Document and Entity Information
Document and Entity Information - shares shares in Millions | 6 Months Ended | |
Jun. 30, 2019 | Jul. 31, 2019 | |
Cover page. | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Jun. 30, 2019 | |
Document Transition Report | false | |
Entity File Number | 1-14106 | |
Entity Registrant Name | DAVITA INC. | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 51-0354549 | |
Entity Address, Address Line One | 2000 16th Street | |
Entity Address, City or Town | Denver, | |
Entity Address, State or Province | CO | |
Entity Address, Postal Zip Code | 80202 | |
City Area Code | 720 | |
Local Phone Number | 631-2100 | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Title of 12(b) Security | Common Stock, $0.001 par value | |
Trading Symbol | DVA | |
Security Exchange Name | NYSE | |
Entity Common Stock, Shares Outstanding | 160.3 | |
Amendment Flag | false | |
Document Fiscal Year Focus | 2019 | |
Document Fiscal Period Focus | Q2 | |
Entity Central Index Key | 0000927066 | |
Current Fiscal Year End Date | --12-31 |
CONSOLIDATED STATEMENTS OF INCO
CONSOLIDATED STATEMENTS OF INCOME (unaudited) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Income Statement [Abstract] | ||||
Dialysis and related lab patient service revenues | $ 2,734,065 | $ 2,718,403 | $ 5,369,217 | $ 5,309,477 |
Provision for uncollectible accounts | (10,249) | (49,406) | (15,712) | (23,861) |
Net dialysis and related lab patient service revenues | 2,723,816 | 2,668,997 | 5,353,505 | 5,285,616 |
Other revenues | 118,889 | 217,956 | 232,312 | 450,781 |
Total revenues | 2,842,705 | 2,886,953 | 5,585,817 | 5,736,397 |
Operating expenses and charges: | ||||
Patient care costs | 1,957,753 | 2,069,089 | 3,922,688 | 4,104,674 |
General and administrative | 275,338 | 264,094 | 526,151 | 530,623 |
Depreciation and amortization | 152,242 | 147,079 | 300,770 | 289,878 |
Provision for uncollectible accounts | 0 | (2,100) | 0 | (8,100) |
Equity investment income | (4,514) | (9,795) | (7,222) | (9,950) |
Impairment of other assets | 0 | 11,245 | 0 | 11,245 |
Goodwill impairment charges | 0 | 3,106 | 41,037 | 3,106 |
Gain on changes in ownership interest, net | 0 | (33,957) | 0 | (33,957) |
Total operating expenses and charges | 2,380,819 | 2,448,761 | 4,783,424 | 4,887,519 |
Operating income | 461,886 | 438,192 | 802,393 | 848,878 |
Debt expense | (131,666) | (119,692) | (263,185) | (233,208) |
Debt prepayment charges | (12,160) | 0 | (12,160) | 0 |
Other income, net | 5,643 | 1,994 | 12,583 | 6,576 |
Income from continuing operations before income taxes | 323,703 | 320,494 | 539,631 | 622,246 |
Income tax expense | 75,938 | 83,868 | 132,684 | 154,605 |
Net income from continuing operations | 247,765 | 236,626 | 406,947 | 467,641 |
Net income from discontinued operations, net of tax | 79,392 | 69,696 | 109,697 | 63,910 |
Net income | 327,157 | 306,322 | 516,644 | 531,551 |
Less: Net income attributable to noncontrolling interests | (53,606) | (39,046) | (93,804) | (85,589) |
Net income attributable to DaVita Inc. | $ 273,551 | $ 267,276 | $ 422,840 | $ 445,962 |
Earnings per share attributable to DaVita Inc.: | ||||
Basic net income from continuing operations per share | $ 1.17 | $ 1.16 | $ 1.89 | $ 2.23 |
Basic net income per share | 1.64 | 1.56 | 2.54 | 2.54 |
Diluted net income from continuing operations per share | 1.16 | 1.15 | 1.89 | 2.19 |
Diluted net income per share | $ 1.64 | $ 1.53 | $ 2.54 | $ 2.51 |
Weighted average shares for earnings per share: | ||||
Basic (in shares) | 166,346,041 | 171,617,238 | 166,366,886 | 175,267,270 |
Diluted (in shares) | 166,799,525 | 174,105,884 | 166,789,978 | 177,949,934 |
Amounts attributable to DaVita Inc.: | ||||
Net income from continuing operations | $ 194,223 | $ 199,603 | $ 314,477 | $ 390,618 |
Net income from discontinued operations | 79,328 | 67,673 | 108,363 | 55,344 |
Net income attributable to DaVita Inc. | $ 273,551 | $ 267,276 | $ 422,840 | $ 445,962 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Statement of Comprehensive Income [Abstract] | ||||
Net income | $ 327,157 | $ 306,322 | $ 516,644 | $ 531,551 |
Unrealized (losses) gains on interest rate cap agreements: | ||||
Unrealized (losses) gains | (31) | (268) | (611) | 782 |
Reclassifications of net realized losses into net income | 1,606 | 1,537 | 3,212 | 3,074 |
Unrealized gains (losses) on foreign currency translation: | ||||
Foreign currency translation adjustments | 12,365 | (50,529) | (1,288) | (30,648) |
Other comprehensive income (loss) | 13,940 | (49,260) | 1,313 | (26,792) |
Total comprehensive income | 341,097 | 257,062 | 517,957 | 504,759 |
Less: Comprehensive income attributable to noncontrolling interests | (53,606) | (39,046) | (93,804) | (85,589) |
Comprehensive income attributable to DaVita Inc. | $ 287,491 | $ 218,016 | $ 424,153 | $ 419,170 |
CONSOLIDATED BALANCE SHEETS (un
CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 |
ASSETS | ||
Cash and cash equivalents | $ 3,575,638 | $ 323,038 |
Restricted cash and equivalents | 106,772 | 92,382 |
Short-term investments | 5,213 | 2,935 |
Accounts receivable, net | 2,010,801 | 1,858,608 |
Inventories | 96,819 | 107,381 |
Other receivables | 525,004 | 469,796 |
Income tax receivable | 15,783 | 68,614 |
Prepaid and other current assets | 54,599 | 111,840 |
Current assets held for sale, net | 0 | 5,389,565 |
Total current assets | 6,390,629 | 8,424,159 |
Property and equipment, net of accumulated depreciation of $3,649,978 and $3,524,098 | 3,405,315 | 3,393,669 |
Operating lease right-of-use asset | 2,790,885 | 0 |
Intangible assets, net of accumulated amortization of $75,283 and $80,566 | 120,574 | 118,846 |
Equity method and other investments | 225,677 | 224,611 |
Long-term investments | 35,051 | 35,424 |
Other long-term assets | 97,443 | 71,583 |
Goodwill | 6,865,386 | 6,841,960 |
Total assets | 19,930,960 | 19,110,252 |
LIABILITIES AND EQUITY | ||
Accounts payable | 388,955 | 463,270 |
Other liabilities | 726,011 | 595,850 |
Accrued compensation and benefits | 628,022 | 658,913 |
Current portion of operating lease liabilities | 372,625 | 0 |
Current portion of long-term debt | 3,591,331 | 1,929,369 |
Current liabilities held for sale | 0 | 1,243,759 |
Total current liabilities | 5,706,944 | 4,891,161 |
Long-term operating lease liabilities | 2,689,249 | 0 |
Long-term debt | 5,377,798 | 8,172,847 |
Other long-term liabilities | 134,605 | 450,669 |
Deferred income taxes | 593,562 | 562,536 |
Total liabilities | 14,502,158 | 14,077,213 |
Commitments and contingencies: | ||
Noncontrolling interests subject to put provisions | 1,185,733 | 1,124,641 |
Equity: | ||
Preferred stock ($0.001 par value, 5,000,000 shares authorized; none issued) | 0 | 0 |
Common stock ($0.001 par value, 450,000,000 shares authorized; 166,532,889 and 166,387,307 shares issued and 164,472,913 and 166,387,307 shares outstanding, respectively) | 167 | 166 |
Additional paid-in capital | 989,021 | 995,006 |
Retained earnings | 3,205,910 | 2,743,194 |
Treasury Stock, Value | (112,189) | 0 |
Accumulated other comprehensive (loss) income | (33,611) | (34,924) |
Total DaVita Inc. shareholders' equity | 4,049,298 | 3,703,442 |
Noncontrolling interests not subject to put provisions | 193,771 | 204,956 |
Total equity | 4,243,069 | 3,908,398 |
Total liabilities and equity | $ 19,930,960 | $ 19,110,252 |
CONSOLIDATED BALANCE SHEETS (_2
CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 |
Statement of Financial Position [Abstract] | ||
Property and equipment, accumulated depreciation | $ 3,649,978 | $ 3,524,098 |
Intangible assets, accumulated amortization | $ 75,283 | $ 80,566 |
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) | 166,532,889 | 166,387,307 |
Common stock, shares outstanding (in shares) | 164,472,913 | 166,387,307 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2019 | Jun. 30, 2018 | |
Cash flows from operating activities: | ||
Net income | $ 516,644 | $ 531,551 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 300,770 | 289,878 |
Impairment charges | 41,037 | 14,351 |
Stock-based compensation expense | 29,045 | 19,861 |
Deferred income taxes | 60,706 | 56,882 |
Equity investment income (loss), net | 2,631 | (434) |
Loss (gain) on sales of business interests, net | 23,022 | (59,053) |
Other non-cash charges, net | 25,857 | 44,337 |
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures: | ||
Accounts receivable | (288,437) | (101,746) |
Inventories | 11,542 | 71,632 |
Other receivables and other current assets | (5,142) | (91,685) |
Other long-term assets | (410) | 3,454 |
Accounts payable | (68,887) | 35,228 |
Accrued compensation and benefits | (88,473) | 23,818 |
Other current liabilities | 151,780 | 58,321 |
Income taxes | 57,551 | 24,356 |
Other long-term liabilities | (18,121) | 3,824 |
Net cash provided by operating activities | 751,115 | 924,575 |
Cash flows from investing activities: | ||
Additions of property and equipment | (373,918) | (473,977) |
Acquisitions | (65,970) | (89,465) |
Proceeds from asset and business sales | 3,851,381 | 116,241 |
Purchase of other debt and equity investments | (4,812) | (4,195) |
Purchase of investments held-to-maturity | (3,322) | (3,726) |
Proceeds from sale of other debt and equity investments | 5,893 | 5,662 |
Proceeds from investments held-to-maturity | 0 | 32,628 |
Purchase of equity investments | (6,715) | (10,241) |
Distributions received on equity investments | 155 | 3,009 |
Net cash provided by (used in) investing activities | 3,402,692 | (424,064) |
Cash flows from financing activities: | ||
Borrowings | 32,367,300 | 28,128,131 |
Payments on long-term debt and other financing costs | (33,531,409) | (27,556,348) |
Purchase of treasury stock | (73,078) | (805,179) |
Distributions to noncontrolling interests | (95,714) | (94,006) |
Stock award exercises and other share issuances, net | 2,107 | 3,132 |
Contributions from noncontrolling interests | 31,281 | 31,569 |
Proceeds from sales of additional noncontrolling interest | 0 | 15 |
Purchases of noncontrolling interests | (11,040) | (13,223) |
Net cash used in financing activities | (1,310,553) | (305,909) |
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (77) | (3,473) |
Net increase in cash, cash equivalents and restricted cash | 2,843,177 | 191,129 |
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 415,420 | 518,920 |
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 3,682,410 | 480,148 |
Discontinued Operations | ||
Cash flows from financing activities: | ||
Net increase in cash, cash equivalents and restricted cash | (423,813) | 229,901 |
Continuing Operations | ||
Cash flows from financing activities: | ||
Net increase in cash, cash equivalents and restricted cash | $ 3,266,990 | $ (38,772) |
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 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||||||||||
Cumulative effect of change in accounting principle | $ 0 | $ 8,368 | $ (8,368) | ||||||||||||
Temporary equity, start balance at Dec. 31, 2017 | 1,011,360 | ||||||||||||||
Increase (Decrease) in Temporary Equity [Roll Forward] | |||||||||||||||
Net income | 52,278 | ||||||||||||||
Distributions | (57,997) | ||||||||||||||
Contributions | 19,176 | ||||||||||||||
Acquisitions and divestitures | 665 | ||||||||||||||
Partial purchases | (820) | ||||||||||||||
Fair value remeasurements | 22,496 | ||||||||||||||
Temporary equity, ending balance at Jun. 30, 2018 | 1,047,158 | ||||||||||||||
Beginning balance at Dec. 31, 2017 | 4,690,029 | $ 182 | $ 1,042,899 | 3,633,713 | $ 0 | 13,235 | $ 196,037 | ||||||||
Beginning balance (in shares) at Dec. 31, 2017 | 182,462,000 | 0 | |||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | $ 445,962 | 445,962 | 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-settled SAR shares issued | $ (448) | $ (4,885) | $ (1) | $ (448) | $ (4,886) | ||||||||||
Stock-settled stock-based compensation expense | 19,832 | 19,832 | |||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Distributions | (36,009) | ||||||||||||||
Contributions | 12,393 | ||||||||||||||
Acquisitions and divestitures | 79 | 79 | |||||||||||||
Acquisitions and divestitures, non-controlling interest | (203) | ||||||||||||||
Partial purchases | (12,197) | (12,197) | (206) | ||||||||||||
Fair value remeasurements | (98) | (22,496) | (22,496) | ||||||||||||
Purchase of treasury stock (in shares) | (11,995,000) | ||||||||||||||
Purchase of treasury stock | (809,900) | $ (809,900) | |||||||||||||
Ending balance at Jun. 30, 2018 | 4,279,184 | $ 183 | 1,022,783 | 4,088,043 | $ (809,900) | (21,925) | 205,323 | ||||||||
Ending balance (in shares) at Jun. 30, 2018 | 182,815,000 | (11,995,000) | |||||||||||||
Temporary equity, start balance at Mar. 31, 2018 | 1,034,501 | ||||||||||||||
Increase (Decrease) in Temporary Equity [Roll Forward] | |||||||||||||||
Net income | 28,171 | ||||||||||||||
Distributions | (31,831) | ||||||||||||||
Contributions | 9,668 | ||||||||||||||
Acquisitions and divestitures | (23) | ||||||||||||||
Partial purchases | (820) | ||||||||||||||
Fair value remeasurements | 7,492 | ||||||||||||||
Temporary equity, ending balance at Jun. 30, 2018 | 1,047,158 | ||||||||||||||
Beginning balance at Mar. 31, 2018 | 4,580,680 | $ 183 | 1,030,772 | 3,820,767 | $ (298,377) | 27,335 | 201,401 | ||||||||
Beginning balance (in shares) at Mar. 31, 2018 | 182,661,000 | (4,197,000) | |||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | 267,276 | 267,276 | 267,276 | 10,875 | |||||||||||
Other comprehensive income (loss) | (49,260) | (49,260) | (49,260) | ||||||||||||
Stock unit shares issued (in shares) | 142,000 | 12,000 | |||||||||||||
Stock-settled SAR shares issued | (448) | (1) | (448) | $ (1) | |||||||||||
Stock-settled stock-based compensation expense | 10,150 | 10,150 | |||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Distributions | (16,708) | ||||||||||||||
Contributions | 9,892 | ||||||||||||||
Acquisitions and divestitures | 3 | 3 | |||||||||||||
Acquisitions and divestitures, non-controlling interest | (137) | ||||||||||||||
Partial purchases | (10,203) | (10,203) | |||||||||||||
Fair value remeasurements | (98) | (7,492) | (7,492) | ||||||||||||
Purchase of treasury stock (in shares) | (7,798,000) | ||||||||||||||
Purchase of treasury stock | (511,523) | $ (511,523) | |||||||||||||
Ending balance at Jun. 30, 2018 | 4,279,184 | $ 183 | 1,022,783 | 4,088,043 | $ (809,900) | (21,925) | 205,323 | ||||||||
Ending balance (in shares) at Jun. 30, 2018 | 182,815,000 | (11,995,000) | |||||||||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||||||||||
Cumulative effect of change in accounting principle | 39,876 | (38) | 39,876 | (6) | |||||||||||
Temporary equity, start balance at Dec. 31, 2018 | 1,124,641 | ||||||||||||||
Increase (Decrease) in Temporary Equity [Roll Forward] | |||||||||||||||
Net income | 63,300 | ||||||||||||||
Distributions | (60,235) | ||||||||||||||
Contributions | 15,768 | ||||||||||||||
Acquisitions and divestitures | 1,873 | ||||||||||||||
Partial purchases | (2,248) | ||||||||||||||
Fair value remeasurements | 42,672 | ||||||||||||||
Temporary equity, ending balance at Jun. 30, 2019 | 1,185,733 | ||||||||||||||
Beginning balance at Dec. 31, 2018 | $ 3,908,398 | 3,703,442 | $ 166 | 995,006 | 2,743,194 | $ 0 | (34,924) | 204,956 | |||||||
Beginning balance (in shares) at Dec. 31, 2018 | 166,387,307 | 166,387,000 | 0 | ||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | $ 422,840 | 422,840 | 422,840 | 30,504 | |||||||||||
Other comprehensive income (loss) | 1,313 | 1,313 | 1,313 | ||||||||||||
Stock Issued During Period, Shares, Employee Stock Purchase Plans | 0 | ||||||||||||||
Stock Issued During Period, Value, Employee Stock Purchase Plan | 0 | 0 | |||||||||||||
Stock unit shares issued (in shares) | 146,000 | 0 | |||||||||||||
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures | $ 1 | ||||||||||||||
Stock-settled SAR shares issued | (3,245) | 0 | (3,246) | ||||||||||||
Stock-settled stock-based compensation expense | 28,999 | 28,999 | |||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Distributions | (35,479) | ||||||||||||||
Contributions | 15,513 | ||||||||||||||
Acquisitions and divestitures | 0 | 0 | |||||||||||||
Acquisitions and divestitures, non-controlling interest | (1,991) | ||||||||||||||
Partial purchases | 10,934 | 10,934 | (19,726) | ||||||||||||
Fair value remeasurements | $ 0 | (42,672) | (42,672) | ||||||||||||
Purchase of treasury stock (in shares) | (2,060,000) | (2,060,000) | |||||||||||||
Purchase of treasury stock | $ (112,189) | (112,189) | $ (112,189) | ||||||||||||
Ending balance at Jun. 30, 2019 | $ 4,243,069 | 4,049,298 | $ 167 | 989,021 | 3,205,910 | $ (112,189) | (33,611) | 193,771 | |||||||
Ending balance (in shares) at Jun. 30, 2019 | 164,472,913 | 166,533,000 | (2,060,000) | ||||||||||||
Temporary equity, start balance at Mar. 31, 2019 | 1,143,044 | ||||||||||||||
Increase (Decrease) in Temporary Equity [Roll Forward] | |||||||||||||||
Net income | 37,911 | ||||||||||||||
Distributions | (32,670) | ||||||||||||||
Contributions | 9,353 | ||||||||||||||
Acquisitions and divestitures | 111 | ||||||||||||||
Partial purchases | (281) | ||||||||||||||
Fair value remeasurements | 28,265 | ||||||||||||||
Temporary equity, ending balance at Jun. 30, 2019 | $ 1,185,733 | ||||||||||||||
Beginning balance at Mar. 31, 2019 | 3,875,354 | $ 166 | 990,380 | 2,932,359 | $ 0 | (47,551) | 211,319 | ||||||||
Beginning balance (in shares) at Mar. 31, 2019 | 166,396,000 | 0 | |||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | $ 273,551 | 273,551 | 273,551 | 15,695 | |||||||||||
Other comprehensive income (loss) | 13,940 | 13,940 | 13,940 | ||||||||||||
Stock Issued During Period, Shares, Employee Stock Purchase Plans | 0 | ||||||||||||||
Stock Issued During Period, Value, Employee Stock Purchase Plan | 0 | 0 | |||||||||||||
Stock unit shares issued (in shares) | 137,000 | 0 | |||||||||||||
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures | $ 1 | ||||||||||||||
Stock-settled SAR shares issued | $ (3,141) | $ 0 | $ (3,142) | ||||||||||||
Stock-settled stock-based compensation expense | 16,908 | 16,908 | |||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Distributions | (18,814) | ||||||||||||||
Contributions | 2,981 | ||||||||||||||
Acquisitions and divestitures | 0 | 0 | |||||||||||||
Acquisitions and divestitures, non-controlling interest | (1,991) | ||||||||||||||
Partial purchases | 13,140 | 13,140 | (15,419) | ||||||||||||
Fair value remeasurements | $ 0 | (28,265) | (28,265) | ||||||||||||
Purchase of treasury stock (in shares) | (2,060,000) | (2,060,000) | |||||||||||||
Purchase of treasury stock | $ (112,189) | (112,189) | $ (112,189) | ||||||||||||
Ending balance at Jun. 30, 2019 | $ 4,243,069 | $ 4,049,298 | $ 167 | $ 989,021 | $ 3,205,910 | $ (112,189) | $ (33,611) | $ 193,771 | |||||||
Ending balance (in shares) at Jun. 30, 2019 | 164,472,913 | 166,533,000 | (2,060,000) |
Condensed consolidated interim
Condensed consolidated interim financial statements Condensed consolidated interim financial statements | 6 Months Ended |
Jun. 30, 2019 | |
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, leases, impairments of goodwill and investments, accounting for income taxes, consolidation of variable interest entities and certain fair value estimates. The results of operations for the six months ended June 30, 2019 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, 2018 (10-K). 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, 2019 | |
Text Block [Abstract] | |
Revenue Recognition [Text Block] | Revenue recognition The Company’s allowance for doubtful accounts related to performance obligations satisfied in years prior to January 1, 2018 was $29,022 and $52,924 as of June 30, 2019 and December 31, 2018 , respectively. There are significant uncertainties 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, without limitation, determination of 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 of $12,617 and $39,795 was recognized during the three and six months ended June 30, 2019 , respectively, associated with performance obligations satisfied prior to January 1, 2019. Additional revenue of $8,817 and $76,227 was recognized during the three and six months ended June 30, 2018 , respectively, associated with performance obligations satisfied prior to January 1, 2018, which included a benefit of $12,000 and $36,000 for those respective periods from electing to apply Topic 606, Revenue from Contracts with Customers 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, 2019 June 30, 2018 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 $ 1,520,193 $ $ 1,520,193 $ 1,526,066 $ $ 1,526,066 Medicaid and Managed Medicaid 160,242 160,242 150,288 150,288 Other government 110,565 88,770 199,335 110,338 86,530 196,868 Commercial 840,993 33,095 874,088 796,732 19,139 815,871 Other revenues: Medicare and Medicare Advantage 64,012 64,012 154,028 154,028 Medicaid and Managed Medicaid 94 94 16,158 16,158 Commercial 32,307 32,307 17,006 17,006 Other (1) 5,501 20,670 26,171 4,919 35,034 39,953 Eliminations of intersegment revenues (30,334 ) (3,403 ) (33,737 ) (20,096 ) (9,189 ) (29,285 ) Total $ 2,607,160 $ 235,545 $ 2,842,705 $ 2,568,247 $ 318,706 $ 2,886,953 (1) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives. For the six months ended June 30, 2019 June 30, 2018 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 $ 3,013,709 $ $ 3,013,709 $ 3,011,258 $ $ 3,011,258 Medicaid and Managed Medicaid 314,431 314,431 307,783 307,783 Other government 216,692 173,245 389,937 217,458 169,068 386,526 Commercial 1,629,407 66,483 1,695,890 1,579,711 38,857 1,618,568 Other revenues: Medicare and Medicare Advantage 125,713 125,713 296,786 296,786 Medicaid and Managed Medicaid 100 100 31,949 31,949 Commercial 64,925 64,925 57,427 57,427 Other (1) 10,406 38,420 48,826 10,033 73,973 84,006 Eliminations of intersegment revenues (60,975 ) (6,739 ) (67,714 ) (38,519 ) (19,387 ) (57,906 ) Total $ 5,123,670 $ 462,147 $ 5,585,817 $ 5,087,724 $ 648,673 $ 5,736,397 (1) 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 services; however, actual collectible revenue is normally recognized at a discount from the fee schedule. 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. |
Earnings per share (Notes)
Earnings per share (Notes) | 6 Months Ended |
Jun. 30, 2019 | |
Earnings Per Share [Abstract] | |
Earnings Per Share [Text Block] | 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 outstanding, net of the weighted average shares held in escrow that under certain circumstances may have been returned to the Company. Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units (under the treasury stock method) as well as the weighted average shares held in escrow that were outstanding during the period. 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, 2019 2018 2019 2018 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 194,223 $ 199,603 $ 314,477 $ 390,618 Change in noncontrolling interest redemption rights in excess of fair value — (98 ) — (98 ) Net income from continuing operations for earnings per share calculation 194,223 199,505 314,477 390,520 Net income from discontinued operations attributable to DaVita Inc. 79,328 67,673 108,363 55,344 Net income attributable to DaVita Inc. for earnings per share calculation $ 273,551 $ 267,178 $ 422,840 $ 445,864 Basic: Weighted average shares outstanding during the period 166,346 173,811 166,367 177,461 Weighted average contingently returnable shares held in escrow for the — (2,194 ) — (2,194 ) Weighted average shares for basic earnings per share calculation 166,346 171,617 166,367 175,267 Basic net income attributable to DaVita Inc. from: Continuing operations per share $ 1.17 $ 1.16 $ 1.89 $ 2.23 Discontinued operations per share 0.47 0.40 0.65 0.31 Basic net income per share attributable to DaVita Inc. $ 1.64 $ 1.56 $ 2.54 $ 2.54 Diluted: Weighted average shares outstanding during the period 166,346 173,811 166,367 177,461 Assumed incremental shares from stock plans 454 295 423 489 Weighted average shares for diluted earnings per share calculation 166,800 174,106 166,790 177,950 Diluted net income attributable to DaVita Inc. from: Continuing operations per share $ 1.16 $ 1.15 $ 1.89 $ 2.19 Discontinued operations per share 0.48 0.38 0.65 0.32 Diluted net income per share attributable to DaVita Inc. $ 1.64 $ 1.53 $ 2.54 $ 2.51 Anti-dilutive stock-settled awards excluded from calculation (1) 5,797 6,227 5,974 4,840 (1) Shares associated with stock-settled stock appreciation rights and performance stock units were excluded from the diluted denominator calculation because they are anti-dilutive under the treasury stock method. |
Restricted Cash and equivalents
Restricted Cash and equivalents Restricted Cash and equivalents | 6 Months Ended |
Jun. 30, 2019 | |
Restricted Cash [Abstract] | |
Cash and Cash Equivalents Disclosure [Text Block] | Restricted cash and equivalents The Company had restricted cash and cash equivalents at June 30, 2019 and December 31, 2018 . There has been no material change in the nature of the Company's restricted cash and cash equivalents from that described in Note 4 to the Company's consolidated financial statements included in the 10-K. |
Investments in debt and equity
Investments in debt and equity securities | 6 Months Ended |
Jun. 30, 2019 | |
Investments, Debt and Equity Securities [Abstract] | |
Investments in debt and equity securities | Short-term and long-term investments The Company’s short-term and long-term debt and equity investments consist of the following: June 30, 2019 December 31, 2018 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 3,113 $ — $ 3,113 $ 2,235 $ — $ 2,235 Investments in mutual funds and common stock — 37,151 37,151 — 36,124 36,124 $ 3,113 $ 37,151 $ 40,264 $ 2,235 $ 36,124 $ 38,359 Short-term investments $ 3,113 $ 2,100 $ 5,213 $ 2,235 $ 700 $ 2,935 Long-term investments — 35,051 35,051 — 35,424 35,424 $ 3,113 $ 37,151 $ 40,264 $ 2,235 $ 36,124 $ 38,359 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, 2019 and December 31, 2018 . 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, 2019 , the Company recognized pre-tax net gains in the income statement of $2,634 associated with changes in the fair value of these equity securities, comprised of pre-tax realized gains of $308 and a net increase in unrealized gains of $2,326 . During the six months ended June 30, 2018 , the Company recognized pre-tax realized gains in the income statement of $619 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 . |
Equity method and other investm
Equity method and other investments | 6 Months Ended |
Jun. 30, 2019 | |
Equity Method Investments and Joint Ventures [Abstract] | |
Equity method and other investments | Equity method and other investments Equity investments in nonconsolidated businesses over which the Company maintains significant influence, but which do not have readily determinable fair values, are carried on the equity method. 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 Company's equity method and other investments were comprised of the following: June 30, 2019 December 31, 2018 APAC joint venture $ 124,493 $ 129,173 Other equity method partnerships 90,736 83,052 Adjusted cost method investments 10,448 12,386 $ 225,677 $ 224,611 During the six months ended June 30, 2019 and 2018, the Company recognized equity investment income of $7,222 and $9,950 , 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 joint venture, or APAC JV). Subsequent to June 30, 2019 , the investors in the APAC JV have jointly agreed to a deferral of the capital contributions scheduled for August 1, 2019 to December 1, 2019 . The Company continues to expect the economic interests of the noncontrolling investors in the APAC JV to adjust to match their voting interests by December 1, 2019. The Company's other equity method investments include legal entities for which the Company maintains significant influence but in which it does not have a controlling financial interest. Almost all of these are U.S. partnerships in the form of limited liability companies. The Company's ownership interests in these partnerships vary, but typically range from 30% to 50% . During the six months ended June 30, 2019 , the Company recognized a $1,938 downward valuation adjustment on one of its adjusted cost method investments. During the six months ended June 30, 2018 , there were no meaningful impairments or other valuation adjustments recognized on these investments. |
Goodwill
Goodwill | 6 Months Ended |
Jun. 30, 2019 | |
