DaVita (DVA) 10-Q 7 Nov 17 2017 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares shares in Millions	9 Months Ended
	Sep. 30, 2017	Nov. 03, 2017
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q3
Trading Symbol	DVA
Entity Registrant Name	DAVITA INC.
Entity Central Index Key	927,066
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		183.3

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS (unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Income Statement [Abstract]
Patient service revenues	$ 2,746,257	$ 2,643,194	$ 8,030,102	$ 7,708,641
Less: Provision for uncollectible accounts	(123,760)	(115,555)	(352,228)	(336,188)
Net patient service revenues	2,622,497	2,527,639	7,677,874	7,372,453
Capitated revenues	1,016,365	872,538	2,956,479	2,660,532
Other revenues	283,969	330,399	863,238	996,378
Total net revenues	3,922,831	3,730,576	11,497,591	11,029,363
Operating expenses and charges:
Patient care costs and other costs	2,925,975	2,697,629	8,508,706	7,950,987
General and administrative	400,018	406,890	1,174,113	1,180,214
Depreciation and amortization	203,283	181,739	593,527	531,475
Provision for uncollectible accounts	(2,685)	3,773	(1,381)	9,856
Equity investment loss (income)	4,852	(4,237)	(2,697)	(5,119)
Goodwill and asset impairment charges	601,040	0	701,523	253,000
Gain on changes in ownership interests, net	(17,129)	(374,374)	(23,402)	(404,165)
Gain on settlement, net	0	0	(526,827)	0
Total operating expenses and charges	4,115,354	2,911,420	10,423,562	9,516,248
Operating (loss) income	(192,523)	819,156	1,074,029	1,513,115
Debt expense	(109,623)	(104,581)	(322,014)	(310,359)
Other income, net	4,370	1,876	13,866	8,067
(Loss) income before income taxes	(297,776)	716,451	765,881	1,210,823
Income tax (benefit) expense	(125,742)	104,301	276,005	366,011
Net (loss) income	(172,034)	612,150	489,876	844,812
Less: Net income attributable to noncontrolling interests	(42,442)	(40,818)	(129,654)	(122,664)
Net (loss) income attributable to DaVita Inc.	$ (214,476)	$ 571,332	$ 360,222	$ 722,148
Earnings per share:
Basic net (loss) income per share attributable to DaVita Inc. (usd per share)	$ (1.14)	$ 2.80	$ 1.89	$ 3.54
Diluted net (loss) income per share attributable to DaVita Inc. (usd per share)	$ (1.14)	$ 2.76	$ 1.86	$ 3.48
Weighted average shares for earnings per share:
Basic (in shares)	188,883,922	203,761,433	190,770,165	204,206,979
Diluted (in shares)	188,883,922	206,961,450	193,546,245	207,643,794

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (172,034)	$ 612,150	$ 489,876	$ 844,812
Unrealized losses on interest rate cap and swap agreements:
Unrealized losses on interest rate cap and swap agreements	(478)	(153)	(5,479)	(8,238)
Reclassifications of net rate cap and swap agreements realized losses into net (loss) income	1,265	388	3,793	1,301
Unrealized gains on investments:
Unrealized gains on investments	863	1,121	3,478	1,988
Reclassification of net investment realized gains into net (loss) income	(9)	(50)	(221)	(143)
Unrealized gains on foreign currency translation:
Foreign currency translation adjustments	29,143	(951)	91,546	5,386
Reclassification of foreign currency translation adjustment realized loss into net (loss) income	0	7,513	0	7,513
Other comprehensive income	30,784	7,868	93,117	7,807
Total comprehensive (loss) income	(141,250)	620,018	582,993	852,619
Less: Comprehensive income attributable to noncontrolling interests	(42,442)	(40,876)	(129,652)	(122,871)
Comprehensive (loss) income attributable to DaVita Inc.	$ (183,692)	$ 579,142	$ 453,341	$ 729,748

CONSOLIDATED BALANCE SHEETS (un

CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
ASSETS
Cash and cash equivalents	$ 846,110	$ 913,187
Short-term investments	137,358	310,198
Accounts receivable, less allowance of $221,329 and $252,056	2,091,074	1,917,302
Inventories	154,422	164,858
Other receivables	599,374	453,483
Prepaid and other current assets	205,211	210,604
Income taxes receivable	0	10,596
Total current assets	4,033,549	3,980,228
Property and equipment, net of accumulated depreciation of $3,151,402 and $2,832,160	3,386,056	3,175,367
Intangible assets, net of accumulated amortization of $1,084,682 and $940,731	1,451,033	1,527,767
Equity method and other investments	545,053	502,389
Long-term investments	120,129	103,679
Other long-term assets	61,642	44,510
Goodwill	9,415,877	9,407,317
Total assets	19,013,339	18,741,257
LIABILITIES AND EQUITY
Accounts payable	566,918	522,415
Other liabilities	928,123	856,847
Accrued compensation and benefits	775,280	815,761
Medical payables	400,259	336,381
Current portion of long-term debt	189,822	165,041
Income tax payable	14,391	0
Total current liabilities	2,874,793	2,696,445
Long-term debt	8,908,703	8,947,327
Other long-term liabilities	548,226	465,358
Deferred income taxes	685,598	809,128
Total liabilities	13,017,320	12,918,258
Commitments and contingencies
Noncontrolling interests subject to put provisions	1,026,890	973,258
Equity:
Preferred stock ($0.001 par value, 5,000,000 shares authorized; none issued)
Common stock ($0.001 par value, 450,000,000 shares authorized; 194,788,516 and 194,554,491 shares issued and 189,231,693 and 194,554,491 shares outstanding, respectively)	195	195
Additional paid-in capital	1,059,176	1,027,182
Retained earnings	4,070,535	3,710,313
Treasury stock (5,556,823 shares at September 30, 2017)	(348,801)	0
Accumulated other comprehensive income (loss)	3,476	(89,643)
Total DaVita Inc. shareholders’ equity	4,784,581	4,648,047
Noncontrolling interests not subject to put provisions	184,548	201,694
Total equity	4,969,129	4,849,741
Total liabilities and equity	$ 19,013,339	$ 18,741,257

CONSOLIDATED BALANCE SHEETS (u5

CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 221,329	$ 252,056
Property and equipment, accumulated depreciation	3,151,402	2,832,160
Intangible assets, accumulated amortization	$ 1,084,682	$ 940,731
Preferred stock, par value (usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, issued (in shares)	0	0
Common stock, par value (usd per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	450,000,000	450,000,000
Common stock, shares issued (in shares)	194,788,516	194,554,491
Common stock, shares outstanding (in shares)	189,231,693	194,554,491
Treasury Stock, Common, Shares	5,556,823	0

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Cash flows from operating activities:
Net income	$ 489,876	$ 844,812
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	593,527	531,475
Goodwill and asset impairment charges	701,523	253,000
Stock-based compensation expense	28,478	29,817
Deferred income taxes	(132,781)	48,778
Equity investment income, net	19,071	16,825
Gain on changes in ownership interests, net	(23,402)	(404,165)
Other non-cash charges	41,709	9,163
Changes in operating assets and liabilities, other than from acquisitions and divestitures:
Accounts receivable	(146,024)	(85,660)
Inventories	14,272	(13,045)
Other receivables and other current assets	(47,173)	(1,616)
Other long-term assets	(13,831)	31,081
Accounts payable	18,595	(45,507)
Accrued compensation and benefits	(60,063)	79,289
Other current liabilities	39,445	119,549
Income taxes	22,669	79,592
Other long-term liabilities	18,648	(12,126)
Net cash provided by operating activities	1,564,539	1,481,262
Cash flows from investing activities:
Additions of property and equipment	(639,829)	(575,243)
Acquisitions	(726,538)	(497,331)
Proceeds from asset and business sales	92,529	18,991
Purchase of investments available for sale	(9,882)	(9,041)
Purchase of investments held-to-maturity	(225,166)	(976,411)
Proceeds from sale of investments available for sale	5,822	8,636
Proceeds from investments held-to-maturity	398,765	743,941
Purchase of intangible assets	0	(75)
Purchase of equity investments	(3,014)	(11,629)
Proceeds from sale of equity investments	0	40,920
Distributions received on equity investments	80	0
Net cash used in investing activities	(1,107,233)	(1,257,242)
Cash flows from financing activities:
Borrowings	38,160,821	39,102,302
Payments on long-term debt and other financing costs	(38,269,284)	(39,201,204)
Purchase of treasury stock	(321,411)	(620,898)
Distributions to noncontrolling interests	(165,463)	(145,072)
Stock award exercises and other share issuances, net	15,781	18,515
Contributions from noncontrolling interests	51,156	35,524
Purchase of noncontrolling interests	(1,432)	(9,727)
Other	0	12,584
Net cash used in financing activities	(529,832)	(807,976)
Effect of exchange rate changes on cash and cash equivalents	5,449	(1,664)
Net decrease in cash and cash equivalents	(67,077)	(585,620)
Cash and cash equivalents at beginning of period	913,187	1,499,116
Cash and cash equivalents at end of period	$ 846,110	$ 913,496

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY (unaudited) - USD ($) $ in Thousands	Total	Total	TotalRestricted Stock Units	TotalStock Appreciation Rights	Non- controlling interests subject to put provisions	Common stock	Common stockRestricted Stock Units	Common stockStock Appreciation Rights	Additional paid-in capital	Additional paid-in capitalRestricted Stock Units	Additional paid-in capitalStock Appreciation Rights	Retained earnings	Treasury stock	Treasury stockRestricted Stock Units	Treasury stockStock Appreciation Rights	Accumulated other comprehensive (loss) income	Non- controlling interests not subject to put provisions
Beginning balance at Dec. 31, 2015		$ 4,870,780			$ 864,066	$ 217			$ 1,118,326			$ 4,356,835	$ (544,772)			$ (59,826)	$ 213,392
Beginning Balance (in shares) at Dec. 31, 2015						217,120,000							(7,366,000)
Comprehensive income:
Other comprehensive income (loss)	$ 7,807
Beginning balance at Dec. 31, 2015		4,870,780			864,066	$ 217			1,118,326			4,356,835	$ (544,772)			(59,826)	213,392
Beginning Balance (in shares) at Dec. 31, 2015						217,120,000							(7,366,000)
Comprehensive income:
Net income		879,874			99,834							879,874					53,374
Other comprehensive income (loss)		(29,817)														(29,817)	190
Stock purchase shares issued (in shares)						438,000
Stock purchase shares issued		23,903				$ 1			23,902
Stock unit shares issued/settled (in shares)							4,000	218,000						276,000	513,000
Stock unit shares issued/settled			$ 0	$ 0						$ (19,815)	$ (36,685)			$ (19,815)	$ (36,685)
Stock-settled stock-based compensation expense		37,970							37,970
Excess tax benefits from stock awards exercised		13,251							13,251
Changes in noncontrolling interest from:
Distributions					(111,092)												(81,309)
Contributions					33,517												14,073
Acquisitions and divestitures		3,423			28,874				3,423								2,585
Partial purchases		(13,105)			(6,660)				(13,105)								(1,747)
Fair value remeasurements		(65,855)			65,855				(65,855)
Reclassifications and expirations of puts					(1,136)												1,136
Purchase of treasury stock (in shares)													(16,649,000)
Purchase of treasury stock		(1,072,377)											$ (1,072,377)
Retirement of treasury stock (in shares)						23,226,000							23,226,000
Retirement of treasury stock		0				$ 23			34,230			1,526,396	$ 1,560,649
Ending balance at Dec. 31, 2016	$ 4,849,741	4,648,047			973,258	$ 195			1,027,182			3,710,313	$ 0			(89,643)	201,694
Ending Balance (in shares) at Dec. 31, 2016	194,554,491					194,554,000							0
Comprehensive income:
Other comprehensive income (loss)	$ 7,868
Net income		360,222			83,000							360,222					46,654
Other comprehensive income (loss)	$ 93,117	93,119														93,119	(2)
Stock unit shares issued/settled (in shares)							114,000	121,000
Stock unit shares issued/settled			$ (94)	$ 0						$ (94)
Stock-settled stock-based compensation expense		28,463							28,463
Changes in noncontrolling interest from:
Distributions		0			(102,205)												(63,258)
Contributions		0			40,937												10,219
Acquisitions and divestitures		(708)			35,456				(708)								(8,550)
Partial purchases		195			(1,544)				195								(83)
Fair value remeasurements		4,138			(4,138)				4,138
Reclassifications and expirations of puts					2,126												(2,126)
Purchase of treasury stock (in shares)	(5,557,000)												(5,557,000)
Purchase of treasury stock	$ (348,801)	(348,801)											$ (348,801)
Ending balance at Sep. 30, 2017	$ 4,969,129	4,784,581			1,026,890	$ 195			1,059,176			4,070,535	$ (348,801)			3,476	184,548
Ending Balance (in shares) at Sep. 30, 2017	189,231,693					194,789,000							(5,557,000)
Comprehensive income:
Other comprehensive income (loss)	$ 30,784
Ending balance at Sep. 30, 2017	$ 4,969,129	$ 4,784,581			$ 1,026,890	$ 195			$ 1,059,176			$ 4,070,535	$ (348,801)			$ 3,476	$ 184,548
Ending Balance (in shares) at Sep. 30, 2017	189,231,693					194,789,000							(5,557,000)

Condensed consolidated interim

Condensed consolidated interim financial statements	9 Months Ended
	Sep. 30, 2017
Accounting Policies [Abstract]
Condensed consolidated interim financial statements	Condensed consolidated interim financial statements The condensed consolidated interim financial statements included in this report are prepared by the Company without audit. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these condensed consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and other long-lived assets, fair value estimates, accounting for income taxes, variable compensation accruals, consolidation of variable interest entities, purchase accounting valuation estimates, long-term incentive program compensation and medical liability claims. The results of operations for the nine months ended September 30, 2017 are not necessarily indicative of the operating results for the full year. The condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2016 . Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these condensed consolidated financial statements were issued and has included all necessary adjustments and disclosures.

Earnings (loss) per share

Earnings (loss) per share	9 Months Ended
	Sep. 30, 2017
Earnings Per Share [Abstract]
Earnings (loss) per share	Earnings (loss) per share Basic net income per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interests redemption rights in excess of fair value, by the weighted average number of common shares and vested stock units outstanding, net of shares held in escrow from the DaVita HealthCare Partners merger that under certain circumstances may be returned to the Company. Diluted net income per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units (under the treasury stock method) as well as contingently returnable shares held in escrow. The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows: Three months ended Nine months ended 2017 2016 2017 2016 Basic: Net (loss) income attributable to DaVita Inc. $ (214,476 ) $ 571,332 $ 360,222 $ 722,148 Weighted average shares outstanding during the period 191,078 205,955 192,964 206,401 Contingently returnable shares held in escrow from the DaVita (2,194 ) (2,194 ) (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 188,884 203,761 190,770 204,207 Basic net (loss) income per share attributable to DaVita Inc. $ (1.14 ) $ 2.80 $ 1.89 $ 3.54 Diluted: Net (loss) income attributable to DaVita Inc. $ (214,476 ) $ 571,332 $ 360,222 $ 722,148 Weighted average shares outstanding during the period 191,078 205,955 192,964 206,401 Contingently returnable shares held in escrow from the DaVita (2,194 ) — — — Assumed incremental shares from stock plans — 1,006 582 1,243 Weighted average shares for diluted earnings per share calculation 188,884 206,961 193,546 207,644 Diluted net (loss) income per share attributable to DaVita Inc. $ (1.14 ) $ 2.76 $ 1.86 $ 3.48 Anti-dilutive potential common shares excluded from calculation 8,510 (1) 2,375 (2) 5,239 (2) 2,153 (2) (1) Shares associated with stock-settled stock appreciation rights and contingently returnable shares that are excluded from the diluted denominator calculation because they are anti-dilutive due to the Company’s net loss attributable to DaVita Inc. (2) Shares associated with stock-settled stock appreciation rights that are excluded from the diluted denominator calculation because they are anti-dilutive under the treasury stock method.

Accounts receivable

Accounts receivable	9 Months Ended
	Sep. 30, 2017
Receivables [Abstract]
Accounts receivable	Accounts receivable Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the ultimate collectability of accounts receivable, the Company analyzes its historical cash collection experience and trends for each of its government payors and commercial payors to estimate the adequacy of the allowance for doubtful accounts and the amount of the provision for uncollectible accounts. Management regularly updates its analysis based upon the most recent information available to determine its current provision for uncollectible accounts and the adequacy of its allowance for doubtful accounts. For receivables associated with dialysis patient services covered by Medicare, the Company receives 80% of the payment directly from Medicare as established under the government’s bundled payment system and determines an appropriate allowance for doubtful accounts and provision for uncollectible accounts on the remaining balance due depending upon the Company’s estimate of the amounts ultimately collectible from other secondary coverage sources or from the patients. For receivables associated with services to patients covered by commercial payors that are either based upon contractual terms or for non-contracted health plan coverage, the Company provides an allowance for doubtful accounts by recording a provision for uncollectible accounts based upon its historical collection experience, potential inefficiencies in its billing processes and for which collectability is determined to be unlikely. For receivables associated with health plans under capitated arrangements, the balances remain on the balance sheet for as long as the respective plan years are open, which varies by health plan but is generally two years in length, with collections occurring on a periodic basis throughout the duration of the corresponding plan year. Approximately 1% of the Company’s net accounts receivable are associated with patient pay. The Company’s policy is to reserve 100% of the outstanding accounts receivable balances for dialysis services when those amounts due have been outstanding for more than three months and to reserve 100% of the outstanding accounts receivable balances for services of DaVita Medical Group (DMG, formerly known as HealthCare Partners or HCP) when those amounts due have been outstanding for more than twelve months and when the amount is not subject to a payment plan. During the nine months ended September 30, 2017 , the Company’s allowance for doubtful accounts decreased by $30,727 . This was primarily due to an increase in write-offs of aged balances related to the U.S. dialysis and related lab business. There were no unusual transactions impacting the allowance for doubtful accounts.

Investments in debt and equity

Investments in debt and equity securities	9 Months Ended
	Sep. 30, 2017
Investments, Debt and Equity Securities [Abstract]
Investments in debt and equity securities	Investments in debt and equity securities The Company classifies certain debt securities as held-to-maturity and records them at amortized cost based on the Company’s intentions and strategy concerning those investments. Equity securities that have readily determinable fair values, and certain other financial instruments that have readily determinable fair values or redemption values, are classified as available-for-sale and recorded at estimated fair value. The Company’s investments in these securities and certain other financial instruments consist of the following: September 30, 2017 December 31, 2016 Held to Available Total Held to Available Total Certificates of deposit, commercial paper and $ 136,158 $ — $ 136,158 $ 256,827 $ — $ 256,827 Investments in mutual funds and common stock — 57,089 57,089 50,000 47,404 97,404 Cash surrender value of life insurance policies — 64,240 64,240 — 59,646 59,646 $ 136,158 $ 121,329 $ 257,487 $ 306,827 $ 107,050 $ 413,877 Short-term investments $ 136,158 $ 1,200 $ 137,358 $ 306,827 $ 3,371 $ 310,198 Long-term investments — 120,129 120,129 — 103,679 103,679 $ 136,158 $ 121,329 $ 257,487 $ 306,827 $ 107,050 $ 413,877 The cost of the certificates of deposit, commercial paper and money market funds at September 30, 2017 and December 31, 2016 approximates their fair value. As of September 30, 2017 and December 31, 2016 , the available-for-sale investments included $8,021 and $3,701 of gross pre-tax unrealized gains, respectively. During the nine months ended September 30, 2017 , the Company recorded gross pre-tax unrealized gains of $4,682 , or $3,480 after tax, in other comprehensive income associated with changes in the fair value of these investments. During the nine months ended September 30, 2017 , the Company sold investments in mutual funds and debt securities for net proceeds of $5,822 and recognized a pre-tax gain of $362 , or $221 after-tax, which was previously recorded in other comprehensive income. During the nine months ended September 30, 2016 , the Company sold investments in mutual funds for net proceeds of $4,645 and recognized a pre-tax gain of $233 , or $143 after-tax, which was previously recorded in other comprehensive income. The investments in mutual funds classified as available-for-sale are held within a trust to fund existing obligations associated with several of the Company’s non-qualified deferred compensation plans. Investments in life insurance policies are carried at their cash surrender value, are held within trusts to fund existing obligations associated with certain of the Company’s non-qualified deferred compensation plans, and are principally classified as long-term to correspond with the long-term classification of the related plan liabilities. Certain DMG legal entities are required to maintain minimum cash balances in order to comply with regulatory requirements in conjunction with medical claim reserves. As of September 30, 2017 , this minimum cash balance was approximately $61,557 .

Equity method and other investm

Equity method and other investments	9 Months Ended
	Sep. 30, 2017
Equity Method Investments and Joint Ventures [Abstract]
Equity method and other investments	Equity method and other investments Equity investments that do not have readily determinable fair values are carried on the cost or equity method, as applicable. The Company maintains equity method investments in nonconsolidated investees in both its DaVita Kidney Care (Kidney Care) and DMG lines of business, as well as minor cost method investments in private securities of certain other healthcare businesses. The Company classifies its non-marketable cost- and equity method investments as equity method and other investments on its balance sheet. Equity method and other investments in nonconsolidated businesses were $545,053 and $502,389 at September 30, 2017 and December 31, 2016, respectively. The increase in these equity investments was primarily due to foreign exchange valuation changes, which caused an increase in the Company's investment in DaVita Care Pte. Ltd. (the APAC JV). During the nine months ended September 30, 2017 and 2016, the Company recognized equity investment income of $2,697 and $5,119 , respectively, from equity method investments in nonconsolidated businesses. Effective as of August 1, 2016, the Company deconsolidated its Asia Pacific dialysis business held by the APAC JV, adjusted its retained investment in the APAC JV to estimated fair value at that time, and has accounted for this retained investment on the equity method since that time. The Company’s partners in the APAC JV made an additional scheduled aggregate capital contribution of $100,000 to the APAC JV effective August 1, 2017. Subsequent to that contribution, the Company now holds a 60% voting interest and a 73.3% current economic interest in the APAC JV. Based on the governance structure and voting rights established for the APAC JV, certain key decisions affecting the joint venture’s operations are no longer at the unilateral discretion of the Company, but rather are shared with the other noncontrolling investors. These other noncontrolling investors now collectively hold a 40% voting interest and a 26.7% current economic interest in the APAC JV, and their economic interests are expected to increase to match their voting interests in the joint venture as they make additional subscribed capital contributions through August 1, 2019. Each of these other noncontrolling investors also holds reserved approval rights over certain key decisions affecting the joint venture’s operations. As a result, the Company has no longer consolidated the APAC JV since its formation on August 1, 2016.

Goodwill

Goodwill	9 Months Ended
	Sep. 30, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill Changes in goodwill by reportable segment were as follows: U.S. dialysis and related lab services DMG Other-ancillary services and strategic initiatives Consolidated total Balance at January 1, 2016 $ 5,629,183 $ 3,398,264 $ 267,032 $ 9,294,479 Acquisitions 75,295 248,901 123,632 447,828 Divestitures (12,891 ) (2,223 ) (29,645 ) (44,759 ) Goodwill impairment charges — (253,000 ) (28,415 ) (281,415 ) Foreign currency and other adjustments — — (8,816 ) (8,816 ) Balance at December 31, 2016 $ 5,691,587 $ 3,391,942 $ 323,788 $ 9,407,317 Acquisitions 441,486 132,778 113,611 687,875 Divestitures (32,260 ) (29 ) (54 ) (32,343 ) Goodwill impairment charges — (651,659 ) (34,696 ) (686,355 ) Foreign currency and other adjustments — — 39,383 39,383 Balance at September 30, 2017 $ 6,100,813 $ 2,873,032 $ 442,032 $ 9,415,877 Balance at September 30, 2017: Goodwill $ 6,100,813 $ 3,966,460 $ 511,052 $ 10,578,325 Accumulated impairment charges — (1,093,428 ) (69,020 ) (1,162,448 ) $ 6,100,813 $ 2,873,032 $ 442,032 $ 9,415,877 The Company elected to early adopt ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment effective January 1, 2017. The amendments in this ASU simplify the test for goodwill impairment by eliminating the second step in the assessment. All goodwill impairment tests performed during 2017 have been performed under this new guidance. Each of the Company’s operating segments described in Note 18 to these condensed consolidated financial statements represents an individual reporting unit for goodwill impairment testing purposes, except that each sovereign jurisdiction within the Company’s international operating segments is considered a separate reporting unit. Within the U.S. dialysis and related lab services operating segment, the Company considers each of its dialysis centers to constitute an individual business for which discrete financial information is available. However, since these dialysis centers have similar operating and economic characteristics, and the allocation of resources and significant investment decisions concerning these businesses are highly centralized and the benefits broadly distributed, the Company has aggregated these centers and deemed them to constitute a single reporting unit. The Company has applied a similar aggregation to the DMG operations in each region, to the vascular access service centers in its vascular access reporting unit, to the physician practices in its physician services and direct primary care reporting units, and to the dialysis centers within each international reporting unit. For the Company’s other operating segments, discrete business components below the operating segment level constitute individual reporting units. Based on continuing developments at the Company’s DMG reporting units during the third quarter of 2017, the Company performed impairment assessments for all of its DMG reporting units. As a result of these assessments, the Company recognized goodwill impairment charges as shown and discussed below: Three months ended Nine months ended Reporting unit September 30, September 30, September 30, September 30, DMG California $ 560,756 $ — $ 560,756 $ — DMG Florida 26,324 — 76,270 91,200 DMG New Mexico 13,960 — 14,633 — DMG Nevada — — — 161,800 Vascular access — — 34,696 — Total $ 601,040 $ — $ 686,355 $ 253,000 The goodwill impairment charges recognized during the three months ended September 30, 2017 resulted primarily from reimbursement pressures, continuing increases in medical costs, and other market factors. Pursuant to further evaluation of this business during the third quarter including the preparation of these interim consolidated financial statements, the Company determined that commercial membership is expected to be lower than previously expected due to increased reimbursement pressure, Medicaid reimbursement rates are expected to trend lower within the state of California, and the gap between Medicare rate increases and medical cost increases is likely to persist. Accordingly, management has revised its expectations for certain DMG reporting units. The Company has identified opportunities to mitigate the effects of some of these challenges and is continuing to evaluate its strategic alternatives concerning the DMG business, but the timing and likelihood of such changes remain uncertain. The goodwill impairment charge recognized at the Company’s DMG California reporting unit includes a $218,134 increase to the goodwill impairment charge, and reduction to deferred tax expense, for the deferred tax assets that the impairment itself generates. As such, the effect of this is a $601,040 charge to operating (loss) income and a $218,134 credit to tax expense, for a net $382,906 impact on net (loss) income. For the Company’s DMG reporting units, this recursive deferred tax effect is unique to DMG California and arises because this component of the DMG business was acquired by the Company in a taxable transaction for which goodwill is amortized for tax purposes. During 2017, the Company also recognized goodwill impairment charges at its DMG Florida and DMG New Mexico reporting units during the three months ended June 30, 2017. These charges resulted primarily from changes in expectations concerning government reimbursement, including the effect of Medicare Advantage final benchmark payment rates for 2018 announced on April 3, 2017 and the Company’s expected ability to mitigate them, as well as medical cost and utilization trends. The goodwill impairment charge recognized at the Company's vascular access reporting unit during the nine months ended September 30, 2017 resulted primarily from continuing changes in the Company’s outlook as the Company’s partners and operators continued to evaluate and make decisions concerning changes in operations, including termination of their management services agreements and center closures as a result of the Centers for Medicare and Medicaid Services (CMS) 2017 Physician Fee Schedule Final Rule and the Ambulatory Surgical Center Payment Final Rule released November 2, 2016, which introduced significant changes in reimbursement structure for this business unit. There is no goodwill remaining at the Company's vascular access reporting unit. During the nine months ended September 30, 2016, the Company recognized goodwill impairment charges at its DMG Florida and DMG Nevada reporting units. These charges resulted primarily from changes in expectations concerning government reimbursement and the Company’s expected ability to mitigate them, as well as medical cost trends and other market conditions. Further reductions in reimbursement rates, increases in medical cost or utilization trends, or other significant adverse changes in expected future cash flows or valuation assumptions could result in goodwill impairment charges in the future for the following reporting units, which remain at risk of goodwill impairment as of September 30, 2017: Goodwill balance Carrying (1) Sensitivities Reporting unit Operating (2) Discount (3) DMG California $ 1,888,609 — % (3.0 )% (5.8 )% DMG Florida $ 378,071 — % (0.9 )% (3.3 )% DMG New Mexico $ 56,293 — % (1.1 )% (2.1 )% DMG Washington $ 247,552 17.1 % (1.7 )% (3.4 )% (1) Excess of estimated fair value of the reporting unit over its carrying amount as of the latest assessment date. (2) Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date. (3) Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date. Except as described above, none of the Company's various other reporting units were considered at risk of goodwill impairment as of September 30, 2017 . Since the dates of their last annual goodwill impairment tests, there have been certain developments, events, changes in operating performance and other changes in key circumstances that have affected these other businesses. However, except as further described above, these changes did not cause management to believe it is more likely than not that the fair value of any of its reporting units would be less than their respective carrying amounts.

