Segment Reporting (Tables)

The following is a summary of segment revenues, segment operating margin, and a reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:


	Year ended December 31,
	2025		2024		2023
Segment revenues:
U.S. dialysis
Patient service revenues:
External sources	$	11,707,376	$	11,294,614	$	10,823,525
Intersegment revenues	60,958		71,747		88,222
U.S. dialysis patient service revenues	11,768,334		11,366,361		10,911,747
Other revenues
External sources	24,610		24,356		25,251
Total U.S. dialysis revenues	11,792,944		11,390,717		10,936,998
Other - Ancillary services
Patient service revenues	1,299,810		965,761		751,416
Other external sources	611,273		530,819		539,955
Intersegment revenues	11,203		13,910		7,852
Total ancillary services	1,922,286		1,510,490		1,299,223
Total net segment revenues	13,715,230		12,901,207		12,236,221
Elimination of intersegment revenues	(72,161)		(85,657)		(96,074)
Consolidated revenues	$	13,643,069	$	12,815,550	$	12,140,147
Significant segment expenses:
U.S. dialysis
Patient care costs	$	7,854,234	$	7,497,576	$	7,394,640
General and administrative	1,253,298		1,173,990		1,102,072
Depreciation and amortization	633,396		661,181		695,674
Other segment items(1)	(32,217)		(63,037)		(29,966)
U.S. dialysis segment expenses	9,708,711		9,269,710		9,162,420
Other - Ancillary services expenses(2)	1,829,907		1,427,833		1,307,970
Segment operating margin:
U.S. dialysis	2,084,233		2,121,007		1,774,578
Other - Ancillary services(3)	92,379		82,657		(8,747)
Total segment margin	2,176,612		2,203,664		1,765,831
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:
Corporate administrative support	(132,997)		(113,181)		(163,047)
Consolidated operating income	2,043,615		2,090,483		1,602,784
Debt expense	(579,926)		(470,469)		(398,551)
Debt extinguishment and modification costs	(14,178)		(19,813)		(7,962)
Other loss, net	(102,688)		(69,808)		(19,177)
Income from continuing operations before income taxes	$	1,346,823	$	1,530,393	$	1,177,094

(1)Other segment items for our U.S. dialysis segment include equity income from nonconsolidated joint ventures and a gain on changes in ownership interest.

(2)Includes depreciation and amortization of $81,952, $62,679 and $49,769 in 2025, 2024 and 2023, respectively.

(3)Segment operating margin (loss) for Other - Ancillary services includes equity investment (income) loss of $(783), $1,701 and $2,103 in 2025, 2024 and 2023, respectively.

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


	Year ended December 31,
	2025		2024		2023
U.S. dialysis	$	471,548	$	469,799	$	501,149
Other - Ancillary services	104,316		85,644		66,836

	$	575,864	$	555,443	$	567,985