DaVita (DVA) 10-Q 3 May 18 2018 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares shares in Millions	3 Months Ended
	Mar. 31, 2018	Apr. 30, 2018
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q1
Trading Symbol	DVA
Entity Registrant Name	DAVITA INC.
Entity Central Index Key	927,066
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		174.5

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS (unaudited) - USD ($)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Income Statement [Abstract]
Dialysis and related lab patient service revenues	$ 2,591,074,000	$ 2,422,786,000
Provision for uncollectible accounts	25,545,000	(107,058,000)
Net dialysis and related lab patient service revenues	2,616,619,000	2,315,728,000
Other revenues	232,825,000	315,523,000
Total revenues	2,849,444,000	2,631,251,000
Operating expenses and charges:
Patient care costs and other costs	2,035,585,000	1,852,045,000
General and administrative	266,529,000	262,895,000
Depreciation and amortization	142,799,000	132,884,000
Equity investment income	(155,000)	(677,000)
Provision for uncollectible accounts	(6,000,000)	1,910,000
Investment and other asset impairments	0	15,168,000
Goodwill impairment charges	0	24,198,000
Gain on changes in ownership interests	0	(6,273,000)
Gain on settlement, net	0	(526,827,000)
Total operating expenses and charges	2,438,758,000	1,755,323,000
Operating income	410,686,000	875,928,000
Debt expense	(113,516,000)	(104,397,000)
Other income, net	4,582,000	3,986,000
Income from continuing operations before income taxes	301,752,000	775,517,000
Income tax expense	70,737,000	281,665,000
Net income from continuing operations	231,015,000	493,852,000
Net (loss) income from discontinued operations, net of tax	(5,786,000)	6,433,000
Net income	225,229,000	500,285,000
Less: Net income attributable to noncontrolling interests	(46,543,000)	(52,588,000)
Net income attributable to DaVita Inc.	$ 178,686,000	$ 447,697,000
Earnings per share:
Basic net income from continuing operations per share attributable to DaVita Inc.	$ 1.07	$ 2.29
Basic net income per share attributable to DaVita Inc.	1	2.33
Diluted net income from continuing operations per share attributable to DaVita Inc.	1.05	2.26
Diluted net income per share attributable to DaVita Inc.	$ 0.98	$ 2.29
Weighted average shares for earnings per share:
Basic (in shares)	178,957,865	192,376,735
Diluted (in shares)	181,834,547	195,281,014
Net income from continuing operations	$ 191,015,000	$ 440,905,000
Net (loss) income from discontinued operations	(12,329,000)	6,792,000
Net income attributable to DaVita Inc.	$ 178,686,000	$ 447,697,000

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Statement of Comprehensive Income [Abstract]
Net income	$ 225,229	$ 500,285
Unrealized gains (losses) on interest rate cap agreements:
Unrealized gains (losses) on interest rate cap agreements	1,050	(3,188)
Reclassifications of net realized losses on interest rate cap agreements into net income	1,537	1,265
Unrealized gains on investments:
Unrealized gains on investments	0	1,557
Reclassification of net investment realized gains into net income	0	(140)
Unrealized gains on foreign currency translation:
Foreign currency translation adjustments	19,881	13,261
Other comprehensive income	22,468	12,755
Total comprehensive income	247,697	513,040
Less: Comprehensive income attributable to noncontrolling interests	(46,543)	(52,586)
Comprehensive income attributable to DaVita Inc.	$ 201,154	$ 460,454

CONSOLIDATED BALANCE SHEETS (un

CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
ASSETS
Cash and cash equivalents	$ 358,874	$ 508,234
Restricted cash and equivalents	88,744	10,686
Short-term investments	4,602	32,830
Accounts receivable, net	1,830,590	1,714,750
Inventories	125,555	181,799
Other receivables	415,914	372,919
Income tax receivable	18,660	49,440
Prepaid and other current assets	106,351	112,058
Current assets held for sale	5,724,265	5,761,642
Total current assets	8,673,555	8,744,358
Property and equipment, net of accumulated depreciation of $3,230,717 and $3,103,662	3,185,223	3,149,213
Intangible assets, net of accumulated amortization of $360,828 and $356,774	113,366	113,827
Equity method and other investments	245,564	245,534
Long-term investments	34,344	37,695
Other long-term assets	51,728	47,287
Goodwill	6,638,592	6,610,279
Total assets	18,942,372	18,948,193
LIABILITIES AND EQUITY
Accounts payable	437,733	509,116
Other liabilities	544,846	552,662
Accrued compensation and benefits	526,183	616,116
Current portion of long-term debt	184,136	178,213
Current liabilities held for sale	1,254,625	1,185,070
Total current liabilities	2,947,523	3,041,177
Long-term debt	9,279,885	9,158,018
Other long-term liabilities	391,156	365,325
Deferred income taxes	507,226	486,247
Total liabilities	13,125,790	13,050,767
Commitments and contingencies:
Noncontrolling interests subject to put provisions	1,034,501	1,011,360
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; 182,660,712 and 182,462,278 shares issued and 178,463,408 and 182,462,278 shares outstanding, respectively)	183	182
Additional paid-in capital	1,030,772	1,042,899
Retained earnings	3,820,767	3,633,713
Treasury stock (4,197,304 and zero shares, respectively)	(298,377)	0
Accumulated other comprehensive income	27,335	13,235
Total DaVita Inc. shareholders' equity	4,580,680	4,690,029
Noncontrolling interests not subject to put provisions	201,401	196,037
Total equity	4,782,081	4,886,066
Total liabilities and equity	$ 18,942,372	$ 18,948,193

CONSOLIDATED BALANCE SHEETS (u5

CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Property and equipment, accumulated depreciation	$ 3,230,717	$ 3,103,662
Intangible assets, accumulated amortization	$ 360,828	$ 356,774
Preferred stock, par value (usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, issued (in shares)	0	0
Common stock, par value (usd per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	450,000,000	450,000,000
Common stock, shares issued (in shares)	182,660,712	182,462,278
Common stock, shares outstanding (in shares)	178,463,408	182,462,278
Treasury Stock, Common, Shares	4,197,304	0

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Cash flows from operating activities:
Net income	$ 225,229	$ 500,285
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	142,799	190,206
Impairment charges	0	39,366
Stock-based compensation expense	9,685	9,601
Deferred income taxes	43,617	20,091
Equity investment income, net	3,564	1,423
Other non-cash charges, net	9,959	9,464
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:
Accounts receivable	(63,701)	16,168
Inventories	57,621	(8,909)
Other receivables and other current assets	(34,120)	(84,511)
Other long-term assets	2,054	(2,310)
Accounts payable	(62,830)	(26,214)
Accrued compensation and benefits	(62,550)	(62,825)
Other current liabilities	49,379	(9,633)
Income taxes	30,772	258,490
Other long-term liabilities	11,061	14,479
Net cash provided by operating activities	362,539	865,171
Cash flows from investing activities:
Additions of property and equipment	(232,443)	(214,535)
Acquisitions	(16,582)	(77,236)
Proceeds from asset and business sales	18,535	46,612
Purchase of investments available for sale	(2,646)	(2,358)
Purchase of investments held-to-maturity	(3,586)	(121,645)
Proceeds from sale of investments available for sale	5,151	4,025
Proceeds from investments held-to-maturity	31,454	116,285
Purchase of equity investments	(2,476)	(1,135)
Distributions received on equity investments	2,465	0
Net cash used in investing activities	(200,128)	(249,987)
Cash flows from financing activities:
Borrowings	13,306,898	12,803,015
Payments on long-term debt and other financing costs	(13,202,225)	(12,839,156)
Purchase of treasury stock	(290,377)	0
Stock award exercises and other share issuances, net	(1,185)
Stock award exercises and other share issuances, net		3,330
Distributions to noncontrolling interests	(45,467)	(43,316)
Contributions from noncontrolling interests	12,009	17,989
Purchases of noncontrolling interests	(2,200)	(799)
Net cash used in financing activities	(222,547)	(58,937)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	6,668	2,820
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(53,468)	559,067
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	518,920	683,463
Cash, cash equivalents and restricted cash of continuing operations at end of the period	447,618	1,218,037
Discontinued Operations
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	17,834	24,493
Continuing Operations
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	$ (71,302)	$ 534,574

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY (unaudited) - USD ($) $ in Thousands	Total	Total	TotalRestricted Stock Units	TotalStock Appreciation Rights	Non- controlling interests subject to put provisions	Common stock	Common stockRestricted Stock Units	Common stockStock Appreciation Rights	Additional paid-in capital	Additional paid-in capitalRestricted Stock Units	Additional paid-in capitalStock Appreciation Rights	Retained earnings	Treasury stock	Accumulated other comprehensive (loss) income	Non- controlling interests not subject to put provisions
Beginning balance at Dec. 31, 2016		$ 4,648,047			$ 973,258	$ 195			$ 1,027,182			$ 3,710,313	$ 0	$ (89,643)	$ 201,694
Beginning Balance (in shares) at Dec. 31, 2016						194,554,000							0
Comprehensive income:
Other comprehensive income (loss)	$ 12,755
Beginning balance at Dec. 31, 2016		4,648,047			973,258	$ 195			1,027,182			3,710,313	$ 0	(89,643)	201,694
Beginning Balance (in shares) at Dec. 31, 2016						194,554,000							0
Comprehensive income:
Net income		663,618			103,641							663,618			63,296
Other comprehensive income (loss)		102,878												102,878	(2)
Stock purchase shares issued (in shares)						360,000
Stock purchase shares issued		22,131							22,131
Stock unit shares issued (in shares)							117,000	398,000
Stock unit shares issued			$ (101)	$ 0						$ 101	$ 0
Stock-settled stock-based compensation expense		34,981							34,981
Changes in noncontrolling interest from:
Distributions					(128,853)										(82,614)
Contributions					52,911										21,641
Acquisitions and divestitures		(823)			43,799				(823)						(5,770)
Partial purchases		(2,752)			(397)				(2,752)						(2,208)
Fair value remeasurements		32,999			(32,999)				32,999
Purchase of treasury stock (in shares)													(12,967,000)
Purchase of treasury stock		(810,949)											$ (810,949)
Retirement of treasury stock						(12,967,000)							12,967,000
Retirement of treasury stock		0				$ (13)			(70,718)			(740,218)	$ 810,949
Ending balance at Dec. 31, 2017	$ 4,886,066	4,690,029			1,011,360	$ 182			1,042,899			3,633,713	$ 0	13,235	196,037
Ending Balance (in shares) at Dec. 31, 2017	182,462,278					182,462,000							0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Cumulative Effect of New Accounting Principle in Period of Adoption		0										8,368		(8,368)
Comprehensive income:
Net income		178,686			24,107							178,686			22,436
Other comprehensive income (loss)	$ 22,468	22,468												22,468
Stock unit shares issued (in shares)							4,000	195,000
Stock unit shares issued				$ (4,886)				$ 1			$ 4,887
Stock-settled stock-based compensation expense		9,682							9,682
Changes in noncontrolling interest from:
Distributions					(26,166)										(19,301)
Contributions					9,508										2,501
Acquisitions and divestitures		76			688				76						(66)
Partial purchases		(1,994)							(1,994)						(206)
Fair value remeasurements		(15,004)			15,004				(15,004)
Purchase of treasury stock (in shares)	(4,197,000)												(4,197,000)
Purchase of treasury stock	$ (298,377)	(298,377)											$ (298,377)
Ending balance at Mar. 31, 2018	$ 4,782,081	$ 4,580,680			$ 1,034,501	$ 183			$ 1,030,772			$ 3,820,767	$ (298,377)	$ 27,335	$ 201,401
Ending Balance (in shares) at Mar. 31, 2018	178,463,408					182,661,000							(4,197,000)

Condensed consolidated interim

Condensed consolidated interim financial statements	3 Months Ended
	Mar. 31, 2018
Accounting Policies [Abstract]
Condensed consolidated interim financial statements	Condensed consolidated interim financial statements The condensed consolidated interim financial statements included in this report are prepared by the Company without audit. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these condensed consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and investments, accounting for income taxes, long-term variable compensation accruals, consolidation of variable interest entities and certain fair value estimates. The results of operations for the three months ended March 31, 2018 are not necessarily indicative of the operating results for the full year. The condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 . Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these condensed consolidated financial statements were issued and has included all necessary adjustments and disclosures.

Revenue Recognition Revenue Rec

Revenue Recognition Revenue Recognition	3 Months Ended
	Mar. 31, 2018
Text Block [Abstract]
Revenue Recognition [Text Block]	Revenue recognition On January 1, 2018, the Company adopted Financial Accounting Standards Board (FASB) Accounting Standards Codification Topic 606 Revenue from Contracts with Customers (Topic 606) using the cumulative effect method for those contracts that were not substantially completed as of January 1, 2018. Results for reporting periods beginning on and after January 1, 2018 are presented under Topic 606, while prior period amounts continue to be presented in accordance with the Company's historical accounting under Revenue Recognition (Topic 605). The adoption of this new standard primarily changed the Company’s presentation of revenues, provision for uncollectible accounts and allowance for doubtful accounts. Topic 606 requires revenue to be recognized based on the Company’s estimate of the transaction price the Company expects to collect as a result of satisfying its performance obligations. Accordingly, for performance obligations satisfied after the adoption of Topic 606, the Company no longer separately presents a provision for uncollectible accounts on the consolidated income statement and no longer presents the related allowance for doubtful accounts on the consolidated balance sheet. However, as a result of the Company’s election to apply Topic 606 only to contracts not substantially completed as of January 1, 2018, the Company continues to maintain an allowance for doubtful accounts related to performance obligations satisfied prior to the adoption of Topic 606. Changes to this allowance for doubtful accounts, other than write-offs of uncollectible accounts, are recorded through the provision for uncollectible accounts on the consolidated income statement in accordance with Topic 605. The Company’s allowance for doubtful accounts related to performance obligations satisfied prior to the adoption of Topic 606 was $162,516 and $218,399 as of March 31, 2018 and December 31, 2017, respectively. There are significant risks associated with estimating revenue, which generally take several years to resolve. These estimates are subject to ongoing insurance coverage changes, geographic coverage differences, differing interpretations of contract coverage and other payor issues, as well as patient issues including determining applicable primary and secondary coverage, changes in patient coverage and coordination of benefits. As these estimates are refined over time, both positive and negative adjustments to revenue are recognized in the current period. As a result of changes in these estimates, additional revenue was recognized during the three months ended March 31, 2018 associated with performance obligations satisfied in years prior to the adoption of Topic 606 of $67,410 , which includes a benefit of $24,000 from electing to apply Topic 606 only to contracts not substantially completed as of January 1, 2018. The following table summarizes the Company's segment revenues by primary payor source: For the three months ended March 31, 2018 March 31, 2017 (1) U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated Patient service revenues: Medicare and Medicare Advantage $ 1,485,192 $ — $ 1,485,192 $ 1,272,595 $ — $ 1,272,595 Medicaid and Managed Medicaid 157,496 — 157,496 144,585 — 144,585 Other government 107,119 82,537 189,656 91,993 47,761 139,754 Commercial 782,979 19,718 802,697 756,710 13,883 770,593 Other revenues: Medicare and Medicare Advantage — 142,758 142,758 — 225,203 225,203 Medicaid and Managed Medicaid — 15,791 15,791 — 18,595 18,595 Commercial — 40,420 40,420 — 25,207 25,207 Other (2) 5,114 38,941 44,055 5,311 47,576 52,887 Eliminations of intersegment revenues (18,422 ) (10,199 ) (28,621 ) (11,799 ) (6,369 ) (18,168 ) Total $ 2,519,478 $ 329,966 $ 2,849,444 $ 2,259,395 $ 371,856 $ 2,631,251 (1) As noted above, prior period amounts have not been adjusted under the cumulative effect method. The Company's dialysis and related lab services revenues for the three months ended March 31, 2017 has been presented net of the provision for uncollectible accounts of $107,058 in this table to conform to the current period presentation. (2) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives. Dialysis and related lab patient service revenues Dialysis and related lab services patient service revenues are recognized in the period services are provided. Revenues consist primarily of payments from Medicare, Medicaid and commercial health plans for dialysis and related lab services provided to patients. A usual and customary fee schedule is maintained for the Company’s dialysis treatments and related lab patient services; however, actual collectible revenue is normally recognized at a discount from the fee schedule. Revenues associated with Medicare and Medicaid programs are estimated 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 is estimated based on its judgment regarding its ability to collect, which depends upon its ability to effectively capture, document and bill for Medicare’s base payment rate as well as these other variable factors. 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. 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. 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 estimated as prescriptions are filled and shipped to patients. Revenues associated with dialysis management services, disease management services, medical consulting services, clinical research programs, physician services, end stage renal disease (ESRD) seamless care organizations, and comprehensive care are estimated in the period services are provided. Revenues associated with direct primary care are estimated over the membership period.

Earnings per share

Earnings per share	3 Months Ended
	Mar. 31, 2018
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 interests redemption rights in excess of fair value, by the weighted average number of common shares, 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 earnings per share were as follows: Three months ended March 31, 2018 2017 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 191,015 $ 440,905 Net (loss) income from discontinued operations attributable to DaVita Inc. (12,329 ) 6,792 Net income attributable to DaVita Inc. for basic earnings per share calculation $ 178,686 $ 447,697 Basic: Weighted average shares outstanding during the period 181,152 194,571 Contingently returnable shares held in escrow for the DaVita HealthCare Partners merger (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 178,958 192,377 Basic net income from continuing operations per share attributable to DaVita Inc. $ 1.07 $ 2.29 Basic net (loss) income from discontinued operations per share attributable to DaVita Inc. (0.07 ) 0.04 Basic net income per share attributable to DaVita Inc. $ 1.00 $ 2.33 Diluted: Weighted average shares outstanding during the period 181,152 194,571 Assumed incremental shares from stock plans 683 710 Weighted average shares for diluted earnings per share calculation 181,835 195,281 Diluted net income from continuing operations per share attributable to DaVita Inc. $ 1.05 $ 2.26 Diluted net (loss) income from discontinued operations per share attributable to DaVita Inc. (0.07 ) 0.03 Diluted net income per share attributable to DaVita Inc. $ 0.98 $ 2.29 Anti-dilutive stock-settled awards excluded from calculation (1) 3,453 3,427 (1) Shares associated with stock-settled stock appreciation rights excluded from the diluted denominator calculation because they are antidilutive under the treasury stock method.

Restricted Cash Restricted Cash

Restricted Cash Restricted Cash	3 Months Ended
	Mar. 31, 2018
Restricted Cash [Abstract]
Cash and Cash Equivalents Disclosure [Text Block]	Restricted cash and equivalents The Company had restricted cash and cash equivalents of $88,744 and $10,686 at March 31, 2018 and December 31, 2017, respectively. Approximately $78,320 of the balance at March 31, 2018 represents restricted cash equivalents held in trust to satisfy insurer and state regulatory requirements related to the Company's self-insurance for professional and general liability and workers' compensation risks administered by wholly-owned captive insurance entities. Prior to the first quarter of 2018, these requirements were satisfied by a letter of credit rather than restricted cash held in trust. The remaining restricted cash and equivalents held at March 31, 2018 and December 31, 2017 primarily represent cash pledged to third parties in connection with two of the Company's ancillary and strategic initiatives businesses.

Investments in debt and equity

Investments in debt and equity securities	3 Months Ended
	Mar. 31, 2018
Investments, Debt and Equity Securities [Abstract]
Investments in debt and equity securities	Short-term and long-term investments Effective January 1, 2018, the Company adopted 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 Company also adopted ASU 2018-03 which provides related technical corrections and improvements. The principal effect of ASUs 2016-01 and 2018-03 on the Company's consolidated financial statements is that, prior to adoption of ASU 2016-01, changes in the fair values of investments in equity securities with readily determinable fair values or redemption values were recognized in other comprehensive income until realized, while under ASU 2016-01 all changes in the fair values of these equity securities are recognized in current earnings. The adoption of these ASUs did not have a material impact on these condensed consolidated financial statements. Effective January 1, 2018, the Company recognized a cumulative effect of change in accounting principle upon adoption of ASUs 2016-01 and 2018-03, in conjunction with ASU 2018-02, the effect of which was to decrease accumulated other comprehensive income, and to increase retained earnings, by $5,662 in after-tax unrealized gains accumulated in other comprehensive income through December 31, 2017 from equity securities classified as available-for-sale investments prior to adoption of ASU 2016-01. From January 1, 2018, equity securities that have readily determinable fair values or redemption values are recorded at estimated fair value with changes in their value recognized in current earnings. The Company classifies its debt securities as held-to-maturity and records them at amortized cost based on its intentions and strategy concerning those investments. The Company classifies these debt and equity investments as "Short-term investments" or "Long-term investments" on its consolidated balance sheet, as applicable, based on the characteristics of the financial instrument or the Company's intentions or expectations for the investment. The Company’s investments in these short-term and long-term debt and equity investments consist of the following: March 31, 2018 December 31, 2017 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 3,402 $ — $ 3,402 $ 31,630 $ — $ 31,630 Investments in mutual funds and common stock — 35,544 35,544 — 38,895 38,895 $ 3,402 $ 35,544 $ 38,946 $ 31,630 $ 38,895 $ 70,525 Short-term investments $ 3,402 $ 1,200 $ 4,602 $ 31,630 $ 1,200 $ 32,830 Long-term investments — 34,344 34,344 — 37,695 37,695 $ 3,402 $ 35,544 $ 38,946 $ 31,630 $ 38,895 $ 70,525 Debt securities: The Company's short-term debt investments are principally comprised of bank certificates of deposit with contractual maturities longer than three months but shorter than one year. These debt securities are accounted for as held to maturity and recorded at amortized cost, which approximates their fair values at March 31, 2018 and December 31, 2017 . Equity securities: The Company's equity investments in mutual funds and common stock are held within a trust to fund existing obligations associated with several of the Company’s non-qualified deferred compensation plans. During the three months ended March 31, 2018 , the Company recognized pre-tax net gains of $86 in the income statement associated with changes in the fair value of these equity securities, comprised of pre-tax realized gains of $3,746 and a net decrease in unrealized gains of $3,660 . During the three months ended March 31, 2017 , the Company recognized pre-tax realized gains on the sale or redemption of equity securities of $229 , or $140 after-tax, which was previously recorded in other comprehensive income.

