DaVita (DVA) 10-K 23 Feb 18 2017 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) shares in Millions, $ in Billions	12 Months Ended
	Dec. 31, 2017	Jan. 31, 2018	Jun. 30, 2017
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	FY
Trading Symbol	DVA
Entity Registrant Name	DAVITA INC.
Entity Central Index Key	927,066
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filer	No
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		182
Entity Public Float			$ 12.4

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Statement [Abstract]
Dialysis and related lab patient service revenues	$ 10,093,670	$ 9,727,360	$ 9,155,447
Less: Provision for uncollectible accounts	(485,398)	(431,308)	(412,905)
Net dialysis and related lab patient service revenues	9,608,272	9,296,052	8,742,542
Other revenues	1,268,362	1,411,415	1,239,703
Total net revenues	10,876,634	10,707,467	9,982,245
Operating expenses and charges:
Patient care costs and other costs	7,640,005	7,431,582	6,856,062
General and administrative	1,064,026	1,072,841	1,031,125
Depreciation and amortization	559,911	509,497	463,905
Provision for uncollectible accounts	(7,033)	11,677	9,240
Equity investment loss (income)	8,640	(16,874)	(13,919)
Investment and other asset impairments	295,234	14,993	0
Goodwill impairment charges	36,196	28,415	4,066
Gain on changes in ownership interests	(6,273)	(374,374)	0
(Gain) loss on settlements, net	(526,827)	0	495,000
Total operating expenses and charges	9,063,879	8,677,757	8,845,479
Operating income	1,812,755	2,029,710	1,136,766
Debt expense	(430,634)	(414,116)	(408,380)
Debt redemption charges	0	0	(48,072)
Other income, net	17,665	7,511	8,073
Income from continuing operations before income taxes	1,399,786	1,623,105	688,387
Income tax expense	323,859	431,761	207,510
Net income from continuing operations	1,075,927	1,191,344	480,877
Net loss from discontinued operations, net of tax	(245,372)	(158,262)	(53,467)
Net income	830,555	1,033,082	427,410
Less: Net income attributable to noncontrolling interests	(166,937)	(153,208)	(157,678)
Net income attributable to DaVita Inc.	$ 663,618	$ 879,874	$ 269,732
Earnings per share:
Basic net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	$ 4.78	$ 5.12	$ 1.53
Basic net income per share attributable to DaVita Inc. (in usd per share)	3.52	4.36	1.27
Diluted net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	4.71	5.04	1.49
Diluted net income per share attributable to DaVita Inc. (in usd per share)	$ 3.47	$ 4.29	$ 1.25
Weighted average shares for earnings per share:
Basic (in shares)	188,625,559	201,641,173	211,867,714
Diluted (in shares)	191,348,533	204,904,656	216,251,807
Amounts attributable to DaVita Inc.:
Net income from continuing operations	$ 901,277	$ 1,032,373	$ 323,199
Net loss from discontinued operations	(237,659)	(152,499)	(53,467)
Net income attributable to DaVita Inc.	$ 663,618	$ 879,874	$ 269,732

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Statement of Comprehensive Income [Abstract]
Net income	$ 830,555	$ 1,033,082	$ 427,410
Unrealized losses on interest rate cap and swap agreements:
Unrealized losses on interest rate cap and swap agreements	(5,437)	(3,670)	(12,241)
Reclassifications of net cap and swap agreements realized losses into net income	5,058	2,566	3,111
Unrealized gains (losses) on investments:
Unrealized gains (losses) on investments	3,705	1,427	(1,413)
Reclassification of net investment realized losses (gains) into net income	(220)	(423)	(377)
Foreign currency translation adjustments:
Foreign currency translation adjustments	99,770	(39,614)	(23,889)
Reclassification of foreign currency translation into net income	0	10,087	0
Other comprehensive income (loss)	102,876	(29,627)	(34,809)
Total comprehensive income	933,431	1,003,455	392,601
Less: Comprehensive income attributable to noncontrolling interests	(166,935)	(153,398)	(157,678)
Comprehensive income attributable to DaVita Inc.	$ 766,496	$ 850,057	$ 234,923

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
ASSETS
Cash and cash equivalents	$ 508,234	$ 674,776
Short-term investments	43,516	306,981
Accounts receivable, less allowance of $218,399 and $238,897	1,714,750	1,503,950
Inventories	181,799	160,419
Other receivables	372,919	288,156
Income tax receivable	49,440	0
Prepaid and other current assets	112,058	99,510
Current assets held for sale	5,761,642	960,956
Total current assets	8,744,358	3,994,748
Property and equipment, net	3,149,213	2,864,121
Intangible assets, net	113,827	73,504
Equity method and other investments	245,534	492,039
Long-term investments	37,695	29,997
Other long-term assets	47,287	33,857
Goodwill	6,610,279	6,015,375
Long-term assets held for sale	0	5,252,135
Total assets	18,948,193	18,755,776
LIABILITIES AND EQUITY
Accounts payable	509,116	456,619
Other liabilities	552,662	578,892
Accrued compensation and benefits	616,116	706,564
Current portion of long-term debt	178,213	160,262
Income tax payable	0	1,394
Current liabilities held for sale	1,185,070	807,233
Total current liabilities	3,041,177	2,710,964
Long-term debt	9,158,018	8,944,676
Other long-term liabilities	365,325	317,383
Deferred income taxes	486,247	530,869
Long-term liabilities held for sale	0	428,885
Total liabilities	13,050,767	12,932,777
Commitments and contingencies
Noncontrolling interests subject to put provisions	1,011,360	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; 182,462,278 and 194,554,491 shares issued and outstanding, respectively)	182	195
Additional paid-in capital	1,042,899	1,027,182
Retained earnings	3,633,713	3,710,313
Accumulated other comprehensive income (loss)	13,235	(89,643)
Total DaVita Inc. shareholders' equity	4,690,029	4,648,047
Noncontrolling interests not subject to put provisions	196,037	201,694
Total equity	4,886,066	4,849,741
Total liabilities and shareholders' equity	$ 18,948,193	$ 18,755,776

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 218,399	$ 238,897
Preferred stock, par value (in 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 (in 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)	182,462,278	194,554,491
Common stock, shares outstanding (in shares)	182,462,278	194,554,491

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Cash flows from operating activities:
Net income	$ 830,555	$ 1,033,082	$ 427,410
Adjustments to reconcile net income to net cash provided by operating activities:
(Gain) loss on settlements, net	(526,827)	0	495,000
Depreciation and amortization	777,485	720,252	638,024
Impairment charges	981,589	296,408	210,234
Debt redemption charges	0	0	48,072
Stock-based compensation expense	35,092	38,338	56,664
Deferred income taxes	(395,217)	52,010	61,744
Equity investment income, net	28,925	17,766	9,293
Gain on sales of business interests, net	(23,402)	(404,165)	0
Other non-cash charges, net	66,925	(7,338)	44,691
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:
Accounts receivable	(156,305)	(152,240)	(202,867)
Inventories	(18,625)	22,920	(48,313)
Other receivables and other current assets	(117,154)	(54,038)	32,761
Other long-term assets	(11,945)	35,893	3,723
Accounts payable	26,876	11,897	30,998
Accrued compensation and benefits	(78,239)	68,272	54,950
Other current liabilities	1,908	176,494	113,470
Settlement receipts (payments)	526,827	0	(493,775)
Income taxes	(52,176)	77,376	41,767
Other long-term liabilities	11,157	30,517	33,354
Net cash provided by operating activities	1,907,449	1,963,444	1,557,200
Cash flows from investing activities:
Additions of property and equipment	(905,250)	(829,095)	(707,998)
Acquisitions	(803,879)	(563,856)	(96,469)
Proceeds from asset and business sales	92,336	64,725	19,715
Purchase of investments available for sale	(13,117)	(13,539)	(8,783)
Purchase of investments held-to-maturity	(230,989)	(1,133,192)	(1,709,883)
Proceeds from sale of investments available for sale	6,408	18,963	2,058
Proceeds from investments held-to-maturity	492,470	1,240,502	1,637,358
Purchase of equity investments	(4,816)	(27,096)	(17,911)
Proceeds from sale of equity investments	0	40,920	0
Distributions received on equity investments	106	0	129
Net cash used in investing activities	(1,366,731)	(1,201,668)	(881,784)
Cash flows from financing activities:
Borrowings	50,991,960	51,991,490	54,541,988
Payments on long-term debt and other financing costs	(50,837,112)	(52,116,120)	(53,998,962)
Purchase of treasury stock	(802,949)	(1,097,822)	(549,935)
Distributions to noncontrolling interests	(211,467)	(192,401)	(174,635)
Stock award exercises and other share issuances, net	21,252	23,543	26,155
Excess tax benefits from stock award exercises	0	13,251	28,157
Contributions from noncontrolling interests	74,552	47,590	54,644
Proceeds from sales of additional noncontrolling interests	2,864	0	0
Purchases of noncontrolling interests	(5,357)	(21,512)	(66,382)
Net cash used in financing activities	(766,257)	(1,351,981)	(138,970)
Effect of exchange rate changes on cash and cash equivalents	254	4,276	(2,571)
Net (decrease) increase in cash and cash equivalents	(225,285)	(585,929)	533,875
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	(58,743)	(15,788)	25,855
Net (decrease) increase in cash and cash equivalents from continuing operations	(166,542)	(570,141)	508,020
Cash and cash equivalents of continuing operations at beginning of the year	674,776	1,244,917	736,897
Cash and cash equivalents of continuing operations at end of the year	$ 508,234	$ 674,776	$ 1,244,917

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY - USD ($)	Total	Non-controlling interests subject to put provisions	Common stock	Common stockRestricted Stock Units (RSUs)	Common stockStock appreciation rights	Additional paid-in capital	Additional paid-in capitalRestricted Stock Units (RSUs)	Additional paid-in capitalStock appreciation rights	Retained earnings	Treasury stock	Treasury stockRestricted Stock Units (RSUs)	Treasury stockStock appreciation rights	Accumulated other comprehensive income (loss)	Total	TotalRestricted Stock Units (RSUs)	Non-controlling interests not subject to put provisions
Temporary equity, beginning balance at Dec. 31, 2014		$ 829,965,000
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income		96,510,000
Distributions		(103,355,000)
Contributions		25,795,000
Acquisitions and divestitures		10,654,000
Partial purchases		(8,538,000)
Fair value remeasurement		13,035,000
Temporary equity, ending balance at Dec. 31, 2015		864,066,000
Beginning balance (in shares) at Dec. 31, 2014			215,641,000							0
Beginning balance at Dec. 31, 2014			$ 216,000			$ 1,108,211,000			$ 4,087,103,000	$ 0			$ (25,017,000)	$ 5,170,513,000		$ 189,798,000
Comprehensive income:
Net income									269,732,000					269,732,000		61,168,000
Other comprehensive income	$ (34,809,000)												(34,809,000)	(34,809,000)
Stock purchase shares issued (in shares)										414,000
Stock purchase shares issued						(6,079,000)				$ 30,608,000				24,529,000
Stock-settled share based payment awards, shares issued (in shares)				348,000	1,131,000
Stock-settled share based payment awards					$ 1,000			$ (1,000)
Stock-settled stock-based compensation expense						56,899,000								56,899,000
Excess tax benefits from stock awards exercised						28,157,000								28,157,000
Distributions																(71,280,000)
Contributions																28,849,000
Acquisitions and divestitures, noncontrolling interest																6,875,000
Partial purchases						(55,826,000)								(55,826,000)		(2,018,000)
Fair value remeasurements						(13,035,000)								(13,035,000)
Purchase of treasury stock (in shares)										(7,780,000)
Purchase of treasury stock	(575,380,000)									$ (575,380,000)
Ending balance at Dec. 31, 2015			$ 217,000			1,118,326,000			4,356,835,000	$ (544,772,000)			(59,826,000)	4,870,780,000		213,392,000
Ending balance (in shares) at Dec. 31, 2015			217,120,000							(7,366,000)
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income		99,834,000
Distributions		(111,092,000)
Contributions		33,517,000
Acquisitions and divestitures		28,874,000
Partial purchases		(6,660,000)
Fair value remeasurement		65,855,000
Reclassifications of Temporary to Permanent Equity		(1,136,000)														1,136,000
Temporary equity, ending balance at Dec. 31, 2016		973,258,000
Comprehensive income:
Net income									879,874,000					879,874,000		53,374,000
Other comprehensive income	$ (29,627,000)												(29,817,000)	(29,817,000)		190,000
Stock purchase shares issued (in shares)			438,000
Stock purchase shares issued			$ 1,000			23,902,000								23,903,000
Stock-settled share based payment awards, shares issued (in shares)				4,000	218,000						276,000	513,000
Stock-settled share based payment awards							$ (19,815,000)	$ (36,685,000)			$ 19,815,000	$ 36,685,000
Stock-settled stock-based compensation expense						37,970,000								37,970,000
Excess tax benefits from stock awards exercised						13,251,000								13,251,000
Distributions																(81,309,000)
Contributions																14,073,000
Acquisitions and divestitures						3,423,000								3,423,000
Acquisitions and divestitures, noncontrolling interest																2,585,000
Partial purchases						(13,105,000)								(13,105,000)		(1,747,000)
Fair value remeasurements						(65,855,000)								(65,855,000)
Reclassifications and expirations of puts		1,136,000														(1,136,000)
Purchase of treasury stock (in shares)	(16,649,090)									(16,649,000)
Purchase of treasury stock	$ (1,072,377,000)									$ (1,072,377,000)				(1,072,377,000)
Retirement of treasury stock (in shares)			(23,226,000)							23,226,000
Retirement of treasury stock			$ (23,000)			(34,230,000)			(1,526,396,000)	$ 1,560,649,000
Ending balance at Dec. 31, 2016	$ 4,849,741,000		$ 195,000			1,027,182,000			3,710,313,000	$ 0			(89,643,000)	4,648,047,000		201,694,000
Ending balance (in shares) at Dec. 31, 2016	194,554,491		194,554,000							0
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income		103,641,000
Distributions		(128,853,000)
Contributions		52,911,000
Acquisitions and divestitures		43,799,000
Partial purchases		(397,000)
Fair value remeasurement		(32,999,000)
Temporary equity, ending balance at Dec. 31, 2017		$ 1,011,360,000
Comprehensive income:
Net income									663,618,000					663,618,000		63,296,000
Other comprehensive income	$ 102,876,000												102,878,000	102,878,000		(2,000)
Stock purchase shares issued (in shares)			360,000
Stock purchase shares issued						22,131,000								22,131,000
Stock-settled share based payment awards, shares issued (in shares)				117,000	398,000
Stock-settled share based payment awards							$ (101,000)								$ (101,000)
Stock-settled stock-based compensation expense						34,981,000								34,981,000
Distributions																(82,614,000)
Contributions																21,641,000
Acquisitions and divestitures						823,000								823,000
Acquisitions and divestitures, noncontrolling interest																5,770,000
Partial purchases						(2,752,000)								(2,752,000)		(2,208,000)
Fair value remeasurements						32,999,000								32,999,000
Purchase of treasury stock (in shares)	(12,966,672)									(12,967,000)
Purchase of treasury stock	$ (810,949,000)									$ (810,949,000)				(810,949,000)
Retirement of treasury stock (in shares)			(12,967,000)							12,967,000
Retirement of treasury stock			$ (13,000)			(70,718,000)			(740,218,000)	$ 810,949,000
Ending balance at Dec. 31, 2017	$ 4,886,066,000		$ 182,000			$ 1,042,899,000			$ 3,633,713,000	$ 0			$ 13,235,000	$ 4,690,029,000		$ 196,037,000
Ending balance (in shares) at Dec. 31, 2017	182,462,278		182,462,000							0

Organization and Summary of Sig

Organization and Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2017
Accounting Policies [Abstract]
Organization and Summary of Significant Accounting Policies	Organization and summary of significant accounting policies Organization DaVita Inc. (the Company) has consisted of two major divisions, DaVita Kidney Care (Kidney Care) and DaVita Medical Group (DMG). The Kidney Care division is comprised of the Company’s U.S. dialysis and related lab services, its ancillary services and strategic initiatives, including its international operations, and its corporate administrative support. The Company’s largest line of business is its U.S. dialysis and related lab services business, which operates kidney dialysis centers in the U.S. for patients suffering from chronic kidney failure also known as end stage renal disease (ESRD). As of December 31, 2017, the Company operated or provided administrative services through a network of 2,510 U.S. outpatient dialysis centers in 46 states and the District of Columbia, serving a total of approximately 197,800 patients. In addition, as of December 31, 2017 , the Company operated or provided administrative services to a total of 237 outpatient dialysis centers serving approximately 22,900 patients located in 11 countries outside of the U.S. The Company’s DMG division is a patient- and physician-focused integrated healthcare delivery and management company that provides medical services to members primarily through capitation contracts with some of the nation’s leading health plans. On December 5, 2017, the Company entered into an equity purchase agreement to sell its DMG division to Collaborative Care Holdings, LLC (Optum), a subsidiary of UnitedHealth Group Inc. The transaction is expected to close in 2018 and is subject to regulatory approval and other customary closing conditions. As a result of this pending transaction, the DMG business has been reclassified as held for sale and its results of operations are reported as discontinued operations for all periods presented in these consolidated financial statements. For financial information about the DMG business, see Note 21. The Company’s U.S. dialysis and related lab services business qualifies as a separately reportable segment and the Company’s other ancillary services and strategic initiatives, including its international operations, have been combined and disclosed in the other segments category. Basis of presentation These consolidated financial statements are prepared in accordance with United States generally accepted accounting principles (U.S. GAAP). The financial statements include DaVita Inc. and its subsidiaries, partnerships and other entities in which it maintains a majority voting interest or other controlling financial interest (collectively, the Company). All significant intercompany transactions and balances have been eliminated. Non-marketable equity investments are recorded under the equity or cost method of accounting based upon whether the Company has significant influence over the investee. For the Company’s international subsidiaries, local currencies are considered their functional currencies. Translation adjustments result from translating the Company’s international subsidiaries’ financial statements from their functional currencies into the Company’s reporting currency (USD). 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 consolidated financial statements were issued and has included all necessary adjustments and disclosures. Use of estimates The preparation of financial statements in conformity with U.S. GAAP requires the use of estimates and assumptions that affect the reported amounts of revenues, expenses, assets, liabilities, contingencies and noncontrolling interests subject to put provisions. Although actual results in subsequent periods will differ from these estimates, such estimates are developed based on the best information available to management and management’s best judgments at the time. All significant assumptions and estimates underlying the amounts reported in the financial statements and accompanying notes are regularly reviewed and updated when necessary. Changes in estimates are reflected in the financial statements based upon on-going actual experience trends, or subsequent settlements and realizations depending on the nature and predictability of the estimates and contingencies. Interim changes in estimates related to annual operating costs are applied prospectively within annual periods. The most significant assumptions and estimates underlying these financial statements and accompanying notes involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and investments, accounting for income taxes, long-term variable compensation accruals, consolidation of variable interest entities, and certain fair value estimates. Specific estimating risks and contingencies are further addressed within these notes to the consolidated financial statements. Patient service net revenues and accounts receivable U.S. dialysis and related lab services U.S. dialysis patient service net revenues are recognized in the period services are provided. Revenues consist primarily of payments from Medicare, Medicaid and commercial health plans for dialysis and ancillary services provided to patients. A usual and customary fee schedule is maintained for the Company’s dialysis treatments and other patient services; however, actual collectible revenue is normally recognized at a discount from the fee schedule. Revenues associated with Medicare and Medicaid programs are recognized based on: (a) the payment rates that are established by statute or regulation for the portion of payment rates paid by the government payor (e.g., 80% for Medicare patients) and (b) for the portion not paid by the primary government payor, estimates of the amounts ultimately collectible from other government programs paying secondary coverage (e.g., Medicaid secondary coverage), the patient’s commercial health plan secondary coverage, or the patient. The Company’s reimbursements from Medicare are subject to certain variations under Medicare’s single bundled payment rate system, whereby reimbursements can be adjusted for certain patient characteristics and other factors. The Company’s revenue recognition will depend upon its ability to effectively capture, document and bill for Medicare’s base payment rate as well as these other variable factors. Revenues associated with commercial health plans are estimated based on contractual terms for the patients under healthcare plans with which the Company has formal agreements, non-contracted health plan coverage terms if known, estimated secondary collections, historical collection experience, historical trends of refunds and payor payment adjustments (retractions), inefficiencies in the Company’s billing and collection processes that can result in denied claims for payments, and regulatory compliance matters. Commercial revenue recognition also involves significant estimating risks. With many larger, commercial insurers the Company has several different contracts and payment arrangements, and these contracts often include only a subset of the Company’s centers. It is often not possible to determine which contract, if any, should be applied prior to billing. In addition, for services provided by non-contracted centers, final collection may require specific negotiation of a payment amount, typically at a significant discount from the Company’s usual and customary rates. Under Medicare’s bundled payment rate system, services covered by Medicare are subject to estimating risk, whereby reimbursements from Medicare can vary significantly depending upon certain patient characteristics and other variable factors. Even with the bundled payment rate system, Medicare payments for bad debt claims as established by cost reports require evidence of collection efforts. As a result, billing and collection of Medicare bad debt claims can be delayed significantly and final payment is subject to audit. Medicaid payments, when Medicaid coverage is secondary, can also be difficult to estimate. For many states, Medicaid payment terms and methods differ from Medicare, and may prevent accurate estimation of individual payment amounts prior to billing. The Company’s range of revenue estimating risk for the U.S. dialysis and related lab services segment is generally expected to be within 1% of its revenue. Changes in revenue estimates for prior periods are not material. Other revenues Other revenues consist of the revenues associated with the ancillary services and strategic initiatives, management and administrative support services that are provided to outpatient dialysis centers that the Company does not own or in which the Company owns a noncontrolling interest, and administrative and management support services to certain other non-dialysis joint ventures in which the Company owns a noncontrolling interest. Revenues associated with pharmacy services are recognized as prescriptions are filled and shipped to patients. Revenues associated with disease management services, medical consulting services, clinical research programs, physician services, ESRD seamless care organizations, and comprehensive care are recognized in the period services are provided. Revenues associated with direct primary care are recognized over the membership period. Management fees are principally determined as a percentage of the managed operations’ revenues or cash collections and in some cases an additional component based upon a percentage of operating income. Management fees are included in net revenues when earned. Allowance for uncollectible accounts Net revenue recognition and allowances for uncollectible billings require the use of estimates of the amounts that will ultimately be realized considering, among other items, retroactive adjustments that may be associated with regulatory reviews, audits, billing reviews and other matters. The Company’s policy is to write off any uncollectible accounts receivable balance only after all collection efforts have been exhausted or when write off is mandated by federal or state policies or required by certain payor contracts. It is also the Company’s policy to write off any accounts receivable balance associated with any payors or patients when the Company receives notification of a bankruptcy filing. Other income Other income includes interest income on cash and cash-equivalents and short- and long-term investments, other non-operating gains from investment transactions, and foreign currency transaction gains and losses. Cash and cash equivalents Cash equivalents are short-term highly liquid investments with maturities of three months or less at date of purchase. 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 strategies 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. Inventories Inventories are stated at the lower of cost (first-in, first-out) or market and consist principally of pharmaceuticals and dialysis-related supplies. Rebates related to inventory purchases are recorded when earned and are based on certain qualification requirements which are dependent on a variety of factors including future pricing levels by the manufacturer and data submission. Property and equipment Property and equipment is stated at cost less accumulated depreciation and amortization and is further reduced by any impairments. Maintenance and repairs are charged to expense as incurred. Depreciation and amortization expenses are computed using the straight-line method over the useful lives of the assets estimated as follows: buildings, 20 to 40 years; leasehold improvements, the shorter of their economic useful life or the expected lease term; and equipment and information systems, principally three to eight years. Disposition gains and losses are included in current operating expenses. Amortizable intangibles Amortizable intangible assets and liabilities include non-competition and similar agreements, lease agreements and hospital acute services contracts, each of which have finite useful lives. Amortization expense is computed using the straight-line method over the useful lives of the assets estimated as follows: non-competition and similar agreements, two to ten years; and lease agreements and hospital acute service contracts, over the term of the lease or contract period, respectively. Indefinite-lived intangibles Indefinite-lived intangible assets include international licenses and accreditations that allow the Company to be reimbursed for providing dialysis services to patients, each of which has an indefinite useful life. 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, net of any other-than-temporary impairment. The Company classifies its cost and equity method investments as “Equity method and other investments” on its balance sheet. See Note 9 to these consolidated financial statements for further details. Goodwill Goodwill represents the difference between the fair value of businesses acquired and the fair value of the identifiable tangible and intangible net assets acquired. Goodwill is not amortized, but is assessed by individual reporting unit for impairment as circumstances warrant and at least annually. An impairment charge is recorded when a reporting unit's carrying amount is determined to exceed its fair value. The Company operates multiple reporting units. See Note 10 to these consolidated financial statements for further details. Impairment of equity method and other investments Equity method and other investments are assessed for other-than-temporary impairment when significant events or changes in circumstances indicate that an other-than-temporary impairment may have occurred. An other-than-temporary impairment charge is recorded when the fair value of an investment has fallen below its carrying amount and the shortfall is expected to be indefinitely or permanently unrecoverable. Impairment of other long-lived assets Other long-lived assets, including property and equipment and intangible assets, are reviewed for possible impairment whenever significant events or changes in circumstances indicate that an impairment may have occurred. Such changes can include changes in the Company’s business strategy and plans, changes in the quality or structure of its relationships with its partners or deteriorating performance of individual outpatient dialysis centers or other business units. An impairment of an amortizable or depreciable asset is indicated when the sum of the expected future undiscounted net cash flows identifiable to the related asset group is less than its carrying amount. Impairment losses are measured based on the difference between the estimated fair value and the carrying amount of the subject asset group and are included in operating expenses. Indefinite-lived intangible assets are reviewed for possible impairment at least annually and whenever significant events or changes in circumstances indicate that an impairment may have occurred. Self-insurance The Company is predominantly self-insured with respect to professional and general liability and workers' compensation risks through wholly-owned captive insurance companies, with excess or reinsurance coverage for additional risk. The Company is also predominantly self-insured with respect to employee medical and other health benefits. The Company records insurance liabilities for the professional and general liability, workers’ compensation, and employee health benefit risks that it retains and estimates its liability for those risks using third party actuarial calculations that are based upon historical claims experience and expectations for future claims. Income taxes Federal and state income taxes are computed at currently enacted tax rates less tax credits using the asset and liability method. Deferred taxes are adjusted both for items that do not currently have tax consequences and for the cumulative effect of any changes in tax rates from those previously used to determine deferred tax assets or liabilities. Tax provisions include amounts that are currently payable, changes in deferred tax assets and liabilities that arise because of temporary differences between the timing of when items of income and expense are recognized for financial reporting and income tax purposes, changes in the recognition of tax positions and any changes in the valuation allowance caused by a change in judgment about the realizability of the related deferred tax assets. A valuation allowance is established when necessary to reduce deferred tax assets to amounts expected to be realized. The Company uses a recognition threshold of more-likely-than-not and a measurement attribute on all tax positions taken or expected to be taken in a tax return in order to be recognized in the financial statements. Once the recognition threshold is met, the tax position is then measured to determine the actual amount of benefit to recognize in the financial statements. Stock-based 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. Stock-based compensation to be settled in shares is recorded to the Company’s shareholders’ equity, while stock-based compensation to be settled in cash is recorded to a liability. Interest rate cap and swap agreements The Company often carries a combination of currently effective interest rate caps, forward interest rate caps, or interest rate swaps on portions of its variable rate debt as a means of hedging its exposure to changes in LIBOR interest rates as part of its overall interest rate risk management strategy. These interest rate caps and swaps are not held for trading or speculative purposes and are typically designated as qualifying cash flow hedges. See Note 13 to these consolidated financial statements for further details. Noncontrolling interests Noncontrolling interests represent third-party equity ownership interests in entities which are consolidated by the Company for financial statement reporting purposes. As of December 31, 2017 , third parties held noncontrolling equity interests in 589 consolidated legal entities, including 586 legal entities classified as continuing operations. Fair value estimates The Company relies on fair value measurements and estimates for purposes that require the recording, reassessment, or adjustment of the carrying amounts of certain assets, liabilities and noncontrolling interests subject to put provisions (temporary equity). These purposes can include the accounting for business combination transactions, impairment assessments for goodwill, investments, or other long-lived assets, and stock-based compensation, as well as recurring valuations of available for sale securities, noncontrolling interests in temporary equity, derivative instruments, and/or contingent consideration, as applicable. The Company has also classified its assets, liabilities and temporary equity into the appropriate fair value hierarchy levels as defined by the Financial Accounting Standards Board (FASB). See Note 24 to these consolidated financial statements for further details. New accounting standards On May 28, 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 2015 and 2016, the FASB issued ASU 2015-14, ASU2016-08, 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. These ASUs will replace most existing revenue recognition guidance in U.S. GAAP. The Company will adopt these ASUs beginning January 1, 2018 using the cumulative effect method and will apply these ASUs only to those contracts that are not completed contracts as of that date with no cumulative effect adjustment. In preparation for the adoption of these ASUs, the Company has concluded that this guidance will result in a change to the presentation of its revenues, provision for uncollectible accounts and allowance for doubtful accounts, which will result in the Company’s provision for uncollectible accounts being recorded as a reduction to revenue. The guidance will also require additional disaggregated revenue disclosures. The guidance will not have a material impact on the Company’s consolidated financial position, results of operations, equity or cash flows. The Company expects to benefit from certain policy elections related to its adoption of these standards of approximately $30,000 in the first half of 2018. 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 Company is still evaluating certain aspects of this ASU as well as the related impacts it may have on its 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 were applied prospectively. The adoption of this ASU did not have a material impact on the Company’s 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 flow, 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 income 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 rather than as a financing activity on the consolidated statements of cash flow. 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 expense to be recognized each period. While this new standard may cause volatility in the Company’s effective tax rates and diluted earnings per share due to tax effects of stock awards being recorded within the Company’s consolidated statements of operations, adoption of this standard did not have a material impact on the Company's consolidated financial statements for the year ended December 31, 2017. 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 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 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 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 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, 2019 and are to be applied prospectively. 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 2018, the FASB issued ASU No. 2018-2, Income Statement - Reporting Comprehensive Income (Topic 220), Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income , which allows for the reclassification of certain income tax effects related to the Tax Cuts and Jobs Act between “Accumulated other comprehensive income” and “Retained earnings.” This ASU relates to the requirement that adjustments to deferred tax liabilities and assets related to a change in tax laws or rates to be included in “Income from continuing operations”, even in situations where the related items were originally recognized in “Other comprehensive income” (rather than in “Income from continuing operations”). The amendments in this ASU are effective for all entities for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. Adoption of this ASU is to be applied either in the period of adoption or retrospectively to each period in which the effect of the change in the tax laws or rates were recognized. The Company is still evaluating certain aspects of this ASU as well as the related impacts it may have on the Company's consolidated financial statements.

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2017
Earnings Per Share [Abstract]
Earnings Per Share	Earnings per share Basic earnings per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interest 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 that under certain circumstances may be returned to the Company. Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights (SSARs) and unvested stock units (under the treasury stock method) as well as shares held in escrow that the Company expects will remain outstanding. The reconciliations of the numerators and denominators used to calculate basic and diluted net income per share are as follows: Year ended December 31, 2017 2016 2015 (shares in thousands) Numerators: Net income from continuing operations attributable to DaVita Inc. $ 901,277 $ 1,032,373 $ 323,199 Net loss from discontinued operations attributable to DaVita Inc. (237,659 ) (152,499 ) (53,467 ) Net income attributable to DaVita Inc. for basic earnings per share $ 663,618 $ 879,874 $ 269,732 Basic: Weighted average shares outstanding during the period 190,820 203,835 214,062 Contingently returnable shares held in escrow for the DaVita (2,194 ) (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 188,626 201,641 211,868 Basic net income from continuing operations per share attributable to $ 4.78 $ 5.12 $ 1.53 Basic net loss from discontinued operations per share attributable to (1.26 ) (0.76 ) (0.26 ) Basic net income per share attributable to DaVita Inc. $ 3.52 $ 4.36 $ 1.27 Diluted: Weighted average shares outstanding during the period 190,820 203,835 214,062 Assumed incremental shares from stock plans 529 1,070 2,190 Weighted average shares for diluted earnings per share calculation 191,349 204,905 216,252 Diluted net income from continuing operations per share attributable to $ 4.71 $ 5.04 $ 1.49 Diluted net loss from discontinued operations per share attributable to DaVita Inc. (1.24 ) (0.75 ) (0.24 ) Diluted net income per share attributable to DaVita Inc. $ 3.47 $ 4.29 $ 1.25 Anti-dilutive stock-settled awards excluded from calculation (1) 4,350 2,523 1,365 (1) Shares associated with stock-settled stock appreciation rights excluded from the diluted denominator calculation because they are anti-dilutive under the treasury stock method.

Investments in Debt and Equity

Investments in Debt and Equity Securities	12 Months Ended
	Dec. 31, 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 strategies 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: December 31, 2017 December 31, 2016 Held to maturity Available for sale Total Held to maturity Available for sale Total Certificates of deposit, commercial paper and money $ 42,316 $ — $ 42,316 $ 255,781 $ — $ 255,781 Investments in mutual funds and common stock — 38,895 38,895 50,000 31,197 81,197 $ 42,316 $ 38,895 $ 81,211 $ 305,781 $ 31,197 $ 336,978 Short-term investments $ 42,316 $ 1,200 $ 43,516 $ 305,781 $ 1,200 $ 306,981 Long-term investments — 37,695 37,695 — 29,997 29,997 $ 42,316 $ 38,895 $ 81,211 $ 305,781 $ 31,197 $ 336,978 The cost of certificates of deposit, commercial paper and money market funds at December 31, 2017 and 2016 approximate their fair value. As of December 31, 2017 and 2016 , available for sale investments included $8,416 and $3,701 , respectively, of gross pre-tax unrealized gains. During 2017 and 2016 the Company recorded gross pre-tax unrealized gains of $5,075 and $1,802 , respectively, in other comprehensive income associated with changes in the fair value of these investments. During 2017 , the Company sold investments in mutual funds and common stock for net proceeds of $6,408 , and recognized a pre-tax gain of $360 , or $220 after tax, that was previously recorded in other comprehensive income. During 2016 , the Company sold investments in mutual funds and common stock for net proceeds of $14,971 , and recognized a pre-tax gain of $690 , or $423 after tax, that was previously recorded in other comprehensive income. Investments in mutual funds classified as available for sale are held within trusts to fund existing obligations associated with several of the Company’s non-qualified deferred compensation plans.

Accounts Receivable

Accounts Receivable	12 Months Ended
	Dec. 31, 2017
Receivables [Abstract]
Accounts Receivable	Accounts receivable Approximately 21% and 16% of the Company’s net patient services accounts receivable balances as of December 31, 2017 and 2016 , respectively, were more than six months old. The increase was primarily due to changes the Company made in its collection policies and procedures to improve overall collections. There were no significant balances over one year old. Accounts receivable are principally from Medicare and Medicaid programs and commercial insurance plans. Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the ultimate collectability of its accounts receivable, the Company analyzes its historical cash collection experience and trends for each payor 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 it to determine its current provision for uncollectible accounts and the adequacy of its allowance for doubtful accounts. For receivables associated with U.S. dialysis and related lab services covered by government payors, like 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. Approximately 1% of the Company’s U.S. dialysis and related lab services net accounts receivable are associated with patient pay and it is the Company’s policy to reserve 100% of the outstanding accounts receivable balances for dialysis services when those amounts due are outstanding for more than three months . During the year ended December 31, 2017 , the Company’s allowance for doubtful accounts decreased by $20,498 . The decrease in 2017 was primarily due to an increase in write-offs of aged balances from an increase in uninsured and underinsured uncollectible patient balances related to the U.S. dialysis and related lab business. During the year ended December 31, 2016 , the Company’s allowance for doubtful accounts decreased by $12,837 . The decrease in 2016 was primarily due to an increase in the write-offs of patient pay billings in the Company's U.S. dialysis business. The decrease was also due to a reduction in accounts receivable older than six months.

