2018. The Company disputes these allegations and intends to defend this action accordingly. In re DaVita Inc. Stockholder Derivative Litigation : On August 15, 2017, the U.S. District Court for the District of Delaware consolidated three previously disclosed shareholder derivative lawsuits: the Blackburn Shareholder action filed on February 10, 2017, the Gabilondo Shareholder action filed on May 30, 2017, and the City of Warren Police and Fire Retirement System Shareholder action filed on June 9, 2017. The complaint covers the time period from 2015 to present and alleges, generally, breach of fiduciary duty, unjust enrichment, abuse of control, gross mismanagement, corporate waste, and misrepresentations and/or failures to disclose certain information in violation of the federal securities laws in connection with an alleged practice to direct patients with government-subsidized health insurance into private health insurance plans to maximize the Company’s profits. An amended complaint was filed in September 2017, and on December 18, 2017 the Company filed a motion to dismiss and a motion to stay proceedings in the alternative. The plaintiffs filed an opposition to the motion to dismiss on March 9, 2018. On June 25, 2018, the U.S. District Court for the District of Delaware granted the Company’s motion to stay proceedings and stayed the case until November 1, 2018. The Company disputes these allegations and intends to defend this action accordingly. Other Proceedings White, Kathleen, et al. v. DaVita Healthcare Partners, Inc., Civil Action No. 15-cv-2106, U.S. District Court for the District of Colorado : Three actions (Menchaca v. DaVita Healthcare Partners, Inc., Saldana v. DaVita Healthcare Partners, Inc. and Hardin v. DaVita Healthcare Partners, Inc.) were consolidated in December 2016 into one action in U.S. District Court for the District of Colorado. In all three actions, the plaintiffs brought claims for wrongful death, negligence and fraudulent concealment related to Granuflo®, a product used as a component of the dialysis process. The Menchaca and Saldana actions arose out of the treatment of patients in California, while the Hardin action arose out of the treatment of a patient in Illinois. On June 27, 2018, the jury returned a verdict in favor of the plaintiffs, collectively awarding $8,500 in compensatory damages and $375,000 in punitive damages. The Company intends to challenge the verdict and damage awards through post-trial motions and, if necessary, an appeal of the judgment. The Company has recorded a liability of its estimate of probable damages and awards that may be paid in this case. The Company intends to seek recovery from insurers, indemnitors and the like to cover any ultimate damages and awards relating to this matter; however, the Company can make no assurances that any such recoveries will cover the full amount of the Company’s potential losses related to this matter. The net amounts recorded are not material to the financial results in the period. In addition to the foregoing, from time to time the Company is subject to other lawsuits, demands, claims, governmental investigations and audits and legal proceedings that arise due to the nature of its business, including contractual disputes, such as with payors, suppliers and others, employee-related matters and professional and general liability claims. From time to time, the Company also initiates litigation or other legal proceedings as a plaintiff arising out of contracts or other matters. Resolved Matters 2011 Suit against the U.S. Department of Veterans Affairs : As previously disclosed, the Company had a pending lawsuit in the U.S. Court of Federal Claims against the federal government which was originally filed in May 2011. The lawsuit related to the U.S. Department of Veterans Affairs (VA) underpayment of dialysis services the Company provided from 2005 through 2011 to veterans pursuant to VA regulations. In the first quarter of 2017, the Company received a payment of $538,000 related to the settlement with the VA. The Company's consolidated entities recognized a net gain of $527,000 on this settlement. The Company's nonconsolidated and managed entities recognized a gain of $9,000 , of which the Company's equity investment share was $3,000 . The net effect was a net increase of $530,000 to the Company's operating income. * * * Other than as described above, the Company cannot predict the ultimate outcomes of the various legal proceedings and regulatory matters to which the Company is or may be subject from time to time, including those described in this Note 10 to these condensed consolidated financial statements, or the timing of their resolution or the ultimate losses or impact of developments in those matters, which could have a material adverse effect on the Company’s revenues, earnings and cash flows. Further, any legal proceedings or regulatory matters involving the Company, whether meritorious or not, are time consuming, and often require management’s attention and result in significant legal expense, and may result in the diversion of significant operational resources, or otherwise harm the Company’s business, financial results or reputation. |
Noncontrolling interests subjec
Noncontrolling interests subject to put provisions and other commitments | 6 Months Ended |
Jun. 30, 2018 | |
Commitments and Contingencies Disclosure [Abstract] | |
Noncontrolling interests subject to put provisions and other commitments | Noncontrolling interests subject to put provisions and other commitments The Company has potential obligations to purchase the equity interests held by third parties in several of its majority-owned joint ventures and other nonconsolidated entities. These obligations are in the form of put provisions that are exercisable at the third-party owners’ discretion within specified periods as outlined in each specific put provision. If these put provisions were exercised, the Company would be required to purchase the third-party owners’ equity interests at either the appraised fair market value or a predetermined multiple of earnings or cash flows attributable to the equity interests put to the Company, which is intended to approximate fair value. The methodology the Company uses to estimate the fair values of noncontrolling interests subject to put provisions assumes the higher of either a liquidation value of net assets or an average multiple of earnings, based on historical earnings, patient mix and other performance indicators that can affect future results, as well as other factors. The estimated fair values of noncontrolling interests subject to put provisions are a critical accounting estimate that involves significant judgments and assumptions and may not be indicative of the actual values at which the noncontrolling interests may ultimately be settled, which could vary significantly from the Company’s current estimates. The estimated fair values of noncontrolling interests subject to put provisions can fluctuate and the implicit multiple of earnings at which these noncontrolling interests obligations may be settled will vary significantly depending upon market conditions including potential purchasers’ access to the capital markets, which can impact the level of competition for dialysis and non-dialysis related businesses, the economic performance of these businesses and the restricted marketability of the third-party owners’ equity interests. The amount of noncontrolling interests subject to put provisions that employ a contractually predetermined multiple of earnings rather than fair value are immaterial. The Company has certain other potential commitments to provide operating capital to a number of dialysis centers that are wholly-owned by third parties or businesses in which the Company maintains a noncontrolling equity interest as well as to physician-owned vascular access clinics or medical practices that the Company operates under management and administrative services agreements of approximately $5,446 . Certain consolidated joint ventures are originally contractually scheduled to dissolve after terms ranging from 10 to 50 years. While noncontrolling interests in these limited life entities qualify as mandatorily redeemable financial instruments, they are subject to a classification and measurement scope exception from the accounting guidance generally applicable to other mandatorily redeemable financial instruments. Future distributions upon dissolution of these entities would be valued below the related noncontrolling interest carrying balances in the consolidated balance sheet. |
Long-term incentive compensatio
Long-term incentive compensation | 6 Months Ended |
Jun. 30, 2018 | |
Disclosure of Compensation Related Costs, Share-based Payments [Abstract] | |
Long-term incentive compensation | Long-term incentive compensation Long-term incentive program (LTIP) compensation includes both stock-based awards (principally stock-settled stock appreciation rights, restricted stock units, and performance stock units) as well as long-term performance-based cash awards. Long-term incentive compensation expense, which was primarily general and administrative in nature, was attributed to the Company’s U.S. dialysis and related lab services business, corporate administrative support, and ancillary services and strategic initiatives. The Company’s stock-based compensation awards are measured at their estimated fair values on the date of grant if settled in shares or at their estimated fair values at the end of each reporting period if settled in cash. The value of stock-based awards so measured is recognized as compensation expense on a cumulative straight-line basis over the vesting terms of the awards, adjusted for expected forfeitures. During the six months ended June 30, 2018 , the Company granted 1,780 stock-settled stock appreciation rights with an aggregate grant-date fair value of $28,630 and a weighted-average expected life of approximately 4.2 years and 1,094 stock units with an aggregate grant-date fair value of $72,469 and a weighted-average expected life of approximately 3.4 years. For the six months ended June 30, 2018 and 2017 , the Company recognized $31,301 and $27,183 , respectively, in total LTIP expense, of which $20,717 and $16,404 , respectively, represented stock-based compensation expense for stock appreciation rights, restricted stock units, and discounted employee stock plan purchases, which are primarily included in general and administrative expense. The estimated tax benefits recorded for stock-based compensation for the six months ended June 30, 2018 and 2017 was $3,941 and $5,636 , respectively. As of June 30, 2018 , the Company had $153,984 of total estimated but unrecognized compensation expense for outstanding LTIP awards, including $128,115 related to stock-based compensation arrangements under the Company’s equity compensation and employee stock purchase plans. The Company expects to recognize the performance-based cash component of these LTIP costs over a weighted average remaining period of 1.0 year and the stock-based component of these LTIP costs over a weighted average remaining period of 1.7 years. For the six months ended June 30, 2018 and 2017 , the Company recognized $7,671 and $5,693 , respectively, in actual tax benefits upon the exercise of stock awards. |
Share repurchases
Share repurchases | 6 Months Ended |
Jun. 30, 2018 | |
Equity [Abstract] | |
Share repurchases | Share repurchases During the six months ended June 30, 2018 , the Company repurchased a total of 11,995 shares of its common stock for $809,900 at an average price of $67.52 per share. The Company also repurchased 3,872 shares of its common stock for $272,902 at an average price of $70.48 per share, subsequent to June 30, 2018 through July 31, 2018. On July 11, 2018, the Company's Board of Directors approved an additional share repurchase authorization in the amount of $1,389,999 . This share repurchase authorization was in addition to the $110,001 remaining at that time under the Company’s Board of Directors’ prior share repurchase authorization approved in October 2017. Accordingly, as of July 31, 2018, the Company has a total of $1,426,313 remaining available under the current Board repurchase authorizations for additional share repurchases. Although these share repurchase authorizations do not have expiration dates, the Company remains subject to share repurchase limitations under the terms of its senior secured credit facilities and the indentures governing its senior notes. |
Comprehensive income
Comprehensive income | 6 Months Ended |
Jun. 30, 2018 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | ther comprehensive (loss) income For the three months ended June 30, 2018 For the six months ended June 30, 2018 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (12,527 ) $ 39,862 $ 27,335 $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 Cumulative effect (1) — — — (2,706 ) (5,662 ) — (8,368 ) Unrealized (losses) (361 ) (50,529 ) (50,890 ) 1,053 — (30,648 ) (29,595 ) Related income tax 93 — 93 (271 ) — — (271 ) (268 ) (50,529 ) (50,797 ) 782 — (30,648 ) (29,866 ) Reclassification 2,070 — 2,070 4,140 — — 4,140 Related income tax (533 ) — (533 ) (1,066 ) — — (1,066 ) 1,537 — 1,537 3,074 — — 3,074 Ending balance $ (11,258 ) $ (10,667 ) $ (21,925 ) $ (11,258 ) $ — $ (10,667 ) $ (21,925 ) _________________ (1) Reflects the cumulative effect of a change in accounting principle for ASUs 2016-01 and 2018-03 on classification and measurement of financial instruments and ASU 2018-02 on remeasurement and reclassification of deferred tax effects in accumulated other comprehensive income associated with the 2017 Tax Act. For the three months ended June 30, 2017 For the six months ended June 30, 2017 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (13,952 ) $ 3,594 $ (66,528 ) $ (76,886 ) $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Unrealized (losses) (2,969 ) 1,446 49,142 47,619 (8,186 ) 3,428 62,403 57,645 Related income tax 1,154 (389 ) — 765 3,184 (812 ) — 2,372 (1,815 ) 1,057 49,142 48,384 (5,002 ) 2,616 62,403 60,017 Reclassification 2,070 (117 ) — 1,953 4,139 (346 ) — 3,793 Related income tax (805 ) 46 — (759 ) (1,610 ) 135 — (1,475 ) 1,265 (71 ) — 1,194 2,529 (211 ) — 2,318 Ending balance $ (14,502 ) $ 4,580 $ (17,386 ) $ (27,308 ) $ (14,502 ) $ 4,580 $ (17,386 ) $ (27,308 ) Net realized losses on interest rate cap agreements that are reclassified into income are recorded as debt expense in the corresponding consolidated statements of operations. See Note 9 to these condensed consolidated financial statements for further details. Net realized gains on investment securities reclassified into income for the six months ended June 30, 2017 were recognized in other income in the corresponding consolidated statements of operations. See Note 5 to these condensed consolidated financial statements for further details. |
Acquisitions and divestitures
Acquisitions and divestitures | 6 Months Ended |
Jun. 30, 2018 | |
Business Combinations [Abstract] | |
Acquisitions and divestitures | Acquisitions and divestitures Routine acquisitions During the six months ended June 30, 2018 , the Company acquired dialysis businesses consisting of two dialysis centers located in the U.S. and 18 dialysis centers located outside the U.S. for a total of $88,185 in net cash, $15,968 in deferred purchase price obligations, and $4,900 in liabilities assumed and earn-out obligations. The assets and liabilities for these acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s condensed consolidated financial statements, as are their operating results, from the designated effective dates of the acquisitions. The initial purchase price allocations for these transactions have been recorded at estimated fair values based on the best information available to management and will be finalized when certain information arranged to be obtained has been received. In particular, certain income tax amounts are pending final evaluation and quantification of pre-acquisition tax contingencies and filing of final tax returns. In addition, valuation of certain working capital items, fixed assets and intangibles are pending final audits and related valuation reports. The following table summarizes the assets acquired and liabilities assumed in these transactions at their estimated acquisition date fair values: Current assets $ 8,854 Property and equipment 4,303 Intangible and other long-term assets 1,486 Goodwill 106,220 Current liabilities (10,290 ) Long-term liabilities (171 ) Noncontrolling interests (1,349 ) $ 109,053 Amortizable intangible assets acquired during the first six months of 2018 primarily represent non-compete agreements which had weighted-average estimated useful lives of approximately five years. The total estimated amount of goodwill deductible for tax purposes associated with these acquisitions was approximately $100,885 . Sale of Paladina Health Effective June 1, 2018 the Company sold 100% of the equity of DaVita DPC Holding Co., LLC (Paladina Health), our direct primary care business, resulting in an initial estimated gain of $35,205 . Contingent earn-out obligations The Company has several contingent earn-out obligations associated with acquisitions that could result in the Company paying the former owners of acquired companies a total of up to $14,333 if certain EBITDA, operating income performance targets or quality margins are met primarily over the next one to five years. Contingent earn-out obligations are remeasured at fair value at each reporting date until the contingencies are resolved with changes in the liability due to the remeasurement recorded in earnings. See Note 18 to these condensed consolidated financial statements for further details. As of June 30, 2018 , the Company has estimated the fair value of its contingent earn-out obligations to be $7,489 , of which a total of $438 is included in other liabilities and the remaining $7,051 is included in other long-term liabilities in the Company’s consolidated balance sheet. The following is a reconciliation of changes in liabilities for contingent earn-out obligations: For the six months ended June 30, 2018 Beginning balance $ 6,388 Contingent earn-out obligations associated with acquisitions 1,436 Remeasurement of fair value for contingent earn-out obligations (335 ) Ending balance $ 7,489 |
Held for Sale and Discontinued
Held for Sale and Discontinued Operations Held for Sale and Discontinued Operations | 6 Months Ended |
Jun. 30, 2018 | |
Held for Sale and Discontinued Operations [Abstract] | |
Disposal Groups, Including Discontinued Operations, Disclosure [Text Block] | Held for sale and discontinued operations DaVita Medical Group In December 2017, the Company entered into an equity purchase agreement to sell its DMG division to Collaborative Care Holdings, LLC (Optum), a subsidiary of UnitedHealth Group Inc., for $4,900,000 in cash, subject to net working capital and other customary adjustments. The transaction is expected to close in 2018 and is subject to regulatory approvals and other customary closing conditions. As a result of this pending transaction, the DMG business has been classified as held for sale and its results of operations are reported as discontinued operations for all periods presented in these condensed consolidated financial statements. The following table presents the financial results of discontinued operations related to DMG: Three months ended Six months ended 2018 2017 2018 2017 Revenues $ 1,252,430 $ 1,196,066 $ 2,480,362 $ 2,283,050 Expenses 1,192,528 1,157,901 2,418,935 2,232,352 Goodwill impairment charges — 50,619 — 50,619 Income (loss) from discontinued operations before taxes 59,902 (12,454 ) 61,427 79 Income tax benefit (expense) 9,794 (12,066 ) 2,483 (18,166 ) Net income (loss) from discontinued operations, net of tax $ 69,696 $ (24,520 ) $ 63,910 $ (18,087 ) The following table presents the financial position of discontinued operations related to DMG: June 30, 2018 December 31, 2017 Assets Cash and cash equivalents $ 404,435 $ 179,668 Other current assets 862,764 826,608 Property and equipment, net 425,943 379,945 Intangible assets, net 1,316,468 1,316,550 Other long-term assets 161,622 178,894 Goodwill 2,881,849 2,879,977 Total current assets held for sale $ 6,053,081 $ 5,761,642 Liabilities Other liabilities $ 580,978 $ 505,734 Medical payables 487,920 457,040 Current portion of long-term debt 2,636 2,845 Long-term debt 34,076 35,003 Other long-term liabilities 165,754 184,448 Total current liabilities held for sale $ 1,271,364 $ 1,185,070 The following table presents cash flows of discontinued operations related to DMG: June 30, 2018 June 30, 2017 Net cash provided by operating activities from discontinued operations $ 112,683 $ 101,215 Net cash used in investing activities from discontinued operations $ (20,982 ) $ (85,289 ) DMG acquisitions During the first six months of 2018, the Company's DMG business acquired two medical businesses for a total of $1,280 in cash and deferred purchase price of $99 . Certain income tax amounts are pending final evaluation and quantification of any pre-acquisition tax contingencies. In addition, valuation of medical claims liabilities and certain other working capital items relating to acquisitions are pending final quantification. The assets and liabilities for all acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s current held for sale assets and liabilities. Sale of Tandigm Health Investment Effective June 1, 2018, DMG sold its 19% ownership interest in the Tandigm Health joint venture and a related supporting business resulting in a gain, net of tax, of $18,636 . Goodwill impairment charges As previously disclosed, prior to being reclassified as held for sale the Company recorded goodwill impairment charges for the DMG business of $50,619 for the three and six months ended June 30, 2017. These charges resulted from continuing developments in the Company’s DMG business, including recent annual updates to Medicare Advantage benchmark reimbursement rates, changes in expectations concerning future government reimbursement rates and the Company’s expected ability to mitigate them, as well as medical cost and utilization trends. |
Variable interest entities
Variable interest entities | 6 Months Ended |
Jun. 30, 2018 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Variable interest entities | Variable interest entities The Company relies on the operating activities of certain legal entities that it does not directly own or control, but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are subject to the consolidation guidance applicable to variable interest entities (VIEs). Under U.S. generally accepted accounting principles (GAAP), VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. The Company has determined that substantially all of the legal entities it is associated with that qualify as VIEs must be included in its consolidated financial statements. A number of these VIEs are within the Company's DMG business, which is classified as held for sale and as a discontinued operation in these condensed consolidated financial statements. The Company manages these entities and provides operating and capital funding as necessary for these entities to accomplish their operational and strategic objectives. A number of these entities are subject to nominee share ownership or share transfer restriction agreements that effectively transfer the majority of the economic risks and rewards of their ownership to the Company. In other cases the Company’s management agreements with these entities include both financial terms and protective and participating rights to the entities’ operating, strategic and non-clinical governance decisions which transfer substantial powers over and economic responsibility for the entities to the Company. In some cases such entities are subject to broad exclusivity or noncompetition restrictions that benefit the Company. Further, in some cases the Company has contractual arrangements with its related party nominee owners that effectively indemnify these parties from the economic losses from, or entitle the Company to the economic benefits of, these entities. The analyses upon which these consolidation determinations rest are complex, involve uncertainties, and require significant judgment on various matters, some of which could be subject to different interpretations. At June 30, 2018 , these condensed consolidated financial statements include total assets of VIEs of $880,290 and total liabilities and noncontrolling interests of VIEs to third parties of $490,229 , including assets of $625,573 and liabilities and noncontrolling interests of $341,327 related to the Company's DMG business classified as held for sale. The Company also sponsors certain deferred compensation plans whose trusts qualify as VIEs and the Company consolidates these plans as their primary beneficiary. The assets of these plans are recorded in short-term or long-term investments with matching offsetting liabilities recorded in accrued compensation and benefits and other long-term liabilities. See Note 5 to these condensed consolidated financial statements for disclosures on the assets of these consolidated non-qualified deferred compensation plans. |
Fair value of financial instrum
Fair value of financial instruments | 6 Months Ended |
Jun. 30, 2018 | |
Fair Value Disclosures [Abstract] | |
