v3.26.1
Segment reporting
 6 Months Ended
Jun. 30, 2026
Segment Reporting [Abstract]  
Segment Reporting 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 June 30,Six months ended June 30,
2026202520262025
Segment revenues:
U.S. dialysis
Patient service revenues:
External sources$2,993,948 $2,890,709 $5,908,902 $5,696,136 
Intersegment revenues11,361 16,716 31,833 28,450 
U.S. dialysis patient service revenues3,005,309 2,907,425 5,940,735 5,724,586 
Other revenues
External sources6,514 5,966 12,790 11,974 
Total U.S. dialysis revenues3,011,823 2,913,391 5,953,525 5,736,560 
Other—Ancillary services
Patient service revenues372,429 316,162 730,272 613,728 
Other external sources181,193 166,689 317,668 281,217 
Intersegment revenues3,087 2,836 6,375 5,565 
Total ancillary services556,709 485,687 1,054,315 900,510 
Total net segment revenues3,568,532 3,399,078 7,007,840 6,637,070 
Elimination of intersegment revenues(14,448)(19,552)(38,208)(34,015)
Consolidated revenues$3,554,084 $3,379,526 $6,969,632 $6,603,055 
Significant segment expenses:
U.S. dialysis
Patient care costs$2,004,694 $1,928,462 $3,973,750 $3,841,890 
General and administrative330,892 312,089 650,664 594,768 
Depreciation and amortization146,461 156,782 301,631 313,681 
Other segment items(1)
(8,200)(6,786)(16,464)(12,396)
U.S. dialysis segment expenses2,473,847 2,390,547 4,909,581 4,737,943 
Segment operating margin:
U.S. dialysis537,976 522,844 1,043,944 998,617 
Other—Ancillary services(2)
57,050 56,714 62,882 53,906 
Total segment operating margin595,026 579,558 1,106,826 1,052,523 
Reconciliation of segment operating income to consolidated
 income before income taxes:
Corporate administrative support(16,025)(41,717)(45,933)(75,745)
Consolidated operating income579,001 537,841 1,060,893 976,778 
Debt expense(150,256)(146,062)(295,387)(281,117)
Debt extinguishment and modification costs(2,035)— (2,035)— 
Other income (loss), net8,300 (22,851)12,773 (40,400)
Income before income taxes$435,010 $368,928 $776,244 $655,261 
 
(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 $21,347 and $17,923 for the three months ended June 30, 2026 and 2025, respectively, and $44,006 and $37,474 for the six months ended June 30, 2026 and 2025, respectively.
Expenditures for property and equipment by reportable segment were as follows:
Six months ended June 30,
20262025
U.S. dialysis$229,523 $216,902 
Other—Ancillary services42,313 47,447 
$271,836 $264,349