Other Receivables Other Receiva

Other Receivables Other Receivables	12 Months Ended
	Dec. 31, 2017
Receivables [Abstract]
Other Receivables	Other receivables Other receivables were comprised of the following: December 31, 2017 2016 Supplier rebates and non-trade receivables $ 268,949 $ 183,498 Medicare bad debt claims 103,970 104,658 $ 372,919 $ 288,156

Other Current Assets

Other Current Assets	12 Months Ended
	Dec. 31, 2017
Prepaid Expense and Other Assets, Current [Abstract]
Prepaid and Other Current Assets	Prepaid and other current assets Other current assets were comprised of the following: December 31, 2017 2016 Prepaid expenses $ 104,727 $ 96,818 Other 7,331 2,692 $ 112,058 $ 99,510

Property and Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2017
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment Property and equipment were comprised of the following: December 31, 2017 2016 Land $ 33,814 $ 26,339 Buildings 473,489 429,039 Leasehold improvements 2,816,675 2,495,070 Equipment and information systems, including internally developed software 2,352,246 2,182,912 New center and capital asset projects in progress 576,651 429,037 6,252,875 5,562,397 Less accumulated depreciation (3,103,662 ) (2,698,276 ) $ 3,149,213 $ 2,864,121 Depreciation expense on property and equipment was $544,129 , $494,945 , and $444,720 for 2017 , 2016 and 2015 , respectively. In addition, during the first quarter of 2017, the Company recognized an asset impairment charge of $15,168 related to the restructuring of its pharmacy business. Interest on debt incurred during the development of new centers and other capital asset projects is capitalized as a component of the asset cost based on the respective in-process capital asset balances. Interest capitalized was $19,176 , $12,990 and $9,723 for 2017 , 2016 and 2015 , respectively.

Intangibles

Intangibles	12 Months Ended
	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Intangibles	Intangibles Intangible assets other than goodwill were comprised of the following: December 31, 2017 2016 Noncompetition and other agreements $ 429,140 $ 407,220 Lease agreements 7,623 7,244 Indefinite-lived assets 33,255 1,125 Other 583 583 470,601 416,172 Less accumulated amortization (356,774 ) (342,668 ) $ 113,827 $ 73,504 Amortization expense from amortizable intangible assets, other than lease agreements, was $15,782 , $14,552 , and $19,185 for 2017 , 2016 and 2015 , respectively. Lease agreement intangible assets and liabilities were amortized to rent expense in the amounts of $(203) , $(232) and $(331) for 2017 , 2016 and 2015 , respectively. During the years ended December 31, 2017 , 2016 and 2015, the Company recognized no impairment charges on any intangible assets other than goodwill. Amortizable intangible liabilities as of December 31, 2017 and 2016 were comprised of lease agreements of $5,447 and $6,011 , respectively, which were net of accumulated amortization of $3,508 and $3,618 , respectively. There was no amortization benefit recognized from the alliance and product supply agreement in 2017 and 2016 as it expired in September 2015. Amortization benefit related to this agreement was $3,997 for 2015 . Lease agreement intangible liabilities are classified in other long-term liabilities and amortized to rent expense. Scheduled amortization charges from amortizable intangible assets and liabilities as of December 31, 2017 were as follows: Noncompetition and other agreements Lease liabilities Other 2018 $ 15,581 $ (849 ) $ 102 2019 14,051 (658 ) 87 2020 12,629 (628 ) 44 2021 9,929 (602 ) — 2022 6,808 (553 ) — Thereafter 21,341 (2,157 ) — Total $ 80,339 $ (5,447 ) $ 233

Equity Method and Other Investm

Equity Method and Other Investments	12 Months Ended
	Dec. 31, 2017
Investments, Debt and Equity Securities [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 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. As described in Note 20, effective as of August 1, 2016, the Company deconsolidated its Asia Pacific dialysis business held by DaVita Care Pte. Ltd. (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. During the year ended December 31, 2017 , the Company recognized a non-cash other-than-temporary impairment charge of $280,066 on its investment in the APAC JV. This charge resulted from changes in its expectations for the joint venture based on continuing market research and assessments by both the Company and the APAC JV concerning the size of the addressable market available to the joint venture at attractive risk-adjusted returns. The Company estimated the fair value of its retained interest in the APAC JV with the assistance of an independent third party valuation firm based on information available to management as of December 31, 2017 . After this charge, the Company’s investment in the APAC JV was carried at $160,481 as of December 31, 2017 . During the year ended December 31, 2016 , the Company recorded an impairment of $14,993 related to an investment at one of its other international reporting units. Total equity method and other investments in nonconsolidated businesses were $245,534 and $492,039 at December 31, 2017 and 2016 , respectively. The decrease in these equity investments was primarily due to the impairment of the Company's investment in the APAC JV. During 2017 , 2016 and 2015 , the Company recognized equity investment (loss) income of $(8,640) , $16,874 and $13,919 , respectively, from its equity method investments in nonconsolidated businesses.

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill Changes in the carrying value of goodwill by reportable segments were as follows: U.S. dialysis and related lab services Other ancillary services and strategic initiatives Consolidated total Balance at January 1, 2016 $ 5,629,183 $ 267,032 $ 5,896,215 Acquisitions 75,295 123,632 198,927 Divestitures (12,891 ) (29,645 ) (42,536 ) Goodwill impairment charges — (28,415 ) (28,415 ) Foreign currency and other adjustments — (8,816 ) (8,816 ) Balance at December 31, 2016 $ 5,691,587 $ 323,788 $ 6,015,375 Acquisitions 485,434 131,598 617,032 Divestitures (32,260 ) (126 ) (32,386 ) Goodwill impairment charges — (36,196 ) (36,196 ) Foreign currency and other adjustments — 46,454 46,454 Balance at December 31, 2017 $ 6,144,761 $ 465,518 $ 6,610,279 Goodwill $ 6,144,761 $ 536,038 $ 6,680,799 Accumulated impairment charges — (70,520 ) (70,520 ) $ 6,144,761 $ 465,518 $ 6,610,279 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 25 to these 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 vascular access service centers in its vascular access services 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. During the year ended December 31, 2016, the Company recognized a goodwill impairment charge of $28,415 related to the Company’s vascular access reporting unit as a result of changes in future governmental reimbursement rates for this business and the Company’s expected ability to mitigate them. Specifically, on November 2, 2016, CMS released the 2017 Physician Fee Schedule Final Rule and the Ambulatory Surgical Center Payment Final Rule which reflected significant changes in reimbursement structure for this business unit. During the year ended December 31, 2017, the Company recognized an additional goodwill impairment charge of $34,696 at its vascular access reporting unit. This charge resulted primarily from continuing changes in the Company’s outlook for this business unit 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 changes in reimbursement structure discussed above. As of December 31, 2017, there was no goodwill remaining at the Company's vascular access reporting unit. During the year ended December 31, 2017 , the Company also performed annual impairment assessments for various other reporting units. As a result of these assessments, the Company also recognized a goodwill impairment charge of $1,500 at one of its international reporting units during the year ended December 31, 2017. During the year ended December 31, 2015, the Company also recognized a goodwill impairment charge of $4,066 at another international reporting unit. Based on the most recent assessments, the Company determined that reductions in reimbursement rates, changes in actual or expected growth rates, 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 December 31, 2017: Reporting unit Goodwill Carrying amount (1) Sensitivities Operating (2) Discount (3) Kidney Care Germany $ 316,369 13.7% (1.6)% (11.1)% Kidney Care Portugal $ 46,713 16.9% (1.9)% (6.0)% Kidney Care Poland $ 46,610 11.8% (1.9)% (6.0)% (1) Excess of estimated fair value of the reporting unit over 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. There were no major changes in the business, prospects, or expected future results of these reporting units from their latest assessment date through December 31, 2017 . Except as described above, none of the Company’s other reporting units were considered at risk of significant goodwill impairment as of December 31, 2017 . Since the dates of the Company’s last annual goodwill impairment tests, there have been certain developments, events, changes in operating performance and other changes in key circumstances that have affected the Company’s businesses. However, except as further described above, these did not cause management to believe it is more likely than not that the fair values of any of the Company’s reporting units would be less than their respective carrying amounts as of December 31, 2017 .

Other Liabilities

Other Liabilities	12 Months Ended
	Dec. 31, 2017
Other Liabilities Disclosure [Abstract]
Other Liabilities	Other liabilities Other liabilities were comprised of the following: December 31, 2017 2016 Payor refunds and retractions $ 292,370 $ 270,298 Insurance and self-insurance accruals 64,924 76,857 Accrued interest 83,362 82,234 Accrued non-income tax liabilities 28,317 23,643 Other 83,689 125,860 $ 552,662 $ 578,892

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Income Taxes	Income taxes The Company accounts for income taxes under the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements. Under this method, deferred tax assets and liabilities are determined on the basis of the differences between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Income before income taxes from continuing operations consisted of the following: Year ended December 31, 2017 2016 2015 Domestic $ 1,725,822 $ 1,278,754 $ 730,249 International (326,036 ) 344,351 (41,862 ) $ 1,399,786 $ 1,623,105 $ 688,387 Income tax expense (benefit) for continuing operations consisted of the following: Year ended December 31, 2017 2016 2015 Current: Federal $ 330,191 $ 322,940 $ 124,503 State 47,228 44,525 20,442 International 3,422 1,928 856 Total current income tax 380,841 369,393 145,801 Deferred: Federal (98,760 ) 88,412 71,016 State 37,347 (28,530 ) (9,737 ) International 4,431 2,486 430 Total deferred income tax (56,982 ) 62,368 61,709 $ 323,859 $ 431,761 $ 207,510 Income taxes are allocated between continuing and discontinued operations as follows: Year ended December 31, 2017 2016 2015 Continuing operations $ 323,859 $ 431,761 $ 207,510 Discontinued operations (364,856 ) 24,052 88,216 $ (40,997 ) $ 455,813 $ 295,726 The reconciliation between the Company’s effective tax rate from continuing operations and the U.S. federal income tax rate is as follows: Year ended December 31, 2017 2016 2015 Federal income tax rate 35.0 % 35.0 % 35.0 % State income taxes, net of federal benefit 3.7 2.6 1.7 Gain on APAC JV ownership changes (0.2 ) (9.9 ) — APAC investment impairment 6.4 — — Impact of 2017 Tax Act (20.5 ) — — Other 2.0 1.8 2.3 Impact of noncontrolling interests primarily attributable to (3.3 ) (2.9 ) (8.9 ) Effective tax rate 23.1 % 26.6 % 30.1 % On December 22, 2017, the President signed into law the tax legislation known as the Tax Cuts and Jobs Act (the 2017 Tax Act). The 2017 Tax Act includes a number of changes to existing U.S. tax laws that impact the Company, most notably a reduction in the U.S. corporate income tax rate from 35.0% to 21.0% effective January 1, 2018. The 2017 Tax Act also provides for full expensing of qualified assets placed into service after September 27, 2017, as well as prospective changes beginning in 2018, imposes a one-time transition tax on certain foreign subsidiaries, and changes how foreign earnings are subject to U.S. tax prospectively. The Company recognized the income tax effects of the 2017 Tax Act in its 2017 financial statements in accordance with Staff Accounting Bulletin No. 118, which provides SEC staff guidance for the application of ASC Topic 740, Income Taxes , in the reporting period in which the 2017 Tax Act was signed into law. As such, the Company’s financial results reflect the income tax effects of the 2017 Tax Act for which accounting under ASC Topic 740 is complete and provisional amounts, primarily as it relates to the full expensing provisions of the 2017 Tax Act, for those specific income tax effects for which the accounting is incomplete but a reasonable estimate could be determined. The Company has completed the accounting for income taxes with respect to the mandatory one-time tax on accumulated earnings of its foreign subsidiaries and has determined that there is no mandatory repatriation and therefore no income tax liability associated with this one-time tax. The Company measures deferred tax assets and liabilities using enacted tax rates that will apply in the years in which the temporary differences are expected to be recovered or paid. Accordingly, the Company’s deferred tax assets and liabilities were remeasured to reflect a reasonable estimate of the reduction in the U.S. corporate income tax rate from 35.0% to 21.0%, resulting in a provisional $251,510 net tax benefit. While the Company has substantially completed its provisional analysis of the income tax effects of the 2017 Tax Act and recorded a reasonable estimate of such effects, the net one-time benefit related to the 2017 Tax Act may differ, possibly materially, due to, among other things, further refinement of the underlying calculations, changes in interpretations and assumptions that the Company has made, additional guidance that may be issued by the U.S. Government, and actions and related accounting policy decisions the Company may take as a result of the 2017 Tax Act. The Company will complete its analysis over a one-year measurement period ending December 22, 2018, and any adjustments during this measurement period will be included in net earnings from continuing operations as an adjustment to income tax expense in the reporting period in which such adjustments are determined. Deferred tax assets and liabilities arising from temporary differences for continuing operations were as follows: December 31, 2017 2016 Receivables $ 19,705 $ 25,197 Accrued liabilities 96,537 224,712 Net operating loss carryforwards 108,429 128,813 Other 37,794 73,525 Deferred tax assets 262,465 452,247 Valuation allowance (61,282 ) (56,016 ) Net deferred tax assets 201,183 396,231 Intangible assets (501,763 ) (676,781 ) Property and equipment (100,376 ) (141,919 ) Investments in partnerships (61,529 ) (95,936 ) Other (23,762 ) (12,464 ) Deferred tax liabilities (687,430 ) (927,100 ) Net deferred tax liabilities $ (486,247 ) $ (530,869 ) At December 31, 2017 , the Company had federal net operating loss carryforwards of approximately $137,852 that expire through 2036 , although a substantial amount expire by 2028 . The Company also had state net operating loss carryforwards of $445,554 that expire through 2036 and international net operating loss carryforwards of $138,717 , some of which have an indefinite life. The utilization of a portion of these losses may be limited in future years based on the profitability of certain entities. The net increase of $5,266 in the valuation allowance is primarily due to newly created net operating loss carryforwards in state and foreign jurisdictions that the Company does not anticipate being able to utilize. The 2017 Tax Act includes a mandatory one-time tax on accumulated earnings of foreign subsidiaries, and as a result, all previously unremitted earnings for which no U.S. deferred tax liability had been accrued would now be subject to U.S. tax. Irrespective of the fact that the Company will not experience any one-time tax under this provision of the 2017 Tax Act, it intends to continue to indefinitely reinvest these earnings, as well as capital invested and future earnings from its foreign subsidiaries to fund its international operations. In addition, the Company expects future U.S. cash generation will be sufficient to meet future U.S. cash needs. Determination of the amount of any applicable deferred taxes on the earnings is not practical since the computation would depend on a number of factors that cannot be known unless a decision is made to repatriate the earnings. Unrecognized tax benefits A reconciliation of the beginning and ending liability for unrecognized tax benefits that do not meet the more-likely-than-not threshold is as follows: Year ended December 31, 2017 2016 Beginning balance $ 24,066 $ 39,011 Additions for tax positions related to current year 7,606 9,714 Additions for tax positions related to prior years 804 — Reductions related to lapse of applicable statute (1,380 ) (1,277 ) Impact of 2017 Tax Act 3,731 — Reductions related to settlements with taxing authorities (2,051 ) (23,382 ) Ending balance $ 32,776 $ 24,066 As of December 31, 2017 , the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold is $32,776 , all of which would impact the Company’s effective tax rate if recognized. This balance represents an increase of $8,710 from the December 31, 2016 balance of $24,066 , primarily due to additions for tax positions related to the current year. The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. At December 31, 2017 and 2016 , the Company had approximately $4,195 and $2,595 , respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefit. The Company and its subsidiaries file U.S. federal and state income tax returns and various foreign income tax returns. The Company is no longer subject to U.S. federal and state examinations by tax authorities for years before 2013 and 2008, respectively.

Long-Term Debt

Long-Term Debt	12 Months Ended
	Dec. 31, 2017
Debt Disclosure [Abstract]
Long-Term Debt	Long-term debt Long-term debt was comprised of the following: December 31, 2017 2016 Senior Secured Credit Facilities: Term Loan A $ 775,000 $ 862,500 Term Loan B 3,377,500 3,412,500 Revolver 300,000 — Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 150,512 117,547 Capital lease obligations 297,170 292,252 Total debt principal outstanding 9,400,182 9,184,799 Discount and deferred financing costs (63,951 ) (79,861 ) 9,336,231 9,104,938 Less current portion (178,213 ) (160,262 ) $ 9,158,018 $ 8,944,676 Scheduled maturities of long-term debt at December 31, 2017 were as follows: 2018 178,213 2019 1,049,091 2020 73,362 2021 3,307,507 2022 1,283,671 Thereafter 3,508,338 Term Loans Total outstanding borrowings under Term Loan A and Term Loan B can consist of various individual tranches that can range in maturity from one month to twelve months (currently all tranches are one month in duration). For Term Loan A and Term Loan B, each tranche bears interest at a London Interbank Offered Rate (LIBOR) that is determined by the duration of such tranche plus an interest rate margin. The LIBOR variable component of the interest rate for each tranche is reset as such tranche matures and a new tranche is established. At December 31, 2017 , the overall weighted average interest rate for Term Loan A was determined based upon the LIBOR interest rates in effect for all of the individual tranches plus the interest rate margin of 2.00% . At December 31, 2017 , Term Loan B bears interest at LIBOR (floor of 0.75% ) plus a margin of 2.75% . The Company is subject to LIBOR-based interest rate volatility on Term Loan B as the LIBOR-based component of the interest rate exceeded the floor of 0.75% as of December 31, 2017 . The overall weighted average interest rate for Term Loan B was determined based upon the LIBOR interest rates in effect for all individual tranches plus the interest rate margin. The Company has several interest rate cap agreements that have the economic effect of capping the LIBOR variable component of the Company’s interest rate at a maximum of 3.50% on $3,500,000 of outstanding principal debt. The remaining $652,500 outstanding principal balance of Term Loan A would still be subject to LIBOR-based interest rate volatility. In addition, the Company maintains several forward interest rate cap agreements with notional amounts totaling $3,500,000 , which will be effective June 29, 2018 . The cap agreements 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 the Company’s debt. See below for further details. The Company is restricted from paying dividends under the terms of its senior secured credit facilities. During the year ended December 31, 2017 , the Company made mandatory principal payments under its senior secured credit facilities totaling $87,500 on Term Loan A and $35,000 on Term Loan B. Revolving lines of credit The Company has $300,000 drawn on its $1,000,000 revolving line of credit under its senior secured credit facilities, in addition to approximately $14,383 committed for outstanding letters of credit. The Company also has approximately $90,085 of additional outstanding letters of credit related to Kidney Care and $211 of committed outstanding letters of credit related to DMG, which is backed by a certificate of deposit. Senior Notes The Company’s senior notes as of December 31, 2017 consisted of $1,500,000 of 5.0% Senior Notes due 2025 , $1,750,000 5 1 / 8 % senior notes due 2024 and $1,250,000 of 5 3 / 4 % senior notes due 2022 (collectively Senior Notes). The Senior Notes are unsecured obligations, rank equally in right of payment with the Company’s existing and future unsecured senior indebtedness, and are guaranteed by substantially all of the Company’s direct and indirect wholly-owned domestic subsidiaries and require semi-annual interest payments. The Company may redeem some or all of the Senior Notes at any time on or after certain specific dates and at certain specific redemption prices as outlined in each senior note agreement. The Company is restricted from paying dividends under the indentures governing its Senior Notes. Interest rate cap and swap agreements During the year ended December 31, 2017 the Company had several currently effective and forward interest rate cap agreements as a means of hedging its exposure to and volatility from variable-based interest rate changes as part of its overall interest rate risk management strategy. These agreements were not held for trading or speculative purposes and had 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. These cap agreements are also 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 December 31, 2017 , the Company maintains several currently effective 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. These cap agreements expire on June 30, 2018 . As of December 31, 2017 , these cap agreements had an immaterial fair value. During the year ended December 31, 2017 , the Company recognized debt expense of $8,278 from these caps. During the year ended December 31, 2017 , the Company recorded a loss of $115 in other comprehensive income due to a decrease in the unrealized fair value of these cap agreements. As of December 31, 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 December 31, 2017 , the total fair value of these cap agreements was an asset of approximately $1,032 . During the year ended December 31, 2017 , the Company recorded a loss of $8,782 in other comprehensive income due to a decrease in the unrealized fair value of these cap agreements. The following table summarizes the Company’s derivative instruments as of December 31, 2017 and 2016 : Fair value Derivatives designated as hedging instruments Balance sheet location December 31, 2017 December 31, 2016 Interest rate cap agreements Other long-term assets $ 1,032 $ 9,929 The following table summarizes the effects of the Company’s interest rate cap and swap agreements for the years ended December 31, 2017 , 2016 and 2015 : Amount of unrealized losses in OCI Location of losses reclassified from accumulated OCI into Amount of losses Year ended December 31, Year ended December 31, Derivatives designated as cash flow hedges 2017 2016 2015 2017 2016 2015 Interest rate cap agreements $ (8,897 ) $ (5,198 ) $ (16,114 ) Debt expense $ 8,278 $ 3,899 $ 2,439 Interest rate swap agreements — (815 ) (3,971 ) Debt expense — 299 2,664 Tax benefit 3,460 2,343 7,844 Tax expense (3,220 ) (1,632 ) (1,992 ) Total $ (5,437 ) $ (3,670 ) $ (12,241 ) $ 5,058 $ 2,566 $ 3,111 As of December 31, 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 an interest rate cap 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 $122,500 . In addition, the uncapped portion of Term Loan A, which is subject to the variability of LIBOR, is $652,500 . See above for further details. Interest rates on the Company’s Senior Notes are fixed by their terms. The Company’s overall weighted average effective interest rate on the senior secured credit facilities was 4.45% , based upon the current margins in effect of 2.00% for Term Loan A and the Revolver and 2.75% for Term Loan B, as of December 31, 2017 . The Company’s overall weighted average effective interest rate during the year ended December 31, 2017 was 4.70% and as of December 31, 2017 was 4.88% . Debt expense Debt expense consisted of interest expense of $406,341 , $394,013 and $389,755 and the amortization and accretion of debt discounts and premiums, amortization of deferred financing costs and the amortization of interest rate cap agreements of $24,293 , $20,103 and $18,625 for 2017 , 2016 and 2015 , respectively. The interest expense amounts are net of capitalized interest.

Leases

Leases	12 Months Ended
	Dec. 31, 2017
Leases [Abstract]
Leases	Leases The majority of the Company’s facilities are leased under non-cancellable operating leases ranging in terms from five to fifteen years and which contain renewal options of five to ten years at the fair rental value at the time of renewal. The Company’s leases are generally subject to periodic consumer price index increases or contain fixed escalation clauses. The Company also leases certain facilities and equipment under capital leases. Future minimum lease payments under non-cancellable operating and capital leases are as follows: Operating leases Capital leases 2018 $ 446,935 $ 35,258 2019 422,245 36,038 2020 384,764 36,689 2021 351,962 32,578 2022 313,005 33,004 Thereafter 1,303,594 234,094 $ 3,222,505 407,661 Less portion representing interest (110,491 ) Total capital lease obligations, including current portion $ 297,170 Rent expense under all operating leases for 2017 , 2016 , and 2015 was $530,748 , $478,531 and $440,601 , respectively. Rent expense is recorded on a straight-line basis over the term of the lease for leases that contain fixed escalation clauses or include abatement provisions. Leasehold improvement incentives are deferred and amortized to rent expense over the term of the lease. The net book value of property and equipment under capital leases was $257,772 and $263,438 at December 31, 2017 and 2016 , respectively. Capital lease obligations are included in long-term debt. See Note 13 to these consolidated financial statements.

Employee Benefit Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2017
Compensation and Retirement Disclosure [Abstract]
Employee Benefit Plans	Employee benefit plans The Company has a savings plan for substantially all of its Kidney Care employees which has been established pursuant to the provisions of Section 401(k) of the Internal Revenue Code (IRC). The plan allows for employees to contribute a percentage of their base annual salaries on a tax-deferred basis not to exceed IRC limitations. The Company has not provided any matching contributions for its Kidney Care employees through December 31, 2017. Beginning in 2018, the Company has implemented a 401(k) matching program under which the Company will match 50% of the employee's contribution up to 6% of the employee's salary, subject to certain limitations. The matching contributions will be subject to certain eligibility and vesting conditions. The Company also maintains a voluntary compensation deferral plan, the DaVita Voluntary Deferral Plan. This plan is non-qualified and permits certain employees whose annualized base salary equals or exceeds a minimum annual threshold amount as set by the Company to elect to defer all or a portion of their annual bonus payment and up to 50% of their base salary into a deferral account maintained by the Company. Total contributions to this plan in 2017 , 2016 and 2015 were $4,497 , $5,344 and $4,234 , respectively. Deferred amounts are generally paid out in cash at the participant’s election either in the first or second year following retirement or in a specified future period at least three to four years after the deferral election was effective . During 2017 , 2016 and 2015 the Company distributed $1,731 , $916 and $1,270 , respectively, to participants in this plan. Participants are credited with their proportional amount of annual earnings from the plan. The assets of this plan are held in a rabbi trust and as such are subject to the claims of the Company’s general creditors in the event of its bankruptcy. As of December 31, 2017 and 2016 , the total fair value of assets held in this plan’s trust were $38,816 and $30,192 , respectively. The Company also maintains a legacy Executive Retirement Plan for certain members of management. This plan is non-qualified and contributions to the plan were made at the discretion of DVA Renal Healthcare based upon a pre-determined percentage of a participant’s base salary. Effective November 2005, all contributions to this plan were discontinued and the balance of the plan assets will be paid out upon termination or retirement of each individual participant. During 2017 , 2016 and 2015 the Company distributed $1,058 and $149 , $25 respectively, to participants in this plan. As of December 31, 2017 and 2016 , the total fair value of assets held under this plan’s trust was $79 and $1,005 , respectively. The fair value of all of the assets held in plan trusts as of December 31, 2017 , and 2016 totaled $38,895 and $31,197 , respectively. The assets of these plans are available for sale and as such are recorded at fair value with changes in the fair market values being recorded in other comprehensive income. Any fair value changes to the corresponding liability balance are recorded as compensation expense. See Note 3 to these consolidated financial statements. Most of the Company’s outstanding employee stock plan awards include a provision accelerating the vesting of the award in the event of a change of control. The Company also maintains a change of control protection program for its employees who do not have a significant number of stock awards, which has been in place since 2001, and which provides for cash bonuses to employees in the event of a change of control. Based on the market price of the Company’s common stock and shares outstanding on December 31, 2017 , these cash bonuses would total approximately $520,778 if a change of control transaction occurred at that price and the Company’s Board of Directors did not modify the program. This amount has not been accrued at December 31, 2017 , and would only be accrued upon a change of control. These change of control provisions may affect the price an acquirer would be willing to pay for the Company.

Contingencies

Contingencies	12 Months Ended
	Dec. 31, 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, qui tam suits, 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 December 31, 2017 and December 31, 2016, the Company’s total recorded accruals, including DMG, with respect to legal proceedings and regulatory matters, net of anticipated third party recoveries, were approximately $6,000 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 also may be impacted 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 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) requesting 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 civil subpoena from the OIG covering the period from January 1, 2008 through the present and seeking 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 HealthCare Partners (now known as the Company's DMG business), 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, some of which were the subject of the Swoben Private Civil Suit, and is in discussions with the DOJ relating to those practices. The Company is cooperating with the government. 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 Company's acquisition of DMG in 2012, 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 Civil Investigative Demand (CID) from the U.S. Attorney’s Office for the Northern District of Texas. The government is conducting a federal False Claims Act (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. In connection with the Company’s ongoing efforts working with the government the Company learned that a qui tam complaint had been filed covering some of the issues in the CID and the Company’s self-disclosure. In December 2017, the Company finalized and executed a settlement agreement with the government and relators in the qui tam matter and that included total monetary consideration of $63,700 , as previously announced, of which $41,500 was an incremental cash payment and $22,200 was for amounts previously refunded, and all of which was previously accrued. The government’s investigation into the Company's relationship with pharmaceutical manufacturers is ongoing and the Company is continuing to cooperate with the government in this investigation. 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." In November 2017, the court appointed the lead plaintiff and an amended complaint was filed on January 12, 2018. The Company's response is due March 13, 2018. The Company disputes these allegations and intends to defend this action accordingly. In re DaVita Inc. Stockholder Derivative Litigation : On August 15, 2017, the U.S. District Court for the District of Delaware consolidated the three previously disclosed shareholder derivative lawsuits: the Blackburn Shareholder action filed on February 10, 2017, the Gabilondo Shareholder action filed on May 30, 2017, and the City of Warren Police and Fire Retirement System Shareholder action filed on June 9, 2017. 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. An amended complaint was filed in September 2017, and on December 18, 2017 the Company filed a motion to dismiss and a motion to stay proceedings in the alternative. 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 Swoben Private Civil Suit : On July 13, 2009, pursuant to the qui tam provisions of the 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. 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. The allegations in the complaint relate to alleged overpayments received from government healthcare programs, including allegations of violations of the federal FCA and the California False Claims Act and allegations against HCP relating to patient diagnosis coding. The complaint sought monetary damages and civil penalties as well as costs and expenses. 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. 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. In October 2017, the Company finalized and executed a settlement agreement with the OIG including payment of an immaterial amount. 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 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. * * * 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 16, 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	12 Months Ended
	Dec. 31, 2017
Accounting Policies [Abstract]
Noncontrolling Interests Subject to Put Provisions and Other Commitments	Noncontrolling interests subject to put provisions and other commitments Noncontrolling interests subject to put provisions The Company has potential obligations to purchase the equity interests held by third parties in several of its majority-owned joint ventures and other nonconsolidated entities. These obligations are in the form of put provisions that 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 flows 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 noncontrolling interests subject to put provisions are 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 interests obligations may be settled will 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 certain 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 owns a noncontrolling equity interest as well as to physician-owned vascular access clinics or medical practices that the Company operates under management and administrative service agreements of approximately $5,385 . 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. Other commitments In January 2017, the Company entered into a Sourcing and Supply Agreement with Amgen USA Inc. (Amgen) that expires on December 31, 2022 , replacing the Company’s prior agreement that was to expire in 2018 . Under the terms of the agreement, the Company will purchase EPO in amounts necessary to meet no less than 90% of its requirements for erythropoiesis-stimulating agents (ESAs) through the expiration of the contract from Amgen. The actual amount of EPO that the Company will purchase will depend upon the amount of EPO administered during dialysis as prescribed by physicians and the overall number of patients that the Company serves. In 2010, the Company entered into an agreement with Fresenius Medical Care (FMC) which committed the Company to purchase a certain amount of dialysis equipment, parts and supplies from FMC through 2013 . This agreement has been subsequently extended through December 31, 2020 . During 2017 , 2016 and 2015 , the Company purchased $176,212 , $164,766 and $154,566 , respectively, of certain equipment, parts and supplies from FMC. In 2014, the Company entered into an agreement with Baxter Healthcare (Baxter) which committed the Company to purchase a certain amount of its hemodialysis non-equipment product supplies, such as dialyzers, at fixed prices through 2018 . During 2017 , 2016 and 2015 , the Company purchased $166,764 , $162,109 and $112,931 of hemodialysis product supplies from Baxter under this agreement. Other than operating leases disclosed in Note 14 to the consolidated financial statements, the letters of credit disclosed in Note 13 to the consolidated financial statements, and the arrangements as described above, the Company has no off balance sheet financing arrangements as of December 31, 2017 .

Long-term Incentive Compensatio

Long-term Incentive Compensation and Shareholders’ Equity	12 Months Ended
	Dec. 31, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Long-term Incentive Compensation and Shareholders’ Equity	Long-term incentive compensation and shareholders’ equity 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, corporate administrative support, and the ancillary services and strategic initiatives. 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. See the New accounting standards section in Note 1 for further details. 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. Stock-based compensation to be settled in shares is recorded to the Company’s shareholders’ equity, while stock-based compensation to be settled in cash is recorded to a liability. Shares issued upon exercise of stock awards have generally been issued from authorized but unissued shares. Long-term incentive compensation plans The Company’s 2011 Incentive Award Plan (the 2011 Plan) is the Company’s omnibus equity compensation plan and provides for grants of stock-based awards to employees, directors and other individuals providing services to the Company, except that incentive stock options may only be awarded to employees. The 2011 Plan authorizes the Company to award stock options, stock appreciation rights, restricted stock units, restricted stock, and other stock-based or performance-based awards, and is designed to enable the Company to grant equity and cash awards that qualified as performance-based compensation under Section 162(m) of the Internal Revenue Code for tax years 2017 and prior. The 2011 Plan mandates a maximum award term of five years and stipulates that stock appreciation rights and stock options be granted with prices not less than fair market value on the date of grant. The 2011 Plan also requires that full value share awards such as restricted stock units reduce shares available under the 2011 Plan at a ratio of 3.5 :1. The Company’s nonqualified stock appreciation rights and stock units awarded under the 2011 Plan generally vest over 36 to 48 months from the date of grant. At December 31, 2017 , there were 6,648,199 stock-settled stock appreciation rights, 1,075,572 stock-settled stock units, 23,000 cash-settled stock appreciation rights and 1,600 cash-settled stock units outstanding, and 27,369,515 shares available for future grants, under the 2011 Plan. A combined summary of the status of the Company’s stock-settled awards under the 2011 Plan, including base shares for stock-settled stock appreciation rights (SSARs) and stock-settled stock unit awards is as follows: Year ended December 31, 2017 Stock appreciation rights Stock units Awards Weighted Weighted Awards Weighted Outstanding at beginning of year 7,337,266 $ 64.90 785,553 Granted 1,692,154 65.29 528,968 Exercised (2,022,418 ) 54.27 (119,000 ) Canceled (358,803 ) 70.61 (119,949 ) Outstanding at end of period 6,648,199 $ 67.92 2.3 1,075,572 2.0 Exercisable at end of period 2,628,008 $ 62.78 0.6 — 0.0 Weighted-average fair value of grants 2017 $ 14.51 $ 65.73 2016 $ 13.74 $ 70.99 2015 $ 17.97 $ 80.25 Awards Outstanding Weighted average exercise price Awards exercisable Weighted average exercise price Range of SSARs base prices $50.01–$60.00 1,856,145 59.05 1,712,675 59.15 $60.01–$70.00 2,715,542 66.70 632,849 67.47 $70.01–$80.00 1,443,749 74.77 243,041 73.16 $80.01–$90.00 632,763 83.59 39,443 81.51 Total 6,648,199 $ 67.92 2,628,008 $ 62.78 The Company granted 15,000 cash-settled stock-based awards during 2017 . Liability-classified stock-based awards contributed $114 , $376 and $(236) to stock-based compensation expense for the years ended December 31, 2017 , 2016 and 2015 , respectively. As of December 31, 2017 the Company had 24,600 liability-classified stock-based awards outstanding, none of which were vested, and a total stock-based compensation liability balance of $99 . For the years ended December 31, 2017 , 2016 , and 2015 , the aggregate intrinsic value of stock-based awards exercised was $34,895 , $73,944 and $117,260 , respectively. At December 31, 2017 , the aggregate intrinsic value of stock-based awards outstanding was $117,722 and the aggregate intrinsic value of stock awards exercisable was $25,609 . Estimated fair value of stock-based compensation awards The Company has estimated the grant-date fair value of stock-settled stock appreciation rights awards using the Black-Scholes-Merton valuation model and stock-settled stock unit awards at intrinsic value on the date of grant, except for portions of the Company’s performance stock unit awards for which a Monte Carlo simulation was used to estimate the grant-date fair value. The following assumptions were used in estimating these values and determining the related stock-based compensation expense attributable to the current period: Expected term of the awards: The expected term of awards granted represents the period of time that they are expected to remain outstanding from the date of grant. The Company determines the expected term of its stock awards based on its historical experience with similar awards, considering the Company’s historical exercise and post-vesting termination patterns, and the terms expected by peer companies in near industries. Expected volatility: Expected volatility represents the volatility anticipated over the expected term of the award. The Company determines the expected volatility for its awards based on the volatility of the price of its common stock over the most recent retrospective period commensurate with the expected term of the award, considering the volatility expectations implied by the market price of its exchange-traded options and the volatilities expected by peer companies in near industries. Expected dividend yield: The Company has not paid dividends on its common stock and does not currently expect to pay dividends during the term of stock awards granted. Risk-free interest rate: The Company bases the expected risk-free interest rate on the implied yield currently available on stripped interest coupons of U.S. Treasury issues with a remaining term equivalent to the expected term of the award. A summary of the weighted average valuation inputs described above used for estimating the grant-date fair value of stock-settled stock appreciation rights awards granted in the periods indicated is as follows: Year ended December 31, 2017 2016 2015 Expected term 4.2 4.2 4.1 Expected volatility 23.9 % 21.0 % 24.6 % Expected dividend yield — % — % — % Risk-free interest rate 1.7 % 1.0 % 1.5 % The Company estimates expected forfeitures based upon historical experience with separate groups of employees that have exhibited similar forfeiture behavior in the past. Stock-based compensation expense is recorded only for awards that are expected to vest. Employee stock purchase plan The Employee Stock Purchase Plan entitles qualifying employees to purchase up to $25 of the Company’s common stock during each calendar year. The amounts used to purchase stock are accumulated through payroll withholdings or through optional lump sum payments made in advance of the first day of the purchase right period. This compensatory plan allows employees to purchase stock for the lesser of 100% of its fair market value on the first day of the purchase right period or 85% of its fair market value on the last day of the purchase right period. Purchase right periods begin on January 1 and July 1, and end on December 31. Contributions used to purchase the Company’s common stock under this plan for the 2017 , 2016 and 2015 participation periods were $22,131 , $23,902 and $24,523 , respectively. Shares purchased pursuant to the plan’s 2017 , 2016 and 2015 participation periods were 360,368 , 438,002 and 413,859 , respectively. At December 31, 2017 , there were 7,124,027 shares remaining available for future grants under this plan, after an additional 7,500,000 shares were approved to the plan by stockholders on June 20, 2016. The fair value of participants’ purchase rights was estimated as of the beginning dates of the purchase right periods using the Black-Scholes-Merton valuation model with the following weighted average assumptions for purchase right periods in 2017 , 2016 and 2015 , respectively: expected volatility of 23% , 22% and 26% ; risk-free interest rate of 1.3% , 0.8% and 0.2% , and no dividends. Using these assumptions, the weighted average estimated fair value of these purchase rights was $15.19 , $16.73 and $18.76 for 2017 , 2016 and 2015 , respectively. Long-term incentive compensation expense and proceeds For the years ended December 31, 2017 , 2016 and 2015 , the Company recognized $61,978 , $64,956 and $123,957 , respectively, in total long-term incentive program (LTIP) expense, of which $34,431 , $34,530 and $52,665 , respectively, was stock-based compensation expense for stock appreciation rights, stock units and discounted employee stock plan purchases, which are primarily included in general and administrative expenses. The estimated tax benefits recorded for stock-based compensation in 2017 , 2016 and 2015 were $7,717 , $12,731 and $19,689 , respectively. As of December 31, 2017 , there was $98,015 total estimated unrecognized compensation expense for outstanding LTIP awards, including $61,166 related to stock-based compensation arrangements under the Company’s equity compensation and stock purchase plans. The Company expects to recognize the performance-based cash component of this LTIP expense over a weighted average remaining period of 1.1 years and the stock-based component of this LTIP expense over a weighted average remaining period of 1.4 years. For the years ended December 31, 2017 , 2016 and 2015 , the Company received $13,473 , $28,397 and $45,749 , respectively, in actual tax benefits upon the exercise of stock awards. Since the Company issues stock-settled stock appreciation rights rather than stock options, there have been no cash proceeds from stock option exercises during the years ended December 31, 2017, 2016 and 2015. Stock repurchases During the years ended December 31, 2017 and 2016 , the Company repurchased a total of 12,966,672 shares and 16,649,090 shares of its common stock for $810,949 and $1,072,377 , or an average price of $62.54 and $64.41 per share, respectively, pursuant to previously announced authorizations by the Board of Directors. The Company also repurchased 1,237,800 shares of its common stock for $92,790 , or an average price of $74.96 per share, subsequent to December 31, 2017 through February 22, 2018. 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 February 22, 2018, the Company has a total of $1,026,326 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. The Company retired all shares held in its treasury effective as of December 31, 2017 and 2016. Charter documents & Delaware law The Company’s charter documents include provisions that may deter hostile takeovers, delay or prevent changes of control or changes in management, or limit the ability of stockholders to approve transactions that they may otherwise determine to be in their best interests. These include provisions prohibiting stockholders from acting by written consent, requiring 90 days advance notice of stockholder proposals or nominations to the Board of Directors and granting the Board of Directors the authority to issue up to five million shares of preferred stock and to determine the rights and preferences of the preferred stock without the need for further stockholder approval. The Company is also subject to Section 203 of the Delaware General Corporation Law which, subject to exceptions, would prohibit the Company from engaging in any business combinations with any interested stockholder, as defined in that section, for a period of three years following the date on which that stockholder became an interested stockholder. These restrictions may discourage, delay or prevent a change in the control of the Company. 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 are as follows: Year ended December 31, 2017 2016 2015 Net income attributable to DaVita Inc. $ 663,618 $ 879,874 $ 269,732 Changes in paid-in-capital for: Sales of noncontrolling interest (114 ) — — Purchase of noncontrolling interests (2,752 ) (13,105 ) (55,826 ) Net transfer in noncontrolling interests (2,866 ) (13,105 ) (55,826 ) Net income attributable to DaVita Inc. net of transfers in noncontrolling $ 660,752 $ 866,769 $ 213,906 The Company acquired additional ownership interests in several existing majority-owned joint ventures for $5,357 , $21,512 , and $66,382 in 2017 , 2016 , and 2015 , respectively.