Fair value of financial instruments | Fair values of financial instruments The Company measures the fair value of certain assets, liabilities and noncontrolling interests subject to put provisions (temporary equity) based upon certain valuation techniques that include observable or unobservable inputs and assumptions that market participants would use in pricing these assets, liabilities, temporary equity and commitments. The Company has also classified certain assets, liabilities and temporary equity that are measured at fair value into the appropriate fair value hierarchy levels as defined by the FASB. The following table summarizes the Company’s assets, liabilities and temporary equity that are measured at fair value on a recurring basis as of June 30, 2018 : Total Quoted prices in Significant other Significant Assets Investments in mutual funds and common stock $ 36,500 $ 36,500 $ — $ — Interest rate cap agreements $ 2,085 $ — $ 2,085 $ — Liabilities Contingent earn-out obligations $ 7,489 $ — $ — $ 7,489 Temporary equity Noncontrolling interests subject to put provisions $ 1,047,158 $ — $ — $ 1,047,158 Investments in mutual funds and common stock represent equity securities that are recorded at estimated fair value based upon quoted redemption prices reported by each mutual fund. See Note 5 to these condensed consolidated financial statements for further discussion. Interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 9 to these condensed consolidated financial statements for further discussion. The estimated fair value of contingent earn-out obligations are primarily based on unobservable inputs including projected EBITDA. The estimated fair value of these contingent earn-out obligations is remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company credit risk-adjusted rate that is used to discount the obligations to present value. See Note 15 to these condensed consolidated financial statements for further discussion. See Note 11 to these condensed consolidated financial statements for a discussion of the Company’s methodology for estimating the fair value of noncontrolling interests subject to put obligations. The carrying balance of the Company’s senior secured credit facilities totaled $5,015,669 as of June 30, 2018 , and the fair value was approximately $5,064,405 based upon quoted market prices, a level 2 input. The carrying balance of the Company’s senior notes was $4,463,430 as of June 30, 2018 and their fair value was approximately $4,391,600 , based upon quoted market prices, a level 2 input. Other financial instruments consist primarily of cash and cash equivalents, accounts receivable, accounts payable, other accrued liabilities and debt. The balances of the Company's financial instruments other than the senior secured credit facilities and the senior notes are presented in the condensed consolidated financial statements at June 30, 2018 at their approximate fair values due to the short-term nature of their settlements. |
Segment reporting
Segment reporting | 6 Months Ended |
Jun. 30, 2018 | |
Segment Reporting [Abstract] | |
Segment reporting | Segment reporting The Company has consisted of two major divisions, DaVita Kidney Care (Kidney Care) and DMG. The Kidney Care division is comprised of the Company’s U.S. dialysis and related lab services business, various ancillary services and strategic initiatives, including its international operations, and the Company’s corporate administrative support. The Company’s U.S. dialysis and related lab services business is its largest line of business and is a leading provider of kidney dialysis services in the U.S. for patients suffering from chronic kidney failure, also known as ESRD. The Company’s ancillary services and strategic initiatives consist primarily of pharmacy services, disease management services, vascular access services, clinical research programs, physician services, direct primary care, ESRD seamless care organizations and comprehensive care, as well as the Company’s international operations. The Company’s DMG division is a patient- and physician-focused integrated healthcare delivery and management company with over two decades of providing coordinated outcomes-based medical care in a cost-effective manner. In December 2017, the Company entered into an equity purchase agreement to sell its DMG division to Optum, a subsidiary of UnitedHealth Group Inc. The transaction is expected to close in 2018 and is subject to regulatory approvals and other customary closing conditions. As a result of this pending transaction, the DMG business has been classified as held for sale and its results of operations are reported as discontinued operations for all periods presented in these condensed consolidated financial statements. See Note 16 to these condensed consolidated financial statements for further discussion. The Company’s operating segments have been defined based on the separate financial information that is regularly produced and reviewed by the Company’s chief operating decision maker in making decisions about allocating resources to and assessing the financial performance of the Company’s various operating lines of business. The chief operating decision maker for the Company is its Chief Executive Officer. The Company’s separate operating segments include its U.S. dialysis and related lab services business, each of its ancillary services and strategic initiatives, its consolidated international kidney care operations in each country and under the Saudi Ministry of Health charter, its equity method investment in the Asia Pacific joint venture, and its other health operations in Europe. The U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other ancillary services and strategic initiatives operating segments, including the international operating segments, have been combined and disclosed in the other segments category. The Company’s operating segment financial information included in this report is prepared on the internal management reporting basis that the chief operating decision maker uses to allocate resources and assess the financial performance of the Company's operating segments. For internal management reporting, segment operations include direct segment operating expenses but generally exclude corporate administrative support costs, which consist primarily of indirect labor, benefits and long-term incentive-based compensation expenses of certain departments which provide support to all of the Company’s various operating lines of business, except to the extent that such costs are charged to and borne by certain ancillary services and strategic initiatives via internal management fees. These corporate administrative support costs are reduced by internal management fees received from the Company’s ancillary lines of business. The following is a summary of segment net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes: Three months ended June 30, Six months ended June 30, 2018 2017 2018 2017 Segment net revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,612,734 $ 2,416,373 $ 5,101,899 $ 4,777,234 Intersegment revenues 20,096 13,285 38,519 25,084 U.S. dialysis and related lab services patient service 2,632,830 2,429,658 5,140,418 4,802,318 Provision for uncollectible accounts (49,406 ) (109,292 ) (24,208 ) (216,069 ) Net U.S. dialysis and related lab services patient 2,583,424 2,320,366 5,116,210 4,586,249 Other revenues (1) 4,919 4,849 10,033 10,159 Total U.S. dialysis and related lab services revenues 2,588,343 2,325,215 5,126,243 4,596,408 Other—Ancillary services and strategic initiatives Patient service revenues 105,669 77,928 207,925 139,572 Other external sources 213,037 309,541 440,748 619,754 Intersegment revenues 9,189 6,124 19,387 12,493 Total ancillary services and strategic initiatives revenues 327,895 393,593 668,060 771,819 Total net segment revenues 2,916,238 2,718,808 5,794,303 5,368,227 Elimination of intersegment revenues (29,285 ) (19,409 ) (57,906 ) (37,577 ) Consolidated revenues $ 2,886,953 $ 2,699,399 $ 5,736,397 $ 5,330,650 Segment operating margin: U.S. dialysis and related lab services $ 449,443 $ 450,472 $ 882,822 $ 1,395,212 Other—Ancillary services and strategic initiatives 2,815 (48,245 ) (4,175 ) (106,466 ) Total segment operating margin 452,258 402,227 878,647 1,288,746 Reconciliation of segment operating margin to consolidated Corporate administrative support (14,066 ) (11,031 ) (29,769 ) (21,622 ) Consolidated operating income 438,192 391,196 848,878 1,267,124 Debt expense (119,692 ) (107,934 ) (233,208 ) (212,331 ) Other income, net 1,994 4,798 6,576 8,784 Consolidated income from continuing operations before $ 320,494 $ 288,060 $ 622,246 $ 1,063,577 (1) Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment. Depreciation and amortization expense by reportable segment was as follows: Three months ended June 30, Six months ended June 30, 2018 2017 2018 2017 U.S. dialysis and related lab services $ 138,252 $ 130,001 $ 273,028 $ 255,030 Other — Ancillary services and strategic initiatives 8,827 10,025 16,850 17,880 $ 147,079 $ 140,026 $ 289,878 $ 272,910 Assets by reportable segment were as follows: June 30, 2018 December 31, 2017 Segment assets U.S. dialysis and related lab services (including equity $ 11,989,864 $ 11,776,042 Other—Ancillary services and strategic initiatives (including 1,392,619 1,410,509 DMG—Held for sale (including equity investments of $5,099 and 6,053,081 5,761,642 Consolidated assets $ 19,435,564 $ 18,948,193 Expenditures for property and equipment by reportable segment were as follows: Three months ended Six months ended 2018 2017 2018 2017 U.S. dialysis and related lab services $ 194,188 $ 152,233 $ 383,238 $ 325,761 Other—Ancillary services and strategic initiatives 25,047 11,289 37,392 24,508 DMG—Held for sale 22,299 20,883 53,347 48,671 $ 241,534 $ 184,405 $ 473,977 $ 398,940 |
Changes in DaVita Inc.'s owners
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries | 6 Months Ended |
Jun. 30, 2018 | |
Noncontrolling Interest [Abstract] | |
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries | Changes in DaVita Inc.’s ownership interest in consolidated subsidiaries The effects of changes in DaVita Inc.’s ownership interest in consolidated subsidiaries on the Company’s equity were as follows: Three months ended June 30, Six months ended June 30, 2018 2017 2018 2017 Net income attributable to DaVita Inc. $ 267,276 $ 127,001 $ 445,962 $ 574,698 Changes in paid-in capital for: Sales of noncontrolling interests 3 — 79 — Purchases of noncontrolling interests (10,203 ) 618 (12,197 ) 195 Net transfers to noncontrolling interests (10,200 ) 618 (12,118 ) 195 Net income attributable to DaVita Inc., net of transfers to $ 257,076 $ 127,619 $ 433,844 $ 574,893 |
New accounting standards
New accounting standards | 6 Months Ended |
Jun. 30, 2018 | |
Accounting Changes and Error Corrections [Abstract] | |
New accounting standards | New accounting standards On May 28, 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. In 2015, 2016 and 2017, the FASB issued ASU 2015-14, ASU 2016-08, ASU 2016-10, ASU 2016-11, ASU 2016-12, and ASU 2017-10, each of which amends the guidance in ASU 2014-09. These ASUs replaced most existing revenue recognition guidance in GAAP. The Company adopted these ASUs beginning January 1, 2018. See Note 2 for further details. In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities . In February 2018, the FASB issued ASU 2018-03, which provides various related technical corrections and improvements. The Company adopted these ASUs beginning January 1, 2018. See Note 5 for further details. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in this ASU revise the accounting related to lessee accounting. Under the new guidance, lessees will be required to recognize a lease liability and a right-of-use asset for substantially all leases with lease terms in excess of twelve months. The new lease guidance also simplifies the accounting for sale and leaseback transactions primarily because lessees must recognize lease assets and lease liabilities. In July 2018, the FASB issued ASU No. 2018-10, Codification Amendments to Topic 842, and ASU No. 2018-11, which include targeted improvements to the guidance issued in ASU 2016-02. The amendments in these ASUs are effective for the Company beginning on January 1, 2019 and are to be applied through a modified retrospective transition approach for leases existing at, or entered into after, either at the beginning of the earliest comparative period presented in the financial statements or at the adoption date with a cumulative effect adjustment. Early adoption is permitted. The Company has assembled an internal cross-functional lease task force that meets regularly to discuss and evaluate the current lease portfolio and related systems, processes, controls and policy changes necessary. The Company has made progress in gathering the necessary data elements for the lease population and a system provider has been selected, with system configuration and implementation underway. The Company is currently evaluating the impact of the new guidance on its consolidated financial statements and believes it will have a material impact on its consolidated balance sheet but will not have a material impact on its results of operations or liquidity. The Company expects to adopt this ASU on January 1, 2019 and is currently planning on electing the package of practical expedients to not reassess prior conclusions related to contracts containing leases, lease classification and initial direct costs. The Company continues to evaluate the transition options and other practical expedients available under the guidance as well as the effect that the implementation of this guidance will have on its consolidated financial statements, related disclosures and controls, and ongoing business policies and processes. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments . The amendments in this ASU clarify how certain cash receipts and cash payments should be classified on the statement of cash flows. In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted cash. The amendments in this ASU require that the statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted cash equivalents. The adoption of these ASUs did not have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2018. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory . The amendments in this ASU allow entities to recognize the income tax consequences of an intra-entity transfer of an asset other than inventory when the transfer occurs. The current guidance does not allow recognition until the asset has been sold to an outside party. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied on a modified retrospective basis. The adoption of this ASU did not have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2018. In August 2017, the FASB issued ASU No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities. The amendments in this ASU better align an entity’s risk management activities and financial reporting for hedging relationships through changes to both the designation and measurement guidance for qualifying hedging relationships and the presentation of hedge results. The amendments in the new ASU are effective for the Company on January 1, 2019 and are to be applied prospectively. The adoption of this ASU is not expected to have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2019. In February 2018, the FASB issued ASU No. 2018-02, Income Statement - Reporting Comprehensive Income (Topic 220), Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income , which allows for the reclassification of certain income tax effects related to the Tax Cuts and Jobs Act between “Accumulated other comprehensive income” and “Retained earnings.” This ASU relates to the requirement that adjustments to deferred tax liabilities and assets related to a change in tax laws or rates to be included in “Income from continuing operations”, even in situations where the related items were originally recognized in “Other comprehensive income” (rather than in “Income from continuing operations”). The amendments in this ASU are effective for all entities for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. The Company elected to early adopt this ASU on January 1, 2018 and applied the change in the period of adoption. The adoption of this ASU resulted in the reclassification of an immaterial amount of deferred tax effects from accumulated other comprehensive income to retained earnings via a cumulative change in accounting principle effective January 1, 2018. See Note 14 for more details. |
Condensed consolidating financi
Condensed consolidating financial statements | 6 Months Ended |
Jun. 30, 2018 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Condensed consolidating financial statements | Condensed consolidating financial statements The following information is presented in accordance with Rule 3-10 of Regulation S-X. The operating and investing activities of the separate legal entities included in the Company’s condensed consolidated financial statements are fully interdependent and integrated. Revenues and operating expenses of the separate legal entities include intercompany charges for management and other administrative services. The Company’s senior notes are guaranteed by a substantial majority of its domestic subsidiaries as measured by revenue, income and assets. The subsidiary guarantors have guaranteed the senior notes on a joint and several basis. However, a subsidiary guarantor will be released from its obligations under its guarantee of the senior notes and the indentures governing the senior notes if, in general, there is a sale or other disposition of all or substantially all of the assets of such subsidiary guarantor, including by merger or consolidation, or a sale or other disposition of all of the equity interests in such subsidiary guarantor held by the Company and its restricted subsidiaries, as defined in the indentures; such subsidiary guarantor is designated by the Company as an unrestricted subsidiary, as defined in the indentures, or otherwise ceases to be a restricted subsidiary of the Company, in each case in accordance with the indentures; or such subsidiary guarantor no longer guarantees any other indebtedness, as defined in the indentures, of the Company or any of its restricted subsidiaries, except for guarantees that are contemporaneously released. The senior notes are not guaranteed by certain of the Company’s domestic subsidiaries, any of the Company’s foreign subsidiaries, or any entities that do not constitute subsidiaries within the meaning of the indentures, such as corporations in which the Company holds capital stock with less than a majority of the voting power, joint ventures and partnerships in which the Company holds less than a majority of the equity or voting interests, non-owned entities and third parties. Condensed Consolidating Statements of Operations DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended June 30, 2018 Patient services revenues $ — $ 1,831,545 $ 936,646 $ (49,788 ) $ 2,718,403 Provision for uncollectible accounts — (27,159 ) (22,247 ) — (49,406 ) Net patient service revenues — 1,804,386 914,399 (49,788 ) 2,668,997 Other revenues 205,317 214,266 43,137 (244,764 ) 217,956 Total net revenues 205,317 2,018,652 957,536 (294,552 ) 2,886,953 Operating expenses and charges 145,649 1,850,377 747,287 (294,552 ) 2,448,761 Operating income 59,668 168,275 210,249 — 438,192 Debt expense (120,814 ) (52,363 ) (9,274 ) 62,759 (119,692 ) Other income, net 105,344 2,856 4,440 (110,646 ) 1,994 Income tax expense 13,257 40,019 30,592 — 83,868 Equity earnings in subsidiaries 236,335 192,356 — (428,691 ) — Net income from continuing operations 267,276 271,105 174,823 (476,578 ) 236,626 Net (loss) income from discontinued operations, net of — (34,770 ) 56,579 47,887 69,696 Net income 267,276 236,335 231,402 (428,691 ) 306,322 Less: Net income attributable to noncontrolling interests — — — (39,046 ) (39,046 ) Net income attributable to DaVita Inc. $ 267,276 $ 236,335 $ 231,402 $ (467,737 ) $ 267,276 Guarantor Non- Consolidating Consolidated For The Three Months Ended June 30, 2017 DaVita Inc. Patient service revenues $ — $ 1,654,430 $ 879,780 $ (39,601 ) $ 2,494,609 Provision for uncollectible accounts — (72,845 ) (36,755 ) — (109,600 ) Net patient service revenues — 1,581,585 843,025 (39,601 ) 2,385,009 Other revenues 193,585 305,319 15,835 (200,349 ) 314,390 Total net revenues 193,585 1,886,904 858,860 (239,950 ) 2,699,399 Operating expenses 138,104 1,682,483 727,566 (239,950 ) 2,308,203 Operating income 55,481 204,421 131,294 — 391,196 Debt expense (106,159 ) (48,117 ) (13,038 ) 59,380 (107,934 ) Other income 102,299 1,369 5,997 (104,867 ) 4,798 Income tax expense 20,528 71,299 10,088 — 101,915 Equity earnings in subsidiaries 95,908 85,549 — (181,457 ) — Net income from continuing operations 127,001 171,923 114,165 (226,944 ) 186,145 Net (loss) income from discontinued operations, net of — (76,015 ) 6,008 45,487 (24,520 ) Net income 127,001 95,908 120,173 (181,457 ) 161,625 Less: Net income attributable to noncontrolling interests — — — (34,624 ) (34,624 ) Net income attributable to DaVita Inc. $ 127,001 $ 95,908 $ 120,173 $ (216,081 ) $ 127,001 DaVita Inc. Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2018 Patient service revenues $ — $ 3,621,733 $ 1,785,047 $ (97,303 ) $ 5,309,477 Provision for uncollectible accounts — (17,531 ) (6,330 ) — (23,861 ) Net patient service revenues — 3,604,202 1,778,717 (97,303 ) 5,285,616 Other revenues 400,882 419,226 114,070 (483,397 ) 450,781 Total net revenues 400,882 4,023,428 1,892,787 (580,700 ) 5,736,397 Operating expenses 279,005 3,641,471 1,547,743 (580,700 ) 4,887,519 Operating income 121,877 381,957 345,044 — 848,878 Debt expense (235,148 ) (104,560 ) (16,649 ) 123,149 (233,208 ) Other income 209,425 5,379 10,144 (218,372 ) 6,576 Income tax expense 27,644 88,962 37,999 — 154,605 Equity earnings in subsidiaries 377,452 258,851 — (636,303 ) — Net income from continuing operations 445,962 452,665 300,540 (731,526 ) 467,641 Net (loss) income from discontinued operations, net of — (75,213 ) 43,900 95,223 63,910 Net income 445,962 377,452 344,440 (636,303 ) 531,551 Less: Net income attributable to noncontrolling interests — — — (85,589 ) (85,589 ) Net income attributable to DaVita Inc. $ 445,962 $ 377,452 $ 344,440 $ (721,892 ) $ 445,962 DaVita Inc. Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2017 Patient service revenues $ — $ 3,185,156 $ 1,809,011 $ (76,772 ) $ 4,917,395 Provision for uncollectible accounts — (133,898 ) (82,760 ) — (216,658 ) Net patient service revenues — 3,051,258 1,726,251 (76,772 ) 4,700,737 Other revenues 414,971 610,937 31,925 (427,920 ) 629,913 Total net revenues 414,971 3,662,195 1,758,176 (504,692 ) 5,330,650 Operating expenses 270,014 2,891,303 1,406,901 (504,692 ) 4,063,526 Operating income 144,957 770,892 351,275 — 1,267,124 Debt expense (208,823 ) (95,760 ) (25,270 ) 117,522 (212,331 ) Other income 202,636 4,172 9,583 (207,607 ) 8,784 Income tax expense 54,481 307,165 21,934 — 383,580 Equity earnings in subsidiaries 490,409 248,165 — (738,574 ) — Net income from continuing operations 574,698 620,304 313,654 (828,659 ) 679,997 Net (loss) income from discontinued operations, net of — (129,895 ) 21,723 90,085 (18,087 ) Net income 574,698 490,409 335,377 (738,574 ) 661,910 Less: Net income attributable to noncontrolling interests — — — (87,212 ) (87,212 ) Net income attributable to DaVita Inc. $ 574,698 $ 490,409 $ 335,377 $ (825,786 ) $ 574,698 Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended June 30, 2018 DaVita Inc. Net income $ 267,276 $ 236,335 $ 231,402 $ (428,691 ) $ 306,322 Other comprehensive income (loss) 1,269 — (50,529 ) — (49,260 ) Total comprehensive income 268,545 236,335 180,873 (428,691 ) 257,062 Less: Comprehensive income attributable to — — — (39,046 ) (39,046 ) Comprehensive income attributable to DaVita Inc. $ 268,545 $ 236,335 $ 180,873 $ (467,737 ) $ 218,016 Guarantor Non- Consolidating Consolidated For The Three Months Ended June 30, 2017 DaVita Inc. Net income $ 127,001 $ 95,908 $ 120,173 $ (181,457 ) $ 161,625 Other comprehensive income 436 — 49,142 — 49,578 Total comprehensive income 127,437 95,908 169,315 (181,457 ) 211,203 Less: Comprehensive income attributable to the — — — (34,624 ) (34,624 ) Comprehensive income attributable to DaVita Inc. $ 127,437 $ 95,908 $ 169,315 $ (216,081 ) $ 176,579 Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2018 DaVita Inc. Net income $ 445,962 $ 377,452 $ 344,440 $ (636,303 ) $ 531,551 Other comprehensive income (loss) 3,856 — (30,648 ) — (26,792 ) Total comprehensive income 449,818 377,452 313,792 (636,303 ) 504,759 Less: Comprehensive income attributable to — — — (85,589 ) (85,589 ) Comprehensive income attributable to DaVita Inc. $ 449,818 $ 377,452 $ 313,792 $ (721,892 ) $ 419,170 Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2017 DaVita Inc. Net income $ 574,698 $ 490,409 $ 335,377 $ (738,574 ) $ 661,910 Other comprehensive (loss) income (70 ) — 62,403 — 62,333 Total comprehensive income 574,628 490,409 397,780 (738,574 ) 724,243 Less: Comprehensive income attributable to the — — — (87,210 ) (87,210 ) Comprehensive income attributable to DaVita Inc. $ 574,628 $ 490,409 $ 397,780 $ (825,784 ) $ 637,033 Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of June 30, 2018 DaVita Inc. Cash and cash equivalents $ 193,991 $ — $ 195,273 $ — $ 389,264 Restricted cash and equivalents 1,004 11,367 78,513 — 90,884 Accounts receivable, net — 1,274,067 568,041 — 1,842,108 Other current assets 37,185 547,928 124,912 — 710,025 Current assets held for sale — 5,101,853 951,228 — 6,053,081 Total current assets 232,180 6,935,215 1,917,967 — 9,085,362 Property and equipment, net 441,159 1,553,931 1,234,008 — 3,229,098 Intangible assets, net 199 46,491 53,565 — 100,255 Investments in subsidiaries 10,304,847 3,163,787 — (13,468,634 ) — Intercompany receivables 3,579,186 — 1,386,117 (4,965,303 ) — Other long-term assets and investments 54,077 68,922 219,291 — 342,290 Goodwill — 4,767,041 1,911,518 — 6,678,559 Total assets $ 14,611,648 $ 16,535,387 $ 6,722,466 $ (18,433,937 ) $ 19,435,564 Current liabilities $ 1,831,526 $ 1,219,455 $ 461,433 $ — $ 3,512,414 Current liabilities held for sale — 734,745 536,619 — 1,271,364 Intercompany payables — 3,548,086 1,417,217 (4,965,303 ) — Long-term debt and other long-term liabilities 7,897,430 