Document and Entity Information
Document and Entity Information - shares shares in Millions | 9 Months Ended | |
Sep. 30, 2019 | Nov. 01, 2019 | |
Cover page. | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Sep. 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 | |
Title of 12(b) Security | Common Stock, $0.001 par value | |
Trading Symbol | DVA | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 129.7 | |
Amendment Flag | false | |
Document Fiscal Year Focus | 2019 | |
Document Fiscal Period Focus | Q3 | |
Entity Central Index Key | 0000927066 | |
Current Fiscal Year End Date | --12-31 |
CONSOLIDATED STATEMENTS OF INCO
CONSOLIDATED STATEMENTS OF INCOME (unaudited) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Income Statement [Abstract] | ||||
Dialysis and related lab patient service revenues | $ 2,781,169 | $ 2,670,701 | $ 8,150,386 | $ 7,980,178 |
Provision for uncollectible accounts | (3,977) | (11,977) | (19,689) | (35,838) |
Net dialysis and related lab patient service revenues | 2,777,192 | 2,658,724 | 8,130,697 | 7,944,340 |
Other revenues | 126,886 | 188,606 | 359,198 | 639,387 |
Total revenues | 2,904,078 | 2,847,330 | 8,489,895 | 8,583,727 |
Operating expenses and charges: | ||||
Patient care costs | 1,991,172 | 2,063,770 | 5,913,860 | 6,168,444 |
General and administrative | 298,736 | 336,299 | 824,887 | 866,922 |
Depreciation and amortization | 155,915 | 146,000 | 456,685 | 435,878 |
Provision for uncollectible accounts | 0 | 800 | 0 | (7,300) |
Equity investment (income) loss | (3,936) | 3,824 | (11,158) | (6,126) |
Investment and other asset impairments | 0 | 6,093 | 0 | 17,338 |
Goodwill impairment charges | 83,855 | 0 | 124,892 | 3,106 |
Loss (gain) on changes in ownership interest, net | 0 | 1,506 | 0 | (32,451) |
Total operating expenses and charges | 2,525,742 | 2,558,292 | 7,309,166 | 7,445,811 |
Operating income | 378,336 | 289,038 | 1,180,729 | 1,137,916 |
Debt expense | (88,589) | (125,927) | (351,774) | (359,135) |
Debt prepayment, refinancing and redemption charges | (21,242) | 0 | (33,402) | 0 |
Other income, net | 5,280 | 4,007 | 17,863 | 10,583 |
Income from continuing operations before income taxes | 273,785 | 167,118 | 813,416 | 789,364 |
Income tax expense | 65,254 | 52,047 | 197,938 | 206,652 |
Net income from continuing operations | 208,531 | 115,071 | 615,478 | 582,712 |
Net (loss) income from discontinued operations, net of tax | (6,843) | (211,739) | 102,854 | (147,829) |
Net income (loss) | 201,688 | (96,668) | 718,332 | 434,883 |
Less: Net income attributable to noncontrolling interests | (58,418) | (40,128) | (152,222) | (125,717) |
Net income attributable to DaVita Inc. | $ 143,270 | $ (136,796) | $ 566,110 | $ 309,166 |
Earnings per share attributable to DaVita Inc.: | ||||
Basic net income from continuing operations per share | $ 1 | $ 0.44 | $ 2.88 | $ 2.69 |
Basic net income (loss) per share | 0.95 | (0.82) | 3.51 | 1.79 |
Diluted net income from continuing operations per share | 0.99 | 0.44 | 2.87 | 2.66 |
Diluted net income (loss) per share | $ 0.95 | $ (0.82) | $ 3.50 | $ 1.77 |
Weighted average shares for earnings per share: | ||||
Basic (in shares) | 150,675,465 | 166,770,664 | 161,147,122 | 172,403,944 |
Diluted (in shares) | 151,295,950 | 167,262,358 | 161,636,011 | 174,348,421 |
Amounts attributable to DaVita Inc.: | ||||
Net income from continuing operations | $ 150,113 | $ 73,371 | $ 464,590 | $ 463,989 |
Net (loss) income from discontinued operations | (6,843) | (210,167) | 101,520 | (154,823) |
Net income (loss) attributable to DaVita Inc. | $ 143,270 | $ (136,796) | $ 566,110 | $ 309,166 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Statement of Comprehensive Income [Abstract] | ||||
Net income (loss) | $ 201,688 | $ (96,668) | $ 718,332 | $ 434,883 |
Unrealized (losses) gains on interest rate cap agreements: | ||||
Unrealized (losses) gains | (1,060) | 37 | (1,672) | 819 |
Reclassifications of net realized losses into net income (loss) | 1,569 | 1,606 | 4,782 | 4,680 |
Unrealized losses on foreign currency translation: | ||||
Foreign currency translation adjustments | (44,502) | (8,827) | (45,790) | (39,475) |
Other comprehensive loss | (43,993) | (7,184) | (42,680) | (33,976) |
Total comprehensive income (loss) | 157,695 | (103,852) | 675,652 | 400,907 |
Less: Comprehensive income attributable to noncontrolling interests | (58,418) | (40,128) | (152,222) | (125,717) |
Comprehensive income (loss) attributable to DaVita Inc. | $ 99,277 | $ (143,980) | $ 523,430 | $ 275,190 |
CONSOLIDATED BALANCE SHEETS (un
CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
ASSETS | ||
Cash and cash equivalents | $ 1,253,256 | $ 323,038 |
Restricted cash and equivalents | 103,885 | 92,382 |
Short-term investments | 100,713 | 2,935 |
Accounts receivable, net | 1,901,225 | 1,858,608 |
Inventories | 98,641 | 107,381 |
Other receivables | 474,145 | 469,796 |
Income tax receivable | 16,236 | 68,614 |
Prepaid and other current assets | 50,617 | 111,840 |
Current assets held for sale, net | 0 | 5,389,565 |
Total current assets | 3,998,718 | 8,424,159 |
Property and equipment, net of accumulated depreciation of $3,792,683 and $3,524,098, respectively | 3,419,238 | 3,393,669 |
Operating lease right-of-use asset | 2,781,288 | 0 |
Intangible assets, net of accumulated amortization of $78,437 and $80,566, respectively | 117,666 | 118,846 |
Equity method and other investments | 219,386 | 224,611 |
Long-term investments | 35,041 | 35,424 |
Other long-term assets | 114,834 | 71,583 |
Goodwill | 6,765,659 | 6,841,960 |
Total assets | 17,451,830 | 19,110,252 |
LIABILITIES AND EQUITY | ||
Accounts payable | 332,136 | 463,270 |
Other liabilities | 716,023 | 595,850 |
Accrued compensation and benefits | 662,826 | 658,913 |
Current portion of operating lease liabilities | 374,214 | 0 |
Current portion of long-term debt | 121,441 | 1,929,369 |
Current liabilities held for sale | 0 | 1,243,759 |
Total current liabilities | 2,206,640 | 4,891,161 |
Long-term operating lease liabilities | 2,682,125 | 0 |
Long-term debt | 8,014,475 | 8,172,847 |
Other long-term liabilities | 135,087 | 450,669 |
Deferred income taxes | 604,921 | 562,536 |
Total liabilities | 13,643,248 | 14,077,213 |
Commitments and contingencies: | ||
Noncontrolling interests subject to put provisions | 1,296,059 | 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; 166,540,590 and 166,387,307 shares issued and 133,888,864 and 166,387,307 shares outstanding, respectively) | 167 | 166 |
Additional paid-in capital | 906,990 | 995,006 |
Retained earnings | 3,349,180 | 2,743,194 |
Treasury Stock, Value | (1,860,157) | 0 |
Accumulated other comprehensive (loss) income | (77,604) | (34,924) |
Total DaVita Inc. shareholders' equity | 2,318,576 | 3,703,442 |
Noncontrolling interests not subject to put provisions | 193,947 | 204,956 |
Total equity | 2,512,523 | 3,908,398 |
Total liabilities and equity | $ 17,451,830 | $ 19,110,252 |
CONSOLIDATED BALANCE SHEETS (_2
CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
Statement of Financial Position [Abstract] | ||
Property and equipment, accumulated depreciation | $ 3,792,683 | $ 3,524,098 |
Intangible assets, accumulated amortization | $ 78,437 | $ 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) | 166,540,590 | 166,387,307 |
Common stock, shares outstanding (in shares) | 133,888,864 | 166,387,307 |
Treasury Stock, Common, Shares | 32,651,726 | 0 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2019 | Sep. 30, 2018 | |
Cash flows from operating activities: | ||
Net income | $ 718,332 | $ 434,883 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 456,685 | 435,878 |
Impairment charges | 124,892 | 20,444 |
Debt Prepayment Refinancing Redemption Charges | 33,402 | 0 |
Stock-based compensation expense | 47,811 | 59,605 |
Deferred income taxes | 72,590 | 200,056 |
Equity investment loss, net | 5,131 | 8,611 |
Gain (loss) on sales of business interests, net | 23,022 | (57,547) |
Other non-cash charges, net | 24,291 | 164,856 |
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures: | ||
Accounts receivable | (182,684) | (74,622) |
Inventories | 9,519 | 88,355 |
Other receivables and other current assets | 51,319 | (757) |
Other long-term assets | 2,324 | 2,142 |
Accounts payable | (106,662) | (12,800) |
Accrued compensation and benefits | (57,930) | 40,225 |
Other current liabilities | 140,046 | 45,624 |
Income taxes | 57,279 | 21,749 |
Other long-term liabilities | (27,542) | 5,546 |
Net cash provided by operating activities | 1,391,825 | 1,382,248 |
Cash flows from investing activities: | ||
Additions of property and equipment | (547,183) | (705,659) |
Acquisitions | (77,348) | (113,526) |
Proceeds from asset and business sales | 3,863,619 | 135,268 |
Purchase of other debt and equity investments | (5,160) | (5,791) |
Purchase of investments held-to-maturity | (98,322) | (3,728) |
Proceeds from sale of other debt and equity investments | 5,893 | 8,783 |
Proceeds from investments held-to-maturity | 0 | 32,628 |
Purchase of equity investments | (8,770) | (12,874) |
Distributions received on equity investments | 1,296 | 3,580 |
Net cash provided by (used in) investing activities | 3,134,025 | (661,319) |
Cash flows from financing activities: | ||
Borrowings | 38,519,991 | 41,674,279 |
Payments on long-term debt and other financing costs | (40,570,003) | (40,828,443) |
Purchase of treasury stock | (1,837,022) | (1,161,511) |
Distributions to noncontrolling interests | (157,170) | (139,673) |
Stock award exercises and other share issuances, net | 7,333 | 8,803 |
Contributions from noncontrolling interests | 44,095 | 43,179 |
Proceeds from sales of additional noncontrolling interest | 0 | 15 |
Purchases of noncontrolling interests | (10,988) | (19,988) |
Net cash used in financing activities | (4,003,764) | (423,339) |
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (4,178) | (5,790) |
Net increase in cash, cash equivalents and restricted cash | 517,908 | 291,800 |
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 | 1,357,141 | 540,155 |
Discontinued Operations | ||
Cash flows from financing activities: | ||
Net increase in cash, cash equivalents and restricted cash | (423,813) | 270,565 |
Continuing Operations | ||
Cash flows from financing activities: | ||
Net increase in cash, cash equivalents and restricted cash | $ 941,721 | $ 21,235 |
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 | 77,803 | ||||||||||||||
Distributions | (85,372) | ||||||||||||||
Contributions | 26,367 | ||||||||||||||
Acquisitions and divestitures | 11,262 | ||||||||||||||
Partial purchases | (869) | ||||||||||||||
Fair value remeasurements | 23,861 | ||||||||||||||
Temporary equity, ending balance at Sep. 30, 2018 | 1,064,412 | ||||||||||||||
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. | $ 309,166 | 309,166 | 309,166 | 47,914 | |||||||||||
Other comprehensive income (loss) | (33,976) | (33,976) | (33,976) | ||||||||||||
Stock unit shares issued (in shares) | 154,000 | 212,000 | |||||||||||||
Stock-settled SAR shares issued | $ (448) | $ (4,886) | $ (1) | $ (448) | $ (4,887) | ||||||||||
Stock-settled stock-based compensation expense | 59,539 | 59,539 | |||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Distributions | (54,301) | ||||||||||||||
Contributions | 16,812 | ||||||||||||||
Acquisitions and divestitures | 79 | 79 | |||||||||||||
Acquisitions and divestitures, non-controlling interest | (212) | ||||||||||||||
Partial purchases | (17,482) | (17,482) | (1,637) | ||||||||||||
Fair value remeasurements | 0 | (23,861) | (23,861) | ||||||||||||
Purchase of treasury stock (in shares) | (16,844,000) | ||||||||||||||
Purchase of treasury stock | (1,153,511) | $ (1,153,511) | |||||||||||||
Ending balance at Sep. 30, 2018 | 3,824,649 | $ 183 | 1,055,839 | 3,951,247 | $ (1,153,511) | (29,109) | 204,613 | ||||||||
Ending balance (in shares) at Sep. 30, 2018 | 182,828,000 | (16,844,000) | |||||||||||||
Temporary equity, start balance at Jun. 30, 2018 | 1,047,158 | ||||||||||||||
Increase (Decrease) in Temporary Equity [Roll Forward] | |||||||||||||||
Net income | 25,525 | ||||||||||||||
Distributions | (27,375) | ||||||||||||||
Contributions | 7,191 | ||||||||||||||
Acquisitions and divestitures | 10,597 | ||||||||||||||
Partial purchases | (49) | ||||||||||||||
Fair value remeasurements | 1,365 | ||||||||||||||
Temporary equity, ending balance at Sep. 30, 2018 | 1,064,412 | ||||||||||||||
Beginning balance at Jun. 30, 2018 | 4,279,184 | $ 183 | 1,022,783 | 4,088,043 | $ (809,900) | (21,925) | 205,323 | ||||||||
Beginning balance (in shares) at Jun. 30, 2018 | 182,815,000 | (11,995,000) | |||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | (136,796) | (136,796) | (136,796) | 14,603 | |||||||||||
Other comprehensive income (loss) | (7,184) | (7,184) | (7,184) | ||||||||||||
Stock unit shares issued (in shares) | 8,000 | 5,000 | |||||||||||||
Stock-settled SAR shares issued | $ (1) | $ (1) | |||||||||||||
Stock-settled stock-based compensation expense | 39,707 | 39,707 | |||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Distributions | (18,292) | ||||||||||||||
Contributions | 4,419 | ||||||||||||||
Acquisitions and divestitures, non-controlling interest | (9) | ||||||||||||||
Partial purchases | (5,285) | (5,285) | (1,431) | ||||||||||||
Fair value remeasurements | 98 | (1,365) | (1,365) | ||||||||||||
Purchase of treasury stock (in shares) | (4,849,000) | ||||||||||||||
Purchase of treasury stock | (343,611) | $ (343,611) | |||||||||||||
Ending balance at Sep. 30, 2018 | 3,824,649 | $ 183 | 1,055,839 | 3,951,247 | $ (1,153,511) | (29,109) | 204,613 | ||||||||
Ending balance (in shares) at Sep. 30, 2018 | 182,828,000 | (16,844,000) | |||||||||||||
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 | 102,078 | ||||||||||||||
Distributions | 98,103 | ||||||||||||||
Contributions | 24,714 | ||||||||||||||
Acquisitions and divestitures | 1,782 | ||||||||||||||
Partial purchases | (2,240) | ||||||||||||||
Fair value remeasurements | 143,225 | ||||||||||||||
Temporary equity, ending balance at Sep. 30, 2019 | 1,296,059 | ||||||||||||||
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. | $ 566,110 | 566,110 | 566,110 | 50,144 | |||||||||||
Other comprehensive income (loss) | (42,680) | (42,680) | (42,680) | ||||||||||||
Stock unit shares issued (in shares) | 154,000 | ||||||||||||||
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures | $ 1 | ||||||||||||||
Stock-settled SAR shares issued | (3,245) | $ (3,246) | |||||||||||||
Stock-settled stock-based compensation expense | 47,723 | 47,723 | |||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Distributions | 59,067 | ||||||||||||||
Contributions | 19,381 | ||||||||||||||
Acquisitions and divestitures, non-controlling interest | (1,981) | ||||||||||||||
Partial purchases | 10,732 | 10,732 | (19,480) | ||||||||||||
Fair value remeasurements | $ 0 | (143,225) | (143,225) | ||||||||||||
Purchase of treasury stock (in shares) | (32,652,000) | (32,652,000) | |||||||||||||
Purchase of treasury stock | $ (1,860,157) | (1,860,157) | $ (1,860,157) | ||||||||||||
Ending balance at Sep. 30, 2019 | $ 2,512,523 | 2,318,576 | $ 167 | 906,990 | 3,349,180 | $ (1,860,157) | (77,604) | 193,947 | |||||||
Ending balance (in shares) at Sep. 30, 2019 | 133,888,864 | 166,541,000 | (32,652,000) | ||||||||||||
Temporary equity, start balance at Jun. 30, 2019 | 1,185,733 | ||||||||||||||
Increase (Decrease) in Temporary Equity [Roll Forward] | |||||||||||||||
Net income | 38,778 | ||||||||||||||
Distributions | (37,868) | ||||||||||||||
Contributions | 8,946 | ||||||||||||||
Acquisitions and divestitures | (91) | ||||||||||||||
Partial purchases | 8 | ||||||||||||||
Fair value remeasurements | 100,553 | ||||||||||||||
Temporary equity, ending balance at Sep. 30, 2019 | $ 1,296,059 | ||||||||||||||
Beginning balance at Jun. 30, 2019 | 4,049,298 | $ 167 | 989,021 | 3,205,910 | $ (112,189) | (33,611) | 193,771 | ||||||||
Beginning balance (in shares) at Jun. 30, 2019 | 166,533,000 | (2,060,000) | |||||||||||||
Comprehensive income: | |||||||||||||||
Net income attributable to DaVita Inc. | $ 143,270 | 143,270 | 143,270 | 19,640 | |||||||||||
Other comprehensive income (loss) | (43,993) | (43,993) | (43,993) | ||||||||||||
Stock unit shares issued (in shares) | 8,000 | ||||||||||||||
Stock-settled SAR shares issued | $ 0 | ||||||||||||||
Stock-settled stock-based compensation expense | 18,724 | 18,724 | |||||||||||||
Changes in noncontrolling interest from: | |||||||||||||||
Distributions | (23,588) | ||||||||||||||
Contributions | 3,868 | ||||||||||||||
Acquisitions and divestitures, non-controlling interest | 10 | ||||||||||||||
Partial purchases | (202) | (202) | 246 | ||||||||||||
Fair value remeasurements | $ 0 | (100,553) | (100,553) | ||||||||||||
Purchase of treasury stock (in shares) | (30,592,000) | (30,592,000) | |||||||||||||
Purchase of treasury stock | $ (1,747,968) | (1,747,968) | $ (1,747,968) | ||||||||||||
Ending balance at Sep. 30, 2019 | $ 2,512,523 | $ 2,318,576 | $ 167 | $ 906,990 | $ 3,349,180 | $ (1,860,157) | $ (77,604) | $ 193,947 | |||||||
Ending balance (in shares) at Sep. 30, 2019 | 133,888,864 | 166,541,000 | (32,652,000) |
Condensed consolidated interim
Condensed consolidated interim financial statements Condensed consolidated interim financial statements | 9 Months Ended |
Sep. 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 nine months ended September 30, 2019 are not necessarily indicative of the operating results for the full year. These 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 interim financial statements were issued and has included all necessary adjustments and disclosures. |
Revenue Recognition Revenue Rec
Revenue Recognition Revenue Recognition | 9 Months Ended |
Sep. 30, 2019 | |
Text Block [Abstract] | |
Revenue Recognition [Text Block] | Revenue recognition 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, a reduction in revenue of $4,138 was recognized during the three months ended September 30, 2019 and additional revenue of $35,658 was recognized during the nine months ended September 30, 2019 , associated with performance obligations satisfied prior to January 1, 2019. Additional revenue of $1,246 and $77,473 was recognized during the three and nine months ended September 30, 2018 , respectively, associated with performance obligations satisfied prior to January 1, 2018, which included a benefit of $36,000 for the nine months ended September 30, 2018 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 September 30, 2019 September 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 $ 1,558,890 $ $ 1,558,890 $ 1,513,191 $ $ 1,513,191 Medicaid and Managed Medicaid 176,292 176,292 159,165 159,165 Other government 116,984 90,947 207,931 113,043 80,915 193,958 Commercial 828,953 37,276 866,229 786,470 31,364 817,834 Other revenues: Medicare and Medicare Advantage 65,759 65,759 130,746 130,746 Medicaid and Managed Medicaid 227 227 12,042 12,042 Commercial 33,503 33,503 20,205 20,205 Other (1) 10,308 20,784 31,092 4,932 29,042 33,974 Eliminations of intersegment revenues (32,362 ) (3,483 ) (35,845 ) (25,424 ) (8,361 ) (33,785 ) Total $ 2,659,065 $ 245,013 $ 2,904,078 $ 2,551,377 $ 295,953 $ 2,847,330 (1) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives. For the nine months ended September 30, 2019 September 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 $ 4,572,599 $ $ 4,572,599 $ 4,524,449 $ $ 4,524,449 Medicaid and Managed Medicaid 490,723 490,723 466,948 466,948 Other government 333,675 264,191 597,866 330,500 250,048 580,548 Commercial 2,458,360 103,760 2,562,120 2,366,182 70,156 2,436,338 Other revenues: Medicare and Medicare Advantage 191,472 191,472 427,532 427,532 Medicaid and Managed Medicaid 327 327 43,991 43,991 Commercial 98,428 98,428 77,633 77,633 Other (1) 20,715 59,204 79,919 14,965 103,014 117,979 Eliminations of intersegment revenues (93,337 ) (10,222 ) (103,559 ) (63,943 ) (27,748 ) (91,691 ) Total $ 7,782,735 $ 707,160 $ 8,489,895 $ 7,639,101 $ 944,626 $ 8,583,727 (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. The Company’s allowance for doubtful accounts related to performance obligations satisfied in years prior to January 1, 2018 was $15,090 and $52,924 as of September 30, 2019 and December 31, 2018 , respectively. |
Earnings per share (Notes)
Earnings per share (Notes) | 9 Months Ended |
Sep. 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. Weighted average common shares outstanding include vested restricted stock unit awards for which recipients have satisfied either the explicit vesting terms or retirement eligibility requirements. 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 Nine months ended 2019 2018 2019 2018 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 150,113 $ 73,371 $ 464,590 $ 463,989 Change in noncontrolling interest redemption rights in excess of fair value — 98 — — Net income from continuing operations for earnings per share calculation 150,113 73,469 464,590 463,989 Net (loss) income from discontinued operations attributable to DaVita Inc. (6,843 ) (210,167 ) 101,520 (154,823 ) Net income (loss) attributable to DaVita Inc. for earnings per share calculation $ 143,270 $ (136,698 ) $ 566,110 $ 309,166 Basic: Weighted average shares outstanding during the period 150,675 166,819 161,147 173,875 Weighted average contingently returnable shares held in escrow for the — (48 ) — (1,471 ) Weighted average shares for basic earnings per share calculation 150,675 166,771 161,147 172,404 Basic net income (loss) attributable to DaVita Inc. from: Continuing operations per share $ 1.00 $ 0.44 $ 2.88 $ 2.69 Discontinued operations per share (0.05 ) (1.26 ) 0.63 (0.90 ) Basic net income (loss) per share attributable to DaVita Inc. $ 0.95 $ (0.82 ) $ 3.51 $ 1.79 Diluted: Weighted average shares outstanding during the period 150,675 166,819 161,147 173,875 Assumed incremental shares from stock plans 621 443 489 473 Weighted average shares for diluted earnings per share calculation 151,296 167,262 161,636 174,348 Diluted net income (loss) attributable to DaVita Inc. from: Continuing operations per share $ 0.99 $ 0.44 $ 2.87 $ 2.66 Discontinued operations per share (0.04 ) (1.26 ) 0.63 (0.89 ) Diluted net income (loss) per share attributable to DaVita Inc. $ 0.95 $ (0.82 ) $ 3.50 $ 1.77 Anti-dilutive stock-settled awards excluded from calculation (1) 7,293 5,281 6,414 4,987 (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 | 9 Months Ended |
Sep. 30, 2019 | |
Restricted Cash [Abstract] | |
Cash and Cash Equivalents Disclosure [Text Block] | Restricted cash and equivalents The Company had restricted cash and cash equivalents of $103,885 and $92,382 at September 30, 2019 and December 31, 2018 , respectively. 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 | 9 Months Ended |
Sep. 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: September 30, 2019 December 31, 2018 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 98,113 $ — $ 98,113 $ 2,235 $ — $ 2,235 Investments in mutual funds and common stock — 37,641 37,641 — 36,124 36,124 $ 98,113 $ 37,641 $ 135,754 $ 2,235 $ 36,124 $ 38,359 Short-term investments $ 98,113 $ 2,600 $ 100,713 $ 2,235 $ 700 $ 2,935 Long-term investments — 35,041 35,041 — 35,424 35,424 $ 98,113 $ 37,641 $ 135,754 $ 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 September 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 nine months ended September 30, 2019 , the Company recognized pre-tax net gains in the income statement of $2,776 associated with changes in the fair value of these equity securities, comprised of pre-tax realized gains of $586 and a net increase in unrealized gains of $2,190 . During the nine months ended September 30, 2018 , the Company recognized pre-tax realized gains in the income statement of $1,597 associated with changes in the fair value of these equity securities, comprised of pre-tax realized gains of $4,101 and a net decrease in unrealized gains of $2,504 . |
Equity method and other investm
Equity method and other investments | 9 Months Ended |
Sep. 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: September 30, 2019 December 31, 2018 APAC joint venture $ 118,528 $ 129,173 Other equity method partnerships 90,410 83,052 Adjusted cost method investments 10,448 12,386 $ 219,386 $ 224,611 During the nine months ended September 30, 2019 and 2018 , the Company recognized equity investment income of $11,158 and $6,126 , 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). In the third quarter of 2019 , the investors in the APAC JV jointly agreed to a deferral of the capital contributions that were 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 or shortly thereafter. 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 nine months ended September 30, 2019 , the Company recognized a $1,938 downward valuation adjustment on one of its adjusted cost method investments. During the nine months ended September 30, 2018 , there were no meaningful impairments or other valuation adjustments recognized on these investments. |
Goodwill
Goodwill | 9 Months Ended |