Equity method and other investm

Equity method and other investments	3 Months Ended
	Mar. 31, 2018
Equity Method Investments and Joint Ventures [Abstract]
Equity method and other investments	Equity method and other investments Equity investments in nonconsolidated investees over which the Company maintains significant influence, but which do not have readily determinable fair values, are carried on the equity method. As described in Note 5 to these condensed consolidated financial statements, effective January 1, 2018, the Company adopted ASU 2016-01 and related ASU 2018-03 concerning recognition and measurement of financial assets and financial liabilities. In adopting this new guidance, the Company has made an accounting policy election to adopt an adjusted cost method measurement alternative for investments in equity securities without readily determinable fair values. Specifically, under this measurement alternative, unless elected otherwise for a particular investment, the Company initially records equity investments that qualify for the measurement alternative at cost but remeasures them to fair value through earnings when there is an observable transaction involving the same or a similar investment with the same issuer or upon an impairment. The Company maintains equity method and minor adjusted cost method investments in the private securities of certain other healthcare and healthcare-related businesses. The Company classifies these investments as "Equity method and other investments" on its consolidated balance sheet. Total equity method and other investments in nonconsolidated businesses were $245,564 and $245,534 at March 31, 2018 and December 31, 2017, respectively. During the three months ended March 31, 2018 and 2017, the Company recognized equity investment income of $155 and $677 , respectively, from equity method investments in nonconsolidated businesses. The Company's largest equity method investment is its ownership interest in DaVita Care Pte. Ltd. (the APAC JV), which was carried at $160,535 and $160,481 at March 31, 2018 and December 31, 2017, respectively. The Company recognized a non-cash other-than-temporary impairment on this investment of $280,066 in the fourth quarter of 2017. As of March 31, 2018 and December 31, 2017, the Company holds a 60% voting interest and a 73.3% current economic interest in the APAC JV. Based on the governance structure and voting rights established for the APAC JV at its formation on August 1, 2016, certain key decisions affecting the joint venture’s operations are not subject to the unilateral discretion of the Company, but rather are shared with the other noncontrolling investors. These other noncontrolling investors currently collectively hold a 40% voting interest and a 26.7% economic interest in the APAC JV, and their economic interests are expected to increase to match their voting interests in the joint venture as they make additional subscribed capital contributions through August 1, 2019. The total carrying amount of equity investments carried under the adjusted cost method measurement alternative at March 31, 2018 was $5,386 . Through March 31, 2018, there have been no meaningful impairments or other downward or upward valuation adjustments recognized on these investments.

Goodwill

Goodwill	3 Months Ended
	Mar. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill Changes in goodwill by reportable segment were as follows: U.S. dialysis and related lab services Other-ancillary services and strategic initiatives Consolidated total Balance at January 1, 2017 $ 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 Acquisitions 2,137 13,905 16,042 Foreign currency and other adjustments — 12,271 12,271 Balance at March 31, 2018 $ 6,146,898 $ 491,694 $ 6,638,592 Balance at March 31, 2018: Goodwill $ 6,146,898 $ 562,214 $ 6,709,112 Accumulated impairment charges — (70,520 ) (70,520 ) $ 6,146,898 $ 491,694 $ 6,638,592 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 and 2018 have been performed under this new guidance. Each of the Company’s operating segments described in Note 19 to these condensed consolidated financial statements represents an individual reporting unit for goodwill impairment testing purposes, except that each sovereign jurisdiction within the Company’s international operating segments is considered a separate reporting unit. Within the U.S. dialysis and related lab services operating segment, the Company considers each of its dialysis centers to constitute an individual business for which discrete financial information is available. However, since these dialysis centers have similar operating and economic characteristics, and the allocation of resources and significant investment decisions concerning these businesses are highly centralized and the benefits broadly distributed, the Company has aggregated these centers and deemed them to constitute a single reporting unit. The Company has applied a similar aggregation to the vascular access service centers in its vascular access reporting unit, to the physician practices in its physician services and direct primary care reporting units, and to the dialysis centers within each international reporting unit. For the Company’s other operating segments, discrete business components below the operating segment level constitute individual reporting units. During the three months ended March 31, 2018 , the Company did not recognize any goodwill impairment charges. During the three months ended March 31, 2017 , the Company recognized a goodwill impairment charge of $24,198 at the Company’s vascular access reporting unit. This charge resulted primarily from changes in the Company's outlook as the Company's partners and operators continued to evaluate potential changes in operations, including termination of their management services agreements and center closures, as a result of recent changes in Medicare reimbursement. There is no goodwill remaining at the Company's vascular access reporting unit. For the reporting units considered at risk as of December 31, 2017 listed in the table below, there have been no major changes in the business, prospects, or expected future results of these reporting units from their latest assessment date through March 31, 2018 . 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 March 31, 2018 : Goodwill balance Carrying (1) Sensitivities Reporting unit Operating (2) Discount (3) Kidney Care Germany $ 337,619 13.7 % (1.6 )% (11.1 )% Kidney Care Portugal $ 48,066 16.9 % (1.9 )% (6.0 )% Kidney Care Poland $ 47,669 11.8 % (1.9 )% (6.0 )% (1) Excess of estimated fair value of the reporting unit over its carrying amount as of the latest assessment date. (2) Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date. (3) Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date. Except as described above, none of the Company's various other reporting units were considered at risk of significant goodwill impairment as of March 31, 2018 . 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, these changes did not cause management to believe it is more likely than not that the fair value of any of the Company's reporting units would be less than their respective carrying amounts as of March 31, 2018 .

Income taxes

Income taxes	3 Months Ended
	Mar. 31, 2018
Income Tax Disclosure [Abstract]
Income taxes	Income taxes As of March 31, 2018 , the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold was $33,880 , all of which would impact the Company’s effective tax rate if recognized. This balance represents an increase of $1,104 from the December 31, 2017 balance of $32,776 . The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. At March 31, 2018 and December 31, 2017 , the Company had approximately $3,971 and $4,195 , respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefits. The Company performed a provisional analysis of the Tax Cuts and Jobs Act of 2017 (2017 Tax Act) and recorded a reasonable estimate of its effect for the year ended December 31, 2017. The Company is in the process of completing its analysis with respect to the 2017 Tax Act and will record any adjustments to its estimate on or before December 22, 2018, with any adjustments to be recorded to income tax expense in the period when the adjustments are determined. As of March 31, 2018, the Company has not made any material adjustments to the December 31, 2017 estimates. The 2018 effective tax rate reduction is primarily due to the impact of the 2017 Tax Act which reduced the federal tax rate from 35% to 21%.

Long-term debt

Long-term debt	3 Months Ended
	Mar. 31, 2018
Debt Disclosure [Abstract]
Long-term debt	Long-term debt Long-term debt was comprised of the following: March 31, 2018 December 31, 2017 Senior secured credit facilities: Term Loan A $ 750,000 $ 775,000 Term Loan A-2 452,000 — Term Loan B 3,368,750 3,377,500 Revolver — 300,000 Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 151,167 150,512 Capital lease obligations 304,062 297,170 Total debt principal outstanding 9,525,979 9,400,182 Discount and deferred financing costs (61,958 ) (63,951 ) 9,464,021 9,336,231 Less current portion (184,136 ) (178,213 ) $ 9,279,885 $ 9,158,018 Scheduled maturities of long-term debt at March 31, 2018 were as follows: 2018 (remainder of the year) 136,885 2019 1,206,668 2020 72,608 2021 3,307,539 2022 1,283,255 2023 32,340 Thereafter 3,486,684 On March 29, 2018, the Company entered into an Increase Joinder No. 1 (Increase Joinder Agreement) under its existing senior secured credit facilities. Pursuant to this Increase Joinder Agreement, the Company entered into an additional $995,000 Term Loan A-2. The new Term Loan A-2 bears interest at LIBOR plus an interest rate margin of 1.00% . As of March 31, 2018 , the Company has initially drawn $452,000 of the Term Loan A-2, and the Company can draw up to an incremental $543,000 on Term Loan A-2 through its maturity date in June 2019 . During the first three months of 2018 , the Company made mandatory principal payments under its senior secured credit facilities totaling $25,000 on Term Loan A and $8,750 on Term Loan B. As of March 31, 2018 , the Company maintains several active and forward interest rate cap agreements that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt, as described below. The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the terms of the cap agreements. The cap agreements do not contain credit-risk contingent features. As of March 31, 2018 , 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 March 31, 2018 , these cap agreements had an immaterial fair value. During the three months ended March 31, 2018 , the Company recognized debt expense of $2,070 from these caps. During the three months ended March 31, 2018 , the Company recorded an immaterial loss in other comprehensive income due to a decrease in unrealized fair value of these cap agreements. As of March 31, 2018 , 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 March 31, 2018 , the total fair value of these cap agreements was an asset of approximately $2,446 . During the three months ended March 31, 2018 , the Company recorded a gain of $1,414 in other comprehensive income due to an increase in the unrealized fair value of these forward cap agreements. The following table summarizes the Company’s derivative instruments as of March 31, 2018 and December 31, 2017 : March 31, 2018 December 31, 2017 Derivatives designated as hedging instruments Balance sheet location Fair value Balance sheet location Fair value Interest rate cap agreements Other long-term assets $ 2,446 Other long-term assets $ 1,032 The following table summarizes the effects of the Company’s interest rate cap agreements for the three months ended March 31, 2018 and 2017 : Amount of unrecognized gains (losses) in OCI on interest rate cap agreements Location of losses reclassified from accumulated OCI into income Amount of losses reclassified from accumulated OCI into income Three months ended Three months ended Derivatives designated as cash flow hedges 2018 2017 2018 2017 Interest rate cap agreements $ 1,414 $ (5,217 ) Debt expense $ 2,070 $ 2,070 Tax (benefit) expense (364 ) 2,029 Tax expense (533 ) (805 ) Total $ 1,050 $ (3,188 ) $ 1,537 $ 1,265 As of March 31, 2018 , the Company’s Term Loan B debt bears interest at LIBOR plus an interest rate margin of 2.75% . Term Loan B is subject to interest rate caps if LIBOR should rise above 3.50% . Term Loan A bears interest at LIBOR plus an interest rate margin of 2.00% . The capped portion of Term Loan A is $131,250 if LIBOR should rise above 3.50% . In addition, the uncapped portion of Term Loan A, which is subject to the variability of LIBOR, is $618,750 . Term Loan A-2 is subject to the variability of LIBOR plus an interest rate margin of 1.00% . Interest rates on the Company’s senior notes are fixed by their terms. The Company’s weighted average effective interest rate on the senior secured credit facilities at the end of the quarter was 4.67% , based on the current margins in effect of 2.00% for Term Loan A, 1.00% for Term Loan A-2, and 2.75% for Term Loan B, as of March 31, 2018 . The Company’s overall weighted average effective interest rate during the quarter ended March 31, 2018 was 4.87% and as of March 31, 2018 was 4.98% . As of March 31, 2018 , the Company’s interest rates are fixed on approximately 51.34% of its total debt. As of March 31, 2018 , the Company had undrawn revolving credit facilities totaling $1,000,000 , of which approximately $14,355 was committed for outstanding letters of credit. The remaining amount is unencumbered. The Company also has approximately $22,351 of additional outstanding letters of credit related to its Kidney Care business and $211 of committed outstanding letters of credit related to DaVita Medical Group (DMG), which is backed by a certificate of deposit.

Contingencies

Contingencies	3 Months Ended
	Mar. 31, 2018
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 March 31, 2018 and December 31, 2017, the Company’s total recorded accruals, including DMG, with respect to legal proceedings and regulatory matters, net of anticipated third party recoveries, were immaterial. 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 Centers for Medicare and Medicaid Services (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 previously disclosed and dismissed 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 Texas Investigation : In early February 2016, the Company announced that its pharmacy services’ wholly-owned subsidiary, DaVita Rx, LLC, (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 Massachusetts Investigation : In January 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. 2017 U.S. Attorney Colorado Investigation : In November 2017, United States Attorney’s Office, District of Colorado informed the Company of an investigation it was conducting into possible federal health care offenses involving DaVita Kidney Care, as well as several of the Company's wholly-owned subsidiaries, including DMG, DaVita Rx, DaVita Laboratory Services, Inc. (DaVita Labs), and RMS Lifeline Inc. (Lifeline). There is overlap between the Colorado investigation and the other reported investigations concerning DMG and DaVita Rx. The Company is cooperating with the government. 2017 U.S. Attorney Florida Investigation : In November 2017, United States Attorney’s Office, Southern District of Florida informed the Company of an investigation it was conducting into possible federal healthcare offenses involving the Company's wholly-owned subsidiary, Lifeline. The Company is cooperating with the government. 2018 U.S. Attorney Florida Investigation : In March 2018, DaVita Labs, received two CIDs from the United States Attorney’s Office, Middle District of Florida that were identical in nature but directed to the two different labs. According to the face of the CIDs, the U.S. Attorney’s Office is conducting an investigation as to whether the Company's subsidiary submitted claims for blood, urine, and fecal testing, where there were insufficient test validation or stability studies to ensure accurate results, in violation of the False Claims Act. The Company is cooperating with the government. * * * 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 and to develop over the course of time. In addition to the inquiries and proceedings specifically identified above, the Company frequently is 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 and Derivative 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. On March 27, 2018, the Company and various individual defendants filed a motion to dismiss. 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 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 plaintiffs filed an opposition to the motion to dismiss on March 9, 2018. 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 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. * * * Other than as described above, the Company cannot predict the ultimate outcomes of the various legal proceedings and regulatory matters to which the Company is or may be subject from time to time, including those described in this Note 10 to these condensed consolidated financial statements, 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	3 Months Ended
	Mar. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Noncontrolling interests subject to put provisions and other commitments	Noncontrolling interests subject to put provisions and other commitments The Company has potential obligations to purchase the 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 maintains a noncontrolling equity interest as well as to physician-owned vascular access clinics or medical practices that the Company operates under management and administrative services agreements of approximately $5,542 . Certain consolidated joint ventures are originally contractually scheduled to dissolve after terms ranging from 10 to 50 years. While noncontrolling interests in these limited life entities qualify as mandatorily redeemable financial instruments, they are subject to a classification and measurement scope exception from the accounting guidance generally applicable to other mandatorily redeemable financial instruments. Future distributions upon dissolution of these entities would be valued below the related noncontrolling interest carrying balances in the consolidated balance sheet.

Long-term incentive compensatio

Long-term incentive compensation	3 Months Ended
	Mar. 31, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Long-term incentive compensation	Long-term incentive compensation Long-term incentive program (LTIP) compensation includes both stock-based awards (principally stock-settled stock appreciation rights, restricted stock units, and performance stock units) as well as long-term performance-based cash awards. Long-term incentive compensation expense, which was primarily general and administrative in nature, was attributed to the Company’s U.S. dialysis and related lab services business, corporate administrative support, and ancillary services and strategic initiatives. The Company’s stock-based compensation awards are measured at their estimated fair values on the date of grant if settled in shares or at their estimated fair values at the end of each reporting period if settled in cash. The value of stock-based awards so measured is recognized as compensation expense on a cumulative straight-line basis over the vesting terms of the awards, adjusted for expected forfeitures. During the three months ended March 31, 2018 , the Company granted 11 stock-settled stock appreciation rights with an aggregate grant-date fair value of $200 and a weighted-average expected life of approximately 3.7 years and 60 stock units with an aggregate grant-date fair value of $3,995 and a weighted-average expected life of approximately 1.0 years. For the three months ended March 31, 2018 and 2017 , the Company recognized $15,215 and $15,254 , respectively, in total LTIP expense, of which $9,155 and $8,425 , respectively, represented stock-based compensation expense for stock appreciation rights, restricted stock units, and discounted employee stock plan purchases, which are primarily included in general and administrative expense. The estimated tax benefits recorded for stock-based compensation for the three months ended March 31, 2018 and 2017 was $2,088 and $2,922 , respectively. As of March 31, 2018 , the Company had $91,823 of total estimated but unrecognized compensation expense for outstanding LTIP awards, including $62,013 related to stock-based compensation arrangements under the Company’s equity compensation and employee stock purchase plans. The Company expects to recognize the performance-based cash component of these LTIP costs over a weighted average remaining period of 1.1 years and the stock-based component of these LTIP costs over a weighted average remaining period of 1.3 years. For the three months ended March 31, 2018 and 2017 , the Company recognized $4,895 and $1,091 , respectively, in actual tax benefits upon the exercise of stock awards.

Share repurchases

Share repurchases	3 Months Ended
	Mar. 31, 2018
Equity [Abstract]
Share repurchases	Share repurchases During the three months ended March 31, 2018 , the Company repurchased a total of 4,197 shares of its common stock for $298,377 at an average price of $71.09 per share. The Company also repurchased 4,350 shares of its common stock for $275,992 at an average price of $63.44 per share, subsequent to March 31, 2018 through May 2, 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 May 2, 2018, the Company has a total of $544,747 available under the current Board repurchase authorizations for additional share repurchases. Although these share repurchase authorizations do not have expiration dates, the Company remains subject to share repurchase limitations under the terms of its senior secured credit facilities and the indentures governing its senior notes.

Comprehensive income

Comprehensive income	3 Months Ended
	Mar. 31, 2018
Statement of Comprehensive Income [Abstract]
Comprehensive income	Other comprehensive income For the three months ended March 31, 2018 For the three months ended March 31, 2017 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Cumulative effect (1) (2,706 ) (5,662 ) — (8,368 ) — — — — Unrealized gains 1,414 — 19,881 21,295 (5,217 ) 2,113 13,261 10,157 Related income tax (expense) benefit (364 ) — — (364 ) 2,029 (554 ) — 1,475 1,050 — 19,881 20,931 (3,188 ) 1,559 13,261 11,632 Reclassification 2,070 — — 2,070 2,070 (229 ) — 1,841 Related income tax (expense) benefit (533 ) — — (533 ) (805 ) 89 — (716 ) 1,537 — — 1,537 1,265 (140 ) — 1,125 Ending balance $ (12,527 ) $ — $ 39,862 $ 27,335 $ (13,952 ) $ 3,594 $ (66,528 ) $ (76,886 ) (1) Reflects the cumulative effect of a change in accounting principle for ASUs 2016-01 and 2018-03 on classification and measurement of financial instruments and ASU 2018-02 on remeasurement and reclassification of deferred tax effects in accumulated other comprehensive income associated with the 2017 Tax Act. Net realized losses on interest rate cap agreements that are reclassified into income are recorded as debt expense in the corresponding consolidated statements of operations. See Note 9 to these condensed consolidated financial statements for further details. Net realized gains on investment securities reclassified into income for the three months ended March 31, 2017 were recognized in other income in the corresponding consolidated statements of operations. See Note 5 to these condensed consolidated financial statements for further details.

