Document and Entity Information
Document and Entity Information - shares shares in Millions | 3 Months Ended | |
Mar. 31, 2021 | Apr. 26, 2021 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Mar. 31, 2021 | |
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, $0.001 par value | |
Trading Symbol | DVA | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 106.2 | |
Amendment Flag | false | |
Document Fiscal Year Focus | 2021 | |
Document Fiscal Period Focus | Q1 | |
Entity Central Index Key | 0000927066 | |
Current Fiscal Year End Date | --12-31 |
CONSOLIDATED STATEMENTS OF INCO
CONSOLIDATED STATEMENTS OF INCOME (unaudited) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Income Statement [Abstract] | ||
Dialysis patient service revenues | $ 2,714,587 | $ 2,713,281 |
Other revenues | 105,414 | 127,956 |
Total revenues | 2,820,001 | 2,841,237 |
Operating expenses: | ||
Patient care costs | 1,938,330 | 1,975,449 |
General and administrative | 281,426 | 263,576 |
Depreciation and amortization | 165,701 | 154,679 |
Equity investment income | (8,058) | (17,843) |
Total operating expenses | 2,377,399 | 2,375,861 |
Operating income | 442,602 | 465,376 |
Debt expense | (67,014) | (88,603) |
Debt refinancing charges | 0 | (2,948) |
Other income (loss), net | 1,168 | (4,350) |
Income from continuing operations before income taxes | 376,756 | 369,475 |
Income tax expense | 85,211 | 91,560 |
Net income from continuing operations | 291,545 | 277,915 |
Net income from discontinued operations, net of tax | 0 | 9,980 |
Net income | 291,545 | 287,895 |
Less: Net income attributable to noncontrolling interests | (54,142) | (48,302) |
Net income attributable to DaVita Inc. | $ 237,403 | $ 239,593 |
Earnings per share attributable to DaVita Inc.: | ||
Basic net income from continuing operations | $ 2.18 | $ 1.84 |
Basic net income | 2.18 | 1.92 |
Diluted net income from continuing operations | 2.09 | 1.81 |
Diluted net income | $ 2.09 | $ 1.89 |
Weighted average shares for earnings per share: | ||
Basic (in shares) | 109,014,000 | 124,902,000 |
Diluted (in shares) | 113,852,000 | 126,895,000 |
Amounts attributable to DaVita Inc.: | ||
Net income from continuing operations | $ 237,403 | $ 229,613 |
Net income from discontinued operations | 0 | 9,980 |
Net income attributable to DaVita Inc. | $ 237,403 | $ 239,593 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Statement of Comprehensive Income [Abstract] | ||
Net income | $ 291,545 | $ 287,895 |
Unrealized gains (losses) on interest rate cap agreements: | ||
Unrealized gains (losses) | 4,882 | (13,018) |
Reclassifications of net realized losses into net income | 1,033 | 1,623 |
Unrealized losses on foreign currency translation | (62,544) | (81,632) |
Other comprehensive loss | (56,629) | (93,027) |
Total comprehensive income | 234,916 | 194,868 |
Less: Comprehensive income attributable to noncontrolling interests | (54,142) | (48,302) |
Comprehensive income attributable to DaVita Inc. | $ 180,774 | $ 146,566 |
CONSOLIDATED BALANCE SHEETS (un
CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
ASSETS | ||
Cash and cash equivalents | $ 884,205 | $ 324,958 |
Restricted cash and equivalents | 176,835 | 176,832 |
Short-term investments | 11,060 | 20,101 |
Accounts receivable, net | 2,040,813 | 1,824,282 |
Inventories | 116,322 | 111,625 |
Other receivables | 535,521 | 544,376 |
Prepaid and other current assets | 73,765 | 76,387 |
Income tax receivable | 28,160 | 70,163 |
Total current assets | 3,866,681 | 3,148,724 |
Property and equipment, net | 3,490,442 | 3,521,824 |
Operating lease right-of-use asset | 2,868,292 | 2,863,089 |
Intangible assets, net | 150,706 | 166,585 |
Equity method and other investments | 257,513 | 257,491 |
Long-term investments | 31,891 | 32,193 |
Other long-term assets | 90,534 | 79,501 |
Goodwill | 6,891,209 | 6,919,109 |
Total assets | 17,647,268 | 16,988,516 |
LIABILITIES AND EQUITY | ||
Accounts payable | 348,105 | 434,253 |
Other liabilities | 846,710 | 810,529 |
Accrued compensation and benefits | 550,671 | 685,555 |
Current portion of operating lease liabilities | 372,737 | 369,497 |
Current portion of long-term debt | 168,191 | 168,541 |
Income tax payable | 28,310 | 7,768 |
Total current liabilities | 2,314,724 | 2,476,143 |
Long-term operating lease liabilities | 2,739,311 | 2,738,670 |
Long-term debt | 8,829,765 | 7,917,263 |
Other long-term liabilities | 150,724 | 150,060 |
Deferred income taxes | 830,369 | 809,600 |
Total liabilities | 14,864,893 | 14,091,736 |
Commitments and contingencies: | ||
Noncontrolling interests subject to put provisions | 1,349,160 | 1,330,028 |
Equity: | ||
Preferred Stock, Value, Issued | 0 | 0 |
Common Stock, Value, Issued | 110 | 110 |
Additional paid-in capital | 603,172 | 597,073 |
Retained earnings | 1,089,940 | 852,537 |
Treasury Stock, Value | (322,333) | 0 |
Accumulated other comprehensive loss | (122,783) | (66,154) |
Total DaVita Inc. shareholders' equity | 1,248,106 | 1,383,566 |
Noncontrolling interests not subject to put provisions | 185,109 | 183,186 |
Total equity | 1,433,215 | 1,566,752 |
Total liabilities and equity | $ 17,647,268 | $ 16,988,516 |
CONSOLIDATED BALANCE SHEETS (_2
CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - USD ($) shares in Thousands, $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Statement of Financial Position [Abstract] | ||
Property and equipment, accumulated depreciation | $ 4,622,798 | $ 4,480,429 |
Intangible assets, accumulated amortization | $ 69,691 | $ 70,141 |
Preferred stock, par value (usd per share) | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized (in shares) | 5,000 | 5,000 |
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 | 450,000 |
Common stock, shares issued (in shares) | 110,027 | 109,933 |
Common stock, shares outstanding (in shares) | 107,078 | 109,933 |
Treasury Stock, Common, Shares | 2,949 | 0 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Cash flows from operating activities: | ||
Net income | $ 291,545 | $ 287,895 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 165,701 | 154,679 |
Debt refinancing charges | 0 | 884 |
Stock-based compensation expense | 23,595 | 19,870 |
Deferred income taxes | 18,688 | 103,301 |
Equity investment income, net | (2,924) | (9,482) |
Other non-cash charges, net | 3,979 | 5,055 |
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures: | ||
Accounts receivable | (224,274) | (32,966) |
Inventories | (5,303) | 1,835 |
Other receivables and prepaid and other current assets | 13,756 | (24,965) |
Other long-term assets | (6,521) | 2,673 |
Accounts payable | (75,504) | (24,045) |
Accrued compensation and benefits | (126,330) | (96,428) |
Other current liabilities | 26,970 | 3,982 |
Income taxes | 62,719 | (32,616) |
Other long-term liabilities | (11,793) | 709 |
Net cash provided by operating activities | 154,304 | 360,381 |
Cash flows from investing activities: | ||
Additions of property and equipment | (144,913) | (154,942) |
Acquisitions | (3,668) | (34,107) |
Proceeds from asset and business sales | 16,337 | 31,518 |
Purchase of debt investments held-to-maturity | (5,349) | (5,049) |
Purchase of other debt and equity investments | (1,779) | (2,633) |
Proceeds from debt investments held-to-maturity | 5,349 | 5,049 |
Proceeds from sale of other debt and equity investments | 11,879 | 3,268 |
Purchase of equity method investments | (3,200) | (6,174) |
Distributions from equity method investments | 978 | 445 |
Net cash used in investing activities | (124,366) | (162,625) |
Cash flows from financing activities: | ||
Borrowings | 1,606,969 | 570,779 |
Payments on long-term debt | (698,298) | (104,592) |
Deferred financing costs | (8,346) | (350) |
Purchase of treasury stock | (316,250) | (321,798) |
Distributions to noncontrolling interests | (53,867) | (58,131) |
Net (payments) receipts related to stock purchases and awards | (2,524) | |
Net (payments) receipts related to stock purchases and awards | 2,397 | |
Contributions from noncontrolling interests | 10,689 | 9,387 |
Purchases of noncontrolling interests | (1,095) | (700) |
Net cash provided by financing activities | 537,278 | 96,992 |
Effect of exchange rate changes on cash, cash equivalents and restricted cash | (7,966) | (14,978) |
Net increase in cash, cash equivalents and restricted cash | 559,250 | 279,770 |
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year | 501,790 | 1,208,718 |
Cash, cash equivalents and restricted cash of continuing operations at end of the year | 1,061,040 | 1,488,488 |
Discontinued Operations | ||
Cash flows from financing activities: | ||
Net increase in cash, cash equivalents and restricted cash | 0 | 0 |
Continuing Operations | ||
Cash flows from financing activities: | ||
Net increase in cash, cash equivalents and restricted cash | $ 559,250 | $ 279,770 |
CONSOLIDATED STATEMENTS OF EQUI
CONSOLIDATED STATEMENTS OF EQUITY (unaudited) - USD ($) shares in Thousands, $ in Thousands | Total | Total | Non- controlling interests subject to put provisions | Common stock | Additional paid-in capital | Retained earnings | Treasury stock | Accumulated other comprehensive loss | Non- controlling interests not subject to put provisions |
Temporary equity, start balance at Dec. 31, 2019 | $ 1,180,376 | ||||||||
Increase (Decrease) in Temporary Equity [Roll Forward] | |||||||||
Net income | 32,176 | ||||||||
Distributions | (37,566) | ||||||||
Contributions | 5,283 | ||||||||
Partial purchases | (255) | ||||||||
Fair value remeasurements | 48,022 | ||||||||
Temporary equity, ending balance at Mar. 31, 2020 | 1,228,036 | ||||||||
Beginning balance at Dec. 31, 2019 | $ 2,133,409 | $ 126 | $ 749,043 | $ 1,431,738 | $ 0 | $ (47,498) | $ 185,833 | ||
Beginning balance (in shares) at Dec. 31, 2019 | 125,843 | 0 | |||||||
Comprehensive income: | |||||||||
Net income attributable to DaVita Inc. | 239,593 | 239,593 | 16,126 | ||||||
Other comprehensive income (loss) | $ (93,027) | (93,027) | (93,027) | ||||||
Stock award plan | (320) | (320) | |||||||
Stock award plan (in shares) | 14 | ||||||||
Stock-settled stock-based compensation expense | 19,797 | 19,797 | |||||||
Changes in noncontrolling interest from: | |||||||||
Distributions | (20,565) | ||||||||
Contributions | 4,104 | ||||||||
Partial purchases | (445) | (445) | |||||||
Fair value remeasurements | (48,022) | (48,022) | |||||||
Purchase of treasury stock | (303,139) | $ (303,139) | |||||||
Purchase of treasury stock (in shares) | (4,052) | ||||||||
Ending balance at Mar. 31, 2020 | 1,947,846 | $ 126 | 720,053 | 1,671,331 | $ (303,139) | (140,525) | 185,498 | ||
Ending balance (in shares) at Mar. 31, 2020 | 125,857 | (4,052) | |||||||
Temporary equity, start balance at Dec. 31, 2020 | 1,330,028 | ||||||||
Increase (Decrease) in Temporary Equity [Roll Forward] | |||||||||
Net income | 35,600 | ||||||||
Distributions | (34,259) | ||||||||
Contributions | 7,695 | ||||||||