Sep. 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 18,089 59,149 77,238 Impairment charges — (124,892 ) (124,892 ) Foreign currency and other adjustments — (28,647 ) (28,647 ) Balance at September 30, 2019 $ 6,293,093 $ 472,566 $ 6,765,659 Balance at September 30, 2019 Goodwill $ 6,293,093 $ 622,307 $ 6,915,400 Accumulated impairment charges — (149,741 ) (149,741 ) $ 6,293,093 $ 472,566 $ 6,765,659 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 March 31, 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, as well as a decline in current and expected future patient census and an increase in first quarter and expected future costs, principally due to wage increases expected to result from recently announced legislation. During the three months ended September 30, 2019 , the Company completed additional goodwill impairment assessments of reporting units previously disclosed as at-risk of significant goodwill impairment, including its Germany kidney care business. As a result of these assessments, the Company recognized a further goodwill impairment charge of $78,439 in its Germany kidney care business and a $5,416 goodwill impairment charge in its German other health operations. The incremental charge recognized in the Germany kidney care business resulted from changes and developments in the Company's outlook for this business since its last assessment. These primarily concern developments in the business in response to evolving market conditions and changes in the Company's expected timing and ability to mitigate them, which was based on results of in-depth operating and strategic reviews completed by the Company’s new Germany management team during the third quarter. The impairment charges recognized in the third quarter of 2019 at the Company’s Germany kidney care business and its German other health operations include increases of $16,756 and $1,013 , respectively, to the goodwill impairment charges, and reductions to deferred tax expense, related to deferred tax assets that the impairments themselves generated. The result is an $83,855 goodwill impairment charge to operating income and a $17,769 credit to tax expense, for a net $66,086 impact on net income. As of September 30, 2019 , the Company's Germany kidney care business and its German other health operations remain at risk of further goodwill impairment. During the nine months ended September 30, 2019 , the Company recognized total goodwill impairment charges of $124,892 consisting of the charges described above. Further 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: Reporting unit Goodwill balance as of September 30, 2019 Carrying amount (1) Sensitivities Operating income (2) Discount rate (3) Germany Kidney Care $ 287,256 —% (1.3)% (11.0)% Brazil Kidney Care $ 72,461 4.4% (2.8)% (7.0)% (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 did not recognize any goodwill impairment charges during the three months ended September 30, 2018 and recognized a goodwill impairment charge of $3,106 at its German other health operations during the nine months ended September 30, 2018 . Except as described above, in Note 11 to the Company's consolidated financial statements included in the 10-K and in Note 7 to the Company’s condensed consolidated financial statements included in subsequent 10-Q filings, none of the Company's various other reporting units were considered at risk of significant goodwill impairment as of September 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 September 30, 2019 . |
Income taxes
Income taxes | 9 Months Ended |
Sep. 30, 2019 | |
Income Tax Disclosure [Abstract] | |
Income taxes | Income taxes As of September 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 $52,769 , of which $49,926 would impact the Company's effective tax rate if recognized. The total balance increased $12,387 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 September 30, 2019 and December 31, 2018 , the Company had approximately $11,292 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 | 9 Months Ended |
Sep. 30, 2019 | |
Debt Disclosure [Abstract] | |
Long-term debt | Long-term debt Long-term debt was comprised of the following: As of September 30, 2019 September 30, 2019 December 31, 2018 Maturity date Interest rate Estimated fair value (4) Senior Secured Credit Facilities (1) : New Term Loan A $ 1,750,000 $ 8/12/2024 LIBOR + 1.50% $ 1,750,000 New Term Loan B 2,750,000 8/12/2026 LIBOR + 2.25% $ 2,770,625 Prior Term Loan A (2) 675,000 12/24/2019 (3) $ — Prior Term Loan A-2 (2) 995,000 12/24/2019 (3) $ — Prior Term Loan B 3,342,500 6/24/2021 (3) $ — Prior revolving line of credit (2) 175,000 12/24/2019 (3) $ — Senior Notes: 5 1/8% Senior Notes 1,750,000 1,750,000 7/15/2024 5.125 % $ 1,776,250 5% Senior Notes 1,500,000 1,500,000 5/1/2025 5.00 % $ 1,492,200 5 3/4% Senior Notes — 1,250,000 8/15/2022 $ — Acquisition obligations and other notes payable (5) 181,757 183,979 2019-2027 5.50 % $ 181,757 Financing lease obligations (6) 280,138 282,737 2020-2037 5.36 % $ 280,138 Total debt principal outstanding 8,211,895 10,154,216 Discount and deferred financing costs (7) (75,979 ) (52,000 ) 8,135,916 10,102,216 Less current portion (121,441 ) (1,929,369 ) $ 8,014,475 $ 8,172,847 (1) As of September 30, 2019 , the Company has an undrawn new revolving line of credit under its new senior secured credit facilities of $1,000,000 . The new revolving line of credit interest rate in effect at September 30, 2019 was 1.50% plus London Interbank Offered Rate (LIBOR) and it matures on August 12, 2024 . (2) On May 6, 2019, the Company entered into an agreement to extend the maturity dates of its then existing Term Loan A, Term Loan A-2 and revolving line of credit under its prior senior secured credit facilities by six months , to December 24, 2019 . (3) At June 30, 2019, the interest rate on the Company's then existing term loan debt was LIBOR plus interest rate margins in effect of 2.00% for the prior Term Loan A and prior revolving line of credit, 1.00% for the prior Term Loan A-2 and 2.75% for the prior Term Loan B. (4) Fair value estimates are based upon bid and ask quotes for these instruments, typically 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 as of September 30, 2019 at their approximate fair values due to the short-term nature of their settlements. (5) 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. (6) The interest rate presented for financing lease obligations is their weighted average discount rate. (7) As of September 30, 2019 , the carrying amount of the Company’s current senior secured credit facilities includes a discount of $6,708 and deferred financing costs of $47,255 , and the carrying amount of the Company’s senior notes includes deferred financing costs of $22,016 . As of December 31, 2018, the carrying amount of the Company’s then existing 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 . Scheduled maturities of long-term debt at September 30, 2019 were as follows: 2019 (remainder of the year) 29,841 2020 129,082 2021 153,120 2022 168,824 2023 224,455 2024 3,171,804 Thereafter 4,334,769 The Company closed the DaVita Medical Group (DMG) sale on June 19, 2019 and, as required by the terms of its prior senior secured credit agreement, used all of the net proceeds from the sale of DMG to prepay term debt outstanding under that credit agreement. During the nine months ended September 30, 2019 , the Company made mandatory principal prepayments of $647,424 on the prior Term Loan A, $995,000 on the prior Term Loan A-2 and $2,823,447 on the prior Term Loan B. On August 12, 2019 , the Company entered into a new $5,500,000 senior secured credit agreement (the New Credit Agreement) consisting of a secured term loan A facility in the aggregate principal amount of $1,750,000 with a delayed draw feature, a secured term loan B facility in the aggregate principal amount of $2,750,000 and a secured revolving line of credit in the aggregate principal amount of $1,000,000 (the foregoing referred as the new Term Loan A, new Term Loan B and new revolving line of credit, respectively). In addition, the Company can increase the existing revolving commitments and enter into one or more incremental term loan facilities in an amount not to exceed the sum of $1,500,000 (less the amount of other permitted indebtedness incurred or issued in reliance on such amount), plus an amount of indebtedness such that the senior secured leverage ratio is not in excess of 3.50 :1.00 after giving effect to such borrowings. The new Term Loan A and new revolving line of credit initially bear interest at LIBOR plus an interest rate margin of 1.50% , which is subject to adjustment depending upon the Company's leverage ratio under the New Credit Agreement and can range from 1.00% to 2.00% . The new Term Loan A requires amortizing quarterly principal payments beginning on December 31, 2019 in annual amounts of $10,938 in 2019, $54,688 in 2020, $87,500 in 2021, $98,437 in 2022, and $142,187 in 2023, with the balance of $1,356,250 due in 2024. The new Term Loan B bears interest at LIBOR plus an interest rate margin of 2.25% . The new Term Loan B requires amortizing quarterly principal payments beginning on December 31, 2019 in annual amounts of $6,875 in 2019, and $27,500 for each year from 2020 through 2025, with the balance of $2,578,125 due in 2026. The Company's term loans and revolving line of credit under its New Credit Agreement are guaranteed by certain of the Company’s direct and indirect wholly-owned domestic subsidiaries, which hold most of the Company’s domestic assets, and are secured by substantially all of the assets of DaVita Inc. and these guarantors. Contemporaneously with the Company entering into the New Credit Agreement and pursuant to the indentures governing the Company’s senior notes, certain subsidiaries of the Company were released from their guarantees of the Company's senior notes such that, after that release, the remaining subsidiary guarantors of the senior notes were the same subsidiaries guaranteeing the New Credit Agreement. The New Credit Agreement contains certain customary affirmative and negative covenants such as various restrictions or limitations on permitted amounts of investments, acquisitions, share repurchases, the payment of dividends, and redemptions and incurrence of other indebtedness. Many of these restrictions and limitations will not apply as long as the Company’s leverage ratio calculated in accordance with the New Credit Agreement is below 4.00 :1.00. In addition, the New Credit Agreement places limitations on the amount of gross revenue from individual immaterial subsidiaries and also requires compliance with a maximum leverage ratio covenant of 5.00 :1.00 through 2022 and 4.50 :1.00 thereafter. In the third quarter of 2019 , the Company used a portion of the proceeds from the new Term Loan A and new Term Loan B to pay off the remaining principal balances outstanding and accrued interest and fees on its prior Term Loan B and prior revolving line of credit in the amount of $1,153,274 ; to redeem all of its outstanding 5.75% Senior Notes due in 2022 for an aggregate cash payment consisting of principal; redemption premium and accrued but unpaid interest to the redemption date of $1,267,565 ; and to repurchase 21,802 shares of common stock under the modified “Dutch auction” tender offer (the Tender Offer) for a total cost of $1,233,886 , including fees and expenses, as described in Note 14 to these condensed consolidated financial statements. The remaining debt borrowings added cash to the balance sheet for potential acquisitions, share repurchases and other general corporate purposes. In addition to the prepayments described above, during the first nine months of 2019 the Company made regularly scheduled principal payments under its then existing senior secured credit facilities of $27,576 on its prior Term Loan A and $17,500 on its prior Term Loan B. The Company did not have any regularly scheduled principal payments under its new senior secured credit facilities during the first nine months of 2019 . As a result of the transactions described above, the Company recognized debt prepayment, refinancing and redemption charges of $21,242 and $33,402 in the three and nine month periods ended September 30, 2019 , respectively, as a result of the repayment of all principal balances outstanding on the Company's prior senior secured credit facilities and the redemption of its 5.75% Senior Notes. The $21,242 of such charges recognized in the third quarter of 2019 represented debt discount and deferred financing cost write-offs associated with the portion of the Company's prior senior secured debt that was paid in full in the third quarter of 2019 , as well as redemption charges on its 5.75% Senior Notes redeemed in the third quarter of 2019 . The $12,160 of such charges recognized in the second quarter of 2019 represented accelerated amortization of debt discount and deferred financing costs associated with the portion of the Company's prior senior secured debt that was mandatorily prepaid in or shortly after the second quarter of 2019 and prior extensions thereof. As of September 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 the new Term Loan B and a portion of the new Term Loan A. The remaining $1,000,000 outstanding principal balance of the new Term Loan A 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. In August 2019, the Company entered into several forward interest rate cap agreements with a notional amount of $3,500,000 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 (2019 cap agreements). These 2019 cap agreements are designated as cash flow hedges and, as a result, changes in their fair values are reported in other comprehensive income. These 2019 cap agreements do not contain credit-risk contingent features, and become effective on June 30, 2020 . The following table summarizes the Company’s interest rate cap agreements outstanding as of September 30, 2019 and December 31, 2018 , which are classified in "Other long-term assets" on its consolidated balance sheet: Nine months ended September 30, 2019 Fair value Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI loss September 30, 2019 December 31, 2018 2015 cap agreements $ 3,500,000 3.50% 6/29/2018 6/30/2020 $ 6,428 $ 851 $ — $ 851 2019 cap agreements $ 3,500,000 2.00% 6/30/2020 6/30/2024 $ 1,393 $ 20,642 The following table summarizes the effects of the Company’s interest rate cap agreements for the three and nine months ended September 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 Nine months ended Three months ended Nine months ended Derivatives designated as cash flow hedges 2019 2018 2019 2018 2019 2018 2019 2018 Interest rate cap agreements $ (1,420 ) $ 50 $ (2,244 ) $ 1,103 Debt expense $ 2,101 $ 2,163 $ 6,428 $ 6,303 Related income tax 360 (13 ) 572 (284 ) Related income tax (532 ) (557 ) (1,646 ) (1,623 ) Total $ (1,060 ) $ 37 $ (1,672 ) $ 819 $ 1,569 $ 1,606 $ 4,782 $ 4,680 See Note 15 to these condensed consolidated financial statements for further details on amounts recorded and reclassified from accumulated other comprehensive (loss) income. The Company’s weighted average effective interest rate on the senior secured credit facilities at the end of the third quarter of 2019 was 4.30% , based on the current margins in effect for the new Term Loan A and the new Term Loan B as of September 30, 2019 , as described above. The Company’s overall weighted average effective interest rate for the three and nine months ended September 30, 2019 was 5.09% and 5.14% , respectively, and as of September 30, 2019 was 4.66% . As of September 30, 2019 , the Company’s interest rates are fixed on approximately 44.03% of its total debt. As of September 30, 2019 , the Company has an undrawn revolving line of credit under its new senior secured credit facilities of $1,000,000 , for which approximately $13,055 was committed for outstanding letters of credit. The Company also has approximately $59,723 of outstanding letters of credit under a separate bilateral secured letter of credit facility. |
Leases Leases
Leases Leases | 9 Months Ended |
Sep. 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 September 30, 2019 and December 31, 2018 , assets recorded under finance leases were $254,967 and $367,164 , respectively, and accumulated amortization associated with finance leases was $21,606 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 September 30, 2019 Nine months ended September 30, 2019 Operating lease cost (1) : Fixed lease expense $ 133,342 $ 392,398 Variable lease expense 30,786 89,264 Financing lease cost: Amortization of leased assets 6,164 17,693 Interest on lease liabilities 3,803 11,293 Net lease cost $ 174,095 $ 510,648 (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 September 30, 2019 Weighted average remaining lease term (years): Operating leases 9.1 Finance leases 10.5 Weighted average discount rate: Operating leases 4.2 % Finance leases 5.4 % Other information Nine months ended September 30, 2019 Gains on sale leasebacks, net $ 13,903 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 467,338 Operating cash flows from finance leases $ 16,226 Financing cash flows from finance leases $ 21,905 Net operating lease assets obtained in exchange for new or modified $ 299,697 Future minimum lease payments under non-cancellable leases as of September 30, 2019 were as follows: Operating leases Finance leases 2019 (remainder of the year) $ 121,795 $ 8,384 2020 497,654 38,411 2021 474,292 33,950 2022 437,481 34,369 2023 390,993 34,511 2024 340,662 34,540 Thereafter 1,433,145 183,786 Total future minimum lease payments $ 3,696,022 $ 367,951 Less portion representing interest (639,683 ) (87,813 ) Present value of lease liabilities $ 3,056,339 $ 280,138 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 | 9 Months Ended |
Sep. 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 September 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 U.S. 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 FCA 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. On September 30, 2019, the U.S. Attorney’s Office notified the U.S. District Court, Middle District of Florida, of its decision not to elect to intervene at this time in the matter of U.S. ex rel. Lorne Holland, et al. v. DaVita Healthcare Partners, Inc., et al . The court then unsealed the complaint, which alleges violations of the FCA, by order dated the same day. The Company has not been served with the complaint. * * * 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. * * * 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 | 9 Months Ended |
Sep. 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 $6,935 . |
Long-term incentive compensatio
Long-term incentive compensation | 9 Months Ended |
Sep. 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 is primarily general and administrative in nature, is 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 the expected ultimate shares to be issued 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 nine months ended September 30, 2019 , the Company granted 1,921 restricted and performance stock units with an aggregate grant-date fair value of $96,472 and a weighted-average expected life of approximately 3.4 years and 2,390 stock-settled stock appreciation rights with an aggregate grant-date fair value of $33,545 and a weighted-average expected life of approximately 4.0 years . For the nine months ended September 30, 2019 and 2018 , the Company recognized $82,469 and $74,077 , respectively, in total LTIP expense, of which $43,666 and $60,461 , 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 nine months ended September 30, 2019 and 2018 was $6,798 and $10,887 , respectively. As of September 30, 2019 , the Company had $166,502 in total estimated but unrecognized compensation expense for outstanding LTIP awards, including $151,805 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 0.6 years and the stock-based component of these LTIP expenses over a weighted average remaining period of 1.6 years . For the nine months ended September 30, 2019 and 2018 , the Company recognized $2,791 and $7,919 , respectively, in actual tax benefits upon the settlement of stock awards. On November 4, 2019, the independent members of the Company’s Board of Directors (Board) unanimously approved an award of 2,500 premium-priced stock-settled stock appreciation rights (Premium-Priced Award) to the Company’s Chief Executive Officer (CEO), which is subject to stockholder approval of a related amendment to the Company's 2011 Incentive Award Plan. The base price of the Premium-Priced Award is $67.80 per share, which is a 20% premium to the Tender Offer clearing price. The award vests 50% on each of the third and fourth anniversaries of the date of Board approval and expires after five years . The award includes a holding period requiring that the CEO hold any shares acquired upon exercise until the five-year anniversary of the Board approval, that is, for the full term of the award, subject to lapse of the holding period upon a change in control of the Company or due to Mr. Rodriguez’s death or termination due to disability. |
Share repurchases
Share repurchases | 9 Months Ended |
Sep. 30, 2019 | |
Equity [Abstract] | |
Share repurchases | Share repurchases The following table summarizes the Company's repurchases of its common stock during the three and nine months ended September 30, 2019 . Three months ended September 30, 2019 Nine months ended September 30, 2019 Shares repurchased Amount paid Average amount Shares repurchased Amount paid Average amount Tender Offer (1) 21,802 $ 1,233,886 $ 56.60 21,802 $ 1,233,886 $ 56.60 Open market repurchases 8,790 514,082 58.49 10,850 626,271 57.72 30,592 $ 1,747,968 $ 57.14 32,652 $ 1,860,157 $ 56.97 (1) The amount paid for shares repurchased associated with the Company's Tender Offer during the three and nine months ended September 30, 2019 includes the clearing price of $56.50 per share plus related fees and expenses of $2,074 . In addition, the Company also repurchased 4,283 shares of its common stock for $245,544 at an average cost of $57.32 per share, subsequent to September 30, 2019 through November 4, 2019. Effective July 17, 2019, the Board terminated all remaining prior share repurchase authorizations available to the Company at that time and approved a new share repurchase authorization of $2,000,000 . As of the close of business on November 4, 2019, the Company had repurchased a total of 30,661 of shares of its common stock for $1,753,627 under this repurchase authorization. Effective as of the close of business on November 4, 2019, the Board terminated all remaining prior share repurchase authorizations available to the Company under the aforementioned July 17, 2019 authorization and approved a new share repurchase authorization of $2,000,000 . Accordingly, as of November 6, 2019, the Company had a total of $2,000,000 available under the current repurchase authorization for additional share repurchases. Although this share repurchase authorization does not have an expiration date, the Company remains subject to share repurchase limitations, including under the terms of its current senior secured credit facilities and the indentures governing its senior notes. |
Accumulated other comprehensive
Accumulated other comprehensive (loss) income | 9 Months Ended |
Sep. 30, 2019 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | Accumulated other comprehensive (loss) income For the three months ended September 30, 2019 For the nine months ended September 30, 2019 Interest Foreign Accumulated Interest Foreign Accumulated Beginning balance $ (6,360 ) $ (27,251 ) $ (33,611 ) $ (8,961 ) $ (25,963 ) $ (34,924 ) Unrealized losses (1,420 ) (44,502 ) (45,922 ) (2,244 ) (45,790 ) (48,034 ) Related income tax 360 — 360 572 — 572 (1,060 ) (44,502 ) (45,562 ) (1,672 ) (45,790 ) (47,462 ) Reclassification into net income 2,101 — 2,101 6,428 — 6,428 Related income tax (532 ) — (532 ) (1,646 ) — (1,646 ) 1,569 — 1,569 4,782 — 4,782 Ending balance $ (5,851 ) $ (71,753 ) $ (77,604 ) $ (5,851 ) $ (71,753 ) $ (77,604 ) For the three months ended September 30, 2018 For the nine months ended September 30, 2018 Interest Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (11,258 ) $ (10,667 ) $ (21,925 ) $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 Cumulative effect of change (1) — — — (2,706 ) (5,662 ) — (8,368 ) Unrealized gains (losses) 50 (8,827 ) (8,777 ) 1,103 — (39,475 ) (38,372 ) Related income tax (13 ) — (13 ) (284 ) — — (284 ) 37 (8,827 ) (8,790 ) 819 — (39,475 ) (38,656 ) Reclassification into net income 2,163 — 2,163 6,303 — — 6,303 Related income tax (557 ) — (557 ) (1,623 ) — — (1,623 ) 1,606 — 1,606 4,680 — — 4,680 Ending balance $ (9,615 ) $ (19,494 ) $ (29,109 ) $ (9,615 ) $ — $ (19,494 ) $ (29,109 ) (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. Subsequent to 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 | 9 Months Ended |
Sep. 30, 2019 | |
Business Combinations [Abstract] | |
Acquisitions and divestitures | Acquisitions and divestitures Routine acquisitions During the nine months ended September 30, 2019 , the Company acquired dialysis businesses consisting of seven dialysis centers located in the U.S. and nine dialysis centers located outside the U.S. for a total of $75,323 in net cash, $529 in deferred purchase price obligations, and $19,818 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 $ 5,238 Property and equipment 3,607 Intangible and other long-term assets 15,848 Goodwill 77,238 Current liabilities (3,360 ) Long-term liabilities (1,139 ) Noncontrolling interests (1,762 ) $ 95,670 Amortizable intangible assets acquired during the first nine 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 $75,529 . 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 $35,338 if certain EBITDA, operating income performance targets or quality margins are met primarily over the next one year to five years . As of September 30, 2019 , the estimated fair values of these contingent earn-out obligations is $19,833 , of which $4,401 is included in other current liabilities and the remaining $15,432 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 nine months ended September 30, 2019 : Beginning balance December 31, 2018 $ 2,608 Contingent earn-out obligations associated with acquisitions 19,731 Remeasurement of fair value for contingent earn-out obligations (2,179 ) Payments on contingent earn-out obligations (327 ) Ending balance September 30, 2019 $ 19,833 |
Held for Sale and Discontinued
Held for Sale and Discontinued Operations Held for Sale and Discontinued Operations | 9 Months Ended |
Sep. 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 nine months ended September 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 ultimate net proceeds 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 retained by the Company or the total amount of its loss on the sale of this business. The following table presents the financial results of discontinued operations related to DMG: Three months ended September 30, Nine months ended September 30, 2019 2018 2019 2018 Revenues $ — $ 1,252,909 $ 2,713,059 $ 3,733,270 Expenses 1,996 1,260,814 2,541,783 3,679,747 Valuation adjustment — 98,201 — 98,201 (Loss) income from discontinued operations before taxes (1,996 ) (106,106 ) 171,276 (44,678 ) Loss on sale of discontinued operations before taxes — — (23,022 ) — Income tax expense 4,847 105,633 45,400 103,151 Net (loss) income from discontinued operations, net of tax $ (6,843 ) $ (211,739 ) $ 102,854 $ (147,829 ) The following table presents cash flows of discontinued operations related to DMG: Nine months ended September 30, 2019 2018 Net cash provided by operating activities from discontinued operations $ 97,005 $ 208,570 Net cash used in investing activities from discontinued operations $ (43,442 ) $ (32,860 ) 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 businesses for a total of $2,025 in cash and deferred purchase price of $212 . |