Medical payables

Medical payables	9 Months Ended
	Sep. 30, 2017
Health Care Organizations [Abstract]
Medical payables	Medical payables The following table includes estimates for the cost of professional medical services provided by non-employed physicians and other providers, as well as inpatient and other ancillary costs, other than California's non-global risk contracts. The Company does not include inpatient and other ancillary costs for non-global risk contracts held in California, as state regulation does not allow medical group entities to assume risk for inpatient services. Healthcare costs payable are included in medical payables in the consolidated balance sheet. The following table shows the components of changes in healthcare costs payables: For the nine months ended September 30, 2017 Healthcare costs payables, beginning of the period $ 214,275 Add: Components of incurred health care costs Current year 1,509,433 Prior years (12,597 ) Acquired balance (1) 3,218 Total incurred health care costs 1,500,054 Less: Claims paid Current year 1,226,953 Prior years 194,285 Total claims paid 1,421,238 Healthcare costs payables, end of the period $ 293,091 (1) Represents healthcare cost payables acquired in the Magan Medical Clinic, Inc. (Magan) acquisition. See Note 15 to these condensed consolidated financial statements for further discussion of the Magan acquisition. The Company’s prior year estimates of healthcare costs payable resulted in medical claims being settled for amounts that differed from those originally estimated. When significant increases (decreases) in prior-year health care cost estimates occur that the Company believes significantly impact its current year operating results, the Company discloses that amount as unfavorable (favorable) development of prior-year’s health care cost estimates. Actual claim payments for prior year services have not differed materially from the Company’s year-end estimates.

Income taxes

Income taxes	9 Months Ended
	Sep. 30, 2017
Income Tax Disclosure [Abstract]
Income taxes	Income taxes As of September 30, 2017 , the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold was $27,196 , all of which would impact the Company’s effective tax rate if recognized. This balance represents an increase of $3,130 from the December 31, 2016 balance of $24,066 . The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. At September 30, 2017 and December 31, 2016 , the Company had approximately $3,838 and $2,595 , respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefits.

Long-term debt

Long-term debt	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Long-term debt	Long-term debt Long-term debt was comprised of the following: September 30, 2017 December 31, 2016 Senior secured credit facilities: Term Loan A $ 800,000 $ 862,500 Term Loan B 3,386,250 3,412,500 Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 149,734 117,547 Capital lease obligations 330,446 299,682 Total debt principal outstanding 9,166,430 9,192,229 Discount and deferred financing costs (67,905 ) (79,861 ) 9,098,525 9,112,368 Less current portion (189,822 ) (165,041 ) $ 8,908,703 $ 8,947,327 Scheduled maturities of long-term debt at September 30, 2017 were as follows: 2017 (remainder of the year) 59,481 2018 171,825 2019 747,908 2020 72,346 2021 3,305,940 2022 1,282,115 Thereafter 3,526,815 During the first nine months of 2017 , the Company made mandatory principal payments under its senior secured credit facilities totaling $62,500 on Term Loan A and $26,250 on Term Loan B. As of September 30, 2017, the Company maintains several active and forward interest rate cap agreements that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt, as described below. The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the term of the cap agreements. The cap agreements do not contain credit-risk contingent features. As of September 30, 2017 , the Company maintains several interest rate cap agreements that were entered into in November 2014 with notional amounts totaling $3,500,000 . These cap agreements became effective September 30, 2016 and have the economic effect of capping the LIBOR variable component of the Company’s interest rate at a maximum of 3.50% on an equivalent amount of the Company’s debt. The cap agreements expire on June 30, 2018 . As of September 30, 2017 , these cap agreements had an immaterial fair value. During the nine months ended September 30, 2017 , the Company recognized debt expense of $6,208 from these caps. During the nine months ended September 30, 2017 , the Company recorded a loss of $115 in other comprehensive income due to a decrease in unrealized fair value of these cap agreements. As of September 30, 2017 , the Company also maintains several forward interest rate cap agreements that were entered into in October 2015 with notional amounts totaling $3,500,000 . These forward cap agreements will become effective June 29, 2018 and will have the economic effect of capping the LIBOR variable component of the Company’s interest rate at a maximum of 3.50% on an equivalent amount of its debt. These cap agreements expire on June 30, 2020 . As of September 30, 2017 , the total fair value of these cap agreements was an asset of approximately $962 . During the nine months ended September 30, 2017 , the Company recorded a loss of $8,852 in other comprehensive income due to a decrease in the unrealized fair value of these forward cap agreements. The following table summarizes the Company’s derivative instruments as of September 30, 2017 and December 31, 2016 : September 30, 2017 December 31, 2016 Derivatives designated as hedging instruments Balance sheet location Fair value Balance sheet location Fair value Interest rate cap agreements Other long-term assets $ 962 Other long-term assets $ 9,929 The following table summarizes the effects of the Company’s interest rate cap and swap agreements for the three and nine months ended September 30, 2017 and 2016 : Amount of losses Location of losses reclassified from accumulated OCI into income Amount of losses Three months ended Nine months ended Three months ended Nine months ended Derivatives designated as cash flow hedges 2017 2016 2017 2016 2017 2016 2017 2016 Interest rate swap $ — $ 45 $ — $ (815 ) Debt expense $ — $ 25 $ — $ 299 Interest rate cap (782 ) (300 ) (8,967 ) (12,674 ) Debt expense 2,070 609 6,208 1,829 Tax benefit 304 102 3,488 5,251 Tax expense (805 ) (246 ) (2,415 ) (827 ) Total $ (478 ) $ (153 ) $ (5,479 ) $ (8,238 ) $ 1,265 $ 388 $ 3,793 $ 1,301 As of September 30, 2017 , the Company’s Term Loan B debt bears interest at LIBOR plus an interest rate margin of 2.75% . Term Loan B is subject to interest rate caps if LIBOR should rise above 3.50% . Term Loan A bears interest at LIBOR plus an interest rate margin of 2.00% . The capped portion of Term Loan A is $113,750 if LIBOR should rise above 3.50% . In addition, the uncapped portion of Term Loan A, which is subject to the variability of LIBOR, is $686,250 . Interest rates on the Company’s senior notes are fixed by their terms. The Company’s weighted average effective interest rate on the senior secured credit facilities at the end of the quarter was 4.22% , based on the current margins in effect of 2.00% for Term Loan A and 2.75% for Term Loan B, as of September 30, 2017 . The Company’s overall weighted average effective interest rate during the quarter ended September 30, 2017 was 4.77% and as of September 30, 2017 was 4.78% . As of September 30, 2017 , the Company’s interest rates are fixed on approximately 53.67% of its total debt. As of September 30, 2017 , the Company had undrawn revolving credit facilities totaling $1,000,000 , of which approximately $94,568 was committed for outstanding letters of credit. The remaining amount is unencumbered. In addition, the Company has approximately $211 of committed letters of credit outstanding related to DMG, which is backed by a certificate of deposit.

Contingencies

Contingencies	9 Months Ended
	Sep. 30, 2017
Commitments and Contingencies Disclosure [Abstract]
Contingencies	Contingencies The majority of the Company’s revenues are from government programs and may be subject to adjustment as a result of: (i) examination by government agencies or contractors, for which the resolution of any matters raised may take extended periods of time to finalize; (ii) differing interpretations of government regulations by different Medicare contractors or regulatory authorities; (iii) differing opinions regarding a patient’s medical diagnosis or the medical necessity of services provided; and (iv) retroactive applications or interpretations of governmental requirements. In addition, the Company’s revenues from commercial payors may be subject to adjustment as a result of potential claims for refunds, as a result of government actions or as a result of other claims by commercial payors. The Company operates in a highly regulated industry and is a party to various lawsuits, claims, governmental investigations and audits (including investigations resulting from its obligation to self-report suspected violations of law) and other legal proceedings. The Company records accruals for certain legal proceedings and regulatory matters to the extent that the Company determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. As of September 30, 2017 and December 31, 2016, the Company’s total recorded accruals with respect to legal proceedings and regulatory matters, net of anticipated third party recoveries, were approximately $51,000 and $69,000 , respectively. While these accruals reflect the Company’s best estimate of the probable loss for those matters as of the dates of those accruals, the recorded amounts may differ materially from the actual amount of the losses for those matters, and any anticipated third party recoveries for any such losses may not ultimately be recoverable. Additionally, in some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal proceedings and regulatory matters, which may be exacerbated by various factors, including that they may involve indeterminate claims for monetary damages or may involve fines, penalties or non-monetary remedies; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; are in the early stages of the proceedings; or result in a change of business practices. Further, there may be various levels of judicial review available to the Company in connection with any such proceeding. The following is a description of certain lawsuits, claims, governmental investigations and audits and other legal proceedings to which the Company is subject. Inquiries by the Federal Government and Certain Related Civil Proceedings Swoben Private Civil Suit : In April 2013, HealthCare Partners (HCP), now known as the Company’s DMG subsidiary, was one of several defendants served with a civil complaint filed by a former employee of SCAN Health Plan (SCAN), an HMO. On July 13, 2009, pursuant to the qui tam provisions of the federal False Claims Act (FCA) and the California False Claims Act, James M. Swoben, as relator, filed his initial qui tam action in the United States District Court for the Central District of California purportedly on behalf of the United States of America and the State of California against SCAN, and certain other defendants whose identities were under seal. The allegations in the complaint relate to alleged overpayments received from government healthcare programs. In 2009 and 2010, the relator twice amended his complaint and added additional defendants, and in November 2011, he filed his Third Amended Complaint under seal alleging violations of the federal FCA and the California False Claims Act, and added additional defendants, including HCP and certain health insurance companies (the defendant HMOs). The allegations in the complaint against HCP relate to patient diagnosis coding to determine reimbursement in the Medicare Advantage (MA) program, referred to as HCC and RAF scores. The complaint sought monetary damages and civil penalties as well as costs and expenses. The U.S. Department of Justice (DOJ) reviewed these allegations and in January 2013 declined to intervene in the case. HCP and the other defendants filed motions to dismiss the Third Amended Complaint, and the court dismissed with prejudice the claims and judgment was entered in September 2013. Upon the plaintiff’s appeal, a panel of the Ninth Circuit overturned the trial court’s ruling and vacated the dismissal of the case. The Company, with certain defendants, petitioned the Ninth Circuit for a rehearing, but in December 2016, the Ninth Circuit rejected the petition and determined the relator should be given an opportunity to amend the complaint, and remanded the case back to district court. In March 2017, the relator filed his Fourth Amended Complaint alleging that HCP and certain health insurance companies employed one-way retrospective reviews that were designed only to identify additional diagnoses that would be submitted to CMS for risk adjustment purposes, and thereby drive higher risk scores that would increase the capitated payments made by the federal government under the MA program. In March 2017, the DOJ partially intervened as to certain defendant HMOs, but elected not to intervene with respect to HCP. In October 2017, the court dismissed a portion of the Fourth Amended Complaint finding that some claims were time-barred and that the relator had waived an alleged theory of liability. On October 18, 2017, the relator filed a Notice of Dismissal of the action as to HCP, and the government consented to the dismissal, as a result of which the suit is now dismissed, without prejudice. 2015 U.S. Office of Inspector General (OIG) Medicare Advantage Civil Investigation : In March 2015, JSA HealthCare Corporation (JSA), a subsidiary of DMG, received a subpoena from the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS). The Company has been advised by an attorney with the Civil Division of the DOJ in Washington, D.C. that the subpoena relates to an ongoing civil investigation concerning MA service providers’ risk adjustment practices and data, including identification and verification of patient diagnoses and factors used in making the diagnoses. The subpoena requests documents and information for the period from January 1, 2008 through December 31, 2013, for certain MA plans for which JSA provided services. It also requests information regarding JSA’s communications about patient diagnoses as they relate to certain MA plans generally, and more specifically as related to two Florida physicians with whom JSA previously contracted. The Company is producing the requested information and is cooperating with the government’s investigation. In addition to the subpoena described above, in June 2015, the Company received a subpoena from the OIG. This civil subpoena covers the period from January 1, 2008 through the present and seeks production of a wide range of documents relating to the Company’s and its subsidiaries’ (including DMG’s and its subsidiary JSA’s) provision of services to MA plans and related patient diagnosis coding and risk adjustment submissions and payments. The Company believes that the request is part of a broader industry investigation into MA patient diagnosis coding and risk adjustment practices and potential overpayments by the government. The information requested includes information relating to patient diagnosis coding practices for a number of conditions, including potentially improper historical DMG coding for a particular condition. With respect to that condition, the guidance related to that coding issue was discontinued following the Company’s November 1, 2012 acquisition of DMG, and the Company notified CMS in April 2015 of the coding practice and potential overpayments. In that regard, the Company has identified certain additional coding practices which may have been problematic and is in discussions with the DOJ about the scope and nature of a review of claims relating to those practices. The Company is cooperating with the government and is producing the requested information. In addition, the Company is continuing to review other DMG coding practices to determine whether there were any improper coding issues. In connection with the DMG merger, the Company has certain indemnification rights against the sellers and an escrow was established as security for the indemnification. The Company has submitted an indemnification claim against the sellers secured by the escrow for any and all liabilities incurred relating to these matters and intends to pursue recovery from the escrow. However, the Company can make no assurances that the indemnification and escrow will cover the full amount of the Company’s potential losses related to these matters. 2016 U.S. Attorney Prescription Drug Investigation : In early February 2016, the Company announced that its pharmacy services’ wholly-owned subsidiary, DaVita Rx, received a CID from the U.S. Attorney’s Office for the Northern District of Texas. The government is conducting an FCA investigation concerning allegations that DaVita Rx presented or caused to be presented false claims for payment to the government for prescription medications, as well as into the Company’s relationship with pharmaceutical manufacturers. The CID covers the period from January 1, 2006 through the present. In the spring of 2015, the Company initiated an internal compliance review of DaVita Rx during which it identified potential billing and operational issues, including potential write-offs and discounts of patient co-payment obligations, and credits to payors for returns of prescription drugs related to DaVita Rx. The Company notified the government in September 2015 that it was conducting this review of DaVita Rx and began providing regular updates of its review. Upon completion of its review, the Company filed a self-disclosure with the OIG in February 2016 and has been working to address and update the practices it identified in the self-disclosure, some of which overlap with information requested by the U.S. Attorney’s Office. The OIG informed the Company in February 2016 that its submission was not accepted. They indicated that the OIG is not expressing an opinion regarding the conduct disclosed or the Company’s legal positions. The Company is cooperating with the government. Solari Post-Acquisition Matter : In 2016, HCP Nevada disclosed to the OIG for the HHS that proper procedures for clinical and eligibility determinations may not have been followed by Las Vegas Solari Hospice (Solari), which was acquired in March 2013 and sold in September 2016 by HCP Nevada. In June 2016, the Company was notified by the OIG that the disclosure submission had been accepted into the OIG’s Self Disclosure Protocol. HCP Nevada had previously made a disclosure and repayment of overpayments to National Government Services (NGS), the Medicare Administrative Contractor for HCP Nevada, for claims submitted by Solari to the federal government prior to DMG’s acquisition of Solari and claims made to the government post-acquisition for which the sellers had certain responsibilities pursuant to a management services agreement. The Company is cooperating with the government in this matter. In October 2017, the Company finalized and executed a settlement agreement with the OIG including payment of an immaterial amount. 2017 U.S. Attorney American Kidney Fund Investigation : On January 4, 2017, the Company was served with an administrative subpoena for records by the United States Attorney’s Office, District of Massachusetts, relating to an investigation into possible federal health care offenses. The subpoena covers the period from January 1, 2007 through the present, and seeks documents relevant to charitable patient assistance organizations, particularly the American Kidney Fund, including documents related to efforts to provide patients with information concerning the availability of charitable assistance. The Company is cooperating with the government and is producing the requested information. Although the Company cannot predict whether or when proceedings might be initiated or when these matters may be resolved (other than as described above), it is not unusual for inquiries such as these to continue for a considerable period of time through the various phases of document and witness requests and on-going discussions with regulators. In addition to the inquiries and proceedings specifically identified above, the Company is frequently subject to other inquiries by state or federal government agencies and/or private civil qui tam complaints filed by relators. Negative findings or terms and conditions that the Company might agree to accept as part of a negotiated resolution of pending or future government inquiries or relator proceedings could result in, among other things, substantial financial penalties or awards against the Company, substantial payments made by the Company, harm to the Company’s reputation, required changes to the Company’s business practices, exclusion from future participation in the Medicare, Medicaid and other federal health care programs and, if criminal proceedings were initiated against the Company, possible criminal penalties, any of which could have a material adverse effect on the Company. Shareholder Claims Peace Officers’ Annuity and Benefit Fund of Georgia Securities Class Action Civil Suit : On February 1, 2017, the Peace Officers’ Annuity and Benefit Fund of Georgia filed a putative federal securities class action complaint in the U.S. District Court for the District of Colorado against the Company and certain executives. The complaint covers the time period of August 2015 to October 2016 and alleges, generally, that the Company and its executives violated federal securities laws concerning the Company’s financial results and revenue derived from patients who received charitable premium assistance from an industry-funded non-profit organization. The complaint further alleges that the process by which patients obtained commercial insurance and received charitable premium assistance was improper and "created a false impression of DaVita’s business and operational status and future growth prospects." The Company disputes these allegations and intends to defend this action accordingly. Blackburn Shareholder Derivative Civil Suit : On February 10, 2017, Charles Blackburn filed a derivative shareholder lawsuit in the U.S. District Court for the District of Delaware against the Company, as nominal defendant, the Board of Directors and certain executives. The complaint covers the time period from 2015 to present and alleges, generally, breach of fiduciary duty, unjust enrichment and misrepresentations and/or failures to disclose certain information in violation of the federal securities laws in connection with an alleged practice to direct patients with government-subsidized health insurance into private health insurance plans to maximize the Company’s profits. On August 15, 2017, the District Court consolidated this action with the Gabilondo and City of Warren Police and Fire Retirement System suits. The Company disputes these allegations and intends to defend this action accordingly. Gabilondo Shareholder Derivative Civil Suit : On May 30, 2017, Antonio Gabilondo filed a derivative shareholder lawsuit in the U.S. District Court for the District of Delaware against the Company, as nominal defendant, the Board of Directors and certain executives. The complaint covers the time period from 2015 to present and alleges, generally, breach of fiduciary duty, unjust enrichment, abuse of control, gross mismanagement, corporate waste, and misrepresentations and/or failures to disclose certain information in violation of the federal securities laws in connection with an alleged practice to direct patients with government-subsidized health insurance into private health insurance plans to maximize the Company’s profits. On August 15, 2017, the District Court consolidated this action with the Blackburn and City of Warren Police and Fire Retirement System suits. The Company disputes these allegations and intends to defend this action accordingly. City of Warren Police and Fire Retirement System Shareholder Derivative Civil Suit : On June 9, 2017, the City of Warren Police and Fire Retirement System filed a derivative shareholder lawsuit in the U.S. District Court for the District of Delaware against the Company, as nominal defendant, the Board of Directors, and certain executives. The complaint covers the time period of 2015 to the present and alleges, generally, a breach of fiduciary duty, corporate waste, unjust enrichment, and misrepresentations and/or failures to disclose certain information in violation of the federal securities laws in connection with an alleged practice to direct patients with government-subsidized health insurance into private health insurance plans to maximize the Company’s profits. On August 15, 2017, the District Court consolidated this action with the Blackburn and Gabilondo suits. The Company disputes these allegations and intends to defend this action accordingly. Other Proceedings In addition to the foregoing, from time to time the Company is subject to other lawsuits, demands, claims, governmental investigations and audits and legal proceedings that arise due to the nature of its business, including contractual disputes, such as with payors, suppliers and others, employee-related matters and professional and general liability claims. From time to time, the Company also initiates litigation or other legal proceedings as a plaintiff arising out of contracts or other matters. Resolved Matters 2015 U.S. Attorney Transportation Investigation : In February 2015, the Company announced that it received six administrative subpoenas from the OIG for medical records from six different dialysis centers in southern California operated by the Company. Specifically, each subpoena sought the medical records of a single patient of each respective dialysis center. In February 2016, the Company received four additional subpoenas for four additional dialysis centers in southern California. The subpoenas were similarly limited in scope to the subpoenas received in 2015. On February 8, 2017, the Company was served with a qui tam complaint in the U.S. District Court for the Central District of California. The Company was advised by an attorney with the United States Attorney’s Office for the Central District of California that the qui tam was related to the investigation concerning the medical necessity of patient transportation, which was the basis for the subpoenas. The relator alleged that an ambulance company submitted false claims for patient transportation. Although the Company does not provide transportation nor does it bill for the transport of its dialysis patients, the relator alleged that two of its purported clinical staff caused the submission of a small number of those claims through improper certifications of medical necessity. The DOJ has declined to intervene. In April 2017, the court granted the Company's motion to dismiss and dismissed the complaint without prejudice for failing to state a claim upon which relief can be granted. In May 2017, the relator filed a First Amended Complaint and the Company filed an additional motion to dismiss. In June 2017, the court granted the Company’s motion and dismissed the complaint without prejudice. Plaintiff was given until July 24, 2017 to file an amended complaint. Instead, the plaintiff decided not to proceed against the Company and filed a notice of dismissal on July 25, 2017. 2011 Suit against the U.S. Department of Veterans Affairs : As previously disclosed, the Company had a pending lawsuit in the U.S. Court of Federal Claims against the federal government which was originally filed in May 2011. The lawsuit related to the U.S. Department of Veterans Affairs (VA) underpayment of dialysis services the Company provided from 2005 through 2011 to veterans pursuant to VA regulations. In the first quarter of 2017, the Company received a payment of $538,000 related to the settlement with the VA. The Company's consolidated entities recognized a net gain of $527,000 on this settlement. The Company's nonconsolidated and managed entities recognized a gain of $9,000 , of which the Company's equity investment share was $3,000 . The net effect was a net increase of $530,000 to the Company's operating income. 2015 U.S. Department of Justice Vascular Access Investigation and Related Qui Tam Litigation : In November 2015, the Company announced that RMS Lifeline, Inc., a wholly-owned subsidiary of the Company that operates under the name Lifeline Vascular Access (Lifeline), received a Civil Investigative Demand (CID) from the DOJ. The CID relates to two vascular access centers in Florida that are part of Lifeline’s vascular access business. The CID covers the period from January 1, 2008 through the present. The Company acquired these two centers in December 2012. Based on the language of the CID, the DOJ appeared to be looking at whether angiograms performed at the two centers were medically unnecessary and therefore whether related claims filed with federal healthcare programs possibly violated the FCA. Lifeline does not perform dialysis services but instead provides vascular access management services for dialysis patients. The Company cooperated with the government and produced the requested information. The DOJ investigation was initiated pursuant to a complaint brought under the qui tam provisions of the FCA (the Complaint). The Complaint was originally filed under seal in August 2014 in the U.S. District Court, Middle District of Florida, United States ex. rel James Spafford v. DaVita HealthCare Partners, Inc., et al., Case Number 6:14-cv-1251-Orl-41DAB, naming several doctors along with the Company as defendants. In December 2015, a First Amended Complaint was filed under seal. In May 2016, the First Amended Complaint was unsealed. The First Amended Complaint alleged violations of the FCA due to the submission of claims to the government for allegedly medically unnecessary angiograms and angiography procedures at the two vascular access centers as well as employment-related claims. The Complaint covers alleged conduct dating from July 2008, prior to the Company’s acquisition of the centers, to the present. The DOJ declined to intervene. In January 2017, the Company finalized and executed a settlement agreement with the relator and the government for an immaterial amount, and in April 2017, the court dismissed the case with prejudice. Vainer Private Civil Suit : As previously disclosed, the Company received a subpoena for documents from the OIG relating to the pharmaceutical products Zemplar, Hectorol, Venofer, Ferrlecit and erythropoietin (EPO), as well as other related matters, covering the period from January 2003 to December 2008. The Company subsequently learned that the allegations underlying this inquiry were made as part of a civil complaint filed by relators, Daniel Barbir and Dr. Alon Vainer, pursuant to the qui tam provisions of the federal FCA. The relators also alleged that the Company’s drug administration practices for the Company’s dialysis operations for Vitamin D and iron agents from 2003 through 2010 fraudulently created unnecessary waste, which was billed to and paid for by the government. In June 2015, the Company finalized the terms of the settlement with plaintiffs, including a settlement amount of $450,000 and attorney fees and other costs of $45,000 which was paid in 2015. 2011 U.S. Attorney Medicaid Investigation : In October 2011, the Company announced that it would be receiving a request for documents, which could include an administrative subpoena from the OIG. Subsequent to the Company’s announcement of this 2011 U.S. Attorney Medicaid Investigation, the Company received a request for documents in connection with the inquiry by the U.S. Attorney’s Office for the Eastern District of New York. The request related to payments for infusion drugs covered by Medicaid composite payments for dialysis. The Company cooperated with the government and produced the requested documents. In April 2014, the Company reached an agreement in principle with the government. In March 2016, the Company finalized and executed settlement agreements with the State of New York and the DOJ, including a settlement payment of an immaterial amount. * * * Other than as described above, the Company cannot predict the ultimate outcomes of the various legal proceedings and regulatory matters to which the Company is or may be subject from time to time, including those described in this Note 10, or the timing of their resolution or the ultimate losses or impact of developments in those matters, which could have a material adverse effect on the Company’s revenues, earnings and cash flows. Further, any legal proceedings or regulatory matters involving the Company, whether meritorious or not, are time consuming, and often require management’s attention and result in significant legal expense, and may result in the diversion of significant operational resources, or otherwise harm the Company’s business, financial results or reputation.

Noncontrolling interests subjec

Noncontrolling interests subject to put provisions and other commitments	9 Months Ended
	Sep. 30, 2017
Commitments and Contingencies Disclosure [Abstract]
Noncontrolling interests subject to put provisions and other commitments	Noncontrolling interests subject to put provisions and other commitments The Company has potential obligations to purchase the noncontrolling interests held by third parties in several of its majority-owned and other nonconsolidated entities. These obligations are in the form of put provisions and are exercisable at the third-party owners’ discretion within specified periods as outlined in each specific put provision. If these put provisions were exercised, the Company would be required to purchase the third-party owners’ equity interests at either the appraised fair market value or a predetermined multiple of earnings or cash flow attributable to the equity interests put to the Company, which is intended to approximate fair value. The methodology the Company uses to estimate the fair values of noncontrolling interests subject to put provisions assumes the higher of either a liquidation value of net assets or an average multiple of earnings, based on historical earnings, patient mix and other performance indicators that can affect future results, as well as other factors. The estimated fair values of the noncontrolling interests subject to put provisions is a critical accounting estimate that involves significant judgments and assumptions and may not be indicative of the actual values at which the noncontrolling interests may ultimately be settled, which could vary significantly from the Company’s current estimates. The estimated fair values of noncontrolling interests subject to put provisions can fluctuate and the implicit multiple of earnings at which these noncontrolling interest obligations may be settled could vary significantly depending upon market conditions including potential purchasers’ access to the capital markets, which can impact the level of competition for dialysis and non-dialysis related businesses, the economic performance of these businesses and the restricted marketability of the third-party owners’ equity interests. The amount of noncontrolling interests subject to put provisions that employ a contractually predetermined multiple of earnings rather than fair value are immaterial. The Company has other potential commitments to provide operating capital to a number of dialysis centers that are wholly-owned by third parties or businesses in which the Company maintains a noncontrolling equity interest as well as to physician-owned vascular access clinics or medical practices that the Company operates under management and administrative services agreements of approximately $5,629 . Certain consolidated joint ventures are originally contractually scheduled to dissolve after terms ranging from 10 to 50 years. While noncontrolling interests in these limited life entities qualify as mandatorily redeemable financial instruments, they are subject to a classification and measurement scope exception from the accounting guidance generally applicable to other mandatorily redeemable financial instruments. Future distributions upon dissolution of these entities would be valued below the related noncontrolling interest carrying balances in the consolidated balance sheet.

Long-term incentive compensatio

Long-term incentive compensation	9 Months Ended
	Sep. 30, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Long-term incentive compensation	Long-term incentive compensation Long-term incentive program (LTIP) compensation includes both stock-based awards (principally stock-settled stock appreciation rights, restricted stock units, and performance stock units) as well as long-term performance-based cash awards. Long-term incentive compensation expense, which was primarily general and administrative in nature, was attributed to the Company’s U.S. dialysis and related lab services business, DMG business, corporate administrative support, and the other ancillary services and strategic initiatives. The Company’s stock-based compensation awards are measured at their estimated fair values on the date of grant if settled in shares or at their estimated fair values at the end of each reporting period if settled in cash. The value of stock-based awards so measured is recognized as compensation expense on a cumulative straight-line basis over the vesting terms of the awards, adjusted for expected forfeitures. During the nine months ended September 30, 2017 , the Company granted 1,672 stock-settled stock appreciation rights with an aggregate grant-date fair value of $24,246 and a weighted-average expected life of approximately 4.2 years, 526 stock units with an aggregate grant-date fair value of $34,540 and a weighted-average expected life of approximately 3.4 years, and 15 cash-settled stock appreciation rights with an aggregate grant-date fair value of $204 and a weighted-average expected life of approximately 4.3 years. For the nine months ended September 30, 2017 and 2016 , the Company recognized $59,481 and $61,042 , respectively, in total LTIP expense, of which $28,478 and $29,817 , respectively, represented stock-based compensation expense for stock appreciation rights, restricted stock units, and discounted employee stock plan purchases, which are primarily included in general and administrative expense. The estimated tax benefits recorded for stock-based compensation for the nine months ended September 30, 2017 and 2016 was $9,474 and $9,769 , respectively. As of September 30, 2017 , the Company had $144,184 of total estimated but unrecognized compensation expense for outstanding LTIP awards, including $82,765 related to stock-based compensation arrangements under the Company’s equity compensation and employee stock purchase plans. The Company expects to recognize the performance-based cash component of these LTIP costs over a weighted average remaining period of 1.1 years and the stock-based component of these LTIP costs over a weighted average remaining period of 1.5 years. For the nine months ended September 30, 2017 and 2016 , the Company received $6,046 and $27,012 , respectively, in actual tax benefits upon the exercise of stock awards.