Partial purchases | (201) | ||||||||
Fair value remeasurements | 10,297 | ||||||||
Temporary equity, ending balance at Mar. 31, 2021 | $ 1,349,160 | ||||||||
Beginning balance at Dec. 31, 2020 | $ 1,566,752 | 1,383,566 | $ 110 | 597,073 | 852,537 | $ 0 | (66,154) | 183,186 | |
Beginning balance (in shares) at Dec. 31, 2020 | 109,933 | 109,933 | 0 | ||||||
Comprehensive income: | |||||||||
Net income attributable to DaVita Inc. | 237,403 | 237,403 | 18,542 | ||||||
Other comprehensive income (loss) | $ (56,629) | (56,629) | (56,629) | ||||||
Stock award plan | (6,270) | (6,270) | |||||||
Stock award plan (in shares) | 94 | ||||||||
Stock-settled stock-based compensation expense | 23,555 | 23,555 | |||||||
Changes in noncontrolling interest from: | |||||||||
Distributions | (19,608) | ||||||||
Contributions | 2,994 | ||||||||
Partial purchases | (889) | (889) | (5) | ||||||
Fair value remeasurements | (10,297) | (10,297) | |||||||
Purchase of treasury stock | (322,333) | $ (322,333) | |||||||
Purchase of treasury stock (in shares) | (2,949) | ||||||||
Ending balance at Mar. 31, 2021 | $ 1,433,215 | $ 1,248,106 | $ 110 | $ 603,172 | $ 1,089,940 | $ (322,333) | $ (122,783) | $ 185,109 | |
Ending balance (in shares) at Mar. 31, 2021 | 107,078 | 110,027 | (2,949) |
Condensed consolidated interim
Condensed consolidated interim financial statements Condensed consolidated interim financial statements | 3 Months Ended |
Mar. 31, 2021 | |
Text Block [Abstract] | |
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block] | Condensed consolidated interim financial statementsThe unaudited condensed consolidated interim financial statements included in this report are prepared by the Company. 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 revenues, expenses, assets, liabilities, contingencies and noncontrolling interests subject to put provisions. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, impairments of goodwill, accounting for income taxes, certain fair value estimates and loss contingencies. The results of operations reflected in these interim financial statements may not necessarily be indicative of annual operating results. 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, 2020 (2020 10-K). Prior period classifications have been conformed to the current period 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 | 3 Months Ended |
Mar. 31, 2021 | |
Text Block [Abstract] | |
Revenue Recognition [Text Block] | Revenue recognition The following table summarizes the Company's segment revenues by primary payor source: Three months ended March 31, 2021 Three months ended March 31, 2020 U.S. dialysis Other - Ancillary services Consolidated U.S. dialysis Other - Ancillary services Consolidated Dialysis patient service revenues: Medicare and Medicare Advantage (1) $ 1,480,297 $ $ 1,480,297 $ 1,531,033 $ $ 1,531,033 Medicaid and Managed Medicaid 187,243 187,243 171,467 171,467 Other government (1) 80,184 106,830 187,014 83,099 94,574 177,673 Commercial 835,479 51,498 886,977 825,582 39,467 865,049 Other revenues: Medicare and Medicare Advantage 85,595 85,595 98,478 98,478 Medicaid and Managed Medicaid 300 300 366 366 Commercial 6,034 6,034 10,521 10,521 Other (2) 6,675 11,162 17,837 5,442 17,602 23,044 Eliminations of intersegment revenues (27,003) (4,293) (31,296) (32,242) (4,152) (36,394) Total $ 2,562,875 $ 257,126 $ 2,820,001 $ 2,584,381 $ 256,856 $ 2,841,237 (1) During the first quarter of 2021, the Company realigned the classification of revenue previously disclosed in the “Other government” category to the “Medicare and Medicare Advantage” category for certain government-reimbursed plans which have structure and payment characteristics similar to traditional Medicare Advantage plans. The classification of revenue for these plans for the three months ended March 31, 2020 has also been recast to conform to the current period presentation. (2) Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services. 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 determination of applicable primary and secondary coverage, changes in patient insurance 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. Dialysis patient service revenues. Revenues are recognized based on the Company’s estimate of the transaction price the Company expects to collect as a result of satisfying its performance obligations. Dialysis patient service revenues are recognized in the period services are provided based on these estimates. Revenues consist primarily of payments from government and commercial health plans for dialysis services provided to patients. A usual and customary fee schedule is |
Earnings per share (Notes)
Earnings per share (Notes) | 3 Months Ended |
Mar. 31, 2021 | |
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 by the weighted average number of common shares outstanding. Weighted average common shares outstanding include restricted stock unit awards that are no longer subject to forfeiture because the 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 as computed under the treasury stock method. The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows: Three months ended 2021 2020 Net income attributable to DaVita Inc.: Continuing operations $ 237,403 $ 229,613 Discontinued operations — 9,980 Net income attributable to DaVita Inc. $ 237,403 $ 239,593 Weighted average shares outstanding: Basic shares 109,014 124,902 Assumed incremental from stock plans 4,838 1,993 Diluted shares 113,852 126,895 Basic net income attributable to DaVita Inc.: Continuing operations per share $ 2.18 $ 1.84 Discontinued operations per share — 0.08 Basic net income per share attributable to DaVita Inc. $ 2.18 $ 1.92 Diluted net income attributable to DaVita Inc.: Continuing operations per share $ 2.09 $ 1.81 Discontinued operations per share — 0.08 Diluted net income per share attributable to DaVita Inc. $ 2.09 $ 1.89 Anti-dilutive stock-settled awards excluded from calculation (1) 27 3,207 (1) Shares associated with stock awards excluded from the diluted denominator calculation because they were anti-dilutive under the treasury stock method. |
Investments in debt and equity
Investments in debt and equity securities | 3 Months Ended |
Mar. 31, 2021 | |
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, consisting of debt instruments classified as held-to-maturity and equity investments with readily determinable fair values or redemption values, were as follows: March 31, 2021 December 31, 2020 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 8,221 $ — $ 8,221 $ 8,217 $ — $ 8,217 Investments in mutual funds and common stock — 34,730 34,730 — 44,077 44,077 $ 8,221 $ 34,730 $ 42,951 $ 8,217 $ 44,077 $ 52,294 Short-term investments $ 8,221 $ 2,839 $ 11,060 $ 8,217 $ 11,884 $ 20,101 Long-term investments — 31,891 31,891 — 32,193 32,193 $ 8,221 $ 34,730 $ 42,951 $ 8,217 $ 44,077 $ 52,294 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 approximated their fair values at March 31, 2021 and December 31, 2020. 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. |
Goodwill
Goodwill | 3 Months Ended |
Mar. 31, 2021 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Goodwill | Goodwill Changes in goodwill by reportable segments were as follows: U.S. dialysis Other - Ancillary services Consolidated Balance at December 31, 2019 $ 6,287,100 $ 500,535 $ 6,787,635 Acquisitions 24,377 105,680 130,057 Divestitures (1,549) (6,744) (8,293) Foreign currency and other adjustments — 9,710 9,710 Balance at December 31, 2020 $ 6,309,928 $ 609,181 $ 6,919,109 Acquisitions — 5,456 5,456 Foreign currency and other adjustments — (33,356) (33,356) Balance at March 31, 2021 $ 6,309,928 $ 581,281 $ 6,891,209 Balance at March 31, 2021: Goodwill $ 6,309,928 $ 711,854 $ 7,021,782 Accumulated impairment charges — (130,573) (130,573) $ 6,309,928 $ 581,281 $ 6,891,209 The Company did not recognize any goodwill impairment charges during the three months ended March 31, 2021 and 2020. As dialysis treatments are an essential, life-sustaining service for patients who depend on them, the Company's operations have continued throughout the novel coronavirus (COVID-19) pandemic. However, the ultimate impact of the dynamic and evolving COVID-19 pandemic on the Company will depend on future developments that are highly uncertain and difficult to predict, including among other things the ultimate severity and duration of the pandemic, further spread or resurgence of the virus (including as a result of the emergence of new strains of the virus), its impact on the chronic kidney disease (CKD) patient population and the Company's patient population, the availability, acceptance, impact and efficacy of COVID-19 vaccines and other treatments, or therapies, the pandemic’s continuing impact on the U.S. and global economies and unemployment, the responses of the Company's competitors to the pandemic and related changes in the marketplace, and the timing, scope and effectiveness of federal, state and local governmental responses. While the Company does not currently expect a material adverse impact to its business as a result of this public health crisis, there can be no assurance that the COVID-19 pandemic will not have a material adverse impact on one or more of the Company's businesses. |
Long-term debt
Long-term debt | 3 Months Ended |
Mar. 31, 2021 | |
Debt Disclosure [Abstract] | |