Variable interest entities
Variable interest entities | 9 Months Ended |
Sep. 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 September 30, 2019 , these condensed consolidated financial statements include total assets of VIEs of $389,284 and total liabilities and noncontrolling interests of VIEs to third parties of $273,660 . |
Fair value of financial instrum
Fair value of financial instruments | 9 Months Ended |
Sep. 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 September 30, 2019 : Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 37,641 $ 37,641 $ — $ — Interest rate cap agreements $ 20,642 $ — $ 20,642 $ — Liabilities Contingent earn-out obligations $ 19,833 $ — $ — $ 19,833 Temporary equity Noncontrolling interests subject to put provisions $ 1,296,059 $ — $ — $ 1,296,059 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 fair value estimates for its senior secured credit facilities and senior notes are based upon bid and ask quotes for these instruments, typically a level 2 input. See Note 9 to these condensed consolidated financial statements for further discussion of the Company's debt. 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 September 30, 2019 at their approximate fair values due to the short-term nature of their settlements. |
Segment reporting
Segment reporting | 9 Months Ended |
Sep. 30, 2019 | |
Segment Reporting [Abstract] | |
Segment Reporting Disclosure | Segment reporting The Company’s operations are 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 Nine months ended 2019 2018 2019 2018 Segment revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,652,946 $ 2,559,345 $ 7,782,435 $ 7,661,244 Intersegment revenues 32,150 25,424 92,611 63,943 U.S. dialysis and related lab services patient service 2,685,096 2,584,769 7,875,046 7,725,187 Provision for uncollectible accounts (3,977 ) (12,900 ) (19,689 ) (37,108 ) Net U.S. dialysis and related lab services patient 2,681,119 2,571,869 7,855,357 7,688,079 Other revenues (1) : External sources 10,096 4,932 19,989 14,965 Intersegment revenues 212 — 726 — Total U.S. dialysis and related lab services revenues 2,691,427 2,576,801 7,876,072 7,703,044 Other—Ancillary services and strategic initiatives Patient service revenues, net 128,223 112,279 367,951 320,204 Other external sources 116,790 183,674 339,209 624,422 Intersegment revenues 3,483 8,361 10,222 27,748 Total ancillary services and strategic initiatives revenues 248,496 304,314 717,382 972,374 Total net segment revenues 2,939,923 2,881,115 8,593,454 8,675,418 Elimination of intersegment revenues (35,845 ) (33,785 ) (103,559 ) (91,691 ) Consolidated revenues $ 2,904,078 $ 2,847,330 $ 8,489,895 $ 8,583,727 Segment operating margin: U.S. dialysis and related lab services $ 500,742 $ 390,006 $ 1,416,680 $ 1,272,828 Other—Ancillary services and strategic initiatives (97,725 ) (60,132 ) (170,405 ) (64,307 ) Total segment operating margin 403,017 329,874 1,246,275 1,208,521 Reconciliation of segment operating margin to consolidated Corporate administrative support (24,681 ) (40,836 ) (65,546 ) (70,605 ) Consolidated operating income 378,336 289,038 1,180,729 1,137,916 Debt expense (88,589 ) (125,927 ) (351,774 ) (359,135 ) Debt prepayment, refinancing and redemption charges (21,242 ) — (33,402 ) — Other income, net 5,280 4,007 17,863 10,583 Consolidated income from continuing operations before $ 273,785 $ 167,118 $ 813,416 $ 789,364 (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: September 30, 2019 December 31, 2018 Segment assets U.S. dialysis and related lab services (including equity $ 15,997,552 $ 12,333,641 Other—Ancillary services and strategic initiatives (including 1,454,278 1,387,046 DMG—Held for sale (including equity investments of $0 and — 5,389,565 Consolidated assets $ 17,451,830 $ 19,110,252 Depreciation and amortization expense by reportable segment was as follows: Three months ended Nine months ended 2019 2018 2019 2018 U.S. dialysis and related lab services $ 147,607 $ 138,669 $ 433,008 $ 411,697 Other — Ancillary services and strategic initiatives 8,308 7,331 23,677 24,181 $ 155,915 $ 146,000 $ 456,685 $ 435,878 Expenditures for property and equipment by reportable segment were as follows: Three months ended Nine months ended 2019 2018 2019 2018 U.S. dialysis and related lab services $ 157,721 $ 214,728 $ 477,533 $ 603,186 Other—Ancillary services and strategic initiatives 15,544 5,019 31,184 37,191 DMG—Held for sale — 11,935 38,466 65,282 $ 173,265 $ 231,682 $ 547,183 $ 705,659 |
Changes in DaVita Inc.'s owners
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries | 9 Months Ended |
Sep. 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 September 30, Nine months ended 2019 2018 2019 2018 Net income (loss) attributable to DaVita Inc. $ 143,270 $ (136,796 ) $ 566,110 $ 309,166 Changes in paid-in capital for: Sales of noncontrolling interests — — — 79 Purchases of noncontrolling interests (202 ) (5,285 ) 10,732 (17,482 ) Net transfers to noncontrolling interests (202 ) (5,285 ) 10,732 (17,403 ) Net income (loss) attributable to DaVita Inc., net of transfers to noncontrolling interests $ 143,068 $ (142,081 ) $ 576,842 $ 291,763 |
New accounting standards
New accounting standards | 9 Months Ended |
Sep. 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 | 9 Months Ended |
Sep. 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. Contemporaneously with the Company entering into the New Credit Agreement and pursuant to the indentures governing the Company’s senior notes, certain subsidiaries of the Company were released from their guarantees of the Company's senior notes such that, after that release, the remaining subsidiary guarantors of the senior notes were the same subsidiaries guaranteeing the New Credit Agreement. The following condensed consolidating financial statements have been prepared for all periods presented based on the current subsidiary guarantors and non-guarantors stipulated in the Company's New Credit Agreement. Condensed Consolidating Statements of Operations For the three months ended September 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 1,761,235 $ 1,087,531 $ (67,597 ) $ 2,781,169 Provision for uncollectible accounts — (2,728 ) (1,249 ) — (3,977 ) Net patient service revenues — 1,758,507 1,086,282 (67,597 ) 2,777,192 Other revenues 204,183 140,956 83,860 (302,113 ) 126,886 Total net revenues 204,183 1,899,463 1,170,142 (369,710 ) 2,904,078 Operating expenses 11,046 1,823,752 1,060,654 (369,710 ) 2,525,742 Operating income 193,137 75,711 109,488 — 378,336 Debt expense (110,712 ) (43,535 ) (14,206 ) 58,622 (109,831 ) Other income, net 51,150 2,994 9,758 (58,622 ) 5,280 Income tax expense 33,364 28,320 3,570 — 65,254 Equity earnings in subsidiaries 43,059 123,186 — (166,245 ) — Net income from continuing operations 143,270 130,036 101,470 (166,245 ) 208,531 Net loss from discontinued operations, net of tax — — (6,843 ) — (6,843 ) Net income 143,270 130,036 94,627 (166,245 ) 201,688 Less: Net income attributable to noncontrolling interests — — — (58,418 ) (58,418 ) Net income attributable to DaVita Inc. $ 143,270 $ 130,036 $ 94,627 $ (224,663 ) $ 143,270 For the three months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Patient service revenues $ — $ 1,699,109 $ 1,028,548 $ (56,956 ) $ 2,670,701 Provision for uncollectible accounts — (9,246 ) (2,731 ) — (11,977 ) Net patient service revenues — 1,689,863 1,025,817 (56,956 ) 2,658,724 Other revenues 207,968 127,269 136,448 (283,079 ) 188,606 Total net revenues 207,968 1,817,132 1,162,265 (340,035 ) 2,847,330 Operating expenses and charges 205,324 1,649,128 1,043,875 (340,035 ) 2,558,292 Operating income 2,644 168,004 118,390 — 289,038 Debt expense (127,353 ) (50,254 ) (10,570 ) 62,250 (125,927 ) Other income, net 106,148 603 7,719 (110,463 ) 4,007 Income tax (benefit) expense (3,536 ) 43,583 12,000 — 52,047 Equity earnings in subsidiaries (121,771 ) 60,448 — 61,323 — Net (loss) income from continuing operations (136,796 ) 135,218 103,539 13,110 115,071 Net loss from discontinued operations, net of tax — — (259,952 ) 48,213 (211,739 ) Net (loss) income (136,796 ) 135,218 (156,413 ) 61,323 (96,668 ) Less: Net income attributable to noncontrolling interests — — — (40,128 ) (40,128 ) Net (loss) income attributable to DaVita Inc. $ (136,796 ) $ 135,218 $ (156,413 ) $ 21,195 $ (136,796 ) For the nine months ended September 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 5,181,017 $ 3,164,726 $ (195,357 ) $ 8,150,386 Provision for uncollectible accounts — (13,530 ) (6,159 ) — (19,689 ) Net patient service revenues — 5,167,487 3,158,567 (195,357 ) 8,130,697 Other revenues 600,318 438,058 130,345 (809,523 ) 359,198 Total net revenues 600,318 5,605,545 3,288,912 (1,004,880 ) 8,489,895 Operating expenses and charges 315,169 5,106,307 2,892,570 (1,004,880 ) 7,309,166 Operating income 285,149 499,238 396,342 — 1,180,729 Debt expense (389,203 ) (145,110 ) (39,807 ) 188,944 (385,176 ) Other income, net 263,407 4,332 31,800 (281,676 ) 17,863 Income tax expense 41,017 122,633 34,288 — 197,938 Equity earnings in subsidiaries 447,774 318,431 — (766,205 ) — Net income from continuing operations 566,110 554,258 354,047 (858,937 ) 615,478 Net income from discontinued operations, net of tax — — 10,122 92,732 102,854 Net income 566,110 554,258 364,169 (766,205 ) 718,332 Less: Net income attributable to noncontrolling interests — — — (152,222 ) (152,222 ) Net income attributable to DaVita Inc. $ 566,110 $ 554,258 $ 364,169 $ (918,427 ) $ 566,110 For the nine months ended September 30, 2018 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 5,100,487 $ 3,039,056 $ (159,365 ) $ 7,980,178 Provision for uncollectible accounts — (26,430 ) (9,408 ) — (35,838 ) Net patient service revenues — 5,074,057 3,029,648 (159,365 ) 7,944,340 Other revenues 608,850 355,055 512,025 (836,543 ) 639,387 Total net revenues 608,850 5,429,112 3,541,673 (995,908 ) 8,583,727 Operating expenses and charges 484,329 4,949,070 3,008,320 (995,908 ) 7,445,811 Operating income 124,521 480,042 533,353 — 1,137,916 Debt expense (362,501 ) (151,373 ) (30,660 ) 185,399 (359,135 ) Other income, net 315,573 2,864 20,981 (328,835 ) 10,583 Income tax expense 24,108 112,193 70,351 — 206,652 Equity earnings in subsidiaries 255,681 328,042 — (583,723 ) — Net income from continuing operations 309,166 547,382 453,323 (727,159 ) 582,712 Net loss from discontinued operations, net of tax — — (291,265 ) 143,436 (147,829 ) Net income 309,166 547,382 162,058 (583,723 ) 434,883 Less: Net income attributable to noncontrolling interests — — — (125,717 ) (125,717 ) Net income attributable to DaVita Inc. $ 309,166 $ 547,382 $ 162,058 $ (709,440 ) $ 309,166 Condensed Consolidating Statements of Comprehensive Income For the three months ended September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 143,270 $ 130,036 $ 94,627 $ (166,245 ) $ 201,688 Other comprehensive income (loss) 509 — (44,502 ) — (43,993 ) Total comprehensive income 143,779 130,036 50,125 (166,245 ) 157,695 Less: Comprehensive income attributable to noncontrolling interest — — — (58,418 ) (58,418 ) Comprehensive income attributable to DaVita Inc. $ 143,779 $ 130,036 $ 50,125 $ (224,663 ) $ 99,277 For the three months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net (loss) income $ (136,796 ) $ 135,218 $ (156,413 ) $ 61,323 $ (96,668 ) Other comprehensive income (loss) 1,643 — (8,827 ) — (7,184 ) Total comprehensive (loss) income (135,153 ) 135,218 (165,240 ) 61,323 (103,852 ) Less: Comprehensive income attributable to noncontrolling interest — — — (40,128 ) (40,128 ) Comprehensive (loss) income attributable to DaVita Inc. $ (135,153 ) $ 135,218 $ (165,240 ) $ 21,195 $ (143,980 ) For the nine months ended September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 566,110 $ 554,258 $ 364,169 $ (766,205 ) $ 718,332 Other comprehensive income (loss) 3,110 — (45,790 ) — (42,680 ) Total comprehensive income 569,220 554,258 318,379 (766,205 ) 675,652 Less: Comprehensive income attributable to noncontrolling interest — — — (152,222 ) (152,222 ) Comprehensive income attributable to DaVita Inc. $ 569,220 $ 554,258 $ 318,379 $ (918,427 ) $ 523,430 For the nine months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 309,166 $ 547,382 $ 162,058 $ (583,723 ) $ 434,883 Other comprehensive income (loss) 5,499 — (39,475 ) — (33,976 ) Total comprehensive income 314,665 547,382 122,583 (583,723 ) 400,907 Less: Comprehensive income attributable to noncontrolling interest — — — (125,717 ) (125,717 ) Comprehensive income attributable to DaVita Inc. $ 314,665 $ 547,382 $ 122,583 $ (709,440 ) $ 275,190 Condensed Consolidating Balance Sheets As of September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 831,514 $ 213,635 $ 208,107 $ — $ 1,253,256 Restricted cash and equivalents — 14,444 89,441 — 103,885 Accounts receivable, net — 1,221,169 680,056 — 1,901,225 Other current assets 161,548 455,616 123,188 — 740,352 Total current assets 993,062 1,904,864 1,100,792 — 3,998,718 Property and equipment, net 515,952 1,576,140 1,327,146 — 3,419,238 Operating lease right-of-use assets 103,621 1,592,472 1,085,195 — 2,781,288 Intangible assets, net 85 34,493 83,088 — 117,666 Investments in and advances to affiliates, net 10,465,104 7,110,581 3,074,784 (20,650,469 ) — Other long-term assets and investments 96,953 91,115 181,193 — 369,261 Goodwill — 4,818,001 1,947,658 — 6,765,659 Total assets $ 12,174,777 $ 17,127,666 $ 8,799,856 $ (20,650,469 ) $ 17,451,830 Current liabilities $ 313,934 $ 1,233,054 $ 659,652 $ — $ 2,206,640 Intercompany liabilities, net 922,571 3,074,785 2,572,810 (6,570,166 ) — Long-term operating leases liabilities 131,743 1,508,343 1,042,039 — 2,682,125 Long-term debt and other long-term liabilities 7,746,653 664,470 343,360 — 8,754,483 Noncontrolling interests subject to put provisions 741,300 — — 554,759 1,296,059 Total DaVita Inc. shareholders' equity 2,318,576 10,647,014 3,433,289 (14,080,303 ) 2,318,576 Noncontrolling interests not subject to put — — 748,706 (554,759 ) 193,947 Total equity 2,318,576 10,647,014 4,181,995 (14,635,062 ) 2,512,523 Total liabilities and equity $ 12,174,777 $ 17,127,666 $ 8,799,856 $ (20,650,469 ) $ 17,451,830 As of December 31, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 60,653 $ 1,232 $ 261,153 $ — $ 323,038 Restricted cash and equivalents 1,005 12,048 79,329 — 92,382 Accounts receivable, net — 1,204,122 654,486 — 1,858,608 Other current assets 37,185 565,974 157,407 — 760,566 Current assets held for sale — — 5,389,565 — 5,389,565 Total current assets 98,843 1,783,376 6,541,940 — 8,424,159 Property and equipment, net 491,462 1,584,321 1,317,886 — 3,393,669 Intangible assets, net 153 42,896 75,797 — 118,846 Investments in and advances to affiliates, net 13,522,198 6,196,801 2,498,545 (22,217,544 ) — Other long-term assets and investments 53,385 90,037 188,196 — 331,618 Goodwill — 4,806,939 2,035,021 — 6,841,960 Total assets $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252 Current liabilities $ 1,945,943 $ 1,217,526 $ 483,933 $ — $ 3,647,402 Current liabilities held for sale — — 1,243,759 — 1,243,759 Intercompany liabilities, net — 2,498,545 6,161,292 (8,659,837 ) — Long-term debt and other long-term liabilities 7,918,581 687,443 580,028 — 9,186,052 Noncontrolling interests subject to put provisions 598,075 — — 526,566 1,124,641 Total DaVita Inc. shareholders' equity 3,703,442 10,100,856 3,456,851 (13,557,707 ) 3,703,442 Noncontrolling interests not subject to put — — 731,522 (526,566 ) 204,956 Total equity 3,703,442 10,100,856 4,188,373 (14,084,273 ) 3,908,398 Total liabilities and equity $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252 Condensed Consolidating Statements of Cash Flows For the nine months ended September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows provided by operating activities: Net income $ 566,110 $ 554,258 $ 364,169 $ (766,205 ) $ 718,332 Changes in operating assets and liabilities and non-cash (336,223 ) (74,600 ) 318,111 766,205 673,493 Net cash provided by operating activities 229,887 479,658 682,280 — 1,391,825 Cash flows provided by (used in) investing activities: Additions of property and equipment (106,476 ) (218,839 ) (221,868 ) — (547,183 ) Acquisitions — (11,832 ) (65,516 ) — (77,348 ) Proceeds (purchases) from asset and business sales 3,824,516 (244 ) 39,347 — 3,863,619 purchases from investment sales and other items, net (94,322 ) (7,474 ) (3,267 ) — (105,063 ) Net cash provided by (used in) investing activities 3,623,718 (238,389 ) (251,304 ) — 3,134,025 Cash flows used in financing activities: Long-term debt and related financing costs, net (2,028,954 ) (8,025 ) (13,033 ) — (2,050,012 ) Intercompany borrowings (payments) 785,450 (14,854 ) (770,596 ) — — Other items (1,840,245 ) (3,591 ) (109,916 ) — (1,953,752 ) Net cash used in financing activities (3,083,749 ) (26,470 ) (893,545 ) — (4,003,764 ) Effect of exchange rate changes on cash, cash — — (4,178 ) — (4,178 ) Net increase (decrease) in cash, cash equivalents and 769,856 214,799 (466,747 ) — 517,908 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 769,856 214,799 (42,934 ) — 941,721 Cash, cash equivalents and restricted cash of continuing 61,658 13,280 340,482 — 415,420 Cash, cash equivalents and restricted cash of continuing $ 831,514 $ 228,079 $ 297,548 $ — $ 1,357,141 For the nine months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows provided by operating activities: Net income $ 309,166 $ 547,382 $ 162,058 $ (583,723 ) $ 434,883 Changes in operating assets and liabilities and non-cash (235,558 ) (104,179 ) 703,379 583,723 947,365 Net cash provided by operating activities 73,608 443,203 865,437 — 1,382,248 Cash flows used in investing activities: Additions of property and equipment (124,585 ) (296,028 ) (285,046 ) — (705,659 ) Acquisitions — (5,646 ) (107,880 ) — (113,526 ) Proceeds from asset and business sales — 55,035 80,233 — 135,268 Proceeds (purchases) from investment sales and other items, net 32,345 (2,295 ) (7,452 ) — 22,598 Net cash used in investing activities (92,240 ) (248,934 ) (320,145 ) — (661,319 ) Cash flows provided by (used in) financing activities: Long-term debt and related financing costs, net 866,537 (8,601 ) (12,100 ) — 845,836 Intercompany borrowings (payments) 454,410 (174,148 ) (280,262 ) — — Other items (1,154,921 ) (18,713 ) (95,541 ) — (1,269,175 ) Net cash provided by (used in) financing activities 166,026 (201,462 ) (387,903 ) — (423,339 ) Effect of exchange rate changes on cash, cash — — (5,790 ) — (5,790 ) Net increase (decrease) in cash, cash equivalents and restricted cash 147,394 (7,193 ) 151,599 — 291,800 Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations — — 270,565 — 270,565 Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 147,394 (7,193 ) (118,966 ) — 21,235 Cash, cash equivalents and restricted cash of continuing 150,307 19,963 348,650 — 518,920 Cash, cash equivalents and restricted cash of continuing $ 297,701 $ 12,770 $ 229,684 $ — $ 540,155 |
Supplemental data
Supplemental data | 9 Months Ended |
Sep. 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. Prior to the DMG sale, the Company provided services to certain physician groups within its DMG business which, while consolidated in its financial statements for financial reporting purposes, were not subsidiaries of nor owned by the Company, did not constitute “Subsidiaries” as defined in the indentures governing our outstanding senior notes, and did not guarantee those senior notes. In addition, the Company operated under management agreements with these physician groups pursuant to which it received management fees from these physician groups. From and after June 19, 2019, these physician groups were no longer included in the Company's financial statements as they were deconsolidated upon the sale of DMG to Optum. Condensed Consolidating Statements of Income For the nine months ended September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Patient service operating revenues $ 8,150,386 $ — $ — $ 8,150,386 Provision for uncollectible accounts (19,689 ) — — (19,689 ) Net patient service operating revenues 8,130,697 — — 8,130,697 Other revenues 359,198 — — 359,198 Total net operating revenues 8,489,895 — — 8,489,895 Operating expenses 7,309,166 — — 7,309,166 Operating income 1,180,729 — — 1,180,729 Debt expense (385,176 ) — — (385,176 ) Other income 17,863 — — 17,863 Income tax expense 197,938 — — 197,938 Net income from continuing operations 615,478 — — 615,478 Net income from discontinued operations, net of tax 102,854 12,706 249 89,899 Net income 718,332 12,706 249 705,377 Less: Net income attributable to noncontrolling interests (152,222 ) (1,255 ) — (150,967 ) Net income attributable to DaVita Inc. $ 566,110 $ 11,451 $ 249 $ 554,410 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Comprehensive Income For the nine months ended September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Net income $ 718,332 $ 12,706 $ 249 $ 705,377 Other comprehensive income (42,680 ) — — (42,680 ) Total comprehensive income 675,652 12,706 249 662,697 Less: Comprehensive income attributable to the noncontrolling (152,222 ) (1,255 ) — (150,967 ) Comprehensive income attributable to DaVita Inc. $ 523,430 $ 11,451 $ 249 $ 511,730 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Balance Sheets As of September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash and cash equivalents $ 1,253,256 $ — $ — $ 1,253,256 Restricted cash and equivalents 103,885 — — 103,885 Accounts receivable, net 1,901,225 — — 1,901,225 Other current assets 740,352 — — 740,352 Total current assets 3,998,718 — — 3,998,718 Property and equipment, net 3,419,238 — — 3,419,238 Operating lease right-of-use assets 2,781,288 — — 2,781,288 Amortizable intangibles, net 117,666 — — 117,666 Other long-term assets 369,261 — — 369,261 Goodwill 6,765,659 — — 6,765,659 Total assets $ 17,451,830 $ — $ — $ 17,451,830 Current liabilities $ 2,206,640 $ — $ — $ 2,206,640 Long-term operating leases liabilities 2,682,125 — — 2,682,125 Long-term debt and other long-term liabilities 8,754,483 — — 8,754,483 Noncontrolling interests subject to put provisions 1,296,059 — — 1,296,059 Total DaVita Inc. shareholders’ equity 2,318,576 — — 2,318,576 Noncontrolling interests not subject to put provisions 193,947 — — 193,947 Shareholders’ equity 2,512,523 — — 2,512,523 Total liabilities and shareholder’s equity $ 17,451,830 $ — $ — $ 17,451,830 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Cash Flows For the nine months ended September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash flows from operating activities: Net income $ 718,332 $ 12,706 $ 249 $ 705,377 Changes in operating and intercompany assets and liabilities and 673,493 (4,607 ) (249 ) 678,349 Net cash provided by operating activities 1,391,825 8,099 — 1,383,726 Cash flows from investing activities: Additions of property and equipment (547,183 ) (846 ) — (546,337 ) Acquisitions (77,348 ) — — (77,348 ) Proceeds from asset and business sales 3,863,619 — — 3,863,619 Investments and other items (105,063 ) (1,882 ) — (103,181 ) Net cash provided by (used in) investing activities 3,134,025 (2,728 ) — 3,136,753 Cash flows from financing activities: Long-term debt (2,050,012 ) — — (2,050,012 ) Intercompany — (247,175 ) — 247,175 Other items (1,953,752 ) — — (1,953,752 ) Net cash used in financing activities (4,003,764 ) (247,175 ) — (3,756,589 ) Effect of exchange rate changes on cash, cash equivalents and (4,178 ) — — (4,178 ) Net increase (decrease) in cash, cash equivalents and restricted cash 517,908 (241,804 ) — 759,712 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 941,721 — — 941,721 Cash, cash equivalents and restricted cash of continuing operations 415,420 — — 415,420 Cash, cash equivalents and restricted cash of continuing operations $ 1,357,141 $ — $ — $ 1,357,141 (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) | 9 Months Ended |
Sep. 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 nine months ended September 30, 2019 are not necessarily indicative of the operating results for the full year. These 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 interim 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. Weighted average common shares outstanding include vested restricted stock unit awards for which recipients have satisfied either the explicit vesting terms or retirement eligibility requirements. 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 September 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 the expected ultimate shares to be issued 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. Subsequent to 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) | 9 Months Ended |
Sep. 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 September 30, 2019 September 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 $ 1,558,890 $ $ 1,558,890 $ 1,513,191 $ $ 1,513,191 Medicaid and Managed Medicaid 176,292 176,292 159,165 159,165 Other government 116,984 90,947 207,931 113,043 80,915 193,958 Commercial 828,953 37,276 866,229 786,470 31,364 817,834 Other revenues: Medicare and Medicare Advantage 65,759 65,759 130,746 130,746 Medicaid and Managed Medicaid 227 227 12,042 12,042 Commercial 33,503 33,503 20,205 20,205 Other (1) 10,308 20,784 31,092 4,932 29,042 33,974 Eliminations of intersegment revenues (32,362 ) (3,483 ) (35,845 ) (25,424 ) (8,361 ) (33,785 ) Total $ 2,659,065 $ 245,013 $ 2,904,078 $ 2,551,377 $ 295,953 $ 2,847,330 (1) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives. For the nine months ended September 30, 2019 September 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 $ 4,572,599 $ $ 4,572,599 $ 4,524,449 $ $ 4,524,449 Medicaid and Managed Medicaid 490,723 490,723 466,948 466,948 Other government 333,675 264,191 597,866 330,500 250,048 580,548 Commercial 2,458,360 103,760 2,562,120 2,366,182 70,156 2,436,338 Other revenues: Medicare and Medicare Advantage 191,472 191,472 427,532 427,532 Medicaid and Managed Medicaid 327 327 43,991 43,991 Commercial 98,428 98,428 77,633 77,633 Other (1) 20,715 59,204 79,919 14,965 103,014 117,979 Eliminations of intersegment revenues (93,337 ) (10,222 ) (103,559 ) (63,943 ) (27,748 ) (91,691 ) Total $ 7,782,735 $ 707,160 $ 8,489,895 $ 7,639,101 $ 944,626 $ 8,583,727 (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) | 9 Months Ended |