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 December 31, 2017 $ 6,144,761 $ 465,518 $ 6,610,279 Acquisitions 130,574 147,774 278,348 Divestitures (331 ) (15,166 ) (15,497 ) Impairment charges — (3,106 ) (3,106 ) Foreign currency and other adjustments — (28,064 ) (28,064 ) Balance at December 31, 2018 $ 6,275,004 $ 566,956 $ 6,841,960 Acquisitions 15,714 50,900 66,614 Impairment charges — (41,037 ) (41,037 ) Foreign currency and other adjustments — (2,151 ) (2,151 ) Balance at June 30, 2019 $ 6,290,718 $ 574,668 $ 6,865,386 Balance at June 30, 2019: Goodwill $ 6,290,718 $ 643,266 $ 6,933,984 Accumulated impairment charges — (68,598 ) (68,598 ) $ 6,290,718 $ 574,668 $ 6,865,386 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. The amendments in this ASU simplify the test for goodwill impairment by eliminating the second step in the assessment. All goodwill impairment tests performed since adoption were performed under this new guidance. During the three months ended June 30, 2019 , the Company performed annual and other goodwill impairment assessments for various reporting units, including its Brazil kidney care operations. No goodwill impairment was recognized as part of these assessments. During the six months ended June 30, 2019 , the Company recognized a $41,037 goodwill impairment charge in its Germany kidney care business. This charge resulted primarily from a change in relevant discount rates, a decline in current and expected patient census in the period and higher than expected current and future costs, primarily due to newly announced legislation that is expected to increase wages in that market. This impairment charge included an $8,865 increase to the goodwill impairment charge, and reduction to deferred tax expense, related to deferred tax assets that the impairment itself generated. The effect was a $41,037 goodwill impairment charge to operating income and an $8,865 credit to tax expense, for a net $32,172 impact on net income. Based on the most recent assessments, the Company determined that changes in expected patient census, increases in operating costs, 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 the following reporting units, which remain at risk of goodwill impairment as of June 30, 2019 . Reporting unit Goodwill balance as Carrying amount (1) Sensitivities Operating income (2) Discount rate (3) Brazil Kidney Care $ 69,887 4.4% (2.8)% (7.0)% Germany Kidney Care $ 380,340 —% (1.4)% (9.3)% (1) Excess of estimated fair value of the reporting unit over its carrying amount as of the latest assessment date. (2) Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date. (3) Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date. The Company recognized a $3,106 goodwill impairment charge during the three and six months ended June 30, 2018 at its German other health operations. Except as described above and in Note 11 to the Company's consolidated financial statements included in the 10-K, none of the Company's various other reporting units were considered at risk of significant goodwill impairment as of June 30, 2019 . 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 values of any of the Company's reporting units would be less than their respective carrying amounts as of June 30, 2019 . |
Income taxes
Income taxes | 6 Months Ended |
Jun. 30, 2019 | |
Income Tax Disclosure [Abstract] | |
Income taxes | Income taxes As of June 30, 2019 , the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold was $49,877 , of which $47,034 would impact the Company's effective tax rate if recognized. The total balance increased $9,495 from the December 31, 2018 balance of $40,382 . The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. At June 30, 2019 and December 31, 2018 , the Company had approximately $10,642 and $9,019 , respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefits. |
Long-term debt
Long-term debt | 6 Months Ended |
Jun. 30, 2019 | |
Debt Disclosure [Abstract] | |
Long-term debt | Long-term debt Long-term debt was comprised of the following: As of June 30, 2019 June 30, 2019 December 31, 2018 Maturity date Interest rate Estimated fair value (2) Senior Secured Credit Facilities: Term Loan A (1) $ 64,383 $ 675,000 12/24/2019 2.00% + LIBOR $ 64,300 Term Loan A-2 (1) 102,498 995,000 12/24/2019 1.00% + LIBOR $ 103,011 Term Loan B 3,325,000 3,342,500 6/24/2021 2.75% + LIBOR (3) $ 3,333,313 Revolving line of credit (1) 550,000 175,000 12/24/2019 2.00% + LIBOR $ 550,000 Senior Notes: 5 3/4% Senior Notes 1,250,000 1,250,000 8/15/2022 5.75% $ 1,264,000 5 1/8% Senior Notes 1,750,000 1,750,000 7/15/2024 5.125% $ 1,748,250 5% Senior Notes 1,500,000 1,500,000 5/1/2025 5.00% $ 1,479,000 Acquisition obligations and other notes payable (4) 184,170 183,979 2019-2027 5.70% $ 184,170 Financing lease obligations (5) 277,580 282,737 2019-2036 5.43% $ 277,580 Total debt principal outstanding 9,003,631 10,154,216 Discount and deferred financing costs (6) (34,502 ) (52,000 ) 8,969,129 10,102,216 Less current portion (3,591,331 ) (1,929,369 ) $ 5,377,798 $ 8,172,847 (1) On May 6, 2019, the Company entered into an agreement to extend the maturity dates of its Term Loan A, Term Loan A-2 and revolving line of credit under its senior secured credit facilities by six months , to December 24, 2019 . (2) Fair values are based upon quoted market prices for similar instruments, a level 2 input. The balances of acquisition obligations and other notes payable and financing lease obligations are presented in the condensed consolidated financial statements at June 30, 2019 at their approximate fair values due to the short-term nature of their settlements. (3) Term Loan B is subject to a LIBOR component floor of 0.75% . (4) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current interest rate in effect and assuming no changes to the LIBOR based interest rates. (5) The interest rate presented for financing lease obligations is their weighted average discount rate. (6) The carrying amount of the Company’s senior secured credit facilities includes a discount of $696 and deferred financing costs of $3,744 , and the carrying amount of the Company’s senior notes includes deferred financing costs of $30,062 as of June 30, 2019 . The carrying amount of the Company’s senior secured credit facilities included a discount of $6,104 and deferred financing costs of $12,580 , and the carrying amount of the Company’s senior notes included deferred financing costs of $33,316 as of December 31, 2018. Scheduled maturities of long-term debt at June 30, 2019 were as follows: 2019 (remainder of the year) (1) 3,564,562 2020 53,182 2021 533,377 2022 1,292,979 2023 54,372 2024 1,785,765 Thereafter 1,719,394 (1) Includes $2,990,328 of senior secured credit facility debt paid after June 30, 2019 from proceeds of the DMG sale, as described below. As disclosed in the Company’s current report on Form 8-K filed November 26, 2018 , the first amendment to the credit agreement governing the Company’s senior secured credit facilities amended existing covenants to permit the sale of the DMG business and require net cash proceeds from the sale in excess of $750,000 to be used to prepay debt outstanding under the Company’s credit facilities. The Company closed the DMG sale on June 19, 2019 and, as required by the terms of its senior secured credit agreement, used all of the net proceeds from the sale to prepay term debt outstanding under that credit agreement. Specifically, on June 20, 2019 the Company made initial mandatory principal prepayments of $583,041 on Term Loan A and $892,502 on Term Loan A-2, followed by final mandatory prepayments required under the credit agreement made on July 3, 2019 in the amounts of $64,383 on Term Loan A, $102,498 on Term Loan A-2, and $2,823,447 on Term Loan B, based on elections made by the Term Loan B lenders. In addition to the mandatory prepayments described above, during the first six months of 2019 the Company made regularly scheduled principal payments of $27,576 on Term Loan A and $17,500 on Term Loan B. As a result of the principal payments described above, as of July 31, 2019, Term Loan A and Term Loan A-2 have been paid in full and Term Loan B has a remaining balance outstanding of $501,553 . In addition, the Company accelerated the amortization of debt discount and deferred financing costs associated with senior secured credit facility mandatory principal payments made prior to and after June 30, 2019 , resulting in an additional charge of $10,668 in the three and six month periods ended June 30, 2019 . The Company also recognized expenses of $1,492 associated with the May 6, 2019 amendment to extend the maturity dates for Term Loan A and Term Loan A-2 to December 24, 2019 during the three and six months ended June 30, 2019 . The Company plans to enter into a new credit agreement which is expected to consist of a $1,000,000 senior secured revolving line of credit facility, a $1,750,000 senior secured term loan A facility with a delayed draw feature and a $2,500,000 senior secured term loan B facility. The Company expects to use the funds from the new credit agreement to pay off the remaining balances outstanding under its existing senior credit facilities on Term Loan B and the revolving line of credit, to call the outstanding 5.75% Senior Notes due in 2022, fund the tender offer as described in Note 14 to these condensed consolidated financial statements, and add cash to the balance sheet for potential future share repurchases, acquisitions and other general corporate purposes. These condensed consolidated interim financial statements do not constitute a call notice of the 5.75% Senior Notes. The Company expects the call notice for the 5.75% Senior Notes to be issued following completion of the new credit agreement. However, whether or not the Company enters into the new credit agreement and is able to make borrowings thereunder to fund the proposed redemption of the 5.75% Senior Notes, the repurchase of common stock in the tender offer referred to above or for the other purposes described above is subject to risks and uncertainties, and there can be no assurance that any of the foregoing will occur on the terms currently contemplated, or at all. As of June 30, 2019 , the Company maintains several 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, including all of Term Loan A, Term Loan A-2, and Term Loan B and a portion of the revolving line of credit. The remaining $541,881 outstanding principal balance of the revolving line of credit is subject to LIBOR-based interest rate volatility. 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. These cap agreements do not contain credit-risk contingent features. The following table summarizes the Company’s derivative instruments outstanding as of June 30, 2019 and December 31, 2018 , which are classified in "Other long-term assets" on its consolidated balance sheet: Six months ended Fair value Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI loss June 30, 2019 December 31, 2018 October 2015 caps $ 3,500,000 3.5% 6/29/2018 6/30/2020 $ 4,326 $ 823 $ 28 $ 851 The following table summarizes the effects of the Company’s interest rate cap agreements for the three and six months ended June 30, 2019 and 2018 : Amount of unrecognized (losses) gains in OCI on interest rate cap agreements Income statement location Reclassification from accumulated other comprehensive income into net income Three months ended Six months ended Three months ended Six months ended Derivatives designated as cash flow hedges 2019 2018 2019 2018 2019 2018 2019 2018 Interest rate cap agreements $ (42 ) $ (361 ) $ (823 ) $ 1,053 Debt expense $ 2,163 $ 2,070 $ 4,326 $ 4,140 Related income tax 11 93 212 (271 ) Related income tax (557 ) (533 ) (1,114 ) (1,066 ) Total $ (31 ) $ (268 ) $ (611 ) $ 782 $ 1,606 $ 1,537 $ 3,212 $ 3,074 See Note 15 to these condensed consolidated financial statements for further details on amounts recorded and reclassified from accumulated other comprehensive income. The Company’s weighted average effective interest rate on the senior secured credit facilities at the end of the second quarter of 2019 was 5.31% , based on the current margins in effect for Term Loan A, Term Loan A-2, Term Loan B and the revolving line of credit, as of June 30, 2019 , as described above. The Company’s overall weighted average effective interest rate for the three and six months ended June 30, 2019 was 5.17% and 5.16% , respectively and as of June 30, 2019 was 5.30% . As of June 30, 2019 , the Company’s interest rates are fixed on approximately 54.10% of its total debt. As of June 30, 2019 , the Company had $550,000 drawn on its $1,000,000 revolving line of credit under its senior secured credit facilities. The Company also has approximately $72,763 of outstanding letters of credit under separate bilateral secured letter of credit facilities. |
Leases Leases
Leases Leases | 6 Months Ended |
Jun. 30, 2019 | |
Leases [Abstract] | |
Leases of Lessee Disclosure [Text Block] | Leases The majority of the Company’s facilities are leased under non-cancellable operating leases ranging in terms from five years to fifteen years and which contain renewal options of five years to ten years at the fair rental value at the time of renewal. These renewal options are included in the Company’s determination of the right-of-use assets and related lease liabilities when renewal is considered reasonably certain at the commencement date. Certain of the Company’s leases are subject to periodic consumer price index increases or contain fixed escalation clauses. The Company also leases certain facilities and equipment under finance leases. The Company has elected the practical expedient to not separate lease components from non-lease components related to its real estate financing and operating leases. Financing and operating right-of-use assets are recognized based on the net present value of lease payments over the lease term at the commencement date. Since most of the Company's leases do not provide an implicit rate of return, the Company uses its incremental borrowing rate based on information available at the commencement date in determining the present value of lease payments. As of June 30, 2019 and December 31, 2018 , assets recorded under finance leases were $246,261 and $367,164 , respectively, and accumulated amortization associated with finance leases was $15,525 and $131,971 , respectively, included in property and equipment, net, on the Company's consolidated balance sheet. In certain markets, the Company acquires and develops dialysis centers. Upon completion, the Company sells the center to a third party and leases the space back with the intent of operating the center on a long term basis. Both the sale and leaseback terms are generally market terms. The lease terms are consistent with the Company's other operating leases with the majority of the leases under non-cancellable operating leases ranging in terms from five years to fifteen years and which contain renewal options of five years to ten years at the fair rental value at the time of renewal. The Company adopted Topic 842, Leases beginning on January 1, 2019 through a modified retrospective approach for leases existing at the adoption date with a cumulative effect adjustment. Consequently, financial information was not updated for dates and periods before January 1, 2019. The components of lease expense were as follows: Lease cost Three months ended Six months ended Operating lease cost (1) : Fixed lease expense $ 130,946 $ 259,056 Variable lease expense 29,907 58,478 Financing lease cost: Amortization of leased assets 5,703 11,529 Interest on lease liabilities 3,715 7,490 Net lease cost $ 170,271 $ 336,553 (1) Includes short-term lease expense and sublease income, which are immaterial. Other information related to leases was as follows: Lease term and discount rate June 30, 2019 Weighted average remaining lease term (years): Operating leases 9.1 Finance leases 10.6 Weighted average discount rate: Operating leases 4.2 % Finance leases 5.4 % Other information Six months ended Gain on sale leaseback, net $ 10,336 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 309,115 Operating cash flows from finance leases $ 10,585 Financing cash flows from finance leases $ 16,910 Net operating lease assets obtained in exchange for new or modified operating lease liabilities $ 195,771 Future minimum lease payments under non-cancellable leases as of June 30, 2019 were as follows: Operating leases Finance leases 2019 (remainder of the year) $ 259,928 $ 16,493 2020 490,779 37,805 2021 463,495 33,317 2022 426,182 33,599 2023 380,070 33,709 2024 326,541 33,723 Thereafter 1,375,473 175,202 Total future minimum lease payments $ 3,722,468 $ 363,848 Less portion representing interest (660,594 ) (86,268 ) Present value of lease liabilities $ 3,061,874 $ 277,580 Future minimum lease payments under non-cancellable leases as of December 31, 2018 were as follows: Operating leases Capital leases 2019 $ 483,488 $ 36,754 2020 462,154 41,044 2021 432,950 34,026 2022 395,462 33,690 2023 349,649 33,845 Thereafter 1,589,949 194,611 $ 3,713,652 373,970 Less portion representing interest (91,233 ) Total capital lease obligations, including current portion $ 282,737 |
Contingencies
Contingencies | 6 Months Ended |
Jun. 30, 2019 | |
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, demands, claims, qui tam suits, governmental investigations and audits (including, without limitation, investigations or other actions 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, 2019 and December 31, 2018 , the Company’s total recorded accruals 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, without limitation, 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 may 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. Governmental Inquiries and Certain Related Proceedings 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, 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 an investigation into the Company’s relationships with pharmaceutical manufacturers. The CID covers the period from January 1, 2006 through the present. 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 practices that had been identified by the Company in a self-disclosure filed with the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) in February 2016. In December 2017, the Company finalized and executed a settlement agreement with the government and relators in the qui tam matter that included total monetary consideration of $63,700 , as previously disclosed, 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 OIG served the Company with a 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 covered the period from January 1, 2007 to the present, and sought 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 Department of Justice notified the Court on July 23, 2019 of its decision to elect not to intervene in the matter of U.S. ex rel. David Gonzalez v. DaVita Healthcare Partners, et al . The complaint then was unsealed in the US. District Court, District of Massachusetts by order entered on August 1, 2019. The Department of Justice has confirmed that the complaint, which alleges violations of the federal False Claims Act and various state false claims acts, was the basis of its investigation initiated in January 2017. The Company has not been served with the complaint. 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 healthcare offenses involving DaVita Kidney Care, as well as several of the Company’s wholly-owned subsidiaries. The matter currently includes an investigation into DaVita Rx, DaVita Laboratory Services, Inc. (DaVita Labs), and RMS Lifeline Inc. (Lifeline). In each of August 2018 and May 2019, the Company received a CID pursuant to the FCA from the U.S. Attorney's Office relating to this investigation. The Company is continuing to cooperate with the government in this investigation. 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 FCA. In October 2018, DaVita Labs received a subpoena from the OIG in connection with this matter requesting certain patient records linked to clinical laboratory tests. The Company is continuing to cooperate with the government in this investigation. * * * Although the Company cannot predict whether or when proceedings might be initiated or when these matters may be resolved (other than as may be 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, members of its board of directors or management, 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. On March 28, 2019, the U.S. District Court for the District of Colorado denied the motion to dismiss. The Company answered the complaint on May 28, 2019. 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. On April 25, 2019, the court denied the Company's motion to dismiss. The Company answered the complaint on May 28, 2019. The Company disputes these allegations and intends to defend this action accordingly. Other Proceedings 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, without limitation, 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 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 U.S. Attorney's Office, Southern District of Florida notified the court on April 4, 2019 of its decision to elect not to intervene in the matter of Gabriel Valle, M.D., et al, v. RMS Lifeline, Inc., et al . The complaint then was unsealed in the U.S. District Court, Southern District of Florida by order dated April 5, 2019. The U.S. Attorney's Office confirmed that the complaint, which alleges violations of the FCA, was the basis of its investigation initiated in November 2017. On July 16, 2019, the private party relators filed a Notice of Voluntary Dismissal of the matter, and the court dismissed the lawsuit without prejudice and closed the case. * * * Other than as may be 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 11 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, results of operations, financial condition, cash flows or reputation. |
Other commitments
Other commitments | 6 Months Ended |
Jun. 30, 2019 | |
Commitments and Contingencies Disclosure [Abstract] | |
Noncontrolling interests subject to put provisions and other commitments | Other commitments 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 $7,154 . |
Long-term incentive compensatio
Long-term incentive compensation | 6 Months Ended |
Jun. 30, 2019 | |
Share-based Payment Arrangement [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 expense for stock-settled awards is measured at the estimated fair value of awards on the date of grant and recognized on a cumulative straight-line basis over the vesting terms of the awards unless the stock awards are based on non-market based performance metrics, in which case expense is adjusted for expected ultimate payouts as of the end of each reporting period. Stock-based compensation expense for cash-settled awards is based on their estimated fair values as of the end of each reporting period. The expense for all stock-based awards is recognized net of expected forfeitures. During the six months ended June 30, 2019 , the Company granted 1,885 restricted and performance stock units with an aggregate grant-date fair value of $94,414 and a weighted-average expected life of approximately 3.4 years and 2,343 stock-settled stock appreciation rights with an aggregate grant-date fair value of $32,870 and a weighted-average expected life of approximately 4.0 years . For the six months ended June 30, 2019 and 2018 , the Company recognized $41,054 and $31,301 , respectively, in total LTIP expense, of which $24,900 and $20,717 , respectively, represented stock-based compensation expense for stock appreciation rights, restricted stock units, performance 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, 2019 and 2018 was $3,835 and $3,941 , respectively. As of June 30, 2019 , the Company had $169,602 of total estimated but unrecognized compensation expense for outstanding LTIP awards, including $155,951 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 expenses over a weighted average remaining period of 0.8 years and the stock-based component of these LTIP expenses over a weighted average remaining period of 1.7 years . For the six months ended June 30, 2019 and 2018 , the Company recognized $2,675 and $7,671 |
Share repurchases
Share repurchases | 6 Months Ended |
Jun. 30, 2019 | |
Equity [Abstract] | |
Share repurchases | Share repurchases During the three and six months ended June 30, 2019 , the Company repurchased a total of 2,060 shares of its common stock for $112,189 at an average price of $54.46 per share. The Company also repurchased 4,214 shares of its common stock for $237,811 at an average price of $56.43 per share, subsequent to June 30, 2019 through July 17, 2019. Effective July 17, 2019, the Company's Board of Directors terminated all remaining prior share repurchase authorizations available to the Company and approved a new share repurchase authorization of $2,000,000 . Although this share repurchase authorization does not have an expiration date, the Company remains subject to share repurchase limitations under the terms of its senior secured credit facilities and the indentures governing its senior notes. On July 22, 2019 the Company commenced a modified "Dutch auction” tender offer (Tender Offer) to purchase for cash shares of its common stock for an aggregate purchase price of up to $1,200,000 at a price per share not less than $53.50 and not more than $61.50 . The Tender Offer will expire at 12:00 midnight Eastern time at the end of day on August 16, 2019, unless extended or otherwise terminated. The Tender Offer is conditioned on the successful execution of a new credit agreement with terms reasonably satisfactory to the Company and total lender commitments of not less than $5,250,000 and the funds being accessible thereunder. Completion of the new credit agreement and the Tender Offer are subject to risks and uncertainties and there can be no assurance that the new credit agreement will be entered into or the Tender Offer will be completed in each case on the terms currently contemplated, or at all. |
Accumulated other comprehensive
Accumulated other comprehensive (loss) income | 6 Months Ended |
Jun. 30, 2019 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | Accumulated other comprehensive (loss) income For the three months ended June 30, 2019 For the six months ended June 30, 2019 Interest Foreign Accumulated Interest Foreign Accumulated Beginning balance $ (7,935 ) $ (39,616 ) $ (47,551 ) $ (8,961 ) $ (25,963 ) $ (34,924 ) Unrealized (losses) gains (42 ) 12,365 12,323 (823 ) (1,288 ) (2,111 ) Related income tax 11 — 11 212 — 212 (31 ) 12,365 12,334 (611 ) (1,288 ) (1,899 ) Reclassification into net income 2,163 — 2,163 4,326 — 4,326 Related income tax (557 ) — (557 ) (1,114 ) — (1,114 ) 1,606 — 1,606 3,212 — 3,212 Ending balance $ (6,360 ) $ (27,251 ) $ (33,611 ) $ (6,360 ) $ (27,251 ) $ (33,611 ) For the three months ended June 30, 2018 For the six months ended June 30, 2018 Interest Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (12,527 ) $ 39,862 $ 27,335 $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 Cumulative effect of change (1) — — — (2,706 ) (5,662 ) — (8,368 ) Unrealized (losses) gains (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 into net 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 Tax Cuts and Jobs Act of 2017. Net cap realized losses reclassified into income are recorded as debt expense in the corresponding consolidated statements of income. See Note 9 to these condensed consolidated financial statements for further details. Prior to January 1, 2018, unrealized gains and losses on available-for-sale equity securities were recorded to accumulated other comprehensive income and reclassified to other income when realized. From January 1, 2018, unrealized gains and losses on investment securities are recorded directly to other income rather than to accumulated other comprehensive income. |
Acquisitions and divestitures
Acquisitions and divestitures | 6 Months Ended |
Jun. 30, 2019 | |
Business Combinations [Abstract] | |