Acquisitions and divestitures

Acquisitions and divestitures	3 Months Ended
	Mar. 31, 2018
Business Combinations [Abstract]
Acquisitions and divestitures	Acquisitions and divestitures Routine acquisitions During the three months ended March 31, 2018 , the Company acquired dialysis businesses consisting of one dialysis center located in the U.S. and four dialysis centers located outside the U.S. for a total of $15,677 in net cash, $655 in deferred purchase price obligations, and $2,408 in liabilities assumed. The assets and liabilities for these acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s condensed consolidated financial statements, as are their operating results, from the designated effective dates of the acquisitions. The initial purchase price allocations for these transactions have been recorded at estimated fair values based on the best information available to management and will be finalized when certain information arranged to be obtained has been received. In particular, certain income tax amounts are pending final evaluation and quantification of pre-acquisition tax contingencies and filing of final tax returns. In addition, valuation of certain working capital items, fixed assets and intangibles are pending final audits and related valuation reports. The following table summarizes the assets acquired and liabilities assumed in these transactions at their estimated acquisition date fair values: Current assets $ 1,572 Property and equipment 1,643 Amortizable intangible and other long-term assets 2,563 Goodwill 16,042 Current liabilities (2,392 ) Noncontrolling interests (688 ) $ 18,740 Amortizable intangible assets acquired during the first three months of 2018 primarily represent non-compete agreements which had weighted-average estimated useful lives of approximately five years. The total estimated amount of goodwill deductible for tax purposes associated with these acquisitions was approximately $15,383 . Contingent earn-out obligations The Company has several contingent earn-out obligations associated with acquisitions that could result in the Company paying the former owners of acquired companies a total of up to $11,555 if certain EBITDA, operating income performance targets or quality margins are met primarily over the next one to six years. Contingent earn-out obligations are remeasured at fair value at each reporting date until the contingencies are resolved with changes in the liability due to the remeasurement recorded in earnings. See Note 18 to these condensed consolidated financial statements for further details. As of March 31, 2018 , the Company has estimated the fair value of these contingent earn-out obligations to be $6,562 , of which a total of $222 is included in other liabilities and the remaining $6,340 is included in other long-term liabilities in the Company’s consolidated balance sheet. The following is a reconciliation of changes in liabilities for contingent earn-out obligations: For the three months ended March 31, 2018 Beginning balance $ 6,388 Remeasurement of fair value for contingent earn-out obligations 174 Ending balance $ 6,562

Held for Sale and Discontinued

Held for Sale and Discontinued Operations Held for Sale and Discontinued Operations	3 Months Ended
	Mar. 31, 2018
Held for Sale and Discontinued Operations [Abstract]
Disposal Groups, Including Discontinued Operations, Disclosure [Text Block]	Held for sale and discontinued operations DaVita Medical Group In December 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., 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 approvals and other customary closing conditions. As a result of this pending transaction, the DMG business has been classified 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: Three months ended March 31, 2018 2017 Revenues $ 1,227,932 $ 1,086,985 Expenses 1,226,407 1,074,452 Income from discontinued operations before taxes 1,525 12,533 Income tax expense 7,311 6,100 Net (loss) income from discontinued operations, net of tax $ (5,786 ) $ 6,433 The following table presents the financial position of discontinued operations related to DMG: March 31, 2018 December 31, 2017 Assets Cash and cash equivalents 192,399 179,668 Other current assets 768,388 826,608 Property and equipment, net 410,127 379,945 Intangible assets, net 1,316,462 1,316,550 Other long-term assets 155,385 178,894 Goodwill 2,881,504 2,879,977 Total current assets held for sale $ 5,724,265 $ 5,761,642 Liabilities Other liabilities 529,354 505,734 Medical payables 505,872 457,040 Current portion of long-term debt 2,735 2,845 Long-term debt 34,541 35,003 Other long-term liabilities 182,123 184,448 Total current liabilities held for sale $ 1,254,625 $ 1,185,070 The following table presents cash flows of discontinued operations related to DMG: March 31, 2018 March 31, 2017 Net cash provided by operating activities from discontinued operations 156,248 95,585 Net cash used in investing activities from discontinued operations (33,068 ) (41,686 ) DMG acquisitions During the first quarter of 2018, the Company's DMG business acquired one medical business for a total of $905 in cash and deferred purchase price of $99 . 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 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	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Variable interest entities	Variable interest entities The Company relies on the operating activities of certain legal entities that it does not directly own or control, but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are subject to the consolidation guidance applicable to variable interest entities (VIEs). Under U.S. generally accepted accounting principles (GAAP), VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. The Company has determined that substantially all of the legal entities it is associated with that qualify as VIEs must be included in its consolidated financial statements. A number of these VIEs are within the Company's DMG business, which is classified as held for sale and as a discontinued operation in these condensed consolidated financial statements. The Company manages these entities and provides operating and capital funding as necessary for these entities to accomplish their operational and strategic objectives. A number of these entities are subject to nominee 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 March 31, 2018 , these condensed consolidated financial statements include total assets of VIEs of $852,912 and total liabilities and noncontrolling interests of VIEs to third parties of $507,962 , including assets of $580,039 and liabilities and noncontrolling interests of $345,926 related to the Company's DMG business classified as held for sale. The Company also sponsors certain deferred compensation plans whose trusts qualify as VIEs and the Company consolidates these plans as their primary beneficiary. The assets of these plans are recorded in short-term or long-term investments with matching offsetting liabilities recorded in accrued compensation and benefits and other long-term liabilities. See Note 5 to these condensed consolidated financial statements for disclosures on the assets of these consolidated non-qualified deferred compensation plans.

Fair value of financial instrum

Fair value of financial instruments	3 Months Ended
	Mar. 31, 2018
Fair Value Disclosures [Abstract]
Fair value 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 table summarizes the Company’s assets, liabilities and temporary equity that are measured at fair value on a recurring basis as of March 31, 2018 : Total Quoted prices in Significant other Significant Assets Investments in mutual funds and common stock $ 35,544 $ 35,544 $ — $ — Interest rate cap agreements $ 2,446 $ — $ 2,446 $ — Liabilities Contingent earn-out obligations $ 6,562 $ — $ — $ 6,562 Temporary equity Noncontrolling interests subject to put provisions $ 1,034,501 $ — $ — $ 1,034,501 Investments in mutual funds and common stock represent equity securities that are recorded at estimated fair value based upon quoted redemption prices reported by each mutual fund. See Note 5 to these condensed consolidated financial statements for further discussion. Interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 9 to these condensed consolidated financial statements for further discussion. The estimated fair value 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 the obligations to present value. See Note 15 to these condensed consolidated financial statements for further discussion. See Note 11 to these condensed consolidated financial statements for a discussion of the Company’s methodology for estimating the fair value of noncontrolling interests subject to put obligations. The carrying balance of the Company’s senior secured credit facilities totaled $4,546,990 as of March 31, 2018 , and the fair value was approximately $4,616,019 based upon quoted market prices, a level 2 input. The carrying balance of the Company’s senior notes was $4,461,802 as of March 31, 2018 and their fair value was approximately $4,433,500 , based upon quoted market prices, a level 2 input. Other financial instruments consist primarily of cash and cash equivalents, accounts receivable, accounts payable, other accrued liabilities and debt. The balances of the Company's financial instruments other than the senior secured credit facilities and the senior notes are presented in the condensed consolidated financial statements at March 31, 2018 at their approximate fair values due to the short-term nature of their settlements.

Segment reporting

Segment reporting	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
Segment reporting	Segment reporting The Company has consisted of two major divisions, DaVita Kidney Care (Kidney Care) and 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. In December 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 approvals and other customary closing conditions. As a result of this pending transaction, the DMG business has been classified as held for sale and its results of operations are reported as discontinued operations for all periods presented in these condensed consolidated financial statements. See Note 16 to these condensed consolidated financial statements for further discussion. 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 net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes: Three months ended March 31, 2018 2017 Segment net revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,489,165 $ 2,360,861 Intersegment revenues 18,422 11,799 U.S. dialysis and related lab services patient service revenues 2,507,587 2,372,660 Provision for uncollectible accounts 25,199 (106,777 ) Net U.S. dialysis and related lab services patient service revenues 2,532,786 2,265,883 Other revenues (1) 5,114 5,311 Total U.S. dialysis and related lab services revenues 2,537,900 2,271,194 Other—Ancillary services and strategic initiatives Patient service revenues 102,255 61,644 Other external sources 227,711 310,212 Intersegment revenues 10,199 6,369 Total ancillary services and strategic initiatives revenues 340,165 378,225 Total net segment revenues 2,878,065 2,649,419 Elimination of intersegment revenues (28,621 ) (18,168 ) Consolidated revenues $ 2,849,444 $ 2,631,251 Segment operating margin: U.S. dialysis and related lab services $ 433,380 $ 944,740 Other—Ancillary services and strategic initiatives (6,990 ) (58,220 ) Total segment operating margin 426,390 886,520 Reconciliation of segment operating margin to consolidated income before income taxes: Corporate administrative support (15,704 ) (10,592 ) Consolidated operating income 410,686 875,928 Debt expense (113,516 ) (104,397 ) Other income, net 4,582 3,986 Consolidated income before income taxes $ 301,752 $ 775,517 (1) Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment. Depreciation and amortization expense by reportable segment was as follows: Three months ended March 31, 2018 2017 U.S. dialysis and related lab services $ 134,776 $ 125,029 Other — Ancillary services and strategic initiatives 8,023 7,855 $ 142,799 $ 132,884 Assets by reportable segment were as follows: March 31, 2018 December 31, 2017 Segment assets U.S. dialysis and related lab services (including equity $ 11,798,202 $ 11,776,042 Other—Ancillary services and strategic initiatives (including 1,419,905 1,410,509 DMG—Held for sale (including equity investments of $11,642 and 5,724,265 5,761,642 Consolidated assets $ 18,942,372 $ 18,948,193 Expenditures for property and equipment by reportable segment were as follows: Three months ended 2018 2017 U.S. dialysis and related lab services $ 189,049 $ 173,528 Other—Ancillary services and strategic initiatives 12,345 13,219 DMG—Held for sale 31,049 27,788 $ 232,443 $ 214,535

Changes in DaVita Inc.'s owners

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries	3 Months Ended
	Mar. 31, 2018
Noncontrolling Interest [Abstract]
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries	Changes in DaVita Inc.’s ownership interest in consolidated subsidiaries The effects of changes in DaVita Inc.’s ownership interest in consolidated subsidiaries on the Company’s equity were as follows: Three months ended March 31, 2018 2017 Net income attributable to DaVita Inc. $ 178,686 $ 447,697 Changes in paid-in capital for: Sales of noncontrolling interests 76 — Purchases of noncontrolling interests (1,994 ) (423 ) Net transfers to noncontrolling interests (1,918 ) (423 ) Net income attributable to DaVita Inc., net of transfers to noncontrolling interests $ 176,768 $ 447,274

New accounting standards

New accounting standards	3 Months Ended
	Mar. 31, 2018
Accounting Changes and Error Corrections [Abstract]
New accounting standards	New accounting standards On May 28, 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), 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, 2016 and 2017, the FASB issued ASU 2015-14, ASU 2016-08, ASU 2016-10, ASU 2016-11, ASU 2016-12, and ASU 2017-10, each of which amends the guidance in ASU 2014-09. These ASUs replaced most existing revenue recognition guidance in GAAP. The Company adopted these ASUs beginning January 1, 2018. See Note 2 for further details. 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 . In February 2018, the FASB issued ASU 2018-03, which provides various related technical corrections and improvements. The Company adopted these ASUs beginning January 1, 2018. See Note 5 for further details. 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 and evaluating 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 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. In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted cash. The amendments in this ASU require that the statement of cash flows explains the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted cash equivalents. The adoption of these ASUs did not 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 did not have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2018. 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, 2019. In February 2018, the FASB issued ASU No. 2018-02, 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. The Company elected to early adopt this ASU on January 1, 2018 and applied the change in the period of adoption. The adoption of this ASU resulted in the reclassification of an immaterial amount of deferred tax effects from accumulated other comprehensive income to retained earnings via accumulative change in accounting principle effective January 1, 2018. See Note 14 for more details.

Condensed consolidating financi

Condensed consolidating financial statements	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Condensed consolidating financial statements	Condensed consolidating financial statements The following information is presented in accordance with Rule 3-10 of Regulation S-X. The operating and investing activities of the separate legal entities included in the Company’s condensed consolidated financial statements are fully interdependent and integrated. Revenues and operating expenses of the separate legal entities include intercompany charges for management and other administrative services. The Company’s senior notes are guaranteed by a substantial majority of its domestic subsidiaries as measured by revenue, income and assets. The subsidiary guarantors have guaranteed the senior notes on a joint and several basis. However, a subsidiary guarantor will be released from its obligations under its guarantee of the senior notes and the indentures governing the senior notes if, in general, there is a sale or other disposition of all or substantially all of the assets of such subsidiary guarantor, including by merger or consolidation, or a sale or other disposition of all of the equity interests in such subsidiary guarantor held by the Company and its restricted subsidiaries, as defined in the indentures; such subsidiary guarantor is designated by the Company as an unrestricted subsidiary, as defined in the indentures, or otherwise ceases to be a restricted subsidiary of the Company, in each case in accordance with the indentures; or such subsidiary guarantor no longer guarantees any other indebtedness, as defined in the indentures, of the Company or any of its restricted subsidiaries, except for guarantees that are contemporaneously released. The senior notes are not guaranteed by certain of the Company’s domestic subsidiaries, any of the Company’s foreign subsidiaries, or any entities that do not constitute subsidiaries within the meaning of the indentures, such as corporations in which the Company holds capital stock with less than a majority of the voting power, joint ventures and partnerships in which the Company holds less than a majority of the equity or voting interests, non-owned entities and third parties. Condensed Consolidating Statements of Operations DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended March 31, 2018 Patient services revenues $ — $ 1,790,188 $ 848,401 $ (47,515 ) $ 2,591,074 Provision for uncollectible accounts — 9,628 15,917 — 25,545 Net patient service revenues — 1,799,816 864,318 (47,515 ) 2,616,619 Other revenues 195,565 204,960 70,933 (238,633 ) 232,825 Total net revenues 195,565 2,004,776 935,251 (286,148 ) 2,849,444 Operating expenses and charges 133,356 1,791,094 800,456 (286,148 ) 2,438,758 Operating income 62,209 213,682 134,795 — 410,686 Debt expense (114,334 ) (52,197 ) (7,375 ) 60,390 (113,516 ) Other income, net 104,081 2,523 5,704 (107,726 ) 4,582 Income tax expense 14,387 48,944 7,406 — 70,737 Equity earnings in subsidiaries 141,117 66,496 — (207,613 ) — Net income from continuing operations 178,686 181,560 125,718 (254,949 ) 231,015 Net (loss) income from discontinued operations, net of — (40,443 ) (12,679 ) 47,336 (5,786 ) Net income 178,686 141,117 113,039 (207,613 ) 225,229 Less: Net income attributable to noncontrolling interests — — — (46,543 ) (46,543 ) Net income attributable to DaVita Inc. $ 178,686 $ 141,117 $ 113,039 $ (254,156 ) $ 178,686 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Patient service revenues $ — $ 1,530,726 $ 929,231 $ (37,171 ) $ 2,422,786 Provision for uncollectible accounts — (61,053 ) (46,005 ) — (107,058 ) Net patient service revenues — 1,469,673 883,226 (37,171 ) 2,315,728 Other revenues 221,386 305,618 16,090 (227,571 ) 315,523 Total net revenues 221,386 1,775,291 899,316 (264,742 ) 2,631,251 Operating expenses 131,910 1,208,820 679,335 (264,742 ) 1,755,323 Operating income 89,476 566,471 219,981 — 875,928 Debt expense (102,664 ) (47,643 ) (12,232 ) 58,142 (104,397 ) Other income 100,337 2,803 3,586 (102,740 ) 3,986 Income tax expense 33,953 235,865 11,847 — 281,665 Equity earnings in subsidiaries 394,501 162,615 — (557,116 ) — Net income from continuing operations 447,697 448,381 199,488 (601,714 ) 493,852 Net (loss) income from discontinued operations, net of — (53,880 ) 15,715 44,598 6,433 Net income 447,697 394,501 215,203 (557,116 ) 500,285 Less: Net income attributable to noncontrolling interests — — — (52,588 ) (52,588 ) Net income attributable to DaVita Inc. $ 447,697 $ 394,501 $ 215,203 $ (609,704 ) $ 447,697 Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2018 DaVita Inc. Net income $ 178,686 $ 141,117 $ 113,039 $ (207,613 ) $ 225,229 Other comprehensive income 2,587 — 19,881 — 22,468 Total comprehensive income 181,273 141,117 132,920 (207,613 ) 247,697 Less: Comprehensive income attributable to — — — (46,543 ) (46,543 ) Comprehensive income attributable to DaVita Inc. $ 181,273 $ 141,117 $ 132,920 $ (254,156 ) $ 201,154 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Net income $ 447,697 $ 394,501 $ 215,203 $ (557,116 ) $ 500,285 Other comprehensive income (506 ) — 13,261 — 12,755 Total comprehensive income 447,191 394,501 228,464 (557,116 ) 513,040 Less: Comprehensive income attributable to the — — — (52,586 ) (52,586 ) Comprehensive income attributable to DaVita Inc. $ 447,191 $ 394,501 $ 228,464 $ (609,702 ) $ 460,454 Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of March 31, 2018 DaVita Inc. Cash and cash equivalents $ 122,047 $ — $ 236,827 $ — $ 358,874 Restricted cash and equivalents 1,003 9,421 78,320 — 88,744 Accounts receivable, net — 1,257,461 573,129 — 1,830,590 Other current assets 35,555 368,131 267,396 — 671,082 Current assets held for sale — 5,004,717 719,548 — 5,724,265 Total current assets 158,605 6,639,730 1,875,220 — 8,673,555 Property and equipment, net 413,949 1,554,591 1,216,683 — 3,185,223 Intangible assets, net 224 50,396 62,746 — 113,366 Investments in subsidiaries 10,180,619 3,138,371 — (13,318,990 ) — Intercompany receivables 3,593,688 — 1,488,211 (5,081,899 ) — Other long-term assets and investments 54,952 58,467 218,217 — 331,636 Goodwill — 4,730,205 1,908,387 — 6,638,592 Total assets $ 14,402,037 $ 16,171,760 $ 6,769,464 $ (18,400,889 ) $ 18,942,372 Current liabilities $ 247,486 $ 968,018 $ 477,394 $ — $ 1,692,898 Current liabilities held for sale — 759,020 495,605 — 1,254,625 Intercompany payables — 3,589,494 1,492,405 (5,081,899 ) — Long-term debt and other long-term liabilities 8,984,265 674,609 519,393 — 10,178,267 Noncontrolling interests subject to put provisions 589,606 — — 444,895 1,034,501 Total DaVita Inc. shareholders' equity 4,580,680 10,180,619 3,138,371 (13,318,990 ) 4,580,680 Noncontrolling interests not subject to put — — 646,296 (444,895 ) 201,401 Total equity 4,580,680 10,180,619 3,784,667 (13,763,885 ) 4,782,081 Total liabilities and equity $ 14,402,037 $ 16,171,760 $ 6,769,464 $ (18,400,889 ) $ 18,942,372 Guarantor Non- Consolidating Consolidated As of December 31, 2017 DaVita Inc. Cash and cash equivalents $ 149,305 $ — $ 358,929 $ — $ 508,234 Restricted cash and equivalents 1,002 9,384 300 — 10,686 Accounts receivable, net — 1,208,715 506,035 — 1,714,750 Other current assets 67,025 595,066 86,955 — 749,046 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 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 Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2018 DaVita Inc. Cash flows from operating activities: Net income $ 178,686 $ 141,117 $ 113,039 $ (207,613 ) $ 225,229 Changes in operating assets and liabilities and non-cash (82,391 ) 32,484 (20,396 ) 207,613 137,310 Net cash provided by operating activities 96,295 173,601 92,643 — 362,539 Cash flows from investing activities: Additions of property and equipment (27,356 ) (125,375 ) (79,712 ) — (232,443 ) Acquisitions — (4,417 ) (12,165 ) — (16,582 ) Proceeds from asset and business sales — 18,535 — — 18,535 Proceeds (purchases) from investment sales and other 31,665 (762 ) (541 ) — 30,362 Net cash provided by (used in) investing activities 4,309 (112,019 ) (92,418 ) — (200,128 ) Cash flows from financing activities: Long-term debt and related financing costs, net 116,307 (3,377 ) (8,257 ) — 104,673 Intercompany borrowing (payments) 47,394 (49,783 ) 2,389 — — Other items (291,562 ) (2,200 ) (33,458 ) — (327,220 ) Net cash used in financing activities (127,861 ) (55,360 ) (39,326 ) — (222,547 ) Effect of exchange rate changes on cash, cash — — 6,668 — 6,668 Net (decrease) increase in cash, cash equivalents and (27,257 ) 6,222 (32,433 ) — (53,468 ) Less: Net increase in cash, cash equivalents and — 6,185 11,649 — 17,834 Net (decrease) increase in cash, cash equivalents and (27,257 ) 37 (44,082 ) — (71,302 ) Cash, cash equivalents and restricted cash of continuing 150,307 9,384 359,229 — 518,920 Cash, cash equivalents and restricted cash of continuing $ 123,050 $ 9,421 $ 315,147 $ — $ 447,618 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 447,697 $ 394,501 $ 215,203 $ (557,116 ) $ 500,285 Changes in operating assets and liabilities and non-cash (149,627 ) (142,597 ) 99,994 557,116 364,886 Net cash provided by operating activities 298,070 251,904 315,197 — 865,171 Cash flows from investing activities: Additions of property and equipment (30,580 ) (133,909 ) (50,046 ) — (214,535 ) Acquisitions — (70,237 ) (6,999 ) — (77,236 ) Proceeds from asset and business sales, net of cash — 46,612 — — 46,612 (Purchases) proceeds from investment sales and other (54,150 ) (1,951 ) 51,273 — (4,828 ) Net cash used in investing activities (84,730 ) (159,485 ) (5,772 ) — (249,987 ) Cash flows from financing activities: Long-term debt and related financing costs, net (27,504 ) (4,616 ) (4,021 ) — (36,141 ) Intercompany borrowing (payments) 338,984 (71,541 ) (267,443 ) — — Other items 3,330 (799 ) (25,327 ) — (22,796 ) Net cash used in financing activities 314,810 (76,956 ) (296,791 ) — (58,937 ) Effect of exchange rate changes on cash, cash — — 2,820 — 2,820 Net increase in cash, cash equivalents and restricted cash 528,150 15,463 15,454 — 559,067 Less: Net increase in cash, cash equivalents and — 15,438 9,055 — 24,493 Net increase in cash, cash equivalents and restricted cash 528,150 25 6,399 534,574 Cash, cash equivalents and restricted cash of continuing 549,921 8,687 124,855 — 683,463 Cash, cash equivalents and restricted cash of continuing $ 1,078,071 $ 8,712 $ 131,254 $ 1,218,037

Supplemental data

Supplemental data	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Supplemental data	Supplemental data The following information is presented as supplemental data as required by the indentures governing the Company’s senior notes. Condensed Consolidating Statements of Income Consolidated Total Physician Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2018 Patient service operating revenues $ 2,591,074 $ — $ — $ 2,591,074 Provision for uncollectible accounts 25,545 — — 25,545 Net patient service operating revenues 2,616,619 — — 2,616,619 Other revenues 232,825 — — 232,825 Total net operating revenues 2,849,444 — — 2,849,444 Operating expenses 2,438,758 — — 2,438,758 Operating income 410,686 — — 410,686 Debt expense, including refinancing charges (113,516 ) — — (113,516 ) Other income 4,582 — — 4,582 Income tax expense 70,737 — — 70,737 Net income from continuing operations 231,015 — — 231,015 Net (loss) income from discontinued operations, net of tax (5,786 ) 7,397 490 (13,673 ) Net income 225,229 7,397 490 217,342 Less: Net income attributable to noncontrolling interests (46,543 ) (6,543 ) — (40,000 ) Net income attributable to DaVita Inc. $ 178,686 $ 854 $ 490 $ 177,342 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2018 Net income $ 225,229 $ 7,397 $ 490 $ 217,342 Other comprehensive income 22,468 — — 22,468 Total comprehensive income 247,697 7,397 490 239,810 Less: Comprehensive income attributable to the noncontrolling (46,543 ) (6,543 ) — (40,000 ) Comprehensive income attributable to DaVita Inc. $ 201,154 $ 854 $ 490 $ 199,810 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of March 31, 2018 Cash and cash equivalents $ 358,874 $ — $ — $ 358,874 Restricted cash and equivalents 88,744 — — 88,744 Accounts receivable, net 1,830,590 — — 1,830,590 Other current assets 671,082 133,199 — 537,883 Current assets held for sale 5,724,265 319,968 3,223 5,401,074 Total current assets 8,673,555 453,167 3,223 8,217,165 Property and equipment, net 3,185,223 — — 3,185,223 Amortizable intangibles, net 113,366 — — 113,366 Other long-term assets 331,636 — — 331,636 Goodwill 6,638,592 — — 6,638,592 Total assets $ 18,942,372 $ 453,167 $ 3,223 $ 18,485,982 Current liabilities $ 1,692,898 $ — $ — $ 1,692,898 Current liabilities held for sale 1,254,625 328,493 — 926,132 Payables to parent — — 3,223 (3,223 ) Long-term debt and other long-term liabilities 10,178,267 — — 10,178,267 Noncontrolling interests subject to put provisions 1,034,501 — — 1,034,501 Total DaVita Inc. shareholders’ equity 4,580,680 124,674 — 4,456,006 Noncontrolling interests not subject to put provisions 201,401 — — 201,401 Shareholders’ equity 4,782,081 124,674 — 4,657,407 Total liabilities and shareholder’s equity $ 18,942,372 $ 453,167 $ 3,223 $ 18,485,982 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2018 Cash flows from operating activities: Net income $ 225,229 $ 7,397 $ 490 $ 217,342 Changes in operating and intercompany assets and liabilities and 137,310 (20,189 ) (490 ) 157,989 Net cash provided by (used in) operating activities 362,539 (12,792 ) — 375,331 Cash flows from investing activities: Additions of property and equipment (232,443 ) (1,165 ) — (231,278 ) Acquisitions (16,582 ) — — (16,582 ) Proceeds from asset and business sales 18,535 — — 18,535 Investments and other items 30,362 (541 ) — 30,903 Net cash used in investing activities (200,128 ) (1,706 ) — (198,422 ) Cash flows from financing activities: Long-term debt 104,673 — — 104,673 Intercompany — 1,082 — (1,082 ) Other items (327,220 ) — — (327,220 ) Net cash (used in) provided by financing activities (222,547 ) 1,082 — (223,629 ) Effect of exchange rate changes on cash, cash equivalents and 6,668 — — 6,668 Net decrease in cash, cash equivalents and restricted cash (53,468 ) (13,416 ) — (40,052 ) Less: Net increase (decrease) in cash, cash equivalents and 17,834 (13,416 ) — 31,250 Net decrease in cash, cash equivalents and restricted cash from (71,302 ) — — (71,302 ) Cash, cash equivalents and restricted cash of continuing operations 518,920 — — 518,920 Cash, cash equivalents and restricted cash of continuing operations $ 447,618 $ — $ — $ 447,618 (1) After elimination of the unrestricted subsidiaries and the physician groups.

