v3.26.1
Segment reporting
 3 Months Ended
Mar. 31, 2026
Segment Reporting [Abstract]  
Segment Reporting Disclosure Segment reporting
The Company’s separate operating segments include 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 operations in each foreign jurisdiction (collectively, its ancillary services). The Company also maintains a corporate administrative support function.
The Company’s operating segments have been defined based on the separate financial information that is regularly produced and reviewed by the Company’s chief operating decision maker, its Chief Executive Officer, in making decisions about allocating resources to and assessing the financial performance of the Company’s various operating lines of business. The chief operating decision maker does not review total assets by segment to make decisions regarding resources; therefore, the total assets by segment disclosure has not been included.
Currently, 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 2025 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, and a reconciliation of segment operating margin to consolidated income before income taxes:
Three months ended March 31,
 20262025
Segment revenues:  
U.S. dialysis  
Patient service revenues:  
External sources$2,914,954 $2,805,427 
Intersegment revenues20,472 11,734 
U.S. dialysis patient service revenues2,935,426 2,817,161 
Other revenues
External sources6,275 6,008 
Total U.S. dialysis revenues2,941,701 2,823,169 
Other—Ancillary services
Patient service revenues357,843 297,566 
Other external sources136,476 114,528 
Intersegment revenues3,288 2,728 
Total ancillary services497,607 414,822 
Total net segment revenues3,439,308 3,237,991 
Elimination of intersegment revenues(23,760)(14,462)
Consolidated revenues$3,415,548 $3,223,529 
Significant segment expenses:
U.S. dialysis
Patient care costs$1,969,056 $1,913,428 
General and administrative319,772 282,679 
Depreciation and amortization155,170 156,899 
Other segment items(1)
(8,264)(5,609)
U.S. dialysis segment expenses2,435,734 2,347,397 
Segment operating margin:  
U.S. dialysis505,967 475,772 
Other—Ancillary services(2)
5,832 (2,809)
Total segment operating margin511,799 472,963 
Reconciliation of segment operating income to consolidated
 income before income taxes:		  
Corporate administrative support(29,907)(34,026)
Consolidated operating income481,892 438,937 
Debt expense(145,131)(135,055)
Other income (loss), net4,473 (17,549)
Income from continuing operations before income taxes$341,234 $286,333 
 
(1)Other segment items for the Company's U.S. dialysis segment include equity income from nonconsolidated joint ventures for all periods presented.
(2)Includes depreciation and amortization of $22,659 and $19,552 for the three months ended March 31, 2026 and 2025, respectively.
Expenditures for property and equipment by reportable segment were as follows:
Three months ended March 31,
 20262025
U.S. dialysis$88,441 $113,591 
Other—Ancillary services13,577 29,667 
 $102,018 $143,258