Acquisitions and divestitures | Acquisitions and divestitures Routine acquisitions During the six months ended June 30, 2019 , the Company acquired dialysis businesses consisting of five dialysis centers located in the U.S. and seven dialysis centers located outside the U.S. for a total of $63,945 in net cash, $453 in deferred purchase price obligations, and $12,484 in earn-out obligations and assumed liabilities. 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 $ 3,607 Property and equipment 2,135 Intangible and other long-term assets 8,443 Goodwill 66,614 Current liabilities (2,067 ) Long-term liabilities (88 ) Noncontrolling interests (1,762 ) $ 76,882 Amortizable intangible assets acquired during the first six months of 2019 primarily represent non-compete agreements which had weighted-average estimated useful lives of approximately six years . The total estimated amount of goodwill deductible for tax purposes associated with these acquisitions was approximately $64,905 . 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 $25,875 if certain EBITDA, operating income performance targets or quality margins are met primarily over the next one year to five years . As of June 30, 2019 , the estimated fair values of these contingent earn-out obligations is $14,730 , of which $4,090 is included in other liabilities and the remaining $10,640 is included in other long-term liabilities in the Company’s consolidated balance sheet. The following is a reconciliation of changes in contingent earn-out obligations for the six months ended June 30, 2019 : Beginning balance December 31, 2018 $ 2,608 Contingent earn-out obligations associated with acquisitions 12,440 Remeasurement of fair value for contingent earn-out obligations (101 ) Payments on contingent earn-out obligations (217 ) Ending balance June 30, 2019 $ 14,730 |
Held for Sale and Discontinued
Held for Sale and Discontinued Operations Held for Sale and Discontinued Operations | 6 Months Ended |
Jun. 30, 2019 | |
Held for Sale and Discontinued Operations [Abstract] | |
Disposal Groups, Including Discontinued Operations, Disclosure [Text Block] | Held for sale and discontinued operations DaVita Medical Group On June 19, 2019 , the Company completed the sale of its DMG division to Collaborative Care Holdings, LLC (Optum), a subsidiary of UnitedHealth Group Inc., for an aggregate purchase price of $4,340,000 , prior to certain closing and post-closing adjustments specified in the related equity purchase agreement dated as of December 5, 2017 , as amended as of September 20, 2018 and as of December 11, 2018 (as amended, the equity purchase agreement). The Company has recorded a preliminary estimated pre-tax net loss of approximately $23,022 on the sale of its DMG division for the three and six months ended June 30, 2019 . This preliminary net loss is based on initial estimates of the Company's expected aggregate proceeds from the sale, net of transaction costs and obligations, as well as the estimated values of DMG net assets sold as of the closing date. These estimated net proceeds include $4,465,476 in cash received from Optum at closing, or $3,824,509 net of cash and restricted cash included in DMG net assets sold. The total net proceeds expected from the DMG sale, as well as the value of its previously held for sale net assets sold, remain subject to estimate revisions and post-closing adjustments pursuant to the equity purchase agreement, which could be material. Under the equity purchase agreement, the Company also has certain indemnification obligations that could require payments to the buyer relating to the Company's previous ownership and operation of the DMG business. Potential payments under these provisions, if any, remain subject to significant uncertainties and could have a material adverse effect on the net proceeds ultimately received and retained by the Company. The following table presents the financial results of discontinued operations related to DMG: Three months ended June 30, Six months ended June 30, 2019 2018 2019 2018 Revenues $ 1,330,777 $ 1,252,430 $ 2,713,059 $ 2,480,362 Expenses 1,201,633 1,192,528 2,539,787 2,418,935 Income from operations of discontinued operations before taxes 129,144 59,902 173,272 61,427 Loss on sale of discontinued operations before taxes (23,022 ) — (23,022 ) — Income tax expense (benefit) 26,730 (9,794 ) 40,553 (2,483 ) Net income from discontinued operations, net of tax $ 79,392 $ 69,696 $ 109,697 $ 63,910 The following table presents cash flows of discontinued operations related to DMG: Six months ended June 30, 2019 2018 Net cash provided by operating activities from discontinued operations $ 103,848 $ 112,683 Net cash used in investing activities from discontinued operations $ (43,442 ) $ (20,982 ) DMG acquisitions During the period from January 1, 2019 to June 18, 2019 immediately prior to sale, the Company's DMG business acquired two medical business for a total of $2,025 in cash and deferred purchase price of $212 . |
Variable interest entities
Variable interest entities | 6 Months Ended |
Jun. 30, 2019 | |
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). There have been no material changes in the nature of the Company's arrangements with VIEs or its judgments concerning them from those described in Note 23 to the Company's consolidated financial statements included in the 10-K. At June 30, 2019 , these condensed consolidated financial statements include total assets of VIEs of $390,935 and total liabilities and noncontrolling interests of VIEs to third parties of $277,638 |
Fair value of financial instrum
Fair value of financial instruments | 6 Months Ended |
Jun. 30, 2019 | |
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, 2019 : Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 37,151 $ 37,151 $ — $ — Interest rate cap agreements $ 28 $ — $ 28 $ — Liabilities Contingent earn-out obligations $ 14,730 $ — $ — $ 14,730 Temporary equity Noncontrolling interests subject to put provisions $ 1,185,733 $ — $ — $ 1,185,733 Investments in equity securities represent investments in various open-ended registered investment companies (mutual funds) and common stock and are recorded at estimated fair value based on reported market prices or redemption prices, as applicable. 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. See Note 9 to these condensed consolidated financial statements for further discussion. The estimated fair value measurements of contingent earn-out obligations are primarily based on unobservable inputs, including projected EBITDA. See Note 16 to these condensed consolidated financial statements for further discussion. See Note 18 to the Company's consolidated financial statements included in the 10-K for a discussion of the Company’s methodology for estimating the fair value of noncontrolling interests subject to put obligations. The Company's senior secured credit facilities and senior notes fair values are based upon quoted market prices for similar instruments, a level 2 input. See Note 9 to these condensed consolidated financial statements for further discussion. Other financial instruments consist primarily of cash and cash equivalents, accounts receivable, accounts payable, other accrued liabilities, lease liabilities and debt. The balances of non-debt financial instruments are presented in these condensed consolidated financial statements at June 30, 2019 at their approximate fair values due to the short-term nature of their settlements. |
Segment reporting
Segment reporting | 6 Months Ended |
Jun. 30, 2019 | |
Segment Reporting [Abstract] | |
Segment Reporting Disclosure | Segment reporting The Company’s business is comprised of its U.S. dialysis and related lab services business, various ancillary services and strategic initiatives, including its international operations, and its corporate administrative support. On June 19, 2019 , the Company completed the sale of its DMG division to Optum, a subsidiary of UnitedHealth Group Inc. As a result of this transaction, DMG's results of operations have been reported as discontinued operations for all periods presented. 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 kidney care operations in each foreign sovereign jurisdiction, its other health operations in each foreign sovereign jurisdiction, and its equity method investment in the APAC JV. 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, 2019 2018 2019 2018 Segment revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,612,200 $ 2,612,734 $ 5,129,489 $ 5,101,899 Intersegment revenues 30,042 20,096 60,462 38,519 U.S. dialysis and related lab services patient service 2,642,242 2,632,830 5,189,951 5,140,418 Provision for uncollectible accounts (10,249 ) (49,406 ) (15,712 ) (24,208 ) Net U.S. dialysis and related lab services patient 2,631,993 2,583,424 5,174,239 5,116,210 Other revenues (1) : External sources 5,209 4,919 9,893 10,033 Intersegment revenues 292 — 513 — Total U.S. dialysis and related lab services revenues $ 2,637,494 $ 2,588,343 $ 5,184,645 $ 5,126,243 Other—Ancillary services and strategic initiatives Patient service revenues, net $ 121,865 $ 105,669 $ 239,728 $ 207,925 Other external sources 113,680 213,037 222,419 440,748 Intersegment revenues 3,403 9,189 6,739 19,387 Total ancillary services and strategic initiatives revenues 238,948 327,895 468,886 668,060 Total net segment revenues 2,876,442 2,916,238 5,653,531 5,794,303 Elimination of intersegment revenues (33,737 ) (29,285 ) (67,714 ) (57,906 ) Consolidated revenues $ 2,842,705 $ 2,886,953 $ 5,585,817 $ 5,736,397 Segment operating margin: U.S. dialysis and related lab services $ 498,957 $ 449,443 $ 915,939 $ 882,822 Other—Ancillary services and strategic initiatives (15,050 ) 2,815 (72,680 ) (4,175 ) Total segment operating margin 483,907 452,258 843,259 878,647 Reconciliation of segment operating margin to consolidated Corporate administrative support (22,021 ) (14,066 ) (40,866 ) (29,769 ) Consolidated operating income 461,886 438,192 802,393 848,878 Debt expense (131,666 ) (119,692 ) (263,185 ) (233,208 ) Debt prepayment charges (12,160 ) — (12,160 ) — Other income, net 5,643 1,994 12,583 6,576 Consolidated income from continuing operations before $ 323,703 $ 320,494 $ 539,631 $ 622,246 (1) Includes management fee revenue from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling equity investment or which are wholly-owned by third parties. A summary of assets by reportable segment was as follows: June 30, 2019 December 31, 2018 Segment assets U.S. dialysis and related lab services (including equity $ 18,352,683 $ 12,333,641 Other—Ancillary services and strategic initiatives (including 1,578,277 1,387,046 DMG—Held for sale (including equity investments of $0 and — 5,389,565 Consolidated assets $ 19,930,960 $ 19,110,252 Depreciation and amortization expense by reportable segment was as follows: Three months ended June 30, Six months ended June 30, 2019 2018 2019 2018 U.S. dialysis and related lab services $ 144,621 $ 138,252 $ 285,401 $ 273,028 Other — Ancillary services and strategic initiatives 7,621 8,827 15,369 16,850 $ 152,242 $ 147,079 $ 300,770 $ 289,878 Expenditures for property and equipment by reportable segment were as follows: Three months ended June 30, Six months ended June 30, 2019 2018 2019 2018 U.S. dialysis and related lab services $ 149,264 $ 197,051 $ 319,812 $ 388,458 Other—Ancillary services and strategic initiatives 7,062 22,184 15,640 32,172 DMG—Held for sale 18,714 22,299 38,466 53,347 $ 175,040 $ 241,534 $ 373,918 $ 473,977 |
Changes in DaVita Inc.'s owners
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries | 6 Months Ended |
Jun. 30, 2019 | |
Noncontrolling Interest [Abstract] | |
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries | Changes in DaVita Inc.’s ownership interests in consolidated subsidiaries The effects of changes in DaVita Inc.’s ownership interests in consolidated subsidiaries on the Company’s consolidated equity were as follows: Three months ended June 30, Six months ended June 30, 2019 2018 2019 2018 Net income attributable to DaVita Inc. $ 273,551 $ 267,276 $ 422,840 $ 445,962 Changes in paid-in capital for: Sales of noncontrolling interests — 3 — 79 Purchases of noncontrolling interests 13,140 (10,203 ) 10,934 (12,197 ) Net transfers to noncontrolling interests 13,140 (10,200 ) 10,934 (12,118 ) Net income attributable to DaVita Inc., net of transfers to noncontrolling interests $ 286,691 $ 257,076 $ 433,774 $ 433,844 |
New accounting standards
New accounting standards | 6 Months Ended |
Jun. 30, 2019 | |
Accounting Changes and Error Corrections [Abstract] | |
New accounting standards | New accounting standards In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in Topic 842 revise the accounting related to lessee accounting. Under the new guidance, lessees are 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. The Company adopted Topic 842 beginning on January 1, 2019 through a modified retrospective approach for leases existing at the adoption date with a cumulative effect adjustment. The Company elected to apply the package of practical expedients to not recast prior conclusions related to contracts containing leases, lease classification and initial direct costs. Adoption of the new standard resulted in the recording of operating right-of-use assets of $2,783,784 , operating lease liabilities of $3,001,354 and an adjustment to retained earnings of $39,876 , primarily related to deferred gains on prior sale leaseback transactions as of January 1, 2019. The standard did not materially impact the Company's consolidated net earnings and had no impact on cash flows. See Note 10 to these condensed consolidated financial statements for further details. In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The amendments in this ASU change the approach for recognizing credit losses on financial assets from the incurred loss methodology in current GAAP to a methodology that reflects current expected credit losses, which requires consideration of a broader range of reasonable and supportable information to inform those credit loss estimates. The current incurred loss model delays recognition of credit losses until it is probable that a loss has been incurred, while this ASU’s new current expected credit loss model requires estimation of credit losses expected over the life of the financial asset or group of similar financial assets. The amendments in this ASU are effective for the Company on January 1, 2020 and are to be applied on a modified-retrospective approach. The Company is still evaluating certain aspects of this ASU as well as the impacts it may have on its consolidated financial statements when adopted on January 1, 2020. 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 this ASU were effective for the Company on January 1, 2019 and are to be applied prospectively. The adoption of this ASU did not have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2019. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework -Changes to the Disclosure Requirements for Fair Value Measurement . The applicable amendments in this ASU remove requirements for disclosures concerning transfers between fair value measurement levels 1, 2 and 3 and disclosures concerning valuation processes for level 3 fair value measurements. The applicable amendments in this ASU also add a requirement to separately disclose the changes in unrealized gains and losses included in other comprehensive income for the reporting period for level 3 items measured at fair value on a recurring basis, and require disclosure of the range and weighted average of significant unobservable inputs used to develop level 3 fair value measurements. The amendments in this ASU are effective for the Company beginning on January 1, 2020 and its new requirements are to be applied on a prospective basis. The adoption of this ASU is not expected to have a material impact on the Company’s consolidated financial statements. |
Condensed consolidating financi
Condensed consolidating financial statements | 6 Months Ended |
Jun. 30, 2019 | |
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. As a result of the DMG sale consummated in June 2019, the DMG subsidiaries which were previously subsidiary guarantors under the Company's senior notes have been released from these guarantees and have been reclassified from guarantor subsidiaries to non-guarantor subsidiaries for all periods presented in the following condensed consolidating financial statements. Condensed Consolidating Statements of Operations For the three months ended June 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 1,781,066 $ 1,014,869 $ (61,870 ) $ 2,734,065 Provision for uncollectible accounts — (7,246 ) (3,003 ) — (10,249 ) Net patient service revenues — 1,773,820 1,011,866 (61,870 ) 2,723,816 Other revenues 207,299 115,226 37,035 (240,671 ) 118,889 Total net revenues 207,299 1,889,046 1,048,901 (302,541 ) 2,842,705 Operating expenses 160,464 1,673,331 849,565 (302,541 ) 2,380,819 Operating income 46,835 215,715 199,336 — 461,886 Debt expense (144,896 ) (52,762 ) (11,217 ) 65,049 (143,826 ) Other income, net 102,059 2,716 8,958 (108,090 ) 5,643 Income tax expense 627 63,930 11,381 — 75,938 Equity earnings in subsidiaries 270,180 168,441 — (438,621 ) — Net income from continuing operations 273,551 270,180 185,696 (481,662 ) 247,765 Net income from discontinued operations, net of tax — — 36,351 43,041 79,392 Net income 273,551 270,180 222,047 (438,621 ) 327,157 Less: Net income attributable to noncontrolling interests — — — (53,606 ) (53,606 ) Net income attributable to DaVita Inc. $ 273,551 $ 270,180 $ 222,047 $ (492,227 ) $ 273,551 For the three months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Patient service 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 236,335 157,586 — (393,921 ) — Net income from continuing operations 267,276 236,335 174,823 (441,808 ) 236,626 Net income from discontinued operations, net of tax — — 21,809 47,887 69,696 Net income 267,276 236,335 196,632 (393,921 ) 306,322 Less: Net income attributable to noncontrolling interests — — — (39,046 ) (39,046 ) Net income attributable to DaVita Inc. $ 267,276 $ 236,335 $ 196,632 $ (432,967 ) $ 267,276 For the six months ended June 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 3,558,312 $ 1,933,473 $ (122,568 ) $ 5,369,217 Provision for uncollectible accounts — (11,216 ) (4,496 ) — (15,712 ) Net patient service revenues — 3,547,096 1,928,977 (122,568 ) 5,353,505 Other revenues 396,135 226,367 72,654 (462,844 ) 232,312 Total net revenues 396,135 3,773,463 2,001,631 (585,412 ) 5,585,817 Operating expenses and charges 304,123 3,333,784 1,730,929 (585,412 ) 4,783,424 Operating income 92,012 439,679 270,702 — 802,393 Debt expense (278,491 ) (105,241 ) (21,936 ) 130,323 (275,345 ) Other income, net 212,257 5,312 18,069 (223,055 ) 12,583 Income tax expense 7,653 110,474 14,557 — 132,684 Equity earnings in subsidiaries 404,715 175,439 — (580,154 ) — Net income from continuing operations 422,840 404,715 252,278 (672,886 ) 406,947 Net income from discontinued operations, net of tax — — 16,965 92,732 109,697 Net income 422,840 404,715 269,243 (580,154 ) 516,644 Less: Net income attributable to noncontrolling interests — — — (93,804 ) (93,804 ) Net income attributable to DaVita Inc. $ 422,840 $ 404,715 $ 269,243 $ (673,958 ) $ 422,840 For the six months ended June 30, 2018 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services 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 and charges 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, net 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 377,452 183,638 — (561,090 ) — Net income from continuing operations 445,962 377,452 300,540 (656,313 ) 467,641 Net (loss) income from discontinued operations, net of tax — — (31,313 ) 95,223 63,910 Net income 445,962 377,452 269,227 (561,090 ) 531,551 Less: Net income attributable to noncontrolling interests — — — (85,589 ) (85,589 ) Net income attributable to DaVita Inc. $ 445,962 $ 377,452 $ 269,227 $ (646,679 ) $ 445,962 Condensed Consolidating Statements of Comprehensive Income For the three months ended June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 273,551 $ 270,180 $ 222,047 $ (438,621 ) $ 327,157 Other comprehensive income 1,575 — 12,365 — 13,940 Total comprehensive income 275,126 270,180 234,412 (438,621 ) 341,097 Less: Comprehensive income attributable to noncontrolling interest — — — (53,606 ) (53,606 ) Comprehensive income attributable to DaVita Inc. $ 275,126 $ 270,180 $ 234,412 $ (492,227 ) $ 287,491 For the three months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 267,276 $ 236,335 $ 196,632 $ (393,921 ) $ 306,322 Other comprehensive income (loss) 1,269 — (50,529 ) — (49,260 ) Total comprehensive income 268,545 236,335 146,103 (393,921 ) 257,062 Less: Comprehensive income attributable to noncontrolling interest — — — (39,046 ) (39,046 ) Comprehensive income attributable to DaVita Inc. $ 268,545 $ 236,335 $ 146,103 $ (432,967 ) $ 218,016 For the six months ended June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 422,840 $ 404,715 $ 269,243 $ (580,154 ) $ 516,644 Other comprehensive income (loss) 2,601 — (1,288 ) — 1,313 Total comprehensive income 425,441 404,715 267,955 (580,154 ) 517,957 Less: Comprehensive income attributable to noncontrolling interest — — — (93,804 ) (93,804 ) Comprehensive income attributable to DaVita Inc. $ 425,441 $ 404,715 $ 267,955 $ (673,958 ) $ 424,153 For the six months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 445,962 $ 377,452 $ 269,227 $ (561,090 ) $ 531,551 Other comprehensive income (loss) 3,856 — (30,648 ) — (26,792 ) Total comprehensive income 449,818 377,452 238,579 (561,090 ) 504,759 Less: Comprehensive income attributable to noncontrolling interest — — — (85,589 ) (85,589 ) Comprehensive income attributable to DaVita Inc. $ 449,818 $ 377,452 $ 238,579 $ (646,679 ) $ 419,170 Condensed Consolidating Balance Sheets As of June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 3,374,887 $ — $ 200,751 $ — $ 3,575,638 Restricted cash and equivalents 1,007 12,181 93,584 — 106,772 Accounts receivable, net — 1,352,844 657,957 — 2,010,801 Other current assets 37,185 545,881 114,352 — 697,418 Total current assets 3,413,079 1,910,906 1,066,644 — 6,390,629 Property and equipment, net 501,219 1,613,193 1,290,903 — 3,405,315 Operating lease right-of-use assets 105,137 1,636,360 1,049,388 — 2,790,885 Intangible assets, net 107 37,272 83,195 — 120,574 Investments in subsidiaries 11,304,840 3,184,913 — (14,489,753 ) — Intercompany receivables — 1,563,270 1,483,874 (3,047,144 ) — Other long-term assets and investments 80,491 81,567 196,113 — 358,171 Goodwill — 4,821,054 2,044,332 — 6,865,386 Total assets $ 15,404,873 $ 14,848,535 $ 7,214,449 $ (17,536,897 ) $ 19,930,960 Current liabilities $ 3,767,482 $ 1,348,798 $ 590,664 $ — $ 5,706,944 Intercompany payables 1,710,121 — 1,337,023 (3,047,144 ) — Long-term operating leases liabilities 133,349 1,550,461 1,005,439 — 2,689,249 Long-term debt and other long-term liabilities 5,103,876 644,436 357,653 — 6,105,965 Noncontrolling interests subject to put provisions 640,747 — — 544,986 1,185,733 Total DaVita Inc. shareholders' equity 4,049,298 11,304,840 3,184,913 (14,489,753 ) 4,049,298 Noncontrolling interests not subject to put — — 738,757 (544,986 ) 193,771 Total equity 4,049,298 11,304,840 3,923,670 (15,034,739 ) 4,243,069 Total liabilities and equity $ 15,404,873 $ 14,848,535 $ 7,214,449 $ (17,536,897 ) $ 19,930,960 As of December 31, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 60,653 $ — $ 262,385 $ — $ 323,038 Restricted cash and equivalents 1,005 12,048 79,329 — 92,382 Accounts receivable, net — 1,264,290 594,318 — 1,858,608 Other current assets 37,185 601,318 122,063 — 760,566 Current assets held for sale — — 5,389,565 — 5,389,565 Total current assets 98,843 1,877,656 6,447,660 — 8,424,159 Property and equipment, net 491,462 1,624,835 1,277,372 — 3,393,669 Intangible assets, net 153 42,933 75,760 — 118,846 Investments in subsidiaries 10,102,750 3,371,450 — (13,474,200 ) — Intercompany receivables 3,419,448 259,573 1,788,043 (5,467,064 ) — Other long-term assets and investments 53,385 80,537 197,696 — 331,618 Goodwill — 4,812,365 2,029,595 — 6,841,960 Total assets $ 14,166,041 $ 12,069,349 $ 11,816,126 $ (18,941,264 ) $ 19,110,252 Current liabilities $ 1,945,943 $ 1,251,534 $ 449,925 $ — $ 3,647,402 Current liabilities held for sale — — 1,243,759 — 1,243,759 Intercompany payables — — 5,467,064 (5,467,064 ) — Long-term debt and other long-term liabilities 7,918,581 715,065 552,406 — 9,186,052 Noncontrolling interests subject to put provisions 598,075 — — 526,566 1,124,641 Total DaVita Inc. shareholders' equity 3,703,442 10,102,750 3,371,450 (13,474,200 ) 3,703,442 Noncontrolling interests not subject to put — — 731,522 (526,566 ) 204,956 Total equity 3,703,442 10,102,750 4,102,972 (14,000,766 ) 3,908,398 Total liabilities and equity $ 14,166,041 $ 12,069,349 $ 11,816,126 $ (18,941,264 ) $ 19,110,252 Condensed Consolidating Statements of Cash Flows For the six months ended June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows from operating activities: Net income $ 422,840 $ 404,715 $ 269,243 $ (580,154 ) $ 516,644 Changes in operating assets and liabilities and non-cash (292,988 ) (210,545 ) 157,850 580,154 234,471 Net cash provided by operating activities 129,852 194,170 427,093 — 751,115 Cash flows from investing activities: Additions of property and equipment (63,037 ) (174,483 ) (136,398 ) — (373,918 ) Acquisitions — (8,975 ) (56,995 ) — (65,970 ) Proceeds from asset and business sales 3,824,509 33 26,839 — 3,851,381 Proceeds (purchases) from investment sales and other items, net 729 (6,560 ) (2,970 ) — (8,801 ) Net cash provided by (used in) investing activities 3,762,201 (189,985 ) (169,524 ) — 3,402,692 Cash flows from financing activities: Long-term debt and related financing costs, net (1,152,510 ) (5,270 ) (6,329 ) — (1,164,109 ) Intercompany borrowing (payments) 656,704 1,218 (657,922 ) — — Other items (82,011 ) — (64,433 ) — (146,444 ) Net cash used in financing activities (577,817 ) (4,052 ) (728,684 ) — (1,310,553 ) Effect of exchange rate changes on cash, cash — — (77 ) — (77 ) Net increase (decrease) in cash, cash equivalents and 3,314,236 133 (471,192 ) — 2,843,177 Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations — — (423,813 ) — (423,813 ) Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 3,314,236 133 (47,379 ) — 3,266,990 Cash, cash equivalents and restricted cash of continuing 61,658 12,048 341,714 — 415,420 Cash, cash equivalents and restricted cash of continuing $ 3,375,894 $ 12,181 $ 294,335 $ — $ 3,682,410 For the six months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows from operating activities: Net income $ 445,962 $ 377,452 $ 269,227 $ (561,090 ) $ 531,551 Changes in operating assets and liabilities and non-cash (361,134 ) 31,554 161,514 561,090 393,024 Net cash provided by operating activities 84,828 409,006 430,741 — 924,575 Cash flows from investing activities: Additions of property and equipment (77,169 ) (216,103 ) (180,705 ) — (473,977 ) Acquisitions — (6,916 ) (82,549 ) — (89,465 ) Proceeds from asset and business sales — 28,546 87,695 — 116,241 Proceeds (purchases) from investment sales and other items, net 32,415 (7,232 ) (2,046 ) — 23,137 Net cash used in investing activities (44,754 ) (201,705 ) (177,605 ) — (424,064 ) Cash flows from financing activities: Long-term debt and related financing costs, net 584,500 (4,398 ) (6,121 ) — 573,981 Intercompany borrowing (payments) 224,359 (187,712 ) (36,647 ) — — Other items (804,245 ) (13,208 ) (62,437 ) — (879,890 ) Net cash provided by (used in) financing activities 4,614 (205,318 ) (105,205 ) — (305,909 ) Effect of exchange rate changes on cash, cash — — (3,473 ) — (3,473 ) Net increase in cash, cash equivalents and restricted cash 44,688 1,983 144,458 — 191,129 Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations — — 229,901 — 229,901 Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 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 |
Supplemental data
Supplemental data | 6 Months Ended |
Jun. 30, 2019 | |