Condensed consolidated interi31

Condensed consolidated interim financial statements (Policies)	3 Months Ended
	Mar. 31, 2018
Accounting Policies [Abstract]
Condensed consolidated interim financial statements	The condensed consolidated interim financial statements included in this report are prepared by the Company without audit. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these condensed consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and investments, accounting for income taxes, long-term variable compensation accruals, consolidation of variable interest entities and certain fair value estimates. The results of operations for the three months ended March 31, 2018 are not necessarily indicative of the operating results for the full year. The condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 . Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these condensed consolidated financial statements were issued and has included all necessary adjustments and disclosures.
Earnings per share	Basic earnings per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interests redemption rights in excess of fair value, by the weighted average number of common shares, 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.
Investments in debt and equity securities	From January 1, 2018, equity securities that have readily determinable fair values or redemption values are recorded at estimated fair value with changes in their value recognized in current earnings. The Company classifies its debt securities as held-to-maturity and records them at amortized cost based on its intentions and strategy concerning those investments. The Company classifies these debt and equity investments as "Short-term investments" or "Long-term investments" on its consolidated balance sheet, as applicable, based on the characteristics of the financial instrument or the Company's intentions or expectations for the investment.
Income taxes	The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense.
Long-term debt	the Company maintains several active and forward interest rate cap agreements that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt, as described below. The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the terms of the cap agreements. The cap agreements do not contain credit-risk contingent features.
Noncontrolling interests subject to put provisions and other commitments	The Company has potential obligations to purchase the 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.
Long-term incentive compensation	The Company’s stock-based compensation awards are measured at their estimated fair values on the date of grant if settled in shares or at their estimated fair values at the end of each reporting period if settled in cash. The value of stock-based awards so measured is recognized as compensation expense on a cumulative straight-line basis over the vesting terms of the awards, adjusted for expected forfeitures.
Comprehensive income	Net realized losses on interest rate cap agreements that are reclassified into income are recorded as debt expense in the corresponding consolidated statements of operations. See Note 9 to these condensed consolidated financial statements for further details. Net realized gains on investment securities reclassified into income for the three months ended March 31, 2017 were recognized in other income in the corresponding consolidated statements of operations. See Note 5 to these condensed consolidated financial statements for further details.
Variable interest entities	The Company relies on the operating activities of certain legal entities that it does not directly own or control, but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are subject to the consolidation guidance applicable to variable interest entities (VIEs). Under U.S. generally accepted accounting principles (GAAP), VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. The Company has determined that substantially all of the legal entities it is associated with that qualify as VIEs must be included in its consolidated financial statements. A number of these VIEs are within the Company's DMG business, which is classified as held for sale and as a discontinued operation in these condensed consolidated financial statements. The Company manages these entities and provides operating and capital funding as necessary for these entities to accomplish their operational and strategic objectives. A number of these entities are subject to nominee 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.
Fair value of financial instruments	Investments in mutual funds and common stock represent equity securities that are recorded at estimated fair value based upon quoted redemption prices reported by each mutual fund. See Note 5 to these condensed consolidated financial statements for further discussion. Interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 9 to these condensed consolidated financial statements for further discussion. The estimated fair value 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 the obligations to present value.
New accounting standards	On May 28, 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), 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, 2016 and 2017, the FASB issued ASU 2015-14, ASU 2016-08, ASU 2016-10, ASU 2016-11, ASU 2016-12, and ASU 2017-10, each of which amends the guidance in ASU 2014-09. These ASUs replaced most existing revenue recognition guidance in GAAP. The Company adopted these ASUs beginning January 1, 2018. See Note 2 for further details. 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 . In February 2018, the FASB issued ASU 2018-03, which provides various related technical corrections and improvements. The Company adopted these ASUs beginning January 1, 2018. See Note 5 for further details. 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 and evaluating 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 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. In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted cash. The amendments in this ASU require that the statement of cash flows explains the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted cash equivalents. The adoption of these ASUs did not 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 did not have a material impact on the Company’s consolidated financial statements when adopted on January 1, 2018. 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, 2019. In February 2018, the FASB issued ASU No. 2018-02, 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. The Company elected to early adopt this ASU on January 1, 2018 and applied the change in the period of adoption. The adoption of this ASU resulted in the reclassification of an immaterial amount of deferred tax effects from accumulated other comprehensive income to retained earnings via accumulative change in accounting principle effective January 1, 2018. See Note 14 for more details.

Revenue Recognition Segment rev

Revenue Recognition Segment revenue by major payor (Tables)	3 Months Ended
	Mar. 31, 2018
Revenues by major payor [Abstract]
Schedule of Revenue Sources, Health Care Organization [Table Text Block]	The following table summarizes the Company's segment revenues by primary payor source: For the three months ended March 31, 2018 March 31, 2017 (1) U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated U.S. dialysis and related lab services Other - Ancillary services and strategic initiatives Consolidated Patient service revenues: Medicare and Medicare Advantage $ 1,485,192 $ — $ 1,485,192 $ 1,272,595 $ — $ 1,272,595 Medicaid and Managed Medicaid 157,496 — 157,496 144,585 — 144,585 Other government 107,119 82,537 189,656 91,993 47,761 139,754 Commercial 782,979 19,718 802,697 756,710 13,883 770,593 Other revenues: Medicare and Medicare Advantage — 142,758 142,758 — 225,203 225,203 Medicaid and Managed Medicaid — 15,791 15,791 — 18,595 18,595 Commercial — 40,420 40,420 — 25,207 25,207 Other (2) 5,114 38,941 44,055 5,311 47,576 52,887 Eliminations of intersegment revenues (18,422 ) (10,199 ) (28,621 ) (11,799 ) (6,369 ) (18,168 ) Total $ 2,519,478 $ 329,966 $ 2,849,444 $ 2,259,395 $ 371,856 $ 2,631,251 (1) As noted above, prior period amounts have not been adjusted under the cumulative effect method. The Company's dialysis and related lab services revenues for the three months ended March 31, 2017 has been presented net of the provision for uncollectible accounts of $107,058 in this table to conform to the current period presentation. (2) Other consists of management fees and revenue from the Company's ancillary services and strategic initiatives.

Earnings per share (Tables)

Earnings per share (Tables)	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Earnings Per Share	The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows: Three months ended March 31, 2018 2017 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 191,015 $ 440,905 Net (loss) income from discontinued operations attributable to DaVita Inc. (12,329 ) 6,792 Net income attributable to DaVita Inc. for basic earnings per share calculation $ 178,686 $ 447,697 Basic: Weighted average shares outstanding during the period 181,152 194,571 Contingently returnable shares held in escrow for the DaVita HealthCare Partners merger (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 178,958 192,377 Basic net income from continuing operations per share attributable to DaVita Inc. $ 1.07 $ 2.29 Basic net (loss) income from discontinued operations per share attributable to DaVita Inc. (0.07 ) 0.04 Basic net income per share attributable to DaVita Inc. $ 1.00 $ 2.33 Diluted: Weighted average shares outstanding during the period 181,152 194,571 Assumed incremental shares from stock plans 683 710 Weighted average shares for diluted earnings per share calculation 181,835 195,281 Diluted net income from continuing operations per share attributable to DaVita Inc. $ 1.05 $ 2.26 Diluted net (loss) income from discontinued operations per share attributable to DaVita Inc. (0.07 ) 0.03 Diluted net income per share attributable to DaVita Inc. $ 0.98 $ 2.29 Anti-dilutive stock-settled awards excluded from calculation (1) 3,453 3,427 (1) Shares associated with stock-settled stock appreciation rights excluded from the diluted denominator calculation because they are antidilutive under the treasury stock method.

Investments in debt and equit34

Investments in debt and equity securities (Tables)	3 Months Ended
	Mar. 31, 2018
Investments, Debt and Equity Securities [Abstract]
Investments	The Company’s investments in these short-term and long-term debt and equity investments consist of the following: March 31, 2018 December 31, 2017 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 3,402 $ — $ 3,402 $ 31,630 $ — $ 31,630 Investments in mutual funds and common stock — 35,544 35,544 — 38,895 38,895 $ 3,402 $ 35,544 $ 38,946 $ 31,630 $ 38,895 $ 70,525 Short-term investments $ 3,402 $ 1,200 $ 4,602 $ 31,630 $ 1,200 $ 32,830 Long-term investments — 34,344 34,344 — 37,695 37,695 $ 3,402 $ 35,544 $ 38,946 $ 31,630 $ 38,895 $ 70,525

Goodwill (Tables)

Goodwill (Tables)	3 Months Ended
	Mar. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in Goodwill by Reportable Segments	Changes in goodwill by reportable segment were as follows: U.S. dialysis and related lab services Other-ancillary services and strategic initiatives Consolidated total Balance at January 1, 2017 $ 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 Acquisitions 2,137 13,905 16,042 Foreign currency and other adjustments — 12,271 12,271 Balance at March 31, 2018 $ 6,146,898 $ 491,694 $ 6,638,592 Balance at March 31, 2018: Goodwill $ 6,146,898 $ 562,214 $ 6,709,112 Accumulated impairment charges — (70,520 ) (70,520 ) $ 6,146,898 $ 491,694 $ 6,638,592
Schedule of Reporting Units Goodwill Balances	Goodwill balance Carrying (1) Sensitivities Reporting unit Operating (2) Discount (3) Kidney Care Germany $ 337,619 13.7 % (1.6 )% (11.1 )% Kidney Care Portugal $ 48,066 16.9 % (1.9 )% (6.0 )% Kidney Care Poland $ 47,669 11.8 % (1.9 )% (6.0 )% (1) Excess of estimated fair value of the reporting unit over its carrying amount as of the latest assessment date. (2) Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date. (3) Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date.

Long-term debt (Tables)

Long-term debt (Tables)	3 Months Ended
	Mar. 31, 2018
Debt Disclosure [Abstract]
Long-term Debt	Long-term debt was comprised of the following: March 31, 2018 December 31, 2017 Senior secured credit facilities: Term Loan A $ 750,000 $ 775,000 Term Loan A-2 452,000 — Term Loan B 3,368,750 3,377,500 Revolver — 300,000 Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 151,167 150,512 Capital lease obligations 304,062 297,170 Total debt principal outstanding 9,525,979 9,400,182 Discount and deferred financing costs (61,958 ) (63,951 ) 9,464,021 9,336,231 Less current portion (184,136 ) (178,213 ) $ 9,279,885 $ 9,158,018
Scheduled Maturities of Long-term Debt	Scheduled maturities of long-term debt at March 31, 2018 were as follows: 2018 (remainder of the year) 136,885 2019 1,206,668 2020 72,608 2021 3,307,539 2022 1,283,255 2023 32,340 Thereafter 3,486,684
Derivative Instruments	The following table summarizes the Company’s derivative instruments as of March 31, 2018 and December 31, 2017 : March 31, 2018 December 31, 2017 Derivatives designated as hedging instruments Balance sheet location Fair value Balance sheet location Fair value Interest rate cap agreements Other long-term assets $ 2,446 Other long-term assets $ 1,032
Effects of Interest Rate Swap and Cap Agreements	The following table summarizes the effects of the Company’s interest rate cap agreements for the three months ended March 31, 2018 and 2017 : Amount of unrecognized gains (losses) in OCI on interest rate cap agreements Location of losses reclassified from accumulated OCI into income Amount of losses reclassified from accumulated OCI into income Three months ended Three months ended Derivatives designated as cash flow hedges 2018 2017 2018 2017 Interest rate cap agreements $ 1,414 $ (5,217 ) Debt expense $ 2,070 $ 2,070 Tax (benefit) expense (364 ) 2,029 Tax expense (533 ) (805 ) Total $ 1,050 $ (3,188 ) $ 1,537 $ 1,265

Comprehensive income (Tables)

Comprehensive income (Tables)	3 Months Ended
	Mar. 31, 2018
Statement of Comprehensive Income [Abstract]
Comprehensive income	For the three months ended March 31, 2018 For the three months ended March 31, 2017 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Cumulative effect (1) (2,706 ) (5,662 ) — (8,368 ) — — — — Unrealized gains 1,414 — 19,881 21,295 (5,217 ) 2,113 13,261 10,157 Related income tax (expense) benefit (364 ) — — (364 ) 2,029 (554 ) — 1,475 1,050 — 19,881 20,931 (3,188 ) 1,559 13,261 11,632 Reclassification 2,070 — — 2,070 2,070 (229 ) — 1,841 Related income tax (expense) benefit (533 ) — — (533 ) (805 ) 89 — (716 ) 1,537 — — 1,537 1,265 (140 ) — 1,125 Ending balance $ (12,527 ) $ — $ 39,862 $ 27,335 $ (13,952 ) $ 3,594 $ (66,528 ) $ (76,886 )

Acquisitions and divestitures (

Acquisitions and divestitures (Tables)	3 Months Ended
	Mar. 31, 2018
Business Acquisition [Line Items]
Reconciliation of Changes in Contingent Earn-Out Obligations	The following is a reconciliation of changes in liabilities for contingent earn-out obligations: For the three months ended March 31, 2018 Beginning balance $ 6,388 Remeasurement of fair value for contingent earn-out obligations 174 Ending balance $ 6,562
Dialysis and other businesses
Business Acquisition [Line Items]
Assets Acquired and Liabilities Assumed in Business Acquisitions	The following table summarizes the assets acquired and liabilities assumed in these transactions at their estimated acquisition date fair values: Current assets $ 1,572 Property and equipment 1,643 Amortizable intangible and other long-term assets 2,563 Goodwill 16,042 Current liabilities (2,392 ) Noncontrolling interests (688 ) $ 18,740

Held for Sale and Discontinue39

Held for Sale and Discontinued Operations (Tables)	3 Months Ended
	Mar. 31, 2018
Discontinued Operations and Disposal Groups [Abstract]
Disposal Groups, Including Discontinued Operations [Table Text Block]	The following table presents the financial results of discontinued operations related to DMG: Three months ended March 31, 2018 2017 Revenues $ 1,227,932 $ 1,086,985 Expenses 1,226,407 1,074,452 Income from discontinued operations before taxes 1,525 12,533 Income tax expense 7,311 6,100 Net (loss) income from discontinued operations, net of tax $ (5,786 ) $ 6,433 The following table presents the financial position of discontinued operations related to DMG: March 31, 2018 December 31, 2017 Assets Cash and cash equivalents 192,399 179,668 Other current assets 768,388 826,608 Property and equipment, net 410,127 379,945 Intangible assets, net 1,316,462 1,316,550 Other long-term assets 155,385 178,894 Goodwill 2,881,504 2,879,977 Total current assets held for sale $ 5,724,265 $ 5,761,642 Liabilities Other liabilities 529,354 505,734 Medical payables 505,872 457,040 Current portion of long-term debt 2,735 2,845 Long-term debt 34,541 35,003 Other long-term liabilities 182,123 184,448 Total current liabilities held for sale $ 1,254,625 $ 1,185,070 The following table presents cash flows of discontinued operations related to DMG: March 31, 2018 March 31, 2017 Net cash provided by operating activities from discontinued operations 156,248 95,585 Net cash used in investing activities from discontinued operations (33,068 ) (41,686 )

Fair value of financial instr40

Fair value of financial instruments (Tables)	3 Months Ended
	Mar. 31, 2018
Fair Value Disclosures [Abstract]
Assets, Liabilities and Temporary Equity Measured at Fair Value on a Recurring Basis	The following table summarizes the Company’s assets, liabilities and temporary equity that are measured at fair value on a recurring basis as of March 31, 2018 : Total Quoted prices in Significant other Significant Assets Investments in mutual funds and common stock $ 35,544 $ 35,544 $ — $ — Interest rate cap agreements $ 2,446 $ — $ 2,446 $ — Liabilities Contingent earn-out obligations $ 6,562 $ — $ — $ 6,562 Temporary equity Noncontrolling interests subject to put provisions $ 1,034,501 $ — $ — $ 1,034,501

Segment reporting (Tables)

Segment reporting (Tables)	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes	The following is a summary of segment net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes: Three months ended March 31, 2018 2017 Segment net revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,489,165 $ 2,360,861 Intersegment revenues 18,422 11,799 U.S. dialysis and related lab services patient service revenues 2,507,587 2,372,660 Provision for uncollectible accounts 25,199 (106,777 ) Net U.S. dialysis and related lab services patient service revenues 2,532,786 2,265,883 Other revenues (1) 5,114 5,311 Total U.S. dialysis and related lab services revenues 2,537,900 2,271,194 Other—Ancillary services and strategic initiatives Patient service revenues 102,255 61,644 Other external sources 227,711 310,212 Intersegment revenues 10,199 6,369 Total ancillary services and strategic initiatives revenues 340,165 378,225 Total net segment revenues 2,878,065 2,649,419 Elimination of intersegment revenues (28,621 ) (18,168 ) Consolidated revenues $ 2,849,444 $ 2,631,251 Segment operating margin: U.S. dialysis and related lab services $ 433,380 $ 944,740 Other—Ancillary services and strategic initiatives (6,990 ) (58,220 ) Total segment operating margin 426,390 886,520 Reconciliation of segment operating margin to consolidated income before income taxes: Corporate administrative support (15,704 ) (10,592 ) Consolidated operating income 410,686 875,928 Debt expense (113,516 ) (104,397 ) Other income, net 4,582 3,986 Consolidated income before income taxes $ 301,752 $ 775,517 (1) Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment.
Summary of Depreciation and Amortization Expense by Reportable Segment	Depreciation and amortization expense by reportable segment was as follows: Three months ended March 31, 2018 2017 U.S. dialysis and related lab services $ 134,776 $ 125,029 Other — Ancillary services and strategic initiatives 8,023 7,855 $ 142,799 $ 132,884
Summary of Assets by Reportable Segment	Assets by reportable segment were as follows: March 31, 2018 December 31, 2017 Segment assets U.S. dialysis and related lab services (including equity $ 11,798,202 $ 11,776,042 Other—Ancillary services and strategic initiatives (including 1,419,905 1,410,509 DMG—Held for sale (including equity investments of $11,642 and 5,724,265 5,761,642 Consolidated assets $ 18,942,372 $ 18,948,193
Summary of Expenditures for Property and Equipment by Reportable Segment	Expenditures for property and equipment by reportable segment were as follows: Three months ended 2018 2017 U.S. dialysis and related lab services $ 189,049 $ 173,528 Other—Ancillary services and strategic initiatives 12,345 13,219 DMG—Held for sale 31,049 27,788 $ 232,443 $ 214,535