Other Comprehensive (Loss) Inco

Other Comprehensive (Loss) Income	12 Months Ended
	Dec. 31, 2017
Statement of Comprehensive Income [Abstract]
Other Comprehensive (Loss) Income	. Other comprehensive (loss) income Charges and credits to other comprehensive (loss) income have been as follows: Interest rate cap and swap agreements Investment securities Foreign currency translation adjustments Accumulated other comprehensive (loss) income Balance at January 1, 2015 $ (1,795 ) $ 3,151 $ (26,373 ) $ (25,017 ) Unrealized losses (20,085 ) (1,974 ) (23,889 ) (45,948 ) Related income tax 7,844 561 — 8,405 (12,241 ) (1,413 ) (23,889 ) (37,543 ) Reclassification from accumulated other comprehensive losses 5,103 (618 ) — 4,485 Related income tax (1,992 ) 241 — (1,751 ) 3,111 (377 ) — 2,734 Balance at December 31, 2015 $ (10,925 ) $ 1,361 $ (50,262 ) $ (59,826 ) Unrealized (losses) gains (6,013 ) 1,802 (39,614 ) (43,825 ) Related income tax 2,343 (565 ) — 1,778 (3,670 ) 1,237 (39,614 ) (42,047 ) Reclassification from accumulated other comprehensive losses 4,198 (690 ) 10,087 13,595 Related income tax (1,632 ) 267 — (1,365 ) 2,566 (423 ) 10,087 12,230 Balance at December 31, 2016 $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Unrealized (losses) gains (8,897 ) 5,075 99,770 95,948 Related income tax 3,460 (1,368 ) — 2,092 (5,437 ) 3,707 99,770 98,040 Reclassification from accumulated other comprehensive losses 8,278 (360 ) — 7,918 Related income tax (3,220 ) 140 — (3,080 ) 5,058 (220 ) — 4,838 Balance at December 31, 2017 $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 The reclassification of net cap and swap realized losses into income are recorded as debt expense in the corresponding consolidated statements of income. See Note 13 to these 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 income. See Note 3 to these consolidated financial statements for further details.

Acquisitions and Divestitures

Acquisitions and Divestitures	12 Months Ended
	Dec. 31, 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 $359,913 in net cash. Renal Ventures operated 36 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 $11,950 in transaction and integration costs during the year ended December 31, 2017 associated with this 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, net of cash acquired $ 22,739 Property and equipment 36,295 Amortizable intangible and other long-term assets 11,547 Goodwill 298,200 Current liabilities (8,389 ) Long-term liabilities (479 ) $ 359,913 Amortizable intangible assets acquired, primarily related to non-compete agreements, had weighted-average estimated useful lives of five years. The total estimated amount of goodwill deductible for tax purposes associated with this acquisition was approximately $298,200 . Other routine acquisitions During 2017 , the Company also acquired 30 dialysis centers in the U.S. and 68 dialysis centers outside the U.S. for a total of $308,550 in net cash, earn-outs of $2,692 , and deferred purchase price and liabilities assumed of $23,748 . During 2016, the Company acquired eight dialysis centers in the U.S. and 21 dialysis centers outside the U.S. for a total of $165,108 in net cash, earn-outs of $1,511 , and deferred purchase price of $17,963 . During 2015, the Company acquired six dialysis centers in the U.S. and 21 dialysis centers outside the U.S. for a total of $54,551 in net cash and deferred purchase price of $7,452 . The assets and liabilities for all acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s financial statements and operating results from the effective dates of the acquisitions. For several of the 2017 acquisitions, certain income tax amounts are pending final evaluation and quantification of any pre-acquisition tax contingencies. In addition, valuation of intangibles and certain other working capital items relating to several of these acquisitions are pending final quantification. The following table summarizes the assets acquired and liabilities assumed in the above described transactions and recognized at their acquisition dates at estimated fair values, as well as the estimated fair value of noncontrolling interests assumed in these transactions: Year ended December 31, 2017 2016 2015 Current assets $ 14,366 $ 3,996 $ 2,647 Property and equipment 18,192 8,840 4,466 Amortizable intangible and other long-term assets 11,663 5,876 8,924 Non-amortizable intangibles 32,296 — — Goodwill 318,832 198,927 67,183 Deferred income taxes (210 ) 597 (717 ) Noncontrolling interests assumed (44,303 ) (30,337 ) (18,905 ) Liabilities assumed (15,846 ) (3,317 ) (1,595 ) Aggregate purchase cost $ 334,990 $ 184,582 $ 62,003 Amortizable intangible assets acquired, primarily related to non-compete agreements, during 2017 , 2016 and 2015 had weighted-average estimated useful lives of seven , seven and eleven years, respectively. The total amount of goodwill deductible for tax purposes associated with these acquisitions for 2017 , 2016 , and 2015 was approximately $237,363 , $169,379 and $43,823 , respectively. Change in ownership interests in Asia Pacific joint venture On August 1, 2016, the Company consummated an agreement with Khazanah Nasional Berhad (Khazanah) and Mitsui and Co., Ltd (Mitsui) whereby Khazanah and Mitsui subscribed to invest a total of $300,000 over three years in exchange for a 40% total equity interest in the Company’s APAC JV. Khazanah and Mitsui made initial investments of $50,000 each on August 1, 2016 as well as additional subscribed contributions of $50,000 each on August 1, 2017. Subsequent to those contributions, 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 put in place upon the formation of the APAC JV, certain key decisions affecting the JV’s operations are no longer at the unilateral discretion of the Company, but rather are shared with the noncontrolling investors. As a result, the Company deconsolidated its Asia Pacific dialysis business in the third quarter of 2016 and recognized an initial non-cash non-taxable estimated gain of $374,374 on its retained investment, net of contingent obligations. This retained interest was adjusted to the Company’s proportionate share of the estimated fair value of the business, as implied by the Khazanah and Mitsui investment and adjusted for certain time value of money and uncertainty discounts. The Company then recognized an additional $6,293 gain in the first quarter of 2017 upon resolution of certain post-closing adjustments related to this transaction. The Company’s non-cash gain on its retained investment in the APAC JV in the third quarter of 2016 was computed with the assistance of an independent third party valuation firm and was based upon the best information available to management at that time. Subsequent to its deconsolidation on August 1 2016, the Company’s retained interest in the APAC JV has been accounted for under the equity method. See Note 9 for further details on the accounting for this retained investment and a subsequent other-than-temporary impairment thereof recognized in 2017. Pro forma financial information (unaudited) The following summary, prepared on a pro forma basis, combines the results of operations as if all acquisitions within continuing operations in 2017 and 2016 had been consummated as of the beginning of 2016, including the impact of certain adjustments such as amortization of intangibles, interest expense on acquisition financing and income tax effects. Year ended December 31, 2017 2016 (unaudited) Pro forma net revenues $ 11,005,330 $ 11,076,750 Pro forma net income from continuing operations 907,443 1,052,700 Pro forma basic net income per share from continuing operations 4.81 5.22 Pro forma diluted net income per share from continuing operations 4.74 5.14 Contingent earn-out obligations The Company has several contingent earn-out obligations associated with acquisitions that could result in the Company paying the former shareholders of acquired companies a total of up to approximately $11,466 if certain EBITDA, operating income performance targets or quality margins are met over the next two to six years. Contingent earn-out obligations are remeasured to fair value at each reporting date until the contingencies are resolved with changes in the liability due to the remeasurement recognized in earnings. See Note 24 to these consolidated financial statements for further details. As of December 31, 2017 , the Company estimated the fair value of these contingent earn-out obligations to be $6,388 , of which a total of $216 is included in other liabilities, and the remaining $6,172 is included in other long-term liabilities in the Company’s consolidated balance sheet. The following is a reconciliation of changes in the contingent earn-out obligations for the year ended December 31, 2017 : Beginning balance January 1, 2017 $ 2,950 Contingent earn-out obligations associated with acquisitions 2,692 Remeasurement of fair value 746 $ 6,388

Held for Sale and Discontinued

Held for Sale and Discontinued Operations	12 Months Ended
	Dec. 31, 2017
Discontinued Operations and Disposal Groups [Abstract]
Held for Sale and Discontinued Operations	Held for sale and discontinued operations DaVita Medical Group (DMG) On December 5, 2017, we entered into an equity purchase agreement to sell our DMG division to Optum, a subsidiary of UnitedHealth Group Inc., for $4,900,000 in cash, subject to net working capital and other customary adjustments. The transaction is expected to close in 2018 and is subject to regulatory approval and other customary closing conditions. As a result of this pending transaction, the DMG business has been reclassified as held for sale and its results of operations are reported as discontinued operations for all periods presented. The following table presents the financial results of discontinued operations related to DMG: Year ended December 31, 2017 2016 2015 Net revenues $ 4,676,213 $ 4,113,414 $ 3,837,260 Expenses 4,634,782 3,994,624 3,596,342 Goodwill and other asset impairment charges 651,659 253,000 206,169 (Loss) income from discontinued operations before taxes (610,228 ) (134,210 ) 34,749 Income tax benefit (expense) 364,856 (24,052 ) (88,216 ) Net loss from discontinued operations, net of tax $ (245,372 ) $ (158,262 ) $ (53,467 ) As previously disclosed, the Company’s DMG business has continued to experience declining operating results in recent years, and prior to being reclassified as held for sale the Company recorded goodwill and other asset impairment charges for the DMG business of $651,659 , $253,000 and $206,169 in 2017, 2016 and 2015, respectively. These charges resulted from continuing developments in the Company’s DMG business, including recent annual updates to Medicare Advantage benchmark reimbursement rates, changes in expectations concerning future government reimbursement rates and the Company’s expected ability to mitigate them, medical cost and utilization trends, commercial pricing pressures, underperformance of certain DMG business units and other market factors. The following table presents the financial position of discontinued operations related to DMG: December 31, 2017 December 31, 2016 Assets Cash and cash equivalents $ 179,668 $ 238,411 Other current assets 888,697 722,545 Property and equipment, net 379,945 311,246 Intangible assets, net 1,316,550 1,454,263 Other long-term assets 116,805 94,684 Goodwill 2,879,977 3,391,942 Total assets held for sale $ 5,761,642 $ 6,213,091 Total current assets held for sale $ 5,761,642 $ 960,956 Total long-term assets held for sale $ — $ 5,252,135 Liabilities Other liabilities $ 505,734 $ 460,458 Medical payables 457,040 349,506 Current portion of long-term debt 2,845 4,779 Long-term debt 35,003 2,652 Other long-term liabilities 184,448 418,723 Total liabilities held for sale $ 1,185,070 $ 1,236,118 Total current liabilities held for sale $ 1,185,070 $ 807,233 Total long-term liabilities held for sale $ — $ 428,885 The following table presents cash flows of discontinued operations related to DMG: Year ended December 31, 2017 2016 2015 Net cash provided by operating activities from discontinued $ 351,557 $ 287,049 $ 365,138 Net cash used in investing activities from discontinued operations $ (232,329 ) $ (430,917 ) $ (121,893 ) DMG acquisitions During 2017, the Company's DMG business acquired other medical businesses for a total of $135,416 in net cash, deferred purchase price of $1,038 , and liabilities assumed of $10,145 . During 2016, the Company acquired other medical businesses for a total of $398,748 in net cash and deferred purchase price and liabilities assumed of $7,694 . During 2015, the Company acquired other medical businesses for a total of $41,918 in net cash and deferred purchase price of $944 . For several of the 2017 acquisitions, certain income tax amounts are pending final evaluation and quantification of any pre-acquisition tax contingencies. In addition, valuation of medical claims liabilities and certain other working capital items relating to several of these acquisitions are pending final quantification. The assets and liabilities for all acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s current held for sale assets and liabilities.

Variable Interest Entities

Variable Interest Entities	12 Months Ended
	Dec. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Variable Interest Entities	Variable interest entities The Company relies on the operating activities of certain 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. 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 entities it is associated with that qualify as VIEs must be included in its consolidated financial statements. A number of these VIEs are within the Company's DMG business, which has been reclassified as held for sale and as a discontinued operation in these financial statements. The Company manages these entities and provides operating and capital funding as necessary for the entities to accomplish their operational and strategic objectives. A number of these entities are subject to nominee share ownership or share 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 its related party 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 December 31, 2017 , these consolidated financial statements include total assets of VIEs of $870,314 and total liabilities and noncontrolling interests of VIEs to third parties of $475,143 , including assets of $595,670 and liabilities and noncontrolling interests of $319,777 related to the Company's DMG business which is classified as held for sale. 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 related liabilities recorded in accrued compensation and benefits and other long-term liabilities. See Note 15 to these consolidated financial statements for disclosures on the assets of these consolidated non-qualified deferred compensation plans.

Concentrations

Concentrations	12 Months Ended
	Dec. 31, 2017
Risks and Uncertainties [Abstract]
Concentrations	Concentrations Approximately 67% , 64% and 66% of total U.S. dialysis services revenues in 2017 , 2016 and 2015 , respectively, are from government-based programs, principally Medicare and Medicaid. Related net accounts receivable and other receivables from Medicare, including Medicare-assigned plans, and Medicaid, including Managed Medicaid plans, were approximately $869,083 and $831,445 , as of December 31, 2017 and 2016 , respectively. There is no single commercial payor that accounted for more than 10% of total consolidated accounts receivable or consolidated net revenues at December 31, 2017 and 2016 .

Fair Values of Financial Instru

Fair Values of Financial Instruments	12 Months Ended
	Dec. 31, 2017
Fair Value Disclosures [Abstract]
Fair Values of Financial Instruments	Fair values of financial instruments The Company measures the fair value of certain assets, liabilities and noncontrolling interests subject to put provisions (temporary equity) based upon certain 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 certain assets, liabilities and temporary equity that are measured at fair value into the appropriate fair value hierarchy levels as defined by the FASB. The following tables summarize the Company’s assets, liabilities and temporary equity measured at fair value on a recurring basis as of December 31, 2017 and 2016 : December 31, 2017 Total Quoted prices in Significant other Significant Assets Available for sale securities $ 38,895 $ 38,895 $ — $ — Interest rate cap agreements $ 1,032 $ — $ 1,032 $ — Liabilities Contingent earn-out obligations $ 6,388 $ — $ — $ 6,388 Temporary equity Noncontrolling interests subject to put provisions $ 1,011,360 $ — $ — $ 1,011,360 December 31, 2016 Assets Available for sale securities $ 31,197 $ 31,197 $ — $ — Interest rate cap agreements $ 9,929 $ — $ 9,929 $ — Liabilities Contingent earn-out obligations $ 2,950 $ — $ — $ 2,950 Temporary equity Noncontrolling interests subject to put provisions $ 973,258 $ — $ — $ 973,258 Available for sale securities represent investments in various open-ended registered investment companies, or mutual funds, and are recorded at fair value estimated based upon redemption prices reported by each mutual fund. See Note 3 to these consolidated financial statements for further discussion. The 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 13 to these consolidated financial statements for further discussion. The estimated fair value measurements of contingent earn-out obligations are primarily based on unobservable inputs, including projected EBITDA. The estimated fair value of these contingent earn-out obligations is 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 17 to these consolidated financial statements for a discussion of the Company’s methodology for estimating the fair values 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 non-debt financial instruments are presented in the consolidated financial statements at December 31, 2017 and 2016 at their approximate fair values due to the short-term nature of their settlements. The carrying amount of the Company’s senior secured credit facilities totaled $4,428,376 as of December 31, 2017 , and their fair value was approximately $4,495,649 based upon quoted market prices. The carrying amount of the Company’s Senior Notes was approximately $4,460,176 at December 31, 2017 and their fair value was approximately $4,566,175 at December 31, 2017 based upon quoted market prices.

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2017
Segment Reporting [Abstract]
Segment Reporting	Segment reporting The Company has consisted of two major divisions, DaVita Kidney Care (Kidney Care) and DaVita Medical Group (DMG). The Kidney Care division is comprised of the Company’s U.S. dialysis and related lab services business, various 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 ESRD. 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, ESRD seamless care organizations and comprehensive care as well as the Company’s international operations. The Company’s DMG division is a patient- and physician-focused integrated healthcare delivery and management company with over two decades of providing coordinated outcomes-based medical care in a cost-effective manner. On December 5, 2017, the Company entered into an equity purchase agreement to sell its DMG division to Optum, a subsidiary of UnitedHealth Group Inc. The transaction is expected to close in 2018 and is subject to regulatory approval and other customary closing conditions. As a result of this pending transaction, the DMG business has been reclassified as held for sale and its results of operations are reported as discontinued operations for all periods presented in these consolidated financial statements. 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, each of its ancillary services and strategic initiatives, its consolidated international kidney care operations in each country and under the Saudi Ministry of Health charter, its equity method investment in the Asia Pacific joint venture, and its other health operations in Europe. The U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all 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 Company's operating segments. For internal management reporting, segment operations include direct segment operating expenses but generally exclude corporate administrative support costs, which consist primarily of indirect labor, benefits and long-term incentive-based compensation expenses of certain departments which provide support to all of the Company’s various operating lines of business, except to the extent that such costs are charged to and borne by certain ancillary services and strategic initiatives via internal management fees. These corporate administrative support costs are reduced by internal management fees received from the Company’s ancillary lines of business. The following is a summary of segment revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Year ended December 31, 2017 2016 2015 Segment revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 9,767,123 $ 9,524,067 $ 9,014,577 Intersegment revenues 55,175 27,355 19,414 Total U.S. dialysis and related lab services revenues 9,822,298 9,551,422 9,033,991 Less: Provision for uncollectible accounts (482,007 ) (429,882 ) (406,530 ) Net U.S. dialysis and related lab services patient service revenues 9,340,291 9,121,540 8,627,461 Other revenues (1) 19,774 16,649 13,971 Total net U.S. dialysis and related lab services revenues 9,360,065 9,138,189 8,641,432 Other - Ancillary services and strategic initiatives Net patient service revenues 323,156 201,867 134,496 Other external sources 1,248,588 1,394,766 1,225,731 Intersegment revenues 24,603 24,739 22,204 Total ancillary services and strategic initiatives revenues 1,596,347 1,621,372 1,382,431 Total net segment revenues 10,956,412 10,759,561 10,023,863 Elimination of intersegment revenues (79,778 ) (52,094 ) (41,618 ) Consolidated net revenues $ 10,876,634 $ 10,707,467 $ 9,982,245 Segment operating margin (loss): U.S. dialysis and related lab services $ 2,297,198 $ 1,777,014 $ 1,259,632 Other—Ancillary services and strategic initiatives (439,477 ) 266,324 (103,901 ) Total segment margin 1,857,721 2,043,338 1,155,731 Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Corporate administrative support (44,966 ) (13,628 ) (18,965 ) Consolidated operating income 1,812,755 2,029,710 1,136,766 Debt expense (430,634 ) (414,116 ) (408,380 ) Debt redemption charges — — (48,072 ) Other income 17,665 7,511 8,073 Consolidated income from continuing operations before income $ 1,399,786 $ 1,623,105 $ 688,387 (1) Includes management fee revenues from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling interest or which are wholly-owned by third parties. Depreciation and amortization expense by segment is as follows: Year ended December 31, 2017 2016 2015 U.S. dialysis and related lab services $ 520,965 $ 482,768 $ 438,238 Other - Ancillary services and strategic initiatives 38,946 26,729 25,667 $ 559,911 $ 509,497 $ 463,905 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. Summary of assets by segment is as follows: Year ended December 31, 2017 2016 Segment assets U.S. dialysis and related lab services (including equity investments of $ 11,776,042 $ 11,108,386 Other - Ancillary services and strategic initiatives (1) (including equity 1,410,509 1,434,299 DMG - Held for sale (including equity investments of $10,321 and $10,350, respectively) 5,761,642 6,213,091 Consolidated assets $ 18,948,193 $ 18,755,776 (1) Includes approximately $125,932 and $96,396 in 2017 and 2016 , respectively, of net property and equipment related to the Company’s international operations. Expenditures for property and equipment by segment is as follows: Year ended December 31, 2017 2016 2015 U.S. dialysis and related lab services $ 759,218 $ 675,994 $ 584,513 Other - Ancillary services and strategic initiatives 50,891 68,702 56,685 DMG - Held for sale 95,141 84,399 66,800 $ 905,250 $ 829,095 $ 707,998

Supplemental Cash Flow Informat

Supplemental Cash Flow Information	12 Months Ended
	Dec. 31, 2017
Supplemental Cash Flow Elements [Abstract]
Supplemental Cash Flow Information	Supplemental cash flow information The table below provides supplemental cash flow information: Year ended December 31, 2017 2016 2015 Cash paid: Income taxes $ 387,159 $ 339,411 $ 156,075 Interest 424,547 406,987 405,120 Non-cash investing and financing activities: Fixed assets under capital lease obligations 48,378 28,127 74,035

Selected Quarterly Financial Da

Selected Quarterly Financial Data (unaudited)	12 Months Ended
	Dec. 31, 2017
Quarterly Financial Information Disclosure [Abstract]
Selected Quarterly Financial Data (unaudited)	Selected quarterly financial data (unaudited) 2017 2016 December 31 September 30 June 30 March 31 December 31 September 30 June 30 March 31 Net revenues $ 2,780,913 $ 2,765,071 $ 2,699,399 $ 2,631,251 $ 2,699,419 $ 2,725,407 $ 2,675,474 $ 2,607,167 Operating income $ 150,337 $ 395,294 $ 391,196 $ 875,928 $ 363,445 $ 813,103 $ 431,129 $ 422,033 Net income from $ 46,825 $ 289,384 $ 288,060 $ 775,517 $ 259,669 $ 710,246 $ 331,231 $ 321,959 Net income (loss) $ 143,587 $ (370,872 ) $ (24,520 ) $ 6,433 $ 11,772 $ 20,213 $ (118,443 ) $ (71,804 ) Net income (loss) $ 303,396 $ (214,476 ) $ 127,001 $ 447,697 $ 157,726 $ 571,332 $ 53,382 $ 97,434 Basic net income $ 0.86 $ 0.81 $ 0.79 $ 2.29 $ 0.74 $ 2.69 $ 0.84 $ 0.83 Basic net income $ 0.80 $ (1.95 ) $ (0.13 ) $ 0.04 $ 0.07 $ 0.11 $ (0.58 ) $ (0.35 ) Basic net income $ 1.66 $ (1.14 ) $ 0.66 $ 2.33 $ 0.81 $ 2.80 $ 0.26 $ 0.48 Diluted net income $ 0.85 $ 0.80 $ 0.78 $ 2.26 $ 0.73 $ 2.65 $ 0.82 $ 0.81 Diluted net income $ 0.79 $ (1.92 ) $ (0.13 ) $ 0.03 $ 0.07 $ 0.11 $ (0.56 ) $ (0.34 ) Diluted net income $ 1.64 $ (1.12 ) $ 0.65 $ 2.29 $ 0.80 $ 2.76 $ 0.26 $ 0.47

Consolidating Financial Stateme

Consolidating Financial Statements	12 Months Ended
	Dec. 31, 2017
Condensed Financial Information of Parent Company Only Disclosure [Abstract]
Consolidating Financial Statements	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 consolidated financial statements are fully interdependent and integrated. Revenues and operating expenses of the separate legal entities include intercompany charges for management and other services. The Company’s Senior Notes are guaranteed by substantially all of its domestic subsidiaries. Each of the guarantor subsidiaries has guaranteed the Senior Notes on a joint and several basis. However, the guarantor subsidiaries can be released from their obligations in the event of a sale or other disposition of all or substantially all of the assets of such subsidiary, including by merger or consolidation or the sale of all equity interests in such subsidiary owned by the Company, if such subsidiary guarantor is designated as an unrestricted subsidiary or otherwise ceases to be a restricted subsidiary, and if such subsidiary guarantor no longer guaranties any other indebtedness of the Company. Certain domestic subsidiaries, foreign subsidiaries, joint ventures, partnerships and third parties are not guarantors of the Senior Notes. Consolidating Statements of Income DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For twelve months ended December 31, 2017 Dialysis and related lab patient service revenues $ — $ 6,884,750 $ 3,393,026 $ (184,106 ) $ 10,093,670 Less: Provision for uncollectible accounts — (340,586 ) (151,982 ) 7,170 (485,398 ) Net dialysis and related lab patient service revenues — 6,544,164 3,241,044 (176,936 ) 9,608,272 Other revenues 793,751 1,204,501 68,322 (798,212 ) 1,268,362 Total net revenues 793,751 7,748,665 3,309,366 (975,148 ) 10,876,634 Operating expenses and charges 527,942 6,475,550 3,035,535 (975,148 ) 9,063,879 Operating income 265,809 1,273,115 273,831 — 1,812,755 Debt expense (426,149 ) (209,612 ) (34,831 ) 239,958 (430,634 ) Other income, net 411,731 11,169 18,467 (423,702 ) 17,665 Income tax expense 65,965 237,670 20,224 — 323,859 Equity earnings in subsidiaries 478,192 74,375 — (552,567 ) — Net income from continuing operations 663,618 911,377 237,243 (736,311 ) 1,075,927 Net (loss) income from discontinued operations, net — (433,185 ) 4,069 183,744 (245,372 ) Net income 663,618 478,192 241,312 (552,567 ) 830,555 Less: Net income attributable to noncontrolling — — — (166,937 ) (166,937 ) Net income attributable to DaVita Inc. $ 663,618 $ 478,192 $ 241,312 $ (719,504 ) $ 663,618 For twelve months ended December 31, 2016 Dialysis and related lab patient service revenues $ — $ 6,665,601 $ 3,215,085 $ (153,326 ) $ 9,727,360 Less: Provision for uncollectible accounts — (272,430 ) (158,878 ) — (431,308 ) Net dialysis and related lab patient service revenues — 6,393,171 3,056,207 (153,326 ) 9,296,052 Other revenues 767,791 1,378,956 30,184 (765,516 ) 1,411,415 Total net revenues 767,791 7,772,127 3,086,391 (918,842 ) 10,707,467 Operating expenses and charges 493,175 6,907,469 2,195,955 (918,842 ) 8,677,757 Operating income 274,616 864,658 890,436 — 2,029,710 Debt expense (407,925 ) (191,083 ) (40,434 ) 225,326 (414,116 ) Other income, net 396,797 3,726 7,694 (400,706 ) 7,511 Income tax expense 77,334 238,446 115,981 — 431,761 Equity earnings in subsidiaries 693,720 667,278 — (1,360,998 ) — Net income from continuing operations 879,874 1,106,133 741,715 (1,536,378 ) 1,191,344 Net (loss) income from discontinued operations, net — (412,413 ) 78,771 175,380 (158,262 ) Net income 879,874 693,720 820,486 (1,360,998 ) 1,033,082 Less: Net income attributable to noncontrolling — — — (153,208 ) (153,208 ) Net income attributable to DaVita Inc. $ 879,874 $ 693,720 $ 820,486 $ (1,514,206 ) $ 879,874 Consolidating Statements of Income - (continued) DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For twelve months ended December 31, 2015 Dialysis and related lab patient service revenues $ — $ 6,471,702 $ 2,814,909 $ (131,164 ) $ 9,155,447 Less: Provision for uncollectible accounts — (281,976 ) (130,929 ) — (412,905 ) Net dialysis and related lab patient service — 6,189,726 2,683,980 (131,164 ) 8,742,542 Other revenues 727,887 1,208,607 24,013 (720,804 ) 1,239,703 Total net revenues 727,887 7,398,333 2,707,993 (851,968 ) 9,982,245 Operating expenses and charges 488,595 6,925,234 2,283,618 (851,968 ) 8,845,479 Operating income 239,292 473,099 424,375 — 1,136,766 Debt (expense) and refinancing charges (449,598 ) (178,389 ) (32,450 ) 203,985 (456,452 ) Other income, net 365,752 1,261 6,921 (365,861 ) 8,073 Income tax expense (benefit) 60,671 163,401 (16,562 ) — 207,510 Equity earnings in subsidiaries 174,957 322,022 — (496,979 ) — Net income from continuing operations 269,732 454,592 415,408 (658,855 ) 480,877 Net (loss) income from discontinued operations, — (279,635 ) 64,292 161,876 (53,467 ) Net income 269,732 174,957 479,700 (496,979 ) 427,410 Less: Net income attributable to noncontrolling — — — (157,678 ) (157,678 ) Net income attributable to DaVita Inc. $ 269,732 $ 174,957 $ 479,700 $ (654,657 ) $ 269,732 Consolidating Statements of Comprehensive Income DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For the year ended December 31, 2017 Net income $ 663,618 $ 478,192 $ 241,312 $ (552,567 ) $ 830,555 Other comprehensive income 3,106 — 99,770 — 102,876 Total comprehensive income 666,724 478,192 341,082 (552,567 ) 933,431 Less: Comprehensive income attributable to — — — (166,935 ) (166,935 ) Comprehensive income attributable to DaVita Inc. $ 666,724 $ 478,192 $ 341,082 $ (719,502 ) $ 766,496 For the year ended December 31, 2016 Net income $ 879,874 $ 693,720 $ 820,486 $ (1,360,998 ) $ 1,033,082 Other comprehensive loss (290 ) — (29,337 ) — (29,627 ) Total comprehensive income 879,584 693,720 791,149 (1,360,998 ) 1,003,455 Less: Comprehensive income attributable to — — — (153,398 ) (153,398 ) Comprehensive income attributable to DaVita Inc. $ 879,584 $ 693,720 $ 791,149 $ (1,514,396 ) $ 850,057 For the year ended December 31, 2015 Net income $ 269,732 $ 174,957 $ 479,700 $ (496,979 ) $ 427,410 Other comprehensive loss (10,920 ) — (23,889 ) — (34,809 ) Total comprehensive income 258,812 174,957 455,811 (496,979 ) 392,601 Less: Comprehensive income attributable to — — — (157,678 ) (157,678 ) Comprehensive income attributable to DaVita Inc. $ 258,812 $ 174,957 $ 455,811 $ (654,657 ) $ 234,923 Consolidating Balance Sheets DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total As of December 31, 2017 Cash and cash equivalents $ 149,305 $ — $ 358,929 $ — $ 508,234 Accounts receivable, net — 1,208,715 506,035 — 1,714,750 Other current assets 68,027 604,450 87,255 — 759,732 Current assets held for sale — 4,992,067 769,575 — 5,761,642 Total current assets 217,332 6,805,232 1,721,794 — 8,744,358 Property and equipment, net 408,010 1,560,390 1,180,813 — 3,149,213 Intangible assets, net 250 50,971 62,606 — 113,827 Investments in subsidiaries 10,009,874 3,085,722 — (13,095,596 ) — Intercompany receivables 3,677,947 — 1,313,213 (4,991,160 ) — Other long-term assets and investments 47,297 68,344 214,875 — 330,516 Goodwill — 4,732,320 1,877,959 — 6,610,279 Total assets $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Current liabilities $ 238,706 $ 1,181,139 $ 436,262 $ — $ 1,856,107 Current liabilities held for sale — 739,294 445,776 — 1,185,070 Total current liabilities 238,706 1,920,433 882,038 — 3,041,177 Intercompany payables — 3,690,042 1,301,118 (4,991,160 ) — Long-term debt and other long-term liabilities 8,857,373 682,630 469,587 — 10,009,590 Noncontrolling interests subject to put provisions 574,602 — — 436,758 1,011,360 Total DaVita Inc. shareholders' equity 4,690,029 10,009,874 3,085,722 (13,095,596 ) 4,690,029 Noncontrolling interests not subject to put — — 632,795 (436,758 ) 196,037 Total equity 4,690,029 10,009,874 3,718,517 (13,532,354 ) 4,886,066 Total liabilities and equity $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Consolidating Balance Sheets - (continued) DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total As of December 31, 2016 Cash and cash equivalents $ 549,921 $ — $ 124,855 $ — $ 674,776 Accounts receivable, net — 1,048,580 455,370 — 1,503,950 Other current assets 277,911 462,684 114,471 — 855,066 Current assets held for sale — 514,407 446,549 — 960,956 Total current assets 827,832 2,025,671 1,141,245 — 3,994,748 Property and equipment, net 337,200 1,444,248 1,082,673 — 2,864,121 Intangible assets, net 487 42,037 30,980 — 73,504 Investments in subsidiaries 9,717,728 2,021,062 — (11,738,790 ) — Intercompany receivables 3,250,692 — 866,955 (4,117,647 ) — Other long-term assets and investments 39,994 73,466 442,433 — 555,893 Goodwill — 4,480,344 1,535,031 — 6,015,375 Long-term assets held for sale — 5,066,453 185,682 — 5,252,135 Total assets $ 14,173,933 $ 15,153,281 $ 5,284,999 $ (15,856,437 ) $ 18,755,776 Current liabilities $ 303,840 $ 1,343,748 $ 256,143 $ — $ 1,903,731 Current liabilities held for sale — 533,250 273,983 — 807,233 Total current liabilities 303,840 1,876,998 530,126 — 2,710,964 Intercompany payables — 2,382,428 1,735,219 (4,117,647 ) — Long-term debt and other long-term liabilities 8,614,445 835,845 342,638 — 9,792,928 Long-term liabilities held for sale — 340,282 88,603 — 428,885 Noncontrolling interests subject to put provisions 607,601 — — 365,657 973,258 Total DaVita Inc. shareholders' equity 4,648,047 9,717,728 2,021,062 (11,738,790 ) 4,648,047 Noncontrolling interests not subject to put — — 567,351 (365,657 ) 201,694 Total equity 4,648,047 9,717,728 2,588,413 (12,104,447 ) 4,849,741 Total liabilities and equity $ 14,173,933 $ 15,153,281 $ 5,284,999 $ (15,856,437 ) $ 18,755,776 Consolidating Statements of Cash Flow DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated For the year ended December 31, 2017 Cash flows from operating activities: Net income $ 663,618 $ 478,192 $ 241,312 $ (552,567 ) $ 830,555 Changes in operating assets and liabilities and (534,302 ) 366,947 691,682 552,567 1,076,894 Net cash provided by operating activities 129,316 845,139 932,994 — 1,907,449 Cash flows from investing activities: Additions of property and equipment, net (155,972 ) (490,800 ) (258,478 ) — (905,250 ) Acquisitions — (693,522 ) (110,357 ) — (803,879 ) Proceeds from asset sales, net of cash divested — 90,340 1,996 — 92,336 Investments and other items 211,619 (9,003 ) 47,446 — 250,062 Net cash provided by (used in) investing 55,647 (1,102,985 ) (319,393 ) — (1,366,731 ) Cash flows from financing activities: Long-term debt and related financing costs, net 173,529 (12,662 ) (6,019 ) — 154,848 Intercompany borrowing 22,589 218,980 (241,569 ) — — Other items (781,697 ) (2,493 ) (136,915 ) — (921,105 ) Net cash (used in) provided by financing (585,579 ) 203,825 (384,503 ) — (766,257 ) Effect of exchange rate changes on cash — — 254 — 254 Net (decrease) increase in cash and cash (400,616 ) (54,021 ) 229,352 — (225,285 ) Less: Net decrease in cash and cash equivalents — (54,021 ) (4,722 ) — (58,743 ) Net (decrease) increase in cash and cash (400,616 ) — 234,074 — (166,542 ) Cash and cash equivalents of continuing operations 549,921 — 124,855 — 674,776 Cash and cash equivalents of continuing operations $ 149,305 $ — $ 358,929 $ — $ 508,234 Consolidating Statements of Cash Flow - (continued) DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated For the year ended December 31, 2016 Cash flows from operating activities: Net income $ 879,874 $ 693,720 $ 820,486 $ (1,360,998 ) $ 1,033,082 Changes in operating assets and liabilities and (612,706 ) 350,684 (168,614 ) 1,360,998 930,362 Net cash provided by operating activities 267,168 1,044,404 651,872 — 1,963,444 Cash flows from investing activities: Additions of property and equipment, net (139,303 ) (382,305 ) (307,487 ) — (829,095 ) Acquisitions — (472,413 ) (91,443 ) — (563,856 ) Proceeds from asset and business sales, net of cash — 70,342 (5,617 ) — 64,725 Investments and other items 153,031 (29,038 ) 2,565 — 126,558 Net cash provided by (used in) investing 13,728 (813,414 ) (401,982 ) — (1,201,668 ) Cash flows from financing activities: Long-term debt and related financing costs, net (92,460 ) (27,830 ) (4,152 ) — (124,442 ) Intercompany borrowing 236,052 (231,800 ) (4,252 ) — — Other items (1,061,203 ) (21,525 ) (144,811 ) — (1,227,539 ) Net cash used in financing activities (917,611 ) (281,155 ) (153,215 ) — (1,351,981 ) Effect of exchange rate changes on cash — — 4,276 — 4,276 Net (decrease) increase in cash and cash (636,715 ) (50,165 ) 100,951 — (585,929 ) Less: Net (decrease) increase in cash and cash — (50,165 ) 34,377 — (15,788 ) Net (decrease) increase in cash and cash (636,715 ) — 66,574 — (570,141 ) Cash and cash equivalents of continuing operations 1,186,636 — 58,281 — 1,244,917 Cash and cash equivalents of continuing operations $ 549,921 $ — $ 124,855 $ — $ 674,776 Consolidating Statements of Cash Flow - (continued) DaVita Inc. Guarantor Subsidiaries Non-Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For the year ended December 31, 2015 Cash flows from operating activities: Net income $ 269,732 $ 174,957 $ 479,700 $ (496,979 ) $ 427,410 Changes in operating assets and liabilities and (125,981 ) 684,760 74,032 496,979 1,129,790 Net cash provided by operating activities 143,751 859,717 553,732 — 1,557,200 Cash flows from investing activities: Additions of property and equipment, net (115,269 ) (319,695 ) (273,034 ) — (707,998 ) Acquisitions — (76,983 ) (19,486 ) — (96,469 ) Proceeds from asset sales — 19,715 — — 19,715 Investments and other items (74,474 ) (2,144 ) (20,414 ) — (97,032 ) Net cash used in investing activities (189,743 ) (379,107 ) (312,934 ) — (881,784 ) Cash flows from financing activities: Long-term debt and related financing costs, net 640,009 (11,953 ) (8,358 ) — 619,698 Intercompany borrowing 466,038 (370,839 ) (95,199 ) — — Other items (572,295 ) (66,382 ) (119,991 ) — (758,668 ) Net cash provided by (used in) financing 533,752 (449,174 ) (223,548 ) — (138,970 ) Effect of exchange rate changes on cash — — (2,571 ) — (2,571 ) Net increase in cash and cash equivalents 487,760 31,436 14,679 — 533,875 Less: Net increase (decrease) in cash and cash — 31,436 (5,581 ) — 25,855 Net increase in cash and cash equivalents from 487,760 — 20,260 — 508,020 Cash and cash equivalents of continuing operations 698,876 — 38,021 — 736,897 Cash and cash equivalents of continuing operations $ 1,186,636 $ — $ 58,281 $ — $ 1,244,917