Long-term debt | Long-term debt Long-term debt was comprised of the following: As of March 31, 2021 March 31, 2021 December 31, 2020 Maturity date Interest rate Estimated fair value (1) Senior Secured Credit Facilities: Term Loan A $ 1,662,500 $ 1,684,375 8/12/2024 LIBOR + 1.50% $ 1,666,656 Term Loan B-1 2,708,836 2,715,694 8/12/2026 LIBOR + 1.75% $ 2,698,678 Revolving line of credit — 75,000 8/12/2024 LIBOR + 1.50% Senior Notes: 4.625% Senior Notes 2,750,000 1,750,000 6/1/2030 4.625 % $ 2,801,150 3.75% Senior Notes 1,500,000 1,500,000 2/15/2031 3.750 % $ 1,436,220 Acquisition obligations and other notes payable (2) 152,531 164,160 2021-2036 4.95 % $ 152,531 Financing lease obligations (3) 289,324 274,292 2022-2038 4.83 % Total debt principal outstanding 9,063,191 8,163,521 Discount, premium and deferred financing costs (4) (65,235) (77,717) 8,997,956 8,085,804 Less current portion (168,191) (168,541) $ 8,829,765 $ 7,917,263 (1) For the Company's senior secured credit facilities and senior notes, fair value estimates are based upon bid and ask quotes, typically a level 2 input. For acquisition obligations and other notes payable, the carrying values presented approximate their estimated fair values, based on estimates of their present values using level 2 interest rate inputs. (2) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current fixed and LIBOR interest rate components in effect as of March 31, 2021. (3) Financing lease obligations are measured at their approximate present values at inception. The interest rate presented is the weighted average discount rate embedded in financing leases outstanding. The term of one ground lease runs to 2070, in addition to the other lease maturity dates presented in the table above. (4) As of March 31, 2021, the carrying amount of the Company's senior secured credit facilities includes a discount of $5,212 and deferred financing costs of $33,650 and the carrying amount of the Company's senior notes includes a premium of $(17,327) and deferred financing costs of $43,700. As of December 31, 2020, the carrying amount of the Company's senior secured credit facilities included a discount of $5,461 and deferred financing costs of $35,825, and the carrying amount of the Company's senior notes included deferred financing costs of $36,431. During the first three months of 2021, the Company made regularly scheduled mandatory principal payments under its senior secured credit facilities totaling $21,875 on Term Loan A and $6,858 on Term Loan B-1. On February 26, 2021, the Company completed an unregistered add-on offering of $1,000,000 aggregate principal amount to the existing 4.625% senior notes due June 1, 2030 (the Additional 2030 Notes) pursuant to Rule 144A and Regulation S under the Securities Act of 1933, as amended. The Additional 2030 Notes were issued at an offering price of 101.750% of face amount, plus an interest payment advance to the Company for interest that would have accrued from December 1, 2020 (the last interest payment date) through the closing date. These Additional 2030 Notes will then bear full six months' semi-annual coupon interest payments beginning June 1, 2021. The terms of the Additional 2030 Notes, other than their issue date, offering price and first interest payment date, are identical to the terms of the $1,750,000 principal amount of the Company’s 4.625% Senior Notes due June 1, 2030 previously issued by the Company on June 9, 2020. The Additional 2030 Notes are unsecured senior obligations and rank equally in right of payment with the Company's existing and future unsecured senior indebtedness. During the three months ended March 31, 2021, the Company incurred $8,346 in fees and other professional expenses associated with this transaction, which were capitalized and will amortize over the term of the Additional 2030 Notes. As of March 31, 2021, the Company's 2019 interest rate cap agreements have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on equivalent amounts of the Company's floating rate debt, including all of Term Loan B-1 and a portion of Term Loan A. The remaining $871,336 outstanding principal balance of Term Loan A is subject to LIBOR-based interest rate volatility. These cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of the cap agreements are reported in other comprehensive income. The original premiums paid for the caps are amortized to debt expense on a straight-line basis over the term of each cap agreement starting from its effective date. These cap agreements do not contain credit risk-contingent features. The following table summarizes the Company’s interest rate cap agreements outstanding as of March 31, 2021 and December 31, 2020, which are classified in "Other long-term assets" on its consolidated balance sheet: Three months ended Fair value Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI gain March 31, 2021 December 31, 2020 2019 cap agreements $ 3,500,000 2.00% 6/30/2020 6/30/2024 $ 1,377 $ 6,505 $ 9,176 $ 2,671 See Note 9 for further details on amounts reclassified from accumulated other comprehensive loss and recorded as debt expense related to the Company’s interest rate cap agreements for the three months ended March 31, 2021 and 2020. The Company’s weighted average effective interest rate on its senior secured credit facilities at the end of the first quarter of 2021 was 1.97%, based on the current margins in effect for Term Loan A and Term Loan B-1 as of March 31, 2021, as described above. The Company’s overall weighted average effective interest rate for the three months ended March 31, 2021 was 3.08% and as of March 31, 2021 was 3.18%. As of March 31, 2021, the Company’s interest rates were fixed on approximately 51% of its total debt. As of March 31, 2021, the Company had an undrawn $1,000,000 revolving line of credit under its senior secured credit facilities. Credit available under this facility is reduced by the amount of any letters of credit outstanding under this facility, but there were no such letters of credit outstanding as of March 31, 2021. The Company also had approximately $64,650 of outstanding letters of credit under a separate bilateral secured letter of credit facility as of March 31, 2021. |
Commitments and Contingencies
Commitments and Contingencies | 3 Months Ended |
Mar. 31, 2021 | |
Commitments and Contingencies Disclosure [Abstract] | |
Contingencies | Commitments and 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 (which frequently arise from qui tam suits) and audits (including, without limitation, investigations or other actions resulting from its obligation to self-report suspected violations of law) and other legal proceedings, including, without limitation, those described below. 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 March 31, 2021 and December 31, 2020, 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. Certain Governmental Inquiries and Related Proceedings 2016 U.S. Attorney Texas Investigation : In February 2016, DaVita Rx, LLC (DaVita Rx), a wholly-owned subsidiary of the Company, 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 government’s investigation covers the period from January 1, 2006 through December 31, 2018. In December 2017, the Company finalized and executed a settlement agreement that resolved certain of the issues in the government’s investigation and 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 is ongoing with respect to issues related to DaVita Rx’s historic relationships with certain pharmaceutical manufacturers, and in July 2018 the Office of Inspector General (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 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. In addition to DaVita Kidney Care, 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. In May 2020, the Company sold its interest in Lifeline, but the Company retained certain liabilities of the Lifeline business, including those related 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. In January 2020, the private party relators served the Company and DaVita Labs with an amended complaint. On February 24, 2020, the Company and DaVita Labs filed a motion to dismiss the amended complaint. On June 25, 2020, the court denied the motion to dismiss. The Company and DaVita Labs answered the complaint on July 23, 2020. The Company and DaVita Labs dispute these allegations and intend to defend this action accordingly. 2020 U.S. Attorney New Jersey Investigation : In March 2020, the U.S. Attorney’s Office, District of New Jersey served the Company with a subpoena and a CID relating to an investigation being conducted by that office and the U.S. Attorney’s Office, Eastern District of Pennsylvania. The subpoena and CID request information on several topics, including certain of the Company’s joint venture arrangements with physicians and physician groups, medical director agreements, and compliance with its five-year Corporate Integrity Agreement, the term of which expired October 22, 2019. The Company is cooperating with the government in this investigation. 2020 California Department of Insurance Investigation : In April 2020, the California Department of Insurance (CDI) sent the Company an Investigative Subpoena relating to an investigation being conducted by that office. CDI issued a superseding subpoena in September 2020. The subpoena, as revised, requests information on a number of topics, including but not limited to the Company’s communications with patients about insurance plans and financial assistance from the American Kidney Fund (AKF), analyses of the potential impact of patients’ decisions to change insurance providers, and documents relating to donations or contributions to the AKF. The Company is cooperating with CDI in this investigation. 2020 Department of Justice Investigation : In October 2020, the Company received a CID from the Department of Justice pursuant to a False Claims Act investigation concerning allegations that DaVita Medical Group (DMG) may have submitted undocumented or unsupported diagnosis codes in connection with Medicare Advantage beneficiaries. The CID covers the period from January 1, 2015 through June 19, 2019, the date the Company completed the divestiture of DMG to Collaborative Care Holdings, LLC. The Company is cooperating with the government in this investigation. * * * Although the Company cannot predict whether or when proceedings might be initiated or when these matters may be resolved (other than as may be described above), it is not unusual for inquiries such as these to continue for a considerable period of time through the various phases of document and witness requests and on-going discussions with regulators and to develop over the course of time. In addition to the inquiries and proceedings specifically identified above, the Company frequently is subject to other inquiries by state or federal government agencies, many of which relate to 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 court denied the motion to dismiss. The Company answered the complaint on May 28, 2019. On January 31, 2020, the plaintiffs filed a motion for class certification and the Company filed its opposition on June 29, 2020. While the Company continues to dispute the allegations, in July 2020, it reached an agreement in principle to resolve this matter without admitting to any liability. Settlement of this matter was covered primarily with insurance proceeds. The Company contributed an amount that did not have a material impact on the Company’s consolidated financial position, results of operations or cash flows. On April 13, 2021, the court granted final approval of the settlement. 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. While the defendants continue to dispute the allegations, in July 2020, an agreement in principle was reached to resolve this matter without admitting to any liability. The Company’s Board of Directors (Board) approved the settlement on October 20, 2020. The court approved the settlement on January 29, 2021. As part of the settlement, the Company agreed to certain corporate governance policies, but did not make any financial contribution towards the settlement. 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 7, 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. |
