DaVita (DVA) 10-K 21 Feb 20 2019 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) shares in Millions, $ in Billions	12 Months Ended
	Dec. 31, 2019	Jan. 31, 2020	Jun. 28, 2019
Cover page.
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2019
Document Transition Report	false
Entity File Number	1-14106
Entity Registrant Name	DAVITA INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	51-0354549
Entity Address, Address Line One	2000 16th Street
Entity Address, City or Town	Denver,
Entity Address, State or Province	CO
Entity Address, Postal Zip Code	80202
City Area Code	720
Local Phone Number	631-2100
Title of 12(b) Security	Common Stock, $0.001 par value
Trading Symbol	DVA
Security Exchange Name	NYSE
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filer	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Public Float			$ 9.3
Entity Common Stock, Shares Outstanding		125.6
Amendment Flag	false
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	FY
Entity Central Index Key	0000927066
Current Fiscal Year End Date	--12-31

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Statement [Abstract]
Dialysis patient service revenues	$ 10,918,421	$ 10,709,981	$ 10,093,670
Provision for uncollectible accounts	(21,715)	(49,587)	(485,364)
Net dialysis patient service revenues	10,896,706	10,660,394	9,608,306
Other revenues	491,773	744,457	1,268,328
Total revenues	11,388,479	11,404,851	10,876,634
Operating expenses and charges:
Patient care costs	7,914,485	8,195,513	7,640,005
General and administrative	1,103,312	1,135,454	1,064,026
Depreciation and amortization	615,152	591,035	559,911
Provision for uncollectible accounts	0	(7,300)	(7,033)
Equity investment (income) loss	(12,679)	4,484	8,640
Investment and other asset impairments	0	17,338	295,234
Goodwill impairment charges	124,892	3,106	36,196
Gain on changes in ownership interest, net	0	(60,603)	(6,273)
Gain on settlement, net	0	0	(526,827)
Total operating expenses and charges	9,745,162	9,879,027	9,063,879
Operating income	1,643,317	1,525,824	1,812,755
Debt expense	(443,824)	(487,435)	(430,634)
Debt prepayment, refinancing and redemption charges	(33,402)	0	0
Other income, net	29,348	10,089	17,665
Income from continuing operations before income taxes	1,195,439	1,048,478	1,399,786
Income tax expense	279,628	258,400	323,859
Net income from continuing operations	915,811	790,078	1,075,927
Net income (loss) from discontinuing operations, net of tax	105,483	(457,038)	(245,372)
Net income	1,021,294	333,040	830,555
Less: Net income attributable to noncontrolling interests	(210,313)	(173,646)	(166,937)
Net income attributable DaVita Inc.	$ 810,981	$ 159,394	$ 663,618
Earnings per share attributable to DaVita Inc.:
Basic net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	$ 4.61	$ 3.66	$ 4.78
Basic net income per share attributable to DaVita Inc. (in usd per share)	5.29	0.93	3.52
Diluted net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	4.60	3.62	4.71
Diluted net income per share attributable to DaVita Inc. (in usd per share)	$ 5.27	$ 0.92	$ 3.47
Weighted average shares for earnings per share:
Basic (in shares)	153,180,908	170,785,999	188,625,559
Diluted (in shares)	153,812,064	172,364,581	191,348,533
Amounts attributable to DaVita Inc.:
Net income from continuing operations	$ 706,832	$ 624,321	$ 901,277
Net income (loss) from discontinued operations	104,149	(464,927)	(237,659)
Net (loss) income attributable to DaVita Inc.	$ 810,981	$ 159,394	$ 663,618

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Statement of Comprehensive Income [Abstract]
Net income	$ 1,021,294	$ 333,040	$ 830,555
Unrealized gains (losses) on interest rate cap agreements, net:
Unrealized gains (losses)	1,151	(133)	(5,437)
Reclassification into net income	6,377	6,286	5,058
Unrealized losses on investments, net:
Unrealized losses	0	0	3,705
Reclassification into net income	0	0	(220)
Unrealized (losses) gains on foreign currency translation:
Foreign currency translation adjustments	(20,102)	(45,944)	99,770
Other comprehensive (loss) income	(12,574)	(39,791)	102,876
Total comprehensive income	1,008,720	293,249	933,431
Less: Comprehensive income attributable to noncontrolling interests	(210,313)	(173,646)	(166,935)
Comprehensive income attributable to DaVita Inc.	$ 798,407	$ 119,603	$ 766,496

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
ASSETS
Cash and cash equivalents	$ 1,102,372	$ 323,038
Restricted cash and equivalents	106,346	92,382
Short-term investments	11,572	2,935
Accounts receivable, net	1,795,598	1,858,608
Inventories	97,949	107,381
Other receivables	489,695	469,796
Prepaid and other current assets	66,866	111,840
Income tax receivable	19,772	68,614
Current assets held for sale, net	0	5,389,565
Total current assets	3,690,170	8,424,159
Property and equipment, net	3,473,384	3,393,669
Operating lease right-of-use assets	2,830,047	0
Intangible assets, net	135,684	118,846
Equity method and other investments	241,983	224,611
Long-term investments	36,519	35,424
Other long-term assets	115,972	71,583
Goodwill	6,787,635	6,841,960
Total assets	17,311,394	19,110,252
LIABILITIES AND EQUITY
Accounts payable	403,840	463,270
Other liabilities	756,174	595,850
Accrued compensation and benefits	695,052	658,913
Current portion of operating lease liabilities	343,912	0
Current portion of long-term debt	130,708	1,929,369
Income tax payable	42,412	0
Current liabilities held for sale	0	1,243,759
Total current liabilities	2,372,098	4,891,161
Long-term operating lease liabilities	2,723,800	0
Long-term debt	7,977,526	8,172,847
Other long-term liabilities	160,809	450,669
Deferred income taxes	577,543	562,536
Total liabilities	13,811,776	14,077,213
Commitments and contingencies
Noncontrolling interests subject to put provisions	1,180,376	1,124,641
Equity:
Preferred stock ($0.001 par value, 5,000,000 shares authorized; none issued)	0	0
Common stock ($0.001 par value, 450,000,000 shares authorized; 125,842,853 and 166,387,307 shares issued and outstanding at December 31, 2019 and 2018, respectively)	126	166
Additional paid-in capital	749,043	995,006
Retained earnings	1,431,738	2,743,194
Accumulated other comprehensive loss	(47,498)	(34,924)
Total DaVita Inc. shareholders' equity	2,133,409	3,703,442
Noncontrolling interests not subject to put provisions	185,833	204,956
Total equity	2,319,242	3,908,398
Total liabilities and shareholders' equity	$ 17,311,394	$ 19,110,252

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Preferred stock, par value (in usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, issued (in shares)	0	0
Common stock, par value (in usd per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	450,000,000	450,000,000
Common stock, shares issued (in shares)	125,842,853	166,387,307
Common stock, shares outstanding (in shares)	125,842,853	166,387,307

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Cash flows from operating activities:
Net income	$ 1,021,294	$ 333,040	$ 830,555
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	615,152	591,035	777,485
Impairment charges	124,892	61,981	981,589
Valuation adjustment on disposal group	0	316,840	0
Debt prepayment, refinancing, and redemption charges	33,402	0	0
Stock-based compensation expense	67,850	73,061	35,092
Deferred income taxes	41,723	273,660	(395,217)
Equity investment income, net	8,582	26,449	28,925
(Loss) gain on sales of business interests, net	23,022	(85,699)	(23,402)
Other non-cash charges, net	49,579	82,374	66,920
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:
Accounts receivable	(79,957)	(81,176)	(156,305)
Inventories	10,158	73,505	(18,625)
Other receivables and other current assets	2,790	236,995	(111,432)
Other long-term assets	6,965	3,497	(11,945)
Accounts payable	(84,539)	(35,959)	26,876
Accrued compensation and benefits	(14,697)	84,165	(78,239)
Other current liabilities	181,940	(157,462)	1,908
Income taxes	95,645	(23,635)	(52,176)
Other long-term liabilities	(31,446)	(1,031)	11,157
Net cash provided by operating activities	2,072,355	1,771,640	1,913,166
Cash flows from investing activities:
Additions of property and equipment	(766,546)	(987,138)	(905,250)
Acquisitions	(100,861)	(183,156)	(803,879)
Proceeds from asset and business sales	3,877,392	150,205	92,336
Purchase of other debt and equity investments	(5,458)	(8,448)	(13,117)
Purchase of investments held-to-maturity	(101,462)	(5,963)	(228,990)
Proceeds from sale of other debt and equity investments	3,676	9,526	6,408
Proceeds from investments held-to-maturity	95,376	34,862	492,470
Purchase of equity investments	(9,366)	(19,177)	(4,816)
Distributions received on equity investments	2,589	3,646	106
Net cash provided by (used in) investing activities	2,995,340	(1,005,643)	(1,364,732)
Cash flows from financing activities:
Borrowings	38,525,850	59,934,750	50,991,960
Payments on long-term debt and other financing costs	(40,606,041)	(59,239,973)	(50,837,112)
Purchase of treasury stock	(2,383,816)	(1,161,511)	(802,949)
Distributions to noncontrolling interests	(233,123)	(196,441)	(211,467)
Stock award exercises and other share issuances, net	11,382	13,577	21,252
Contributions from noncontrolling interests	57,317	52,311	74,552
Proceeds from sales of additional noncontrolling interests	0	15	2,864
Purchases of noncontrolling interests	(68,019)	(28,082)	(5,357)
Net cash used in financing activities	(4,696,450)	(625,354)	(766,257)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(1,760)	(3,350)	254
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	369,485	137,293	(217,569)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	415,420	518,920	683,463
Cash, cash equivalents and restricted cash of continuing operations at end of the year	1,208,718	415,420	518,920
Discontinued Operations
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	(423,813)	240,793	(53,026)
Continuing Operations
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	$ 793,298	$ (103,500)	$ (164,543)

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY - USD ($) $ in Thousands	Total	Total	TotalRestricted Stock Units (RSUs)	TotalStock appreciation rights	Non-controlling interests subject to put provisions	Common stock	Common stockRestricted Stock Units (RSUs)	Common stockStock appreciation rights	Additional paid-in capital	Additional paid-in capitalRestricted Stock Units (RSUs)	Additional paid-in capitalStock appreciation rights	Retained earnings	Treasury stock	Accumulated other comprehensive income (loss)	Non-controlling interests not subject to put provisions
Temporary equity, beginning balance at Dec. 31, 2016					$ 973,258
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income					103,641
Distributions					(128,853)
Contributions					52,911
Acquisitions and divestitures					43,799
Partial purchases					(397)
Fair value remeasurements					(32,999)
Temporary equity, ending balance at Dec. 31, 2017					1,011,360
Beginning balance (in shares) at Dec. 31, 2016						(194,554,000)							0
Beginning balance at Dec. 31, 2016		$ 4,648,047				$ 195			$ 1,027,182			$ 3,710,313	$ 0	$ (89,643)	$ 201,694
Comprehensive income:
Net income	$ 663,618	663,618										663,618			63,296
Other comprehensive income	$ 102,876	102,878												102,878	(2)
Stock purchase shares issued (in shares)						360,000
Stock purchase shares issued		22,131							22,131
Stock-settled share based payment awards, shares issued (in shares)							117,000	398,000
Stock-settled share based payment awards			$ (101)	$ 0						$ (101)	$ 0
Stock-settled stock-based compensation expense		34,981							34,981
Changes in noncontrolling interest from:
Distributions															(82,614)
Contributions															21,641
Acquisitions and divestitures		(823)							(823)
Acquisitions and divestitures, noncontrolling interest															(5,770)
Partial purchases		(2,752)							(2,752)						(2,208)
Fair value remeasurements		32,999							32,999
Purchase of treasury stock (in shares)	(12,967,000)												(12,967,000)
Purchase of treasury stock	$ (810,949)	(810,949)											$ (810,949)
Retirement of treasury stock (in shares)						(12,967,000)							12,967,000
Retirement of treasury stock						$ (13)			(70,718)			(740,218)	$ 810,949
Ending balance at Dec. 31, 2017		4,690,029				$ 182			1,042,899			3,633,713	$ 0	13,235	196,037
Ending balance (in shares) at Dec. 31, 2017						(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)
Net income					105,531
Distributions					(119,173)
Contributions					32,918
Acquisitions and divestitures					79,078
Partial purchases					(8,546)
Fair value remeasurements					23,473
Temporary equity, ending balance at Dec. 31, 2018					1,124,641
Comprehensive income:
Net income	159,394	159,394										159,394			68,115
Other comprehensive income	$ (39,791)	(39,791)												(39,791)
Stock purchase shares issued (in shares)						398,000
Stock purchase shares issued		17,398							17,398
Stock-settled share based payment awards, shares issued (in shares)							158,000	213,000
Stock-settled share based payment awards			(448)	(4,886)				$ (1)		(448)	(4,887)
Stock-settled stock-based compensation expense		73,081							73,081
Changes in noncontrolling interest from:
Distributions															(77,268)
Contributions															19,393
Acquisitions and divestitures		3,546							3,546
Acquisitions and divestitures, noncontrolling interest															318
Partial purchases		(17,897)							(17,897)						(1,639)
Fair value remeasurements		(23,473)							(23,473)
Purchase of treasury stock (in shares)	(16,844,000)												(16,844,000)
Purchase of treasury stock	$ (1,153,511)	(1,153,511)											$ (1,153,511)
Retirement of treasury stock (in shares)						(16,844,000)							16,844,000
Retirement of treasury stock		0				$ (17)			(95,213)			(1,058,281)	$ 1,153,511
Ending balance at Dec. 31, 2018	$ 3,908,398	3,703,442				$ 166			995,006			2,743,194	$ 0	(34,924)	204,956
Ending balance (in shares) at Dec. 31, 2018	(166,387,307)					(166,387,000)							0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Cumulative Effect of New Accounting Principle in Period of Adoption		39,876			(38)							39,876			(6)
Net income					143,413
Distributions					(155,011)
Contributions					35,572
Acquisitions and divestitures					(6,332)
Partial purchases					(11,394)
Fair value remeasurements					49,525
Temporary equity, ending balance at Dec. 31, 2019					$ 1,180,376
Comprehensive income:
Net income	$ 810,981	810,981										810,981			66,900
Other comprehensive income	$ (12,574)	(12,574)												(12,574)
Stock purchase shares issued (in shares)						315,000
Stock purchase shares issued		16,570				$ 1			16,569
Stock-settled share based payment awards, shares issued (in shares)							160,000	1,000
Stock-settled share based payment awards			$ (3,246)	$ (44)						$ (3,246)	$ (44)
Stock-settled stock-based compensation expense		67,549							67,549
Changes in noncontrolling interest from:
Distributions															(78,112)
Contributions															21,745
Acquisitions and divestitures, noncontrolling interest															(10,170)
Partial purchases		(37,145)							(37,145)						(19,480)
Fair value remeasurements		(49,525)							(49,525)
Purchase of treasury stock (in shares)	(41,020,000)												(41,020,000)
Purchase of treasury stock	$ (2,402,475)	(2,402,475)											$ (2,402,475)
Retirement of treasury stock (in shares)						(41,020,000)							41,020,000
Retirement of treasury stock		0				$ (41)			(240,121)			(2,162,313)	$ 2,402,475
Ending balance at Dec. 31, 2019	$ 2,319,242	$ 2,133,409				$ 126			$ 749,043			$ 1,431,738	$ 0	$ (47,498)	$ 185,833
Ending balance (in shares) at Dec. 31, 2019	(125,842,853)					(125,843,000)							0

