Segment reporting (Tables)

3 Months Ended

Mar. 31, 2024

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 revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:

	Three months ended March 31,
	2024		2023
Segment revenues:
U.S. dialysis
Dialysis patient service revenues:
External sources	$	2,725,575	$	2,583,933
Intersegment revenues	24,463		22,047
U.S. dialysis patient service revenues	2,750,038		2,605,980
Other revenues:
External sources	6,122		6,180
Intersegment revenues	—		—
Total U.S. dialysis revenues	2,756,160		2,612,160
Other—Ancillary services
Dialysis patient service revenues	215,957		176,101
Other external sources	122,901		106,485
Intersegment revenues	2,747		1,368
Total ancillary services revenues	341,605		283,954
Total net segment revenues	3,097,765		2,896,114
Elimination of intersegment revenues	(27,210)		(23,415)
Consolidated revenues	$	3,070,555	$	2,872,699
Segment operating margin (loss):
U.S. dialysis	$	525,737	$	361,098
Other—Ancillary services	(11,502)		(24,865)
Total segment operating margin	514,235		336,233
Reconciliation of segment operating income to consolidated income before income  taxes:
Corporate administrative support	(30,390)		(24,588)
Consolidated operating income	483,845		311,645
Debt expense	(99,418)		(100,774)
Other (loss) income, net	(12,641)		3,752
Consolidated income before income taxes	$	371,786	$	214,623

Summary of Depreciation and Amortization Expense by Reportable Segment

Depreciation and amortization expense by reportable segment was as follows:

	Three months ended March 31,
	2024		2023
U.S. dialysis	$	172,852	$	166,961
Other—Ancillary services	14,231		11,110
	$	187,083	$	178,071

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,
	2024		2023
U.S. dialysis	$	104,953	$	130,966
Other—Ancillary services	16,062		16,739
	$	121,015	$	147,705