Noncontrolling interests subject to put provisions and other commitments | Other Commitments The Company also has certain potential commitments to provide working capital funding, if necessary, to certain nonconsolidated outpatient dialysis businesses that the Company manages and in which the Company owns a noncontrolling equity interest or which are wholly-owned by third parties of approximately $8,449. |
Shareholders' equity
Shareholders' equity | 3 Months Ended |
Mar. 31, 2021 | |
Equity [Abstract] | |
Long-term incentive compensation | Shareholders' equity Stock-based compensation During the three months ended March 31, 2021, the Company granted 706 restricted and performance stock units with an aggregate grant-date fair value of $77,279 and a weighted-average expected life of approximately 3.5 years and 132 stock-settled stock appreciation rights with an aggregate grant-date fair value of $4,250 and a weighted-average expected life of approximately 4.5 years. As of March 31, 2021, the Company had $230,270 in total estimated but unrecognized stock-based compensation expense under the Company's equity compensation and employee stock purchase plans. The Company expects to recognize this expense over a weighted average remaining period of 1.5 years. |
Share repurchases | Share repurchases The following table summarizes the Company's common stock repurchases during the three months ended March 31, 2021 and 2020: Three months ended March 31, 2021 Three months ended March 31, 2020 Shares repurchased Amount paid Average paid per share Shares repurchased Amount paid Average paid per share Open market repurchases 2,949 $ 322,333 $ 109.28 4,052 $ 303,139 $ 74.81 The Company repurchased 991 shares of its common stock for $108,892 at an average cost of $109.91 per share subsequent to March 31, 2021 through April 28, 2021. Effective on December 10, 2020, the Company's Board of Directors (Board) terminated all remaining prior share repurchase authorizations available to the Company and approved a new share repurchase authorization of $2,000,000. As of April 28, 2021, the Company had a total of $1,498,730 available under the current 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. |
Accumulated other comprehensive
Accumulated other comprehensive (loss) income | 3 Months Ended |
Mar. 31, 2021 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | Accumulated other comprehensive loss Three months ended March 31, 2021 Three months ended March 31, 2020 Interest Foreign Accumulated Interest Foreign Accumulated Beginning balance $ (12,466) $ (53,688) $ (66,154) $ (1,433) $ (46,065) $ (47,498) Unrealized gains (losses) 6,505 (62,544) (56,039) (17,346) (81,632) (98,978) Related income tax (1,623) — (1,623) 4,328 — 4,328 4,882 (62,544) (57,662) (13,018) (81,632) (94,650) Reclassification into net income 1,377 — 1,377 2,163 — 2,163 Related income tax (344) — (344) (540) — (540) 1,033 — 1,033 1,623 — 1,623 Ending balance $ (6,551) $ (116,232) $ (122,783) $ (12,828) $ (127,697) $ (140,525) The interest rate cap agreement net realized losses reclassified into net income are recorded as debt expense in the corresponding consolidated statements of income. See Note 6 for further details. |
Acquisitions and divestitures
Acquisitions and divestitures | 3 Months Ended |
Mar. 31, 2021 | |
Business Combinations [Abstract] | |
Acquisitions and divestitures | Acquisitions and divestitures Routine acquisitions During the three months ended March 31, 2021, the Company acquired dialysis businesses consisting of two dialysis centers located outside the U.S. for a total of $3,668 in net cash, contingent earn-out obligations of $538 and deferred purchase price and liabilities assumed of $1,094. 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 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 any pre-acquisition tax contingencies. In addition, valuation of intangibles, leases and certain other working capital items relating to several of these acquisitions are pending final quantification. Goodwill deductible for tax purposes associated with acquisitions completed during the three months ended March 31, 2021 was $5,456. 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 approximately $40,173 if certain performance targets or quality margins are met over the next one year to five years. Contingent earn-out obligations are remeasured to fair value at each reporting date until the contingencies are resolved with changes in the liability due to the remeasurement recognized in earnings. As of March 31, 2021, the Company estimated the fair value of these contingent earn-out obligations to be $28,225, of which $11,613 is included in other current liabilities and the remaining $16,612 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 three months ended March 31, 2021: Three months ended March 31, 2021 Beginning balance $ 30,248 Acquisitions 538 Foreign currency translation (2,080) Fair value remeasurements (214) Payments (267) Ending balance $ 28,225 |
Discontinued operations | Discontinued operations On June 19, 2019, the Company completed the sale of its DaVita Medical Group (DMG) business to Collaborative Care Holdings, LLC (Optum), a subsidiary of UnitedHealth Group Inc. At close of the DMG sale, the Company's ultimate net sale proceeds remained subject to resolution of certain post-closing purchase price adjustments described in the equity purchase agreement, which adjustments were finalized in the fourth quarter of 2020. In the first quarter of 2020, the Company recognized $9,980 in additional tax benefits under the Coronavirus Aid, Relief, and Economic Security Act related to its period of DMG ownership, which were recognized as an adjustment to the Company's loss on sale of the DMG business. |
Variable interest entities
Variable interest entities | 3 Months Ended |
Mar. 31, 2021 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Variable interest entities | Variable interest entities (VIEs)At March 31, 2021, these condensed consolidated financial statements include total assets of VIEs of $300,849 and total liabilities and noncontrolling interests of VIEs to third parties of $207,527. 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 2020 10-K. |
Fair value of financial instrum
Fair value of financial instruments | 3 Months Ended |
Mar. 31, 2021 | |
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 (redeemable equity interests classified as 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 assets, liabilities and temporary equities that are measured at fair value on a recurring basis into the appropriate fair value hierarchy levels as defined by the Financial Accounting Standards Board (FASB). The following table summarizes the Company’s assets, liabilities and temporary equities measured at fair value on a recurring basis as of March 31, 2021: Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 34,730 $ 34,730 $ — $ — Interest rate cap agreements $ 9,176 $ — $ 9,176 $ — Liabilities Contingent earn-out obligations $ 28,225 $ — $ — $ 28,225 Temporary equity Noncontrolling interests subject to put provisions $ 1,349,160 $ — $ — $ 1,349,160 For reconciliations of changes in contingent earn-out obligations and noncontrolling interests subject to put provisions during the three months ended March 31, 2021, see Note 10 and the consolidated statement of equity, respectively. Investments in equity securities represent investments in various open-ended registered investment companies (mutual funds) and common stock which are held within a trust to fund existing obligations associated with several of the Company's non-qualified deferred compensation plans. These investments are recorded at fair value estimated based on reported market prices or redemption prices, as applicable. See Note 4 for further discussion. Interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 6 for further discussion. The estimated fair value measurements of contingent earn-out obligations are primarily based on unobservable inputs, including projected earnings before interest, taxes, depreciation, and amortization (EBITDA) and revenue. The estimated fair values of these contingent earn-out obligations are remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company's credit risk adjusted rate that is used to discount obligations to present value. See Note 10 for further discussion. The estimated fair value of noncontrolling interests subject to put provisions is based principally on the higher of either estimated liquidation value of net assets or a multiple of earnings for each subject dialysis partnership, based on historical earnings, revenue mix, and other performance indicators that can affect future results. The multiples used for these valuations are derived from observed ownership transactions for dialysis businesses between unrelated parties in the U.S. in recent years, and the specific valuation multiple applied to each dialysis partnership is principally determined by its recent and expected revenue mix and contribution margin. As of March 31, 2021, an increase or decrease in the weighted average multiple used in these valuations of one times EBITDA would change the estimated fair value of these noncontrolling interests by approximately $170,000. See Note 17 and Note 24 to the Company's consolidated financial statements included in the 2020 10-K for further 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 6 for further discussion of the Company's debt. Other financial instruments consist primarily of cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, accounts payable, other accrued liabilities, lease liabilities and debt. The balances of financial instruments other than debt and lease liabilities are presented in these condensed consolidated financial statements at March 31, 2021 at their approximate fair values due to the short-term nature of their settlements. |
Segment reporting
Segment reporting | 3 Months Ended |
Mar. 31, 2021 | |
Segment Reporting [Abstract] | |