Organization and Summary of Sig

Organization and Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Organization and Summary of Significant Accounting Policies	Organization and summary of significant accounting policies Organization The Company's operations are comprised of its dialysis and related lab services to patients in the United States (its U.S. dialysis business), its ancillary services and strategic initiatives including its international operations (collectively, its ancillary services), and its corporate administrative support. The Company’s largest line of business is its U.S. dialysis business, which operates kidney dialysis centers in the U.S. for patients suffering from chronic kidney failure, also known as end stage renal disease (ESRD). As of December 31, 2019 , the Company operated or provided administrative services through a network of 2,753 U.S. outpatient dialysis centers in 46 states and the District of Columbia, serving a total of approximately 206,900 patients. In addition, as of December 31, 2019 , the Company operated or provided administrative services to a total of 259 outpatient dialysis centers serving approximately 28,700 patients located in ten countries outside of the U.S. On June 19, 2019, the Company completed the sale of its DaVita Medical Group (DMG) business to Collaborative Care Holdings, LLC (Optum), a subsidiary of UnitedHealth Group Inc. As a result of this transaction, DMG's results of operations have been reported as discontinued operations for all periods presented in these consolidated financial statements. For financial information about the DMG business, see Note 22 . The Company’s U.S. dialysis business qualifies as a separately reportable segment and the Company’s ancillary services, including its international operations, have been combined and disclosed in the other segments category. Basis of presentation These consolidated financial statements are prepared in accordance with United States generally accepted accounting principles (U.S. GAAP). The financial statements include DaVita Inc. and its subsidiaries, partnerships and other entities in which it maintains a majority voting or other controlling financial interest (collectively, the Company). All significant intercompany transactions and balances have been eliminated. Equity investments in investees over which the Company only has significant influence are recorded on the equity method, while investments in other equity securities are recorded at fair value or on the adjusted cost method, as applicable. For the Company’s international subsidiaries, local currencies are considered their functional currencies. Translation adjustments result from translating the financial statements of the Company’s international subsidiaries from their functional currencies into the Company’s reporting currency (the U.S. dollar, or USD). Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these consolidated financial statements were issued and has included all necessary adjustments and disclosures. Use of estimates The preparation of financial statements in conformity with U.S. GAAP requires the use of estimates and assumptions that affect the reported amounts of revenues, expenses, assets, liabilities, contingencies and noncontrolling interests subject to put provisions. Although actual results in subsequent periods will differ from these estimates, such estimates are developed based on the best information available to management and management’s best judgments at the time. All significant assumptions and estimates underlying the amounts reported in the financial statements and accompanying notes are regularly reviewed and updated when necessary. Changes in estimates are reflected in the financial statements based upon on-going actual experience trends or subsequent settlements and realizations depending on the nature and predictability of the estimates and contingencies. Interim changes in estimates related to annual operating costs are applied prospectively within annual periods. The most significant assumptions and estimates underlying these consolidated financial statements and accompanying notes involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and investments, accounting for income taxes and certain fair value estimates. Specific estimating risks and contingencies are further addressed within these notes to the consolidated financial statements. Revenues 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. Net collections or write-offs of accounts receivable generated prior to January 1, 2018, beyond amounts previously reserved thereon, are presented in the provision for uncollectible accounts on the consolidated income statement in accordance with Topic 605. Dialysis patient service revenues Revenues are recognized based on the Company’s estimate of the transaction price the Company expects to collect as a result of satisfying its performance obligations. Dialysis patient service revenues are recognized in the period services are provided based on these estimates. Revenues consist primarily of payments from government and commercial health plans for dialysis services provided to patients. A usual and customary fee schedule is maintained for the Company’s dialysis treatments and related lab 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 providing secondary coverage (e.g., Medicaid secondary coverage), the patient’s commercial health plan secondary coverage, or the patient. 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. 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. 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, delays in collections due to payor payment inefficiencies, 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. In certain circumstances, it may not be 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 fees for management and administrative support services provided to outpatient dialysis centers that the Company does not own or in which the Company owns a noncontrolling interest, revenues associated with the Company's non-dialysis ancillary services and strategic initiatives, and administrative and management support services to certain non-dialysis joint ventures in which the Company owns a noncontrolling interest. Revenues associated with dialysis management services, disease management services, clinical research programs, physician services, ESRD seamless care organizations, and comprehensive care are estimated in the period services are provided. Revenues associated with pharmacy services were estimated as prescriptions were filled and shipped to patients. Revenues associated with direct primary care were estimated over the membership period. Other income Other income includes interest income on cash and cash equivalents and short- and long-term investments, realized and unrealized gains and losses recognized on investments, and foreign currency transaction gains and losses. Cash and cash equivalents Cash equivalents are short-term highly liquid investments with maturities of three months or less at date of purchase. Restricted cash and equivalents Restricted cash and cash equivalents are primarily held in trust to satisfy insurer and state regulatory requirements related to the wholly-owned captive insurance companies that bear professional and general liability and workers' compensation risks for the Company. Investments in debt and equity securities The Company classifies certain debt securities as held-to-maturity and records them at amortized cost based on the Company’s intentions and strategies concerning those investments. Equity securities that have readily determinable fair values or redemption values are classified as short-term or long-term investments and recorded at estimated fair value with changes in fair value recognized in current earnings. Inventories Inventories are stated at the lower of cost (first-in, first-out) or net realizable value and consist principally of pharmaceuticals and dialysis-related supplies. Rebates related to inventory purchases are recorded when earned and are based on certain qualification requirements which are dependent on a variety of factors including future pricing levels from the manufacturer and related data submission. Property and equipment Property and equipment is stated at cost less accumulated depreciation and amortization and is further reduced by any impairments. Maintenance and repairs are charged to expense as incurred. Depreciation and amortization expenses are computed using the straight-line method over the useful lives of the assets estimated as follows: buildings, 25 years to 40 years ; leasehold improvements, the shorter of ten years or the expected lease term; and equipment and information systems, principally three years to 15 years . Disposition gains and losses are included in current operating expenses. Property and equipment assets are reviewed for possible impairment whenever significant events or changes in circumstances indicate that an impairment may have occurred. Leases The Company leases substantially all of its U.S. dialysis facilities. The Company categorizes leases with contractual terms longer than twelve months as either operating or finance leases. Finance leases are generally those leases that allow the Company to substantially utilize or pay for the entire asset over its estimated life. All other leases are categorized as operating leases. Assets acquired under finance leases are recorded on the balance sheet within property and equipment, net and liabilities for finance lease obligations are recorded within long-term debt. Finance lease assets are amortized to depreciation expense on a straight-line basis over the shorter of their estimated useful lives or the lease term. Rights to use assets under operating leases are recorded on the balance sheet as operating lease right-of-use assets and liabilities for operating lease obligations are recorded as operating lease liabilities. Reductions in the carrying amount of operating lease right-of-use assets are recorded to rent expense over the lease term. The majority of the Company’s facilities are leased under non-cancellable operating leases ranging in terms from five years to 15 years and which contain renewal options of five years to ten years at the fair rental value at the time of renewal. The Company has elected the practical expedient to not separate lease components from non-lease components for its financing and operating leases. Amortizable intangibles Amortizable intangible assets and liabilities include noncompetition agreements and hospital acute services contracts, each of which have finite useful lives. Amortization expense is computed using the straight-line method over the useful lives of the assets estimated as follows: non-competition agreements over three years to ten years , and hospital acute service contracts over the contract period. Amortizable intangible assets are reviewed for possible impairment whenever significant events or changes in circumstances indicate that an impairment may have occurred. Indefinite-lived intangibles Indefinite-lived intangible assets include international licenses and accreditations that allow the Company to be reimbursed for providing dialysis services to patients, each of which has an indefinite useful life. Indefinite-lived intangibles are not amortized, but are assessed for impairment at least annually and whenever significant events or changes in circumstances indicate that an impairment may have occurred. Equity method and other investments Equity investments that do not have readily determinable fair values are carried on the equity method if the Company maintains significant influence over the investee or on the adjusted cost method if it does not. The adjusted cost method represents the Company's cost for an investment, net of any other-than-temporary impairment, or a subsequent observation of the investment's fair value. The Company classifies its equity and adjusted cost method investments as “Equity method and other investments” on its balance sheet. See Note 9 for further details, including recent changes to the Company's accounting for these investments. Equity method and other investments are assessed for other-than-temporary impairment when significant events or changes in circumstances indicate that an other-than-temporary impairment may have occurred. An other-than-temporary impairment charge is recorded when the fair value of an investment has fallen below its carrying amount and the shortfall is expected to be indefinitely or permanently unrecoverable. Goodwill Goodwill represents the difference between the fair value of businesses acquired and the fair value of the identifiable tangible and intangible net assets acquired. Goodwill is not amortized, but is assessed by individual reporting unit for impairment as circumstances warrant and at least annually. An impairment charge is recognized when and to the extent a reporting unit's carrying amount is determined to exceed its fair value. The Company operates multiple reporting units. See Note 10 for further details. Self-insurance The Company predominantly self-insures its professional and general liability and workers' compensation risks through its wholly-owned captive insurance companies, with excess or reinsurance coverage for additional risk. The Company is also predominantly self-insured with respect to employee medical and other health benefits. The Company records insurance liabilities for the professional and general liability, workers’ compensation, and employee health benefit risks that it retains and estimates its liability for those risks using third party actuarial calculations that are based upon historical claims experience and expectations for future claims. Income taxes Federal and state income taxes are computed at currently enacted tax rates less tax credits using the asset and liability method. Deferred taxes are adjusted both for items that do not currently have tax consequences and for the cumulative effect of any changes in tax rates from those previously used to determine deferred tax assets or liabilities. Tax provisions include amounts that are currently payable, changes in deferred tax assets and liabilities that arise because of temporary differences between the timing of when items of income and expense are recognized for financial reporting and income tax purposes, changes in the recognition of tax positions and any changes in the valuation allowance caused by a change in judgment about the realizability of the related deferred tax assets. A valuation allowance is established when necessary to reduce deferred tax assets to amounts expected to be realized. The Company uses a recognition threshold of more-likely-than-not and a measurement attribute on all tax positions taken or expected to be taken in a tax return in order to be recognized in the financial statements. Once the recognition threshold is met, the tax position is then measured to determine the actual amount of benefit to recognize in the financial statements. Stock-based compensation The Company’s stock-based compensation expense for stock-settled awards is measured at the estimated fair value of awards on the date of grant and recognized on a cumulative straight-line basis over the vesting terms of the awards, unless the stock awards are based on non-market based performance metrics, in which case expense is adjusted for the ultimate number of shares expected to be issued as of the end of each reporting period. Stock-based compensation expense for cash-settled awards is based on their estimated fair values as of the end of each reporting period. The expense for all stock-based awards is recognized net of expected forfeitures. Interest rate cap agreements The Company often carries a combination of current or forward interest rate caps on portions of its variable rate debt as a means of hedging its exposure to changes in LIBOR interest rates as part of its overall interest rate risk management strategy. These interest rate caps are not held for trading or speculative purposes and are designated as qualifying cash flow hedges. See Note 13 for further details. Noncontrolling interests Noncontrolling interests represent third-party equity ownership interests in entities which are consolidated by the Company for financial statement reporting purposes. As of December 31, 2019 , third parties held noncontrolling equity interests in 672 consolidated legal entities. Fair value estimates The Company relies on fair value measurements and estimates for purposes that require the recording, reassessment, or adjustment of the carrying amounts of certain assets, liabilities, and noncontrolling interests subject to put provisions (redeemable equity interests classified as temporary equity). These purposes can include the accounting for business combination transactions; impairment assessments for goodwill, other intangible assets, or other long-lived assets; recurrent revaluation of investments in debt and equity securities, contingent earn-out obligations, interest rate cap agreements or other derivative instruments, and noncontrolling interests subject to put provisions; and the accounting for equity method and other investments and stock-based compensation, as applicable. The Company has also classified its assets, liabilities and temporary equity into the appropriate fair value hierarchy levels as defined by the FASB. See Note 24 for further details. New accounting standards New standards recently adopted In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in Topic 842 revise lessee accounting for leases. Under the new guidance, lessees are 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 leaseback transactions primarily because lessees must recognize lease assets and lease liabilities. The Company adopted Topic 842 as of January 1, 2019 using a modified retrospective transition approach with a cumulative effect adjustment for leases existing at the adoption date. The Company elected to apply the package of practical expedients to not reassess prior conclusions related to contracts containing leases, lease classification and initial direct costs. Adoption of Topic 842 as of January 1, 2019 resulted in the recognition of operating right-of-use assets of $2,783,784 , operating lease liabilities of $3,001,354 and a cumulative effect adjustment to retained earnings of $39,876 , primarily related to deferred gains on prior sale leaseback transactions. Adoption of this new lease guidance did not materially impact the Company's consolidated net earnings and had no impact on cash flows. See Note 14 for further details. 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 this ASU were effective for the Company on January 1, 2019. Adoption of this ASU did not have a material impact on the Company’s consolidated financial statements. New standards not yet adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The amendments in this ASU change the approach for recognizing credit losses on financial assets from the incurred loss methodology in current U.S. GAAP to a methodology that reflects current expected credit losses, which requires consideration of a broader range of reasonable and supportable information to inform those credit loss estimates. The current incurred loss model delays recognition of credit losses until it is probable that a loss has been incurred, while this ASU’s new current expected credit loss model requires estimation of credit losses expected over the life of the financial asset or group of similar financial assets. The amendments in this ASU are effective for the Company on January 1, 2020 and are to be applied on a modified retrospective approach. The Company has evaluated the impact of this standard on its consolidated financial statements, including accounting policies, processes, and systems, and does not expect the impact to be material. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework -Changes to the Disclosure Requirements for Fair Value Measurement . The applicable amendments in this ASU remove requirements for disclosures concerning transfers between fair value measurement Levels 1, 2 and 3 and disclosures concerning valuation processes for Level 3 fair value measurements. The applicable amendments also add a requirement to separately disclose the changes in unrealized gains and losses included in other comprehensive income for the reporting period for Level 3 items measured at fair value on a recurring basis, and require disclosure of the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements. The amendments in this ASU are effective for the Company beginning on January 1, 2020 and its new requirements are to be applied on a prospective basis. Adoption of this ASU is not expected to have a material impact on the Company’s consolidated financial statements. In December 2019, the FASB issued ASU 2019-12 , Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes . ASU 2019-12 attempts to simplify aspects of accounting for franchise taxes and enacted changes in tax laws or rates, and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. ASU 2019-12 is effective for public business entities for fiscal years beginning after December 15, 2020, including interim periods within that fiscal year. Early adoption is permitted for all entities. The Company is currently assessing the effect this guidance may have on its consolidated financial statements.

Revenue Recognition

Revenue Recognition	12 Months Ended
	Dec. 31, 2019
Text Block [Abstract]
Revenue Recognition [Text Block]	Revenue recognition and accounts receivable The following table summarizes the Company's segment revenues by primary payor source: Year ended December 31, 2019 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,129,697 $ $ 6,129,697 Medicaid and Managed Medicaid 669,089 669,089 Other government 446,010 352,765 798,775 Commercial 3,286,089 144,256 3,430,345 Other revenues: Medicare and Medicare Advantage 264,538 264,538 Medicaid and Managed Medicaid 606 606 Commercial 130,823 130,823 Other (1) 32,021 78,940 110,961 Eliminations of intersegment revenues (132,325 ) (14,030 ) (146,355 ) Total $ 10,430,581 $ 957,898 $ 11,388,479 (1) Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services. Year ended December 31, 2018 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,063,891 $ $ 6,063,891 Medicaid and Managed Medicaid 628,766 628,766 Other government 446,999 335,594 782,593 Commercial 3,176,413 101,681 3,278,094 Other revenues: Medicare and Medicare Advantage 492,812 492,812 Medicaid and Managed Medicaid 44,246 44,246 Commercial 90,890 90,890 Other (1) 19,880 130,865 150,745 Eliminations of intersegment revenues (92,950 ) (34,236 ) (127,186 ) Total $ 10,242,999 $ 1,161,852 $ 11,404,851 (1) Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services. Year ended December 31, 2017 (1) U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 5,253,012 $ $ 5,253,012 Medicaid and Managed Medicaid 606,827 606,827 Other government 362,567 259,651 622,218 Commercial 3,117,920 63,505 3,181,425 Other revenues: Medicare and Medicare Advantage 902,289 902,289 Medicaid and Managed Medicaid 71,426 71,426 Commercial 116,503 116,503 Other (2) 19,739 182,974 202,713 Eliminations of intersegment revenues (55,176 ) (24,603 ) (79,779 ) Total $ 9,304,889 $ 1,571,745 $ 10,876,634 (1) As noted above, prior period amounts have not been adjusted under the cumulative effect method. In this table, the Company's U.S. dialysis revenues for the year ended December 31, 2017 has been presented net of the provision for uncollectible accounts of $485,364 to conform to the current period presentation. (2) Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services. The Company’s allowance for doubtful accounts related to performance obligations satisfied prior to the adoption of Topic 606 was $8,328 and $52,924 as of December 31, 2019 and 2018 , respectively. As described in Note 1, there are significant risks associated with estimating revenue, many of which 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 these changes in estimates, additional revenue of $37,274 was recognized during the year ended December 31, 2019 associated with performance obligations satisfied prior to January 1, 2019 and additional revenue of $88,495 was recognized during the year ended December 31, 2018 associated with performance obligations satisfied in years prior to the adoption of Topic 606, which included a benefit of $36,000 from electing to apply Topic 606 only to contracts not substantially completed as of January 1, 2018 . There is no single commercial payor that accounted for more than 10% of total consolidated accounts receivable or consolidated revenues at or for the years ended December 31, 2019 or 2018 . Net dialysis services accounts receivable and other receivables from Medicare, including Medicare-assigned plans, and Medicaid, including managed Medicaid plans, were approximately $1,038,248 and $1,080,561 as of December 31, 2019 and 2018 , respectively. Approximately 18% of the Company’s net patient services accounts receivable balances as of both December 31, 2019 and 2018 , were more than six months old. There were no significant balances over one year old at December 31, 2019 . The Company's accounts receivable are principally due from Medicare and Medicaid programs and commercial insurance plans.

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2019
Earnings Per Share [Abstract]
Earnings Per Share	Earnings per share Basic earnings per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interest redemption rights in excess of fair value, by the weighted average number of common shares outstanding, reduced for 2018 and 2017 by the weighted average shares held in escrow that under certain circumstances may have been returned to the Company. Weighted average common shares outstanding include restricted stock unit awards that are no longer subject to forfeiture because the recipients have satisfied either their explicit vesting terms or retirement eligibility requirements. Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units (under the treasury stock method) and, for 2018 and 2017, the weighted average contingently returnable shares held in escrow that were outstanding during the period. The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows: Year ended December 31, 2019 2018 2017 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 706,832 $ 624,321 $ 901,277 Net income (loss) from discontinued operations attributable to DaVita Inc. 104,149 (464,927 ) (237,659 ) Net income attributable to DaVita Inc. for earnings per share calculation $ 810,981 $ 159,394 $ 663,618 Basic: Weighted average shares outstanding during the period 153,181 171,886 190,820 Weighted average contingently returnable shares previously held in escrow for — (1,100 ) (2,194 ) Weighted average shares for basic earnings per share calculation 153,181 170,786 188,626 Basic net income (loss) attributable to DaVita Inc. from: Continuing operations per share $ 4.61 $ 3.66 $ 4.78 Discontinued operations per share 0.68 (2.73 ) (1.26 ) Basic net income per share attributable to DaVita Inc. $ 5.29 $ 0.93 $ 3.52 Diluted: Weighted average shares outstanding during the period 153,181 171,886 190,820 Assumed incremental shares from stock plans 631 479 529 Weighted average shares for diluted earnings per share calculation 153,812 172,365 $ 191,349 Diluted net income (loss) attributable to DaVita Inc. from: Continuing operations per share $ 4.60 $ 3.62 $ 4.71 Discontinued operations per share 0.67 (2.70 ) (1.24 ) Diluted net income per share attributable to DaVita Inc. $ 5.27 $ 0.92 $ 3.47 Anti-dilutive stock-settled awards excluded from calculation (1) 5,936 5,295 4,350 (1) Shares associated with stock-settled stock appreciation rights excluded from the diluted denominator calculation because they were anti-dilutive under the treasury stock method.

Restricted Cash Restricted Cash

Restricted Cash Restricted Cash	12 Months Ended
	Dec. 31, 2019
Restricted Cash [Abstract]
Cash and Cash Equivalents Disclosure [Text Block]	Restricted cash and equivalents The Company had restricted cash and cash equivalents of $106,346 and $92,382 at December 31, 2019 and 2018 , respectively. Approximately $91,847 of the balance at December 31, 2019 represents restricted cash equivalents held in trust to satisfy insurer and state regulatory requirements related to the wholly-owned captive insurance companies that bear professional and general liability and workers' compensation risks for the Company. The remaining restricted cash and cash equivalents held at December 31, 2019 primarily represent cash pledged to third parties in connection with one of the Company's ancillary and strategic initiatives businesses.

Short-term and long-term invest

Short-term and long-term investments	12 Months Ended
	Dec. 31, 2019
Investments, Debt and Equity Securities [Abstract]
Investments in Debt and Equity Securities	Short-term and long-term investments The Company adopted ASU No. 2016-01, Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities, and related ASU 2018-03 concerning certain technical corrections and improvements, effective January 1, 2018 . Under ASU 2016-01 all changes in the fair values of equity securities with readily determinable fair values are to be recognized in current earnings. Adoption of these ASUs, in conjunction with ASU 2018-02, resulted in a cumulative effect of change in accounting principle effective January 1, 2018 which decreased accumulated other comprehensive income and increased retained earnings by $5,662 in after-tax unrealized gains accumulated in other comprehensive income through December 31, 2017 from equity securities previously classified as available-for-sale investments. 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 within "Other income, net". 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: December 31, 2019 December 31, 2018 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 8,140 $ — $ 8,140 $ 2,235 $ — $ 2,235 Investments in mutual funds and common stock — 39,951 39,951 — 36,124 36,124 $ 8,140 $ 39,951 $ 48,091 $ 2,235 $ 36,124 $ 38,359 Short-term investments $ 8,140 $ 3,432 $ 11,572 $ 2,235 $ 700 $ 2,935 Long-term investments — 36,519 36,519 — 35,424 35,424 $ 8,140 $ 39,951 $ 48,091 $ 2,235 $ 36,124 $ 38,359 Debt securities: The Company's short-term debt investments are principally 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 approximated their fair values at December 31, 2019 and 2018 . 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 2019 , the Company recognized pre-tax net gains of $4,383 in other income associated with changes in the fair value of these equity securities, comprised of pre-tax realized gains of $1,459 and a net increase in unrealized gains of $2,924 . During 2018 , the Company recognized pre-tax net losses of $1,208 in other income associated with changes in the fair value of these equity securities, comprised of pre-tax realized gains of $4,490 and a net decrease in unrealized gains of $5,698

Other Receivables Other Receiva

Other Receivables Other Receivables	12 Months Ended
	Dec. 31, 2019
Receivables [Abstract]
Other Receivables	Other receivables Other receivables were comprised of the following: December 31, 2019 2018 Supplier rebates and non-trade receivables $ 351,650 $ 334,156 Medicare bad debt claims 138,045 135,640 $ 489,695 $ 469,796

Property and Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment Property and equipment were comprised of the following: December 31, 2019 2018 Land $ 36,480 $ 37,384 Buildings 392,256 467,181 Leasehold improvements 3,545,224 3,164,943 Equipment and information systems, including internally developed software 2,880,645 2,586,564 New center and capital asset projects in progress 588,345 661,695 7,442,950 6,917,767 Less accumulated depreciation (3,969,566 ) (3,524,098 ) $ 3,473,384 $ 3,393,669 Depreciation expense on property and equipment was $600,905 , $574,799 , and $544,129 for 2019 , 2018 and 2017 , respectively. Interest on debt incurred during the development of new centers and other capital asset projects is capitalized as a component of the asset cost based on the respective in-process capital asset balances. Interest capitalized was $27,322 , $25,978 and $19,176 for 2019 , 2018 and 2017 , respectively. During 2018 , the Company recognized asset impairment charges of $17,338 related to the restructuring of its pharmacy business.