Sep. 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 Nine months ended 2019 2018 2019 2018 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 150,113 $ 73,371 $ 464,590 $ 463,989 Change in noncontrolling interest redemption rights in excess of fair value — 98 — — Net income from continuing operations for earnings per share calculation 150,113 73,469 464,590 463,989 Net (loss) income from discontinued operations attributable to DaVita Inc. (6,843 ) (210,167 ) 101,520 (154,823 ) Net income (loss) attributable to DaVita Inc. for earnings per share calculation $ 143,270 $ (136,698 ) $ 566,110 $ 309,166 Basic: Weighted average shares outstanding during the period 150,675 166,819 161,147 173,875 Weighted average contingently returnable shares held in escrow for the — (48 ) — (1,471 ) Weighted average shares for basic earnings per share calculation 150,675 166,771 161,147 172,404 Basic net income (loss) attributable to DaVita Inc. from: Continuing operations per share $ 1.00 $ 0.44 $ 2.88 $ 2.69 Discontinued operations per share (0.05 ) (1.26 ) 0.63 (0.90 ) Basic net income (loss) per share attributable to DaVita Inc. $ 0.95 $ (0.82 ) $ 3.51 $ 1.79 Diluted: Weighted average shares outstanding during the period 150,675 166,819 161,147 173,875 Assumed incremental shares from stock plans 621 443 489 473 Weighted average shares for diluted earnings per share calculation 151,296 167,262 161,636 174,348 Diluted net income (loss) attributable to DaVita Inc. from: Continuing operations per share $ 0.99 $ 0.44 $ 2.87 $ 2.66 Discontinued operations per share (0.04 ) (1.26 ) 0.63 (0.89 ) Diluted net income (loss) per share attributable to DaVita Inc. $ 0.95 $ (0.82 ) $ 3.50 $ 1.77 Anti-dilutive stock-settled awards excluded from calculation (1) 7,293 5,281 6,414 4,987 (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) | 9 Months Ended |
Sep. 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: September 30, 2019 December 31, 2018 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 98,113 $ — $ 98,113 $ 2,235 $ — $ 2,235 Investments in mutual funds and common stock — 37,641 37,641 — 36,124 36,124 $ 98,113 $ 37,641 $ 135,754 $ 2,235 $ 36,124 $ 38,359 Short-term investments $ 98,113 $ 2,600 $ 100,713 $ 2,235 $ 700 $ 2,935 Long-term investments — 35,041 35,041 — 35,424 35,424 $ 98,113 $ 37,641 $ 135,754 $ 2,235 $ 36,124 $ 38,359 |
Equity method and other inves_2
Equity method and other investments Equity Method and Other Investments (Tables) | 9 Months Ended |
Sep. 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: September 30, 2019 December 31, 2018 APAC joint venture $ 118,528 $ 129,173 Other equity method partnerships 90,410 83,052 Adjusted cost method investments 10,448 12,386 $ 219,386 $ 224,611 |
Goodwill (Tables)
Goodwill (Tables) | 9 Months Ended |
Sep. 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 18,089 59,149 77,238 Impairment charges — (124,892 ) (124,892 ) Foreign currency and other adjustments — (28,647 ) (28,647 ) Balance at September 30, 2019 $ 6,293,093 $ 472,566 $ 6,765,659 Balance at September 30, 2019 Goodwill $ 6,293,093 $ 622,307 $ 6,915,400 Accumulated impairment charges — (149,741 ) (149,741 ) $ 6,293,093 $ 472,566 $ 6,765,659 |
Schedule Of Reporting Units Goodwill Balances [Text Block] | Reporting unit Goodwill balance as of September 30, 2019 Carrying amount (1) Sensitivities Operating income (2) Discount rate (3) Germany Kidney Care $ 287,256 —% (1.3)% (11.0)% Brazil Kidney Care $ 72,461 4.4% (2.8)% (7.0)% (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) | 9 Months Ended |
Sep. 30, 2019 | |
Debt Disclosure [Abstract] | |
Long-term Debt | Long-term debt was comprised of the following: As of September 30, 2019 September 30, 2019 December 31, 2018 Maturity date Interest rate Estimated fair value (4) Senior Secured Credit Facilities (1) : New Term Loan A $ 1,750,000 $ 8/12/2024 LIBOR + 1.50% $ 1,750,000 New Term Loan B 2,750,000 8/12/2026 LIBOR + 2.25% $ 2,770,625 Prior Term Loan A (2) 675,000 12/24/2019 (3) $ — Prior Term Loan A-2 (2) 995,000 12/24/2019 (3) $ — Prior Term Loan B 3,342,500 6/24/2021 (3) $ — Prior revolving line of credit (2) 175,000 12/24/2019 (3) $ — Senior Notes: 5 1/8% Senior Notes 1,750,000 1,750,000 7/15/2024 5.125 % $ 1,776,250 5% Senior Notes 1,500,000 1,500,000 5/1/2025 5.00 % $ 1,492,200 5 3/4% Senior Notes — 1,250,000 8/15/2022 $ — Acquisition obligations and other notes payable (5) 181,757 183,979 2019-2027 5.50 % $ 181,757 Financing lease obligations (6) 280,138 282,737 2020-2037 5.36 % $ 280,138 Total debt principal outstanding 8,211,895 10,154,216 Discount and deferred financing costs (7) (75,979 ) (52,000 ) 8,135,916 10,102,216 Less current portion (121,441 ) (1,929,369 ) $ 8,014,475 $ 8,172,847 (1) As of September 30, 2019 , the Company has an undrawn new revolving line of credit under its new senior secured credit facilities of $1,000,000 . The new revolving line of credit interest rate in effect at September 30, 2019 was 1.50% plus London Interbank Offered Rate (LIBOR) and it matures on August 12, 2024 . (2) On May 6, 2019, the Company entered into an agreement to extend the maturity dates of its then existing Term Loan A, Term Loan A-2 and revolving line of credit under its prior senior secured credit facilities by six months , to December 24, 2019 . (3) At June 30, 2019, the interest rate on the Company's then existing term loan debt was LIBOR plus interest rate margins in effect of 2.00% for the prior Term Loan A and prior revolving line of credit, 1.00% for the prior Term Loan A-2 and 2.75% for the prior Term Loan B. (4) Fair value estimates are based upon bid and ask quotes for these instruments, typically 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 as of September 30, 2019 at their approximate fair values due to the short-term nature of their settlements. (5) 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. (6) The interest rate presented for financing lease obligations is their weighted average discount rate. (7) As of September 30, 2019 , the carrying amount of the Company’s current senior secured credit facilities includes a discount of $6,708 and deferred financing costs of $47,255 , and the carrying amount of the Company’s senior notes includes deferred financing costs of $22,016 . As of December 31, 2018, the carrying amount of the Company’s then existing 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 . |
Scheduled Maturities of Long-term Debt | Scheduled maturities of long-term debt at September 30, 2019 were as follows: 2019 (remainder of the year) 29,841 2020 129,082 2021 153,120 2022 168,824 2023 224,455 2024 3,171,804 Thereafter 4,334,769 |
Schedule of Derivative Instruments | The following table summarizes the Company’s interest rate cap agreements outstanding as of September 30, 2019 and December 31, 2018 , which are classified in "Other long-term assets" on its consolidated balance sheet: Nine months ended September 30, 2019 Fair value Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI loss September 30, 2019 December 31, 2018 2015 cap agreements $ 3,500,000 3.50% 6/29/2018 6/30/2020 $ 6,428 $ 851 $ — $ 851 2019 cap agreements $ 3,500,000 2.00% 6/30/2020 6/30/2024 $ 1,393 $ 20,642 |
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 nine months ended September 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 Nine months ended Three months ended Nine months ended Derivatives designated as cash flow hedges 2019 2018 2019 2018 2019 2018 2019 2018 Interest rate cap agreements $ (1,420 ) $ 50 $ (2,244 ) $ 1,103 Debt expense $ 2,101 $ 2,163 $ 6,428 $ 6,303 Related income tax 360 (13 ) 572 (284 ) Related income tax (532 ) (557 ) (1,646 ) (1,623 ) Total $ (1,060 ) $ 37 $ (1,672 ) $ 819 $ 1,569 $ 1,606 $ 4,782 $ 4,680 |
Leases Leases (Tables)
Leases Leases (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Leases [Abstract] | |
Lease Expense Components | The components of lease expense were as follows: Lease cost Three months ended September 30, 2019 Nine months ended September 30, 2019 Operating lease cost (1) : Fixed lease expense $ 133,342 $ 392,398 Variable lease expense 30,786 89,264 Financing lease cost: Amortization of leased assets 6,164 17,693 Interest on lease liabilities 3,803 11,293 Net lease cost $ 174,095 $ 510,648 (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 September 30, 2019 Weighted average remaining lease term (years): Operating leases 9.1 Finance leases 10.5 Weighted average discount rate: Operating leases 4.2 % Finance leases 5.4 % Other information Nine months ended September 30, 2019 Gains on sale leasebacks, net $ 13,903 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 467,338 Operating cash flows from finance leases $ 16,226 Financing cash flows from finance leases $ 21,905 Net operating lease assets obtained in exchange for new or modified $ 299,697 |
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 September 30, 2019 were as follows: Operating leases Finance leases 2019 (remainder of the year) $ 121,795 $ 8,384 2020 497,654 38,411 2021 474,292 33,950 2022 437,481 34,369 2023 390,993 34,511 2024 340,662 34,540 Thereafter 1,433,145 183,786 Total future minimum lease payments $ 3,696,022 $ 367,951 Less portion representing interest (639,683 ) (87,813 ) Present value of lease liabilities $ 3,056,339 $ 280,138 |
Share repurchases Share Repurch
Share repurchases Share Repurchases (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Treasury Stock, Value [Abstract] | |
Class of Treasury Stock [Table Text Block] | The following table summarizes the Company's repurchases of its common stock during the three and nine months ended September 30, 2019 . Three months ended September 30, 2019 Nine months ended September 30, 2019 Shares repurchased Amount paid Average amount Shares repurchased Amount paid Average amount Tender Offer (1) 21,802 $ 1,233,886 $ 56.60 21,802 $ 1,233,886 $ 56.60 Open market repurchases 8,790 514,082 58.49 10,850 626,271 57.72 30,592 $ 1,747,968 $ 57.14 32,652 $ 1,860,157 $ 56.97 (1) The amount paid for shares repurchased associated with the Company's Tender Offer during the three and nine months ended September 30, 2019 includes the clearing price of $56.50 per share plus related fees and expenses of $2,074 . |
Accumulated other comprehensi_2
Accumulated other comprehensive (loss) income (Tables) | 9 Months Ended |
Sep. 30, 2019 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | For the three months ended September 30, 2019 For the nine months ended September 30, 2019 Interest Foreign Accumulated Interest Foreign Accumulated Beginning balance $ (6,360 ) $ (27,251 ) $ (33,611 ) $ (8,961 ) $ (25,963 ) $ (34,924 ) Unrealized losses (1,420 ) (44,502 ) (45,922 ) (2,244 ) (45,790 ) (48,034 ) Related income tax 360 — 360 572 — 572 (1,060 ) (44,502 ) (45,562 ) (1,672 ) (45,790 ) (47,462 ) Reclassification into net income 2,101 — 2,101 6,428 — 6,428 Related income tax (532 ) — (532 ) (1,646 ) — (1,646 ) 1,569 — 1,569 4,782 — 4,782 Ending balance $ (5,851 ) $ (71,753 ) $ (77,604 ) $ (5,851 ) $ (71,753 ) $ (77,604 ) For the three months ended September 30, 2018 For the nine months ended September 30, 2018 Interest Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (11,258 ) $ (10,667 ) $ (21,925 ) $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 Cumulative effect of change (1) — — — (2,706 ) (5,662 ) — (8,368 ) Unrealized gains (losses) 50 (8,827 ) (8,777 ) 1,103 — (39,475 ) (38,372 ) Related income tax (13 ) — (13 ) (284 ) — — (284 ) 37 (8,827 ) (8,790 ) 819 — (39,475 ) (38,656 ) Reclassification into net income 2,163 — 2,163 6,303 — — 6,303 Related income tax (557 ) — (557 ) (1,623 ) — — (1,623 ) 1,606 — 1,606 4,680 — — 4,680 Ending balance $ (9,615 ) $ (19,494 ) $ (29,109 ) $ (9,615 ) $ — $ (19,494 ) $ (29,109 ) (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) | 9 Months Ended |
Sep. 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 nine months ended September 30, 2019 : Beginning balance December 31, 2018 $ 2,608 Contingent earn-out obligations associated with acquisitions 19,731 Remeasurement of fair value for contingent earn-out obligations (2,179 ) Payments on contingent earn-out obligations (327 ) Ending balance September 30, 2019 $ 19,833 |
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 $ 5,238 Property and equipment 3,607 Intangible and other long-term assets 15,848 Goodwill 77,238 Current liabilities (3,360 ) Long-term liabilities (1,139 ) Noncontrolling interests (1,762 ) $ 95,670 |
Held for Sale and Discontinue_2
Held for Sale and Discontinued Operations (Tables) | 9 Months Ended |
Sep. 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 September 30, Nine months ended September 30, 2019 2018 2019 2018 Revenues $ — $ 1,252,909 $ 2,713,059 $ 3,733,270 Expenses 1,996 1,260,814 2,541,783 3,679,747 Valuation adjustment — 98,201 — 98,201 (Loss) income from discontinued operations before taxes (1,996 ) (106,106 ) 171,276 (44,678 ) Loss on sale of discontinued operations before taxes — — (23,022 ) — Income tax expense 4,847 105,633 45,400 103,151 Net (loss) income from discontinued operations, net of tax $ (6,843 ) $ (211,739 ) $ 102,854 $ (147,829 ) The following table presents cash flows of discontinued operations related to DMG: Nine months ended September 30, 2019 2018 Net cash provided by operating activities from discontinued operations $ 97,005 $ 208,570 Net cash used in investing activities from discontinued operations $ (43,442 ) $ (32,860 ) |
Fair value of financial instr_2
Fair value of financial instruments (Tables) | 9 Months Ended |
Sep. 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 September 30, 2019 : Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 37,641 $ 37,641 $ — $ — Interest rate cap agreements $ 20,642 $ — $ 20,642 $ — Liabilities Contingent earn-out obligations $ 19,833 $ — $ — $ 19,833 Temporary equity Noncontrolling interests subject to put provisions $ 1,296,059 $ — $ — $ 1,296,059 |
Segment reporting (Tables)
Segment reporting (Tables) | 9 Months Ended |
Sep. 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 Nine months ended 2019 2018 2019 2018 Segment revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,652,946 $ 2,559,345 $ 7,782,435 $ 7,661,244 Intersegment revenues 32,150 25,424 92,611 63,943 U.S. dialysis and related lab services patient service 2,685,096 2,584,769 7,875,046 7,725,187 Provision for uncollectible accounts (3,977 ) (12,900 ) (19,689 ) (37,108 ) Net U.S. dialysis and related lab services patient 2,681,119 2,571,869 7,855,357 7,688,079 Other revenues (1) : External sources 10,096 4,932 19,989 14,965 Intersegment revenues 212 — 726 — Total U.S. dialysis and related lab services revenues 2,691,427 2,576,801 7,876,072 7,703,044 Other—Ancillary services and strategic initiatives Patient service revenues, net 128,223 112,279 367,951 320,204 Other external sources 116,790 183,674 339,209 624,422 Intersegment revenues 3,483 8,361 10,222 27,748 Total ancillary services and strategic initiatives revenues 248,496 304,314 717,382 972,374 Total net segment revenues 2,939,923 2,881,115 8,593,454 8,675,418 Elimination of intersegment revenues (35,845 ) (33,785 ) (103,559 ) (91,691 ) Consolidated revenues $ 2,904,078 $ 2,847,330 $ 8,489,895 $ 8,583,727 Segment operating margin: U.S. dialysis and related lab services $ 500,742 $ 390,006 $ 1,416,680 $ 1,272,828 Other—Ancillary services and strategic initiatives (97,725 ) (60,132 ) (170,405 ) (64,307 ) Total segment operating margin 403,017 329,874 1,246,275 1,208,521 Reconciliation of segment operating margin to consolidated Corporate administrative support (24,681 ) (40,836 ) (65,546 ) (70,605 ) Consolidated operating income 378,336 289,038 1,180,729 1,137,916 Debt expense (88,589 ) (125,927 ) (351,774 ) (359,135 ) Debt prepayment, refinancing and redemption charges (21,242 ) — (33,402 ) — Other income, net 5,280 4,007 17,863 10,583 Consolidated income from continuing operations before $ 273,785 $ 167,118 $ 813,416 $ 789,364 (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: September 30, 2019 December 31, 2018 Segment assets U.S. dialysis and related lab services (including equity $ 15,997,552 $ 12,333,641 Other—Ancillary services and strategic initiatives (including 1,454,278 1,387,046 DMG—Held for sale (including equity investments of $0 and — 5,389,565 Consolidated assets $ 17,451,830 $ 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 Nine months ended 2019 2018 2019 2018 U.S. dialysis and related lab services $ 147,607 $ 138,669 $ 433,008 $ 411,697 Other — Ancillary services and strategic initiatives 8,308 7,331 23,677 24,181 $ 155,915 $ 146,000 $ 456,685 $ 435,878 |
Summary of Expenditures for Property and Equipment by Reportable Segment | Expenditures for property and equipment by reportable segment were as follows: Three months ended Nine months ended 2019 2018 2019 2018 U.S. dialysis and related lab services $ 157,721 $ 214,728 $ 477,533 $ 603,186 Other—Ancillary services and strategic initiatives 15,544 5,019 31,184 37,191 DMG—Held for sale — 11,935 38,466 65,282 $ 173,265 $ 231,682 $ 547,183 $ 705,659 |
Changes in DaVita Inc.'s owne_2
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries (Tables) | 9 Months Ended |
Sep. 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 September 30, Nine months ended 2019 2018 2019 2018 Net income (loss) attributable to DaVita Inc. $ 143,270 $ (136,796 ) $ 566,110 $ 309,166 Changes in paid-in capital for: Sales of noncontrolling interests — — — 79 Purchases of noncontrolling interests (202 ) (5,285 ) 10,732 (17,482 ) Net transfers to noncontrolling interests (202 ) (5,285 ) 10,732 (17,403 ) Net income (loss) attributable to DaVita Inc., net of transfers to noncontrolling interests $ 143,068 $ (142,081 ) $ 576,842 $ 291,763 |
Condensed Consolidating finan_2
Condensed Consolidating financial statements (Tables) | 9 Months Ended |
Sep. 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 September 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 1,761,235 $ 1,087,531 $ (67,597 ) $ 2,781,169 Provision for uncollectible accounts — (2,728 ) (1,249 ) — (3,977 ) Net patient service revenues — 1,758,507 1,086,282 (67,597 ) 2,777,192 Other revenues 204,183 140,956 83,860 (302,113 ) 126,886 Total net revenues 204,183 1,899,463 1,170,142 (369,710 ) 2,904,078 Operating expenses 11,046 1,823,752 1,060,654 (369,710 ) 2,525,742 Operating income 193,137 75,711 109,488 — 378,336 Debt expense (110,712 ) (43,535 ) (14,206 ) 58,622 (109,831 ) Other income, net 51,150 2,994 9,758 (58,622 ) 5,280 Income tax expense 33,364 28,320 3,570 — 65,254 Equity earnings in subsidiaries 43,059 123,186 — (166,245 ) — Net income from continuing operations 143,270 130,036 101,470 (166,245 ) 208,531 Net loss from discontinued operations, net of tax — — (6,843 ) — (6,843 ) Net income 143,270 130,036 94,627 (166,245 ) 201,688 Less: Net income attributable to noncontrolling interests — — — (58,418 ) (58,418 ) Net income attributable to DaVita Inc. $ 143,270 $ 130,036 $ 94,627 $ (224,663 ) $ 143,270 For the three months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Patient service revenues $ — $ 1,699,109 $ 1,028,548 $ (56,956 ) $ 2,670,701 Provision for uncollectible accounts — (9,246 ) (2,731 ) — (11,977 ) Net patient service revenues — 1,689,863 1,025,817 (56,956 ) 2,658,724 Other revenues 207,968 127,269 136,448 (283,079 ) 188,606 Total net revenues 207,968 1,817,132 1,162,265 (340,035 ) 2,847,330 Operating expenses and charges 205,324 1,649,128 1,043,875 (340,035 ) 2,558,292 Operating income 2,644 168,004 118,390 — 289,038 Debt expense (127,353 ) (50,254 ) (10,570 ) 62,250 (125,927 ) Other income, net 106,148 603 7,719 (110,463 ) 4,007 Income tax (benefit) expense (3,536 ) 43,583 12,000 — 52,047 Equity earnings in subsidiaries (121,771 ) 60,448 — 61,323 — Net (loss) income from continuing operations (136,796 ) 135,218 103,539 13,110 115,071 Net loss from discontinued operations, net of tax — — (259,952 ) 48,213 (211,739 ) Net (loss) income (136,796 ) 135,218 (156,413 ) 61,323 (96,668 ) Less: Net income attributable to noncontrolling interests — — — (40,128 ) (40,128 ) Net (loss) income attributable to DaVita Inc. $ (136,796 ) $ 135,218 $ (156,413 ) $ 21,195 $ (136,796 ) For the nine months ended September 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 5,181,017 $ 3,164,726 $ (195,357 ) $ 8,150,386 Provision for uncollectible accounts — (13,530 ) (6,159 ) — (19,689 ) Net patient service revenues — 5,167,487 3,158,567 (195,357 ) 8,130,697 Other revenues 600,318 438,058 130,345 (809,523 ) 359,198 Total net revenues 600,318 5,605,545 3,288,912 (1,004,880 ) 8,489,895 Operating expenses and charges 315,169 5,106,307 2,892,570 (1,004,880 ) 7,309,166 Operating income 285,149 499,238 396,342 — 1,180,729 Debt expense (389,203 ) (145,110 ) (39,807 ) 188,944 (385,176 ) Other income, net 263,407 4,332 31,800 (281,676 ) 17,863 Income tax expense 41,017 122,633 34,288 — 197,938 Equity earnings in subsidiaries 447,774 318,431 — (766,205 ) — Net income from continuing operations 566,110 554,258 354,047 (858,937 ) 615,478 Net income from discontinued operations, net of tax — — 10,122 92,732 102,854 Net income 566,110 554,258 364,169 (766,205 ) 718,332 Less: Net income attributable to noncontrolling interests — — — (152,222 ) (152,222 ) Net income attributable to DaVita Inc. $ 566,110 $ 554,258 $ 364,169 $ (918,427 ) $ 566,110 For the nine months ended September 30, 2018 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 5,100,487 $ 3,039,056 $ (159,365 ) $ 7,980,178 Provision for uncollectible accounts — (26,430 ) (9,408 ) — (35,838 ) Net patient service revenues — 5,074,057 3,029,648 (159,365 ) 7,944,340 Other revenues 608,850 355,055 512,025 (836,543 ) 639,387 Total net revenues 608,850 5,429,112 3,541,673 (995,908 ) 8,583,727 Operating expenses and charges 484,329 4,949,070 3,008,320 (995,908 ) 7,445,811 Operating income 124,521 480,042 533,353 — 1,137,916 Debt expense (362,501 ) (151,373 ) (30,660 ) 185,399 (359,135 ) Other income, net 315,573 2,864 20,981 (328,835 ) 10,583 Income tax expense 24,108 112,193 70,351 — 206,652 Equity earnings in subsidiaries 255,681 328,042 — (583,723 ) — Net income from continuing operations 309,166 547,382 453,323 (727,159 ) 582,712 Net loss from discontinued operations, net of tax — — (291,265 ) 143,436 (147,829 ) Net income 309,166 547,382 162,058 (583,723 ) 434,883 Less: Net income attributable to noncontrolling interests — — — (125,717 ) (125,717 ) Net income attributable to DaVita Inc. $ 309,166 $ 547,382 $ 162,058 $ (709,440 ) $ 309,166 Condensed Consolidating Statements of Income For the nine months ended September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Patient service operating revenues $ 8,150,386 $ — $ — $ 8,150,386 Provision for uncollectible accounts (19,689 ) — — (19,689 ) Net patient service operating revenues 8,130,697 — — 8,130,697 Other revenues 359,198 — — 359,198 Total net operating revenues 8,489,895 — — 8,489,895 Operating expenses 7,309,166 — — 7,309,166 Operating income 1,180,729 — — 1,180,729 Debt expense (385,176 ) — — (385,176 ) Other income 17,863 — — 17,863 Income tax expense 197,938 — — 197,938 Net income from continuing operations 615,478 — — 615,478 Net income from discontinued operations, net of tax 102,854 12,706 249 89,899 Net income 718,332 12,706 249 705,377 Less: Net income attributable to noncontrolling interests (152,222 ) (1,255 ) — (150,967 ) Net income attributable to DaVita Inc. $ 566,110 $ 11,451 $ 249 $ 554,410 (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 September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 143,270 $ 130,036 $ 94,627 $ (166,245 ) $ 201,688 Other comprehensive income (loss) 509 — (44,502 ) — (43,993 ) Total comprehensive income 143,779 130,036 50,125 (166,245 ) 157,695 Less: Comprehensive income attributable to noncontrolling interest — — — (58,418 ) (58,418 ) Comprehensive income attributable to DaVita Inc. $ 143,779 $ 130,036 $ 50,125 $ (224,663 ) $ 99,277 For the three months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net (loss) income $ (136,796 ) $ 135,218 $ (156,413 ) $ 61,323 $ (96,668 ) Other comprehensive income (loss) 1,643 — (8,827 ) — (7,184 ) Total comprehensive (loss) income (135,153 ) 135,218 (165,240 ) 61,323 (103,852 ) Less: Comprehensive income attributable to noncontrolling interest — — — (40,128 ) (40,128 ) Comprehensive (loss) income attributable to DaVita Inc. $ (135,153 ) $ 135,218 $ (165,240 ) $ 21,195 $ (143,980 ) For the nine months ended September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 566,110 $ 554,258 $ 364,169 $ (766,205 ) $ 718,332 Other comprehensive income (loss) 3,110 — (45,790 ) — (42,680 ) Total comprehensive income 569,220 554,258 318,379 (766,205 ) 675,652 Less: Comprehensive income attributable to noncontrolling interest — — — (152,222 ) (152,222 ) Comprehensive income attributable to DaVita Inc. $ 569,220 $ 554,258 $ 318,379 $ (918,427 ) $ 523,430 For the nine months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 309,166 $ 547,382 $ 162,058 $ (583,723 ) $ 434,883 Other comprehensive income (loss) 5,499 — (39,475 ) — (33,976 ) Total comprehensive income 314,665 547,382 122,583 (583,723 ) 400,907 Less: Comprehensive income attributable to noncontrolling interest — — — (125,717 ) (125,717 ) Comprehensive income attributable to DaVita Inc. $ 314,665 $ 547,382 $ 122,583 $ (709,440 ) $ 275,190 Condensed Consolidating Statements of Comprehensive Income For the nine months ended September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Net income $ 718,332 $ 12,706 $ 249 $ 705,377 Other comprehensive income (42,680 ) — — (42,680 ) Total comprehensive income 675,652 12,706 249 662,697 Less: Comprehensive income attributable to the noncontrolling (152,222 ) (1,255 ) — (150,967 ) Comprehensive income attributable to DaVita Inc. $ 523,430 $ 11,451 $ 249 $ 511,730 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Balance