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 For the six months ended June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Patient service operating revenues $ 5,369,217 $ — $ — $ 5,369,217 Provision for uncollectible accounts (15,712 ) — — (15,712 ) Net patient service operating revenues 5,353,505 — — 5,353,505 Other revenues 232,312 — — 232,312 Total net operating revenues 5,585,817 — — 5,585,817 Operating expenses 4,783,424 — — 4,783,424 Operating income 802,393 — — 802,393 Debt expense (275,345 ) — — (275,345 ) Other income 12,583 — — 12,583 Income tax expense 132,684 — — 132,684 Net income from continuing operations 406,947 — — 406,947 Net income from discontinued operations, net of tax 109,697 12,706 249 96,742 Net income 516,644 12,706 249 503,689 Less: Net income attributable to noncontrolling interests (93,804 ) (1,255 ) — (92,549 ) Net income attributable to DaVita Inc. $ 422,840 $ 11,451 $ 249 $ 411,140 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Comprehensive Income For the six months ended June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Net income $ 516,644 $ 12,706 $ 249 $ 503,689 Other comprehensive income 1,313 — — 1,313 Total comprehensive income 517,957 12,706 249 505,002 Less: Comprehensive income attributable to the noncontrolling (93,804 ) (1,255 ) — (92,549 ) Comprehensive income attributable to DaVita Inc. $ 424,153 $ 11,451 $ 249 $ 412,453 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Balance Sheets As of June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash and cash equivalents $ 3,575,638 $ — $ — $ 3,575,638 Restricted cash and equivalents 106,772 — — 106,772 Accounts receivable, net 2,010,801 — — 2,010,801 Other current assets 697,418 — — 697,418 Total current assets 6,390,629 — — 6,390,629 Property and equipment, net 3,405,315 — — 3,405,315 Operating lease right-of-use assets 2,790,885 — — 2,790,885 Amortizable intangibles, net 120,574 — — 120,574 Other long-term assets 358,171 — — 358,171 Goodwill 6,865,386 — — 6,865,386 Total assets $ 19,930,960 $ — $ — $ 19,930,960 Current liabilities $ 5,706,944 $ — $ — $ 5,706,944 Long-term operating leases liabilities 2,689,249 — — 2,689,249 Long-term debt and other long-term liabilities 6,105,965 — — 6,105,965 Noncontrolling interests subject to put provisions 1,185,733 — — 1,185,733 Total DaVita Inc. shareholders’ equity 4,049,298 — — 4,049,298 Noncontrolling interests not subject to put provisions 193,771 — — 193,771 Shareholders’ equity 4,243,069 — — 4,243,069 Total liabilities and shareholder’s equity $ 19,930,960 $ — $ — $ 19,930,960 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Cash Flows For the six months ended June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash flows from operating activities: Net income $ 516,644 $ 12,706 $ 249 $ 503,689 Changes in operating and intercompany assets and liabilities and 234,471 (4,607 ) (249 ) 239,327 Net cash provided by operating activities 751,115 8,099 — 743,016 Cash flows from investing activities: Additions of property and equipment (373,918 ) (846 ) — (373,072 ) Acquisitions (65,970 ) — — (65,970 ) Proceeds from asset and business sales 3,851,381 — — 3,851,381 Investments and other items (8,801 ) (1,882 ) — (6,919 ) Net cash provided by (used in) investing activities 3,402,692 (2,728 ) — 3,405,420 Cash flows from financing activities: Long-term debt (1,164,109 ) — — (1,164,109 ) Intercompany — (247,175 ) — 247,175 Other items (146,444 ) — — (146,444 ) Net cash used in financing activities (1,310,553 ) (247,175 ) — (1,063,378 ) Effect of exchange rate changes on cash, cash equivalents and (77 ) — — (77 ) Net increase (decrease) in cash, cash equivalents and restricted cash 2,843,177 (241,804 ) — 3,084,981 Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations (423,813 ) (241,804 ) — (182,009 ) Net increase in cash, cash equivalents and restricted cash from continuing operations 3,266,990 — — 3,266,990 Cash, cash equivalents and restricted cash of continuing operations 415,420 — — 415,420 Cash, cash equivalents and restricted cash of continuing operations $ 3,682,410 $ — $ — $ 3,682,410 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed consolidated interi_2
Condensed consolidated interim financial statements Condensed consolidaed interim financial statements (Policies) | 6 Months Ended |
Jun. 30, 2019 | |
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, leases, impairments of goodwill and investments, accounting for income taxes, consolidation of variable interest entities and certain fair value estimates. The results of operations for the six months ended June 30, 2019 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, 2018 (10-K). 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 outstanding, net of the weighted average shares held in escrow that under certain circumstances may have been returned to the Company. Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units (under the treasury stock method) as well as the weighted average shares held in escrow that were outstanding during the period. |
Short-term and Long-term Investments | 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, 2019 and December 31, 2018 . Equity securities: |
Income Taxes | The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. |
Long-term debt | 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. |
Long-term incentive compensation | The Company’s stock-based compensation expense for stock-settled awards is measured at the estimated fair value of awards on the date of grant and recognized on a cumulative straight-line basis over the vesting terms of the awards unless the stock awards are based on non-market based performance metrics, in which case expense is adjusted for expected ultimate payouts as of the end of each reporting period. Stock-based compensation expense for cash-settled awards is based on their estimated fair values as of the end of each reporting period. The expense for all stock-based awards is recognized net of expected forfeitures. |
Comprehensive Income | Prior to January 1, 2018, unrealized gains and losses on available-for-sale equity securities were recorded to accumulated other comprehensive income and reclassified to other income when realized. From January 1, 2018, unrealized gains and losses on investment securities are recorded directly to other income rather than to accumulated other comprehensive income. |
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). There have been no material changes in the nature of the Company's arrangements with VIEs or its judgments concerning them from those described in Note 23 to the Company's consolidated financial statements included in the 10-K. |
Fair Value of Financial Instruments | Investments in equity securities represent investments in various open-ended registered investment companies (mutual funds) and common stock and are recorded at estimated fair value based on reported market prices or redemption prices, as applicable. 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. See Note 9 to these condensed consolidated financial statements for further discussion. |
New Accounting Standards | In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in Topic 842 revise the accounting related to lessee accounting. Under the new guidance, lessees are 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. The Company adopted Topic 842 beginning on January 1, 2019 through a modified retrospective approach for leases existing at the adoption date with a cumulative effect adjustment. The Company elected to apply the package of practical expedients to not recast prior conclusions related to contracts containing leases, lease classification and initial direct costs. Adoption of the new standard resulted in the recording of operating right-of-use assets of $2,783,784 , operating lease liabilities of $3,001,354 and an adjustment to retained earnings of $39,876 , primarily related to deferred gains on prior sale leaseback transactions as of January 1, 2019. The standard did not materially impact the Company's consolidated net earnings and had no impact on cash flows. See Note 10 to these condensed consolidated financial statements for further details. In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The amendments in this ASU change the approach for recognizing credit losses on financial assets from the incurred loss methodology in current GAAP to a methodology that reflects current expected credit losses, which requires consideration of a broader range of reasonable and supportable information to inform those credit loss estimates. The current incurred loss model delays recognition of credit losses until it is probable that a loss has been incurred, while this ASU’s new current expected credit loss model requires estimation of credit losses expected over the life of the financial asset or group of similar financial assets. The amendments in this ASU are effective for the Company on January 1, 2020 and are to be applied on a modified-retrospective approach. The Company is still evaluating certain aspects of this ASU as well as the impacts it may have on its consolidated financial statements when adopted on January 1, 2020. 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 this ASU were effective for the Company on January 1, 2019 and are to be applied prospectively. The adoption of this ASU did not have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2019. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework -Changes to the Disclosure Requirements for Fair Value Measurement . The applicable amendments in this ASU remove requirements for disclosures concerning transfers between fair value measurement levels 1, 2 and 3 and disclosures concerning valuation processes for level 3 fair value measurements. The applicable amendments in this ASU also add a requirement to separately disclose the changes in unrealized gains and losses included in other comprehensive income for the reporting period for level 3 items measured at fair value on a recurring basis, and require disclosure of the range and weighted average of significant unobservable inputs used to develop level 3 fair value measurements. The amendments in this ASU are effective for the Company beginning on January 1, 2020 and its new requirements are to be applied on a prospective basis. The adoption of this ASU is not expected to have a material impact on the Company’s consolidated financial statements. |
Revenue Recognition Segment rev
Revenue Recognition Segment revenue by major payor (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
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, 2019 June 30, 2018 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 $ 1,520,193 $ $ 1,520,193 $ 1,526,066 $ $ 1,526,066 Medicaid and Managed Medicaid 160,242 160,242 150,288 150,288 Other government 110,565 88,770 199,335 110,338 86,530 196,868 Commercial 840,993 33,095 874,088 796,732 19,139 815,871 Other revenues: Medicare and Medicare Advantage 64,012 64,012 154,028 154,028 Medicaid and Managed Medicaid 94 94 16,158 16,158 Commercial 32,307 32,307 17,006 17,006 Other (1) 5,501 20,670 26,171 4,919 35,034 39,953 Eliminations of intersegment revenues (30,334 ) (3,403 ) (33,737 ) (20,096 ) (9,189 ) (29,285 ) Total $ 2,607,160 $ 235,545 $ 2,842,705 $ 2,568,247 $ 318,706 $ 2,886,953 (1) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives. For the six months ended June 30, 2019 June 30, 2018 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 $ 3,013,709 $ $ 3,013,709 $ 3,011,258 $ $ 3,011,258 Medicaid and Managed Medicaid 314,431 314,431 307,783 307,783 Other government 216,692 173,245 389,937 217,458 169,068 386,526 Commercial 1,629,407 66,483 1,695,890 1,579,711 38,857 1,618,568 Other revenues: Medicare and Medicare Advantage 125,713 125,713 296,786 296,786 Medicaid and Managed Medicaid 100 100 31,949 31,949 Commercial 64,925 64,925 57,427 57,427 Other (1) 10,406 38,420 48,826 10,033 73,973 84,006 Eliminations of intersegment revenues (60,975 ) (6,739 ) (67,714 ) (38,519 ) (19,387 ) (57,906 ) Total $ 5,123,670 $ 462,147 $ 5,585,817 $ 5,087,724 $ 648,673 $ 5,736,397 (1) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives. |
Earnings per share Earnings Per
Earnings per share Earnings Per Share (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Earnings Per Share [Abstract] | |
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block] | 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, 2019 2018 2019 2018 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 194,223 $ 199,603 $ 314,477 $ 390,618 Change in noncontrolling interest redemption rights in excess of fair value — (98 ) — (98 ) Net income from continuing operations for earnings per share calculation 194,223 199,505 314,477 390,520 Net income from discontinued operations attributable to DaVita Inc. 79,328 67,673 108,363 55,344 Net income attributable to DaVita Inc. for earnings per share calculation $ 273,551 $ 267,178 $ 422,840 $ 445,864 Basic: Weighted average shares outstanding during the period 166,346 173,811 166,367 177,461 Weighted average contingently returnable shares held in escrow for the — (2,194 ) — (2,194 ) Weighted average shares for basic earnings per share calculation 166,346 171,617 166,367 175,267 Basic net income attributable to DaVita Inc. from: Continuing operations per share $ 1.17 $ 1.16 $ 1.89 $ 2.23 Discontinued operations per share 0.47 0.40 0.65 0.31 Basic net income per share attributable to DaVita Inc. $ 1.64 $ 1.56 $ 2.54 $ 2.54 Diluted: Weighted average shares outstanding during the period 166,346 173,811 166,367 177,461 Assumed incremental shares from stock plans 454 295 423 489 Weighted average shares for diluted earnings per share calculation 166,800 174,106 166,790 177,950 Diluted net income attributable to DaVita Inc. from: Continuing operations per share $ 1.16 $ 1.15 $ 1.89 $ 2.19 Discontinued operations per share 0.48 0.38 0.65 0.32 Diluted net income per share attributable to DaVita Inc. $ 1.64 $ 1.53 $ 2.54 $ 2.51 Anti-dilutive stock-settled awards excluded from calculation (1) 5,797 6,227 5,974 4,840 (1) Shares associated with stock-settled stock appreciation rights and performance stock units were excluded from the diluted denominator calculation because they are anti-dilutive under the treasury stock method. |
Investments in debt and equit_2
Investments in debt and equity securities (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Investments, Debt and Equity Securities [Abstract] | |
Investments | The Company’s short-term and long-term debt and equity investments consist of the following: June 30, 2019 December 31, 2018 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 3,113 $ — $ 3,113 $ 2,235 $ — $ 2,235 Investments in mutual funds and common stock — 37,151 37,151 — 36,124 36,124 $ 3,113 $ 37,151 $ 40,264 $ 2,235 $ 36,124 $ 38,359 Short-term investments $ 3,113 $ 2,100 $ 5,213 $ 2,235 $ 700 $ 2,935 Long-term investments — 35,051 35,051 — 35,424 35,424 $ 3,113 $ 37,151 $ 40,264 $ 2,235 $ 36,124 $ 38,359 |
Equity method and other inves_2
Equity method and other investments Equity Method and Other Investments (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Equity Method Investments and Joint Ventures [Abstract] | |
Equity Method Investments | The Company's equity method and other investments were comprised of the following: June 30, 2019 December 31, 2018 APAC joint venture $ 124,493 $ 129,173 Other equity method partnerships 90,736 83,052 Adjusted cost method investments 10,448 12,386 $ 225,677 $ 224,611 |
Goodwill (Tables)
Goodwill (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Changes in Goodwill by Reportable Segments [Text Block] | 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 December 31, 2017 $ 6,144,761 $ 465,518 $ 6,610,279 Acquisitions 130,574 147,774 278,348 Divestitures (331 ) (15,166 ) (15,497 ) Impairment charges — (3,106 ) (3,106 ) Foreign currency and other adjustments — (28,064 ) (28,064 ) Balance at December 31, 2018 $ 6,275,004 $ 566,956 $ 6,841,960 Acquisitions 15,714 50,900 66,614 Impairment charges — (41,037 ) (41,037 ) Foreign currency and other adjustments — (2,151 ) (2,151 ) Balance at June 30, 2019 $ 6,290,718 $ 574,668 $ 6,865,386 Balance at June 30, 2019: Goodwill $ 6,290,718 $ 643,266 $ 6,933,984 Accumulated impairment charges — (68,598 ) (68,598 ) $ 6,290,718 $ 574,668 $ 6,865,386 |
Schedule Of Reporting Units Goodwill Balances [Text Block] | Reporting unit Goodwill balance as Carrying amount (1) Sensitivities Operating income (2) Discount rate (3) Brazil Kidney Care $ 69,887 4.4% (2.8)% (7.0)% Germany Kidney Care $ 380,340 —% (1.4)% (9.3)% (1) Excess of estimated fair value of the reporting unit over its carrying amount as of the latest assessment date. (2) Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date. (3) Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date. |
Long-term debt (Tables)
Long-term debt (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Debt Disclosure [Abstract] | |
Long-term Debt | Long-term debt was comprised of the following: As of June 30, 2019 June 30, 2019 December 31, 2018 Maturity date Interest rate Estimated fair value (2) Senior Secured Credit Facilities: Term Loan A (1) $ 64,383 $ 675,000 12/24/2019 2.00% + LIBOR $ 64,300 Term Loan A-2 (1) 102,498 995,000 12/24/2019 1.00% + LIBOR $ 103,011 Term Loan B 3,325,000 3,342,500 6/24/2021 2.75% + LIBOR (3) $ 3,333,313 Revolving line of credit (1) 550,000 175,000 12/24/2019 2.00% + LIBOR $ 550,000 Senior Notes: 5 3/4% Senior Notes 1,250,000 1,250,000 8/15/2022 5.75% $ 1,264,000 5 1/8% Senior Notes 1,750,000 1,750,000 7/15/2024 5.125% $ 1,748,250 5% Senior Notes 1,500,000 1,500,000 5/1/2025 5.00% $ 1,479,000 Acquisition obligations and other notes payable (4) 184,170 183,979 2019-2027 5.70% $ 184,170 Financing lease obligations (5) 277,580 282,737 2019-2036 5.43% $ 277,580 Total debt principal outstanding 9,003,631 10,154,216 Discount and deferred financing costs (6) (34,502 ) (52,000 ) 8,969,129 10,102,216 Less current portion (3,591,331 ) (1,929,369 ) $ 5,377,798 $ 8,172,847 (1) On May 6, 2019, the Company entered into an agreement to extend the maturity dates of its Term Loan A, Term Loan A-2 and revolving line of credit under its senior secured credit facilities by six months , to December 24, 2019 . (2) Fair values are based upon quoted market prices for similar instruments, a level 2 input. The balances of acquisition obligations and other notes payable and financing lease obligations are presented in the condensed consolidated financial statements at June 30, 2019 at their approximate fair values due to the short-term nature of their settlements. (3) Term Loan B is subject to a LIBOR component floor of 0.75% . (4) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current interest rate in effect and assuming no changes to the LIBOR based interest rates. (5) The interest rate presented for financing lease obligations is their weighted average discount rate. (6) The carrying amount of the Company’s senior secured credit facilities includes a discount of $696 and deferred financing costs of $3,744 , and the carrying amount of the Company’s senior notes includes deferred financing costs of $30,062 as of June 30, 2019 . The carrying amount of the Company’s senior secured credit facilities included a discount of $6,104 and deferred financing costs of $12,580 , and the carrying amount of the Company’s senior notes included deferred financing costs of $33,316 as of December 31, 2018. |
Scheduled Maturities of Long-term Debt | Scheduled maturities of long-term debt at June 30, 2019 were as follows: 2019 (remainder of the year) (1) 3,564,562 2020 53,182 2021 533,377 2022 1,292,979 2023 54,372 2024 1,785,765 Thereafter 1,719,394 (1) Includes $2,990,328 of senior secured credit facility debt paid after June 30, 2019 from proceeds of the DMG sale, as described below. |
Schedule of Derivative Instruments | The following table summarizes the Company’s derivative instruments outstanding as of June 30, 2019 and December 31, 2018 , which are classified in "Other long-term assets" on its consolidated balance sheet: Six months ended Fair value Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI loss June 30, 2019 December 31, 2018 October 2015 caps $ 3,500,000 3.5% 6/29/2018 6/30/2020 $ 4,326 $ 823 $ 28 $ 851 |
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, 2019 and 2018 : Amount of unrecognized (losses) gains in OCI on interest rate cap agreements Income statement location Reclassification from accumulated other comprehensive income into net income Three months ended Six months ended Three months ended Six months ended Derivatives designated as cash flow hedges 2019 2018 2019 2018 2019 2018 2019 2018 Interest rate cap agreements $ (42 ) $ (361 ) $ (823 ) $ 1,053 Debt expense $ 2,163 $ 2,070 $ 4,326 $ 4,140 Related income tax 11 93 212 (271 ) Related income tax (557 ) (533 ) (1,114 ) (1,066 ) Total $ (31 ) $ (268 ) $ (611 ) $ 782 $ 1,606 $ 1,537 $ 3,212 $ 3,074 |
Leases Leases (Tables)
Leases Leases (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Leases [Abstract] | |
Lease Expense Components | The components of lease expense were as follows: Lease cost Three months ended Six months ended Operating lease cost (1) : Fixed lease expense $ 130,946 $ 259,056 Variable lease expense 29,907 58,478 Financing lease cost: Amortization of leased assets 5,703 11,529 Interest on lease liabilities 3,715 7,490 Net lease cost $ 170,271 $ 336,553 (1) Includes short-term lease expense and sublease income, which are immaterial. |
Leases Other Information | Other information related to leases was as follows: Lease term and discount rate June 30, 2019 Weighted average remaining lease term (years): Operating leases 9.1 Finance leases 10.6 Weighted average discount rate: Operating leases 4.2 % Finance leases 5.4 % Other information Six months ended Gain on sale leaseback, net $ 10,336 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 309,115 Operating cash flows from finance leases $ 10,585 Financing cash flows from finance leases $ 16,910 Net operating lease assets obtained in exchange for new or modified operating lease liabilities $ 195,771 |
Schedule Of Minimum Lease Payments | Future minimum lease payments under non-cancellable leases as of December 31, 2018 were as follows: Operating leases Capital leases 2019 $ 483,488 $ 36,754 2020 462,154 41,044 2021 432,950 34,026 2022 395,462 33,690 2023 349,649 33,845 Thereafter 1,589,949 194,611 $ 3,713,652 373,970 Less portion representing interest (91,233 ) Total capital lease obligations, including current portion $ 282,737 Future minimum lease payments under non-cancellable leases as of June 30, 2019 were as follows: Operating leases Finance leases 2019 (remainder of the year) $ 259,928 $ 16,493 2020 490,779 37,805 2021 463,495 33,317 2022 426,182 33,599 2023 380,070 33,709 2024 326,541 33,723 Thereafter 1,375,473 175,202 Total future minimum lease payments $ 3,722,468 $ 363,848 Less portion representing interest (660,594 ) (86,268 ) Present value of lease liabilities $ 3,061,874 $ 277,580 |
Accumulated other comprehensi_2
Accumulated other comprehensive (loss) income (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | For the three months ended June 30, 2019 For the six months ended June 30, 2019 Interest Foreign Accumulated Interest Foreign Accumulated Beginning balance $ (7,935 ) $ (39,616 ) $ (47,551 ) $ (8,961 ) $ (25,963 ) $ (34,924 ) Unrealized (losses) gains (42 ) 12,365 12,323 (823 ) (1,288 ) (2,111 ) Related income tax 11 — 11 212 — 212 (31 ) 12,365 12,334 (611 ) (1,288 ) (1,899 ) Reclassification into net income 2,163 — 2,163 4,326 — 4,326 Related income tax (557 ) — (557 ) (1,114 ) — (1,114 ) 1,606 — 1,606 3,212 — 3,212 Ending balance $ (6,360 ) $ (27,251 ) $ (33,611 ) $ (6,360 ) $ (27,251 ) $ (33,611 ) For the three months ended June 30, 2018 For the six months ended June 30, 2018 Interest Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (12,527 ) $ 39,862 $ 27,335 $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 Cumulative effect of change (1) — — — (2,706 ) (5,662 ) — (8,368 ) Unrealized (losses) gains (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 into net 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 Tax Cuts and Jobs Act of 2017. |
Acquisitions and divestitures (
Acquisitions and divestitures (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Business Acquisition [Line Items] | |
Schedule of Business Acquisitions by Acquisition, Contingent Consideration | The following is a reconciliation of changes in contingent earn-out obligations for the six months ended June 30, 2019 : Beginning balance December 31, 2018 $ 2,608 Contingent earn-out obligations associated with acquisitions 12,440 Remeasurement of fair value for contingent earn-out obligations (101 ) Payments on contingent earn-out obligations (217 ) Ending balance June 30, 2019 $ 14,730 |
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 $ 3,607 Property and equipment 2,135 Intangible and other long-term assets 8,443 Goodwill 66,614 Current liabilities (2,067 ) Long-term liabilities (88 ) Noncontrolling interests (1,762 ) $ 76,882 |
Held for Sale and Discontinue_2
Held for Sale and Discontinued Operations (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
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 June 30, Six months ended June 30, 2019 2018 2019 2018 Revenues $ 1,330,777 $ 1,252,430 $ 2,713,059 $ 2,480,362 Expenses 1,201,633 1,192,528 2,539,787 2,418,935 Income from operations of discontinued operations before taxes 129,144 59,902 173,272 61,427 Loss on sale of discontinued operations before taxes (23,022 ) — (23,022 ) — Income tax expense (benefit) 26,730 (9,794 ) 40,553 (2,483 ) Net income from discontinued operations, net of tax $ 79,392 $ 69,696 $ 109,697 $ 63,910 The following table presents cash flows of discontinued operations related to DMG: Six months ended June 30, 2019 2018 Net cash provided by operating activities from discontinued operations $ 103,848 $ 112,683 Net cash used in investing activities from discontinued operations $ (43,442 ) $ (20,982 ) |
Fair value of financial instr_2
Fair value of financial instruments (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
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, 2019 : Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 37,151 $ 37,151 $ — $ — Interest rate cap agreements $ 28 $ — $ 28 $ — Liabilities Contingent earn-out obligations $ 14,730 $ — $ — $ 14,730 Temporary equity Noncontrolling interests subject to put provisions $ 1,185,733 $ — $ — $ 1,185,733 |
Segment reporting (Tables)
Segment reporting (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
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, 2019 2018 2019 2018 Segment revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,612,200 $ 2,612,734 $ 5,129,489 $ 5,101,899 Intersegment revenues 30,042 20,096 60,462 38,519 U.S. dialysis and related lab services patient service 2,642,242 2,632,830 5,189,951 5,140,418 Provision for uncollectible accounts (10,249 ) (49,406 ) (15,712 ) (24,208 ) Net U.S. dialysis and related lab services patient 2,631,993 2,583,424 5,174,239 5,116,210 Other revenues (1) : External sources 5,209 4,919 9,893 10,033 Intersegment revenues 292 — 513 — Total U.S. dialysis and related lab services revenues $ 2,637,494 $ 2,588,343 $ 5,184,645 $ 5,126,243 Other—Ancillary services and strategic initiatives Patient service revenues, net $ 121,865 $ 105,669 $ 239,728 $ 207,925 Other external sources 113,680 213,037 222,419 440,748 Intersegment revenues 3,403 9,189 6,739 19,387 Total ancillary services and strategic initiatives revenues 238,948 327,895 468,886 668,060 Total net segment revenues 2,876,442 2,916,238 5,653,531 5,794,303 Elimination of intersegment revenues (33,737 ) (29,285 ) (67,714 ) (57,906 ) Consolidated revenues $ 2,842,705 $ 2,886,953 $ 5,585,817 $ 5,736,397 Segment operating margin: U.S. dialysis and related lab services $ 498,957 $ 449,443 $ 915,939 $ 882,822 Other—Ancillary services and strategic initiatives (15,050 ) 2,815 (72,680 ) (4,175 ) Total segment operating margin 483,907 452,258 843,259 878,647 Reconciliation of segment operating margin to consolidated Corporate administrative support (22,021 ) (14,066 ) (40,866 ) (29,769 ) Consolidated operating income 461,886 438,192 802,393 848,878 Debt expense (131,666 ) (119,692 ) (263,185 ) (233,208 ) Debt prepayment charges (12,160 ) — (12,160 ) — Other income, net 5,643 1,994 12,583 6,576 Consolidated income from continuing operations before $ 323,703 $ 320,494 $ 539,631 $ 622,246 (1) Includes management fee revenue from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling equity investment or which are wholly-owned by third parties. |
Summary of Assets by Reportable Segment | A summary of assets by reportable segment was as follows: June 30, 2019 December 31, 2018 Segment assets U.S. dialysis and related lab services (including equity $ 18,352,683 $ 12,333,641 Other—Ancillary services and strategic initiatives (including 1,578,277 1,387,046 DMG—Held for sale (including equity investments of $0 and — 5,389,565 Consolidated assets $ 19,930,960 $ 19,110,252 |
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, 2019 2018 2019 2018 U.S. dialysis and related lab services $ 144,621 $ 138,252 $ 285,401 $ 273,028 Other — Ancillary services and strategic initiatives 7,621 8,827 15,369 16,850 $ 152,242 $ 147,079 $ 300,770 $ 289,878 |
Summary of Expenditures for Property and Equipment by Reportable Segment | Three months ended June 30, Six months ended June 30, 2019 2018 2019 2018 U.S. dialysis and related lab services $ 144,621 $ 138,252 $ 285,401 $ 273,028 Other — Ancillary services and strategic initiatives 7,621 8,827 15,369 16,850 $ 152,242 $ 147,079 $ 300,770 $ 289,878 Expenditures for property and equipment by reportable segment were as follows: |