Supplemental Data (unaudited)

Supplemental Data (unaudited)	12 Months Ended
	Dec. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Supplemental Data (unaudited)	Supplemental data (unaudited) 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 year ended December 31, 2017 Dialysis and related lab patient service revenues $ 10,093,670 $ — $ — $ 10,093,670 Less: Provision for uncollectible accounts (485,398 ) — — (485,398 ) Net dialysis and related lab patient service revenues 9,608,272 — — 9,608,272 Other revenues 1,268,362 — — 1,268,362 Total net revenues 10,876,634 — — 10,876,634 Operating expenses and charges 9,063,879 — — 9,063,879 Operating income 1,812,755 — — 1,812,755 Debt expense (430,634 ) — — (430,634 ) Other income, net 17,665 — — 17,665 Income tax expense 323,859 — — 323,859 Net income from continuing operations 1,075,927 — — 1,075,927 Net (loss) income from discontinued operations, net of tax (245,372 ) 13,611 19 (259,002 ) Net income 830,555 13,611 19 816,925 Less: Net income attributable to noncontrolling interests (166,937 ) 7,183 — (174,120 ) Net income attributable to DaVita Inc. $ 663,618 $ 20,794 $ 19 $ 642,805 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For the year ended December 31, 2017 Net income $ 830,555 $ 13,611 $ 19 $ 816,925 Other comprehensive income 102,876 — — 102,876 Total comprehensive income 933,431 13,611 19 919,801 Less: Comprehensive income attributable to noncontrolling (166,935 ) 7,183 — (174,118 ) Comprehensive income attributable to DaVita Inc. $ 766,496 $ 20,794 $ 19 $ 745,683 (1) After the 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 December 31, 2017 Cash and cash equivalents $ 508,234 $ — $ — $ 508,234 Accounts receivable, net 1,714,750 — — 1,714,750 Other current assets 759,732 3,033 — 756,699 Other current assets held for sale 5,761,642 423,205 2,733 5,335,704 Total current assets 8,744,358 426,238 2,733 8,315,387 Property and equipment, net 3,149,213 — — 3,149,213 Amortizable intangibles, net 113,827 — — 113,827 Other long-term assets 330,516 — — 330,516 Goodwill 6,610,279 — — 6,610,279 Total assets $ 18,948,193 $ 426,238 $ 2,733 $ 18,519,222 Current liabilities $ 1,856,107 $ — $ — $ 1,856,107 Current liabilities held for sale 1,185,070 308,884 — 876,186 Total current liabilities 3,041,177 308,884 — 2,732,293 Payables to parent — — 2,733 (2,733 ) Long-term debt and other long-term liabilities 10,009,590 — — 10,009,590 Noncontrolling interests subject to put provisions 1,011,360 — — 1,011,360 Total DaVita Inc. shareholders' equity 4,690,029 117,354 — 4,572,675 Noncontrolling interests not subject to put provisions 196,037 — — 196,037 Shareholders' equity 4,886,066 117,354 — 4,768,712 Total liabilities and shareholders' equity $ 18,948,193 $ 426,238 $ 2,733 $ 18,519,222 C ondensed Consolidating Statements of Cash Flow Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For the year ended December 31, 2017 Cash flows from operating activities: Net income $ 830,555 $ 13,611 $ 19 $ 816,925 Changes in operating and intercompany assets and liabilities and 1,076,894 27,312 (19 ) 1,049,601 Net cash provided by operating activities 1,907,449 40,923 — 1,866,526 Cash flows from investing activities: Additions of property and equipment (905,250 ) (5,406 ) — (899,844 ) Acquisitions and divestitures, net (803,879 ) — — (803,879 ) Proceeds from asset sales 92,336 — — 92,336 Investments and other items, net 250,062 (3,800 ) — 253,862 Net cash used in investing activities (1,366,731 ) (9,206 ) — (1,357,525 ) Cash flows from financing activities: Long-term debt and related financing costs, net 154,848 — — 154,848 Intercompany — (36,220 ) — 36,220 Other items (921,105 ) — — (921,105 ) Net cash used in financing activities (766,257 ) (36,220 ) — (730,037 ) Effect of exchange rate changes on cash 254 — — 254 Net decrease in cash and cash equivalents (225,285 ) (4,503 ) — (220,782 ) Less: Net decrease in cash and cash equivalents from discontinued operations (58,743 ) (4,503 ) — (54,240 ) Net decrease in cash and cash equivalents from continuing operations (166,542 ) — — (166,542 ) Cash and cash equivalents of continuing operations at beginning of the year 674,776 — — 674,776 Cash and cash equivalents of continuing operations at end of the year $ 508,234 $ — $ — $ 508,234 (1) After the elimination of the unrestricted subsidiaries and the physician groups

SCHEDULE II-VALUATION AND QUALI

SCHEDULE II-VALUATION AND QUALIFYING ACCOUNTS	12 Months Ended
	Dec. 31, 2017
Valuation and Qualifying Accounts [Abstract]
SCHEDULE II-VALUATION AND QUALIFYING ACCOUNTS	SCHEDULE II—VALUATION AND QUALIFYING ACCOUNTS Balance at Acquisitions Amounts Amounts written off Balance Description (in thousands) Allowance for uncollectible accounts: Year ended December 31, 2017 $ 238,897 $ — $ 478,365 $ 498,863 $ 218,399 Year ended December 31, 2016 $ 251,734 $ — $ 442,985 $ 455,822 $ 238,897 Year ended December 31, 2015 $ 229,802 $ — $ 422,145 $ 400,213 $ 251,734

Organization and Summary of S38

Organization and Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2017
Accounting Policies [Abstract]
Basis of presentation	Basis of presentation These consolidated financial statements are prepared in accordance with United States generally accepted accounting principles (U.S. GAAP). The financial statements include DaVita Inc. and its subsidiaries, partnerships and other entities in which it maintains a majority voting interest or other controlling financial interest (collectively, the Company). All significant intercompany transactions and balances have been eliminated. Non-marketable equity investments are recorded under the equity or cost method of accounting based upon whether the Company has significant influence over the investee. For the Company’s international subsidiaries, local currencies are considered their functional currencies. Translation adjustments result from translating the Company’s international subsidiaries’ financial statements from their functional currencies into the Company’s reporting currency (USD). 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 consolidated financial statements were issued and has included all necessary adjustments and disclosures.
Use of estimates	Use of estimates The preparation of financial statements in conformity with U.S. GAAP requires the use of estimates and assumptions that affect the reported amounts of revenues, expenses, assets, liabilities, contingencies and noncontrolling interests subject to put provisions. Although actual results in subsequent periods will differ from these estimates, such estimates are developed based on the best information available to management and management’s best judgments at the time. All significant assumptions and estimates underlying the amounts reported in the financial statements and accompanying notes are regularly reviewed and updated when necessary. Changes in estimates are reflected in the financial statements based upon on-going actual experience trends, or subsequent settlements and realizations depending on the nature and predictability of the estimates and contingencies. Interim changes in estimates related to annual operating costs are applied prospectively within annual periods. The most significant assumptions and estimates underlying these financial statements and accompanying notes involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and investments, accounting for income taxes, long-term variable compensation accruals, consolidation of variable interest entities, and certain fair value estimates. Specific estimating risks and contingencies are further addressed within these notes to the consolidated financial statements.
Patient service net revenues and accounts receivable	Patient service net revenues and accounts receivable U.S. dialysis and related lab services U.S. dialysis patient service net revenues are recognized in the period services are provided. Revenues consist primarily of payments from Medicare, Medicaid and commercial health plans for dialysis and ancillary services provided to patients. A usual and customary fee schedule is maintained for the Company’s dialysis treatments and other patient services; however, actual collectible revenue is normally recognized at a discount from the fee schedule. Revenues associated with Medicare and Medicaid programs are recognized based on: (a) the payment rates that are established by statute or regulation for the portion of payment rates paid by the government payor (e.g., 80% for Medicare patients) and (b) for the portion not paid by the primary government payor, estimates of the amounts ultimately collectible from other government programs paying secondary coverage (e.g., Medicaid secondary coverage), the patient’s commercial health plan secondary coverage, or the patient. The Company’s reimbursements from Medicare are subject to certain variations under Medicare’s single bundled payment rate system, whereby reimbursements can be adjusted for certain patient characteristics and other factors. The Company’s revenue recognition will depend upon its ability to effectively capture, document and bill for Medicare’s base payment rate as well as these other variable factors. Revenues associated with commercial health plans are estimated based on contractual terms for the patients under healthcare plans with which the Company has formal agreements, non-contracted health plan coverage terms if known, estimated secondary collections, historical collection experience, historical trends of refunds and payor payment adjustments (retractions), inefficiencies in the Company’s billing and collection processes that can result in denied claims for payments, and regulatory compliance matters. Commercial revenue recognition also involves significant estimating risks. With many larger, commercial insurers the Company has several different contracts and payment arrangements, and these contracts often include only a subset of the Company’s centers. It is often not possible to determine which contract, if any, should be applied prior to billing. In addition, for services provided by non-contracted centers, final collection may require specific negotiation of a payment amount, typically at a significant discount from the Company’s usual and customary rates. Under Medicare’s bundled payment rate system, services covered by Medicare are subject to estimating risk, whereby reimbursements from Medicare can vary significantly depending upon certain patient characteristics and other variable factors. Even with the bundled payment rate system, Medicare payments for bad debt claims as established by cost reports require evidence of collection efforts. As a result, billing and collection of Medicare bad debt claims can be delayed significantly and final payment is subject to audit. Medicaid payments, when Medicaid coverage is secondary, can also be difficult to estimate. For many states, Medicaid payment terms and methods differ from Medicare, and may prevent accurate estimation of individual payment amounts prior to billing. The Company’s range of revenue estimating risk for the U.S. dialysis and related lab services segment is generally expected to be within 1% of its revenue. Changes in revenue estimates for prior periods are not material. Other revenues Other revenues consist of the revenues associated with the ancillary services and strategic initiatives, management and administrative support services that are provided to outpatient dialysis centers that the Company does not own or in which the Company owns a noncontrolling interest, and administrative and management support services to certain other non-dialysis joint ventures in which the Company owns a noncontrolling interest. Revenues associated with pharmacy services are recognized as prescriptions are filled and shipped to patients. Revenues associated with disease management services, medical consulting services, clinical research programs, physician services, ESRD seamless care organizations, and comprehensive care are recognized in the period services are provided. Revenues associated with direct primary care are recognized over the membership period. Management fees are principally determined as a percentage of the managed operations’ revenues or cash collections and in some cases an additional component based upon a percentage of operating income. Management fees are included in net revenues when earned.
Allowance for uncollectible accounts	Allowance for uncollectible accounts Net revenue recognition and allowances for uncollectible billings require the use of estimates of the amounts that will ultimately be realized considering, among other items, retroactive adjustments that may be associated with regulatory reviews, audits, billing reviews and other matters. The Company’s policy is to write off any uncollectible accounts receivable balance only after all collection efforts have been exhausted or when write off is mandated by federal or state policies or required by certain payor contracts. It is also the Company’s policy to write off any accounts receivable balance associated with any payors or patients when the Company receives notification of a bankruptcy filing.
Other income	Other income Other income includes interest income on cash and cash-equivalents and short- and long-term investments, other non-operating gains from investment transactions, and foreign currency transaction gains and losses.
Cash and cash equivalents	Cash and cash equivalents Cash equivalents are short-term highly liquid investments with maturities of three months or less at date of purchase.
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 strategies 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.
Inventories	Inventories Inventories are stated at the lower of cost (first-in, first-out) or market and consist principally of pharmaceuticals and dialysis-related supplies. Rebates related to inventory purchases are recorded when earned and are based on certain qualification requirements which are dependent on a variety of factors including future pricing levels by the manufacturer and data submission.
Property and equipment	Property and equipment Property and equipment is stated at cost less accumulated depreciation and amortization and is further reduced by any impairments. Maintenance and repairs are charged to expense as incurred. Depreciation and amortization expenses are computed using the straight-line method over the useful lives of the assets estimated as follows: buildings, 20 to 40 years; leasehold improvements, the shorter of their economic useful life or the expected lease term; and equipment and information systems, principally three to eight years. Disposition gains and losses are included in current operating expenses.
Amortizable intangibles	Amortizable intangibles Amortizable intangible assets and liabilities include non-competition and similar agreements, lease agreements and hospital acute services contracts, each of which have finite useful lives. Amortization expense is computed using the straight-line method over the useful lives of the assets estimated as follows: non-competition and similar agreements, two to ten years; and lease agreements and hospital acute service contracts, over the term of the lease or contract period, respectively.
Indefinite-lived intangibles	Indefinite-lived intangibles Indefinite-lived intangible assets include international licenses and accreditations that allow the Company to be reimbursed for providing dialysis services to patients, each of which has an indefinite useful life.
Equity investments 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, net of any other-than-temporary impairment. The Company classifies its cost and equity method investments as “Equity method and other investments” on its balance sheet. See Note 9 to these consolidated financial statements for further details.
Goodwill	Goodwill Goodwill represents the difference between the fair value of businesses acquired and the fair value of the identifiable tangible and intangible net assets acquired. Goodwill is not amortized, but is assessed by individual reporting unit for impairment as circumstances warrant and at least annually. An impairment charge is recorded when a reporting unit's carrying amount is determined to exceed its fair value. The Company operates multiple reporting units. See Note 10 to these consolidated financial statements for further details.
Impairment of equity method and other investments	Impairment of equity method and other investments Equity method and other investments are assessed for other-than-temporary impairment when significant events or changes in circumstances indicate that an other-than-temporary impairment may have occurred. An other-than-temporary impairment charge is recorded when the fair value of an investment has fallen below its carrying amount and the shortfall is expected to be indefinitely or permanently unrecoverable.
Impairment of other long-lived assets	Impairment of other long-lived assets Other long-lived assets, including property and equipment and intangible assets, are reviewed for possible impairment whenever significant events or changes in circumstances indicate that an impairment may have occurred. Such changes can include changes in the Company’s business strategy and plans, changes in the quality or structure of its relationships with its partners or deteriorating performance of individual outpatient dialysis centers or other business units. An impairment of an amortizable or depreciable asset is indicated when the sum of the expected future undiscounted net cash flows identifiable to the related asset group is less than its carrying amount. Impairment losses are measured based on the difference between the estimated fair value and the carrying amount of the subject asset group and are included in operating expenses. Indefinite-lived intangible assets are reviewed for possible impairment at least annually and whenever significant events or changes in circumstances indicate that an impairment may have occurred.
Self insurance	Self-insurance The Company is predominantly self-insured with respect to professional and general liability and workers' compensation risks through wholly-owned captive insurance companies, with excess or reinsurance coverage for additional risk. The Company is also predominantly self-insured with respect to employee medical and other health benefits. The Company records insurance liabilities for the professional and general liability, workers’ compensation, and employee health benefit risks that it retains and estimates its liability for those risks using third party actuarial calculations that are based upon historical claims experience and expectations for future claims.
Income taxes	Income taxes Federal and state income taxes are computed at currently enacted tax rates less tax credits using the asset and liability method. Deferred taxes are adjusted both for items that do not currently have tax consequences and for the cumulative effect of any changes in tax rates from those previously used to determine deferred tax assets or liabilities. Tax provisions include amounts that are currently payable, changes in deferred tax assets and liabilities that arise because of temporary differences between the timing of when items of income and expense are recognized for financial reporting and income tax purposes, changes in the recognition of tax positions and any changes in the valuation allowance caused by a change in judgment about the realizability of the related deferred tax assets. A valuation allowance is established when necessary to reduce deferred tax assets to amounts expected to be realized. The Company uses a recognition threshold of more-likely-than-not and a measurement attribute on all tax positions taken or expected to be taken in a tax return in order to be recognized in the financial statements. Once the recognition threshold is met, the tax position is then measured to determine the actual amount of benefit to recognize in the financial statements.
Stock-based compensation	Stock-based 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. Stock-based compensation to be settled in shares is recorded to the Company’s shareholders’ equity, while stock-based compensation to be settled in cash is recorded to a liability.
Interest rate swap and cap agreements	Interest rate cap and swap agreements The Company often carries a combination of currently effective interest rate caps, forward interest rate caps, or interest rate swaps on portions of its variable rate debt as a means of hedging its exposure to changes in LIBOR interest rates as part of its overall interest rate risk management strategy. These interest rate caps and swaps are not held for trading or speculative purposes and are typically designated as qualifying cash flow hedges. See Note 13 to these consolidated financial statements for further details.
Noncontrolling interests	Noncontrolling interests Noncontrolling interests represent third-party equity ownership interests in entities which are consolidated by the Company for financial statement reporting purposes. Noncontrolling interests subject to put provisions The Company has potential obligations to purchase the equity interests held by third parties in several of its majority-owned joint ventures and other nonconsolidated entities. These obligations are in the form of put provisions that 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 flows 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 noncontrolling interests subject to put provisions are 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 interests obligations may be settled will 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.
Fair value estimates	Fair value estimates The Company relies on fair value measurements and estimates for purposes that require the recording, reassessment, or adjustment of the carrying amounts of certain assets, liabilities and noncontrolling interests subject to put provisions (temporary equity). These purposes can include the accounting for business combination transactions, impairment assessments for goodwill, investments, or other long-lived assets, and stock-based compensation, as well as recurring valuations of available for sale securities, noncontrolling interests in temporary equity, derivative instruments, and/or contingent consideration, as applicable. The Company has also classified its assets, liabilities and temporary equity into the appropriate fair value hierarchy levels as defined by the Financial Accounting Standards Board (FASB). See Note 24 to these consolidated financial statements for further details.
New accounting standards	New accounting standards On May 28, 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 2015 and 2016, the FASB issued ASU 2015-14, ASU2016-08, 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. These ASUs will replace most existing revenue recognition guidance in U.S. GAAP. The Company will adopt these ASUs beginning January 1, 2018 using the cumulative effect method and will apply these ASUs only to those contracts that are not completed contracts as of that date with no cumulative effect adjustment. In preparation for the adoption of these ASUs, the Company has concluded that this guidance will result in a change to the presentation of its revenues, provision for uncollectible accounts and allowance for doubtful accounts, which will result in the Company’s provision for uncollectible accounts being recorded as a reduction to revenue. The guidance will also require additional disaggregated revenue disclosures. The guidance will not have a material impact on the Company’s consolidated financial position, results of operations, equity or cash flows. The Company expects to benefit from certain policy elections related to its adoption of these standards of approximately $30,000 in the first half of 2018. 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 Company is still evaluating certain aspects of this ASU as well as the related impacts it may have on its 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 were applied prospectively. The adoption of this ASU did not have a material impact on the Company’s 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 flow, 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 income 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 rather than as a financing activity on the consolidated statements of cash flow. 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 expense to be recognized each period. While this new standard may cause volatility in the Company’s effective tax rates and diluted earnings per share due to tax effects of stock awards being recorded within the Company’s consolidated statements of operations, adoption of this standard did not have a material impact on the Company's consolidated financial statements for the year ended December 31, 2017. 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 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 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 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 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, 2019 and are to be applied prospectively. 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 2018, the FASB issued ASU No. 2018-2, Income Statement - Reporting Comprehensive Income (Topic 220), Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income , which allows for the reclassification of certain income tax effects related to the Tax Cuts and Jobs Act between “Accumulated other comprehensive income” and “Retained earnings.” This ASU relates to the requirement that adjustments to deferred tax liabilities and assets related to a change in tax laws or rates to be included in “Income from continuing operations”, even in situations where the related items were originally recognized in “Other comprehensive income” (rather than in “Income from continuing operations”). The amendments in this ASU are effective for all entities for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. Adoption of this ASU is to be applied either in the period of adoption or retrospectively to each period in which the effect of the change in the tax laws or rates were recognized. The Company is still evaluating certain aspects of this ASU as well as the related impacts it may have on the Company's consolidated financial statements.
Earnings per share	Basic earnings per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interest 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 that under certain circumstances may be returned to the Company. Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights (SSARs) and unvested stock units (under the treasury stock method) as well as shares held in escrow that the Company expects will remain outstanding.
Accounts receivable	Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the ultimate collectability of its accounts receivable, the Company analyzes its historical cash collection experience and trends for each payor 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 it to determine its current provision for uncollectible accounts and the adequacy of its allowance for doubtful accounts. For receivables associated with U.S. dialysis and related lab services covered by government payors, like 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.
Other Comprehensive (Loss) Income	The reclassification of net cap and swap realized losses into income are recorded as debt expense in the corresponding consolidated statements of income. See Note 13 to these 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 income. See Note 3 to these 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 related liabilities recorded in accrued compensation and benefits and other long-term liabilities. The Company relies on the operating activities of certain 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. 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 entities it is associated with that qualify as VIEs must be included in its consolidated financial statements. A number of these VIEs are within the Company's DMG business, which has been reclassified as held for sale and as a discontinued operation in these financial statements. The Company manages these entities and provides operating and capital funding as necessary for the entities to accomplish their operational and strategic objectives. A number of these entities are subject to nominee share ownership or share 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 its related party nominee owners that effectively indemnify these parties from the economic losses from, or entitle the Company to the economic benefits of, these entities.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2017
Earnings Per Share [Abstract]
Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Net Income Per Share	The reconciliations of the numerators and denominators used to calculate basic and diluted net income per share are as follows: Year ended December 31, 2017 2016 2015 (shares in thousands) Numerators: Net income from continuing operations attributable to DaVita Inc. $ 901,277 $ 1,032,373 $ 323,199 Net loss from discontinued operations attributable to DaVita Inc. (237,659 ) (152,499 ) (53,467 ) Net income attributable to DaVita Inc. for basic earnings per share $ 663,618 $ 879,874 $ 269,732 Basic: Weighted average shares outstanding during the period 190,820 203,835 214,062 Contingently returnable shares held in escrow for the DaVita (2,194 ) (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 188,626 201,641 211,868 Basic net income from continuing operations per share attributable to $ 4.78 $ 5.12 $ 1.53 Basic net loss from discontinued operations per share attributable to (1.26 ) (0.76 ) (0.26 ) Basic net income per share attributable to DaVita Inc. $ 3.52 $ 4.36 $ 1.27 Diluted: Weighted average shares outstanding during the period 190,820 203,835 214,062 Assumed incremental shares from stock plans 529 1,070 2,190 Weighted average shares for diluted earnings per share calculation 191,349 204,905 216,252 Diluted net income from continuing operations per share attributable to $ 4.71 $ 5.04 $ 1.49 Diluted net loss from discontinued operations per share attributable to DaVita Inc. (1.24 ) (0.75 ) (0.24 ) Diluted net income per share attributable to DaVita Inc. $ 3.47 $ 4.29 $ 1.25 Anti-dilutive stock-settled awards excluded from calculation (1) 4,350 2,523 1,365 (1) Shares associated with stock-settled stock appreciation rights excluded from the diluted denominator calculation because they are anti-dilutive under the treasury stock method.

Investments in Debt and Equit40

Investments in Debt and Equity Securities (Tables)	12 Months Ended
	Dec. 31, 2017
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	The Company’s investments in these securities and certain other financial instruments consist of the following: December 31, 2017 December 31, 2016 Held to maturity Available for sale Total Held to maturity Available for sale Total Certificates of deposit, commercial paper and money $ 42,316 $ — $ 42,316 $ 255,781 $ — $ 255,781 Investments in mutual funds and common stock — 38,895 38,895 50,000 31,197 81,197 $ 42,316 $ 38,895 $ 81,211 $ 305,781 $ 31,197 $ 336,978 Short-term investments $ 42,316 $ 1,200 $ 43,516 $ 305,781 $ 1,200 $ 306,981 Long-term investments — 37,695 37,695 — 29,997 29,997 $ 42,316 $ 38,895 $ 81,211 $ 305,781 $ 31,197 $ 336,978

Other Receivables (Tables)

Other Receivables (Tables)	12 Months Ended
	Dec. 31, 2017
Receivables [Abstract]
Schedule of Other Receivables	Other receivables were comprised of the following: December 31, 2017 2016 Supplier rebates and non-trade receivables $ 268,949 $ 183,498 Medicare bad debt claims 103,970 104,658 $ 372,919 $ 288,156

Other Current Assets (Tables)

Other Current Assets (Tables)	12 Months Ended
	Dec. 31, 2017
Prepaid Expense and Other Assets, Current [Abstract]
Schedule of Prepaid and Other Current Assets	Other current assets were comprised of the following: December 31, 2017 2016 Prepaid expenses $ 104,727 $ 96,818 Other 7,331 2,692 $ 112,058 $ 99,510

Property and Equipment (Tables)

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2017
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment were comprised of the following: December 31, 2017 2016 Land $ 33,814 $ 26,339 Buildings 473,489 429,039 Leasehold improvements 2,816,675 2,495,070 Equipment and information systems, including internally developed software 2,352,246 2,182,912 New center and capital asset projects in progress 576,651 429,037 6,252,875 5,562,397 Less accumulated depreciation (3,103,662 ) (2,698,276 ) $ 3,149,213 $ 2,864,121

Intangibles (Tables)

Intangibles (Tables)	12 Months Ended
	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets other than Goodwill	Intangible assets other than goodwill were comprised of the following: December 31, 2017 2016 Noncompetition and other agreements $ 429,140 $ 407,220 Lease agreements 7,623 7,244 Indefinite-lived assets 33,255 1,125 Other 583 583 470,601 416,172 Less accumulated amortization (356,774 ) (342,668 ) $ 113,827 $ 73,504
Scheduled Amortization Charges from Intangible Assets and Liabilities	Scheduled amortization charges from amortizable intangible assets and liabilities as of December 31, 2017 were as follows: Noncompetition and other agreements Lease liabilities Other 2018 $ 15,581 $ (849 ) $ 102 2019 14,051 (658 ) 87 2020 12,629 (628 ) 44 2021 9,929 (602 ) — 2022 6,808 (553 ) — Thereafter 21,341 (2,157 ) — Total $ 80,339 $ (5,447 ) $ 233

Goodwill (Tables)

Goodwill (Tables)	12 Months Ended
	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in Carrying Value of Goodwill by Reportable Segments	Changes in the carrying value of goodwill by reportable segments were as follows: U.S. dialysis and related lab services Other ancillary services and strategic initiatives Consolidated total Balance at January 1, 2016 $ 5,629,183 $ 267,032 $ 5,896,215 Acquisitions 75,295 123,632 198,927 Divestitures (12,891 ) (29,645 ) (42,536 ) Goodwill impairment charges — (28,415 ) (28,415 ) Foreign currency and other adjustments — (8,816 ) (8,816 ) Balance at December 31, 2016 $ 5,691,587 $ 323,788 $ 6,015,375 Acquisitions 485,434 131,598 617,032 Divestitures (32,260 ) (126 ) (32,386 ) Goodwill impairment charges — (36,196 ) (36,196 ) Foreign currency and other adjustments — 46,454 46,454 Balance at December 31, 2017 $ 6,144,761 $ 465,518 $ 6,610,279 Goodwill $ 6,144,761 $ 536,038 $ 6,680,799 Accumulated impairment charges — (70,520 ) (70,520 ) $ 6,144,761 $ 465,518 $ 6,610,279
Schedule of Reporting Units Goodwill Balances	Based on the most recent assessments, the Company determined that reductions in reimbursement rates, changes in actual or expected growth rates, 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 December 31, 2017: Reporting unit Goodwill Carrying amount (1) Sensitivities Operating (2) Discount (3) Kidney Care Germany $ 316,369 13.7% (1.6)% (11.1)% Kidney Care Portugal $ 46,713 16.9% (1.9)% (6.0)% Kidney Care Poland $ 46,610 11.8% (1.9)% (6.0)% (1) Excess of estimated fair value of the reporting unit over 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.