Sheets | Condensed Consolidating Balance Sheets As of September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 831,514 $ 213,635 $ 208,107 $ — $ 1,253,256 Restricted cash and equivalents — 14,444 89,441 — 103,885 Accounts receivable, net — 1,221,169 680,056 — 1,901,225 Other current assets 161,548 455,616 123,188 — 740,352 Total current assets 993,062 1,904,864 1,100,792 — 3,998,718 Property and equipment, net 515,952 1,576,140 1,327,146 — 3,419,238 Operating lease right-of-use assets 103,621 1,592,472 1,085,195 — 2,781,288 Intangible assets, net 85 34,493 83,088 — 117,666 Investments in and advances to affiliates, net 10,465,104 7,110,581 3,074,784 (20,650,469 ) — Other long-term assets and investments 96,953 91,115 181,193 — 369,261 Goodwill — 4,818,001 1,947,658 — 6,765,659 Total assets $ 12,174,777 $ 17,127,666 $ 8,799,856 $ (20,650,469 ) $ 17,451,830 Current liabilities $ 313,934 $ 1,233,054 $ 659,652 $ — $ 2,206,640 Intercompany liabilities, net 922,571 3,074,785 2,572,810 (6,570,166 ) — Long-term operating leases liabilities 131,743 1,508,343 1,042,039 — 2,682,125 Long-term debt and other long-term liabilities 7,746,653 664,470 343,360 — 8,754,483 Noncontrolling interests subject to put provisions 741,300 — — 554,759 1,296,059 Total DaVita Inc. shareholders' equity 2,318,576 10,647,014 3,433,289 (14,080,303 ) 2,318,576 Noncontrolling interests not subject to put — — 748,706 (554,759 ) 193,947 Total equity 2,318,576 10,647,014 4,181,995 (14,635,062 ) 2,512,523 Total liabilities and equity $ 12,174,777 $ 17,127,666 $ 8,799,856 $ (20,650,469 ) $ 17,451,830 As of December 31, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 60,653 $ 1,232 $ 261,153 $ — $ 323,038 Restricted cash and equivalents 1,005 12,048 79,329 — 92,382 Accounts receivable, net — 1,204,122 654,486 — 1,858,608 Other current assets 37,185 565,974 157,407 — 760,566 Current assets held for sale — — 5,389,565 — 5,389,565 Total current assets 98,843 1,783,376 6,541,940 — 8,424,159 Property and equipment, net 491,462 1,584,321 1,317,886 — 3,393,669 Intangible assets, net 153 42,896 75,797 — 118,846 Investments in and advances to affiliates, net 13,522,198 6,196,801 2,498,545 (22,217,544 ) — Other long-term assets and investments 53,385 90,037 188,196 — 331,618 Goodwill — 4,806,939 2,035,021 — 6,841,960 Total assets $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252 Current liabilities $ 1,945,943 $ 1,217,526 $ 483,933 $ — $ 3,647,402 Current liabilities held for sale — — 1,243,759 — 1,243,759 Intercompany liabilities, net — 2,498,545 6,161,292 (8,659,837 ) — Long-term debt and other long-term liabilities 7,918,581 687,443 580,028 — 9,186,052 Noncontrolling interests subject to put provisions 598,075 — — 526,566 1,124,641 Total DaVita Inc. shareholders' equity 3,703,442 10,100,856 3,456,851 (13,557,707 ) 3,703,442 Noncontrolling interests not subject to put — — 731,522 (526,566 ) 204,956 Total equity 3,703,442 10,100,856 4,188,373 (14,084,273 ) 3,908,398 Total liabilities and equity $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252 Condensed Consolidating Balance Sheets As of September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash and cash equivalents $ 1,253,256 $ — $ — $ 1,253,256 Restricted cash and equivalents 103,885 — — 103,885 Accounts receivable, net 1,901,225 — — 1,901,225 Other current assets 740,352 — — 740,352 Total current assets 3,998,718 — — 3,998,718 Property and equipment, net 3,419,238 — — 3,419,238 Operating lease right-of-use assets 2,781,288 — — 2,781,288 Amortizable intangibles, net 117,666 — — 117,666 Other long-term assets 369,261 — — 369,261 Goodwill 6,765,659 — — 6,765,659 Total assets $ 17,451,830 $ — $ — $ 17,451,830 Current liabilities $ 2,206,640 $ — $ — $ 2,206,640 Long-term operating leases liabilities 2,682,125 — — 2,682,125 Long-term debt and other long-term liabilities 8,754,483 — — 8,754,483 Noncontrolling interests subject to put provisions 1,296,059 — — 1,296,059 Total DaVita Inc. shareholders’ equity 2,318,576 — — 2,318,576 Noncontrolling interests not subject to put provisions 193,947 — — 193,947 Shareholders’ equity 2,512,523 — — 2,512,523 Total liabilities and shareholder’s equity $ 17,451,830 $ — $ — $ 17,451,830 (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 nine months ended September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows provided by operating activities: Net income $ 566,110 $ 554,258 $ 364,169 $ (766,205 ) $ 718,332 Changes in operating assets and liabilities and non-cash (336,223 ) (74,600 ) 318,111 766,205 673,493 Net cash provided by operating activities 229,887 479,658 682,280 — 1,391,825 Cash flows provided by (used in) investing activities: Additions of property and equipment (106,476 ) (218,839 ) (221,868 ) — (547,183 ) Acquisitions — (11,832 ) (65,516 ) — (77,348 ) Proceeds (purchases) from asset and business sales 3,824,516 (244 ) 39,347 — 3,863,619 purchases from investment sales and other items, net (94,322 ) (7,474 ) (3,267 ) — (105,063 ) Net cash provided by (used in) investing activities 3,623,718 (238,389 ) (251,304 ) — 3,134,025 Cash flows used in financing activities: Long-term debt and related financing costs, net (2,028,954 ) (8,025 ) (13,033 ) — (2,050,012 ) Intercompany borrowings (payments) 785,450 (14,854 ) (770,596 ) — — Other items (1,840,245 ) (3,591 ) (109,916 ) — (1,953,752 ) Net cash used in financing activities (3,083,749 ) (26,470 ) (893,545 ) — (4,003,764 ) Effect of exchange rate changes on cash, cash — — (4,178 ) — (4,178 ) Net increase (decrease) in cash, cash equivalents and 769,856 214,799 (466,747 ) — 517,908 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 769,856 214,799 (42,934 ) — 941,721 Cash, cash equivalents and restricted cash of continuing 61,658 13,280 340,482 — 415,420 Cash, cash equivalents and restricted cash of continuing $ 831,514 $ 228,079 $ 297,548 $ — $ 1,357,141 For the nine months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows provided by operating activities: Net income $ 309,166 $ 547,382 $ 162,058 $ (583,723 ) $ 434,883 Changes in operating assets and liabilities and non-cash (235,558 ) (104,179 ) 703,379 583,723 947,365 Net cash provided by operating activities 73,608 443,203 865,437 — 1,382,248 Cash flows used in investing activities: Additions of property and equipment (124,585 ) (296,028 ) (285,046 ) — (705,659 ) Acquisitions — (5,646 ) (107,880 ) — (113,526 ) Proceeds from asset and business sales — 55,035 80,233 — 135,268 Proceeds (purchases) from investment sales and other items, net 32,345 (2,295 ) (7,452 ) — 22,598 Net cash used in investing activities (92,240 ) (248,934 ) (320,145 ) — (661,319 ) Cash flows provided by (used in) financing activities: Long-term debt and related financing costs, net 866,537 (8,601 ) (12,100 ) — 845,836 Intercompany borrowings (payments) 454,410 (174,148 ) (280,262 ) — — Other items (1,154,921 ) (18,713 ) (95,541 ) — (1,269,175 ) Net cash provided by (used in) financing activities 166,026 (201,462 ) (387,903 ) — (423,339 ) Effect of exchange rate changes on cash, cash — — (5,790 ) — (5,790 ) Net increase (decrease) in cash, cash equivalents and restricted cash 147,394 (7,193 ) 151,599 — 291,800 Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations — — 270,565 — 270,565 Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 147,394 (7,193 ) (118,966 ) — 21,235 Cash, cash equivalents and restricted cash of continuing 150,307 19,963 348,650 — 518,920 Cash, cash equivalents and restricted cash of continuing $ 297,701 $ 12,770 $ 229,684 $ — $ 540,155 Condensed Consolidating Statements of Cash Flows For the nine months ended September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash flows from operating activities: Net income $ 718,332 $ 12,706 $ 249 $ 705,377 Changes in operating and intercompany assets and liabilities and 673,493 (4,607 ) (249 ) 678,349 Net cash provided by operating activities 1,391,825 8,099 — 1,383,726 Cash flows from investing activities: Additions of property and equipment (547,183 ) (846 ) — (546,337 ) Acquisitions (77,348 ) — — (77,348 ) Proceeds from asset and business sales 3,863,619 — — 3,863,619 Investments and other items (105,063 ) (1,882 ) — (103,181 ) Net cash provided by (used in) investing activities 3,134,025 (2,728 ) — 3,136,753 Cash flows from financing activities: Long-term debt (2,050,012 ) — — (2,050,012 ) Intercompany — (247,175 ) — 247,175 Other items (1,953,752 ) — — (1,953,752 ) Net cash used in financing activities (4,003,764 ) (247,175 ) — (3,756,589 ) Effect of exchange rate changes on cash, cash equivalents and (4,178 ) — — (4,178 ) Net increase (decrease) in cash, cash equivalents and restricted cash 517,908 (241,804 ) — 759,712 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 941,721 — — 941,721 Cash, cash equivalents and restricted cash of continuing operations 415,420 — — 415,420 Cash, cash equivalents and restricted cash of continuing operations $ 1,357,141 $ — $ — $ 1,357,141 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Supplemental Data (Tables)
Supplemental Data (Tables) | 9 Months Ended |
Sep. 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 September 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 1,761,235 $ 1,087,531 $ (67,597 ) $ 2,781,169 Provision for uncollectible accounts — (2,728 ) (1,249 ) — (3,977 ) Net patient service revenues — 1,758,507 1,086,282 (67,597 ) 2,777,192 Other revenues 204,183 140,956 83,860 (302,113 ) 126,886 Total net revenues 204,183 1,899,463 1,170,142 (369,710 ) 2,904,078 Operating expenses 11,046 1,823,752 1,060,654 (369,710 ) 2,525,742 Operating income 193,137 75,711 109,488 — 378,336 Debt expense (110,712 ) (43,535 ) (14,206 ) 58,622 (109,831 ) Other income, net 51,150 2,994 9,758 (58,622 ) 5,280 Income tax expense 33,364 28,320 3,570 — 65,254 Equity earnings in subsidiaries 43,059 123,186 — (166,245 ) — Net income from continuing operations 143,270 130,036 101,470 (166,245 ) 208,531 Net loss from discontinued operations, net of tax — — (6,843 ) — (6,843 ) Net income 143,270 130,036 94,627 (166,245 ) 201,688 Less: Net income attributable to noncontrolling interests — — — (58,418 ) (58,418 ) Net income attributable to DaVita Inc. $ 143,270 $ 130,036 $ 94,627 $ (224,663 ) $ 143,270 For the three months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Patient service revenues $ — $ 1,699,109 $ 1,028,548 $ (56,956 ) $ 2,670,701 Provision for uncollectible accounts — (9,246 ) (2,731 ) — (11,977 ) Net patient service revenues — 1,689,863 1,025,817 (56,956 ) 2,658,724 Other revenues 207,968 127,269 136,448 (283,079 ) 188,606 Total net revenues 207,968 1,817,132 1,162,265 (340,035 ) 2,847,330 Operating expenses and charges 205,324 1,649,128 1,043,875 (340,035 ) 2,558,292 Operating income 2,644 168,004 118,390 — 289,038 Debt expense (127,353 ) (50,254 ) (10,570 ) 62,250 (125,927 ) Other income, net 106,148 603 7,719 (110,463 ) 4,007 Income tax (benefit) expense (3,536 ) 43,583 12,000 — 52,047 Equity earnings in subsidiaries (121,771 ) 60,448 — 61,323 — Net (loss) income from continuing operations (136,796 ) 135,218 103,539 13,110 115,071 Net loss from discontinued operations, net of tax — — (259,952 ) 48,213 (211,739 ) Net (loss) income (136,796 ) 135,218 (156,413 ) 61,323 (96,668 ) Less: Net income attributable to noncontrolling interests — — — (40,128 ) (40,128 ) Net (loss) income attributable to DaVita Inc. $ (136,796 ) $ 135,218 $ (156,413 ) $ 21,195 $ (136,796 ) For the nine months ended September 30, 2019 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 5,181,017 $ 3,164,726 $ (195,357 ) $ 8,150,386 Provision for uncollectible accounts — (13,530 ) (6,159 ) — (19,689 ) Net patient service revenues — 5,167,487 3,158,567 (195,357 ) 8,130,697 Other revenues 600,318 438,058 130,345 (809,523 ) 359,198 Total net revenues 600,318 5,605,545 3,288,912 (1,004,880 ) 8,489,895 Operating expenses and charges 315,169 5,106,307 2,892,570 (1,004,880 ) 7,309,166 Operating income 285,149 499,238 396,342 — 1,180,729 Debt expense (389,203 ) (145,110 ) (39,807 ) 188,944 (385,176 ) Other income, net 263,407 4,332 31,800 (281,676 ) 17,863 Income tax expense 41,017 122,633 34,288 — 197,938 Equity earnings in subsidiaries 447,774 318,431 — (766,205 ) — Net income from continuing operations 566,110 554,258 354,047 (858,937 ) 615,478 Net income from discontinued operations, net of tax — — 10,122 92,732 102,854 Net income 566,110 554,258 364,169 (766,205 ) 718,332 Less: Net income attributable to noncontrolling interests — — — (152,222 ) (152,222 ) Net income attributable to DaVita Inc. $ 566,110 $ 554,258 $ 364,169 $ (918,427 ) $ 566,110 For the nine months ended September 30, 2018 DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total Patient services revenues $ — $ 5,100,487 $ 3,039,056 $ (159,365 ) $ 7,980,178 Provision for uncollectible accounts — (26,430 ) (9,408 ) — (35,838 ) Net patient service revenues — 5,074,057 3,029,648 (159,365 ) 7,944,340 Other revenues 608,850 355,055 512,025 (836,543 ) 639,387 Total net revenues 608,850 5,429,112 3,541,673 (995,908 ) 8,583,727 Operating expenses and charges 484,329 4,949,070 3,008,320 (995,908 ) 7,445,811 Operating income 124,521 480,042 533,353 — 1,137,916 Debt expense (362,501 ) (151,373 ) (30,660 ) 185,399 (359,135 ) Other income, net 315,573 2,864 20,981 (328,835 ) 10,583 Income tax expense 24,108 112,193 70,351 — 206,652 Equity earnings in subsidiaries 255,681 328,042 — (583,723 ) — Net income from continuing operations 309,166 547,382 453,323 (727,159 ) 582,712 Net loss from discontinued operations, net of tax — — (291,265 ) 143,436 (147,829 ) Net income 309,166 547,382 162,058 (583,723 ) 434,883 Less: Net income attributable to noncontrolling interests — — — (125,717 ) (125,717 ) Net income attributable to DaVita Inc. $ 309,166 $ 547,382 $ 162,058 $ (709,440 ) $ 309,166 Condensed Consolidating Statements of Income For the nine months ended September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Patient service operating revenues $ 8,150,386 $ — $ — $ 8,150,386 Provision for uncollectible accounts (19,689 ) — — (19,689 ) Net patient service operating revenues 8,130,697 — — 8,130,697 Other revenues 359,198 — — 359,198 Total net operating revenues 8,489,895 — — 8,489,895 Operating expenses 7,309,166 — — 7,309,166 Operating income 1,180,729 — — 1,180,729 Debt expense (385,176 ) — — (385,176 ) Other income 17,863 — — 17,863 Income tax expense 197,938 — — 197,938 Net income from continuing operations 615,478 — — 615,478 Net income from discontinued operations, net of tax 102,854 12,706 249 89,899 Net income 718,332 12,706 249 705,377 Less: Net income attributable to noncontrolling interests (152,222 ) (1,255 ) — (150,967 ) Net income attributable to DaVita Inc. $ 566,110 $ 11,451 $ 249 $ 554,410 (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 September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 143,270 $ 130,036 $ 94,627 $ (166,245 ) $ 201,688 Other comprehensive income (loss) 509 — (44,502 ) — (43,993 ) Total comprehensive income 143,779 130,036 50,125 (166,245 ) 157,695 Less: Comprehensive income attributable to noncontrolling interest — — — (58,418 ) (58,418 ) Comprehensive income attributable to DaVita Inc. $ 143,779 $ 130,036 $ 50,125 $ (224,663 ) $ 99,277 For the three months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net (loss) income $ (136,796 ) $ 135,218 $ (156,413 ) $ 61,323 $ (96,668 ) Other comprehensive income (loss) 1,643 — (8,827 ) — (7,184 ) Total comprehensive (loss) income (135,153 ) 135,218 (165,240 ) 61,323 (103,852 ) Less: Comprehensive income attributable to noncontrolling interest — — — (40,128 ) (40,128 ) Comprehensive (loss) income attributable to DaVita Inc. $ (135,153 ) $ 135,218 $ (165,240 ) $ 21,195 $ (143,980 ) For the nine months ended September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 566,110 $ 554,258 $ 364,169 $ (766,205 ) $ 718,332 Other comprehensive income (loss) 3,110 — (45,790 ) — (42,680 ) Total comprehensive income 569,220 554,258 318,379 (766,205 ) 675,652 Less: Comprehensive income attributable to noncontrolling interest — — — (152,222 ) (152,222 ) Comprehensive income attributable to DaVita Inc. $ 569,220 $ 554,258 $ 318,379 $ (918,427 ) $ 523,430 For the nine months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Net income $ 309,166 $ 547,382 $ 162,058 $ (583,723 ) $ 434,883 Other comprehensive income (loss) 5,499 — (39,475 ) — (33,976 ) Total comprehensive income 314,665 547,382 122,583 (583,723 ) 400,907 Less: Comprehensive income attributable to noncontrolling interest — — — (125,717 ) (125,717 ) Comprehensive income attributable to DaVita Inc. $ 314,665 $ 547,382 $ 122,583 $ (709,440 ) $ 275,190 Condensed Consolidating Statements of Comprehensive Income For the nine months ended September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Net income $ 718,332 $ 12,706 $ 249 $ 705,377 Other comprehensive income (42,680 ) — — (42,680 ) Total comprehensive income 675,652 12,706 249 662,697 Less: Comprehensive income attributable to the noncontrolling (152,222 ) (1,255 ) — (150,967 ) Comprehensive income attributable to DaVita Inc. $ 523,430 $ 11,451 $ 249 $ 511,730 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Balance Sheets | Condensed Consolidating Balance Sheets As of September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 831,514 $ 213,635 $ 208,107 $ — $ 1,253,256 Restricted cash and equivalents — 14,444 89,441 — 103,885 Accounts receivable, net — 1,221,169 680,056 — 1,901,225 Other current assets 161,548 455,616 123,188 — 740,352 Total current assets 993,062 1,904,864 1,100,792 — 3,998,718 Property and equipment, net 515,952 1,576,140 1,327,146 — 3,419,238 Operating lease right-of-use assets 103,621 1,592,472 1,085,195 — 2,781,288 Intangible assets, net 85 34,493 83,088 — 117,666 Investments in and advances to affiliates, net 10,465,104 7,110,581 3,074,784 (20,650,469 ) — Other long-term assets and investments 96,953 91,115 181,193 — 369,261 Goodwill — 4,818,001 1,947,658 — 6,765,659 Total assets $ 12,174,777 $ 17,127,666 $ 8,799,856 $ (20,650,469 ) $ 17,451,830 Current liabilities $ 313,934 $ 1,233,054 $ 659,652 $ — $ 2,206,640 Intercompany liabilities, net 922,571 3,074,785 2,572,810 (6,570,166 ) — Long-term operating leases liabilities 131,743 1,508,343 1,042,039 — 2,682,125 Long-term debt and other long-term liabilities 7,746,653 664,470 343,360 — 8,754,483 Noncontrolling interests subject to put provisions 741,300 — — 554,759 1,296,059 Total DaVita Inc. shareholders' equity 2,318,576 10,647,014 3,433,289 (14,080,303 ) 2,318,576 Noncontrolling interests not subject to put — — 748,706 (554,759 ) 193,947 Total equity 2,318,576 10,647,014 4,181,995 (14,635,062 ) 2,512,523 Total liabilities and equity $ 12,174,777 $ 17,127,666 $ 8,799,856 $ (20,650,469 ) $ 17,451,830 As of December 31, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash and cash equivalents $ 60,653 $ 1,232 $ 261,153 $ — $ 323,038 Restricted cash and equivalents 1,005 12,048 79,329 — 92,382 Accounts receivable, net — 1,204,122 654,486 — 1,858,608 Other current assets 37,185 565,974 157,407 — 760,566 Current assets held for sale — — 5,389,565 — 5,389,565 Total current assets 98,843 1,783,376 6,541,940 — 8,424,159 Property and equipment, net 491,462 1,584,321 1,317,886 — 3,393,669 Intangible assets, net 153 42,896 75,797 — 118,846 Investments in and advances to affiliates, net 13,522,198 6,196,801 2,498,545 (22,217,544 ) — Other long-term assets and investments 53,385 90,037 188,196 — 331,618 Goodwill — 4,806,939 2,035,021 — 6,841,960 Total assets $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252 Current liabilities $ 1,945,943 $ 1,217,526 $ 483,933 $ — $ 3,647,402 Current liabilities held for sale — — 1,243,759 — 1,243,759 Intercompany liabilities, net — 2,498,545 6,161,292 (8,659,837 ) — Long-term debt and other long-term liabilities 7,918,581 687,443 580,028 — 9,186,052 Noncontrolling interests subject to put provisions 598,075 — — 526,566 1,124,641 Total DaVita Inc. shareholders' equity 3,703,442 10,100,856 3,456,851 (13,557,707 ) 3,703,442 Noncontrolling interests not subject to put — — 731,522 (526,566 ) 204,956 Total equity 3,703,442 10,100,856 4,188,373 (14,084,273 ) 3,908,398 Total liabilities and equity $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252 Condensed Consolidating Balance Sheets As of September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash and cash equivalents $ 1,253,256 $ — $ — $ 1,253,256 Restricted cash and equivalents 103,885 — — 103,885 Accounts receivable, net 1,901,225 — — 1,901,225 Other current assets 740,352 — — 740,352 Total current assets 3,998,718 — — 3,998,718 Property and equipment, net 3,419,238 — — 3,419,238 Operating lease right-of-use assets 2,781,288 — — 2,781,288 Amortizable intangibles, net 117,666 — — 117,666 Other long-term assets 369,261 — — 369,261 Goodwill 6,765,659 — — 6,765,659 Total assets $ 17,451,830 $ — $ — $ 17,451,830 Current liabilities $ 2,206,640 $ — $ — $ 2,206,640 Long-term operating leases liabilities 2,682,125 — — 2,682,125 Long-term debt and other long-term liabilities 8,754,483 — — 8,754,483 Noncontrolling interests subject to put provisions 1,296,059 — — 1,296,059 Total DaVita Inc. shareholders’ equity 2,318,576 — — 2,318,576 Noncontrolling interests not subject to put provisions 193,947 — — 193,947 Shareholders’ equity 2,512,523 — — 2,512,523 Total liabilities and shareholder’s equity $ 17,451,830 $ — $ — $ 17,451,830 (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 nine months ended September 30, 2019 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows provided by operating activities: Net income $ 566,110 $ 554,258 $ 364,169 $ (766,205 ) $ 718,332 Changes in operating assets and liabilities and non-cash (336,223 ) (74,600 ) 318,111 766,205 673,493 Net cash provided by operating activities 229,887 479,658 682,280 — 1,391,825 Cash flows provided by (used in) investing activities: Additions of property and equipment (106,476 ) (218,839 ) (221,868 ) — (547,183 ) Acquisitions — (11,832 ) (65,516 ) — (77,348 ) Proceeds (purchases) from asset and business sales 3,824,516 (244 ) 39,347 — 3,863,619 purchases from investment sales and other items, net (94,322 ) (7,474 ) (3,267 ) — (105,063 ) Net cash provided by (used in) investing activities 3,623,718 (238,389 ) (251,304 ) — 3,134,025 Cash flows used in financing activities: Long-term debt and related financing costs, net (2,028,954 ) (8,025 ) (13,033 ) — (2,050,012 ) Intercompany borrowings (payments) 785,450 (14,854 ) (770,596 ) — — Other items (1,840,245 ) (3,591 ) (109,916 ) — (1,953,752 ) Net cash used in financing activities (3,083,749 ) (26,470 ) (893,545 ) — (4,003,764 ) Effect of exchange rate changes on cash, cash — — (4,178 ) — (4,178 ) Net increase (decrease) in cash, cash equivalents and 769,856 214,799 (466,747 ) — 517,908 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 769,856 214,799 (42,934 ) — 941,721 Cash, cash equivalents and restricted cash of continuing 61,658 13,280 340,482 — 415,420 Cash, cash equivalents and restricted cash of continuing $ 831,514 $ 228,079 $ 297,548 $ — $ 1,357,141 For the nine months ended September 30, 2018 DaVita Inc. Guarantor Non- Consolidating Consolidated Cash flows provided by operating activities: Net income $ 309,166 $ 547,382 $ 162,058 $ (583,723 ) $ 434,883 Changes in operating assets and liabilities and non-cash (235,558 ) (104,179 ) 703,379 583,723 947,365 Net cash provided by operating activities 73,608 443,203 865,437 — 1,382,248 Cash flows used in investing activities: Additions of property and equipment (124,585 ) (296,028 ) (285,046 ) — (705,659 ) Acquisitions — (5,646 ) (107,880 ) — (113,526 ) Proceeds from asset and business sales — 55,035 80,233 — 135,268 Proceeds (purchases) from investment sales and other items, net 32,345 (2,295 ) (7,452 ) — 22,598 Net cash used in investing activities (92,240 ) (248,934 ) (320,145 ) — (661,319 ) Cash flows provided by (used in) financing activities: Long-term debt and related financing costs, net 866,537 (8,601 ) (12,100 ) — 845,836 Intercompany borrowings (payments) 454,410 (174,148 ) (280,262 ) — — Other items (1,154,921 ) (18,713 ) (95,541 ) — (1,269,175 ) Net cash provided by (used in) financing activities 166,026 (201,462 ) (387,903 ) — (423,339 ) Effect of exchange rate changes on cash, cash — — (5,790 ) — (5,790 ) Net increase (decrease) in cash, cash equivalents and restricted cash 147,394 (7,193 ) 151,599 — 291,800 Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations — — 270,565 — 270,565 Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 147,394 (7,193 ) (118,966 ) — 21,235 Cash, cash equivalents and restricted cash of continuing 150,307 19,963 348,650 — 518,920 Cash, cash equivalents and restricted cash of continuing $ 297,701 $ 12,770 $ 229,684 $ — $ 540,155 Condensed Consolidating Statements of Cash Flows For the nine months ended September 30, 2019 Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) Cash flows from operating activities: Net income $ 718,332 $ 12,706 $ 249 $ 705,377 Changes in operating and intercompany assets and liabilities and 673,493 (4,607 ) (249 ) 678,349 Net cash provided by operating activities 1,391,825 8,099 — 1,383,726 Cash flows from investing activities: Additions of property and equipment (547,183 ) (846 ) — (546,337 ) Acquisitions (77,348 ) — — (77,348 ) Proceeds from asset and business sales 3,863,619 — — 3,863,619 Investments and other items (105,063 ) (1,882 ) — (103,181 ) Net cash provided by (used in) investing activities 3,134,025 (2,728 ) — 3,136,753 Cash flows from financing activities: Long-term debt (2,050,012 ) — — (2,050,012 ) Intercompany — (247,175 ) — 247,175 Other items (1,953,752 ) — — (1,953,752 ) Net cash used in financing activities (4,003,764 ) (247,175 ) — (3,756,589 ) Effect of exchange rate changes on cash, cash equivalents and (4,178 ) — — (4,178 ) Net increase (decrease) in cash, cash equivalents and restricted cash 517,908 (241,804 ) — 759,712 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 941,721 — — 941,721 Cash, cash equivalents and restricted cash of continuing operations 415,420 — — 415,420 Cash, cash equivalents and restricted cash of continuing operations $ 1,357,141 $ — $ — $ 1,357,141 (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 | 9 Months Ended | |||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | Dec. 31, 2018 | |