728,254 494,437 — 9,120,121 Noncontrolling interests subject to put provisions 603,508 — — 443,650 1,047,158 Total DaVita Inc. shareholders' equity 4,279,184 10,304,847 3,163,787 (13,468,634 ) 4,279,184 Noncontrolling interests not subject to put — — 648,973 (443,650 ) 205,323 Total equity 4,279,184 10,304,847 3,812,760 (13,912,284 ) 4,484,507 Total liabilities and equity $ 14,611,648 $ 16,535,387 $ 6,722,466 $ (18,433,937 ) $ 19,435,564 Guarantor Non- Consolidating Consolidated As of December 31, 2017 DaVita Inc. Cash and cash equivalents $ 149,305 $ — $ 358,929 $ — $ 508,234 Restricted cash and equivalents 1,002 9,384 300 — 10,686 Accounts receivable, net — 1,208,715 506,035 — 1,714,750 Other current assets 67,025 595,066 86,955 — 749,046 Current assets held for sale — 4,992,067 769,575 — 5,761,642 Total current assets 217,332 6,805,232 1,721,794 — 8,744,358 Property and equipment, net 408,010 1,560,390 1,180,813 — 3,149,213 Intangible assets, net 250 50,971 62,606 — 113,827 Investments in subsidiaries 10,009,874 3,085,722 — (13,095,596 ) — Intercompany receivables 3,677,947 — 1,313,213 (4,991,160 ) — Other long-term assets and investments 47,297 68,344 214,875 — 330,516 Goodwill — 4,732,320 1,877,959 — 6,610,279 Total assets $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Current liabilities $ 238,706 $ 1,181,139 $ 436,262 $ — $ 1,856,107 Current liabilities held for sale — 739,294 445,776 — 1,185,070 Intercompany payables — 3,690,042 1,301,118 (4,991,160 ) — Long-term debt and other long-term liabilities 8,857,373 682,630 469,587 — 10,009,590 Noncontrolling interests subject to put provisions 574,602 — — 436,758 1,011,360 Total DaVita Inc. shareholders' equity 4,690,029 10,009,874 3,085,722 (13,095,596 ) 4,690,029 Noncontrolling interests not subject to put — — 632,795 (436,758 ) 196,037 Total equity 4,690,029 10,009,874 3,718,517 (13,532,354 ) 4,886,066 Total liabilities and equity $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2018 DaVita Inc. Cash flows from operating activities: Net income $ 445,962 $ 377,452 $ 344,440 $ (636,303 ) $ 531,551 Changes in operating assets and liabilities and non-cash (361,991 ) 26,502 92,210 636,303 393,024 Net cash provided by operating activities 83,971 403,954 436,650 — 924,575 Cash flows from investing activities: Additions of property and equipment (77,169 ) (258,471 ) (138,337 ) — (473,977 ) Acquisitions — (8,195 ) (81,270 ) — (89,465 ) Proceeds from asset and business sales — 28,546 87,695 — 116,241 Proceeds (purchases) from investment sales and other 32,415 (8,257 ) (1,021 ) — 23,137 Net cash used in investing activities (44,754 ) (246,377 ) (132,933 ) — (424,064 ) Cash flows from financing activities: Long-term debt and related financing costs, net 584,500 (5,429 ) (5,090 ) — 573,981 Intercompany borrowing (payments) 225,216 (130,553 ) (94,663 ) — — Other items (804,245 ) (13,208 ) (62,437 ) — (879,890 ) Net cash provided by (used in) financing activities 5,471 (149,190 ) (162,190 ) — (305,909 ) Effect of exchange rate changes on cash, cash — — (3,473 ) — (3,473 ) Net increase in cash, cash equivalents and 44,688 8,387 138,054 — 191,129 Less: Net increase in cash, cash equivalents and — 6,404 223,497 — 229,901 Net increase (decrease) in cash, cash equivalents and 44,688 1,983 (85,443 ) — (38,772 ) Cash, cash equivalents and restricted cash of continuing 150,307 9,384 359,229 — 518,920 Cash, cash equivalents and restricted cash of continuing $ 194,995 $ 11,367 $ 273,786 $ — $ 480,148 Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 574,698 $ 490,409 $ 335,377 $ (738,574 ) $ 661,910 Changes in operating assets and liabilities and non-cash (429,399 ) 37,851 6,121 738,574 353,147 Net cash provided by operating activities 145,299 528,260 341,498 — 1,015,057 Cash flows from investing activities: Additions of property and equipment (50,966 ) (182,494 ) (165,480 ) — (398,940 ) Acquisitions — (538,450 ) (81,389 ) — (619,839 ) Proceeds from asset and business sales, net of cash — 70,127 109 — 70,236 Proceeds (purchases) from investment sales and other 49,036 (2,933 ) 50,833 — 96,936 Net cash used in investing activities (1,930 ) (653,750 ) (195,927 ) — (851,607 ) Cash flows from financing activities: Long-term debt and related financing costs, net (54,992 ) (6,893 ) (2,147 ) — (64,032 ) Intercompany (payments) borrowing (39,814 ) 117,661 (77,847 ) — — Other items (223,511 ) (1,432 ) (76,203 ) — (301,146 ) Net cash (used in) provided by financing activities (318,317 ) 109,336 (156,197 ) — (365,178 ) Effect of exchange rate changes on cash, cash — — 4,192 — 4,192 Net decrease in cash, cash equivalents and restricted cash (174,948 ) (16,154 ) (6,434 ) — (197,536 ) Less: Net (decrease) increase in cash, cash equivalents — (16,194 ) 48,914 — 32,720 Net (decrease) increase in cash, cash equivalents and (174,948 ) 40 (55,348 ) — (230,256 ) Cash, cash equivalents and restricted cash of continuing 549,921 8,687 124,855 — 683,463 Cash, cash equivalents and restricted cash of continuing $ 374,973 $ 8,727 $ 69,507 $ — $ 453,207 |
Supplemental data
Supplemental data | 6 Months Ended |
Jun. 30, 2018 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Supplemental data | Supplemental data The following information is presented as supplemental data as required by the indentures governing the Company’s senior notes. Condensed Consolidating Statements of Income Consolidated Total Physician Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Six Months Ended June 30, 2018 Patient service operating revenues $ 5,309,477 $ — $ — $ 5,309,477 Provision for uncollectible accounts (23,861 ) — — (23,861 ) Net patient service operating revenues 5,285,616 — — 5,285,616 Other revenues 450,781 — — 450,781 Total net operating revenues 5,736,397 — — 5,736,397 Operating expenses 4,887,519 — — 4,887,519 Operating income 848,878 — — 848,878 Debt expense, including refinancing charges (233,208 ) — — (233,208 ) Other income 6,576 — — 6,576 Income tax expense 154,605 — — 154,605 Net income from continuing operations 467,641 — — 467,641 Net income from discontinued operations, net of tax 63,910 16,466 323 47,121 Net income 531,551 16,466 323 514,762 Less: Net income attributable to noncontrolling interests (85,589 ) (8,544 ) — (77,045 ) Net income attributable to DaVita Inc. $ 445,962 $ 7,922 $ 323 $ 437,717 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Six Months Ended June 30, 2018 Net income $ 531,551 $ 16,466 $ 323 $ 514,762 Other comprehensive loss (26,792 ) — — (26,792 ) Total comprehensive income 504,759 16,466 323 487,970 Less: Comprehensive income attributable to the noncontrolling (85,589 ) (8,544 ) — (77,045 ) Comprehensive income attributable to DaVita Inc. $ 419,170 $ 7,922 $ 323 $ 410,925 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of June 30, 2018 Cash and cash equivalents $ 389,264 $ — $ — $ 389,264 Restricted cash and equivalents 90,884 — — 90,884 Accounts receivable, net 1,842,108 — — 1,842,108 Other current assets 710,025 — — 710,025 Current assets held for sale 6,053,081 524,595 3,056 5,525,430 Total current assets 9,085,362 524,595 3,056 8,557,711 Property and equipment, net 3,229,098 — — 3,229,098 Amortizable intangibles, net 100,255 — — 100,255 Other long-term assets 342,290 — — 342,290 Goodwill 6,678,559 — — 6,678,559 Total assets $ 19,435,564 $ 524,595 $ 3,056 $ 18,907,913 Current liabilities $ 3,512,414 $ — $ — $ 3,512,414 Current liabilities held for sale 1,271,364 334,091 — 937,273 Payables to parent — 56,761 3,056 (59,817 ) Long-term debt and other long-term liabilities 9,120,121 — — 9,120,121 Noncontrolling interests subject to put provisions 1,047,158 — — 1,047,158 Total DaVita Inc. shareholders’ equity 4,279,184 133,743 — 4,145,441 Noncontrolling interests not subject to put provisions 205,323 — — 205,323 Shareholders’ equity 4,484,507 133,743 — 4,350,764 Total liabilities and shareholder’s equity $ 19,435,564 $ 524,595 $ 3,056 $ 18,907,913 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Six Months Ended June 30, 2018 Cash flows from operating activities: Net income $ 531,551 $ 16,466 $ 323 $ 514,762 Changes in operating and intercompany assets and liabilities and 393,024 101,201 (323 ) 292,146 Net cash provided by (used in) operating activities 924,575 117,667 — 806,908 Cash flows from investing activities: Additions of property and equipment (473,977 ) (2,097 ) — (471,880 ) Acquisitions (89,465 ) — — (89,465 ) Proceeds from asset and business sales 116,241 — — 116,241 Investments and other items 23,137 (1,021 ) — 24,158 Net cash used in investing activities (424,064 ) (3,118 ) — (420,946 ) Cash flows from financing activities: Long-term debt 573,981 — — 573,981 Intercompany — 57,783 — (57,783 ) Other items (879,890 ) — — (879,890 ) Net cash (used in) provided by financing activities (305,909 ) 57,783 — (363,692 ) Effect of exchange rate changes on cash, cash equivalents and (3,473 ) — — (3,473 ) Net increase in cash, cash equivalents and restricted cash 191,129 172,332 — 18,797 Less: Net increase in cash, cash equivalents and 229,901 172,332 — 57,569 Net decrease in cash, cash equivalents and restricted cash from (38,772 ) — — (38,772 ) Cash, cash equivalents and restricted cash of continuing operations 518,920 — — 518,920 Cash, cash equivalents and restricted cash of continuing operations $ 480,148 $ — $ — $ 480,148 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed consolidated interi31
Condensed consolidated interim financial statements Condensed consolidaed interim financial statements (Policies) | 6 Months Ended |
Jun. 30, 2018 | |
Accounting Policies [Abstract] | |
Condensed consolidated interim financial statements | The condensed consolidated interim financial statements included in this report are prepared by the Company without audit. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these condensed consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and investments, accounting for income taxes, long-term variable compensation accruals, consolidation of variable interest entities and certain fair value estimates. The results of operations for the six months ended June 30, 2018 are not necessarily indicative of the operating results for the full year. The condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 . Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these condensed consolidated financial statements were issued and has included all necessary adjustments and disclosures. |
Earnings Per Share | Basic earnings per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interest redemption rights in excess of fair value, by the weighted average number of common shares, net of shares held in escrow that under certain circumstances may be returned to the Company. Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights (SSARs) and unvested stock units (under the treasury stock method) as well as shares held in escrow that the Company expects will remain outstanding. |
Short-term and Long-term Investments | From January 1, 2018, equity securities that have readily determinable fair values or redemption values are recorded at estimated fair value with changes in their value recognized in current earnings. The Company classifies its debt securities as held-to-maturity and records them at amortized cost based on its intentions and strategy concerning those investments. The Company classifies these debt and equity investments as "Short-term investments" or "Long-term investments" on its consolidated balance sheet, as applicable, based on the characteristics of the financial instrument or the Company's intentions or expectations for the investment. |
Income Taxes | The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. |
Long-term debt | the Company maintains several active and forward interest rate cap agreements that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt, as described below. The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the terms of the cap agreements. The cap agreements do not contain credit-risk contingent features. |
Noncontrolling interest subject to put provisions and other commitments | The Company has potential obligations to purchase the equity interests held by third parties in several of its majority-owned joint ventures and other nonconsolidated entities. These obligations are in the form of put provisions that are exercisable at the third-party owners’ discretion within specified periods as outlined in each specific put provision. If these put provisions were exercised, the Company would be required to purchase the third-party owners’ equity interests at either the appraised fair market value or a predetermined multiple of earnings or cash flows attributable to the equity interests put to the Company, which is intended to approximate fair value. The methodology the Company uses to estimate the fair values of noncontrolling interests subject to put provisions assumes the higher of either a liquidation value of net assets or an average multiple of earnings, based on historical earnings, patient mix and other performance indicators that can affect future results, as well as other factors. The estimated fair values of noncontrolling interests subject to put provisions are a critical accounting estimate that involves significant judgments and assumptions and may not be indicative of the actual values at which the noncontrolling interests may ultimately be settled, which could vary significantly from the Company’s current estimates. The estimated fair values of noncontrolling interests subject to put provisions can fluctuate and the implicit multiple of earnings at which these noncontrolling interests obligations may be settled will vary significantly depending upon market conditions including potential purchasers’ access to the capital markets, which can impact the level of competition for dialysis and non-dialysis related businesses, the economic performance of these businesses and the restricted marketability of the third-party owners’ equity interests. The amount of noncontrolling interests subject to put provisions that employ a contractually predetermined multiple of earnings rather than fair value are immaterial. |
Long-term incentive compensation | The Company’s stock-based compensation awards are measured at their estimated fair values on the date of grant if settled in shares or at their estimated fair values at the end of each reporting period if settled in cash. The value of stock-based awards so measured is recognized as compensation expense on a cumulative straight-line basis over the vesting terms of the awards, adjusted for expected forfeitures. |
Comprehensive Income | Net realized losses on interest rate cap agreements that are reclassified into income are recorded as debt expense in the corresponding consolidated statements of operations. See Note 9 to these condensed consolidated financial statements for further details. Net realized gains on investment securities reclassified into income for the six months ended June 30, 2017 were recognized in other income in the corresponding consolidated statements of operations. See Note 5 to these condensed consolidated financial statements for further details. |
Variable Interest Entities | The Company relies on the operating activities of certain legal entities that it does not directly own or control, but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are subject to the consolidation guidance applicable to variable interest entities (VIEs). Under U.S. generally accepted accounting principles (GAAP), VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. The Company has determined that substantially all of the legal entities it is associated with that qualify as VIEs must be included in its consolidated financial statements. A number of these VIEs are within the Company's DMG business, which is classified as held for sale and as a discontinued operation in these condensed consolidated financial statements. The Company manages these entities and provides operating and capital funding as necessary for these entities to accomplish their operational and strategic objectives. A number of these entities are subject to nominee share ownership or share transfer restriction agreements that effectively transfer the majority of the economic risks and rewards of their ownership to the Company. In other cases the Company’s management agreements with these entities include both financial terms and protective and participating rights to the entities’ operating, strategic and non-clinical governance decisions which transfer substantial powers over and economic responsibility for the entities to the Company. In some cases such entities are subject to broad exclusivity or noncompetition restrictions that benefit the Company. Further, in some cases the Company has contractual arrangements with its related party nominee owners that effectively indemnify these parties from the economic losses from, or entitle the Company to the economic benefits of, these entities. The analyses upon which these consolidation determinations rest are complex, involve uncertainties, and require significant judgment on various matters, some of which could be subject to different interpretations. |
Fair Value of Financial Instruments | Investments in mutual funds and common stock represent equity securities that are recorded at estimated fair value based upon quoted redemption prices reported by each mutual fund. See Note 5 to these condensed consolidated financial statements for further discussion. Interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 9 to these condensed consolidated financial statements for further discussion. The estimated fair value of contingent earn-out obligations are primarily based on unobservable inputs including projected EBITDA. The estimated fair value of these contingent earn-out obligations is remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company credit risk-adjusted rate that is used to discount the obligations to present value. |
New Accounting Standards | On May 28, 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. In 2015, 2016 and 2017, the FASB issued ASU 2015-14, ASU 2016-08, ASU 2016-10, ASU 2016-11, ASU 2016-12, and ASU 2017-10, each of which amends the guidance in ASU 2014-09. These ASUs replaced most existing revenue recognition guidance in GAAP. The Company adopted these ASUs beginning January 1, 2018. See Note 2 for further details. In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities . In February 2018, the FASB issued ASU 2018-03, which provides various related technical corrections and improvements. The Company adopted these ASUs beginning January 1, 2018. See Note 5 for further details. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in this ASU revise the accounting related to lessee accounting. Under the new guidance, lessees will be required to recognize a lease liability and a right-of-use asset for substantially all leases with lease terms in excess of twelve months. The new lease guidance also simplifies the accounting for sale and leaseback transactions primarily because lessees must recognize lease assets and lease liabilities. In July 2018, the FASB issued ASU No. 2018-10, Codification Amendments to Topic 842, and ASU No. 2018-11, which include targeted improvements to the guidance issued in ASU 2016-02. The amendments in these ASUs are effective for the Company beginning on January 1, 2019 and are to be applied through a modified retrospective transition approach for leases existing at, or entered into after, either at the beginning of the earliest comparative period presented in the financial statements or at the adoption date with a cumulative effect adjustment. Early adoption is permitted. The Company has assembled an internal cross-functional lease task force that meets regularly to discuss and evaluate the current lease portfolio and related systems, processes, controls and policy changes necessary. The Company has made progress in gathering the necessary data elements for the lease population and a system provider has been selected, with system configuration and implementation underway. The Company is currently evaluating the impact of the new guidance on its consolidated financial statements and believes it will have a material impact on its consolidated balance sheet but will not have a material impact on its results of operations or liquidity. The Company expects to adopt this ASU on January 1, 2019 and is currently planning on electing the package of practical expedients to not reassess prior conclusions related to contracts containing leases, lease classification and initial direct costs. The Company continues to evaluate the transition options and other practical expedients available under the guidance as well as the effect that the implementation of this guidance will have on its consolidated financial statements, related disclosures and controls, and ongoing business policies and processes. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments . The amendments in this ASU clarify how certain cash receipts and cash payments should be classified on the statement of cash flows. In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted cash. The amendments in this ASU require that the statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted cash equivalents. The adoption of these ASUs did not have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2018. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory . The amendments in this ASU allow entities to recognize the income tax consequences of an intra-entity transfer of an asset other than inventory when the transfer occurs. The current guidance does not allow recognition until the asset has been sold to an outside party. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied on a modified retrospective basis. The adoption of this ASU did not have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2018. In August 2017, the FASB issued ASU No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities. The amendments in this ASU better align an entity’s risk management activities and financial reporting for hedging relationships through changes to both the designation and measurement guidance for qualifying hedging relationships and the presentation of hedge results. The amendments in the new ASU are effective for the Company on January 1, 2019 and are to be applied prospectively. The adoption of this ASU is not expected to have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2019. In February 2018, the FASB issued ASU No. 2018-02, Income Statement - Reporting Comprehensive Income (Topic 220), Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income , which allows for the reclassification of certain income tax effects related to the Tax Cuts and Jobs Act between “Accumulated other comprehensive income” and “Retained earnings.” This ASU relates to the requirement that adjustments to deferred tax liabilities and assets related to a change in tax laws or rates to be included in “Income from continuing operations”, even in situations where the related items were originally recognized in “Other comprehensive income” (rather than in “Income from continuing operations”). The amendments in this ASU are effective for all entities for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. The Company elected to early adopt this ASU on January 1, 2018 and applied the change in the period of adoption. The adoption of this ASU resulted in the reclassification of an immaterial amount of deferred tax effects from accumulated other comprehensive income to retained earnings via a cumulative change in accounting principle effective January 1, 2018. See Note 14 for more details. |
Revenue Recognition Segment rev
Revenue Recognition Segment revenue by major payor (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Revenues by major payor [Abstract] | |
Schedule of Revenue Sources, Health Care Organization [Table Text Block] | The following table summarizes the Company's segment revenues by primary payor source: For the three months ended June 30, 2018 June 30, 2017 (1) U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated Patient service revenues: Medicare and Medicare Advantage $ 1,526,066 $ $ 1,526,066 $ 1,313,504 $ $ 1,313,504 Medicaid and Managed Medicaid 150,288 150,288 151,286 151,286 Other government 110,338 86,530 196,868 90,712 62,604 153,316 Commercial 796,732 19,139 815,871 764,864 15,324 780,188 Other revenues: Medicare and Medicare Advantage 154,028 154,028 225,511 225,511 Medicaid and Managed Medicaid 16,158 16,158 19,020 19,020 Commercial 17,006 17,006 26,812 26,812 Other (2) 4,919 35,034 39,953 4,849 44,322 49,171 Eliminations of intersegment revenues (20,096 ) (9,189 ) (29,285 ) (13,285 ) (6,124 ) (19,409 ) Total $ 2,568,247 $ 318,706 $ 2,886,953 $ 2,311,930 $ 387,469 $ 2,699,399 (1) As noted above, prior period amounts have not been adjusted under the cumulative effect method. The Company's dialysis and related lab services revenues for the three months ended June 30, 2017 has been presented net of the provision for uncollectible accounts of $109,600 in this table to conform to the current period presentation. (2) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives. For the six months ended June 30, 2018 June 30, 2017 (1) U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated Patient service revenues: Medicare and Medicare Advantage $ 3,011,258 $ $ 3,011,258 $ 2,586,100 $ $ 2,586,100 Medicaid and Managed Medicaid 307,783 307,783 295,871 295,871 Other government 217,458 169,068 386,526 182,704 110,366 293,070 Commercial 1,579,711 38,857 1,618,568 1,521,574 29,206 1,550,780 Other revenues: Medicare and Medicare Advantage 296,786 296,786 450,713 450,713 Medicaid and Managed Medicaid 31,949 31,949 37,615 37,615 Commercial 57,427 57,427 52,020 52,020 Other (2) 10,033 73,973 84,006 10,159 91,899 102,058 Eliminations of intersegment revenues (38,519 ) (19,387 ) (57,906 ) (25,084 ) (12,493 ) (37,577 ) Total $ 5,087,724 $ 648,673 $ 5,736,397 $ 4,571,324 $ 759,326 $ 5,330,650 (1) As noted above, prior period amounts have not been adjusted under the cumulative effect method. The Company's dialysis and related lab services revenues for the six months ended June 30, 2017 has been presented net of the provision for uncollectible accounts of $216,658 in this table to conform to the current period presentation. |