Changes in DaVita Inc.'s owne_2
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
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 interests in consolidated subsidiaries on the Company’s consolidated equity were as follows: Three months ended June 30, Six months ended June 30, 2019 2018 2019 2018 Net income attributable to DaVita Inc. $ 273,551 $ 267,276 $ 422,840 $ 445,962 Changes in paid-in capital for: Sales of noncontrolling interests — 3 — 79 Purchases of noncontrolling interests 13,140 (10,203 ) 10,934 (12,197 ) Net transfers to noncontrolling interests 13,140 (10,200 ) 10,934 (12,118 ) Net income attributable to DaVita Inc., net of transfers to noncontrolling interests $ 286,691 $ 257,076 $ 433,774 $ 433,844 |
Condensed Consolidating finan_2
Condensed Consolidating financial statements (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Condensed Consolidating Statements of Operations | Condensed Consolidating Statements of Operations For the three months ended June 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 1,781,066 $ 1,014,869 $ (61,870 ) $ 2,734,065 Provision for uncollectible accounts — (7,246 ) (3,003 ) — (10,249 ) Net patient service revenues — 1,773,820 1,011,866 (61,870 ) 2,723,816 Other revenues 207,299 115,226 37,035 (240,671 ) 118,889 Total net revenues 207,299 1,889,046 1,048,901 (302,541 ) 2,842,705 Operating expenses 160,464 1,673,331 849,565 (302,541 ) 2,380,819 Operating income 46,835 215,715 199,336 — 461,886 Debt expense (144,896 ) (52,762 ) (11,217 ) 65,049 (143,826 ) Other income, net 102,059 2,716 8,958 (108,090 ) 5,643 Income tax expense 627 63,930 11,381 — 75,938 Equity earnings in subsidiaries 270,180 168,441 — (438,621 ) — Net income from continuing operations 273,551 270,180 185,696 (481,662 ) 247,765 Net income from discontinued operations, net of tax — — 36,351 43,041 79,392 Net income 273,551 270,180 222,047 (438,621 ) 327,157 Less: Net income attributable to noncontrolling interests — — — (53,606 ) (53,606 ) Net income attributable to DaVita Inc. $ 273,551 $ 270,180 $ 222,047 $ (492,227 ) $ 273,551 For the three months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Patient service 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 236,335 157,586 — (393,921 ) — Net income from continuing operations 267,276 236,335 174,823 (441,808 ) 236,626 Net income from discontinued operations, net of tax — — 21,809 47,887 69,696 Net income 267,276 236,335 196,632 (393,921 ) 306,322 Less: Net income attributable to noncontrolling interests — — — (39,046 ) (39,046 ) Net income attributable to DaVita Inc. $ 267,276 $ 236,335 $ 196,632 $ (432,967 ) $ 267,276 For the six months ended June 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 3,558,312 $ 1,933,473 $ (122,568 ) $ 5,369,217 Provision for uncollectible accounts — (11,216 ) (4,496 ) — (15,712 ) Net patient service revenues — 3,547,096 1,928,977 (122,568 ) 5,353,505 Other revenues 396,135 226,367 72,654 (462,844 ) 232,312 Total net revenues 396,135 3,773,463 2,001,631 (585,412 ) 5,585,817 Operating expenses and charges 304,123 3,333,784 1,730,929 (585,412 ) 4,783,424 Operating income 92,012 439,679 270,702 — 802,393 Debt expense (278,491 ) (105,241 ) (21,936 ) 130,323 (275,345 ) Other income, net 212,257 5,312 18,069 (223,055 ) 12,583 Income tax expense 7,653 110,474 14,557 — 132,684 Equity earnings in subsidiaries 404,715 175,439 — (580,154 ) — Net income from continuing operations 422,840 404,715 252,278 (672,886 ) 406,947 Net income from discontinued operations, net of tax — — 16,965 92,732 109,697 Net income 422,840 404,715 269,243 (580,154 ) 516,644 Less: Net income attributable to noncontrolling interests — — — (93,804 ) (93,804 ) Net income attributable to DaVita Inc. $ 422,840 $ 404,715 $ 269,243 $ (673,958 ) $ 422,840 For the six months ended June 30, 2018 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services 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 and charges 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, net 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 377,452 183,638 — (561,090 ) — Net income from continuing operations 445,962 377,452 300,540 (656,313 ) 467,641 Net (loss) income from discontinued operations, net of tax — — (31,313 ) 95,223 63,910 Net income 445,962 377,452 269,227 (561,090 ) 531,551 Less: Net income attributable to noncontrolling interests — — — (85,589 ) (85,589 ) Net income attributable to DaVita Inc. $ 445,962 $ 377,452 $ 269,227 $ (646,679 ) $ 445,962 Condensed Consolidating Statements of Income For the six months ended June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Patient service operating revenues $ 5,369,217 $ — $ — $ 5,369,217 Provision for uncollectible accounts (15,712 ) — — (15,712 ) Net patient service operating revenues 5,353,505 — — 5,353,505 Other revenues 232,312 — — 232,312 Total net operating revenues 5,585,817 — — 5,585,817 Operating expenses 4,783,424 — — 4,783,424 Operating income 802,393 — — 802,393 Debt expense (275,345 ) — — (275,345 ) Other income 12,583 — — 12,583 Income tax expense 132,684 — — 132,684 Net income from continuing operations 406,947 — — 406,947 Net income from discontinued operations, net of tax 109,697 12,706 249 96,742 Net income 516,644 12,706 249 503,689 Less: Net income attributable to noncontrolling interests (93,804 ) (1,255 ) — (92,549 ) Net income attributable to DaVita Inc. $ 422,840 $ 11,451 $ 249 $ 411,140 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Comprehensive Income | Condensed Consolidating Statements of Comprehensive Income For the three months ended June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 273,551 $ 270,180 $ 222,047 $ (438,621 ) $ 327,157 Other comprehensive income 1,575 — 12,365 — 13,940 Total comprehensive income 275,126 270,180 234,412 (438,621 ) 341,097 Less: Comprehensive income attributable to noncontrolling interest — — — (53,606 ) (53,606 ) Comprehensive income attributable to DaVita Inc. $ 275,126 $ 270,180 $ 234,412 $ (492,227 ) $ 287,491 For the three months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 267,276 $ 236,335 $ 196,632 $ (393,921 ) $ 306,322 Other comprehensive income (loss) 1,269 — (50,529 ) — (49,260 ) Total comprehensive income 268,545 236,335 146,103 (393,921 ) 257,062 Less: Comprehensive income attributable to noncontrolling interest — — — (39,046 ) (39,046 ) Comprehensive income attributable to DaVita Inc. $ 268,545 $ 236,335 $ 146,103 $ (432,967 ) $ 218,016 For the six months ended June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 422,840 $ 404,715 $ 269,243 $ (580,154 ) $ 516,644 Other comprehensive income (loss) 2,601 — (1,288 ) — 1,313 Total comprehensive income 425,441 404,715 267,955 (580,154 ) 517,957 Less: Comprehensive income attributable to noncontrolling interest — — — (93,804 ) (93,804 ) Comprehensive income attributable to DaVita Inc. $ 425,441 $ 404,715 $ 267,955 $ (673,958 ) $ 424,153 For the six months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 445,962 $ 377,452 $ 269,227 $ (561,090 ) $ 531,551 Other comprehensive income (loss) 3,856 — (30,648 ) — (26,792 ) Total comprehensive income 449,818 377,452 238,579 (561,090 ) 504,759 Less: Comprehensive income attributable to noncontrolling interest — — — (85,589 ) (85,589 ) Comprehensive income attributable to DaVita Inc. $ 449,818 $ 377,452 $ 238,579 $ (646,679 ) $ 419,170 Condensed Consolidating Statements of Comprehensive Income For the six months ended June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Net income $ 516,644 $ 12,706 $ 249 $ 503,689 Other comprehensive income 1,313 — — 1,313 Total comprehensive income 517,957 12,706 249 505,002 Less: Comprehensive income attributable to the noncontrolling (93,804 ) (1,255 ) — (92,549 ) Comprehensive income attributable to DaVita Inc. $ 424,153 $ 11,451 $ 249 $ 412,453 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Balance Sheets | Condensed Consolidating Balance Sheets As of June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 3,374,887 $ — $ 200,751 $ — $ 3,575,638 Restricted cash and equivalents 1,007 12,181 93,584 — 106,772 Accounts receivable, net — 1,352,844 657,957 — 2,010,801 Other current assets 37,185 545,881 114,352 — 697,418 Total current assets 3,413,079 1,910,906 1,066,644 — 6,390,629 Property and equipment, net 501,219 1,613,193 1,290,903 — 3,405,315 Operating lease right-of-use assets 105,137 1,636,360 1,049,388 — 2,790,885 Intangible assets, net 107 37,272 83,195 — 120,574 Investments in subsidiaries 11,304,840 3,184,913 — (14,489,753 ) — Intercompany receivables — 1,563,270 1,483,874 (3,047,144 ) — Other long-term assets and investments 80,491 81,567 196,113 — 358,171 Goodwill — 4,821,054 2,044,332 — 6,865,386 Total assets $ 15,404,873 $ 14,848,535 $ 7,214,449 $ (17,536,897 ) $ 19,930,960 Current liabilities $ 3,767,482 $ 1,348,798 $ 590,664 $ — $ 5,706,944 Intercompany payables 1,710,121 — 1,337,023 (3,047,144 ) — Long-term operating leases liabilities 133,349 1,550,461 1,005,439 — 2,689,249 Long-term debt and other long-term liabilities 5,103,876 644,436 357,653 — 6,105,965 Noncontrolling interests subject to put provisions 640,747 — — 544,986 1,185,733 Total DaVita Inc. shareholders' equity 4,049,298 11,304,840 3,184,913 (14,489,753 ) 4,049,298 Noncontrolling interests not subject to put — — 738,757 (544,986 ) 193,771 Total equity 4,049,298 11,304,840 3,923,670 (15,034,739 ) 4,243,069 Total liabilities and equity $ 15,404,873 $ 14,848,535 $ 7,214,449 $ (17,536,897 ) $ 19,930,960 As of December 31, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 60,653 $ — $ 262,385 $ — $ 323,038 Restricted cash and equivalents 1,005 12,048 79,329 — 92,382 Accounts receivable, net — 1,264,290 594,318 — 1,858,608 Other current assets 37,185 601,318 122,063 — 760,566 Current assets held for sale — — 5,389,565 — 5,389,565 Total current assets 98,843 1,877,656 6,447,660 — 8,424,159 Property and equipment, net 491,462 1,624,835 1,277,372 — 3,393,669 Intangible assets, net 153 42,933 75,760 — 118,846 Investments in subsidiaries 10,102,750 3,371,450 — (13,474,200 ) — Intercompany receivables 3,419,448 259,573 1,788,043 (5,467,064 ) — Other long-term assets and investments 53,385 80,537 197,696 — 331,618 Goodwill — 4,812,365 2,029,595 — 6,841,960 Total assets $ 14,166,041 $ 12,069,349 $ 11,816,126 $ (18,941,264 ) $ 19,110,252 Current liabilities $ 1,945,943 $ 1,251,534 $ 449,925 $ — $ 3,647,402 Current liabilities held for sale — — 1,243,759 — 1,243,759 Intercompany payables — — 5,467,064 (5,467,064 ) — Long-term debt and other long-term liabilities 7,918,581 715,065 552,406 — 9,186,052 Noncontrolling interests subject to put provisions 598,075 — — 526,566 1,124,641 Total DaVita Inc. shareholders' equity 3,703,442 10,102,750 3,371,450 (13,474,200 ) 3,703,442 Noncontrolling interests not subject to put — — 731,522 (526,566 ) 204,956 Total equity 3,703,442 10,102,750 4,102,972 (14,000,766 ) 3,908,398 Total liabilities and equity $ 14,166,041 $ 12,069,349 $ 11,816,126 $ (18,941,264 ) $ 19,110,252 Condensed Consolidating Balance Sheets As of June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash and cash equivalents $ 3,575,638 $ — $ — $ 3,575,638 Restricted cash and equivalents 106,772 — — 106,772 Accounts receivable, net 2,010,801 — — 2,010,801 Other current assets 697,418 — — 697,418 Total current assets 6,390,629 — — 6,390,629 Property and equipment, net 3,405,315 — — 3,405,315 Operating lease right-of-use assets 2,790,885 — — 2,790,885 Amortizable intangibles, net 120,574 — — 120,574 Other long-term assets 358,171 — — 358,171 Goodwill 6,865,386 — — 6,865,386 Total assets $ 19,930,960 $ — $ — $ 19,930,960 Current liabilities $ 5,706,944 $ — $ — $ 5,706,944 Long-term operating leases liabilities 2,689,249 — — 2,689,249 Long-term debt and other long-term liabilities 6,105,965 — — 6,105,965 Noncontrolling interests subject to put provisions 1,185,733 — — 1,185,733 Total DaVita Inc. shareholders’ equity 4,049,298 — — 4,049,298 Noncontrolling interests not subject to put provisions 193,771 — — 193,771 Shareholders’ equity 4,243,069 — — 4,243,069 Total liabilities and shareholder’s equity $ 19,930,960 $ — $ — $ 19,930,960 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Cash Flows | Condensed Consolidating Statements of Cash Flows For the six months ended June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows from operating activities: Net income $ 422,840 $ 404,715 $ 269,243 $ (580,154 ) $ 516,644 Changes in operating assets and liabilities and non-cash (292,988 ) (210,545 ) 157,850 580,154 234,471 Net cash provided by operating activities 129,852 194,170 427,093 — 751,115 Cash flows from investing activities: Additions of property and equipment (63,037 ) (174,483 ) (136,398 ) — (373,918 ) Acquisitions — (8,975 ) (56,995 ) — (65,970 ) Proceeds from asset and business sales 3,824,509 33 26,839 — 3,851,381 Proceeds (purchases) from investment sales and other items, net 729 (6,560 ) (2,970 ) — (8,801 ) Net cash provided by (used in) investing activities 3,762,201 (189,985 ) (169,524 ) — 3,402,692 Cash flows from financing activities: Long-term debt and related financing costs, net (1,152,510 ) (5,270 ) (6,329 ) — (1,164,109 ) Intercompany borrowing (payments) 656,704 1,218 (657,922 ) — — Other items (82,011 ) — (64,433 ) — (146,444 ) Net cash used in financing activities (577,817 ) (4,052 ) (728,684 ) — (1,310,553 ) Effect of exchange rate changes on cash, cash — — (77 ) — (77 ) Net increase (decrease) in cash, cash equivalents and 3,314,236 133 (471,192 ) — 2,843,177 Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations — — (423,813 ) — (423,813 ) Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 3,314,236 133 (47,379 ) — 3,266,990 Cash, cash equivalents and restricted cash of continuing 61,658 12,048 341,714 — 415,420 Cash, cash equivalents and restricted cash of continuing $ 3,375,894 $ 12,181 $ 294,335 $ — $ 3,682,410 For the six months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows from operating activities: Net income $ 445,962 $ 377,452 $ 269,227 $ (561,090 ) $ 531,551 Changes in operating assets and liabilities and non-cash (361,134 ) 31,554 161,514 561,090 393,024 Net cash provided by operating activities 84,828 409,006 430,741 — 924,575 Cash flows from investing activities: Additions of property and equipment (77,169 ) (216,103 ) (180,705 ) — (473,977 ) Acquisitions — (6,916 ) (82,549 ) — (89,465 ) Proceeds from asset and business sales — 28,546 87,695 — 116,241 Proceeds (purchases) from investment sales and other items, net 32,415 (7,232 ) (2,046 ) — 23,137 Net cash used in investing activities (44,754 ) (201,705 ) (177,605 ) — (424,064 ) Cash flows from financing activities: Long-term debt and related financing costs, net 584,500 (4,398 ) (6,121 ) — 573,981 Intercompany borrowing (payments) 224,359 (187,712 ) (36,647 ) — — Other items (804,245 ) (13,208 ) (62,437 ) — (879,890 ) Net cash provided by (used in) financing activities 4,614 (205,318 ) (105,205 ) — (305,909 ) Effect of exchange rate changes on cash, cash — — (3,473 ) — (3,473 ) Net increase in cash, cash equivalents and restricted cash 44,688 1,983 144,458 — 191,129 Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations — — 229,901 — 229,901 Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 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 Condensed Consolidating Statements of Cash Flows For the six months ended June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash flows from operating activities: Net income $ 516,644 $ 12,706 $ 249 $ 503,689 Changes in operating and intercompany assets and liabilities and 234,471 (4,607 ) (249 ) 239,327 Net cash provided by operating activities 751,115 8,099 — 743,016 Cash flows from investing activities: Additions of property and equipment (373,918 ) (846 ) — (373,072 ) Acquisitions (65,970 ) — — (65,970 ) Proceeds from asset and business sales 3,851,381 — — 3,851,381 Investments and other items (8,801 ) (1,882 ) — (6,919 ) Net cash provided by (used in) investing activities 3,402,692 (2,728 ) — 3,405,420 Cash flows from financing activities: Long-term debt (1,164,109 ) — — (1,164,109 ) Intercompany — (247,175 ) — 247,175 Other items (146,444 ) — — (146,444 ) Net cash used in financing activities (1,310,553 ) (247,175 ) — (1,063,378 ) Effect of exchange rate changes on cash, cash equivalents and (77 ) — — (77 ) Net increase (decrease) in cash, cash equivalents and restricted cash 2,843,177 (241,804 ) — 3,084,981 Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations (423,813 ) (241,804 ) — (182,009 ) Net increase in cash, cash equivalents and restricted cash from continuing operations 3,266,990 — — 3,266,990 Cash, cash equivalents and restricted cash of continuing operations 415,420 — — 415,420 Cash, cash equivalents and restricted cash of continuing operations $ 3,682,410 $ — $ — $ 3,682,410 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Supplemental Data (Tables)
Supplemental Data (Tables) | 6 Months Ended |
Jun. 30, 2019 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Condensed Consolidating Statements of Operations | Condensed Consolidating Statements of Operations For the three months ended June 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 1,781,066 $ 1,014,869 $ (61,870 ) $ 2,734,065 Provision for uncollectible accounts — (7,246 ) (3,003 ) — (10,249 ) Net patient service revenues — 1,773,820 1,011,866 (61,870 ) 2,723,816 Other revenues 207,299 115,226 37,035 (240,671 ) 118,889 Total net revenues 207,299 1,889,046 1,048,901 (302,541 ) 2,842,705 Operating expenses 160,464 1,673,331 849,565 (302,541 ) 2,380,819 Operating income 46,835 215,715 199,336 — 461,886 Debt expense (144,896 ) (52,762 ) (11,217 ) 65,049 (143,826 ) Other income, net 102,059 2,716 8,958 (108,090 ) 5,643 Income tax expense 627 63,930 11,381 — 75,938 Equity earnings in subsidiaries 270,180 168,441 — (438,621 ) — Net income from continuing operations 273,551 270,180 185,696 (481,662 ) 247,765 Net income from discontinued operations, net of tax — — 36,351 43,041 79,392 Net income 273,551 270,180 222,047 (438,621 ) 327,157 Less: Net income attributable to noncontrolling interests — — — (53,606 ) (53,606 ) Net income attributable to DaVita Inc. $ 273,551 $ 270,180 $ 222,047 $ (492,227 ) $ 273,551 For the three months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Patient service 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 236,335 157,586 — (393,921 ) — Net income from continuing operations 267,276 236,335 174,823 (441,808 ) 236,626 Net income from discontinued operations, net of tax — — 21,809 47,887 69,696 Net income 267,276 236,335 196,632 (393,921 ) 306,322 Less: Net income attributable to noncontrolling interests — — — (39,046 ) (39,046 ) Net income attributable to DaVita Inc. $ 267,276 $ 236,335 $ 196,632 $ (432,967 ) $ 267,276 For the six months ended June 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 3,558,312 $ 1,933,473 $ (122,568 ) $ 5,369,217 Provision for uncollectible accounts — (11,216 ) (4,496 ) — (15,712 ) Net patient service revenues — 3,547,096 1,928,977 (122,568 ) 5,353,505 Other revenues 396,135 226,367 72,654 (462,844 ) 232,312 Total net revenues 396,135 3,773,463 2,001,631 (585,412 ) 5,585,817 Operating expenses and charges 304,123 3,333,784 1,730,929 (585,412 ) 4,783,424 Operating income 92,012 439,679 270,702 — 802,393 Debt expense (278,491 ) (105,241 ) (21,936 ) 130,323 (275,345 ) Other income, net 212,257 5,312 18,069 (223,055 ) 12,583 Income tax expense 7,653 110,474 14,557 — 132,684 Equity earnings in subsidiaries 404,715 175,439 — (580,154 ) — Net income from continuing operations 422,840 404,715 252,278 (672,886 ) 406,947 Net income from discontinued operations, net of tax — — 16,965 92,732 109,697 Net income 422,840 404,715 269,243 (580,154 ) 516,644 Less: Net income attributable to noncontrolling interests — — — (93,804 ) (93,804 ) Net income attributable to DaVita Inc. $ 422,840 $ 404,715 $ 269,243 $ (673,958 ) $ 422,840 For the six months ended June 30, 2018 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services 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 and charges 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, net 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 377,452 183,638 — (561,090 ) — Net income from continuing operations 445,962 377,452 300,540 (656,313 ) 467,641 Net (loss) income from discontinued operations, net of tax — — (31,313 ) 95,223 63,910 Net income 445,962 377,452 269,227 (561,090 ) 531,551 Less: Net income attributable to noncontrolling interests — — — (85,589 ) (85,589 ) Net income attributable to DaVita Inc. $ 445,962 $ 377,452 $ 269,227 $ (646,679 ) $ 445,962 Condensed Consolidating Statements of Income For the six months ended June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Patient service operating revenues $ 5,369,217 $ — $ — $ 5,369,217 Provision for uncollectible accounts (15,712 ) — — (15,712 ) Net patient service operating revenues 5,353,505 — — 5,353,505 Other revenues 232,312 — — 232,312 Total net operating revenues 5,585,817 — — 5,585,817 Operating expenses 4,783,424 — — 4,783,424 Operating income 802,393 — — 802,393 Debt expense (275,345 ) — — (275,345 ) Other income 12,583 — — 12,583 Income tax expense 132,684 — — 132,684 Net income from continuing operations 406,947 — — 406,947 Net income from discontinued operations, net of tax 109,697 12,706 249 96,742 Net income 516,644 12,706 249 503,689 Less: Net income attributable to noncontrolling interests (93,804 ) (1,255 ) — (92,549 ) Net income attributable to DaVita Inc. $ 422,840 $ 11,451 $ 249 $ 411,140 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Comprehensive Income | Condensed Consolidating Statements of Comprehensive Income For the three months ended June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 273,551 $ 270,180 $ 222,047 $ (438,621 ) $ 327,157 Other comprehensive income 1,575 — 12,365 — 13,940 Total comprehensive income 275,126 270,180 234,412 (438,621 ) 341,097 Less: Comprehensive income attributable to noncontrolling interest — — — (53,606 ) (53,606 ) Comprehensive income attributable to DaVita Inc. $ 275,126 $ 270,180 $ 234,412 $ (492,227 ) $ 287,491 For the three months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 267,276 $ 236,335 $ 196,632 $ (393,921 ) $ 306,322 Other comprehensive income (loss) 1,269 — (50,529 ) — (49,260 ) Total comprehensive income 268,545 236,335 146,103 (393,921 ) 257,062 Less: Comprehensive income attributable to noncontrolling interest — — — (39,046 ) (39,046 ) Comprehensive income attributable to DaVita Inc. $ 268,545 $ 236,335 $ 146,103 $ (432,967 ) $ 218,016 For the six months ended June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 422,840 $ 404,715 $ 269,243 $ (580,154 ) $ 516,644 Other comprehensive income (loss) 2,601 — (1,288 ) — 1,313 Total comprehensive income 425,441 404,715 267,955 (580,154 ) 517,957 Less: Comprehensive income attributable to noncontrolling interest — — — (93,804 ) (93,804 ) Comprehensive income attributable to DaVita Inc. $ 425,441 $ 404,715 $ 267,955 $ (673,958 ) $ 424,153 For the six months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 445,962 $ 377,452 $ 269,227 $ (561,090 ) $ 531,551 Other comprehensive income (loss) 3,856 — (30,648 ) — (26,792 ) Total comprehensive income 449,818 377,452 238,579 (561,090 ) 504,759 Less: Comprehensive income attributable to noncontrolling interest — — — (85,589 ) (85,589 ) Comprehensive income attributable to DaVita Inc. $ 449,818 $ 377,452 $ 238,579 $ (646,679 ) $ 419,170 Condensed Consolidating Statements of Comprehensive Income For the six months ended June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Net income $ 516,644 $ 12,706 $ 249 $ 503,689 Other comprehensive income 1,313 — — 1,313 Total comprehensive income 517,957 12,706 249 505,002 Less: Comprehensive income attributable to the noncontrolling (93,804 ) (1,255 ) — (92,549 ) Comprehensive income attributable to DaVita Inc. $ 424,153 $ 11,451 $ 249 $ 412,453 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Balance Sheets | Condensed Consolidating Balance Sheets As of June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 3,374,887 $ — $ 200,751 $ — $ 3,575,638 Restricted cash and equivalents 1,007 12,181 93,584 — 106,772 Accounts receivable, net — 1,352,844 657,957 — 2,010,801 Other current assets 37,185 545,881 114,352 — 697,418 Total current assets 3,413,079 1,910,906 1,066,644 — 6,390,629 Property and equipment, net 501,219 1,613,193 1,290,903 — 3,405,315 Operating lease right-of-use assets 105,137 1,636,360 1,049,388 — 2,790,885 Intangible assets, net 107 37,272 83,195 — 120,574 Investments in subsidiaries 11,304,840 3,184,913 — (14,489,753 ) — Intercompany receivables — 1,563,270 1,483,874 (3,047,144 ) — Other long-term assets and investments 80,491 81,567 196,113 — 358,171 Goodwill — 4,821,054 2,044,332 — 6,865,386 Total assets $ 15,404,873 $ 14,848,535 $ 7,214,449 $ (17,536,897 ) $ 19,930,960 Current liabilities $ 3,767,482 $ 1,348,798 $ 590,664 $ — $ 5,706,944 Intercompany payables 1,710,121 — 1,337,023 (3,047,144 ) — Long-term operating leases liabilities 133,349 1,550,461 1,005,439 — 2,689,249 Long-term debt and other long-term liabilities 5,103,876 644,436 357,653 — 6,105,965 Noncontrolling interests subject to put provisions 640,747 — — 544,986 1,185,733 Total DaVita Inc. shareholders' equity 4,049,298 11,304,840 3,184,913 (14,489,753 ) 4,049,298 Noncontrolling interests not subject to put — — 738,757 (544,986 ) 193,771 Total equity 4,049,298 11,304,840 3,923,670 (15,034,739 ) 4,243,069 Total liabilities and equity $ 15,404,873 $ 14,848,535 $ 7,214,449 $ (17,536,897 ) $ 19,930,960 As of December 31, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 60,653 $ — $ 262,385 $ — $ 323,038 Restricted cash and equivalents 1,005 12,048 79,329 — 92,382 Accounts receivable, net — 1,264,290 594,318 — 1,858,608 Other current assets 37,185 601,318 122,063 — 760,566 Current assets held for sale — — 5,389,565 — 5,389,565 Total current assets 98,843 1,877,656 6,447,660 — 8,424,159 Property and equipment, net 491,462 1,624,835 1,277,372 — 3,393,669 Intangible assets, net 153 42,933 75,760 — 118,846 Investments in subsidiaries 10,102,750 3,371,450 — (13,474,200 ) — Intercompany receivables 3,419,448 259,573 1,788,043 (5,467,064 ) — Other long-term assets and investments 53,385 80,537 197,696 — 331,618 Goodwill — 4,812,365 2,029,595 — 6,841,960 Total assets $ 14,166,041 $ 12,069,349 $ 11,816,126 $ (18,941,264 ) $ 19,110,252 Current liabilities $ 1,945,943 $ 1,251,534 $ 449,925 $ — $ 3,647,402 Current liabilities held for sale — — 1,243,759 — 1,243,759 Intercompany payables — — 5,467,064 (5,467,064 ) — Long-term debt and other long-term liabilities 7,918,581 715,065 552,406 — 9,186,052 Noncontrolling interests subject to put provisions 598,075 — — 526,566 1,124,641 Total DaVita Inc. shareholders' equity 3,703,442 10,102,750 3,371,450 (13,474,200 ) 3,703,442 Noncontrolling interests not subject to put — — 731,522 (526,566 ) 204,956 Total equity 3,703,442 10,102,750 4,102,972 (14,000,766 ) 3,908,398 Total liabilities and equity $ 14,166,041 $ 12,069,349 $ 11,816,126 $ (18,941,264 ) $ 19,110,252 Condensed Consolidating Balance Sheets As of June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash and cash equivalents $ 3,575,638 $ — $ — $ 3,575,638 Restricted cash and equivalents 106,772 — — 106,772 Accounts receivable, net 2,010,801 — — 2,010,801 Other current assets 697,418 — — 697,418 Total current assets 6,390,629 — — 6,390,629 Property and equipment, net 3,405,315 — — 3,405,315 Operating lease right-of-use assets 2,790,885 — — 2,790,885 Amortizable intangibles, net 120,574 — — 120,574 Other long-term assets 358,171 — — 358,171 Goodwill 6,865,386 — — 6,865,386 Total assets $ 19,930,960 $ — $ — $ 19,930,960 Current liabilities $ 5,706,944 $ — $ — $ 5,706,944 Long-term operating leases liabilities 2,689,249 — — 2,689,249 Long-term debt and other long-term liabilities 6,105,965 — — 6,105,965 Noncontrolling interests subject to put provisions 1,185,733 — — 1,185,733 Total DaVita Inc. shareholders’ equity 4,049,298 — — 4,049,298 Noncontrolling interests not subject to put provisions 193,771 — — 193,771 Shareholders’ equity 4,243,069 — — 4,243,069 Total liabilities and shareholder’s equity $ 19,930,960 $ — $ — $ 19,930,960 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Cash Flows | Condensed Consolidating Statements of Cash Flows For the six months ended June 