Revenue, Initial Application Period Cumulative Effect Transition [Line Items] | |||||
Accounts Receivable, Allowance for Credit Loss | $ 15,090 | $ 15,090 | $ 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 | $ (4,138) | $ 1,246 | $ 35,658 | $ 77,473 | |
Contract With Customer Performance Obligation Not Substantially Completed | $ 36,000 |
Revenue Recognition Segment R_2
Revenue Recognition Segment Revenue by Payor (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | $ 2,781,169 | $ 2,670,701 | $ 8,150,386 | $ 7,980,178 |
Other revenues | 126,886 | 188,606 | 359,198 | 639,387 |
Total revenues | 2,904,078 | 2,847,330 | 8,489,895 | 8,583,727 |
Intersegment Elimination | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | (35,845) | (33,785) | (103,559) | (91,691) |
Medicare and Medicare Advantage | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 1,558,890 | 1,513,191 | 4,572,599 | 4,524,449 |
Other revenues | 65,759 | 130,746 | 191,472 | 427,532 |
Medicaid and Managed Medicaid | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 176,292 | 159,165 | 490,723 | 466,948 |
Other revenues | 227 | 12,042 | 327 | 43,991 |
Other Government Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 207,931 | 193,958 | 597,866 | 580,548 |
Commercial Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 866,229 | 817,834 | 2,562,120 | 2,436,338 |
Other revenues | 33,503 | 20,205 | 98,428 | 77,633 |
Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 31,092 | 33,974 | 79,919 | 117,979 |
U.S. dialysis and related lab services | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | 2,659,065 | 2,551,377 | 7,782,735 | 7,639,101 |
U.S. dialysis and related lab services | Intersegment Elimination | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | (32,362) | (25,424) | (93,337) | (63,943) |
U.S. dialysis and related lab services | Medicare and Medicare Advantage | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 1,558,890 | 1,513,191 | 4,572,599 | 4,524,449 |
U.S. dialysis and related lab services | Medicaid and Managed Medicaid | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 176,292 | 159,165 | 490,723 | 466,948 |
U.S. dialysis and related lab services | Other Government Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 116,984 | 113,043 | 333,675 | 330,500 |
U.S. dialysis and related lab services | Commercial Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 828,953 | 786,470 | 2,458,360 | 2,366,182 |
U.S. dialysis and related lab services | Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 10,308 | 4,932 | 20,715 | 14,965 |
Other—Ancillary services and strategic initiatives | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | 245,013 | 295,953 | 707,160 | 944,626 |
Other—Ancillary services and strategic initiatives | Intersegment Elimination | ||||
Disaggregation of Revenue [Line Items] | ||||
Total revenues | (3,483) | (8,361) | (10,222) | (27,748) |
Other—Ancillary services and strategic initiatives | Medicare and Medicare Advantage | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 65,759 | 130,746 | 191,472 | 427,532 |
Other—Ancillary services and strategic initiatives | Medicaid and Managed Medicaid | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | 227 | 12,042 | 327 | 43,991 |
Other—Ancillary services and strategic initiatives | Other Government Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 90,947 | 80,915 | 264,191 | 250,048 |
Other—Ancillary services and strategic initiatives | Commercial Payors | ||||
Disaggregation of Revenue [Line Items] | ||||
Patient service revenues | 37,276 | 31,364 | 103,760 | 70,156 |
Other revenues | 33,503 | 20,205 | 98,428 | 77,633 |
Other—Ancillary services and strategic initiatives | Other | ||||
Disaggregation of Revenue [Line Items] | ||||
Other revenues | $ 20,784 | $ 29,042 | $ 59,204 | $ 103,014 |
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 | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Numerators: | ||||
Net income from continuing operations attributable to DaVita Inc. | $ 150,113 | $ 73,371 | $ 464,590 | $ 463,989 |
Change in noncontrolling interest redemption rights in excess of fair value | 0 | 98 | 0 | 0 |
Net income from continuing operations for earnings per share calculation | 150,113 | 73,469 | 464,590 | 463,989 |
Net income from discontinued operations attributable to DaVita Inc. | (6,843) | (210,167) | 101,520 | (154,823) |
Net income (loss) attributable to DeVita Inc. for earnings per share calculation | $ 143,270 | $ (136,698) | $ 566,110 | $ 309,166 |
Basic: | ||||
Weighted average shares outstanding during period | 150,675,000 | 166,819,000 | 161,147,000 | 173,875,000 |
Weighted average contingently returnable shares held in escrow for the DaVita HealthCare Partners merger | 0 | (48,000) | 0 | (1,471,000) |
Weighted average shares for basic earnings per share calculation | 150,675,465 | 166,770,664 | 161,147,122 | 172,403,944 |
Basic net income from continuing operations per share | $ 1 | $ 0.44 | $ 2.88 | $ 2.69 |
Basic net income (loss) from discontinued operations per share | (0.05) | (1.26) | 0.63 | (0.90) |
Basic net income per share attributable to DaVita Inc. | $ 0.95 | $ (0.82) | $ 3.51 | $ 1.79 |
Diluted: | ||||
Weighted average shares outstanding during period | 150,675,000 | 166,819,000 | 161,147,000 | 173,875,000 |
Assumed incremental shares from stock plans | 621,000 | 443,000 | 489,000 | 473,000 |
Weighted average shares for diluted earnings per share calculation | 151,295,950 | 167,262,358 | 161,636,011 | 174,348,421 |
Diluted net income from continuing operations per share | $ 0.99 | $ 0.44 | $ 2.87 | $ 2.66 |
Diluted net income from discontinued operations per share | (0.04) | (1.26) | 0.63 | (0.89) |
Diluted net income per share attributable to DaVita Inc. | $ 0.95 | $ (0.82) | $ 3.50 | $ 1.77 |
Anti-dilutive stock-settled awards excluded from calculation | 7,293,000 | 5,281,000 | 6,414,000 | 4,987,000 |
Restricted Cash and equivalen_2
Restricted Cash and equivalents Restricted Cash and Cash Equivalents - Additional Information (Details) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
Restricted Cash and Cash Equivalents [Abstract] | ||
Restricted cash and equivalents | $ 103,885 | $ 92,382 |
Investments in debt and equit_3
Investments in debt and equity securities (Detail) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
Investment Holdings [Line Items] | ||
Held to maturity | $ 98,113 | $ 2,235 |
Held to maturity, short-term investments | 98,113 | 2,235 |
Held to maturity, long-term investments | 0 | 0 |
Equity Securities, FV-NI | 37,641 | 36,124 |
Total | 135,754 | 38,359 |
Total, short-term investments | 100,713 | 2,935 |
Total, long-term investments | 35,041 | 35,424 |
Certificates of deposit and other time deposits | ||
Investment Holdings [Line Items] | ||
Held to maturity | 98,113 | 2,235 |
Equity Securities, FV-NI | 0 | 0 |
Total | 98,113 | 2,235 |
Investments in mutual funds and common stock | ||
Investment Holdings [Line Items] | ||
Held to maturity | 0 | 0 |
Equity Securities, FV-NI | 37,641 | 36,124 |
Total | 37,641 | 36,124 |
Short-term Investments | ||
Investment Holdings [Line Items] | ||
Equity Securities, FV-NI | 2,600 | 700 |
Long-term Investments | ||
Investment Holdings [Line Items] | ||
Equity Securities, FV-NI | $ 35,041 | $ 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 | 9 Months Ended | |
Sep. 30, 2019 | Sep. 30, 2018 | |
Schedule Of Trading Securities And Other Trading Assets [Line Items] | ||
Pre-tax Net Gain (Loss) recognized in Income Statement | $ 2,776 | $ 1,597 |
Pre-tax Realized Gain (Loss) on Securities Arising During Period | 586 | 4,101 |
Net Increase (Decrease) in Unrealized Gain on Equity Securities due to changes in Fair Value | $ 2,190 | $ 2,504 |
Equity method and other inves_3
Equity method and other investments Equity Method and Other Investments (Details) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
Schedule of Equity Method Investments [Line Items] | ||
Equity method and other investments | $ 219,386 | $ 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 | 90,410 | 83,052 |
APAC joint venture | ||
Schedule of Equity Method Investments [Line Items] | ||
Equity method and other investments | $ 118,528 | $ 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 | Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 |
Noncontrolling Interest [Line Items] | ||||||
Equity investment income | $ 3,936 | $ (3,824) | $ 11,158 | $ 6,126 | ||
Partnership Capital Contribution Scheduled Date | Aug. 1, 2019 | |||||
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 Deferred Date | Dec. 1, 2019 |
Goodwill - Changes in Goodwill
Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | 12 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | Dec. 31, 2018 | |
Goodwill [Roll Forward] | |||||
Beginning balance | $ 6,841,960 | $ 6,610,279 | $ 6,610,279 | ||
Acquisitions | 77,238 | 278,348 | |||
Divestitures | (15,497) | ||||
Impairment charges | $ (83,855) | $ 0 | (124,892) | (3,106) | (3,106) |
Foreign currency and other adjustments | (28,647) | (28,064) | |||
Ending balance | 6,765,659 | 6,765,659 | 6,841,960 | ||
Goodwill, before accumulated impairment charges | 6,915,400 | 6,915,400 | |||
Accumulated impairment charges | (149,741) | (149,741) | |||
Ending balance | 6,765,659 | 6,765,659 | 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 | 18,089 | 130,574 | |||
Divestitures | (331) | ||||
Impairment charges | 0 | 0 | |||
Foreign currency and other adjustments | 0 | 0 | |||
Ending balance | 6,293,093 | 6,293,093 | 6,275,004 | ||
Goodwill, before accumulated impairment charges | 6,293,093 | 6,293,093 | |||
Accumulated impairment charges | 0 | 0 | |||
Ending balance | 6,293,093 | 6,293,093 | 6,275,004 | ||
Other—Ancillary services and strategic initiatives | |||||
Goodwill [Roll Forward] | |||||
Beginning balance | 566,956 | $ 465,518 | 465,518 | ||
Acquisitions | 59,149 | 147,774 | |||
Divestitures | (15,166) | ||||
Impairment charges | (83,855) | (124,892) | (3,106) | ||
Foreign currency and other adjustments | (28,647) | (28,064) | |||
Ending balance | 472,566 | 472,566 | 566,956 | ||
Goodwill, before accumulated impairment charges | 622,307 | 622,307 | |||
Accumulated impairment charges | (149,741) | (149,741) | |||
Ending balance | $ 472,566 | $ 472,566 | $ 566,956 |
Goodwill Goodwill - Schedule of
Goodwill Goodwill - Schedule of Reporting Units Goodwill Balances (Details) (Details) - USD ($) $ in Thousands | 9 Months Ended | ||
Sep. 30, 2019 | Dec. 31, 2018 | Dec. 31, 2017 | |
Goodwill [Line Items] | |||
Goodwill | $ 6,765,659 | $ 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 | $ 287,256 | ||
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 | (1.30%) | ||
Potential Impact On Fair Value For Basis Point Increase In Discount Rate | (11.00%) | ||
GERMANY | Kidney Care | |||
Goodwill [Line Items] | |||
Goodwill | $ 72,461 | ||
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%) |
Goodwill - Narrative (Details)
Goodwill - Narrative (Details) $ in Thousands | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||
Sep. 30, 2019USD ($) | Mar. 31, 2019USD ($) | Sep. 30, 2018USD ($) | Sep. 30, 2019USD ($)segment | Sep. 30, 2018USD ($) | Dec. 31, 2018USD ($) | |
Goodwill [Line Items] | ||||||
Goodwill impairment charges | $ 83,855 | $ 0 | $ 124,892 | $ 3,106 | $ 3,106 | |
Goodwill, Subsequent Recognition of Deferred Tax Asset | 17,769 | |||||
Goodwill, Impairment Loss, Net of Tax | 66,086 | |||||
Other Reporting Units | ||||||
Goodwill [Line Items] | ||||||
Number of Reportable Segments | segment | 0 | |||||
Other—Ancillary services and strategic initiatives | ||||||
Goodwill [Line Items] | ||||||
Goodwill impairment charges | 83,855 | $ 124,892 | $ 3,106 | |||
GERMANY | Other Reporting Units | ||||||
Goodwill [Line Items] | ||||||
Goodwill impairment charges | 5,416 | $ 3,106 | ||||
Goodwill, Subsequent Recognition of Deferred Tax Asset | 1,013 | |||||
GERMANY | Kidney Care | ||||||
Goodwill [Line Items] | ||||||
Goodwill impairment charges | 78,439 | $ 41,037 | ||||
Goodwill, Subsequent Recognition of Deferred Tax Asset | $ 16,756 |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2019 | Dec. 31, 2018 | |
Income Tax Disclosure [Abstract] | ||
Liability for unrecognized tax benefits | $ 52,769 | $ 40,382 |
Unrecognized Tax Benefits that Would Impact Effective Tax Rate | 49,926 | |
Increase in liability for unrecognized tax benefits | 12,387 | |
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits | $ 11,292 | $ 9,019 |
Long-term debt (Detail)
Long-term debt (Detail) - USD ($) $ in Thousands | May 06, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Sep. 30, 2019 | Dec. 31, 2018 |
Senior Notes | |||||
Acquisition obligations and other notes payable | $ 181,757 | $ 181,757 | $ 183,979 | ||
Finance Lease, Liability | $ 280,138 | $ 280,138 | 282,737 | ||
Debt Instrument, Interest Rate During Period | 5.09% | 5.14% | |||
Long-term Debt, Weighted Average Interest Rate, at Point in Time | 4.66% | 4.66% | |||
Total debt principal outstanding | $ 8,211,895 | $ 8,211,895 | 10,154,216 | ||
Discount and deferred financing costs | (75,979) | (75,979) | (52,000) | ||
Total amount of long-term debt | 8,135,916 | 8,135,916 | 10,102,216 | ||
Less current portion | (121,441) | (121,441) | (1,929,369) | ||
Long-term debt | 8,014,475 | $ 8,014,475 | 8,172,847 | ||
Debt Instrument, table footnotes | |||||
Long-Term Debt Maturity Extension Term | 6 months | ||||
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 | 1,776,250 | $ 1,776,250 | |||
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 | 1,492,200 | $ 1,492,200 | |||
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 | ||||
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 | 0 | $ 0 | |||
Senior Notes | |||||
Senior Notes | $ 0 | $ 0 | 1,250,000 | ||
Debt Instrument, Interest Rate During Period | |||||
Debt Instrument, table footnotes | |||||
Debt Instrument, Maturity Date | Aug. 15, 2022 | ||||
Notes Payable, Other Payables | |||||
Senior Notes | |||||
Long-term Debt, Weighted Average Interest Rate, at Point in Time | 5.50% | 5.50% | |||
Debt Instrument, Maturity Date, Description | 2019-2027 | ||||
Finance Lease | |||||
Senior Notes | |||||
Finance Lease, Weighted Average Discount Rate, Percent | 5.36% | 5.36% | |||
Debt Instrument, Maturity Date, Description | 2020-2037 | ||||
New Term Loan A | |||||
Debt Instrument [Line Items] | |||||
Senior Secured Credit Facilities | $ 1,750,000 | $ 1,750,000 | |||
Debt Instrument, Description of Variable Rate Basis | LIBOR + 1.50% | ||||
Debt Instrument, Maturity Date | Aug. 12, 2024 | ||||
Debt Instrument, Fair Value Disclosure | 1,750,000 | $ 1,750,000 | |||
Debt Instrument, table footnotes | |||||
Debt Instrument, Maturity Date | Aug. 12, 2024 | ||||
New Term Loan B | |||||
Debt Instrument [Line Items] | |||||
Senior Secured Credit Facilities | 2,750,000 | $ 2,750,000 | |||
Debt Instrument, Description of Variable Rate Basis | LIBOR + 2.25% | ||||
Debt Instrument, Maturity Date | Aug. 12, 2026 | ||||
Debt Instrument, Fair Value Disclosure | 2,770,625 | $ 2,770,625 | |||
Debt Instrument, table footnotes | |||||
Debt Instrument, Maturity Date | Aug. 12, 2026 | ||||
Prior Term Loan A | |||||
Debt Instrument [Line Items] | |||||
Senior Secured Credit Facilities | 675,000 | ||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | ||||
Debt Instrument, Fair Value Disclosure | 0 | $ 0 | |||
Debt Instrument, table footnotes | |||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | ||||
Prior Term Loan A-2 | |||||
Debt Instrument [Line Items] | |||||
Senior Secured Credit Facilities | 995,000 | ||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | ||||
Debt Instrument, Fair Value Disclosure | 0 | $ 0 | |||
Debt Instrument, table footnotes | |||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | ||||
Prior Term Loan B | |||||
Debt Instrument [Line Items] | |||||
Senior Secured Credit Facilities | 3,342,500 | ||||
Debt Instrument, Maturity Date | Jun. 24, 2021 | ||||
Debt Instrument, Fair Value Disclosure | $ 0 | $ 0 | |||
Debt Instrument, table footnotes | |||||
Debt Instrument, Maturity Date | Jun. 24, 2021 | ||||
Senior Secured Credit Facilities | |||||
Senior Notes | |||||
Long-term Debt, Weighted Average Interest Rate, at Point in Time | 4.30% | 4.30% | |||
Debt Instrument, table footnotes | |||||
Debt Instrument, Unamortized Discount | $ 6,708 | $ 6,708 | 6,104 | ||
Deferred Offering Costs | 47,255 | 47,255 | 12,580 | ||
Senior Notes | |||||
Debt Instrument, table footnotes | |||||
Deferred Offering Costs | 22,016 | $ 22,016 | 33,316 | ||
London Interbank Offered Rate (LIBOR) | New Term Loan A | |||||
Debt Instrument, table footnotes | |||||
LIBOR plus interest rate margin | 1.50% | ||||
Minimum | London Interbank Offered Rate (LIBOR) | New Term Loan A | |||||
Debt Instrument, table footnotes | |||||
LIBOR plus interest rate margin | 1.00% | ||||
Minimum | London Interbank Offered Rate (LIBOR) | New Term Loan B | |||||
Debt Instrument, table footnotes | |||||
LIBOR plus interest rate margin | 2.25% | ||||
Minimum | London Interbank Offered Rate (LIBOR) | Prior Term Loan A | |||||
Debt Instrument, table footnotes | |||||
LIBOR plus interest rate margin | 2.00% | ||||
Minimum | London Interbank Offered Rate (LIBOR) | Prior Term Loan A-2 | |||||
Debt Instrument, table footnotes | |||||
LIBOR plus interest rate margin | 1.00% | ||||
Minimum | London Interbank Offered Rate (LIBOR) | Prior Term Loan B | |||||
Debt Instrument, table footnotes | |||||
LIBOR plus interest rate margin | 2.75% | ||||
Prior revolving line of credit | |||||
Debt Instrument [Line Items] | |||||
Senior Secured Credit Facilities | $ 175,000 | ||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | ||||
Debt Instrument, Fair Value Disclosure | 0 | $ 0 | |||
Debt Instrument, table footnotes | |||||
Debt Instrument, Maturity Date | Dec. 24, 2019 | ||||
Prior revolving line of credit | Minimum | London Interbank Offered Rate (LIBOR) | |||||
Debt Instrument, table footnotes | |||||
LIBOR plus interest rate margin | 2.00% | ||||
New revolving line of credit | |||||
Debt Instrument [Line Items] | |||||
Debt Instrument, Maturity Date | Aug. 12, 2024 | ||||
Debt Instrument, table footnotes | |||||
Maximum borrowing capacity on the revolving credit facilities | $ 1,000,000 | $ 1,000,000 | |||
Debt Instrument, Maturity Date | Aug. 12, 2024 | ||||
New revolving line of credit | London Interbank Offered Rate (LIBOR) | |||||
Debt Instrument, table footnotes | |||||
LIBOR plus interest rate margin | 1.50% |
Long-term debt - Scheduled Matu
Long-term debt - Scheduled Maturities of Long-term Debt (Detail) $ in Thousands | Sep. 30, 2019USD ($) |
Debt Instrument [Line Items] | |
2019 (remainder of the year) | $ 29,841 |
2020 | 129,082 |
2021 | 153,120 |
2022 | 168,824 |
2023 | 224,455 |
2024 | 3,171,804 |
Thereafter | $ 4,334,769 |
Long-term debt Schedule of Deri
Long-term debt Schedule of Derivative Instruments (Details) - USD ($) | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 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 | ||||
Interest Rate Cap Agreements Effective August 12, 2019 | |||||
Derivative [Line Items] | |||||
Derivative, effective date | Jun. 30, 2020 | ||||
Derivative, expiration date | Jun. 30, 2024 | ||||
Term Loan Facility | Interest Rate Cap Agreements Effective June 29, 2018 | 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% | ||||
Term Loan Facility | Interest Rate Cap Agreements Effective August 12, 2019 | Maximum | |||||
Derivative [Line Items] | |||||
Notional amounts of interest rate agreements | 3,500,000,000 | $ 3,500,000,000 | |||
LIBOR plus interest rate margin | 2.00% | ||||
Cash Flow Hedging | |||||
Derivative [Line Items] | |||||
Amount of losses reclassified from accumulated OCI into income | (1,569,000) | $ (1,606,000) | $ (4,782,000) | $ (4,680,000) | |
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | 1,060,000 | $ (37,000) | 1,672,000 | $ (819,000) | |
Debt Expense | Cash Flow Hedging | Interest Rate Cap Agreements Effective June 29, 2018 | |||||
Derivative [Line Items] | |||||
Amount of losses reclassified from accumulated OCI into income | (6,428,000) | ||||
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | 851,000 | ||||
Debt Expense | Cash Flow Hedging | Interest Rate Cap Agreements Effective August 12, 2019 | |||||
Derivative [Line Items] | |||||
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | 1,393,000 | ||||
Other Long-term Assets | Interest Rate Cap Agreements Effective June 29, 2018 | |||||
Derivative [Line Items] | |||||
Derivative Asset, Fair Value, Gross Asset | 0 | 0 | $ 851,000 | ||
Other Long-term Assets | Interest Rate Cap Agreements Effective August 12, 2019 | |||||
Derivative [Line Items] | |||||
Derivative Asset, Fair Value, Gross Asset | $ 20,642,000 | $ 20,642,000 |
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 | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Derivative Instruments Gain Loss [Line Items] | ||||
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | $ (1,060) | $ 37 | $ (1,672) | $ 819 |
Reclassification from accumulated other comprehensive income into net income | 1,569 | 1,606 | 4,782 | 4,680 |
Tax benefit (expense) | ||||
Derivative Instruments Gain Loss [Line Items] | ||||
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | 360 | (13) | 572 | (284) |
Reclassification from accumulated other comprehensive income into net income | (532) | (557) | (1,646) | (1,623) |
Interest rate cap agreements | Debt Expense | ||||
Derivative Instruments Gain Loss [Line Items] | ||||
Amount of unrecognized (losses) gains in OCI on interest rate cap agreements | (1,420) | 50 | (2,244) | 1,103 |
Reclassification from accumulated other comprehensive income into net income | $ 2,101 | $ 2,163 | $ 6,428 | $ 6,303 |
Long-term debt - Additional Inf
Long-term debt - Additional Information (Detail) shares in Thousands, $ in Thousands | Jul. 03, 2019USD ($) | Jun. 20, 2019USD ($) | Jun. 19, 2019 | Sep. 30, 2019USD ($)shares | Jun. 30, 2019USD ($) | Sep. 30, 2018USD ($) | Jun. 30, 2019 | Sep. 30, 2019USD ($)shares | Sep. 30, 2018USD ($) | Aug. 12, 2019USD ($) | Dec. 31, 2018USD ($) |
Annual principal payments: | |||||||||||
2019 (remainder of the year) | $ 29,841 | $ 29,841 | |||||||||
2020 | 129,082 | 129,082 | |||||||||
2021 | 153,120 | 153,120 | |||||||||
2022 | 168,824 | 168,824 | |||||||||
2023 | 224,455 | 224,455 | |||||||||
2024 | $ 3,171,804 | $ 3,171,804 | |||||||||
Repurchase of common stock (in shares) | shares | 30,592 | 32,652 | |||||||||
Value of treasury stock acquired | $ 1,747,968 | $ 1,860,157 | |||||||||
Debt Prepayment Refinancing Redemption Charges | $ 21,242 | $ 0 | $ 33,402 | $ 0 | |||||||
Accelerated Amortization Of Debt Discount And Deferred Financing Costs | $ 12,160 | ||||||||||
Weighted average effective interest rate at quarter end | 4.66% | 4.66% | |||||||||
Weighted average effective interest rate during quarter | 5.09% | 5.14% | |||||||||
Percentage of debt instruments bearing fixed interest rate | 44.03% | 44.03% | |||||||||
Letters of credit outstanding | $ 59,723 | $ 59,723 | |||||||||
Interest Rate Cap Agreements Effective August 12, 2019 | |||||||||||
Annual principal payments: | |||||||||||
Derivative, effective date | Jun. 30, 2020 | ||||||||||
Senior Notes Five Point Seven Five Percentage Senior Notes Due Twenty Twenty Two | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Early repayment of Senior debt | $ 1,267,565 | ||||||||||
Annual principal payments: | |||||||||||
Weighted average effective interest rate during quarter | |||||||||||
Tender Offer | |||||||||||
Annual principal payments: | |||||||||||
Repurchase of common stock (in shares) | shares | 21,802 | 21,802 | |||||||||
Value of treasury stock acquired | $ 1,233,886 | $ 1,233,886 | |||||||||
Maximum | Term Loan Facility | Interest Rate Cap Agreements Effective August 12, 2019 | |||||||||||
Debt Instrument [Line Items] | |||||||||||
LIBOR plus interest rate margin | 2.00% | ||||||||||
Annual principal payments: | |||||||||||
Notional amounts of interest rate agreements | 3,500,000 | $ 3,500,000 | |||||||||
New revolving line of credit | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Maximum borrowing capacity on the revolving credit facilities | 1,000,000 | 1,000,000 | |||||||||
Annual principal payments: | |||||||||||
Letters of credit outstanding | 13,055 | $ 13,055 | |||||||||
New revolving line of credit | London Interbank Offered Rate (LIBOR) | |||||||||||
Debt Instrument [Line Items] | |||||||||||
LIBOR plus interest rate margin | 1.50% | ||||||||||
Incremental Revolving Line Of Credit | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Maximum borrowing capacity on the revolving credit facilities | $ 1,500,000 | ||||||||||
Incremental Revolving Line Of Credit | Maximum | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Required Leverage Ratio Covenant | 3.50 | ||||||||||
Prior Term Loan A | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Early repayment of Senior debt | $ 647,424 | ||||||||||
Secured Debt | $ 675,000 | ||||||||||
Annual principal payments: | |||||||||||
Mandatory principal payments | 27,576 | $ 27,576 | |||||||||
Prior Term Loan A | London Interbank Offered Rate (LIBOR) | Minimum | |||||||||||
Debt Instrument [Line Items] | |||||||||||
LIBOR plus interest rate margin | 2.00% | ||||||||||
Prior Term Loan A-2 | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Early repayment of Senior debt | $ 995,000 | ||||||||||
Secured Debt | 995,000 | ||||||||||
Prior Term Loan A-2 | London Interbank Offered Rate (LIBOR) | Minimum | |||||||||||
Debt Instrument [Line Items] | |||||||||||
LIBOR plus interest rate margin | 1.00% | ||||||||||
Prior Term Loan B | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Early repayment of Senior debt | $ 2,823,447 | ||||||||||
Secured Debt | $ 3,342,500 | ||||||||||
Annual principal payments: | |||||||||||
Mandatory principal payments | 17,500 | 17,500 | |||||||||
Prior Term Loan B | London Interbank Offered Rate (LIBOR) | Minimum | |||||||||||
Debt Instrument [Line Items] | |||||||||||
LIBOR plus interest rate margin | 2.75% | ||||||||||
New Credit Agreement | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Secured Debt | $ 5,500,000 | ||||||||||
New Credit Agreement | Maximum | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Required Leverage Ratio Covenant | 4 | ||||||||||