Other Liabilities (Tables)

Other Liabilities (Tables)	12 Months Ended
	Dec. 31, 2017
Other Liabilities Disclosure [Abstract]
Schedule of Other Liabilities	Other liabilities were comprised of the following: December 31, 2017 2016 Payor refunds and retractions $ 292,370 $ 270,298 Insurance and self-insurance accruals 64,924 76,857 Accrued interest 83,362 82,234 Accrued non-income tax liabilities 28,317 23,643 Other 83,689 125,860 $ 552,662 $ 578,892

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Schedule of Income Before Income Taxes	Income before income taxes from continuing operations consisted of the following: Year ended December 31, 2017 2016 2015 Domestic $ 1,725,822 $ 1,278,754 $ 730,249 International (326,036 ) 344,351 (41,862 ) $ 1,399,786 $ 1,623,105 $ 688,387
Components of Income Tax Expense (Benefit)	Income tax expense (benefit) for continuing operations consisted of the following: Year ended December 31, 2017 2016 2015 Current: Federal $ 330,191 $ 322,940 $ 124,503 State 47,228 44,525 20,442 International 3,422 1,928 856 Total current income tax 380,841 369,393 145,801 Deferred: Federal (98,760 ) 88,412 71,016 State 37,347 (28,530 ) (9,737 ) International 4,431 2,486 430 Total deferred income tax (56,982 ) 62,368 61,709 $ 323,859 $ 431,761 $ 207,510
Schedule of Allocation of Income Tax Expense (Benefit)	Income taxes are allocated between continuing and discontinued operations as follows: Year ended December 31, 2017 2016 2015 Continuing operations $ 323,859 $ 431,761 $ 207,510 Discontinued operations (364,856 ) 24,052 88,216 $ (40,997 ) $ 455,813 $ 295,726
Reconciliation between U.S. Federal Income Tax Rate and Effective Tax Rate	The reconciliation between the Company’s effective tax rate from continuing operations and the U.S. federal income tax rate is as follows: Year ended December 31, 2017 2016 2015 Federal income tax rate 35.0 % 35.0 % 35.0 % State income taxes, net of federal benefit 3.7 2.6 1.7 Gain on APAC JV ownership changes (0.2 ) (9.9 ) — APAC investment impairment 6.4 — — Impact of 2017 Tax Act (20.5 ) — — Other 2.0 1.8 2.3 Impact of noncontrolling interests primarily attributable to (3.3 ) (2.9 ) (8.9 ) Effective tax rate 23.1 % 26.6 % 30.1 %
Deferred Tax Assets and Liabilities Arising from Temporary Differences	Deferred tax assets and liabilities arising from temporary differences for continuing operations were as follows: December 31, 2017 2016 Receivables $ 19,705 $ 25,197 Accrued liabilities 96,537 224,712 Net operating loss carryforwards 108,429 128,813 Other 37,794 73,525 Deferred tax assets 262,465 452,247 Valuation allowance (61,282 ) (56,016 ) Net deferred tax assets 201,183 396,231 Intangible assets (501,763 ) (676,781 ) Property and equipment (100,376 ) (141,919 ) Investments in partnerships (61,529 ) (95,936 ) Other (23,762 ) (12,464 ) Deferred tax liabilities (687,430 ) (927,100 ) Net deferred tax liabilities $ (486,247 ) $ (530,869 )
Reconciliation of the Beginning and Ending Liability for Unrecognized Tax Benefits that Do Not Meet the More-Likely-Than-Not Threshold	A reconciliation of the beginning and ending liability for unrecognized tax benefits that do not meet the more-likely-than-not threshold is as follows: Year ended December 31, 2017 2016 Beginning balance $ 24,066 $ 39,011 Additions for tax positions related to current year 7,606 9,714 Additions for tax positions related to prior years 804 — Reductions related to lapse of applicable statute (1,380 ) (1,277 ) Impact of 2017 Tax Act 3,731 — Reductions related to settlements with taxing authorities (2,051 ) (23,382 ) Ending balance $ 32,776 $ 24,066

Long-Term Debt (Tables)

Long-Term Debt (Tables)	12 Months Ended
	Dec. 31, 2017
Debt Disclosure [Abstract]
Long-term Debt	Long-term debt was comprised of the following: December 31, 2017 2016 Senior Secured Credit Facilities: Term Loan A $ 775,000 $ 862,500 Term Loan B 3,377,500 3,412,500 Revolver 300,000 — Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 150,512 117,547 Capital lease obligations 297,170 292,252 Total debt principal outstanding 9,400,182 9,184,799 Discount and deferred financing costs (63,951 ) (79,861 ) 9,336,231 9,104,938 Less current portion (178,213 ) (160,262 ) $ 9,158,018 $ 8,944,676
Scheduled Maturities of Long-term Debt	Scheduled maturities of long-term debt at December 31, 2017 were as follows: 2018 178,213 2019 1,049,091 2020 73,362 2021 3,307,507 2022 1,283,671 Thereafter 3,508,338
Derivative Instruments	The following table summarizes the Company’s derivative instruments as of December 31, 2017 and 2016 : Fair value Derivatives designated as hedging instruments Balance sheet location December 31, 2017 December 31, 2016 Interest rate cap agreements Other long-term assets $ 1,032 $ 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 years ended December 31, 2017 , 2016 and 2015 : Amount of unrealized losses in OCI Location of losses reclassified from accumulated OCI into Amount of losses Year ended December 31, Year ended December 31, Derivatives designated as cash flow hedges 2017 2016 2015 2017 2016 2015 Interest rate cap agreements $ (8,897 ) $ (5,198 ) $ (16,114 ) Debt expense $ 8,278 $ 3,899 $ 2,439 Interest rate swap agreements — (815 ) (3,971 ) Debt expense — 299 2,664 Tax benefit 3,460 2,343 7,844 Tax expense (3,220 ) (1,632 ) (1,992 ) Total $ (5,437 ) $ (3,670 ) $ (12,241 ) $ 5,058 $ 2,566 $ 3,111

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2017
Leases [Abstract]
Future Minimum Lease Payments Under Non-cancelable Operating and Capital Leases	Future minimum lease payments under non-cancellable operating and capital leases are as follows: Operating leases Capital leases 2018 $ 446,935 $ 35,258 2019 422,245 36,038 2020 384,764 36,689 2021 351,962 32,578 2022 313,005 33,004 Thereafter 1,303,594 234,094 $ 3,222,505 407,661 Less portion representing interest (110,491 ) Total capital lease obligations, including current portion $ 297,170

Long-term Incentive Compensat50

Long-term Incentive Compensation and Shareholders’ Equity (Tables)	12 Months Ended
	Dec. 31, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Summary of Status of Awards Under Stock-Based Compensation Plans and Agreements	A combined summary of the status of the Company’s stock-settled awards under the 2011 Plan, including base shares for stock-settled stock appreciation rights (SSARs) and stock-settled stock unit awards is as follows: Year ended December 31, 2017 Stock appreciation rights Stock units Awards Weighted Weighted Awards Weighted Outstanding at beginning of year 7,337,266 $ 64.90 785,553 Granted 1,692,154 65.29 528,968 Exercised (2,022,418 ) 54.27 (119,000 ) Canceled (358,803 ) 70.61 (119,949 ) Outstanding at end of period 6,648,199 $ 67.92 2.3 1,075,572 2.0 Exercisable at end of period 2,628,008 $ 62.78 0.6 — 0.0 Weighted-average fair value of grants 2017 $ 14.51 $ 65.73 2016 $ 13.74 $ 70.99 2015 $ 17.97 $ 80.25
Summary of Range of Exercise Prices	Awards Outstanding Weighted average exercise price Awards exercisable Weighted average exercise price Range of SSARs base prices $50.01–$60.00 1,856,145 59.05 1,712,675 59.15 $60.01–$70.00 2,715,542 66.70 632,849 67.47 $70.01–$80.00 1,443,749 74.77 243,041 73.16 $80.01–$90.00 632,763 83.59 39,443 81.51 Total 6,648,199 $ 67.92 2,628,008 $ 62.78
Summary of Weighted Average Valuation Inputs	A summary of the weighted average valuation inputs described above used for estimating the grant-date fair value of stock-settled stock appreciation rights awards granted in the periods indicated is as follows: Year ended December 31, 2017 2016 2015 Expected term 4.2 4.2 4.1 Expected volatility 23.9 % 21.0 % 24.6 % Expected dividend yield — % — % — % Risk-free interest rate 1.7 % 1.0 % 1.5 %
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 are as follows: Year ended December 31, 2017 2016 2015 Net income attributable to DaVita Inc. $ 663,618 $ 879,874 $ 269,732 Changes in paid-in-capital for: Sales of noncontrolling interest (114 ) — — Purchase of noncontrolling interests (2,752 ) (13,105 ) (55,826 ) Net transfer in noncontrolling interests (2,866 ) (13,105 ) (55,826 ) Net income attributable to DaVita Inc. net of transfers in noncontrolling $ 660,752 $ 866,769 $ 213,906

Other Comprehensive (Loss) In51

Other Comprehensive (Loss) Income (Tables)	12 Months Ended
	Dec. 31, 2017
Statement of Comprehensive Income [Abstract]
Changes in Other Comprehensive (Loss) Income	Charges and credits to other comprehensive (loss) income have been as follows: Interest rate cap and swap agreements Investment securities Foreign currency translation adjustments Accumulated other comprehensive (loss) income Balance at January 1, 2015 $ (1,795 ) $ 3,151 $ (26,373 ) $ (25,017 ) Unrealized losses (20,085 ) (1,974 ) (23,889 ) (45,948 ) Related income tax 7,844 561 — 8,405 (12,241 ) (1,413 ) (23,889 ) (37,543 ) Reclassification from accumulated other comprehensive losses 5,103 (618 ) — 4,485 Related income tax (1,992 ) 241 — (1,751 ) 3,111 (377 ) — 2,734 Balance at December 31, 2015 $ (10,925 ) $ 1,361 $ (50,262 ) $ (59,826 ) Unrealized (losses) gains (6,013 ) 1,802 (39,614 ) (43,825 ) Related income tax 2,343 (565 ) — 1,778 (3,670 ) 1,237 (39,614 ) (42,047 ) Reclassification from accumulated other comprehensive losses 4,198 (690 ) 10,087 13,595 Related income tax (1,632 ) 267 — (1,365 ) 2,566 (423 ) 10,087 12,230 Balance at December 31, 2016 $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Unrealized (losses) gains (8,897 ) 5,075 99,770 95,948 Related income tax 3,460 (1,368 ) — 2,092 (5,437 ) 3,707 99,770 98,040 Reclassification from accumulated other comprehensive losses 8,278 (360 ) — 7,918 Related income tax (3,220 ) 140 — (3,080 ) 5,058 (220 ) — 4,838 Balance at December 31, 2017 $ (12,408 ) $ 5,662 $ 19,981 $ 13,235

Acquisitions and Divestitures (

Acquisitions and Divestitures (Tables)	12 Months Ended
	Dec. 31, 2017
Business Combinations [Abstract]
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, net of cash acquired $ 22,739 Property and equipment 36,295 Amortizable intangible and other long-term assets 11,547 Goodwill 298,200 Current liabilities (8,389 ) Long-term liabilities (479 ) $ 359,913 The following table summarizes the assets acquired and liabilities assumed in the above described transactions and recognized at their acquisition dates at estimated fair values, as well as the estimated fair value of noncontrolling interests assumed in these transactions: Year ended December 31, 2017 2016 2015 Current assets $ 14,366 $ 3,996 $ 2,647 Property and equipment 18,192 8,840 4,466 Amortizable intangible and other long-term assets 11,663 5,876 8,924 Non-amortizable intangibles 32,296 — — Goodwill 318,832 198,927 67,183 Deferred income taxes (210 ) 597 (717 ) Noncontrolling interests assumed (44,303 ) (30,337 ) (18,905 ) Liabilities assumed (15,846 ) (3,317 ) (1,595 ) Aggregate purchase cost $ 334,990 $ 184,582 $ 62,003
Pro Forma Summary of Results of Operations	operations in 2017 and 2016 had been consummated as of the beginning of 2016, including the impact of certain adjustments such as amortization of intangibles, interest expense on acquisition financing and income tax effects. Year ended December 31, 2017 2016 (unaudited) Pro forma net revenues $ 11,005,330 $ 11,076,750 Pro forma net income from continuing operations 907,443 1,052,700 Pro forma basic net income per share from continuing operations 4.81 5.22 Pro forma diluted net income per share from continuing operations 4.74 5.14
Reconciliation of Changes in Contingent Earn-Out Obligations	The following is a reconciliation of changes in the contingent earn-out obligations for the year ended December 31, 2017 : Beginning balance January 1, 2017 $ 2,950 Contingent earn-out obligations associated with acquisitions 2,692 Remeasurement of fair value 746 $ 6,388

Held for Sale and Discontinue53

Held for Sale and Discontinued Operations (Tables)	12 Months Ended
	Dec. 31, 2017
Discontinued Operations and Disposal Groups [Abstract]
Summary of Information Related to Assets Held For Sale and Discontinued Operations	The following table presents the financial results of discontinued operations related to DMG: Year ended December 31, 2017 2016 2015 Net revenues $ 4,676,213 $ 4,113,414 $ 3,837,260 Expenses 4,634,782 3,994,624 3,596,342 Goodwill and other asset impairment charges 651,659 253,000 206,169 (Loss) income from discontinued operations before taxes (610,228 ) (134,210 ) 34,749 Income tax benefit (expense) 364,856 (24,052 ) (88,216 ) Net loss from discontinued operations, net of tax $ (245,372 ) $ (158,262 ) $ (53,467 ) The following table presents the financial position of discontinued operations related to DMG: December 31, 2017 December 31, 2016 Assets Cash and cash equivalents $ 179,668 $ 238,411 Other current assets 888,697 722,545 Property and equipment, net 379,945 311,246 Intangible assets, net 1,316,550 1,454,263 Other long-term assets 116,805 94,684 Goodwill 2,879,977 3,391,942 Total assets held for sale $ 5,761,642 $ 6,213,091 Total current assets held for sale $ 5,761,642 $ 960,956 Total long-term assets held for sale $ — $ 5,252,135 Liabilities Other liabilities $ 505,734 $ 460,458 Medical payables 457,040 349,506 Current portion of long-term debt 2,845 4,779 Long-term debt 35,003 2,652 Other long-term liabilities 184,448 418,723 Total liabilities held for sale $ 1,185,070 $ 1,236,118 Total current liabilities held for sale $ 1,185,070 $ 807,233 Total long-term liabilities held for sale $ — $ 428,885
Reconciliation of Cash Flows	The following table presents cash flows of discontinued operations related to DMG: Year ended December 31, 2017 2016 2015 Net cash provided by operating activities from discontinued $ 351,557 $ 287,049 $ 365,138 Net cash used in investing activities from discontinued operations $ (232,329 ) $ (430,917 ) $ (121,893 )

Fair Values of Financial Inst54

Fair Values of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2017
Fair Value Disclosures [Abstract]
Assets, Liabilities and Temporary Equity Measured at Fair Value on a Recurring Basis	The following tables summarize the Company’s assets, liabilities and temporary equity measured at fair value on a recurring basis as of December 31, 2017 and 2016 : December 31, 2017 Total Quoted prices in Significant other Significant Assets Available for sale securities $ 38,895 $ 38,895 $ — $ — Interest rate cap agreements $ 1,032 $ — $ 1,032 $ — Liabilities Contingent earn-out obligations $ 6,388 $ — $ — $ 6,388 Temporary equity Noncontrolling interests subject to put provisions $ 1,011,360 $ — $ — $ 1,011,360 December 31, 2016 Assets Available for sale securities $ 31,197 $ 31,197 $ — $ — Interest rate cap agreements $ 9,929 $ — $ 9,929 $ — Liabilities Contingent earn-out obligations $ 2,950 $ — $ — $ 2,950 Temporary equity Noncontrolling interests subject to put provisions $ 973,258 $ — $ — $ 973,258

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2017
Segment Reporting [Abstract]
Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes	The following is a summary of segment revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Year ended December 31, 2017 2016 2015 Segment revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 9,767,123 $ 9,524,067 $ 9,014,577 Intersegment revenues 55,175 27,355 19,414 Total U.S. dialysis and related lab services revenues 9,822,298 9,551,422 9,033,991 Less: Provision for uncollectible accounts (482,007 ) (429,882 ) (406,530 ) Net U.S. dialysis and related lab services patient service revenues 9,340,291 9,121,540 8,627,461 Other revenues (1) 19,774 16,649 13,971 Total net U.S. dialysis and related lab services revenues 9,360,065 9,138,189 8,641,432 Other - Ancillary services and strategic initiatives Net patient service revenues 323,156 201,867 134,496 Other external sources 1,248,588 1,394,766 1,225,731 Intersegment revenues 24,603 24,739 22,204 Total ancillary services and strategic initiatives revenues 1,596,347 1,621,372 1,382,431 Total net segment revenues 10,956,412 10,759,561 10,023,863 Elimination of intersegment revenues (79,778 ) (52,094 ) (41,618 ) Consolidated net revenues $ 10,876,634 $ 10,707,467 $ 9,982,245 Segment operating margin (loss): U.S. dialysis and related lab services $ 2,297,198 $ 1,777,014 $ 1,259,632 Other—Ancillary services and strategic initiatives (439,477 ) 266,324 (103,901 ) Total segment margin 1,857,721 2,043,338 1,155,731 Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Corporate administrative support (44,966 ) (13,628 ) (18,965 ) Consolidated operating income 1,812,755 2,029,710 1,136,766 Debt expense (430,634 ) (414,116 ) (408,380 ) Debt redemption charges — — (48,072 ) Other income 17,665 7,511 8,073 Consolidated income from continuing operations before income $ 1,399,786 $ 1,623,105 $ 688,387 (1) Includes management fee revenues from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling interest or which are wholly-owned by third parties.
Summary of Depreciation and Amortization Expense by Segment	Depreciation and amortization expense by segment is as follows: Year ended December 31, 2017 2016 2015 U.S. dialysis and related lab services $ 520,965 $ 482,768 $ 438,238 Other - Ancillary services and strategic initiatives 38,946 26,729 25,667 $ 559,911 $ 509,497 $ 463,905
Summary of Assets by Segment	Summary of assets by segment is as follows: Year ended December 31, 2017 2016 Segment assets U.S. dialysis and related lab services (including equity investments of $ 11,776,042 $ 11,108,386 Other - Ancillary services and strategic initiatives (1) (including equity 1,410,509 1,434,299 DMG - Held for sale (including equity investments of $10,321 and $10,350, respectively) 5,761,642 6,213,091 Consolidated assets $ 18,948,193 $ 18,755,776 (1) Includes approximately $125,932 and $96,396 in 2017 and 2016 , respectively, of net property and equipment related to the Company’s international operations.
Summary of Expenditures for Property and Equipment by Segment	Expenditures for property and equipment by segment is as follows: Year ended December 31, 2017 2016 2015 U.S. dialysis and related lab services $ 759,218 $ 675,994 $ 584,513 Other - Ancillary services and strategic initiatives 50,891 68,702 56,685 DMG - Held for sale 95,141 84,399 66,800 $ 905,250 $ 829,095 $ 707,998

Supplemental Cash Flow Inform56

Supplemental Cash Flow Information (Tables)	12 Months Ended
	Dec. 31, 2017
Supplemental Cash Flow Elements [Abstract]
Supplemental Cash Flow Information	The table below provides supplemental cash flow information: Year ended December 31, 2017 2016 2015 Cash paid: Income taxes $ 387,159 $ 339,411 $ 156,075 Interest 424,547 406,987 405,120 Non-cash investing and financing activities: Fixed assets under capital lease obligations 48,378 28,127 74,035

Selected Quarterly Financial 57

Selected Quarterly Financial Data (unaudited) (Tables)	12 Months Ended
	Dec. 31, 2017
Quarterly Financial Information Disclosure [Abstract]
Selected Quarterly Financial Data (unaudited)	2017 2016 December 31 September 30 June 30 March 31 December 31 September 30 June 30 March 31 Net revenues $ 2,780,913 $ 2,765,071 $ 2,699,399 $ 2,631,251 $ 2,699,419 $ 2,725,407 $ 2,675,474 $ 2,607,167 Operating income $ 150,337 $ 395,294 $ 391,196 $ 875,928 $ 363,445 $ 813,103 $ 431,129 $ 422,033 Net income from $ 46,825 $ 289,384 $ 288,060 $ 775,517 $ 259,669 $ 710,246 $ 331,231 $ 321,959 Net income (loss) $ 143,587 $ (370,872 ) $ (24,520 ) $ 6,433 $ 11,772 $ 20,213 $ (118,443 ) $ (71,804 ) Net income (loss) $ 303,396 $ (214,476 ) $ 127,001 $ 447,697 $ 157,726 $ 571,332 $ 53,382 $ 97,434 Basic net income $ 0.86 $ 0.81 $ 0.79 $ 2.29 $ 0.74 $ 2.69 $ 0.84 $ 0.83 Basic net income $ 0.80 $ (1.95 ) $ (0.13 ) $ 0.04 $ 0.07 $ 0.11 $ (0.58 ) $ (0.35 ) Basic net income $ 1.66 $ (1.14 ) $ 0.66 $ 2.33 $ 0.81 $ 2.80 $ 0.26 $ 0.48 Diluted net income $ 0.85 $ 0.80 $ 0.78 $ 2.26 $ 0.73 $ 2.65 $ 0.82 $ 0.81 Diluted net income $ 0.79 $ (1.92 ) $ (0.13 ) $ 0.03 $ 0.07 $ 0.11 $ (0.56 ) $ (0.34 ) Diluted net income $ 1.64 $ (1.12 ) $ 0.65 $ 2.29 $ 0.80 $ 2.76 $ 0.26 $ 0.47

Consolidating Financial State58

Consolidating Financial Statements (Tables)	12 Months Ended
	Dec. 31, 2017
Condensed Financial Information of Parent Company Only Disclosure [Abstract]
Consolidating Statements of Income	Consolidating Statements of Income DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For twelve months ended December 31, 2017 Dialysis and related lab patient service revenues $ — $ 6,884,750 $ 3,393,026 $ (184,106 ) $ 10,093,670 Less: Provision for uncollectible accounts — (340,586 ) (151,982 ) 7,170 (485,398 ) Net dialysis and related lab patient service revenues — 6,544,164 3,241,044 (176,936 ) 9,608,272 Other revenues 793,751 1,204,501 68,322 (798,212 ) 1,268,362 Total net revenues 793,751 7,748,665 3,309,366 (975,148 ) 10,876,634 Operating expenses and charges 527,942 6,475,550 3,035,535 (975,148 ) 9,063,879 Operating income 265,809 1,273,115 273,831 — 1,812,755 Debt expense (426,149 ) (209,612 ) (34,831 ) 239,958 (430,634 ) Other income, net 411,731 11,169 18,467 (423,702 ) 17,665 Income tax expense 65,965 237,670 20,224 — 323,859 Equity earnings in subsidiaries 478,192 74,375 — (552,567 ) — Net income from continuing operations 663,618 911,377 237,243 (736,311 ) 1,075,927 Net (loss) income from discontinued operations, net — (433,185 ) 4,069 183,744 (245,372 ) Net income 663,618 478,192 241,312 (552,567 ) 830,555 Less: Net income attributable to noncontrolling — — — (166,937 ) (166,937 ) Net income attributable to DaVita Inc. $ 663,618 $ 478,192 $ 241,312 $ (719,504 ) $ 663,618 For twelve months ended December 31, 2016 Dialysis and related lab patient service revenues $ — $ 6,665,601 $ 3,215,085 $ (153,326 ) $ 9,727,360 Less: Provision for uncollectible accounts — (272,430 ) (158,878 ) — (431,308 ) Net dialysis and related lab patient service revenues — 6,393,171 3,056,207 (153,326 ) 9,296,052 Other revenues 767,791 1,378,956 30,184 (765,516 ) 1,411,415 Total net revenues 767,791 7,772,127 3,086,391 (918,842 ) 10,707,467 Operating expenses and charges 493,175 6,907,469 2,195,955 (918,842 ) 8,677,757 Operating income 274,616 864,658 890,436 — 2,029,710 Debt expense (407,925 ) (191,083 ) (40,434 ) 225,326 (414,116 ) Other income, net 396,797 3,726 7,694 (400,706 ) 7,511 Income tax expense 77,334 238,446 115,981 — 431,761 Equity earnings in subsidiaries 693,720 667,278 — (1,360,998 ) — Net income from continuing operations 879,874 1,106,133 741,715 (1,536,378 ) 1,191,344 Net (loss) income from discontinued operations, net — (412,413 ) 78,771 175,380 (158,262 ) Net income 879,874 693,720 820,486 (1,360,998 ) 1,033,082 Less: Net income attributable to noncontrolling — — — (153,208 ) (153,208 ) Net income attributable to DaVita Inc. $ 879,874 $ 693,720 $ 820,486 $ (1,514,206 ) $ 879,874 Consolidating Statements of Income - (continued) DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For twelve months ended December 31, 2015 Dialysis and related lab patient service revenues $ — $ 6,471,702 $ 2,814,909 $ (131,164 ) $ 9,155,447 Less: Provision for uncollectible accounts — (281,976 ) (130,929 ) — (412,905 ) Net dialysis and related lab patient service — 6,189,726 2,683,980 (131,164 ) 8,742,542 Other revenues 727,887 1,208,607 24,013 (720,804 ) 1,239,703 Total net revenues 727,887 7,398,333 2,707,993 (851,968 ) 9,982,245 Operating expenses and charges 488,595 6,925,234 2,283,618 (851,968 ) 8,845,479 Operating income 239,292 473,099 424,375 — 1,136,766 Debt (expense) and refinancing charges (449,598 ) (178,389 ) (32,450 ) 203,985 (456,452 ) Other income, net 365,752 1,261 6,921 (365,861 ) 8,073 Income tax expense (benefit) 60,671 163,401 (16,562 ) — 207,510 Equity earnings in subsidiaries 174,957 322,022 — (496,979 ) — Net income from continuing operations 269,732 454,592 415,408 (658,855 ) 480,877 Net (loss) income from discontinued operations, — (279,635 ) 64,292 161,876 (53,467 ) Net income 269,732 174,957 479,700 (496,979 ) 427,410 Less: Net income attributable to noncontrolling — — — (157,678 ) (157,678 ) Net income attributable to DaVita Inc. $ 269,732 $ 174,957 $ 479,700 $ (654,657 ) $ 269,732 Condensed Consolidating Statements of Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For the year ended December 31, 2017 Dialysis and related lab patient service revenues $ 10,093,670 $ — $ — $ 10,093,670 Less: Provision for uncollectible accounts (485,398 ) — — (485,398 ) Net dialysis and related lab patient service revenues 9,608,272 — — 9,608,272 Other revenues 1,268,362 — — 1,268,362 Total net revenues 10,876,634 — — 10,876,634 Operating expenses and charges 9,063,879 — — 9,063,879 Operating income 1,812,755 — — 1,812,755 Debt expense (430,634 ) — — (430,634 ) Other income, net 17,665 — — 17,665 Income tax expense 323,859 — — 323,859 Net income from continuing operations 1,075,927 — — 1,075,927 Net (loss) income from discontinued operations, net of tax (245,372 ) 13,611 19 (259,002 ) Net income 830,555 13,611 19 816,925 Less: Net income attributable to noncontrolling interests (166,937 ) 7,183 — (174,120 ) Net income attributable to DaVita Inc. $ 663,618 $ 20,794 $ 19 $ 642,805
Consolidating Statements of Comprehensive Income	Consolidating Statements of Comprehensive Income DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For the year ended December 31, 2017 Net income $ 663,618 $ 478,192 $ 241,312 $ (552,567 ) $ 830,555 Other comprehensive income 3,106 — 99,770 — 102,876 Total comprehensive income 666,724 478,192 341,082 (552,567 ) 933,431 Less: Comprehensive income attributable to — — — (166,935 ) (166,935 ) Comprehensive income attributable to DaVita Inc. $ 666,724 $ 478,192 $ 341,082 $ (719,502 ) $ 766,496 For the year ended December 31, 2016 Net income $ 879,874 $ 693,720 $ 820,486 $ (1,360,998 ) $ 1,033,082 Other comprehensive loss (290 ) — (29,337 ) — (29,627 ) Total comprehensive income 879,584 693,720 791,149 (1,360,998 ) 1,003,455 Less: Comprehensive income attributable to — — — (153,398 ) (153,398 ) Comprehensive income attributable to DaVita Inc. $ 879,584 $ 693,720 $ 791,149 $ (1,514,396 ) $ 850,057 For the year ended December 31, 2015 Net income $ 269,732 $ 174,957 $ 479,700 $ (496,979 ) $ 427,410 Other comprehensive loss (10,920 ) — (23,889 ) — (34,809 ) Total comprehensive income 258,812 174,957 455,811 (496,979 ) 392,601 Less: Comprehensive income attributable to — — — (157,678 ) (157,678 ) Comprehensive income attributable to DaVita Inc. $ 258,812 $ 174,957 $ 455,811 $ (654,657 ) $ 234,923 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For the year ended December 31, 2017 Net income $ 830,555 $ 13,611 $ 19 $ 816,925 Other comprehensive income 102,876 — — 102,876 Total comprehensive income 933,431 13,611 19 919,801 Less: Comprehensive income attributable to noncontrolling (166,935 ) 7,183 — (174,118 ) Comprehensive income attributable to DaVita Inc. $ 766,496 $ 20,794 $ 19 $ 745,683 (1) After the elimination of the unrestricted subsidiaries and the physician groups
Consolidating Balance Sheets	Consolidating Balance Sheets DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total As of December 31, 2017 Cash and cash equivalents $ 149,305 $ — $ 358,929 $ — $ 508,234 Accounts receivable, net — 1,208,715 506,035 — 1,714,750 Other current assets 68,027 604,450 87,255 — 759,732 Current assets held for sale — 4,992,067 769,575 — 5,761,642 Total current assets 217,332 6,805,232 1,721,794 — 8,744,358 Property and equipment, net 408,010 1,560,390 1,180,813 — 3,149,213 Intangible assets, net 250 50,971 62,606 — 113,827 Investments in subsidiaries 10,009,874 3,085,722 — (13,095,596 ) — Intercompany receivables 3,677,947 — 1,313,213 (4,991,160 ) — Other long-term assets and investments 47,297 68,344 214,875 — 330,516 Goodwill — 4,732,320 1,877,959 — 6,610,279 Total assets $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Current liabilities $ 238,706 $ 1,181,139 $ 436,262 $ — $ 1,856,107 Current liabilities held for sale — 739,294 445,776 — 1,185,070 Total current liabilities 238,706 1,920,433 882,038 — 3,041,177 Intercompany payables — 3,690,042 1,301,118 (4,991,160 ) — Long-term debt and other long-term liabilities 8,857,373 682,630 469,587 — 10,009,590 Noncontrolling interests subject to put provisions 574,602 — — 436,758 1,011,360 Total DaVita Inc. shareholders' equity 4,690,029 10,009,874 3,085,722 (13,095,596 ) 4,690,029 Noncontrolling interests not subject to put — — 632,795 (436,758 ) 196,037 Total equity 4,690,029 10,009,874 3,718,517 (13,532,354 ) 4,886,066 Total liabilities and equity $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of December 31, 2017 Cash and cash equivalents $ 508,234 $ — $ — $ 508,234 Accounts receivable, net 1,714,750 — — 1,714,750 Other current assets 759,732 3,033 — 756,699 Other current assets held for sale 5,761,642 423,205 2,733 5,335,704 Total current assets 8,744,358 426,238 2,733 8,315,387 Property and equipment, net 3,149,213 — — 3,149,213 Amortizable intangibles, net 113,827 — — 113,827 Other long-term assets 330,516 — — 330,516 Goodwill 6,610,279 — — 6,610,279 Total assets $ 18,948,193 $ 426,238 $ 2,733 $ 18,519,222 Current liabilities $ 1,856,107 $ — $ — $ 1,856,107 Current liabilities held for sale 1,185,070 308,884 — 876,186 Total current liabilities 3,041,177 308,884 — 2,732,293 Payables to parent — — 2,733 (2,733 ) Long-term debt and other long-term liabilities 10,009,590 — — 10,009,590 Noncontrolling interests subject to put provisions 1,011,360 — — 1,011,360 Total DaVita Inc. shareholders' equity 4,690,029 117,354 — 4,572,675 Noncontrolling interests not subject to put provisions 196,037 — — 196,037 Shareholders' equity 4,886,066 117,354 — 4,768,712 Total liabilities and shareholders' equity $ 18,948,193 $ 426,238 $ 2,733 $ 18,519,222
Consolidating Statements of Cash Flows	Consolidating Statements of Cash Flow DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated For the year ended December 31, 2017 Cash flows from operating activities: Net income $ 663,618 $ 478,192 $ 241,312 $ (552,567 ) $ 830,555 Changes in operating assets and liabilities and (534,302 ) 366,947 691,682 552,567 1,076,894 Net cash provided by operating activities 129,316 845,139 932,994 — 1,907,449 Cash flows from investing activities: Additions of property and equipment, net (155,972 ) (490,800 ) (258,478 ) — (905,250 ) Acquisitions — (693,522 ) (110,357 ) — (803,879 ) Proceeds from asset sales, net of cash divested — 90,340 1,996 — 92,336 Investments and other items 211,619 (9,003 ) 47,446 — 250,062 Net cash provided by (used in) investing 55,647 (1,102,985 ) (319,393 ) — (1,366,731 ) Cash flows from financing activities: Long-term debt and related financing costs, net 173,529 (12,662 ) (6,019 ) — 154,848 Intercompany borrowing 22,589 218,980 (241,569 ) — — Other items (781,697 ) (2,493 ) (136,915 ) — (921,105 ) Net cash (used in) provided by financing (585,579 ) 203,825 (384,503 ) — (766,257 ) Effect of exchange rate changes on cash — — 254 — 254 Net (decrease) increase in cash and cash (400,616 ) (54,021 ) 229,352 — (225,285 ) Less: Net decrease in cash and cash equivalents — (54,021 ) (4,722 ) — (58,743 ) Net (decrease) increase in cash and cash (400,616 ) — 234,074 — (166,542 ) Cash and cash equivalents of continuing operations 549,921 — 124,855 — 674,776 Cash and cash equivalents of continuing operations $ 149,305 $ — $ 358,929 $ — $ 508,234 Consolidating Statements of Cash Flow - (continued) DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated For the year ended December 31, 2016 Cash flows from operating activities: Net income $ 879,874 $ 693,720 $ 820,486 $ (1,360,998 ) $ 1,033,082 Changes in operating assets and liabilities and (612,706 ) 350,684 (168,614 ) 1,360,998 930,362 Net cash provided by operating activities 267,168 1,044,404 651,872 — 1,963,444 Cash flows from investing activities: Additions of property and equipment, net (139,303 ) (382,305 ) (307,487 ) — (829,095 ) Acquisitions — (472,413 ) (91,443 ) — (563,856 ) Proceeds from asset and business sales, net of cash — 70,342 (5,617 ) — 64,725 Investments and other items 153,031 (29,038 ) 2,565 — 126,558 Net cash provided by (used in) investing 13,728 (813,414 ) (401,982 ) — (1,201,668 ) Cash flows from financing activities: Long-term debt and related financing costs, net (92,460 ) (27,830 ) (4,152 ) — (124,442 ) Intercompany borrowing 236,052 (231,800 ) (4,252 ) — — Other items (1,061,203 ) (21,525 ) (144,811 ) — (1,227,539 ) Net cash used in financing activities (917,611 ) (281,155 ) (153,215 ) — (1,351,981 ) Effect of exchange rate changes on cash — — 4,276 — 4,276 Net (decrease) increase in cash and cash (636,715 ) (50,165 ) 100,951 — (585,929 ) Less: Net (decrease) increase in cash and cash — (50,165 ) 34,377 — (15,788 ) Net (decrease) increase in cash and cash (636,715 ) — 66,574 — (570,141 ) Cash and cash equivalents of continuing operations 1,186,636 — 58,281 — 1,244,917 Cash and cash equivalents of continuing operations $ 549,921 $ — $ 124,855 $ — $ 674,776 Consolidating Statements of Cash Flow - (continued) DaVita Inc. Guarantor Subsidiaries Non-Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For the year ended December 31, 2015 Cash flows from operating activities: Net income $ 269,732 $ 174,957 $ 479,700 $ (496,979 ) $ 427,410 Changes in operating assets and liabilities and (125,981 ) 684,760 74,032 496,979 1,129,790 Net cash provided by operating activities 143,751 859,717 553,732 — 1,557,200 Cash flows from investing activities: Additions of property and equipment, net (115,269 ) (319,695 ) (273,034 ) — (707,998 ) Acquisitions — (76,983 ) (19,486 ) — (96,469 ) Proceeds from asset sales — 19,715 — — 19,715 Investments and other items (74,474 ) (2,144 ) (20,414 ) — (97,032 ) Net cash used in investing activities (189,743 ) (379,107 ) (312,934 ) — (881,784 ) Cash flows from financing activities: Long-term debt and related financing costs, net 640,009 (11,953 ) (8,358 ) — 619,698 Intercompany borrowing 466,038 (370,839 ) (95,199 ) — — Other items (572,295 ) (66,382 ) (119,991 ) — (758,668 ) Net cash provided by (used in) financing 533,752 (449,174 ) (223,548 ) — (138,970 ) Effect of exchange rate changes on cash — — (2,571 ) — (2,571 ) Net increase in cash and cash equivalents 487,760 31,436 14,679 — 533,875 Less: Net increase (decrease) in cash and cash — 31,436 (5,581 ) — 25,855 Net increase in cash and cash equivalents from 487,760 — 20,260 — 508,020 Cash and cash equivalents of continuing operations 698,876 — 38,021 — 736,897 Cash and cash equivalents of continuing operations $ 1,186,636 $ — $ 58,281 $ — $ 1,244,917 C ondensed Consolidating Statements of Cash Flow Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For the year ended December 31, 2017 Cash flows from operating activities: Net income $ 830,555 $ 13,611 $ 19 $ 816,925 Changes in operating and intercompany assets and liabilities and 1,076,894 27,312 (19 ) 1,049,601 Net cash provided by operating activities 1,907,449 40,923 — 1,866,526 Cash flows from investing activities: Additions of property and equipment (905,250 ) (5,406 ) — (899,844 ) Acquisitions and divestitures, net (803,879 ) — — (803,879 ) Proceeds from asset sales 92,336 — — 92,336 Investments and other items, net 250,062 (3,800 ) — 253,862 Net cash used in investing activities (1,366,731 ) (9,206 ) — (1,357,525 ) Cash flows from financing activities: Long-term debt and related financing costs, net 154,848 — — 154,848 Intercompany — (36,220 ) — 36,220 Other items (921,105 ) — — (921,105 ) Net cash used in financing activities (766,257 ) (36,220 ) — (730,037 ) Effect of exchange rate changes on cash 254 — — 254 Net decrease in cash and cash equivalents (225,285 ) (4,503 ) — (220,782 ) Less: Net decrease in cash and cash equivalents from discontinued operations (58,743 ) (4,503 ) — (54,240 ) Net decrease in cash and cash equivalents from continuing operations (166,542 ) — — (166,542 ) Cash and cash equivalents of continuing operations at beginning of the year 674,776 — — 674,776 Cash and cash equivalents of continuing operations at end of the year $ 508,234 $ — $ — $ 508,234 (1) After the elimination of the unrestricted subsidiaries and the physician groups