Changes in DaVita Inc.'s owne42

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries (Tables)	3 Months Ended
	Mar. 31, 2018
Noncontrolling Interest [Abstract]
Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity	The effects of changes in DaVita Inc.’s ownership interest in consolidated subsidiaries on the Company’s equity were as follows: Three months ended March 31, 2018 2017 Net income attributable to DaVita Inc. $ 178,686 $ 447,697 Changes in paid-in capital for: Sales of noncontrolling interests 76 — Purchases of noncontrolling interests (1,994 ) (423 ) Net transfers to noncontrolling interests (1,918 ) (423 ) Net income attributable to DaVita Inc., net of transfers to noncontrolling interests $ 176,768 $ 447,274

Condensed Consolidating finan43

Condensed Consolidating financial statements (Tables)	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Condensed Consolidating Statements of Operations	Condensed Consolidating Statements of Operations DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended March 31, 2018 Patient services revenues $ — $ 1,790,188 $ 848,401 $ (47,515 ) $ 2,591,074 Provision for uncollectible accounts — 9,628 15,917 — 25,545 Net patient service revenues — 1,799,816 864,318 (47,515 ) 2,616,619 Other revenues 195,565 204,960 70,933 (238,633 ) 232,825 Total net revenues 195,565 2,004,776 935,251 (286,148 ) 2,849,444 Operating expenses and charges 133,356 1,791,094 800,456 (286,148 ) 2,438,758 Operating income 62,209 213,682 134,795 — 410,686 Debt expense (114,334 ) (52,197 ) (7,375 ) 60,390 (113,516 ) Other income, net 104,081 2,523 5,704 (107,726 ) 4,582 Income tax expense 14,387 48,944 7,406 — 70,737 Equity earnings in subsidiaries 141,117 66,496 — (207,613 ) — Net income from continuing operations 178,686 181,560 125,718 (254,949 ) 231,015 Net (loss) income from discontinued operations, net of — (40,443 ) (12,679 ) 47,336 (5,786 ) Net income 178,686 141,117 113,039 (207,613 ) 225,229 Less: Net income attributable to noncontrolling interests — — — (46,543 ) (46,543 ) Net income attributable to DaVita Inc. $ 178,686 $ 141,117 $ 113,039 $ (254,156 ) $ 178,686 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Patient service revenues $ — $ 1,530,726 $ 929,231 $ (37,171 ) $ 2,422,786 Provision for uncollectible accounts — (61,053 ) (46,005 ) — (107,058 ) Net patient service revenues — 1,469,673 883,226 (37,171 ) 2,315,728 Other revenues 221,386 305,618 16,090 (227,571 ) 315,523 Total net revenues 221,386 1,775,291 899,316 (264,742 ) 2,631,251 Operating expenses 131,910 1,208,820 679,335 (264,742 ) 1,755,323 Operating income 89,476 566,471 219,981 — 875,928 Debt expense (102,664 ) (47,643 ) (12,232 ) 58,142 (104,397 ) Other income 100,337 2,803 3,586 (102,740 ) 3,986 Income tax expense 33,953 235,865 11,847 — 281,665 Equity earnings in subsidiaries 394,501 162,615 — (557,116 ) — Net income from continuing operations 447,697 448,381 199,488 (601,714 ) 493,852 Net (loss) income from discontinued operations, net of — (53,880 ) 15,715 44,598 6,433 Net income 447,697 394,501 215,203 (557,116 ) 500,285 Less: Net income attributable to noncontrolling interests — — — (52,588 ) (52,588 ) Net income attributable to DaVita Inc. $ 447,697 $ 394,501 $ 215,203 $ (609,704 ) $ 447,697 Condensed Consolidating Statements of Income Consolidated Total Physician Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2018 Patient service operating revenues $ 2,591,074 $ — $ — $ 2,591,074 Provision for uncollectible accounts 25,545 — — 25,545 Net patient service operating revenues 2,616,619 — — 2,616,619 Other revenues 232,825 — — 232,825 Total net operating revenues 2,849,444 — — 2,849,444 Operating expenses 2,438,758 — — 2,438,758 Operating income 410,686 — — 410,686 Debt expense, including refinancing charges (113,516 ) — — (113,516 ) Other income 4,582 — — 4,582 Income tax expense 70,737 — — 70,737 Net income from continuing operations 231,015 — — 231,015 Net (loss) income from discontinued operations, net of tax (5,786 ) 7,397 490 (13,673 ) Net income 225,229 7,397 490 217,342 Less: Net income attributable to noncontrolling interests (46,543 ) (6,543 ) — (40,000 ) Net income attributable to DaVita Inc. $ 178,686 $ 854 $ 490 $ 177,342 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Comprehensive Income	Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2018 DaVita Inc. Net income $ 178,686 $ 141,117 $ 113,039 $ (207,613 ) $ 225,229 Other comprehensive income 2,587 — 19,881 — 22,468 Total comprehensive income 181,273 141,117 132,920 (207,613 ) 247,697 Less: Comprehensive income attributable to — — — (46,543 ) (46,543 ) Comprehensive income attributable to DaVita Inc. $ 181,273 $ 141,117 $ 132,920 $ (254,156 ) $ 201,154 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Net income $ 447,697 $ 394,501 $ 215,203 $ (557,116 ) $ 500,285 Other comprehensive income (506 ) — 13,261 — 12,755 Total comprehensive income 447,191 394,501 228,464 (557,116 ) 513,040 Less: Comprehensive income attributable to the — — — (52,586 ) (52,586 ) Comprehensive income attributable to DaVita Inc. $ 447,191 $ 394,501 $ 228,464 $ (609,702 ) $ 460,454 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2018 Net income $ 225,229 $ 7,397 $ 490 $ 217,342 Other comprehensive income 22,468 — — 22,468 Total comprehensive income 247,697 7,397 490 239,810 Less: Comprehensive income attributable to the noncontrolling (46,543 ) (6,543 ) — (40,000 ) Comprehensive income attributable to DaVita Inc. $ 201,154 $ 854 $ 490 $ 199,810 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Balance Sheets	Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of March 31, 2018 DaVita Inc. Cash and cash equivalents $ 122,047 $ — $ 236,827 $ — $ 358,874 Restricted cash and equivalents 1,003 9,421 78,320 — 88,744 Accounts receivable, net — 1,257,461 573,129 — 1,830,590 Other current assets 35,555 368,131 267,396 — 671,082 Current assets held for sale — 5,004,717 719,548 — 5,724,265 Total current assets 158,605 6,639,730 1,875,220 — 8,673,555 Property and equipment, net 413,949 1,554,591 1,216,683 — 3,185,223 Intangible assets, net 224 50,396 62,746 — 113,366 Investments in subsidiaries 10,180,619 3,138,371 — (13,318,990 ) — Intercompany receivables 3,593,688 — 1,488,211 (5,081,899 ) — Other long-term assets and investments 54,952 58,467 218,217 — 331,636 Goodwill — 4,730,205 1,908,387 — 6,638,592 Total assets $ 14,402,037 $ 16,171,760 $ 6,769,464 $ (18,400,889 ) $ 18,942,372 Current liabilities $ 247,486 $ 968,018 $ 477,394 $ — $ 1,692,898 Current liabilities held for sale — 759,020 495,605 — 1,254,625 Intercompany payables — 3,589,494 1,492,405 (5,081,899 ) — Long-term debt and other long-term liabilities 8,984,265 674,609 519,393 — 10,178,267 Noncontrolling interests subject to put provisions 589,606 — — 444,895 1,034,501 Total DaVita Inc. shareholders' equity 4,580,680 10,180,619 3,138,371 (13,318,990 ) 4,580,680 Noncontrolling interests not subject to put — — 646,296 (444,895 ) 201,401 Total equity 4,580,680 10,180,619 3,784,667 (13,763,885 ) 4,782,081 Total liabilities and equity $ 14,402,037 $ 16,171,760 $ 6,769,464 $ (18,400,889 ) $ 18,942,372 Guarantor Non- Consolidating Consolidated As of December 31, 2017 DaVita Inc. Cash and cash equivalents $ 149,305 $ — $ 358,929 $ — $ 508,234 Restricted cash and equivalents 1,002 9,384 300 — 10,686 Accounts receivable, net — 1,208,715 506,035 — 1,714,750 Other current assets 67,025 595,066 86,955 — 749,046 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 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 March 31, 2018 Cash and cash equivalents $ 358,874 $ — $ — $ 358,874 Restricted cash and equivalents 88,744 — — 88,744 Accounts receivable, net 1,830,590 — — 1,830,590 Other current assets 671,082 133,199 — 537,883 Current assets held for sale 5,724,265 319,968 3,223 5,401,074 Total current assets 8,673,555 453,167 3,223 8,217,165 Property and equipment, net 3,185,223 — — 3,185,223 Amortizable intangibles, net 113,366 — — 113,366 Other long-term assets 331,636 — — 331,636 Goodwill 6,638,592 — — 6,638,592 Total assets $ 18,942,372 $ 453,167 $ 3,223 $ 18,485,982 Current liabilities $ 1,692,898 $ — $ — $ 1,692,898 Current liabilities held for sale 1,254,625 328,493 — 926,132 Payables to parent — — 3,223 (3,223 ) Long-term debt and other long-term liabilities 10,178,267 — — 10,178,267 Noncontrolling interests subject to put provisions 1,034,501 — — 1,034,501 Total DaVita Inc. shareholders’ equity 4,580,680 124,674 — 4,456,006 Noncontrolling interests not subject to put provisions 201,401 — — 201,401 Shareholders’ equity 4,782,081 124,674 — 4,657,407 Total liabilities and shareholder’s equity $ 18,942,372 $ 453,167 $ 3,223 $ 18,485,982 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Cash Flows	Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2018 DaVita Inc. Cash flows from operating activities: Net income $ 178,686 $ 141,117 $ 113,039 $ (207,613 ) $ 225,229 Changes in operating assets and liabilities and non-cash (82,391 ) 32,484 (20,396 ) 207,613 137,310 Net cash provided by operating activities 96,295 173,601 92,643 — 362,539 Cash flows from investing activities: Additions of property and equipment (27,356 ) (125,375 ) (79,712 ) — (232,443 ) Acquisitions — (4,417 ) (12,165 ) — (16,582 ) Proceeds from asset and business sales — 18,535 — — 18,535 Proceeds (purchases) from investment sales and other 31,665 (762 ) (541 ) — 30,362 Net cash provided by (used in) investing activities 4,309 (112,019 ) (92,418 ) — (200,128 ) Cash flows from financing activities: Long-term debt and related financing costs, net 116,307 (3,377 ) (8,257 ) — 104,673 Intercompany borrowing (payments) 47,394 (49,783 ) 2,389 — — Other items (291,562 ) (2,200 ) (33,458 ) — (327,220 ) Net cash used in financing activities (127,861 ) (55,360 ) (39,326 ) — (222,547 ) Effect of exchange rate changes on cash, cash — — 6,668 — 6,668 Net (decrease) increase in cash, cash equivalents and (27,257 ) 6,222 (32,433 ) — (53,468 ) Less: Net increase in cash, cash equivalents and — 6,185 11,649 — 17,834 Net (decrease) increase in cash, cash equivalents and (27,257 ) 37 (44,082 ) — (71,302 ) Cash, cash equivalents and restricted cash of continuing 150,307 9,384 359,229 — 518,920 Cash, cash equivalents and restricted cash of continuing $ 123,050 $ 9,421 $ 315,147 $ — $ 447,618 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 447,697 $ 394,501 $ 215,203 $ (557,116 ) $ 500,285 Changes in operating assets and liabilities and non-cash (149,627 ) (142,597 ) 99,994 557,116 364,886 Net cash provided by operating activities 298,070 251,904 315,197 — 865,171 Cash flows from investing activities: Additions of property and equipment (30,580 ) (133,909 ) (50,046 ) — (214,535 ) Acquisitions — (70,237 ) (6,999 ) — (77,236 ) Proceeds from asset and business sales, net of cash — 46,612 — — 46,612 (Purchases) proceeds from investment sales and other (54,150 ) (1,951 ) 51,273 — (4,828 ) Net cash used in investing activities (84,730 ) (159,485 ) (5,772 ) — (249,987 ) Cash flows from financing activities: Long-term debt and related financing costs, net (27,504 ) (4,616 ) (4,021 ) — (36,141 ) Intercompany borrowing (payments) 338,984 (71,541 ) (267,443 ) — — Other items 3,330 (799 ) (25,327 ) — (22,796 ) Net cash used in financing activities 314,810 (76,956 ) (296,791 ) — (58,937 ) Effect of exchange rate changes on cash, cash — — 2,820 — 2,820 Net increase in cash, cash equivalents and restricted cash 528,150 15,463 15,454 — 559,067 Less: Net increase in cash, cash equivalents and — 15,438 9,055 — 24,493 Net increase in cash, cash equivalents and restricted cash 528,150 25 6,399 534,574 Cash, cash equivalents and restricted cash of continuing 549,921 8,687 124,855 — 683,463 Cash, cash equivalents and restricted cash of continuing $ 1,078,071 $ 8,712 $ 131,254 $ 1,218,037 Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2018 Cash flows from operating activities: Net income $ 225,229 $ 7,397 $ 490 $ 217,342 Changes in operating and intercompany assets and liabilities and 137,310 (20,189 ) (490 ) 157,989 Net cash provided by (used in) operating activities 362,539 (12,792 ) — 375,331 Cash flows from investing activities: Additions of property and equipment (232,443 ) (1,165 ) — (231,278 ) Acquisitions (16,582 ) — — (16,582 ) Proceeds from asset and business sales 18,535 — — 18,535 Investments and other items 30,362 (541 ) — 30,903 Net cash used in investing activities (200,128 ) (1,706 ) — (198,422 ) Cash flows from financing activities: Long-term debt 104,673 — — 104,673 Intercompany — 1,082 — (1,082 ) Other items (327,220 ) — — (327,220 ) Net cash (used in) provided by financing activities (222,547 ) 1,082 — (223,629 ) Effect of exchange rate changes on cash, cash equivalents and 6,668 — — 6,668 Net decrease in cash, cash equivalents and restricted cash (53,468 ) (13,416 ) — (40,052 ) Less: Net increase (decrease) in cash, cash equivalents and 17,834 (13,416 ) — 31,250 Net decrease in cash, cash equivalents and restricted cash from (71,302 ) — — (71,302 ) Cash, cash equivalents and restricted cash of continuing operations 518,920 — — 518,920 Cash, cash equivalents and restricted cash of continuing operations $ 447,618 $ — $ — $ 447,618 (1) After elimination of the unrestricted subsidiaries and the physician groups.

Supplemental Data (Tables)

Supplemental Data (Tables)	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Condensed Consolidating Statements of Operations	Condensed Consolidating Statements of Operations DaVita Inc. Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended March 31, 2018 Patient services revenues $ — $ 1,790,188 $ 848,401 $ (47,515 ) $ 2,591,074 Provision for uncollectible accounts — 9,628 15,917 — 25,545 Net patient service revenues — 1,799,816 864,318 (47,515 ) 2,616,619 Other revenues 195,565 204,960 70,933 (238,633 ) 232,825 Total net revenues 195,565 2,004,776 935,251 (286,148 ) 2,849,444 Operating expenses and charges 133,356 1,791,094 800,456 (286,148 ) 2,438,758 Operating income 62,209 213,682 134,795 — 410,686 Debt expense (114,334 ) (52,197 ) (7,375 ) 60,390 (113,516 ) Other income, net 104,081 2,523 5,704 (107,726 ) 4,582 Income tax expense 14,387 48,944 7,406 — 70,737 Equity earnings in subsidiaries 141,117 66,496 — (207,613 ) — Net income from continuing operations 178,686 181,560 125,718 (254,949 ) 231,015 Net (loss) income from discontinued operations, net of — (40,443 ) (12,679 ) 47,336 (5,786 ) Net income 178,686 141,117 113,039 (207,613 ) 225,229 Less: Net income attributable to noncontrolling interests — — — (46,543 ) (46,543 ) Net income attributable to DaVita Inc. $ 178,686 $ 141,117 $ 113,039 $ (254,156 ) $ 178,686 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Patient service revenues $ — $ 1,530,726 $ 929,231 $ (37,171 ) $ 2,422,786 Provision for uncollectible accounts — (61,053 ) (46,005 ) — (107,058 ) Net patient service revenues — 1,469,673 883,226 (37,171 ) 2,315,728 Other revenues 221,386 305,618 16,090 (227,571 ) 315,523 Total net revenues 221,386 1,775,291 899,316 (264,742 ) 2,631,251 Operating expenses 131,910 1,208,820 679,335 (264,742 ) 1,755,323 Operating income 89,476 566,471 219,981 — 875,928 Debt expense (102,664 ) (47,643 ) (12,232 ) 58,142 (104,397 ) Other income 100,337 2,803 3,586 (102,740 ) 3,986 Income tax expense 33,953 235,865 11,847 — 281,665 Equity earnings in subsidiaries 394,501 162,615 — (557,116 ) — Net income from continuing operations 447,697 448,381 199,488 (601,714 ) 493,852 Net (loss) income from discontinued operations, net of — (53,880 ) 15,715 44,598 6,433 Net income 447,697 394,501 215,203 (557,116 ) 500,285 Less: Net income attributable to noncontrolling interests — — — (52,588 ) (52,588 ) Net income attributable to DaVita Inc. $ 447,697 $ 394,501 $ 215,203 $ (609,704 ) $ 447,697 Condensed Consolidating Statements of Income Consolidated Total Physician Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2018 Patient service operating revenues $ 2,591,074 $ — $ — $ 2,591,074 Provision for uncollectible accounts 25,545 — — 25,545 Net patient service operating revenues 2,616,619 — — 2,616,619 Other revenues 232,825 — — 232,825 Total net operating revenues 2,849,444 — — 2,849,444 Operating expenses 2,438,758 — — 2,438,758 Operating income 410,686 — — 410,686 Debt expense, including refinancing charges (113,516 ) — — (113,516 ) Other income 4,582 — — 4,582 Income tax expense 70,737 — — 70,737 Net income from continuing operations 231,015 — — 231,015 Net (loss) income from discontinued operations, net of tax (5,786 ) 7,397 490 (13,673 ) Net income 225,229 7,397 490 217,342 Less: Net income attributable to noncontrolling interests (46,543 ) (6,543 ) — (40,000 ) Net income attributable to DaVita Inc. $ 178,686 $ 854 $ 490 $ 177,342 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Comprehensive Income	Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2018 DaVita Inc. Net income $ 178,686 $ 141,117 $ 113,039 $ (207,613 ) $ 225,229 Other comprehensive income 2,587 — 19,881 — 22,468 Total comprehensive income 181,273 141,117 132,920 (207,613 ) 247,697 Less: Comprehensive income attributable to — — — (46,543 ) (46,543 ) Comprehensive income attributable to DaVita Inc. $ 181,273 $ 141,117 $ 132,920 $ (254,156 ) $ 201,154 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Net income $ 447,697 $ 394,501 $ 215,203 $ (557,116 ) $ 500,285 Other comprehensive income (506 ) — 13,261 — 12,755 Total comprehensive income 447,191 394,501 228,464 (557,116 ) 513,040 Less: Comprehensive income attributable to the — — — (52,586 ) (52,586 ) Comprehensive income attributable to DaVita Inc. $ 447,191 $ 394,501 $ 228,464 $ (609,702 ) $ 460,454 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2018 Net income $ 225,229 $ 7,397 $ 490 $ 217,342 Other comprehensive income 22,468 — — 22,468 Total comprehensive income 247,697 7,397 490 239,810 Less: Comprehensive income attributable to the noncontrolling (46,543 ) (6,543 ) — (40,000 ) Comprehensive income attributable to DaVita Inc. $ 201,154 $ 854 $ 490 $ 199,810 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Balance Sheets	Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of March 31, 2018 DaVita Inc. Cash and cash equivalents $ 122,047 $ — $ 236,827 $ — $ 358,874 Restricted cash and equivalents 1,003 9,421 78,320 — 88,744 Accounts receivable, net — 1,257,461 573,129 — 1,830,590 Other current assets 35,555 368,131 267,396 — 671,082 Current assets held for sale — 5,004,717 719,548 — 5,724,265 Total current assets 158,605 6,639,730 1,875,220 — 8,673,555 Property and equipment, net 413,949 1,554,591 1,216,683 — 3,185,223 Intangible assets, net 224 50,396 62,746 — 113,366 Investments in subsidiaries 10,180,619 3,138,371 — (13,318,990 ) — Intercompany receivables 3,593,688 — 1,488,211 (5,081,899 ) — Other long-term assets and investments 54,952 58,467 218,217 — 331,636 Goodwill — 4,730,205 1,908,387 — 6,638,592 Total assets $ 14,402,037 $ 16,171,760 $ 6,769,464 $ (18,400,889 ) $ 18,942,372 Current liabilities $ 247,486 $ 968,018 $ 477,394 $ — $ 1,692,898 Current liabilities held for sale — 759,020 495,605 — 1,254,625 Intercompany payables — 3,589,494 1,492,405 (5,081,899 ) — Long-term debt and other long-term liabilities 8,984,265 674,609 519,393 — 10,178,267 Noncontrolling interests subject to put provisions 589,606 — — 444,895 1,034,501 Total DaVita Inc. shareholders' equity 4,580,680 10,180,619 3,138,371 (13,318,990 ) 4,580,680 Noncontrolling interests not subject to put — — 646,296 (444,895 ) 201,401 Total equity 4,580,680 10,180,619 3,784,667 (13,763,885 ) 4,782,081 Total liabilities and equity $ 14,402,037 $ 16,171,760 $ 6,769,464 $ (18,400,889 ) $ 18,942,372 Guarantor Non- Consolidating Consolidated As of December 31, 2017 DaVita Inc. Cash and cash equivalents $ 149,305 $ — $ 358,929 $ — $ 508,234 Restricted cash and equivalents 1,002 9,384 300 — 10,686 Accounts receivable, net — 1,208,715 506,035 — 1,714,750 Other current assets 67,025 595,066 86,955 — 749,046 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 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 March 31, 2018 Cash and cash equivalents $ 358,874 $ — $ — $ 358,874 Restricted cash and equivalents 88,744 — — 88,744 Accounts receivable, net 1,830,590 — — 1,830,590 Other current assets 671,082 133,199 — 537,883 Current assets held for sale 5,724,265 319,968 3,223 5,401,074 Total current assets 8,673,555 453,167 3,223 8,217,165 Property and equipment, net 3,185,223 — — 3,185,223 Amortizable intangibles, net 113,366 — — 113,366 Other long-term assets 331,636 — — 331,636 Goodwill 6,638,592 — — 6,638,592 Total assets $ 18,942,372 $ 453,167 $ 3,223 $ 18,485,982 Current liabilities $ 1,692,898 $ — $ — $ 1,692,898 Current liabilities held for sale 1,254,625 328,493 — 926,132 Payables to parent — — 3,223 (3,223 ) Long-term debt and other long-term liabilities 10,178,267 — — 10,178,267 Noncontrolling interests subject to put provisions 1,034,501 — — 1,034,501 Total DaVita Inc. shareholders’ equity 4,580,680 124,674 — 4,456,006 Noncontrolling interests not subject to put provisions 201,401 — — 201,401 Shareholders’ equity 4,782,081 124,674 — 4,657,407 Total liabilities and shareholder’s equity $ 18,942,372 $ 453,167 $ 3,223 $ 18,485,982 (1) After elimination of the unrestricted subsidiaries and the physician groups.
Condensed Consolidating Statements of Cash Flows	Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2018 DaVita Inc. Cash flows from operating activities: Net income $ 178,686 $ 141,117 $ 113,039 $ (207,613 ) $ 225,229 Changes in operating assets and liabilities and non-cash (82,391 ) 32,484 (20,396 ) 207,613 137,310 Net cash provided by operating activities 96,295 173,601 92,643 — 362,539 Cash flows from investing activities: Additions of property and equipment (27,356 ) (125,375 ) (79,712 ) — (232,443 ) Acquisitions — (4,417 ) (12,165 ) — (16,582 ) Proceeds from asset and business sales — 18,535 — — 18,535 Proceeds (purchases) from investment sales and other 31,665 (762 ) (541 ) — 30,362 Net cash provided by (used in) investing activities 4,309 (112,019 ) (92,418 ) — (200,128 ) Cash flows from financing activities: Long-term debt and related financing costs, net 116,307 (3,377 ) (8,257 ) — 104,673 Intercompany borrowing (payments) 47,394 (49,783 ) 2,389 — — Other items (291,562 ) (2,200 ) (33,458 ) — (327,220 ) Net cash used in financing activities (127,861 ) (55,360 ) (39,326 ) — (222,547 ) Effect of exchange rate changes on cash, cash — — 6,668 — 6,668 Net (decrease) increase in cash, cash equivalents and (27,257 ) 6,222 (32,433 ) — (53,468 ) Less: Net increase in cash, cash equivalents and — 6,185 11,649 — 17,834 Net (decrease) increase in cash, cash equivalents and (27,257 ) 37 (44,082 ) — (71,302 ) Cash, cash equivalents and restricted cash of continuing 150,307 9,384 359,229 — 518,920 Cash, cash equivalents and restricted cash of continuing $ 123,050 $ 9,421 $ 315,147 $ — $ 447,618 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 447,697 $ 394,501 $ 215,203 $ (557,116 ) $ 500,285 Changes in operating assets and liabilities and non-cash (149,627 ) (142,597 ) 99,994 557,116 364,886 Net cash provided by operating activities 298,070 251,904 315,197 — 865,171 Cash flows from investing activities: Additions of property and equipment (30,580 ) (133,909 ) (50,046 ) — (214,535 ) Acquisitions — (70,237 ) (6,999 ) — (77,236 ) Proceeds from asset and business sales, net of cash — 46,612 — — 46,612 (Purchases) proceeds from investment sales and other (54,150 ) (1,951 ) 51,273 — (4,828 ) Net cash used in investing activities (84,730 ) (159,485 ) (5,772 ) — (249,987 ) Cash flows from financing activities: Long-term debt and related financing costs, net (27,504 ) (4,616 ) (4,021 ) — (36,141 ) Intercompany borrowing (payments) 338,984 (71,541 ) (267,443 ) — — Other items 3,330 (799 ) (25,327 ) — (22,796 ) Net cash used in financing activities 314,810 (76,956 ) (296,791 ) — (58,937 ) Effect of exchange rate changes on cash, cash — — 2,820 — 2,820 Net increase in cash, cash equivalents and restricted cash 528,150 15,463 15,454 — 559,067 Less: Net increase in cash, cash equivalents and — 15,438 9,055 — 24,493 Net increase in cash, cash equivalents and restricted cash 528,150 25 6,399 534,574 Cash, cash equivalents and restricted cash of continuing 549,921 8,687 124,855 — 683,463 Cash, cash equivalents and restricted cash of continuing $ 1,078,071 $ 8,712 $ 131,254 $ 1,218,037 Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2018 Cash flows from operating activities: Net income $ 225,229 $ 7,397 $ 490 $ 217,342 Changes in operating and intercompany assets and liabilities and 137,310 (20,189 ) (490 ) 157,989 Net cash provided by (used in) operating activities 362,539 (12,792 ) — 375,331 Cash flows from investing activities: Additions of property and equipment (232,443 ) (1,165 ) — (231,278 ) Acquisitions (16,582 ) — — (16,582 ) Proceeds from asset and business sales 18,535 — — 18,535 Investments and other items 30,362 (541 ) — 30,903 Net cash used in investing activities (200,128 ) (1,706 ) — (198,422 ) Cash flows from financing activities: Long-term debt 104,673 — — 104,673 Intercompany — 1,082 — (1,082 ) Other items (327,220 ) — — (327,220 ) Net cash (used in) provided by financing activities (222,547 ) 1,082 — (223,629 ) Effect of exchange rate changes on cash, cash equivalents and 6,668 — — 6,668 Net decrease in cash, cash equivalents and restricted cash (53,468 ) (13,416 ) — (40,052 ) Less: Net increase (decrease) in cash, cash equivalents and 17,834 (13,416 ) — 31,250 Net decrease in cash, cash equivalents and restricted cash from (71,302 ) — — (71,302 ) Cash, cash equivalents and restricted cash of continuing operations 518,920 — — 518,920 Cash, cash equivalents and restricted cash of continuing operations $ 447,618 $ — $ — $ 447,618 (1) After elimination of the unrestricted subsidiaries and the physician groups.

