v3.26.1
Segment reporting (Tables)
 3 Months Ended
Mar. 31, 2026
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, 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 
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,
 20262025
U.S. dialysis$88,441 $113,591 
Other—Ancillary services13,577 29,667 
 $102,018 $143,258