Earnings per share (Tables)
Earnings per share (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Earnings Per Share [Abstract] | |
Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Earnings Per Share | The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows: Three months ended June 30, Six months ended June 30, 2018 2017 2018 2017 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 199,603 $ 151,292 $ 390,618 $ 592,197 Change in noncontrolling interest redemption rights in excess of fair value (98 ) — (98 ) — Net income from continuing operations for basic earnings per share 199,505 151,292 390,520 592,197 Net income (loss) from discontinued operations attributable to DaVita Inc. 67,673 (24,291 ) 55,344 (17,499 ) Net income attributable to DaVita Inc. for basic earnings per share $ 267,178 $ 127,001 $ 445,864 $ 574,698 Basic: Weighted average shares outstanding during the period 173,811 193,282 177,461 193,923 Contingently returnable shares held in escrow for the DaVita HealthCare (2,194 ) (2,194 ) (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 171,617 191,088 175,267 191,729 Basic net income from continuing operations per share attributable to $ 1.16 $ 0.79 $ 2.23 $ 3.09 Basic net income (loss) from discontinued operations per share 0.40 (0.13 ) 0.31 (0.09 ) Basic net income per share attributable to DaVita Inc. $ 1.56 $ 0.66 $ 2.54 $ 3.00 Diluted: Weighted average shares outstanding during the period 173,811 193,282 177,461 193,923 Assumed incremental shares from stock plans 295 706 489 708 Weighted average shares for diluted earnings per share calculation 174,106 193,988 177,950 194,631 Diluted net income from continuing operations per share attributable to $ 1.15 $ 0.78 $ 2.19 $ 3.04 Diluted net income (loss) from discontinued operations per share 0.38 (0.13 ) 0.32 (0.09 ) Diluted net income per share attributable to DaVita Inc. $ 1.53 $ 0.65 $ 2.51 $ 2.95 Anti-dilutive stock-settled awards excluded from calculation (1) 6,227 3,780 4,840 3,603 (1) Shares associated with stock-settled stock appreciation rights excluded from the diluted denominator calculation because they are antidilutive under the treasury stock method. |
Investments in debt and equit34
Investments in debt and equity securities (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Investments, Debt and Equity Securities [Abstract] | |
Investments | The Company’s investments in these short-term and long-term debt and equity investments consist of the following: June 30, 2018 December 31, 2017 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 2,228 $ — $ 2,228 $ 31,630 $ — $ 31,630 Investments in mutual funds and common stock — 36,500 36,500 — 38,895 38,895 $ 2,228 $ 36,500 $ 38,728 $ 31,630 $ 38,895 $ 70,525 Short-term investments $ 2,228 $ 2,300 $ 4,528 $ 31,630 $ 1,200 $ 32,830 Long-term investments — 34,200 34,200 — 37,695 37,695 $ 2,228 $ 36,500 $ 38,728 $ 31,630 $ 38,895 $ 70,525 |
Goodwill (Tables)
Goodwill (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Changes in Goodwill by Reportable Segments | Changes in goodwill by reportable segment were as follows: U.S. dialysis and related lab services Other-ancillary services and strategic initiatives Consolidated total Balance at January 1, 2017 $ 5,691,587 $ 323,788 $ 6,015,375 Acquisitions 485,434 131,598 617,032 Divestitures (32,260 ) (126 ) (32,386 ) Goodwill impairment charges — (36,196 ) (36,196 ) Foreign currency and other adjustments — 46,454 46,454 Balance at December 31, 2017 $ 6,144,761 $ 465,518 $ 6,610,279 Acquisitions 6,357 99,863 106,220 Divestitures (218 ) (15,166 ) (15,384 ) Goodwill impairment charges — (3,106 ) (3,106 ) Foreign currency and other adjustments — (19,450 ) (19,450 ) Balance at June 30, 2018 $ 6,150,900 $ 527,659 $ 6,678,559 Balance at June 30, 2018: Goodwill $ 6,150,900 $ 561,937 $ 6,712,837 Accumulated impairment charges — (34,278 ) (34,278 ) $ 6,150,900 $ 527,659 $ 6,678,559 |
Long-term debt (Tables)
Long-term debt (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Debt Disclosure [Abstract] | |
Long-term Debt | Long-term debt was comprised of the following: June 30, 2018 December 31, 2017 Senior secured credit facilities: Term Loan A $ 725,000 $ 775,000 Term Loan A-2 952,000 — Term Loan B 3,360,000 3,377,500 Revolver — 300,000 Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 172,692 150,512 Capital lease obligations 292,296 297,170 Total debt principal outstanding 10,001,988 9,400,182 Discount and deferred financing costs (57,901 ) (63,951 ) 9,944,087 9,336,231 Less current portion (1,768,514 ) (178,213 ) $ 8,175,573 $ 9,158,018 |
Scheduled Maturities of Long-term Debt | Scheduled maturities of long-term debt at June 30, 2018 were as follows: 2018 (remainder of the year) 95,011 2019 1,712,246 2020 74,792 2021 3,311,046 2022 1,287,741 2023 162,580 Thereafter 3,358,572 |
Derivative Instruments | The following table summarizes the Company’s derivative instruments outstanding as of June 30, 2018 and December 31, 2017 : June 30, 2018 December 31, 2017 Derivatives designated as hedging instruments Balance sheet location Fair value Balance sheet location Fair value Interest rate cap agreements Other long-term assets $ 2,085 Other long-term assets $ 1,032 |
Effects of Interest Rate Swap and Cap Agreements | The following table summarizes the effects of the Company’s interest rate cap agreements for the three and six months ended June 30, 2018 and 2017 : Amount of unrecognized gains (losses) in OCI on interest rate cap agreements Location of losses reclassified from accumulated OCI into income Amount of losses reclassified from accumulated OCI into income Three months ended Six months ended Three months ended Six months ended Derivatives designated as cash flow hedges 2018 2017 2018 2017 2018 2017 2018 2017 Interest rate cap $ (361 ) $ (2,969 ) $ 1,053 $ (8,186 ) Debt expense $ 2,070 $ 2,070 $ 4,140 $ 4,139 Tax benefit 93 1,154 (271 ) 3,184 Tax expense (533 ) (805 ) (1,066 ) (1,610 ) Total $ (268 ) $ (1,815 ) $ 782 $ (5,002 ) $ 1,537 $ 1,265 $ 3,074 $ 2,529 |
Comprehensive income (Tables)
Comprehensive income (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | For the three months ended June 30, 2018 For the six months ended June 30, 2018 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (12,527 ) $ 39,862 $ 27,335 $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 Cumulative effect (1) — — — (2,706 ) (5,662 ) — (8,368 ) Unrealized (losses) (361 ) (50,529 ) (50,890 ) 1,053 — (30,648 ) (29,595 ) Related income tax 93 — 93 (271 ) — — (271 ) (268 ) (50,529 ) (50,797 ) 782 — (30,648 ) (29,866 ) Reclassification 2,070 — 2,070 4,140 — — 4,140 Related income tax (533 ) — (533 ) (1,066 ) — — (1,066 ) 1,537 — 1,537 3,074 — — 3,074 Ending balance $ (11,258 ) $ (10,667 ) $ (21,925 ) $ (11,258 ) $ — $ (10,667 ) $ (21,925 ) _________________ (1) Reflects the cumulative effect of a change in accounting principle for ASUs 2016-01 and 2018-03 on classification and measurement of financial instruments and ASU 2018-02 on remeasurement and reclassification of deferred tax effects in accumulated other comprehensive income associated with the 2017 Tax Act. For the three months ended June 30, 2017 For the six months ended June 30, 2017 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (13,952 ) $ 3,594 $ (66,528 ) $ (76,886 ) $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Unrealized (losses) (2,969 ) 1,446 49,142 47,619 (8,186 ) 3,428 62,403 57,645 Related income tax 1,154 (389 ) — 765 3,184 (812 ) — 2,372 (1,815 ) 1,057 49,142 48,384 (5,002 ) 2,616 62,403 60,017 Reclassification 2,070 (117 ) — 1,953 4,139 (346 ) — 3,793 Related income tax (805 ) 46 — (759 ) (1,610 ) 135 — (1,475 ) 1,265 (71 ) — 1,194 2,529 (211 ) — 2,318 Ending balance $ (14,502 ) $ 4,580 $ (17,386 ) $ (27,308 ) $ (14,502 ) $ 4,580 $ (17,386 ) $ (27,308 ) |
Acquisitions and divestitures (
Acquisitions and divestitures (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Business Acquisition [Line Items] | |
Reconciliation of Changes in Contingent Earn-Out Obligations | The following is a reconciliation of changes in liabilities for contingent earn-out obligations: For the six months ended June 30, 2018 Beginning balance $ 6,388 Contingent earn-out obligations associated with acquisitions 1,436 Remeasurement of fair value for contingent earn-out obligations (335 ) Ending balance $ 7,489 |
Dialysis and other businesses | |
Business Acquisition [Line Items] | |
Assets Acquired and Liabilities Assumed in Business Acquisitions | The following table summarizes the assets acquired and liabilities assumed in these transactions at their estimated acquisition date fair values: Current assets $ 8,854 Property and equipment 4,303 Intangible and other long-term assets 1,486 Goodwill 106,220 Current liabilities (10,290 ) Long-term liabilities (171 ) Noncontrolling interests (1,349 ) $ 109,053 |
Held for Sale and Discontinue39
Held for Sale and Discontinued Operations (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Discontinued Operations and Disposal Groups [Abstract] | |
Disposal Groups, Including Discontinued Operations [Table Text Block] | The following table presents the financial results of discontinued operations related to DMG: Three months ended Six months ended 2018 2017 2018 2017 Revenues $ 1,252,430 $ 1,196,066 $ 2,480,362 $ 2,283,050 Expenses 1,192,528 1,157,901 2,418,935 2,232,352 Goodwill impairment charges — 50,619 — 50,619 Income (loss) from discontinued operations before taxes 59,902 (12,454 ) 61,427 79 Income tax benefit (expense) 9,794 (12,066 ) 2,483 (18,166 ) Net income (loss) from discontinued operations, net of tax $ 69,696 $ (24,520 ) $ 63,910 $ (18,087 ) The following table presents the financial position of discontinued operations related to DMG: June 30, 2018 December 31, 2017 Assets Cash and cash equivalents $ 404,435 $ 179,668 Other current assets 862,764 826,608 Property and equipment, net 425,943 379,945 Intangible assets, net 1,316,468 1,316,550 Other long-term assets 161,622 178,894 Goodwill 2,881,849 2,879,977 Total current assets held for sale $ 6,053,081 $ 5,761,642 Liabilities Other liabilities $ 580,978 $ 505,734 Medical payables 487,920 457,040 Current portion of long-term debt 2,636 2,845 Long-term debt 34,076 35,003 Other long-term liabilities 165,754 184,448 Total current liabilities held for sale $ 1,271,364 $ 1,185,070 The following table presents cash flows of discontinued operations related to DMG: June 30, 2018 June 30, 2017 Net cash provided by operating activities from discontinued operations $ 112,683 $ 101,215 Net cash used in investing activities from discontinued operations $ (20,982 ) $ (85,289 ) |
Fair value of financial instr40
Fair value of financial instruments (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Fair Value Disclosures [Abstract] | |
Assets, Liabilities and Temporary Equity Measured at Fair Value on a Recurring Basis | The following table summarizes the Company’s assets, liabilities and temporary equity that are measured at fair value on a recurring basis as of June 30, 2018 : Total Quoted prices in Significant other Significant Assets Investments in mutual funds and common stock $ 36,500 $ 36,500 $ — $ — Interest rate cap agreements $ 2,085 $ — $ 2,085 $ — Liabilities Contingent earn-out obligations $ 7,489 $ — $ — $ 7,489 Temporary equity Noncontrolling interests subject to put provisions $ 1,047,158 $ — $ — $ 1,047,158 |
Segment reporting (Tables)
Segment reporting (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
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 margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes: Three months ended June 30, Six months ended June 30, 2018 2017 2018 2017 Segment net revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,612,734 $ 2,416,373 $ 5,101,899 $ 4,777,234 Intersegment revenues 20,096 13,285 38,519 25,084 U.S. dialysis and related lab services patient service 2,632,830 2,429,658 5,140,418 4,802,318 Provision for uncollectible accounts (49,406 ) (109,292 ) (24,208 ) (216,069 ) Net U.S. dialysis and related lab services patient 2,583,424 2,320,366 5,116,210 4,586,249 Other revenues (1) 4,919 4,849 10,033 10,159 Total U.S. dialysis and related lab services revenues 2,588,343 2,325,215 5,126,243 4,596,408 Other—Ancillary services and strategic initiatives Patient service revenues 105,669 77,928 207,925 139,572 Other external sources 213,037 309,541 440,748 619,754 Intersegment revenues 9,189 6,124 19,387 12,493 Total ancillary services and strategic initiatives revenues 327,895 393,593 668,060 771,819 Total net segment revenues 2,916,238 2,718,808 5,794,303 5,368,227 Elimination of intersegment revenues (29,285 ) (19,409 ) (57,906 ) (37,577 ) Consolidated revenues $ 2,886,953 $ 2,699,399 $ 5,736,397 $ 5,330,650 Segment operating margin: U.S. dialysis and related lab services $ 449,443 $ 450,472 $ 882,822 $ 1,395,212 Other—Ancillary services and strategic initiatives 2,815 (48,245 ) (4,175 ) (106,466 ) Total segment operating margin 452,258 402,227 878,647 1,288,746 Reconciliation of segment operating margin to consolidated Corporate administrative support (14,066 ) (11,031 ) (29,769 ) (21,622 ) Consolidated operating income 438,192 391,196 848,878 1,267,124 Debt expense (119,692 ) (107,934 ) (233,208 ) (212,331 ) Other income, net 1,994 4,798 6,576 8,784 Consolidated income from continuing operations before $ 320,494 $ 288,060 $ 622,246 $ 1,063,577 (1) Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment. |
Summary of Depreciation and Amortization Expense by Reportable Segment | Depreciation and amortization expense by reportable segment was as follows: Three months ended June 30, Six months ended June 30, 2018 2017 2018 2017 U.S. dialysis and related lab services $ 138,252 $ 130,001 $ 273,028 $ 255,030 Other — Ancillary services and strategic initiatives 8,827 10,025 16,850 17,880 $ 147,079 $ 140,026 $ 289,878 $ 272,910 |
Summary of Assets by Reportable Segment | Assets by reportable segment were as follows: June 30, 2018 December 31, 2017 Segment assets U.S. dialysis and related lab services (including equity $ 11,989,864 $ 11,776,042 Other—Ancillary services and strategic initiatives (including 1,392,619 1,410,509 DMG—Held for sale (including equity investments of $5,099 and 6,053,081 5,761,642 Consolidated assets $ 19,435,564 $ 18,948,193 |
Summary of Expenditures for Property and Equipment by Reportable Segment | Expenditures for property and equipment by reportable segment were as follows: Three months ended Six months ended 2018 2017 2018 2017 U.S. dialysis and related lab services $ 194,188 $ 152,233 $ 383,238 $ 325,761 Other—Ancillary services and strategic initiatives 25,047 11,289 37,392 24,508 DMG—Held for sale 22,299 20,883 53,347 48,671 $ 241,534 $ 184,405 $ 473,977 $ 398,940 |
Changes in DaVita Inc.'s owne42
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Noncontrolling Interest [Abstract] | |
Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity | The effects of changes in DaVita Inc.’s ownership interest in consolidated subsidiaries on the Company’s equity were as follows: Three months ended June 30, Six months ended June 30, 2018 2017 2018 2017 Net income attributable to DaVita Inc. $ 267,276 $ 127,001 $ 445,962 $ 574,698 Changes in paid-in capital for: Sales of noncontrolling interests 3 — 79 — Purchases of noncontrolling interests (10,203 ) 618 (12,197 ) 195 Net transfers to noncontrolling interests (10,200 ) 618 (12,118 ) 195 Net income attributable to DaVita Inc., net of transfers to $ 257,076 $ 127,619 $ 433,844 $ 574,893 |
Condensed Consolidating finan43
Condensed Consolidating financial statements (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Condensed Consolidating Statements of Operations | Condensed Consolidating Statements of Operations DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended June 30, 2018 Patient services revenues $ — $ 1,831,545 $ 936,646 $ (49,788 ) $ 2,718,403 Provision for uncollectible accounts — (27,159 ) (22,247 ) — (49,406 ) Net patient service revenues — 1,804,386 914,399 (49,788 ) 2,668,997 Other revenues 205,317 214,266 43,137 (244,764 ) 217,956 Total net revenues 205,317 2,018,652 957,536 (294,552 ) 2,886,953 Operating expenses and charges 145,649 1,850,377 747,287 (294,552 ) 2,448,761 Operating income 59,668 168,275 210,249 — 438,192 Debt expense (120,814 ) (52,363 ) (9,274 ) 62,759 (119,692 ) Other income, net 105,344 2,856 4,440 (110,646 ) 1,994 Income tax expense 13,257 40,019 30,592 — 83,868 Equity earnings in subsidiaries 236,335 192,356 — (428,691 ) — Net income from continuing operations 267,276 271,105 174,823 (476,578 ) 236,626 Net (loss) income from discontinued operations, net of — (34,770 ) 56,579 47,887 69,696 Net income 267,276 236,335 231,402 (428,691 ) 306,322 Less: Net income attributable to noncontrolling interests — — — (39,046 ) (39,046 ) Net income attributable to DaVita Inc. $ 267,276 $ 236,335 $ 231,402 $ (467,737 ) $ 267,276 Guarantor Non- Consolidating Consolidated For The Three Months Ended June 30, 2017 DaVita Inc. Patient service revenues $ — $ 1,654,430 $ 879,780 $ (39,601 ) $ 2,494,609 Provision for uncollectible accounts — (72,845 ) (36,755 ) — (109,600 ) Net patient service revenues — 1,581,585 843,025 (39,601 ) 2,385,009 Other revenues 193,585 305,319 15,835 (200,349 ) 314,390 Total net revenues 193,585 1,886,904 858,860 (239,950 ) 2,699,399 Operating expenses 138,104 1,682,483 727,566 (239,950 ) 2,308,203 Operating income 55,481 204,421 131,294 — 391,196 Debt expense (106,159 ) (48,117 ) (13,038 ) 59,380 (107,934 ) Other income 102,299 1,369 5,997 (104,867 ) 4,798 Income tax expense 20,528 71,299 10,088 — 101,915 Equity earnings in subsidiaries 95,908 85,549 — (181,457 ) — Net income from continuing operations 127,001 171,923 114,165 (226,944 ) 186,145 Net (loss) income from discontinued operations, net of — (76,015 ) 6,008 45,487 (24,520 ) Net income 127,001 95,908 120,173 (181,457 ) 161,625 Less: Net income attributable to noncontrolling interests — — — (34,624 ) (34,624 ) Net income attributable to DaVita Inc. $ 127,001 $ 95,908 $ 120,173 $ (216,081 ) $ 127,001 DaVita Inc. Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2018 Patient service revenues $ — $ 3,621,733 $ 1,785,047 $ (97,303 ) $ 5,309,477 Provision for uncollectible accounts — (17,531 ) (6,330 ) — (23,861 ) Net patient service revenues — 3,604,202 1,778,717 (97,303 ) 5,285,616 Other revenues 400,882 419,226 114,070 (483,397 ) 450,781 Total net revenues 400,882 4,023,428 1,892,787 (580,700 ) 5,736,397 Operating expenses 279,005 3,641,471 1,547,743 (580,700 ) 4,887,519 Operating income 121,877 381,957 345,044 — 848,878 Debt expense (235,148 ) (104,560 ) (16,649 ) 123,149 (233,208 ) Other income 209,425 5,379 10,144 (218,372 ) 6,576 Income tax expense 27,644 88,962 37,999 — 154,605 Equity earnings in subsidiaries 377,452 258,851 — (636,303 ) — Net income from continuing operations 445,962 452,665 300,540 (731,526 ) 467,641 Net (loss) income from discontinued operations, net of — (75,213 ) 43,900 95,223 63,910 Net income 445,962 377,452 344,440 (636,303 ) 531,551 Less: Net income attributable to noncontrolling interests — — — (85,589 ) (85,589 ) Net income attributable to DaVita Inc. $ 445,962 $ 377,452 $ 344,440 $ (721,892 ) $ 445,962 DaVita Inc. Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2017 Patient service revenues $ — $ 3,185,156 $ 1,809,011 $ (76,772 ) $ 4,917,395 Provision for uncollectible accounts — (133,898 ) (82,760 ) — (216,658 ) Net patient service revenues — 3,051,258 1,726,251 (76,772 ) 4,700,737 Other revenues 414,971 610,937 31,925 (427,920 ) 629,913 Total net revenues 414,971 3,662,195 1,758,176 (504,692 ) 5,330,650 Operating expenses 270,014 2,891,303 1,406,901 (504,692 ) 4,063,526 Operating income 144,957 770,892 351,275 — 1,267,124 Debt expense (208,823 ) (95,760 ) (25,270 ) 117,522 (212,331 ) Other income 202,636 4,172 9,583 (207,607 ) 8,784 Income tax expense 54,481 307,165 21,934 — 383,580 Equity earnings in subsidiaries 490,409 248,165 — (738,574 ) — Net income from continuing operations 574,698 620,304 313,654 (828,659 ) 679,997 Net (loss) income from discontinued operations, net of — (129,895 ) 21,723 90,085 (18,087 ) Net income 574,698 490,409 335,377 (738,574 ) 661,910 Less: Net income attributable to noncontrolling interests — — — (87,212 ) (87,212 ) Net income attributable to DaVita Inc. $ 574,698 $ 490,409 $ 335,377 $ (825,786 ) $ 574,698 Condensed Consolidating Statements of Income Consolidated Total Physician Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Six Months Ended June 30, 2018 Patient service operating revenues $ 5,309,477 $ — $ — $ 5,309,477 Provision for uncollectible accounts (23,861 ) — — (23,861 ) Net patient service operating revenues 5,285,616 — — 5,285,616 Other revenues 450,781 — — 450,781 Total net operating revenues 5,736,397 — — 5,736,397 Operating expenses 4,887,519 — — 4,887,519 Operating income 848,878 — — 848,878 Debt expense, including refinancing charges (233,208 ) — — (233,208 ) Other income 6,576 — — 6,576 Income tax expense 154,605 — — 154,605 Net income from continuing operations 467,641 — — 467,641 Net income from discontinued operations, net of tax 63,910 16,466 323 47,121 Net income 531,551 16,466 323 514,762 Less: Net income attributable to noncontrolling interests (85,589 ) (8,544 ) — (77,045 ) Net income attributable to DaVita Inc. $ 445,962 $ 7,922 $ 323 $ 437,717 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Comprehensive Income | Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended June 30, 2018 DaVita Inc. Net income $ 267,276 $ 236,335 $ 231,402 $ (428,691 ) $ 306,322 Other comprehensive income (loss) 1,269 — (50,529 ) — (49,260 ) Total comprehensive income 268,545 236,335 180,873 (428,691 ) 257,062 Less: Comprehensive income attributable to — — — (39,046 ) (39,046 ) Comprehensive income attributable to DaVita Inc. $ 268,545 $ 236,335 $ 180,873 $ (467,737 ) $ 218,016 Guarantor Non- Consolidating Consolidated For The Three Months Ended June 30, 2017 DaVita Inc. Net income $ 127,001 $ 95,908 $ 120,173 $ (181,457 ) $ 161,625 Other comprehensive income 436 — 49,142 — 49,578 Total comprehensive income 127,437 95,908 169,315 (181,457 ) 211,203 Less: Comprehensive income attributable to the — — — (34,624 ) (34,624 ) Comprehensive income attributable to DaVita Inc. $ 127,437 $ 95,908 $ 169,315 $ (216,081 ) $ 176,579 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Six Months Ended June 30, 2018 Net income $ 531,551 $ 16,466 $ 323 $ 514,762 Other comprehensive loss (26,792 ) — — (26,792 ) Total comprehensive income 504,759 16,466 323 487,970 Less: Comprehensive income attributable to the noncontrolling (85,589 ) (8,544 ) — (77,045 ) Comprehensive income attributable to DaVita Inc. $ 419,170 $ 7,922 $ 323 $ 410,925 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Balance Sheets | Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of June 30, 2018 DaVita Inc. Cash and cash equivalents $ 193,991 $ — $ 195,273 $ — $ 389,264 Restricted cash and equivalents 1,004 11,367 78,513 — 90,884 Accounts receivable, net — 1,274,067 568,041 — 1,842,108 Other current assets 37,185 547,928 124,912 — 710,025 Current assets held for sale — 5,101,853 951,228 — 6,053,081 Total current assets 232,180 6,935,215 1,917,967 — 9,085,362 Property and equipment, net 441,159 1,553,931 1,234,008 — 3,229,098 Intangible assets, net 199 46,491 53,565 — 100,255 Investments in subsidiaries 10,304,847 3,163,787 — (13,468,634 ) — Intercompany receivables 3,579,186 — 1,386,117 (4,965,303 ) — Other long-term assets and investments 54,077 68,922 219,291 — 342,290 Goodwill — 4,767,041 1,911,518 — 6,678,559 Total assets $ 14,611,648 $ 16,535,387 $ 6,722,466 $ (18,433,937 ) $ 19,435,564 Current liabilities $ 1,831,526 $ 1,219,455 $ 461,433 $ — $ 3,512,414 Current liabilities held for sale — 734,745 536,619 — 1,271,364 Intercompany payables — 3,548,086 1,417,217 (4,965,303 ) — Long-term debt and other long-term liabilities 7,897,430 728,254 494,437 — 9,120,121 Noncontrolling interests subject to put provisions 603,508 — — 443,650 1,047,158 Total DaVita Inc. shareholders' equity 4,279,184 10,304,847 3,163,787 (13,468,634 ) 4,279,184 Noncontrolling interests not subject to put — — 648,973 (443,650 ) 205,323 Total equity 4,279,184 10,304,847 3,812,760 (13,912,284 ) 4,484,507 Total liabilities and equity $ 14,611,648 $ 16,535,387 $ 6,722,466 $ (18,433,937 ) $ 19,435,564 Guarantor Non- Consolidating Consolidated As of December 31, 2017 DaVita Inc. Cash and cash equivalents $ 149,305 $ — $ 358,929 $ — $ 508,234 Restricted cash and equivalents 1,002 9,384 300 — 10,686 Accounts receivable, net — 1,208,715 506,035 — 1,714,750 Other current assets 67,025 595,066 86,955 — 749,046 Current assets held for sale — 4,992,067 769,575 — 5,761,642 Total current assets 217,332 6,805,232 1,721,794 — 8,744,358 Property and equipment, net 408,010 1,560,390 1,180,813 — 3,149,213 Intangible assets, net 250 50,971 62,606 — 113,827 Investments in subsidiaries 10,009,874 3,085,722 — (13,095,596 ) — Intercompany receivables 3,677,947 — 1,313,213 (4,991,160 ) — Other long-term assets and investments 47,297 68,344 214,875 — 330,516 Goodwill — 4,732,320 1,877,959 — 6,610,279 Total assets $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Current liabilities $ 238,706 $ 1,181,139 $ 436,262 $ — $ 1,856,107 Current liabilities held for sale — 739,294 445,776 — 1,185,070 Intercompany payables — 3,690,042 1,301,118 (4,991,160 ) — Long-term debt and other long-term liabilities 8,857,373 682,630 469,587 — 10,009,590 Noncontrolling interests subject to put provisions 574,602 — — 436,758 1,011,360 Total DaVita