Revenue Recognition Revenue R45

Revenue Recognition Revenue Recognition (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Allowance for Doubtful Accounts Receivable	$ 162,516		$ 218,399
Contract with Customer, Performance Obligation Satisfied in Previous Period	67,410
Provision for uncollectible accounts	(25,545)	$ 107,058
Difference between Revenue Guidance in Effect before and after Topic 606 [Member]
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Contract with Customer, Performance Obligation Satisfied in Previous Period	$ 24,000
Medicare
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Percent of revenue paid by a payor	80.00%

Revenue Recognition Segment R46

Revenue Recognition Segment Revenue by Payor (Details) - USD ($)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	$ 2,591,074,000	$ 2,422,786,000
Other revenues	232,825,000	315,523,000
Health Care Organization, Revenue	2,849,444,000	2,631,251,000
Intersegment Elimination
Disaggregation of Revenue [Line Items]
Other revenues	(28,621,000)	(18,168,000)
Health Care Organization, Revenue	(28,621,000)	(18,168,000)
Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	1,485,192,000	1,272,595,000
Other revenues	142,758,000	225,203,000
Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	157,496,000	144,585,000
Other revenues	15,791,000	18,595,000
Other Government Payors
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	189,656,000	139,754,000
Commercial Payors
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	802,697,000	770,593,000
Other revenues	40,420,000	25,207,000
Other
Disaggregation of Revenue [Line Items]
Other revenues	44,055,000	52,887,000
U.S. dialysis and related lab services
Disaggregation of Revenue [Line Items]
Health Care Organization, Revenue	2,519,478,000	2,259,395,000
U.S. dialysis and related lab services | Intersegment Elimination
Disaggregation of Revenue [Line Items]
Other revenues	(18,422,000)	(11,799,000)
U.S. dialysis and related lab services | Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	1,485,192,000	1,272,595,000
Other revenues	0	0
U.S. dialysis and related lab services | Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	157,496,000	144,585,000
Other revenues	0	0
U.S. dialysis and related lab services | Other Government Payors
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	107,119,000	91,993,000
U.S. dialysis and related lab services | Commercial Payors
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	782,979,000	756,710,000
Other revenues	0	0
U.S. dialysis and related lab services | Other
Disaggregation of Revenue [Line Items]
Other revenues	5,114,000	5,311,000
Other—Ancillary services and strategic initiatives
Disaggregation of Revenue [Line Items]
Health Care Organization, Revenue	329,966,000	371,856,000
Other—Ancillary services and strategic initiatives | Intersegment Elimination
Disaggregation of Revenue [Line Items]
Other revenues	(10,199,000)	(6,369,000)
Other—Ancillary services and strategic initiatives | Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	0	0
Other revenues	142,758,000	225,203,000
Other—Ancillary services and strategic initiatives | Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	0	0
Other revenues	15,791,000	18,595,000
Other—Ancillary services and strategic initiatives | Other Government Payors
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	82,537,000	47,761,000
Other—Ancillary services and strategic initiatives | Commercial Payors
Disaggregation of Revenue [Line Items]
Dialysis and related lab patient service revenues	19,718,000	13,883,000
Other revenues	40,420,000	25,207,000
Other—Ancillary services and strategic initiatives | Other
Disaggregation of Revenue [Line Items]
Other revenues	$ 38,941,000	$ 47,576,000

Earnings per share - Reconcilia

Earnings per share - Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Earnings Per Share [Abstract]
Net income from continuing operations	$ 191,015	$ 440,905
Net (loss) income from discontinued operations	(12,329)	6,792
Net income attributable to DaVita Inc.	$ 178,686	$ 447,697
Numerators:
Weighted Average Number of Shares Issued, Basic	181,152,000	194,571,000
Contingently returnable shares held in escrow from the DaVita HealthCare Partners merger (in shares)	(2,194,000)	(2,194,000)
Weighted average shares for basic earnings per share calculation (in shares)	178,957,865	192,376,735
Basic net income from continuing operations per share attributable to DaVita Inc.	$ 1.07	$ 2.29
Income (Loss) from Discontinued Operations and Disposal of Discontinued Operations, Net of Tax, Per Basic Share	(0.07)	0.04
Basic net (loss) income per share attributable to DaVita Inc. (usd per share)	$ 1	$ 2.33
Contingently returnable shares held in escrow for the DaVita HealthCare Partners merger
Weighted Average Number of Shares Issued, Basic	181,152,000	194,571,000
Assumed incremental shares from stock plans (in shares)	683,000	710,000
Weighted average shares for diluted earnings per share calculation (in shares)	181,834,547	195,281,014
Diluted net income from continuing operations per share attributable to DaVita Inc.	$ 1.05	$ 2.26
Discontinued Operation, Income (Loss) from Discontinued Operation, Net of Tax, Per Diluted Share	(0.07)	0.03
Diluted net (loss) income per share attributable to DaVita Inc. (usd per share)	$ 0.98	$ 2.29
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	3,453,000	3,427,000

Restricted Cash (Details)

Restricted Cash (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Restricted Cash [Abstract]
Restricted cash and equivalents	$ 88,744	$ 10,686
Assets Held-in-trust, Current	$ 78,320

Investments in debt and equit49

Investments in debt and equity securities (Detail) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Investment Holdings [Line Items]
Held to maturity	$ 3,402	$ 31,630
Available for sale	35,544	38,895
Total	38,946	70,525
Held to maturity, short-term investments	3,402	31,630
Available for sale, short-term investments	1,200	1,200
Total, short-term investments	4,602	32,830
Held to maturity, long-term investments	0	0
Available for sale, long-term investments	34,344	37,695
Total, long-term investments	34,344	37,695
Certificates of deposit and other time deposits
Investment Holdings [Line Items]
Held to maturity	3,402	31,630
Available for sale, equity securities	0	0
Total	3,402	31,630
Investments in mutual funds and common stock
Investment Holdings [Line Items]
Held to maturity	0	0
Available for sale, equity securities	35,544	38,895
Total	$ 35,544	$ 38,895

Investments in debt and equit50

Investments in debt and equity securities - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Jan. 01, 2018	Jan. 01, 2017
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Equity securities realized gain loss before tax	$ 3,746
Equity securities investments gross pre-tax unrealized gain (loss)	3,660
Pre tax reclassification of net investment realized gain (loss) into net income		$ 229
Reclassification of net investment realized gain (loss) into net income, net tax		$ 140
Certificates of deposit and other time deposits
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Income (Loss), Unrealized Holding Gain (Loss) on Securities Arising During Period, before Tax	$ 86
Investment securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Cumulative Effect of New Accounting Principle in Period of Adoption			$ (5,662)	$ 0

Equity method and other inves51

Equity method and other investments - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2018	Dec. 31, 2017	Mar. 31, 2017
Noncontrolling Interest [Line Items]
Equity investments in nonconsolidated businesses	$ 245,564,000	$ 245,534,000
Equity investment income	155,000		$ 677,000
Equity Method Investment, Other than Temporary Impairment	0
Cost method total carrying amount of equity investments	$ 5,386,000
Parent Company And Restricted Subsidiaries
Noncontrolling Interest [Line Items]
Voting interest (in percent)	60.00%
Current economic interest in DaVita Care Pte. Ltd.	73.30%
Deconsolidated Noncontrolling Entity
Noncontrolling Interest [Line Items]
Equity investments in nonconsolidated businesses	$ 160,535,000	160,481,000
Equity Method Investment, Other than Temporary Impairment		$ 280,066,000
Voting interest (in percent)	40.00%
Current economic interest in APAC JV	26.70%

Goodwill - Changes in Goodwill

Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017	Mar. 31, 2018
Goodwill [Roll Forward]
Beginning balance	$ 6,610,279,000	$ 6,015,375,000	$ 6,015,375,000
Acquisitions	16,042,000		617,032,000
Divestitures			(32,386,000)
Goodwill impairment charges	0	(24,198,000)	(36,196,000)
Foreign currency and other adjustments	12,271,000		46,454,000
Ending balance	6,638,592,000		6,610,279,000
Goodwill				$ 6,709,112,000
Accumulated impairment charges				(70,520,000)
Total goodwill by reportable segments	6,610,279,000	6,015,375,000	6,015,375,000	6,638,592,000
U.S. dialysis and related lab services
Goodwill [Roll Forward]
Beginning balance	6,144,761,000	5,691,587,000	5,691,587,000
Acquisitions	2,137,000		485,434,000
Divestitures			(32,260,000)
Goodwill impairment charges			0
Foreign currency and other adjustments	0		0
Ending balance	6,146,898,000		6,144,761,000
Goodwill				6,146,898,000
Accumulated impairment charges				0
Total goodwill by reportable segments	6,144,761,000	5,691,587,000	5,691,587,000	6,146,898,000
Other—Ancillary services and strategic initiatives
Goodwill [Roll Forward]
Beginning balance	465,518,000	323,788,000	323,788,000
Acquisitions	13,905,000		131,598,000
Divestitures			(126,000)
Goodwill impairment charges			(36,196,000)
Foreign currency and other adjustments	12,271,000		46,454,000
Ending balance	491,694,000		465,518,000
Goodwill				562,214,000
Accumulated impairment charges				(70,520,000)
Total goodwill by reportable segments	$ 465,518,000	$ 323,788,000	$ 323,788,000	$ 491,694,000

Goodwill - Narrative (Details)

Goodwill - Narrative (Details) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Goodwill [Line Items]
Goodwill impairment charges	$ 0	$ 24,198,000	$ 36,196,000
Vascular Access Clinic
Goodwill [Line Items]
Goodwill impairment charges		$ 24,198,000

Goodwill - Schedule of Reportin

Goodwill - Schedule of Reporting Units Goodwill Balances (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Line Items]
Goodwill	$ 6,638,592	$ 6,610,279	$ 6,015,375
Percentage Change In Operating Income Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment	3.00%
Percentage Change In Discount Rate Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment	1.00%
GERMANY
Goodwill [Line Items]
Goodwill	$ 337,619
Carrying amount coverage	13.70%
Sensitivities, operating income	(1.60%)
Sensitivities, discount rate	(11.10%)
PORTUGAL
Goodwill [Line Items]
Goodwill	$ 48,066
Carrying amount coverage	16.90%
Sensitivities, operating income	(1.90%)
Sensitivities, discount rate	(6.00%)
POLAND
Goodwill [Line Items]
Goodwill	$ 47,669
Carrying amount coverage	11.80%
Sensitivities, operating income	(1.90%)
Sensitivities, discount rate	(6.00%)

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Liability for unrecognized tax benefits	$ 33,880	$ 32,776
Increase in liability for unrecognized tax benefits	1,104
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits	$ 3,971	$ 4,195

Long-term debt (Detail)

Long-term debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Senior notes	$ 4,500,000	$ 4,500,000
Acquisition obligations and other notes payable	151,167	150,512
Capital lease obligations	304,062	297,170
Total debt principal outstanding	9,525,979	9,400,182
Discount and deferred financing costs	(61,958)	(63,951)
Total amount of long-term debt	9,464,021	9,336,231
Less current portion	(184,136)	(178,213)
Long-term debt	9,279,885	9,158,018
Term Loan A
Debt Instrument [Line Items]
Senior Secured Credit Facilities	750,000	775,000
Term Loan A-2
Debt Instrument [Line Items]
Senior Secured Credit Facilities	452,000	0
Term Loan B
Debt Instrument [Line Items]
Senior Secured Credit Facilities	3,368,750	3,377,500
Revolver
Debt Instrument [Line Items]
Senior Secured Credit Facilities	$ 0	$ 300,000

Long-term debt - Scheduled Matu

Long-term debt - Scheduled Maturities of Long-term Debt (Detail) $ in Thousands	Mar. 31, 2018USD ($)
Debt Disclosure [Abstract]
2018 (remainder of the year)	$ 136,885
2,019	1,206,668
2,020	72,608
2,021	3,307,539
2,022	1,283,255
2,023	32,340
Thereafter	$ 3,486,684

Long-term debt - Additional Inf

Long-term debt - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Mar. 28, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Debt Instrument, Maturity Date	Jun. 28, 2019
Unrealized gains (losses) on interest rate cap agreements	$ 1,050	$ (3,188)
Weighted average effective interest rate on senior secured credit facilities	4.98%
Weighted average effective interest rate during quarter	4.87%
Fixed interest rate	51.34%
U.S. dialysis and related lab services
Debt Instrument [Line Items]
Letters of credit outstanding	$ 22,351
DMG
Debt Instrument [Line Items]
Letters of credit outstanding	211
Revolving Credit Facility
Debt Instrument [Line Items]
Undrawn revolving credit facilities	1,000,000
Letter of Credit
Debt Instrument [Line Items]
Letters of credit outstanding	14,355
Interest Rate Cap Agreements Effective September 30, 2016
Debt Instrument [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000
Derivative, effective date	Sep. 30, 2016
Derivative, expiration date	Jun. 30, 2018
Debt expense recognized	$ 2,070
Interest Rate Cap Agreements Effective June 29, 2018
Debt Instrument [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000
Derivative, effective date	Jun. 29, 2018
Derivative, expiration date	Jun. 30, 2020
Fair value of assets	$ 2,446
Unrealized gains (losses) on interest rate cap agreements	$ 1,414
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective September 30, 2016
Debt Instrument [Line Items]
LIBOR variable rate	3.50%
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective June 29, 2018
Debt Instrument [Line Items]
LIBOR variable rate	3.50%
Term Loan A
Debt Instrument [Line Items]
Mandatory principal payments	$ 25,000
Capped portion of interest payments	$ 750,000			$ 775,000
Term Loan A | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest rate margin	2.00%
Term Loan A-2
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity			$ 995,000
Proceeds from Long-term Lines of Credit	$ 452,000
Debt Instrument, Unused Borrowing Capacity, Amount			$ 543,000
Capped portion of interest payments	$ 452,000			0
Term Loan A-2 | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest rate margin	1.00%
Term Loan B
Debt Instrument [Line Items]
Mandatory principal payments	$ 8,750
Capped portion of interest payments	$ 3,368,750			$ 3,377,500
Term Loan B | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest rate margin	2.75%
Term Loan B | London Interbank Offered Rate (LIBOR) | Maximum
Debt Instrument [Line Items]
LIBOR plus interest rate margin	3.50%
Term Loan A subject to interest rate caps
Debt Instrument [Line Items]
Capped portion of interest payments	$ 131,250
Term Loan A subject to uncapped portion of variability of LIBOR
Debt Instrument [Line Items]
Capped portion of interest payments	$ 618,750
Senior Secured Credit Facilities
Debt Instrument [Line Items]
Weighted average effective interest rate on senior secured credit facilities	4.67%

Long-term debt - Derivative Ins

Long-term debt - Derivative Instruments (Detail) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Designated as Hedging Instrument | Interest rate cap agreements | Other long-term assets
Derivative [Line Items]
Derivative assets, Fair value	$ 2,446	$ 1,032