Share repurchases

Share repurchases	9 Months Ended
	Sep. 30, 2017
Equity [Abstract]
Share repurchases	Share repurchases During the nine months ended September 30, 2017, the Company repurchased a total of 5,557 shares of its common stock for $348,801 at an average price of $62.77 per share. The Company also repurchased 5,889 shares of its common stock for $352,873 at an average price of $59.92 per share, subsequent to Sep tember 30, 2017. On October 10, 2017, the Company's Board of Directors approved an additional share repurchase authorization in the amount of $1,252,961 . This share repurchase authorization was in addition to the $247,039 remaining at that time under the Company’s Board of Directors’ prior share repurchase authorization announced in July 2016. Accordingly, as of November 7, 2017, the Company has a total of $1,228,391 available under the current Board repurchase authorizations for additional share repurchases. Although these share repurchase authorizations do not have expiration dates, the Company remains subject to share repurchase limitations under the terms of its senior secured credit facilities and the indentures governing its senior notes.

Comprehensive income

Comprehensive income	9 Months Ended
	Sep. 30, 2017
Statement of Comprehensive Income [Abstract]
Comprehensive income	Comprehensive income For the three months ended September 30, 2017 For the nine months ended September 30, 2017 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (14,502 ) $ 4,580 $ (17,386 ) $ (27,308 ) $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Unrealized (losses) (782 ) 1,253 29,143 29,614 (8,967 ) 4,682 91,546 87,261 Related income tax 304 (390 ) — (86 ) 3,488 (1,202 ) — 2,286 (478 ) 863 29,143 29,528 (5,479 ) 3,480 91,546 89,547 Reclassification 2,070 (15 ) — 2,055 6,208 (362 ) — 5,846 Related income tax (expense) benefit (805 ) 6 — (799 ) (2,415 ) 141 — (2,274 ) 1,265 (9 ) — 1,256 3,793 (221 ) — 3,572 Ending balance $ (13,715 ) $ 5,434 $ 11,757 $ 3,476 $ (13,715 ) $ 5,434 $ 11,757 $ 3,476 For the three months ended September 30, 2016 For the nine months ended September 30, 2016 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (18,097 ) $ 1,986 $ (43,925 ) $ (60,036 ) $ (10,925 ) $ 1,361 $ (50,262 ) $ (59,826 ) Unrealized (losses) (255 ) 1,454 (951 ) 248 (13,489 ) 2,578 5,386 (5,525 ) Related income tax 102 (391 ) — (289 ) 5,251 (797 ) — 4,454 (153 ) 1,063 (951 ) (41 ) (8,238 ) 1,781 5,386 (1,071 ) Reclassification 634 (81 ) 7,513 8,066 2,128 (233 ) 7,513 9,408 Related income tax (246 ) 31 — (215 ) (827 ) 90 — (737 ) 388 (50 ) 7,513 7,851 1,301 (143 ) 7,513 8,671 Ending balance $ (17,862 ) $ 2,999 $ (37,363 ) $ (52,226 ) $ (17,862 ) $ 2,999 $ (37,363 ) $ (52,226 ) The reclassification of net cap and swap realized losses into income are recorded as debt expense in the corresponding consolidated statements of operations. See Note 9 to these condensed consolidated financial statements for further details. The reclassification of net investment realized gains into income are recorded in other income in the corresponding consolidated statements of operations. See Note 4 to these condensed consolidated financial statements for further details.

Acquisitions and divestitures

Acquisitions and divestitures	9 Months Ended
	Sep. 30, 2017
Business Combinations [Abstract]
Acquisitions and divestitures	Acquisitions and divestitures Acquisition of Renal Ventures On May 1, 2017 , the Company completed its acquisition of 100% of the equity of Colorado-based Renal Ventures Management, LLC (Renal Ventures) for approximately $361,563 in net cash, subject to certain post-closing adjustments. Renal Ventures operated 36 operating dialysis centers, one uncertified dialysis center and one home program that provided services to approximately 2,600 patients in six states. As a part of this transaction, the Company was required to divest three Renal Ventures outpatient dialysis centers, and three outpatient dialysis centers and one uncertified dialysis center of the Company for approximately $21,219 in net cash. The Company also incurred approximately $9,400 in transaction and integration costs during the nine months ended September 30, 2017 associated with the acquisition that are included in general and administrative expenses. The initial purchase price allocation for the Renal Ventures acquisition is recorded at estimated fair values based upon the best information available to management and will be finalized when certain information arranged to be obtained has been received. In particular, certain working capital items, income tax amounts and the fair value of intangibles and fixed assets are pending final audit, issuance of final tax returns and valuation reports. The following table summarizes the assets acquired and liabilities assumed in the transactions and recognized at the acquisition date at estimated fair values: Current assets $ 24,525 Property and equipment 36,295 Amortizable intangible and other long-term assets 11,547 Goodwill 298,358 Current liabilities (8,684 ) Long-term liabilities (478 ) $ 361,563 The amortizable intangible assets acquired relate to non-compete agreements having a weighted-average useful life of five years. The total estimated amount of goodwill deductible for tax purposes associated with this acquisition was approximately $298,358 . Other routine acquisitions During the nine months ended September 30, 2017 , the Company acquired dialysis and other businesses consisting of 21 dialysis centers located in the U.S., 63 dialysis centers located outside the U.S., and eight other medical businesses, including Magan Medical Clinic, Inc. (Magan), as discussed below, for a total of $364,975 in net cash, $13,290 in deferred purchase price obligations, $19,411 in earn-outs and liabilities assumed, and $17,233 in non-cash gains, primarily recognized as a result of the Magan acquisition. The assets and liabilities for these acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s condensed consolidated financial statements, as are their operating results, from the designated effective dates of the acquisitions. Effective July 1, 2017, the Company's DMG business acquired Magan. As part of the Magan acquisition, the Company acquired 100% ownership of a DMG-Magan joint venture of which the Company previously owned only a noncontrolling 50% interest. As a result, the Company recognized a non-cash gain on DMG's previously held 50% interest in this joint venture based on its fair value at the time of the acquisition. The initial purchase price allocations for these transactions have been recorded at estimated fair values based on the best information available to management and will be finalized when certain information arranged to be obtained has been received. In particular, certain income tax amounts are pending final evaluation and quantification of pre-acquisition tax contingencies and filing of final tax returns. In addition, valuation of medical claims liabilities, certain working capital items, and the fair value of fixed assets and intangibles are pending final audits and related valuation reports. The following table summarizes the assets acquired and liabilities assumed in these transactions and recognized at their acquisition dates at estimated fair values: Current assets $ 11,548 Property and equipment 28,384 Amortizable intangible and other long-term assets 18,403 Non-amortizable intangibles 31,983 Goodwill 389,517 Current liabilities (20,628 ) Long-term liabilities (8,223 ) Noncontrolling interests (36,075 ) $ 414,909 Amortizable intangible assets acquired during the first nine months of 2017 had weighted-average estimated useful lives of approximately five years. The majority of the intangible assets acquired during the first nine months of 2017 relate to non-compete agreements. The total estimated amount of goodwill deductible for tax purposes associated with these acquisitions was approximately $227,762 . Pro forma financial information The following summary, prepared on a pro forma basis, combines the results of operations as if the acquisitions through September 30, 2017 had been consummated as of the beginning of 2017 and 2016, after including the impact of certain adjustments such as amortization of intangibles and income tax effects. Three months ended Nine months ended 2017 2016 2017 2016 (unaudited) Pro forma net revenues $ 3,925,402 $ 3,844,174 $ 11,638,894 $ 11,467,643 Pro forma net (loss) income attributable to DaVita Inc. $ (214,156 ) $ 572,873 $ 360,679 $ 728,759 Pro forma basic net (loss) income per share attributable to DaVita Inc. $ (1.13 ) $ 2.81 $ 1.89 $ 3.57 Pro forma diluted net (loss) income per share attributable to $ (1.13 ) $ 2.77 $ 1.86 $ 3.51 Contingent earn-out obligations The Company has several contingent earn-out obligations associated with acquisitions that could result in the Company paying the former owners of acquired companies a total of up to $13,524 if certain EBITDA, operating income performance targets or quality margins are met primarily over the next one to six years. Contingent earn-out obligations are remeasured at fair value at each reporting date until the contingencies are resolved with changes in the liability due to the remeasurement recorded in earnings. See Note 17 to these condensed consolidated financial statements for further details. As of September 30, 2017 , the Company has estimated the fair value of these contingent earn-out obligations to be $8,955 , of which a total of $1,674 is included in other liabilities and the remaining $7,281 is included in other long-term liabilities in the Company’s consolidated balance sheet. The following is a reconciliation of changes in liabilities for contingent earn-out obligations: For the nine months ended September 30, 2017 Beginning balance, January 1, 2017 $ 9,977 Contingent earn-out obligations associated with acquisitions 4,110 Remeasurement of fair value for contingent earn-out obligations (1,072 ) Payments on contingent earn-out obligations (4,060 ) $ 8,955

Variable interest entities

Variable interest entities	9 Months Ended
	Sep. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Variable interest entities	Variable interest entities The Company relies on the operating activities of certain legal entities that it does not directly own or control, but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are subject to the consolidation guidance applicable to variable interest entities (VIEs). Under U.S. generally accepted accounting principles (GAAP), VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. The Company has determined that substantially all of the legal entities it is associated with that qualify as VIEs must be included in its consolidated financial statements. The Company manages these entities and provides operating and capital funding as necessary for these entities to accomplish their operational and strategic objectives. A number of these entities are subject to nominee ownership transfer restriction agreements that effectively transfer the majority of the economic risks and rewards of their ownership to the Company. In other cases, the Company’s management agreements with these entities include both financial terms and protective and participating rights to the entities’ operating, strategic and non-clinical governance decisions which transfer substantial powers over and economic responsibility for the entities to the Company. In some cases, such entities are subject to broad exclusivity or noncompetition restrictions that benefit the Company. Further, in some cases, the Company has contractual arrangements with the nominee owners that effectively indemnify these parties from the economic losses from, or entitle the Company to the economic benefits of, these entities. The analyses upon which these consolidation determinations rest are complex, involve uncertainties, and require significant judgment on various matters, some of which could be subject to different interpretations. At September 30, 2017 , these condensed consolidated financial statements include total assets of VIEs of $840,164 and total liabilities and noncontrolling interests of VIEs to third parties of $436,994 . The Company also sponsors certain deferred compensation plans whose trusts qualify as VIEs and the Company consolidates each of these plans as their primary beneficiary. The assets of these plans are recorded in short-term or long-term investments with matching offsetting liabilities recorded in accrued compensation and benefits and other long-term liabilities. See Note 4 to these condensed consolidated financial statements for disclosures on the assets of these consolidated non-qualified deferred compensation plans.

Fair value of financial instrum

Fair value of financial instruments	9 Months Ended
	Sep. 30, 2017
Fair Value Disclosures [Abstract]
Fair value of financial instruments	Fair value of financial instruments The Company measures the fair value of certain assets, liabilities and noncontrolling interests subject to put provisions (temporary equity) based upon valuation techniques that include observable or unobservable inputs and assumptions that market participants would use in pricing these assets, liabilities, temporary equity and commitments. The Company has also classified assets, liabilities and temporary equity that are measured at fair value on a recurring basis into the appropriate fair value hierarchy levels as defined by the Financial Accounting Standards Board (FASB). The following table summarizes the Company’s assets, liabilities and temporary equity that are measured at fair value on a recurring basis as of September 30, 2017 : Total Quoted prices in Significant other Significant Assets Investments in mutual funds and common stock $ 57,089 $ 57,089 $ — $ — Cash surrender value of life insurance policies $ 64,240 $ — $ 64,240 $ — Interest rate cap agreements $ 962 $ — $ 962 $ — Funds on deposit with third parties $ 76,456 $ 76,456 $ — $ — Liabilities Contingent earn-out obligations $ 8,955 $ — $ — $ 8,955 Temporary equity Noncontrolling interests subject to put provisions $ 1,026,890 $ — $ — $ 1,026,890 Investments in mutual funds and common stock represent available-for-sale investments that are recorded at estimated fair value based upon quoted redemption prices reported by each mutual fund. See Note 4 to these condensed consolidated financial statements for further discussion. Investments in life insurance policies are carried at their cash surrender value which approximates their fair value. See Note 4 to these condensed consolidated financial statements for further discussion. Interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 9 to these condensed consolidated financial statements for further discussion. Funds on deposit with third parties represent funds held with various third parties as required by regulation or contract and invested by those parties in various investments, which are measured at estimated fair value based primarily on quoted market prices. Contingent earn-out obligations are measured at estimated fair value based primarily on unobservable inputs including projected EBITDA, estimated probability of achieving gross margins or quality margins of certain medical procedures and the estimated probability of earn-out payments being made using an option pricing technique and a simulation model for expected EBITDA and operating income. In addition, a probability adjusted model was used to estimate the fair value amounts of the quality margins. The estimated fair value of these contingent earn-out obligations are remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company credit risk-adjusted rate that is used to discount obligations to present value. See Note 15 to these condensed consolidated financial statements for further discussion. See Note 11 to these condensed consolidated financial statements for a discussion of the Company’s methodology for estimating the fair value of noncontrolling interests subject to put obligations. Other financial instruments consist primarily of cash, accounts receivable, accounts payable, other accrued liabilities and debt. The balances of the non-debt financial instruments are presented in the condensed consolidated financial statements at September 30, 2017 at their approximate fair values due to the short-term nature of their settlements. The carrying balance of the Company’s senior secured credit facilities totaled $4,159,799 as of September 30, 2017 , and the fair value was approximately $4,217,710 based upon quoted market prices, a level 2 input. The carrying balance of the Company’s senior notes was $4,458,549 as of September 30, 2017 and their fair value was approximately $4,519,525 , based upon quoted market prices, a level 2 input.

Segment reporting

Segment reporting	9 Months Ended
	Sep. 30, 2017
Segment Reporting [Abstract]
Segment reporting	Segment reporting The Company operates two major divisions, Kidney Care and DMG. The Kidney Care division is comprised of the Company’s U.S. dialysis and related lab services business, its ancillary services and strategic initiatives, including its international operations, and the Company’s corporate administrative support. The Company’s U.S. dialysis and related lab services business is its largest line of business, and is a leading provider of kidney dialysis services in the U.S. for patients suffering from chronic kidney failure, also known as end stage renal disease (ESRD). The Company’s DMG division is a patient- and physician-focused integrated healthcare delivery and management company with over two decades of experience providing coordinated outcomes-based medical care in a cost-effective manner. The Company’s ancillary services and strategic initiatives consist primarily of pharmacy services, disease management services, vascular access services, clinical research programs, physician services, direct primary care and the Company’s international dialysis and integrated health operations. 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 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 for the Company is its Chief Executive Officer. The Company’s separate operating segments include its U.S. dialysis and related lab services business, its DMG operations in each region, each of its ancillary services and strategic initiatives, and its consolidated international kidney care and other healthcare operations in the European and Middle Eastern, Latin America, and Asia Pacific markets, and under the Saudi Ministry of Health charter. The U.S. dialysis and related lab services business and the DMG business each qualify as separately reportable segments, and all of the other ancillary services and strategic initiatives operating segments, including the international operating segments, have been combined and disclosed in the other segments category. The Company’s operating segment financial information included in this report is prepared on the internal management reporting basis that the chief operating decision maker uses to allocate resources and assess the financial performance of the operating segments. For internal management reporting, segment operations include direct segment operating expenses but exclude corporate administrative support costs, which consist primarily of indirect labor, benefits and long-term incentive based compensation of certain departments which provide support to various operating lines of business. These corporate administrative support costs are reduced by internal management fees received from the Company’s ancillary lines of businesses. The following is a summary of segment net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes: Three months ended September 30, Nine months ended September 30, 2017 2016 2017 2016 Segment net revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,457,302 $ 2,412,818 $ 7,209,424 $ 7,079,054 Intersegment revenues 26,342 16,040 76,538 44,819 Total dialysis and related lab services revenues 2,483,644 2,428,858 7,285,962 7,123,873 Less: Provision for uncollectible accounts (117,973 ) (109,299 ) (334,078 ) (320,565 ) Net dialysis and related lab services patient service revenues 2,365,671 2,319,559 6,951,884 6,803,308 Other revenues (1) 4,803 3,912 14,998 12,134 Total net dialysis and related lab services revenues 2,370,474 2,323,471 6,966,882 6,815,442 DMG DMG revenues: Capitated revenues 975,526 846,245 2,852,631 2,586,383 Net patient service revenues 187,678 166,622 556,179 448,222 Other revenues (2) 15,170 15,195 52,509 41,766 Intersegment capitated and other revenues 69 75 174 189 Total net DMG revenues 1,178,443 1,028,137 3,461,493 3,076,560 Other—Ancillary services and strategic initiatives Net patient service revenues 95,490 57,498 246,349 165,742 Capitated revenues 40,839 26,293 103,848 74,149 Other external sources 263,996 311,292 795,731 942,478 Intersegment revenues 13,743 16,642 39,958 43,189 Total ancillary services and strategic initiatives revenues 414,068 411,725 1,185,886 1,225,558 Total net segment revenues 3,962,985 3,763,333 11,614,261 11,117,560 Elimination of intersegment revenues (40,154 ) (32,757 ) (116,670 ) (88,197 ) Consolidated net revenues $ 3,922,831 $ 3,730,576 $ 11,497,591 $ 11,029,363 Segment operating margin: U.S. dialysis and related lab services (3) $ 442,777 $ 452,187 $ 1,837,989 $ 1,341,432 DMG (587,817 ) 33,094 (588,389 ) (126,110 ) Other—Ancillary services and strategic initiatives (36,518 ) 361,903 (142,984 ) 338,159 Total segment operating margin (181,558 ) 847,184 1,106,616 1,553,481 Reconciliation of segment operating margin to consolidated income Corporate administrative support (4) (10,965 ) (28,028 ) (32,587 ) (40,366 ) Consolidated operating (loss) income (192,523 ) 819,156 1,074,029 1,513,115 Debt expense (109,623 ) (104,581 ) (322,014 ) (310,359 ) Other income, net 4,370 1,876 13,866 8,067 Consolidated (loss) income before income taxes $ (297,776 ) $ 716,451 $ 765,881 $ 1,210,823 (1) Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment. (2) Includes medical consulting service fees and management fees for providing management and administrative services to unconsolidated joint ventures and revenue related to the maintenance of existing physician networks. (3) U.S. dialysis and related lab services operating income includes the net gain on the settlement with the VA for the nine months ended September 30, 2017. (4) Corporate administrative support costs includes an adjustment of $27,040 to reduce a receivable associated with the DMG acquisition escrow provision relating to an income tax item for the three and nine months ended September 30, 2016. Depreciation and amortization expense by reportable segment was as follows: Three months ended September 30, Nine months ended September 30, 2017 2016 2017 2016 U.S. dialysis and related lab services $ 132,112 $ 122,540 $ 387,142 $ 358,427 DMG 60,649 52,595 177,983 153,068 Ancillary services and strategic initiatives 10,522 6,604 28,402 19,980 $ 203,283 $ 181,739 $ 593,527 $ 531,475 Subsequent to the issuance of the Company’s fiscal year 2016 consolidated financial statements and their inclusion in its Annual Report on Form 10-K filed with the Securities and Exchange Commission on February 24, 2017 (the 2016 10-K), the Company determined that it had misstated its disclosure of segment assets at December 31, 2016 in Note 25 to those consolidated financial statements. This misstatement resulted in an overstatement of "U.S. dialysis and related lab services" segment assets of $338,963 and a corresponding understatement of "Other - ancillary services and strategic initiatives" segment assets of the same amount. The Company performed an assessment of the materiality of this misstatement and concluded that this misstatement as originally disclosed was not materially misleading in its 2016 consolidated financial statements taken as a whole. The Company therefore has not amended its financial statements filed on its 2016 10-K to correct this misstatement, but has provided the corrected disclosure here. Assets by reportable segment were as follows: September 30, 2017 December 31, 2016 Segment assets U.S. dialysis and related lab services (including equity $ 11,649,092 $ 11,099,137 DMG (including equity investments of $9,155 and $10,350, 5,788,387 6,213,091 Other—Ancillary services and strategic initiatives (including 1,575,860 1,429,029 Consolidated assets $ 19,013,339 $ 18,741,257 Expenditures for property and equipment by reportable segment were as follows: Three months ended Nine months ended 2017 2016 2017 2016 U.S. dialysis and related lab services $ 205,266 $ 182,741 $ 531,027 $ 467,121 DMG 24,282 17,396 72,953 55,639 Ancillary services and strategic initiatives 11,341 16,479 35,849 52,483 $ 240,889 $ 216,616 $ 639,829 $ 575,243

Changes in DaVita Inc.'s owners

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries	9 Months Ended
	Sep. 30, 2017
Noncontrolling Interest [Abstract]
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries	Changes in DaVita Inc.’s ownership interest in consolidated subsidiaries The effects of changes in DaVita Inc.’s ownership interest in consolidated subsidiaries on the Company’s equity were as follows: Three months ended September 30, Nine months ended September 30, 2017 2016 2017 2016 Net (loss) income attributable to DaVita Inc. $ (214,476 ) $ 571,332 $ 360,222 $ 722,148 Changes in paid-in capital for: Purchases of noncontrolling interests — (604 ) 195 (5,135 ) Net transfers to noncontrolling interests — (604 ) 195 (5,135 ) Net (loss) income attributable to DaVita Inc., net of $ (214,476 ) $ 570,728 $ 360,417 $ 717,013

New accounting standards

New accounting standards	9 Months Ended
	Sep. 30, 2017
Accounting Changes and Error Corrections [Abstract]
New accounting standards	New accounting standards In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers , which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. In July 2015, the FASB issued ASU 2015-14, Revenue from Contracts with Customers (Topic 606): Deferral of Effective Date . This guidance approves a one-year deferral of the effective date of ASU 2014-09. The ASU now permits the Company to adopt this standard effective January 1, 2018. Early application is permitted as of January 1, 2017. In March, April, and May 2016, the FASB issued ASU 2016-08, ASU 2016-10, ASU 2016-11, and ASU 2016-12, Revenue from Contracts with Customers (Topic 606) , each of which amends the guidance in ASU 2014-09. When they become effective, these ASUs will replace most existing revenue recognition guidance in GAAP. The Company has assembled an internal revenue task force that meets regularly to discuss and evaluate the overall impact this guidance will have on various revenue streams in the consolidated financial statements and related disclosures. Based on the Company's current assessment, which is still ongoing, the Company does not expect this guidance to have a material effect on its net income, and is continuing to evaluate the impact it will have on its disclosures and controls. The Company plans to adopt these ASUs as of January 1, 2018 using the cumulative effect method and to apply these ASUs only to those contracts that are not completed contracts as of that date. The Company does not currently expect to record a cumulative effect adjustment on the date of initial adoption. In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities. The amendments in this ASU revise accounting related to (i) the classification and measurement of investments in equity securities and (ii) the presentation of certain fair value changes for financial liabilities at fair value. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied through a cumulative effect adjustment to the statement of financial position. Early adoption is permitted under certain circumstances. The adoption of this ASU is not expected to have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2018. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in this ASU revise the accounting related to lessee accounting. Under the new guidance, lessees will be required to recognize a lease liability and a right-of-use asset for substantially all leases with lease terms in excess of twelve months. The new lease guidance also simplifies the accounting for sale and leaseback transactions primarily because lessees must recognize lease assets and lease liabilities. The amendments in this ASU are effective for the Company beginning on January 1, 2019 and are to be applied through a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements. Early adoption is permitted. The Company has assembled an internal lease task force that meets regularly to discuss and evaluate the overall impact of this guidance on its consolidated financial statements and related disclosures, as well as the expected timing of adoption. The Company is currently gathering information from its existing leases and believes that the new standard will have a material impact on its consolidated balance sheet but will not have a material impact on its results of operations or liquidity. The Company expects to adopt this ASU on January 1, 2019, and continues to evaluate the effect that the implementation of this ASU will have on its consolidated financial statements, related disclosures and controls. In March 2016, the FASB issued ASU No. 2016-07, Investments - Equity Method and Joint Ventures (Topic 323): Simplifying the Transition to the Equity Method of Accounting. The amendments in this ASU eliminate the requirement that when an investment qualifies for use of the equity method as a result of an increase in the level of ownership interest or degree of influence, an investor must adjust the investment, results of operations, and retained earnings retroactively on a step-by-step basis as if the equity method had been in effect during all previous periods that the investment had been held. The amendments in this ASU were effective for the Company beginning on January 1, 2017 and was applied prospectively. The adoption of this ASU did not have a material impact on the Company’s condensed consolidated financial statements. In March 2016, the FASB issued ASU No. 2016-09, Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting . The changes required by this ASU involve several aspects of the accounting for share-based payment transactions, including income tax consequences, classification of awards as either equity or liabilities, classification on the statement of cash flows, and an election on estimating forfeitures. The amendments in this ASU were effective for the Company beginning January 1, 2017. The method of adoption differs for each of the topics covered by the ASU. The primary effect of this ASU for the Company is the presentation of excess tax benefits or deficiencies as a component of income tax expense within the Company's consolidated statements of operations rather than within additional paid-in capital on its consolidated balance sheet. In addition, these excess tax benefits or deficiencies are presented as an operating activity on the consolidated statement of cash flows rather than as a financing activity. The Company elected to apply the presentation requirements for cash flows related to excess tax benefits prospectively. Additionally, the Company has elected to continue to estimate forfeitures expected to occur in determining the amount of compensation cost to be recognized each period. This new standard may cause volatility in the Company’s effective tax rates and diluted earnings per share due to the tax effects related to share-based payments being recorded within the Company’s consolidated statements of operations, including a potential increase in the Company’s provision for income taxes if a significant number of outstanding stock awards are exercised at recent levels of the Company’s stock price. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments . The amendments in this ASU clarify how certain cash receipts and cash payments should be classified on the statement of cash flows. The new standard is effective for the Company beginning January 1, 2018 and is to be applied retrospectively to all periods presented. The Company has not yet determined the effect that adoption of this ASU will have on its consolidated financial statements. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory . The amendments in this ASU allow entities to recognize the income tax consequences of an intra-entity transfer of an asset other than inventory when the transfer occurs. The current guidance does not allow recognition until the asset has been sold to an outside party. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied on a modified retrospective basis. The Company has not yet determined the effect that adoption of this ASU will have on its consolidated financial statements. In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment . The amendments in this ASU simplify the test for goodwill impairment by eliminating the second step in goodwill impairment assessments. The Company early adopted this ASU as of January 1, 2017. In August 2017, the FASB issued ASU No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities. The amendments in this ASU better align an entity’s risk management activities and financial reporting for hedging relationships through changes to both the designation and measurement guidance for qualifying hedging relationships and the presentation of hedge results. The amendments in the new ASU are effective for the Company on January 1, 2018 and are to be applied prospectively. The Company has not yet determined the effect that adoption of this ASU will have on its consolidated financial statements.