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows from operating activities: Net income $ 422,840 $ 404,715 $ 269,243 $ (580,154 ) $ 516,644 Changes in operating assets and liabilities and non-cash (292,988 ) (210,545 ) 157,850 580,154 234,471 Net cash provided by operating activities 129,852 194,170 427,093 — 751,115 Cash flows from investing activities: Additions of property and equipment (63,037 ) (174,483 ) (136,398 ) — (373,918 ) Acquisitions — (8,975 ) (56,995 ) — (65,970 ) Proceeds from asset and business sales 3,824,509 33 26,839 — 3,851,381 Proceeds (purchases) from investment sales and other items, net 729 (6,560 ) (2,970 ) — (8,801 ) Net cash provided by (used in) investing activities 3,762,201 (189,985 ) (169,524 ) — 3,402,692 Cash flows from financing activities: Long-term debt and related financing costs, net (1,152,510 ) (5,270 ) (6,329 ) — (1,164,109 ) Intercompany borrowing (payments) 656,704 1,218 (657,922 ) — — Other items (82,011 ) — (64,433 ) — (146,444 ) Net cash used in financing activities (577,817 ) (4,052 ) (728,684 ) — (1,310,553 ) Effect of exchange rate changes on cash, cash — — (77 ) — (77 ) Net increase (decrease) in cash, cash equivalents and 3,314,236 133 (471,192 ) — 2,843,177 Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations — — (423,813 ) — (423,813 ) Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 3,314,236 133 (47,379 ) — 3,266,990 Cash, cash equivalents and restricted cash of continuing 61,658 12,048 341,714 — 415,420 Cash, cash equivalents and restricted cash of continuing $ 3,375,894 $ 12,181 $ 294,335 $ — $ 3,682,410 For the six months ended June 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows from operating activities: Net income $ 445,962 $ 377,452 $ 269,227 $ (561,090 ) $ 531,551 Changes in operating assets and liabilities and non-cash (361,134 ) 31,554 161,514 561,090 393,024 Net cash provided by operating activities 84,828 409,006 430,741 — 924,575 Cash flows from investing activities: Additions of property and equipment (77,169 ) (216,103 ) (180,705 ) — (473,977 ) Acquisitions — (6,916 ) (82,549 ) — (89,465 ) Proceeds from asset and business sales — 28,546 87,695 — 116,241 Proceeds (purchases) from investment sales and other items, net 32,415 (7,232 ) (2,046 ) — 23,137 Net cash used in investing activities (44,754 ) (201,705 ) (177,605 ) — (424,064 ) Cash flows from financing activities: Long-term debt and related financing costs, net 584,500 (4,398 ) (6,121 ) — 573,981 Intercompany borrowing (payments) 224,359 (187,712 ) (36,647 ) — — Other items (804,245 ) (13,208 ) (62,437 ) — (879,890 ) Net cash provided by (used in) financing activities 4,614 (205,318 ) (105,205 ) — (305,909 ) Effect of exchange rate changes on cash, cash — — (3,473 ) — (3,473 ) Net increase in cash, cash equivalents and restricted cash 44,688 1,983 144,458 — 191,129 Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations — — 229,901 — 229,901 Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 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 Condensed Consolidating Statements of Cash Flows For the six months ended June 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash flows from operating activities: Net income $ 516,644 $ 12,706 $ 249 $ 503,689 Changes in operating and intercompany assets and liabilities and 234,471 (4,607 ) (249 ) 239,327 Net cash provided by operating activities 751,115 8,099 — 743,016 Cash flows from investing activities: Additions of property and equipment (373,918 ) (846 ) — (373,072 ) Acquisitions (65,970 ) — — (65,970 ) Proceeds from asset and business sales 3,851,381 — — 3,851,381 Investments and other items (8,801 ) (1,882 ) — (6,919 ) Net cash provided by (used in) investing activities 3,402,692 (2,728 ) — 3,405,420 Cash flows from financing activities: Long-term debt (1,164,109 ) — — (1,164,109 ) Intercompany — (247,175 ) — 247,175 Other items (146,444 ) — — (146,444 ) Net cash used in financing activities (1,310,553 ) (247,175 ) — (1,063,378 ) Effect of exchange rate changes on cash, cash equivalents and (77 ) — — (77 ) Net increase (decrease) in cash, cash equivalents and restricted cash 2,843,177 (241,804 ) — 3,084,981 Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations (423,813 ) (241,804 ) — (182,009 ) Net increase in cash, cash equivalents and restricted cash from continuing operations 3,266,990 — — 3,266,990 Cash, cash equivalents and restricted cash of continuing operations 415,420 — — 415,420 Cash, cash equivalents and restricted cash of continuing operations $ 3,682,410 $ — $ — $ 3,682,410 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Revenue Recognition Revenue R_2
Revenue Recognition Revenue Recognition (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | Mar. 31, 2019 | Dec. 31, 2018 | |
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] | ||||||
Accounts Receivable, Allowance for Credit Loss | $ 29,022 | $ 52,924 | ||||
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 | $ 12,617 | $ 8,817 | $ 39,795 | $ 76,227 | ||
Contract With Customer Performance Obligation Not Substantially Completed | $ 12,000 | $ 36,000 |
Revenue Recognition Segment R_2
Revenue Recognition Segment Revenue by Payor (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | $ 2,734,065 | $ 2,718,403 | $ 5,369,217 | $ 5,309,477 |
Other revenues | 118,889 | 217,956 | 232,312 | 450,781 |
Total revenues | 2,842,705 | 2,886,953 | 5,585,817 | 5,736,397 |
Intersegment Elimination | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | (33,737) | (29,285) | (67,714) | (57,906) |
Medicare and Medicare Advantage | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 1,520,193 | 1,526,066 | 3,013,709 | 3,011,258 |
Other revenues | 64,012 | 154,028 | 125,713 | 296,786 |
Medicaid and Managed Medicaid | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 160,242 | 150,288 | 314,431 | 307,783 |
Other revenues | 94 | 16,158 | 100 | 31,949 |
Other Government Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 199,335 | 196,868 | 389,937 | 386,526 |
Commercial Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 874,088 | 815,871 | 1,695,890 | 1,618,568 |
Other revenues | 32,307 | 17,006 | 64,925 | 57,427 |
Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 26,171 | 39,953 | 48,826 | 84,006 |
U.S. dialysis and related lab services | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | 2,607,160 | 2,568,247 | 5,123,670 | 5,087,724 |
U.S. dialysis and related lab services | Intersegment Elimination | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | (30,334) | (20,096) | (60,975) | (38,519) |
U.S. dialysis and related lab services | Medicare and Medicare Advantage | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 1,520,193 | 1,526,066 | 3,013,709 | 3,011,258 |
Other revenues | ||||
U.S. dialysis and related lab services | Medicaid and Managed Medicaid | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 160,242 | 150,288 | 314,431 | 307,783 |
Other revenues | ||||
U.S. dialysis and related lab services | Other Government Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 110,565 | 110,338 | 216,692 | 217,458 |
U.S. dialysis and related lab services | Commercial Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 840,993 | 796,732 | 1,629,407 | 1,579,711 |
Other revenues | ||||
U.S. dialysis and related lab services | Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 5,501 | 4,919 | 10,406 | 10,033 |
Other—Ancillary services and strategic initiatives | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | 235,545 | 318,706 | 462,147 | 648,673 |
Other—Ancillary services and strategic initiatives | Intersegment Elimination | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | (3,403) | (9,189) | (6,739) | (19,387) |
Other—Ancillary services and strategic initiatives | Medicare and Medicare Advantage | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 64,012 | 154,028 | 125,713 | 296,786 |
Other—Ancillary services and strategic initiatives | Medicaid and Managed Medicaid | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | ||||
Other revenues | 94 | 16,158 | 100 | 31,949 |
Other—Ancillary services and strategic initiatives | Other Government Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 88,770 | 86,530 | 173,245 | 169,068 |
Other—Ancillary services and strategic initiatives | Commercial Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 33,095 | 19,139 | 66,483 | 38,857 |
Other revenues | 32,307 | 17,006 | 64,925 | 57,427 |
Other—Ancillary services and strategic initiatives | Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | $ 20,670 | $ 35,034 | $ 38,420 | $ 73,973 |
Earnings per share Earnings p_2
Earnings per share Earnings per share - Reconciliation of numberators and denominators used to calculate basic and diluted earnings per share (Details) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Numerators: | ||||
Net income from continuing operations attributable to DaVita Inc. | $ 194,223 | $ 199,603 | $ 314,477 | $ 390,618 |
Change in noncontrolling interest redemption rights in excess of fair value | 0 | (98) | 0 | (98) |
Net income from continuing operations for earnings per share calculation | 194,223 | 199,505 | 314,477 | 390,520 |
Net income from discontinued operations attributable to DaVita Inc. | 79,328 | 67,673 | 108,363 | 55,344 |
Income Loss From Continuing Operations Attributable to Parent Available To Common Stockholders Basic | $ 273,551 | $ 267,178 | $ 422,840 | $ 445,864 |
Basic: | ||||
Weighted average shares outstanding during period | 166,346,000 | 173,811,000 | 166,367,000 | 177,461,000 |
Weighted average contingently returnable shares held in escrow for the DaVita HealthCare Partners merger | 0 | (2,194,000) | 0 | (2,194,000) |
Weighted average shares for basic earnings per share calculation | 166,346,041 | 171,617,238 | 166,366,886 | 175,267,270 |
Basic net income from continuing operations per share | $ 1.17 | $ 1.16 | $ 1.89 | $ 2.23 |
Basic net income (loss) from discontinued operations per share | 0.47 | 0.40 | 0.65 | 0.31 |
Basic net income per share attributable to DaVita Inc. | $ 1.64 | $ 1.56 | $ 2.54 | $ 2.54 |
Diluted: | ||||
Weighted average shares outstanding during period | 166,346,000 | 173,811,000 | 166,367,000 | 177,461,000 |
Assumed incremental shares from stock plans | 454,000 | 295,000 | 423,000 | 489,000 |
Weighted average shares for diluted earnings per share calculation | 166,799,525 | 174,105,884 | 166,789,978 | 177,949,934 |
Diluted net income from continuing operations per share | $ 1.16 | $ 1.15 | $ 1.89 | $ 2.19 |
Diluted net income from discontinued operations per share | 0.48 | 0.38 | 0.65 | 0.32 |
Diluted net income per share attributable to DaVita Inc. | $ 1.64 | $ 1.53 | $ 2.54 | $ 2.51 |
Anti-dilutive stock-settled awards excluded from calculation | 5,797,000 | 6,227,000 | 5,974,000 | 4,840,000 |
Investments in debt and equit_3
Investments in debt and equity securities (Detail) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 |
Investment Holdings [Line Items] | ||
Held to maturity | $ 3,113 | $ 2,235 |
Held to maturity, short-term investments | 3,113 | 2,235 |
Held to maturity, long-term investments | 0 | 0 |
Equity Securities, FV-NI | 37,151 | 36,124 |
Total | 40,264 | 38,359 |
Total, short-term investments | 5,213 | 2,935 |
Total, long-term investments | 35,051 | 35,424 |
Certificates of deposit and other time deposits | ||
Investment Holdings [Line Items] | ||
Held to maturity | 3,113 | 2,235 |
Equity Securities, FV-NI | 0 | 0 |
Total | 3,113 | 2,235 |
Investments in mutual funds and common stock | ||
Investment Holdings [Line Items] | ||
Held to maturity | 0 | 0 |
Equity Securities, FV-NI | 37,151 | 36,124 |
Total | 37,151 | 36,124 |
Short-term Investments | ||
Investment Holdings [Line Items] | ||
Equity Securities, FV-NI | 2,100 | 700 |
Long-term Investments | ||
Investment Holdings [Line Items] | ||
Equity Securities, FV-NI | $ 35,051 | $ 35,424 |
Investments in debt and equit_4
Investments in debt and equity securities - Additional Information (Detail) - Investments in mutual funds and common stock - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2019 | Jun. 30, 2018 | |
Schedule Of Trading Securities And Other Trading Assets [Line Items] | ||
Pre-tax Net Gain (Loss) recognized in Income Statement | $ 2,634 | $ 619 |
Pre-tax Realized Gain (Loss) on Securities Arising During Period | 308 | 3,904 |
Net Increase (Decrease) in Unrealized Gain on Equity Securities due to changes in Fair Value | $ 2,326 | $ 3,285 |
Equity method and other inves_3
Equity method and other investments Equity Method and Other Investments (Details) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 |
Schedule of Equity Method Investments [Line Items] | ||
Equity method and other investments | $ 225,677 | $ 224,611 |
Adjusted cost method investments | ||
Schedule of Equity Method Investments [Line Items] | ||
Equity method and other investments | 10,448 | 12,386 |
Other equity method partnerships | ||
Schedule of Equity Method Investments [Line Items] | ||
Equity method and other investments | 90,736 | 83,052 |
APAC joint venture | ||
Schedule of Equity Method Investments [Line Items] | ||
Equity method and other investments | $ 124,493 | $ 129,173 |
Equity method and other inves_4
Equity method and other investments - Additional Information (Details) - USD ($) $ in Thousands | Dec. 01, 2019 | Aug. 01, 2019 | Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 |
Noncontrolling Interest [Line Items] | ||||||
Equity investment income | $ 4,514 | $ 9,795 | $ 7,222 | $ 9,950 | ||
Valuation Adjustment | $ 1,938 | $ 0 | ||||
Minimum | ||||||
Noncontrolling Interest [Line Items] | ||||||
Current economic interest in the APAC JV, Owned by the Parent Company | 30.00% | 30.00% | ||||
Maximum | ||||||
Noncontrolling Interest [Line Items] | ||||||
Current economic interest in the APAC JV, Owned by the Parent Company | 50.00% | 50.00% | ||||
Forecast | ||||||
Noncontrolling Interest [Line Items] | ||||||
Partnership Capital Contribution Scheduled Date | Aug. 1, 2019 | |||||
Partnership Capital Contribution Deferred Date | Dec. 1, 2019 |
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, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | Dec. 31, 2018 | |
Goodwill [Roll Forward] | |||||
Beginning balance | $ 6,841,960 | $ 6,610,279 | $ 6,610,279 | ||
Acquisitions | 66,614 | 278,348 | |||
Divestitures | (15,497) | ||||
Impairment charges | $ 0 | $ (3,106) | (41,037) | (3,106) | (3,106) |
Foreign currency and other adjustments | (2,151) | (28,064) | |||
Ending balance | 6,865,386 | 6,865,386 | 6,841,960 | ||
Goodwill | 6,933,984 | 6,933,984 | |||
Accumulated impairment charges | (68,598) | (68,598) | |||
Ending balance | 6,865,386 | 6,865,386 | 6,841,960 | ||
U.S. dialysis and related lab services | |||||
Goodwill [Roll Forward] | |||||
Beginning balance | 6,275,004 | 6,144,761 | 6,144,761 | ||
Acquisitions | 15,714 | 130,574 | |||
Divestitures | (331) | ||||
Impairment charges | 0 | 0 | |||
Foreign currency and other adjustments | 0 | 0 | |||
Ending balance | 6,290,718 | 6,290,718 | 6,275,004 | ||
Goodwill | 6,290,718 | 6,290,718 | |||
Accumulated impairment charges | 0 | 0 | |||
Ending balance | 6,290,718 | 6,290,718 | 6,275,004 | ||
Other—Ancillary services and strategic initiatives | |||||
Goodwill [Roll Forward] | |||||
Beginning balance | 566,956 | $ 465,518 | 465,518 | ||
Acquisitions | 50,900 | 147,774 | |||
Divestitures | (15,166) | ||||
Impairment charges | (41,037) | (3,106) | |||
Foreign currency and other adjustments | (2,151) | (28,064) | |||
Ending balance | 574,668 | 574,668 | 566,956 | ||
Goodwill | 643,266 | 643,266 | |||
Accumulated impairment charges | (68,598) | (68,598) | |||
Ending balance | $ 574,668 | $ 574,668 | $ 566,956 |
Goodwill Goodwill - Schedule of
Goodwill Goodwill - Schedule of Reporting Units Goodwill Balances (Details) (Details) - USD ($) $ in Thousands | 6 Months Ended | ||
Jun. 30, 2019 | Dec. 31, 2018 | Dec. 31, 2017 | |
Goodwill [Line Items] | |||
Goodwill | $ 6,865,386 | $ 6,841,960 | $ 6,610,279 |
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% | ||
BRAZIL | Kidney Care | |||
Goodwill [Line Items] | |||
Goodwill | $ 69,887 | ||
Reporting Unit Percentage Of Fair Value In Excess Of Short Of Carrying Amount | 4.40% | ||
Potential Impact On Fair Value For Reduction In Operating Income | (2.80%) | ||
Potential Impact On Fair Value For Basis Point Increase In Discount Rate | (7.00%) | ||
GERMANY | Kidney Care | |||
Goodwill [Line Items] | |||
Goodwill | $ 380,340 | ||
Reporting Unit Percentage Of Fair Value In Excess Of Short Of Carrying Amount | 0.00% | ||
Potential Impact On Fair Value For Reduction In Operating Income | (1.40%) | ||
Potential Impact On Fair Value For Basis Point Increase In Discount Rate | (9.30%) |
Goodwill - Narrative (Details)
Goodwill - Narrative (Details) $ in Thousands | 3 Months Ended | 6 Months Ended | 12 Months Ended | ||
Jun. 30, 2019USD ($) | Jun. 30, 2018USD ($) | Jun. 30, 2019USD ($)segment | Jun. 30, 2018USD ($) | Dec. 31, 2018USD ($) | |
Goodwill [Line Items] | |||||
Goodwill impairment charges | $ 0 | $ 3,106 | $ 41,037 | $ 3,106 | $ 3,106 |
Other Reporting Units | |||||
Goodwill [Line Items] | |||||
Goodwill impairment charges | $ 0 | ||||
Number of Reportable Segments | segment | 0 | ||||
GERMANY | Other Reporting Units | |||||
Goodwill [Line Items] | |||||
Goodwill impairment charges | $ 3,106 | ||||
GERMANY | Kidney Care | |||||
Goodwill [Line Items] | |||||
Goodwill impairment charges | $ 41,037 | ||||
Goodwill, Subsequent Recognition of Deferred Tax Asset | 8,865 | ||||
Goodwill, Impairment Loss, Net of Tax | $ 32,172 |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2019 | Dec. 31, 2018 | |
Income Tax Disclosure [Abstract] | ||
Liability for unrecognized tax benefits | $ 49,877 | $ 40,382 |
Unrecognized Tax Benefits that Would Impact Effective Tax Rate | 47,034 | |
Increase in liability for unrecognized tax benefits | 9,495 | |
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits | $ 10,642 | $ 9,019 |
Long-term debt (Detail)
Long-term debt (Detail) - USD ($) $ in Thousands | May 06, 2019 | Jun. 30, 2019 | Jun. 30, 2019 | Dec. 31, 2018 |
Debt Instrument [Line Items] | ||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | |||
Senior Notes | ||||
Acquisition obligations and other notes payable | $ 184,170 | $ 184,170 | $ 183,979 | |
Finance Lease, Liability | $ 277,580 | $ 277,580 | 282,737 | |
Debt Instrument, Interest Rate During Period | 5.17% | 5.16% | ||
Long-term Debt, Weighted Average Interest Rate, at Point in Time | 5.30% | 5.30% | ||
Total debt principal outstanding | $ 9,003,631 | $ 9,003,631 | 10,154,216 | |
Discount and deferred financing costs | (34,502) | (34,502) | (52,000) | |
Total amount of long-term debt | 8,969,129 | 8,969,129 | 10,102,216 | |
Less current portion | (3,591,331) | (3,591,331) | (1,929,369) | |
Long-term debt | 5,377,798 | $ 5,377,798 | 8,172,847 | |
Debt Instrument, table footnotes | ||||
Long-Term Debt Maturity Extension Term | 6 months | |||
Debt Instrument, Maturity Date | Dec. 24, 2019 | |||
Senior Notes Five Point Seven Five Percentage Senior Notes Due Twenty Twenty Two | ||||
Debt Instrument [Line Items] | ||||
Debt Instrument, Maturity Date | Aug. 15, 2022 | |||
Debt Instrument, Fair Value Disclosure | 1,264,000 | $ 1,264,000 | ||
Senior Notes | ||||
Senior Notes | 1,250,000 | $ 1,250,000 | 1,250,000 | |
Debt Instrument, Interest Rate During Period | 5.75% | |||
Debt Instrument, table footnotes | ||||
Debt Instrument, Maturity Date | Aug. 15, 2022 | |||
Senior Notes Five Point One Two Five Percent Due Twenty Twenty Four | ||||
Debt Instrument [Line Items] | ||||
Debt Instrument, Maturity Date | Jul. 15, 2024 | |||
Debt Instrument, Fair Value Disclosure | 1,748,250 | $ 1,748,250 | ||
Senior Notes | ||||
Senior Notes | 1,750,000 | $ 1,750,000 | 1,750,000 | |
Debt Instrument, Interest Rate During Period | 5.125% | |||
Debt Instrument, table footnotes | ||||
Debt Instrument, Maturity Date | Jul. 15, 2024 | |||
Senior Notes Five Point Zero Percent Due Twenty Twenty Five | ||||
Debt Instrument [Line Items] | ||||
Debt Instrument, Maturity Date | May 1, 2025 | |||
Debt Instrument, Fair Value Disclosure | 1,479,000 | $ 1,479,000 | ||
Senior Notes | ||||
Senior Notes | $ 1,500,000 | $ 1,500,000 | 1,500,000 | |
Debt Instrument, Interest Rate During Period | 5.00% | |||
Debt Instrument, table footnotes | ||||
Debt Instrument, Maturity Date | May 1, 2025 | |||
Notes Payable, Other Payables | ||||
Senior Notes | ||||
Long-term Debt, Weighted Average Interest Rate, at Point in Time | 5.70% | 5.70% | ||
Debt Instrument, Maturity Date, Description | 2019-2027 | |||
Finance Lease | ||||
Senior Notes | ||||
Finance Lease, Weighted Average Discount Rate, Percent | 5.43% | 5.43% | ||
Debt Instrument, Maturity Date, Description | 2019-2036 | |||
Senior Secured Credit Facilities | ||||
Senior Notes | ||||
Long-term Debt, Weighted Average Interest Rate, at Point in Time | 5.31% | 5.31% | ||
Debt Instrument, table footnotes | ||||
Debt Instrument, Unamortized Discount | $ 696 | $ 696 | 6,104 | |
Deferred Offering Costs | 3,744 | 3,744 | 12,580 | |
Senior Notes | ||||
Debt Instrument, table footnotes | ||||
Deferred Offering Costs | 30,062 | 30,062 | 33,316 | |
Term Loan A | ||||
Debt Instrument [Line Items] | ||||
Senior Secured Credit Facilities | 64,383 | $ 64,383 | 675,000 | |
Debt Instrument, Description of Variable Rate Basis | 2.00% + LIBOR | |||
Debt Instrument, Maturity Date | Dec. 24, 2019 | |||
Debt Instrument, Fair Value Disclosure | 64,300 | $ 64,300 | ||
Debt Instrument, table footnotes | ||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | |||
Term Loan A-2 | ||||
Debt Instrument [Line Items] | ||||
Senior Secured Credit Facilities | 102,498 | $ 102,498 | 995,000 | |
Debt Instrument, Description of Variable Rate Basis | 1.00% + LIBOR | |||
Debt Instrument, Maturity Date | Dec. 24, 2019 | |||
Debt Instrument, Fair Value Disclosure | 103,011 | $ 103,011 | ||
Debt Instrument, table footnotes | ||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | |||
Term Loan B | ||||
Debt Instrument [Line Items] | ||||
Senior Secured Credit Facilities | 3,325,000 | $ 3,325,000 | 3,342,500 | |
Debt Instrument, Description of Variable Rate Basis | 2.75% + LIBOR | |||
Debt Instrument, Maturity Date | Jun. 24, 2021 | |||
Debt Instrument, Fair Value Disclosure | 3,333,313 | $ 3,333,313 | ||
Debt Instrument, table footnotes | ||||
Debt Instrument, Maturity Date | Jun. 24, 2021 | |||
Revolver | ||||
Debt Instrument [Line Items] | ||||
Senior Secured Credit Facilities | 550,000 | $ 550,000 | $ 175,000 | |
Debt Instrument, Description of Variable Rate Basis | 2.00% + LIBOR | |||
Debt Instrument, Maturity Date | Dec. 24, 2019 | |||
Debt Instrument, Fair Value Disclosure | $ 550,000 | $ 550,000 | ||
Debt Instrument, table footnotes | ||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | |||
Minimum | London Interbank Offered Rate (LIBOR) | Term Loan B | ||||
Debt Instrument, table footnotes | ||||
LIBOR plus interest rate margin | 0.75% |
Long-term debt - Scheduled Matu
Long-term debt - Scheduled Maturities of Long-term Debt (Detail) - USD ($) $ in Thousands | Jul. 03, 2019 | Jun. 30, 2019 |
Debt Instrument [Line Items] | ||
2019 (remainder of the year) | $ 3,564,562 | |
2020 | 53,182 | |
2021 | 533,377 | |
2022 | 1,292,979 | |
2023 | 54,372 | |
2024 | 1,785,765 | |
Thereafter | $ 1,719,394 | |
Subsequent Event | ||
Repayments of Long-term Debt | ||
Early repayment of Senior debt | $ 2,990,328 |
Long-term debt Schedule of Deri
Long-term debt Schedule of Derivative Instruments (Details) - USD ($) | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | Dec. 31, 2018 | |
Interest Rate Cap Agreements Effective June 29, 2018 | |||||
Derivative [Line Items] | |||||
Derivative, effective date | Jun. 29, 2018 | ||||
Derivative, expiration date | Jun. 30, 2020 | ||||
Derivative Asset, Fair Value, Gross Asset | $ 28,000 | $ 28,000 | $ 851,000 | ||
Term Loan Facility | Interest Rate Cap One | Maximum | |||||
Derivative [Line Items] | |||||
Notional amounts of interest rate agreements | 3,500,000,000 | $ 3,500,000,000 | |||
LIBOR plus interest rate margin | 3.50% | ||||
Cash Flow Hedging | |||||
Derivative [Line Items] | |||||
Amount of losses reclassified from accumulated OCI into income | (1,606,000) | $ (1,537,000) | $ (3,212,000) | $ (3,074,000) | |
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | 31,000 | 268,000 | 611,000 | (782,000) | |
Debt Expense | Cash Flow Hedging | Interest rate cap agreements | |||||
Derivative [Line Items] | |||||
Amount of losses reclassified from accumulated OCI into income | (2,163,000) | (2,070,000) | (4,326,000) | (4,140,000) | |
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | $ 42,000 | $ 361,000 | $ 823,000 | $ (1,053,000) |
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, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Derivative Instruments Gain Loss [Line Items] | ||||
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | $ (31) | $ (268) | $ (611) | $ 782 |
Reclassification from accumulated other comprehensive income into net income | 1,606 | 1,537 | 3,212 | 3,074 |
Tax benefit (expense) | ||||
Derivative Instruments Gain Loss [Line Items] | ||||
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | 11 | 93 | 212 | (271) |
Reclassification from accumulated other comprehensive income into net income | (557) | (533) | (1,114) | (1,066) |
Interest rate cap agreements | Debt Expense | ||||
Derivative Instruments Gain Loss [Line Items] | ||||
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | (42) | (361) | (823) | 1,053 |
Reclassification from accumulated other comprehensive income into net income | $ 2,163 | $ 2,070 | $ 4,326 | $ 4,140 |
Long-term debt - Additional Inf
Long-term debt - Additional Information (Detail) - USD ($) $ in Thousands | Jul. 03, 2019 | Jun. 20, 2019 | Jun. 19, 2019 | Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | Jul. 31, 2019 | Dec. 31, 2018 |
Debt Instrument [Line Items] | |||||||||
Debt prepayment charges | $ 12,160 | $ 0 | $ 12,160 | $ 0 | |||||
Weighted average effective interest rate at quarter end | 5.30% | 5.30% | |||||||
Weighted average effective interest rate during quarter | 5.17% | 5.16% | |||||||
Percentage of debt instruments bearing fixed interest rate | 54.10% | 54.10% | |||||||
Letters of credit outstanding | $ 72,763 | $ 72,763 | |||||||
Revolving Credit Facility | |||||||||
Debt Instrument [Line Items] | |||||||||
Proceeds from Long-term Lines of Credit | 550,000 | ||||||||
Maximum borrowing capacity on the revolving credit facilities | $ 1,000,000 | $ 1,000,000 | |||||||
Senior Secured Credit Facilities | |||||||||
Debt Instrument [Line Items] | |||||||||
Weighted average effective interest rate at quarter end | 5.31% | 5.31% | |||||||
Term Loan A and A-2 | |||||||||
Debt Instrument [Line Items] | |||||||||
Debt prepayment charges | $ 1,492 | $ 1,492 | |||||||
Term Loan A | |||||||||
Debt Instrument [Line Items] | |||||||||
Early repayment of Senior debt | $ 583,041 | ||||||||
Mandatory principal payments | 27,576 | 27,576 | |||||||
Secured Debt | (64,383) | (64,383) | $ (675,000) | ||||||
Term Loan A-2 | |||||||||
Debt Instrument [Line Items] | |||||||||
Early repayment of Senior debt | $ 892,502 | ||||||||
Secured Debt | (102,498) | (102,498) | (995,000) | ||||||
Term Loan B | |||||||||
Debt Instrument [Line Items] | |||||||||
Mandatory principal payments | 17,500 | 17,500 | |||||||
Secured Debt | (3,325,000) | (3,325,000) | $ (3,342,500) | ||||||
Debt prepayment charges | 10,668 | 10,668 | |||||||
Term Loan A subject to uncapped portion of variability of LIBOR | |||||||||
Debt Instrument [Line Items] | |||||||||
Line of credit outstanding principal balance | $ (541,881) | (541,881) | |||||||
Maximum | |||||||||
Debt Instrument [Line Items] | |||||||||
Unrestricted proceeds from divestiture of business | $ 750,000 | ||||||||
Forecast | Revolving Credit Facility | |||||||||
Debt Instrument [Line Items] | |||||||||
Secured Debt | $ (1,000,000) | ||||||||
Forecast | Term Loan A | |||||||||
Debt Instrument [Line Items] | |||||||||
Secured Debt | (1,750,000) | ||||||||
Forecast | Term Loan B | |||||||||
Debt Instrument [Line Items] | |||||||||
Secured Debt | (2,500,000) | ||||||||
Subsequent Event | |||||||||
Debt Instrument [Line Items] | |||||||||
Early repayment of Senior debt | $ 2,990,328 | ||||||||
Subsequent Event | Term Loan A | |||||||||
Debt Instrument [Line Items] | |||||||||
Early repayment of Senior debt | 64,383 | ||||||||
Subsequent Event | Term Loan A-2 | |||||||||
Debt Instrument [Line Items] | |||||||||
Early repayment of Senior debt | 102,498 | ||||||||
Subsequent Event | Term Loan B | |||||||||