Required Leverage Ratio Covenant Through Year Four | 5 | ||||||||||
Required Leverage Ratio Covenant After Year Four | 4.50 | ||||||||||
New Term Loan A | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Secured Debt | 1,750,000 | 1,750,000 | |||||||||
Annual principal payments: | |||||||||||
2019 (remainder of the year) | 10,938 | 10,938 | |||||||||
2020 | 54,688 | 54,688 | |||||||||
2021 | 87,500 | 87,500 | |||||||||
2022 | 98,437 | 98,437 | |||||||||
2023 | 142,187 | 142,187 | |||||||||
2024 | 1,356,250 | $ 1,356,250 | |||||||||
New Term Loan A | London Interbank Offered Rate (LIBOR) | |||||||||||
Debt Instrument [Line Items] | |||||||||||
LIBOR plus interest rate margin | 1.50% | ||||||||||
New Term Loan A | London Interbank Offered Rate (LIBOR) | Minimum | |||||||||||
Debt Instrument [Line Items] | |||||||||||
LIBOR plus interest rate margin | 1.00% | ||||||||||
New Term Loan A | London Interbank Offered Rate (LIBOR) | Maximum | |||||||||||
Debt Instrument [Line Items] | |||||||||||
LIBOR plus interest rate margin | 2.00% | ||||||||||
New Term Loan B | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Secured Debt | 2,750,000 | $ 2,750,000 | |||||||||
Annual principal payments: | |||||||||||
2019 (remainder of the year) | 6,875 | 6,875 | |||||||||
2020 | 27,500 | 27,500 | |||||||||
2021 | 27,500 | 27,500 | |||||||||
2022 | 27,500 | 27,500 | |||||||||
2023 | 27,500 | 27,500 | |||||||||
2024 | 27,500 | 27,500 | |||||||||
2025 | 27,500 | 27,500 | |||||||||
2026 | 2,578,125 | $ 2,578,125 | |||||||||
New Term Loan B | London Interbank Offered Rate (LIBOR) | Minimum | |||||||||||
Debt Instrument [Line Items] | |||||||||||
LIBOR plus interest rate margin | 2.25% | ||||||||||
Prior Term Loan B and Prior Revolving Line Of Credit | |||||||||||
Debt Instrument [Line Items] | |||||||||||
Early repayment of Senior debt | 1,153,274 | ||||||||||
Term Loan A subject to uncapped portion of variability of LIBOR | |||||||||||
Annual principal payments: | |||||||||||
Line of credit outstanding principal balance | (1,000,000) | $ (1,000,000) | |||||||||
Senior Secured Credit Facilities | |||||||||||
Annual principal payments: | |||||||||||
Mandatory principal payments | $ 0 | $ 0 | |||||||||
Weighted average effective interest rate at quarter end | 4.30% | 4.30% | |||||||||
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 | 9 Months Ended |
Sep. 30, 2019 | Sep. 30, 2019 | |
Operating lease cost: | ||
Fixed Lease Expense | $ 133,342 | $ 392,398 |
Variable Lease Expense | 30,786 | 89,264 |
Finance lease cost: | ||
Finance Lease, Right-of-Use Asset, Amortization | 6,164 | 17,693 |
Finance Lease, Interest Expense | 3,803 | 11,293 |
Net Lease Cost | $ 174,095 | $ 510,648 |
Leases Leases Other Information
Leases Leases Other Information (Details) $ in Thousands | 9 Months Ended |
Sep. 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 6 months |
Operating Lease, Weighted Average Discount Rate, Percent | 4.20% |
Leases other information | |
Sale and Leaseback Transaction, Gain (Loss), Net | $ 13,903 |
Cash paid for amounts included in the measurement of lease liabilities | |
Operating Lease, Payments | 467,338 |
Finance Lease, Interest Payment on Liability | 16,226 |
Finance Lease, Principal Payments | 21,905 |
Net Operating Lease Assets Obtained In Exchange For Lease Liabilities | $ 299,697 |
Finance Lease | |
Leases term and discount rate | |
Finance Lease, Weighted Average Discount Rate, Percent | 5.36% |
Leases Schedule of Minimum Leas
Leases Schedule of Minimum Lease Payments (Details) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
Operating Lease Liabilities, Payments Due | ||
Lessee, Operating Lease, Liability, Payments, Remainder of Fiscal Year | $ 121,795 | |
Lessee, Operating Lease, Liability, Payments, Due Next Twelve Months | 497,654 | |
Lessee, Operating Lease, Liability, Payments, Due Year Two | 474,292 | |
Lessee, Operating Lease, Liability, Payments, Due Year Three | 437,481 | |
Lessee, Operating Lease, Liability, Payments, Due Year Four | 390,993 | |
Lessee, Operating Lease, Liability, Payments, Due Year Five | 340,662 | |
Lessee, Operating Lease, Liability, Payments, Due after Year Five | 1,433,145 | |
Lessee, Operating Lease, Liability, Payments, Due | 3,696,022 | |
Less Portion Representing Interest, Operating Lease Liability | (639,683) | |
Operating Lease, Liability | 3,056,339 | |
Finance Lease Liabilities, Payments, Due | ||
Finance Lease, Liability, Payments, Remainder of Fiscal Year | 8,384 | |
Finance Lease, Liability, Payments, Due Next Twelve Months | 38,411 | |
Finance Lease, Liability, Payments, Due Year Two | 33,950 | |
Finance Lease, Liability, Payments, Due Year Three | 34,369 | |
Finance Lease, Liability, Payments, Due Year Four | 34,511 | |
Finance Lease, Liability, Payments, Due Year Five | 34,540 | |
Finance Lease, Liability, Payments, Due after Year Five | 183,786 | |
Finance Lease, Liability, Payment, Due | 367,951 | |
Less Portion Representing Interest, Finance Lease Liability | (87,813) | |
Finance Lease, Liability | $ 280,138 | $ 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 | Sep. 30, 2019 | Dec. 31, 2018 |
Lessee, Lease, Description [Line Items] | ||
Finance Lease, Right-of-Use Asset | $ 254,967 | $ 367,164 |
Finance Lease Accumulated Depreciation | $ 21,606 | $ 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 | Sep. 30, 2019USD ($) |
Commitments to provide operating capital | |
Other Commitments [Line Items] | |
Other potential commitments to provide operating capital to several dialysis centers | $ 6,935 |
Long-term incentive compensat_2
Long-term incentive compensation - Additional Information (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | Nov. 04, 2019 | Sep. 30, 2019 | Sep. 30, 2018 |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||
Long-term incentive program (LTIP) expense | $ 82,469 | $ 74,077 | |
Stock-based compensation expense | 47,811 | 59,605 | |
Estimated tax benefits recorded for stock-based compensation | 6,798 | 10,887 | |
Unrecognized compensation cost related to outstanding LTIP awards | 166,502 | ||
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans | $ 151,805 | ||
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under performance-based cash component of LTIP costs, weighted average remaining period (in years) | 7 months 6 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 7 months 6 days | ||
Share-based Payment Arrangement, Expense, Tax Benefit | $ 2,791 | 7,919 | |
Restricted and Performance Stock Units | |||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||
Stock-settled awards granted (in shares) | 1,921 | ||
Aggregate grant-date fair value | $ 96,472 | ||
Weighted-average expected life (in years) | 3 years 4 months 24 days | ||
Stock Appreciation Rights | |||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||
Stock-settled awards granted (in shares) | 2,390 | ||
Aggregate grant-date fair value | $ 33,545 | ||
Weighted-average expected life (in years) | 4 years | ||
General and Administrative Expense | |||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||
Stock-based compensation expense | $ 43,666 | $ 60,461 | |
Subsequent Event | Premium Priced Stock-Settled Stock Appreciation Rights | |||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||
Stock-settled awards granted (in shares) | 2,500 | ||
Premium Priced Award Base Price Per Share | $ 67.80 | ||
Premium To The Tender Offer Share Purchase Price | 20.00% | ||
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period | 5 years | ||
Subsequent Event | Vesting period, tranche one | Premium Priced Stock-Settled Stock Appreciation Rights | |||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage | 50.00% | ||
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period | 4 years | ||
Subsequent Event | Vesting period, tranche two | Premium Priced Stock-Settled Stock Appreciation Rights | |||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage | 50.00% | ||
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period | 3 years |
Share repurchases Share Repur_2
Share repurchases Share Repurchase Tender Offer (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | 9 Months Ended |
Sep. 30, 2019 | Sep. 30, 2019 | |
Equity, Class of Treasury Stock [Line Items] | ||
Repurchase of common stock (in shares) | 30,592 | 32,652 |
Value of treasury stock acquired | $ 1,747,968 | $ 1,860,157 |
Treasury stock acquired, average cost per share | $ 57.14 | $ 56.97 |
Tender Offer | ||
Equity, Class of Treasury Stock [Line Items] | ||
Repurchase of common stock (in shares) | 21,802 | 21,802 |
Value of treasury stock acquired | $ 1,233,886 | $ 1,233,886 |
Treasury stock acquired, average cost per share | $ 56.60 | $ 56.60 |
Treasury Stock, Shares Repurchases, Table Footnotes: | ||
Treasury Stock Acquired, Average Cost Per Share, Clearing Price | $ 56.50 | $ 56.50 |
Share Repurchase Fees And Expenses | $ 2,074 | $ 2,074 |
Open Market Purchases | ||
Equity, Class of Treasury Stock [Line Items] | ||
Repurchase of common stock (in shares) | 8,790 | 10,850 |
Value of treasury stock acquired | $ 514,082 | $ 626,271 |
Treasury stock acquired, average cost per share | $ 58.49 | $ 57.72 |
Share repurchases (Details)
Share repurchases (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 1 Months Ended | 3 Months Ended | 4 Months Ended | 9 Months Ended | ||
Nov. 04, 2019 | Sep. 30, 2019 | Nov. 04, 2019 | Sep. 30, 2019 | Nov. 06, 2019 | Jul. 17, 2019 | |
Equity, Class of Treasury Stock [Line Items] | ||||||
Repurchase of common stock (in shares) | 30,592 | 32,652 | ||||
Value of treasury stock acquired | $ 1,747,968 | $ 1,860,157 | ||||
Treasury stock acquired, average cost per share | $ 57.14 | $ 56.97 | ||||
Stock Repurchase Program, Authorized Amount | $ 2,000,000 | |||||
Terminated Remaining Prior Share Repurchases Authorized, Amount | $ 1,005,605 | |||||
Tender Offer | ||||||
Equity, Class of Treasury Stock [Line Items] | ||||||
Repurchase of common stock (in shares) | 21,802 | 21,802 | ||||
Value of treasury stock acquired | $ 1,233,886 | $ 1,233,886 | ||||
Treasury stock acquired, average cost per share | $ 56.60 | $ 56.60 | ||||
Subsequent Event | ||||||
Equity, Class of Treasury Stock [Line Items] | ||||||
Repurchase of common stock (in shares) | 4,283 | 30,661 | ||||
Value of treasury stock acquired | $ 245,544 | $ 1,753,627 | ||||
Treasury stock acquired, average cost per share | $ 57.32 | |||||
Stock Repurchase Program, Authorized Amount | $ 2,000,000 | 2,000,000 | ||||
Stock Repurchase Program, Remaining Authorized Repurchase Amount | $ 2,000,000 | |||||
Terminated Remaining Prior Share Repurchases Authorized, Amount | $ 246,373 | $ 246,373 |
Accumulated other comprehensi_3
Accumulated other comprehensive (loss) income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | Jul. 01, 2018 | Jan. 01, 2018 | |
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | $ 3,908,398 | |||||
Ending balance | $ 2,512,523 | 2,512,523 | ||||
Interest rate cap and swap agreements | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | (6,360) | $ (11,258) | (8,961) | $ (12,408) | ||
Cumulative effect of change in accounting principle | $ 0 | $ (2,706) | ||||
Unrealized (losses) gains | (1,420) | 50 | (2,244) | 1,103 | ||
Related income tax benefit | 360 | (13) | 572 | (284) | ||
Unrealized (losses) gains net | (1,060) | 37 | (1,672) | 819 | ||
Reclassification into net income | 2,101 | 2,163 | 6,428 | 6,303 | ||
Related income | (532) | (557) | (1,646) | (1,623) | ||
Reclassification from accumulated other comprehensive income into net income net of tax | 1,569 | 1,606 | 4,782 | 4,680 | ||
Ending balance | (5,851) | (9,615) | (5,851) | (9,615) | ||
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 | (27,251) | (10,667) | (25,963) | 19,981 | ||
Cumulative effect of change in accounting principle | 0 | 0 | ||||
Unrealized (losses) gains | (44,502) | (8,827) | (45,790) | (39,475) | ||
Related income tax benefit | 0 | 0 | 0 | 0 | ||
Unrealized (losses) gains net | (44,502) | (8,827) | (45,790) | (39,475) | ||
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 | (71,753) | (19,494) | (71,753) | (19,494) | ||
Accumulated other comprehensive (loss) income | ||||||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||||||
Beginning balance | (33,611) | (21,925) | (34,924) | 13,235 | ||
Cumulative effect of change in accounting principle | $ 0 | $ (8,368) | ||||
Unrealized (losses) gains | (45,922) | (8,777) | (48,034) | (38,372) | ||
Related income tax benefit | 360 | (13) | 572 | (284) | ||
Unrealized (losses) gains net | (45,562) | (8,790) | (47,462) | (38,656) | ||
Reclassification into net income | 2,101 | 2,163 | 6,428 | 6,303 | ||
Related income | (532) | (557) | (1,646) | (1,623) | ||
Reclassification from accumulated other comprehensive income into net income net of tax | 1,569 | 1,606 | 4,782 | 4,680 | ||
Ending balance | $ (77,604) | $ (29,109) | $ (77,604) | $ (29,109) |
Acquisitions and divestitures -
Acquisitions and divestitures - Aggregate Purchase Cost Allocations for Acquisitions (Detail) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 | Dec. 31, 2017 |
Business Acquisition [Line Items] | |||
Goodwill | $ 6,765,659 | $ 6,841,960 | $ 6,610,279 |
Dialysis and other businesses | |||
Business Acquisition [Line Items] | |||
Current assets | 5,238 | ||
Property and equipment | 3,607 | ||
Intangible and other long-term assets | 15,848 | ||
Goodwill | 77,238 | ||
Current liabilities | (3,360) | ||
Long-term liabilities | (1,139) | ||
Noncontrolling interests | (1,762) | ||
Aggregate purchase price | $ 95,670 |
Acquisitions and divestitures C
Acquisitions and divestitures Contingent Earn-out obligations (Details) $ in Thousands | 9 Months Ended |
Sep. 30, 2019USD ($) | |
Business Combination, Contingent Consideration Arrangements [Abstract] | |
Contingent Earn-out Obligations, Beginning balance | $ 2,608 |
Business Combination Contingent Consideration Acquisitions | 19,731 |
Business Combination Contingent Consideration Acquisitions Fair Value Remeasurement Gain Loss | (2,179) |
Business Combination Contingent Consideration Acquisitions Earnouts Payments | (327) |
Contingent Earn-out Obligations, Ending balance | $ 19,833 |
Acquisitions and divestitures_2
Acquisitions and divestitures - Additional Information (Detail) $ in Thousands | 9 Months Ended | |
Sep. 30, 2019USD ($)clinic | Sep. 30, 2018USD ($) | |
Business Acquisition [Line Items] | ||
Cash paid to acquire businesses | $ 77,348 | $ 113,526 |
Deferred purchase price obligations | 19,818 | |
Contingent earn-out obligations and liabilities assumed associated with acquisitions | 35,338 | |
Other accrued liabilities | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations | 4,401 | |
Other long-term liabilities | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations | 15,432 | |
Other companies | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations | $ 19,833 | |
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 | $ 75,323 | |
Deferred purchase price obligations | 529 | |
Goodwill deductible for tax purposes associated with acquisitions | $ 75,529 | |
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 | 7 | |
Foreign Dialysis Centers | Dialysis and other businesses | ||
Business Acquisition [Line Items] | ||
Number of businesses acquired | clinic | 9 |
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 | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||
Net (loss) income from discontinued operations, net of tax | $ (6,843) | $ (211,739) | $ 102,854 | $ (147,829) |
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 | 0 | 1,252,909 | 2,713,059 | 3,733,270 |
Expenses | 1,996 | 1,260,814 | 2,541,783 | 3,679,747 |
Valuation adjustment | 0 | 98,201 | 0 | 98,201 |
(Loss) income from discontinued operations before taxes | (1,996) | (106,106) | 171,276 | (44,678) |
Loss on sale of discontinued operations before taxes | 0 | 0 | (23,022) | 0 |
Income tax expense | $ 4,847 | $ 105,633 | $ 45,400 | $ 103,151 |
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 | |
Sep. 30, 2019 | Sep. 30, 2018 | |
Discontinued Operations and Disposal Groups [Abstract] | ||
Net cash provided by operating activities from discontinued operations | $ 97,005 | $ 208,570 |
Net cash used in investing activities from discontinued operations | $ (43,442) | $ (32,860) |
Held for Sale and Discontinue_5
Held for Sale and Discontinued Operations Additional Information (Details) $ in Thousands | Jun. 19, 2019USD ($) | Dec. 05, 2017 | Sep. 30, 2019USD ($) | Sep. 30, 2018USD ($) | Jun. 18, 2019USD ($)clinic | Sep. 30, 2019USD ($) | Sep. 30, 2018USD ($) |
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 | $ 77,348 | $ 113,526 | |||||
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 | 75,323 | ||||||
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 | $ 0 | $ 0 | $ (23,022) | $ 0 |
Variable interest entities - Ad
Variable interest entities - Additional Information (Detail) $ in Thousands | Sep. 30, 2019USD ($) |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Total assets of variable interest entities | $ 389,284 |
Total liabilities of variable interest entities | $ 273,660 |
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 | Sep. 30, 2019 | Dec. 31, 2018 |
Assets | ||
Investments in equity securities | $ 37,641 | $ 36,124 |
Fair Value, Measurements, Recurring | ||
Assets | ||
Investments in equity securities | 37,641 | |
Liabilities | ||
Contingent earn-out obligations | 19,833 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 1,296,059 | |
Fair Value, Measurements, Recurring | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | 20,642 | |
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1) | ||
Assets | ||
Investments in equity securities | 37,641 | |
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 | 20,642 | |
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | ||
Assets | ||
Investments in equity securities | 0 | |
Liabilities | ||
Contingent earn-out obligations | 19,833 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 1,296,059 | |
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 | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,781,169 | $ 2,670,701 | $ 8,150,386 | $ 7,980,178 |
Provision for uncollectible accounts | (3,977) | (11,977) | (19,689) | (35,838) |
Net U.S. dialysis and related lab services patient service revenues | 2,777,192 | 2,658,724 | 8,130,697 | 7,944,340 |
Other revenues | 126,886 | 188,606 | 359,198 | 639,387 |
Total revenues | 2,904,078 | 2,847,330 | 8,489,895 | 8,583,727 |
Operating income (loss) | 378,336 | 289,038 | 1,180,729 | 1,137,916 |
Corporate administrative support | (24,681) | (40,836) | (65,546) | (70,605) |
Debt expense | (88,589) | (125,927) | (351,774) | (359,135) |
Debt prepayment, refinancing and redemption charges | (21,242) | 0 | (33,402) | 0 |
Other income, net | 5,280 | 4,007 | 17,863 | 10,583 |
Income from continuing operations before income taxes | 273,785 | 167,118 | 813,416 | 789,364 |
U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | 2,659,065 | 2,551,377 | 7,782,735 | 7,639,101 |
Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | 245,013 | 295,953 | 707,160 | 944,626 |
Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | 2,939,923 | 2,881,115 | 8,593,454 | 8,675,418 |
Operating income (loss) | 403,017 | 329,874 | 1,246,275 | 1,208,521 |
Operating Segments | U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 2,685,096 | 2,584,769 | 7,875,046 | 7,725,187 |
Provision for uncollectible accounts | (3,977) | (12,900) | (19,689) | (37,108) |
Net U.S. dialysis and related lab services patient service revenues | 2,681,119 | 2,571,869 | 7,855,357 | 7,688,079 |
Total revenues | 2,691,427 | 2,576,801 | 7,876,072 | 7,703,044 |
Operating income (loss) | 500,742 | 390,006 | 1,416,680 | 1,272,828 |
Operating Segments | U.S. dialysis and related lab services | External Sources | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 2,652,946 | 2,559,345 | 7,782,435 | 7,661,244 |
Other revenues | 10,096 | 4,932 | 19,989 | 14,965 |
Operating Segments | U.S. dialysis and related lab services | Intersubsegment Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 32,150 | 25,424 | 92,611 | 63,943 |
Other revenues | 212 | 0 | 726 | 0 |
Operating Segments | Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 128,223 | 112,279 | 367,951 | 320,204 |
Other revenues | 116,790 | 183,674 | 339,209 | 624,422 |
Total revenues | 248,496 | 304,314 | 717,382 | 972,374 |
Operating income (loss) | (97,725) | (60,132) | (170,405) | (64,307) |
Operating Segments | Other—Ancillary services and strategic initiatives | Intersubsegment Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Dialysis and related lab patient service revenues | 3,483 | 8,361 | 10,222 | 27,748 |
Intersegment Elimination | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | (35,845) | (33,785) | (103,559) | (91,691) |
Intersegment Elimination | U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | (32,362) | (25,424) | (93,337) | (63,943) |
Intersegment Elimination | Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Total revenues | $ (3,483) | $ (8,361) | $ (10,222) | $ (27,748) |
Segment reporting - Summary o_2
Segment reporting - Summary of Assets by Segment (Detail) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 |
ASSETS | ||
Total assets | $ 17,451,830 | $ 19,110,252 |
U.S. dialysis and related lab services | ||
ASSETS | ||
Total assets | 15,997,552 | 12,333,641 |
Other—Ancillary services and strategic initiatives | ||
ASSETS | ||
Total assets | 1,454,278 | 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 | Sep. 30, 2019 | Dec. 31, 2018 |
Segment Reporting Information [Line Items] | ||
Equity method and other investments | $ 219,386 | $ 224,611 |
U.S. dialysis and related lab services | ||
Segment Reporting Information [Line Items] | ||
Equity method and other investments | 100,815 | 95,290 |
Other—Ancillary services and strategic initiatives | ||
Segment Reporting Information [Line Items] | ||
Equity method and other investments | 118,571 | 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 | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Segment Reporting Information [Line Items] | ||||
Depreciation and amortization | $ 155,915 | $ 146,000 | $ 456,685 | $ 435,878 |
U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Depreciation and amortization | 147,607 | 138,669 | 433,008 | 411,697 |
Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Depreciation and amortization | $ 8,308 | $ 7,331 | $ 23,677 | $ 24,181 |
Segment reporting - Summary o_5
Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | $ 173,265 | $ 231,682 | $ 547,183 | $ 705,659 |
U.S. dialysis and related lab services | ||||
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | 157,721 | 214,728 | 477,533 | 603,186 |
Other—Ancillary services and strategic initiatives | ||||
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | 15,544 | 5,019 | 31,184 | 37,191 |
DMG held for sale | ||||
Segment Reporting Information [Line Items] | ||||
Expenditures for property and equipment | $ 0 | $ 11,935 | $ 38,466 | $ 65,282 |
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 | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 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. | $ 143,270 | $ (136,796) | $ 566,110 | $ 309,166 |
Changes in paid-in capital for: | ||||
Sales of noncontrolling interests | 0 | 0 | 0 | 79 |
Purchases of noncontrolling interests | 10,732 | |||
Purchases of noncontrolling interests | (202) | (5,285) | (17,482) | |
Net transfers to noncontrolling interests | (202) | (5,285) | 10,732 | (17,403) |
Net income (loss) attributable to DaVita Inc., net of transfers to noncontrolling interests | $ 143,068 | $ (142,081) | $ 576,842 | $ 291,763 |
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 | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,781,169 | $ 2,670,701 | $ 8,150,386 | $ 7,980,178 |
Less: Provision for uncollectible accounts | (3,977) | (11,977) | (19,689) | (35,838) |
Net dialysis and related lab patient service revenues | 2,777,192 | 2,658,724 | 8,130,697 | 7,944,340 |
Other revenues | 126,886 | 188,606 | 359,198 | 639,387 |
Total revenues | 2,904,078 | 2,847,330 | 8,489,895 | 8,583,727 |
Operating expenses | 2,525,742 | 2,558,292 | 7,309,166 | 7,445,811 |
Operating income | 378,336 | 289,038 | 1,180,729 | 1,137,916 |
Debt expense | (109,831) | (125,927) | (385,176) | (359,135) |
Other income, net | 5,280 | 4,007 | 17,863 | 10,583 |
Income tax (benefit) expense | 65,254 | 52,047 | 197,938 | 206,652 |
Equity earnings in subsidiaries | 0 | 0 | 0 | 0 |
Net income from continuing operations | 208,531 | 115,071 | 615,478 | 582,712 |
Net (loss) income from discontinued operations, net of tax | (6,843) | (211,739) | 102,854 | (147,829) |
Net income (loss) | 201,688 | (96,668) | 718,332 | 434,883 |
Less: Net income attributable to noncontrolling interests | (58,418) | (40,128) | (152,222) | (125,717) |
Net income (loss) attributable to DaVita Inc. | 143,270 | (136,796) | 566,110 | 309,166 |
Consolidating adjustments | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | (67,597) | (56,956) | (195,357) | (159,365) |
Less: Provision for uncollectible accounts | 0 | 0 | 0 | 0 |
Net dialysis and related lab patient service revenues | (67,597) | (56,956) | (195,357) | (159,365) |
Other revenues | (302,113) | (283,079) | (809,523) | (836,543) |
Total revenues | (369,710) | (340,035) | (1,004,880) | (995,908) |
Operating expenses | (369,710) | (340,035) | (1,004,880) | (995,908) |
Operating income | 0 | 0 | 0 | 0 |
Debt expense | 58,622 | 62,250 | 188,944 | 185,399 |
Other income, net | (58,622) | (110,463) | (281,676) | (328,835) |
Income tax (benefit) expense | 0 | 0 | 0 | 0 |
Equity earnings in subsidiaries | (166,245) | 61,323 | (766,205) | (583,723) |
Net income from continuing operations | (166,245) | 13,110 | (858,937) | (727,159) |
Net (loss) income from discontinued operations, net of tax | 0 | 48,213 | 92,732 | 143,436 |
Net income (loss) | (166,245) | 61,323 | (766,205) | (583,723) |
Less: Net income attributable to noncontrolling interests | (58,418) | (40,128) | (152,222) | (125,717) |
Net income (loss) attributable to DaVita Inc. | (224,663) | 21,195 | (918,427) | (709,440) |
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 | 204,183 | 207,968 | 600,318 | 608,850 |
Total revenues | 204,183 | 207,968 | 600,318 | 608,850 |