Inc. shareholders' equity 4,690,029 10,009,874 3,085,722 (13,095,596 ) 4,690,029 Noncontrolling interests not subject to put — — 632,795 (436,758 ) 196,037 Total equity 4,690,029 10,009,874 3,718,517 (13,532,354 ) 4,886,066 Total liabilities and equity $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of June 30, 2018 Cash and cash equivalents $ 389,264 $ — $ — $ 389,264 Restricted cash and equivalents 90,884 — — 90,884 Accounts receivable, net 1,842,108 — — 1,842,108 Other current assets 710,025 — — 710,025 Current assets held for sale 6,053,081 524,595 3,056 5,525,430 Total current assets 9,085,362 524,595 3,056 8,557,711 Property and equipment, net 3,229,098 — — 3,229,098 Amortizable intangibles, net 100,255 — — 100,255 Other long-term assets 342,290 — — 342,290 Goodwill 6,678,559 — — 6,678,559 Total assets $ 19,435,564 $ 524,595 $ 3,056 $ 18,907,913 Current liabilities $ 3,512,414 $ — $ — $ 3,512,414 Current liabilities held for sale 1,271,364 334,091 — 937,273 Payables to parent — 56,761 3,056 (59,817 ) Long-term debt and other long-term liabilities 9,120,121 — — 9,120,121 Noncontrolling interests subject to put provisions 1,047,158 — — 1,047,158 Total DaVita Inc. shareholders’ equity 4,279,184 133,743 — 4,145,441 Noncontrolling interests not subject to put provisions 205,323 — — 205,323 Shareholders’ equity 4,484,507 133,743 — 4,350,764 Total liabilities and shareholder’s equity $ 19,435,564 $ 524,595 $ 3,056 $ 18,907,913 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Cash Flows | Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2018 DaVita Inc. Cash flows from operating activities: Net income $ 445,962 $ 377,452 $ 344,440 $ (636,303 ) $ 531,551 Changes in operating assets and liabilities and non-cash (361,991 ) 26,502 92,210 636,303 393,024 Net cash provided by operating activities 83,971 403,954 436,650 — 924,575 Cash flows from investing activities: Additions of property and equipment (77,169 ) (258,471 ) (138,337 ) — (473,977 ) Acquisitions — (8,195 ) (81,270 ) — (89,465 ) Proceeds from asset and business sales — 28,546 87,695 — 116,241 Proceeds (purchases) from investment sales and other 32,415 (8,257 ) (1,021 ) — 23,137 Net cash used in investing activities (44,754 ) (246,377 ) (132,933 ) — (424,064 ) Cash flows from financing activities: Long-term debt and related financing costs, net 584,500 (5,429 ) (5,090 ) — 573,981 Intercompany borrowing (payments) 225,216 (130,553 ) (94,663 ) — — Other items (804,245 ) (13,208 ) (62,437 ) — (879,890 ) Net cash provided by (used in) financing activities 5,471 (149,190 ) (162,190 ) — (305,909 ) Effect of exchange rate changes on cash, cash — — (3,473 ) — (3,473 ) Net increase in cash, cash equivalents and 44,688 8,387 138,054 — 191,129 Less: Net increase in cash, cash equivalents and — 6,404 223,497 — 229,901 Net increase (decrease) in cash, cash equivalents and 44,688 1,983 (85,443 ) — (38,772 ) Cash, cash equivalents and restricted cash of continuing 150,307 9,384 359,229 — 518,920 Cash, cash equivalents and restricted cash of continuing $ 194,995 $ 11,367 $ 273,786 $ — $ 480,148 Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 574,698 $ 490,409 $ 335,377 $ (738,574 ) $ 661,910 Changes in operating assets and liabilities and non-cash (429,399 ) 37,851 6,121 738,574 353,147 Net cash provided by operating activities 145,299 528,260 341,498 — 1,015,057 Cash flows from investing activities: Additions of property and equipment (50,966 ) (182,494 ) (165,480 ) — (398,940 ) Acquisitions — (538,450 ) (81,389 ) — (619,839 ) Proceeds from asset and business sales, net of cash — 70,127 109 — 70,236 Proceeds (purchases) from investment sales and other 49,036 (2,933 ) 50,833 — 96,936 Net cash used in investing activities (1,930 ) (653,750 ) (195,927 ) — (851,607 ) Cash flows from financing activities: Long-term debt and related financing costs, net (54,992 ) (6,893 ) (2,147 ) — (64,032 ) Intercompany (payments) borrowing (39,814 ) 117,661 (77,847 ) — — Other items (223,511 ) (1,432 ) (76,203 ) — (301,146 ) Net cash (used in) provided by financing activities (318,317 ) 109,336 (156,197 ) — (365,178 ) Effect of exchange rate changes on cash, cash — — 4,192 — 4,192 Net decrease in cash, cash equivalents and restricted cash (174,948 ) (16,154 ) (6,434 ) — (197,536 ) Less: Net (decrease) increase in cash, cash equivalents — (16,194 ) 48,914 — 32,720 Net (decrease) increase in cash, cash equivalents and (174,948 ) 40 (55,348 ) — (230,256 ) Cash, cash equivalents and restricted cash of continuing 549,921 8,687 124,855 — 683,463 Cash, cash equivalents and restricted cash of continuing $ 374,973 $ 8,727 $ 69,507 $ — $ 453,207 Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Six Months Ended June 30, 2018 Cash flows from operating activities: Net income $ 531,551 $ 16,466 $ 323 $ 514,762 Changes in operating and intercompany assets and liabilities and 393,024 101,201 (323 ) 292,146 Net cash provided by (used in) operating activities 924,575 117,667 — 806,908 Cash flows from investing activities: Additions of property and equipment (473,977 ) (2,097 ) — (471,880 ) Acquisitions (89,465 ) — — (89,465 ) Proceeds from asset and business sales 116,241 — — 116,241 Investments and other items 23,137 (1,021 ) — 24,158 Net cash used in investing activities (424,064 ) (3,118 ) — (420,946 ) Cash flows from financing activities: Long-term debt 573,981 — — 573,981 Intercompany — 57,783 — (57,783 ) Other items (879,890 ) — — (879,890 ) Net cash (used in) provided by financing activities (305,909 ) 57,783 — (363,692 ) Effect of exchange rate changes on cash, cash equivalents and (3,473 ) — — (3,473 ) Net increase in cash, cash equivalents and restricted cash 191,129 172,332 — 18,797 Less: Net increase in cash, cash equivalents and 229,901 172,332 — 57,569 Net decrease in cash, cash equivalents and restricted cash from (38,772 ) — — (38,772 ) Cash, cash equivalents and restricted cash of continuing operations 518,920 — — 518,920 Cash, cash equivalents and restricted cash of continuing operations $ 480,148 $ — $ — $ 480,148 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Supplemental Data (Tables)
Supplemental Data (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Condensed Consolidating Statements of Operations | Condensed Consolidating Statements of Operations DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended June 30, 2018 Patient services revenues $ — $ 1,831,545 $ 936,646 $ (49,788 ) $ 2,718,403 Provision for uncollectible accounts — (27,159 ) (22,247 ) — (49,406 ) Net patient service revenues — 1,804,386 914,399 (49,788 ) 2,668,997 Other revenues 205,317 214,266 43,137 (244,764 ) 217,956 Total net revenues 205,317 2,018,652 957,536 (294,552 ) 2,886,953 Operating expenses and charges 145,649 1,850,377 747,287 (294,552 ) 2,448,761 Operating income 59,668 168,275 210,249 — 438,192 Debt expense (120,814 ) (52,363 ) (9,274 ) 62,759 (119,692 ) Other income, net 105,344 2,856 4,440 (110,646 ) 1,994 Income tax expense 13,257 40,019 30,592 — 83,868 Equity earnings in subsidiaries 236,335 192,356 — (428,691 ) — Net income from continuing operations 267,276 271,105 174,823 (476,578 ) 236,626 Net (loss) income from discontinued operations, net of — (34,770 ) 56,579 47,887 69,696 Net income 267,276 236,335 231,402 (428,691 ) 306,322 Less: Net income attributable to noncontrolling interests — — — (39,046 ) (39,046 ) Net income attributable to DaVita Inc. $ 267,276 $ 236,335 $ 231,402 $ (467,737 ) $ 267,276 Guarantor Non- Consolidating Consolidated For The Three Months Ended June 30, 2017 DaVita Inc. Patient service revenues $ — $ 1,654,430 $ 879,780 $ (39,601 ) $ 2,494,609 Provision for uncollectible accounts — (72,845 ) (36,755 ) — (109,600 ) Net patient service revenues — 1,581,585 843,025 (39,601 ) 2,385,009 Other revenues 193,585 305,319 15,835 (200,349 ) 314,390 Total net revenues 193,585 1,886,904 858,860 (239,950 ) 2,699,399 Operating expenses 138,104 1,682,483 727,566 (239,950 ) 2,308,203 Operating income 55,481 204,421 131,294 — 391,196 Debt expense (106,159 ) (48,117 ) (13,038 ) 59,380 (107,934 ) Other income 102,299 1,369 5,997 (104,867 ) 4,798 Income tax expense 20,528 71,299 10,088 — 101,915 Equity earnings in subsidiaries 95,908 85,549 — (181,457 ) — Net income from continuing operations 127,001 171,923 114,165 (226,944 ) 186,145 Net (loss) income from discontinued operations, net of — (76,015 ) 6,008 45,487 (24,520 ) Net income 127,001 95,908 120,173 (181,457 ) 161,625 Less: Net income attributable to noncontrolling interests — — — (34,624 ) (34,624 ) Net income attributable to DaVita Inc. $ 127,001 $ 95,908 $ 120,173 $ (216,081 ) $ 127,001 DaVita Inc. Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2018 Patient service revenues $ — $ 3,621,733 $ 1,785,047 $ (97,303 ) $ 5,309,477 Provision for uncollectible accounts — (17,531 ) (6,330 ) — (23,861 ) Net patient service revenues — 3,604,202 1,778,717 (97,303 ) 5,285,616 Other revenues 400,882 419,226 114,070 (483,397 ) 450,781 Total net revenues 400,882 4,023,428 1,892,787 (580,700 ) 5,736,397 Operating expenses 279,005 3,641,471 1,547,743 (580,700 ) 4,887,519 Operating income 121,877 381,957 345,044 — 848,878 Debt expense (235,148 ) (104,560 ) (16,649 ) 123,149 (233,208 ) Other income 209,425 5,379 10,144 (218,372 ) 6,576 Income tax expense 27,644 88,962 37,999 — 154,605 Equity earnings in subsidiaries 377,452 258,851 — (636,303 ) — Net income from continuing operations 445,962 452,665 300,540 (731,526 ) 467,641 Net (loss) income from discontinued operations, net of — (75,213 ) 43,900 95,223 63,910 Net income 445,962 377,452 344,440 (636,303 ) 531,551 Less: Net income attributable to noncontrolling interests — — — (85,589 ) (85,589 ) Net income attributable to DaVita Inc. $ 445,962 $ 377,452 $ 344,440 $ (721,892 ) $ 445,962 DaVita Inc. Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2017 Patient service revenues $ — $ 3,185,156 $ 1,809,011 $ (76,772 ) $ 4,917,395 Provision for uncollectible accounts — (133,898 ) (82,760 ) — (216,658 ) Net patient service revenues — 3,051,258 1,726,251 (76,772 ) 4,700,737 Other revenues 414,971 610,937 31,925 (427,920 ) 629,913 Total net revenues 414,971 3,662,195 1,758,176 (504,692 ) 5,330,650 Operating expenses 270,014 2,891,303 1,406,901 (504,692 ) 4,063,526 Operating income 144,957 770,892 351,275 — 1,267,124 Debt expense (208,823 ) (95,760 ) (25,270 ) 117,522 (212,331 ) Other income 202,636 4,172 9,583 (207,607 ) 8,784 Income tax expense 54,481 307,165 21,934 — 383,580 Equity earnings in subsidiaries 490,409 248,165 — (738,574 ) — Net income from continuing operations 574,698 620,304 313,654 (828,659 ) 679,997 Net (loss) income from discontinued operations, net of — (129,895 ) 21,723 90,085 (18,087 ) Net income 574,698 490,409 335,377 (738,574 ) 661,910 Less: Net income attributable to noncontrolling interests — — — (87,212 ) (87,212 ) Net income attributable to DaVita Inc. $ 574,698 $ 490,409 $ 335,377 $ (825,786 ) $ 574,698 Condensed Consolidating Statements of Income Consolidated Total Physician Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Six Months Ended June 30, 2018 Patient service operating revenues $ 5,309,477 $ — $ — $ 5,309,477 Provision for uncollectible accounts (23,861 ) — — (23,861 ) Net patient service operating revenues 5,285,616 — — 5,285,616 Other revenues 450,781 — — 450,781 Total net operating revenues 5,736,397 — — 5,736,397 Operating expenses 4,887,519 — — 4,887,519 Operating income 848,878 — — 848,878 Debt expense, including refinancing charges (233,208 ) — — (233,208 ) Other income 6,576 — — 6,576 Income tax expense 154,605 — — 154,605 Net income from continuing operations 467,641 — — 467,641 Net income from discontinued operations, net of tax 63,910 16,466 323 47,121 Net income 531,551 16,466 323 514,762 Less: Net income attributable to noncontrolling interests (85,589 ) (8,544 ) — (77,045 ) Net income attributable to DaVita Inc. $ 445,962 $ 7,922 $ 323 $ 437,717 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Comprehensive Income | Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended June 30, 2018 DaVita Inc. Net income $ 267,276 $ 236,335 $ 231,402 $ (428,691 ) $ 306,322 Other comprehensive income (loss) 1,269 — (50,529 ) — (49,260 ) Total comprehensive income 268,545 236,335 180,873 (428,691 ) 257,062 Less: Comprehensive income attributable to — — — (39,046 ) (39,046 ) Comprehensive income attributable to DaVita Inc. $ 268,545 $ 236,335 $ 180,873 $ (467,737 ) $ 218,016 Guarantor Non- Consolidating Consolidated For The Three Months Ended June 30, 2017 DaVita Inc. Net income $ 127,001 $ 95,908 $ 120,173 $ (181,457 ) $ 161,625 Other comprehensive income 436 — 49,142 — 49,578 Total comprehensive income 127,437 95,908 169,315 (181,457 ) 211,203 Less: Comprehensive income attributable to the — — — (34,624 ) (34,624 ) Comprehensive income attributable to DaVita Inc. $ 127,437 $ 95,908 $ 169,315 $ (216,081 ) $ 176,579 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Six Months Ended June 30, 2018 Net income $ 531,551 $ 16,466 $ 323 $ 514,762 Other comprehensive loss (26,792 ) — — (26,792 ) Total comprehensive income 504,759 16,466 323 487,970 Less: Comprehensive income attributable to the noncontrolling (85,589 ) (8,544 ) — (77,045 ) Comprehensive income attributable to DaVita Inc. $ 419,170 $ 7,922 $ 323 $ 410,925 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Balance Sheets | Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of June 30, 2018 DaVita Inc. Cash and cash equivalents $ 193,991 $ — $ 195,273 $ — $ 389,264 Restricted cash and equivalents 1,004 11,367 78,513 — 90,884 Accounts receivable, net — 1,274,067 568,041 — 1,842,108 Other current assets 37,185 547,928 124,912 — 710,025 Current assets held for sale — 5,101,853 951,228 — 6,053,081 Total current assets 232,180 6,935,215 1,917,967 — 9,085,362 Property and equipment, net 441,159 1,553,931 1,234,008 — 3,229,098 Intangible assets, net 199 46,491 53,565 — 100,255 Investments in subsidiaries 10,304,847 3,163,787 — (13,468,634 ) — Intercompany receivables 3,579,186 — 1,386,117 (4,965,303 ) — Other long-term assets and investments 54,077 68,922 219,291 — 342,290 Goodwill — 4,767,041 1,911,518 — 6,678,559 Total assets $ 14,611,648 $ 16,535,387 $ 6,722,466 $ (18,433,937 ) $ 19,435,564 Current liabilities $ 1,831,526 $ 1,219,455 $ 461,433 $ — $ 3,512,414 Current liabilities held for sale — 734,745 536,619 — 1,271,364 Intercompany payables — 3,548,086 1,417,217 (4,965,303 ) — Long-term debt and other long-term liabilities 7,897,430 728,254 494,437 — 9,120,121 Noncontrolling interests subject to put provisions 603,508 — — 443,650 1,047,158 Total DaVita Inc. shareholders' equity 4,279,184 10,304,847 3,163,787 (13,468,634 ) 4,279,184 Noncontrolling interests not subject to put — — 648,973 (443,650 ) 205,323 Total equity 4,279,184 10,304,847 3,812,760 (13,912,284 ) 4,484,507 Total liabilities and equity $ 14,611,648 $ 16,535,387 $ 6,722,466 $ (18,433,937 ) $ 19,435,564 Guarantor Non- Consolidating Consolidated As of December 31, 2017 DaVita Inc. Cash and cash equivalents $ 149,305 $ — $ 358,929 $ — $ 508,234 Restricted cash and equivalents 1,002 9,384 300 — 10,686 Accounts receivable, net — 1,208,715 506,035 — 1,714,750 Other current assets 67,025 595,066 86,955 — 749,046 Current assets held for sale — 4,992,067 769,575 — 5,761,642 Total current assets 217,332 6,805,232 1,721,794 — 8,744,358 Property and equipment, net 408,010 1,560,390 1,180,813 — 3,149,213 Intangible assets, net 250 50,971 62,606 — 113,827 Investments in subsidiaries 10,009,874 3,085,722 — (13,095,596 ) — Intercompany receivables 3,677,947 — 1,313,213 (4,991,160 ) — Other long-term assets and investments 47,297 68,344 214,875 — 330,516 Goodwill — 4,732,320 1,877,959 — 6,610,279 Total assets $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Current liabilities $ 238,706 $ 1,181,139 $ 436,262 $ — $ 1,856,107 Current liabilities held for sale — 739,294 445,776 — 1,185,070 Intercompany payables — 3,690,042 1,301,118 (4,991,160 ) — Long-term debt and other long-term liabilities 8,857,373 682,630 469,587 — 10,009,590 Noncontrolling interests subject to put provisions 574,602 — — 436,758 1,011,360 Total DaVita Inc. shareholders' equity 4,690,029 10,009,874 3,085,722 (13,095,596 ) 4,690,029 Noncontrolling interests not subject to put — — 632,795 (436,758 ) 196,037 Total equity 4,690,029 10,009,874 3,718,517 (13,532,354 ) 4,886,066 Total liabilities and equity $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of June 30, 2018 Cash and cash equivalents $ 389,264 $ — $ — $ 389,264 Restricted cash and equivalents 90,884 — — 90,884 Accounts receivable, net 1,842,108 — — 1,842,108 Other current assets 710,025 — — 710,025 Current assets held for sale 6,053,081 524,595 3,056 5,525,430 Total current assets 9,085,362 524,595 3,056 8,557,711 Property and equipment, net 3,229,098 — — 3,229,098 Amortizable intangibles, net 100,255 — — 100,255 Other long-term assets 342,290 — — 342,290 Goodwill 6,678,559 — — 6,678,559 Total assets $ 19,435,564 $ 524,595 $ 3,056 $ 18,907,913 Current liabilities $ 3,512,414 $ — $ — $ 3,512,414 Current liabilities held for sale 1,271,364 334,091 — 937,273 Payables to parent — 56,761 3,056 (59,817 ) Long-term debt and other long-term liabilities 9,120,121 — — 9,120,121 Noncontrolling interests subject to put provisions 1,047,158 — — 1,047,158 Total DaVita Inc. shareholders’ equity 4,279,184 133,743 — 4,145,441 Noncontrolling interests not subject to put provisions 205,323 — — 205,323 Shareholders’ equity 4,484,507 133,743 — 4,350,764 Total liabilities and shareholder’s equity $ 19,435,564 $ 524,595 $ 3,056 $ 18,907,913 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Cash Flows | Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2018 DaVita Inc. Cash flows from operating activities: Net income $ 445,962 $ 377,452 $ 344,440 $ (636,303 ) $ 531,551 Changes in operating assets and liabilities and non-cash (361,991 ) 26,502 92,210 636,303 393,024 Net cash provided by operating activities 83,971 403,954 436,650 — 924,575 Cash flows from investing activities: Additions of property and equipment (77,169 ) (258,471 ) (138,337 ) — (473,977 ) Acquisitions — (8,195 ) (81,270 ) — (89,465 ) Proceeds from asset and business sales — 28,546 87,695 — 116,241 Proceeds (purchases) from investment sales and other 32,415 (8,257 ) (1,021 ) — 23,137 Net cash used in investing activities (44,754 ) (246,377 ) (132,933 ) — (424,064 ) Cash flows from financing activities: Long-term debt and related financing costs, net 584,500 (5,429 ) (5,090 ) — 573,981 Intercompany borrowing (payments) 225,216 (130,553 ) (94,663 ) — — Other items (804,245 ) (13,208 ) (62,437 ) — (879,890 ) Net cash provided by (used in) financing activities 5,471 (149,190 ) (162,190 ) — (305,909 ) Effect of exchange rate changes on cash, cash — — (3,473 ) — (3,473 ) Net increase in cash, cash equivalents and 44,688 8,387 138,054 — 191,129 Less: Net increase in cash, cash equivalents and — 6,404 223,497 — 229,901 Net increase (decrease) in cash, cash equivalents and 44,688 1,983 (85,443 ) — (38,772 ) Cash, cash equivalents and restricted cash of continuing 150,307 9,384 359,229 — 518,920 Cash, cash equivalents and restricted cash of continuing $ 194,995 $ 11,367 $ 273,786 $ — $ 480,148 Guarantor Non- Consolidating Consolidated For The Six Months Ended June 30, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 574,698 $ 490,409 $ 335,377 $ (738,574 ) $ 661,910 Changes in operating assets and liabilities and non-cash (429,399 ) 37,851 6,121 738,574 353,147 Net cash provided by operating activities 145,299 528,260 341,498 — 1,015,057 Cash flows from investing activities: Additions of property and equipment (50,966 ) (182,494 ) (165,480 ) — (398,940 ) Acquisitions — (538,450 ) (81,389 ) — (619,839 ) Proceeds from asset and business sales, net of cash — 70,127 109 — 70,236 Proceeds (purchases) from investment sales and other 49,036 (2,933 ) 50,833 — 96,936 Net cash used in investing activities (1,930 ) (653,750 ) (195,927 ) — (851,607 ) Cash flows from financing activities: Long-term debt and related financing costs, net (54,992 ) (6,893 ) (2,147 ) — (64,032 ) Intercompany (payments) borrowing (39,814 ) 117,661 (77,847 ) — — Other items (223,511 ) (1,432 ) (76,203 ) — (301,146 ) Net cash (used in) provided by financing activities (318,317 ) 109,336 (156,197 ) — (365,178 ) Effect of exchange rate changes on cash, cash — — 4,192 — 4,192 Net decrease in cash, cash equivalents and restricted cash (174,948 ) (16,154 ) (6,434 ) — (197,536 ) Less: Net (decrease) increase in cash, cash equivalents — (16,194 ) 48,914 — 32,720 Net (decrease) increase in cash, cash equivalents and (174,948 ) 40 (55,348 ) — (230,256 ) Cash, cash equivalents and restricted cash of continuing 549,921 8,687 124,855 — 683,463 Cash, cash equivalents and restricted cash of continuing $ 374,973 $ 8,727 $ 69,507 $ — $ 453,207 Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Six Months Ended June 30, 2018 Cash flows from operating activities: Net income $ 531,551 $ 16,466 $ 323 $ 514,762 Changes in operating and intercompany assets and liabilities and 393,024 101,201 (323 ) 292,146 Net cash provided by (used in) operating activities 924,575 117,667 — 806,908 Cash flows from investing activities: Additions of property and equipment (473,977 ) (2,097 ) — (471,880 ) Acquisitions (89,465 ) — — (89,465 ) Proceeds from asset and business sales 116,241 — — 116,241 Investments and other items 23,137 (1,021 ) — 24,158 Net cash used in investing activities (424,064 ) (3,118 ) — (420,946 ) Cash flows from financing activities: Long-term debt 573,981 — — 573,981 Intercompany — 57,783 — (57,783 ) Other items (879,890 ) — — (879,890 ) Net cash (used in) provided by financing activities (305,909 ) 57,783 — (363,692 ) Effect of exchange rate changes on cash, cash equivalents and (3,473 ) — — (3,473 ) Net increase in cash, cash equivalents and restricted cash 191,129 172,332 — 18,797 Less: Net increase in cash, cash equivalents and 229,901 172,332 — 57,569 Net decrease in cash, cash equivalents and restricted cash from (38,772 ) — — (38,772 ) Cash, cash equivalents and restricted cash of continuing operations 518,920 — — 518,920 Cash, cash equivalents and restricted cash of continuing operations $ 480,148 $ — $ — $ 480,148 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Revenue Recognition Revenue R45
Revenue Recognition Revenue Recognition (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | Dec. 31, 2017 | |
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] | |||||
Allowance for Doubtful Accounts Receivable | $ 110,962 | $ 110,962 | $ 218,399 | ||
Provision for uncollectible accounts | 49,406 | $ 109,600 | 23,861 | $ 216,658 | |
Difference between Revenue Guidance in Effect before and after Topic 606 [Member] | |||||
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] | |||||
Contract with Customer, Performance Obligation Satisfied in Previous Period | 8,817 | 76,227 | |||
Change in Accounting Principle Topic 606, Effect of Adoption, Quantification | $ 12,000 | $ 36,000 | |||
Medicare | |||||
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] | |||||
Percent of revenue paid by a payor | 80.00% |
Revenue Recognition Segment R46
Revenue Recognition Segment Revenue by Payor (Details) - USD ($) | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,718,403,000 | $ 2,494,609,000 | $ 5,309,477,000 | $ 4,917,395,000 |
Other revenues | 217,956,000 | 314,390,000 | 450,781,000 | 629,913,000 |
Total revenues | 2,886,953,000 | 2,699,399,000 | 5,736,397,000 | 5,330,650,000 |
Intersegment Elimination | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | (29,285,000) | (19,409,000) | (57,906,000) | (37,577,000) |
Total revenues | (29,285,000) | (19,409,000) | (57,906,000) | (37,577,000) |
Medicare and Medicare Advantage | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 1,526,066,000 | 1,313,504,000 | 3,011,258,000 | 2,586,100,000 |
Other revenues | 154,028,000 | 225,511,000 | 296,786,000 | 450,713,000 |
Medicaid and Managed Medicaid | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 150,288,000 | 151,286,000 | 307,783,000 | 295,871,000 |
Other revenues | 16,158,000 | 19,020,000 | 31,949,000 | 37,615,000 |
Other Government Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 196,868,000 | 153,316,000 | 386,526,000 | 293,070,000 |
Commercial Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 815,871,000 | 780,188,000 | 1,618,568,000 | 1,550,780,000 |
Other revenues | 17,006,000 | 26,812,000 | 57,427,000 | 52,020,000 |
Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 39,953,000 | 49,171,000 | 84,006,000 | 102,058,000 |
U.S. dialysis and related lab services | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | 2,568,247,000 | 2,311,930,000 | 5,087,724,000 | 4,571,324,000 |
U.S. dialysis and related lab services | Intersegment Elimination | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | (20,096,000) | (13,285,000) | (38,519,000) | (25,084,000) |
U.S. dialysis and related lab services | Medicare and Medicare Advantage | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 1,526,066,000 | 1,313,504,000 | 3,011,258,000 | 2,586,100,000 |
U.S. dialysis and related lab services | Medicaid and Managed Medicaid | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 150,288,000 | 151,286,000 | 307,783,000 | 295,871,000 |
U.S. dialysis and related lab services | Other Government Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 110,338,000 | 90,712,000 | 217,458,000 | 182,704,000 |
U.S. dialysis and related lab services | Commercial Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 796,732,000 | 764,864,000 | 1,579,711,000 | 1,521,574,000 |
U.S. dialysis and related lab services | Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 4,919,000 | 4,849,000 | 10,033,000 | 10,159,000 |
Other—Ancillary services and strategic initiatives | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | 318,706,000 | 387,469,000 | 648,673,000 | 759,326,000 |