Supplemental Data (unaudited) (

Supplemental Data (unaudited) (Tables)	12 Months Ended
	Dec. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Consolidating Statements of Income	Consolidating Statements of Income DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For twelve months ended December 31, 2017 Dialysis and related lab patient service revenues $ — $ 6,884,750 $ 3,393,026 $ (184,106 ) $ 10,093,670 Less: Provision for uncollectible accounts — (340,586 ) (151,982 ) 7,170 (485,398 ) Net dialysis and related lab patient service revenues — 6,544,164 3,241,044 (176,936 ) 9,608,272 Other revenues 793,751 1,204,501 68,322 (798,212 ) 1,268,362 Total net revenues 793,751 7,748,665 3,309,366 (975,148 ) 10,876,634 Operating expenses and charges 527,942 6,475,550 3,035,535 (975,148 ) 9,063,879 Operating income 265,809 1,273,115 273,831 — 1,812,755 Debt expense (426,149 ) (209,612 ) (34,831 ) 239,958 (430,634 ) Other income, net 411,731 11,169 18,467 (423,702 ) 17,665 Income tax expense 65,965 237,670 20,224 — 323,859 Equity earnings in subsidiaries 478,192 74,375 — (552,567 ) — Net income from continuing operations 663,618 911,377 237,243 (736,311 ) 1,075,927 Net (loss) income from discontinued operations, net — (433,185 ) 4,069 183,744 (245,372 ) Net income 663,618 478,192 241,312 (552,567 ) 830,555 Less: Net income attributable to noncontrolling — — — (166,937 ) (166,937 ) Net income attributable to DaVita Inc. $ 663,618 $ 478,192 $ 241,312 $ (719,504 ) $ 663,618 For twelve months ended December 31, 2016 Dialysis and related lab patient service revenues $ — $ 6,665,601 $ 3,215,085 $ (153,326 ) $ 9,727,360 Less: Provision for uncollectible accounts — (272,430 ) (158,878 ) — (431,308 ) Net dialysis and related lab patient service revenues — 6,393,171 3,056,207 (153,326 ) 9,296,052 Other revenues 767,791 1,378,956 30,184 (765,516 ) 1,411,415 Total net revenues 767,791 7,772,127 3,086,391 (918,842 ) 10,707,467 Operating expenses and charges 493,175 6,907,469 2,195,955 (918,842 ) 8,677,757 Operating income 274,616 864,658 890,436 — 2,029,710 Debt expense (407,925 ) (191,083 ) (40,434 ) 225,326 (414,116 ) Other income, net 396,797 3,726 7,694 (400,706 ) 7,511 Income tax expense 77,334 238,446 115,981 — 431,761 Equity earnings in subsidiaries 693,720 667,278 — (1,360,998 ) — Net income from continuing operations 879,874 1,106,133 741,715 (1,536,378 ) 1,191,344 Net (loss) income from discontinued operations, net — (412,413 ) 78,771 175,380 (158,262 ) Net income 879,874 693,720 820,486 (1,360,998 ) 1,033,082 Less: Net income attributable to noncontrolling — — — (153,208 ) (153,208 ) Net income attributable to DaVita Inc. $ 879,874 $ 693,720 $ 820,486 $ (1,514,206 ) $ 879,874 Consolidating Statements of Income - (continued) DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For twelve months ended December 31, 2015 Dialysis and related lab patient service revenues $ — $ 6,471,702 $ 2,814,909 $ (131,164 ) $ 9,155,447 Less: Provision for uncollectible accounts — (281,976 ) (130,929 ) — (412,905 ) Net dialysis and related lab patient service — 6,189,726 2,683,980 (131,164 ) 8,742,542 Other revenues 727,887 1,208,607 24,013 (720,804 ) 1,239,703 Total net revenues 727,887 7,398,333 2,707,993 (851,968 ) 9,982,245 Operating expenses and charges 488,595 6,925,234 2,283,618 (851,968 ) 8,845,479 Operating income 239,292 473,099 424,375 — 1,136,766 Debt (expense) and refinancing charges (449,598 ) (178,389 ) (32,450 ) 203,985 (456,452 ) Other income, net 365,752 1,261 6,921 (365,861 ) 8,073 Income tax expense (benefit) 60,671 163,401 (16,562 ) — 207,510 Equity earnings in subsidiaries 174,957 322,022 — (496,979 ) — Net income from continuing operations 269,732 454,592 415,408 (658,855 ) 480,877 Net (loss) income from discontinued operations, — (279,635 ) 64,292 161,876 (53,467 ) Net income 269,732 174,957 479,700 (496,979 ) 427,410 Less: Net income attributable to noncontrolling — — — (157,678 ) (157,678 ) Net income attributable to DaVita Inc. $ 269,732 $ 174,957 $ 479,700 $ (654,657 ) $ 269,732 Condensed Consolidating Statements of Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For the year ended December 31, 2017 Dialysis and related lab patient service revenues $ 10,093,670 $ — $ — $ 10,093,670 Less: Provision for uncollectible accounts (485,398 ) — — (485,398 ) Net dialysis and related lab patient service revenues 9,608,272 — — 9,608,272 Other revenues 1,268,362 — — 1,268,362 Total net revenues 10,876,634 — — 10,876,634 Operating expenses and charges 9,063,879 — — 9,063,879 Operating income 1,812,755 — — 1,812,755 Debt expense (430,634 ) — — (430,634 ) Other income, net 17,665 — — 17,665 Income tax expense 323,859 — — 323,859 Net income from continuing operations 1,075,927 — — 1,075,927 Net (loss) income from discontinued operations, net of tax (245,372 ) 13,611 19 (259,002 ) Net income 830,555 13,611 19 816,925 Less: Net income attributable to noncontrolling interests (166,937 ) 7,183 — (174,120 ) Net income attributable to DaVita Inc. $ 663,618 $ 20,794 $ 19 $ 642,805
Consolidating Statements of Comprehensive Income	Consolidating Statements of Comprehensive Income DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For the year ended December 31, 2017 Net income $ 663,618 $ 478,192 $ 241,312 $ (552,567 ) $ 830,555 Other comprehensive income 3,106 — 99,770 — 102,876 Total comprehensive income 666,724 478,192 341,082 (552,567 ) 933,431 Less: Comprehensive income attributable to — — — (166,935 ) (166,935 ) Comprehensive income attributable to DaVita Inc. $ 666,724 $ 478,192 $ 341,082 $ (719,502 ) $ 766,496 For the year ended December 31, 2016 Net income $ 879,874 $ 693,720 $ 820,486 $ (1,360,998 ) $ 1,033,082 Other comprehensive loss (290 ) — (29,337 ) — (29,627 ) Total comprehensive income 879,584 693,720 791,149 (1,360,998 ) 1,003,455 Less: Comprehensive income attributable to — — — (153,398 ) (153,398 ) Comprehensive income attributable to DaVita Inc. $ 879,584 $ 693,720 $ 791,149 $ (1,514,396 ) $ 850,057 For the year ended December 31, 2015 Net income $ 269,732 $ 174,957 $ 479,700 $ (496,979 ) $ 427,410 Other comprehensive loss (10,920 ) — (23,889 ) — (34,809 ) Total comprehensive income 258,812 174,957 455,811 (496,979 ) 392,601 Less: Comprehensive income attributable to — — — (157,678 ) (157,678 ) Comprehensive income attributable to DaVita Inc. $ 258,812 $ 174,957 $ 455,811 $ (654,657 ) $ 234,923 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For the year ended December 31, 2017 Net income $ 830,555 $ 13,611 $ 19 $ 816,925 Other comprehensive income 102,876 — — 102,876 Total comprehensive income 933,431 13,611 19 919,801 Less: Comprehensive income attributable to noncontrolling (166,935 ) 7,183 — (174,118 ) Comprehensive income attributable to DaVita Inc. $ 766,496 $ 20,794 $ 19 $ 745,683 (1) After the elimination of the unrestricted subsidiaries and the physician groups
Consolidating Balance Sheets	Consolidating Balance Sheets DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total As of December 31, 2017 Cash and cash equivalents $ 149,305 $ — $ 358,929 $ — $ 508,234 Accounts receivable, net — 1,208,715 506,035 — 1,714,750 Other current assets 68,027 604,450 87,255 — 759,732 Current assets held for sale — 4,992,067 769,575 — 5,761,642 Total current assets 217,332 6,805,232 1,721,794 — 8,744,358 Property and equipment, net 408,010 1,560,390 1,180,813 — 3,149,213 Intangible assets, net 250 50,971 62,606 — 113,827 Investments in subsidiaries 10,009,874 3,085,722 — (13,095,596 ) — Intercompany receivables 3,677,947 — 1,313,213 (4,991,160 ) — Other long-term assets and investments 47,297 68,344 214,875 — 330,516 Goodwill — 4,732,320 1,877,959 — 6,610,279 Total assets $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Current liabilities $ 238,706 $ 1,181,139 $ 436,262 $ — $ 1,856,107 Current liabilities held for sale — 739,294 445,776 — 1,185,070 Total current liabilities 238,706 1,920,433 882,038 — 3,041,177 Intercompany payables — 3,690,042 1,301,118 (4,991,160 ) — Long-term debt and other long-term liabilities 8,857,373 682,630 469,587 — 10,009,590 Noncontrolling interests subject to put provisions 574,602 — — 436,758 1,011,360 Total DaVita Inc. shareholders' equity 4,690,029 10,009,874 3,085,722 (13,095,596 ) 4,690,029 Noncontrolling interests not subject to put — — 632,795 (436,758 ) 196,037 Total equity 4,690,029 10,009,874 3,718,517 (13,532,354 ) 4,886,066 Total liabilities and equity $ 14,360,710 $ 16,302,979 $ 6,371,260 $ (18,086,756 ) $ 18,948,193 Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of December 31, 2017 Cash and cash equivalents $ 508,234 $ — $ — $ 508,234 Accounts receivable, net 1,714,750 — — 1,714,750 Other current assets 759,732 3,033 — 756,699 Other current assets held for sale 5,761,642 423,205 2,733 5,335,704 Total current assets 8,744,358 426,238 2,733 8,315,387 Property and equipment, net 3,149,213 — — 3,149,213 Amortizable intangibles, net 113,827 — — 113,827 Other long-term assets 330,516 — — 330,516 Goodwill 6,610,279 — — 6,610,279 Total assets $ 18,948,193 $ 426,238 $ 2,733 $ 18,519,222 Current liabilities $ 1,856,107 $ — $ — $ 1,856,107 Current liabilities held for sale 1,185,070 308,884 — 876,186 Total current liabilities 3,041,177 308,884 — 2,732,293 Payables to parent — — 2,733 (2,733 ) Long-term debt and other long-term liabilities 10,009,590 — — 10,009,590 Noncontrolling interests subject to put provisions 1,011,360 — — 1,011,360 Total DaVita Inc. shareholders' equity 4,690,029 117,354 — 4,572,675 Noncontrolling interests not subject to put provisions 196,037 — — 196,037 Shareholders' equity 4,886,066 117,354 — 4,768,712 Total liabilities and shareholders' equity $ 18,948,193 $ 426,238 $ 2,733 $ 18,519,222
Consolidating Statements of Cash Flows	Consolidating Statements of Cash Flow DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated For the year ended December 31, 2017 Cash flows from operating activities: Net income $ 663,618 $ 478,192 $ 241,312 $ (552,567 ) $ 830,555 Changes in operating assets and liabilities and (534,302 ) 366,947 691,682 552,567 1,076,894 Net cash provided by operating activities 129,316 845,139 932,994 — 1,907,449 Cash flows from investing activities: Additions of property and equipment, net (155,972 ) (490,800 ) (258,478 ) — (905,250 ) Acquisitions — (693,522 ) (110,357 ) — (803,879 ) Proceeds from asset sales, net of cash divested — 90,340 1,996 — 92,336 Investments and other items 211,619 (9,003 ) 47,446 — 250,062 Net cash provided by (used in) investing 55,647 (1,102,985 ) (319,393 ) — (1,366,731 ) Cash flows from financing activities: Long-term debt and related financing costs, net 173,529 (12,662 ) (6,019 ) — 154,848 Intercompany borrowing 22,589 218,980 (241,569 ) — — Other items (781,697 ) (2,493 ) (136,915 ) — (921,105 ) Net cash (used in) provided by financing (585,579 ) 203,825 (384,503 ) — (766,257 ) Effect of exchange rate changes on cash — — 254 — 254 Net (decrease) increase in cash and cash (400,616 ) (54,021 ) 229,352 — (225,285 ) Less: Net decrease in cash and cash equivalents — (54,021 ) (4,722 ) — (58,743 ) Net (decrease) increase in cash and cash (400,616 ) — 234,074 — (166,542 ) Cash and cash equivalents of continuing operations 549,921 — 124,855 — 674,776 Cash and cash equivalents of continuing operations $ 149,305 $ — $ 358,929 $ — $ 508,234 Consolidating Statements of Cash Flow - (continued) DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated For the year ended December 31, 2016 Cash flows from operating activities: Net income $ 879,874 $ 693,720 $ 820,486 $ (1,360,998 ) $ 1,033,082 Changes in operating assets and liabilities and (612,706 ) 350,684 (168,614 ) 1,360,998 930,362 Net cash provided by operating activities 267,168 1,044,404 651,872 — 1,963,444 Cash flows from investing activities: Additions of property and equipment, net (139,303 ) (382,305 ) (307,487 ) — (829,095 ) Acquisitions — (472,413 ) (91,443 ) — (563,856 ) Proceeds from asset and business sales, net of cash — 70,342 (5,617 ) — 64,725 Investments and other items 153,031 (29,038 ) 2,565 — 126,558 Net cash provided by (used in) investing 13,728 (813,414 ) (401,982 ) — (1,201,668 ) Cash flows from financing activities: Long-term debt and related financing costs, net (92,460 ) (27,830 ) (4,152 ) — (124,442 ) Intercompany borrowing 236,052 (231,800 ) (4,252 ) — — Other items (1,061,203 ) (21,525 ) (144,811 ) — (1,227,539 ) Net cash used in financing activities (917,611 ) (281,155 ) (153,215 ) — (1,351,981 ) Effect of exchange rate changes on cash — — 4,276 — 4,276 Net (decrease) increase in cash and cash (636,715 ) (50,165 ) 100,951 — (585,929 ) Less: Net (decrease) increase in cash and cash — (50,165 ) 34,377 — (15,788 ) Net (decrease) increase in cash and cash (636,715 ) — 66,574 — (570,141 ) Cash and cash equivalents of continuing operations 1,186,636 — 58,281 — 1,244,917 Cash and cash equivalents of continuing operations $ 549,921 $ — $ 124,855 $ — $ 674,776 Consolidating Statements of Cash Flow - (continued) DaVita Inc. Guarantor Subsidiaries Non-Guarantor Subsidiaries Consolidating Adjustments Consolidated Total For the year ended December 31, 2015 Cash flows from operating activities: Net income $ 269,732 $ 174,957 $ 479,700 $ (496,979 ) $ 427,410 Changes in operating assets and liabilities and (125,981 ) 684,760 74,032 496,979 1,129,790 Net cash provided by operating activities 143,751 859,717 553,732 — 1,557,200 Cash flows from investing activities: Additions of property and equipment, net (115,269 ) (319,695 ) (273,034 ) — (707,998 ) Acquisitions — (76,983 ) (19,486 ) — (96,469 ) Proceeds from asset sales — 19,715 — — 19,715 Investments and other items (74,474 ) (2,144 ) (20,414 ) — (97,032 ) Net cash used in investing activities (189,743 ) (379,107 ) (312,934 ) — (881,784 ) Cash flows from financing activities: Long-term debt and related financing costs, net 640,009 (11,953 ) (8,358 ) — 619,698 Intercompany borrowing 466,038 (370,839 ) (95,199 ) — — Other items (572,295 ) (66,382 ) (119,991 ) — (758,668 ) Net cash provided by (used in) financing 533,752 (449,174 ) (223,548 ) — (138,970 ) Effect of exchange rate changes on cash — — (2,571 ) — (2,571 ) Net increase in cash and cash equivalents 487,760 31,436 14,679 — 533,875 Less: Net increase (decrease) in cash and cash — 31,436 (5,581 ) — 25,855 Net increase in cash and cash equivalents from 487,760 — 20,260 — 508,020 Cash and cash equivalents of continuing operations 698,876 — 38,021 — 736,897 Cash and cash equivalents of continuing operations $ 1,186,636 $ — $ 58,281 $ — $ 1,244,917 C ondensed Consolidating Statements of Cash Flow Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For the year ended December 31, 2017 Cash flows from operating activities: Net income $ 830,555 $ 13,611 $ 19 $ 816,925 Changes in operating and intercompany assets and liabilities and 1,076,894 27,312 (19 ) 1,049,601 Net cash provided by operating activities 1,907,449 40,923 — 1,866,526 Cash flows from investing activities: Additions of property and equipment (905,250 ) (5,406 ) — (899,844 ) Acquisitions and divestitures, net (803,879 ) — — (803,879 ) Proceeds from asset sales 92,336 — — 92,336 Investments and other items, net 250,062 (3,800 ) — 253,862 Net cash used in investing activities (1,366,731 ) (9,206 ) — (1,357,525 ) Cash flows from financing activities: Long-term debt and related financing costs, net 154,848 — — 154,848 Intercompany — (36,220 ) — 36,220 Other items (921,105 ) — — (921,105 ) Net cash used in financing activities (766,257 ) (36,220 ) — (730,037 ) Effect of exchange rate changes on cash 254 — — 254 Net decrease in cash and cash equivalents (225,285 ) (4,503 ) — (220,782 ) Less: Net decrease in cash and cash equivalents from discontinued operations (58,743 ) (4,503 ) — (54,240 ) Net decrease in cash and cash equivalents from continuing operations (166,542 ) — — (166,542 ) Cash and cash equivalents of continuing operations at beginning of the year 674,776 — — 674,776 Cash and cash equivalents of continuing operations at end of the year $ 508,234 $ — $ — $ 508,234 (1) After the elimination of the unrestricted subsidiaries and the physician groups

Organization and Summary of S60

Organization and Summary of Significant Accounting Policies - Additional Information (Details) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2018USD ($)	Dec. 31, 2017statepatientsegmentCountryoutpatient_dialysis_centerentity
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Operating divisions | segment		2
Percentage of risk on revenue		1.00%
Number of legal entities that third parties held noncontrolling equity interests | entity		589
Minimum | Noncompetition and other agreements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period		2 years
Minimum | Buildings
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		20 years
Minimum | Equipment and Information Systems
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		3 years
Maximum | Noncompetition and other agreements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period		10 years
Maximum | Buildings
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		40 years
Maximum | Equipment and Information Systems
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		8 years
United States
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of dialysis centers that the company operated or provided administrative services | outpatient_dialysis_center		2,510
Number of states where dialysis centers are located | state		46
Number of patients served | patient		197,800
International Operations
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of dialysis centers that the company operated or provided administrative services | outpatient_dialysis_center		237
Number of patients served | patient		22,900
Number of countries in which dialysis centers located | Country		11
Continuing Operations
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of legal entities that third parties held noncontrolling equity interests | entity		586
ASU 2015-04, ASU 2016-08, ASU 2016-10, ASU 2016-11, ASU 2016-12 | Difference Between Revenue Guidance In Effect Before And After Topic 606 | Scenario, Forecast
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Projected benefit to be recognized | $	$ 30,000

Earnings Per Share - Reconcilia

Earnings Per Share - Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Net Income Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Numerators:
Net income from continuing operations									$ 901,277	$ 1,032,373	$ 323,199
Net loss from discontinued operations attributable to DaVita Inc.	$ 143,587	$ (370,872)	$ (24,520)	$ 6,433	$ 11,772	$ 20,213	$ (118,443)	$ (71,804)	(237,659)	(152,499)	(53,467)
Net income attributable to DaVita Inc.	$ 303,396	$ (214,476)	$ 127,001	$ 447,697	$ 157,726	$ 571,332	$ 53,382	$ 97,434	$ 663,618	$ 879,874	$ 269,732
Weighted average shares outstanding during the period (in shares)									190,820,000	203,835,000	214,062,000
Contingently returnable shares held in escrow for the DaVita HealthCare Partners merger (in shares)									(2,194,000)	(2,194,000)	(2,194,000)
Weighted average shares for basic earnings per share calculation (in shares)									188,625,559	201,641,173	211,867,714
Basic net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	$ 0.86	$ 0.81	$ 0.79	$ 2.29	$ 0.74	$ 2.69	$ 0.84	$ 0.83	$ 4.78	$ 5.12	$ 1.53
Basic net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)	0.80	(1.95)	(0.13)	0.04	0.07	0.11	(0.58)	(0.35)	(1.26)	(0.76)	(0.26)
Basic net income per share attributable to DaVita Inc. (in usd per share)	1.66	(1.14)	0.66	2.33	0.81	2.80	0.26	0.48	$ 3.52	$ 4.36	$ 1.27
Diluted:
Weighted average shares outstanding during the period (in shares)									190,820,000	203,835,000	214,062,000
Assumed incremental shares from stock plans (in shares)									529,000	1,070,000	2,190,000
Weighted average shares for diluted earnings per share calculation (in shares)									191,348,533	204,904,656	216,251,807
Diluted net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	0.85	0.80	0.78	2.26	0.73	2.65	0.82	0.81	$ 4.71	$ 5.04	$ 1.49
Diluted net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)	0.79	(1.92)	(0.13)	0.03	0.07	0.11	(0.56)	(0.34)	(1.24)	(0.75)	(0.24)
Diluted net income per share attributable to DaVita Inc. (in usd per share)	$ 1.64	$ (1.12)	$ 0.65	$ 2.29	$ 0.80	$ 2.76	$ 0.26	$ 0.47	$ 3.47	$ 4.29	$ 1.25
Anti-dilutive stock-settled awards excluded from calculation (in shares)									4,350,000	2,523,000	1,365,000

Investments in Debt and Equit62

Investments in Debt and Equity Securities (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Investment Holdings [Line Items]
Held to maturity	$ 42,316	$ 305,781
Available for sale	38,895	31,197
Total	81,211	336,978
Held to maturity, short-term investments	42,316	305,781
Available for sale, short-term investments	1,200	1,200
Total, short-term investments	43,516	306,981
Held to maturity, long-term investments	0	0
Available for sale, long-term investments	37,695	29,997
Total, long-term investments	37,695	29,997
Certificates of deposit, commercial paper and money market funds due within one year
Investment Holdings [Line Items]
Held to maturity	42,316	255,781
Available for sale, debt securities	0	0
Total	42,316	255,781
Investments in mutual funds and common stock
Investment Holdings [Line Items]
Held to maturity	0	50,000
Available for sale, equity securities	38,895	31,197
Total	$ 38,895	$ 81,197

Investments in Debt and Equit63

Investments in Debt and Equity Securities - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Schedule of Trading Securities and Other Trading Assets [Line Items]
Available for sale investments gross pre-tax unrealized gain (loss)	$ 8,416	$ 3,701
Proceeds from sale of investments available for sale	6,408	14,971
Pre tax reclassification of net investment realized gain into net income	360	690
Reclassification of net investment realized gain into net income, net of tax	220	423
Certificates of deposit, commercial paper and money market funds due within one year
Schedule of Trading Securities and Other Trading Assets [Line Items]
Unrealized gains on investments, pre tax	$ 5,075	$ 1,802

Accounts Receivable - Additiona

Accounts Receivable - Additional Information (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2017	Dec. 31, 2016
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable, less allowance of $218,399 and $238,897	$ 1,714,750	$ 1,714,750	$ 1,503,950
Decrease in allowance for doubtful accounts		$ 20,498	$ 12,837
U.S. dialysis and related lab services
Accounts, Notes, Loans and Financing Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	100.00%	100.00%
Outstanding period in which receivables are reserved 100%		3 months
Health Care Patient Services | Accounts Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Net accounts receivable, percentage of balances more than six months old	21.00%	21.00%	16.00%
Percentage of accounts receivable due		1.00%
Outstanding period in which receivables are reserved 100%	6 months	1 year
Accounts receivable, less allowance of $218,399 and $238,897	$ 0	$ 0
Government-based Programs, Medicare and Medicaid | Accounts Receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy	80.00%	80.00%

Other Receivables (Details)

Other Receivables (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	$ 372,919	$ 288,156
Supplier rebates and non-trade receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	268,949	183,498
Medicare bad debt claims
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	$ 103,970	$ 104,658

Other Current Assets (Details)

Other Current Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Prepaid Expense and Other Assets, Current [Abstract]
Prepaid expenses	$ 104,727	$ 96,818
Other	7,331	2,692
Other current assets	$ 112,058	$ 99,510

Property and Equipment (Details

Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Property, Plant and Equipment [Abstract]
Land	$ 33,814	$ 26,339
Buildings	473,489	429,039
Leasehold improvements	2,816,675	2,495,070
Equipment and information systems, including internally developed software	2,352,246	2,182,912
New center and capital asset projects in progress	576,651	429,037
Property, plant and equipment, gross, total	6,252,875	5,562,397
Less accumulated depreciation	(3,103,662)	(2,698,276)
Property and equipment, net	$ 3,149,213	$ 2,864,121

Property and Equipment - Additi

Property and Equipment - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Depreciation expense on property and equipment		$ 544,129	$ 494,945	$ 444,720
Capitalized interest		$ 19,176	$ 12,990	$ 9,723
Pharmacy Business
Property, Plant and Equipment [Line Items]
Other Asset Impairment Charges	$ 15,168

Intangibles - Amortizable Intan

Intangibles - Amortizable Intangible Assets Other Than Goodwill (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Goodwill and Intangible Assets Disclosure [Abstract]
Noncompetition and other agreements	$ 429,140	$ 407,220
Lease agreements	7,623	7,244
Indefinite-lived assets	33,255	1,125
Other	583	583
Intangible assets, gross (excluding goodwill)	470,601	416,172
Less accumulated amortization	(356,774)	(342,668)
Total intangible assets	$ 113,827	$ 73,504

Intangibles - Additional Inform

Intangibles - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense from amortizable intangible assets, other than lease agreements	$ 15,782,000	$ 14,552,000	$ 19,185,000
Amortization of lease agreement intangible assets and liabilities	(203,000)	(232,000)	(331,000)
Impairment of Intangible Assets (Excluding Goodwill)			0
Impairment charge on indefinite-lived intangible asset	0	0
Amortizable intangible lease liabilities	5,447,000	6,011,000
Lease agreements, accumulated amortization	3,508,000	3,618,000
Amortization benefit recognized from the alliance and product supply agreement	$ 0	$ 0	$ 3,997,000

Intangibles - Scheduled Amortiz

Intangibles - Scheduled Amortization Charges from Intangible Assets and Liabilities (Details) $ in Thousands	Dec. 31, 2017USD ($)
Noncompetition and other agreements
Expected Amortization Expense [Line Items]
2,018	$ (15,581)
2,019	(14,051)
2,020	(12,629)
2,021	(9,929)
2,022	(6,808)
Thereafter	(21,341)
Total	80,339
Lease liabilities
Expected Amortization Expense [Line Items]
2,018	(849)
2,019	(658)
2,020	(628)
2,021	(602)
2,022	(553)
Thereafter	(2,157)
Total	5,447
Other
Expected Amortization Expense [Line Items]
2,018	(102)
2,019	(87)
2,020	(44)
2,021	0
2,022	0
Thereafter	0
Total	$ 233

Equity Method and Other Inves72

Equity Method and Other Investments - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Noncontrolling Interest [Line Items]
Carrying value of investment in APAC	$ 0	$ 0
Equity investments in nonconsolidated businesses	245,534	492,039
Equity investment (loss) income	(8,640)	16,874	$ 13,919
Deconsolidated Noncontrolling Entity [Member]
Noncontrolling Interest [Line Items]
Equity investments in nonconsolidated businesses	245,534	492,039
Equity investment (loss) income	(8,640)	16,874	$ 13,919
Company and Restricted Subsidiaries(1)
Noncontrolling Interest [Line Items]
Impairment related to minority equity investment		$ 14,993
Asia-Pacific dialysis business | Deconsolidated Noncontrolling Entity [Member]
Noncontrolling Interest [Line Items]
Non-cash other than temporary impairment losses	280,066
Carrying value of investment in APAC	$ 160,481

Goodwill - Changes in Carrying

Goodwill - Changes in Carrying Value of Goodwill by Reportable Segments (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Goodwill [Roll Forward]
Beginning balance	$ 6,015,375	$ 5,896,215
Acquisitions	617,032	198,927
Divestitures	(32,386)	(42,536)
Goodwill impairment charges	(36,196)	(28,415)	$ (4,066)
Foreign currency and other adjustments	46,454	(8,816)
Ending balance	6,610,279	6,015,375	5,896,215
Goodwill	6,680,799
Accumulated impairment charges	(70,520)
U.S. dialysis and related lab services
Goodwill [Roll Forward]
Beginning balance	5,691,587	5,629,183
Acquisitions	485,434	75,295
Divestitures	(32,260)	(12,891)
Goodwill impairment charges	0	0
Foreign currency and other adjustments	0	0
Ending balance	6,144,761	5,691,587	5,629,183
Goodwill	6,144,761
Accumulated impairment charges	0
Other ancillary services and strategic initiatives
Goodwill [Roll Forward]
Beginning balance	323,788	267,032
Acquisitions	131,598	123,632
Divestitures	(126)	(29,645)
Goodwill impairment charges	(36,196)	(28,415)
Foreign currency and other adjustments	46,454	(8,816)
Ending balance	465,518	$ 323,788	$ 267,032
Goodwill	536,038
Accumulated impairment charges	$ (70,520)

Goodwill - Additional Informati

Goodwill - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Goodwill [Line Items]
Goodwill impairment charges	$ 36,196,000	$ 28,415,000	$ 4,066,000
Goodwill	6,610,279,000	6,015,375,000	5,896,215,000
Vascular access
Goodwill [Line Items]
Goodwill impairment charges	34,696,000	$ 28,415,000
Goodwill	0
International Operations
Goodwill [Line Items]
Goodwill impairment charges	1,500,000		$ 4,066,000
Reporting Units Other Than DaVita Medical Group
Goodwill [Line Items]
Goodwill impairment charges	$ 0

Goodwill - Schedule of Reportin

Goodwill - Schedule of Reporting Units Goodwill Balances (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Goodwill [Line Items]
Goodwill balance as of 12/31/2017	$ 6,610,279	$ 6,015,375	$ 5,896,215
Percentage change in operating income used to evaluate fair value of reporting unit for goodwill assessment	3.00%
Percentage change in operating income used to evaluate fair value of reporting unit for goodwill assessment	1.00%
GERMANY
Goodwill [Line Items]
Goodwill balance as of 12/31/2017	$ 316,369
Carrying amount coverage	13.70%
Sensitivities, Operating Income	(1.60%)
Sensitivities, Discount rate	(11.10%)
PORTUGAL
Goodwill [Line Items]
Goodwill balance as of 12/31/2017	$ 46,713
Carrying amount coverage	16.90%
Sensitivities, Operating Income	(1.90%)
Sensitivities, Discount rate	(6.00%)
POLAND
Goodwill [Line Items]
Goodwill balance as of 12/31/2017	$ 46,610
Carrying amount coverage	11.80%
Sensitivities, Operating Income	(1.90%)
Sensitivities, Discount rate	(6.00%)

Other Liabilities (Details)

Other Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Other Liabilities Disclosure [Abstract]
Payor refunds and retractions	$ 292,370	$ 270,298
Insurance and self-insurance accruals	64,924	76,857
Accrued interest	83,362	82,234
Accrued non-income tax liabilities	28,317	23,643
Other	83,689	125,860
Other liabilities	$ 552,662	$ 578,892

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Before Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Domestic									$ 1,725,822	$ 1,278,754	$ 730,249
International									(326,036)	344,351	(41,862)
Income from continuing operations before income taxes	$ 46,825	$ 289,384	$ 288,060	$ 775,517	$ 259,669	$ 710,246	$ 331,231	$ 321,959	$ 1,399,786	$ 1,623,105	$ 688,387

Income Taxes - Components of In

Income Taxes - Components of Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current:
Federal	$ 330,191	$ 322,940	$ 124,503
State	47,228	44,525	20,442
International	3,422	1,928	856
Total current income tax	380,841	369,393	145,801
Deferred:
Federal	(98,760)	88,412	71,016
State	37,347	(28,530)	(9,737)
International	4,431	2,486	430
Total deferred income tax	(56,982)	62,368	61,709
Continuing operations	$ 323,859	$ 431,761	$ 207,510

Income Taxes - Reconciliation B

Income Taxes - Reconciliation Between U.S. Federal Income Tax Rate and Our Effective Tax Rate From Continuing Operations (Details)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Federal income tax rate	35.00%	35.00%	35.00%
State income taxes, net of federal benefit	3.70%	2.60%	1.70%
Gain on APAC JV ownership changes	(0.20%)	(9.90%)	0.00%
APAC investment impairment	6.40%	0.00%	0.00%
Impact of 2017 Tax Act	(20.50%)	0.00%	0.00%
Other	2.00%	1.80%	2.30%
Impact of noncontrolling interests primarily attributable to non-tax paying entities	(3.30%)	(2.90%)	(8.90%)
Effective tax rate	23.10%	26.60%	30.10%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Taxes [Line Items]
Tax Cuts And Jobs Act Of 2017, Transition Tax For Accumulated Foreign Earnings, Liability	$ 0
Tax Cuts And Jobs Act Of 2017, Incomplete Accounting, Change In Tax Rate, Deferred Tax Asset, Provisional Income Tax Expense	251,510,000
Decrease in valuation allowance related to changes in the estimated tax benefit of federal and state operating losses of separate-return entities	5,266,000
Liability for unrecognized tax benefits	32,776,000	$ 24,066,000	$ 39,011,000
Increase in liability for unrecognized tax benefits	8,710,000
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits	4,195,000	$ 2,595,000
Domestic Tax Authority
Income Taxes [Line Items]
Net operating loss carryforwards	137,852,000
State
Income Taxes [Line Items]
Net operating loss carryforwards	445,554,000
Foreign Tax Authority
Income Taxes [Line Items]
Net operating loss carryforwards	$ 138,717,000

Income Taxes - Deferred Tax and

Income Taxes - Deferred Tax and Liabilities Arising from Temporary Differences (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Receivables	$ 19,705	$ 25,197
Accrued liabilities	96,537	224,712
Net operating loss carryforwards	108,429	128,813
Other	37,794	73,525
Deferred tax assets	262,465	452,247
Valuation allowance	(61,282)	(56,016)
Net deferred tax assets	201,183	396,231
Intangible assets	(501,763)	(676,781)
Property and equipment	(100,376)	(141,919)
Investments in partnerships	(61,529)	(95,936)
Other	(23,762)	(12,464)
Deferred tax liabilities	(687,430)	(927,100)
Net deferred tax liabilities	$ (486,247)	$ (530,869)

Income Taxes - Reconciliation o

Income Taxes - Reconciliation of Beginning and Ending Liability for Unrecognized Tax Benefits that Do Not Meet More-Likely-Than-Not Threshold (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Beginning balance	$ 24,066	$ 39,011
Additions for tax positions related to current year	7,606	9,714
Additions for tax positions related to prior years	804	0
Reductions related to lapse of applicable statute	(1,380)	(1,277)
Impact of 2017 Tax Act	3,731	0
Reductions related to settlements with taxing authorities	(2,051)	(23,382)
Ending balance	$ 32,776	$ 24,066

Income Taxes Income Taxes - All

Income Taxes Income Taxes - Allocation of Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Continuing operations	$ 323,859	$ 431,761	$ 207,510
Discontinued operations	(364,856)	24,052	88,216
Income tax (benefit) expense from continuing and discontinued operations	$ (40,997)	$ 455,813	$ 295,726

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Senior notes	$ 4,500,000	$ 4,500,000
Acquisition obligations and other notes payable	150,512	117,547
Capital lease obligations	297,170	292,252
Total debt principal outstanding	9,400,182	9,184,799
Discount and deferred financing costs	(63,951)	(79,861)
Carrying amount of long-term debt, net of unamortized discounts	9,336,231	9,104,938
Less current portion	(178,213)	(160,262)
Long-term debt	9,158,018	8,944,676
Term Loan A
Debt Instrument [Line Items]
Senior secured credit facilities	775,000	862,500
Term Loan B
Debt Instrument [Line Items]
Senior secured credit facilities	3,377,500	3,412,500
Revolver
Debt Instrument [Line Items]
Senior secured credit facilities	$ 300,000	$ 0

Long-Term Debt - Scheduled Matu

Long-Term Debt - Scheduled Maturities of Long-term Debt (Details) $ in Thousands	Dec. 31, 2017USD ($)
Debt Disclosure [Abstract]
2,018	$ 178,213
2,019	1,049,091
2,020	73,362
2,021	3,307,507
2,022	1,283,671
Thereafter	$ 3,508,338