Condensed consolidating financi

Condensed consolidating financial statements	9 Months Ended
	Sep. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Condensed consolidating financial statements	Condensed consolidating financial statements The following information is presented in accordance with Rule 3-10 of Regulation S-X. The operating and investing activities of the separate legal entities included in the Company’s condensed consolidated financial statements are fully interdependent and integrated. Revenues and operating expenses of the separate legal entities include intercompany charges for management and other administrative services. The Company’s senior notes are guaranteed by a substantial majority of its domestic subsidiaries as measured by revenue, income and assets. The subsidiary guarantors have guaranteed the senior notes on a joint and several basis. However, a subsidiary guarantor will be released from its obligations under its guarantee of the senior notes and the indentures governing the senior notes if, in general, there is a sale or other disposition of all or substantially all of the assets of such subsidiary guarantor, including by merger or consolidation, or a sale or other disposition of all of the equity interests in such subsidiary guarantor held by the Company and its restricted subsidiaries, as defined in the indentures; such subsidiary guarantor is designated by the Company as an unrestricted subsidiary, as defined in the indentures, or otherwise ceases to be a restricted subsidiary of the Company, in each case in accordance with the indentures; or such subsidiary guarantor no longer guarantees any other indebtedness, as defined in the indentures, of the Company or any of its restricted subsidiaries, except for guarantees that are contemporaneously released. The senior notes are not guaranteed by certain of the Company’s domestic subsidiaries, any of the Company’s foreign subsidiaries, or any entities that do not constitute subsidiaries within the meaning of the indentures, such as corporations in which the Company holds capital stock with less than a majority of the voting power, joint ventures and partnerships in which the Company holds less than a majority of the equity or voting interests, non-owned entities and third parties. Condensed Consolidating Statements of Operations DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended September 30, 2017 Patient services revenues $ — $ 1,732,287 $ 1,076,035 $ (62,065 ) $ 2,746,257 Less: Provision for uncollectible accounts — (82,860 ) (46,989 ) 6,089 (123,760 ) Net patient service revenues — 1,649,427 1,029,046 (55,976 ) 2,622,497 Capitated revenues — 461,866 555,481 (982 ) 1,016,365 Other revenues 189,275 468,948 52,283 (426,537 ) 283,969 Total net revenues 189,275 2,580,241 1,636,810 (483,495 ) 3,922,831 Operating expenses and charges 128,488 2,964,867 1,505,494 (483,495 ) 4,115,354 Operating income (loss) 60,787 (384,626 ) 131,316 — (192,523 ) Debt expense (108,453 ) (93,243 ) (16,168 ) 108,241 (109,623 ) Other income, net 104,250 1,774 6,587 (108,241 ) 4,370 Income tax expense (benefit) 27,624 (150,192 ) (3,174 ) — (125,742 ) Equity (losses) earnings in subsidiaries (243,436 ) 82,467 — 160,969 — Net (loss) income (214,476 ) (243,436 ) 124,909 160,969 (172,034 ) Less: Net income attributable to noncontrolling interests — — — (42,442 ) (42,442 ) Net (loss) income attributable to DaVita Inc. $ (214,476 ) $ (243,436 ) $ 124,909 $ 118,527 $ (214,476 ) Guarantor Non- Consolidating Consolidated For The Three Months Ended September 30, 2016 DaVita Inc. Patient service revenues $ — $ 1,726,892 $ 959,193 $ (42,891 ) $ 2,643,194 Less: Provision for uncollectible accounts — (73,833 ) (41,722 ) — (115,555 ) Net patient service revenues — 1,653,059 917,471 (42,891 ) 2,527,639 Capitated revenues — 465,684 406,893 (39 ) 872,538 Other revenues 191,815 506,619 32,652 (400,687 ) 330,399 Total net revenues 191,815 2,625,362 1,357,016 (443,617 ) 3,730,576 Operating expenses 143,784 2,388,114 823,139 (443,617 ) 2,911,420 Operating income 48,031 237,248 533,877 — 819,156 Debt expense (101,895 ) (91,716 ) (14,402 ) 103,432 (104,581 ) Other income 99,446 2,659 3,203 (103,432 ) 1,876 Income tax (benefit) expense (20,898 ) (21,486 ) 146,685 — 104,301 Equity earnings in subsidiaries 504,852 335,175 — (840,027 ) — Net income 571,332 504,852 375,993 (840,027 ) 612,150 Less: Net income attributable to noncontrolling interests — — — (40,818 ) (40,818 ) Net income attributable to DaVita Inc. $ 571,332 $ 504,852 $ 375,993 $ (880,845 ) $ 571,332 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2017 DaVita Inc. Patient services revenues $ — $ 4,966,892 $ 3,230,584 $ (167,374 ) $ 8,030,102 Less: Provision for uncollectible accounts — (219,554 ) (138,763 ) 6,089 (352,228 ) Net patient service revenues — 4,747,338 3,091,821 (161,285 ) 7,677,874 Capitated revenues — 1,393,345 1,566,382 (3,248 ) 2,956,479 Other revenues 604,246 1,448,484 122,177 (1,311,669 ) 863,238 Total net revenues 604,246 7,589,167 4,780,380 (1,476,202 ) 11,497,591 Operating expenses and charges 398,502 7,241,745 4,259,517 (1,476,202 ) 10,423,562 Operating income 205,744 347,422 520,863 — 1,074,029 Debt expense (317,276 ) (276,990 ) (44,827 ) 317,079 (322,014 ) Other income, net 306,886 7,502 16,557 (317,079 ) 13,866 Income tax expense 84,686 142,156 49,163 — 276,005 Equity earnings in subsidiaries 249,554 313,776 — (563,330 ) — Net income 360,222 249,554 443,430 (563,330 ) 489,876 Less: Net income attributable to noncontrolling interests — — — (129,654 ) (129,654 ) Net income attributable to DaVita Inc. $ 360,222 $ 249,554 $ 443,430 $ (692,984 ) $ 360,222 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2016 DaVita Inc. Patient services revenues $ — $ 5,044,565 $ 2,787,176 $ (123,100 ) $ 7,708,641 Less: Provision for uncollectible accounts — (207,144 ) (129,044 ) — (336,188 ) Net patient service revenues — 4,837,421 2,658,132 (123,100 ) 7,372,453 Capitated revenues — 1,397,378 1,263,404 (250 ) 2,660,532 Other revenues 575,700 1,512,039 91,921 (1,183,282 ) 996,378 Total net revenues 575,700 7,746,838 4,013,457 (1,306,632 ) 11,029,363 Operating expenses and charges 400,129 7,275,863 3,146,888 (1,306,632 ) 9,516,248 Operating income 175,571 470,975 866,569 — 1,513,115 Debt expense (305,097 ) (275,148 ) (38,914 ) 308,800 (310,359 ) Other income, net 296,660 12,416 7,791 (308,800 ) 8,067 Income tax expense 56,190 140,972 168,849 — 366,011 Equity earnings in subsidiaries 611,204 543,933 — (1,155,137 ) — Net income 722,148 611,204 666,597 (1,155,137 ) 844,812 Less: Net income attributable to noncontrolling interests — — — (122,664 ) (122,664 ) Net income attributable to DaVita Inc. $ 722,148 $ 611,204 $ 666,597 $ (1,277,801 ) $ 722,148 Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended September 30, 2017 DaVita Inc. Net (loss) income $ (214,476 ) $ (243,436 ) $ 124,909 $ 160,969 $ (172,034 ) Other comprehensive income 1,641 — 29,143 — 30,784 Total comprehensive (loss) income (212,835 ) (243,436 ) 154,052 160,969 (141,250 ) Less: Comprehensive income attributable to — — — (42,442 ) (42,442 ) Comprehensive (loss) income attributable to DaVita Inc. $ (212,835 ) $ (243,436 ) $ 154,052 $ 118,527 $ (183,692 ) Guarantor Non- Consolidating Consolidated For The Three Months Ended September 30, 2016 DaVita Inc. Net income $ 571,332 $ 504,852 $ 375,993 $ (840,027 ) $ 612,150 Other comprehensive income 1,248 — 6,620 — 7,868 Total comprehensive income 572,580 504,852 382,613 (840,027 ) 620,018 Less: Comprehensive income attributable to the — — — (40,876 ) (40,876 ) Comprehensive income attributable to DaVita Inc. $ 572,580 $ 504,852 $ 382,613 $ (880,903 ) $ 579,142 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2017 DaVita Inc. Net income $ 360,222 $ 249,554 $ 443,430 $ (563,330 ) $ 489,876 Other comprehensive income 1,571 — 91,546 — 93,117 Total comprehensive income 361,793 249,554 534,976 (563,330 ) 582,993 Less: Comprehensive income attributable to — — — (129,652 ) (129,652 ) Comprehensive income attributable to DaVita Inc. $ 361,793 $ 249,554 $ 534,976 $ (692,982 ) $ 453,341 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2016 DaVita Inc. Net income $ 722,148 $ 611,204 $ 666,597 $ (1,155,137 ) $ 844,812 Other comprehensive (loss) income (5,299 ) — 13,106 — 7,807 Total comprehensive income 716,849 611,204 679,703 (1,155,137 ) 852,619 Less: Comprehensive income attributable to the — — — (122,871 ) (122,871 ) Comprehensive income attributable to DaVita Inc. $ 716,849 $ 611,204 $ 679,703 $ (1,278,008 ) $ 729,748 Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of September 30, 2017 DaVita Inc. Cash and cash equivalents $ 447,627 $ 14,768 $ 383,715 $ — $ 846,110 Accounts receivable, net — 1,325,029 766,045 — 2,091,074 Other current assets 178,901 804,580 112,884 — 1,096,365 Total current assets 626,528 2,144,377 1,262,644 — 4,033,549 Property and equipment, net 368,233 1,752,690 1,265,133 — 3,386,056 Intangible assets, net 289 1,370,085 80,659 — 1,451,033 Investments in subsidiaries 10,116,956 2,738,851 — (12,855,807 ) — Intercompany receivables 3,079,514 — 1,172,721 (4,252,235 ) — Other long-term assets and investments 46,028 99,584 581,212 — 726,824 Goodwill — 7,248,275 2,167,602 — 9,415,877 Total assets $ 14,237,548 $ 15,353,862 $ 6,529,971 $ (17,108,042 ) $ 19,013,339 Current liabilities $ 283,770 $ 1,907,482 $ 683,541 $ — $ 2,874,793 Intercompany payables — 2,231,303 2,020,932 (4,252,235 ) — Long-term debt and other long-term liabilities 8,565,734 1,098,121 478,672 — 10,142,527 Noncontrolling interests subject to put provisions 603,463 — — 423,427 1,026,890 Total DaVita Inc. shareholder's equity 4,784,581 10,116,956 2,738,851 (12,855,807 ) 4,784,581 Noncontrolling interests not subject to put — — 607,975 (423,427 ) 184,548 Total equity 4,784,581 10,116,956 3,346,826 (13,279,234 ) 4,969,129 Total liabilities and equity $ 14,237,548 $ 15,353,862 $ 6,529,971 $ (17,108,042 ) $ 19,013,339 Guarantor Non- Consolidating Consolidated As of December 31, 2016 DaVita Inc. Cash and cash equivalents $ 549,921 $ 59,192 $ 304,074 $ — $ 913,187 Accounts receivable, net — 1,215,232 702,070 — 1,917,302 Other current assets 277,911 736,727 135,101 — 1,149,739 Total current assets 827,832 2,011,151 1,141,245 — 3,980,228 Property and equipment, net 337,200 1,689,798 1,148,369 — 3,175,367 Intangible assets, net 487 1,491,057 36,223 — 1,527,767 Investments in subsidiaries 9,717,728 2,002,660 — (11,720,388 ) — Intercompany receivables 3,250,692 — 866,955 (4,117,647 ) — Other long-term assets and investments 39,994 86,710 523,874 — 650,578 Goodwill — 7,838,984 1,568,333 — 9,407,317 Total assets $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Current liabilities $ 303,840 $ 1,865,193 $ 527,412 $ — $ 2,696,445 Intercompany payables — 2,322,124 1,795,523 (4,117,647 ) — Long-term debt and other long-term liabilities 8,614,445 1,215,315 392,053 — 10,221,813 Noncontrolling interests subject to put provisions 607,601 — — 365,657 973,258 Total DaVita Inc. shareholder's equity 4,648,047 9,717,728 2,002,660 (11,720,388 ) 4,648,047 Noncontrolling interests not subject to put — — 567,351 (365,657 ) 201,694 Total equity 4,648,047 9,717,728 2,570,011 (12,086,045 ) 4,849,741 Total liabilities and equity $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 360,222 $ 249,554 $ 443,430 $ (563,330 ) $ 489,876 Changes in operating assets and liabilities and non-cash items included in net income (291,657 ) 606,783 196,207 563,330 1,074,663 Net cash provided by operating activities 68,565 856,337 639,637 — 1,564,539 Cash flows from investing activities: Additions of property and equipment (94,385 ) (305,261 ) (240,183 ) — (639,829 ) Acquisitions — (627,324 ) (99,214 ) — (726,538 ) Proceeds from asset and business sales — 90,533 1,996 — 92,529 Proceeds (purchases) from investment sales and other items, net 123,894 (6,472 ) 49,183 — 166,605 Net cash provided by (used in) investing activities 29,509 (848,524 ) (288,218 ) — (1,107,233 ) Cash flows from financing activities: Long-term debt and related financing costs, net (92,721 ) (10,394 ) (5,348 ) — (108,463 ) Intercompany borrowing (payments) 197,983 (40,411 ) (157,572 ) — — Other items (305,630 ) (1,432 ) (114,307 ) — (421,369 ) Net cash used in financing activities (200,368 ) (52,237 ) (277,227 ) — (529,832 ) Effect of exchange rate changes on cash — — 5,449 — 5,449 Net (decrease) increase in cash and cash equivalents (102,294 ) (44,424 ) 79,641 — (67,077 ) Cash and cash equivalents at beginning of period 549,921 59,192 304,074 — 913,187 Cash and cash equivalents at end of period $ 447,627 $ 14,768 $ 383,715 $ — $ 846,110 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2016 DaVita Inc. Cash flows from operating activities: Net income $ 722,148 $ 611,204 $ 666,597 $ (1,155,137 ) $ 844,812 Changes in operating assets and liabilities and non-cash (586,804 ) 228,991 (160,874 ) 1,155,137 636,450 Net cash provided by operating activities 135,344 840,195 505,723 — 1,481,262 Cash flows from investing activities: Additions of property and equipment (81,785 ) (248,339 ) (245,119 ) — (575,243 ) Acquisitions — (458,556 ) (38,775 ) — (497,331 ) Proceeds from asset and business sales, net of cash — 24,608 (5,617 ) — 18,991 (Purchases) proceeds from investment sales and other (236,150 ) (12,825 ) 45,316 — (203,659 ) Net cash used in investing activities (317,935 ) (695,112 ) (244,195 ) — (1,257,242 ) Cash flows from financing activities: Long-term debt and related financing costs, net (73,889 ) (20,684 ) (4,151 ) — (98,724 ) Intercompany borrowing (payments) 283,709 (188,247 ) (95,462 ) — — Other items (589,964 ) (9,740 ) (109,548 ) — (709,252 ) Net cash used in financing activities (380,144 ) (218,671 ) (209,161 ) — (807,976 ) Effect of exchange rate changes on cash — — (1,664 ) — (1,664 ) Net (decrease) increase in cash and cash equivalents (562,735 ) (73,588 ) 50,703 — (585,620 ) Cash and cash equivalents at beginning of period 1,186,636 109,357 203,123 — 1,499,116 Cash and cash equivalents at end of period $ 623,901 $ 35,769 $ 253,826 $ — $ 913,496

Supplemental data

Supplemental data	9 Months Ended
	Sep. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Supplemental data	Supplemental data The following information is presented as supplemental data as required by the indentures governing the Company’s senior notes. Condensed Consolidating Statements of Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Nine Months Ended September 30, 2017 Patient service operating revenues $ 8,030,102 $ 414,784 $ — $ 7,615,318 Less: Provision for uncollectible accounts (352,228 ) (11,010 ) — (341,218 ) Net patient service operating revenues 7,677,874 403,774 — 7,274,100 Capitated revenues 2,956,479 1,186,185 — 1,770,294 Other revenues 863,238 33,688 — 829,550 Total net operating revenues 11,497,591 1,623,647 — 9,873,944 Operating expenses 10,423,562 1,572,064 (147 ) 8,851,645 Operating income 1,074,029 51,583 147 1,022,299 Debt expense, including refinancing charges (322,014 ) (6,458 ) — (315,556 ) Other income 13,866 478 — 13,388 Income tax expense 276,005 38,059 59 237,887 Net income 489,876 7,544 88 482,244 Less: Net income attributable to noncontrolling interests (129,654 ) — — (129,654 ) Net income attributable to DaVita Inc. $ 360,222 $ 7,544 $ 88 $ 352,590 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Nine Months Ended September 30, 2017 Net income $ 489,876 $ 7,544 $ 88 $ 482,244 Other comprehensive income 93,117 — — 93,117 Total comprehensive income 582,993 7,544 88 575,361 Less: Comprehensive income attributable to the noncontrolling (129,652 ) — — (129,652 ) Comprehensive income attributable to DaVita Inc. $ 453,341 $ 7,544 $ 88 $ 445,709 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of September 30, 2017 Cash and cash equivalents $ 846,110 $ 162,536 $ — $ 683,574 Accounts receivable, net 2,091,074 174,944 — 1,916,130 Other current assets 1,096,365 17,722 — 1,078,643 Total current assets 4,033,549 355,202 — 3,678,347 Property and equipment, net 3,386,056 3,334 — 3,382,722 Amortizable intangibles, net 1,451,033 4,313 — 1,446,720 Other long-term assets 726,824 81,877 2,861 642,086 Goodwill 9,415,877 30,993 — 9,384,884 Total assets $ 19,013,339 $ 475,719 $ 2,861 $ 18,534,759 Current liabilities $ 2,874,793 $ 202,386 $ — $ 2,672,407 Payables to parent — 97,434 2,861 (100,295 ) Long-term debt and other long-term liabilities 10,142,527 63,272 — 10,079,255 Noncontrolling interests subject to put provisions 1,026,890 — — 1,026,890 Total DaVita Inc. shareholders’ equity 4,784,581 112,627 — 4,671,954 Noncontrolling interests not subject to put provisions 184,548 — — 184,548 Shareholders’ equity 4,969,129 112,627 — 4,856,502 Total liabilities and shareholder’s equity $ 19,013,339 $ 475,719 $ 2,861 $ 18,534,759 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Nine Months Ended September 30, 2017 Cash flows from operating activities: Net income $ 489,876 $ 7,544 $ 88 $ 482,244 Changes in operating and intercompany assets and liabilities 1,074,663 29,753 (88 ) 1,044,998 Net cash provided by operating activities 1,564,539 37,297 — 1,527,242 Cash flows from investing activities: Additions of property and equipment (639,829 ) (5,903 ) — (633,926 ) Acquisitions (726,538 ) — — (726,538 ) Proceeds from asset and business sales 92,529 — — 92,529 Investments and other items 166,605 (2,378 ) — 168,983 Net cash used in investing activities (1,107,233 ) (8,281 ) — (1,098,952 ) Cash flows from financing activities: Long-term debt (108,463 ) — — (108,463 ) Intercompany — 28,829 — (28,829 ) Other items (421,369 ) — — (421,369 ) Net cash (used in) provided by financing activities (529,832 ) 28,829 — (558,661 ) Effect of exchange rate changes on cash 5,449 — — 5,449 Net (decrease) increase in cash (67,077 ) 57,845 — (124,922 ) Cash and cash equivalents at beginning of period 913,187 104,691 — 808,496 Cash and cash equivalents at end of period $ 846,110 $ 162,536 $ — $ 683,574 (1) After elimination of the unrestricted subsidiaries and the physician groups.

Condensed consolidated interi30

Condensed consolidated interim financial statements (Policies)	9 Months Ended
	Sep. 30, 2017
Accounting Policies [Abstract]
Condensed consolidated interim financial statements	The condensed consolidated interim financial statements included in this report are prepared by the Company without audit. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these condensed consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and other long-lived assets, fair value estimates, accounting for income taxes, variable compensation accruals, consolidation of variable interest entities, purchase accounting valuation estimates, long-term incentive program compensation and medical liability claims. The results of operations for the nine months ended September 30, 2017 are not necessarily indicative of the operating results for the full year. The condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2016 . Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these condensed consolidated financial statements were issued and has included all necessary adjustments and disclosures.
Earnings per share	Basic net income per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interests redemption rights in excess of fair value, by the weighted average number of common shares and vested stock units outstanding, net of shares held in escrow from the DaVita HealthCare Partners merger that under certain circumstances may be returned to the Company. Diluted net income per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units (under the treasury stock method) as well as contingently returnable shares held in escrow.
Accounts receivable	Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the ultimate collectability of accounts receivable, the Company analyzes its historical cash collection experience and trends for each of its government payors and commercial payors to estimate the adequacy of the allowance for doubtful accounts and the amount of the provision for uncollectible accounts. Management regularly updates its analysis based upon the most recent information available to determine its current provision for uncollectible accounts and the adequacy of its allowance for doubtful accounts. For receivables associated with dialysis patient services covered by Medicare, the Company receives 80% of the payment directly from Medicare as established under the government’s bundled payment system and determines an appropriate allowance for doubtful accounts and provision for uncollectible accounts on the remaining balance due depending upon the Company’s estimate of the amounts ultimately collectible from other secondary coverage sources or from the patients. For receivables associated with services to patients covered by commercial payors that are either based upon contractual terms or for non-contracted health plan coverage, the Company provides an allowance for doubtful accounts by recording a provision for uncollectible accounts based upon its historical collection experience, potential inefficiencies in its billing processes and for which collectability is determined to be unlikely. For receivables associated with health plans under capitated arrangements, the balances remain on the balance sheet for as long as the respective plan years are open, which varies by health plan but is generally two years in length, with collections occurring on a periodic basis throughout the duration of the corresponding plan year. Approximately 1% of the Company’s net accounts receivable are associated with patient pay. The Company’s policy is to reserve 100% of the outstanding accounts receivable balances for dialysis services when those amounts due have been outstanding for more than three months and to reserve 100% of the outstanding accounts receivable balances for services of DaVita Medical Group (DMG, formerly known as HealthCare Partners or HCP) when those amounts due have been outstanding for more than twelve months and when the amount is not subject to a payment plan.
Investments in debt and equity securities	The Company classifies certain debt securities as held-to-maturity and records them at amortized cost based on the Company’s intentions and strategy concerning those investments. Equity securities that have readily determinable fair values, and certain other financial instruments that have readily determinable fair values or redemption values, are classified as available-for-sale and recorded at estimated fair value.
Income taxes	The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense.
Long-term debt	the Company maintains several active and forward interest rate cap agreements that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt, as described below. The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the term of the cap agreements. The cap agreements do not contain credit-risk contingent features.
Noncontrolling interests subject to put provisions and other commitments	The Company has potential obligations to purchase the noncontrolling interests held by third parties in several of its majority-owned and other nonconsolidated entities. These obligations are in the form of put provisions and are exercisable at the third-party owners’ discretion within specified periods as outlined in each specific put provision. If these put provisions were exercised, the Company would be required to purchase the third-party owners’ equity interests at either the appraised fair market value or a predetermined multiple of earnings or cash flow attributable to the equity interests put to the Company, which is intended to approximate fair value. The methodology the Company uses to estimate the fair values of noncontrolling interests subject to put provisions assumes the higher of either a liquidation value of net assets or an average multiple of earnings, based on historical earnings, patient mix and other performance indicators that can affect future results, as well as other factors. The estimated fair values of the noncontrolling interests subject to put provisions is a critical accounting estimate that involves significant judgments and assumptions and may not be indicative of the actual values at which the noncontrolling interests may ultimately be settled, which could vary significantly from the Company’s current estimates. The estimated fair values of noncontrolling interests subject to put provisions can fluctuate and the implicit multiple of earnings at which these noncontrolling interest obligations may be settled could vary significantly depending upon market conditions including potential purchasers’ access to the capital markets, which can impact the level of competition for dialysis and non-dialysis related businesses, the economic performance of these businesses and the restricted marketability of the third-party owners’ equity interests. The amount of noncontrolling interests subject to put provisions that employ a contractually predetermined multiple of earnings rather than fair value are immaterial.
Long-term incentive compensation	The Company’s stock-based compensation awards are measured at their estimated fair values on the date of grant if settled in shares or at their estimated fair values at the end of each reporting period if settled in cash. The value of stock-based awards so measured is recognized as compensation expense on a cumulative straight-line basis over the vesting terms of the awards, adjusted for expected forfeitures.
Comprehensive income	The reclassification of net cap and swap realized losses into income are recorded as debt expense in the corresponding consolidated statements of operations. See Note 9 to these condensed consolidated financial statements for further details. The reclassification of net investment realized gains into income are recorded in other income in the corresponding consolidated statements of operations. See Note 4 to these condensed consolidated financial statements for further details.
Variable interest entities	The Company also sponsors certain deferred compensation plans whose trusts qualify as VIEs and the Company consolidates each of these plans as their primary beneficiary. The assets of these plans are recorded in short-term or long-term investments with matching offsetting liabilities recorded in accrued compensation and benefits and other long-term liabilities. The Company relies on the operating activities of certain legal entities that it does not directly own or control, but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are subject to the consolidation guidance applicable to variable interest entities (VIEs). Under U.S. generally accepted accounting principles (GAAP), VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. The analyses upon which these consolidation determinations rest are complex, involve uncertainties, and require significant judgment on various matters, some of which could be subject to different interpretations.
Fair value of financial instruments	Investments in mutual funds and common stock represent available-for-sale investments that are recorded at estimated fair value based upon quoted redemption prices reported by each mutual fund. See Note 4 to these condensed consolidated financial statements for further discussion. Investments in life insurance policies are carried at their cash surrender value which approximates their fair value. See Note 4 to these condensed consolidated financial statements for further discussion. Interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 9 to these condensed consolidated financial statements for further discussion. Funds on deposit with third parties represent funds held with various third parties as required by regulation or contract and invested by those parties in various investments, which are measured at estimated fair value based primarily on quoted market prices. Contingent earn-out obligations are measured at estimated fair value based primarily on unobservable inputs including projected EBITDA, estimated probability of achieving gross margins or quality margins of certain medical procedures and the estimated probability of earn-out payments being made using an option pricing technique and a simulation model for expected EBITDA and operating income. In addition, a probability adjusted model was used to estimate the fair value amounts of the quality margins. The estimated fair value of these contingent earn-out obligations are remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company credit risk-adjusted rate that is used to discount obligations to present value.
New accounting standards	In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers , which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. In July 2015, the FASB issued ASU 2015-14, Revenue from Contracts with Customers (Topic 606): Deferral of Effective Date . This guidance approves a one-year deferral of the effective date of ASU 2014-09. The ASU now permits the Company to adopt this standard effective January 1, 2018. Early application is permitted as of January 1, 2017. In March, April, and May 2016, the FASB issued ASU 2016-08, ASU 2016-10, ASU 2016-11, and ASU 2016-12, Revenue from Contracts with Customers (Topic 606) , each of which amends the guidance in ASU 2014-09. When they become effective, these ASUs will replace most existing revenue recognition guidance in GAAP. The Company has assembled an internal revenue task force that meets regularly to discuss and evaluate the overall impact this guidance will have on various revenue streams in the consolidated financial statements and related disclosures. Based on the Company's current assessment, which is still ongoing, the Company does not expect this guidance to have a material effect on its net income, and is continuing to evaluate the impact it will have on its disclosures and controls. The Company plans to adopt these ASUs as of January 1, 2018 using the cumulative effect method and to apply these ASUs only to those contracts that are not completed contracts as of that date. The Company does not currently expect to record a cumulative effect adjustment on the date of initial adoption. In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities. The amendments in this ASU revise accounting related to (i) the classification and measurement of investments in equity securities and (ii) the presentation of certain fair value changes for financial liabilities at fair value. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied through a cumulative effect adjustment to the statement of financial position. Early adoption is permitted under certain circumstances. The adoption of this ASU is not expected to have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2018. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in this ASU revise the accounting related to lessee accounting. Under the new guidance, lessees will be required to recognize a lease liability and a right-of-use asset for substantially all leases with lease terms in excess of twelve months. The new lease guidance also simplifies the accounting for sale and leaseback transactions primarily because lessees must recognize lease assets and lease liabilities. The amendments in this ASU are effective for the Company beginning on January 1, 2019 and are to be applied through a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements. Early adoption is permitted. The Company has assembled an internal lease task force that meets regularly to discuss and evaluate the overall impact of this guidance on its consolidated financial statements and related disclosures, as well as the expected timing of adoption. The Company is currently gathering information from its existing leases and believes that the new standard will have a material impact on its consolidated balance sheet but will not have a material impact on its results of operations or liquidity. The Company expects to adopt this ASU on January 1, 2019, and continues to evaluate the effect that the implementation of this ASU will have on its consolidated financial statements, related disclosures and controls. In March 2016, the FASB issued ASU No. 2016-07, Investments - Equity Method and Joint Ventures (Topic 323): Simplifying the Transition to the Equity Method of Accounting. The amendments in this ASU eliminate the requirement that when an investment qualifies for use of the equity method as a result of an increase in the level of ownership interest or degree of influence, an investor must adjust the investment, results of operations, and retained earnings retroactively on a step-by-step basis as if the equity method had been in effect during all previous periods that the investment had been held. The amendments in this ASU were effective for the Company beginning on January 1, 2017 and was applied prospectively. The adoption of this ASU did not have a material impact on the Company’s condensed consolidated financial statements. In March 2016, the FASB issued ASU No. 2016-09, Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting . The changes required by this ASU involve several aspects of the accounting for share-based payment transactions, including income tax consequences, classification of awards as either equity or liabilities, classification on the statement of cash flows, and an election on estimating forfeitures. The amendments in this ASU were effective for the Company beginning January 1, 2017. The method of adoption differs for each of the topics covered by the ASU. The primary effect of this ASU for the Company is the presentation of excess tax benefits or deficiencies as a component of income tax expense within the Company's consolidated statements of operations rather than within additional paid-in capital on its consolidated balance sheet. In addition, these excess tax benefits or deficiencies are presented as an operating activity on the consolidated statement of cash flows rather than as a financing activity. The Company elected to apply the presentation requirements for cash flows related to excess tax benefits prospectively. Additionally, the Company has elected to continue to estimate forfeitures expected to occur in determining the amount of compensation cost to be recognized each period. This new standard may cause volatility in the Company’s effective tax rates and diluted earnings per share due to the tax effects related to share-based payments being recorded within the Company’s consolidated statements of operations, including a potential increase in the Company’s provision for income taxes if a significant number of outstanding stock awards are exercised at recent levels of the Company’s stock price. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments . The amendments in this ASU clarify how certain cash receipts and cash payments should be classified on the statement of cash flows. The new standard is effective for the Company beginning January 1, 2018 and is to be applied retrospectively to all periods presented. The Company has not yet determined the effect that adoption of this ASU will have on its consolidated financial statements. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory . The amendments in this ASU allow entities to recognize the income tax consequences of an intra-entity transfer of an asset other than inventory when the transfer occurs. The current guidance does not allow recognition until the asset has been sold to an outside party. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied on a modified retrospective basis. The Company has not yet determined the effect that adoption of this ASU will have on its consolidated financial statements. In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment . The amendments in this ASU simplify the test for goodwill impairment by eliminating the second step in goodwill impairment assessments. The Company early adopted this ASU as of January 1, 2017. In August 2017, the FASB issued ASU No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities. The amendments in this ASU better align an entity’s risk management activities and financial reporting for hedging relationships through changes to both the designation and measurement guidance for qualifying hedging relationships and the presentation of hedge results. The amendments in the new ASU are effective for the Company on January 1, 2018 and are to be applied prospectively. The Company has not yet determined the effect that adoption of this ASU will have on its consolidated financial statements.

Earnings (loss) per share (Tabl

Earnings (loss) per share (Tables)	9 Months Ended
	Sep. 30, 2017
Earnings Per Share [Abstract]
Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Earnings Per Share	The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows: Three months ended Nine months ended 2017 2016 2017 2016 Basic: Net (loss) income attributable to DaVita Inc. $ (214,476 ) $ 571,332 $ 360,222 $ 722,148 Weighted average shares outstanding during the period 191,078 205,955 192,964 206,401 Contingently returnable shares held in escrow from the DaVita (2,194 ) (2,194 ) (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 188,884 203,761 190,770 204,207 Basic net (loss) income per share attributable to DaVita Inc. $ (1.14 ) $ 2.80 $ 1.89 $ 3.54 Diluted: Net (loss) income attributable to DaVita Inc. $ (214,476 ) $ 571,332 $ 360,222 $ 722,148 Weighted average shares outstanding during the period 191,078 205,955 192,964 206,401 Contingently returnable shares held in escrow from the DaVita (2,194 ) — — — Assumed incremental shares from stock plans — 1,006 582 1,243 Weighted average shares for diluted earnings per share calculation 188,884 206,961 193,546 207,644 Diluted net (loss) income per share attributable to DaVita Inc. $ (1.14 ) $ 2.76 $ 1.86 $ 3.48 Anti-dilutive potential common shares excluded from calculation 8,510 (1) 2,375 (2) 5,239 (2) 2,153 (2) (1) Shares associated with stock-settled stock appreciation rights and contingently returnable shares that are excluded from the diluted denominator calculation because they are anti-dilutive due to the Company’s net loss attributable to DaVita Inc. (2) Shares associated with stock-settled stock appreciation rights that are excluded from the diluted denominator calculation because they are anti-dilutive under the treasury stock method.