Other—Ancillary services and strategic initiatives | Intersegment Elimination | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | (9,189,000) | (6,124,000) | (19,387,000) | (12,493,000) |
Other—Ancillary services and strategic initiatives | Medicare and Medicare Advantage | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 154,028,000 | 225,511,000 | 296,786,000 | 450,713,000 |
Other—Ancillary services and strategic initiatives | Medicaid and Managed Medicaid | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 16,158,000 | 19,020,000 | 31,949,000 | 37,615,000 |
Other—Ancillary services and strategic initiatives | Other Government Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 86,530,000 | 62,604,000 | 169,068,000 | 110,366,000 |
Other—Ancillary services and strategic initiatives | Commercial Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Dialysis and related lab patient service revenues | 19,139,000 | 15,324,000 | 38,857,000 | 29,206,000 |
Other revenues | 17,006,000 | 26,812,000 | 57,427,000 | 52,020,000 |
Other—Ancillary services and strategic initiatives | Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | $ 35,034,000 | $ 44,322,000 | $ 73,973,000 | $ 91,899,000 |
Earnings per share - Reconcilia
Earnings per share - Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Earnings Per Share [Abstract] | ||||
Net income from continuing operations | $ 199,603 | $ 151,292 | $ 390,618 | $ 592,197 |
Change in noncontrolling interest redemption rights in excess of fair value | (98) | 0 | (98) | 0 |
Net income from continuing operations for basic earnings per share calculation | 199,505 | 151,292 | 390,520 | 592,197 |
Net income (loss) from discontinued operations | 67,673 | (24,291) | 55,344 | (17,499) |
Net income attributable to DaVita Inc. for basic earnings per share calculation | $ 267,178 | $ 127,001 | $ 445,864 | $ 574,698 |
Basic: | ||||
Weighted Average Number of Shares Issued, Basic | 173,811,000 | 193,282,000 | 177,461,000 | 193,923,000 |
Contingently returnable shares held in escrow from the DaVita HealthCare Partners merger (in shares) | (2,194,000) | (2,194,000) | (2,194,000) | (2,194,000) |
Weighted average shares for basic earnings per share calculation (in shares) | 171,617,238 | 191,088,216 | 175,267,270 | 191,728,913 |
Basic net income from continuing operations per share attributable to DaVita Inc. | $ 1.16 | $ 0.79 | $ 2.23 | $ 3.09 |
Basic net income (loss) from discontinued operations per share attributable to DaVita Inc. | 0.40 | (0.13) | 0.31 | (0.09) |
Basic net (loss) income per share attributable to DaVita Inc. (usd per share) | $ 1.56 | $ 0.66 | $ 2.54 | $ 3 |
Diluted: | ||||
Weighted Average Number of Shares Issued, Basic | 173,811,000 | 193,282,000 | 177,461,000 | 193,923,000 |
Assumed incremental shares from stock plans (in shares) | 295,000 | 706,000 | 489,000 | 708,000 |
Weighted average shares for diluted earnings per share calculation (in shares) | 174,105,884 | 193,987,983 | 177,949,934 | 194,630,936 |
Diluted net income from continuing operations per share attributable to DaVita Inc. | $ 1.15 | $ 0.78 | $ 2.19 | $ 3.04 |
Discontinued Operation, Income (Loss) from Discontinued Operation, Net of Tax, Per Diluted Share | 0.38 | (0.13) | 0.32 | (0.09) |
Diluted net (loss) income per share attributable to DaVita Inc. (usd per share) | $ 1.53 | $ 0.65 | $ 2.51 | $ 2.95 |
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount | 6,227,000 | 3,780,000 | 4,840,000 | 3,603,000 |
Restricted Cash (Details)
Restricted Cash (Details) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Restricted Cash [Abstract] | ||
Restricted cash and equivalents | $ 90,884 | $ 10,686 |
Assets Held-in-trust, Current | $ 78,513 |
Investments in debt and equit49
Investments in debt and equity securities (Detail) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Investment Holdings [Line Items] | ||
Held to maturity | $ 2,228 | $ 31,630 |
Equity Securities, FV-NI | 36,500 | |
Available for sale | 38,895 | |
Total | 38,728 | 70,525 |
Held to maturity, short-term investments | 2,228 | 31,630 |
Available for sale, short-term investments | 1,200 | |
Total, short-term investments | 4,528 | 32,830 |
Held to maturity, long-term investments | 0 | 0 |
Available for sale, long-term investments | 37,695 | |
Total, long-term investments | 34,200 | 37,695 |
Certificates of deposit and other time deposits | ||
Investment Holdings [Line Items] | ||
Held to maturity | 2,228 | 31,630 |
Equity Securities, FV-NI | 0 | |
Available for sale, equity securities | 0 | |
Total | 2,228 | 31,630 |
Investments in mutual funds and common stock | ||
Investment Holdings [Line Items] | ||
Held to maturity | 0 | 0 |
Equity Securities, FV-NI | 36,500 | |
Available for sale, equity securities | 38,895 | |
Total | 36,500 | $ 38,895 |
Short-term Investments [Member] | ||
Investment Holdings [Line Items] | ||
Equity Securities, FV-NI | 2,300 | |
Other Long-term Investments [Member] | ||
Investment Holdings [Line Items] | ||
Equity Securities, FV-NI | $ 34,200 |
Investments in debt and equit50
Investments in debt and equity securities - Additional Information (Detail) - USD ($) $ in Thousands | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jan. 01, 2018 | |
Schedule Of Trading Securities And Other Trading Assets [Line Items] | |||
Pre tax reclassification of net investment realized gain (loss) into net income | $ 346 | ||
Reclassification of net investment realized gain (loss) into net income, net tax | $ 211 | ||
Investments in mutual funds and common stock | |||
Schedule Of Trading Securities And Other Trading Assets [Line Items] | |||
Net Gain (Loss) recognized in Income Statement, before tax | $ 619 | ||
Income (Loss), Unrealized Holding Gain (Loss) on Securities Arising During Period, before Tax | 3,904 | ||
Unrealized Gain on Equity Securities due to changes in Fair Value | $ 3,285 | ||
Investment securities | |||
Schedule Of Trading Securities And Other Trading Assets [Line Items] | |||
Cumulative Effect of New Accounting Principle in Period of Adoption | $ (5,662) |
Equity method and other inves51
Equity method and other investments - Additional Information (Details) - USD ($) | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2018 | Dec. 31, 2017 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Noncontrolling Interest [Line Items] | |||||
Equity investments in nonconsolidated businesses | $ 249,020,000 | $ 245,534,000 | $ 249,020,000 | ||
Equity investment income | 9,795,000 | $ (825,000) | 9,950,000 | $ (148,000) | |
Equity Method Investment, Other than Temporary Impairment | 0 | ||||
Cost method total carrying amount of equity investments | $ 12,386,000 | $ 12,386,000 | |||
Parent Company And Restricted Subsidiaries | |||||
Noncontrolling Interest [Line Items] | |||||
Voting interest (in percent) | 60.00% | 60.00% | |||
Current economic interest in DaVita Care Pte. Ltd. | 73.30% | 73.30% | |||
Deconsolidated Noncontrolling Entity | |||||
Noncontrolling Interest [Line Items] | |||||
Equity investments in nonconsolidated businesses | $ 155,802,000 | 160,481,000 | $ 155,802,000 | ||
Equity Method Investment, Other than Temporary Impairment | $ 280,066,000 | ||||
Voting interest (in percent) | 40.00% | 40.00% | |||
Current economic interest in APAC JV | 26.70% | 26.70% |
Goodwill - Changes in Goodwill
Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | 12 Months Ended | |||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | Dec. 31, 2017 | Jun. 30, 2018 | |
Goodwill [Roll Forward] | ||||||
Beginning balance | $ 6,610,279 | $ 6,015,375 | $ 6,015,375 | |||
Acquisitions | 106,220 | 617,032 | ||||
Divestitures | (15,384) | (32,386) | ||||
Goodwill impairment charges | $ (3,106) | $ (10,498) | (3,106) | (34,696) | (36,196) | |
Foreign currency and other adjustments | (19,450) | 46,454 | ||||
Ending balance | 6,678,559 | 6,678,559 | 6,610,279 | |||
Goodwill | $ 6,712,837 | |||||
Accumulated impairment charges | (34,278) | |||||
Total goodwill by reportable segments | 6,678,559 | 6,610,279 | 6,015,375 | 6,015,375 | 6,678,559 | |
U.S. dialysis and related lab services | ||||||
Goodwill [Roll Forward] | ||||||
Beginning balance | 6,144,761 | 5,691,587 | 5,691,587 | |||
Acquisitions | 6,357 | 485,434 | ||||
Divestitures | (218) | (32,260) | ||||
Goodwill impairment charges | 0 | 0 | ||||
Foreign currency and other adjustments | 0 | 0 | ||||
Ending balance | 6,150,900 | 6,150,900 | 6,144,761 | |||
Goodwill | 6,150,900 | |||||
Accumulated impairment charges | 0 | |||||
Total goodwill by reportable segments | 6,150,900 | 6,144,761 | 5,691,587 | 5,691,587 | 6,150,900 | |
Other—Ancillary services and strategic initiatives | ||||||
Goodwill [Roll Forward] | ||||||
Beginning balance | 465,518 | 323,788 | 323,788 | |||
Acquisitions | 99,863 | 131,598 | ||||
Divestitures | (15,166) | (126) | ||||
Goodwill impairment charges | (3,106) | (36,196) | ||||
Foreign currency and other adjustments | (19,450) | 46,454 | ||||
Ending balance | 527,659 | 527,659 | 465,518 | |||
Goodwill | 561,937 | |||||
Accumulated impairment charges | (34,278) | |||||
Total goodwill by reportable segments | $ 527,659 | $ 465,518 | $ 323,788 | $ 323,788 | $ 527,659 |
Goodwill - Narrative (Details)
Goodwill - Narrative (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | 12 Months Ended | |||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | Dec. 31, 2017 | Dec. 31, 2016 | |
Goodwill [Line Items] | ||||||
Goodwill impairment charges | $ 3,106 | $ 10,498 | $ 3,106 | $ 34,696 | $ 36,196 | |
Goodwill | $ 6,678,559 | 6,678,559 | $ 6,610,279 | $ 6,015,375 | ||
Percentage Change In Operating Income Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment | 3.00% | |||||
Percentage Change In Discount Rate Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment | 1.00% | |||||
Vascular Access Clinic | ||||||
Goodwill [Line Items] | ||||||
Goodwill impairment charges | $ 10,498 | $ 34,696 | ||||
Goodwill | $ 0 | 0 | ||||
GERMANY | ||||||
Goodwill [Line Items] | ||||||
Goodwill impairment charges | 3,106 | |||||
BRAZIL | ||||||
Goodwill [Line Items] | ||||||
Goodwill | $ 54,940 | $ 54,940 | ||||
Carrying amount coverage | 9.80% | 9.80% | ||||
Sensitivities, operating income | (2.50%) | (2.50%) | ||||
Sensitivities, discount rate | (7.30%) |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2018 | Dec. 31, 2017 | |
Income Tax Disclosure [Abstract] | ||
Liability for unrecognized tax benefits | $ 39,966 | $ 32,776 |
Unrecognized Tax Benefits that Would Impact Effective Tax Rate | 37,123 | |
Increase in liability for unrecognized tax benefits | 7,190 | |
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits | $ 6,642 | $ 4,195 |
Long-term debt (Detail)
Long-term debt (Detail) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Debt Instrument [Line Items] | ||
Senior notes | $ 4,500,000 | $ 4,500,000 |
Acquisition obligations and other notes payable | 172,692 | 150,512 |
Capital lease obligations | 292,296 | 297,170 |
Total debt principal outstanding | 10,001,988 | 9,400,182 |
Discount and deferred financing costs | (57,901) | (63,951) |
Total amount of long-term debt | 9,944,087 | 9,336,231 |
Less current portion | (1,768,514) | (178,213) |
Long-term debt | 8,175,573 | 9,158,018 |
Term Loan A | ||
Debt Instrument [Line Items] | ||
Senior Secured Credit Facilities | 725,000 | 775,000 |
Term Loan A-2 | ||
Debt Instrument [Line Items] | ||
Senior Secured Credit Facilities | 952,000 | 0 |
Term Loan B | ||
Debt Instrument [Line Items] | ||
Senior Secured Credit Facilities | 3,360,000 | 3,377,500 |
Revolver | ||
Debt Instrument [Line Items] | ||
Senior Secured Credit Facilities | $ 0 | $ 300,000 |
Long-term debt - Scheduled Matu
Long-term debt - Scheduled Maturities of Long-term Debt (Detail) $ in Thousands | Jun. 30, 2018USD ($) |
Debt Disclosure [Abstract] | |
2018 (remainder of the year) | $ 95,011 |
2,019 | 1,712,246 |
2,020 | 74,792 |
2,021 | 3,311,046 |
2,022 | 1,287,741 |
2,023 | 162,580 |
Thereafter | $ 3,358,572 |
Long-term debt - Additional Inf
Long-term debt - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | |||||
Sep. 30, 2018 | Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | Mar. 29, 2018 | Dec. 31, 2017 | |
Debt Instrument [Line Items] | |||||||
Unrealized (losses) gains on interest rate cap agreements | $ (268) | $ (1,815) | $ 782 | $ (5,002) | |||
Weighted average effective interest rate on senior secured credit facilities | 4.99% | 4.99% | |||||
Weighted average effective interest rate during quarter | 4.91% | ||||||
Fixed interest rate | 48.82% | 48.82% | |||||
U.S. dialysis and related lab services | |||||||
Debt Instrument [Line Items] | |||||||
Letters of credit outstanding | $ 22,351 | $ 22,351 | |||||
DMG | |||||||
Debt Instrument [Line Items] | |||||||
Letters of credit outstanding | 211 | 211 | |||||
Revolving Credit Facility | |||||||
Debt Instrument [Line Items] | |||||||
Undrawn revolving credit facilities | 1,000,000 | 1,000,000 | |||||
Letter of Credit | |||||||
Debt Instrument [Line Items] | |||||||
Letters of credit outstanding | 14,355 | 14,355 | |||||
Interest Rate Cap Agreements Effective September 30, 2016 | |||||||
Debt Instrument [Line Items] | |||||||
Notional amounts of interest rate agreements | 3,500,000 | $ 3,500,000 | |||||
Derivative, effective date | Sep. 30, 2016 | ||||||
Debt expense recognized | $ 4,140 | ||||||
Interest Rate Cap Agreements Effective June 29, 2018 | |||||||
Debt Instrument [Line Items] | |||||||
Notional amounts of interest rate agreements | 3,500,000 | $ 3,500,000 | |||||
Derivative, effective date | Jun. 29, 2018 | ||||||
Derivative, expiration date | Jun. 30, 2020 | ||||||
Fair value of assets | $ 2,085 | $ 2,085 | |||||
Unrealized (losses) gains on interest rate cap agreements | $ 1,053 | ||||||
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective September 30, 2016 | |||||||
Debt Instrument [Line Items] | |||||||
LIBOR variable rate | 3.50% | 3.50% | |||||
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective June 29, 2018 | |||||||
Debt Instrument [Line Items] | |||||||
LIBOR variable rate | 3.50% | 3.50% | |||||
Term Loan A-2 | |||||||
Debt Instrument [Line Items] | |||||||
Line of Credit Facility, Maximum Borrowing Capacity | $ 995,000 | ||||||
Proceeds from Long-term Lines of Credit | $ 952,000 | ||||||
Senior Secured Credit Facilities | $ 952,000 | $ 952,000 | $ 0 | ||||
Term Loan A-2 | London Interbank Offered Rate (LIBOR) | |||||||
Debt Instrument [Line Items] | |||||||
LIBOR plus interest rate margin | 1.00% | ||||||
Term Loan A | |||||||
Debt Instrument [Line Items] | |||||||
Mandatory principal payments | 50,000 | $ 50,000 | |||||
Senior Secured Credit Facilities | 725,000 | $ 725,000 | 775,000 | ||||
Term Loan A | London Interbank Offered Rate (LIBOR) | |||||||
Debt Instrument [Line Items] | |||||||
LIBOR plus interest rate margin | 2.00% | ||||||
Term Loan B | |||||||
Debt Instrument [Line Items] | |||||||
Mandatory principal payments | 17,500 | $ 17,500 | |||||
Senior Secured Credit Facilities | 3,360,000 | $ 3,360,000 | $ 3,377,500 | ||||
Term Loan B | London Interbank Offered Rate (LIBOR) | |||||||
Debt Instrument [Line Items] | |||||||
LIBOR plus interest rate margin | 2.75% | ||||||
Term Loan A subject to interest rate caps | |||||||
Debt Instrument [Line Items] | |||||||
Senior Secured Credit Facilities | 140,000 | $ 140,000 | |||||
Term Loan A subject to uncapped portion of variability of LIBOR | |||||||
Debt Instrument [Line Items] | |||||||
Senior Secured Credit Facilities | $ 585,000 | $ 585,000 | |||||
Senior Secured Credit Facilities | |||||||
Debt Instrument [Line Items] | |||||||
Weighted average effective interest rate on senior secured credit facilities | 4.72% | 4.72% | |||||
Subsequent Event | Term Loan A-2 | |||||||
Debt Instrument [Line Items] | |||||||
Proceeds from Long-term Lines of Credit | $ 43,000 |
Long-term debt - Derivative Ins
Long-term debt - Derivative Instruments (Detail) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Designated as Hedging Instrument | Interest rate cap agreements | Other long-term assets | ||
Derivative [Line Items] | ||
Derivative assets, Fair value | $ 2,085 | $ 1,032 |
Long-term debt - Effects of Int
Long-term debt - Effects of Interest Rate Swap and Cap Agreements (Detail) - Cash Flow Hedging - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Derivative Instruments Gain Loss [Line Items] | ||||
Amount of unrecognized gains (losses) in OCI on interest rate cap agreements | $ (268) | $ (1,815) | $ 782 | $ (5,002) |
Amount of losses reclassified from accumulated OCI into income | 1,537 | 1,265 | 3,074 | 2,529 |
Tax benefit (expense) | ||||
Derivative Instruments Gain Loss [Line Items] | ||||
Amount of unrecognized gains (losses) in OCI on interest rate cap agreements | 93 | 1,154 | (271) | 3,184 |
Amount of losses reclassified from accumulated OCI into income | (533) | (805) | (1,066) | (1,610) |
Interest rate cap agreements | Debt Expense (Including Refinancing Charges) | ||||
Derivative Instruments Gain Loss [Line Items] | ||||
Amount of unrecognized gains (losses) in OCI on interest rate cap agreements | (361) | (2,969) | 1,053 | (8,186) |
Amount of losses reclassified from accumulated OCI into income | $ 2,070 | $ 2,070 | $ 4,140 | $ 4,139 |
Contingencies - Additional Info
Contingencies - Additional Information (Detail) - USD ($) $ in Thousands | Jun. 27, 2018 | Dec. 31, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 |
Other Commitments [Line Items] | ||||||
Gain on litigation settlement | $ 0 | $ 0 | $ 0 | $ 526,827 | ||
2016 U.S. Attorney Prescription Drug Investigation | ||||||
Other Commitments [Line Items] | ||||||
Litigation Settlement, Amount Awarded to Other Party | $ 63,700 | |||||
Loss Contingency Accrual, Payments | 41,500 | |||||
Loss Contingency Accrual, Partial Payment | $ 22,200 | |||||
White, Kathleen, et al | ||||||
Other Commitments [Line Items] | ||||||
Litigation Settlement, Amount Awarded to Other Party | $ 375,000 | |||||
Loss Contingency, Damages Awarded, Value | $ 8,500 | |||||
US Department Of Veterans Affairs Suit | ||||||
Other Commitments [Line Items] | ||||||
Litigation Settlement, Amount Awarded from Other Party | 538,000 | |||||
Gain on litigation settlement | 527,000 | |||||
Noncontrolling Interest | US Department Of Veterans Affairs Suit | ||||||
Other Commitments [Line Items] | ||||||
Gain on litigation settlement | 9,000 | |||||
Operating Income (Loss) | US Department Of Veterans Affairs Suit | ||||||
Other Commitments [Line Items] | ||||||
Gain on litigation settlement | 530,000 | |||||
Equity Method Investments | Noncontrolling Interest | US Department Of Veterans Affairs Suit | ||||||
Other Commitments [Line Items] | ||||||
Gain on litigation settlement | $ 3,000 |
Noncontrolling interests subj61
Noncontrolling interests subject to put provisions and other commitments - additional information (Detail) $ in Thousands | 6 Months Ended |
Jun. 30, 2018USD ($) | |
Minimum | |
Other Commitments [Line Items] | |
Scheduled dissolution term of joint ventures | 10 years |
Maximum | |
Other Commitments [Line Items] | |
Scheduled dissolution term of joint ventures | 50 years |
Commitments to provide operating capital | |
Other Commitments [Line Items] | |
Other potential commitments to provide operating capital to several dialysis centers | $ 5,446 |
Long-term incentive compensat62
Long-term incentive compensation - Additional Information (Detail) - USD ($) shares in Thousands, $ in Thousands | 6 Months Ended | |
Jun. 30, 2018 | Jun. 30, 2017 | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Long-term incentive program (LTIP) expense | $ 31,301 | $ 27,183 |
Stock-based compensation expense | 19,861 | 17,504 |
Estimated tax benefits recorded for stock-based compensation | 3,941 | 5,636 |
Unrecognized compensation cost related to outstanding LTIP awards | 153,984 | |
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans | $ 128,115 | |
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under performance-based cash component of LTIP costs, weighted average remaining period (in years) | 1 year | |
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under stock-based component of LTIP costs, weighted average remaining period (in years) | 1 year 8 months 12 days | |
Employee Service Share-based Compensation, Tax Benefit from Compensation Expense | $ 7,671 | 5,693 |
Stock Appreciation Rights | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock granted (in shares) | 1,780 | |
Aggregate grant-date fair value | $ 28,630 | |
Weighted-average expected life (in years) | 4 years 2 months 12 days | |
Restricted Stock Units | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock granted (in shares) | 1,094 | |
Aggregate grant-date fair value | $ 72,469 | |
Weighted-average expected life (in years) | 3 years 5 months | |
General and Administrative Expense | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock-based compensation expense | $ 20,717 | $ 16,404 |
Share repurchases (Details)
Share repurchases (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 1 Months Ended | 6 Months Ended | |
Jul. 31, 2018 | Jun. 30, 2018 | Oct. 10, 2017 | |
Equity, Class of Treasury Stock [Line Items] | |||
Repurchase of common stock (in shares) | 11,995 | ||
Value of treasury stock acquired | $ 809,900 | ||
Average cost of treasury stock (usd per share) | $ 67.52 | ||
Stock repurchase additional authorization amount | $ 1,389,999 | ||
Prior shares under repurchase authorization (in shares) | 110,001 | ||
Subsequent Event | |||
Equity, Class of Treasury Stock [Line Items] | |||
Repurchase of common stock (in shares) | 3,872 | ||
Value of treasury stock acquired | $ 272,902 | ||
Average cost of treasury stock (usd per share) | $ 70.48 | ||
Remaining repurchase authorized amount | $ 1,426,313 |
Comprehensive income (Detail)
Comprehensive income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | Apr. 01, 2018 | Jan. 01, 2018 | |
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | $ 4,886,066 | |||||
Ending balance | $ 4,484,507 | 4,484,507 | ||||
Interest rate cap and swap agreements | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | (12,527) | $ (13,952) | (12,408) | $ (12,029) | ||
Cumulative Effect of New Accounting Principle in Period of Adoption | $ 0 | $ (2,706) | ||||
Unrealized gains (losses) | (361) | (2,969) | 1,053 | (8,186) | ||
Related income tax (expense) benefit | 93 | 1,154 | (271) | 3,184 | ||
Unrealized (losses) gains net | (268) | (1,815) | 782 | (5,002) | ||
Reclassification from accumulated other comprehensive income into net income | 2,070 | 2,070 | 4,140 | 4,139 | ||
Related income tax (expense) benefit | (533) | (805) | (1,066) | (1,610) | ||
Reclassification from accumulated other comprehensive income into net income net of tax | 1,537 | 1,265 | 3,074 | 2,529 | ||
Ending balance | (11,258) | (14,502) | (11,258) | (14,502) | ||
Investment securities | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | 3,594 | 5,662 | 2,175 | |||
Cumulative Effect of New Accounting Principle in Period of Adoption | (5,662) | |||||
Unrealized gains (losses) | 1,446 | 0 | 3,428 | |||
Related income tax (expense) benefit | (389) | 0 | (812) | |||
Unrealized (losses) gains net | 1,057 | 0 | 2,616 | |||
Reclassification from accumulated other comprehensive income into net income | (117) | 0 | (346) | |||
Related income tax (expense) benefit | 46 | 0 | 135 | |||
Reclassification from accumulated other comprehensive income into net income net of tax | (71) | 0 | (211) | |||
Ending balance | 0 | 4,580 | 0 | 4,580 | ||
Foreign currency translation adjustments | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | 39,862 | (66,528) | 19,981 | (79,789) | ||
Cumulative Effect of New Accounting Principle in Period of Adoption | 0 | 0 | ||||
Unrealized gains (losses) | (50,529) | 49,142 | (30,648) | 62,403 | ||
Related income tax (expense) benefit | 0 | 0 | 0 | 0 | ||
Unrealized (losses) gains net | (50,529) | 49,142 | (30,648) | 62,403 | ||
Reclassification from accumulated other comprehensive income into net income | 0 | 0 | 0 | 0 | ||
Related income tax (expense) benefit | 0 | 0 | 0 | 0 | ||
Reclassification from accumulated other comprehensive income into net income net of tax | 0 | 0 | 0 | 0 | ||
Ending balance | (10,667) | (17,386) | (10,667) | (17,386) | ||
Accumulated other comprehensive income (loss) | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | 27,335 | (76,886) | 13,235 | (89,643) | ||
Cumulative Effect of New Accounting Principle in Period of Adoption | $ 0 | $ (8,368) | ||||
Unrealized gains (losses) | (50,890) | 47,619 | (29,595) | 57,645 | ||
Related income tax (expense) benefit | 93 | 765 | (271) | 2,372 | ||
Unrealized (losses) gains net | (50,797) | 48,384 | (29,866) | 60,017 | ||
Reclassification from accumulated other comprehensive income into net income | 2,070 | 1,953 | 4,140 | 3,793 | ||
Related income tax (expense) benefit | (533) | (759) | (1,066) | (1,475) | ||
Reclassification from accumulated other comprehensive income into net income net of tax | 1,537 | 1,194 | 3,074 | 2,318 | ||
Ending balance | $ (21,925) | $ (27,308) | $ (21,925) | $ (27,308) |
Acquisitions and divestitures -
Acquisitions and divestitures - Additional Information (Detail) $ in Thousands | Jun. 01, 2018USD ($) | Jun. 30, 2018USD ($) | Jun. 30, 2017USD ($) | Jun. 30, 2018USD ($)Clinic | Jun. 30, 2017USD ($) | Dec. 31, 2017USD ($) |
Business Acquisition [Line Items] | ||||||
Cash paid to acquire businesses | $ 89,465 | $ 619,839 | ||||
Contingent earn-out obligations and liabilities assumed associated with acquisitions | 14,333 | |||||
Gain (Loss) on Disposition of Business | $ 33,957 | $ 0 | 33,957 | $ 6,273 | ||
Contingent earn-out obligations | 7,489 | 7,489 | $ 6,388 | |||
Other Accrued Liabilities | ||||||
Business Acquisition [Line Items] | ||||||
Contingent earn-out obligations | 438 | 438 | ||||
Other long-term liabilities | ||||||
Business Acquisition [Line Items] | ||||||
Contingent earn-out obligations | 7,051 | 7,051 | ||||
Other companies | ||||||
Business Acquisition [Line Items] | ||||||
Contingent earn-out obligations | 7,489 | $ 7,489 | ||||