Debt Instrument [Line Items] | |||||||||
Early repayment of Senior debt | $ 2,823,447 | ||||||||
Secured Debt | $ (501,553) | ||||||||
Discontinued Operations, Held-for-sale | DMG held for sale | |||||||||
Debt Instrument [Line Items] | |||||||||
Business acquisition, Effective date of acquisition | Jun. 19, 2019 |
Leases Lease Expense Components
Leases Lease Expense Components (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended |
Jun. 30, 2019 | Jun. 30, 2019 | |
Operating lease cost: | ||
Fixed Lease Expense | $ 130,946 | $ 259,056 |
Variable Lease Expense | 29,907 | 58,478 |
Finance lease cost: | ||
Finance Lease, Right-of-Use Asset, Amortization | 5,703 | 11,529 |
Finance Lease, Interest Expense | 3,715 | 7,490 |
Net Lease Cost | $ 170,271 | $ 336,553 |
Leases Leases Other Information
Leases Leases Other Information (Details) $ in Thousands | 6 Months Ended |
Jun. 30, 2019USD ($) | |
Leases term and discount rate | |
Operating Lease, Weighted Average Remaining Lease Term | 9 years 1 month 6 days |
Finance Lease, Weighted Average Remaining Lease Term | 10 years 7 months 6 days |
Operating Lease, Weighted Average Discount Rate, Percent | 4.20% |
Leases other information | |
Sale and Leaseback Transaction, Gain (Loss), Net | $ 10,336 |
Cash paid for amounts included in the measurement of lease liabilities | |
Operating Lease, Payments | 309,115 |
Finance Lease, Interest Payment on Liability | 10,585 |
Finance Lease, Principal Payments | 16,910 |
Net Operating Lease Assets Obtained In Exchange For Lease Liabilities | $ 195,771 |
Finance Lease | |
Leases term and discount rate | |
Finance Lease, Weighted Average Discount Rate, Percent | 5.43% |
Leases Schedule of Minimum Leas
Leases Schedule of Minimum Lease Payments (Details) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 |
Operating Lease Liabilities, Payments Due | ||
Lessee, Operating Lease, Liability, Payments, Remainder of Fiscal Year | $ 259,928 | |
Lessee, Operating Lease, Liability, Payments, Due Next Twelve Months | 490,779 | |
Lessee, Operating Lease, Liability, Payments, Due Year Two | 463,495 | |
Lessee, Operating Lease, Liability, Payments, Due Year Three | 426,182 | |
Lessee, Operating Lease, Liability, Payments, Due Year Four | 380,070 | |
Lessee, Operating Lease, Liability, Payments, Due Year Five | 326,541 | |
Lessee, Operating Lease, Liability, Payments, Due after Year Five | 1,375,473 | |
Lessee, Operating Lease, Liability, Payments, Due | 3,722,468 | |
Less Portion Representing Interest, Operating Lease Liability | (660,594) | |
Operating Lease, Liability | 3,061,874 | |
Finance Lease Liabilities, Payments, Due | ||
Finance Lease, Liability, Payments, Remainder of Fiscal Year | 16,493 | |
Finance Lease, Liability, Payments, Due Next Twelve Months | 37,805 | |
Finance Lease, Liability, Payments, Due Year Two | 33,317 | |
Finance Lease, Liability, Payments, Due Year Three | 33,599 | |
Finance Lease, Liability, Payments, Due Year Four | 33,709 | |
Finance Lease, Liability, Payments, Due Year Five | 33,723 | |
Finance Lease, Liability, Payments, Due after Year Five | 175,202 | |
Finance Lease, Liability, Payment, Due | 363,848 | |
Less Portion Representing Interest, Finance Lease Liability | (86,268) | |
Finance Lease, Liability | $ 277,580 | $ 282,737 |
Operating Leases Liabilities, Future Payments, Due | ||
Operating Leases, Future Minimum Payments Due, Next Twelve Months | 483,488 | |
Operating Leases, Future Minimum Payments, Due in Two Years | 462,154 | |
Operating Leases, Future Minimum Payments, Due in Three Years | 432,950 | |
Operating Leases, Future Minimum Payments, Due in Four Years | 395,462 | |
Operating Leases, Future Minimum Payments, Due in Five Years | 349,649 | |
Operating Leases, Future Minimum Payments, Due Thereafter | 1,589,949 | |
Operating Leases, Future Minimum Payments Due | 3,713,652 | |
Capital Leases Liabilities, Future Payments, Due | ||
Capital Leases, Future Minimum Payments Due, Next Twelve Months | 36,754 | |
Capital Leases, Future Minimum Payments Due in Two Years | 41,044 | |
Capital Leases, Future Minimum Payments Due in Three Years | 34,026 | |
Capital Leases, Future Minimum Payments Due in Four Years | 33,690 | |
Capital Leases, Future Minimum Payments Due in Five Years | 33,845 | |
Capital Leases, Future Minimum Payments Due Thereafter | 194,611 | |
Capital Leases, Future Minimum Payments Due | 373,970 | |
Capital Leases, Future Minimum Payments, Interest Included in Payments | (91,233) | |
Capital Leases, Future Minimum Payments, Present Value of Net Minimum Payments | $ 282,737 |
Leases Leases - Additional Info
Leases Leases - Additional Information (Details) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 |
Lessee, Lease, Description [Line Items] | ||
Finance Lease, Right-of-Use Asset | $ 246,261 | $ 367,164 |
Finance Lease Accumulated Depreciation | $ 15,525 | $ 131,971 |
Minimum | ||
Lessee, Lease, Description [Line Items] | ||
Lessee, Operating Lease, Term of Contract | 5 years | |
Lessee, Operating Lease, Renewal Term | 5 years | |
Maximum | ||
Lessee, Lease, Description [Line Items] | ||
Lessee, Operating Lease, Term of Contract | 15 years | |
Lessee, Operating Lease, Renewal Term | 10 years |
Contingencies - Additional Info
Contingencies - Additional Information (Detail) $ in Thousands | Aug. 15, 2017 | Dec. 31, 2017USD ($) |
US Attorney Prescription Drug Investigation | ||
Other Commitments [Line Items] | ||
Litigation Settlement, Amount Awarded to Other Party | $ 63,700 | |
Stockholder Derivative Litigation | ||
Other Commitments [Line Items] | ||
Loss Contingency Number of Previously Disclosed Lawsuits Consolidated Into One | 3 | |
Incremental Cash Portion | US Attorney Prescription Drug Investigation | ||
Other Commitments [Line Items] | ||
Litigation Settlement, Amount Awarded to Other Party | 41,500 | |
Cash Paid For Portion Previously Refunded | US Attorney Prescription Drug Investigation | ||
Other Commitments [Line Items] | ||
Litigation Settlement, Amount Awarded to Other Party | $ 22,200 |
Other commitments - additional
Other commitments - additional information (Detail) $ in Thousands | Jun. 30, 2019USD ($) |
Commitments to provide operating capital | |
Other Commitments [Line Items] | |
Other potential commitments to provide operating capital to several dialysis centers | $ 7,154 |
Long-term incentive compensat_2
Long-term incentive compensation - Additional Information (Detail) - USD ($) shares in Thousands, $ in Thousands | 6 Months Ended | |
Jun. 30, 2019 | Jun. 30, 2018 | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Long-term incentive program (LTIP) expense | $ 41,054 | $ 31,301 |
Stock-based compensation expense | 29,045 | 19,861 |
Estimated tax benefits recorded for stock-based compensation | 3,835 | 3,941 |
Unrecognized compensation cost related to outstanding LTIP awards | 169,602 | |
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans | $ 155,951 | |
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under performance-based cash component of LTIP costs, weighted average remaining period (in years) | 9 months 18 days | |
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 | |
Share-based Payment Arrangement, Expense, Tax Benefit | $ 2,675 | 7,671 |
Stock Appreciation Rights | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock granted (in shares) | 2,343 | |
Aggregate grant-date fair value | $ 32,870 | |
Weighted-average expected life (in years) | 4 years | |
Restricted and Performance Stock Units | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock granted (in shares) | 1,885 | |
Aggregate grant-date fair value | $ 94,414 | |
Weighted-average expected life (in years) | 3 years 4 months 24 days | |
General and Administrative Expense | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock-based compensation expense | $ 24,900 | $ 20,717 |
Share repurchases (Details)
Share repurchases (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 1 Months Ended | 3 Months Ended | 6 Months Ended | |
Aug. 16, 2019 | Jul. 17, 2019 | Jun. 30, 2019 | Jun. 30, 2019 | |
Equity, Class of Treasury Stock [Line Items] | ||||
Repurchase of common stock (in shares) | 2,060 | 2,060 | ||
Value of treasury stock acquired | $ 112,189 | $ 112,189 | ||
Average cost of treasury stock (usd per share) | $ 54.46 | $ 54.46 | ||
Subsequent Event | ||||
Equity, Class of Treasury Stock [Line Items] | ||||
Repurchase of common stock (in shares) | 4,214 | |||
Value of treasury stock acquired | $ 237,811 | |||
Average cost of treasury stock (usd per share) | $ 56.43 | |||
Prior shares under repurchase authorization (in shares) | 2,000,000 | |||
Minimum | Subsequent Event | ||||
Equity, Class of Treasury Stock [Line Items] | ||||
Tender Offer Treasury Stock Value To Be Acquired | $ 1,200,000 | |||
Tender Offer Treasury Stock Price Per Share | $ 53.50 | |||
Maximum | Subsequent Event | ||||
Equity, Class of Treasury Stock [Line Items] | ||||
Tender Offer Treasury Stock Price Per Share | $ 61.50 | |||
Forecast | Minimum | ||||
Equity, Class of Treasury Stock [Line Items] | ||||
Credit Agreement, Lender Commitment | $ 5,250,000 |
Accumulated other comprehensi_3
Accumulated other comprehensive (loss) income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | Apr. 01, 2018 | Jan. 01, 2018 | |
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | $ 3,908,398 | |||||
Ending balance | $ 4,243,069 | 4,243,069 | ||||
Interest rate cap and swap agreements | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | (7,935) | $ (12,527) | (8,961) | $ (12,408) | ||
Cumulative effect of change in accounting principle | $ 0 | $ (2,706) | ||||
Unrealized (losses) gains | (42) | (361) | (823) | 1,053 | ||
Related income tax benefit | 11 | 93 | 212 | (271) | ||
Unrealized (losses) gains net | (31) | (268) | (611) | 782 | ||
Reclassification into net income | 2,163 | 2,070 | 4,326 | 4,140 | ||
Related income | (557) | (533) | (1,114) | (1,066) | ||
Reclassification from accumulated other comprehensive income into net income net of tax | 1,606 | 1,537 | 3,212 | 3,074 | ||
Ending balance | (6,360) | (11,258) | (6,360) | (11,258) | ||
Investment securities | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | 5,662 | |||||
Cumulative effect of change in accounting principle | (5,662) | |||||
Unrealized (losses) gains | 0 | |||||
Related income tax benefit | 0 | |||||
Unrealized (losses) gains net | 0 | |||||
Reclassification into net income | 0 | |||||
Related income | 0 | |||||
Reclassification from accumulated other comprehensive income into net income net of tax | 0 | |||||
Ending balance | 0 | 0 | ||||
Foreign currency translation adjustments | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | (39,616) | 39,862 | (25,963) | 19,981 | ||
Cumulative effect of change in accounting principle | 0 | 0 | ||||
Unrealized (losses) gains | 12,365 | (50,529) | (1,288) | (30,648) | ||
Related income tax benefit | 0 | 0 | 0 | 0 | ||
Unrealized (losses) gains net | 12,365 | (50,529) | (1,288) | (30,648) | ||
Reclassification into net income | 0 | 0 | 0 | 0 | ||
Related income | 0 | 0 | 0 | 0 | ||
Reclassification from accumulated other comprehensive income into net income net of tax | 0 | 0 | 0 | 0 | ||
Ending balance | (27,251) | (10,667) | (27,251) | (10,667) | ||
Accumulated other comprehensive (loss) income | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | (47,551) | 27,335 | (34,924) | 13,235 | ||
Cumulative effect of change in accounting principle | $ 0 | $ (8,368) | ||||
Unrealized (losses) gains | 12,323 | (50,890) | (2,111) | (29,595) | ||
Related income tax benefit | 11 | 93 | 212 | (271) | ||
Unrealized (losses) gains net | 12,334 | (50,797) | (1,899) | (29,866) | ||
Reclassification into net income | 2,163 | 2,070 | 4,326 | 4,140 | ||
Related income | (557) | (533) | (1,114) | (1,066) | ||
Reclassification from accumulated other comprehensive income into net income net of tax | 1,606 | 1,537 | 3,212 | 3,074 | ||
Ending balance | $ (33,611) | $ (21,925) | $ (33,611) | $ (21,925) |
Acquisitions and divestitures -
Acquisitions and divestitures - Aggregate Purchase Cost Allocations for Acquisitions (Detail) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 | Dec. 31, 2017 |
Business Acquisition [Line Items] | |||
Goodwill | $ 6,865,386 | $ 6,841,960 | $ 6,610,279 |
Dialysis and other businesses | |||
Business Acquisition [Line Items] | |||
Current assets | 3,607 | ||
Property and equipment | 2,135 | ||
Intangible and other long-term assets | 8,443 | ||
Goodwill | 66,614 | ||
Current liabilities | (2,067) | ||
Long-term liabilities | (88) | ||
Noncontrolling interests | (1,762) | ||
Aggregate purchase price | $ 76,882 |
Acquisitions and divestitures C
Acquisitions and divestitures Contingent Earn-out obligations (Details) $ in Thousands | 6 Months Ended |
Jun. 30, 2019USD ($) | |
Business Combination, Contingent Consideration Arrangements [Abstract] | |
Contingent Earn-out Obligations, Beginning balance | $ 2,608 |
Business Combination Contingent Consideration Acquisitions | 12,440 |
Business Combination Contingent Consideration Acquisitions Fair Value Remeasurement Gain Loss | (101) |
Business Combination Contingent Consideration Acquisitions Earnouts Payments | (217) |
Contingent Earn-out Obligations, Ending balance | $ 14,730 |
Acquisitions and divestitures_2
Acquisitions and divestitures - Additional Information (Detail) $ in Thousands | 6 Months Ended | |
Jun. 30, 2019USD ($)clinic | Jun. 30, 2018USD ($) | |
Business Acquisition [Line Items] | ||
Cash paid to acquire businesses | $ 65,970 | $ 89,465 |
Deferred purchase price obligations | 12,484 | |
Contingent earn-out obligations and liabilities assumed associated with acquisitions | 25,875 | |
Other Accrued Liabilities | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations | 4,090 | |
Other long-term liabilities | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations | 10,640 | |
Other companies | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations | $ 14,730 | |
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 | $ 63,945 | |
Deferred purchase price obligations | 453 | |
Goodwill deductible for tax purposes associated with acquisitions | $ 64,905 | |
Noncompete Agreements | ||
Business Acquisition [Line Items] | ||
Amortizable intangible assets acquired, weighted-average estimated useful lives | 6 years | |
U.S. dialysis and related lab services | Dialysis and other businesses | ||
Business Acquisition [Line Items] | ||
Number of businesses acquired | clinic | 5 | |
Foreign Dialysis Centers | Dialysis and other businesses | ||
Business Acquisition [Line Items] | ||
Number of businesses acquired | clinic | 7 |
Held for Sale and Discontinue_3
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 | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||
Net income from discontinued operations, net of tax | $ 79,392 | $ 69,696 | $ 109,697 | $ 63,910 |
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 | 1,330,777 | 1,252,430 | 2,713,059 | 2,480,362 |
Expenses | 1,201,633 | 1,192,528 | 2,539,787 | 2,418,935 |
Income from operations of discontinued operations before taxes | 129,144 | 59,902 | 173,272 | 61,427 |
Income tax expense (benefit) | 26,730 | (9,794) | 40,553 | (2,483) |
Loss on sale of discontinued operations before taxes | $ (23,022) | $ 0 | $ (23,022) | $ 0 |
Held for Sale and Discontinue_4
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, 2019 | Jun. 30, 2018 | |
Discontinued Operations and Disposal Groups [Abstract] | ||
Net cash provided by operating activities from discontinued operations | $ 103,848 | $ 112,683 |
Net cash used in investing activities from discontinued operations | $ (43,442) | $ (20,982) |
Held for Sale and Discontinue_5
Held for Sale and Discontinued Operations Additional Information (Details) $ in Thousands | Jun. 19, 2019USD ($) | Dec. 05, 2017 | Jun. 30, 2019USD ($) | Jun. 30, 2018USD ($) | Jun. 30, 2019USD ($) | Jun. 18, 2019USD ($)clinic | Jun. 30, 2018USD ($) |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Proceeds from Divestiture of Businesses | $ 4,465,476 | ||||||
Proceeds from Divestiture of Businesses, Net of Cash Divested | $ 3,824,509 | ||||||
Payments to Acquire Businesses, Gross | $ 65,970 | $ 89,465 | |||||
Series of Individually Immaterial Business Acquisitions | |||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Payments to Acquire Businesses, Gross | 63,945 | ||||||
DMG held for sale | Series of Individually Immaterial Business Acquisitions | |||||||
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 | $ 2,025 | ||||||
Business Combination, Consideration Transferred, Other | $ 212 | ||||||
Discontinued Operations, Held-for-sale | DMG held for sale | |||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||
Business acquisition, Effective date of acquisition | Jun. 19, 2019 | ||||||
Purchase and Sale Agreement, Aggregate purchase price | $ 4,340,000 | ||||||
Business Acquisition, Date of Acquisition Agreement | Dec. 5, 2017 | ||||||
Loss on sale of discontinued operations before taxes | $ (23,022) | $ 0 | $ (23,022) | $ 0 |
Variable interest entities - Ad
Variable interest entities - Additional Information (Detail) $ in Thousands | Jun. 30, 2019USD ($) |
Variable Interest Entity [Line Items] | |
Total assets of variable interest entities | $ 390,935 |
Total liabilities of variable interest entities | $ 277,638 |
Fair value of financial instr_3
Fair value of financial instruments - Assets, Liabilities and Temporary Equity Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 |
Assets | ||
Investments in equity securities | $ 37,151 | $ 36,124 |
Fair Value, Measurements, Recurring | ||
Assets | ||
Investments in equity securities | 37,151 | |
Liabilities | ||
Contingent earn-out obligations | 14,730 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 1,185,733 | |
Fair Value, Measurements, Recurring | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | 28 | |
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1) | ||
Assets | ||
Investments in equity securities | 37,151 | |
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 equity securities | 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 | 28 | |
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | ||
Assets | ||
Investments in equity securities | 0 | |
Liabilities | ||
Contingent earn-out obligations | 14,730 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 1,185,733 | |
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | $ 0 |
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 ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,734,065 | $ 2,718,403 | $ 5,369,217 | $ 5,309,477 |
Provision for uncollectible accounts | (10,249) | (49,406) | (15,712) | (23,861) |
Net U.S. dialysis and related lab services patient service revenues | 2,723,816 | 2,668,997 | 5,353,505 | 5,285,616 |
Other revenues | 118,889 | 217,956 | 232,312 | 450,781 |
Total revenues | 2,842,705 | 2,886,953 | 5,585,817 | 5,736,397 |
Operating income (loss) | 461,886 | 438,192 | 802,393 | 848,878 |
Corporate administrative support | (22,021) | (14,066) | (40,866) | (29,769) |
Debt expense | (131,666) | (119,692) | (263,185) | (233,208) |
Debt prepayment charges | (12,160) | 0 | (12,160) | 0 |
Other income, net | 5,643 | 1,994 | 12,583 | 6,576 |
Income from continuing operations before income taxes | 323,703 | 320,494 | 539,631 | 622,246 |
U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | 2,607,160 | 2,568,247 | 5,123,670 | 5,087,724 |
Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | 235,545 | 318,706 | 462,147 | 648,673 |
Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | 2,876,442 | 2,916,238 | 5,653,531 | 5,794,303 |
Operating income (loss) | 483,907 | 452,258 | 843,259 | 878,647 |
Operating Segments | U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 2,642,242 | 2,632,830 | 5,189,951 | 5,140,418 |
Provision for uncollectible accounts | (10,249) | (49,406) | (15,712) | (24,208) |
Net U.S. dialysis and related lab services patient service revenues | 2,631,993 | 2,583,424 | 5,174,239 | 5,116,210 |
Total revenues | 2,637,494 | 2,588,343 | 5,184,645 | 5,126,243 |
Operating income (loss) | 498,957 | 449,443 | 915,939 | 882,822 |
Operating Segments | U.S. dialysis and related lab services | External Sources | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 2,612,200 | 2,612,734 | 5,129,489 | 5,101,899 |
Other revenues | 5,209 | 4,919 | 9,893 | 10,033 |
Operating Segments | U.S. dialysis and related lab services | Intersubsegment Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 30,042 | 20,096 | 60,462 | 38,519 |
Other revenues | 292 | 0 | 513 | 0 |
Operating Segments | Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 121,865 | 105,669 | 239,728 | 207,925 |
Other revenues | 113,680 | 213,037 | 222,419 | 440,748 |
Total revenues | 238,948 | 327,895 | 468,886 | 668,060 |
Operating income (loss) | (15,050) | 2,815 | (72,680) | (4,175) |
Operating Segments | Other—Ancillary services and strategic initiatives | Intersubsegment Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 3,403 | 9,189 | 6,739 | 19,387 |
Intersegment Elimination | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | (33,737) | (29,285) | (67,714) | (57,906) |
Intersegment Elimination | U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | (30,334) | (20,096) | (60,975) | (38,519) |
Intersegment Elimination | Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | $ (3,403) | $ (9,189) | $ (6,739) | $ (19,387) |
Segment reporting - Summary o_2
Segment reporting - Summary of Assets by Segment (Detail) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 |
ASSETS | ||
Total assets | $ 19,930,960 | $ 19,110,252 |
U.S. dialysis and related lab services | ||
ASSETS | ||
Total assets | 18,352,683 | 12,333,641 |
Other—Ancillary services and strategic initiatives | ||
ASSETS | ||
Total assets | 1,578,277 | 1,387,046 |
DMG held for sale | ||
ASSETS | ||
Total assets | $ 0 | $ 5,389,565 |
Segment reporting - Summary o_3
Segment reporting - Summary of Assets by Segment (Phantom) (Detail) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 |
Segment Reporting Information [Line Items] | ||
Equity method and other investments | $ 225,677 | $ 224,611 |
U.S. dialysis and related lab services | ||
Segment Reporting Information [Line Items] | ||
Equity method and other investments | 101,161 | 95,290 |
Other—Ancillary services and strategic initiatives | ||
Segment Reporting Information [Line Items] | ||
Equity method and other investments | 124,516 | 129,321 |
DMG held for sale | ||
Segment Reporting Information [Line Items] | ||
Equity method and other investments | $ 0 | $ 4,833 |
Segment reporting - Summary o_4
Segment reporting - Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Segment Reporting Information [Line Items] | ||||
Depreciation and amortization | $ 152,242 | $ 147,079 | $ 300,770 | $ 289,878 |
U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Depreciation and amortization | 144,621 | 138,252 | 285,401 | 273,028 |
Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Depreciation and amortization | $ 7,621 | $ 8,827 | $ 15,369 | $ 16,850 |
Segment reporting - Summary o_5
Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | $ 175,040 | $ 241,534 | $ 373,918 | $ 473,977 |
U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | 149,264 | 197,051 | 319,812 | 388,458 |
Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | 7,062 | 22,184 | 15,640 | 32,172 |
DMG held for sale | ||||
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | $ 18,714 | $ 22,299 | $ 38,466 | $ 53,347 |
Segment reporting Segment Repor
Segment reporting Segment Reporting - Additional Information (Details) | Jun. 19, 2019 |
DMG held for sale | Discontinued Operations, Held-for-sale | |
Segment Reporting Information [Line Items] | |
Business acquisition, Effective date of acquisition | Jun. 19, 2019 |
Changes in DaVita Inc.'s owne_3
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, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Change Due to Net Income Attributable to Parent and Effects of Changes, Net [Abstract] | ||||
Net income attributable to DaVita Inc. | $ 273,551 | $ 267,276 | $ 422,840 | $ 445,962 |
Changes in paid-in capital for: | ||||
Sales of noncontrolling interests | 0 | 3 | 0 | 79 |
Consolidation Less Than Wholly Owned Subsidiary Parent Ownership Interest Changes Purchase Or Sale Of Interest By Parent | 13,140 | 10,934 | ||
Purchases of noncontrolling interests | (10,203) | (12,197) | ||
Net transfers to noncontrolling interests | 13,140 | (10,200) | 10,934 | (12,118) |
Net income attributable to DaVita Inc., net of transfers to noncontrolling interests | $ 286,691 | $ 257,076 | $ 433,774 | $ 433,844 |
New accounting standards New ac
New accounting standards New accounting standards (Details) - USD ($) $ in Thousands | Jan. 01, 2019 | Dec. 31, 2018 | Dec. 31, 2017 |
Accounting Standards Update 2016-02 | Lease Assets | |||
New Accounting Pronouncements or Change in Accounting Principle [Line Items] | |||
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification | $ 2,783,784 | ||
Accounting Standards Update 2016-02 | Lease Liabilities | |||
New Accounting Pronouncements or Change in Accounting Principle [Line Items] | |||
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification | 3,001,354 | ||
Cash Flow Impact | Accounting Standards Update 2016-02 | |||
New Accounting Pronouncements or Change in Accounting Principle [Line Items] | |||
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification | $ 0 | ||
Retained earnings | |||
New Accounting Pronouncements or Change in Accounting Principle [Line Items] | |||
Cumulative effect of change in accounting principle | $ 39,876 | $ 8,368 |
Condensed consolidating finan_3
Condensed consolidating financial statements - Condensed Consolidating Statements of Operations (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,734,065 | $ 2,718,403 | $ 5,369,217 | $ 5,309,477 |
Less: Provision for uncollectible accounts | (10,249) | (49,406) | (15,712) | (23,861) |
Net dialysis and related lab patient service revenues | 2,723,816 | 2,668,997 | 5,353,505 | 5,285,616 |
Other revenues | 118,889 | 217,956 | 232,312 | 450,781 |
Total revenues | 2,842,705 | 2,886,953 | 5,585,817 | 5,736,397 |
Operating expenses | 2,380,819 | 2,448,761 | 4,783,424 | 4,887,519 |
Operating income | 461,886 | 438,192 | 802,393 | 848,878 |
Debt expense | (143,826) | (119,692) | (275,345) | (233,208) |
Other income, net | 5,643 | 1,994 | 12,583 | 6,576 |
Income tax expense | 75,938 | 83,868 | 132,684 | 154,605 |
Equity earnings in subsidiaries | 0 | 0 | 0 | 0 |
Net income from continuing operations | 247,765 | 236,626 | 406,947 | 467,641 |
Net income from discontinued operations, net of tax | 79,392 | 69,696 | 109,697 | 63,910 |
Net income | 327,157 | 306,322 | 516,644 | 531,551 |
Less: Net income attributable to noncontrolling interests | (53,606) | (39,046) | (93,804) | (85,589) |
Net income attributable to DaVita Inc. | 273,551 | 267,276 | 422,840 | 445,962 |
Consolidating adjustments | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | (61,870) | (49,788) | (122,568) | (97,303) |
Less: Provision for uncollectible accounts | 0 | 0 | 0 | 0 |
Net dialysis and related lab patient service revenues | (61,870) | (49,788) | (122,568) | (97,303) |
Other revenues | (240,671) | (244,764) | (462,844) | (483,397) |
Total revenues | (302,541) | (294,552) | (585,412) | (580,700) |
Operating expenses | (302,541) | (294,552) | (585,412) | (580,700) |
Operating income | 0 | 0 | 0 | 0 |
Debt expense | 65,049 | 62,759 | 130,323 | 123,149 |
Other income, net | (108,090) | (110,646) | (223,055) | (218,372) |
Income tax expense | 0 | 0 | 0 | 0 |
Equity earnings in subsidiaries | (438,621) | (393,921) | (580,154) | (561,090) |
Net income from continuing operations | (481,662) | (441,808) | (672,886) | (656,313) |
Net income from discontinued operations, net of tax | 43,041 | 47,887 | 92,732 | 95,223 |
Net income | (438,621) | (393,921) | (580,154) | (561,090) |
Less: Net income attributable to noncontrolling interests | (53,606) | (39,046) | (93,804) | (85,589) |
Net income attributable to DaVita Inc. | (492,227) | (432,967) | (673,958) | (646,679) |
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 | 207,299 | 205,317 | 396,135 | 400,882 |
Total revenues | 207,299 | 205,317 | 396,135 | 400,882 |
Operating expenses | 160,464 | 145,649 | 304,123 | 279,005 |
Operating income | 46,835 | 59,668 | 92,012 | 121,877 |
Debt expense | (144,896) | (120,814) | (278,491) | (235,148) |
Other income, net | 102,059 | 105,344 | 212,257 | 209,425 |
Income tax expense | 627 | 13,257 | 7,653 | 27,644 |
Equity earnings in subsidiaries | 270,180 | 236,335 | 404,715 | 377,452 |