Long-Term Debt - Term Loans (De

Long-Term Debt - Term Loans (Details)	12 Months Ended
	Dec. 31, 2017USD ($)
Term Loan A Term Loan B | Minimum
Debt Instrument [Line Items]
Maturity date ranges	1 month
Term Loan A Term Loan B | Maximum
Debt Instrument [Line Items]
Maturity date ranges	12 months
Term Loan A
Debt Instrument [Line Items]
Debt instrument, annual principal payment	$ 87,500,000
Term Loan A | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Debt instrument, variable interest rate margin	2.00%
Term Loan B
Debt Instrument [Line Items]
Debt instrument, annual principal payment	$ 35,000,000
Term Loan B | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Debt instrument, variable interest rate margin	2.75%
Term Loan B | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument [Line Items]
Debt instrument, variable interest rate margin	0.75%
Term Loan B | London Interbank Offered Rate (LIBOR) | Maximum
Debt Instrument [Line Items]
Debt instrument, variable interest rate margin	3.50%
Interest rate cap agreements 1 | Term Loan B | Maximum
Debt Instrument [Line Items]
Debt instrument Interest rate	3.50%
Interest rate agreements, notional amount	$ 3,500,000,000
Remaining outstanding debt	$ 652,500,000
Interest rate cap agreements
Debt Instrument [Line Items]
Derivative, effective date	Jun. 29, 2018

Long-Term Debt - Revolving Line

Long-Term Debt - Revolving Lines Of Credit (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Letter of Credit
Line of Credit Facility [Line Items]
Outstanding letters of credit	$ 14,383
Revolver
Line of Credit Facility [Line Items]
Line of credit outstanding amount	300,000	$ 0
Revolving credit facilities	1,000,000
Kidney Care
Line of Credit Facility [Line Items]
Outstanding letters of credit	90,085
DMG
Line of Credit Facility [Line Items]
Outstanding letters of credit	$ 211

Long-Term Debt - Senior Notes (

Long-Term Debt - Senior Notes (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Apr. 30, 2015	Dec. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Senior notes		$ 4,500,000	$ 4,500,000
Senior Notes 5.0 Percent Due 2025
Debt Instrument [Line Items]
Senior notes		$ 1,500,000
Senior note, interest rate		5.00%
Senior note, due date		2,025
Senior Notes 5.125 Percent Due 2024
Debt Instrument [Line Items]
Senior notes		$ 1,750,000
Senior note, interest rate		5.125%
Senior note, due date		2,024
Senior Notes 5.75 Percent Due 2022
Debt Instrument [Line Items]
Senior notes		$ 1,250,000
Senior note, interest rate		5.75%
Senior note, due date		2,022
Maximum | Senior Notes 5.0 Percent Due 2025
Debt Instrument [Line Items]
Debt Instrument, redemption price percentage	35.00%

Long-Term Debt - Interest Rate

Long-Term Debt - Interest Rate Cap and Swap Agreement (Details) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Derivative [Line Items]
Debt expense recognized	$ 406,341,000	$ 394,013,000	$ 389,755,000
Unrealized losses on interest rate cap and swap agreements	$ (5,437,000)	$ (3,670,000)	$ (12,241,000)
Weighted average effective interest rate	4.88%
Weighted average effective interest rate	4.70%
Interest Rate Cap Agreements Effective September 30, 2016
Derivative [Line Items]
Derivative, effective date	Sep. 30, 2016
Derivative, expiration date	Jun. 30, 2018
Debt expense recognized	$ 8,278,000
Unrealized losses on interest rate cap and swap agreements	$ (115,000)
Interest Rate Cap Agreements Effective June 29, 2018
Derivative [Line Items]
Derivative, effective date	Jun. 29, 2018
Derivative, expiration date	Jun. 30, 2020
Unrealized losses on interest rate cap and swap agreements	$ (8,782,000)
Fair value of assets	1,032,000
Term Loan B | Maximum | Interest rate cap agreements 1
Derivative [Line Items]
Interest rate agreements, notional amount	$ 3,500,000,000
Debt instrument Interest rate	3.50%
Remaining outstanding debt	$ 652,500,000
Senior Secured Credit Facilities
Derivative [Line Items]
Weighted average effective interest rate	4.45%
London Interbank Offered Rate (LIBOR) | Term Loan B
Derivative [Line Items]
Debt instrument, variable interest rate margin	2.75%
London Interbank Offered Rate (LIBOR) | Term Loan B | Maximum
Derivative [Line Items]
Debt instrument, variable interest rate margin	3.50%
London Interbank Offered Rate (LIBOR) | Term Loan A
Derivative [Line Items]
Debt instrument, variable interest rate margin	2.00%
Term Loan A Subject To Interest Rate Caps
Derivative [Line Items]
Senior secured credit facilities	$ 122,500,000

Long-Term Debt - Debt Expense (

Long-Term Debt - Debt Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Debt Disclosure [Abstract]
Debt expense recognized	$ 406,341	$ 394,013	$ 389,755
Amortization of deferred financing costs	$ 24,293	$ 20,103	$ 18,625

Long-Term Debt - Derivative Ins

Long-Term Debt - Derivative Instruments (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Derivatives designated as hedging instruments | Interest rate cap agreements | Other long-term assets
Derivative [Line Items]
Derivative assets, Fair value	$ 1,032	$ 9,929

Long-Term Debt - Effects of Int

Long-Term Debt - Effects of Interest Rate Swap and Cap Agreements (Details) - Cash Flow Hedging - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized losses in OCI on interest rate cap and swap agreements	$ (5,437)	$ (3,670)	$ (12,241)
Amount of losses reclassified from accumulated OCI into income	5,058	2,566	3,111
Tax benefit (expense)
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized losses in OCI on interest rate cap and swap agreements	3,460	2,343	7,844
Amount of losses reclassified from accumulated OCI into income	(3,220)	(1,632)	(1,992)
Interest rate cap agreements | Debt Expense (Including Refinancing Charges)
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized losses in OCI on interest rate cap and swap agreements	(8,897)	(5,198)	(16,114)
Amount of losses reclassified from accumulated OCI into income	8,278	3,899	2,439
Interest rate swap agreements | Debt Expense (Including Refinancing Charges)
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized losses in OCI on interest rate cap and swap agreements	0	(815)	(3,971)
Amount of losses reclassified from accumulated OCI into income	$ 0	$ 299	$ 2,664

Leases - Additional Information

Leases - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Leases Disclosure [Line Items]
Rent expense under all operating leases	$ 530,748	$ 478,531	$ 440,601
Net book value of property and equipment under capital leases	$ 257,772	$ 263,438
Minimum
Leases Disclosure [Line Items]
Facilities leased under non-cancellable operating leases term range	5 years
Facilities leased under non-cancellable operating leases renewal option range	5 years
Maximum
Leases Disclosure [Line Items]
Facilities leased under non-cancellable operating leases term range	15 years
Facilities leased under non-cancellable operating leases renewal option range	10 years

Leases - Future Minimum Lease P

Leases - Future Minimum Lease Payments Under Non-Cancelable Operating and Capital Leases (Details) $ in Thousands	Dec. 31, 2017USD ($)
Operating leases
2,018	$ 446,935
2,019	422,245
2,020	384,764
2,021	351,962
2,022	313,005
Thereafter	1,303,594
Total future minimum lease payments due under operating leases	3,222,505
Capital leases
2,018	35,258
2,019	36,038
2,020	36,689
2,021	32,578
2,022	33,004
Thereafter	234,094
Total future minimum capital lease payments	407,661
Less portion representing interest	(110,491)
Total capital lease obligations, including current portion	$ 297,170

Employee Benefit Plans - Additi

Employee Benefit Plans - Additional Information (Details) - USD ($) $ in Thousands	Jan. 01, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Nonqualified Deferred Compensation Plan | All Trusts
Defined Benefit Plan Disclosure [Line Items]
Total fair value of assets held in trust		$ 38,895	$ 31,197
Nonqualified Deferred Compensation Plan | DaVita Voluntary Deferral Plan
Defined Benefit Plan Disclosure [Line Items]
Maximum percentage of employees' base salary to be maintained into deferral account		50.00%
Non-qualified deferred compensation plan, contributions		$ 4,497	5,344	$ 4,234
Non-qualified deferred compensation plan, distributions		1,731	916	1,270
Nonqualified Deferred Compensation Plan | DaVita Voluntary Deferral Plan | Rabbi Trust
Defined Benefit Plan Disclosure [Line Items]
Total fair value of assets held in trust		38,816	30,192
Nonqualified Deferred Compensation Plan | Executive Retirement Plan
Defined Benefit Plan Disclosure [Line Items]
Total fair value of assets held in trust		79	1,005
Executive Retirement Plan, distributions		1,058	$ 149	$ 25
Change of Control Protection Program
Defined Benefit Plan Disclosure [Line Items]
Cash bonuses to employees in the event of a change of control		$ 520,778
Subsequent Event
Defined Benefit Plan Disclosure [Line Items]
Employer matching contribution, percent of match	50.00%
Employer matching contribution, percent of employees' gross wages	6.00%

Contingencies - Additional Info

Contingencies - Additional Information (Details)	1 Months Ended			3 Months Ended	12 Months Ended
	Dec. 31, 2017USD ($)	Jun. 30, 2015USD ($)	Dec. 31, 2012clinic	Mar. 31, 2017USD ($)	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)
Other Commitments [Line Items]
Loss contingency liability	$ 6,000,000				$ 6,000,000	$ 69,000,000
Gain on litigation settlement					$ 526,827,000	$ 0	$ (495,000,000)
Series of individually immaterial business acquisitions
Other Commitments [Line Items]
Number of vascular centers acquired | clinic			2
US Attorney Prescription Drug Investigation
Other Commitments [Line Items]
Litigation settlement amount awarded (paid)	(63,700,000)
U.S. Department of Veterans Affairs (VA)
Other Commitments [Line Items]
Litigation settlement amount awarded (paid)				$ (538,000,000)
Gain on litigation settlement				527,000,000
Vainer Private Civil Suit
Other Commitments [Line Items]
Litigation settlement amount awarded (paid)		$ 450,000,000
Legal fees		$ 45,000,000
Operating Income (Loss) | U.S. Department of Veterans Affairs (VA)
Other Commitments [Line Items]
Gain on litigation settlement				530,000,000
Noncontrolling Interest | U.S. Department of Veterans Affairs (VA)
Other Commitments [Line Items]
Gain on litigation settlement				9,000,000
Equity Method Investments | Noncontrolling Interest | U.S. Department of Veterans Affairs (VA)
Other Commitments [Line Items]
Gain on litigation settlement				$ 3,000,000
Incremental Cash Portion | US Attorney Prescription Drug Investigation
Other Commitments [Line Items]
Litigation settlement amount awarded (paid)	(41,500,000)
Cash Paid For Portion Previously Refunded | US Attorney Prescription Drug Investigation
Other Commitments [Line Items]
Litigation settlement amount awarded (paid)	$ (22,200,000)

Noncontrolling Interests Subj97

Noncontrolling Interests Subject to Put Provisions and Other Commitments - Additional Information (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Jan. 31, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2010
Epogen
Commitments And Contingencies Disclosure [Line Items]
Long term purchase commitment, expiration date	Dec. 31, 2022
Dialysis Equipment, Parts and Supplies
Commitments And Contingencies Disclosure [Line Items]
Long term purchase commitment, expiration date		Dec. 31, 2020			Dec. 31, 2013
Purchase commitment, purchase during the period		$ 176,212	$ 164,766	$ 154,566
Hemodialysis Products, Supplies and Equipment
Commitments And Contingencies Disclosure [Line Items]
Long term purchase commitment, expiration date		Dec. 31, 2018
Purchase commitment, purchase during the period		$ 166,764	$ 162,109	$ 112,931
Minimum
Commitments And Contingencies Disclosure [Line Items]
Scheduled dissolution term of joint ventures		10 years
Minimum | Epogen
Commitments And Contingencies Disclosure [Line Items]
Long-term purchase commitment, percentage of quantity required	90.00%
Maximum
Commitments And Contingencies Disclosure [Line Items]
Scheduled dissolution term of joint ventures		50 years
Commitments to Provide Operating Capital
Commitments And Contingencies Disclosure [Line Items]
Other potential commitments to provide operating capital to several dialysis centers		$ 5,385

Long-term Incentive Compensat98

Long-term Incentive Compensation and Shareholders’ Equity - Additional Information (Details)	Jul. 01, 2017	Jan. 01, 2017	Feb. 22, 2018USD ($)$ / sharesshares	Dec. 31, 2017USD ($)$ / sharesshares	Dec. 31, 2016USD ($)$ / sharesshares	Dec. 31, 2015USD ($)$ / sharesshares	Oct. 10, 2017USD ($)	Jul. 31, 2016shares	Jun. 20, 2016shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for future grants | shares									7,500,000
Aggregate intrinsic value of stock awards exercised				$ 34,895,000	$ 73,944,000	$ 117,260,000
Aggregate intrinsic value of stock awards outstanding				117,722,000
Aggregate intrinsic value of stock awards exercisable				25,609,000
Contributions used to purchase stock accumulated through payroll withholdings or through optional lump sum payments				616,116,000	706,564,000
Share-based awards, fair value assumptions, expected dividend				0	0	0
Long-term incentive program (LTIP) expense				61,978,000	64,956,000	123,957,000
Stock-based compensation expense				35,092,000	38,338,000	56,664,000
Estimated tax benefits recorded for stock-based compensation				7,717,000	12,731,000	19,689,000
Unrecognized compensation cost related to outstanding LTIP awards				98,015,000
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans				$ 61,166,000
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 12 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 4 months 12 days
Tax benefits from stock award exercises				$ 13,473,000	28,397,000	45,749,000
Proceeds from stock option exercises				$ 0	$ 0	0
Purchase of treasury stock (in shares) | shares				12,966,672	16,649,090
Purchase of treasury stock				$ 810,949,000	$ 1,072,377,000	575,380,000
Purchase of treasury stock, average price per share | $ / shares				$ 62.54	$ 64.41
Stock repurchase program, additional authorized amount							$ 1,252,961,000
Stock repurchase program, number of shares authorized to be repurchased | shares								247,039,000
Preferred stock, shares authorized (in shares) | shares				5,000,000	5,000,000
Acquisition of additional ownership interests in several existing majority-owned joint ventures				$ 5,357,000	$ 21,512,000	$ 66,382,000
Subsequent Event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Purchase of treasury stock (in shares) | shares			1,237,800
Purchase of treasury stock			$ 92,790,000
Purchase of treasury stock, average price per share | $ / shares			$ 74.96
Share repurchase program, available under the current board authorizations for additional share repurchase			$ 1,026,326,000
Stock Incentive Plan 2011
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Terms of award (in years)				5 years
Full share awards to shares available, conversion ratio				3.5
Shares available for future grants | shares				27,369,515
Stock Incentive Plan 2011 | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period				36 months
Stock Incentive Plan 2011 | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period				48 months
Stock appreciation rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding balance of stock-settled stock appreciation rights (in shares) | shares				6,648,199	7,337,266
Weighted average fair value | $ / shares				$ 14.51	$ 13.74	$ 17.97
Stock appreciation rights | Stock Incentive Plan 2011
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding balance of stock-settled stock appreciation rights (in shares) | shares				6,648,199
Stock Settled Stock Units | Stock Incentive Plan 2011
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding balance of stock-settled stock units and cash-settled stock appreciation rights (in shares) | shares				1,075,572
Cash-settled stock appreciation rights | Stock Incentive Plan 2011
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding balance of stock-settled stock units and cash-settled stock appreciation rights (in shares) | shares				23,000
Cash Settled Stock Units | Stock Incentive Plan 2011
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding balance of cash-settled stock units | shares				1,600
Cash-settled stock-based awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock granted | shares				15,000
Liability-classified share awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding balance of cash-settled stock units | shares				24,600
Stock-based compensation expense, fair value adjustment				$ 114,000	$ 376,000	$ (236,000)
Shares vested in period (in shares) | shares				0
Stock-based compensation liability				$ 99,000
Employee stock purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for future grants | shares				7,124,027
Employee entitlement for purchase of the Company's common stock during each calendar year				$ 25,000
Stock purchase price as percentage of fair market value	100.00%	100.00%		85.00%
Contributions used to purchase stock accumulated through payroll withholdings or through optional lump sum payments				$ 22,131,000	$ 23,902,000	$ 24,523,000
Stock issued for employee stock purchase plans | shares				360,368	438,002	413,859
Expected volatility Rate				23.00%	22.00%	26.00%
Risk-free interest rate				1.30%	0.80%	0.20%
Weighted average fair value | $ / shares				$ 15.19	$ 16.73	$ 18.76
General and Administrative Expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense				$ 34,431,000	$ 34,530,000	$ 52,665,000

Long-term Incentive Compensat99

Long-term Incentive Compensation and Shareholders’ Equity - Summary of Status of Awards Under Stock-Based Compensation Plans and Agreements (Details) - $ / shares	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Stock appreciation rights
Awards
Outstanding at beginning of year (in shares)	7,337,266
Granted (in shares)	1,692,154
Exercised (in shares)	(2,022,418)
Canceled (in shares)	(358,803)
Outstanding at end of period (in shares)	6,648,199	7,337,266
Exercisable at end of period (in shares)	2,628,008
Weighted-average fair value of grants	$ 14.51	$ 13.74	$ 17.97
Weighted average exercise price
Outstanding at beginning of year (USD per share)	64.90
Granted (USD per share)	65.29
Exercised (USD per share)	54.27
Canceled (USD per share)	70.61
Outstanding at end of period (USD per share)	67.92	$ 64.90
Exercisable at end of period (USD per share)	$ 62.78
Weighted average remaining contractual life
Outstanding at end of period	2 years 3 months 12 days
Exercisable at end of period	7 months 6 days
Stock units
Awards
Outstanding at beginning of year (in shares)	785,553
Granted (in shares)	528,968
Exercised (in shares)	(119,000)
Canceled (in shares)	(119,949)
Outstanding at end of period (in shares)	1,075,572	785,553
Exercisable at end of period (in shares)	0
Weighted-average fair value of grants (USD per share)	$ 65.73	$ 70.99	$ 80.25
Weighted average remaining contractual life
Outstanding at end of period	2 years
Exercisable at end of period	0 years

Long-term Incentive Compensa100

Long-term Incentive Compensation and Shareholders’ Equity - Summary of Range of Exercise Prices (Details)	12 Months Ended
	Dec. 31, 2017$ / sharesshares
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	6,648,199
Weighted average exercise price (USD per share)	$ 67.92
Awards exercisable (in shares) | shares	2,628,008
Weighted average exercise price (USD per share)	$ 62.78
$50.01–$60.00
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	1,856,145
Weighted average exercise price (USD per share)	$ 59.05
Awards exercisable (in shares) | shares	1,712,675
Weighted average exercise price (USD per share)	$ 59.15
Range of exercise prices, lower range (USD per share)	50.01
Range of exercise prices, upper range (USD per share)	$ 60
$60.01–$70.00
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	2,715,542
Weighted average exercise price (USD per share)	$ 66.70
Awards exercisable (in shares) | shares	632,849
Weighted average exercise price (USD per share)	$ 67.47
Range of exercise prices, lower range (USD per share)	60.01
Range of exercise prices, upper range (USD per share)	$ 70
$70.01–$80.00
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	1,443,749
Weighted average exercise price (USD per share)	$ 74.77
Awards exercisable (in shares) | shares	243,041
Weighted average exercise price (USD per share)	$ 73.16
Range of exercise prices, lower range (USD per share)	70.01
Range of exercise prices, upper range (USD per share)	$ 60
$80.01–$90.00
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	632,763
Weighted average exercise price (USD per share)	$ 83.59
Awards exercisable (in shares) | shares	39,443
Weighted average exercise price (USD per share)	$ 81.51
Range of exercise prices, lower range (USD per share)	80.01
Range of exercise prices, upper range (USD per share)	$ 90

Long-term Incentive Compensa101

Long-term Incentive Compensation and Shareholders Equity - Summary of Weighted Average Valuation Inputs (Details) - Stock Options and Stock Appreciation Rights	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	4 years 2 months 12 days	4 years 2 months 12 days	4 years 1 month 6 days
Expected volatility	23.90%	21.00%	24.60%
Expected dividend yield	0.00%	0.00%	0.00%
Risk-free interest rate	1.70%	1.00%	1.50%

Long-term Incentive Compensa102

Long-term Incentive Compensation and Shareholders’ Equity - Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Net income attributable to DaVita Inc.	$ 303,396	$ (214,476)	$ 127,001	$ 447,697	$ 157,726	$ 571,332	$ 53,382	$ 97,434	$ 663,618	$ 879,874	$ 269,732
Changes in paid-in-capital for:
Net income attributable to DaVita Inc. net of transfers in noncontrolling interests									660,752	866,769	213,906
Additional paid-in capital
Changes in paid-in-capital for:
Sales of noncontrolling interest									(114)	0	0
Purchase of noncontrolling interests									(2,752)	(13,105)	(55,826)
Net transfer in noncontrolling interests									$ (2,866)	$ (13,105)	$ (55,826)

Other Comprehensive (Loss) I103

Other Comprehensive (Loss) Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Comprehensive Income (Loss) [Line Items]
Beginning balance	$ 4,648,047
Beginning balance	4,690,029	$ 4,648,047
Interest rate cap and swap agreements
Comprehensive Income (Loss) [Line Items]
Beginning balance	(12,029)	(10,925)	$ (1,795)
Unrealized (losses) gains	(8,897)	(6,013)	(20,085)
Related income tax	3,460	2,343	7,844
Unrealized (losses) gains net	(5,437)	(3,670)	(12,241)
Reclassification from accumulated other comprehensive losses (income) into net income	8,278	4,198	5,103
Related income tax	(3,220)	(1,632)	(1,992)
Reclassification from accumulated other comprehensive income into net income net of tax	5,058	2,566	3,111
Beginning balance	(12,408)	(12,029)	(10,925)
Investment securities
Comprehensive Income (Loss) [Line Items]
Beginning balance	2,175	1,361	3,151
Unrealized (losses) gains	5,075	1,802	(1,974)
Related income tax	(1,368)	(565)	561
Unrealized (losses) gains net	3,707	1,237	(1,413)
Reclassification from accumulated other comprehensive losses (income) into net income	(360)	(690)	(618)
Related income tax	140	267	241
Reclassification from accumulated other comprehensive income into net income net of tax	(220)	(423)	(377)
Beginning balance	5,662	2,175	1,361
Foreign currency translation adjustments
Comprehensive Income (Loss) [Line Items]
Beginning balance	(79,789)	(50,262)	(26,373)
Unrealized (losses) gains	99,770	(39,614)	(23,889)
Related income tax	0	0	0
Unrealized (losses) gains net	99,770	(39,614)	(23,889)
Reclassification from accumulated other comprehensive losses (income) into net income	0	10,087	0
Related income tax	0	0	0
Reclassification from accumulated other comprehensive income into net income net of tax	0	10,087	0
Beginning balance	19,981	(79,789)	(50,262)
Accumulated other comprehensive (loss) income
Comprehensive Income (Loss) [Line Items]
Beginning balance	(89,643)	(59,826)	(25,017)
Unrealized (losses) gains	95,948	(43,825)	(45,948)
Related income tax	2,092	1,778	8,405
Unrealized (losses) gains net	98,040	(42,047)	(37,543)
Reclassification from accumulated other comprehensive losses (income) into net income	7,918	13,595	4,485
Related income tax	(3,080)	(1,365)	(1,751)
Reclassification from accumulated other comprehensive income into net income net of tax	4,838	12,230	2,734
Beginning balance	$ 13,235	$ (89,643)	$ (59,826)

Acquisitions and Divestitures -

Acquisitions and Divestitures - Additional Information (Details)	May 01, 2017USD ($)statepatientclinic	Aug. 01, 2016USD ($)	Dec. 31, 2012clinic	Mar. 31, 2017USD ($)	Sep. 30, 2016USD ($)	Dec. 31, 2017USD ($)clinic	Dec. 31, 2016USD ($)clinic	Dec. 31, 2015USD ($)clinic	Sep. 30, 2017USD ($)	Aug. 01, 2017USD ($)
Business Acquisition [Line Items]
Cash paid to acquire business						$ 803,879,000	$ 563,856,000	$ 96,469,000
Contingent earn-out obligations associated with acquisitions						2,692,000
Contingent earn-out obligations						11,466
Fair value of contingent earn-out consideration						6,388,000	2,950,000
Other Accrued Liabilities
Business Acquisition [Line Items]
Fair value of contingent earn-out consideration						216,000
Other long-term liabilities
Business Acquisition [Line Items]
Fair value of contingent earn-out consideration						6,172,000
Other companies
Business Acquisition [Line Items]
Fair value of contingent earn-out consideration						$ 6,388,000
Minimum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins
Business Acquisition [Line Items]
Earn-out consideration payment period						2 years
Maximum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins
Business Acquisition [Line Items]
Earn-out consideration payment period						6 years
Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Ownership interest percentage	100.00%
Cash paid to acquire business	$ 359,913
Number of dialysis clinic patients | patient	2,600
Number of states where dialysis centers are located | state	6
Proceeds from divestiture of business	$ 21,219
Business acquisition, transaction costs									$ 11,950
Amortizable intangible assets acquired, weighted-average estimated useful lives						5 years
Goodwill deductible for tax purposes associated with acquisitions						$ 298,200
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Cash paid to acquire business						$ 308,550	$ 165,108	$ 54,551
Number of businesses acquired | clinic			2
Amortizable intangible assets acquired, weighted-average estimated useful lives						7 years	7 years	11 years
Goodwill deductible for tax purposes associated with acquisitions						$ 237,363,000	$ 169,379,000	$ 43,823,000
Contingent earn-out obligations associated with acquisitions						2,692	1,511
Liabilities assumed						$ 23,748	$ 17,963	$ 7,452
U S Dialysis And Related Lab Services | Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Number of businesses acquired | clinic						30	8	6
Foreign Dialysis Centers | Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Number of businesses acquired | clinic						68	21	21
Operating Dialysis Center | Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Number of businesses acquired | clinic	36
Number of businesses divested | clinic	3
New Center Under Construction | Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Number of businesses acquired | clinic	1
Number of businesses divested | clinic	1
Home Dialysis Clinic | Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Number of businesses acquired | clinic	1
Khazanah And Mitsui | Asia-Pacific dialysis business
Business Acquisition [Line Items]
Ownership interest percentage		40.00%								60.00%
Initial investment in equity method investment		$ 300,000
Subscribed investment amount		$ 50,000								$ 50,000
Current economic interest										73.30%
Non-cash non-taxable gain				$ 6,293,000	$ (374,374,000)

Acquisitions and Divestiture105

Acquisitions and Divestitures - Assets Acquired and Liabilities Assumed and Recognized at Acquisition Dates at Estimated Fair Values (Details) - USD ($) $ in Thousands	Dec. 31, 2017	May 01, 2017	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Goodwill	$ 6,610,279		$ 6,015,375	$ 5,896,215
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Current assets, net of cash acquired	14,366		3,996	2,647
Property and equipment	18,192		8,840	4,466
Amortizable intangible and other long-term assets	11,663		5,876	8,924
Goodwill	318,832		198,927	67,183
Long-term liabilities	(15,846)		(3,317)	(1,595)
Aggregate purchase price	$ 334,990		$ 184,582	$ 62,003
Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Current assets, net of cash acquired		$ 22,739
Property and equipment		36,295
Amortizable intangible and other long-term assets		11,547
Goodwill		298,200
Current liabilities		(8,389)
Long-term liabilities		(479)
Aggregate purchase price		$ 359,913

Acquisitions and Divestiture106

Acquisitions and Divestitures - Aggregate Purchase Cost Allocations for Acquisitions (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Goodwill	$ 6,610,279	$ 6,015,375	$ 5,896,215
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Current assets, net of cash acquired	14,366	3,996	2,647
Property and equipment	18,192	8,840	4,466
Amortizable intangible and other long-term assets	11,663	5,876	8,924
Non-amortizable intangibles	32,296	0	0
Goodwill	318,832	198,927	67,183
Deferred income taxes, liabilities	(210)		(717)
Deferred income taxes, assets		597
Noncontrolling interests assumed	(44,303)	(30,337)	(18,905)
Liabilities assumed	(15,846)	(3,317)	(1,595)
Aggregate purchase price	$ 334,990	$ 184,582	$ 62,003

Acquisitions and Divestiture107

Acquisitions and Divestitures - Pro Forma Summary of Results of Operation (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Business Combinations [Abstract]
Pro forma net revenues	$ 11,005,330	$ 11,076,750
Pro forma net income attributable to DaVita Inc.	$ 907,443	$ 1,052,700
Pro forma basic net income per share attributable to DaVita Inc. (USD per share)	$ 4.81	$ 5.22
Pro forma diluted net income per share attributable to DaVita Inc. (USD per share)	$ 4.74	$ 5.14

Acquisitions and Divestiture108

Acquisitions and Divestitures - Reconciliation of Changes in Contingent Earn-Out Obligations (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2017USD ($)
Business Combinations [Abstract]
Beginning balance January 1, 2017	$ 2,950
Contingent earn-out obligations associated with acquisitions	2,692
Remeasurement of fair value	746
Ending balance	$ 6,388

Held for Sale and Discontinu109

Held for Sale and Discontinued Operations - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Series of individually immaterial business acquisitions
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Business combination, liabilities assumed		$ 23,748	$ 17,963	$ 7,452
Scenario, Forecast | DMG Acquisitions
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of DMG division	$ 4,900,000,000
DMG | Series of individually immaterial business acquisitions
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Business combination, net cash received		135,416	398,748	41,918
Business combination, deferred purchase price		1,038		$ 944
Business combination, liabilities assumed		$ 10,145	$ 7,694

Held for Sale and Discontinu110

Held for Sale and Discontinued Operations - Schedule of Financial Results for DMG's Discontinued Operations (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Goodwill impairment charges									$ 36,196	$ 28,415	$ 4,066
Net loss from discontinued operations, net of tax	$ 143,587	$ (370,872)	$ (24,520)	$ 6,433	$ 11,772	$ 20,213	$ (118,443)	$ (71,804)	(237,659)	(152,499)	(53,467)
DMG | Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net revenues									4,676,213	4,113,414	3,837,260
Expenses									4,634,782	3,994,624	3,596,342
Goodwill impairment charges									651,659	253,000	206,169
(Loss) income from discontinued operations before taxes									(610,228)	(134,210)	34,749
Income tax benefit (expense)									364,856	(24,052)	(88,216)
Net loss from discontinued operations, net of tax									$ (245,372)	$ (158,262)	$ (53,467)

Held for Sale and Discontinu111

Held for Sale and Discontinued Operations - Schedule of Financial Position for DMG's Discontinued Operations (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Assets
Total current assets held for sale	$ 5,761,642	$ 960,956
Total long-term assets held for sale	0	5,252,135
Liabilities
Total current liabilities held for sale	1,185,070	807,233
Total long-term liabilities held for sale	0	428,885
DMG | Discontinued Operations, Held-for-sale
Assets
Cash and cash equivalents	179,668	238,411
Other current assets	888,697	722,545
Property and equipment, net	379,945	311,246
Intangible assets, net	1,316,550	1,454,263
Other long-term assets	116,805	94,684
Goodwill	2,879,977	3,391,942
Total assets held for sale	5,761,642	6,213,091
Total current assets held for sale	5,761,642	960,956
Total long-term assets held for sale	0	5,252,135
Liabilities
Other liabilities	505,734	460,458
Medical payables	457,040	349,506
Current portion of long-term debt	2,845	4,779
Long-term debt	35,003	2,652
Other long-term liabilities	184,448	418,723
Total liabilities held for sale	1,185,070	1,236,118
Total current liabilities held for sale	1,185,070	807,233
Total long-term liabilities held for sale	$ 0	$ 428,885

Held for Sale and Discontinu112

Held for Sale and Discontinued Operations - Reconciliation of Cash Flows (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Discontinued Operations and Disposal Groups [Abstract]
Net cash provided by operating activities from discontinued operations	$ 351,557	$ 287,049	$ 365,138
Net cash used in investing activities from discontinued operations	$ (232,329)	$ (430,917)	$ (121,893)

Variable Interest Entities - Ad

Variable Interest Entities - Additional Information (Details) $ in Thousands	Dec. 31, 2017USD ($)
Variable Interest Entities [Line Items]
Total assets of VIEs	$ 870,314
Total liabilities of VIEs	475,143
DMG | Discontinued Operations, Held-for-sale
Variable Interest Entities [Line Items]
Total assets of VIEs	595,670
Total liabilities of VIEs	$ 319,777

Concentrations - Additional Inf

Concentrations - Additional Information (Details) - U.S. dialysis and related lab services - Sales Revenue Services Net - Government-based Programs, Medicare and Medicaid - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Concentration Risk [Line Items]
Percentage of U.S. dialysis service revenues related to government-based programs	67.00%	64.00%	66.00%
Accounts receivable, and other receivables, from Medicare and Medicaid-assigned plans	$ 869,083	$ 831,445

Fair Values of Financial Ins115

Fair Values of Financial Instruments - Assets, Liabilities and Temporary Equity Measured at Fair Value on Recurring Basis (Details) - USD ($)	Dec. 31, 2017	Dec. 31, 2016
Assets
Available for sale securities	$ 38,895,000	$ 31,197,000
Liabilities
Contingent earn-out obligations	11,466
Fair Value, Measurements, Recurring
Assets
Available for sale securities	38,895,000	31,197,000
Interest rate cap agreements	1,032,000	9,929,000
Liabilities
Contingent earn-out obligations	6,388,000	2,950,000
Temporary equity
Noncontrolling interests subject to put provisions	1,011,360,000	973,258,000
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1)
Assets
Available for sale securities	38,895,000	31,197,000
Interest rate cap agreements	0	0
Liabilities
Contingent earn-out obligations	0	0
Temporary equity
Noncontrolling interests subject to put provisions	0	0
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2)
Assets
Available for sale securities	0	0
Interest rate cap agreements	1,032,000	9,929,000
Liabilities
Contingent earn-out obligations	0	0
Temporary equity
Noncontrolling interests subject to put provisions	0	0
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3)
Assets
Available for sale securities	0	0
Interest rate cap agreements	0	0
Liabilities
Contingent earn-out obligations	6,388,000	2,950,000
Temporary equity
Noncontrolling interests subject to put provisions	$ 1,011,360,000	$ 973,258,000

Fair Values of Financial Ins116

Fair Values of Financial Instruments - Additional Information (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Carrying balance of debt	$ 9,400,182	$ 9,184,799
Senior Secured Credit Facilities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Carrying balance of debt	4,428,376
Fair value of debt	4,495,649
Senior Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Carrying balance of debt	4,460,176
Fair value of debt	$ 4,566,175

Segment Reporting - Additional

Segment Reporting - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2017segment	Dec. 31, 2016USD ($)
Segment Reporting Information [Line Items]
Operating divisions | segment	2
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Segment assets, misstatement adjustment		$ 338,963
Other-Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Segment assets, misstatement adjustment		$ (338,963)

Segment Reporting - Summary of

Segment Reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting Information [Line Items]
Dialysis and related lab patient service revenues									$ 10,093,670	$ 9,727,360	$ 9,155,447
Less: Provision for uncollectible accounts									(485,398)	(431,308)	(412,905)
Net U.S. dialysis and related lab services patient service revenues									9,608,272	9,296,052	8,742,542
Other revenues									1,268,362	1,411,415	1,239,703
Total net revenues	$ 2,780,913	$ 2,765,071	$ 2,699,399	$ 2,631,251	$ 2,699,419	$ 2,725,407	$ 2,675,474	$ 2,607,167	10,876,634	10,707,467	9,982,245
Operating income	150,337	395,294	391,196	875,928	363,445	813,103	431,129	422,033	1,812,755	2,029,710	1,136,766
Corporate administrative support									(44,966)	(13,628)	(18,965)
Debt expense									(430,634)	(414,116)	(408,380)
Debt redemption charges									0	0	(48,072)
Other income									17,665	7,511	8,073
Income from continuing operations before income taxes	$ 46,825	$ 289,384	$ 288,060	$ 775,517	$ 259,669	$ 710,246	$ 331,231	$ 321,959	1,399,786	1,623,105	688,387
Operating Segments
Segment Reporting Information [Line Items]
Total net revenues									10,956,412	10,759,561	10,023,863
Operating income									1,857,721	2,043,338	1,155,731
Operating Segments | U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Dialysis and related lab patient service revenues									9,822,298	9,551,422	9,033,991
Less: Provision for uncollectible accounts									(482,007)	(429,882)	(406,530)
Net U.S. dialysis and related lab services patient service revenues									9,340,291	9,121,540	8,627,461
Other revenues									19,774	16,649	13,971
Total net revenues									9,360,065	9,138,189	8,641,432
Operating income									2,297,198	1,777,014	1,259,632
Operating Segments | U.S. dialysis and related lab services | External Sources
Segment Reporting Information [Line Items]
Dialysis and related lab patient service revenues									9,767,123	9,524,067	9,014,577
Operating Segments | U.S. dialysis and related lab services | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis and related lab patient service revenues									55,175	27,355	19,414
Operating Segments | Other-Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Net U.S. dialysis and related lab services patient service revenues									323,156	201,867	134,496
Other revenues									1,248,588	1,394,766	1,225,731
Intersegment revenues									24,603	24,739	22,204
Total net revenues									1,596,347	1,621,372	1,382,431
Operating income									(439,477)	266,324	(103,901)
Intersegment Elimination
Segment Reporting Information [Line Items]
Total net revenues									$ (79,778)	$ (52,094)	$ (41,618)