Investments in debt and equit32

Investments in debt and equity securities (Tables)	9 Months Ended
	Sep. 30, 2017
Investments, Debt and Equity Securities [Abstract]
Investments	The Company’s investments in these securities and certain other financial instruments consist of the following: September 30, 2017 December 31, 2016 Held to Available Total Held to Available Total Certificates of deposit, commercial paper and $ 136,158 $ — $ 136,158 $ 256,827 $ — $ 256,827 Investments in mutual funds and common stock — 57,089 57,089 50,000 47,404 97,404 Cash surrender value of life insurance policies — 64,240 64,240 — 59,646 59,646 $ 136,158 $ 121,329 $ 257,487 $ 306,827 $ 107,050 $ 413,877 Short-term investments $ 136,158 $ 1,200 $ 137,358 $ 306,827 $ 3,371 $ 310,198 Long-term investments — 120,129 120,129 — 103,679 103,679 $ 136,158 $ 121,329 $ 257,487 $ 306,827 $ 107,050 $ 413,877

Goodwill (Tables)

Goodwill (Tables)	9 Months Ended
	Sep. 30, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in Goodwill by Reportable Segments	As a result of these assessments, the Company recognized goodwill impairment charges as shown and discussed below: Three months ended Nine months ended Reporting unit September 30, September 30, September 30, September 30, DMG California $ 560,756 $ — $ 560,756 $ — DMG Florida 26,324 — 76,270 91,200 DMG New Mexico 13,960 — 14,633 — DMG Nevada — — — 161,800 Vascular access — — 34,696 — Total $ 601,040 $ — $ 686,355 $ 253,000 Changes in goodwill by reportable segment were as follows: U.S. dialysis and related lab services DMG Other-ancillary services and strategic initiatives Consolidated total Balance at January 1, 2016 $ 5,629,183 $ 3,398,264 $ 267,032 $ 9,294,479 Acquisitions 75,295 248,901 123,632 447,828 Divestitures (12,891 ) (2,223 ) (29,645 ) (44,759 ) Goodwill impairment charges — (253,000 ) (28,415 ) (281,415 ) Foreign currency and other adjustments — — (8,816 ) (8,816 ) Balance at December 31, 2016 $ 5,691,587 $ 3,391,942 $ 323,788 $ 9,407,317 Acquisitions 441,486 132,778 113,611 687,875 Divestitures (32,260 ) (29 ) (54 ) (32,343 ) Goodwill impairment charges — (651,659 ) (34,696 ) (686,355 ) Foreign currency and other adjustments — — 39,383 39,383 Balance at September 30, 2017 $ 6,100,813 $ 2,873,032 $ 442,032 $ 9,415,877 Balance at September 30, 2017: Goodwill $ 6,100,813 $ 3,966,460 $ 511,052 $ 10,578,325 Accumulated impairment charges — (1,093,428 ) (69,020 ) (1,162,448 ) $ 6,100,813 $ 2,873,032 $ 442,032 $ 9,415,877
Schedule of Reporting Units Goodwill Balances	Further reductions in reimbursement rates, increases in medical cost or utilization trends, or other significant adverse changes in expected future cash flows or valuation assumptions could result in goodwill impairment charges in the future for the following reporting units, which remain at risk of goodwill impairment as of September 30, 2017: Goodwill balance Carrying (1) Sensitivities Reporting unit Operating (2) Discount (3) DMG California $ 1,888,609 — % (3.0 )% (5.8 )% DMG Florida $ 378,071 — % (0.9 )% (3.3 )% DMG New Mexico $ 56,293 — % (1.1 )% (2.1 )% DMG Washington $ 247,552 17.1 % (1.7 )% (3.4 )% (1) Excess of estimated fair value of the reporting unit over its carrying amount as of the latest assessment date. (2) Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date. (3) Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date.

Medical payables (Tables)

Medical payables (Tables)	9 Months Ended
	Sep. 30, 2017
Health Care Organizations [Abstract]
Components of Changes in Health Care Costs Payable	The following table shows the components of changes in healthcare costs payables: For the nine months ended September 30, 2017 Healthcare costs payables, beginning of the period $ 214,275 Add: Components of incurred health care costs Current year 1,509,433 Prior years (12,597 ) Acquired balance (1) 3,218 Total incurred health care costs 1,500,054 Less: Claims paid Current year 1,226,953 Prior years 194,285 Total claims paid 1,421,238 Healthcare costs payables, end of the period $ 293,091 (1) Represents healthcare cost payables acquired in the Magan Medical Clinic, Inc. (Magan) acquisition. See Note 15 to these condensed consolidated financial statements for further discussion of the Magan acquisition.

Long-term debt (Tables)

Long-term debt (Tables)	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Long-term Debt	Long-term debt was comprised of the following: September 30, 2017 December 31, 2016 Senior secured credit facilities: Term Loan A $ 800,000 $ 862,500 Term Loan B 3,386,250 3,412,500 Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 149,734 117,547 Capital lease obligations 330,446 299,682 Total debt principal outstanding 9,166,430 9,192,229 Discount and deferred financing costs (67,905 ) (79,861 ) 9,098,525 9,112,368 Less current portion (189,822 ) (165,041 ) $ 8,908,703 $ 8,947,327
Scheduled Maturities of Long-term Debt	Scheduled maturities of long-term debt at September 30, 2017 were as follows: 2017 (remainder of the year) 59,481 2018 171,825 2019 747,908 2020 72,346 2021 3,305,940 2022 1,282,115 Thereafter 3,526,815
Derivative Instruments	The following table summarizes the Company’s derivative instruments as of September 30, 2017 and December 31, 2016 : September 30, 2017 December 31, 2016 Derivatives designated as hedging instruments Balance sheet location Fair value Balance sheet location Fair value Interest rate cap agreements Other long-term assets $ 962 Other long-term assets $ 9,929
Effects of Interest Rate Swap and Cap Agreements	The following table summarizes the effects of the Company’s interest rate cap and swap agreements for the three and nine months ended September 30, 2017 and 2016 : Amount of losses Location of losses reclassified from accumulated OCI into income Amount of losses Three months ended Nine months ended Three months ended Nine months ended Derivatives designated as cash flow hedges 2017 2016 2017 2016 2017 2016 2017 2016 Interest rate swap $ — $ 45 $ — $ (815 ) Debt expense $ — $ 25 $ — $ 299 Interest rate cap (782 ) (300 ) (8,967 ) (12,674 ) Debt expense 2,070 609 6,208 1,829 Tax benefit 304 102 3,488 5,251 Tax expense (805 ) (246 ) (2,415 ) (827 ) Total $ (478 ) $ (153 ) $ (5,479 ) $ (8,238 ) $ 1,265 $ 388 $ 3,793 $ 1,301

Comprehensive income (Tables)

Comprehensive income (Tables)	9 Months Ended
	Sep. 30, 2017
Statement of Comprehensive Income [Abstract]
Comprehensive income	For the three months ended September 30, 2017 For the nine months ended September 30, 2017 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (14,502 ) $ 4,580 $ (17,386 ) $ (27,308 ) $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Unrealized (losses) (782 ) 1,253 29,143 29,614 (8,967 ) 4,682 91,546 87,261 Related income tax 304 (390 ) — (86 ) 3,488 (1,202 ) — 2,286 (478 ) 863 29,143 29,528 (5,479 ) 3,480 91,546 89,547 Reclassification 2,070 (15 ) — 2,055 6,208 (362 ) — 5,846 Related income tax (expense) benefit (805 ) 6 — (799 ) (2,415 ) 141 — (2,274 ) 1,265 (9 ) — 1,256 3,793 (221 ) — 3,572 Ending balance $ (13,715 ) $ 5,434 $ 11,757 $ 3,476 $ (13,715 ) $ 5,434 $ 11,757 $ 3,476 For the three months ended September 30, 2016 For the nine months ended September 30, 2016 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (18,097 ) $ 1,986 $ (43,925 ) $ (60,036 ) $ (10,925 ) $ 1,361 $ (50,262 ) $ (59,826 ) Unrealized (losses) (255 ) 1,454 (951 ) 248 (13,489 ) 2,578 5,386 (5,525 ) Related income tax 102 (391 ) — (289 ) 5,251 (797 ) — 4,454 (153 ) 1,063 (951 ) (41 ) (8,238 ) 1,781 5,386 (1,071 ) Reclassification 634 (81 ) 7,513 8,066 2,128 (233 ) 7,513 9,408 Related income tax (246 ) 31 — (215 ) (827 ) 90 — (737 ) 388 (50 ) 7,513 7,851 1,301 (143 ) 7,513 8,671 Ending balance $ (17,862 ) $ 2,999 $ (37,363 ) $ (52,226 ) $ (17,862 ) $ 2,999 $ (37,363 ) $ (52,226 )

Acquisitions and divestitures (

Acquisitions and divestitures (Tables)	9 Months Ended
	Sep. 30, 2017
Business Acquisition [Line Items]
Business Acquisition, Pro Forma Information, Nonrecurring Adjustments	The following summary, prepared on a pro forma basis, combines the results of operations as if the acquisitions through September 30, 2017 had been consummated as of the beginning of 2017 and 2016, after including the impact of certain adjustments such as amortization of intangibles and income tax effects. Three months ended Nine months ended 2017 2016 2017 2016 (unaudited) Pro forma net revenues $ 3,925,402 $ 3,844,174 $ 11,638,894 $ 11,467,643 Pro forma net (loss) income attributable to DaVita Inc. $ (214,156 ) $ 572,873 $ 360,679 $ 728,759 Pro forma basic net (loss) income per share attributable to DaVita Inc. $ (1.13 ) $ 2.81 $ 1.89 $ 3.57 Pro forma diluted net (loss) income per share attributable to $ (1.13 ) $ 2.77 $ 1.86 $ 3.51
Reconciliation of Changes in Contingent Earn-Out Obligations	The following is a reconciliation of changes in liabilities for contingent earn-out obligations: For the nine months ended September 30, 2017 Beginning balance, January 1, 2017 $ 9,977 Contingent earn-out obligations associated with acquisitions 4,110 Remeasurement of fair value for contingent earn-out obligations (1,072 ) Payments on contingent earn-out obligations (4,060 ) $ 8,955
Dialysis and other businesses
Business Acquisition [Line Items]
Aggregate Purchase Cost Allocations for Acquisitions	The following table summarizes the assets acquired and liabilities assumed in these transactions and recognized at their acquisition dates at estimated fair values: Current assets $ 11,548 Property and equipment 28,384 Amortizable intangible and other long-term assets 18,403 Non-amortizable intangibles 31,983 Goodwill 389,517 Current liabilities (20,628 ) Long-term liabilities (8,223 ) Noncontrolling interests (36,075 ) $ 414,909
Renal Ventures
Business Acquisition [Line Items]
Aggregate Purchase Cost Allocations for Acquisitions	The following table summarizes the assets acquired and liabilities assumed in the transactions and recognized at the acquisition date at estimated fair values: Current assets $ 24,525 Property and equipment 36,295 Amortizable intangible and other long-term assets 11,547 Goodwill 298,358 Current liabilities (8,684 ) Long-term liabilities (478 ) $ 361,563

Fair value of financial instr38

Fair value of financial instruments (Tables)	9 Months Ended
	Sep. 30, 2017
Fair Value Disclosures [Abstract]
Assets, Liabilities and Temporary Equity Measured at Fair Value on a Recurring Basis	The following table summarizes the Company’s assets, liabilities and temporary equity that are measured at fair value on a recurring basis as of September 30, 2017 : Total Quoted prices in Significant other Significant Assets Investments in mutual funds and common stock $ 57,089 $ 57,089 $ — $ — Cash surrender value of life insurance policies $ 64,240 $ — $ 64,240 $ — Interest rate cap agreements $ 962 $ — $ 962 $ — Funds on deposit with third parties $ 76,456 $ 76,456 $ — $ — Liabilities Contingent earn-out obligations $ 8,955 $ — $ — $ 8,955 Temporary equity Noncontrolling interests subject to put provisions $ 1,026,890 $ — $ — $ 1,026,890

Segment reporting (Tables)

Segment reporting (Tables)	9 Months Ended
	Sep. 30, 2017
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 net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes: Three months ended September 30, Nine months ended September 30, 2017 2016 2017 2016 Segment net revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,457,302 $ 2,412,818 $ 7,209,424 $ 7,079,054 Intersegment revenues 26,342 16,040 76,538 44,819 Total dialysis and related lab services revenues 2,483,644 2,428,858 7,285,962 7,123,873 Less: Provision for uncollectible accounts (117,973 ) (109,299 ) (334,078 ) (320,565 ) Net dialysis and related lab services patient service revenues 2,365,671 2,319,559 6,951,884 6,803,308 Other revenues (1) 4,803 3,912 14,998 12,134 Total net dialysis and related lab services revenues 2,370,474 2,323,471 6,966,882 6,815,442 DMG DMG revenues: Capitated revenues 975,526 846,245 2,852,631 2,586,383 Net patient service revenues 187,678 166,622 556,179 448,222 Other revenues (2) 15,170 15,195 52,509 41,766 Intersegment capitated and other revenues 69 75 174 189 Total net DMG revenues 1,178,443 1,028,137 3,461,493 3,076,560 Other—Ancillary services and strategic initiatives Net patient service revenues 95,490 57,498 246,349 165,742 Capitated revenues 40,839 26,293 103,848 74,149 Other external sources 263,996 311,292 795,731 942,478 Intersegment revenues 13,743 16,642 39,958 43,189 Total ancillary services and strategic initiatives revenues 414,068 411,725 1,185,886 1,225,558 Total net segment revenues 3,962,985 3,763,333 11,614,261 11,117,560 Elimination of intersegment revenues (40,154 ) (32,757 ) (116,670 ) (88,197 ) Consolidated net revenues $ 3,922,831 $ 3,730,576 $ 11,497,591 $ 11,029,363 Segment operating margin: U.S. dialysis and related lab services (3) $ 442,777 $ 452,187 $ 1,837,989 $ 1,341,432 DMG (587,817 ) 33,094 (588,389 ) (126,110 ) Other—Ancillary services and strategic initiatives (36,518 ) 361,903 (142,984 ) 338,159 Total segment operating margin (181,558 ) 847,184 1,106,616 1,553,481 Reconciliation of segment operating margin to consolidated income Corporate administrative support (4) (10,965 ) (28,028 ) (32,587 ) (40,366 ) Consolidated operating (loss) income (192,523 ) 819,156 1,074,029 1,513,115 Debt expense (109,623 ) (104,581 ) (322,014 ) (310,359 ) Other income, net 4,370 1,876 13,866 8,067 Consolidated (loss) income before income taxes $ (297,776 ) $ 716,451 $ 765,881 $ 1,210,823 (1) Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment. (2) Includes medical consulting service fees and management fees for providing management and administrative services to unconsolidated joint ventures and revenue related to the maintenance of existing physician networks. (3) U.S. dialysis and related lab services operating income includes the net gain on the settlement with the VA for the nine months ended September 30, 2017. (4) Corporate administrative support costs includes an adjustment of $27,040 to reduce a receivable associated with the DMG acquisition escrow provision relating to an income tax item for the three and nine months ended September 30, 2016.
Summary of Depreciation and Amortization Expense by Reportable Segment	Depreciation and amortization expense by reportable segment was as follows: Three months ended September 30, Nine months ended September 30, 2017 2016 2017 2016 U.S. dialysis and related lab services $ 132,112 $ 122,540 $ 387,142 $ 358,427 DMG 60,649 52,595 177,983 153,068 Ancillary services and strategic initiatives 10,522 6,604 28,402 19,980 $ 203,283 $ 181,739 $ 593,527 $ 531,475
Summary of Assets by Reportable Segment	The Company therefore has not amended its financial statements filed on its 2016 10-K to correct this misstatement, but has provided the corrected disclosure here. Assets by reportable segment were as follows: September 30, 2017 December 31, 2016 Segment assets U.S. dialysis and related lab services (including equity $ 11,649,092 $ 11,099,137 DMG (including equity investments of $9,155 and $10,350, 5,788,387 6,213,091 Other—Ancillary services and strategic initiatives (including 1,575,860 1,429,029 Consolidated assets $ 19,013,339 $ 18,741,257
Summary of Expenditures for Property and Equipment by Reportable Segment	Expenditures for property and equipment by reportable segment were as follows: Three months ended Nine months ended 2017 2016 2017 2016 U.S. dialysis and related lab services $ 205,266 $ 182,741 $ 531,027 $ 467,121 DMG 24,282 17,396 72,953 55,639 Ancillary services and strategic initiatives 11,341 16,479 35,849 52,483 $ 240,889 $ 216,616 $ 639,829 $ 575,243

Changes in DaVita Inc.'s owne40

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries (Tables)	9 Months Ended
	Sep. 30, 2017
Noncontrolling Interest [Abstract]
Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity	The effects of changes in DaVita Inc.’s ownership interest in consolidated subsidiaries on the Company’s equity were as follows: Three months ended September 30, Nine months ended September 30, 2017 2016 2017 2016 Net (loss) income attributable to DaVita Inc. $ (214,476 ) $ 571,332 $ 360,222 $ 722,148 Changes in paid-in capital for: Purchases of noncontrolling interests — (604 ) 195 (5,135 ) Net transfers to noncontrolling interests — (604 ) 195 (5,135 ) Net (loss) income attributable to DaVita Inc., net of $ (214,476 ) $ 570,728 $ 360,417 $ 717,013

Condensed Consolidating finan41

Condensed Consolidating financial statements (Tables)	9 Months Ended
	Sep. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Condensed Consolidating Statements of Operations	Condensed Consolidating Statements of Operations DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended September 30, 2017 Patient services revenues $ — $ 1,732,287 $ 1,076,035 $ (62,065 ) $ 2,746,257 Less: Provision for uncollectible accounts — (82,860 ) (46,989 ) 6,089 (123,760 ) Net patient service revenues — 1,649,427 1,029,046 (55,976 ) 2,622,497 Capitated revenues — 461,866 555,481 (982 ) 1,016,365 Other revenues 189,275 468,948 52,283 (426,537 ) 283,969 Total net revenues 189,275 2,580,241 1,636,810 (483,495 ) 3,922,831 Operating expenses and charges 128,488 2,964,867 1,505,494 (483,495 ) 4,115,354 Operating income (loss) 60,787 (384,626 ) 131,316 — (192,523 ) Debt expense (108,453 ) (93,243 ) (16,168 ) 108,241 (109,623 ) Other income, net 104,250 1,774 6,587 (108,241 ) 4,370 Income tax expense (benefit) 27,624 (150,192 ) (3,174 ) — (125,742 ) Equity (losses) earnings in subsidiaries (243,436 ) 82,467 — 160,969 — Net (loss) income (214,476 ) (243,436 ) 124,909 160,969 (172,034 ) Less: Net income attributable to noncontrolling interests — — — (42,442 ) (42,442 ) Net (loss) income attributable to DaVita Inc. $ (214,476 ) $ (243,436 ) $ 124,909 $ 118,527 $ (214,476 ) Guarantor Non- Consolidating Consolidated For The Three Months Ended September 30, 2016 DaVita Inc. Patient service revenues $ — $ 1,726,892 $ 959,193 $ (42,891 ) $ 2,643,194 Less: Provision for uncollectible accounts — (73,833 ) (41,722 ) — (115,555 ) Net patient service revenues — 1,653,059 917,471 (42,891 ) 2,527,639 Capitated revenues — 465,684 406,893 (39 ) 872,538 Other revenues 191,815 506,619 32,652 (400,687 ) 330,399 Total net revenues 191,815 2,625,362 1,357,016 (443,617 ) 3,730,576 Operating expenses 143,784 2,388,114 823,139 (443,617 ) 2,911,420 Operating income 48,031 237,248 533,877 — 819,156 Debt expense (101,895 ) (91,716 ) (14,402 ) 103,432 (104,581 ) Other income 99,446 2,659 3,203 (103,432 ) 1,876 Income tax (benefit) expense (20,898 ) (21,486 ) 146,685 — 104,301 Equity earnings in subsidiaries 504,852 335,175 — (840,027 ) — Net income 571,332 504,852 375,993 (840,027 ) 612,150 Less: Net income attributable to noncontrolling interests — — — (40,818 ) (40,818 ) Net income attributable to DaVita Inc. $ 571,332 $ 504,852 $ 375,993 $ (880,845 ) $ 571,332 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2017 DaVita Inc. Patient services revenues $ — $ 4,966,892 $ 3,230,584 $ (167,374 ) $ 8,030,102 Less: Provision for uncollectible accounts — (219,554 ) (138,763 ) 6,089 (352,228 ) Net patient service revenues — 4,747,338 3,091,821 (161,285 ) 7,677,874 Capitated revenues — 1,393,345 1,566,382 (3,248 ) 2,956,479 Other revenues 604,246 1,448,484 122,177 (1,311,669 ) 863,238 Total net revenues 604,246 7,589,167 4,780,380 (1,476,202 ) 11,497,591 Operating expenses and charges 398,502 7,241,745 4,259,517 (1,476,202 ) 10,423,562 Operating income 205,744 347,422 520,863 — 1,074,029 Debt expense (317,276 ) (276,990 ) (44,827 ) 317,079 (322,014 ) Other income, net 306,886 7,502 16,557 (317,079 ) 13,866 Income tax expense 84,686 142,156 49,163 — 276,005 Equity earnings in subsidiaries 249,554 313,776 — (563,330 ) — Net income 360,222 249,554 443,430 (563,330 ) 489,876 Less: Net income attributable to noncontrolling interests — — — (129,654 ) (129,654 ) Net income attributable to DaVita Inc. $ 360,222 $ 249,554 $ 443,430 $ (692,984 ) $ 360,222 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2016 DaVita Inc. Patient services revenues $ — $ 5,044,565 $ 2,787,176 $ (123,100 ) $ 7,708,641 Less: Provision for uncollectible accounts — (207,144 ) (129,044 ) — (336,188 ) Net patient service revenues — 4,837,421 2,658,132 (123,100 ) 7,372,453 Capitated revenues — 1,397,378 1,263,404 (250 ) 2,660,532 Other revenues 575,700 1,512,039 91,921 (1,183,282 ) 996,378 Total net revenues 575,700 7,746,838 4,013,457 (1,306,632 ) 11,029,363 Operating expenses and charges 400,129 7,275,863 3,146,888 (1,306,632 ) 9,516,248 Operating income 175,571 470,975 866,569 — 1,513,115 Debt expense (305,097 ) (275,148 ) (38,914 ) 308,800 (310,359 ) Other income, net 296,660 12,416 7,791 (308,800 ) 8,067 Income tax expense 56,190 140,972 168,849 — 366,011 Equity earnings in subsidiaries 611,204 543,933 — (1,155,137 ) — Net income 722,148 611,204 666,597 (1,155,137 ) 844,812 Less: Net income attributable to noncontrolling interests — — — (122,664 ) (122,664 ) Net income attributable to DaVita Inc. $ 722,148 $ 611,204 $ 666,597 $ (1,277,801 ) $ 722,148 Condensed Consolidating Statements of Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Nine Months Ended September 30, 2017 Patient service operating revenues $ 8,030,102 $ 414,784 $ — $ 7,615,318 Less: Provision for uncollectible accounts (352,228 ) (11,010 ) — (341,218 ) Net patient service operating revenues 7,677,874 403,774 — 7,274,100 Capitated revenues 2,956,479 1,186,185 — 1,770,294 Other revenues 863,238 33,688 — 829,550 Total net operating revenues 11,497,591 1,623,647 — 9,873,944 Operating expenses 10,423,562 1,572,064 (147 ) 8,851,645 Operating income 1,074,029 51,583 147 1,022,299 Debt expense, including refinancing charges (322,014 ) (6,458 ) — (315,556 ) Other income 13,866 478 — 13,388 Income tax expense 276,005 38,059 59 237,887 Net income 489,876 7,544 88 482,244 Less: Net income attributable to noncontrolling interests (129,654 ) — — (129,654 ) Net income attributable to DaVita Inc. $ 360,222 $ 7,544 $ 88 $ 352,590 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Comprehensive Income	Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended September 30, 2017 DaVita Inc. Net (loss) income $ (214,476 ) $ (243,436 ) $ 124,909 $ 160,969 $ (172,034 ) Other comprehensive income 1,641 — 29,143 — 30,784 Total comprehensive (loss) income (212,835 ) (243,436 ) 154,052 160,969 (141,250 ) Less: Comprehensive income attributable to — — — (42,442 ) (42,442 ) Comprehensive (loss) income attributable to DaVita Inc. $ (212,835 ) $ (243,436 ) $ 154,052 $ 118,527 $ (183,692 ) Guarantor Non- Consolidating Consolidated For The Three Months Ended September 30, 2016 DaVita Inc. Net income $ 571,332 $ 504,852 $ 375,993 $ (840,027 ) $ 612,150 Other comprehensive income 1,248 — 6,620 — 7,868 Total comprehensive income 572,580 504,852 382,613 (840,027 ) 620,018 Less: Comprehensive income attributable to the — — — (40,876 ) (40,876 ) Comprehensive income attributable to DaVita Inc. $ 572,580 $ 504,852 $ 382,613 $ (880,903 ) $ 579,142 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2017 DaVita Inc. Net income $ 360,222 $ 249,554 $ 443,430 $ (563,330 ) $ 489,876 Other comprehensive income 1,571 — 91,546 — 93,117 Total comprehensive income 361,793 249,554 534,976 (563,330 ) 582,993 Less: Comprehensive income attributable to — — — (129,652 ) (129,652 ) Comprehensive income attributable to DaVita Inc. $ 361,793 $ 249,554 $ 534,976 $ (692,982 ) $ 453,341 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2016 DaVita Inc. Net income $ 722,148 $ 611,204 $ 666,597 $ (1,155,137 ) $ 844,812 Other comprehensive (loss) income (5,299 ) — 13,106 — 7,807 Total comprehensive income 716,849 611,204 679,703 (1,155,137 ) 852,619 Less: Comprehensive income attributable to the — — — (122,871 ) (122,871 ) Comprehensive income attributable to DaVita Inc. $ 716,849 $ 611,204 $ 679,703 $ (1,278,008 ) $ 729,748 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Nine Months Ended September 30, 2017 Net income $ 489,876 $ 7,544 $ 88 $ 482,244 Other comprehensive income 93,117 — — 93,117 Total comprehensive income 582,993 7,544 88 575,361 Less: Comprehensive income attributable to the noncontrolling (129,652 ) — — (129,652 ) Comprehensive income attributable to DaVita Inc. $ 453,341 $ 7,544 $ 88 $ 445,709 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Balance Sheets	Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of September 30, 2017 DaVita Inc. Cash and cash equivalents $ 447,627 $ 14,768 $ 383,715 $ — $ 846,110 Accounts receivable, net — 1,325,029 766,045 — 2,091,074 Other current assets 178,901 804,580 112,884 — 1,096,365 Total current assets 626,528 2,144,377 1,262,644 — 4,033,549 Property and equipment, net 368,233 1,752,690 1,265,133 — 3,386,056 Intangible assets, net 289 1,370,085 80,659 — 1,451,033 Investments in subsidiaries 10,116,956 2,738,851 — (12,855,807 ) — Intercompany receivables 3,079,514 — 1,172,721 (4,252,235 ) — Other long-term assets and investments 46,028 99,584 581,212 — 726,824 Goodwill — 7,248,275 2,167,602 — 9,415,877 Total assets $ 14,237,548 $ 15,353,862 $ 6,529,971 $ (17,108,042 ) $ 19,013,339 Current liabilities $ 283,770 $ 1,907,482 $ 683,541 $ — $ 2,874,793 Intercompany payables — 2,231,303 2,020,932 (4,252,235 ) — Long-term debt and other long-term liabilities 8,565,734 1,098,121 478,672 — 10,142,527 Noncontrolling interests subject to put provisions 603,463 — — 423,427 1,026,890 Total DaVita Inc. shareholder's equity 4,784,581 10,116,956 2,738,851 (12,855,807 ) 4,784,581 Noncontrolling interests not subject to put — — 607,975 (423,427 ) 184,548 Total equity 4,784,581 10,116,956 3,346,826 (13,279,234 ) 4,969,129 Total liabilities and equity $ 14,237,548 $ 15,353,862 $ 6,529,971 $ (17,108,042 ) $ 19,013,339 Guarantor Non- Consolidating Consolidated As of December 31, 2016 DaVita Inc. Cash and cash equivalents $ 549,921 $ 59,192 $ 304,074 $ — $ 913,187 Accounts receivable, net — 1,215,232 702,070 — 1,917,302 Other current assets 277,911 736,727 135,101 — 1,149,739 Total current assets 827,832 2,011,151 1,141,245 — 3,980,228 Property and equipment, net 337,200 1,689,798 1,148,369 — 3,175,367 Intangible assets, net 487 1,491,057 36,223 — 1,527,767 Investments in subsidiaries 9,717,728 2,002,660 — (11,720,388 ) — Intercompany receivables 3,250,692 — 866,955 (4,117,647 ) — Other long-term assets and investments 39,994 86,710 523,874 — 650,578 Goodwill — 7,838,984 1,568,333 — 9,407,317 Total assets $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Current liabilities $ 303,840 $ 1,865,193 $ 527,412 $ — $ 2,696,445 Intercompany payables — 2,322,124 1,795,523 (4,117,647 ) — Long-term debt and other long-term liabilities 8,614,445 1,215,315 392,053 — 10,221,813 Noncontrolling interests subject to put provisions 607,601 — — 365,657 973,258 Total DaVita Inc. shareholder's equity 4,648,047 9,717,728 2,002,660 (11,720,388 ) 4,648,047 Noncontrolling interests not subject to put — — 567,351 (365,657 ) 201,694 Total equity 4,648,047 9,717,728 2,570,011 (12,086,045 ) 4,849,741 Total liabilities and equity $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of September 30, 2017 Cash and cash equivalents $ 846,110 $ 162,536 $ — $ 683,574 Accounts receivable, net 2,091,074 174,944 — 1,916,130 Other current assets 1,096,365 17,722 — 1,078,643 Total current assets 4,033,549 355,202 — 3,678,347 Property and equipment, net 3,386,056 3,334 — 3,382,722 Amortizable intangibles, net 1,451,033 4,313 — 1,446,720 Other long-term assets 726,824 81,877 2,861 642,086 Goodwill 9,415,877 30,993 — 9,384,884 Total assets $ 19,013,339 $ 475,719 $ 2,861 $ 18,534,759 Current liabilities $ 2,874,793 $ 202,386 $ — $ 2,672,407 Payables to parent — 97,434 2,861 (100,295 ) Long-term debt and other long-term liabilities 10,142,527 63,272 — 10,079,255 Noncontrolling interests subject to put provisions 1,026,890 — — 1,026,890 Total DaVita Inc. shareholders’ equity 4,784,581 112,627 — 4,671,954 Noncontrolling interests not subject to put provisions 184,548 — — 184,548 Shareholders’ equity 4,969,129 112,627 — 4,856,502 Total liabilities and shareholder’s equity $ 19,013,339 $ 475,719 $ 2,861 $ 18,534,759 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Cash Flows	Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 360,222 $ 249,554 $ 443,430 $ (563,330 ) $ 489,876 Changes in operating assets and liabilities and non-cash items included in net income (291,657 ) 606,783 196,207 563,330 1,074,663 Net cash provided by operating activities 68,565 856,337 639,637 — 1,564,539 Cash flows from investing activities: Additions of property and equipment (94,385 ) (305,261 ) (240,183 ) — (639,829 ) Acquisitions — (627,324 ) (99,214 ) — (726,538 ) Proceeds from asset and business sales — 90,533 1,996 — 92,529 Proceeds (purchases) from investment sales and other items, net 123,894 (6,472 ) 49,183 — 166,605 Net cash provided by (used in) investing activities 29,509 (848,524 ) (288,218 ) — (1,107,233 ) Cash flows from financing activities: Long-term debt and related financing costs, net (92,721 ) (10,394 ) (5,348 ) — (108,463 ) Intercompany borrowing (payments) 197,983 (40,411 ) (157,572 ) — — Other items (305,630 ) (1,432 ) (114,307 ) — (421,369 ) Net cash used in financing activities (200,368 ) (52,237 ) (277,227 ) — (529,832 ) Effect of exchange rate changes on cash — — 5,449 — 5,449 Net (decrease) increase in cash and cash equivalents (102,294 ) (44,424 ) 79,641 — (67,077 ) Cash and cash equivalents at beginning of period 549,921 59,192 304,074 — 913,187 Cash and cash equivalents at end of period $ 447,627 $ 14,768 $ 383,715 $ — $ 846,110 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2016 DaVita Inc. Cash flows from operating activities: Net income $ 722,148 $ 611,204 $ 666,597 $ (1,155,137 ) $ 844,812 Changes in operating assets and liabilities and non-cash (586,804 ) 228,991 (160,874 ) 1,155,137 636,450 Net cash provided by operating activities 135,344 840,195 505,723 — 1,481,262 Cash flows from investing activities: Additions of property and equipment (81,785 ) (248,339 ) (245,119 ) — (575,243 ) Acquisitions — (458,556 ) (38,775 ) — (497,331 ) Proceeds from asset and business sales, net of cash — 24,608 (5,617 ) — 18,991 (Purchases) proceeds from investment sales and other (236,150 ) (12,825 ) 45,316 — (203,659 ) Net cash used in investing activities (317,935 ) (695,112 ) (244,195 ) — (1,257,242 ) Cash flows from financing activities: Long-term debt and related financing costs, net (73,889 ) (20,684 ) (4,151 ) — (98,724 ) Intercompany borrowing (payments) 283,709 (188,247 ) (95,462 ) — — Other items (589,964 ) (9,740 ) (109,548 ) — (709,252 ) Net cash used in financing activities (380,144 ) (218,671 ) (209,161 ) — (807,976 ) Effect of exchange rate changes on cash — — (1,664 ) — (1,664 ) Net (decrease) increase in cash and cash equivalents (562,735 ) (73,588 ) 50,703 — (585,620 ) Cash and cash equivalents at beginning of period 1,186,636 109,357 203,123 — 1,499,116 Cash and cash equivalents at end of period $ 623,901 $ 35,769 $ 253,826 $ — $ 913,496 Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Nine Months Ended September 30, 2017 Cash flows from operating activities: Net income $ 489,876 $ 7,544 $ 88 $ 482,244 Changes in operating and intercompany assets and liabilities 1,074,663 29,753 (88 ) 1,044,998 Net cash provided by operating activities 1,564,539 37,297 — 1,527,242 Cash flows from investing activities: Additions of property and equipment (639,829 ) (5,903 ) — (633,926 ) Acquisitions (726,538 ) — — (726,538 ) Proceeds from asset and business sales 92,529 — — 92,529 Investments and other items 166,605 (2,378 ) — 168,983 Net cash used in investing activities (1,107,233 ) (8,281 ) — (1,098,952 ) Cash flows from financing activities: Long-term debt (108,463 ) — — (108,463 ) Intercompany — 28,829 — (28,829 ) Other items (421,369 ) — — (421,369 ) Net cash (used in) provided by financing activities (529,832 ) 28,829 — (558,661 ) Effect of exchange rate changes on cash 5,449 — — 5,449 Net (decrease) increase in cash (67,077 ) 57,845 — (124,922 ) Cash and cash equivalents at beginning of period 913,187 104,691 — 808,496 Cash and cash equivalents at end of period $ 846,110 $ 162,536 $ — $ 683,574 (1) After elimination of the unrestricted subsidiaries and the physician groups.

