Segment reporting

6 Months Ended

Jun. 30, 2024

Segment Reporting [Abstract]

Segment Reporting Disclosure

Segment reporting

The Company’s operating divisions are composed of its U.S. dialysis and related lab services business (its U.S. dialysis business), its U.S. integrated kidney care business, its U.S. other ancillary services and its international operations (collectively, its ancillary services), as well as its corporate administrative support.

The Company’s separate operating segments include its U.S. dialysis and related lab services business, its U.S. integrated kidney care business, its U.S. other ancillary services, its 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 operating segments have been combined and disclosed in the other segments category. See Note 24 to the Company's consolidated financial statements included in the 2023 10-K for further description of how the Company determines and measures results for its operating segments.

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 June 30,				Six months ended June 30,
	2024		2023		2024		2023
Segment revenues:
U.S. dialysis
Dialysis patient service revenues:
External sources	$	2,822,187	$	2,703,850	$	5,547,761	$	5,287,782
Intersegment revenues	12,925		20,361		37,389		42,410
U.S. dialysis patient service revenues	2,835,112		2,724,211		5,585,150		5,330,192
Other revenues:
External sources	5,898		6,404		12,021		12,583
Total U.S. dialysis revenues	2,841,010		2,730,615		5,597,171		5,342,775
Other—Ancillary services
Dialysis patient service revenues	238,915		186,835		454,873		362,937
Other external sources	119,722		103,280		242,622		209,766
Intersegment revenues	3,823		1,408		6,570		2,774
Total ancillary services revenues	362,460		291,523		704,065		575,477
Total net segment revenues	3,203,470		3,022,138		6,301,236		5,918,252
Elimination of intersegment revenues	(16,748)		(21,769)		(43,959)		(45,184)
Consolidated revenues	$	3,186,722	$	3,000,369	$	6,257,277	$	5,873,068
Segment operating margin (loss):
U.S. dialysis	$	550,186	$	460,759	$	1,075,923	$	821,857
Other—Ancillary services	(18,592)		(21,604)		(30,094)		(46,469)
Total segment operating margin	531,594		439,155		1,045,829		775,388
Reconciliation of segment operating income to consolidated  income before income taxes:
Corporate administrative support	(25,196)		(33,864)		(55,586)		(58,452)
Consolidated operating income	506,398		405,291		990,243		716,936
Debt expense	(97,747)		(103,507)		(197,165)		(204,281)
Debt prepayment, extinguishment and modification costs	(9,732)		(7,962)		(9,732)		(7,962)
Other (loss) income, net	(27,479)		1,373		(40,120)		5,125
Consolidated income before income taxes	$	371,440	$	295,195	$	743,226	$	509,818

Depreciation and amortization expense by reportable segment was as follows:

	Three months ended June 30,				Six months ended June 30,
	2024		2023		2024		2023
U.S. dialysis	$	160,410	$	171,842	$	333,262	$	338,803
Other—Ancillary services	15,251		11,830		29,482		22,940
	$	175,661	$	183,672	$	362,744	$	361,743

Expenditures for property and equipment by reportable segment were as follows:

	Six months ended June 30,
	2024		2023
U.S. dialysis	$	211,171	$	240,474
Other—Ancillary services	34,569		31,730
	$	245,740	$	272,204