Segment Reporting Disclosure | Segment reporting The Company’s operations are comprised of its U.S. dialysis and related lab services business (its U.S. dialysis business), its various ancillary services including its international operations (collectively, its ancillary services), and its corporate administrative support. The Company’s separate operating segments include its U.S. dialysis and related lab services business, each of its ancillary services, 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 Asia Pacific joint venture (APAC JV). The U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other ancillary services operating segments, including the international operating segments, have been combined and disclosed in the other segments category. See Note 25 to the Company's consolidated financial statements included in the 2020 10-K for further description of how the Company determines and measures results for its operating segments. The following is a summary of segment net revenues, segment operating income (loss), and a reconciliation of segment operating income (loss) to consolidated income before income taxes: Three months ended 2021 2020 Segment revenues: U.S. dialysis Dialysis patient service revenues: External sources $ 2,556,259 $ 2,579,240 Intersegment revenues 26,944 31,941 U.S. dialysis patient service revenues 2,583,203 2,611,181 Other revenues (1) : External sources 6,616 5,141 Intersegment revenues 59 301 Total U.S. dialysis revenues 2,589,878 2,616,623 Other—Ancillary services Dialysis patient service revenues 158,328 134,041 Other external sources 98,798 122,815 Intersegment revenues 4,293 4,152 Total ancillary services revenues 261,419 261,008 Total net segment revenues 2,851,297 2,877,631 Elimination of intersegment revenues (31,296) (36,394) Consolidated revenues $ 2,820,001 $ 2,841,237 Segment operating income (loss): U.S. dialysis $ 479,906 $ 491,607 Other—Ancillary services (11,860) (2,646) Total segment operating income 468,046 488,961 Reconciliation of segment operating income to consolidated income from continuing Corporate administrative support (25,444) (23,585) Consolidated operating income 442,602 465,376 Debt expense (67,014) (88,603) Debt refinancing charges — (2,948) Other income (loss), net 1,168 (4,350) Consolidated income from continuing operations before income taxes $ 376,756 $ 369,475 (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. Depreciation and amortization expense by reportable segment was as follows: Three months ended March 31, 2021 2020 U.S. dialysis $ 155,946 $ 146,300 Other—Ancillary services 9,755 8,379 $ 165,701 $ 154,679 A summary of assets by reportable segment was as follows: March 31, 2021 December 31, 2020 U.S. dialysis $ 16,036,940 $ 15,344,647 Other—Ancillary services 1,610,328 1,643,869 Consolidated assets $ 17,647,268 $ 16,988,516 Expenditures for property and equipment by reportable segment were as follows: Three months ended March 31, 2021 2020 U.S. dialysis $ 133,804 $ 148,763 Other—Ancillary services 11,109 6,179 $ 144,913 $ 154,942 |
New accounting standards
New accounting standards | 3 Months Ended |
Mar. 31, 2021 | |
Accounting Changes and Error Corrections [Abstract] | |
Accounting Standards Update and Change in Accounting Principle | New accounting standards New standards recently adopted In December 2019, the FASB issued Accounting Standards Update (ASU) No. 2019-12 , Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes . ASU No. 2019-12 attempts to simplify aspects of accounting for franchise taxes and enacted changes in tax laws or rates, and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. ASU No. 2019-12 is effective for public business entities for fiscal years beginning after December 15, 2020, including interim periods within that fiscal year. Early adoption is permitted for all entities. The adoption of ASU No. 2019-12 did not have a material impact on the Company's consolidated financial statements. New standards not yet adopted In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. ASU No. 2020-04 provides optional expedients and exceptions for applying U.S. generally accepted accounting principles to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another rate that is expected to be discontinued. The amendments in this ASU were effective beginning on March 12, 2020, and the Company may elect to apply the amendments prospectively through December 31, 2022. The Company is currently assessing the effect this guidance may have on its consolidated financial statements. |
Condensed consolidated interi_2
Condensed consolidated interim financial statements Condensed consolidaed interim financial statements (Policies) | 3 Months Ended |
Mar. 31, 2021 | |
Accounting Policies [Abstract] | |
Condensed consolidated interim financial statements | The unaudited condensed consolidated interim financial statements included in this report are prepared by the Company. 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 revenues, expenses, assets, liabilities, contingencies and noncontrolling interests subject to put provisions. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, impairments of goodwill, accounting for income taxes, certain fair value estimates and loss contingencies. The results of operations reflected in these interim financial statements may not necessarily be indicative of annual operating results. 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, 2020 (2020 10-K). Prior period classifications have been conformed to the current period 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 by the weighted average number of common shares outstanding. Weighted average common shares outstanding include restricted stock unit awards that are no longer subject to forfeiture because the 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 as computed under the treasury stock method. |
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 approximated their fair values at March 31, 2021 and December 31, 2020. 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. |
Long-term debt | These cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of the cap agreements are reported in other comprehensive income. The original premiums paid for the caps are amortized to debt expense on a straight-line basis over the term of each cap agreement starting from its effective date. |
Accumulated other comprehensive Income | The interest rate cap agreement net realized losses reclassified into net income are recorded as debt expense in the corresponding consolidated statements of income. |
Fair Value of Financial Instruments | Interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 6 for further discussion.The estimated fair value measurements of contingent earn-out obligations are primarily based on unobservable inputs, including projected earnings before interest, taxes, depreciation, and amortization (EBITDA) and revenue. The estimated fair values of these contingent earn-out obligations are remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company's credit risk adjusted rate that is used to discount obligations to present value. |
New Accounting Standards | New standards recently adopted In December 2019, the FASB issued Accounting Standards Update (ASU) No. 2019-12 , Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes . ASU No. 2019-12 attempts to simplify aspects of accounting for franchise taxes and enacted changes in tax laws or rates, and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. ASU No. 2019-12 is effective for public business entities for fiscal years beginning after December 15, 2020, including interim periods within that fiscal year. Early adoption is permitted for all entities. The adoption of ASU No. 2019-12 did not have a material impact on the Company's consolidated financial statements. New standards not yet adopted In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. ASU No. 2020-04 provides optional expedients and exceptions for applying U.S. generally accepted accounting principles to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another rate that is expected to be discontinued. The amendments in this ASU were effective beginning on March 12, 2020, and the Company may elect to apply the amendments prospectively through December 31, 2022. The Company is currently assessing the effect this guidance may have on its consolidated financial statements. |
Revenue Recognition Segment rev
Revenue Recognition Segment revenue by major payor (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Revenues by major payor [Abstract] | |
Disaggregation of Revenue [Table Text Block] | The following table summarizes the Company's segment revenues by primary payor source: Three months ended March 31, 2021 Three months ended March 31, 2020 U.S. dialysis Other - Ancillary services Consolidated U.S. dialysis Other - Ancillary services Consolidated Dialysis patient service revenues: Medicare and Medicare Advantage (1) $ 1,480,297 $ $ 1,480,297 $ 1,531,033 $ $ 1,531,033 Medicaid and Managed Medicaid 187,243 187,243 171,467 171,467 Other government (1) 80,184 106,830 187,014 83,099 94,574 177,673 Commercial 835,479 51,498 886,977 825,582 39,467 865,049 Other revenues: Medicare and Medicare Advantage 85,595 85,595 98,478 98,478 Medicaid and Managed Medicaid 300 300 366 366 Commercial 6,034 6,034 10,521 10,521 Other (2) 6,675 11,162 17,837 5,442 17,602 23,044 Eliminations of intersegment revenues (27,003) (4,293) (31,296) (32,242) (4,152) (36,394) Total $ 2,562,875 $ 257,126 $ 2,820,001 $ 2,584,381 $ 256,856 $ 2,841,237 |
Earnings per share Earnings Per
Earnings per share Earnings Per Share (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
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 2021 2020 Net income attributable to DaVita Inc.: Continuing operations $ 237,403 $ 229,613 Discontinued operations — 9,980 Net income attributable to DaVita Inc. $ 237,403 $ 239,593 Weighted average shares outstanding: Basic shares 109,014 124,902 Assumed incremental from stock plans 4,838 1,993 Diluted shares 113,852 126,895 Basic net income attributable to DaVita Inc.: Continuing operations per share $ 2.18 $ 1.84 Discontinued operations per share — 0.08 Basic net income per share attributable to DaVita Inc. $ 2.18 $ 1.92 Diluted net income attributable to DaVita Inc.: Continuing operations per share $ 2.09 $ 1.81 Discontinued operations per share — 0.08 Diluted net income per share attributable to DaVita Inc. $ 2.09 $ 1.89 Anti-dilutive stock-settled awards excluded from calculation (1) 27 3,207 (1) Shares associated with stock awards excluded from the diluted denominator calculation because they were anti-dilutive under the treasury stock method. |
Investments in debt and equit_2
Investments in debt and equity securities (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Investments, Debt and Equity Securities [Abstract] | |
Schedule of Investments | The Company’s short-term and long-term debt and equity investments, consisting of debt instruments classified as held-to-maturity and equity investments with readily determinable fair values or redemption values, were as follows: March 31, 2021 December 31, 2020 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 8,221 $ — $ 8,221 $ 8,217 $ — $ 8,217 Investments in mutual funds and common stock — 34,730 34,730 — 44,077 44,077 $ 8,221 $ 34,730 $ 42,951 $ 8,217 $ 44,077 $ 52,294 Short-term investments $ 8,221 $ 2,839 $ 11,060 $ 8,217 $ 11,884 $ 20,101 Long-term investments — 31,891 31,891 — 32,193 32,193 $ 8,221 $ 34,730 $ 42,951 $ 8,217 $ 44,077 $ 52,294 |
Goodwill (Tables)