Supplemental Data (Tables)

Supplemental Data (Tables)	9 Months Ended
	Sep. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Condensed Consolidating Statements of Operations	Condensed Consolidating Statements of Operations DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended September 30, 2017 Patient services revenues $ — $ 1,732,287 $ 1,076,035 $ (62,065 ) $ 2,746,257 Less: Provision for uncollectible accounts — (82,860 ) (46,989 ) 6,089 (123,760 ) Net patient service revenues — 1,649,427 1,029,046 (55,976 ) 2,622,497 Capitated revenues — 461,866 555,481 (982 ) 1,016,365 Other revenues 189,275 468,948 52,283 (426,537 ) 283,969 Total net revenues 189,275 2,580,241 1,636,810 (483,495 ) 3,922,831 Operating expenses and charges 128,488 2,964,867 1,505,494 (483,495 ) 4,115,354 Operating income (loss) 60,787 (384,626 ) 131,316 — (192,523 ) Debt expense (108,453 ) (93,243 ) (16,168 ) 108,241 (109,623 ) Other income, net 104,250 1,774 6,587 (108,241 ) 4,370 Income tax expense (benefit) 27,624 (150,192 ) (3,174 ) — (125,742 ) Equity (losses) earnings in subsidiaries (243,436 ) 82,467 — 160,969 — Net (loss) income (214,476 ) (243,436 ) 124,909 160,969 (172,034 ) Less: Net income attributable to noncontrolling interests — — — (42,442 ) (42,442 ) Net (loss) income attributable to DaVita Inc. $ (214,476 ) $ (243,436 ) $ 124,909 $ 118,527 $ (214,476 ) Guarantor Non- Consolidating Consolidated For The Three Months Ended September 30, 2016 DaVita Inc. Patient service revenues $ — $ 1,726,892 $ 959,193 $ (42,891 ) $ 2,643,194 Less: Provision for uncollectible accounts — (73,833 ) (41,722 ) — (115,555 ) Net patient service revenues — 1,653,059 917,471 (42,891 ) 2,527,639 Capitated revenues — 465,684 406,893 (39 ) 872,538 Other revenues 191,815 506,619 32,652 (400,687 ) 330,399 Total net revenues 191,815 2,625,362 1,357,016 (443,617 ) 3,730,576 Operating expenses 143,784 2,388,114 823,139 (443,617 ) 2,911,420 Operating income 48,031 237,248 533,877 — 819,156 Debt expense (101,895 ) (91,716 ) (14,402 ) 103,432 (104,581 ) Other income 99,446 2,659 3,203 (103,432 ) 1,876 Income tax (benefit) expense (20,898 ) (21,486 ) 146,685 — 104,301 Equity earnings in subsidiaries 504,852 335,175 — (840,027 ) — Net income 571,332 504,852 375,993 (840,027 ) 612,150 Less: Net income attributable to noncontrolling interests — — — (40,818 ) (40,818 ) Net income attributable to DaVita Inc. $ 571,332 $ 504,852 $ 375,993 $ (880,845 ) $ 571,332 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2017 DaVita Inc. Patient services revenues $ — $ 4,966,892 $ 3,230,584 $ (167,374 ) $ 8,030,102 Less: Provision for uncollectible accounts — (219,554 ) (138,763 ) 6,089 (352,228 ) Net patient service revenues — 4,747,338 3,091,821 (161,285 ) 7,677,874 Capitated revenues — 1,393,345 1,566,382 (3,248 ) 2,956,479 Other revenues 604,246 1,448,484 122,177 (1,311,669 ) 863,238 Total net revenues 604,246 7,589,167 4,780,380 (1,476,202 ) 11,497,591 Operating expenses and charges 398,502 7,241,745 4,259,517 (1,476,202 ) 10,423,562 Operating income 205,744 347,422 520,863 — 1,074,029 Debt expense (317,276 ) (276,990 ) (44,827 ) 317,079 (322,014 ) Other income, net 306,886 7,502 16,557 (317,079 ) 13,866 Income tax expense 84,686 142,156 49,163 — 276,005 Equity earnings in subsidiaries 249,554 313,776 — (563,330 ) — Net income 360,222 249,554 443,430 (563,330 ) 489,876 Less: Net income attributable to noncontrolling interests — — — (129,654 ) (129,654 ) Net income attributable to DaVita Inc. $ 360,222 $ 249,554 $ 443,430 $ (692,984 ) $ 360,222 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2016 DaVita Inc. Patient services revenues $ — $ 5,044,565 $ 2,787,176 $ (123,100 ) $ 7,708,641 Less: Provision for uncollectible accounts — (207,144 ) (129,044 ) — (336,188 ) Net patient service revenues — 4,837,421 2,658,132 (123,100 ) 7,372,453 Capitated revenues — 1,397,378 1,263,404 (250 ) 2,660,532 Other revenues 575,700 1,512,039 91,921 (1,183,282 ) 996,378 Total net revenues 575,700 7,746,838 4,013,457 (1,306,632 ) 11,029,363 Operating expenses and charges 400,129 7,275,863 3,146,888 (1,306,632 ) 9,516,248 Operating income 175,571 470,975 866,569 — 1,513,115 Debt expense (305,097 ) (275,148 ) (38,914 ) 308,800 (310,359 ) Other income, net 296,660 12,416 7,791 (308,800 ) 8,067 Income tax expense 56,190 140,972 168,849 — 366,011 Equity earnings in subsidiaries 611,204 543,933 — (1,155,137 ) — Net income 722,148 611,204 666,597 (1,155,137 ) 844,812 Less: Net income attributable to noncontrolling interests — — — (122,664 ) (122,664 ) Net income attributable to DaVita Inc. $ 722,148 $ 611,204 $ 666,597 $ (1,277,801 ) $ 722,148 Condensed Consolidating Statements of Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Nine Months Ended September 30, 2017 Patient service operating revenues $ 8,030,102 $ 414,784 $ — $ 7,615,318 Less: Provision for uncollectible accounts (352,228 ) (11,010 ) — (341,218 ) Net patient service operating revenues 7,677,874 403,774 — 7,274,100 Capitated revenues 2,956,479 1,186,185 — 1,770,294 Other revenues 863,238 33,688 — 829,550 Total net operating revenues 11,497,591 1,623,647 — 9,873,944 Operating expenses 10,423,562 1,572,064 (147 ) 8,851,645 Operating income 1,074,029 51,583 147 1,022,299 Debt expense, including refinancing charges (322,014 ) (6,458 ) — (315,556 ) Other income 13,866 478 — 13,388 Income tax expense 276,005 38,059 59 237,887 Net income 489,876 7,544 88 482,244 Less: Net income attributable to noncontrolling interests (129,654 ) — — (129,654 ) Net income attributable to DaVita Inc. $ 360,222 $ 7,544 $ 88 $ 352,590 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Comprehensive Income	Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended September 30, 2017 DaVita Inc. Net (loss) income $ (214,476 ) $ (243,436 ) $ 124,909 $ 160,969 $ (172,034 ) Other comprehensive income 1,641 — 29,143 — 30,784 Total comprehensive (loss) income (212,835 ) (243,436 ) 154,052 160,969 (141,250 ) Less: Comprehensive income attributable to — — — (42,442 ) (42,442 ) Comprehensive (loss) income attributable to DaVita Inc. $ (212,835 ) $ (243,436 ) $ 154,052 $ 118,527 $ (183,692 ) Guarantor Non- Consolidating Consolidated For The Three Months Ended September 30, 2016 DaVita Inc. Net income $ 571,332 $ 504,852 $ 375,993 $ (840,027 ) $ 612,150 Other comprehensive income 1,248 — 6,620 — 7,868 Total comprehensive income 572,580 504,852 382,613 (840,027 ) 620,018 Less: Comprehensive income attributable to the — — — (40,876 ) (40,876 ) Comprehensive income attributable to DaVita Inc. $ 572,580 $ 504,852 $ 382,613 $ (880,903 ) $ 579,142 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2017 DaVita Inc. Net income $ 360,222 $ 249,554 $ 443,430 $ (563,330 ) $ 489,876 Other comprehensive income 1,571 — 91,546 — 93,117 Total comprehensive income 361,793 249,554 534,976 (563,330 ) 582,993 Less: Comprehensive income attributable to — — — (129,652 ) (129,652 ) Comprehensive income attributable to DaVita Inc. $ 361,793 $ 249,554 $ 534,976 $ (692,982 ) $ 453,341 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2016 DaVita Inc. Net income $ 722,148 $ 611,204 $ 666,597 $ (1,155,137 ) $ 844,812 Other comprehensive (loss) income (5,299 ) — 13,106 — 7,807 Total comprehensive income 716,849 611,204 679,703 (1,155,137 ) 852,619 Less: Comprehensive income attributable to the — — — (122,871 ) (122,871 ) Comprehensive income attributable to DaVita Inc. $ 716,849 $ 611,204 $ 679,703 $ (1,278,008 ) $ 729,748 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Nine Months Ended September 30, 2017 Net income $ 489,876 $ 7,544 $ 88 $ 482,244 Other comprehensive income 93,117 — — 93,117 Total comprehensive income 582,993 7,544 88 575,361 Less: Comprehensive income attributable to the noncontrolling (129,652 ) — — (129,652 ) Comprehensive income attributable to DaVita Inc. $ 453,341 $ 7,544 $ 88 $ 445,709 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Balance Sheets	Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of September 30, 2017 DaVita Inc. Cash and cash equivalents $ 447,627 $ 14,768 $ 383,715 $ — $ 846,110 Accounts receivable, net — 1,325,029 766,045 — 2,091,074 Other current assets 178,901 804,580 112,884 — 1,096,365 Total current assets 626,528 2,144,377 1,262,644 — 4,033,549 Property and equipment, net 368,233 1,752,690 1,265,133 — 3,386,056 Intangible assets, net 289 1,370,085 80,659 — 1,451,033 Investments in subsidiaries 10,116,956 2,738,851 — (12,855,807 ) — Intercompany receivables 3,079,514 — 1,172,721 (4,252,235 ) — Other long-term assets and investments 46,028 99,584 581,212 — 726,824 Goodwill — 7,248,275 2,167,602 — 9,415,877 Total assets $ 14,237,548 $ 15,353,862 $ 6,529,971 $ (17,108,042 ) $ 19,013,339 Current liabilities $ 283,770 $ 1,907,482 $ 683,541 $ — $ 2,874,793 Intercompany payables — 2,231,303 2,020,932 (4,252,235 ) — Long-term debt and other long-term liabilities 8,565,734 1,098,121 478,672 — 10,142,527 Noncontrolling interests subject to put provisions 603,463 — — 423,427 1,026,890 Total DaVita Inc. shareholder's equity 4,784,581 10,116,956 2,738,851 (12,855,807 ) 4,784,581 Noncontrolling interests not subject to put — — 607,975 (423,427 ) 184,548 Total equity 4,784,581 10,116,956 3,346,826 (13,279,234 ) 4,969,129 Total liabilities and equity $ 14,237,548 $ 15,353,862 $ 6,529,971 $ (17,108,042 ) $ 19,013,339 Guarantor Non- Consolidating Consolidated As of December 31, 2016 DaVita Inc. Cash and cash equivalents $ 549,921 $ 59,192 $ 304,074 $ — $ 913,187 Accounts receivable, net — 1,215,232 702,070 — 1,917,302 Other current assets 277,911 736,727 135,101 — 1,149,739 Total current assets 827,832 2,011,151 1,141,245 — 3,980,228 Property and equipment, net 337,200 1,689,798 1,148,369 — 3,175,367 Intangible assets, net 487 1,491,057 36,223 — 1,527,767 Investments in subsidiaries 9,717,728 2,002,660 — (11,720,388 ) — Intercompany receivables 3,250,692 — 866,955 (4,117,647 ) — Other long-term assets and investments 39,994 86,710 523,874 — 650,578 Goodwill — 7,838,984 1,568,333 — 9,407,317 Total assets $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Current liabilities $ 303,840 $ 1,865,193 $ 527,412 $ — $ 2,696,445 Intercompany payables — 2,322,124 1,795,523 (4,117,647 ) — Long-term debt and other long-term liabilities 8,614,445 1,215,315 392,053 — 10,221,813 Noncontrolling interests subject to put provisions 607,601 — — 365,657 973,258 Total DaVita Inc. shareholder's equity 4,648,047 9,717,728 2,002,660 (11,720,388 ) 4,648,047 Noncontrolling interests not subject to put — — 567,351 (365,657 ) 201,694 Total equity 4,648,047 9,717,728 2,570,011 (12,086,045 ) 4,849,741 Total liabilities and equity $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of September 30, 2017 Cash and cash equivalents $ 846,110 $ 162,536 $ — $ 683,574 Accounts receivable, net 2,091,074 174,944 — 1,916,130 Other current assets 1,096,365 17,722 — 1,078,643 Total current assets 4,033,549 355,202 — 3,678,347 Property and equipment, net 3,386,056 3,334 — 3,382,722 Amortizable intangibles, net 1,451,033 4,313 — 1,446,720 Other long-term assets 726,824 81,877 2,861 642,086 Goodwill 9,415,877 30,993 — 9,384,884 Total assets $ 19,013,339 $ 475,719 $ 2,861 $ 18,534,759 Current liabilities $ 2,874,793 $ 202,386 $ — $ 2,672,407 Payables to parent — 97,434 2,861 (100,295 ) Long-term debt and other long-term liabilities 10,142,527 63,272 — 10,079,255 Noncontrolling interests subject to put provisions 1,026,890 — — 1,026,890 Total DaVita Inc. shareholders’ equity 4,784,581 112,627 — 4,671,954 Noncontrolling interests not subject to put provisions 184,548 — — 184,548 Shareholders’ equity 4,969,129 112,627 — 4,856,502 Total liabilities and shareholder’s equity $ 19,013,339 $ 475,719 $ 2,861 $ 18,534,759 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Cash Flows	Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 360,222 $ 249,554 $ 443,430 $ (563,330 ) $ 489,876 Changes in operating assets and liabilities and non-cash items included in net income (291,657 ) 606,783 196,207 563,330 1,074,663 Net cash provided by operating activities 68,565 856,337 639,637 — 1,564,539 Cash flows from investing activities: Additions of property and equipment (94,385 ) (305,261 ) (240,183 ) — (639,829 ) Acquisitions — (627,324 ) (99,214 ) — (726,538 ) Proceeds from asset and business sales — 90,533 1,996 — 92,529 Proceeds (purchases) from investment sales and other items, net 123,894 (6,472 ) 49,183 — 166,605 Net cash provided by (used in) investing activities 29,509 (848,524 ) (288,218 ) — (1,107,233 ) Cash flows from financing activities: Long-term debt and related financing costs, net (92,721 ) (10,394 ) (5,348 ) — (108,463 ) Intercompany borrowing (payments) 197,983 (40,411 ) (157,572 ) — — Other items (305,630 ) (1,432 ) (114,307 ) — (421,369 ) Net cash used in financing activities (200,368 ) (52,237 ) (277,227 ) — (529,832 ) Effect of exchange rate changes on cash — — 5,449 — 5,449 Net (decrease) increase in cash and cash equivalents (102,294 ) (44,424 ) 79,641 — (67,077 ) Cash and cash equivalents at beginning of period 549,921 59,192 304,074 — 913,187 Cash and cash equivalents at end of period $ 447,627 $ 14,768 $ 383,715 $ — $ 846,110 Guarantor Non- Consolidating Consolidated For The Nine Months Ended September 30, 2016 DaVita Inc. Cash flows from operating activities: Net income $ 722,148 $ 611,204 $ 666,597 $ (1,155,137 ) $ 844,812 Changes in operating assets and liabilities and non-cash (586,804 ) 228,991 (160,874 ) 1,155,137 636,450 Net cash provided by operating activities 135,344 840,195 505,723 — 1,481,262 Cash flows from investing activities: Additions of property and equipment (81,785 ) (248,339 ) (245,119 ) — (575,243 ) Acquisitions — (458,556 ) (38,775 ) — (497,331 ) Proceeds from asset and business sales, net of cash — 24,608 (5,617 ) — 18,991 (Purchases) proceeds from investment sales and other (236,150 ) (12,825 ) 45,316 — (203,659 ) Net cash used in investing activities (317,935 ) (695,112 ) (244,195 ) — (1,257,242 ) Cash flows from financing activities: Long-term debt and related financing costs, net (73,889 ) (20,684 ) (4,151 ) — (98,724 ) Intercompany borrowing (payments) 283,709 (188,247 ) (95,462 ) — — Other items (589,964 ) (9,740 ) (109,548 ) — (709,252 ) Net cash used in financing activities (380,144 ) (218,671 ) (209,161 ) — (807,976 ) Effect of exchange rate changes on cash — — (1,664 ) — (1,664 ) Net (decrease) increase in cash and cash equivalents (562,735 ) (73,588 ) 50,703 — (585,620 ) Cash and cash equivalents at beginning of period 1,186,636 109,357 203,123 — 1,499,116 Cash and cash equivalents at end of period $ 623,901 $ 35,769 $ 253,826 $ — $ 913,496 Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Nine Months Ended September 30, 2017 Cash flows from operating activities: Net income $ 489,876 $ 7,544 $ 88 $ 482,244 Changes in operating and intercompany assets and liabilities 1,074,663 29,753 (88 ) 1,044,998 Net cash provided by operating activities 1,564,539 37,297 — 1,527,242 Cash flows from investing activities: Additions of property and equipment (639,829 ) (5,903 ) — (633,926 ) Acquisitions (726,538 ) — — (726,538 ) Proceeds from asset and business sales 92,529 — — 92,529 Investments and other items 166,605 (2,378 ) — 168,983 Net cash used in investing activities (1,107,233 ) (8,281 ) — (1,098,952 ) Cash flows from financing activities: Long-term debt (108,463 ) — — (108,463 ) Intercompany — 28,829 — (28,829 ) Other items (421,369 ) — — (421,369 ) Net cash (used in) provided by financing activities (529,832 ) 28,829 — (558,661 ) Effect of exchange rate changes on cash 5,449 — — 5,449 Net (decrease) increase in cash (67,077 ) 57,845 — (124,922 ) Cash and cash equivalents at beginning of period 913,187 104,691 — 808,496 Cash and cash equivalents at end of period $ 846,110 $ 162,536 $ — $ 683,574 (1) After elimination of the unrestricted subsidiaries and the physician groups.

Earnings (loss) per share - Rec

Earnings (loss) per share - Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Basic:
Net (loss) income attributable to DaVita Inc.	$ (214,476)	$ 571,332	$ 360,222	$ 722,148
Weighted average shares outstanding during the period (in shares)	191,078,000	205,955,000	192,964,000	206,401,000
Contingently returnable shares held in escrow from the DaVita HealthCare Partners merger (in shares)	(2,194,000)	(2,194,000)	(2,194,000)	(2,194,000)
Weighted average shares for basic earnings per share calculation (in shares)	188,883,922	203,761,433	190,770,165	204,206,979
Basic net (loss) income per share attributable to DaVita Inc. (usd per share)	$ (1.14)	$ 2.80	$ 1.89	$ 3.54
Diluted:
Net (loss) income attributable to DaVita Inc.	$ (214,476)	$ 571,332	$ 360,222	$ 722,148
Weighted average shares outstanding during the period (in shares)	191,078,000	205,955,000	192,964,000	206,401,000
Contingently returnable shares held in escrow from the DaVita HealthCare Partners merger (in shares)	2,194,000	0	0	0
Assumed incremental shares from stock plans (in shares)	0	1,006,000	582,000	1,243,000
Weighted average shares for diluted earnings per share calculation (in shares)	188,883,922	206,961,450	193,546,245	207,643,794
Diluted net (loss) income per share attributable to DaVita Inc. (usd per share)	$ (1.14)	$ 2.76	$ 1.86	$ 3.48
Anti-dilutive potential common shares excluded from calculation (in shares)	8,510,000	2,375,000	5,239,000	2,153,000

Accounts receivable - Additiona

Accounts receivable - Additional Information (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2017USD ($)
Accounts Notes And Loans Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	100.00%
Account receivable outstanding, number of months	3 months
Decrease in allowance for doubtful accounts	$ 30,727
Government-based Programs, Medicare and Medicaid | Accounts Receivable
Accounts Notes And Loans Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	80.00%
Health Care Patient | Accounts Receivable
Accounts Notes And Loans Receivable [Line Items]
Percentage of accounts receivable due	1.00%
DMG
Accounts Notes And Loans Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	100.00%
Account receivable outstanding, number of months	12 months

Investments in debt and equit45

Investments in debt and equity securities (Detail) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Investment Holdings [Line Items]
Held to maturity	$ 136,158	$ 306,827
Available for sale	121,329	107,050
Total	257,487	413,877
Held to maturity, short-term investments	136,158	306,827
Available for sale, short-term investments	1,200	3,371
Total, short-term investments	137,358	310,198
Held to maturity, long-term investments	0	0
Available for sale, long-term investments	120,129	103,679
Total, long-term investments	120,129	103,679
Certificates of deposit, commercial paper and money market funds due within one year
Investment Holdings [Line Items]
Held to maturity	136,158	256,827
Available for sale, equity securities	0	0
Total	136,158	256,827
Investments in mutual funds and common stock
Investment Holdings [Line Items]
Held to maturity	0	50,000
Available for sale, equity securities	57,089	47,404
Total	57,089	97,404
Cash surrender value of life insurance policies
Investment Holdings [Line Items]
Held to maturity	0	0
Available for sale, equity securities	64,240	59,646
Total	$ 64,240	$ 59,646

Investments in debt and equit46

Investments in debt and equity securities - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Available for sale investments gross pre-tax unrealized gain (loss)	$ 8,021		$ 8,021		$ 3,701
Unrealized gains on investments	863	$ 1,121	3,478	$ 1,988
Proceeds from sale of mutual funds and debt securities			5,822
Pre tax reclassification of net investment realized gain (loss) into net income			362	233
Reclassification of net investment realized gain (loss) into net income, net tax			221	143
Proceeds from sale of investments available for sale				$ 4,645
HealthCare Partners (HCP)
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Required minimum cash balance	$ 61,557		61,557
Certificates of deposit, commercial paper and money market funds due within one year
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Other Comprehensive Income (Loss), Unrealized Holding Gain (Loss) on Securities Arising During Period, before Tax			4,682
Unrealized gains on investments			$ 3,480

Equity method and other inves47

Equity method and other investments - Additional Information (Details) - USD ($) $ in Thousands	Aug. 01, 2017	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Noncontrolling Interest [Line Items]
Equity investments in nonconsolidated businesses		$ 545,053		$ 545,053		$ 502,389
Equity investment income		$ (4,852)	$ 4,237	$ 2,697	$ 5,119
Parent Company And Restricted Subsidiaries
Noncontrolling Interest [Line Items]
Voting interest (in percent)		60.00%		60.00%
Current economic interest in DaVita Care Pte. Ltd.		73.30%		73.30%
Deconsolidated Noncontrolling Entity
Noncontrolling Interest [Line Items]
Additional aggregate capital contributions	$ 100,000
Voting interest (in percent)		40.00%		40.00%
Current economic interest in APAC JV		26.70%		26.70%

