Segment reporting (Tables)

6 Months Ended

Jun. 30, 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 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

Summary of Depreciation and Amortization Expense by Reportable Segment

Depreciation and amortization expense by reportable segment was as follows:

	Three months ended June 30,				Six months ended June 30,
	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

Summary of Expenditures for Property and Equipment by Reportable Segment

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