Goodwill (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Changes in Goodwill by Reportable Segments [Text Block] | Changes in goodwill by reportable segments were as follows: U.S. dialysis Other - Ancillary services Consolidated Balance at December 31, 2019 $ 6,287,100 $ 500,535 $ 6,787,635 Acquisitions 24,377 105,680 130,057 Divestitures (1,549) (6,744) (8,293) Foreign currency and other adjustments — 9,710 9,710 Balance at December 31, 2020 $ 6,309,928 $ 609,181 $ 6,919,109 Acquisitions — 5,456 5,456 Foreign currency and other adjustments — (33,356) (33,356) Balance at March 31, 2021 $ 6,309,928 $ 581,281 $ 6,891,209 Balance at March 31, 2021: Goodwill $ 6,309,928 $ 711,854 $ 7,021,782 Accumulated impairment charges — (130,573) (130,573) $ 6,309,928 $ 581,281 $ 6,891,209 |
Long-term debt (Tables)
Long-term debt (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Debt Disclosure [Abstract] | |
Long-term Debt | Long-term debt was comprised of the following: As of March 31, 2021 March 31, 2021 December 31, 2020 Maturity date Interest rate Estimated fair value (1) Senior Secured Credit Facilities: Term Loan A $ 1,662,500 $ 1,684,375 8/12/2024 LIBOR + 1.50% $ 1,666,656 Term Loan B-1 2,708,836 2,715,694 8/12/2026 LIBOR + 1.75% $ 2,698,678 Revolving line of credit — 75,000 8/12/2024 LIBOR + 1.50% Senior Notes: 4.625% Senior Notes 2,750,000 1,750,000 6/1/2030 4.625 % $ 2,801,150 3.75% Senior Notes 1,500,000 1,500,000 2/15/2031 3.750 % $ 1,436,220 Acquisition obligations and other notes payable (2) 152,531 164,160 2021-2036 4.95 % $ 152,531 Financing lease obligations (3) 289,324 274,292 2022-2038 4.83 % Total debt principal outstanding 9,063,191 8,163,521 Discount, premium and deferred financing costs (4) (65,235) (77,717) 8,997,956 8,085,804 Less current portion (168,191) (168,541) $ 8,829,765 $ 7,917,263 (1) For the Company's senior secured credit facilities and senior notes, fair value estimates are based upon bid and ask quotes, typically a level 2 input. For acquisition obligations and other notes payable, the carrying values presented approximate their estimated fair values, based on estimates of their present values using level 2 interest rate inputs. (2) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current fixed and LIBOR interest rate components in effect as of March 31, 2021. (3) Financing lease obligations are measured at their approximate present values at inception. The interest rate presented is the weighted average discount rate embedded in financing leases outstanding. The term of one ground lease runs to 2070, in addition to the other lease maturity dates presented in the table above. (4) As of March 31, 2021, the carrying amount of the Company's senior secured credit facilities includes a discount of $5,212 and deferred financing costs of $33,650 and the carrying amount of the Company's senior notes includes a premium of $(17,327) and deferred financing costs of $43,700. As of December 31, 2020, the carrying amount of the Company's senior secured credit facilities included a discount of $5,461 and deferred financing costs of $35,825, and the carrying amount of the Company's senior notes included deferred financing costs of $36,431. |
Schedule of Derivative Instruments | The following table summarizes the Company’s interest rate cap agreements outstanding as of March 31, 2021 and December 31, 2020, which are classified in "Other long-term assets" on its consolidated balance sheet: Three months ended Fair value Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI gain March 31, 2021 December 31, 2020 2019 cap agreements $ 3,500,000 2.00% 6/30/2020 6/30/2024 $ 1,377 $ 6,505 $ 9,176 $ 2,671 |
Share repurchases Share Repurch
Share repurchases Share Repurchases (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Treasury Stock, Value [Abstract] | |
Class of Treasury Stock [Table Text Block] | The following table summarizes the Company's common stock repurchases during the three months ended March 31, 2021 and 2020: Three months ended March 31, 2021 Three months ended March 31, 2020 Shares repurchased Amount paid Average paid per share Shares repurchased Amount paid Average paid per share Open market repurchases 2,949 $ 322,333 $ 109.28 4,052 $ 303,139 $ 74.81 |
Accumulated other comprehensi_2
Accumulated other comprehensive (loss) income (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | Three months ended March 31, 2021 Three months ended March 31, 2020 Interest Foreign Accumulated Interest Foreign Accumulated Beginning balance $ (12,466) $ (53,688) $ (66,154) $ (1,433) $ (46,065) $ (47,498) Unrealized gains (losses) 6,505 (62,544) (56,039) (17,346) (81,632) (98,978) Related income tax (1,623) — (1,623) 4,328 — 4,328 4,882 (62,544) (57,662) (13,018) (81,632) (94,650) Reclassification into net income 1,377 — 1,377 2,163 — 2,163 Related income tax (344) — (344) (540) — (540) 1,033 — 1,033 1,623 — 1,623 Ending balance $ (6,551) $ (116,232) $ (122,783) $ (12,828) $ (127,697) $ (140,525) |
Acquisitions and divestitures (
Acquisitions and divestitures (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
Business Combinations [Abstract] | |
Schedule of Business Acquisitions by Acquisition, Contingent Consideration | The following is a reconciliation of changes in contingent earn-out obligations for the three months ended March 31, 2021: Three months ended March 31, 2021 Beginning balance $ 30,248 Acquisitions 538 Foreign currency translation (2,080) Fair value remeasurements (214) Payments (267) Ending balance $ 28,225 |
Fair value of financial instr_2
Fair value of financial instruments (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
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 equities measured at fair value on a recurring basis as of March 31, 2021: Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 34,730 $ 34,730 $ — $ — Interest rate cap agreements $ 9,176 $ — $ 9,176 $ — Liabilities Contingent earn-out obligations $ 28,225 $ — $ — $ 28,225 Temporary equity Noncontrolling interests subject to put provisions $ 1,349,160 $ — $ — $ 1,349,160 |
Segment reporting (Tables)
Segment reporting (Tables) | 3 Months Ended |
Mar. 31, 2021 | |
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 income (loss), and a reconciliation of segment operating income (loss) to consolidated income before income taxes: Three months ended 2021 2020 Segment revenues: U.S. dialysis Dialysis patient service revenues: External sources $ 2,556,259 $ 2,579,240 Intersegment revenues 26,944 31,941 U.S. dialysis patient service revenues 2,583,203 2,611,181 Other revenues (1) : External sources 6,616 5,141 Intersegment revenues 59 301 Total U.S. dialysis revenues 2,589,878 2,616,623 Other—Ancillary services Dialysis patient service revenues 158,328 134,041 Other external sources 98,798 122,815 Intersegment revenues 4,293 4,152 Total ancillary services revenues 261,419 261,008 Total net segment revenues 2,851,297 2,877,631 Elimination of intersegment revenues (31,296) (36,394) Consolidated revenues $ 2,820,001 $ 2,841,237 Segment operating income (loss): U.S. dialysis $ 479,906 $ 491,607 Other—Ancillary services (11,860) (2,646) Total segment operating income 468,046 488,961 Reconciliation of segment operating income to consolidated income from continuing Corporate administrative support (25,444) (23,585) Consolidated operating income 442,602 465,376 Debt expense (67,014) (88,603) Debt refinancing charges — (2,948) Other income (loss), net 1,168 (4,350) Consolidated income from continuing operations before income taxes $ 376,756 $ 369,475 (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 Depreciation and Amortization Expense by Reportable Segment | Depreciation and amortization expense by reportable segment was as follows: Three months ended March 31, 2021 2020 U.S. dialysis $ 155,946 $ 146,300 Other—Ancillary services 9,755 8,379 $ 165,701 $ 154,679 |
Summary of Assets by Reportable Segment | A summary of assets by reportable segment was as follows: March 31, 2021 December 31, 2020 U.S. dialysis $ 16,036,940 $ 15,344,647 Other—Ancillary services 1,610,328 1,643,869 Consolidated assets $ 17,647,268 $ 16,988,516 |
Summary of Expenditures for Property and Equipment by Reportable Segment | Expenditures for property and equipment by reportable segment were as follows: Three months ended March 31, 2021 2020 U.S. dialysis $ 133,804 $ 148,763 Other—Ancillary services 11,109 6,179 $ 144,913 $ 154,942 |
Revenue Recognition Segment R_2
Revenue Recognition Segment Revenue by Payor (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Disaggregation of Revenue [Line Items] | ||
Other revenues | $ 105,414 | $ 127,956 |
Total revenues | 2,820,001 | 2,841,237 |
Elimination of intersegment revenues | ||
Disaggregation of Revenue [Line Items] | ||
Total revenues | (31,296) | (36,394) |
Medicare and Medicare Advantage | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 1,480,297 | 1,531,033 |
Other revenues | 85,595 | 98,478 |
Medicaid and Managed Medicaid | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 187,243 | 171,467 |
Other revenues | 300 | 366 |
Other Government Payors | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 187,014 | 177,673 |
Commercial Payors | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 886,977 | 865,049 |
Other revenues | 6,034 | 10,521 |
Other | ||
Disaggregation of Revenue [Line Items] | ||
Other revenues | 17,837 | 23,044 |
U.S. dialysis | ||
Disaggregation of Revenue [Line Items] | ||
Total revenues | 2,562,875 | 2,584,381 |
U.S. dialysis | Elimination of intersegment revenues | ||
Disaggregation of Revenue [Line Items] | ||
Total revenues | (27,003) | (32,242) |
U.S. dialysis | Medicare and Medicare Advantage | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 1,480,297 | 1,531,033 |
U.S. dialysis | Medicaid and Managed Medicaid | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 187,243 | 171,467 |
U.S. dialysis | Other Government Payors | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 80,184 | 83,099 |
U.S. dialysis | Commercial Payors | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 835,479 | 825,582 |
U.S. dialysis | Other | ||
Disaggregation of Revenue [Line Items] | ||
Other revenues | 6,675 | 5,442 |
Other—Ancillary services | ||
Disaggregation of Revenue [Line Items] | ||
Total revenues | 257,126 | 256,856 |
Other—Ancillary services | Elimination of intersegment revenues | ||
Disaggregation of Revenue [Line Items] | ||
Total revenues | (4,293) | (4,152) |
Other—Ancillary services | Medicare and Medicare Advantage | ||
Disaggregation of Revenue [Line Items] | ||
Other revenues | 85,595 | 98,478 |
Other—Ancillary services | Medicaid and Managed Medicaid | ||
Disaggregation of Revenue [Line Items] | ||
Other revenues | 300 | 366 |
Other—Ancillary services | Other Government Payors | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 106,830 | 94,574 |
Other—Ancillary services | Commercial Payors | ||
Disaggregation of Revenue [Line Items] | ||
Patient service revenues | 51,498 | 39,467 |
Other revenues | 6,034 | 10,521 |
Other—Ancillary services | Other | ||
Disaggregation of Revenue [Line Items] | ||
Other revenues | $ 11,162 | $ 17,602 |