Goodwill - Changes in Goodwill

Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016	Sep. 30, 2017
Goodwill [Roll Forward]
Beginning balance			$ 9,407,317	$ 9,294,479	$ 9,294,479
Acquisitions			687,875		447,828
Divestitures			(32,343)		(44,759)
Goodwill impairment charges	$ (601,040)	$ 0	(686,355)	(253,000)	(281,415)
Foreign currency and other adjustments			39,383		(8,816)
Ending balance	9,415,877		9,415,877		9,407,317
Goodwill						$ 10,578,325
Accumulated impairment charges						(1,162,448)
Total goodwill by reportable segments	9,415,877		9,407,317	9,294,479	9,294,479	9,415,877
U.S. dialysis and related lab services
Goodwill [Roll Forward]
Beginning balance			5,691,587	5,629,183	5,629,183
Acquisitions			441,486		75,295
Divestitures			(32,260)		(12,891)
Goodwill impairment charges			0		0
Foreign currency and other adjustments			0		0
Ending balance	6,100,813		6,100,813		5,691,587
Goodwill						6,100,813
Accumulated impairment charges						0
Total goodwill by reportable segments	6,100,813		5,691,587	5,629,183	5,629,183	6,100,813
DMG
Goodwill [Roll Forward]
Beginning balance			3,391,942	3,398,264	3,398,264
Acquisitions			132,778		248,901
Divestitures			(29)		(2,223)
Goodwill impairment charges			(651,659)		(253,000)
Foreign currency and other adjustments			0		0
Ending balance	2,873,032		2,873,032		3,391,942
Goodwill						3,966,460
Accumulated impairment charges						(1,093,428)
Total goodwill by reportable segments	2,873,032		3,391,942	3,398,264	3,398,264	2,873,032
Ancillary services and strategic initiatives
Goodwill [Roll Forward]
Beginning balance			323,788	267,032	267,032
Acquisitions			113,611		123,632
Divestitures			(54)		(29,645)
Goodwill impairment charges			(34,696)		(28,415)
Foreign currency and other adjustments			39,383		(8,816)
Ending balance	442,032		442,032		323,788
Goodwill						511,052
Accumulated impairment charges						(69,020)
Total goodwill by reportable segments	$ 442,032		$ 323,788	$ 267,032	$ 267,032	$ 442,032

Goodwill - Schedule of Goodwill

Goodwill - Schedule of Goodwill Impairment Charges (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Goodwill [Line Items]
Goodwill impairment charges	$ 601,040	$ 0	$ 686,355	$ 253,000	$ 281,415
DMG
Goodwill [Line Items]
Goodwill impairment charges			651,659		$ 253,000
Vascular Access Clinic
Goodwill [Line Items]
Goodwill impairment charges	0	0	34,696	0
CALIFORNIA | DMG
Goodwill [Line Items]
Goodwill impairment charges	560,756	0	560,756	0
FLORIDA | DMG
Goodwill [Line Items]
Goodwill impairment charges	26,324	0	76,270	91,200
NEW MEXICO | DMG
Goodwill [Line Items]
Goodwill impairment charges	13,960	0	14,633	0
NEVADA | DMG
Goodwill [Line Items]
Goodwill impairment charges	$ 0	$ 0	$ 0	$ 161,800

Goodwill - Narrative (Details)

Goodwill - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016	Dec. 31, 2015
Goodwill [Line Items]
Goodwill impairment charges	$ 601,040	$ 0	$ 686,355	$ 253,000	$ 281,415
Goodwill	9,415,877		9,415,877		9,407,317	$ 9,294,479
DMG
Goodwill [Line Items]
Goodwill impairment charges			651,659		253,000
Goodwill	2,873,032		2,873,032		$ 3,391,942	$ 3,398,264
CALIFORNIA | DMG
Goodwill [Line Items]
Tax expense related to the California impairment charges	218,134
Goodwill impairment charges	560,756	$ 0	560,756	$ 0
Impact on net (loss) income	382,906
Goodwill	$ 1,888,609		$ 1,888,609

Goodwill - Schedule of Reportin

Goodwill - Schedule of Reporting Units Goodwill Balances (Details) - USD ($)	9 Months Ended
	Sep. 30, 2017	Dec. 31, 2016	Dec. 31, 2015
Goodwill [Line Items]
Goodwill	$ 9,415,877,000	$ 9,407,317,000	$ 9,294,479,000
Percentage Change In Operating Income Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment	3.00%
Percentage Change In Discount Rate Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment	1.00%
DMG
Goodwill [Line Items]
Goodwill	$ 2,873,032,000	$ 3,391,942,000	$ 3,398,264,000
DMG | CALIFORNIA
Goodwill [Line Items]
Goodwill	$ 1,888,609,000
Carrying amount coverage	0.00%
Sensitivities, operating income	(3.00%)
Sensitivities, discount rate	(5.80%)
DMG | FLORIDA
Goodwill [Line Items]
Goodwill	$ 378,071,000
Carrying amount coverage	0.00%
Sensitivities, operating income	(0.90%)
Sensitivities, discount rate	(3.30%)
DMG | NEW MEXICO
Goodwill [Line Items]
Goodwill	$ 56,293,000
Carrying amount coverage	0.00%
Sensitivities, operating income	(1.10%)
Sensitivities, discount rate	(2.10%)
DMG | WASHINGTON
Goodwill [Line Items]
Goodwill	$ 247,552,000
Carrying amount coverage	17.10%
Sensitivities, operating income	(1.70%)
Sensitivities, discount rate	(3.40%)
Vascular Access Clinic
Goodwill [Line Items]
Goodwill	$ 0

Medical payables - Components o

Medical payables - Components of Changes in Medical Payables (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2017USD ($)
Health Care Costs Payable [Roll Forward]
Healthcare costs payables, beginning of the period	$ 336,381
Less: Claims paid
Healthcare costs payables, end of the period	400,259
Healthcare Cost
Health Care Costs Payable [Roll Forward]
Healthcare costs payables, beginning of the period	214,275
Add: Components of incurred health care costs
Current year	1,509,433
Prior years	(12,597)
Acquired balance	3,218
Total incurred health care costs	1,500,054
Less: Claims paid
Current year	1,226,953
Prior years	194,285
Total claims paid	1,421,238
Healthcare costs payables, end of the period	$ 293,091

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Liability for unrecognized tax benefits	$ 27,196	$ 24,066
Increase in liability for unrecognized tax benefits	3,130
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits	$ 3,838	$ 2,595

Long-term debt (Detail)

Long-term debt (Detail) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Senior notes	$ 4,500,000	$ 4,500,000
Acquisition obligations and other notes payable	149,734	117,547
Capital lease obligations	330,446	299,682
Total debt principal outstanding	9,166,430	9,192,229
Discount and deferred financing costs	(67,905)	(79,861)
Total amount of long-term debt	9,098,525	9,112,368
Less current portion	(189,822)	(165,041)
Long-term debt	8,908,703	8,947,327
Term Loan A
Debt Instrument [Line Items]
Capped portion of interest payments	800,000	862,500
Term Loan B
Debt Instrument [Line Items]
Capped portion of interest payments	$ 3,386,250	$ 3,412,500

Long-term debt - Scheduled Matu

Long-term debt - Scheduled Maturities of Long-term Debt (Detail) $ in Thousands	Sep. 30, 2017USD ($)
Debt Disclosure [Abstract]
2017 (remainder of the year)	$ 59,481
2,018	171,825
2,019	747,908
2,020	72,346
2,021	3,305,940
2,022	1,282,115
Thereafter	$ 3,526,815

Long-term debt - Additional Inf

Long-term debt - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Debt Instrument [Line Items]
Unrealized losses on interest rate cap and swap agreements	$ (478)	$ (153)	$ (5,479)	$ (8,238)
Weighted average effective interest rate on senior secured credit facilities	4.78%		4.78%
Weighted average effective interest rate during quarter	4.77%
Fixed interest rate	53.67%		53.67%
DMG
Debt Instrument [Line Items]
Letters of credit outstanding	$ 211		$ 211
Revolving Credit Facility
Debt Instrument [Line Items]
Undrawn revolving credit facilities	1,000,000		1,000,000
Letter of Credit
Debt Instrument [Line Items]
Letters of credit outstanding	94,568		94,568
Interest Rate Cap Agreements Effective September 30, 2016
Debt Instrument [Line Items]
Notional amounts of interest rate agreements	3,500,000		$ 3,500,000
Derivative, effective date			Sep. 30, 2016
Derivative, expiration date			Jun. 30, 2018
Debt expense recognized			$ 6,208
Unrealized losses on interest rate cap and swap agreements			115
Interest Rate Cap Agreements Effective June 29, 2018
Debt Instrument [Line Items]
Notional amounts of interest rate agreements	3,500,000		$ 3,500,000
Derivative, effective date			Jun. 29, 2018
Derivative, expiration date			Jun. 30, 2020
Unrealized losses on interest rate cap and swap agreements			$ 8,852
Fair value of assets	$ 962		$ 962
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective September 30, 2016
Debt Instrument [Line Items]
LIBOR variable rate	3.50%		3.50%
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective June 29, 2018
Debt Instrument [Line Items]
LIBOR variable rate	3.50%		3.50%
Term Loan A
Debt Instrument [Line Items]
Mandatory principal payments	$ 62,500		$ 62,500
Capped portion of interest payments	800,000		$ 800,000		$ 862,500
Term Loan A | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest rate margin			2.00%
Term Loan B
Debt Instrument [Line Items]
Mandatory principal payments	26,250		$ 26,250
Capped portion of interest payments	3,386,250		$ 3,386,250		$ 3,412,500
Term Loan B | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest rate margin			2.75%
Term Loan B | London Interbank Offered Rate (LIBOR) | Maximum
Debt Instrument [Line Items]
LIBOR plus interest rate margin			3.50%
Term Loan A subject to interest rate caps
Debt Instrument [Line Items]
Capped portion of interest payments	113,750		$ 113,750
Term Loan A subject to uncapped portion of variability of LIBOR
Debt Instrument [Line Items]
Capped portion of interest payments	$ 686,250		$ 686,250
Senior Secured Credit Facilities
Debt Instrument [Line Items]
Weighted average effective interest rate on senior secured credit facilities	4.22%		4.22%

Long-term debt - Derivative Ins

Long-term debt - Derivative Instruments (Detail) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Designated as Hedging Instrument | Interest rate cap agreements | Other long-term assets
Derivative [Line Items]
Derivative assets, Fair value	$ 962	$ 9,929

Long-term debt - Effects of Int

Long-term debt - Effects of Interest Rate Swap and Cap Agreements (Detail) - Cash Flow Hedging - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Derivative Instruments Gain Loss [Line Items]
Amount of losses recognized in OCI on interest rate cap and swap agreements	$ (478)	$ (153)	$ (5,479)	$ (8,238)
Amount of losses reclassified from accumulated OCI into income	1,265	388	3,793	1,301
Tax benefit
Derivative Instruments Gain Loss [Line Items]
Amount of losses recognized in OCI on interest rate cap and swap agreements	304	102	3,488	5,251
Amount of losses reclassified from accumulated OCI into income	(805)	(246)	(2,415)	(827)
Interest rate swap agreements | Debt Expense (Including Refinancing Charges)
Derivative Instruments Gain Loss [Line Items]
Amount of losses recognized in OCI on interest rate cap and swap agreements	0	45	0	(815)
Amount of losses reclassified from accumulated OCI into income	0	25	0	299
Interest rate cap agreements | Debt Expense (Including Refinancing Charges)
Derivative Instruments Gain Loss [Line Items]
Amount of losses recognized in OCI on interest rate cap and swap agreements	(782)	(300)	(8,967)	(12,674)
Amount of losses reclassified from accumulated OCI into income	$ 2,070	$ 609	$ 6,208	$ 1,829

Contingencies - Additional Info

Contingencies - Additional Information (Detail) $ in Thousands	1 Months Ended		3 Months Ended			9 Months Ended
	Jun. 30, 2015USD ($)	Dec. 31, 2012Clinic	Sep. 30, 2017USD ($)	Mar. 31, 2017USD ($)	Sep. 30, 2016USD ($)	Sep. 30, 2017USD ($)	Sep. 30, 2016USD ($)	Dec. 31, 2016USD ($)
Other Commitments [Line Items]
Loss contingency liability			$ 51,000			$ 51,000		$ 69,000
Gain on litigation settlement			$ 0		$ 0	$ 526,827	$ 0
Dialysis and other businesses
Other Commitments [Line Items]
Number of businesses acquired | Clinic		2
US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Litigation settlement amount				$ 538,000
Gain on litigation settlement				527,000
Vainer Private Civil Suit
Other Commitments [Line Items]
Litigation settlement amount	$ 450,000
Legal fees	$ 45,000
Noncontrolling Interest | US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Gain on litigation settlement				9,000
Operating Income (Loss) | US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Gain on litigation settlement				530,000
Equity Method Investments | Noncontrolling Interest | US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Gain on litigation settlement				$ 3,000

Noncontrolling interests subj60

Noncontrolling interests subject to put provisions and other commitments - additional information (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2017USD ($)
Minimum
Other Commitments [Line Items]
Scheduled dissolution term of joint ventures	10 years
Maximum
Other Commitments [Line Items]
Scheduled dissolution term of joint ventures	50 years
Commitments to provide operating capital
Other Commitments [Line Items]
Other potential commitments to provide operating capital to several dialysis centers	$ 5,629

Long-term incentive compensat61

Long-term incentive compensation - Additional Information (Detail) - USD ($) shares in Thousands, $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Long-term incentive program (LTIP) expense	$ 59,481	$ 61,042
Stock-based compensation expense	28,478	29,817
Estimated tax benefits recorded for stock-based compensation	9,474	9,769
Unrecognized compensation cost related to outstanding LTIP awards	144,184
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans	$ 82,765
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under performance-based cash component of LTIP costs, weighted average remaining period (in years)	1 year 1 month 18 days
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under stock-based component of LTIP costs, weighted average remaining period (in years)	1 year 6 months
Tax benefits from stock award exercises	$ 6,046	$ 27,012
Stock Appreciation Rights
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock granted (in shares)	1,672
Aggregate grant-date fair value	$ 24,246
Weighted-average expected life (in years)	4 years 2 months 28 days
Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock granted (in shares)	526
Aggregate grant-date fair value	$ 34,540
Weighted-average expected life (in years)	3 years 4 months 15 days
Cash Settled Stock Based Awards
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock granted (in shares)	15
Aggregate grant-date fair value	$ 204
Weighted-average expected life (in years)	4 years 3 months 18 days

Share repurchases (Details)

Share repurchases (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	1 Months Ended	9 Months Ended
	Nov. 07, 2017	Sep. 30, 2017	Oct. 10, 2017
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)		5,557
Value of treasury stock acquired		$ 348,801
Average cost of treasury stock (usd per share)		$ 62.77
Prior shares under repurchase authorization (in shares)		247,039
Subsequent Event
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)	5,889
Value of treasury stock acquired	$ 352,873
Average cost of treasury stock (usd per share)	$ 59.92
Stock repurchase additional authorization amount			$ 1,252,961
Remaining repurchase authorized amount	$ 1,228,391

Comprehensive income (Detail)

Comprehensive income (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance			$ 4,849,741
Ending balance	$ 4,969,129		4,969,129
Interest rate cap and swap agreements
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(14,502)	$ (18,097)	(12,029)	$ (10,925)
Unrealized (losses) gains	(782)	(255)	(8,967)	(13,489)
Related income tax benefit (expense)	304	102	3,488	5,251
Unrealized (losses) gains net	(478)	(153)	(5,479)	(8,238)
Reclassification from accumulated other comprehensive income into net income	2,070	634	6,208	2,128
Related income tax (expense) benefit	(805)	(246)	(2,415)	(827)
Reclassification from accumulated other comprehensive income into net income net of tax	1,265	388	3,793	1,301
Ending balance	(13,715)	(17,862)	(13,715)	(17,862)
Investment securities
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	4,580	1,986	2,175	1,361
Unrealized (losses) gains	1,253	1,454	4,682	2,578
Related income tax benefit (expense)	(390)	(391)	(1,202)	(797)
Unrealized (losses) gains net	863	1,063	3,480	1,781
Reclassification from accumulated other comprehensive income into net income	(15)	(81)	(362)	(233)
Related income tax (expense) benefit	6	31	141	90
Reclassification from accumulated other comprehensive income into net income net of tax	(9)	(50)	(221)	(143)
Ending balance	5,434	2,999	5,434	2,999
Foreign currency translation adjustments
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(17,386)	(43,925)	(79,789)	(50,262)
Unrealized (losses) gains	29,143	(951)	91,546	5,386
Related income tax benefit (expense)	0	0	0	0
Unrealized (losses) gains net	29,143	(951)	91,546	5,386
Reclassification from accumulated other comprehensive income into net income	0	7,513	0	7,513
Related income tax (expense) benefit	0	0	0	0
Reclassification from accumulated other comprehensive income into net income net of tax	0	7,513	0	7,513
Ending balance	11,757	(37,363)	11,757	(37,363)
Accumulated other comprehensive (loss) income
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(27,308)	(60,036)	(89,643)	(59,826)
Unrealized (losses) gains	29,614	248	87,261	(5,525)
Related income tax benefit (expense)	(86)	(289)	2,286	4,454
Unrealized (losses) gains net	29,528	(41)	89,547	(1,071)
Reclassification from accumulated other comprehensive income into net income	2,055	8,066	5,846	9,408
Related income tax (expense) benefit	(799)	(215)	(2,274)	(737)
Reclassification from accumulated other comprehensive income into net income net of tax	1,256	7,851	3,572	8,671
Ending balance	$ 3,476	$ (52,226)	$ 3,476	$ (52,226)

Acquisitions and divestitures -

Acquisitions and divestitures - Additional Information (Detail) $ in Thousands	May 01, 2017USD ($)ClinicPerson	Dec. 31, 2012Clinic	Sep. 30, 2017USD ($)	Sep. 30, 2017USD ($)Clinic	Sep. 30, 2016USD ($)	Jul. 01, 2017	Jun. 30, 2017	Dec. 31, 2016USD ($)
Business Acquisition [Line Items]
Cash paid to acquire businesses				$ 726,538	$ 497,331
Amortizable intangible assets acquired, weighted-average estimated useful lives				5 years
Contingent earn-out obligations associated with acquisitions				$ 13,524
Contingent earn-out obligations			$ 8,955	8,955				$ 9,977
Other Accrued Liabilities
Business Acquisition [Line Items]
Contingent earn-out obligations			1,674	1,674
Other long-term liabilities
Business Acquisition [Line Items]
Contingent earn-out obligations			7,281	7,281
Other companies
Business Acquisition [Line Items]
Contingent earn-out obligations			8,955	$ 8,955
Minimum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins
Business Acquisition [Line Items]
Earn-out consideration payment period				1 year
Maximum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins
Business Acquisition [Line Items]
Earn-out consideration payment period				6 years
Dialysis and other businesses
Business Acquisition [Line Items]
Cash paid to acquire businesses				$ 364,975
Number of businesses acquired | Clinic		2
Goodwill deductible for tax purposes associated with acquisitions			227,762	227,762
Deferred purchase price obligations				13,290
Contingent earn-out obligations associated with acquisitions				19,411
Purchase gains				17,233
Renal Ventures
Business Acquisition [Line Items]
Voting interest (in percent)	100.00%
Cash paid to acquire businesses	$ 361,563
Number of dialysis patients | Person	2,600
Number of states	6
Proceeds received from divestiture	$ 21,219
Transaction and integration costs			9,400	9,400
Goodwill deductible for tax purposes associated with acquisitions			$ 298,358	$ 298,358
Magan
Business Acquisition [Line Items]
Voting interest (in percent)						100.00%
Noncompete Agreements | Renal Ventures
Business Acquisition [Line Items]
Amortizable intangible assets acquired, weighted-average estimated useful lives			5 years
U.S. dialysis and related lab services | Dialysis and other businesses
Business Acquisition [Line Items]
Number of businesses acquired | Clinic				21
Foreign Dialysis Centers | Dialysis and other businesses
Business Acquisition [Line Items]
Number of businesses acquired | Clinic				63
Other Medical Businesses | Dialysis and other businesses
Business Acquisition [Line Items]
Number of businesses acquired | Clinic				8
Operating Dialysis Center | Dialysis and other businesses
Business Acquisition [Line Items]
Number of businesses divested of | Clinic	3
Operating Dialysis Center | Renal Ventures
Business Acquisition [Line Items]
Number of businesses acquired | Clinic	36
Number of businesses divested of | Clinic	3
New Center Under Construction | Dialysis and other businesses
Business Acquisition [Line Items]
Number of businesses divested of | Clinic	1
New Center Under Construction | Renal Ventures
Business Acquisition [Line Items]
Number of businesses acquired | Clinic	1
Home Dialysis Clinic | Renal Ventures
Business Acquisition [Line Items]
Number of businesses acquired | Clinic	1
Magan
Business Acquisition [Line Items]
Previous noncontrolling interest percentage							50.00%

Acquisitions and divestitures65

Acquisitions and divestitures - Aggregate Purchase Cost Allocations for Acquisitions (Detail) - USD ($) $ in Thousands	Sep. 30, 2017	May 01, 2017	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Goodwill	$ 9,415,877		$ 9,407,317	$ 9,294,479
Renal Ventures
Business Acquisition [Line Items]
Current assets		$ 24,525
Property and equipment		36,295
Amortizable intangible and other long-term assets		11,547
Goodwill		298,358
Current liabilities		(8,684)
Long-term liabilities		(478)
Aggregate purchase price		$ 361,563
Dialysis and other businesses
Business Acquisition [Line Items]
Current assets	11,548
Property and equipment	28,384
Amortizable intangible and other long-term assets	18,403
Non-amortizable intangibles	31,983
Goodwill	389,517
Current liabilities	(20,628)
Long-term liabilities	(8,223)
Noncontrolling interests	(36,075)
Aggregate purchase price	$ 414,909

Acquisitions and divestitures66

Acquisitions and divestitures - Pro Forma Summary of Results of Opeation (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Business Combinations [Abstract]
Pro forma net revenues	$ 3,925,402	$ 3,844,174	$ 11,638,894	$ 11,467,643
Pro forma net (loss) income attributable to DaVita Inc.	$ (214,156)	$ 572,873	$ 360,679	$ 728,759
Pro forma basic net (loss) income per share attributable to DaVita Inc.	$ (1.13)	$ 2.81	$ 1.89	$ 3.57
Pro forma diluted net (loss) income per share attributable to DaVita Inc.	$ (1.13)	$ 2.77	$ 1.86	$ 3.51

Acquisitions and divestitures67

Acquisitions and divestitures - Reconciliation of Changes in Contingent Earn-Out Obligations (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2017USD ($)
Contingent Earn-Out Obligations [Roll Forward]
Beginning balance, January 1, 2017	$ 9,977
Contingent earn-out obligations associated with acquisitions	4,110
Remeasurement of fair value for contingent earn-out obligations	(1,072)
Payments on contingent earn-out obligations	(4,060)
Ending balance	$ 8,955

Variable interest entities - Ad

Variable interest entities - Additional Information (Detail) $ in Thousands	Sep. 30, 2017USD ($)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Total assets of variable interest entities	$ 840,164
Total liabilities of variable interest entities	$ 436,994

Fair value of financial instr69

Fair value of financial instruments - Assets, Liabilities and Temporary Equity Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Assets
Investments in mutual funds and common stock	$ 121,329	$ 107,050
Liabilities
Contingent earn-out obligations	8,955	$ 9,977
Fair Value, Measurements, Recurring
Assets
Investments in mutual funds and common stock	57,089
Cash surrender value of life insurance policies	64,240
Funds on deposit with third parties	76,456
Liabilities
Contingent earn-out obligations	8,955
Temporary equity
Noncontrolling interests subject to put provisions	1,026,890
Fair Value, Measurements, Recurring | Interest rate cap agreements
Assets
Interest rate cap agreements	962
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1)
Assets
Investments in mutual funds and common stock	57,089
Cash surrender value of life insurance policies	0
Funds on deposit with third parties	76,456
Liabilities
Contingent earn-out obligations	0
Temporary equity
Noncontrolling interests subject to put provisions	0
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1) | Interest rate cap agreements
Assets
Interest rate cap agreements	0
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2)
Assets
Investments in mutual funds and common stock	0
Cash surrender value of life insurance policies	64,240
Funds on deposit with third parties	0
Liabilities
Contingent earn-out obligations	0
Temporary equity
Noncontrolling interests subject to put provisions	0
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2) | Interest rate cap agreements
Assets
Interest rate cap agreements	962
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3)
Assets
Investments in mutual funds and common stock	0
Cash surrender value of life insurance policies	0
Funds on deposit with third parties	0
Liabilities
Contingent earn-out obligations	8,955
Temporary equity
Noncontrolling interests subject to put provisions	1,026,890
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | Interest rate cap agreements
Assets
Interest rate cap agreements	$ 0

Fair Value of financial instr70

Fair Value of financial instruments - Additional Information (Detail) $ in Thousands	Sep. 30, 2017USD ($)
Estimate of Fair Value Measurement | Senior Secured Credit Facilities
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Long-term debt value	$ 4,217,710
Estimate of Fair Value Measurement | Senior Notes
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Long-term debt value	4,519,525
Reported Value Measurement | Senior Secured Credit Facilities
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Long-term debt value	4,159,799
Reported Value Measurement | Senior Notes
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Long-term debt value	$ 4,458,549

Segment reporting - Additional

Segment reporting - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2017Segment
Segment Reporting [Abstract]
Number of operating segments	2

Segment reporting - Summary of

Segment reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes (Detail) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Segment Reporting Information [Line Items]
Patient services revenues	$ 2,746,257,000	$ 2,643,194,000	$ 8,030,102,000	$ 7,708,641,000
Less: Provision for uncollectible accounts	(123,760,000)	(115,555,000)	(352,228,000)	(336,188,000)
Net dialysis and related lab services patient service revenues	2,622,497,000	2,527,639,000	7,677,874,000	7,372,453,000
Other revenues	283,969,000	330,399,000	863,238,000	996,378,000
Capitated revenues	1,016,365,000	872,538,000	2,956,479,000	2,660,532,000
Total net revenues	3,922,831,000	3,730,576,000	11,497,591,000	11,029,363,000
Operating income (loss)	(192,523,000)	819,156,000	1,074,029,000	1,513,115,000
Corporate administrative support	(10,965,000)	(28,028,000)	(32,587,000)	(40,366,000)
Debt expense	(109,623,000)	(104,581,000)	(322,014,000)	(310,359,000)
Other income, net	4,370,000	1,876,000	13,866,000	8,067,000
(Loss) income before income taxes	(297,776,000)	716,451,000	765,881,000	1,210,823,000
Operating Segments
Segment Reporting Information [Line Items]
Total net revenues	3,962,985,000	3,763,333,000	11,614,261,000	11,117,560,000
Operating income (loss)	(181,558,000)	847,184,000	1,106,616,000	1,553,481,000
Operating Segments | U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Patient services revenues	2,483,644,000	2,428,858,000	7,285,962,000	7,123,873,000
Less: Provision for uncollectible accounts	(117,973,000)	(109,299,000)	(334,078,000)	(320,565,000)
Net dialysis and related lab services patient service revenues	2,365,671,000	2,319,559,000	6,951,884,000	6,803,308,000
Other revenues	4,803,000	3,912,000	14,998,000	12,134,000
Total net revenues	2,370,474,000	2,323,471,000	6,966,882,000	6,815,442,000
Operating income (loss)	442,777,000	452,187,000	1,837,989,000	1,341,432,000
Operating Segments | U.S. dialysis and related lab services | External Sources
Segment Reporting Information [Line Items]
Patient services revenues	2,457,302,000	2,412,818,000	7,209,424,000	7,079,054,000
Operating Segments | U.S. dialysis and related lab services | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Patient services revenues	26,342,000	16,040,000	76,538,000	44,819,000
Operating Segments | DMG
Segment Reporting Information [Line Items]
Net dialysis and related lab services patient service revenues	187,678,000	166,622,000	556,179,000	448,222,000
Other revenues	15,170,000	15,195,000	52,509,000	41,766,000
Capitated revenues	975,526,000	846,245,000	2,852,631,000	2,586,383,000
Total net revenues	1,178,443,000	1,028,137,000	3,461,493,000	3,076,560,000
Operating income (loss)	(587,817,000)	33,094,000	(588,389,000)	(126,110,000)
Operating Segments | DMG | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Other revenues	69,000	75,000	174,000	189,000
Operating Segments | Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Net dialysis and related lab services patient service revenues	95,490,000	57,498,000	246,349,000	165,742,000
Other revenues	263,996,000	311,292,000	795,731,000	942,478,000
Capitated revenues	40,839,000	26,293,000	103,848,000	74,149,000
Total net revenues	414,068,000	411,725,000	1,185,886,000	1,225,558,000
Operating income (loss)	(36,518,000)	361,903,000	(142,984,000)	338,159,000
Operating Segments | Ancillary services and strategic initiatives | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Total net segment revenues	13,743,000	16,642,000	39,958,000	43,189,000
Intersegment Elimination
Segment Reporting Information [Line Items]
Total net revenues	$ (40,154,000)	(32,757,000)	$ (116,670,000)	$ (88,197,000)
DMG
Segment Reporting Information [Line Items]
Corporate administrative support		$ (27,040,000)

Segment reporting - Summary o73

Segment reporting - Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 203,283	$ 181,739	$ 593,527	$ 531,475
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Depreciation and amortization	132,112	122,540	387,142	358,427
DMG
Segment Reporting Information [Line Items]
Depreciation and amortization	60,649	52,595	177,983	153,068
Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 10,522	$ 6,604	$ 28,402	$ 19,980

Segment reporting - Summary o74

Segment reporting - Summary of Assets by Segment (Detail) - USD ($) $ in Thousands	Sep. 30, 2017	Feb. 25, 2017	Dec. 31, 2016
ASSETS
Total assets	$ 19,013,339		$ 18,741,257
U.S. dialysis and related lab services
ASSETS
Total assets	11,649,092	$ 338,963	11,099,137
DMG
ASSETS
Total assets	5,788,387		6,213,091
Ancillary services and strategic initiatives
ASSETS
Total assets	$ 1,575,860		$ 1,429,029

Segment reporting - Summary o75

Segment reporting - Summary of Assets by Segment (Phantom) (Detail) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Segment Reporting Information [Line Items]
Equity method and other investments	$ 545,053	$ 502,389
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Equity method and other investments	87,549	66,924
DMG
Segment Reporting Information [Line Items]
Equity method and other investments	9,155	10,350
Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Equity method and other investments	$ 448,349	$ 425,115