Minimum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins | ||||||
Business Acquisition [Line Items] | ||||||
Earn-out consideration payment period | 1 year | |||||
Maximum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins | ||||||
Business Acquisition [Line Items] | ||||||
Earn-out consideration payment period | 5 years | |||||
Dialysis and other businesses | ||||||
Business Acquisition [Line Items] | ||||||
Cash paid to acquire businesses | $ 88,185 | |||||
Deferred purchase price obligations | 15,968 | |||||
Contingent earn-out obligations and liabilities assumed associated with acquisitions | 4,900 | |||||
Goodwill deductible for tax purposes associated with acquisitions | $ 100,885 | $ 100,885 | ||||
Noncompete Agreements | ||||||
Business Acquisition [Line Items] | ||||||
Amortizable intangible assets acquired, weighted-average estimated useful lives | 5 years | |||||
U.S. dialysis and related lab services | Dialysis and other businesses | ||||||
Business Acquisition [Line Items] | ||||||
Number of businesses acquired | Clinic | 2 | |||||
Foreign Dialysis Centers | Dialysis and other businesses | ||||||
Business Acquisition [Line Items] | ||||||
Number of businesses acquired | Clinic | 18 | |||||
Paladina | ||||||
Business Acquisition [Line Items] | ||||||
Sale of Stock, Percentage of Ownership before Transaction | 100.00% | |||||
Gain (Loss) on Disposition of Business | $ 35,205 |
Acquisitions and divestitures66
Acquisitions and divestitures - Aggregate Purchase Cost Allocations for Acquisitions (Detail) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 | Dec. 31, 2016 |
Business Acquisition [Line Items] | |||
Goodwill | $ 6,678,559 | $ 6,610,279 | $ 6,015,375 |
Dialysis and other businesses | |||
Business Acquisition [Line Items] | |||
Current assets | 8,854 | ||
Property and equipment | 4,303 | ||
Intangible and other long-term assets | 1,486 | ||
Goodwill | 106,220 | ||
Current liabilities | (10,290) | ||
Long-term liabilities | (171) | ||
Noncontrolling interests | (1,349) | ||
Aggregate purchase price | $ 109,053 |
Acquisitions and divestitures67
Acquisitions and divestitures - Reconciliation of Changes in Contingent Earn-Out Obligations (Detail) $ in Thousands | 6 Months Ended |
Jun. 30, 2018USD ($) | |
Contingent Earn-Out Obligations [Roll Forward] | |
Beginning balance | $ 6,388 |
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability | (1,436) |
Remeasurement of fair value for contingent earn-out obligations | (335) |
Ending balance | $ 7,489 |
Held for Sale and Discontinue68
Held for Sale and Discontinued Operations Additional Information (Details) $ in Thousands | Jun. 01, 2018USD ($) | Dec. 31, 2017USD ($) | Jun. 30, 2018USD ($) | Jun. 30, 2017USD ($) | Jun. 30, 2018USD ($)clinic | Jun. 30, 2017USD ($) | Dec. 31, 2017USD ($) |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Proceeds from Divestiture of Businesses | $ 4,900,000 | ||||||
Payments to Acquire Businesses, Gross | $ 89,465 | $ 619,839 | |||||
Goodwill impairment charges | $ 3,106 | $ 10,498 | 3,106 | 34,696 | $ 36,196 | ||
Series of Individually Immaterial Business Acquisitions [Member] | |||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Payments to Acquire Businesses, Gross | $ 88,185 | ||||||
DMG held for sale | Series of Individually Immaterial Business Acquisitions [Member] | |||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Number of businesses acquired | clinic | 2 | ||||||
Payments to Acquire Businesses, Gross | $ 1,280 | ||||||
Business Combination, Consideration Transferred, Other | 99 | ||||||
Discontinued Operations, Held-for-sale | DMG held for sale | |||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Goodwill impairment charges | $ 0 | $ 50,619 | $ 0 | $ 50,619 | |||
Tandigm Health | |||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Sale of Stock, Percentage of Ownership before Transaction | 19.00% | ||||||
Gain (Loss) on Disposition of Business, Net of Tax | $ 18,636 |
Held for Sale and Discontinue69
Held for Sale and Discontinued Operations Schedule of Financial Results of DMG's Discontinued Operations (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | 12 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | Dec. 31, 2017 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||
Goodwill impairment charges | $ 3,106 | $ 10,498 | $ 3,106 | $ 34,696 | $ 36,196 |
Net income (loss) from discontinued operations, net of tax | 69,696 | (24,520) | 63,910 | (18,087) | |
DMG held for sale | Discontinued Operations, Held-for-sale | |||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||
Revenues | 1,252,430 | 1,196,066 | 2,480,362 | 2,283,050 | |
Expenses | 1,192,528 | 1,157,901 | 2,418,935 | 2,232,352 | |
Goodwill impairment charges | 0 | 50,619 | 0 | 50,619 | |
Income (loss) from discontinued operations before taxes | 59,902 | (12,454) | 61,427 | 79 | |
Income tax benefit (expense) | $ 9,794 | $ (12,066) | $ 2,483 | $ (18,166) |
Held for Sale and Discontinue70
Held for Sale and Discontinued Operations Schedule of Financial Position of Discontinued Operations Related to DMG (Details) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||
Total current assets held for sale | $ 6,053,081 | $ 5,761,642 |
Total current liabilities held for sale | 1,271,364 | 1,185,070 |
DMG held for sale | Discontinued Operations, Held-for-sale | ||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||
Cash and cash equivalents | 404,435 | 179,668 |
Other current assets | 862,764 | 826,608 |
Property and equipment, net | 425,943 | 379,945 |
Intangible assets, net | 1,316,468 | 1,316,550 |
Other long-term assets | 161,622 | 178,894 |
Goodwill | 2,881,849 | 2,879,977 |
Other liabilities | 580,978 | 505,734 |
Medical payables | 487,920 | 457,040 |
Current portion of long-term debt | 2,636 | 2,845 |
Long-term debt | 34,076 | 35,003 |
Other long-term liabilities | $ 165,754 | $ 184,448 |
Held for Sale and Discontinue71
Held for Sale and Discontinued Operations Schedule of Cash Flows of Discontinued Operations Related to DMG (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Jun. 30, 2018 | Jun. 30, 2017 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||
Net cash provided by operating activities from discontinued operations | $ 112,683 | $ 101,215 |
Net cash used in investing activities from discontinued operations | $ (20,982) | $ (85,289) |
Variable interest entities - Ad
Variable interest entities - Additional Information (Detail) $ in Thousands | Jun. 30, 2018USD ($) |
Variable Interest Entity [Line Items] | |
Total assets of variable interest entities | $ 880,290 |
Total liabilities of variable interest entities | 490,229 |
DMG held for sale | |
Variable Interest Entity [Line Items] | |
Total assets of variable interest entities | 625,573 |
Total liabilities of variable interest entities | $ 341,327 |
Fair value of financial instr73
Fair value of financial instruments - Assets, Liabilities and Temporary Equity Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Assets | ||
Investments in mutual funds and common stock | $ 38,895 | |
Liabilities | ||
Contingent earn-out obligations | $ 7,489 | $ 6,388 |
Fair Value, Measurements, Recurring | ||
Assets | ||
Investments in mutual funds and common stock | 36,500 | |
Liabilities | ||
Contingent earn-out obligations | 7,489 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 1,047,158 | |
Fair Value, Measurements, Recurring | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | 2,085 | |
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1) | ||
Assets | ||
Investments in mutual funds and common stock | 36,500 | |
Liabilities | ||
Contingent earn-out obligations | 0 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 0 | |
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1) | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | 0 | |
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2) | ||
Assets | ||
Investments in mutual funds and common stock | 0 | |
Liabilities | ||
Contingent earn-out obligations | 0 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 0 | |
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2) | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | 2,085 | |
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | ||
Assets | ||
Investments in mutual funds and common stock | 0 | |
Liabilities | ||
Contingent earn-out obligations | 7,489 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 1,047,158 | |
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | $ 0 |
Fair Value of financial instr74
Fair Value of financial instruments - Additional Information (Detail) $ in Thousands | Jun. 30, 2018USD ($) |
Estimate of Fair Value Measurement | Senior Secured Credit Facilities | |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | |
Long-term debt value | $ 5,064,405 |
Estimate of Fair Value Measurement | Senior Notes | |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | |
Long-term debt value | 4,391,600 |
Reported Value Measurement | Senior Secured Credit Facilities | |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | |
Long-term debt value | 5,015,669 |
Reported Value Measurement | Senior Notes | |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | |
Long-term debt value | $ 4,463,430 |
Segment reporting - Additional
Segment reporting - Additional Information (Detail) | 6 Months Ended |
Jun. 30, 2018Segment | |
Segment Reporting [Abstract] | |
Number of operating segments | 2 |
Segment reporting - Summary of
Segment reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes (Detail) - USD ($) | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,718,403,000 | $ 2,494,609,000 | $ 5,309,477,000 | $ 4,917,395,000 |
Provision for uncollectible accounts | (49,406,000) | (109,600,000) | (23,861,000) | (216,658,000) |
Net U.S. dialysis and related lab services patient service revenues | 2,668,997,000 | 2,385,009,000 | 5,285,616,000 | 4,700,737,000 |
Other revenues | 217,956,000 | 314,390,000 | 450,781,000 | 629,913,000 |
Total revenues | 2,886,953,000 | 2,699,399,000 | 5,736,397,000 | 5,330,650,000 |
Operating income (loss) | 438,192,000 | 391,196,000 | 848,878,000 | 1,267,124,000 |
Corporate administrative support | (14,066,000) | (11,031,000) | (29,769,000) | (21,622,000) |
Debt expense | (119,692,000) | (107,934,000) | (233,208,000) | (212,331,000) |
Other income, net | 1,994,000 | 4,798,000 | 6,576,000 | 8,784,000 |
Income from continuing operations before income taxes | 320,494,000 | 288,060,000 | 622,246,000 | 1,063,577,000 |
U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | 2,568,247,000 | 2,311,930,000 | 5,087,724,000 | 4,571,324,000 |
Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | 318,706,000 | 387,469,000 | 648,673,000 | 759,326,000 |
Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | 2,916,238,000 | 2,718,808,000 | 5,794,303,000 | 5,368,227,000 |
Operating income (loss) | 452,258,000 | 402,227,000 | 878,647,000 | 1,288,746,000 |
Operating Segments | U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 2,632,830,000 | 2,429,658,000 | 5,140,418,000 | 4,802,318,000 |
Provision for uncollectible accounts | (49,406,000) | (109,292,000) | (24,208,000) | (216,069,000) |
Net U.S. dialysis and related lab services patient service revenues | 2,583,424,000 | 2,320,366,000 | 5,116,210,000 | 4,586,249,000 |
Other revenues | 4,919,000 | 4,849,000 | 10,033,000 | 10,159,000 |
Total revenues | 2,588,343,000 | 2,325,215,000 | 5,126,243,000 | 4,596,408,000 |
Operating income (loss) | 449,443,000 | 450,472,000 | 882,822,000 | 1,395,212,000 |
Operating Segments | U.S. dialysis and related lab services | External Sources | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 2,612,734,000 | 2,416,373,000 | 5,101,899,000 | 4,777,234,000 |
Operating Segments | U.S. dialysis and related lab services | Intersubsegment Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 20,096,000 | 13,285,000 | 38,519,000 | 25,084,000 |
Operating Segments | Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 105,669,000 | 77,928,000 | 207,925,000 | 139,572,000 |
Other revenues | 213,037,000 | 309,541,000 | 440,748,000 | 619,754,000 |
Total revenues | 327,895,000 | 393,593,000 | 668,060,000 | 771,819,000 |
Operating income (loss) | 2,815,000 | (48,245,000) | (4,175,000) | (106,466,000) |
Operating Segments | Other—Ancillary services and strategic initiatives | Intersubsegment Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 9,189,000 | 6,124,000 | 19,387,000 | 12,493,000 |
Intersegment Elimination | ||||
Segment Reporting Information [Line Items] | ||||
Other revenues | (29,285,000) | (19,409,000) | (57,906,000) | (37,577,000) |
Total revenues | (29,285,000) | (19,409,000) | (57,906,000) | (37,577,000) |
Intersegment Elimination | U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Other revenues | (20,096,000) | (13,285,000) | (38,519,000) | (25,084,000) |
Intersegment Elimination | Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Other revenues | $ (9,189,000) | $ (6,124,000) | $ (19,387,000) | $ (12,493,000) |
Segment reporting - Summary o77
Segment reporting - Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Segment Reporting Information [Line Items] | ||||
Depreciation and amortization | $ 147,079 | $ 140,026 | $ 289,878 | $ 272,910 |
U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Depreciation and amortization | 138,252 | 130,001 | 273,028 | 255,030 |
Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Depreciation and amortization | $ 8,827 | $ 10,025 | $ 16,850 | $ 17,880 |
Segment reporting - Summary o78
Segment reporting - Summary of Assets by Segment (Detail) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
ASSETS | ||
Total assets | $ 19,435,564 | $ 18,948,193 |
U.S. dialysis and related lab services | ||
ASSETS | ||
Total assets | 11,989,864 | 11,776,042 |
Other—Ancillary services and strategic initiatives | ||
ASSETS | ||
Total assets | 1,392,619 | 1,410,509 |
DMG held for sale | ||
ASSETS | ||
Total assets | $ 6,053,081 | $ 5,761,642 |
Segment reporting - Summary o79
Segment reporting - Summary of Assets by Segment (Phantom) (Detail) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Segment Reporting Information [Line Items] | ||
Equity method and other investments | $ 249,020 | $ 245,534 |
U.S. dialysis and related lab services | ||
Segment Reporting Information [Line Items] | ||
Equity method and other investments | 93,282 | 84,866 |
Other—Ancillary services and strategic initiatives | ||
Segment Reporting Information [Line Items] | ||
Equity method and other investments | 155,738 | 160,668 |
DMG held for sale | ||
Segment Reporting Information [Line Items] | ||
Equity method and other investments | $ 5,099 | $ 10,321 |
Segment reporting - Summary o80
Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | $ 241,534 | $ 184,405 | $ 473,977 | $ 398,940 |
U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | 194,188 | 152,233 | 383,238 | 325,761 |
Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | 25,047 | 11,289 | 37,392 | 24,508 |
DMG held for sale | ||||
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | $ 22,299 | $ 20,883 | $ 53,347 | $ 48,671 |
Changes in DaVita Inc.'s owne81
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries - Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | ||||
Net income attributable to DaVita Inc. | $ 267,276 | $ 127,001 | $ 445,962 | $ 574,698 |
Sales of noncontrolling interests | 3 | 0 | 79 | 0 |
Purchases of noncontrolling interests | (10,203) | (12,197) | ||
Purchases of noncontrolling Interests | 618 | 195 | ||
Net transfers to noncontrolling interests | (10,200) | 618 | (12,118) | 195 |
Net income attributable to DaVita Inc., net of transfers to noncontrolling interests | 257,076 | 127,619 | 433,844 | 574,893 |
DaVita Inc. | Reportable Legal Entities | ||||
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | ||||
Net income attributable to DaVita Inc. | $ 267,276 | $ 127,001 | $ 445,962 | $ 574,698 |
Condensed consolidating finan82
Condensed consolidating financial statements - Condensed Consolidating Statements of Operations (Detail) - USD ($) | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,718,403,000 | $ 2,494,609,000 | $ 5,309,477,000 | $ 4,917,395,000 |
Less: Provision for uncollectible accounts | (49,406,000) | (109,600,000) | (23,861,000) | (216,658,000) |
Net dialysis and related lab patient service revenues | 2,668,997,000 | 2,385,009,000 | 5,285,616,000 | 4,700,737,000 |
Other revenues | 217,956,000 | 314,390,000 | 450,781,000 | 629,913,000 |
Total revenues | 2,886,953,000 | 2,699,399,000 | 5,736,397,000 | 5,330,650,000 |
Operating expenses and charges | 2,448,761,000 | 2,308,203,000 | 4,887,519,000 | 4,063,526,000 |
Operating income | 438,192,000 | 391,196,000 | 848,878,000 | 1,267,124,000 |
Debt expense | (119,692,000) | (107,934,000) | (233,208,000) | (212,331,000) |
Other income, net | 1,994,000 | 4,798,000 | 6,576,000 | 8,784,000 |
Income tax expense | 83,868,000 | 101,915,000 | 154,605,000 | 383,580,000 |
Equity (loss) earnings in subsidiaries | 0 | 0 | 0 | 0 |
Net income from continuing operations | 236,626,000 | 186,145,000 | 467,641,000 | 679,997,000 |
Net income (loss) from discontinued operations, net of tax | 69,696,000 | (24,520,000) | 63,910,000 | (18,087,000) |
Net income | 306,322,000 | 161,625,000 | 531,551,000 | 661,910,000 |
Less: Net income attributable to noncontrolling interests | (39,046,000) | (34,624,000) | (85,589,000) | (87,212,000) |
Net income attributable to DaVita Inc. | 267,276,000 | 127,001,000 | 445,962,000 | 574,698,000 |
Consolidating adjustments | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | (49,788,000) | (39,601,000) | (97,303,000) | (76,772,000) |
Less: Provision for uncollectible accounts | 0 | 0 | 0 | 0 |
Net dialysis and related lab patient service revenues | (49,788,000) | (39,601,000) | (97,303,000) | (76,772,000) |
Other revenues | (244,764,000) | (200,349,000) | (483,397,000) | (427,920,000) |
Total revenues | (294,552,000) | (239,950,000) | (580,700,000) | (504,692,000) |
Operating expenses and charges | (294,552,000) | (239,950,000) | (580,700,000) | (504,692,000) |
Operating income | 0 | 0 | 0 | 0 |
Debt expense | 62,759,000 | 59,380,000 | 123,149,000 | 117,522,000 |
Other income, net | (110,646,000) | (104,867,000) | (218,372,000) | (207,607,000) |
Income tax expense | 0 | 0 | 0 | 0 |
Equity (loss) earnings in subsidiaries | (428,691,000) | (181,457,000) | (636,303,000) | (738,574,000) |
Net income from continuing operations | (476,578,000) | (226,944,000) | (731,526,000) | (828,659,000) |
Net income (loss) from discontinued operations, net of tax | 47,887,000 | 45,487,000 | 95,223,000 | 90,085,000 |
Net income | (428,691,000) | (181,457,000) | (636,303,000) | (738,574,000) |
Less: Net income attributable to noncontrolling interests | (39,046,000) | (34,624,000) | (85,589,000) | (87,212,000) |
Net income attributable to DaVita Inc. | (467,737,000) | (216,081,000) | (721,892,000) | (825,786,000) |
DaVita Inc. | Reportable Legal Entities | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 0 | 0 | 0 | 0 |
Less: Provision for uncollectible accounts | 0 | 0 | 0 | 0 |
Net dialysis and related lab patient service revenues | 0 | 0 | 0 | 0 |
Other revenues | 205,317,000 | 193,585,000 | 400,882,000 | 414,971,000 |
Total revenues | 205,317,000 | 193,585,000 | 400,882,000 | 414,971,000 |
Operating expenses and charges | 145,649,000 | 138,104,000 | 279,005,000 | 270,014,000 |
Operating income | 59,668,000 | 55,481,000 | 121,877,000 | 144,957,000 |
Debt expense | (120,814,000) | (106,159,000) | (235,148,000) | (208,823,000) |
Other income, net | 105,344,000 | 102,299,000 | 209,425,000 | 202,636,000 |
Income tax expense | 13,257,000 | 20,528,000 | 27,644,000 | 54,481,000 |
Equity (loss) earnings in subsidiaries | 236,335,000 | 95,908,000 | 377,452,000 | 490,409,000 |
Net income from continuing operations | 267,276,000 | 127,001,000 | 445,962,000 | 574,698,000 |
Net income (loss) from discontinued operations, net of tax | 0 | 0 | 0 | 0 |
Net income | 267,276,000 | 127,001,000 | 445,962,000 | 574,698,000 |
Less: Net income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income attributable to DaVita Inc. | 267,276,000 | 127,001,000 | 445,962,000 | 574,698,000 |
Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 1,831,545,000 | 1,654,430,000 | 3,621,733,000 | 3,185,156,000 |
Less: Provision for uncollectible accounts | (27,159,000) | (72,845,000) | (17,531,000) | (133,898,000) |
Net dialysis and related lab patient service revenues | 1,804,386,000 | 1,581,585,000 | 3,604,202,000 | 3,051,258,000 |
Other revenues | 214,266,000 | 305,319,000 | 419,226,000 | 610,937,000 |
Total revenues | 2,018,652,000 | 1,886,904,000 | 4,023,428,000 | 3,662,195,000 |
Operating expenses and charges | 1,850,377,000 | 1,682,483,000 | 3,641,471,000 | 2,891,303,000 |
Operating income | 168,275,000 | 204,421,000 | 381,957,000 | 770,892,000 |
Debt expense | (52,363,000) | (48,117,000) | (104,560,000) | (95,760,000) |
Other income, net | 2,856,000 | 1,369,000 | 5,379,000 | 4,172,000 |
Income tax expense | 40,019,000 | 71,299,000 | 88,962,000 | 307,165,000 |
Equity (loss) earnings in subsidiaries | 192,356,000 | 85,549,000 | 258,851,000 | 248,165,000 |
Net income from continuing operations | 271,105,000 | 171,923,000 | 452,665,000 | 620,304,000 |
Net income (loss) from discontinued operations, net of tax | (34,770,000) | (76,015,000) | (75,213,000) | (129,895,000) |
Net income | 236,335,000 | 95,908,000 | 377,452,000 | 490,409,000 |
Less: Net income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income attributable to DaVita Inc. | 236,335,000 | 95,908,000 | 377,452,000 | 490,409,000 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 936,646,000 | 879,780,000 | 1,785,047,000 | 1,809,011,000 |
Less: Provision for uncollectible accounts | (22,247,000) | (36,755,000) | (6,330,000) | (82,760,000) |
Net dialysis and related lab patient service revenues | 914,399,000 | 843,025,000 | 1,778,717,000 | 1,726,251,000 |
Other revenues | 43,137,000 | 15,835,000 | 114,070,000 | 31,925,000 |
Total revenues | 957,536,000 | 858,860,000 | 1,892,787,000 | 1,758,176,000 |
Operating expenses and charges | 747,287,000 | 727,566,000 | 1,547,743,000 | 1,406,901,000 |
Operating income | 210,249,000 | 131,294,000 | 345,044,000 | 351,275,000 |
Debt expense | (9,274,000) | (13,038,000) | (16,649,000) | (25,270,000) |
Other income, net | 4,440,000 | 5,997,000 | 10,144,000 | 9,583,000 |
Income tax expense | 30,592,000 | 10,088,000 | 37,999,000 | 21,934,000 |
Equity (loss) earnings in subsidiaries | 0 | 0 | 0 | 0 |
Net income from continuing operations | 174,823,000 | 114,165,000 | 300,540,000 | 313,654,000 |
Net income (loss) from discontinued operations, net of tax | 56,579,000 | 6,008,000 | 43,900,000 | 21,723,000 |
Net income | 231,402,000 | 120,173,000 | 344,440,000 | 335,377,000 |
Less: Net income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income attributable to DaVita Inc. | $ 231,402,000 | $ 120,173,000 | $ 344,440,000 | $ 335,377,000 |
Condensed consolidating finan83
Condensed consolidating financial statements - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Condensed Financial Statements Captions [Line Items] | ||||
Net income | $ 306,322 | $ 161,625 | $ 531,551 | $ 661,910 |
Other comprehensive income | (49,260) | 49,578 | (26,792) | 62,333 |
Total comprehensive income | 257,062 | 211,203 | 504,759 | 724,243 |
Less: Comprehensive income attributable to noncontrolling interests | (39,046) | (34,624) | (85,589) | (87,210) |
Comprehensive income attributable to DaVita Inc. | 218,016 | 176,579 | 419,170 | 637,033 |
Consolidating adjustments | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | (428,691) | (181,457) | (636,303) | (738,574) |
Other comprehensive income | 0 | 0 | 0 | 0 |
Total comprehensive income | (428,691) | (181,457) | (636,303) | (738,574) |
Less: Comprehensive income attributable to noncontrolling interests | (39,046) | (34,624) | (85,589) | (87,210) |
Comprehensive income attributable to DaVita Inc. | (467,737) | (216,081) | (721,892) | (825,784) |
DaVita Inc. | Reportable Legal Entities | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 267,276 | 127,001 | 445,962 | 574,698 |
Other comprehensive income | 1,269 | 436 | 3,856 | (70) |
Total comprehensive income | 268,545 | 127,437 | 449,818 | 574,628 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income attributable to DaVita Inc. | 268,545 | 127,437 | 449,818 | 574,628 |
Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 236,335 | 95,908 | 377,452 | 490,409 |
Other comprehensive income | 0 | 0 | 0 | 0 |
Total comprehensive income | 236,335 | 95,908 | 377,452 | 490,409 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income attributable to DaVita Inc. | 236,335 | 95,908 | 377,452 | 490,409 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 231,402 | 120,173 | 344,440 | 335,377 |
Other comprehensive income | (50,529) | 49,142 | (30,648) | 62,403 |
Total comprehensive income | 180,873 | 169,315 | 313,792 | 397,780 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income attributable to DaVita Inc. | $ 180,873 | $ 169,315 | $ 313,792 | $ 397,780 |
Condensed consolidating finan84
Condensed consolidating financial statements - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 | Dec. 31, 2016 |
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | $ 389,264 | $ 508,234 | |
Restricted cash and equivalents | 90,884 | 10,686 | |
Accounts receivable, net | 1,842,108 | 1,714,750 | |
Other current assets | 710,025 | 749,046 | |
Current assets held for sale | 6,053,081 | 5,761,642 | |
Total current assets | 9,085,362 | 8,744,358 | |
Property and equipment, net | 3,229,098 | 3,149,213 | |
Intangible assets, net | 100,255 | 113,827 | |
Investments in subsidiaries | 0 | 0 | |
Intercompany receivables | 0 | 0 | |
Other long-term assets and investments | 342,290 | 330,516 | |
Goodwill | 6,678,559 | 6,610,279 | $ 6,015,375 |
Total assets | 19,435,564 | 18,948,193 | |
Current liabilities | 3,512,414 | 1,856,107 | |
Current liabilities held for sale | 1,271,364 | 1,185,070 | |