Operating expenses | 11,046 | 205,324 | 315,169 | 484,329 |
Operating income | 193,137 | 2,644 | 285,149 | 124,521 |
Debt expense | (110,712) | (127,353) | (389,203) | (362,501) |
Other income, net | 51,150 | 106,148 | 263,407 | 315,573 |
Income tax (benefit) expense | 33,364 | (3,536) | 41,017 | 24,108 |
Equity earnings in subsidiaries | 43,059 | (121,771) | 447,774 | 255,681 |
Net income from continuing operations | 143,270 | (136,796) | 566,110 | 309,166 |
Net (loss) income from discontinued operations, net of tax | 0 | 0 | 0 | 0 |
Net income (loss) | 143,270 | (136,796) | 566,110 | 309,166 |
Less: Net income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income (loss) attributable to DaVita Inc. | 143,270 | (136,796) | 566,110 | 309,166 |
Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 1,761,235 | 1,699,109 | 5,181,017 | 5,100,487 |
Less: Provision for uncollectible accounts | (2,728) | (9,246) | (13,530) | (26,430) |
Net dialysis and related lab patient service revenues | 1,758,507 | 1,689,863 | 5,167,487 | 5,074,057 |
Other revenues | 140,956 | 127,269 | 438,058 | 355,055 |
Total revenues | 1,899,463 | 1,817,132 | 5,605,545 | 5,429,112 |
Operating expenses | 1,823,752 | 1,649,128 | 5,106,307 | 4,949,070 |
Operating income | 75,711 | 168,004 | 499,238 | 480,042 |
Debt expense | (43,535) | (50,254) | (145,110) | (151,373) |
Other income, net | 2,994 | 603 | 4,332 | 2,864 |
Income tax (benefit) expense | 28,320 | 43,583 | 122,633 | 112,193 |
Equity earnings in subsidiaries | 123,186 | 60,448 | 318,431 | 328,042 |
Net income from continuing operations | 130,036 | 135,218 | 554,258 | 547,382 |
Net (loss) income from discontinued operations, net of tax | 0 | 0 | 0 | 0 |
Net income (loss) | 130,036 | 135,218 | 554,258 | 547,382 |
Less: Net income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income (loss) attributable to DaVita Inc. | 130,036 | 135,218 | 554,258 | 547,382 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 1,087,531 | 1,028,548 | 3,164,726 | 3,039,056 |
Less: Provision for uncollectible accounts | (1,249) | (2,731) | (6,159) | (9,408) |
Net dialysis and related lab patient service revenues | 1,086,282 | 1,025,817 | 3,158,567 | 3,029,648 |
Other revenues | 83,860 | 136,448 | 130,345 | 512,025 |
Total revenues | 1,170,142 | 1,162,265 | 3,288,912 | 3,541,673 |
Operating expenses | 1,060,654 | 1,043,875 | 2,892,570 | 3,008,320 |
Operating income | 109,488 | 118,390 | 396,342 | 533,353 |
Debt expense | (14,206) | (10,570) | (39,807) | (30,660) |
Other income, net | 9,758 | 7,719 | 31,800 | 20,981 |
Income tax (benefit) expense | 3,570 | 12,000 | 34,288 | 70,351 |
Equity earnings in subsidiaries | 0 | 0 | 0 | 0 |
Net income from continuing operations | 101,470 | 103,539 | 354,047 | 453,323 |
Net (loss) income from discontinued operations, net of tax | (6,843) | (259,952) | 10,122 | (291,265) |
Net income (loss) | 94,627 | (156,413) | 364,169 | 162,058 |
Less: Net income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income (loss) attributable to DaVita Inc. | $ 94,627 | $ (156,413) | $ 364,169 | $ 162,058 |
Condensed consolidating finan_4
Condensed consolidating financial statements - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Condensed Financial Statements Captions [Line Items] | ||||
Net income | $ 201,688 | $ (96,668) | $ 718,332 | $ 434,883 |
Other comprehensive income | (43,993) | (7,184) | (42,680) | (33,976) |
Total comprehensive income (loss) | 157,695 | (103,852) | 675,652 | 400,907 |
Less: Comprehensive income attributable to noncontrolling interests | (58,418) | (40,128) | (152,222) | (125,717) |
Comprehensive income (loss) attributable to DaVita Inc. | 99,277 | (143,980) | 523,430 | 275,190 |
Consolidating adjustments | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | (166,245) | 61,323 | (766,205) | (583,723) |
Other comprehensive income | 0 | 0 | 0 | 0 |
Total comprehensive income (loss) | (166,245) | 61,323 | (766,205) | (583,723) |
Less: Comprehensive income attributable to noncontrolling interests | (58,418) | (40,128) | (152,222) | (125,717) |
Comprehensive income (loss) attributable to DaVita Inc. | (224,663) | 21,195 | (918,427) | (709,440) |
DaVita Inc. | Reportable Legal Entities | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 143,270 | (136,796) | 566,110 | 309,166 |
Other comprehensive income | 509 | 1,643 | 3,110 | 5,499 |
Total comprehensive income (loss) | 143,779 | (135,153) | 569,220 | 314,665 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income (loss) attributable to DaVita Inc. | 143,779 | (135,153) | 569,220 | 314,665 |
Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 130,036 | 135,218 | 554,258 | 547,382 |
Other comprehensive income | 0 | 0 | 0 | 0 |
Total comprehensive income (loss) | 130,036 | 135,218 | 554,258 | 547,382 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income (loss) attributable to DaVita Inc. | 130,036 | 135,218 | 554,258 | 547,382 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income | 94,627 | (156,413) | 364,169 | 162,058 |
Other comprehensive income | (44,502) | (8,827) | (45,790) | (39,475) |
Total comprehensive income (loss) | 50,125 | (165,240) | 318,379 | 122,583 |
Less: Comprehensive income attributable to noncontrolling interests | 0 | 0 | 0 | 0 |
Comprehensive income (loss) attributable to DaVita Inc. | $ 50,125 | $ (165,240) | $ 318,379 | $ 122,583 |
Condensed consolidating finan_5
Condensed consolidating financial statements - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 | Dec. 31, 2017 |
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | $ 1,253,256 | $ 323,038 | |
Restricted cash and equivalents | 103,885 | 92,382 | |
Accounts receivable, net | 1,901,225 | 1,858,608 | |
Other current assets | 740,352 | 760,566 | |
Current assets held for sale, net | 0 | 5,389,565 | |
Total current assets | 3,998,718 | 8,424,159 | |
Property and equipment, net | 3,419,238 | 3,393,669 | |
Operating lease right-of-use asset | 2,781,288 | 0 | |
Intangible assets, net | 117,666 | 118,846 | |
Investments in and advances to affiliates, net | 0 | 0 | |
Other long-term assets and investments | 369,261 | 331,618 | |
Goodwill | 6,765,659 | 6,841,960 | $ 6,610,279 |
Total assets | 17,451,830 | 19,110,252 | |
Current liabilities | 2,206,640 | 3,647,402 | |
Current liabilities held for sale | 0 | 1,243,759 | |
Intercompany liabilities, net | 0 | 0 | |
Long-term operating lease liabilities | 2,682,125 | 0 | |
Long-term debt and other long-term liabilities | 8,754,483 | 9,186,052 | |
Noncontrolling interests subject to put provisions | 1,296,059 | 1,124,641 | |
Total DaVita Inc. shareholders' equity | 2,318,576 | 3,703,442 | |
Noncontrolling interests not subject to put provisions | 193,947 | 204,956 | |
Total equity | 2,512,523 | 3,908,398 | |
Total liabilities and equity | 17,451,830 | 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 and advances to affiliates, net | (20,650,469) | (22,217,544) | |
Other long-term assets and investments | 0 | 0 | |
Goodwill | 0 | 0 | |
Total assets | (20,650,469) | (22,217,544) | |
Current liabilities | 0 | 0 | |
Current liabilities held for sale | 0 | ||
Intercompany liabilities, net | (6,570,166) | (8,659,837) | |
Long-term operating lease liabilities | 0 | ||
Long-term debt and other long-term liabilities | 0 | 0 | |
Noncontrolling interests subject to put provisions | 554,759 | 526,566 | |
Total DaVita Inc. shareholders' equity | (14,080,303) | (13,557,707) | |
Noncontrolling interests not subject to put provisions | (554,759) | (526,566) | |
Total equity | (14,635,062) | (14,084,273) | |
Total liabilities and equity | (20,650,469) | (22,217,544) | |
DaVita Inc. | Reportable Legal Entities | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 831,514 | 60,653 | |
Restricted cash and equivalents | 0 | 1,005 | |
Accounts receivable, net | 0 | 0 | |
Other current assets | 161,548 | 37,185 | |
Current assets held for sale, net | 0 | ||
Total current assets | 993,062 | 98,843 | |
Property and equipment, net | 515,952 | 491,462 | |
Operating lease right-of-use asset | 103,621 | ||
Intangible assets, net | 85 | 153 | |
Investments in and advances to affiliates, net | 10,465,104 | 13,522,198 | |
Other long-term assets and investments | 96,953 | 53,385 | |
Goodwill | 0 | 0 | |
Total assets | 12,174,777 | 14,166,041 | |
Current liabilities | 313,934 | 1,945,943 | |
Current liabilities held for sale | 0 | ||
Intercompany liabilities, net | 922,571 | 0 | |
Long-term operating lease liabilities | 131,743 | ||
Long-term debt and other long-term liabilities | 7,746,653 | 7,918,581 | |
Noncontrolling interests subject to put provisions | 741,300 | 598,075 | |
Total DaVita Inc. shareholders' equity | 2,318,576 | 3,703,442 | |
Noncontrolling interests not subject to put provisions | 0 | 0 | |
Total equity | 2,318,576 | 3,703,442 | |
Total liabilities and equity | 12,174,777 | 14,166,041 | |
Guarantor subsidiaries | Reportable Legal Entities | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 213,635 | 1,232 | |
Restricted cash and equivalents | 14,444 | 12,048 | |
Accounts receivable, net | 1,221,169 | 1,204,122 | |
Other current assets | 455,616 | 565,974 | |
Current assets held for sale, net | 0 | ||
Total current assets | 1,904,864 | 1,783,376 | |
Property and equipment, net | 1,576,140 | 1,584,321 | |
Operating lease right-of-use asset | 1,592,472 | ||
Intangible assets, net | 34,493 | 42,896 | |
Investments in and advances to affiliates, net | 7,110,581 | 6,196,801 | |
Other long-term assets and investments | 91,115 | 90,037 | |
Goodwill | 4,818,001 | 4,806,939 | |
Total assets | 17,127,666 | 14,504,370 | |
Current liabilities | 1,233,054 | 1,217,526 | |
Current liabilities held for sale | 0 | ||
Intercompany liabilities, net | 3,074,785 | 2,498,545 | |
Long-term operating lease liabilities | 1,508,343 | ||
Long-term debt and other long-term liabilities | 664,470 | 687,443 | |
Noncontrolling interests subject to put provisions | 0 | 0 | |
Total DaVita Inc. shareholders' equity | 10,647,014 | 10,100,856 | |
Noncontrolling interests not subject to put provisions | 0 | 0 | |
Total equity | 10,647,014 | 10,100,856 | |
Total liabilities and equity | 17,127,666 | 14,504,370 | |
Non- Guarantor subsidiaries | Reportable Legal Entities | |||
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | 208,107 | 261,153 | |
Restricted cash and equivalents | 89,441 | 79,329 | |
Accounts receivable, net | 680,056 | 654,486 | |
Other current assets | 123,188 | 157,407 | |
Current assets held for sale, net | 5,389,565 | ||
Total current assets | 1,100,792 | 6,541,940 | |
Property and equipment, net | 1,327,146 | 1,317,886 | |
Operating lease right-of-use asset | 1,085,195 | ||
Intangible assets, net | 83,088 | 75,797 | |
Investments in and advances to affiliates, net | 3,074,784 | 2,498,545 | |
Other long-term assets and investments | 181,193 | 188,196 | |
Goodwill | 1,947,658 | 2,035,021 | |
Total assets | 8,799,856 | 12,657,385 | |
Current liabilities | 659,652 | 483,933 | |
Current liabilities held for sale | 1,243,759 | ||
Intercompany liabilities, net | 2,572,810 | 6,161,292 | |
Long-term operating lease liabilities | 1,042,039 | ||
Long-term debt and other long-term liabilities | 343,360 | 580,028 | |
Noncontrolling interests subject to put provisions | 0 | 0 | |
Total DaVita Inc. shareholders' equity | 3,433,289 | 3,456,851 | |
Noncontrolling interests not subject to put provisions | 748,706 | 731,522 | |
Total equity | 4,181,995 | 4,188,373 | |
Total liabilities and equity | $ 8,799,856 | $ 12,657,385 |
Condensed consolidating finan_6
Condensed consolidating financial statements - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Cash flows from operating activities: | ||||
Net income (loss) | $ 201,688 | $ (96,668) | $ 718,332 | $ 434,883 |
Changes in operating assets and liabilities and non-cash items included in net income | 673,493 | 947,365 | ||
Net cash provided by operating activities | 1,391,825 | 1,382,248 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (173,265) | (231,682) | (547,183) | (705,659) |
Acquisitions | (77,348) | (113,526) | ||
Proceeds from asset and business sales | 3,863,619 | 135,268 | ||
purchases from investment sales and other items, net | (105,063) | 22,598 | ||
Net cash used in investing activities | 3,134,025 | (661,319) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (2,050,012) | 845,836 | ||
Intercompany borrowings (payments) | 0 | 0 | ||
Other items | (1,953,752) | (1,269,175) | ||
Net cash used in financing activities | (4,003,764) | (423,339) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (4,178) | (5,790) | ||
Net increase in cash, cash equivalents and restricted cash | 517,908 | 291,800 | ||
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 | 1,357,141 | 540,155 | 1,357,141 | 540,155 |
Consolidating adjustments | ||||
Cash flows from operating activities: | ||||
Net income (loss) | (166,245) | 61,323 | (766,205) | (583,723) |
Changes in operating assets and liabilities and non-cash items included in net income | 766,205 | 583,723 | ||
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 | ||
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 borrowings (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 (loss) | 143,270 | (136,796) | 566,110 | 309,166 |
Changes in operating assets and liabilities and non-cash items included in net income | (336,223) | (235,558) | ||
Net cash provided by operating activities | 229,887 | 73,608 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (106,476) | (124,585) | ||
Acquisitions | 0 | |||
Proceeds from asset and business sales | 3,824,516 | 0 | ||
purchases from investment sales and other items, net | (94,322) | 32,345 | ||
Net cash used in investing activities | 3,623,718 | (92,240) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (2,028,954) | 866,537 | ||
Intercompany borrowings (payments) | 785,450 | 454,410 | ||
Other items | (1,840,245) | (1,154,921) | ||
Net cash used in financing activities | (3,083,749) | 166,026 | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | 0 | ||
Net increase in cash, cash equivalents and restricted cash | 769,856 | 147,394 | ||
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 | 831,514 | 297,701 | 831,514 | 297,701 |
Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from operating activities: | ||||
Net income (loss) | 130,036 | 135,218 | 554,258 | 547,382 |
Changes in operating assets and liabilities and non-cash items included in net income | (74,600) | (104,179) | ||
Net cash provided by operating activities | 479,658 | 443,203 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (218,839) | (296,028) | ||
Acquisitions | (11,832) | (5,646) | ||
Proceeds from asset and business sales | (244) | 55,035 | ||
purchases from investment sales and other items, net | (7,474) | (2,295) | ||
Net cash used in investing activities | (238,389) | (248,934) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (8,025) | (8,601) | ||
Intercompany borrowings (payments) | (14,854) | (174,148) | ||
Other items | (3,591) | (18,713) | ||
Net cash used in financing activities | (26,470) | (201,462) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | 0 | ||
Net increase in cash, cash equivalents and restricted cash | 214,799 | (7,193) | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 13,280 | 19,963 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | 228,079 | 12,770 | 228,079 | 12,770 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from operating activities: | ||||
Net income (loss) | 94,627 | (156,413) | 364,169 | 162,058 |
Changes in operating assets and liabilities and non-cash items included in net income | 318,111 | 703,379 | ||
Net cash provided by operating activities | 682,280 | 865,437 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (221,868) | (285,046) | ||
Acquisitions | (65,516) | (107,880) | ||
Proceeds from asset and business sales | 39,347 | 80,233 | ||
purchases from investment sales and other items, net | (3,267) | (7,452) | ||
Net cash used in investing activities | (251,304) | (320,145) | ||
Cash flows from financing activities: | ||||
Long-term debt and related financing costs, net | (13,033) | (12,100) | ||
Intercompany borrowings (payments) | (770,596) | (280,262) | ||
Other items | (109,916) | (95,541) | ||
Net cash used in financing activities | (893,545) | (387,903) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (4,178) | (5,790) | ||
Net increase in cash, cash equivalents and restricted cash | (466,747) | 151,599 | ||
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 340,482 | 348,650 | ||
Cash, cash equivalents and restricted cash of continuing operations at end of the period | $ 297,548 | $ 229,684 | 297,548 | 229,684 |
Discontinued Operations | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | (423,813) | 270,565 | ||
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) | 270,565 | ||
Continuing Operations | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 941,721 | 21,235 | ||
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 | 769,856 | 147,394 | ||
Continuing Operations | Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | 214,799 | (7,193) | ||
Continuing Operations | Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | $ (42,934) | $ (118,966) |
Supplemental Data - Condensed C
Supplemental Data - Condensed Consolidating Statements of Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | $ 2,781,169 | $ 2,670,701 | $ 8,150,386 | $ 7,980,178 |
Provision for uncollectible accounts | (3,977) | (11,977) | (19,689) | (35,838) |
Net dialysis and related lab patient service revenues | 2,777,192 | 2,658,724 | 8,130,697 | 7,944,340 |
Other revenues | 126,886 | 188,606 | 359,198 | 639,387 |
Total revenues | 2,904,078 | 2,847,330 | 8,489,895 | 8,583,727 |
Operating expenses | 2,525,742 | 2,558,292 | 7,309,166 | 7,445,811 |
Operating income | 378,336 | 289,038 | 1,180,729 | 1,137,916 |
Debt expense | (109,831) | (125,927) | (385,176) | (359,135) |
Other income | 5,280 | 4,007 | 17,863 | 10,583 |
Income tax expense | 65,254 | 52,047 | 197,938 | 206,652 |
Net income from continuing operations | 208,531 | 115,071 | 615,478 | 582,712 |
Net (loss) income from discontinued operations, net of tax | (6,843) | (211,739) | 102,854 | (147,829) |
Net income (loss) | 201,688 | (96,668) | 718,332 | 434,883 |
Less: Net income attributable to noncontrolling interests | (58,418) | (40,128) | (152,222) | (125,717) |
Net income (loss) attributable to DaVita Inc. | $ 143,270 | $ (136,796) | 566,110 | $ 309,166 |
Physician Groups | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 0 | |||
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 (loss) income from discontinued operations, net of tax | 12,706 | |||
Net income (loss) | 12,706 | |||
Less: Net income attributable to noncontrolling interests | (1,255) | |||
Net income (loss) attributable to DaVita Inc. | 11,451 | |||
Unrestricted Subsidiaries | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 0 | |||
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 (loss) income from discontinued operations, net of tax | 249 | |||
Net income (loss) | 249 | |||
Less: Net income attributable to noncontrolling interests | 0 | |||
Net income (loss) attributable to DaVita Inc. | 249 | |||
Company and Restricted Subsidiaries | ||||
Condensed Income Statements Captions [Line Items] | ||||
Dialysis and related lab patient service revenues | 8,150,386 | |||
Provision for uncollectible accounts | (19,689) | |||
Net dialysis and related lab patient service revenues | 8,130,697 | |||
Other revenues | 359,198 | |||
Total revenues | 8,489,895 | |||
Operating expenses | 7,309,166 | |||
Operating income | 1,180,729 | |||
Debt expense | (385,176) | |||
Other income | 17,863 | |||
Income tax expense | 197,938 | |||
Net income from continuing operations | 615,478 | |||
Net (loss) income from discontinued operations, net of tax | 89,899 | |||
Net income (loss) | 705,377 | |||
Less: Net income attributable to noncontrolling interests | (150,967) | |||
Net income (loss) attributable to DaVita Inc. | $ 554,410 |
Supplemental Data - Condensed_2
Supplemental Data - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Condensed Financial Statements Captions [Line Items] | ||||
Net income (loss) | $ 201,688 | $ (96,668) | $ 718,332 | $ 434,883 |
Other comprehensive income | (43,993) | (7,184) | (42,680) | (33,976) |
Total comprehensive income (loss) | 157,695 | (103,852) | 675,652 | 400,907 |
Less: Comprehensive income attributable to noncontrolling interests | (58,418) | (40,128) | (152,222) | (125,717) |
Comprehensive income (loss) attributable to DaVita Inc. | $ 99,277 | $ (143,980) | 523,430 | $ 275,190 |
Physician Groups | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income (loss) | 12,706 | |||
Other comprehensive income | 0 | |||
Total comprehensive income (loss) | 12,706 | |||
Less: Comprehensive income attributable to noncontrolling interests | (1,255) | |||
Comprehensive income (loss) attributable to DaVita Inc. | 11,451 | |||
Unrestricted Subsidiaries | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income (loss) | 249 | |||
Other comprehensive income | 0 | |||
Total comprehensive income (loss) | 249 | |||
Less: Comprehensive income attributable to noncontrolling interests | 0 | |||
Comprehensive income (loss) attributable to DaVita Inc. | 249 | |||
Company and Restricted Subsidiaries | ||||
Condensed Financial Statements Captions [Line Items] | ||||
Net income (loss) | 705,377 | |||
Other comprehensive income | (42,680) | |||
Total comprehensive income (loss) | 662,697 | |||
Less: Comprehensive income attributable to noncontrolling interests | (150,967) | |||
Comprehensive income (loss) attributable to DaVita Inc. | $ 511,730 |
Supplemental Data - Condensed_3
Supplemental Data - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018 | Dec. 31, 2017 |
Condensed Balance Sheet Statements Captions [Line Items] | |||
Cash and cash equivalents | $ 1,253,256 | $ 323,038 | |
Restricted cash and equivalents | 103,885 | 92,382 | |
Accounts receivable, net | 1,901,225 | 1,858,608 | |
Other current assets | 740,352 | 760,566 | |
Total current assets | 3,998,718 | 8,424,159 | |
Property and equipment, net | 3,419,238 | 3,393,669 | |
Operating lease right-of-use asset | 2,781,288 | 0 | |
Intangible assets, net | 117,666 | 118,846 | |
Other long-term assets | 369,261 | 331,618 | |
Goodwill | 6,765,659 | 6,841,960 | $ 6,610,279 |
Total assets | 17,451,830 | 19,110,252 | |
Current liabilities | 2,206,640 | 3,647,402 | |
Long-term operating lease liabilities | 2,682,125 | 0 | |
Long-term debt and other long-term liabilities | 8,754,483 | 9,186,052 | |
Noncontrolling interests subject to put provisions | 1,296,059 | 1,124,641 | |
Total DaVita Inc. shareholders’ equity | 2,318,576 | 3,703,442 | |
Noncontrolling interests not subject to put provisions | 193,947 | 204,956 | |
Total equity | 2,512,523 | 3,908,398 | |
Total liabilities and equity | 17,451,830 | $ 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 | 1,253,256 | ||
Restricted cash and equivalents | 103,885 | ||
Accounts receivable, net | 1,901,225 | ||
Other current assets | 740,352 | ||
Total current assets | 3,998,718 | ||
Property and equipment, net | 3,419,238 | ||
Operating lease right-of-use asset | 2,781,288 | ||
Intangible assets, net | 117,666 | ||
Other long-term assets | 369,261 | ||
Goodwill | 6,765,659 | ||
Total assets | 17,451,830 | ||
Current liabilities | 2,206,640 | ||
Long-term operating lease liabilities | 2,682,125 | ||
Long-term debt and other long-term liabilities | 8,754,483 | ||
Noncontrolling interests subject to put provisions | 1,296,059 | ||
Total DaVita Inc. shareholders’ equity | 2,318,576 | ||
Noncontrolling interests not subject to put provisions | 193,947 | ||
Total equity | 2,512,523 | ||
Total liabilities and equity | $ 17,451,830 |
Supplemental Data - Condensed_4
Supplemental Data - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | |
Cash flows from operating activities: | ||||
Net income (loss) | $ 201,688 | $ (96,668) | $ 718,332 | $ 434,883 |
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | 673,493 | 947,365 | ||
Net cash provided by operating activities | 1,391,825 | 1,382,248 | ||
Cash flows from investing activities: | ||||
Additions of property and equipment | (173,265) | (231,682) | (547,183) | (705,659) |
Acquisitions | (77,348) | |||
Proceeds from asset and business sales | 3,863,619 | 135,268 | ||
Investments and other items | (105,063) | 22,598 | ||
Net cash used in investing activities | 3,134,025 | (661,319) | ||
Cash flows from financing activities: | ||||
Long-term debt | (2,050,012) | 845,836 | ||
Intercompany | 0 | 0 | ||
Other items | (1,953,752) | (1,269,175) | ||
Net cash used in financing activities | (4,003,764) | (423,339) | ||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (4,178) | (5,790) | ||
Net increase in cash, cash equivalents and restricted cash | 517,908 | 291,800 | ||
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 | 1,357,141 | $ 540,155 | 1,357,141 | 540,155 |
Physician Groups | ||||
Cash flows from operating activities: | ||||
Net income (loss) | 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 (loss) | 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 (loss) | 705,377 | |||
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | 678,349 | |||
Net cash provided by operating activities | 1,383,726 | |||
Cash flows from investing activities: | ||||
Additions of property and equipment | (546,337) | |||
Acquisitions | (77,348) | |||
Proceeds from asset and business sales | 3,863,619 | |||
Investments and other items | (103,181) | |||
Net cash used in investing activities | 3,136,753 | |||
Cash flows from financing activities: | ||||
Long-term debt | (2,050,012) | |||
Intercompany | 247,175 | |||
Other items | (1,953,752) | |||
Net cash used in financing activities | (3,756,589) | |||
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (4,178) | |||
Net increase in cash, cash equivalents and restricted cash | 759,712 | |||
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 | $ 1,357,141 | 1,357,141 | ||
Discontinued Operations | ||||
Cash flows from financing activities: | ||||
Net increase in cash, cash equivalents and restricted cash | (423,813) | 270,565 | ||
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 | 941,721 | $ 21,235 | ||
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 | $ 941,721 |