Intangibles

Intangibles	12 Months Ended
	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Intangibles	Intangibles Intangible assets other than goodwill were comprised of the following: December 31, 2019 2018 Noncompetition agreements $ 103,510 $ 107,726 Indefinite-lived licenses 90,209 59,885 Other 23,887 31,801 217,606 199,412 Less accumulated amortization (81,922 ) (80,566 ) $ 135,684 $ 118,846 Amortization expense from amortizable intangible assets other than lease agreements was $14,247 , $16,236 , and $15,782 for 2019 , 2018 and 2017 , respectively. Lease agreement intangible assets and liabilities, previously recognized apart from lease right-of-use assets and liabilities prior to adoption of Topic 842, were amortized to rent expense in the amounts of $(296) and $(203) for December 31, 2018 and 2017 , respectively. For the years ended December 31, 2019 , 2018 and 2017 , the Company recognized no impairment charges on any intangible assets other than goodwill. Amortizable intangible liabilities as of December 31, 2018 were comprised of lease agreements of $5,930 , which were net of accumulated amortization of $4,362 . With the adoption of Topic 842 on January 1, 2019, the Company no longer classifies these as intangible assets or intangible liabilities on its balance sheet. See Notes 1 and 14 for further discussion of our adoption of Topic 842. Scheduled amortization charges from amortizable intangible assets and liabilities as of December 31, 2019 were as follows: Noncompetition Other 2020 $ 11,470 $ 1,779 2021 9,703 1,335 2022 6,141 1,330 2023 3,118 1,294 2024 1,429 1,046 Thereafter 525 6,305 Total $ 32,386 $ 13,089

Equity Method and Other Investm

Equity Method and Other Investments	12 Months Ended
	Dec. 31, 2019
Investments, Debt and Equity Securities [Abstract]
Equity Method and Other Investments	Equity method and other investments Equity investments in nonconsolidated businesses 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 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 ASU 2016-01, the Company elected to adopt an adjusted cost method measurement alternative for investments in equity securities without readily determinable fair values that do not qualify for the equity method. Under this alternative, unless elected otherwise for a particular investment, the Company initially records such equity investments 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. The Company's equity method and other investments were comprised of the following: December 31, 2019 2018 APAC joint venture $ 116,924 $ 129,173 Other equity method partnerships 114,611 83,052 Adjusted cost method investments 10,448 12,386 $ 241,983 $ 224,611 During 2019 , 2018 and 2017 , the Company recognized equity investment income (loss) of $12,679 , $(4,484) and $(8,640) , respectively, from its equity method investments in nonconsolidated businesses. The Company's largest equity method investment is its ownership interest in DaVita Care Pte. Ltd. (the APAC joint venture, or APAC JV). During the fourth quarter of 2019, one of the third party noncontrolling investors in the APAC JV made its final subscribed capital contribution to the joint venture and the other third party noncontrolling investor elected to exit the joint venture. As a result, the Company now holds a 75% voting and economic interest in the APAC JV and its other noncontrolling investor holds a 25% voting and economic interest in the joint venture. The governance structure and voting rights established for the APAC JV, which remain unchanged since its formation on August 1, 2016 , provide that 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 joint venture's other noncontrolling investor. As a result, the Company does not consolidate the APAC JV. Prior to the transactions described above and as of December 31, 2018 , the Company held a 60% voting interest and a 73.3% economic interest in the APAC JV, while the other two noncontrolling investors collectively held a 40% voting interest and a 26.7% economic interest in the APAC JV. During the year ended December 31, 2017 , the Company recognized a non-cash other-than-temporary impairment charge of $280,066 on its investment in the APAC JV. This charge resulted from changes in then-current expectations for the joint venture based on continuing market research and assessments by both the Company and the APAC JV concerning the size of the addressable market available to the joint venture at attractive risk-adjusted returns. The Company's other equity method investments include 20 legal entities over which the Company has significant influence but in which it does not maintain a controlling financial interest. Almost all of these are U.S. partnerships in the form of limited liability companies. The Company's ownership interests in these partnerships vary, but typically range from 30% to 50% . There were no significant impairments or other valuation adjustments on the Company's adjusted cost method investments during 2019 or 2018

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill Changes in the carrying value of goodwill by reportable segments were as follows: U.S. dialysis Other - Ancillary services Consolidated Balance at December 31, 2017 $ 6,144,761 $ 465,518 $ 6,610,279 Acquisitions 130,574 147,774 278,348 Divestitures (331 ) (15,166 ) (15,497 ) Impairment charges — (3,106 ) (3,106 ) Foreign currency and other adjustments — (28,064 ) (28,064 ) Balance at December 31, 2018 $ 6,275,004 $ 566,956 $ 6,841,960 Acquisitions 18,089 72,137 90,226 Impairment charges — (124,892 ) (124,892 ) Foreign currency and other adjustments (5,993 ) (13,666 ) (19,659 ) Balance at December 31, 2019 $ 6,287,100 $ 500,535 $ 6,787,635 Goodwill $ 6,287,100 $ 653,870 $ 6,940,970 Accumulated impairment charges — (153,335 ) (153,335 ) $ 6,287,100 $ 500,535 $ 6,787,635 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 since adoption of this ASU were performed under this new guidance. When performing quantitative goodwill impairment assessments, the Company estimates fair value using either appraisals developed with an independent third party valuation firm which consider both discounted cash flow estimates for the subject business and observed market multiples for similar businesses, or offer prices received for the subject business that would be acceptable to the Company. Each of the Company’s operating segments described in Note 25 to these consolidated financial statements represents an individual reporting unit for goodwill impairment assessment purposes and each sovereign jurisdiction within the Company’s international operating segments is considered a separate reporting unit. Within the U.S. dialysis operating segment, the Company considers each of its dialysis centers to constitute an individual business for which discrete financial information is available. However, since these dialysis centers have similar operating and economic characteristics, and the allocation of resources and significant investment decisions concerning these businesses are highly centralized and the benefits broadly distributed, the Company has aggregated these centers and deemed them to constitute a single reporting unit. The Company has applied a similar aggregation to the vascular access service centers in its vascular access services reporting unit, to the physician practices in its physician services reporting units, and to the dialysis centers and other health operations 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, 2019 and September 30, 2019, the Company recognized goodwill impairment charges of $41,037 and $78,439 , respectively, in its Germany kidney care business. The first quarter of 2019 charge resulted primarily from a change in relevant discount rates, as well as a decline in current and expected future patient census and an increase in first quarter of 2019 and expected future costs, principally due to wage increases expected to result from recently announced legislation. The incremental charge recognized during the third quarter of 2019 resulted from changes and developments in the Company's outlook for this business since its last assessment. These primarily concerned developments in the business in response to evolving market conditions and changes in the Company's expected timing and ability to mitigate them, which was based on results of in-depth operating and strategic reviews completed by the Company’s new Germany management team during the third quarter of 2019. During the year ended December 31, 2019, the Company also recognized a goodwill impairment charge of $5,416 in its German other health operations. The impairment charges recognized in 2019 at the Company’s Germany kidney care business and its German other health operations include increases of $25,621 and $1,013 , respectively, to the goodwill impairment charges, and reductions to deferred tax expense, related to deferred tax assets that the impairments themselves generated. The result was $124,892 in total goodwill impairment charges to operating income and reductions of $26,634 in tax expense, for a net $98,258 impact on net income. Based on the most recent assessments, the Company determined that further changes in expected patient census, increases in operating costs, reductions in reimbursement rates, changes in actual or expected growth rates, or other significant adverse changes in expected future cash flows or valuation assumptions could result in goodwill impairment charges in the future for the following reporting units, which remain at risk of goodwill impairment as of December 31, 2019 : Reporting unit Goodwill Carrying amount (1) Sensitivities Operating (2) Discount (3) Germany kidney care $ 295,151 — % (1.3 )% (11.0 )% Brazil kidney care $ 88,551 4.4 % (2.8 )% (7.0 )% (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. During the year ended December 31, 2018 , the Company recognized a goodwill impairment charge of $3,106 at its German other health operations. During the year ended December 31, 2017 , the Company recognized goodwill impairment charge of $34,696 at its vascular access reporting unit. This charge resulted primarily from changes in future governmental reimbursement rates for this business and the Company’s then-evolving plans and expected ability to mitigate them. As of December 31, 2017 , there was no goodwill remaining at the Company's vascular access reporting unit. The Company also recognized a goodwill impairment charge of $1,500 at one of its international reporting units during the year ended December 31, 2017. Except as described above, none of the Company’s other reporting units were considered at risk of significant goodwill impairment as of December 31, 2019 . Since the dates of the Company’s last annual goodwill impairment assessments, 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 did not cause management to believe it is more likely than not that the fair values of any of the Company’s reporting units would be less than their respective carrying amounts as of December 31, 2019 .

Other Liabilities

Other Liabilities	12 Months Ended
	Dec. 31, 2019
Other Liabilities Disclosure [Abstract]
Other Liabilities	Other liabilities Other liabilities were comprised of the following: December 31, 2019 2018 Payor refunds and retractions $ 377,044 $ 302,244 Insurance and self-insurance accruals 58,941 58,569 Accrued interest 54,899 82,827 Accrued non-income tax liabilities 36,285 28,663 Other 229,005 123,547 $ 756,174 $ 595,850

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	Income taxes The Company accounts for income taxes under the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements. Under this method, deferred tax assets and liabilities are determined on the basis of the differences between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Income before income taxes from continuing operations consisted of the following: Year ended December 31, 2019 2018 2017 Domestic $ 1,307,299 $ 1,083,578 $ 1,725,822 International (111,860 ) (35,100 ) (326,036 ) $ 1,195,439 $ 1,048,478 $ 1,399,786 Income tax expense for continuing operations consisted of the following: Year ended December 31, 2019 2018 2017 Current: Federal $ 208,339 $ 140,064 $ 330,191 State 58,026 32,990 47,228 International 15,545 7,557 3,422 Total current income tax 281,910 180,611 380,841 Deferred: Federal 44,263 52,034 (98,760 ) State (25,836 ) 21,096 37,347 International (20,709 ) 4,659 4,431 Total deferred income tax (2,282 ) 77,789 (56,982 ) $ 279,628 $ 258,400 $ 323,859 Income taxes are allocated between continuing and discontinued operations as follows: Year ended December 31, 2019 2018 2017 Continuing operations $ 279,628 $ 258,400 $ 323,859 Discontinued operations 40,689 99,768 (364,856 ) $ 320,317 $ 358,168 $ (40,997 ) The reconciliation between the Company’s effective tax rate from continuing operations and the U.S. federal income tax rate is as follows: Year ended December 31, 2019 2018 2017 Federal income tax rate 21.0 % 21.0 % 35.0 % State income taxes, net of federal benefit 2.3 4.1 3.7 Change in International valuation allowance 1.3 0.9 0.4 Gain on APAC JV ownership changes — — (0.2 ) Political advocacy costs 0.2 2.3 — APAC investment impairment — — 6.4 Impact of 2017 Tax Act — (0.1 ) (20.5 ) Unrecognized tax benefits 2.4 0.2 0.1 Other 1.1 0.8 1.5 Impact of noncontrolling interests primarily attributable (4.9 ) (4.6 ) (3.3 ) Effective tax rate 23.4 % 24.6 % 23.1 % On December 22, 2017, the President signed into law tax legislation known as the Tax Cuts and Jobs Act (2017 Tax Act). Consistent with Securities and Exchange Commission (SEC) Staff Accounting Bulletin No. 118, the Company completed its analysis of certain aspects of the 2017 Tax Act in 2017 and recorded provisional amounts for those items for which the accounting was not complete as of December 31, 2017. The Company completed its analysis of these provisional items in 2018 and recorded immaterial adjustments to the original estimates. Deferred tax assets and liabilities arising from temporary differences for continuing operations were as follows: December 31, 2019 2018 Receivables $ 19,095 $ 19,327 Accrued liabilities 64,458 106,506 Operating lease liabilities 580,110 — Net operating loss carryforwards 139,690 117,511 Other 55,108 36,712 Deferred tax assets 858,461 280,056 Valuation allowance (91,925 ) (70,474 ) Net deferred tax assets 766,536 209,582 Intangible assets (563,914 ) (555,822 ) Property and equipment (162,628 ) (118,008 ) Operating lease assets (527,056 ) — Investments in partnerships (64,960 ) (67,354 ) Other (25,521 ) (30,934 ) Deferred tax liabilities (1,344,079 ) (772,118 ) Net deferred tax liabilities $ (577,543 ) $ (562,536 ) At December 31, 2019 , the Company had federal net operating loss carryforwards of approximately $111,322 that expire through 2036 , although a substantial amount expire by 2028 . The Company also had state net operating loss carryforwards of $434,030 , some of which have an indefinite life, although a substantial amount expire by 2039 and international net operating loss carryforwards of $224,197 , some of which will begin to expire in 2021 though the majority have an indefinite life. We have a state capital loss carryover of $188,823 that expires in 2024 . The utilization of a portion of these losses may be limited in future years based on the profitability of certain entities. A valuation allowance is recorded to account for the unrealizable balances in the table above. The net increase of $21,451 in the valuation allowance is primarily due to newly created net operating loss carryforwards in state and foreign jurisdictions that the Company does not anticipate being able to utilize. The Company's foreign earnings continue to be indefinitely reinvested as of December 31, 2019 . As a result of the passage of the 2017 Tax Act, the Company does not expect such earnings to be taxable if remitted. Unrecognized tax benefits A reconciliation of the beginning and ending liability for unrecognized tax benefits that do not meet the more-likely-than-not threshold is as follows: Year ended December 31, 2019 2018 Beginning balance $ 40,382 $ 32,776 Additions for tax positions related to current year 3,378 6,111 Additions for tax positions related to prior years 24,722 4,134 Reductions related to lapse of applicable statute (268 ) (338 ) Reductions related to settlements with taxing authorities — (2,301 ) Ending balance $ 68,214 $ 40,382 As of December 31, 2019 , the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold is $68,214 , of which $63,968 would impact the Company’s effective tax rate if recognized. This balance represents an increase of $27,832 from the December 31, 2018 balance of $40,382 , primarily due to additions for tax positions related to prior years. The Company recognizes accrued interest and penalties related to unrecognized tax benefits in income tax expense. At December 31, 2019 and 2018 , the Company had approximately $14,428 and $9,019 , respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefit. The Company and its subsidiaries file U.S. federal and state income tax returns and various foreign income tax returns. The Company is no longer subject to U.S. federal and state examinations by tax authorities for years before 2014 and 2009, respectively. In addition to being under audit in various state and local tax jurisdictions, the Company’s federal tax returns are under audit by the Internal Revenue Service for the years 2014-2017.

Long-Term Debt

Long-Term Debt	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Long-Term Debt	Long-term debt Long-term debt was comprised of the following: December 31, As of December 31, 2019 2019 2018 Maturity date Interest rate Estimated fair value (5) Senior Secured Credit Facilities (1) : New Term Loan A $ 1,739,063 $ — 8/12/2024 LIBOR + 1.50% $ 1,739,063 New Term Loan B (2) 2,743,125 — 8/12/2026 LIBOR + 2.25% $ 2,770,556 Prior Term Loan A (3) — 675,000 12/24/2019 (4) $ — Prior Term Loan A-2 (3) — 995,000 12/24/2019 (4) $ — Prior Term Loan B — 3,342,500 6/24/2021 (4) $ — Prior revolving line of credit (3) — 175,000 12/24/2019 (4) $ — Senior Notes: 5 1/8% Senior Notes 1,750,000 1,750,000 7/15/2024 5.125 % $ 1,789,375 5% Senior Notes 1,500,000 1,500,000 5/1/2025 5.00 % $ 1,538,700 5 3/4% Senior Notes — 1,250,000 8/15/2022 Acquisition obligations and other (6) 180,352 183,979 2019-2027 5.35 % $ 180,352 Financing lease obligations (7) 268,534 282,737 2019-2036 5.39 % $ 268,534 Total debt principal outstanding 8,181,074 10,154,216 Discount and deferred financing (8) (72,840 ) (52,000 ) 8,108,234 10,102,216 Less current portion (130,708 ) (1,929,369 ) $ 7,977,526 $ 8,172,847 (1) As of December 31, 2019 , the Company has an undrawn new revolving line of credit under its new senior secured credit facilities of $1,000,000 . The new revolving line of credit interest rate in effect at December 31, 2019 was 1.50% plus London Interbank Offered Rate (LIBOR) and it matures on August 12, 2024 . (2) On February 13, 2020 , the Company entered into an amendment to its credit agreement governing its senior secured credit facilities to refinance the new Term Loan B with a $2,743,125 secured Term Loan B-1 that bears interest at a rate equal to LIBOR plus an applicable margin of 1.75% and matures on August 12, 2026 . (3) On May 6, 2019, the Company entered into an agreement to extend the maturity dates of its then existing Term Loan A, Term Loan A-2 and revolving line of credit under its prior senior secured credit facilities by six months , to December 24, 2019 . (4) At June 30, 2019, the interest rate on the Company's then existing term loan debt was LIBOR plus interest rate margins in effect of 2.00% for the prior Term Loan A and prior revolving line of credit, 1.00% for the prior Term Loan A-2 and 2.75% for the prior Term Loan B. (5) Fair value estimates are based upon quoted bid and ask prices for these instruments, typically a level 2 input. The balances of acquisition obligations and other notes payable and financing lease obligations are presented in the consolidated financial statements as of December 31, 2019 at their approximate fair values due to the short-term nature of their settlements. (6) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current interest rate in effect and assuming no changes to the LIBOR based interest rates. (7) The interest rate presented for financing lease obligations is their weighted average discount rate. (8) As of December 31, 2019 , the carrying amount of the Company’s current senior secured credit facilities includes a discount of $6,457 and deferred financing costs of $45,444 , and the carrying amount of the Company’s senior notes includes deferred financing costs of $20,939 . As of December 31, 2018 , the carrying amount of the Company’s then existing senior secured credit facilities included a discount of $6,104 and deferred financing costs of $12,580 , and the carrying amount of the Company’s senior notes included deferred financing costs of $33,316 . Scheduled maturities of long-term debt at December 31, 2019 were as follows: 2020 $ 130,708 2021 $ 153,110 2022 $ 168,951 2023 $ 224,437 2024 $ 3,172,298 Thereafter $ 4,331,570 The Company completed the sale of its DMG business to Optum on June 19, 2019 , and, in accordance with the terms of its prior senior secured credit agreement, used all of the net proceeds from the sale of DMG to prepay term debt outstanding under that credit agreement. During the year ended December 31, 2019 , the Company made mandatory principal prepayments of $647,424 on the prior Term Loan A, $995,000 on the prior Term Loan A-2 and $2,823,447 on the prior Term Loan B. On August 12, 2019 , the Company entered into a new $5,500,000 senior secured credit agreement (the New Credit Agreement) consisting of a secured term loan A facility in the aggregate principal amount of $1,750,000 with a delayed draw feature, a secured term loan B facility in the aggregate principal amount of $2,750,000 and a secured revolving line of credit in the aggregate principal amount of $1,000,000 (the foregoing referred to as the new Term Loan A, new Term Loan B and new revolving line of credit, respectively). In addition, the Company can increase the existing revolving commitments and enter into one or more incremental term loan facilities in an amount not to exceed the sum of $1,500,000 (less the amount of other permitted indebtedness incurred or issued in reliance on such amount), plus an amount of indebtedness such that the senior secured leverage ratio is not in excess of 3.50 :1.00 after giving effect to such borrowings. The new Term Loan A and new revolving line of credit initially bear interest at LIBOR plus an interest rate margin of 1.50% , which is subject to adjustment depending upon the Company's leverage ratio under the New Credit Agreement and can range from 1.00% to 2.00% . The new Term Loan A requires amortizing quarterly principal payments beginning on December 31, 2019 , in annual amounts of $10,937 in 2019, $54,689 in 2020, $87,500 in 2021, $98,437 in 2022 and $142,187 in 2023, with the balance of $1,356,250 due in 2024. The new Term Loan B bears interest at LIBOR plus an interest rate margin of 2.25% . The new Term Loan B requires amortizing quarterly principal payments beginning on December 31, 2019 , in annual amounts of $6,875 in 2019 and $27,500 for each year from 2020 through 2025, with the balance of $2,578,125 due in 2026. The Company's term loans and revolving line of credit under its New Credit Agreement are guaranteed by certain of the Company’s direct and indirect wholly-owned domestic subsidiaries, which hold most of the Company’s domestic assets, and are secured by substantially all of the assets of DaVita Inc. and these guarantors. Contemporaneous with the Company entering into the New Credit Agreement and pursuant to the indentures governing the Company’s senior notes, certain subsidiaries of the Company were released from their guarantees of the Company's senior notes such that, after that release, the remaining subsidiary guarantors of the senior notes were the same subsidiaries guaranteeing the New Credit Agreement. The New Credit Agreement contains certain customary affirmative and negative covenants such as various restrictions or limitations on permitted amounts of investments, acquisitions, share repurchases, payment of dividends, and redemptions and incurrence of other indebtedness. Many of these restrictions and limitations will not apply as long as the Company’s leverage ratio calculated in accordance with the New Credit Agreement is below 4.00 :1.00. In addition, the New Credit Agreement places limitations on the amount of gross revenue from individual immaterial subsidiaries and also requires compliance with a maximum leverage ratio covenant of 5.00 :1.00 through 2022 and 4.50 :1.00 thereafter. The senior notes are unsecured obligations, rank equally in right of payment with the Company’s existing and future unsecured senior indebtedness, are guaranteed by certain of the Company’s direct and indirect wholly-owned domestic subsidiaries, and require semi-annual interest payments. The Company may redeem some or all of the senior notes at any time on or after certain specific dates and at certain specific redemption prices as outlined in each senior note agreement. Interest rates on the senior notes are fixed by their terms, and the Company is restricted from paying dividends under the indentures governing its senior notes. In 2019 , the Company used a portion of the proceeds from the new Term Loan A and new Term Loan B to pay off the remaining principal balances outstanding and accrued interest and fees on its prior Term Loan B and prior revolving line of credit in the amount of $1,153,274 ; to redeem all of its outstanding 5.75% senior notes due in 2022 for an aggregate cash payment consisting of principal, redemption premium and accrued but unpaid interest to the redemption date of $1,267,565 ; and to repurchase 21,802 shares of common stock under its modified Dutch auction tender offer (Tender Offer) for a total cost of $1,234,154 , including fees and expenses, as described in Note 19 of these consolidated financial statements. The remaining debt borrowings added cash to the balance sheet for potential acquisitions, share repurchases and other general corporate purposes. In addition to the prepayments described above, during the year ended December 31, 2019 , the Company made regularly scheduled principal payments under its then existing senior secured credit facilities of $27,576 on its prior Term Loan A and $17,500 on its prior Term Loan B, as well as $10,937 on its new Term Loan A and $6,875 on its new Term Loan B. As a result of the transactions described above, the Company recognized debt prepayment, refinancing and redemption charges of $33,402 in the year ended December 31, 2019 , as a result of the repayment of all principal balances outstanding on the Company's prior senior secured credit facilities and the redemption of its 5.75% senior notes, of which $21,242 represented debt discount and deferred financing cost write-offs associated with the portion of the Company's prior senior secured debt that was paid in full in the third quarter of 2019 as well as redemption charges on its 5.75% senior notes redeemed in the third quarter of 2019, and $12,160 represented accelerated amortization of debt discount and deferred financing costs associated with the portion of the Company's prior senior secured debt that was mandatorily prepaid in or shortly after the second quarter of 2019 and prior extensions of that debt. On February 13, 2020 , (the “Amendment Date”), the Company entered into an amendment to its credit agreement (the “Repricing Amendment”) governing the senior secured credit facilities to refinance the new Term Loan B with a $2,743,125 secured Term Loan B-1 that bears interest at a rate equal to LIBOR plus an applicable margin of 1.75% and matures on August 12, 2026 . The Repricing Amendment did not change the interest rate on the new Term Loan A or the new revolving line of credit. No additional debt was incurred, nor any proceeds received, by the Company in connection with the Repricing Amendment. As of December 31, 2019 , the Company maintains several 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, including all of the new Term Loan B and a portion of the new Term Loan A. The remaining $982,188 outstanding principal balance of the new Term Loan A is subject to LIBOR-based interest rate volatility. The cap agreements are designated as cash flow hedges and, as a result, changes in their fair values are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on the interest method over the terms of the cap agreements. These cap agreements do not contain credit-risk contingent features. In August 2019, the Company entered into several forward interest rate cap agreements with a notional amount of $3,500,000 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 (2019 cap agreements). These 2019 cap agreements are designated as cash flow hedges and, as a result, changes in their fair values are reported in other comprehensive income. These 2019 cap agreements do not contain credit-risk contingent features and become effective on June 30, 2020 . The following table summarizes the Company’s interest rate cap agreements outstanding as of December 31, 2019 and December 31, 2018 , which are classified in "Other long-term assets" on its consolidated balance sheet: Year ended December 31, December 31, 2019 2019 2018 Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI (loss) gain Fair value 2015 cap agreements $ 3,500,000 3.50% 6/29/2018 6/30/2020 $ 8,654 $ (851 ) $ — $ 851 2019 cap agreements $ 3,500,000 2.00% 6/30/2020 6/30/2024 $ 2,417 $ 24,452 The following table summarizes the effects of the Company’s interest rate cap and swap agreements for the years ended December 31, 2019 , 2018 and 2017 : Amount of unrealized gains (losses) in OCI Location of losses Reclassification from accumulated other comprehensive income into net income Year ended December 31, Year ended December 31, Derivatives designated as cash flow hedges 2019 2018 2017 2019 2018 2017 Interest rate cap agreements $ 1,566 $ (181 ) $ (8,897 ) Debt expense $ 8,591 $ 8,466 $ 8,278 Tax (expense) benefit (415 ) 48 3,460 Tax expense (2,214 ) (2,180 ) (3,220 ) Total $ 1,151 $ (133 ) $ (5,437 ) $ 6,377 $ 6,286 $ 5,058 See Note 20 for further details on amounts recorded and reclassified from accumulated other comprehensive (loss) income. The Company’s weighted average effective interest rate on the senior secured credit facilities at the end of 2019 was 3.93% , based upon the current margins in effect for the new Term Loan A and the new Term Loan B as of December 31, 2019 . The Company’s overall weighted average effective interest rate during the year ended December 31, 2019 was 5.01% and as of December 31, 2019 was 4.46% . As of December 31, 2019 , the Company’s interest rates were fixed on approximately 44.29% of its total debt. As of December 31, 2019 , the Company had an undrawn revolving line of credit under its new senior secured credit facilities of $1,000,000 , of which approximately $13,055 was committed for outstanding letters of credit. The Company also had approximately $59,705 of outstanding letters of credit under a separate bilateral secured letter of credit facility. Debt expense Debt expense consisted of interest expense of $419,639 , $461,897 and $406,341 and the amortization and accretion of debt discounts and premiums, amortization of deferred financing costs and the amortization of interest rate cap agreements of $24,185 , $25,538 and $24,293 for 2019 , 2018 and 2017 , respectively. These interest expense amounts are net of capitalized interest.