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 | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Numerators: | ||
Net income from continuing operations attributable to DaVita Inc. | $ 237,403 | $ 229,613 |
Net income from discontinued operations attributable to DaVita Inc. | 0 | 9,980 |
Net income attributable to DaVita Inc. | $ 237,403 | $ 239,593 |
Weighted average shares outstanding during period | 109,014,000 | 124,902,000 |
Assumed incremental from stock plans | 4,838,000 | 1,993,000 |
Weighted average shares for diluted earnings per share calculation | 113,852,000 | 126,895,000 |
Basic: | ||
Basic net income from continuing operations | $ 2.18 | $ 1.84 |
Basic net income (loss) from discontinued operations per share | 0 | 0.08 |
Basic net income per share attributable to DaVita Inc. | 2.18 | 1.92 |
Diluted: | ||
Diluted net income from continuing operations | 2.09 | 1.81 |
Diluted net income from discontinued operations per share | 0 | 0.08 |
Diluted net income per share attributable to DaVita Inc. | $ 2.09 | $ 1.89 |
Anti-dilutive stock-settled awards excluded from calculation | 27,000 | 3,207,000 |
Investments in debt and equit_3
Investments in debt and equity securities (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Investment Holdings [Line Items] | ||
Debt securities | $ 8,221 | $ 8,217 |
Investments in equity securities | 34,730 | 44,077 |
Total | 42,951 | 52,294 |
Debt securities, short-term investments | 8,221 | 8,217 |
Total, short-term investments | 11,060 | 20,101 |
Debt securities, long-term investments | 0 | 0 |
Total, long-term investments | 31,891 | 32,193 |
Certificates of deposit and other time deposits | ||
Investment Holdings [Line Items] | ||
Debt securities | 8,221 | 8,217 |
Investments in equity securities | 0 | 0 |
Total | 8,221 | 8,217 |
Investments in mutual funds and common stock | ||
Investment Holdings [Line Items] | ||
Debt securities | 0 | 0 |
Investments in equity securities | 34,730 | 44,077 |
Total | 34,730 | 44,077 |
Short-term Investments | ||
Investment Holdings [Line Items] | ||
Investments in equity securities | 2,839 | 11,884 |
Long-term Investments | ||
Investment Holdings [Line Items] | ||
Investments in equity securities | $ 31,891 | $ 32,193 |
Goodwill - Changes in Goodwill
Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended |
Mar. 31, 2021 | Dec. 31, 2020 | |
Goodwill [Roll Forward] | ||
Beginning balance | $ 6,919,109 | $ 6,787,635 |
Acquisitions | 5,456 | 130,057 |
Divestitures | 8,293 | |
Foreign currency and other adjustments | (33,356) | 9,710 |
Ending balance | 6,891,209 | 6,919,109 |
Goodwill, before accumulated impairment charges | 7,021,782 | |
Accumulated impairment charges | (130,573) | |
Ending balance | 6,891,209 | 6,919,109 |
U.S. dialysis | ||
Goodwill [Roll Forward] | ||
Beginning balance | 6,309,928 | 6,287,100 |
Acquisitions | 0 | 24,377 |
Divestitures | 1,549 | |
Foreign currency and other adjustments | 0 | 0 |
Ending balance | 6,309,928 | 6,309,928 |
Goodwill, before accumulated impairment charges | 6,309,928 | |
Accumulated impairment charges | 0 | |
Ending balance | 6,309,928 | 6,309,928 |
Other—Ancillary services | ||
Goodwill [Roll Forward] | ||
Beginning balance | 609,181 | 500,535 |
Acquisitions | 5,456 | 105,680 |
Divestitures | 6,744 | |
Foreign currency and other adjustments | (33,356) | 9,710 |
Ending balance | 581,281 | 609,181 |
Goodwill, before accumulated impairment charges | 711,854 | |
Accumulated impairment charges | (130,573) | |
Ending balance | $ 581,281 | $ 609,181 |
Goodwill - Narrative (Details)
Goodwill - Narrative (Details) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021USD ($)segment | Mar. 31, 2020USD ($) | |
Goodwill [Line Items] | ||
Goodwill impairment charges | $ | $ 0 | $ 0 |
Other Health Operations | ||
Goodwill [Line Items] | ||
Number of Reportable Segments | segment | 0 |
Long-term debt (Detail)
Long-term debt (Detail) - USD ($) $ in Thousands | Feb. 26, 2021 | Jun. 09, 2020 | Mar. 31, 2021 | Dec. 31, 2020 |
Senior Secured Credit Facilities | ||||
Debt interest rate during period | 3.08% | |||
Long-term debt, weighted average interest rate, at point in time | 3.18% | |||
Total debt principal outstanding | $ 9,063,191 | $ 8,163,521 | ||
Discount and deferred financing costs | (65,235) | (77,717) | ||
Carrying amount of long-term debt, net of unamortized discounts | 8,997,956 | 8,085,804 | ||
Less current portion | (168,191) | (168,541) | ||
Total long-term debt | 8,829,765 | 7,917,263 | ||
Senior Notes Four Point Six Two Five Percent Due Twenty Thirty | ||||
Senior Secured Credit Facilities | ||||
Senior Notes | $ 1,750 | $ 2,750,000 | 1,750,000 | |
Debt interest rate during period | 4.625% | 4.625% | ||
Debt Instrument, Maturity Date | Jun. 1, 2030 | Jun. 1, 2030 | ||
Debt Instrument, Fair Value Disclosure | $ 2,801,150 | |||
Senior Notes Three Point Seven Five Percent Due Twenty Thirty One | ||||
Senior Secured Credit Facilities | ||||
Senior Notes | $ 1,500,000 | 1,500,000 | ||
Debt interest rate during period | 3.75% | |||
Debt Instrument, Maturity Date | Feb. 15, 2031 | |||
Debt Instrument, Fair Value Disclosure | $ 1,436,220 | |||
Acquisition obligations and other notes payable | ||||
Senior Secured Credit Facilities | ||||
Acquisition obligations and other notes payable | $ 152,531 | 164,160 | ||
Debt instrument, maturity date, description | 2021-2036 | |||
Long-term debt, weighted average interest rate, at point in time | 4.95% | |||
Acquisition obligations and other notes payable, fair value | $ 152,531 | |||
Financing lease obligations | ||||
Senior Secured Credit Facilities | ||||
Financing lease obligations | $ 289,324 | 274,292 | ||
Debt instrument, maturity date, description | 2022-2038 | |||
Finance lease, weighted average discount rate, percent | 4.83% | |||
Revolving line of credit | ||||
Senior Secured Credit Facilities | ||||
Secured Debt | $ 0 | 75,000 | ||
Debt Instrument, Description of Variable Rate Basis | LIBOR + 1.50% | |||
Debt Instrument, Maturity Date | Aug. 12, 2024 | |||
Term Loan A | ||||
Senior Secured Credit Facilities | ||||
Secured Debt | $ 1,662,500 | 1,684,375 | ||
Debt Instrument, Description of Variable Rate Basis | LIBOR + 1.50% | |||
Debt Instrument, Maturity Date | Aug. 12, 2024 | |||
Debt Instrument, Fair Value Disclosure | $ 1,666,656 | |||
Term Loan B-1 | ||||
Senior Secured Credit Facilities | ||||
Secured Debt | $ 2,708,836 | 2,715,694 | ||
Debt Instrument, Description of Variable Rate Basis | LIBOR + 1.75% | |||
Debt Instrument, Maturity Date | Aug. 12, 2026 | |||
Debt Instrument, Fair Value Disclosure | $ 2,698,678 | |||
Senior Secured Credit Facilities | ||||
Senior Secured Credit Facilities | ||||
Long-term debt, weighted average interest rate, at point in time | 1.97% | |||
Debt Instrument, table footnotes | ||||
Debt Instrument, Unamortized Discount | $ 5,212 | 5,461 | ||
Deferred Offering Costs | 33,650 | 35,825 | ||
Senior Notes | ||||
Debt Instrument, table footnotes | ||||
Debt Instrument, Unamortized Premium | (17,327) | |||
Deferred Offering Costs | $ 43,700 | $ 36,431 |
Long-term debt Schedule of Deri
Long-term debt Schedule of Derivative Instruments (Details) - 2019 Interest Rate Cap Agreements Effective June 30, 2020 - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Dec. 31, 2020 | |
Derivative [Line Items] | ||
Derivative, effective date | Jun. 30, 2020 | |
Derivative, expiration date | Jun. 30, 2024 | |
Other Long-term Assets | ||
Derivative [Line Items] | ||
Derivative asset, fair value, gross asset | $ 9,176 | $ 2,671 |
Debt Expense | Cash Flow Hedging | ||
Derivative [Line Items] | ||
Amount of debt expense reclassified from accumulated OCI into income | 1,377 | |
Other Comprehensive Income (Loss), Unrealized Gain (Loss) on Derivatives Arising During Period, before Tax | 6,505 | |
Term Loan Facility | Maximum | ||
Derivative [Line Items] | ||
Notional amounts of interest rate agreements | $ 3,500,000 | |
LIBOR plus interest rate margin | 2.00% |
Long-term debt - Additional Inf
Long-term debt - Additional Information (Detail) - USD ($) $ in Thousands | Feb. 26, 2021 | Jun. 09, 2020 | Mar. 31, 2021 | Dec. 31, 2020 |
Debt Instrument [Line Items] | ||||
Weighted average effective interest rate at quarter end | 3.18% | |||
Weighted average effective interest rate during quarter | 3.08% | |||
Percentage of debt instruments bearing fixed interest rate | 51.00% | |||
Senior Notes Four Point Six Two Five Percent Due Twenty Thirty | ||||
Debt Instrument [Line Items] | ||||
Additional Debt Principal Amount Due To New Agreement | $ 1,000 | |||
Debt Instrument Offering Price Percentage Of Face Amount | 101.75% | |||
Debt Instrument, Maturity Date | Jun. 1, 2030 | Jun. 1, 2030 | ||
Senior Notes | $ 1,750 | $ 2,750,000 | $ 1,750,000 | |
Debt Instrument related fees, discounts, and other professional expenses | $ 8,346 | |||
Weighted average effective interest rate during quarter | 4.625% | 4.625% | ||
Revolving line of credit | ||||
Debt Instrument [Line Items] | ||||
Debt Instrument, Maturity Date | Aug. 12, 2024 | |||
Maximum borrowing capacity on the revolving credit facilities | $ 1,000,000 | |||
Letter of Credit | ||||
Debt Instrument [Line Items] | ||||
Letters of credit outstanding | 0 | |||
Bilateral Secured Letter Of Credit Facility | ||||
Debt Instrument [Line Items] | ||||
Letters of credit outstanding | 64,650 | |||
Term Loan A | ||||
Debt Instrument [Line Items] | ||||
Debt Instrument, Periodic Payment, Principal | $ 21,875 | |||
Debt Instrument, Maturity Date | Aug. 12, 2024 | |||
Long-term Line of Credit | $ 871,336 | |||
Term Loan B-1 | ||||
Debt Instrument [Line Items] | ||||
Debt Instrument, Periodic Payment, Principal | $ 6,858 | |||
Debt Instrument, Maturity Date | Aug. 12, 2026 | |||
Senior Secured Credit Facilities | ||||
Debt Instrument [Line Items] | ||||
Weighted average effective interest rate at quarter end | 1.97% |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Detail) $ in Thousands | Aug. 15, 2017 | Dec. 31, 2017USD ($) | Mar. 31, 2021USD ($) |
Commitments and Contingencies: | |||
Corporate Integrity Agreement Period | 5 years | ||
Corporate Integrity Agreement Expiration Date | Oct. 22, 2019 | ||
Commitments to provide operating capital | |||
Commitments and Contingencies: | |||
Other potential commitments to provide operating capital to several dialysis centers | $ 8,449 | ||
US Attorney Prescription Drug Investigation | |||
Commitments and Contingencies: | |||
Litigation Settlement, Amount Awarded to Other Party | $ 63,700 | ||
Stockholder Derivative Litigation | |||
Commitments and Contingencies: | |||
Loss Contingency Number of Previously Disclosed Lawsuits Consolidated Into One | 3 | ||
Incremental Cash Portion | US Attorney Prescription Drug Investigation | |||
Commitments and Contingencies: | |||
Litigation Settlement, Amount Awarded to Other Party | 41,500 | ||
Cash Paid For Portion Previously Refunded | US Attorney Prescription Drug Investigation | |||