Intercompany payables | 0 | 0 | |
Long-term debt and other long-term liabilities | 9,120,121 | 10,009,590 | |
Noncontrolling interests subject to put provisions | 1,047,158 | 1,011,360 | |
Total DaVita Inc. shareholders' equity | 4,279,184 | 4,690,029 | |
Noncontrolling interests not subject to put provisions | 205,323 | 196,037 | |
Total equity | 4,484,507 | 4,886,066 | |
Total liabilities and equity | 19,435,564 | 18,948,193 | |
Consolidating adjustments | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 0 | 0 | |
Restricted cash and equivalents | 0 | 0 | |
Accounts receivable, net | 0 | 0 | |
Other current assets | 0 | 0 | |
Current assets held for sale | 0 | 0 | |
Total current assets | 0 | 0 | |
Property and equipment, net | 0 | 0 | |
Intangible assets, net | 0 | 0 | |
Investments in subsidiaries | (13,468,634) | (13,095,596) | |
Intercompany receivables | (4,965,303) | (4,991,160) | |
Other long-term assets and investments | 0 | 0 | |
Goodwill | 0 | 0 | |
Total assets | (18,433,937) | (18,086,756) | |
Current liabilities | 0 | 0 | |
Current liabilities held for sale | 0 | 0 | |
Intercompany payables | (4,965,303) | (4,991,160) | |
Long-term debt and other long-term liabilities | 0 | 0 | |
Noncontrolling interests subject to put provisions | 443,650 | 436,758 | |
Total DaVita Inc. shareholders' equity | (13,468,634) | (13,095,596) | |
Noncontrolling interests not subject to put provisions | (443,650) | (436,758) | |
Total equity | (13,912,284) | (13,532,354) | |
Total liabilities and equity | (18,433,937) | (18,086,756) | |
DaVita Inc. | Reportable Legal Entities | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 193,991 | 149,305 | |
Restricted cash and equivalents | 1,004 | 1,002 | |
Accounts receivable, net | 0 | 0 | |
Other current assets | 37,185 | 67,025 | |
Current assets held for sale | 0 | 0 | |
Total current assets | 232,180 | 217,332 | |
Property and equipment, net | 441,159 | 408,010 | |
Intangible assets, net | 199 | 250 | |
Investments in subsidiaries | 10,304,847 | 10,009,874 | |
Intercompany receivables | 3,579,186 | 3,677,947 | |
Other long-term assets and investments | 54,077 | 47,297 | |
Goodwill | 0 | 0 | |
Total assets | 14,611,648 | 14,360,710 | |
Current liabilities | 1,831,526 | 238,706 | |
Current liabilities held for sale | 0 | 0 | |
Intercompany payables | 0 | 0 | |
Long-term debt and other long-term liabilities | 7,897,430 | 8,857,373 | |
Noncontrolling interests subject to put provisions | 603,508 | 574,602 | |
Total DaVita Inc. shareholders' equity | 4,279,184 | 4,690,029 | |
Noncontrolling interests not subject to put provisions | 0 | 0 | |
Total equity | 4,279,184 | 4,690,029 | |
Total liabilities and equity | 14,611,648 | 14,360,710 | |
Guarantor subsidiaries | Reportable Legal Entities | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 0 | 0 | |
Restricted cash and equivalents | 11,367 | 9,384 | |
Accounts receivable, net | 1,274,067 | 1,208,715 | |
Other current assets | 547,928 | 595,066 | |
Current assets held for sale | 5,101,853 | 4,992,067 | |
Total current assets | 6,935,215 | 6,805,232 | |
Property and equipment, net | 1,553,931 | 1,560,390 | |
Intangible assets, net | 46,491 | 50,971 | |
Investments in subsidiaries | 3,163,787 | 3,085,722 | |
Intercompany receivables | 0 | 0 | |
Other long-term assets and investments | 68,922 | 68,344 | |
Goodwill | 4,767,041 | 4,732,320 | |
Total assets | 16,535,387 | 16,302,979 | |
Current liabilities | 1,219,455 | 1,181,139 | |
Current liabilities held for sale | 734,745 | 739,294 | |
Intercompany payables | 3,548,086 | 3,690,042 | |
Long-term debt and other long-term liabilities | 728,254 | 682,630 | |
Noncontrolling interests subject to put provisions | 0 | 0 | |
Total DaVita Inc. shareholders' equity | 10,304,847 | 10,009,874 | |
Noncontrolling interests not subject to put provisions | 0 | 0 | |
Total equity | 10,304,847 | 10,009,874 | |
Total liabilities and equity | 16,535,387 | 16,302,979 | |
Non- Guarantor subsidiaries | Reportable Legal Entities | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 195,273 | 358,929 | |
Restricted cash and equivalents | 78,513 | 300 | |
Accounts receivable, net | 568,041 | 506,035 | |
Other current assets | 124,912 | 86,955 | |
Current assets held for sale | 951,228 | 769,575 | |
Total current assets | 1,917,967 | 1,721,794 | |
Property and equipment, net | 1,234,008 | 1,180,813 | |
Intangible assets, net | 53,565 | 62,606 | |
Investments in subsidiaries | 0 | 0 | |
Intercompany receivables | 1,386,117 | 1,313,213 | |
Other long-term assets and investments | 219,291 | 214,875 | |
Goodwill | 1,911,518 | 1,877,959 | |
Total assets | 6,722,466 | 6,371,260 | |
Current liabilities | 461,433 | 436,262 | |
Current liabilities held for sale | 536,619 | 445,776 | |
Intercompany payables | 1,417,217 | 1,301,118 | |
Long-term debt and other long-term liabilities | 494,437 | 469,587 | |
Noncontrolling interests subject to put provisions | 0 | 0 | |
Total DaVita Inc. shareholders' equity | 3,163,787 | 3,085,722 | |
Noncontrolling interests not subject to put provisions | 648,973 | 632,795 | |
Total equity | 3,812,760 | 3,718,517 | |
Total liabilities and equity | $ 6,722,466 | $ 6,371,260 |
Condensed consolidating finan85
Condensed consolidating financial statements - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Cash flows from operating activities: | ||||
Net income | $ 306,322 | $ 161,625 | $ 531,551 | $ 661,910 |
Changes in operating assets and liabilities and non-cash items included in net income | 393,024 | 353,147 | ||
Net cash provided by operating activities | 924,575 | 1,015,057 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (241,534) | (184,405) | (473,977) | (398,940) |
Acquisitions | (89,465) | (619,839) | ||
Proceeds from asset and business sales | 116,241 | 70,236 | ||
Proceeds (purchases) from investment sales and other items, net | 23,137 | 96,936 | ||
Net cash used in investing activities | (424,064) | (851,607) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | 573,981 | (64,032) | ||
Intercompany borrowing (payments) | 0 | 0 | ||
Other items | (879,890) | (301,146) | ||
Net cash used in financing activities | (305,909) | (365,178) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (3,473) | 4,192 | ||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 191,129 | (197,536) | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 518,920 | 683,463 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 480,148 | 453,207 | 480,148 | 453,207 |
Consolidating adjustments | ||||
Cash flows from operating activities: | ||||
Net income | (428,691) | (181,457) | (636,303) | (738,574) |
Changes in operating assets and liabilities and non-cash items included in net income | 636,303 | 738,574 | ||
Net cash provided by operating activities | 0 | 0 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | 0 | 0 | ||
Acquisitions | 0 | 0 | ||
Proceeds from asset and business sales | 0 | 0 | ||
Proceeds (purchases) from investment sales and other items, net | 0 | 0 | ||
Net cash used in investing activities | 0 | 0 | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | 0 | 0 | ||
Intercompany borrowing (payments) | 0 | 0 | ||
Other items | 0 | 0 | ||
Net cash used in financing activities | 0 | 0 | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | 0 | ||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 0 | 0 | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 0 | 0 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 0 | 0 | 0 | 0 |
DaVita Inc. | Reportable Legal Entities | ||||
Cash flows from operating activities: | ||||
Net income | 267,276 | 127,001 | 445,962 | 574,698 |
Changes in operating assets and liabilities and non-cash items included in net income | (361,991) | (429,399) | ||
Net cash provided by operating activities | 83,971 | 145,299 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (77,169) | (50,966) | ||
Acquisitions | 0 | |||
Proceeds from asset and business sales | 0 | 0 | ||
Proceeds (purchases) from investment sales and other items, net | 32,415 | 49,036 | ||
Net cash used in investing activities | (44,754) | (1,930) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | 584,500 | (54,992) | ||
Intercompany borrowing (payments) | 225,216 | (39,814) | ||
Other items | (804,245) | (223,511) | ||
Net cash used in financing activities | 5,471 | (318,317) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | 0 | ||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 44,688 | (174,948) | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 150,307 | 549,921 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 194,995 | 374,973 | 194,995 | 374,973 |
Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from operating activities: | ||||
Net income | 236,335 | 95,908 | 377,452 | 490,409 |
Changes in operating assets and liabilities and non-cash items included in net income | 26,502 | 37,851 | ||
Net cash provided by operating activities | 403,954 | 528,260 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (258,471) | (182,494) | ||
Acquisitions | (8,195) | (538,450) | ||
Proceeds from asset and business sales | 28,546 | 70,127 | ||
Proceeds (purchases) from investment sales and other items, net | (8,257) | (2,933) | ||
Net cash used in investing activities | (246,377) | (653,750) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (5,429) | (6,893) | ||
Intercompany borrowing (payments) | (130,553) | 117,661 | ||
Other items | (13,208) | (1,432) | ||
Net cash used in financing activities | (149,190) | 109,336 | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | 0 | ||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 8,387 | (16,154) | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 9,384 | 8,687 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 11,367 | 8,727 | 11,367 | 8,727 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from operating activities: | ||||
Net income | 231,402 | 120,173 | 344,440 | 335,377 |
Changes in operating assets and liabilities and non-cash items included in net income | 92,210 | 6,121 | ||
Net cash provided by operating activities | 436,650 | 341,498 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (138,337) | (165,480) | ||
Acquisitions | (81,270) | (81,389) | ||
Proceeds from asset and business sales | 87,695 | 109 | ||
Proceeds (purchases) from investment sales and other items, net | (1,021) | 50,833 | ||
Net cash used in investing activities | (132,933) | (195,927) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (5,090) | (2,147) | ||
Intercompany borrowing (payments) | (94,663) | (77,847) | ||
Other items | (62,437) | (76,203) | ||
Net cash used in financing activities | (162,190) | (156,197) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (3,473) | 4,192 | ||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 138,054 | (6,434) | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 359,229 | 124,855 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | $ 273,786 | $ 69,507 | 273,786 | 69,507 |
Discontinued Operations | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 229,901 | 32,720 | ||
Discontinued Operations | Consolidating adjustments | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 0 | 0 | ||
Discontinued Operations | DaVita Inc. | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 0 | 0 | ||
Discontinued Operations | Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 6,404 | (16,194) | ||
Discontinued Operations | Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 223,497 | 48,914 | ||
Continuing Operations | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | (38,772) | (230,256) | ||
Continuing Operations | Consolidating adjustments | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 0 | 0 | ||
Continuing Operations | DaVita Inc. | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 44,688 | (174,948) | ||
Continuing Operations | Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 1,983 | 40 | ||
Continuing Operations | Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | $ (85,443) | $ (55,348) |
Supplemental Data - Condensed C
Supplemental Data - Condensed Consolidating Statements of Income (Detail) - USD ($) | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,718,403,000 | $ 2,494,609,000 | $ 5,309,477,000 | $ 4,917,395,000 |
Less: Provision for uncollectible accounts | (49,406,000) | (109,600,000) | (23,861,000) | (216,658,000) |
Net dialysis and related lab patient service revenues | 2,668,997,000 | 2,385,009,000 | 5,285,616,000 | 4,700,737,000 |
Other revenues | 217,956,000 | 314,390,000 | 450,781,000 | 629,913,000 |
Total revenues | 2,886,953,000 | 2,699,399,000 | 5,736,397,000 | 5,330,650,000 |
Operating expenses | 2,448,761,000 | 2,308,203,000 | 4,887,519,000 | 4,063,526,000 |
Operating income | 438,192,000 | 391,196,000 | 848,878,000 | 1,267,124,000 |
Debt expense, including refinancing charges | (233,208,000) | |||
Other income | 1,994,000 | 4,798,000 | 6,576,000 | 8,784,000 |
Income tax expense | 83,868,000 | 101,915,000 | 154,605,000 | 383,580,000 |
Net income from continuing operations | 236,626,000 | 186,145,000 | 467,641,000 | 679,997,000 |
Net income (loss) from discontinued operations, net of tax | 69,696,000 | (24,520,000) | 63,910,000 | (18,087,000) |
Net income | 306,322,000 | 161,625,000 | 531,551,000 | 661,910,000 |
Less: Net income attributable to noncontrolling interests | (39,046,000) | (34,624,000) | (85,589,000) | (87,212,000) |
Net income attributable to DaVita Inc. | $ 267,276,000 | $ 127,001,000 | 445,962,000 | $ 574,698,000 |
Physician Groups | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 0 | |||
Less: Provision for uncollectible accounts | 0 | |||
Net dialysis and related lab patient service revenues | 0 | |||
Other revenues | 0 | |||
Total revenues | 0 | |||
Operating expenses | 0 | |||
Operating income | 0 | |||
Debt expense, including refinancing charges | 0 | |||
Other income | 0 | |||
Income tax expense | 0 | |||
Net income from continuing operations | 0 | |||
Net income (loss) from discontinued operations, net of tax | 16,466,000 | |||
Net income | 16,466,000 | |||
Less: Net income attributable to noncontrolling interests | (8,544,000) | |||
Net income attributable to DaVita Inc. | 7,922,000 | |||
Unrestricted Subsidiaries | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 0 | |||
Less: Provision for uncollectible accounts | 0 | |||
Net dialysis and related lab patient service revenues | 0 | |||
Other revenues | 0 | |||
Total revenues | 0 | |||
Operating expenses | 0 | |||
Operating income | 0 | |||
Debt expense, including refinancing charges | 0 | |||
Other income | 0 | |||
Income tax expense | 0 | |||
Net income from continuing operations | 0 | |||
Net income (loss) from discontinued operations, net of tax | 323,000 | |||
Net income | 323,000 | |||
Less: Net income attributable to noncontrolling interests | 0 | |||
Net income attributable to DaVita Inc. | 323,000 | |||
Company and Restricted Subsidiaries | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 5,309,477,000 | |||
Less: Provision for uncollectible accounts | (23,861,000) | |||
Net dialysis and related lab patient service revenues | 5,285,616,000 | |||
Other revenues | 450,781,000 | |||
Total revenues | 5,736,397,000 | |||
Operating expenses | 4,887,519,000 | |||
Operating income | 848,878,000 | |||
Debt expense, including refinancing charges | (233,208,000) | |||
Other income | 6,576,000 | |||
Income tax expense | 154,605,000 | |||
Net income from continuing operations | 467,641,000 | |||
Net income (loss) from discontinued operations, net of tax | 47,121,000 | |||
Net income | 514,762,000 | |||
Less: Net income attributable to noncontrolling interests | (77,045,000) | |||
Net income attributable to DaVita Inc. | $ 437,717,000 |
Supplemental Data - Condensed87
Supplemental Data - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Condensed Financial Statements Captions [Line Items] | ||||
Net income | $ 306,322 | $ 161,625 | $ 531,551 | $ 661,910 |
Other comprehensive income | (49,260) | 49,578 | (26,792) | 62,333 |
Total comprehensive income | 257,062 | 211,203 | 504,759 | 724,243 |
Less: Comprehensive income attributable to noncontrolling interests | (39,046) | (34,624) | (85,589) | (87,210) |
Comprehensive income attributable to DaVita Inc. | $ 218,016 | $ 176,579 | 419,170 | $ 637,033 |
Physician Groups | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 16,466 | |||
Other comprehensive income | 0 | |||
Total comprehensive income | 16,466 | |||
Less: Comprehensive income attributable to noncontrolling interests | (8,544) | |||
Comprehensive income attributable to DaVita Inc. | 7,922 | |||
Unrestricted Subsidiaries | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 323 | |||
Other comprehensive income | 0 | |||
Total comprehensive income | 323 | |||
Less: Comprehensive income attributable to noncontrolling interests | 0 | |||
Comprehensive income attributable to DaVita Inc. | 323 | |||
Company and Restricted Subsidiaries | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 514,762 | |||
Other comprehensive income | (26,792) | |||
Total comprehensive income | 487,970 | |||
Less: Comprehensive income attributable to noncontrolling interests | (77,045) | |||
Comprehensive income attributable to DaVita Inc. | $ 410,925 |
Supplemental Data - Condensed88
Supplemental Data - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 | Dec. 31, 2016 |
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | $ 389,264 | $ 508,234 | |
Restricted cash and equivalents | 90,884 | 10,686 | |
Accounts receivable, net | 1,842,108 | 1,714,750 | |
Other current assets | 710,025 | 749,046 | |
Current assets held for sale | 6,053,081 | 5,761,642 | |
Total current assets | 9,085,362 | 8,744,358 | |
Property and equipment, net | 3,229,098 | 3,149,213 | |
Intangible assets, net | 100,255 | 113,827 | |
Other long-term assets | 342,290 | 330,516 | |
Goodwill | 6,678,559 | 6,610,279 | $ 6,015,375 |
Total assets | 19,435,564 | 18,948,193 | |
Current liabilities | 3,512,414 | 1,856,107 | |
Current liabilities held for sale | 1,271,364 | 1,185,070 | |
Payables to parent | 0 | ||
Long-term debt and other long-term liabilities | 9,120,121 | 10,009,590 | |
Noncontrolling interests subject to put provisions | 1,047,158 | 1,011,360 | |
Total DaVita Inc. shareholders’ equity | 4,279,184 | 4,690,029 | |
Noncontrolling interests not subject to put provisions | 205,323 | 196,037 | |
Total equity | 4,484,507 | 4,886,066 | |
Total liabilities and equity | 19,435,564 | $ 18,948,193 | |
Physician Groups | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 0 | ||
Restricted cash and equivalents | 0 | ||
Accounts receivable, net | 0 | ||
Other current assets | 0 | ||
Current assets held for sale | 524,595 | ||
Total current assets | 524,595 | ||
Property and equipment, net | 0 | ||
Intangible assets, net | 0 | ||
Other long-term assets | 0 | ||
Goodwill | 0 | ||
Total assets | 524,595 | ||
Current liabilities | 0 | ||
Current liabilities held for sale | 334,091 | ||
Payables to parent | 56,761 | ||
Long-term debt and other long-term liabilities | 0 | ||
Noncontrolling interests subject to put provisions | 0 | ||
Total DaVita Inc. shareholders’ equity | 133,743 | ||
Noncontrolling interests not subject to put provisions | 0 | ||
Total equity | 133,743 | ||
Total liabilities and equity | 524,595 | ||
Unrestricted Subsidiaries | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 0 | ||
Restricted cash and equivalents | 0 | ||
Accounts receivable, net | 0 | ||
Other current assets | 0 | ||
Current assets held for sale | 3,056 | ||
Total current assets | 3,056 | ||
Property and equipment, net | 0 | ||
Intangible assets, net | 0 | ||
Other long-term assets | 0 | ||
Goodwill | 0 | ||
Total assets | 3,056 | ||
Current liabilities | 0 | ||
Current liabilities held for sale | 0 | ||
Payables to parent | 3,056 | ||
Long-term debt and other long-term liabilities | 0 | ||
Noncontrolling interests subject to put provisions | 0 | ||
Total DaVita Inc. shareholders’ equity | 0 | ||
Noncontrolling interests not subject to put provisions | 0 | ||
Total equity | 0 | ||
Total liabilities and equity | 3,056 | ||
Parent Company And Restricted Subsidiaries | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 389,264 | ||
Restricted cash and equivalents | 90,884 | ||
Accounts receivable, net | 1,842,108 | ||
Other current assets | 710,025 | ||
Current assets held for sale | 5,525,430 | ||
Total current assets | 8,557,711 | ||
Property and equipment, net | 3,229,098 | ||
Intangible assets, net | 100,255 | ||
Other long-term assets | 342,290 | ||
Goodwill | 6,678,559 | ||
Total assets | 18,907,913 | ||
Current liabilities | 3,512,414 | ||
Current liabilities held for sale | 937,273 | ||
Payables to parent | (59,817) | ||
Long-term debt and other long-term liabilities | 9,120,121 | ||
Noncontrolling interests subject to put provisions | 1,047,158 | ||
Total DaVita Inc. shareholders’ equity | 4,145,441 | ||
Noncontrolling interests not subject to put provisions | 205,323 | ||
Total equity | 4,350,764 | ||
Total liabilities and equity | $ 18,907,913 |
Supplemental Data - Condensed89
Supplemental Data - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Cash flows from operating activities: | ||||
Net income | $ 306,322 | $ 161,625 | $ 531,551 | $ 661,910 |
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | 393,024 | 353,147 | ||
Net cash provided by operating activities | 924,575 | 1,015,057 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (241,534) | (184,405) | (473,977) | (398,940) |
Acquisitions | (89,465) | |||
Proceeds from asset and business sales | 116,241 | 70,236 | ||
Investments and other items | 23,137 | 96,936 | ||
Net cash used in investing activities | (424,064) | (851,607) | ||
Cash flows from financing activities: | ||||
Long-term debt | 573,981 | (64,032) | ||
Intercompany | 0 | 0 | ||
Other items | (879,890) | (301,146) | ||
Net cash used in financing activities | (305,909) | (365,178) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (3,473) | 4,192 | ||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 191,129 | (197,536) | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 518,920 | 683,463 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 480,148 | $ 453,207 | 480,148 | 453,207 |
Physician Groups | ||||
Cash flows from operating activities: | ||||
Net income | 16,466 | |||
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | 101,201 | |||
Net cash provided by operating activities | 117,667 | |||
Cash flows from investing activities: | ||||
Additions of property and equipment | (2,097) | |||
Acquisitions | 0 | |||
Proceeds from asset and business sales | 0 | |||
Investments and other items | (1,021) | |||
Net cash used in investing activities | (3,118) | |||
Cash flows from financing activities: | ||||
Long-term debt | 0 | |||
Intercompany | 57,783 | |||
Other items | 0 | |||
Net cash used in financing activities | 57,783 | |||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | |||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 172,332 | |||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 0 | |||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 0 | 0 | ||
Unrestricted Subsidiaries | ||||
Cash flows from operating activities: | ||||
Net income | 323 | |||
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | (323) | |||
Net cash provided by operating activities | 0 | |||
Cash flows from investing activities: | ||||
Additions of property and equipment | 0 | |||
Acquisitions | 0 | |||
Proceeds from asset and business sales | 0 | |||
Investments and other items | 0 | |||
Net cash used in investing activities | 0 | |||
Cash flows from financing activities: | ||||
Long-term debt | 0 | |||
Intercompany | 0 | |||
Other items | 0 | |||
Net cash used in financing activities | 0 | |||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | |||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 0 | |||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 0 | |||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 0 | 0 | ||
Company and Restricted Subsidiaries | ||||
Cash flows from operating activities: | ||||
Net income | 514,762 | |||
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | 292,146 | |||
Net cash provided by operating activities | 806,908 | |||
Cash flows from investing activities: | ||||
Additions of property and equipment | (471,880) | |||
Acquisitions | (89,465) | |||
Proceeds from asset and business sales | 116,241 | |||
Investments and other items | 24,158 | |||
Net cash used in investing activities | (420,946) | |||
Cash flows from financing activities: | ||||
Long-term debt | 573,981 | |||
Intercompany | (57,783) | |||
Other items | (879,890) | |||
Net cash used in financing activities | (363,692) | |||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (3,473) | |||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 18,797 | |||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 518,920 | |||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | $ 480,148 | 480,148 | ||
Discontinued Operations | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 229,901 | 32,720 | ||
Discontinued Operations | Physician Groups | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 172,332 | |||
Discontinued Operations | Unrestricted Subsidiaries | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 0 | |||
Discontinued Operations | Company and Restricted Subsidiaries | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 57,569 | |||
Continuing Operations | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | (38,772) | $ (230,256) | ||
Continuing Operations | Physician Groups | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 0 | |||
Continuing Operations | Unrestricted Subsidiaries | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | 0 | |||
Continuing Operations | Company and Restricted Subsidiaries | ||||
Cash flows from financing activities: | ||||
Net decrease in cash, cash equivalents and restricted cash from continuing operations | $ (38,772) |