Leases

Leases	12 Months Ended
	Dec. 31, 2019
Leases [Abstract]
Leases	Leases The Company leases substantially all of its U.S. dialysis facilities. The majority of the Company’s facilities are leased under non-cancellable operating leases ranging in terms from five years to 15 years and which contain renewal options of five years to ten years at the fair rental value at the time of renewal. These renewal options are included in the Company’s determination of the right-of-use assets and related lease liabilities when renewal is considered reasonably certain at the commencement date. Certain of the Company’s leases are subject to periodic consumer price index increases or contain fixed escalation clauses. The Company also leases certain facilities and equipment under finance leases. The Company has elected the practical expedient to not separate lease components from non-lease components for its financing and operating leases. Financing and operating right-of-use assets are recognized based on the net present value of lease payments over the lease term at the commencement date. Since most of the Company's leases do not provide an implicit rate of return, the Company uses its incremental borrowing rate based on information available at the commencement date or remeasurement date in determining the present value of lease payments. As of December 31, 2019 and December 31, 2018 , assets recorded under finance leases were $247,246 and $367,164 , respectively, and accumulated amortization associated with finance leases was $27,193 and $131,971 , respectively, included in property and equipment, net, on the Company's consolidated balance sheet. In certain markets, the Company acquires and develops dialysis centers. Upon completion, the Company sells the center to a third party and leases the space back with the intent of operating the center on a long term basis. Both the sale and leaseback terms are generally market terms. The lease terms are consistent with the Company's other operating leases with the majority of the leases under non-cancellable operating leases ranging in terms from five years to 15 years and which contain renewal options of five years to ten years at the fair rental value at the time of renewal. The Company adopted Topic 842, Leases beginning on January 1, 2019 through a modified retrospective approach for leases existing at the adoption date with a cumulative effect adjustment. Consequently, financial information was not updated for dates and periods before January 1, 2019. The components of lease expense were as follows: Lease cost Year ended December 31, 2019 Operating lease cost (1) : Fixed lease expense $ 526,352 Variable lease expense 119,740 Financing lease cost: Amortization of leased assets 23,724 Interest on lease liabilities 14,932 Net lease cost $ 684,748 (1) Includes short-term lease expense and sublease income, which are immaterial. Other information related to leases was as follows: Lease term and discount rate December 31, 2019 Weighted average remaining lease term (years): Operating leases 9.0 Finance leases 10.2 Weighted average discount rate: Operating leases 4.1 % Finance leases 5.4 % Other information Year ended December 31, 2019 Gains on sale leasebacks, net $ 20,833 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 637,655 Operating cash flows for finance leases $ 22,257 Financing cash flows for finance leases $ 25,692 Net operating lease assets obtained in exchange for new or modified $ 432,074 Future minimum lease payments under non-cancellable leases as of December 31, 2019 are as follows: Operating leases Finance leases 2020 $ 462,131 $ 37,624 2021 489,799 33,267 2022 454,753 33,677 2023 409,655 33,825 2024 358,009 33,841 Thereafter 1,510,665 178,434 Total future minimum lease payments 3,685,012 350,668 Less portion representing interest (617,300 ) (82,134 ) Present value of lease liabilities $ 3,067,712 $ 268,534 Rent expense under all operating leases for 2019 , 2018 , and 2017 was $646,092 , $596,117 and $530,748 , respectively. Rent expense is recorded on a straight-line basis over the term of the lease, including leases that contain fixed escalation clauses or include abatement provisions. Leasehold improvement incentives are deferred and amortized to rent expense over the term of the lease. Finance lease obligations are included in long-term debt. See Note 13 for further details on long-term debt.

Employee Benefit Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2019
Retirement Benefits [Abstract]
Employee Benefit Plans	Employee benefit plans The Company has a 401(k) retirement savings plan for substantially all of its U.S. employees which has been established pursuant to the applicable provisions of the Internal Revenue Code (IRC). The plan allows for employees to contribute a percentage of their base annual salaries on a tax-deferred basis not to exceed IRC limitations. Beginning in 2018, the Company implemented a 401(k) matching program under which the Company matches 50% of the employee's contribution up to 6% of the employee's salary, subject to certain limitations. The matching contributions are subject to certain eligibility and vesting conditions. For the years ended December 31, 2019 and 2018 , the Company accrued matching contributions totaling approximately $64,988 and $67,807 , respectively. Prior to 2018, the Company did not provide matching contributions in connection with the 401(k) savings plan. The Company also maintains a voluntary compensation deferral plan, the Deferred Compensation Plan, as well as other legacy deferral plans. The Deferred Compensation Plan is non-qualified and permits certain employees whose annualized base salary equals or exceeds a minimum annual threshold amount as set by the Company to elect to defer all or a portion of their annual bonus payment and up to 50% of their base salary into a deferral account maintained by the Company. Total contributions to this plan in 2019 , 2018 and 2017 were $1,751 , $3,090 and $4,497 , respectively. Deferred amounts are generally paid out in cash at the participant’s election either in the first or second year following retirement or in a specified future period at least three to four years after the deferral election was effective. During 2019 , 2018 and 2017 the Company distributed $2,730 , $4,652 and $2,789 , respectively, to participants from its deferred compensation plans. Participants are credited with their proportional amount of annual earnings from the plans. The assets of these plans are held in rabbi trusts subject to the claims of the Company’s general creditors in the event of its bankruptcy. As of December 31, 2019 and 2018 , the total fair value of assets held in these plans' trusts was $39,527 and $36,124 , respectively. The assets of these plans are recorded at fair value with changes in fair value recorded in other comprehensive income prior to 2018 and recognized in "Other income, net" since January 1, 2018. Any fair value changes to the corresponding liability balance are recorded as compensation expense. See Note 5 for further details.

Contingencies

Contingencies	12 Months Ended
	Dec. 31, 2019
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, demands, claims, qui tam suits, governmental investigations and audits (including, without limitation, investigations or other actions resulting from its obligation to self-report suspected violations of law) and other legal proceedings. The Company records accruals for certain legal proceedings and regulatory matters to the extent that the Company determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. As of December 31, 2019 and December 31, 2018 , the Company’s total recorded accruals 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, without limitation, 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 may 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. Governmental Inquiries and Certain Related Proceedings 2016 U.S. Attorney Texas Investigation : In February 2016, DaVita Rx, LLC (DaVita Rx), a wholly-owned subsidiary of the Company, received a Civil Investigative Demand (CID) from the U.S. Attorney’s Office, 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 an investigation into the Company’s relationships with pharmaceutical manufacturers. The CID covers the period from January 1, 2006 through the present. 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 practices that had been identified by the Company in a self-disclosure filed with the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) in February 2016. In December 2017, the Company finalized and executed a settlement agreement with the government and relators in the qui tam matter that included total monetary consideration of $63,700 , as previously disclosed, 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 certain of the Company's relationships with pharmaceutical manufacturers is ongoing, and in July 2018 the OIG served the Company with a subpoena seeking additional documents and information relating to those relationships. 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 U.S. Attorney’s Office, District of Massachusetts, relating to an investigation into possible federal health care offenses. The subpoena covered the period from January 1, 2007 to the present, and sought 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 Department of Justice notified the court on July 23, 2019 of its decision to elect not to intervene in the matter of U.S. ex rel. David Gonzalez v. DaVita Healthcare Partners, et al . The complaint then was unsealed in the U.S. District Court, District of Massachusetts by order entered on August 1, 2019. The Department of Justice has confirmed that the complaint, which alleges violations of the FCA and various state false claims acts, was the basis of its investigation initiated in January 2017. The Company has not been served with the complaint. 2017 U.S. Attorney Colorado Investigation : In November 2017, the U.S. Attorney’s Office, District of Colorado informed the Company of an investigation it was conducting into possible federal healthcare offenses involving DaVita Kidney Care, as well as several of the Company’s wholly-owned subsidiaries. In addition to DaVita Kidney Care, the matter currently includes an investigation into DaVita Rx, DaVita Laboratory Services, Inc. (DaVita Labs), and RMS Lifeline Inc. (Lifeline). In each of August 2018 and May 2019, the Company received a CID pursuant to the FCA from the U.S. Attorney's Office relating to this investigation. The Company is continuing to cooperate with the government in this investigation. 2018 U.S. Attorney Florida Investigation : In March 2018, DaVita Labs received two CIDs from the U.S. 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 FCA. In October 2018, DaVita Labs received a subpoena from the OIG in connection with this matter requesting certain patient records linked to clinical laboratory tests. On September 30, 2019, the U.S. Attorney's Office notified the U.S. District Court, Middle District of Florida, of its decision not to elect to intervene at this time in the matter of U.S. ex rel. Lorne Holland, et al. v. DaVita Healthcare Partners, Inc. et al . The court then unsealed the complaint, which alleges violations of the FCA, by order dated the same day. In January 2020, the private party relators served the Company and DaVita Labs with an amended complaint. The Company and DaVita Labs dispute these allegations and intend to defend this action accordingly. * * * Although the Company cannot predict whether or when proceedings might be initiated or when these matters may be resolved (other than as may be 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, members of its board of directors or management, 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. On March 28, 2019, the U.S. District Court for the District of Colorado denied the motion to dismiss. The Company answered the complaint on May 28, 2019. 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. On April 25, 2019, the court denied the Company's motion to dismiss. The Company answered the complaint on May 28, 2019. On January 31, 2020, the plaintiffs filed a motion for class certification that the Company intends to oppose. 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, without limitation, 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. * * * Other than as may be described above, the Company cannot predict the ultimate outcomes of the various legal proceedings and regulatory matters to which the Company is or may be subject from time to time, including those described in this Note 16 to these 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, results of operations, financial condition, cash flows or reputation.

Noncontrolling Interests Subjec

Noncontrolling Interests Subject to Put Provisions and Other Commitments	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Noncontrolling Interests Subject to Put Provisions and Other Commitments	Noncontrolling interests subject to put provisions and other commitments Noncontrolling interests subject to put provisions The Company has potential obligations to purchase the equity interests held by third parties in many of its majority-owned dialysis partnerships and other nonconsolidated entities. These noncontrolling interests subject to put provisions constitute redeemable equity interests and are therefore classified as temporary equity and carried at estimated fair value on the Company's balance sheet. Specifically, these obligations are in the form of put provisions that are exercisable at the third-party owners’ discretion within specified periods 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, generally at the appraised fair market value of the equity interests or in certain cases at a predetermined multiple of earnings or cash flows attributable to the equity interests put to the Company, 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 is immaterial. The Company has certain other potential commitments to provide operating capital to a number of dialysis businesses that are wholly-owned by third parties or in which the Company owns a noncontrolling equity interest as well as to physician-owned vascular access clinics or medical practices that the Company operates under management and administrative service agreements of approximately $9,669 . Certain consolidated dialysis partnerships are originally contractually scheduled to dissolve after terms ranging from ten years to 50 years . While noncontrolling interests in these limited life entities qualify as mandatorily redeemable financial instruments, they are subject to a classification and measurement scope exception from the accounting guidance generally applicable to other mandatorily redeemable financial instruments. Future distributions upon dissolution of these entities would be valued below the related noncontrolling interest carrying balances in the consolidated balance sheet. Other commitments In 2017, the Company entered into a Sourcing and Supply Agreement with Amgen USA Inc. (Amgen) that expires on December 31, 2022 . Under the terms of the agreement, the Company will purchase EPO from Amgen in amounts necessary to meet no less than 90% of its requirements for erythropoiesis-stimulating agents (ESAs) through the expiration of the contract. The actual amount of EPO that the Company will purchase will depend upon the amount of EPO administered during dialysis as prescribed by physicians and the overall number of patients that the Company serves. The Company has an agreement with Fresenius Medical Care (FMC) to purchase a certain amount of dialysis equipment, parts and supplies from FMC, which extends through December 31, 2020 . The Company also has agreements with Baxter Healthcare Corporation (Baxter) that commit the Company to purchase certain amounts of dialysis supplies at fixed prices through 2022 . As of December 31, 2019 , the remaining minimum purchase commitments under these arrangements was approximately $399,042 , $312,119 and $312,101 , for the years 2020 , 2021 and 2022 , respectively. If the Company fails to meet the minimum purchase commitments under these contracts during any year, it is required to pay the difference to the supplier. Other than the letters of credit disclosed in Note 13 to these consolidated financial statements, and the arrangements as described above, the Company has no off balance sheet financing arrangements as of December 31, 2019 .

Long-term Incentive Compensatio

Long-term Incentive Compensation and Shareholders’ Equity	12 Months Ended
	Dec. 31, 2019
Share-based Payment Arrangement [Abstract]
Long-term Incentive Compensation and Shareholders’ Equity	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) and long-term performance-based cash awards. Long-term incentive compensation expense, which is primarily general and administrative in nature, is attributed to the Company’s U.S. dialysis business, its corporate administrative support, and its ancillary services. The Company’s stock-based compensation expense for stock-settled awards is measured at the estimated fair value of awards on the date of grant and recognized on a cumulative straight-line basis over the vesting terms of the awards, unless the stock awards are based on non-market-based performance metrics, in which case expense is adjusted for the ultimate number of shares expected to be issued as of the end of each reporting period. Stock-based compensation expense for cash-settled awards is based on their estimated fair values as of the end of each reporting period. The expense for all stock-based awards is recognized net of expected forfeitures. Stock-based compensation to be settled in shares is recorded to the Company’s shareholders’ contributed capital, while stock-based compensation to be settled in cash is recorded to a liability. Shares issued upon exercise of stock awards are issued from authorized but unissued shares. Long-term incentive compensation plans The Company’s 2011 Incentive Award Plan (the 2011 Plan) is the Company’s omnibus equity compensation plan and provides for grants of stock-based awards to employees, directors and other individuals providing services to the Company, except that incentive stock options may only be awarded to employees. The 2011 Plan authorizes the Company to award stock options, stock appreciation rights, restricted stock units, restricted stock, and other stock-based or performance-based awards. The 2011 Plan mandates a maximum award term of five years and stipulates that stock appreciation rights and stock options be granted with prices not less than fair market value on the date of grant. The 2011 Plan also requires that full value share awards such as restricted stock units reduce shares available under the 2011 Plan at a ratio of 3.5 :1. The Company’s nonqualified stock appreciation rights and stock units awarded under the 2011 Plan generally vest over 36 months to 48 months from the date of grant. At December 31, 2019 , there were 15,547 shares available for future grants under the 2011 Plan. This number of shares available does not reflect reduction for the Premium Priced Award described below, as that Board-approved award remained contingent on stockholder approval of an amendment to the 2011 Plan which did not occur until January 2020. A combined summary of the status of the Company’s stock-settled awards under the 2011 Plan, including base shares for stock-settled stock appreciation rights (SSARs) and stock-settled stock unit awards is as follows: Year ended December 31, 2019 Stock appreciation rights Stock units Awards Weighted Weighted Awards Weighted Outstanding at beginning of year 6,163 $ 69.90 1,860 Granted (1) ( 2) 2,389 $ 52.45 1,961 Exercised (20 ) $ 64.17 (225 ) Expired (1,058 ) $ 70.97 — Canceled (521 ) $ 65.23 (436 ) Outstanding at end of period (1) 6,953 $ 64.10 3.0 3,160 2.3 Exercisable at end of period 1,254 $ 77.68 1.1 — — Weighted-average fair value of grants 2019 $ 14.04 $ 50.58 2018 $ 16.24 $ 66.23 2017 $ 14.51 $ 65.73 (1) Awards granted and outstanding do not reflect the Premium Priced Award described below, as that Board-approved award remained contingent on stockholder approval of an amendment to the 2011 Plan which did not occur until January 2020. (2) Includes approximately 8 shares resulting from the payout of the first tranche of fiscal year 2016 PSU grants due to exceeding target payout. Awards Outstanding Weighted average exercise price Awards exercisable Weighted average exercise price Range of SSARs base prices $50.01–$60.00 2,400 $ 52.63 — $ — $60.01–$70.00 3,069 $ 66.16 186 $ 65.92 $70.01–$80.00 925 $ 75.28 509 $ 75.50 $80.01–$90.00 559 $ 83.59 559 $ 83.59 Total 6,953 $ 64.10 1,254 $ 77.68 For the years ended December 31, 2019 , 2018 , and 2017 , the aggregate intrinsic value of stock-based awards exercised was $11,475 , $31,045 and $34,895 , respectively. At December 31, 2019 , the aggregate intrinsic value of stock-based awards outstanding was $319,486 and the aggregate intrinsic value of stock awards exercisable was $1,783 . Estimated fair value of stock-based compensation awards The Company has estimated the grant-date fair value of stock-settled stock appreciation rights awards using the Black-Scholes-Merton valuation model and stock-settled stock unit awards at intrinsic value on the date of grant, except for portions of the Company’s performance stock unit awards for which a Monte Carlo simulation was used to estimate the grant-date fair value. The following assumptions were used in estimating these values and determining the related stock-based compensation expense attributable to the current period: Expected term of the awards: The expected term of awards granted represents the period of time that they are expected to remain outstanding from the date of grant. The Company determines the expected term of its stock awards based on its historical experience with similar awards, considering the Company’s historical exercise and post-vesting termination patterns, and the terms expected by peer companies in near industries. Expected volatility: Expected volatility represents the volatility anticipated over the expected term of the award. The Company determines the expected volatility for its awards based on the volatility of the price of its common stock over the most recent retrospective period commensurate with the expected term of the award, considering the volatility expectations implied by the market price of its exchange-traded options and the volatilities expected by peer companies in near industries. Expected dividend yield: The Company has not paid dividends on its common stock and does not currently expect to pay dividends during the term of stock awards granted. Risk-free interest rate: The Company bases the expected risk-free interest rate on the implied yield currently available on stripped interest coupons of U.S. Treasury issues with a remaining term equivalent to the expected term of the award. A summary of the weighted average valuation inputs described above used for estimating the grant-date fair value of SSAR awards granted in the periods indicated is as follows: Year ended December 31, 2019 2018 2017 Expected term 4.0 4.2 4.2 Expected volatility 29.5 % 23.8 % 23.9 % Expected dividend yield — % — % — % Risk-free interest rate 2.2 % 2.9 % 1.7 % The Company estimates expected forfeitures based upon historical experience with separate groups of employees that have exhibited similar forfeiture behavior in the past. Stock-based compensation expense is recorded only for awards that are expected to vest. On November 4, 2019, the independent members of the Company’s Board of Directors (Board) approved an award of 2,500 premium-priced stock-settled stock appreciation rights (Premium-Priced Award) to the Company’s Chief Executive Officer (CEO), which award was subject to stockholder approval of a related amendment to the 2011 Plan. Stockholders approved such amendment to the 2011 Plan on January 23, 2020, authorizing the grant to our CEO. Since stockholder approval occurred in 2020, this award was treated as granted in 2020 for accounting purposes. The base price of the Premium-Priced Award was $67.80 per share, which was a 20% premium to the clearing price of the Company's recent modified Dutch auction tender offer (Tender Offer). The award vests 50% on each of November 4, 2022 and November 4, 2023 and expires on November 4, 2024 . The award includes a requirement that the CEO hold any shares acquired upon exercise of this award, net of shares used to cover related taxes, until November 4, 2024 (that is, for the full term of the award), subject to lapse of the holding period upon a change in control of the Company or due to the CEO's death or termination due to disability. Employee stock purchase plan The Employee Stock Purchase Plan entitles qualifying employees to purchase up to $25 of the Company’s common stock during each calendar year. The amounts used to purchase stock are accumulated through payroll withholdings or through optional lump sum payments made in advance of the first day of the purchase right period. This compensatory plan allows employees to purchase stock for the lesser of 100% of its fair market value on the first day of the purchase right period or 85% of its fair market value on the last day of the purchase right period. Purchase right periods begin on January 1 and July 1, and end on December 31. Contributions used to purchase the Company’s common stock under this plan for the 2019 , 2018 and 2017 participation periods were $16,569 , $17,398 and $22,131 , respectively. Shares purchased pursuant to the plan’s 2019 , 2018 and 2017 participation periods were 315 , 398 and 360 , respectively. At December 31, 2019 , there were 6,411 shares remaining available for future grants under this plan. The fair value of participants’ purchase rights was estimated as of the beginning dates of the purchase right periods using the Black-Scholes-Merton valuation model with the following weighted average assumptions for purchase right periods in 2019 , 2018 and 2017 , respectively: expected volatility of 28.8% , 24.2% and 22.7% ; risk-free interest rates of 2.6% , 1.9% and 1.3% , and no dividends. Using these assumptions, the weighted average estimated per share fair value of each purchase right was $13.80 , $17.45 and $15.19 for 2019 , 2018 and 2017 , respectively. Long-term incentive compensation expense and proceeds For the years ended December 31, 2019 , 2018 and 2017 , the Company recognized $118,513 , $85,759 and $61,978 , respectively, in total LTIP expense, of which $63,705 , $73,582 and $34,431 , respectively, was stock-based compensation expense for stock appreciation rights, stock units and discounted employee stock plan purchases, which are primarily included in general and administrative expenses. The estimated tax benefits recorded for stock-based compensation in 2019 , 2018 and 2017 were $9,186 , $13,591 and $7,717 , respectively. As of December 31, 2019 , there was $147,267 of total estimated unrecognized compensation expense for LTIP awards outstanding, including $136,818 related to stock-based compensation arrangements under the Company’s equity compensation and stock purchase plans. The Company expects to recognize the performance-based cash component of this LTIP expense over a weighted average remaining period of 0.6 years and the stock-based component of this LTIP expense over a weighted average remaining period of 1.5 years . During the year ended December 31, 2018, the Company adopted a retirement policy (Rule of 65 policy). The Rule of 65 policy generally provides that Section 16 officers that are a minimum age of 55 with five years of continuous service with the Company receive certain benefits with respect to their outstanding equity awards upon a qualifying retirement if the sum of their age plus years of service is greater than or equal to 65. These benefits generally include accelerated vesting of restricted stock unit awards, continued vesting of stock-settled stock appreciation rights and performance stock unit awards and an exercise window from the original vest date through the original expiration date regardless of continued employment, with pro rata vesting for a Rule of 65 retirement within one year of the award grant date. The adoption of the Rule of 65 policy resulted in a $14,704 modification charge and a net acceleration of expense of $9,727 during the year ended December 31, 2018 that is included in the expense amounts reported above. For the years ended December 31, 2019 , 2018 and 2017 , the Company received $2,251 , $7,988 and $13,473 , respectively, in actual tax benefits upon the exercise of stock awards. Since the Company issues stock-settled stock appreciation rights rather than stock options, there were no cash proceeds from stock option exercises.