Commitments and Contingencies: | |||
Litigation Settlement, Amount Awarded to Other Party | $ 22,200 |
Long-term incentive compensatio
Long-term incentive compensation (Details) $ in Thousands | 3 Months Ended |
Mar. 31, 2021USD ($)shares | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans | $ 230,270 |
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 6 months |
Restricted stock units and Performance stock units | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period | shares | 706,000 |
Aggregate grant-date fair value | $ 77,279 |
Weighted-average expected life (in years) | 3 years 6 months |
Stock Appreciation Rights | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Net of Forfeitures | shares | 132,000 |
Aggregate grant-date fair value | $ 4,250 |
Weighted-average expected life (in years) | 4 years 6 months |
Share repurchases Share Repur_2
Share repurchases Share Repurchase Table (Details) - Open Market Purchases - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Equity, Class of Treasury Stock [Line Items] | ||
Repurchase of common stock (in shares) | 2,949 | 4,052 |
Treasury Stock, Value, Acquired, Cost Method | $ 322,333 | $ 303,139 |
Treasury Stock Acquired, Average Cost Per Share | $ 109.28 | $ 74.81 |
Share repurchases (Details)
Share repurchases (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 1 Months Ended | |
Apr. 28, 2021 | Dec. 10, 2020 | |
Equity, Class of Treasury Stock [Line Items] | ||
Stock Repurchase Program, Authorized Amount | $ 2,000,000 | |
Terminated Remaining Prior Share Repurchases Authorized, Amount | $ 329,302 | |
Subsequent Event | ||
Equity, Class of Treasury Stock [Line Items] | ||
Repurchase of common stock (in shares) | 991 | |
Treasury Stock, Value, Acquired, Cost Method | $ 108,892 | |
Treasury Stock Acquired, Average Cost Per Share | $ 109.91 | |
Stock Repurchase Program, Remaining Authorized Repurchase Amount | $ 1,498,730 |
Accumulated other comprehensi_3
Accumulated other comprehensive (loss) income (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||
Beginning balance | $ (66,154) | |
Ending balance | (122,783) | |
Interest rate cap agreements | ||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||
Beginning balance | (12,466) | $ (1,433) |
Unrealized gains (losses) | 6,505 | (17,346) |
Related income tax benefit | (1,623) | 4,328 |
Unrealized (losses) gains net | 4,882 | (13,018) |
Reclassification into net income | 1,377 | 2,163 |
Related income tax | (344) | (540) |
Reclassification from accumulated other comprehensive income into net income net of tax | 1,033 | 1,623 |
Ending balance | (6,551) | (12,828) |
Foreign currency translation adjustments | ||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||
Beginning balance | (53,688) | (46,065) |
Unrealized gains (losses) | (62,544) | (81,632) |
Related income tax benefit | 0 | 0 |
Unrealized (losses) gains net | (62,544) | (81,632) |
Reclassification into net income | 0 | 0 |
Related income tax | 0 | 0 |
Reclassification from accumulated other comprehensive income into net income net of tax | 0 | 0 |
Ending balance | (116,232) | (127,697) |
Accumulated other comprehensive (loss) income | ||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||
Beginning balance | (66,154) | (47,498) |
Unrealized gains (losses) | (56,039) | (98,978) |
Related income tax benefit | (1,623) | 4,328 |
Unrealized (losses) gains net | (57,662) | (94,650) |
Reclassification into net income | 1,377 | 2,163 |
Related income tax | (344) | (540) |
Reclassification from accumulated other comprehensive income into net income net of tax | 1,033 | 1,623 |
Ending balance | $ (122,783) | $ (140,525) |
Acquisitions and divestitures C
Acquisitions and divestitures Contingent Earn-out obligations (Details) $ in Thousands | 3 Months Ended |
Mar. 31, 2021USD ($) | |
Business Combination, Contingent Consideration Arrangements [Abstract] | |
Contingent Earn-out Obligations, Beginning balance | $ 30,248 |
Acquisitions | 538 |
Foreign currency translation | (2,080) |
Fair value remeasurements | (214) |
Payments | (267) |
Contingent Earn-out Obligations, Ending balance | $ 28,225 |
Acquisitions and divestitures -
Acquisitions and divestitures - Additional Information (Detail) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021USD ($)clinic | Mar. 31, 2020USD ($) | |
Business Acquisition [Line Items] | ||
Cash paid to acquire businesses | $ 3,668 | $ 34,107 |
Goodwill deductible for tax purposes associated with acquisitions | 5,456 | |
Additional tax benefits recognized under the Coronavirus Aid, Relied, and Economic Security Act | 0 | $ 9,980 |
Other current liabilities | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations | 11,613 | |
Other long-term liabilities | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations | 16,612 | |
Other companies | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations | $ 28,225 | |
Minimum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins | ||
Business Acquisition [Line Items] | ||
Earn-out consideration payment period | 1 year | |
Maximum | ||
Business Acquisition [Line Items] | ||
Contingent earn-out obligations and liabilities assumed associated with acquisitions | $ 40,173 | |
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 | $ 3,668 | |
Contingent earn-out obligations and liabilities assumed associated with acquisitions | 538 | |
Deferred purchase price obligations | $ 1,094 | |
Foreign Dialysis Centers | Dialysis and other businesses | ||
Business Acquisition [Line Items] | ||
Number of businesses acquired | clinic | 2 |
Variable interest entities - Ad
Variable interest entities - Additional Information (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
Assets | $ 17,647,268 | $ 16,988,516 |
Liabilities | 14,864,893 | $ 14,091,736 |
Variable Interest Entity | ||
Assets | 300,849 | |
Liabilities | $ 207,527 |
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 | Mar. 31, 2021 | Dec. 31, 2020 |
Assets | ||
Investments in equity securities | $ 34,730 | $ 44,077 |
Fair Value, Measurements, Recurring | ||
Assets | ||
Investments in equity securities | 34,730 | |
Liabilities | ||
Contingent earn-out obligations | 28,225 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 1,349,160 | |
Fair Value, Measurements, Recurring | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | 9,176 | |
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1) | ||
Assets | ||
Investments in equity securities | 34,730 | |
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 | 9,176 | |
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | ||
Assets | ||
Investments in equity securities | 0 | |
Liabilities | ||
Contingent earn-out obligations | 28,225 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 1,349,160 | |
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | $ 0 |
Fair value of financial instr_4
Fair value of financial instruments Fair Value of Financial Instruments (Details) $ in Thousands | 3 Months Ended |
Mar. 31, 2021USD ($) | |
Fair Value Disclosures [Abstract] | |
Potential Increase Decrease In Fair Value Of Noncontrolling Interests Due To Change In Weighted Average EBITDA Multiple | $ 170,000 |
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 | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Segment Reporting Information [Line Items] | ||
Other revenues | $ 105,414 | $ 127,956 |
Total revenues | 2,820,001 | 2,841,237 |
Operating income (loss) | 442,602 | 465,376 |
Corporate administrative support | (25,444) | (23,585) |
Debt expense | (67,014) | (88,603) |
Debt refinancing charges | 0 | (2,948) |
Other income (loss), net | 1,168 | (4,350) |
Income from continuing operations before income taxes | 376,756 | 369,475 |
U.S. dialysis | ||
Segment Reporting Information [Line Items] | ||
Total revenues | 2,562,875 | 2,584,381 |
Other—Ancillary services | ||
Segment Reporting Information [Line Items] | ||
Total revenues | 257,126 | 256,856 |
Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Total revenues | 2,851,297 | 2,877,631 |
Operating income (loss) | 468,046 | 488,961 |
Operating Segments | U.S. dialysis | ||
Segment Reporting Information [Line Items] | ||
Dialysis patient service revenues | 2,583,203 | 2,611,181 |
Total revenues | 2,589,878 | 2,616,623 |
Operating income (loss) | 479,906 | 491,607 |
Operating Segments | U.S. dialysis | External Sources | ||
Segment Reporting Information [Line Items] | ||
Dialysis patient service revenues | 2,556,259 | 2,579,240 |
Other revenues | 6,616 | 5,141 |
Operating Segments | U.S. dialysis | Intersubsegment Eliminations | ||
Segment Reporting Information [Line Items] | ||
Dialysis patient service revenues | 26,944 | 31,941 |
Other revenues | 59 | 301 |
Operating Segments | Other—Ancillary services | ||
Segment Reporting Information [Line Items] | ||
Dialysis patient service revenues | 158,328 | 134,041 |
Other revenues | 98,798 | 122,815 |
Total revenues | 261,419 | 261,008 |
Operating income (loss) | (11,860) | (2,646) |
Operating Segments | Other—Ancillary services | Intersubsegment Eliminations | ||
Segment Reporting Information [Line Items] | ||
Dialysis patient service revenues | 4,293 | 4,152 |
Intersegment Elimination | ||
Segment Reporting Information [Line Items] | ||
Total revenues | (31,296) | (36,394) |
Intersegment Elimination | U.S. dialysis | ||
Segment Reporting Information [Line Items] | ||
Total revenues | (27,003) | (32,242) |
Intersegment Elimination | Other—Ancillary services | ||
Segment Reporting Information [Line Items] | ||
Total revenues | $ (4,293) | $ (4,152) |
Segment reporting - Summary o_2
Segment reporting - Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Segment Reporting Information [Line Items] | ||
Depreciation and amortization | $ 165,701 | $ 154,679 |
U.S. dialysis | ||
Segment Reporting Information [Line Items] | ||
Depreciation and amortization | 155,946 | 146,300 |
Other—Ancillary services | ||
Segment Reporting Information [Line Items] | ||
Depreciation and amortization | $ 9,755 | $ 8,379 |
Segment reporting - Summary o_3
Segment reporting - Summary of Assets by Segment (Detail) - USD ($) $ in Thousands | Mar. 31, 2021 | Dec. 31, 2020 |
ASSETS | ||
Total assets | $ 17,647,268 | $ 16,988,516 |
U.S. dialysis | ||
ASSETS | ||
Total assets | 16,036,940 | 15,344,647 |
Other—Ancillary services | ||
ASSETS | ||
Total assets | $ 1,610,328 | $ 1,643,869 |
Segment reporting - Summary o_4
Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2021 | Mar. 31, 2020 | |
Segment Reporting Information [Line Items] | ||
Expenditures for property and equipment | $ 144,913 | $ 154,942 |
U.S. dialysis | ||
Segment Reporting Information [Line Items] | ||
Expenditures for property and equipment | 133,804 | 148,763 |
Other—Ancillary services | ||
Segment Reporting Information [Line Items] | ||
Expenditures for property and equipment | $ 11,109 | $ 6,179 |