Segment reporting - Summary o76

Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 240,889	$ 216,616	$ 639,829	$ 575,243
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	205,266	182,741	531,027	467,121
DMG
Segment Reporting Information [Line Items]
Expenditures for property and equipment	24,282	17,396	72,953	55,639
Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 11,341	$ 16,479	$ 35,849	$ 52,483

Changes in DaVita Inc.'s owne77

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries - Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Net (loss) income attributable to DaVita Inc.	$ (214,476)	$ 571,332	$ 360,222	$ 722,148
Net transfers to noncontrolling interests	0	(604)	195	(5,135)
Net (loss) income attributable to DaVita Inc., net of transfers to noncontrolling interests	(214,476)	570,728	360,417	717,013
Additional paid-in capital
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Purchases of noncontrolling interests	$ 0	$ (604)	$ 195	$ (5,135)

Condensed consolidating finan78

Condensed consolidating financial statements - Condensed Consolidating Statements of Operations (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Condensed Income Statements Captions [Line Items]
Patient services revenues	$ 2,746,257	$ 2,643,194	$ 8,030,102	$ 7,708,641
Less: Provision for uncollectible accounts	(123,760)	(115,555)	(352,228)	(336,188)
Net patient service revenues	2,622,497	2,527,639	7,677,874	7,372,453
Capitated revenues	1,016,365	872,538	2,956,479	2,660,532
Other revenues	283,969	330,399	863,238	996,378
Total net revenues	3,922,831	3,730,576	11,497,591	11,029,363
Operating expenses and charges	4,115,354	2,911,420	10,423,562	9,516,248
Operating (loss) income	(192,523)	819,156	1,074,029	1,513,115
Debt expense	(109,623)	(104,581)	(322,014)	(310,359)
Other income, net	4,370	1,876	13,866	8,067
Income tax expense (benefit)	(125,742)	104,301	276,005	366,011
Equity (loss) earnings in subsidiaries	0	0	0	0
Net (loss) income	(172,034)	612,150	489,876	844,812
Less: Net income attributable to noncontrolling interests	(42,442)	(40,818)	(129,654)	(122,664)
Net (loss) income attributable to DaVita Inc.	(214,476)	571,332	360,222	722,148
Consolidating adjustments
Condensed Income Statements Captions [Line Items]
Patient services revenues	(62,065)	(42,891)	(167,374)	(123,100)
Less: Provision for uncollectible accounts	6,089	0	6,089	0
Net patient service revenues	(55,976)	(42,891)	(161,285)	(123,100)
Capitated revenues	(982)	(39)	(3,248)	(250)
Other revenues	(426,537)	(400,687)	(1,311,669)	(1,183,282)
Total net revenues	(483,495)	(443,617)	(1,476,202)	(1,306,632)
Operating expenses and charges	(483,495)	(443,617)	(1,476,202)	(1,306,632)
Operating (loss) income	0	0	0	0
Debt expense	108,241	103,432	317,079	308,800
Other income, net	(108,241)	(103,432)	(317,079)	(308,800)
Income tax expense (benefit)	0	0	0	0
Equity (loss) earnings in subsidiaries	160,969	(840,027)	(563,330)	(1,155,137)
Net (loss) income	160,969	(840,027)	(563,330)	(1,155,137)
Less: Net income attributable to noncontrolling interests	(42,442)	(40,818)	(129,654)	(122,664)
Net (loss) income attributable to DaVita Inc.	118,527	(880,845)	(692,984)	(1,277,801)
DaVita Inc. | Reportable Legal Entities
Condensed Income Statements Captions [Line Items]
Patient services revenues	0	0	0	0
Less: Provision for uncollectible accounts	0	0	0	0
Net patient service revenues	0	0	0	0
Capitated revenues	0	0	0	0
Other revenues	189,275	191,815	604,246	575,700
Total net revenues	189,275	191,815	604,246	575,700
Operating expenses and charges	128,488	143,784	398,502	400,129
Operating (loss) income	60,787	48,031	205,744	175,571
Debt expense	(108,453)	(101,895)	(317,276)	(305,097)
Other income, net	104,250	99,446	306,886	296,660
Income tax expense (benefit)	27,624	(20,898)	84,686	56,190
Equity (loss) earnings in subsidiaries	(243,436)	504,852	249,554	611,204
Net (loss) income	(214,476)	571,332	360,222	722,148
Less: Net income attributable to noncontrolling interests	0	0	0	0
Net (loss) income attributable to DaVita Inc.	(214,476)	571,332	360,222	722,148
Guarantor subsidiaries | Reportable Legal Entities
Condensed Income Statements Captions [Line Items]
Patient services revenues	1,732,287	1,726,892	4,966,892	5,044,565
Less: Provision for uncollectible accounts	(82,860)	(73,833)	(219,554)	(207,144)
Net patient service revenues	1,649,427	1,653,059	4,747,338	4,837,421
Capitated revenues	461,866	465,684	1,393,345	1,397,378
Other revenues	468,948	506,619	1,448,484	1,512,039
Total net revenues	2,580,241	2,625,362	7,589,167	7,746,838
Operating expenses and charges	2,964,867	2,388,114	7,241,745	7,275,863
Operating (loss) income	(384,626)	237,248	347,422	470,975
Debt expense	(93,243)	(91,716)	(276,990)	(275,148)
Other income, net	1,774	2,659	7,502	12,416
Income tax expense (benefit)	(150,192)	(21,486)	142,156	140,972
Equity (loss) earnings in subsidiaries	82,467	335,175	313,776	543,933
Net (loss) income	(243,436)	504,852	249,554	611,204
Less: Net income attributable to noncontrolling interests	0	0	0	0
Net (loss) income attributable to DaVita Inc.	(243,436)	504,852	249,554	611,204
Non- Guarantor subsidiaries | Reportable Legal Entities
Condensed Income Statements Captions [Line Items]
Patient services revenues	1,076,035	959,193	3,230,584	2,787,176
Less: Provision for uncollectible accounts	(46,989)	(41,722)	(138,763)	(129,044)
Net patient service revenues	1,029,046	917,471	3,091,821	2,658,132
Capitated revenues	555,481	406,893	1,566,382	1,263,404
Other revenues	52,283	32,652	122,177	91,921
Total net revenues	1,636,810	1,357,016	4,780,380	4,013,457
Operating expenses and charges	1,505,494	823,139	4,259,517	3,146,888
Operating (loss) income	131,316	533,877	520,863	866,569
Debt expense	(16,168)	(14,402)	(44,827)	(38,914)
Other income, net	6,587	3,203	16,557	7,791
Income tax expense (benefit)	(3,174)	146,685	49,163	168,849
Equity (loss) earnings in subsidiaries	0	0	0	0
Net (loss) income	124,909	375,993	443,430	666,597
Less: Net income attributable to noncontrolling interests	0	0	0	0
Net (loss) income attributable to DaVita Inc.	$ 124,909	$ 375,993	$ 443,430	$ 666,597

Condensed consolidating finan79

Condensed consolidating financial statements - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Condensed Financial Statements Captions [Line Items]
Net income	$ (172,034)	$ 612,150	$ 489,876	$ 844,812
Other comprehensive income	30,784	7,868	93,117	7,807
Total comprehensive (loss) income	(141,250)	620,018	582,993	852,619
Less: Comprehensive income attributable to noncontrolling interests	(42,442)	(40,876)	(129,652)	(122,871)
Comprehensive (loss) income attributable to DaVita Inc.	(183,692)	579,142	453,341	729,748
Consolidating adjustments
Condensed Financial Statements Captions [Line Items]
Net income	160,969	(840,027)	(563,330)	(1,155,137)
Other comprehensive income	0	0	0	0
Total comprehensive (loss) income	160,969	(840,027)	(563,330)	(1,155,137)
Less: Comprehensive income attributable to noncontrolling interests	(42,442)	(40,876)	(129,652)	(122,871)
Comprehensive (loss) income attributable to DaVita Inc.	118,527	(880,903)	(692,982)	(1,278,008)
DaVita Inc. | Reportable Legal Entities
Condensed Financial Statements Captions [Line Items]
Net income	(214,476)	571,332	360,222	722,148
Other comprehensive income	1,641	1,248	1,571	(5,299)
Total comprehensive (loss) income	(212,835)	572,580	361,793	716,849
Less: Comprehensive income attributable to noncontrolling interests	0	0	0	0
Comprehensive (loss) income attributable to DaVita Inc.	(212,835)	572,580	361,793	716,849
Guarantor subsidiaries | Reportable Legal Entities
Condensed Financial Statements Captions [Line Items]
Net income	(243,436)	504,852	249,554	611,204
Other comprehensive income	0	0	0	0
Total comprehensive (loss) income	(243,436)	504,852	249,554	611,204
Less: Comprehensive income attributable to noncontrolling interests	0	0	0	0
Comprehensive (loss) income attributable to DaVita Inc.	(243,436)	504,852	249,554	611,204
Non- Guarantor subsidiaries | Reportable Legal Entities
Condensed Financial Statements Captions [Line Items]
Net income	124,909	375,993	443,430	666,597
Other comprehensive income	29,143	6,620	91,546	13,106
Total comprehensive (loss) income	154,052	382,613	534,976	679,703
Less: Comprehensive income attributable to noncontrolling interests	0	0	0	0
Comprehensive (loss) income attributable to DaVita Inc.	$ 154,052	$ 382,613	$ 534,976	$ 679,703

Condensed consolidating finan80

Condensed consolidating financial statements - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016	Sep. 30, 2016	Dec. 31, 2015
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	$ 846,110	$ 913,187	$ 913,496	$ 1,499,116
Accounts receivable, net	2,091,074	1,917,302
Other current assets	1,096,365	1,149,739
Total current assets	4,033,549	3,980,228
Property and equipment, net	3,386,056	3,175,367
Intangible assets, net	1,451,033	1,527,767
Investments in subsidiaries	0	0
Intercompany receivables	0	0
Other long-term assets and investments	726,824	650,578
Goodwill	9,415,877	9,407,317		9,294,479
Total assets	19,013,339	18,741,257
Current liabilities	2,874,793	2,696,445
Intercompany payables	0	0
Long-term debt and other long-term liabilities	10,142,527	10,221,813
Noncontrolling interests subject to put provisions	1,026,890	973,258
Total DaVita Inc. shareholder's equity	4,784,581	4,648,047
Noncontrolling interests not subject to put provisions	184,548	201,694
Total equity	4,969,129	4,849,741
Total liabilities and equity	19,013,339	18,741,257
Consolidating adjustments
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	0	0	0	0
Accounts receivable, net	0	0
Other current assets	0	0
Total current assets	0	0
Property and equipment, net	0	0
Intangible assets, net	0	0
Investments in subsidiaries	(12,855,807)	(11,720,388)
Intercompany receivables	(4,252,235)	(4,117,647)
Other long-term assets and investments	0	0
Goodwill	0	0
Total assets	(17,108,042)	(15,838,035)
Current liabilities	0	0
Intercompany payables	(4,252,235)	(4,117,647)
Long-term debt and other long-term liabilities	0	0
Noncontrolling interests subject to put provisions	423,427	365,657
Total DaVita Inc. shareholder's equity	(12,855,807)	(11,720,388)
Noncontrolling interests not subject to put provisions	(423,427)	(365,657)
Total equity	(13,279,234)	(12,086,045)
Total liabilities and equity	(17,108,042)	(15,838,035)
DaVita Inc. | Reportable Legal Entities
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	447,627	549,921	623,901	1,186,636
Accounts receivable, net	0	0
Other current assets	178,901	277,911
Total current assets	626,528	827,832
Property and equipment, net	368,233	337,200
Intangible assets, net	289	487
Investments in subsidiaries	10,116,956	9,717,728
Intercompany receivables	3,079,514	3,250,692
Other long-term assets and investments	46,028	39,994
Goodwill	0	0
Total assets	14,237,548	14,173,933
Current liabilities	283,770	303,840
Intercompany payables	0	0
Long-term debt and other long-term liabilities	8,565,734	8,614,445
Noncontrolling interests subject to put provisions	603,463	607,601
Total DaVita Inc. shareholder's equity	4,784,581	4,648,047
Noncontrolling interests not subject to put provisions	0	0
Total equity	4,784,581	4,648,047
Total liabilities and equity	14,237,548	14,173,933
Guarantor subsidiaries | Reportable Legal Entities
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	14,768	59,192	35,769	109,357
Accounts receivable, net	1,325,029	1,215,232
Other current assets	804,580	736,727
Total current assets	2,144,377	2,011,151
Property and equipment, net	1,752,690	1,689,798
Intangible assets, net	1,370,085	1,491,057
Investments in subsidiaries	2,738,851	2,002,660
Intercompany receivables	0	0
Other long-term assets and investments	99,584	86,710
Goodwill	7,248,275	7,838,984
Total assets	15,353,862	15,120,360
Current liabilities	1,907,482	1,865,193
Intercompany payables	2,231,303	2,322,124
Long-term debt and other long-term liabilities	1,098,121	1,215,315
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholder's equity	10,116,956	9,717,728
Noncontrolling interests not subject to put provisions	0	0
Total equity	10,116,956	9,717,728
Total liabilities and equity	15,353,862	15,120,360
Non- Guarantor subsidiaries | Reportable Legal Entities
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	383,715	304,074	$ 253,826	$ 203,123
Accounts receivable, net	766,045	702,070
Other current assets	112,884	135,101
Total current assets	1,262,644	1,141,245
Property and equipment, net	1,265,133	1,148,369
Intangible assets, net	80,659	36,223
Investments in subsidiaries	0	0
Intercompany receivables	1,172,721	866,955
Other long-term assets and investments	581,212	523,874
Goodwill	2,167,602	1,568,333
Total assets	6,529,971	5,284,999
Current liabilities	683,541	527,412
Intercompany payables	2,020,932	1,795,523
Long-term debt and other long-term liabilities	478,672	392,053
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholder's equity	2,738,851	2,002,660
Noncontrolling interests not subject to put provisions	607,975	567,351
Total equity	3,346,826	2,570,011
Total liabilities and equity	$ 6,529,971	$ 5,284,999

Condensed consolidating finan81

Condensed consolidating financial statements - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Cash flows from operating activities:
Net (loss) income	$ (172,034)	$ 612,150	$ 489,876	$ 844,812
Changes in operating assets and liabilities and non-cash items included in net income			1,074,663	636,450
Net cash provided by operating activities			1,564,539	1,481,262
Cash flows from investing activities:
Additions of property and equipment	(240,889)	(216,616)	(639,829)	(575,243)
Acquisitions			(726,538)	(497,331)
Proceeds from asset and business sales			92,529	18,991
Proceeds (purchases) from investment sales and other items, net			166,605	(203,659)
Net cash used in investing activities			(1,107,233)	(1,257,242)
Cash flows from financing activities:
Long-term debt and related financing costs, net			(108,463)	(98,724)
Intercompany borrowing (payments)			0	0
Other items			(421,369)	(709,252)
Net cash used in financing activities			(529,832)	(807,976)
Effect of exchange rate changes on cash			5,449	(1,664)
Net decrease in cash and cash equivalents			(67,077)	(585,620)
Cash and cash equivalents at beginning of period			913,187	1,499,116
Cash and cash equivalents at end of period	846,110	913,496	846,110	913,496
Consolidating adjustments
Cash flows from operating activities:
Net (loss) income	160,969	(840,027)	(563,330)	(1,155,137)
Changes in operating assets and liabilities and non-cash items included in net income			563,330	1,155,137
Net cash provided by operating activities			0	0
Cash flows from investing activities:
Additions of property and equipment			0	0
Acquisitions			0	0
Proceeds from asset and business sales			0	0
Proceeds (purchases) from investment sales and other items, net			0	0
Net cash used in investing activities			0	0
Cash flows from financing activities:
Long-term debt and related financing costs, net			0	0
Intercompany borrowing (payments)			0	0
Other items			0	0
Net cash used in financing activities			0	0
Effect of exchange rate changes on cash			0	0
Net decrease in cash and cash equivalents			0	0
Cash and cash equivalents at beginning of period			0	0
Cash and cash equivalents at end of period	0	0	0	0
DaVita Inc. | Reportable Legal Entities
Cash flows from operating activities:
Net (loss) income	(214,476)	571,332	360,222	722,148
Changes in operating assets and liabilities and non-cash items included in net income			(291,657)	(586,804)
Net cash provided by operating activities			68,565	135,344
Cash flows from investing activities:
Additions of property and equipment			(94,385)	(81,785)
Acquisitions			0
Proceeds from asset and business sales			0	0
Proceeds (purchases) from investment sales and other items, net			123,894	(236,150)
Net cash used in investing activities			29,509	(317,935)
Cash flows from financing activities:
Long-term debt and related financing costs, net			(92,721)	(73,889)
Intercompany borrowing (payments)			197,983	283,709
Other items			(305,630)	(589,964)
Net cash used in financing activities			(200,368)	(380,144)
Effect of exchange rate changes on cash			0	0
Net decrease in cash and cash equivalents			(102,294)	(562,735)
Cash and cash equivalents at beginning of period			549,921	1,186,636
Cash and cash equivalents at end of period	447,627	623,901	447,627	623,901
Guarantor subsidiaries | Reportable Legal Entities
Cash flows from operating activities:
Net (loss) income	(243,436)	504,852	249,554	611,204
Changes in operating assets and liabilities and non-cash items included in net income			606,783	228,991
Net cash provided by operating activities			856,337	840,195
Cash flows from investing activities:
Additions of property and equipment			(305,261)	(248,339)
Acquisitions			(627,324)	(458,556)
Proceeds from asset and business sales			90,533	24,608
Proceeds (purchases) from investment sales and other items, net			(6,472)	(12,825)
Net cash used in investing activities			(848,524)	(695,112)
Cash flows from financing activities:
Long-term debt and related financing costs, net			(10,394)	(20,684)
Intercompany borrowing (payments)			(40,411)	(188,247)
Other items			(1,432)	(9,740)
Net cash used in financing activities			(52,237)	(218,671)
Effect of exchange rate changes on cash			0	0
Net decrease in cash and cash equivalents			(44,424)	(73,588)
Cash and cash equivalents at beginning of period			59,192	109,357
Cash and cash equivalents at end of period	14,768	35,769	14,768	35,769
Non- Guarantor subsidiaries | Reportable Legal Entities
Cash flows from operating activities:
Net (loss) income	124,909	375,993	443,430	666,597
Changes in operating assets and liabilities and non-cash items included in net income			196,207	(160,874)
Net cash provided by operating activities			639,637	505,723
Cash flows from investing activities:
Additions of property and equipment			(240,183)	(245,119)
Acquisitions			(99,214)	(38,775)
Proceeds from asset and business sales			1,996	(5,617)
Proceeds (purchases) from investment sales and other items, net			49,183	45,316
Net cash used in investing activities			(288,218)	(244,195)
Cash flows from financing activities:
Long-term debt and related financing costs, net			(5,348)	(4,151)
Intercompany borrowing (payments)			(157,572)	(95,462)
Other items			(114,307)	(109,548)
Net cash used in financing activities			(277,227)	(209,161)
Effect of exchange rate changes on cash			5,449	(1,664)
Net decrease in cash and cash equivalents			79,641	50,703
Cash and cash equivalents at beginning of period			304,074	203,123
Cash and cash equivalents at end of period	$ 383,715	$ 253,826	$ 383,715	$ 253,826

Supplemental Data - Condensed C

Supplemental Data - Condensed Consolidating Statements of Income (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Condensed Income Statements Captions [Line Items]
Patient service operating revenues	$ 2,746,257	$ 2,643,194	$ 8,030,102	$ 7,708,641
Less: Provision for uncollectible accounts	(123,760)	(115,555)	(352,228)	(336,188)
Net patient service revenues	2,622,497	2,527,639	7,677,874	7,372,453
Capitated revenues	1,016,365	872,538	2,956,479	2,660,532
Other revenues	283,969	330,399	863,238	996,378
Total net revenues	3,922,831	3,730,576	11,497,591	11,029,363
Operating expenses	4,115,354	2,911,420	10,423,562	9,516,248
Operating (loss) income	(192,523)	819,156	1,074,029	1,513,115
Debt expense, including refinancing charges			(322,014)
Other income	4,370	1,876	13,866	8,067
Income tax (benefit) expense	(125,742)	104,301	276,005	366,011
Net (loss) income	(172,034)	612,150	489,876	844,812
Less: Net income attributable to noncontrolling interests	(42,442)	(40,818)	(129,654)	(122,664)
Net (loss) income attributable to DaVita Inc.	$ (214,476)	$ 571,332	360,222	$ 722,148
Physician Groups
Condensed Income Statements Captions [Line Items]
Patient service operating revenues			414,784
Less: Provision for uncollectible accounts			(11,010)
Net patient service revenues			403,774
Capitated revenues			1,186,185
Other revenues			33,688
Total net revenues			1,623,647
Operating expenses			1,572,064
Operating (loss) income			51,583
Debt expense, including refinancing charges			(6,458)
Other income			478
Income tax (benefit) expense			38,059
Net (loss) income			7,544
Less: Net income attributable to noncontrolling interests			0
Net (loss) income attributable to DaVita Inc.			7,544
Unrestricted Subsidiaries
Condensed Income Statements Captions [Line Items]
Patient service operating revenues			0
Less: Provision for uncollectible accounts			0
Net patient service revenues			0
Capitated revenues			0
Other revenues			0
Total net revenues			0
Operating expenses			(147)
Operating (loss) income			147
Debt expense, including refinancing charges			0
Other income			0
Income tax (benefit) expense			59
Net (loss) income			88
Less: Net income attributable to noncontrolling interests			0
Net (loss) income attributable to DaVita Inc.			88
Company and Restricted Subsidiaries
Condensed Income Statements Captions [Line Items]
Patient service operating revenues			7,615,318
Less: Provision for uncollectible accounts			(341,218)
Net patient service revenues			7,274,100
Capitated revenues			1,770,294
Other revenues			829,550
Total net revenues			9,873,944
Operating expenses			8,851,645
Operating (loss) income			1,022,299
Debt expense, including refinancing charges			(315,556)
Other income			13,388
Income tax (benefit) expense			237,887
Net (loss) income			482,244
Less: Net income attributable to noncontrolling interests			(129,654)
Net (loss) income attributable to DaVita Inc.			$ 352,590

Supplemental Data - Condensed83

Supplemental Data - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Condensed Financial Statements Captions [Line Items]
Net (loss) income	$ (172,034)	$ 612,150	$ 489,876	$ 844,812
Other comprehensive income	30,784	7,868	93,117	7,807
Total comprehensive (loss) income	(141,250)	620,018	582,993	852,619
Less: Comprehensive income attributable to noncontrolling interests	(42,442)	(40,876)	(129,652)	(122,871)
Comprehensive (loss) income attributable to DaVita Inc.	$ (183,692)	$ 579,142	453,341	$ 729,748
Physician Groups
Condensed Financial Statements Captions [Line Items]
Net (loss) income			7,544
Other comprehensive income			0
Total comprehensive (loss) income			7,544
Less: Comprehensive income attributable to noncontrolling interests			0
Comprehensive (loss) income attributable to DaVita Inc.			7,544
Unrestricted Subsidiaries
Condensed Financial Statements Captions [Line Items]
Net (loss) income			88
Other comprehensive income			0
Total comprehensive (loss) income			88
Less: Comprehensive income attributable to noncontrolling interests			0
Comprehensive (loss) income attributable to DaVita Inc.			88
Company and Restricted Subsidiaries
Condensed Financial Statements Captions [Line Items]
Net (loss) income			482,244
Other comprehensive income			93,117
Total comprehensive (loss) income			575,361
Less: Comprehensive income attributable to noncontrolling interests			(129,652)
Comprehensive (loss) income attributable to DaVita Inc.			$ 445,709

Supplemental Data - Condensed84

Supplemental Data - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016	Sep. 30, 2016	Dec. 31, 2015
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	$ 846,110	$ 913,187	$ 913,496	$ 1,499,116
Accounts receivable, net	2,091,074	1,917,302
Other current assets	1,096,365	1,149,739
Total current assets	4,033,549	3,980,228
Property and equipment, net	3,386,056	3,175,367
Intangible assets, net	1,451,033	1,527,767
Other long-term assets	726,824	650,578
Goodwill	9,415,877	9,407,317		$ 9,294,479
Total assets	19,013,339	18,741,257
Current liabilities	2,874,793	2,696,445
Payables to parent	0
Long-term debt and other long-term liabilities	10,142,527	10,221,813
Noncontrolling interests subject to put provisions	1,026,890	973,258
Total DaVita Inc. shareholders’ equity	4,784,581	4,648,047
Noncontrolling interests not subject to put provisions	184,548	201,694
Total equity	4,969,129	4,849,741
Total liabilities and equity	19,013,339	18,741,257
Physician Groups
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	162,536	104,691
Accounts receivable, net	174,944
Other current assets	17,722
Total current assets	355,202
Property and equipment, net	3,334
Intangible assets, net	4,313
Other long-term assets	81,877
Goodwill	30,993
Total assets	475,719
Current liabilities	202,386
Payables to parent	97,434
Long-term debt and other long-term liabilities	63,272
Noncontrolling interests subject to put provisions	0
Total DaVita Inc. shareholders’ equity	112,627
Noncontrolling interests not subject to put provisions	0
Total equity	112,627
Total liabilities and equity	475,719
Unrestricted Subsidiaries
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	0
Accounts receivable, net	0
Other current assets	0
Total current assets	0
Property and equipment, net	0
Intangible assets, net	0
Other long-term assets	2,861
Goodwill	0
Total assets	2,861
Current liabilities	0
Payables to parent	2,861
Long-term debt and other long-term liabilities	0
Noncontrolling interests subject to put provisions	0
Total DaVita Inc. shareholders’ equity	0
Noncontrolling interests not subject to put provisions	0
Total equity	0
Total liabilities and equity	2,861
Parent Company And Restricted Subsidiaries
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	683,574	$ 808,496
Accounts receivable, net	1,916,130
Other current assets	1,078,643
Total current assets	3,678,347
Property and equipment, net	3,382,722
Intangible assets, net	1,446,720
Other long-term assets	642,086
Goodwill	9,384,884
Total assets	18,534,759
Current liabilities	2,672,407
Payables to parent	(100,295)
Long-term debt and other long-term liabilities	10,079,255
Noncontrolling interests subject to put provisions	1,026,890
Total DaVita Inc. shareholders’ equity	4,671,954
Noncontrolling interests not subject to put provisions	184,548
Total equity	4,856,502
Total liabilities and equity	$ 18,534,759

Supplemental Data - Condensed85

Supplemental Data - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Cash flows from operating activities:
Net (loss) income	$ (172,034)	$ 612,150	$ 489,876	$ 844,812
Changes in operating and intercompany assets and liabilities and non-cash items included in net income			1,074,663	636,450
Net cash provided by operating activities			1,564,539	1,481,262
Cash flows from investing activities:
Additions of property and equipment	(240,889)	(216,616)	(639,829)	(575,243)
Acquisitions			(726,538)
Proceeds from asset and business sales			92,529	18,991
Investments and other items			166,605	(203,659)
Net cash used in investing activities			(1,107,233)	(1,257,242)
Cash flows from financing activities:
Long-term debt			(108,463)	(98,724)
Intercompany			0	0
Other items			(421,369)	(709,252)
Net cash used in financing activities			(529,832)	(807,976)
Effect of exchange rate changes on cash and cash equivalents			5,449	(1,664)
Net decrease in cash and cash equivalents			(67,077)	(585,620)
Cash and cash equivalents at beginning of period			913,187	1,499,116
Cash and cash equivalents at end of period	846,110	$ 913,496	846,110	$ 913,496
Physician Groups
Cash flows from operating activities:
Net (loss) income			7,544
Changes in operating and intercompany assets and liabilities and non-cash items included in net income			29,753
Net cash provided by operating activities			37,297
Cash flows from investing activities:
Additions of property and equipment			(5,903)
Acquisitions			0
Proceeds from asset and business sales			0
Investments and other items			(2,378)
Net cash used in investing activities			(8,281)
Cash flows from financing activities:
Long-term debt			0
Intercompany			28,829
Other items			0
Net cash used in financing activities			28,829
Effect of exchange rate changes on cash and cash equivalents			0
Net decrease in cash and cash equivalents			57,845
Cash and cash equivalents at beginning of period			104,691
Cash and cash equivalents at end of period	162,536		162,536
Unrestricted Subsidiaries
Cash flows from operating activities:
Net (loss) income			88
Changes in operating and intercompany assets and liabilities and non-cash items included in net income			(88)
Net cash provided by operating activities			0
Cash flows from investing activities:
Additions of property and equipment			0
Acquisitions			0
Proceeds from asset and business sales			0
Investments and other items			0
Net cash used in investing activities			0
Cash flows from financing activities:
Long-term debt			0
Intercompany			0
Other items			0
Net cash used in financing activities			0
Effect of exchange rate changes on cash and cash equivalents			0
Net decrease in cash and cash equivalents			0
Cash and cash equivalents at end of period	0		0
Company and Restricted Subsidiaries
Cash flows from operating activities:
Net (loss) income			482,244
Changes in operating and intercompany assets and liabilities and non-cash items included in net income			1,044,998
Net cash provided by operating activities			1,527,242
Cash flows from investing activities:
Additions of property and equipment			(633,926)
Acquisitions			(726,538)
Proceeds from asset and business sales			92,529
Investments and other items			168,983
Net cash used in investing activities			(1,098,952)
Cash flows from financing activities:
Long-term debt			(108,463)
Intercompany			(28,829)
Other items			(421,369)
Net cash used in financing activities			(558,661)
Effect of exchange rate changes on cash and cash equivalents			5,449
Net decrease in cash and cash equivalents			(124,922)
Cash and cash equivalents at beginning of period			808,496
Cash and cash equivalents at end of period	$ 683,574		$ 683,574