Stockholder's equity

Stockholder's equity	12 Months Ended
	Dec. 31, 2019
Equity [Abstract]
Stockholder's equity	Shareholders’ equity Stock repurchases The following table summarizes our repurchases of our common stock during the years ended December 31, 2019 , 2018 and 2017 : 2019 2018 2017 Shares repurchased Amount paid Paid per share Shares repurchased Amount paid Paid per share Shares repurchased Amount paid Paid per share Tender Offer (1) 21,802 $ 1,234,154 $ 56.61 — $ — $ — — $ — $ — Open market 19,218 1,168,321 60.79 16,844 1,153,511 68.48 12,967 810,949 62.54 41,020 $ 2,402,475 $ 58.57 16,844 $ 1,153,511 $ 68.48 12,967 $ 810,949 $ 62.54 (1) The amount paid for shares repurchased associated with the Company's Tender Offer during the year ended December 31, 2019 includes the clearing price of $56.50 per share plus related fees and expenses of $2,343 . Subsequent to December 31, 2019 , the Company has repurchased 291 shares of our common stock for $21,794 at an average cost of $74.92 per share subsequent to December 31, 2019 through February 20, 2020. On July 11, 2018, the Company's Board approved an additional share repurchase authorization in the amount of approximately $1,389,999 . This share repurchase authorization was in addition to the approximately $110,001 remaining at that time under the Board's prior share repurchase authorization approved in October 2017. Effective July 17, 2019, the Board terminated all remaining prior share repurchase authorizations available to the Company at that time and approved a new share repurchase authorization of $2,000,000 . Effective as of the close of business on November 4, 2019, the Board terminated all remaining prior share repurchase authorizations available to the Company under the aforementioned July 17, 2019 authorization and approved a new share repurchase authorization of $2,000,000 . The Company is authorized to make purchases from time to time in the open market or in privately negotiated transactions, including without limitation, through accelerated share repurchase transactions, derivative transactions, tender offers, Rule 10b5-1 plans or any combination of the foregoing, depending upon market conditions and other considerations. As of February 20, 2020, the Company has a total of $1,681,701 available under the current repurchase authorization for additional share repurchases. Although this share repurchase authorization does not have an expiration date, the Company remains subject to share repurchase limitations, including under the terms of the current senior secured credit facilities and the indentures governing the Company's senior notes. The Company retired all shares held in its treasury effective as of December 31, 2019 and December 31, 2018 . Charter documents & Delaware law The Company’s charter documents include provisions that may deter hostile takeovers, delay or prevent changes of control or changes in management, or limit the ability of stockholders to approve transactions that they may otherwise determine to be in their best interests. These include provisions prohibiting stockholders from acting by written consent, requiring 90 days advance notice of stockholder proposals or nominations to the Board and granting the Board the authority to issue up to 5,000 shares of preferred stock and to determine the rights and preferences of the preferred stock without the need for further stockholder approval. The Company is also subject to Section 203 of the Delaware General Corporation Law which, subject to exceptions, would prohibit the Company from engaging in any business combinations with any interested stockholder, as defined in that section, for a period of three years following the date on which that stockholder became an interested stockholder. These restrictions may discourage, delay or prevent a change in the control of the Company. Changes in DaVita Inc.’s ownership interests in consolidated subsidiaries The effects of changes in DaVita Inc.’s ownership interests in consolidated subsidiaries on the Company’s consolidated equity are as follows: Year ended December 31, 2019 2018 2017 Net income attributable to DaVita Inc. $ 810,981 $ 159,394 $ 663,618 Changes in paid-in capital for: Sales of noncontrolling interest — 79 (114 ) Purchase of noncontrolling interests (37,145 ) (17,897 ) (2,752 ) Net transfer in noncontrolling interests (37,145 ) (17,818 ) (2,866 ) Net income attributable to DaVita Inc. net of transfers in $ 773,836 $ 141,576 $ 660,752 The Company acquired additional ownership interests in several existing majority-owned partnerships for $68,019 , $28,082 , and $5,357 in 2019 , 2018 , and 2017 , respectively.

Accumulated Other Comprehensive

Accumulated Other Comprehensive (Loss) Income	12 Months Ended
	Dec. 31, 2019
Statement of Comprehensive Income [Abstract]
Other Comprehensive (Loss) Income	Accumulated other comprehensive (loss) income Charges and credits to other comprehensive (loss) income have been as follows: Interest rate cap agreements Investment securities Foreign currency translation adjustments Accumulated other comprehensive (loss) income Balance at December 31, 2016 $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Unrealized (losses) gains (8,897 ) 5,075 99,770 95,948 Related income tax 3,460 (1,368 ) — 2,092 (5,437 ) 3,707 99,770 98,040 Reclassification of income (loss) into net income 8,278 (360 ) — 7,918 Related income tax (3,220 ) 140 — (3,080 ) 5,058 (220 ) — 4,838 Balance at December 31, 2017 $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 Cumulative effect of change in accounting principle (1) (2,706 ) (5,662 ) — (8,368 ) Unrealized losses (181 ) — (45,944 ) (46,125 ) Related income tax 48 — — 48 (133 ) — (45,944 ) (46,077 ) Reclassification of income into net income 8,466 — — 8,466 Related income tax (2,180 ) — — (2,180 ) 6,286 — — 6,286 Balance at December 31, 2018 $ (8,961 ) $ — $ (25,963 ) $ (34,924 ) Unrealized gains (losses) 1,566 — (20,102 ) (18,536 ) Related income tax (415 ) — — (415 ) 1,151 — (20,102 ) (18,951 ) Reclassification of income into net income 8,591 — — 8,591 Related income tax (2,214 ) — — (2,214 ) 6,377 — — 6,377 Balance at December 31, 2019 $ (1,433 ) $ — $ (46,065 ) $ (47,498 ) (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. See Note 5 for further details. The reclassification of net cap realized losses into income are recorded as debt expense in the corresponding consolidated statements of income. See Note 13 for further details. Prior to January 1, 2018, unrealized gains and losses on available-for-sale equity securities were recorded to accumulated other comprehensive income and reclassified to other income when realized. From January 1, 2018, unrealized gains and losses on investment securities are recorded directly to other income rather than to accumulated other comprehensive income.

Acquisitions and Divestitures

Acquisitions and Divestitures	12 Months Ended
	Dec. 31, 2019
Business Combinations [Abstract]
Acquisitions and Divestitures	Acquisitions and divestitures Routine acquisitions During 2019 , the Company acquired seven dialysis centers in the U.S. and 16 dialysis centers outside the U.S. for a total of $98,836 in net cash paid, earn-outs of $23,536 , and deferred purchase price and liabilities assumed of $4,326 . During 2018 , the Company acquired 18 dialysis centers in the U.S. and 28 dialysis centers outside the U.S. for a total of $176,161 in net cash, earn-outs of $1,246 , and deferred purchase price and liabilities assumed of $34,394 . In one of these transactions the Company acquired a controlling interest in a previously nonconsolidated U.S. dialysis partnership for which the Company recognized a non-cash gain of $28,152 on our prior interest upon consolidation. During 2017 , the Company acquired 30 dialysis centers in the U.S. and 68 dialysis centers outside the U.S. for a total of $308,550 in net cash, earn-outs of $2,692 and deferred purchase price of $23,748 . The assets and liabilities for all acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s financial statements and operating results from the effective dates of the acquisitions. For several of the 2019 acquisitions, certain income tax amounts are pending final evaluation and quantification of any pre-acquisition tax contingencies. In addition, valuation of intangibles and certain other working capital items relating to several of these acquisitions are pending final quantification. The following table summarizes the assets acquired and liabilities assumed in these transactions and recognized at their acquisition dates at estimated fair values, as well as the estimated fair value of noncontrolling interests assumed in these transactions: Year ended December 31, 2019 2018 2017 Current assets $ 6,713 $ 23,686 $ 14,366 Property and equipment 4,842 11,421 18,192 Amortizable intangible and other long-term assets 1,980 3,079 11,663 Indefinite-lived licenses 31,858 23,656 32,296 Goodwill 90,226 278,348 318,832 Deferred income taxes — — (210 ) Noncontrolling interests assumed (1,762 ) (80,291 ) (44,303 ) Liabilities assumed (7,159 ) (19,946 ) (15,846 ) $ 126,698 $ 239,953 $ 334,990 Amortizable intangible assets acquired during 2019 , 2018 and 2017 , primarily related to non-compete agreements, had weighted-average estimated useful lives of six years , six years and seven years , respectively. The total amount of goodwill deductible for tax purposes associated with these acquisitions for 2019 , 2018 , and 2017 was approximately $88,517 , $165,013 and $237,363 , respectively. Acquisition of Renal Ventures On May 1, 2017 , the Company completed its acquisition of 100% of the equity of Colorado-based Renal Ventures Management, LLC (Renal Ventures) for approximately $359,913 in net cash. Renal Ventures operated 36 dialysis centers, one uncertified dialysis center and one home program, which provided services to approximately 2,600 patients in six states. As a part of this transaction, the Company was required to divest three Renal Ventures outpatient dialysis centers, and three outpatient dialysis centers and one uncertified dialysis center of the Company, for approximately $21,219 in net cash. The Company also incurred approximately $11,950 in transaction and integration costs during the year ended December 31, 2017 associated with this acquisition that are included in general and administrative expenses. The purchase price allocation for the Renal Ventures acquisition was finalized in 2018 with no material change to the initial allocation. The following table summarizes the assets acquired and liabilities assumed in this transaction and recognized at the acquisition date at estimated fair values: Current assets, net of cash acquired $ 22,739 Property and equipment 36,295 Amortizable intangible and other long-term assets 11,547 Goodwill 298,200 Current liabilities (8,389 ) Long-term liabilities (479 ) $ 359,913 Amortizable intangible assets acquired, primarily related to non-compete agreements, had weighted-average estimated useful lives of five years . The total estimated amount of goodwill deductible for tax purposes associated with this acquisition was approximately $298,200 . Pro forma financial information (unaudited) The following summary, prepared on a pro forma basis, combines the results of operations as if all acquisitions within continuing operations in 2019 and 2018 had been consummated as of the beginning of 2018 , including the impact of certain adjustments such as amortization of intangibles, interest expense on acquisition financing and income tax effects. Year ended December 31, 2019 2018 (unaudited) Pro forma total revenues $ 11,416,498 $ 11,566,736 Pro forma net income from continuing operations attributable to $ 709,631 $ 640,112 Pro forma basic net income per share from continuing operations $ 4.63 $ 3.75 Pro forma diluted net income per share from continuing operations $ 4.61 $ 3.71 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 approximately $33,889 if certain performance targets or quality margins are met over the next one year to five years . Contingent earn-out obligations are remeasured to fair value at each reporting date until the contingencies are resolved with changes in the liability due to the remeasurement recognized in earnings. See Note 24 for further details. As of December 31, 2019 , the Company estimated the fair value of these contingent earn-out obligations to be $24,586 , of which a total of $6,712 is included in other current liabilities, and the remaining $17,874 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 year ended December 31, 2019 : Balance at December 31, 2017 $ 6,388 Contingent earn-out obligations associated with acquisitions 1,246 Remeasurement of fair value (4,729 ) Payments of contingent earn-out obligations (297 ) Balance at December 31, 2018 $ 2,608 Contingent earn-out obligations associated with acquisitions 23,536 Remeasurement of fair value (784 ) Payments of contingent earn-out obligations (774 ) $ 24,586

Held for Sale and Discontinued

Held for Sale and Discontinued Operations	12 Months Ended
	Dec. 31, 2019
Discontinued Operations and Disposal Groups [Abstract]
Held for Sale and Discontinued Operations	DaVita Medical Group (DMG) On June 19, 2019 , the Company completed the sale of its DMG business to Optum, a subsidiary of UnitedHealth Group Inc., for an aggregate purchase price of $4,340,000 , prior to certain closing and post-closing adjustments specified in the related equity purchase agreement dated as of December 5, 2017 , as amended as of September 20, 2018 and as of December 11, 2018 (as amended, the equity purchase agreement). The Company recorded a preliminary estimated pre-tax net loss of approximately $23,022 on the sale of its DMG business in 2019. This preliminary net loss is based on initial estimates of the Company's expected aggregate proceeds from the sale, net of transaction costs and obligations, as well as the estimated values of DMG net assets sold as of the closing date. These estimated net proceeds include $4,465,476 in cash received from Optum at closing, or $3,824,509 net of cash and restricted cash included in the DMG net assets sold. The ultimate net proceeds from the DMG sale, as well as the value of its previously held for sale net assets sold, remain subject to estimate revisions and post-closing adjustments pursuant to the equity purchase agreement, which could be material. Under the equity purchase agreement, the Company also has certain indemnification obligations that could require payments to the buyer relating to the Company's previous ownership and operation of the DMG business. Potential payments under these provisions, if any, remain subject to significant uncertainties and could have a material adverse effect on the net proceeds ultimately retained by the Company or the total amount of its loss on the sale of this business. The following table presents the financial results of discontinued operations related to DMG: Year ended December 31, 2019 2018 2017 Net revenues $ 2,713,059 $ 4,963,792 $ 4,676,213 Expenses 2,543,865 4,962,686 4,634,782 Goodwill and other asset impairment charges — 41,537 651,659 Valuation adjustment on disposal group — 316,840 — Income (loss) from discontinued operations before taxes 169,194 (357,271 ) (610,228 ) Loss on sale of discontinued operations before taxes (23,022 ) — — Income tax expense (benefit) 40,689 99,768 (364,856 ) Net income (loss) from discontinued operations, net of tax $ 105,483 (457,038 ) $ (245,372 ) The following table presents cash flows of discontinued operations related to DMG: Year ended December 31, 2019 2018 2017 Net cash provided by operating activities from discontinued operations $ 99,634 $ 290,684 $ 357,274 Net cash used in investing activities from discontinued operations $ (43,442 ) $ (57,382 ) $ (232,329 ) DMG acquisitions During the period from January 1, 2019 to June 18, 2019 immediately prior to the sale, the DMG business acquired two medical businesses for a total of $2,025 in net cash and deferred purchase price of $212 . During 2018 , the DMG business acquired other medical businesses for a total of $6,995 in net cash, deferred purchase price of $1,142 . During 2017 , the DMG business acquired other medical businesses for a total of $135,416 in net cash, deferred purchase price of $1,038 and liabilities assumed of $10,145

Variable Interest Entities

Variable Interest Entities	12 Months Ended
	Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Variable Interest Entities	Variable interest entities The Company manages or maintains an ownership interest in certain legal entities subject to the consolidation guidance applicable to variable interest entities (VIEs). Almost all of these legal entities are either U.S. dialysis partnerships encumbered by guaranteed debt, U.S. dialysis limited partnerships, or other legal entities subject to nominee ownership arrangements. Under U.S. GAAP, VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. The substantial majority of VIEs the Company is associated with are U.S. dialysis partnerships which the Company manages and in which it maintains a controlling majority ownership interest. These U.S. dialysis partnerships are considered VIEs because they are either (i) encumbered by debt guaranteed proportionately by the partners that is considered necessary to finance the partnership's activities, or (ii) in the form of limited partnerships for which the limited partners are not considered to have substantive kick-out or participating rights. The Company consolidates virtually all such U.S. dialysis partnerships. The Company also relies on the operating activities of certain legal entities in which it does not maintain a controlling ownership interest but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are typically subject to nominee ownership and transfer restriction agreements that effectively transfer the majority of the economic risks and rewards of their ownership to the Company. The Company’s management, restriction and other agreements concerning such nominee-owned entities typically 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 these entities to the Company. The Company consolidates all of the nominee-owned entities with which it is most closely associated. At December 31, 2019 , these consolidated financial statements include total assets of VIEs of $319,691 and total liabilities and noncontrolling interests of VIEs to third parties of $231,586 . The Company also sponsors certain non-qualified 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 related liabilities recorded in accrued compensation and benefits and other long-term liabilities. See Note 15 for disclosures concerning the assets of these consolidated non-qualified deferred compensation plans.

Fair Values of Financial Instru

Fair Values of Financial Instruments	12 Months Ended
	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Fair Values of Financial Instruments	Fair values of financial instruments Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. Fair value measurements are determined based on the principal or most advantageous market for the item being measured, assume that buyers and sellers are independent, willing and able to transact, and knowledgeable, with access to all information customarily available in such a transaction, and are based on assumptions that market participants would use in pricing the item, not assumptions specific to the reporting entity. The Company measures the fair value of certain assets, liabilities, and noncontrolling interests subject to put provisions (redeemable equity interests classified as 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 measured at fair value on a recurring basis as of December 31, 2019 and 2018 : December 31, 2019 Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 39,951 $ 39,951 $ — $ — Interest rate cap agreements $ 24,452 $ — $ 24,452 $ — Liabilities Contingent earn-out obligations $ 24,586 $ — $ — $ 24,586 Temporary equity Noncontrolling interests subject to put provisions $ 1,180,376 $ — $ — $ 1,180,376 December 31, 2018 Assets Investments in equity securities $ 36,124 $ 36,124 $ — $ — Interest rate cap agreements $ 851 $ — $ 851 $ — Liabilities Contingent earn-out obligations $ 2,608 $ — $ — $ 2,608 Temporary equity Noncontrolling interests subject to put provisions $ 1,124,641 $ — $ — $ 1,124,641 Investments in equity securities represent investments in various open-ended registered investment companies (mutual funds) and common stock and are recorded at fair value estimated based on reported market prices or redemption prices, as applicable. See Note 5 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 13 for further discussion. The estimated fair value measurements of contingent earn-out obligations are primarily based on unobservable inputs, including projected earnings before interest, taxes, depreciation, and amortization (EBITDA) and revenue. The estimated fair value of these contingent earn-out obligations is remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company credit risk adjusted rate that is used to discount obligations to present value. See Note 21 for further discussion. See Note 17 for a discussion of the Company’s methodology for estimating the fair values of noncontrolling interests subject to put obligations. The Company's fair value estimates for its senior secured credit facilities and senior notes are based upon quoted bid and ask prices for these instruments, typically a level 2 input. See Note 13 for further discussion of the Company's debt. Other financial instruments consist primarily of cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, accounts payable, other accrued liabilities, lease liabilities and debt. The balances of non-debt financial instruments are presented in the consolidated financial statements at December 31, 2019 and 2018 at their approximate fair values due to the short-term nature of their settlements.