Long-term debt - Effects of Int

Long-term debt - Effects of Interest Rate Swap and Cap Agreements (Detail) - Cash Flow Hedging - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Derivative Instruments Gain Loss [Line Items]
Amount of unrecognized gains (losses) in OCI on interest rate cap agreements	$ 1,050	$ (3,188)
Amount of losses reclassified from accumulated OCI into income	1,537	1,265
Tax benefit
Derivative Instruments Gain Loss [Line Items]
Amount of unrecognized gains (losses) in OCI on interest rate cap agreements	(364)	2,029
Amount of losses reclassified from accumulated OCI into income	(533)	(805)
Interest rate cap agreements | Debt Expense (Including Refinancing Charges)
Derivative Instruments Gain Loss [Line Items]
Amount of unrecognized gains (losses) in OCI on interest rate cap agreements	1,414	(5,217)
Amount of losses reclassified from accumulated OCI into income	$ 2,070	$ 2,070

Contingencies - Additional Info

Contingencies - Additional Information (Detail) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended
	Dec. 31, 2017	Mar. 31, 2018	Mar. 31, 2017
Other Commitments [Line Items]
Gain on litigation settlement		$ 0	$ 526,827
2016 U.S. Attorney Prescription Drug Investigation
Other Commitments [Line Items]
Litigation Settlement, Amount Awarded to Other Party	$ 63,700
Loss Contingency Accrual, Payments	41,500
Loss Contingency Accrual, Partial Payment	$ 22,200
US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Litigation Settlement, Amount Awarded from Other Party		538,000
Gain on litigation settlement		527,000
Noncontrolling Interest | US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Gain on litigation settlement		9,000
Operating Income (Loss) | US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Gain on litigation settlement		530,000
Equity Method Investments | Noncontrolling Interest | US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Gain on litigation settlement		$ 3,000

Noncontrolling interests subj62

Noncontrolling interests subject to put provisions and other commitments - additional information (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2018USD ($)
Minimum
Other Commitments [Line Items]
Scheduled dissolution term of joint ventures	10 years
Maximum
Other Commitments [Line Items]
Scheduled dissolution term of joint ventures	50 years
Commitments to provide operating capital
Other Commitments [Line Items]
Other potential commitments to provide operating capital to several dialysis centers	$ 5,542

Long-term incentive compensat63

Long-term incentive compensation - Additional Information (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Long-term incentive program (LTIP) expense	$ 15,215	$ 15,254
Stock-based compensation expense	9,685	9,601
Estimated tax benefits recorded for stock-based compensation	2,088	2,922
Unrecognized compensation cost related to outstanding LTIP awards	91,823
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans	$ 62,013
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 6 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 3 months 18 days
Employee Service Share-based Compensation, Tax Benefit from Compensation Expense	$ 4,895	1,091
Stock Appreciation Rights
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock granted (in shares)	11
Aggregate grant-date fair value	$ 200
Weighted-average expected life (in years)	3 years 8 months 12 days
Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock granted (in shares)	60
Aggregate grant-date fair value	$ 3,995
Weighted-average expected life (in years)	1 year
General and Administrative Expense
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock-based compensation expense	$ 9,155	$ 8,425

Share repurchases (Details)

Share repurchases (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	1 Months Ended	3 Months Ended
	May 02, 2018	Mar. 31, 2018	Oct. 10, 2017
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)		4,197
Value of treasury stock acquired		$ 298,377
Average cost of treasury stock (usd per share)		$ 71.09
Stock repurchase additional authorization amount			$ 1,252,961
Prior shares under repurchase authorization (in shares)			247,039
Subsequent Event
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)	4,350
Value of treasury stock acquired	$ 275,992
Average cost of treasury stock (usd per share)	$ 63.44
Remaining repurchase authorized amount	$ 544,747

Comprehensive income (Detail)

Comprehensive income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Jan. 01, 2018	Jan. 01, 2017
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	$ 4,886,066
Ending balance	4,782,081
Interest rate cap and swap agreements
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(12,408)	$ (12,029)
Cumulative Effect of New Accounting Principle in Period of Adoption			$ (2,706)	$ 0
Unrealized gains (losses)	1,414	(5,217)
Related income tax (expense) benefit	(364)	2,029
Unrealized (losses) gains net	1,050	(3,188)
Reclassification from accumulated other comprehensive income into net income	2,070	2,070
Related income tax (expense) benefit	(533)	(805)
Reclassification from accumulated other comprehensive income into net income net of tax	1,537	1,265
Ending balance	(12,527)	(13,952)
Investment securities
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	5,662	2,175
Cumulative Effect of New Accounting Principle in Period of Adoption			(5,662)	0
Unrealized gains (losses)	0	2,113
Related income tax (expense) benefit	0	(554)
Unrealized (losses) gains net	0	1,559
Reclassification from accumulated other comprehensive income into net income	0	(229)
Related income tax (expense) benefit	0	89
Reclassification from accumulated other comprehensive income into net income net of tax	0	(140)
Ending balance	0	3,594
Foreign currency translation adjustments
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	19,981	(79,789)
Cumulative Effect of New Accounting Principle in Period of Adoption			0	0
Unrealized gains (losses)	19,881	13,261
Related income tax (expense) benefit	0	0
Unrealized (losses) gains net	19,881	13,261
Reclassification from accumulated other comprehensive income into net income	0	0
Related income tax (expense) benefit	0	0
Reclassification from accumulated other comprehensive income into net income net of tax	0	0
Ending balance	39,862	(66,528)
Accumulated other comprehensive income (loss)
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	13,235	(89,643)
Cumulative Effect of New Accounting Principle in Period of Adoption			$ (8,368)	$ 0
Unrealized gains (losses)	21,295	10,157
Related income tax (expense) benefit	(364)	1,475
Unrealized (losses) gains net	20,931	11,632
Reclassification from accumulated other comprehensive income into net income	2,070	1,841
Related income tax (expense) benefit	(533)	(716)
Reclassification from accumulated other comprehensive income into net income net of tax	1,537	1,125
Ending balance	$ 27,335	$ (76,886)

Acquisitions and divestitures -

Acquisitions and divestitures - Additional Information (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2018USD ($)Clinic	Mar. 31, 2017USD ($)	Dec. 31, 2017USD ($)
Business Acquisition [Line Items]
Cash paid to acquire businesses	$ 16,582	$ 77,236
Contingent earn-out obligations and liabilities assumed associated with acquisitions	11,555
Contingent earn-out obligations	6,562		$ 6,388
Other Accrued Liabilities
Business Acquisition [Line Items]
Contingent earn-out obligations	222
Other long-term liabilities
Business Acquisition [Line Items]
Contingent earn-out obligations	6,340
Other companies
Business Acquisition [Line Items]
Contingent earn-out obligations	$ 6,562
Minimum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins
Business Acquisition [Line Items]
Earn-out consideration payment period	1 year
Maximum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins
Business Acquisition [Line Items]
Earn-out consideration payment period	6 years
Dialysis and other businesses
Business Acquisition [Line Items]
Cash paid to acquire businesses	$ 15,677
Deferred purchase price obligations	655
Contingent earn-out obligations and liabilities assumed associated with acquisitions	2,408
Goodwill deductible for tax purposes associated with acquisitions	$ 15,383
Noncompete Agreements
Business Acquisition [Line Items]
Amortizable intangible assets acquired, weighted-average estimated useful lives	5 years
U.S. dialysis and related lab services | Dialysis and other businesses
Business Acquisition [Line Items]
Number of businesses acquired | Clinic	1
Foreign Dialysis Centers | Dialysis and other businesses
Business Acquisition [Line Items]
Number of businesses acquired | Clinic	4

Acquisitions and divestitures67

Acquisitions and divestitures - Aggregate Purchase Cost Allocations for Acquisitions (Detail) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill	$ 6,638,592	$ 6,610,279	$ 6,015,375
Dialysis and other businesses
Business Acquisition [Line Items]
Current assets	1,572
Property and equipment	1,643
Amortizable intangible and other long-term assets	2,563
Goodwill	16,042
Current liabilities	(2,392)
Noncontrolling interests	(688)
Aggregate purchase price	$ 18,740

Acquisitions and divestitures68

Acquisitions and divestitures - Reconciliation of Changes in Contingent Earn-Out Obligations (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2018USD ($)
Contingent Earn-Out Obligations [Roll Forward]
Beginning balance	$ 6,388
Remeasurement of fair value for contingent earn-out obligations	174
Ending balance	$ 6,562

Held for Sale and Discontinue69

Held for Sale and Discontinued Operations Additional Information (Details) $ in Thousands	1 Months Ended	3 Months Ended
	Dec. 31, 2017USD ($)	Mar. 31, 2018USD ($)Clinic	Mar. 31, 2017USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from Divestiture of Businesses	$ 4,900,000
Payments to Acquire Businesses, Gross		$ 16,582	$ 77,236
Series of Individually Immaterial Business Acquisitions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Payments to Acquire Businesses, Gross		$ 15,677
DMG | Series of Individually Immaterial Business Acquisitions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of businesses acquired | Clinic		1
Payments to Acquire Businesses, Gross		$ 905
Business Combination, Consideration Transferred, Other		$ 99

Held for Sale and Discontinue70

Held for Sale and Discontinued Operations Schedule of Financial Results of DMG's Discontinued Operations (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net (loss) income from discontinued operations, net of tax	$ (5,786)	$ 6,433
DMG | Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenues	1,227,932	1,086,985
Expenses	1,226,407	1,074,452
Income from discontinued operations before taxes	1,525	12,533
Income tax expense	$ 7,311	$ 6,100

Held for Sale and Discontinue71

Held for Sale and Discontinued Operations Schedule of Financial Position of Discontinued Operations Related to DMG (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total current assets held for sale	$ 5,724,265	$ 5,761,642
Total current liabilities held for sale	1,254,625	1,185,070
DMG | Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash and cash equivalents	192,399	179,668
Other current assets	768,388	826,608
Property and equipment, net	410,127	379,945
Intangible assets, net	1,316,462	1,316,550
Other long-term assets	155,385	178,894
Goodwill	2,881,504	2,879,977
Other liabilities	529,354	505,734
Medical payables	505,872	457,040
Current portion of long-term debt	2,735	2,845
Long-term debt	34,541	35,003
Other long-term liabilities	$ 182,123	$ 184,448

Held for Sale and Discontinue72

Held for Sale and Discontinued Operations Schedule of Cash Flows of Discontinued Operations Related to DMG (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net cash provided by operating activities from discontinued operations	$ 156,248	$ 95,585
Net cash used in investing activities from discontinued operations	$ (33,068)	$ (41,686)

Variable interest entities - Ad

Variable interest entities - Additional Information (Detail) $ in Thousands	Mar. 31, 2018USD ($)
Variable Interest Entity [Line Items]
Total assets of variable interest entities	$ 852,912
Total liabilities of variable interest entities	507,962
DMG
Variable Interest Entity [Line Items]
Total assets of variable interest entities	580,039
Total liabilities of variable interest entities	$ 345,926

Fair value of financial instr74

Fair value of financial instruments - Assets, Liabilities and Temporary Equity Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Assets
Investments in mutual funds and common stock	$ 35,544	$ 38,895
Liabilities
Contingent earn-out obligations	6,562	$ 6,388
Fair Value, Measurements, Recurring
Assets
Investments in mutual funds and common stock	35,544
Liabilities
Contingent earn-out obligations	6,562
Temporary equity
Noncontrolling interests subject to put provisions	1,034,501
Fair Value, Measurements, Recurring | Interest rate cap agreements
Assets
Interest rate cap agreements	2,446
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1)
Assets
Investments in mutual funds and common stock	35,544
Liabilities
Contingent earn-out obligations	0
Temporary equity
Noncontrolling interests subject to put provisions	0
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1) | Interest rate cap agreements
Assets
Interest rate cap agreements	0
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2)
Assets
Investments in mutual funds and common stock	0
Liabilities
Contingent earn-out obligations	0
Temporary equity
Noncontrolling interests subject to put provisions	0
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2) | Interest rate cap agreements
Assets
Interest rate cap agreements	2,446
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3)
Assets
Investments in mutual funds and common stock	0
Liabilities
Contingent earn-out obligations	6,562
Temporary equity
Noncontrolling interests subject to put provisions	1,034,501
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | Interest rate cap agreements
Assets
Interest rate cap agreements	$ 0

Fair Value of financial instr75

Fair Value of financial instruments - Additional Information (Detail) $ in Thousands	Mar. 31, 2018USD ($)
Estimate of Fair Value Measurement | Senior Secured Credit Facilities
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Long-term debt value	$ 4,616,019
Estimate of Fair Value Measurement | Senior Notes
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Long-term debt value	4,433,500
Reported Value Measurement | Senior Secured Credit Facilities
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Long-term debt value	4,546,990
Reported Value Measurement | Senior Notes
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Long-term debt value	$ 4,461,802

Segment reporting - Additional

Segment reporting - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2018Segment
Segment Reporting [Abstract]
Number of operating segments	2

Segment reporting - Summary of

Segment reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Segment Reporting Information [Line Items]
Patient services revenues	$ 2,591,074,000	$ 2,422,786,000
Provision for uncollectible accounts	25,545,000	(107,058,000)
Net U.S. dialysis and related lab services patient service revenues	2,616,619,000	2,315,728,000
Other revenues	232,825,000	315,523,000
Total revenues	2,849,444,000	2,631,251,000
Operating income (loss)	410,686,000	875,928,000
Corporate administrative support	(15,704,000)	(10,592,000)
Debt expense	(113,516,000)	(104,397,000)
Other income, net	4,582,000	3,986,000
Income from continuing operations before income taxes	301,752,000	775,517,000
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Total revenues	2,519,478,000	2,259,395,000
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Total revenues	329,966,000	371,856,000
Operating Segments
Segment Reporting Information [Line Items]
Total revenues	2,878,065,000	2,649,419,000
Operating income (loss)	426,390,000	886,520,000
Operating Segments | U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Patient services revenues	2,507,587,000	2,372,660,000
Provision for uncollectible accounts	25,199,000	(106,777,000)
Net U.S. dialysis and related lab services patient service revenues	2,532,786,000	2,265,883,000
Other revenues	5,114,000	5,311,000
Total revenues	2,537,900,000	2,271,194,000
Operating income (loss)	433,380,000	944,740,000
Operating Segments | U.S. dialysis and related lab services | External Sources
Segment Reporting Information [Line Items]
Patient services revenues	2,489,165,000	2,360,861,000
Operating Segments | U.S. dialysis and related lab services | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Patient services revenues	18,422,000	11,799,000
Operating Segments | Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Patient services revenues	102,255,000	61,644,000
Other revenues	227,711,000	310,212,000
Total revenues	340,165,000	378,225,000
Operating income (loss)	(6,990,000)	(58,220,000)
Operating Segments | Other—Ancillary services and strategic initiatives | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Patient services revenues	10,199,000	6,369,000
Intersegment Elimination
Segment Reporting Information [Line Items]
Other revenues	(28,621,000)	(18,168,000)
Total revenues	(28,621,000)	(18,168,000)
Intersegment Elimination | U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Other revenues	(18,422,000)	(11,799,000)
Intersegment Elimination | Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Other revenues	$ (10,199,000)	$ (6,369,000)

Segment reporting - Summary o78

Segment reporting - Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 142,799	$ 132,884
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Depreciation and amortization	134,776	125,029
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 8,023	$ 7,855

Segment reporting - Summary o79

Segment reporting - Summary of Assets by Segment (Detail) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
ASSETS
Total assets	$ 18,942,372	$ 18,948,193
U.S. dialysis and related lab services
ASSETS
Total assets	11,798,202	11,776,042
Other—Ancillary services and strategic initiatives
ASSETS
Total assets	1,419,905	1,410,509
DMG held for sale
ASSETS
Total assets	$ 5,724,265	$ 5,761,642

Segment reporting - Summary o80

Segment reporting - Summary of Assets by Segment (Phantom) (Detail) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Segment Reporting Information [Line Items]
Equity method and other investments	$ 245,564	$ 245,534
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Equity method and other investments	84,985	84,866
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Equity method and other investments	160,579	160,668
DMG held for sale
Segment Reporting Information [Line Items]
Equity method and other investments	$ 11,642	$ 10,321

Segment reporting - Summary o81

Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 232,443	$ 214,535
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	189,049	173,528
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	12,345	13,219
DMG held for sale
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 31,049	$ 27,788

Changes in DaVita Inc.'s owne82

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries - Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Net income attributable to DaVita Inc.	$ 178,686	$ 447,697
Sales of noncontrolling interests	76	0
Purchases of noncontrolling interests	1,994	423
Net transfers to noncontrolling interests	(1,918)	(423)
Net income attributable to DaVita Inc., net of transfers to noncontrolling interests	176,768	447,274
DaVita Inc. | Reportable Legal Entities
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Net income	178,686
Net income attributable to DaVita Inc.	$ 178,686	$ 447,697

Condensed consolidating finan83

Condensed consolidating financial statements - Condensed Consolidating Statements of Operations (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Condensed Income Statements Captions [Line Items]
Patient services revenues	$ 2,591,074,000	$ 2,422,786,000
Less: Provision for uncollectible accounts	25,545,000	(107,058,000)
Net dialysis and related lab patient service revenues	2,616,619,000	2,315,728,000
Other revenues	232,825,000	315,523,000
Total revenues	2,849,444,000	2,631,251,000
Operating expenses and charges	2,438,758,000	1,755,323,000
Operating income	410,686,000	875,928,000
Debt expense	(113,516,000)	(104,397,000)
Other income, net	4,582,000	3,986,000
Income tax expense	70,737,000	281,665,000
Equity (loss) earnings in subsidiaries	0	0
Net income from continuing operations	231,015,000	493,852,000
Net (loss) income from discontinued operations, net of tax	(5,786,000)	6,433,000
Net income	225,229,000	500,285,000
Less: Net income attributable to noncontrolling interests	(46,543,000)	(52,588,000)
Net income attributable to DaVita Inc.	178,686,000	447,697,000
Consolidating adjustments
Condensed Income Statements Captions [Line Items]
Patient services revenues	(47,515,000)	(37,171,000)
Less: Provision for uncollectible accounts	0	0
Net dialysis and related lab patient service revenues	(47,515,000)	(37,171,000)
Other revenues	(238,633,000)	(227,571,000)
Total revenues	(286,148,000)	(264,742,000)
Operating expenses and charges	(286,148,000)	(264,742,000)
Operating income	0	0
Debt expense	60,390,000	58,142,000
Other income, net	(107,726,000)	(102,740,000)
Income tax expense	0	0
Equity (loss) earnings in subsidiaries	(207,613,000)	(557,116,000)
Net income from continuing operations	(254,949,000)	(601,714,000)
Net (loss) income from discontinued operations, net of tax	47,336,000	44,598,000
Net income	(207,613,000)	(557,116,000)
Less: Net income attributable to noncontrolling interests	(46,543,000)	(52,588,000)
Net income attributable to DaVita Inc.	(254,156,000)	(609,704,000)
DaVita Inc. | Reportable Legal Entities
Condensed Income Statements Captions [Line Items]
Patient services revenues	0	0
Less: Provision for uncollectible accounts	0	0
Net dialysis and related lab patient service revenues	0	0
Other revenues	195,565,000	221,386,000
Total revenues	195,565,000	221,386,000
Operating expenses and charges	133,356,000	131,910,000
Operating income	62,209,000	89,476,000
Debt expense	(114,334,000)	(102,664,000)
Other income, net	104,081,000	100,337,000
Income tax expense	14,387,000	33,953,000
Equity (loss) earnings in subsidiaries	141,117,000	394,501,000
Net income from continuing operations	178,686,000	447,697,000
Net (loss) income from discontinued operations, net of tax	0	0
Net income	178,686,000	447,697,000
Less: Net income attributable to noncontrolling interests	0	0
Net income attributable to DaVita Inc.	178,686,000	447,697,000
Guarantor subsidiaries | Reportable Legal Entities
Condensed Income Statements Captions [Line Items]
Patient services revenues	1,790,188,000	1,530,726,000
Less: Provision for uncollectible accounts	9,628,000	(61,053,000)
Net dialysis and related lab patient service revenues	1,799,816,000	1,469,673,000
Other revenues	204,960,000	305,618,000
Total revenues	2,004,776,000	1,775,291,000
Operating expenses and charges	1,791,094,000	1,208,820,000
Operating income	213,682,000	566,471,000
Debt expense	(52,197,000)	(47,643,000)
Other income, net	2,523,000	2,803,000
Income tax expense	48,944,000	235,865,000
Equity (loss) earnings in subsidiaries	66,496,000	162,615,000
Net income from continuing operations	181,560,000	448,381,000
Net (loss) income from discontinued operations, net of tax	(40,443,000)	(53,880,000)
Net income	141,117,000	394,501,000
Less: Net income attributable to noncontrolling interests	0	0
Net income attributable to DaVita Inc.	141,117,000	394,501,000
Non- Guarantor subsidiaries | Reportable Legal Entities
Condensed Income Statements Captions [Line Items]
Patient services revenues	848,401,000	929,231,000
Less: Provision for uncollectible accounts	15,917,000	(46,005,000)
Net dialysis and related lab patient service revenues	864,318,000	883,226,000
Other revenues	70,933,000	16,090,000
Total revenues	935,251,000	899,316,000
Operating expenses and charges	800,456,000	679,335,000
Operating income	134,795,000	219,981,000
Debt expense	(7,375,000)	(12,232,000)
Other income, net	5,704,000	3,586,000
Income tax expense	7,406,000	11,847,000
Equity (loss) earnings in subsidiaries	0	0
Net income from continuing operations	125,718,000	199,488,000
Net (loss) income from discontinued operations, net of tax	(12,679,000)	15,715,000
Net income	113,039,000	215,203,000
Less: Net income attributable to noncontrolling interests	0	0
Net income attributable to DaVita Inc.	$ 113,039,000	$ 215,203,000