Net income from continuing operations | 273,551 | 267,276 | 422,840 | 445,962 |
Net income from discontinued operations, net of tax | 0 | 0 | 0 | 0 |
Net income | 273,551 | 267,276 | 422,840 | 445,962 |
Less: Net income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income attributable to DaVita Inc. | 273,551 | 267,276 | 422,840 | 445,962 |
Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 1,781,066 | 1,831,545 | 3,558,312 | 3,621,733 |
Less: Provision for uncollectible accounts | (7,246) | (27,159) | (11,216) | (17,531) |
Net dialysis and related lab patient service revenues | 1,773,820 | 1,804,386 | 3,547,096 | 3,604,202 |
Other revenues | 115,226 | 214,266 | 226,367 | 419,226 |
Total revenues | 1,889,046 | 2,018,652 | 3,773,463 | 4,023,428 |
Operating expenses | 1,673,331 | 1,850,377 | 3,333,784 | 3,641,471 |
Operating income | 215,715 | 168,275 | 439,679 | 381,957 |
Debt expense | (52,762) | (52,363) | (105,241) | (104,560) |
Other income, net | 2,716 | 2,856 | 5,312 | 5,379 |
Income tax expense | 63,930 | 40,019 | 110,474 | 88,962 |
Equity earnings in subsidiaries | 168,441 | 157,586 | 175,439 | 183,638 |
Net income from continuing operations | 270,180 | 236,335 | 404,715 | 377,452 |
Net income from discontinued operations, net of tax | 0 | 0 | 0 | 0 |
Net income | 270,180 | 236,335 | 404,715 | 377,452 |
Less: Net income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income attributable to DaVita Inc. | 270,180 | 236,335 | 404,715 | 377,452 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 1,014,869 | 936,646 | 1,933,473 | 1,785,047 |
Less: Provision for uncollectible accounts | (3,003) | (22,247) | (4,496) | (6,330) |
Net dialysis and related lab patient service revenues | 1,011,866 | 914,399 | 1,928,977 | 1,778,717 |
Other revenues | 37,035 | 43,137 | 72,654 | 114,070 |
Total revenues | 1,048,901 | 957,536 | 2,001,631 | 1,892,787 |
Operating expenses | 849,565 | 747,287 | 1,730,929 | 1,547,743 |
Operating income | 199,336 | 210,249 | 270,702 | 345,044 |
Debt expense | (11,217) | (9,274) | (21,936) | (16,649) |
Other income, net | 8,958 | 4,440 | 18,069 | 10,144 |
Income tax expense | 11,381 | 30,592 | 14,557 | 37,999 |
Equity earnings in subsidiaries | 0 | 0 | 0 | 0 |
Net income from continuing operations | 185,696 | 174,823 | 252,278 | 300,540 |
Net income from discontinued operations, net of tax | 36,351 | 21,809 | 16,965 | (31,313) |
Net income | 222,047 | 196,632 | 269,243 | 269,227 |
Less: Net income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income attributable to DaVita Inc. | $ 222,047 | $ 196,632 | $ 269,243 | $ 269,227 |
Condensed consolidating finan_4
Condensed consolidating financial statements - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Condensed Financial Statements Captions [Line Items] | ||||
Net income | $ 327,157 | $ 306,322 | $ 516,644 | $ 531,551 |
Other comprehensive loss | 13,940 | (49,260) | 1,313 | (26,792) |
Total comprehensive income | 341,097 | 257,062 | 517,957 | 504,759 |
Less: Comprehensive income attributable to noncontrolling interests | (53,606) | (39,046) | (93,804) | (85,589) |
Comprehensive income attributable to DaVita Inc. | 287,491 | 218,016 | 424,153 | 419,170 |
Consolidating adjustments | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | (438,621) | (393,921) | (580,154) | (561,090) |
Other comprehensive loss | 0 | 0 | 0 | 0 |
Total comprehensive income | (438,621) | (393,921) | (580,154) | (561,090) |
Less: Comprehensive income attributable to noncontrolling interests | (53,606) | (39,046) | (93,804) | (85,589) |
Comprehensive income attributable to DaVita Inc. | (492,227) | (432,967) | (673,958) | (646,679) |
DaVita Inc. | Reportable Legal Entities | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 273,551 | 267,276 | 422,840 | 445,962 |
Other comprehensive loss | 1,575 | 1,269 | 2,601 | 3,856 |
Total comprehensive income | 275,126 | 268,545 | 425,441 | 449,818 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income attributable to DaVita Inc. | 275,126 | 268,545 | 425,441 | 449,818 |
Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 270,180 | 236,335 | 404,715 | 377,452 |
Other comprehensive loss | 0 | 0 | 0 | 0 |
Total comprehensive income | 270,180 | 236,335 | 404,715 | 377,452 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income attributable to DaVita Inc. | 270,180 | 236,335 | 404,715 | 377,452 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 222,047 | 196,632 | 269,243 | 269,227 |
Other comprehensive loss | 12,365 | (50,529) | (1,288) | (30,648) |
Total comprehensive income | 234,412 | 146,103 | 267,955 | 238,579 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income attributable to DaVita Inc. | $ 234,412 | $ 146,103 | $ 267,955 | $ 238,579 |
Condensed consolidating finan_5
Condensed consolidating financial statements - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 | Dec. 31, 2017 |
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | $ 3,575,638 | $ 323,038 | |
Restricted cash and equivalents | 106,772 | 92,382 | |
Accounts receivable, net | 2,010,801 | 1,858,608 | |
Other current assets | 697,418 | 760,566 | |
Current assets held for sale, net | 0 | 5,389,565 | |
Total current assets | 6,390,629 | 8,424,159 | |
Property and equipment, net | 3,405,315 | 3,393,669 | |
Operating lease right-of-use asset | 2,790,885 | 0 | |
Intangible assets, net | 120,574 | 118,846 | |
Investments in subsidiaries | 0 | 0 | |
Intercompany receivables | 0 | 0 | |
Other long-term assets and investments | 358,171 | 331,618 | |
Goodwill | 6,865,386 | 6,841,960 | $ 6,610,279 |
Total assets | 19,930,960 | 19,110,252 | |
Current liabilities | 5,706,944 | 3,647,402 | |
Current liabilities held for sale | 0 | 1,243,759 | |
Intercompany payables | 0 | 0 | |
Long-term operating lease liabilities | 2,689,249 | 0 | |
Long-term debt and other long-term liabilities | 6,105,965 | 9,186,052 | |
Noncontrolling interests subject to put provisions | 1,185,733 | 1,124,641 | |
Total DaVita Inc. shareholders' equity | 4,049,298 | 3,703,442 | |
Noncontrolling interests not subject to put provisions | 193,771 | 204,956 | |
Total equity | 4,243,069 | 3,908,398 | |
Total liabilities and equity | 19,930,960 | 19,110,252 | |
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, net | 0 | ||
Total current assets | 0 | 0 | |
Property and equipment, net | 0 | 0 | |
Operating lease right-of-use asset | 0 | ||
Intangible assets, net | 0 | 0 | |
Investments in subsidiaries | (14,489,753) | (13,474,200) | |
Intercompany receivables | (3,047,144) | (5,467,064) | |
Other long-term assets and investments | 0 | 0 | |
Goodwill | 0 | 0 | |
Total assets | (17,536,897) | (18,941,264) | |
Current liabilities | 0 | 0 | |
Current liabilities held for sale | 0 | ||
Intercompany payables | (3,047,144) | (5,467,064) | |
Long-term operating lease liabilities | 0 | ||
Long-term debt and other long-term liabilities | 0 | 0 | |
Noncontrolling interests subject to put provisions | 544,986 | 526,566 | |
Total DaVita Inc. shareholders' equity | (14,489,753) | (13,474,200) | |
Noncontrolling interests not subject to put provisions | (544,986) | (526,566) | |
Total equity | (15,034,739) | (14,000,766) | |
Total liabilities and equity | (17,536,897) | (18,941,264) | |
DaVita Inc. | Reportable Legal Entities | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 3,374,887 | 60,653 | |
Restricted cash and equivalents | 1,007 | 1,005 | |
Accounts receivable, net | 0 | 0 | |
Other current assets | 37,185 | 37,185 | |
Current assets held for sale, net | 0 | ||
Total current assets | 3,413,079 | 98,843 | |
Property and equipment, net | 501,219 | 491,462 | |
Operating lease right-of-use asset | 105,137 | ||
Intangible assets, net | 107 | 153 | |
Investments in subsidiaries | 11,304,840 | 10,102,750 | |
Intercompany receivables | 0 | 3,419,448 | |
Other long-term assets and investments | 80,491 | 53,385 | |
Goodwill | 0 | 0 | |
Total assets | 15,404,873 | 14,166,041 | |
Current liabilities | 3,767,482 | 1,945,943 | |
Current liabilities held for sale | 0 | ||
Intercompany payables | 1,710,121 | 0 | |
Long-term operating lease liabilities | 133,349 | ||
Long-term debt and other long-term liabilities | 5,103,876 | 7,918,581 | |
Noncontrolling interests subject to put provisions | 640,747 | 598,075 | |
Total DaVita Inc. shareholders' equity | 4,049,298 | 3,703,442 | |
Noncontrolling interests not subject to put provisions | 0 | 0 | |
Total equity | 4,049,298 | 3,703,442 | |
Total liabilities and equity | 15,404,873 | 14,166,041 | |
Guarantor subsidiaries | Reportable Legal Entities | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 0 | 0 | |
Restricted cash and equivalents | 12,181 | 12,048 | |
Accounts receivable, net | 1,352,844 | 1,264,290 | |
Other current assets | 545,881 | 601,318 | |
Current assets held for sale, net | 0 | ||
Total current assets | 1,910,906 | 1,877,656 | |
Property and equipment, net | 1,613,193 | 1,624,835 | |
Operating lease right-of-use asset | 1,636,360 | ||
Intangible assets, net | 37,272 | 42,933 | |
Investments in subsidiaries | 3,184,913 | 3,371,450 | |
Intercompany receivables | 1,563,270 | 259,573 | |
Other long-term assets and investments | 81,567 | 80,537 | |
Goodwill | 4,821,054 | 4,812,365 | |
Total assets | 14,848,535 | 12,069,349 | |
Current liabilities | 1,348,798 | 1,251,534 | |
Current liabilities held for sale | 0 | ||
Intercompany payables | 0 | 0 | |
Long-term operating lease liabilities | 1,550,461 | ||
Long-term debt and other long-term liabilities | 644,436 | 715,065 | |
Noncontrolling interests subject to put provisions | 0 | 0 | |
Total DaVita Inc. shareholders' equity | 11,304,840 | 10,102,750 | |
Noncontrolling interests not subject to put provisions | 0 | 0 | |
Total equity | 11,304,840 | 10,102,750 | |
Total liabilities and equity | 14,848,535 | 12,069,349 | |
Non- Guarantor subsidiaries | Reportable Legal Entities | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 200,751 | 262,385 | |
Restricted cash and equivalents | 93,584 | 79,329 | |
Accounts receivable, net | 657,957 | 594,318 | |
Other current assets | 114,352 | 122,063 | |
Current assets held for sale, net | 5,389,565 | ||
Total current assets | 1,066,644 | 6,447,660 | |
Property and equipment, net | 1,290,903 | 1,277,372 | |
Operating lease right-of-use asset | 1,049,388 | ||
Intangible assets, net | 83,195 | 75,760 | |
Investments in subsidiaries | 0 | 0 | |
Intercompany receivables | 1,483,874 | 1,788,043 | |
Other long-term assets and investments | 196,113 | 197,696 | |
Goodwill | 2,044,332 | 2,029,595 | |
Total assets | 7,214,449 | 11,816,126 | |
Current liabilities | 590,664 | 449,925 | |
Current liabilities held for sale | 1,243,759 | ||
Intercompany payables | 1,337,023 | 5,467,064 | |
Long-term operating lease liabilities | 1,005,439 | ||
Long-term debt and other long-term liabilities | 357,653 | 552,406 | |
Noncontrolling interests subject to put provisions | 0 | 0 | |
Total DaVita Inc. shareholders' equity | 3,184,913 | 3,371,450 | |
Noncontrolling interests not subject to put provisions | 738,757 | 731,522 | |
Total equity | 3,923,670 | 4,102,972 | |
Total liabilities and equity | $ 7,214,449 | $ 11,816,126 |
Condensed consolidating finan_6
Condensed consolidating financial statements - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Cash flows from operating activities: | ||||
Net income | $ 327,157 | $ 306,322 | $ 516,644 | $ 531,551 |
Changes in operating assets and liabilities and non-cash items included in net income | 234,471 | 393,024 | ||
Net cash provided by operating activities | 751,115 | 924,575 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (175,040) | (241,534) | (373,918) | (473,977) |
Acquisitions | (65,970) | (89,465) | ||
Proceeds from asset and business sales | 3,851,381 | 116,241 | ||
Proceeds (purchases) from investment sales and other items, net | (8,801) | 23,137 | ||
Net cash used in investing activities | 3,402,692 | (424,064) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (1,164,109) | 573,981 | ||
Intercompany borrowing (payments) | 0 | 0 | ||
Other items | (146,444) | (879,890) | ||
Net cash used in financing activities | (1,310,553) | (305,909) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (77) | (3,473) | ||
Net increase in cash, cash equivalents and restricted cash | 2,843,177 | 191,129 | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 415,420 | 518,920 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 3,682,410 | 480,148 | 3,682,410 | 480,148 |
Consolidating adjustments | ||||
Cash flows from operating activities: | ||||
Net income | (438,621) | (393,921) | (580,154) | (561,090) |
Changes in operating assets and liabilities and non-cash items included in net income | 580,154 | 561,090 | ||
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 increase in cash, cash equivalents and restricted cash | 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 | 273,551 | 267,276 | 422,840 | 445,962 |
Changes in operating assets and liabilities and non-cash items included in net income | (292,988) | (361,134) | ||
Net cash provided by operating activities | 129,852 | 84,828 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (63,037) | (77,169) | ||
Acquisitions | 0 | |||
Proceeds from asset and business sales | 3,824,509 | 0 | ||
Proceeds (purchases) from investment sales and other items, net | 729 | 32,415 | ||
Net cash used in investing activities | 3,762,201 | (44,754) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (1,152,510) | 584,500 | ||
Intercompany borrowing (payments) | 656,704 | 224,359 | ||
Other items | (82,011) | (804,245) | ||
Net cash used in financing activities | (577,817) | 4,614 | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | 0 | ||
Net increase in cash, cash equivalents and restricted cash | 3,314,236 | 44,688 | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 61,658 | 150,307 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 3,375,894 | 194,995 | 3,375,894 | 194,995 |
Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from operating activities: | ||||
Net income | 270,180 | 236,335 | 404,715 | 377,452 |
Changes in operating assets and liabilities and non-cash items included in net income | (210,545) | 31,554 | ||
Net cash provided by operating activities | 194,170 | 409,006 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (174,483) | (216,103) | ||
Acquisitions | (8,975) | (6,916) | ||
Proceeds from asset and business sales | 33 | 28,546 | ||
Proceeds (purchases) from investment sales and other items, net | (6,560) | (7,232) | ||
Net cash used in investing activities | (189,985) | (201,705) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (5,270) | (4,398) | ||
Intercompany borrowing (payments) | 1,218 | (187,712) | ||
Other items | 0 | (13,208) | ||
Net cash used in financing activities | (4,052) | (205,318) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | 0 | ||
Net increase in cash, cash equivalents and restricted cash | 133 | 1,983 | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 12,048 | 9,384 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 12,181 | 11,367 | 12,181 | 11,367 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from operating activities: | ||||
Net income | 222,047 | 196,632 | 269,243 | 269,227 |
Changes in operating assets and liabilities and non-cash items included in net income | 157,850 | 161,514 | ||
Net cash provided by operating activities | 427,093 | 430,741 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (136,398) | (180,705) | ||
Acquisitions | (56,995) | (82,549) | ||
Proceeds from asset and business sales | 26,839 | 87,695 | ||
Proceeds (purchases) from investment sales and other items, net | (2,970) | (2,046) | ||
Net cash used in investing activities | (169,524) | (177,605) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (6,329) | (6,121) | ||
Intercompany borrowing (payments) | (657,922) | (36,647) | ||
Other items | (64,433) | (62,437) | ||
Net cash used in financing activities | (728,684) | (105,205) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (77) | (3,473) | ||
Net increase in cash, cash equivalents and restricted cash | (471,192) | 144,458 | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 341,714 | 359,229 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | $ 294,335 | $ 273,786 | 294,335 | 273,786 |
Discontinued Operations | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | (423,813) | 229,901 | ||
Discontinued Operations | Consolidating adjustments | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 0 | 0 | ||
Discontinued Operations | DaVita Inc. | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 0 | 0 | ||
Discontinued Operations | Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 0 | 0 | ||
Discontinued Operations | Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | (423,813) | 229,901 | ||
Continuing Operations | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 3,266,990 | (38,772) | ||
Continuing Operations | Consolidating adjustments | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 0 | 0 | ||
Continuing Operations | DaVita Inc. | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 3,314,236 | 44,688 | ||
Continuing Operations | Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 133 | 1,983 | ||
Continuing Operations | Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | $ (47,379) | $ (85,443) |
Supplemental Data - Condensed C
Supplemental Data - Condensed Consolidating Statements of Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,734,065 | $ 2,718,403 | $ 5,369,217 | $ 5,309,477 |
Less: Provision for uncollectible accounts | (10,249) | (49,406) | (15,712) | (23,861) |
Net dialysis and related lab patient service revenues | 2,723,816 | 2,668,997 | 5,353,505 | 5,285,616 |
Other revenues | 118,889 | 217,956 | 232,312 | 450,781 |
Total revenues | 2,842,705 | 2,886,953 | 5,585,817 | 5,736,397 |
Operating expenses | 2,380,819 | 2,448,761 | 4,783,424 | 4,887,519 |
Operating income | 461,886 | 438,192 | 802,393 | 848,878 |
Debt expense | (143,826) | (119,692) | (275,345) | (233,208) |
Other income | 5,643 | 1,994 | 12,583 | 6,576 |
Income tax expense | 75,938 | 83,868 | 132,684 | 154,605 |
Net income from continuing operations | 247,765 | 236,626 | 406,947 | 467,641 |
Net income from discontinued operations, net of tax | 79,392 | 69,696 | 109,697 | 63,910 |
Net income | 327,157 | 306,322 | 516,644 | 531,551 |
Less: Net income attributable to noncontrolling interests | (53,606) | (39,046) | (93,804) | (85,589) |
Net income attributable to DaVita Inc. | $ 273,551 | $ 267,276 | 422,840 | $ 445,962 |
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 | 0 | |||
Other income | 0 | |||
Income tax expense | 0 | |||
Net income from continuing operations | 0 | |||
Net income from discontinued operations, net of tax | 12,706 | |||
Net income | 12,706 | |||
Less: Net income attributable to noncontrolling interests | (1,255) | |||
Net income attributable to DaVita Inc. | 11,451 | |||
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 | 0 | |||
Other income | 0 | |||
Income tax expense | 0 | |||
Net income from continuing operations | 0 | |||
Net income from discontinued operations, net of tax | 249 | |||
Net income | 249 | |||
Less: Net income attributable to noncontrolling interests | 0 | |||
Net income attributable to DaVita Inc. | 249 | |||
Company and Restricted Subsidiaries | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 5,369,217 | |||
Less: Provision for uncollectible accounts | (15,712) | |||
Net dialysis and related lab patient service revenues | 5,353,505 | |||
Other revenues | 232,312 | |||
Total revenues | 5,585,817 | |||
Operating expenses | 4,783,424 | |||
Operating income | 802,393 | |||
Debt expense | (275,345) | |||
Other income | 12,583 | |||
Income tax expense | 132,684 | |||
Net income from continuing operations | 406,947 | |||
Net income from discontinued operations, net of tax | 96,742 | |||
Net income | 503,689 | |||
Less: Net income attributable to noncontrolling interests | (92,549) | |||
Net income attributable to DaVita Inc. | $ 411,140 |
Supplemental Data - Condensed_2
Supplemental Data - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Condensed Financial Statements Captions [Line Items] | ||||
Net income | $ 327,157 | $ 306,322 | $ 516,644 | $ 531,551 |
Other comprehensive loss | 13,940 | (49,260) | 1,313 | (26,792) |
Total comprehensive income | 341,097 | 257,062 | 517,957 | 504,759 |
Less: Comprehensive income attributable to noncontrolling interests | (53,606) | (39,046) | (93,804) | (85,589) |
Comprehensive income attributable to DaVita Inc. | $ 287,491 | $ 218,016 | 424,153 | $ 419,170 |
Physician Groups | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 12,706 | |||
Other comprehensive loss | 0 | |||
Total comprehensive income | 12,706 | |||
Less: Comprehensive income attributable to noncontrolling interests | (1,255) | |||
Comprehensive income attributable to DaVita Inc. | 11,451 | |||
Unrestricted Subsidiaries | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 249 | |||
Other comprehensive loss | 0 | |||
Total comprehensive income | 249 | |||
Less: Comprehensive income attributable to noncontrolling interests | 0 | |||
Comprehensive income attributable to DaVita Inc. | 249 | |||
Company and Restricted Subsidiaries | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 503,689 | |||
Other comprehensive loss | 1,313 | |||
Total comprehensive income | 505,002 | |||
Less: Comprehensive income attributable to noncontrolling interests | (92,549) | |||
Comprehensive income attributable to DaVita Inc. | $ 412,453 |
Supplemental Data - Condensed_3
Supplemental Data - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018 | Dec. 31, 2017 |
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | $ 3,575,638 | $ 323,038 | |
Restricted cash and equivalents | 106,772 | 92,382 | |
Accounts receivable, net | 2,010,801 | 1,858,608 | |
Other current assets | 697,418 | 760,566 | |
Total current assets | 6,390,629 | 8,424,159 | |
Property and equipment, net | 3,405,315 | 3,393,669 | |
Operating lease right-of-use asset | 2,790,885 | 0 | |
Intangible assets, net | 120,574 | 118,846 | |
Other long-term assets | 358,171 | 331,618 | |
Goodwill | 6,865,386 | 6,841,960 | $ 6,610,279 |
Total assets | 19,930,960 | 19,110,252 | |
Current liabilities | 5,706,944 | 3,647,402 | |
Long-term operating lease liabilities | 2,689,249 | 0 | |
Long-term debt and other long-term liabilities | 6,105,965 | 9,186,052 | |
Noncontrolling interests subject to put provisions | 1,185,733 | 1,124,641 | |
Total DaVita Inc. shareholders’ equity | 4,049,298 | 3,703,442 | |
Noncontrolling interests not subject to put provisions | 193,771 | 204,956 | |
Total equity | 4,243,069 | 3,908,398 | |
Total liabilities and equity | 19,930,960 | $ 19,110,252 | |
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 | ||
Total current assets | 0 | ||
Property and equipment, net | 0 | ||
Operating lease right-of-use asset | 0 | ||
Intangible assets, net | 0 | ||
Other long-term assets | 0 | ||
Goodwill | 0 | ||
Total assets | 0 | ||
Current liabilities | 0 | ||
Long-term operating lease liabilities | 0 | ||
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 | 0 | ||
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 | ||
Total current assets | 0 | ||
Property and equipment, net | 0 | ||
Operating lease right-of-use asset | 0 | ||
Intangible assets, net | 0 | ||
Other long-term assets | 0 | ||
Goodwill | 0 | ||
Total assets | 0 | ||
Current liabilities | 0 | ||
Long-term operating lease liabilities | 0 | ||
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 | 0 | ||
Parent Company And Restricted Subsidiaries | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 3,575,638 | ||
Restricted cash and equivalents | 106,772 | ||
Accounts receivable, net | 2,010,801 | ||
Other current assets | 697,418 | ||
Total current assets | 6,390,629 | ||
Property and equipment, net | 3,405,315 | ||
Operating lease right-of-use asset | 2,790,885 | ||
Intangible assets, net | 120,574 | ||
Other long-term assets | 358,171 | ||
Goodwill | 6,865,386 | ||
Total assets | 19,930,960 | ||
Current liabilities | 5,706,944 | ||
Long-term operating lease liabilities | 2,689,249 | ||
Long-term debt and other long-term liabilities | 6,105,965 | ||
Noncontrolling interests subject to put provisions | 1,185,733 | ||
Total DaVita Inc. shareholders’ equity | 4,049,298 | ||
Noncontrolling interests not subject to put provisions | 193,771 | ||
Total equity | 4,243,069 | ||
Total liabilities and equity | $ 19,930,960 |
Supplemental Data - Condensed_4
Supplemental Data - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2019 | Jun. 30, 2018 | Jun. 30, 2019 | Jun. 30, 2018 | |
Cash flows from operating activities: | ||||
Net income | $ 327,157 | $ 306,322 | $ 516,644 | $ 531,551 |
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | 234,471 | 393,024 | ||
Net cash provided by operating activities | 751,115 | 924,575 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (175,040) | (241,534) | (373,918) | (473,977) |
Acquisitions | (65,970) | |||
Proceeds from asset and business sales | 3,851,381 | 116,241 | ||
Investments and other items | (8,801) | 23,137 | ||
Net cash used in investing activities | 3,402,692 | (424,064) | ||
Cash flows from financing activities: | ||||
Long-term debt | (1,164,109) | 573,981 | ||
Intercompany | 0 | 0 | ||
Other items | (146,444) | (879,890) | ||
Net cash used in financing activities | (1,310,553) | (305,909) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (77) | (3,473) | ||
Net increase in cash, cash equivalents and restricted cash | 2,843,177 | 191,129 | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 415,420 | 518,920 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 3,682,410 | $ 480,148 | 3,682,410 | 480,148 |
Physician Groups | ||||
Cash flows from operating activities: | ||||
Net income | 12,706 | |||
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | (4,607) | |||
Net cash provided by operating activities | 8,099 | |||
Cash flows from investing activities: | ||||
Additions of property and equipment | (846) | |||
Acquisitions | 0 | |||
Cash divested from asset and business sales | 0 | |||
Investments and other items | (1,882) | |||
Net cash used in investing activities | (2,728) | |||
Cash flows from financing activities: | ||||
Long-term debt | 0 | |||
Intercompany | (247,175) | |||
Other items | 0 | |||
Net cash used in financing activities | (247,175) | |||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | |||
Net increase in cash, cash equivalents and restricted cash | (241,804) | |||
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 | 249 | |||
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | (249) | |||
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 increase in cash, cash equivalents and restricted cash | 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 | 503,689 | |||
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | 239,327 | |||
Net cash provided by operating activities | 743,016 | |||
Cash flows from investing activities: | ||||
Additions of property and equipment | (373,072) | |||
Acquisitions | (65,970) | |||
Proceeds from asset and business sales | 3,851,381 | |||
Investments and other items | (6,919) | |||
Net cash used in investing activities | 3,405,420 | |||
Cash flows from financing activities: | ||||
Long-term debt | (1,164,109) | |||
Intercompany | 247,175 | |||
Other items | (146,444) | |||
Net cash used in financing activities | (1,063,378) | |||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (77) | |||
Net increase in cash, cash equivalents and restricted cash | 3,084,981 | |||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 415,420 | |||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | $ 3,682,410 | 3,682,410 | ||
Discontinued Operations | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | (423,813) | 229,901 | ||
Discontinued Operations | Physician Groups | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | (241,804) | |||
Discontinued Operations | Unrestricted Subsidiaries | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 0 | |||
Discontinued Operations | Company and Restricted Subsidiaries | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | (182,009) | |||
Continuing Operations | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 3,266,990 | $ (38,772) | ||
Continuing Operations | Physician Groups | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 0 | |||
Continuing Operations | Unrestricted Subsidiaries | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 0 | |||
Continuing Operations | Company and Restricted Subsidiaries | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | $ 3,266,990 |