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2019
Segment Reporting [Abstract]
Segment Reporting	Segment reporting The Company's operations are comprised of its U.S. dialysis and related lab services business, its various ancillary services and strategic initiatives, including its international operations, and its corporate administrative support. See Note 1 "Organization" for a summary description of the Company's businesses. On June 19, 2019 , the Company completed the sale of its DMG business to Optum. As a result of this transaction, DMG's results of operations have been reported as discontinued operations for all periods presented. 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 kidney care operations in each foreign sovereign jurisdiction, its other health operations in each foreign sovereign jurisdiction, and its equity method investment in the Asia Pacific joint venture. 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 compensation expenses of certain departments which provide support to all of the Company’s various operating lines of business, except to the extent that such costs are charged to and borne by certain ancillary services and strategic initiatives via internal management fees. These corporate administrative support costs are reduced by internal management fees received from the Company’s ancillary lines of business. The following is a summary of segment revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Year ended December 31, 2019 2018 2017 Segment revenues: (1) U.S. dialysis Patient service revenues: External sources $ 10,421,401 $ 10,274,046 $ 9,767,123 Intersegment revenues 131,199 92,950 55,176 Total U.S. dialysis revenues 10,552,600 10,366,996 9,822,299 Provision for uncollectible accounts (21,715 ) (50,927 ) (481,973 ) Net U.S. dialysis patient service revenues 10,530,885 10,316,069 9,340,326 Other revenues (2) External sources 30,895 19,880 19,739 Intersegment revenues 1,126 — — Total net U.S. dialysis revenues $ 10,562,906 $ 10,335,949 $ 9,360,065 Other - Ancillary services Net patient service revenues $ 497,021 $ 437,275 $ 323,156 Other external sources 460,877 724,577 1,248,589 Intersegment revenues 14,030 34,236 24,603 Total ancillary services $ 971,928 $ 1,196,088 $ 1,596,348 Total net segment revenues 11,534,834 11,532,037 10,956,413 Elimination of intersegment revenues (146,355 ) (127,186 ) (79,779 ) Consolidated revenues $ 11,388,479 $ 11,404,851 $ 10,876,634 Segment operating margin (loss): U.S. dialysis $ 1,924,826 $ 1,709,721 $ 2,297,198 Other - Ancillary services (189,174 ) (93,789 ) (439,477 ) Total segment margin 1,735,652 1,615,932 1,857,721 Reconciliation of segment operating margin to consolidated income from Corporate administrative support (92,335 ) (90,108 ) (44,966 ) Consolidated operating income 1,643,317 1,525,824 1,812,755 Debt expense (443,824 ) (487,435 ) (430,634 ) Debt prepayment, refinancing and redemption charges (33,402 ) — — Other income 29,348 10,089 17,665 Income from continuing operations before income taxes $ 1,195,439 $ 1,048,478 $ 1,399,786 (1) On January 1, 2018, the Company adopted 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. See Notes 1 and 2 for further discussion of the Company's adoption of Topic 606. (2) Includes management fee revenues from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling interest or which are wholly-owned by third parties. Depreciation and amortization expense by reportable segment was as follows: Year ended December 31, 2019 2018 2017 U.S. dialysis $ 583,454 $ 558,810 $ 520,965 Other - Ancillary services 31,698 32,225 38,946 $ 615,152 $ 591,035 $ 559,911 Summary of assets by reportable segment was as follows: Year ended December 31, 2019 2018 Segment assets U.S. dialysis (including equity investments of $124,188 and $95,290, $ 15,778,880 $ 12,333,641 Other - Ancillary services (1) (including equity investments of $117,795 1,532,514 1,387,046 DMG - Discontinued operations (including equity investments of — 5,389,565 Consolidated assets $ 17,311,394 $ 19,110,252 (1) Includes approximately $154,572 and $136,052 in 2019 and 2018 , respectively, of net property and equipment related to the Company’s international operations. Expenditures for property and equipment by reportable segment were as follows: Year ended December 31, 2019 2018 2017 U.S. dialysis $ 681,339 $ 856,108 $ 769,732 Other - Ancillary services 46,741 45,806 40,377 DMG - Discontinued operations 38,466 85,224 95,141 $ 766,546 $ 987,138 $ 905,250

Supplemental Cash Flow Informat

Supplemental Cash Flow Information	12 Months Ended
	Dec. 31, 2019
Supplemental Cash Flow Elements [Abstract]
Supplemental Cash Flow Information	Supplemental cash flow information The table below provides supplemental cash flow information: Year ended December 31, 2019 2018 2017 Cash paid: Income taxes, net $ 157,983 $ 92,526 $ 387,159 Interest $ 473,176 $ 488,974 $ 424,547 Non-cash investing and financing activities: Fixed assets under financing lease obligations $ 18,953 $ 8,828 $ 48,378

Selected Quarterly Financial Da

Selected Quarterly Financial Data (unaudited)	12 Months Ended
	Dec. 31, 2019
Quarterly Financial Information Disclosure [Abstract]
Selected Quarterly Financial Data (unaudited)	Selected quarterly financial data (unaudited) December 31, September 30, June 30, March 31, 2019 Total revenues $ 2,898,584 $ 2,904,078 $ 2,842,705 $ 2,743,112 Operating income $ 462,588 $ 378,336 $ 461,886 $ 340,507 Attributable to DaVita Inc.: Net income from continuing operations (1) $ 242,242 $ 150,113 $ 194,223 $ 120,254 Net (loss) income from discontinued operations 2,629 (6,843 ) 79,328 29,035 Net income $ 244,871 $ 143,270 $ 273,551 $ 149,289 Per share attributable to DaVita Inc.: Basic net income from continuing operations $ 1.87 $ 1.00 $ 1.17 $ 0.72 Basic net income (loss) from discontinued operations 0.02 (0.05 ) 0.47 0.18 Basic net income $ 1.89 $ 0.95 $ 1.64 $ 0.90 Diluted net income from continuing operations $ 1.86 $ 0.99 $ 1.16 $ 0.72 Diluted net income (loss) from discontinued operations 0.02 (0.04 ) 0.48 0.18 Diluted net income $ 1.88 $ 0.95 $ 1.64 $ 0.90 2018 Total revenues $ 2,821,124 $ 2,847,330 $ 2,886,953 $ 2,849,444 Operating income $ 387,908 $ 289,038 $ 438,192 $ 410,686 Attributable to DaVita Inc.: Net income from continuing operations (1) $ 160,332 $ 73,371 $ 199,603 $ 191,015 Net (loss) income from discontinued operations (310,104 ) (210,167 ) 67,673 (12,329 ) Net (loss) income $ (149,772 ) $ (136,796 ) $ 267,276 $ 178,686 Per share attributable to DaVita Inc.: Basic net income from continuing operations $ 0.97 $ 0.44 $ 1.16 $ 1.07 Basic net (loss) income from discontinued operations (1.87 ) (1.26 ) 0.40 (0.07 ) Basic net (loss) income $ (0.90 ) $ (0.82 ) $ 1.56 $ 1.00 Diluted net income from continuing operations $ 0.96 $ 0.44 $ 1.15 $ 1.05 Diluted net (loss) income from discontinued operations (1.86 ) (1.26 ) 0.38 (0.07 ) Diluted net (loss) income $ (0.90 ) $ (0.82 ) $ 1.53 $ 0.98 (1) The following table summarizes impairment charges, (gain) loss on changes in ownership interest, restructuring charges, and stock-based compensation modification charges and net acceleration of expense included in operating expenses and charges in 2019 and 2018 by quarter: Quarter ended Quarter ended December 31, September 30, June 30, March 31, December 31, September 30, June 30, March 31, Certain operating expenses and charges: Impairment charges $ 83,855 $ 41,037 $ 1,530 $ 12,088 $ 14,351 (Gain) loss on changes in $ (19,437 ) $ 1,506 $ (33,957 ) Restructuring charges $ 11,366 Stock-based compensation $ 23,470

Consolidating Financial Stateme

Consolidating Financial Statements	12 Months Ended
	Dec. 31, 2019
Condensed Financial Information Disclosure [Abstract]
Consolidating Financial Statements	Consolidating financial statements The following information is presented in accordance with Rule 3-10 of Regulation S-X. The operating and investing activities of the separate legal entities included in the Company’s consolidated financial statements are fully interdependent and integrated. Revenues and operating expenses of the separate legal entities include intercompany charges for management and other 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. Contemporaneously with the Company entering into the New Credit Agreement and pursuant to the indentures governing the Company's senior notes, certain subsidiaries of the Company were released from their guarantees of the Company's senior notes such that, after that release, the remaining subsidiary guarantors of the senior notes were the same subsidiaries guaranteeing the New Credit Agreement. The following consolidating statements have been prepared for all periods presented based on the current subsidiary guarantors and non-guarantors stipulated in the Company's New Credit Agreement. Consolidating Statements of Income For year ended December 31, 2019 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Dialysis patient service revenues $ — $ 6,961,825 $ 4,226,402 $ (269,806 ) $ 10,918,421 Less: Provision for uncollectible accounts — (15,296 ) (6,419 ) — (21,715 ) Net dialysis patient service revenues — 6,946,529 4,219,983 (269,806 ) 10,896,706 Other revenues 804,684 601,394 171,856 (1,086,161 ) 491,773 Total revenues 804,684 7,547,923 4,391,839 (1,355,967 ) 11,388,479 Operating expenses and charges 642,717 6,631,471 3,826,941 (1,355,967 ) 9,745,162 Operating income 161,967 916,452 564,898 — 1,643,317 Debt expense (482,074 ) (183,272 ) (53,043 ) 241,163 (477,226 ) Other income, net 309,623 7,314 46,306 (333,895 ) 29,348 Income tax (benefit) expense (2,616 ) 263,563 18,681 — 279,628 Equity earnings in subsidiaries 818,849 429,628 — (1,248,477 ) — Net income from continuing operations 810,981 906,559 539,480 (1,341,209 ) 915,811 Net income from discontinued operations, net of tax — — 12,751 92,732 105,483 Net income 810,981 906,559 552,231 (1,248,477 ) 1,021,294 Less: Net income attributable to noncontrolling — — — (210,313 ) (210,313 ) Net income attributable to DaVita Inc. $ 810,981 $ 906,559 $ 552,231 $ (1,458,790 ) $ 810,981 Consolidating Statements of Income - (continued) For year ended December 31, 2018 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Dialysis patient service revenues $ — $ 6,834,865 $ 4,096,666 $ (221,550 ) $ 10,709,981 Less: Provision for uncollectible accounts — (34,977 ) (14,610 ) — (49,587 ) Net dialysis patient service revenues — 6,799,888 4,082,056 (221,550 ) 10,660,394 Other revenues 799,230 488,086 558,079 (1,100,938 ) 744,457 Total revenues 799,230 7,287,974 4,640,135 (1,322,488 ) 11,404,851 Operating expenses and charges 646,640 6,551,328 4,003,547 (1,322,488 ) 9,879,027 Operating income 152,590 736,646 636,588 — 1,525,824 Debt expense (491,749 ) (201,496 ) (43,414 ) 249,224 (487,435 ) Other income, net 418,839 3,430 29,132 (441,312 ) 10,089 Income tax expense 23,482 155,372 79,546 — 258,400 Equity earnings in subsidiaries 103,196 388,737 — (491,933 ) — Net income from continuing operations 159,394 771,945 542,760 (684,021 ) 790,078 Net loss from discontinued operations, net of tax — — (649,126 ) 192,088 (457,038 ) Net income (loss) 159,394 771,945 (106,366 ) (491,933 ) 333,040 Less: Net income attributable to noncontrolling — — — (173,646 ) (173,646 ) Net income (loss) attributable to DaVita Inc. $ 159,394 $ 771,945 $ (106,366 ) $ (665,579 ) $ 159,394 For year ended December 31, 2017 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Dialysis patient service revenues $ — $ 6,417,574 $ 3,848,172 $ (172,076 ) $ 10,093,670 Less: Provision for uncollectible accounts — (322,085 ) (170,447 ) 7,168 (485,364 ) Net dialysis patient service — 6,095,489 3,677,725 (164,908 ) 9,608,306 Other revenues 793,751 408,460 1,080,832 (1,014,715 ) 1,268,328 Total net revenues 793,751 6,503,949 4,758,557 (1,179,623 ) 10,876,634 Operating expenses and charges 527,942 5,331,545 4,384,015 (1,179,623 ) 9,063,879 Operating income 265,809 1,172,404 374,542 — 1,812,755 Debt expense (426,149 ) (200,953 ) (43,490 ) 239,958 (430,634 ) Other income, net 411,731 5,979 23,657 (423,702 ) 17,665 Income tax expense 65,965 210,068 47,826 — 323,859 Equity earnings in subsidiaries 478,192 460,261 — (938,453 ) — Net income from continuing operations 663,618 1,227,623 306,883 (1,122,197 ) 1,075,927 Net loss from discontinued operations, net of tax — — (429,116 ) 183,744 (245,372 ) Net income (loss) 663,618 1,227,623 (122,233 ) (938,453 ) 830,555 Less: Net income attributable to noncontrolling — — — (166,937 ) (166,937 ) Net income (loss) attributable to DaVita Inc. $ 663,618 $ 1,227,623 $ (122,233 ) $ (1,105,390 ) $ 663,618 Consolidating Statements of Comprehensive Income For the year ended December 31, 2019 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Net income $ 810,981 $ 906,559 $ 552,231 $ (1,248,477 ) $ 1,021,294 Other comprehensive income (loss) 7,528 — (20,102 ) — (12,574 ) Total comprehensive income 818,509 906,559 532,129 (1,248,477 ) 1,008,720 Less: Comprehensive income attributable to — — — (210,313 ) (210,313 ) Comprehensive income attributable to DaVita Inc. $ 818,509 $ 906,559 $ 532,129 $ (1,458,790 ) $ 798,407 For the year ended December 31, 2018 Net income (loss) $ 159,394 $ 771,945 $ (106,366 ) $ (491,933 ) $ 333,040 Other comprehensive income (loss) 6,153 — (45,944 ) — (39,791 ) Total comprehensive income (loss) 165,547 771,945 (152,310 ) (491,933 ) 293,249 Less: Comprehensive income attributable to — — — (173,646 ) (173,646 ) Comprehensive income (loss) attributable to DaVita Inc. $ 165,547 $ 771,945 $ (152,310 ) $ (665,579 ) $ 119,603 For the year ended December 31, 2017 Net income (loss) $ 663,618 $ 1,227,623 $ (122,233 ) $ (938,453 ) $ 830,555 Other comprehensive income (loss) 3,106 — 99,770 — 102,876 Total comprehensive income (loss) 666,724 1,227,623 (22,463 ) (938,453 ) 933,431 Less: Comprehensive income attributable to — — — (166,935 ) (166,935 ) Comprehensive income (loss) attributable to DaVita Inc. $ 666,724 $ 1,227,623 $ (22,463 ) $ (1,105,388 ) $ 766,496 Consolidating Balance Sheets As of December 31, 2019 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Cash and cash equivalents $ 758,241 $ 532 $ 343,599 $ — $ 1,102,372 Restricted cash and equivalents 14,499 — 91,847 — 106,346 Accounts receivable, net — 1,189,301 606,297 — 1,795,598 Other current assets 76,787 548,553 102,410 (41,896 ) 685,854 Total current assets 849,527 1,738,386 1,144,153 (41,896 ) 3,690,170 Property and equipment, net 543,932 1,589,417 1,344,543 (4,508 ) 3,473,384 Operating lease right-of-use assets 109,415 1,656,145 1,084,552 (20,065 ) 2,830,047 Intangible assets, net 362 31,569 103,753 — 135,684 Investments in and advances to affiliates, net 10,813,991 7,611,402 3,051,208 (21,476,601 ) — Other long-term assets and investments 102,779 133,698 176,315 (18,318 ) 394,474 Goodwill — 4,812,972 1,974,663 — 6,787,635 Total assets $ 12,420,006 $ 17,573,589 $ 8,879,187 $ (21,561,388 ) $ 17,311,394 Current liabilities $ 379,286 $ 1,327,378 $ 666,470 $ (1,036 ) $ 2,372,098 Intercompany payables 1,381,863 3,051,208 2,615,151 (7,048,222 ) — Long-term operating lease liabilities 136,123 1,567,776 1,039,145 (19,244 ) 2,723,800 Long-term debt and other long-term liabilities 7,741,725 674,558 364,102 (64,507 ) 8,715,878 Noncontrolling interests subject to put provisions 647,600 — — 532,776 1,180,376 Total DaVita Inc. shareholders' equity 2,133,409 10,952,669 3,475,710 (14,428,379 ) 2,133,409 Noncontrolling interests not subject to put — — 718,609 (532,776 ) 185,833 Total equity 2,133,409 10,952,669 4,194,319 (14,961,155 ) 2,319,242 Total liabilities and equity $ 12,420,006 $ 17,573,589 $ 8,879,187 $ (21,561,388 ) $ 17,311,394 Consolidating Balance Sheets - (continued) As of December 31, 2018 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Cash and cash equivalents $ 60,653 $ 1,232 $ 261,153 $ — $ 323,038 Restricted cash and equivalents 1,005 12,048 79,329 — 92,382 Accounts receivable, net — 1,204,122 654,486 — 1,858,608 Other current assets 37,185 565,974 157,407 — 760,566 Current assets held for sale — — 5,389,565 — 5,389,565 Total current assets 98,843 1,783,376 6,541,940 — 8,424,159 Property and equipment, net 491,462 1,584,321 1,317,886 — 3,393,669 Intangible assets, net 153 42,896 75,797 — 118,846 Investments in and advances to affiliates, net 13,522,198 6,196,801 2,498,545 (22,217,544 ) — Other long-term assets and investments 53,385 90,037 188,196 — 331,618 Goodwill — 4,806,939 2,035,021 — 6,841,960 Total assets $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252 Current liabilities $ 1,945,943 $ 1,217,526 $ 483,933 $ — $ 3,647,402 Current liabilities held for sale — — 1,243,759 — 1,243,759 Total current liabilities 1,945,943 1,217,526 1,727,692 — 4,891,161 Intercompany payables — 2,498,545 6,161,292 (8,659,837 ) — Long-term debt and other long-term liabilities 7,918,581 687,443 580,028 — 9,186,052 Noncontrolling interests subject to put provisions 598,075 — — 526,566 1,124,641 Total DaVita Inc. shareholders' equity 3,703,442 10,100,856 3,456,851 (13,557,707 ) 3,703,442 Noncontrolling interests not subject to put — — 731,522 (526,566 ) 204,956 Total equity 3,703,442 10,100,856 4,188,373 (14,084,273 ) 3,908,398 Total liabilities and equity $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252 Consolidating Statements of Cash Flow For the year ended December 31, 2019 DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated Cash flows from operating activities: Net income $ 810,981 $ 906,559 $ 552,231 $ (1,248,477 ) $ 1,021,294 Changes in operating assets and liabilities and (602,288 ) (73,356 ) 478,228 1,248,477 1,051,061 Net cash provided by operating activities 208,693 833,203 1,030,459 — 2,072,355 Cash flows from investing activities: Additions of property and equipment, net (145,378 ) (310,032 ) (311,136 ) — (766,546 ) Acquisitions — (11,851 ) (89,010 ) — (100,861 ) Proceeds from asset sales, net of cash divested 3,824,516 1,777 51,099 — 3,877,392 Investments and other items (4,606 ) (6,676 ) (3,363 ) — (14,645 ) Net cash provided by (used in) investing activities 3,674,532 (326,782 ) (352,410 ) — 2,995,340 Cash flows from financing activities: Long-term debt and related financing costs, net (2,052,197 ) (10,481 ) (17,513 ) — (2,080,191 ) Intercompany borrowing 1,267,138 (455,405 ) (811,733 ) — — Other items (2,387,084 ) (53,283 ) (175,892 ) — (2,616,259 ) Net cash used in financing activities (3,172,143 ) (519,169 ) (1,005,138 ) — (4,696,450 ) Effect of exchange rate changes on cash — — (1,760 ) — (1,760 ) Net increase (decrease) in cash, cash equivalents and restricted cash 711,082 (12,748 ) (328,849 ) — 369,485 Less: Net increase in cash, cash equivalents and — — (423,813 ) — (423,813 ) Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 711,082 (12,748 ) 94,964 — 793,298 Cash, cash equivalents and restricted cash of 61,658 13,280 340,482 — 415,420 Cash, cash equivalents and restricted cash of $ 772,740 $ 532 $ 435,446 $ — $ 1,208,718 Consolidating Statements of Cash Flow - (continued) For the year ended December 31, 2018 DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated Cash flows from operating activities: Net income $ 159,394 $ 771,945 $ (106,366 ) $ (491,933 ) $ 333,040 Changes in operating assets and liabilities and (86,070 ) (150,976 ) 1,183,713 491,933 1,438,600 Net cash provided by operating activities 73,324 620,969 1,077,347 — 1,771,640 Cash flows from investing activities: Additions of property and equipment, net (175,787 ) (425,008 ) (386,343 ) — (987,138 ) Acquisitions — (42,987 ) (140,169 ) — (183,156 ) Proceeds from asset and business sales, net of cash — 55,184 95,021 — 150,205 Investments and other items 30,962 (8,286 ) (8,230 ) — 14,446 Net cash used in investing activities (144,825 ) (421,097 ) (439,721 ) — (1,005,643 ) Cash flows from financing activities: Long-term debt and related financing costs, net 725,889 (8,874 ) (22,238 ) — 694,777 Intercompany borrowing 404,897 (168,224 ) (236,673 ) — — Other items (1,147,934 ) (29,457 ) (142,740 ) — (1,320,131 ) Net cash used in financing activities (17,148 ) (206,555 ) (401,651 ) — (625,354 ) Effect of exchange rate changes on cash — — (3,350 ) — (3,350 ) Net (decrease) increase in cash, cash equivalents and restricted cash (88,649 ) (6,683 ) 232,625 — 137,293 Less: Net decrease in cash, cash equivalents — — 240,793 — 240,793 Net decrease in cash, cash equivalents and restricted cash from continuing operations (88,649 ) (6,683 ) (8,168 ) — (103,500 ) Cash, cash equivalents and restricted cash of 150,307 19,963 348,650 — 518,920 Cash, cash equivalents and restricted cash of $ 61,658 $ 13,280 $ 340,482 $ — $ 415,420 Consolidating Statements of Cash Flow - (continued) For the year ended December 31, 2017 DaVita Inc. Guarantor Subsidiaries Non-Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Cash flows from operating activities: Net income $ 663,618 $ 1,227,623 $ (122,233 ) $ (938,453 ) $ 830,555 Changes in operating assets and liabilities and (533,300 ) (739,023 ) 1,416,481 938,453 1,082,611 Net cash provided by operating activities 130,318 488,600 1,294,248 — 1,913,166 Cash flows from investing activities: Additions of property and equipment, net (155,972 ) (348,292 ) (400,986 ) — (905,250 ) Acquisitions — (528,588 ) (275,291 ) — (803,879 ) Proceeds from asset sales — 25,989 66,347 — 92,336 Investments and other items 211,619 (3,526 ) 43,968 — 252,061 Net cash provided by (used in) investing activities 55,647 (854,417 ) (565,962 ) — (1,364,732 ) Cash flows from financing activities: Long-term debt and related financing costs, net 173,529 (8,186 ) (10,495 ) — 154,848 Intercompany borrowing 22,589 382,452 (405,041 ) — — Other items (781,697 ) (2,205 ) (137,203 ) — (921,105 ) Net cash (used in) provided by financing activities (585,579 ) 372,061 (552,739 ) — (766,257 ) Effect of exchange rate changes on cash — — 254 — 254 Net (decrease) increase in cash, cash equivalents and restricted cash (399,614 ) 6,244 175,801 — (217,569 ) Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations — — (53,026 ) — (53,026 ) Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations (399,614 ) 6,244 228,827 — (164,543 ) Cash, cash equivalents and restricted cash of 549,921 13,719 119,823 — 683,463 Cash, cash equivalents and restricted cash of $ 150,307 $ 19,963 $ 348,650 $ — $ 518,920