Condensed consolidating finan84

Condensed consolidating financial statements - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Condensed Financial Statements Captions [Line Items]
Net income	$ 225,229	$ 500,285
Other comprehensive income	22,468	12,755
Total comprehensive income	247,697	513,040
Less: Comprehensive income attributable to noncontrolling interests	(46,543)	(52,586)
Comprehensive income attributable to DaVita Inc.	201,154	460,454
Consolidating adjustments
Condensed Financial Statements Captions [Line Items]
Net income	(207,613)	(557,116)
Other comprehensive income	0	0
Total comprehensive income	(207,613)	(557,116)
Less: Comprehensive income attributable to noncontrolling interests	(46,543)	(52,586)
Comprehensive income attributable to DaVita Inc.	(254,156)	(609,702)
DaVita Inc. | Reportable Legal Entities
Condensed Financial Statements Captions [Line Items]
Net income	178,686	447,697
Other comprehensive income	2,587	(506)
Total comprehensive income	181,273	447,191
Less: Comprehensive income attributable to noncontrolling interests	0	0
Comprehensive income attributable to DaVita Inc.	181,273	447,191
Guarantor subsidiaries | Reportable Legal Entities
Condensed Financial Statements Captions [Line Items]
Net income	141,117	394,501
Other comprehensive income	0	0
Total comprehensive income	141,117	394,501
Less: Comprehensive income attributable to noncontrolling interests	0	0
Comprehensive income attributable to DaVita Inc.	141,117	394,501
Non- Guarantor subsidiaries | Reportable Legal Entities
Condensed Financial Statements Captions [Line Items]
Net income	113,039	215,203
Other comprehensive income	19,881	13,261
Total comprehensive income	132,920	228,464
Less: Comprehensive income attributable to noncontrolling interests	0	0
Comprehensive income attributable to DaVita Inc.	$ 132,920	$ 228,464

Condensed consolidating finan85

Condensed consolidating financial statements - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	$ 358,874	$ 508,234
Restricted cash and equivalents	88,744	10,686
Accounts receivable, net	1,830,590	1,714,750
Other current assets	671,082	749,046
Current assets held for sale	5,724,265	5,761,642
Total current assets	8,673,555	8,744,358
Property and equipment, net	3,185,223	3,149,213
Intangible assets, net	113,366	113,827
Investments in subsidiaries	0	0
Intercompany receivables	0	0
Other long-term assets and investments	331,636	330,516
Goodwill	6,638,592	6,610,279	$ 6,015,375
Total assets	18,942,372	18,948,193
Current liabilities	1,692,898	1,856,107
Current liabilities held for sale	1,254,625	1,185,070
Intercompany payables	0	0
Long-term debt and other long-term liabilities	10,178,267	10,009,590
Noncontrolling interests subject to put provisions	1,034,501	1,011,360
Total DaVita Inc. shareholders' equity	4,580,680	4,690,029
Noncontrolling interests not subject to put provisions	201,401	196,037
Total equity	4,782,081	4,886,066
Total liabilities and equity	18,942,372	18,948,193
Consolidating adjustments
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	0	0
Restricted cash and equivalents	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	(13,318,990)	(13,095,596)
Intercompany receivables	(5,081,899)	(4,991,160)
Other long-term assets and investments	0	0
Goodwill	0	0
Total assets	(18,400,889)	(18,086,756)
Current liabilities	0	0
Current liabilities held for sale	0	0
Intercompany payables	(5,081,899)	(4,991,160)
Long-term debt and other long-term liabilities	0	0
Noncontrolling interests subject to put provisions	444,895	436,758
Total DaVita Inc. shareholders' equity	(13,318,990)	(13,095,596)
Noncontrolling interests not subject to put provisions	(444,895)	(436,758)
Total equity	(13,763,885)	(13,532,354)
Total liabilities and equity	(18,400,889)	(18,086,756)
DaVita Inc. | Reportable Legal Entities
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	122,047	149,305
Restricted cash and equivalents	1,003	1,002
Accounts receivable, net	0	0
Other current assets	35,555	67,025
Current assets held for sale	0	0
Total current assets	158,605	217,332
Property and equipment, net	413,949	408,010
Intangible assets, net	224	250
Investments in subsidiaries	10,180,619	10,009,874
Intercompany receivables	3,593,688	3,677,947
Other long-term assets and investments	54,952	47,297
Goodwill	0	0
Total assets	14,402,037	14,360,710
Current liabilities	247,486	238,706
Current liabilities held for sale	0	0
Intercompany payables	0	0
Long-term debt and other long-term liabilities	8,984,265	8,857,373
Noncontrolling interests subject to put provisions	589,606	574,602
Total DaVita Inc. shareholders' equity	4,580,680	4,690,029
Noncontrolling interests not subject to put provisions	0	0
Total equity	4,580,680	4,690,029
Total liabilities and equity	14,402,037	14,360,710
Guarantor subsidiaries | Reportable Legal Entities
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	0	0
Restricted cash and equivalents	9,421	9,384
Accounts receivable, net	1,257,461	1,208,715
Other current assets	368,131	595,066
Current assets held for sale	5,004,717	4,992,067
Total current assets	6,639,730	6,805,232
Property and equipment, net	1,554,591	1,560,390
Intangible assets, net	50,396	50,971
Investments in subsidiaries	3,138,371	3,085,722
Intercompany receivables	0	0
Other long-term assets and investments	58,467	68,344
Goodwill	4,730,205	4,732,320
Total assets	16,171,760	16,302,979
Current liabilities	968,018	1,181,139
Current liabilities held for sale	759,020	739,294
Intercompany payables	3,589,494	3,690,042
Long-term debt and other long-term liabilities	674,609	682,630
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholders' equity	10,180,619	10,009,874
Noncontrolling interests not subject to put provisions	0	0
Total equity	10,180,619	10,009,874
Total liabilities and equity	16,171,760	16,302,979
Non- Guarantor subsidiaries | Reportable Legal Entities
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	236,827	358,929
Restricted cash and equivalents	78,320	300
Accounts receivable, net	573,129	506,035
Other current assets	267,396	86,955
Current assets held for sale	719,548	769,575
Total current assets	1,875,220	1,721,794
Property and equipment, net	1,216,683	1,180,813
Intangible assets, net	62,746	62,606
Investments in subsidiaries	0	0
Intercompany receivables	1,488,211	1,313,213
Other long-term assets and investments	218,217	214,875
Goodwill	1,908,387	1,877,959
Total assets	6,769,464	6,371,260
Current liabilities	477,394	436,262
Current liabilities held for sale	495,605	445,776
Intercompany payables	1,492,405	1,301,118
Long-term debt and other long-term liabilities	519,393	469,587
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholders' equity	3,138,371	3,085,722
Noncontrolling interests not subject to put provisions	646,296	632,795
Total equity	3,784,667	3,718,517
Total liabilities and equity	$ 6,769,464	$ 6,371,260

Condensed consolidating finan86

Condensed consolidating financial statements - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Cash flows from operating activities:
Net income	$ 225,229	$ 500,285
Changes in operating assets and liabilities and non-cash items included in net income	137,310	364,886
Net cash provided by operating activities	362,539	865,171
Cash flows from investing activities:
Additions of property and equipment	(232,443)	(214,535)
Acquisitions	(16,582)	(77,236)
Proceeds from asset and business sales	18,535	46,612
Proceeds (purchases) from investment sales and other items, net	30,362	(4,828)
Net cash used in investing activities	(200,128)	(249,987)
Cash flows from financing activities:
Long-term debt and related financing costs, net	104,673	(36,141)
Intercompany borrowing (payments)	0	0
Other items	(327,220)	(22,796)
Net cash used in financing activities	(222,547)	(58,937)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	6,668	2,820
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(53,468)	559,067
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	518,920	683,463
Cash, cash equivalents and restricted cash of continuing operations at end of the period	447,618	1,218,037
Consolidating adjustments
Cash flows from operating activities:
Net income	(207,613)	(557,116)
Changes in operating assets and liabilities and non-cash items included in net income	207,613	557,116
Net cash provided by operating activities	0	0
Cash flows from investing activities:
Additions of property and equipment	0	0
Acquisitions	0	0
Proceeds from asset and business sales	0	0
Proceeds (purchases) from investment sales and other items, net	0	0
Net cash used in investing activities	0	0
Cash flows from financing activities:
Long-term debt and related financing costs, net	0	0
Intercompany borrowing (payments)	0	0
Other items	0	0
Net cash used in financing activities	0	0
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0	0
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	0	0
Cash, cash equivalents and restricted cash of continuing operations at end of the period	0
DaVita Inc. | Reportable Legal Entities
Cash flows from operating activities:
Net income	178,686	447,697
Changes in operating assets and liabilities and non-cash items included in net income	(82,391)	(149,627)
Net cash provided by operating activities	96,295	298,070
Cash flows from investing activities:
Additions of property and equipment	(27,356)	(30,580)
Acquisitions	0
Proceeds from asset and business sales	0	0
Proceeds (purchases) from investment sales and other items, net	31,665	(54,150)
Net cash used in investing activities	4,309	(84,730)
Cash flows from financing activities:
Long-term debt and related financing costs, net	116,307	(27,504)
Intercompany borrowing (payments)	47,394	338,984
Other items	(291,562)	3,330
Net cash used in financing activities	(127,861)	314,810
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(27,257)	528,150
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	150,307	549,921
Cash, cash equivalents and restricted cash of continuing operations at end of the period	123,050	1,078,071
Guarantor subsidiaries | Reportable Legal Entities
Cash flows from operating activities:
Net income	141,117	394,501
Changes in operating assets and liabilities and non-cash items included in net income	32,484	(142,597)
Net cash provided by operating activities	173,601	251,904
Cash flows from investing activities:
Additions of property and equipment	(125,375)	(133,909)
Acquisitions	(4,417)	(70,237)
Proceeds from asset and business sales	18,535	46,612
Proceeds (purchases) from investment sales and other items, net	(762)	(1,951)
Net cash used in investing activities	(112,019)	(159,485)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(3,377)	(4,616)
Intercompany borrowing (payments)	(49,783)	(71,541)
Other items	(2,200)	(799)
Net cash used in financing activities	(55,360)	(76,956)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	6,222	15,463
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	9,384	8,687
Cash, cash equivalents and restricted cash of continuing operations at end of the period	9,421	8,712
Non- Guarantor subsidiaries | Reportable Legal Entities
Cash flows from operating activities:
Net income	113,039	215,203
Changes in operating assets and liabilities and non-cash items included in net income	(20,396)	99,994
Net cash provided by operating activities	92,643	315,197
Cash flows from investing activities:
Additions of property and equipment	(79,712)	(50,046)
Acquisitions	(12,165)	(6,999)
Proceeds from asset and business sales	0	0
Proceeds (purchases) from investment sales and other items, net	(541)	51,273
Net cash used in investing activities	(92,418)	(5,772)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(8,257)	(4,021)
Intercompany borrowing (payments)	2,389	(267,443)
Other items	(33,458)	(25,327)
Net cash used in financing activities	(39,326)	(296,791)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	6,668	2,820
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(32,433)	15,454
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	359,229	124,855
Cash, cash equivalents and restricted cash of continuing operations at end of the period	315,147	131,254
Discontinued Operations
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	17,834	24,493
Discontinued Operations | Consolidating adjustments
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0	0
Discontinued Operations | DaVita Inc. | Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0	0
Discontinued Operations | Guarantor subsidiaries | Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	6,185	15,438
Discontinued Operations | Non- Guarantor subsidiaries | Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	11,649	9,055
Continuing Operations
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(71,302)	534,574
Continuing Operations | Consolidating adjustments
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0
Continuing Operations | DaVita Inc. | Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(27,257)	528,150
Continuing Operations | Guarantor subsidiaries | Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	37	25
Continuing Operations | Non- Guarantor subsidiaries | Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	$ (44,082)	$ 6,399

Supplemental Data - Condensed C

Supplemental Data - Condensed Consolidating Statements of Income (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Condensed Income Statements Captions [Line Items]
Patient service operating revenues	$ 2,591,074,000	$ 2,422,786,000
Less: Provision for uncollectible accounts	25,545,000	(107,058,000)
Net dialysis and related lab patient service revenues	2,616,619,000	2,315,728,000
Other revenues	232,825,000	315,523,000
Total revenues	2,849,444,000	2,631,251,000
Operating expenses	2,438,758,000	1,755,323,000
Operating income	410,686,000	875,928,000
Debt expense, including refinancing charges	(113,516,000)
Other income	4,582,000	3,986,000
Income tax expense	70,737,000	281,665,000
Net income from continuing operations	231,015,000	493,852,000
Net (loss) income from discontinued operations, net of tax	(5,786,000)	6,433,000
Net income	225,229,000	500,285,000
Less: Net income attributable to noncontrolling interests	(46,543,000)	(52,588,000)
Net income attributable to DaVita Inc.	178,686,000	$ 447,697,000
Physician Groups
Condensed Income Statements Captions [Line Items]
Patient service operating revenues	0
Less: Provision for uncollectible accounts	0
Net dialysis and related lab patient service revenues	0
Other revenues	0
Total revenues	0
Operating expenses	0
Operating income	0
Debt expense, including refinancing charges	0
Other income	0
Income tax expense	0
Net income from continuing operations	0
Net (loss) income from discontinued operations, net of tax	7,397,000
Net income	7,397,000
Less: Net income attributable to noncontrolling interests	(6,543,000)
Net income attributable to DaVita Inc.	854,000
Unrestricted Subsidiaries
Condensed Income Statements Captions [Line Items]
Patient service operating revenues	0
Less: Provision for uncollectible accounts	0
Net dialysis and related lab patient service revenues	0
Other revenues	0
Total revenues	0
Operating expenses	0
Operating income	0
Debt expense, including refinancing charges	0
Other income	0
Income tax expense	0
Net income from continuing operations	0
Net (loss) income from discontinued operations, net of tax	490,000
Net income	490,000
Less: Net income attributable to noncontrolling interests	0
Net income attributable to DaVita Inc.	490,000
Company and Restricted Subsidiaries
Condensed Income Statements Captions [Line Items]
Patient service operating revenues	2,591,074,000
Less: Provision for uncollectible accounts	25,545,000
Net dialysis and related lab patient service revenues	2,616,619,000
Other revenues	232,825,000
Total revenues	2,849,444,000
Operating expenses	2,438,758,000
Operating income	410,686,000
Debt expense, including refinancing charges	(113,516,000)
Other income	4,582,000
Income tax expense	70,737,000
Net income from continuing operations	231,015,000
Net (loss) income from discontinued operations, net of tax	(13,673,000)
Net income	217,342,000
Less: Net income attributable to noncontrolling interests	(40,000,000)
Net income attributable to DaVita Inc.	$ 177,342,000

Supplemental Data - Condensed88

Supplemental Data - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Condensed Financial Statements Captions [Line Items]
Net income	$ 225,229	$ 500,285
Other comprehensive income	22,468	12,755
Total comprehensive income	247,697	513,040
Less: Comprehensive income attributable to noncontrolling interests	(46,543)	(52,586)
Comprehensive income attributable to DaVita Inc.	201,154	$ 460,454
Physician Groups
Condensed Financial Statements Captions [Line Items]
Net income	7,397
Other comprehensive income	0
Total comprehensive income	7,397
Less: Comprehensive income attributable to noncontrolling interests	(6,543)
Comprehensive income attributable to DaVita Inc.	854
Unrestricted Subsidiaries
Condensed Financial Statements Captions [Line Items]
Net income	490
Other comprehensive income	0
Total comprehensive income	490
Less: Comprehensive income attributable to noncontrolling interests	0
Comprehensive income attributable to DaVita Inc.	490
Company and Restricted Subsidiaries
Condensed Financial Statements Captions [Line Items]
Net income	217,342
Other comprehensive income	22,468
Total comprehensive income	239,810
Less: Comprehensive income attributable to noncontrolling interests	(40,000)
Comprehensive income attributable to DaVita Inc.	$ 199,810

Supplemental Data - Condensed89

Supplemental Data - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	$ 358,874	$ 508,234
Restricted cash and equivalents	88,744	10,686
Accounts receivable, net	1,830,590	1,714,750
Other current assets	671,082	749,046
Current assets held for sale	5,724,265	5,761,642
Total current assets	8,673,555	8,744,358
Property and equipment, net	3,185,223	3,149,213
Intangible assets, net	113,366	113,827
Other long-term assets	331,636	330,516
Goodwill	6,638,592	6,610,279	$ 6,015,375
Total assets	18,942,372	18,948,193
Current liabilities	1,692,898	1,856,107
Current liabilities held for sale	1,254,625	1,185,070
Payables to parent	0
Long-term debt and other long-term liabilities	10,178,267	10,009,590
Noncontrolling interests subject to put provisions	1,034,501	1,011,360
Total DaVita Inc. shareholders’ equity	4,580,680	4,690,029
Noncontrolling interests not subject to put provisions	201,401	196,037
Total equity	4,782,081	4,886,066
Total liabilities and equity	18,942,372	$ 18,948,193
Physician Groups
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	0
Restricted cash and equivalents	0
Accounts receivable, net	0
Other current assets	133,199
Current assets held for sale	319,968
Total current assets	453,167
Property and equipment, net	0
Intangible assets, net	0
Other long-term assets	0
Goodwill	0
Total assets	453,167
Current liabilities	0
Current liabilities held for sale	328,493
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	124,674
Noncontrolling interests not subject to put provisions	0
Total equity	124,674
Total liabilities and equity	453,167
Unrestricted Subsidiaries
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	0
Restricted cash and equivalents	0
Accounts receivable, net	0
Other current assets	0
Current assets held for sale	3,223
Total current assets	3,223
Property and equipment, net	0
Intangible assets, net	0
Other long-term assets	0
Goodwill	0
Total assets	3,223
Current liabilities	0
Current liabilities held for sale	0
Payables to parent	3,223
Long-term debt and other long-term liabilities	0
Noncontrolling interests subject to put provisions	0
Total DaVita Inc. shareholders’ equity	0
Noncontrolling interests not subject to put provisions	0
Total equity	0
Total liabilities and equity	3,223
Parent Company And Restricted Subsidiaries
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	358,874
Restricted cash and equivalents	88,744
Accounts receivable, net	1,830,590
Other current assets	537,883
Current assets held for sale	5,401,074
Total current assets	8,217,165
Property and equipment, net	3,185,223
Intangible assets, net	113,366
Other long-term assets	331,636
Goodwill	6,638,592
Total assets	18,485,982
Current liabilities	1,692,898
Current liabilities held for sale	926,132
Payables to parent	(3,223)
Long-term debt and other long-term liabilities	10,178,267
Noncontrolling interests subject to put provisions	1,034,501
Total DaVita Inc. shareholders’ equity	4,456,006
Noncontrolling interests not subject to put provisions	201,401
Total equity	4,657,407
Total liabilities and equity	$ 18,485,982

Supplemental Data - Condensed90

Supplemental Data - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Cash flows from operating activities:
Net income	$ 225,229	$ 500,285
Changes in operating and intercompany assets and liabilities and non-cash items included in net income	137,310	364,886
Net cash provided by operating activities	362,539	865,171
Cash flows from investing activities:
Additions of property and equipment	(232,443)	(214,535)
Acquisitions	(16,582)
Proceeds from asset and business sales	18,535	46,612
Investments and other items	30,362	(4,828)
Net cash used in investing activities	(200,128)	(249,987)
Cash flows from financing activities:
Long-term debt	104,673	(36,141)
Intercompany	0	0
Other items	(327,220)	(22,796)
Net cash used in financing activities	(222,547)	(58,937)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	6,668	2,820
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(53,468)	559,067
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	518,920	683,463
Cash, cash equivalents and restricted cash of continuing operations at end of the period	447,618	1,218,037
Physician Groups
Cash flows from operating activities:
Net income	7,397
Changes in operating and intercompany assets and liabilities and non-cash items included in net income	(20,189)
Net cash provided by operating activities	(12,792)
Cash flows from investing activities:
Additions of property and equipment	(1,165)
Acquisitions	0
Proceeds from asset and business sales	0
Investments and other items	(541)
Net cash used in investing activities	(1,706)
Cash flows from financing activities:
Long-term debt	0
Intercompany	1,082
Other items	0
Net cash used in financing activities	1,082
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(13,416)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	0
Cash, cash equivalents and restricted cash of continuing operations at end of the period	0
Unrestricted Subsidiaries
Cash flows from operating activities:
Net income	490
Changes in operating and intercompany assets and liabilities and non-cash items included in net income	(490)
Net cash provided by operating activities	0
Cash flows from investing activities:
Additions of property and equipment	0
Acquisitions	0
Proceeds from asset and business sales	0
Investments and other items	0
Net cash used in investing activities	0
Cash flows from financing activities:
Long-term debt	0
Intercompany	0
Other items	0
Net cash used in financing activities	0
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	0
Cash, cash equivalents and restricted cash of continuing operations at end of the period	0
Company and Restricted Subsidiaries
Cash flows from operating activities:
Net income	217,342
Changes in operating and intercompany assets and liabilities and non-cash items included in net income	157,989
Net cash provided by operating activities	375,331
Cash flows from investing activities:
Additions of property and equipment	(231,278)
Acquisitions	(16,582)
Proceeds from asset and business sales	18,535
Investments and other items	30,903
Net cash used in investing activities	(198,422)
Cash flows from financing activities:
Long-term debt	104,673
Intercompany	(1,082)
Other items	(327,220)
Net cash used in financing activities	(223,629)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	6,668
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(40,052)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	518,920
Cash, cash equivalents and restricted cash of continuing operations at end of the period	447,618
Discontinued Operations
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	17,834	24,493
Discontinued Operations | Physician Groups
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(13,416)
Discontinued Operations | Unrestricted Subsidiaries
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0
Discontinued Operations | Company and Restricted Subsidiaries
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	31,250
Continuing Operations
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(71,302)	$ 534,574
Continuing Operations | Physician Groups
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0
Continuing Operations | Unrestricted Subsidiaries
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0
Continuing Operations | Company and Restricted Subsidiaries
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	$ (71,302)