Segment Reporting - Summary 119

Segment Reporting - Summary of Depreciation and Amortization Expense by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 559,911	$ 509,497	$ 463,905
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Depreciation and amortization	520,965	482,768	438,238
Other-Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 38,946	$ 26,729	$ 25,667

Segment Reporting - Summary 120

Segment Reporting - Summary of Assets by Segment (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
ASSETS
Consolidated assets	$ 18,948,193	$ 18,755,776
Equity method and other investments	245,534	492,039
Property and equipment, net	3,149,213	2,864,121
U.S. dialysis and related lab services
ASSETS
Consolidated assets	11,776,042	11,108,386
Equity method and other investments	84,866	66,924
Other-Ancillary services and strategic initiatives
ASSETS
Consolidated assets	1,410,509	1,434,299
Equity method and other investments	160,668	425,115
DMG - Held for sale
ASSETS
Consolidated assets	5,761,642	6,213,091
Equity method and other investments	10,321	10,350
Non-US | Other-Ancillary services and strategic initiatives
ASSETS
Property and equipment, net	$ 125,932	$ 96,396

Segment Reporting - Summary 121

Segment Reporting - Summary of Expenditures for Property and Equipment by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 905,250	$ 829,095	$ 707,998
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	759,218	675,994	584,513
Other-Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	50,891	68,702	56,685
DMG - Held for sale
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 95,141	$ 84,399	$ 66,800

Supplemental Cash Flow Infor122

Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Cash paid:
Income taxes	$ 387,159	$ 339,411	$ 156,075
Interest	424,547	406,987	405,120
Non-cash investing and financing activities:
Fixed assets under capital lease obligations	$ 48,378	$ 28,127	$ 74,035

Selected Quarterly Financial123

Selected Quarterly Financial Data (unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Quarterly Financial Information Disclosure [Abstract]
Net revenues	$ 2,780,913	$ 2,765,071	$ 2,699,399	$ 2,631,251	$ 2,699,419	$ 2,725,407	$ 2,675,474	$ 2,607,167	$ 10,876,634	$ 10,707,467	$ 9,982,245
Operating income	150,337	395,294	391,196	875,928	363,445	813,103	431,129	422,033	1,812,755	2,029,710	1,136,766
Net income from continuing operations, before taxes	46,825	289,384	288,060	775,517	259,669	710,246	331,231	321,959	1,399,786	1,623,105	688,387
Net loss from discontinued operations	143,587	(370,872)	(24,520)	6,433	11,772	20,213	(118,443)	(71,804)	(237,659)	(152,499)	(53,467)
Net income (loss) attributable to DaVita Inc.	$ 303,396	$ (214,476)	$ 127,001	$ 447,697	$ 157,726	$ 571,332	$ 53,382	$ 97,434	$ 663,618	$ 879,874	$ 269,732
Basic net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	$ 0.86	$ 0.81	$ 0.79	$ 2.29	$ 0.74	$ 2.69	$ 0.84	$ 0.83	$ 4.78	$ 5.12	$ 1.53
Basic net income (loss) from discontinued operations per share attributable to DaVita Inc. (in usd per share)	0.80	(1.95)	(0.13)	0.04	0.07	0.11	(0.58)	(0.35)	(1.26)	(0.76)	(0.26)
Basic net income (loss) per share attributable to DaVita Inc. (in usd per share)	1.66	(1.14)	0.66	2.33	0.81	2.80	0.26	0.48	3.52	4.36	1.27
Diluted net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	0.85	0.80	0.78	2.26	0.73	2.65	0.82	0.81	4.71	5.04	1.49
Diluted net income (loss) from discontinued operations per share attributable to DaVita Inc. (in usd per share)	0.79	(1.92)	(0.13)	0.03	0.07	0.11	(0.56)	(0.34)	(1.24)	(0.75)	(0.24)
Diluted net income (loss) per share attributable to DaVita Inc. (in usd per share)	$ 1.64	$ (1.12)	$ 0.65	$ 2.29	$ 0.80	$ 2.76	$ 0.26	$ 0.47	$ 3.47	$ 4.29	$ 1.25

Consolidating Financial Stat124

Consolidating Financial Statements - Consolidating Statements of Income (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Condensed Income Statements, Captions [Line Items]
Dialysis and related lab patient service revenues									$ 10,093,670	$ 9,727,360	$ 9,155,447
Less: Provision for uncollectible accounts									(485,398)	(431,308)	(412,905)
Net dialysis and related lab patient service revenues									9,608,272	9,296,052	8,742,542
Other revenues									1,268,362	1,411,415	1,239,703
Total net revenues	$ 2,780,913	$ 2,765,071	$ 2,699,399	$ 2,631,251	$ 2,699,419	$ 2,725,407	$ 2,675,474	$ 2,607,167	10,876,634	10,707,467	9,982,245
Operating expenses and charges									9,063,879	8,677,757	8,845,479
Operating income	150,337	395,294	391,196	875,928	363,445	813,103	431,129	422,033	1,812,755	2,029,710	1,136,766
Debt expense									(430,634)	(414,116)	(408,380)
Debt (expense) and refinancing charges											(456,452)
Other income, net									17,665	7,511	8,073
Income tax expense									323,859	431,761	207,510
Equity earnings in subsidiaries									0	0	0
Net income from continuing operations									1,075,927	1,191,344	480,877
Net loss from discontinued operations, net of tax									(245,372)	(158,262)	(53,467)
Net income									830,555	1,033,082	427,410
Less: Net income attributable to noncontrolling interests									(166,937)	(153,208)	(157,678)
Net income attributable to DaVita Inc.	$ 303,396	$ (214,476)	$ 127,001	$ 447,697	$ 157,726	$ 571,332	$ 53,382	$ 97,434	663,618	879,874	269,732
Consolidating Adjustments
Condensed Income Statements, Captions [Line Items]
Dialysis and related lab patient service revenues									(184,106)	(153,326)	(131,164)
Less: Provision for uncollectible accounts									7,170	0	0
Net dialysis and related lab patient service revenues									(176,936)	(153,326)	(131,164)
Other revenues									(798,212)	(765,516)	(720,804)
Total net revenues									(975,148)	(918,842)	(851,968)
Operating expenses and charges									(975,148)	(918,842)	(851,968)
Operating income									0	0	0
Debt expense									239,958	225,326
Debt (expense) and refinancing charges											203,985
Other income, net									(423,702)	(400,706)	(365,861)
Income tax expense									0	0	0
Equity earnings in subsidiaries									(552,567)	(1,360,998)	(496,979)
Net income from continuing operations									(736,311)	(1,536,378)	(658,855)
Net loss from discontinued operations, net of tax									183,744	175,380	161,876
Net income									(552,567)	(1,360,998)	(496,979)
Less: Net income attributable to noncontrolling interests									(166,937)	(153,208)	(157,678)
Net income attributable to DaVita Inc.									(719,504)	(1,514,206)	(654,657)
DaVita Inc. | Reportable Legal Entites
Condensed Income Statements, Captions [Line Items]
Dialysis and related lab patient service revenues									0	0	0
Less: Provision for uncollectible accounts									0	0	0
Net dialysis and related lab patient service revenues									0	0	0
Other revenues									793,751	767,791	727,887
Total net revenues									793,751	767,791	727,887
Operating expenses and charges									527,942	493,175	488,595
Operating income									265,809	274,616	239,292
Debt expense									(426,149)	(407,925)
Debt (expense) and refinancing charges											(449,598)
Other income, net									411,731	396,797	365,752
Income tax expense									65,965	77,334	60,671
Equity earnings in subsidiaries									478,192	693,720	174,957
Net income from continuing operations									663,618	879,874	269,732
Net loss from discontinued operations, net of tax									0	0	0
Net income									663,618	879,874	269,732
Less: Net income attributable to noncontrolling interests									0	0	0
Net income attributable to DaVita Inc.									663,618	879,874	269,732
Guarantor Subsidiaries | Reportable Legal Entites
Condensed Income Statements, Captions [Line Items]
Dialysis and related lab patient service revenues									6,884,750	6,665,601	6,471,702
Less: Provision for uncollectible accounts									(340,586)	(272,430)	(281,976)
Net dialysis and related lab patient service revenues									6,544,164	6,393,171	6,189,726
Other revenues									1,204,501	1,378,956	1,208,607
Total net revenues									7,748,665	7,772,127	7,398,333
Operating expenses and charges									6,475,550	6,907,469	6,925,234
Operating income									1,273,115	864,658	473,099
Debt expense									(209,612)	(191,083)
Debt (expense) and refinancing charges											(178,389)
Other income, net									11,169	3,726	1,261
Income tax expense									237,670	238,446	163,401
Equity earnings in subsidiaries									74,375	667,278	322,022
Net income from continuing operations									911,377	1,106,133	454,592
Net loss from discontinued operations, net of tax									(433,185)	(412,413)	(279,635)
Net income									478,192	693,720	174,957
Less: Net income attributable to noncontrolling interests									0	0	0
Net income attributable to DaVita Inc.									478,192	693,720	174,957
Non- Guarantor Subsidiaries | Reportable Legal Entites
Condensed Income Statements, Captions [Line Items]
Dialysis and related lab patient service revenues									3,393,026	3,215,085	2,814,909
Less: Provision for uncollectible accounts									(151,982)	(158,878)	(130,929)
Net dialysis and related lab patient service revenues									3,241,044	3,056,207	2,683,980
Other revenues									68,322	30,184	24,013
Total net revenues									3,309,366	3,086,391	2,707,993
Operating expenses and charges									3,035,535	2,195,955	2,283,618
Operating income									273,831	890,436	424,375
Debt expense									(34,831)	(40,434)
Debt (expense) and refinancing charges											(32,450)
Other income, net									18,467	7,694	6,921
Income tax expense									20,224	115,981	(16,562)
Equity earnings in subsidiaries									0	0	0
Net income from continuing operations									237,243	741,715	415,408
Net loss from discontinued operations, net of tax									4,069	78,771	64,292
Net income									241,312	820,486	479,700
Less: Net income attributable to noncontrolling interests									0	0	0
Net income attributable to DaVita Inc.									$ 241,312	$ 820,486	$ 479,700

Consolidating Financial Stat125

Consolidating Financial Statements - Consolidating Statements of Comprehensive Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Condensed Financial Statements, Captions [Line Items]
Net income	$ 830,555	$ 1,033,082	$ 427,410
Other comprehensive loss	102,876	(29,627)	(34,809)
Total comprehensive income	933,431	1,003,455	392,601
Less: Comprehensive income attributable to noncontrolling interests	(166,935)	(153,398)	(157,678)
Comprehensive income attributable to DaVita Inc.	766,496	850,057	234,923
Reportable Legal Entites | DaVita Inc.
Condensed Financial Statements, Captions [Line Items]
Net income	663,618	879,874	269,732
Other comprehensive loss	3,106	(290)	(10,920)
Total comprehensive income	666,724	879,584	258,812
Less: Comprehensive income attributable to noncontrolling interests	0	0	0
Comprehensive income attributable to DaVita Inc.	666,724	879,584	258,812
Reportable Legal Entites | Guarantor Subsidiaries
Condensed Financial Statements, Captions [Line Items]
Net income	478,192	693,720	174,957
Other comprehensive loss	0	0	0
Total comprehensive income	478,192	693,720	174,957
Less: Comprehensive income attributable to noncontrolling interests	0	0	0
Comprehensive income attributable to DaVita Inc.	478,192	693,720	174,957
Reportable Legal Entites | Non- Guarantor Subsidiaries
Condensed Financial Statements, Captions [Line Items]
Net income	241,312	820,486	479,700
Other comprehensive loss	99,770	(29,337)	(23,889)
Total comprehensive income	341,082	791,149	455,811
Less: Comprehensive income attributable to noncontrolling interests	0	0	0
Comprehensive income attributable to DaVita Inc.	341,082	791,149	455,811
Consolidating Adjustments
Condensed Financial Statements, Captions [Line Items]
Net income	(552,567)	(1,360,998)	(496,979)
Other comprehensive loss	0	0	0
Total comprehensive income	(552,567)	(1,360,998)	(496,979)
Less: Comprehensive income attributable to noncontrolling interests	(166,935)	(153,398)	(157,678)
Comprehensive income attributable to DaVita Inc.	$ (719,502)	$ (1,514,396)	$ (654,657)

Consolidating Financial Stat126

Consolidating Financial Statements - Consolidating Balance Sheets (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	$ 508,234	$ 674,776	$ 1,244,917	$ 736,897
Accounts receivable, net	1,714,750	1,503,950
Other current assets	759,732	855,066
Current assets held for sale	5,761,642	960,956
Total current assets	8,744,358	3,994,748
Property and equipment, net	3,149,213	2,864,121
Intangible assets, net	113,827	73,504
Investments in subsidiaries	0	0
Intercompany receivables	0	0
Other long-term assets and investments	330,516	555,893
Goodwill	6,610,279	6,015,375	5,896,215
Long-term assets held for sale	0	5,252,135
Total assets	18,948,193	18,755,776
Current liabilities	1,856,107	1,903,731
Current liabilities held for sale	1,185,070	807,233
Total current liabilities	3,041,177	2,710,964
Intercompany payables	0	0
Long-term debt and other long-term liabilities	10,009,590	9,792,928
Long-term liabilities held for sale	0	428,885
Noncontrolling interests subject to put provisions	1,011,360	973,258
Total DaVita Inc. shareholders' equity	4,690,029	4,648,047
Noncontrolling interests not subject to put provisions	196,037	201,694
Total equity	4,886,066	4,849,741
Total liabilities and shareholders' equity	18,948,193	18,755,776
Reportable Legal Entites | DaVita Inc.
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	149,305	549,921	1,186,636	698,876
Accounts receivable, net	0	0
Other current assets	68,027	277,911
Current assets held for sale	0	0
Total current assets	217,332	827,832
Property and equipment, net	408,010	337,200
Intangible assets, net	250	487
Investments in subsidiaries	10,009,874	9,717,728
Intercompany receivables	3,677,947	3,250,692
Other long-term assets and investments	47,297	39,994
Goodwill	0	0
Long-term assets held for sale		0
Total assets	14,360,710	14,173,933
Current liabilities	238,706	303,840
Current liabilities held for sale	0	0
Total current liabilities	238,706	303,840
Intercompany payables	0	0
Long-term debt and other long-term liabilities	8,857,373	8,614,445
Long-term liabilities held for sale		0
Noncontrolling interests subject to put provisions	574,602	607,601
Total DaVita Inc. shareholders' equity	4,690,029	4,648,047
Noncontrolling interests not subject to put provisions	0	0
Total equity	4,690,029	4,648,047
Total liabilities and shareholders' equity	14,360,710	14,173,933
Reportable Legal Entites | Guarantor Subsidiaries
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	0	0	0	0
Accounts receivable, net	1,208,715	1,048,580
Other current assets	604,450	462,684
Current assets held for sale	4,992,067	514,407
Total current assets	6,805,232	2,025,671
Property and equipment, net	1,560,390	1,444,248
Intangible assets, net	50,971	42,037
Investments in subsidiaries	3,085,722	2,021,062
Intercompany receivables	0	0
Other long-term assets and investments	68,344	73,466
Goodwill	4,732,320	4,480,344
Long-term assets held for sale		5,066,453
Total assets	16,302,979	15,153,281
Current liabilities	1,181,139	1,343,748
Current liabilities held for sale	739,294	533,250
Total current liabilities	1,920,433	1,876,998
Intercompany payables	3,690,042	2,382,428
Long-term debt and other long-term liabilities	682,630	835,845
Long-term liabilities held for sale		340,282
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholders' equity	10,009,874	9,717,728
Noncontrolling interests not subject to put provisions	0	0
Total equity	10,009,874	9,717,728
Total liabilities and shareholders' equity	16,302,979	15,153,281
Reportable Legal Entites | Non- Guarantor Subsidiaries
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	358,929	124,855	58,281	38,021
Accounts receivable, net	506,035	455,370
Other current assets	87,255	114,471
Current assets held for sale	769,575	446,549
Total current assets	1,721,794	1,141,245
Property and equipment, net	1,180,813	1,082,673
Intangible assets, net	62,606	30,980
Investments in subsidiaries	0	0
Intercompany receivables	1,313,213	866,955
Other long-term assets and investments	214,875	442,433
Goodwill	1,877,959	1,535,031
Long-term assets held for sale		185,682
Total assets	6,371,260	5,284,999
Current liabilities	436,262	256,143
Current liabilities held for sale	445,776	273,983
Total current liabilities	882,038	530,126
Intercompany payables	1,301,118	1,735,219
Long-term debt and other long-term liabilities	469,587	342,638
Long-term liabilities held for sale		88,603
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholders' equity	3,085,722	2,021,062
Noncontrolling interests not subject to put provisions	632,795	567,351
Total equity	3,718,517	2,588,413
Total liabilities and shareholders' equity	6,371,260	5,284,999
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
Current assets held for sale	0	0
Total current assets	0	0
Property and equipment, net	0	0
Intangible assets, net	0	0
Investments in subsidiaries	(13,095,596)	(11,738,790)
Intercompany receivables	(4,991,160)	(4,117,647)
Other long-term assets and investments	0	0
Goodwill	0	0
Long-term assets held for sale		0
Total assets	(18,086,756)	(15,856,437)
Current liabilities	0	0
Current liabilities held for sale	0	0
Total current liabilities	0	0
Intercompany payables	(4,991,160)	(4,117,647)
Long-term debt and other long-term liabilities	0	0
Long-term liabilities held for sale		0
Noncontrolling interests subject to put provisions	436,758	365,657
Total DaVita Inc. shareholders' equity	(13,095,596)	(11,738,790)
Noncontrolling interests not subject to put provisions	(436,758)	(365,657)
Total equity	(13,532,354)	(12,104,447)
Total liabilities and shareholders' equity	$ (18,086,756)	$ (15,856,437)

Consolidating Financial Stat127

Consolidating Financial Statements - Consolidating Statements of Cash Flows (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Cash flows from operating activities:
Net income	$ 830,555	$ 1,033,082	$ 427,410
Changes in operating assets and liabilities and non-cash items included in net income	1,076,894	930,362	1,129,790
Net cash provided by operating activities	1,907,449	1,963,444	1,557,200
Cash flows from investing activities:
Additions of property and equipment	(905,250)	(829,095)	(707,998)
Acquisitions	(803,879)	(563,856)	(96,469)
Proceeds from asset and business sales	92,336	64,725	19,715
Investments and other items	250,062	126,558	(97,032)
Net cash used in investing activities	(1,366,731)	(1,201,668)	(881,784)
Cash flows from financing activities:
Long-term debt and related financing costs, net	154,848	(124,442)	619,698
Intercompany borrowing	0	0	0
Other items	(921,105)	(1,227,539)	(758,668)
Net cash used in financing activities	(766,257)	(1,351,981)	(138,970)
Effect of exchange rate changes on cash	254	4,276	(2,571)
Net (decrease) increase in cash and cash equivalents	(225,285)	(585,929)	533,875
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	(58,743)	(15,788)	25,855
Net (decrease) increase in cash and cash equivalents from continuing operations	(166,542)	(570,141)	508,020
Cash and cash equivalents of continuing operations at beginning of the year	674,776	1,244,917	736,897
Cash and cash equivalents of continuing operations at end of the year	508,234	674,776	1,244,917
Reportable Legal Entites | DaVita Inc.
Cash flows from operating activities:
Net income	663,618	879,874	269,732
Changes in operating assets and liabilities and non-cash items included in net income	(534,302)	(612,706)	(125,981)
Net cash provided by operating activities	129,316	267,168	143,751
Cash flows from investing activities:
Additions of property and equipment	(155,972)	(139,303)	(115,269)
Acquisitions	0	0	0
Proceeds from asset and business sales	0	0	0
Investments and other items	211,619	153,031	(74,474)
Net cash used in investing activities	55,647	13,728	(189,743)
Cash flows from financing activities:
Long-term debt and related financing costs, net	173,529	(92,460)	640,009
Intercompany borrowing	22,589	236,052	466,038
Other items	(781,697)	(1,061,203)	(572,295)
Net cash used in financing activities	(585,579)	(917,611)	533,752
Effect of exchange rate changes on cash	0	0	0
Net (decrease) increase in cash and cash equivalents	(400,616)	(636,715)	487,760
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	0	0	0
Net (decrease) increase in cash and cash equivalents from continuing operations	(400,616)	(636,715)	487,760
Cash and cash equivalents of continuing operations at beginning of the year	549,921	1,186,636	698,876
Cash and cash equivalents of continuing operations at end of the year	149,305	549,921	1,186,636
Reportable Legal Entites | Guarantor Subsidiaries
Cash flows from operating activities:
Net income	478,192	693,720	174,957
Changes in operating assets and liabilities and non-cash items included in net income	366,947	350,684	684,760
Net cash provided by operating activities	845,139	1,044,404	859,717
Cash flows from investing activities:
Additions of property and equipment	(490,800)	(382,305)	(319,695)
Acquisitions	(693,522)	(472,413)	(76,983)
Proceeds from asset and business sales	90,340	70,342	19,715
Investments and other items	(9,003)	(29,038)	(2,144)
Net cash used in investing activities	(1,102,985)	(813,414)	(379,107)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(12,662)	(27,830)	(11,953)
Intercompany borrowing	218,980	(231,800)	(370,839)
Other items	(2,493)	(21,525)	(66,382)
Net cash used in financing activities	203,825	(281,155)	(449,174)
Effect of exchange rate changes on cash	0	0	0
Net (decrease) increase in cash and cash equivalents	(54,021)	(50,165)	31,436
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	(54,021)	(50,165)	31,436
Net (decrease) increase in cash and cash equivalents from continuing operations	0	0	0
Cash and cash equivalents of continuing operations at beginning of the year	0	0	0
Cash and cash equivalents of continuing operations at end of the year	0	0	0
Reportable Legal Entites | Non- Guarantor Subsidiaries
Cash flows from operating activities:
Net income	241,312	820,486	479,700
Changes in operating assets and liabilities and non-cash items included in net income	691,682	(168,614)	74,032
Net cash provided by operating activities	932,994	651,872	553,732
Cash flows from investing activities:
Additions of property and equipment	(258,478)	(307,487)	(273,034)
Acquisitions	(110,357)	(91,443)	(19,486)
Proceeds from asset and business sales	1,996	(5,617)	0
Investments and other items	47,446	2,565	(20,414)
Net cash used in investing activities	(319,393)	(401,982)	(312,934)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(6,019)	(4,152)	(8,358)
Intercompany borrowing	(241,569)	(4,252)	(95,199)
Other items	(136,915)	(144,811)	(119,991)
Net cash used in financing activities	(384,503)	(153,215)	(223,548)
Effect of exchange rate changes on cash	254	4,276	(2,571)
Net (decrease) increase in cash and cash equivalents	229,352	100,951	14,679
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	(4,722)	34,377	(5,581)
Net (decrease) increase in cash and cash equivalents from continuing operations	234,074	66,574	20,260
Cash and cash equivalents of continuing operations at beginning of the year	124,855	58,281	38,021
Cash and cash equivalents of continuing operations at end of the year	358,929	124,855	58,281
Consolidating Adjustments
Cash flows from operating activities:
Net income	(552,567)	(1,360,998)	(496,979)
Changes in operating assets and liabilities and non-cash items included in net income	552,567	1,360,998	496,979
Net cash provided by operating activities	0	0	0
Cash flows from investing activities:
Additions of property and equipment	0	0	0
Acquisitions	0	0	0
Proceeds from asset and business sales	0	0	0
Investments and other items	0	0	0
Net cash used in investing activities	0	0	0
Cash flows from financing activities:
Long-term debt and related financing costs, net	0	0	0
Intercompany borrowing	0	0	0
Other items	0	0	0
Net cash used in financing activities	0	0	0
Effect of exchange rate changes on cash	0	0	0
Net (decrease) increase in cash and cash equivalents	0	0	0
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	0	0	0
Net (decrease) increase in cash and cash equivalents from continuing operations	0	0	0
Cash and cash equivalents of continuing operations at beginning of the year	0	0	0
Cash and cash equivalents of continuing operations at end of the year	$ 0	$ 0	$ 0

Supplemental Data (unaudited) -

Supplemental Data (unaudited) - Condensed Consolidating Statements of Income (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Condensed Income Statements, Captions [Line Items]
Dialysis and related lab patient service revenues									$ 10,093,670	$ 9,727,360	$ 9,155,447
Less: Provision for uncollectible accounts									(485,398)	(431,308)	(412,905)
Net dialysis and related lab patient service revenues									9,608,272	9,296,052	8,742,542
Other revenues									1,268,362	1,411,415	1,239,703
Total net revenues	$ 2,780,913	$ 2,765,071	$ 2,699,399	$ 2,631,251	$ 2,699,419	$ 2,725,407	$ 2,675,474	$ 2,607,167	10,876,634	10,707,467	9,982,245
Operating expenses and charges									9,063,879	8,677,757	8,845,479
Operating income	150,337	395,294	391,196	875,928	363,445	813,103	431,129	422,033	1,812,755	2,029,710	1,136,766
Debt expense									(430,634)	(414,116)	(408,380)
Other income, net									17,665	7,511	8,073
Income tax expense									323,859	431,761	207,510
Net income from continuing operations									1,075,927	1,191,344	480,877
Net loss from discontinued operations, net of tax									(245,372)	(158,262)	(53,467)
Net income									830,555	1,033,082	427,410
Less: Net income attributable to noncontrolling interests									(166,937)	(153,208)	(157,678)
Net income attributable to DaVita Inc.	$ 303,396	$ (214,476)	$ 127,001	$ 447,697	$ 157,726	$ 571,332	$ 53,382	$ 97,434	663,618	$ 879,874	$ 269,732
Physician Groups
Condensed Income Statements, Captions [Line Items]
Dialysis and related lab patient service revenues									0
Less: Provision for uncollectible accounts									0
Net dialysis and related lab patient service revenues									0
Other revenues									0
Total net revenues									0
Operating expenses and charges									0
Operating income									0
Debt expense									0
Other income, net									0
Income tax expense									0
Net income from continuing operations									0
Net loss from discontinued operations, net of tax									13,611
Net income									13,611
Less: Net income attributable to noncontrolling interests									7,183
Net income attributable to DaVita Inc.									20,794
Unrestricted Subsidiaries
Condensed Income Statements, Captions [Line Items]
Dialysis and related lab patient service revenues									0
Less: Provision for uncollectible accounts									0
Net dialysis and related lab patient service revenues									0
Other revenues									0
Total net revenues									0
Operating expenses and charges									0
Operating income									0
Debt expense									0
Other income, net									0
Income tax expense									0
Net income from continuing operations									0
Net loss from discontinued operations, net of tax									19
Net income									19
Less: Net income attributable to noncontrolling interests									0
Net income attributable to DaVita Inc.									19
Company and Restricted Subsidiaries(1)
Condensed Income Statements, Captions [Line Items]
Dialysis and related lab patient service revenues									10,093,670
Less: Provision for uncollectible accounts									(485,398)
Net dialysis and related lab patient service revenues									9,608,272
Other revenues									1,268,362
Total net revenues									10,876,634
Operating expenses and charges									9,063,879
Operating income									1,812,755
Debt expense									(430,634)
Other income, net									17,665
Income tax expense									323,859
Net income from continuing operations									1,075,927
Net loss from discontinued operations, net of tax									(259,002)
Net income									816,925
Less: Net income attributable to noncontrolling interests									(174,120)
Net income attributable to DaVita Inc.									$ 642,805

Supplemental Data (unaudited129

Supplemental Data (unaudited) - Condensed Consolidating Statements of Comprehensive Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Condensed Financial Statements, Captions [Line Items]
Net income	$ 830,555	$ 1,033,082	$ 427,410
Other comprehensive income	102,876	(29,627)	(34,809)
Total comprehensive income	933,431	1,003,455	392,601
Less: Comprehensive income attributable to noncontrolling interests	(166,935)	(153,398)	(157,678)
Comprehensive income attributable to DaVita Inc.	766,496	$ 850,057	$ 234,923
Physician Groups
Condensed Financial Statements, Captions [Line Items]
Net income	13,611
Other comprehensive income	0
Total comprehensive income	13,611
Less: Comprehensive income attributable to noncontrolling interests	7,183
Comprehensive income attributable to DaVita Inc.	20,794
Unrestricted Subsidiaries
Condensed Financial Statements, Captions [Line Items]
Net income	19
Other comprehensive income	0
Total comprehensive income	19
Less: Comprehensive income attributable to noncontrolling interests	0
Comprehensive income attributable to DaVita Inc.	19
Company and Restricted Subsidiaries(1)
Condensed Financial Statements, Captions [Line Items]
Net income	816,925
Other comprehensive income	102,876
Total comprehensive income	919,801
Less: Comprehensive income attributable to noncontrolling interests	(174,118)
Comprehensive income attributable to DaVita Inc.	$ 745,683

Supplemental Data (unaudited130

Supplemental Data (unaudited) - Condensed Consolidating Balance Sheets (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	$ 508,234	$ 674,776	$ 1,244,917	$ 736,897
Accounts receivable, net	1,714,750	1,503,950
Other current assets	759,732	855,066
Current assets held for sale	5,761,642	960,956
Total current assets	8,744,358	3,994,748
Property and equipment, net	3,149,213	2,864,121
Amortizable intangibles, net	113,827	73,504
Other long-term assets	330,516	555,893
Goodwill	6,610,279	6,015,375	$ 5,896,215
Total assets	18,948,193	18,755,776
Current liabilities	1,856,107	1,903,731
Current liabilities held for sale	1,185,070	807,233
Liabilities, Current	3,041,177	2,710,964
Payables to parent	0
Long-term debt and other long-term liabilities	10,009,590	9,792,928
Noncontrolling interests subject to put provisions	1,011,360	973,258
Total DaVita Inc. shareholders' equity	4,690,029	4,648,047
Noncontrolling interests not subject to put provisions	196,037	201,694
Total equity	4,886,066	4,849,741
Total liabilities and shareholders' equity	18,948,193	18,755,776
Physician Groups
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	0	0
Accounts receivable, net	0
Other current assets	3,033
Current assets held for sale	423,205
Total current assets	426,238
Property and equipment, net	0
Amortizable intangibles, net	0
Other long-term assets	0
Goodwill	0
Total assets	426,238
Current liabilities	0
Current liabilities held for sale	308,884
Liabilities, Current	308,884
Payables to parent	0
Long-term debt and other long-term liabilities	0
Noncontrolling interests subject to put provisions	0
Total DaVita Inc. shareholders' equity	117,354
Noncontrolling interests not subject to put provisions	0
Total equity	117,354
Total liabilities and shareholders' equity	426,238
Unrestricted Subsidiaries
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	0	0
Accounts receivable, net	0
Other current assets	0
Current assets held for sale	2,733
Total current assets	2,733
Property and equipment, net	0
Amortizable intangibles, net	0
Other long-term assets	0
Goodwill	0
Total assets	2,733
Current liabilities	0
Current liabilities held for sale	0
Liabilities, Current	0
Payables to parent	2,733
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 shareholders' equity	2,733
Company and Restricted Subsidiaries(1)
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	508,234	$ 674,776
Accounts receivable, net	1,714,750
Other current assets	756,699
Current assets held for sale	5,335,704
Total current assets	8,315,387
Property and equipment, net	3,149,213
Amortizable intangibles, net	113,827
Other long-term assets	330,516
Goodwill	6,610,279
Total assets	18,519,222
Current liabilities	1,856,107
Current liabilities held for sale	876,186
Liabilities, Current	2,732,293
Payables to parent	(2,733)
Long-term debt and other long-term liabilities	10,009,590
Noncontrolling interests subject to put provisions	1,011,360
Total DaVita Inc. shareholders' equity	4,572,675
Noncontrolling interests not subject to put provisions	196,037
Total equity	4,768,712
Total liabilities and shareholders' equity	$ 18,519,222

Supplemental Data (unaudited131

Supplemental Data (unaudited) - Condensed Consolidating Statements of Cash Flows (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Cash flows from operating activities:
Net income	$ 830,555	$ 1,033,082	$ 427,410
Changes in operating and intercompany assets and liabilities and non-cash items included in net income	1,076,894	930,362	1,129,790
Net cash provided by operating activities	1,907,449	1,963,444	1,557,200
Cash flows from investing activities:
Additions of property and equipment	(905,250)	(829,095)	(707,998)
Acquisitions and divestitures, net	(803,879)
Proceeds from asset sales	92,336
Investments and other items, net	250,062	126,558	(97,032)
Net cash used in investing activities	(1,366,731)	(1,201,668)	(881,784)
Cash flows from financing activities:
Long-term debt and related financing costs, net	154,848	(124,442)	619,698
Intercompany	0	0	0
Other items	(921,105)	(1,227,539)	(758,668)
Net cash used in financing activities	(766,257)	(1,351,981)	(138,970)
Effect of exchange rate changes on cash	254	4,276	(2,571)
Net (decrease) increase in cash and cash equivalents	(225,285)	(585,929)	533,875
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	(58,743)	(15,788)	25,855
Net (decrease) increase in cash and cash equivalents from continuing operations	(166,542)	(570,141)	508,020
Cash and cash equivalents of continuing operations at beginning of the year	674,776	1,244,917	736,897
Cash and cash equivalents of continuing operations at end of the year	508,234	674,776	$ 1,244,917
Physician Groups
Cash flows from operating activities:
Net income	13,611
Changes in operating and intercompany assets and liabilities and non-cash items included in net income	27,312
Net cash provided by operating activities	40,923
Cash flows from investing activities:
Additions of property and equipment	(5,406)
Acquisitions and divestitures, net	0
Proceeds from asset sales	0
Investments and other items, net	(3,800)
Net cash used in investing activities	(9,206)
Cash flows from financing activities:
Long-term debt and related financing costs, net	0
Intercompany	(36,220)
Other items	0
Net cash used in financing activities	(36,220)
Effect of exchange rate changes on cash	0
Net (decrease) increase in cash and cash equivalents	(4,503)
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	(4,503)
Net (decrease) increase in cash and cash equivalents from continuing operations	0
Cash and cash equivalents of continuing operations at beginning of the year	0
Cash and cash equivalents of continuing operations at end of the year	0	0
Unrestricted Subsidiaries
Cash flows from operating activities:
Net income	19
Changes in operating and intercompany assets and liabilities and non-cash items included in net income	(19)
Net cash provided by operating activities	0
Cash flows from investing activities:
Additions of property and equipment	0
Acquisitions and divestitures, net	0
Proceeds from asset sales	0
Investments and other items, net	0
Net cash used in investing activities	0
Cash flows from financing activities:
Long-term debt and related financing costs, net	0
Intercompany	0
Other items	0
Net cash used in financing activities	0
Effect of exchange rate changes on cash	0
Net (decrease) increase in cash and cash equivalents	0
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	0
Net (decrease) increase in cash and cash equivalents from continuing operations	0
Cash and cash equivalents of continuing operations at beginning of the year	0
Cash and cash equivalents of continuing operations at end of the year	0	0
Company and Restricted Subsidiaries(1)
Cash flows from operating activities:
Net income	816,925
Changes in operating and intercompany assets and liabilities and non-cash items included in net income	1,049,601
Net cash provided by operating activities	1,866,526
Cash flows from investing activities:
Additions of property and equipment	(899,844)
Acquisitions and divestitures, net	(803,879)
Proceeds from asset sales	92,336
Investments and other items, net	253,862
Net cash used in investing activities	(1,357,525)
Cash flows from financing activities:
Long-term debt and related financing costs, net	154,848
Intercompany	36,220
Other items	(921,105)
Net cash used in financing activities	(730,037)
Effect of exchange rate changes on cash	254
Net (decrease) increase in cash and cash equivalents	(220,782)
Less: Net (decrease) increase in cash and cash equivalents from discontinued operations	(54,240)
Net (decrease) increase in cash and cash equivalents from continuing operations	(166,542)
Cash and cash equivalents of continuing operations at beginning of the year	674,776
Cash and cash equivalents of continuing operations at end of the year	$ 508,234	$ 674,776

SCHEDULE II - VALUATION AND QUA

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS (Details) - Allowance for uncollectible Accounts - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at beginning of year	$ 238,897	$ 251,734	$ 229,802
Acquisitions	0	0	0
Amounts charged to income	478,365	442,985	422,145
Amounts written off	498,863	455,822	400,213
Balance at end of year	$ 218,399	$ 238,897	$ 251,734