Supplemental Data (unaudited) S

Supplemental Data (unaudited) Supplemental Data (unaudited)	12 Months Ended
	Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Additional Financial Information Disclosure [Text Block]	Supplemental data under senior note indentures (unaudited) The Company previously disclosed certain unaudited supplemental data concerning entities that do not constitute “Subsidiaries” as defined in the indentures governing the Company’s senior notes with its consolidated financial statements, as required by those indentures. As a result of the sale of the DMG business to Optum on June 19, 2019, the Company no longer has subsidiaries large enough to require this additional unaudited supplemental disclosure under the terms of its senior note indentures.

SCHEDULE II-VALUATION AND QUALI

SCHEDULE II-VALUATION AND QUALIFYING ACCOUNTS	12 Months Ended
	Dec. 31, 2019
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
SCHEDULE II-VALUATION AND QUALIFYING ACCOUNTS	SCHEDULE II—VALUATION AND QUALIFYING ACCOUNTS Balance at Acquisitions Amounts Amounts written off Balance Description (in thousands) Allowance for uncollectible accounts: Year ended December 31, 2019 $ 52,924 $ — $ 21,715 $ 66,311 $ 8,328 Year ended December 31, 2018 $ 218,399 $ — $ 42,287 $ 207,762 $ 52,924 Year ended December 31, 2017 $ 238,897 $ — $ 478,365 $ 498,863 $ 218,399

Organization and Summary of S_2

Organization and Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Basis of presentation	Basis of presentation These consolidated financial statements are prepared in accordance with United States generally accepted accounting principles (U.S. GAAP). The financial statements include DaVita Inc. and its subsidiaries, partnerships and other entities in which it maintains a majority voting or other controlling financial interest (collectively, the Company). All significant intercompany transactions and balances have been eliminated. Equity investments in investees over which the Company only has significant influence are recorded on the equity method, while investments in other equity securities are recorded at fair value or on the adjusted cost method, as applicable. For the Company’s international subsidiaries, local currencies are considered their functional currencies. Translation adjustments result from translating the financial statements of the Company’s international subsidiaries from their functional currencies into the Company’s reporting currency (the U.S. dollar, or USD). Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these consolidated financial statements were issued and has included all necessary adjustments and disclosures.
Use of estimates	Use of estimates The preparation of financial statements in conformity with U.S. GAAP requires the use of estimates and assumptions that affect the reported amounts of revenues, expenses, assets, liabilities, contingencies and noncontrolling interests subject to put provisions. Although actual results in subsequent periods will differ from these estimates, such estimates are developed based on the best information available to management and management’s best judgments at the time. All significant assumptions and estimates underlying the amounts reported in the financial statements and accompanying notes are regularly reviewed and updated when necessary. Changes in estimates are reflected in the financial statements based upon on-going actual experience trends or subsequent settlements and realizations depending on the nature and predictability of the estimates and contingencies. Interim changes in estimates related to annual operating costs are applied prospectively within annual periods. The most significant assumptions and estimates underlying these consolidated financial statements and accompanying notes involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and investments, accounting for income taxes and certain fair value estimates. Specific estimating risks and contingencies are further addressed within these notes to the consolidated financial statements.
Patient service net revenues and accounts receivable	Revenues 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. Net collections or write-offs of accounts receivable generated prior to January 1, 2018, beyond amounts previously reserved thereon, are presented in the provision for uncollectible accounts on the consolidated income statement in accordance with Topic 605. Dialysis patient service revenues Revenues are recognized based on the Company’s estimate of the transaction price the Company expects to collect as a result of satisfying its performance obligations. Dialysis patient service revenues are recognized in the period services are provided based on these estimates. Revenues consist primarily of payments from government and commercial health plans for dialysis services provided to patients. A usual and customary fee schedule is maintained for the Company’s dialysis treatments and related lab 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 providing secondary coverage (e.g., Medicaid secondary coverage), the patient’s commercial health plan secondary coverage, or the patient. 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. 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. 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, delays in collections due to payor payment inefficiencies, 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. In certain circumstances, it may not be 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 fees for management and administrative support services provided to outpatient dialysis centers that the Company does not own or in which the Company owns a noncontrolling interest, revenues associated with the Company's non-dialysis ancillary services and strategic initiatives, and administrative and management support services to certain non-dialysis joint ventures in which the Company owns a noncontrolling interest. Revenues associated with dialysis management services, disease management services, clinical research programs, physician services, ESRD seamless care organizations, and comprehensive care are estimated in the period services are provided. Revenues associated with pharmacy services were estimated as prescriptions were filled and shipped to patients. Revenues associated with direct primary care were estimated over the membership period.
Allowance for uncollectible accounts	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. Net collections or write-offs of accounts receivable generated prior to January 1, 2018, beyond amounts previously reserved thereon, are presented in the provision for uncollectible accounts on the consolidated income statement in accordance with Topic 605.
Other income	Other income Other income includes interest income on cash and cash equivalents and short- and long-term investments, realized and unrealized gains and losses recognized on investments, and foreign currency transaction gains and losses.
Cash and cash equivalents	Cash and cash equivalents Cash equivalents are short-term highly liquid investments with maturities of three months or less at date of purchase.
Restricted cash and equivalents	Restricted cash and equivalents Restricted cash and cash equivalents are primarily held in trust to satisfy insurer and state regulatory requirements related to the wholly-owned captive insurance companies that bear professional and general liability and workers' compensation risks for the Company.
Investments in debt and equity securities	Investments in debt and equity securities The Company classifies certain debt securities as held-to-maturity and records them at amortized cost based on the Company’s intentions and strategies concerning those investments. Equity securities that have readily determinable fair values or redemption values are classified as short-term or long-term investments and recorded at estimated fair value with changes in fair value recognized in current earnings.
Inventories	Inventories Inventories are stated at the lower of cost (first-in, first-out) or net realizable value and consist principally of pharmaceuticals and dialysis-related supplies. Rebates related to inventory purchases are recorded when earned and are based on certain qualification requirements which are dependent on a variety of factors including future pricing levels from the manufacturer and related data submission.
Property and equipment	Property and equipment Property and equipment is stated at cost less accumulated depreciation and amortization and is further reduced by any impairments. Maintenance and repairs are charged to expense as incurred. Depreciation and amortization expenses are computed using the straight-line method over the useful lives of the assets estimated as follows: buildings, 25 years to 40 years ; leasehold improvements, the shorter of ten years or the expected lease term; and equipment and information systems, principally three years to 15 years . Disposition gains and losses are included in current operating expenses. Property and equipment assets are reviewed for possible impairment whenever significant events or changes in circumstances indicate that an impairment may have occurred.
Leases	Leases The Company leases substantially all of its U.S. dialysis facilities. The Company categorizes leases with contractual terms longer than twelve months as either operating or finance leases. Finance leases are generally those leases that allow the Company to substantially utilize or pay for the entire asset over its estimated life. All other leases are categorized as operating leases. Assets acquired under finance leases are recorded on the balance sheet within property and equipment, net and liabilities for finance lease obligations are recorded within long-term debt. Finance lease assets are amortized to depreciation expense on a straight-line basis over the shorter of their estimated useful lives or the lease term. Rights to use assets under operating leases are recorded on the balance sheet as operating lease right-of-use assets and liabilities for operating lease obligations are recorded as operating lease liabilities. Reductions in the carrying amount of operating lease right-of-use assets are recorded to rent expense over the lease term. The majority of the Company’s facilities are leased under non-cancellable operating leases ranging in terms from five years to 15 years and which contain renewal options of five years to ten years at the fair rental value at the time of renewal. The Company has elected the practical expedient to not separate lease components from non-lease components for its financing and operating leases.
Amortizable intangibles	Amortizable intangibles Amortizable intangible assets and liabilities include noncompetition agreements and hospital acute services contracts, each of which have finite useful lives. Amortization expense is computed using the straight-line method over the useful lives of the assets estimated as follows: non-competition agreements over three years to ten years , and hospital acute service contracts over the contract period. Amortizable intangible assets are reviewed for possible impairment whenever significant events or changes in circumstances indicate that an impairment may have occurred.
Indefinite-lived intangibles	Indefinite-lived intangibles Indefinite-lived intangible assets include international licenses and accreditations that allow the Company to be reimbursed for providing dialysis services to patients, each of which has an indefinite useful life. Indefinite-lived intangibles are not amortized, but are assessed for impairment at least annually and whenever significant events or changes in circumstances indicate that an impairment may have occurred.
Equity investments and other investments	Equity method and other investments Equity investments that do not have readily determinable fair values are carried on the equity method if the Company maintains significant influence over the investee or on the adjusted cost method if it does not. The adjusted cost method represents the Company's cost for an investment, net of any other-than-temporary impairment, or a subsequent observation of the investment's fair value. The Company classifies its equity and adjusted cost method investments as “Equity method and other investments” on its balance sheet. See Note 9 for further details, including recent changes to the Company's accounting for these investments. Equity method and other investments are assessed for other-than-temporary impairment when significant events or changes in circumstances indicate that an other-than-temporary impairment may have occurred. An other-than-temporary impairment charge is recorded when the fair value of an investment has fallen below its carrying amount and the shortfall is expected to be indefinitely or permanently unrecoverable.
Goodwill	Goodwill Goodwill represents the difference between the fair value of businesses acquired and the fair value of the identifiable tangible and intangible net assets acquired. Goodwill is not amortized, but is assessed by individual reporting unit for impairment as circumstances warrant and at least annually. An impairment charge is recognized when and to the extent a reporting unit's carrying amount is determined to exceed its fair value. The Company operates multiple reporting units. See Note 10 for further details.
Self insurance	Self-insurance The Company predominantly self-insures its professional and general liability and workers' compensation risks through its wholly-owned captive insurance companies, with excess or reinsurance coverage for additional risk. The Company is also predominantly self-insured with respect to employee medical and other health benefits. The Company records insurance liabilities for the professional and general liability, workers’ compensation, and employee health benefit risks that it retains and estimates its liability for those risks using third party actuarial calculations that are based upon historical claims experience and expectations for future claims.
Income taxes	Income taxes Federal and state income taxes are computed at currently enacted tax rates less tax credits using the asset and liability method. Deferred taxes are adjusted both for items that do not currently have tax consequences and for the cumulative effect of any changes in tax rates from those previously used to determine deferred tax assets or liabilities. Tax provisions include amounts that are currently payable, changes in deferred tax assets and liabilities that arise because of temporary differences between the timing of when items of income and expense are recognized for financial reporting and income tax purposes, changes in the recognition of tax positions and any changes in the valuation allowance caused by a change in judgment about the realizability of the related deferred tax assets. A valuation allowance is established when necessary to reduce deferred tax assets to amounts expected to be realized. The Company uses a recognition threshold of more-likely-than-not and a measurement attribute on all tax positions taken or expected to be taken in a tax return in order to be recognized in the financial statements. Once the recognition threshold is met, the tax position is then measured to determine the actual amount of benefit to recognize in the financial statements. The Company accounts for income taxes under the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements. Under this method, deferred tax assets and liabilities are determined on the basis of the differences between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse.
Stock-based compensation	Stock-based compensation The Company’s stock-based compensation expense for stock-settled awards is measured at the estimated fair value of awards on the date of grant and recognized on a cumulative straight-line basis over the vesting terms of the awards, unless the stock awards are based on non-market based performance metrics, in which case expense is adjusted for the ultimate number of shares expected to be issued as of the end of each reporting period. Stock-based compensation expense for cash-settled awards is based on their estimated fair values as of the end of each reporting period. The expense for all stock-based awards is recognized net of expected forfeitures.
Interest rate swap and cap agreements	Interest rate cap agreements The Company often carries a combination of current or forward interest rate caps on portions of its variable rate debt as a means of hedging its exposure to changes in LIBOR interest rates as part of its overall interest rate risk management strategy. These interest rate caps are not held for trading or speculative purposes and are designated as qualifying cash flow hedges. See Note 13 for further details.
Noncontrolling interests	Noncontrolling interests Noncontrolling interests subject to put provisions The Company has potential obligations to purchase the equity interests held by third parties in many of its majority-owned dialysis partnerships and other nonconsolidated entities. These noncontrolling interests subject to put provisions constitute redeemable equity interests and are therefore classified as temporary equity and carried at estimated fair value on the Company's balance sheet. Specifically, these obligations are in the form of put provisions that are exercisable at the third-party owners’ discretion within specified periods 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, generally at the appraised fair market value of the equity interests or in certain cases at a predetermined multiple of earnings or cash flows attributable to the equity interests put to the Company, 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 is immaterial.
Fair value estimates	Fair value estimates
New accounting standards	New accounting standards New standards recently adopted In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in Topic 842 revise lessee accounting for leases. Under the new guidance, lessees are 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 leaseback transactions primarily because lessees must recognize lease assets and lease liabilities. The Company adopted Topic 842 as of January 1, 2019 using a modified retrospective transition approach with a cumulative effect adjustment for leases existing at the adoption date. The Company elected to apply the package of practical expedients to not reassess prior conclusions related to contracts containing leases, lease classification and initial direct costs. Adoption of Topic 842 as of January 1, 2019 resulted in the recognition of operating right-of-use assets of $2,783,784 , operating lease liabilities of $3,001,354 and a cumulative effect adjustment to retained earnings of $39,876 , primarily related to deferred gains on prior sale leaseback transactions. Adoption of this new lease guidance did not materially impact the Company's consolidated net earnings and had no impact on cash flows. See Note 14 for further details. 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 this ASU were effective for the Company on January 1, 2019. Adoption of this ASU did not have a material impact on the Company’s consolidated financial statements. New standards not yet adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The amendments in this ASU change the approach for recognizing credit losses on financial assets from the incurred loss methodology in current U.S. GAAP to a methodology that reflects current expected credit losses, which requires consideration of a broader range of reasonable and supportable information to inform those credit loss estimates. The current incurred loss model delays recognition of credit losses until it is probable that a loss has been incurred, while this ASU’s new current expected credit loss model requires estimation of credit losses expected over the life of the financial asset or group of similar financial assets. The amendments in this ASU are effective for the Company on January 1, 2020 and are to be applied on a modified retrospective approach. The Company has evaluated the impact of this standard on its consolidated financial statements, including accounting policies, processes, and systems, and does not expect the impact to be material. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework -Changes to the Disclosure Requirements for Fair Value Measurement . The applicable amendments in this ASU remove requirements for disclosures concerning transfers between fair value measurement Levels 1, 2 and 3 and disclosures concerning valuation processes for Level 3 fair value measurements. The applicable amendments also add a requirement to separately disclose the changes in unrealized gains and losses included in other comprehensive income for the reporting period for Level 3 items measured at fair value on a recurring basis, and require disclosure of the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements. The amendments in this ASU are effective for the Company beginning on January 1, 2020 and its new requirements are to be applied on a prospective basis. Adoption of this ASU is not expected to have a material impact on the Company’s consolidated financial statements. In December 2019, the FASB issued ASU 2019-12 , Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes . ASU 2019-12 attempts to simplify aspects of accounting for franchise taxes and enacted changes in tax laws or rates, and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. ASU 2019-12 is effective for public business entities for fiscal years beginning after December 15, 2020, including interim periods within that fiscal year. Early adoption is permitted for all entities. The Company is currently assessing the effect this guidance may have on its consolidated financial statements.
Earnings per share	Basic earnings per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interest redemption rights in excess of fair value, by the weighted average number of common shares outstanding, reduced for 2018 and 2017 by the weighted average shares held in escrow that under certain circumstances may have been returned to the Company. Weighted average common shares outstanding include restricted stock unit awards that are no longer subject to forfeiture because the recipients have satisfied either their explicit vesting terms or retirement eligibility requirements. Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units (under the treasury stock method) and, for 2018 and 2017, the weighted average contingently returnable shares held in escrow that were outstanding during the period.
Short-term and long-term investments	Debt securities: The Company's short-term debt investments are principally 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 approximated their fair values at December 31, 2019 and 2018 . Equity securities:
Long-term incentive compensation	The Company’s stock-based compensation expense for stock-settled awards is measured at the estimated fair value of awards on the date of grant and recognized on a cumulative straight-line basis over the vesting terms of the awards, unless the stock awards are based on non-market-based performance metrics, in which case expense is adjusted for the ultimate number of shares expected to be issued as of the end of each reporting period. Stock-based compensation expense for cash-settled awards is based on their estimated fair values as of the end of each reporting period. The expense for all stock-based awards is recognized net of expected forfeitures.
Other Comprehensive (Loss) Income	The reclassification of net cap realized losses into income are recorded as debt expense in the corresponding consolidated statements of income.
Variable Interest Entities	The Company manages or maintains an ownership interest in certain legal entities subject to the consolidation guidance applicable to variable interest entities (VIEs). Almost all of these legal entities are either U.S. dialysis partnerships encumbered by guaranteed debt, U.S. dialysis limited partnerships, or other legal entities subject to nominee ownership arrangements. Under U.S. GAAP, VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. The substantial majority of VIEs the Company is associated with are U.S. dialysis partnerships which the Company manages and in which it maintains a controlling majority ownership interest. These U.S. dialysis partnerships are considered VIEs because they are either (i) encumbered by debt guaranteed proportionately by the partners that is considered necessary to finance the partnership's activities, or (ii) in the form of limited partnerships for which the limited partners are not considered to have substantive kick-out or participating rights. The Company consolidates virtually all such U.S. dialysis partnerships. The Company also relies on the operating activities of certain legal entities in which it does not maintain a controlling ownership interest but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are typically subject to nominee ownership and transfer restriction agreements that effectively transfer the majority of the economic risks and rewards of their ownership to the Company. The Company’s management, restriction and other agreements concerning such nominee-owned entities typically 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 these entities to the Company. The Company consolidates all of the nominee-owned entities with which it is most closely associated.

Revenue Recognition and Account

Revenue Recognition and Accounts Receivable Segment revenue by major payor (Tables)	12 Months Ended
	Dec. 31, 2019
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: Year ended December 31, 2019 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,129,697 $ $ 6,129,697 Medicaid and Managed Medicaid 669,089 669,089 Other government 446,010 352,765 798,775 Commercial 3,286,089 144,256 3,430,345 Other revenues: Medicare and Medicare Advantage 264,538 264,538 Medicaid and Managed Medicaid 606 606 Commercial 130,823 130,823 Other (1) 32,021 78,940 110,961 Eliminations of intersegment revenues (132,325 ) (14,030 ) (146,355 ) Total $ 10,430,581 $ 957,898 $ 11,388,479 (1) Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services. Year ended December 31, 2018 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,063,891 $ $ 6,063,891 Medicaid and Managed Medicaid 628,766 628,766 Other government 446,999 335,594 782,593 Commercial 3,176,413 101,681 3,278,094 Other revenues: Medicare and Medicare Advantage 492,812 492,812 Medicaid and Managed Medicaid 44,246 44,246 Commercial 90,890 90,890 Other (1) 19,880 130,865 150,745 Eliminations of intersegment revenues (92,950 ) (34,236 ) (127,186 ) Total $ 10,242,999 $ 1,161,852 $ 11,404,851 (1) Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services. Year ended December 31, 2017 (1) U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 5,253,012 $ $ 5,253,012 Medicaid and Managed Medicaid 606,827 606,827 Other government 362,567 259,651 622,218 Commercial 3,117,920 63,505 3,181,425 Other revenues: Medicare and Medicare Advantage 902,289 902,289 Medicaid and Managed Medicaid 71,426 71,426 Commercial 116,503 116,503 Other (2) 19,739 182,974 202,713 Eliminations of intersegment revenues (55,176 ) (24,603 ) (79,779 ) Total $ 9,304,889 $ 1,571,745 $ 10,876,634 (1) As noted above, prior period amounts have not been adjusted under the cumulative effect method. In this table, the Company's U.S. dialysis revenues for the year ended December 31, 2017 has been presented net of the provision for uncollectible accounts of $485,364 to conform to the current period presentation. (2) Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2019
Earnings Per Share [Abstract]
Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Net Income Per Share	The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows: Year ended December 31, 2019 2018 2017 Numerators: Net income from continuing operations attributable to DaVita Inc. $ 706,832 $ 624,321 $ 901,277 Net income (loss) from discontinued operations attributable to DaVita Inc. 104,149 (464,927 ) (237,659 ) Net income attributable to DaVita Inc. for earnings per share calculation $ 810,981 $ 159,394 $ 663,618 Basic: Weighted average shares outstanding during the period 153,181 171,886 190,820 Weighted average contingently returnable shares previously held in escrow for — (1,100 ) (2,194 ) Weighted average shares for basic earnings per share calculation 153,181 170,786 188,626 Basic net income (loss) attributable to DaVita Inc. from: Continuing operations per share $ 4.61 $ 3.66 $ 4.78 Discontinued operations per share 0.68 (2.73 ) (1.26 ) Basic net income per share attributable to DaVita Inc. $ 5.29 $ 0.93 $ 3.52 Diluted: Weighted average shares outstanding during the period 153,181 171,886 190,820 Assumed incremental shares from stock plans 631 479 529 Weighted average shares for diluted earnings per share calculation 153,812 172,365 $ 191,349 Diluted net income (loss) attributable to DaVita Inc. from: Continuing operations per share $ 4.60 $ 3.62 $ 4.71 Discontinued operations per share 0.67 (2.70 ) (1.24 ) Diluted net income per share attributable to DaVita Inc. $ 5.27 $ 0.92 $ 3.47 Anti-dilutive stock-settled awards excluded from calculation (1) 5,936 5,295 4,350 (1) Shares associated with stock-settled stock appreciation rights excluded from the diluted denominator calculation because they were anti-dilutive under the treasury stock method.

Short-term and long-term invesm

Short-term and long-term invesmtents (Tables)	12 Months Ended
	Dec. 31, 2019
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	The Company’s investments in these short-term and long-term debt and equity investments consist of the following: December 31, 2019 December 31, 2018 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 8,140 $ — $ 8,140 $ 2,235 $ — $ 2,235 Investments in mutual funds and common stock — 39,951 39,951 — 36,124 36,124 $ 8,140 $ 39,951 $ 48,091 $ 2,235 $ 36,124 $ 38,359 Short-term investments $ 8,140 $ 3,432 $ 11,572 $ 2,235 $ 700 $ 2,935 Long-term investments — 36,519 36,519 — 35,424 35,424 $ 8,140 $ 39,951 $ 48,091 $ 2,235 $ 36,124 $ 38,359

Other Receivables (Tables)

Other Receivables (Tables)	12 Months Ended
	Dec. 31, 2019
Receivables [Abstract]
Schedule of Other Receivables	Other receivables were comprised of the following: December 31, 2019 2018 Supplier rebates and non-trade receivables $ 351,650 $ 334,156 Medicare bad debt claims 138,045 135,640 $ 489,695 $ 469,796

Property and Equipment (Tables)

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment were comprised of the following: December 31, 2019 2018 Land $ 36,480 $ 37,384 Buildings 392,256 467,181 Leasehold improvements 3,545,224 3,164,943 Equipment and information systems, including internally developed software 2,880,645 2,586,564 New center and capital asset projects in progress 588,345 661,695 7,442,950 6,917,767 Less accumulated depreciation (3,969,566 ) (3,524,098 ) $ 3,473,384 $ 3,393,669

Intangibles (Tables)

Intangibles (Tables)	12 Months Ended
	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets other than Goodwill	Intangible assets other than goodwill were comprised of the following: December 31, 2019 2018 Noncompetition agreements $ 103,510 $ 107,726 Indefinite-lived licenses 90,209 59,885 Other 23,887 31,801 217,606 199,412 Less accumulated amortization (81,922 ) (80,566 ) $ 135,684 $ 118,846
Scheduled Amortization Charges from Intangible Assets and Liabilities	Scheduled amortization charges from amortizable intangible assets and liabilities as of December 31, 2019 were as follows: Noncompetition Other 2020 $ 11,470 $ 1,779 2021 9,703 1,335 2022 6,141 1,330 2023 3,118 1,294 2024 1,429 1,046 Thereafter 525 6,305 Total $ 32,386 $ 13,089

Equity Method and Other Inves_2

Equity Method and Other Investmetns Equity Method and Other Investments (Tables)	12 Months Ended
	Dec. 31, 2019
Equity Method Investments and Joint Ventures [Abstract]
Equity Method Investments	The Company's equity method and other investments were comprised of the following: December 31, 2019 2018 APAC joint venture $ 116,924 $ 129,173 Other equity method partnerships 114,611 83,052 Adjusted cost method investments 10,448 12,386 $ 241,983 $ 224,611

Goodwill (Tables)

Goodwill (Tables)	12 Months Ended
	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in Carrying Value of Goodwill by Reportable Segments	Changes in the carrying value of goodwill by reportable segments were as follows: U.S. dialysis Other - Ancillary services Consolidated Balance at December 31, 2017 $ 6,144,761 $ 465,518 $ 6,610,279 Acquisitions 130,574 147,774 278,348 Divestitures (331 ) (15,166 ) (15,497 ) Impairment charges — (3,106 ) (3,106 ) Foreign currency and other adjustments — (28,064 ) (28,064 ) Balance at December 31, 2018 $ 6,275,004 $ 566,956 $ 6,841,960 Acquisitions 18,089 72,137 90,226 Impairment charges — (124,892 ) (124,892 ) Foreign currency and other adjustments (5,993 ) (13,666 ) (19,659 ) Balance at December 31, 2019 $ 6,287,100 $ 500,535 $ 6,787,635 Goodwill $ 6,287,100 $ 653,870 $ 6,940,970 Accumulated impairment charges — (153,335 ) (153,335 ) $ 6,287,100 $ 500,535 $ 6,787,635
Schedule of Reporting Units Goodwill Balances	Reporting unit Goodwill Carrying amount (1) Sensitivities Operating (2) Discount (3) Germany kidney care $ 295,151 — % (1.3 )% (11.0 )% Brazil kidney care $ 88,551 4.4 % (2.8 )% (7.0 )% (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.

Other Liabilities (Tables)

Other Liabilities (Tables)	12 Months Ended
	Dec. 31, 2019
Other Liabilities Disclosure [Abstract]
Schedule of Other Liabilities	Other liabilities were comprised of the following: December 31, 2019 2018 Payor refunds and retractions $ 377,044 $ 302,244 Insurance and self-insurance accruals 58,941 58,569 Accrued interest 54,899 82,827 Accrued non-income tax liabilities 36,285 28,663 Other 229,005 123,547 $ 756,174 $ 595,850

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Schedule of Income Before Income Taxes	Income before income taxes from continuing operations consisted of the following: Year ended December 31, 2019 2018 2017 Domestic $ 1,307,299 $ 1,083,578 $ 1,725,822 International (111,860 ) (35,100 ) (326,036 ) $ 1,195,439 $ 1,048,478 $ 1,399,786
Components of Income Tax Expense (Benefit)	Income tax expense for continuing operations consisted of the following: Year ended December 31, 2019 2018 2017 Current: Federal $ 208,339 $ 140,064 $ 330,191 State 58,026 32,990 47,228 International 15,545 7,557 3,422 Total current income tax 281,910 180,611 380,841 Deferred: Federal 44,263 52,034 (98,760 ) State (25,836 ) 21,096 37,347 International (20,709 ) 4,659 4,431 Total deferred income tax (2,282 ) 77,789 (56,982 ) $ 279,628 $ 258,400 $ 323,859
Schedule of Allocation of Income Tax Expense (Benefit)	Income taxes are allocated between continuing and discontinued operations as follows: Year ended December 31, 2019 2018 2017 Continuing operations $ 279,628 $ 258,400 $ 323,859 Discontinued operations 40,689 99,768 (364,856 ) $ 320,317 $ 358,168 $ (40,997 )
Reconciliation between U.S. Federal Income Tax Rate and Effective Tax Rate	The reconciliation between the Company’s effective tax rate from continuing operations and the U.S. federal income tax rate is as follows: Year ended December 31, 2019 2018 2017 Federal income tax rate 21.0 % 21.0 % 35.0 % State income taxes, net of federal benefit 2.3 4.1 3.7 Change in International valuation allowance 1.3 0.9 0.4 Gain on APAC JV ownership changes — — (0.2 ) Political advocacy costs 0.2 2.3 — APAC investment impairment — — 6.4 Impact of 2017 Tax Act — (0.1 ) (20.5 ) Unrecognized tax benefits 2.4 0.2 0.1 Other 1.1 0.8 1.5 Impact of noncontrolling interests primarily attributable (4.9 ) (4.6 ) (3.3 ) Effective tax rate 23.4 % 24.6 % 23.1 %
Deferred Tax Assets and Liabilities Arising from Temporary Differences	Deferred tax assets and liabilities arising from temporary differences for continuing operations were as follows: December 31, 2019 2018 Receivables $ 19,095 $ 19,327 Accrued liabilities 64,458 106,506 Operating lease liabilities 580,110 — Net operating loss carryforwards 139,690 117,511 Other 55,108 36,712 Deferred tax assets 858,461 280,056 Valuation allowance (91,925 ) (70,474 ) Net deferred tax assets 766,536 209,582 Intangible assets (563,914 ) (555,822 ) Property and equipment (162,628 ) (118,008 ) Operating lease assets (527,056 ) — Investments in partnerships (64,960 ) (67,354 ) Other (25,521 ) (30,934 ) Deferred tax liabilities (1,344,079 ) (772,118 ) Net deferred tax liabilities $ (577,543 ) $ (562,536 )
Reconciliation of the Beginning and Ending Liability for Unrecognized Tax Benefits that Do Not Meet the More-Likely-Than-Not Threshold	A reconciliation of the beginning and ending liability for unrecognized tax benefits that do not meet the more-likely-than-not threshold is as follows: Year ended December 31, 2019 2018 Beginning balance $ 40,382 $ 32,776 Additions for tax positions related to current year 3,378 6,111 Additions for tax positions related to prior years 24,722 4,134 Reductions related to lapse of applicable statute (268 ) (338 ) Reductions related to settlements with taxing authorities — (2,301 ) Ending balance $ 68,214 $ 40,382

Long-Term Debt (Tables)

Long-Term Debt (Tables)	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Long-term Debt	Long-term debt was comprised of the following: December 31, As of December 31, 2019 2019 2018 Maturity date Interest rate Estimated fair value (5) Senior Secured Credit Facilities (1) : New Term Loan A $ 1,739,063 $ — 8/12/2024 LIBOR + 1.50% $ 1,739,063 New Term Loan B (2) 2,743,125 — 8/12/2026 LIBOR + 2.25% $ 2,770,556 Prior Term Loan A (3) — 675,000 12/24/2019 (4) $ — Prior Term Loan A-2 (3) — 995,000 12/24/2019 (4) $ — Prior Term Loan B — 3,342,500 6/24/2021 (4) $ — Prior revolving line of credit (3) — 175,000 12/24/2019 (4) $ — Senior Notes: 5 1/8% Senior Notes 1,750,000 1,750,000 7/15/2024 5.125 % $ 1,789,375 5% Senior Notes 1,500,000 1,500,000 5/1/2025 5.00 % $ 1,538,700 5 3/4% Senior Notes — 1,250,000 8/15/2022 Acquisition obligations and other (6) 180,352 183,979 2019-2027 5.35 % $ 180,352 Financing lease obligations (7) 268,534 282,737 2019-2036 5.39 % $ 268,534 Total debt principal outstanding 8,181,074 10,154,216 Discount and deferred financing (8) (72,840 ) (52,000 ) 8,108,234 10,102,216 Less current portion (130,708 ) (1,929,369 ) $ 7,977,526 $ 8,172,847 (1) As of December 31, 2019 , the Company has an undrawn new revolving line of credit under its new senior secured credit facilities of $1,000,000 . The new revolving line of credit interest rate in effect at December 31, 2019 was 1.50% plus London Interbank Offered Rate (LIBOR) and it matures on August 12, 2024 . (2) On February 13, 2020 , the Company entered into an amendment to its credit agreement governing its senior secured credit facilities to refinance the new Term Loan B with a $2,743,125 secured Term Loan B-1 that bears interest at a rate equal to LIBOR plus an applicable margin of 1.75% and matures on August 12, 2026 . (3) On May 6, 2019, the Company entered into an agreement to extend the maturity dates of its then existing Term Loan A, Term Loan A-2 and revolving line of credit under its prior senior secured credit facilities by six months , to December 24, 2019 . (4) At June 30, 2019, the interest rate on the Company's then existing term loan debt was LIBOR plus interest rate margins in effect of 2.00% for the prior Term Loan A and prior revolving line of credit, 1.00% for the prior Term Loan A-2 and 2.75% for the prior Term Loan B. (5) Fair value estimates are based upon quoted bid and ask prices for these instruments, typically a level 2 input. The balances of acquisition obligations and other notes payable and financing lease obligations are presented in the consolidated financial statements as of December 31, 2019 at their approximate fair values due to the short-term nature of their settlements. (6) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current interest rate in effect and assuming no changes to the LIBOR based interest rates. (7) The interest rate presented for financing lease obligations is their weighted average discount rate. (8) As of December 31, 2019 , the carrying amount of the Company’s current senior secured credit facilities includes a discount of $6,457 and deferred financing costs of $45,444 , and the carrying amount of the Company’s senior notes includes deferred financing costs of $20,939 . As of December 31, 2018 , the carrying amount of the Company’s then existing senior secured credit facilities included a discount of $6,104 and deferred financing costs of $12,580 , and the carrying amount of the Company’s senior notes included deferred financing costs of $33,316 .
Scheduled Maturities of Long-term Debt	Scheduled maturities of long-term debt at December 31, 2019 were as follows: 2020 $ 130,708 2021 $ 153,110 2022 $ 168,951 2023 $ 224,437 2024 $ 3,172,298 Thereafter $ 4,331,570
Derivative Instruments	The following table summarizes the Company’s interest rate cap agreements outstanding as of December 31, 2019 and December 31, 2018 , which are classified in "Other long-term assets" on its consolidated balance sheet: Year ended December 31, December 31, 2019 2019 2018 Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI (loss) gain Fair value 2015 cap agreements $ 3,500,000 3.50% 6/29/2018 6/30/2020 $ 8,654 $ (851 ) $ — $ 851 2019 cap agreements $ 3,500,000 2.00% 6/30/2020 6/30/2024 $ 2,417 $ 24,452
Effects of Interest Rate Swap and Cap Agreements	The following table summarizes the effects of the Company’s interest rate cap and swap agreements for the years ended December 31, 2019 , 2018 and 2017 : Amount of unrealized gains (losses) in OCI Location of losses Reclassification from accumulated other comprehensive income into net income Year ended December 31, Year ended December 31, Derivatives designated as cash flow hedges 2019 2018 2017 2019 2018 2017 Interest rate cap agreements $ 1,566 $ (181 ) $ (8,897 ) Debt expense $ 8,591 $ 8,466 $ 8,278 Tax (expense) benefit (415 ) 48 3,460 Tax expense (2,214 ) (2,180 ) (3,220 ) Total $ 1,151 $ (133 ) $ (5,437 ) $ 6,377 $ 6,286 $ 5,058

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2019
Leases [Abstract]
Lease Expense Components	The components of lease expense were as follows: Lease cost Year ended December 31, 2019 Operating lease cost (1) : Fixed lease expense $ 526,352 Variable lease expense 119,740 Financing lease cost: Amortization of leased assets 23,724 Interest on lease liabilities 14,932 Net lease cost $ 684,748
Leases Other Information	Other information related to leases was as follows: Lease term and discount rate December 31, 2019 Weighted average remaining lease term (years): Operating leases 9.0 Finance leases 10.2 Weighted average discount rate: Operating leases 4.1 % Finance leases 5.4 % Other information Year ended December 31, 2019 Gains on sale leasebacks, net $ 20,833 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 637,655 Operating cash flows for finance leases $ 22,257 Financing cash flows for finance leases $ 25,692 Net operating lease assets obtained in exchange for new or modified $ 432,074
Schedule Of Minimum Lease Payments	Future minimum lease payments under non-cancellable leases as of December 31, 2019 are as follows: Operating leases Finance leases 2020 $ 462,131 $ 37,624 2021 489,799 33,267 2022 454,753 33,677 2023 409,655 33,825 2024 358,009 33,841 Thereafter 1,510,665 178,434 Total future minimum lease payments 3,685,012 350,668 Less portion representing interest (617,300 ) (82,134 ) Present value of lease liabilities $ 3,067,712 $ 268,534

Long-term Incentive Compensat_2

Long-term Incentive Compensation and Shareholders’ Equity (Tables)	12 Months Ended
	Dec. 31, 2019
Share-based Payment Arrangement [Abstract]
Summary of Status of Awards Under Stock-Based Compensation Plans and Agreements	A combined summary of the status of the Company’s stock-settled awards under the 2011 Plan, including base shares for stock-settled stock appreciation rights (SSARs) and stock-settled stock unit awards is as follows: Year ended December 31, 2019 Stock appreciation rights Stock units Awards Weighted Weighted Awards Weighted Outstanding at beginning of year 6,163 $ 69.90 1,860 Granted (1) ( 2) 2,389 $ 52.45 1,961 Exercised (20 ) $ 64.17 (225 ) Expired (1,058 ) $ 70.97 — Canceled (521 ) $ 65.23 (436 ) Outstanding at end of period (1) 6,953 $ 64.10 3.0 3,160 2.3 Exercisable at end of period 1,254 $ 77.68 1.1 — — Weighted-average fair value of grants 2019 $ 14.04 $ 50.58 2018 $ 16.24 $ 66.23 2017 $ 14.51 $ 65.73 (1) Awards granted and outstanding do not reflect the Premium Priced Award described below, as that Board-approved award remained contingent on stockholder approval of an amendment to the 2011 Plan which did not occur until January 2020. (2) Includes approximately 8 shares resulting from the payout of the first tranche of fiscal year 2016 PSU grants due to exceeding target payout. Awards Outstanding Weighted average exercise price Awards exercisable Weighted average exercise price Range of SSARs base prices $50.01–$60.00 2,400 $ 52.63 — $ — $60.01–$70.00 3,069 $ 66.16 186 $ 65.92 $70.01–$80.00 925 $ 75.28 509 $ 75.50 $80.01–$90.00 559 $ 83.59 559 $ 83.59 Total 6,953 $ 64.10 1,254 $ 77.68
Summary of Range of Exercise Prices	Awards Outstanding Weighted average exercise price Awards exercisable Weighted average exercise price Range of SSARs base prices $50.01–$60.00 2,400 $ 52.63 — $ — $60.01–$70.00 3,069 $ 66.16 186 $ 65.92 $70.01–$80.00 925 $ 75.28 509 $ 75.50 $80.01–$90.00 559 $ 83.59 559 $ 83.59 Total 6,953 $ 64.10 1,254 $ 77.68
Summary of Weighted Average Valuation Inputs	A summary of the weighted average valuation inputs described above used for estimating the grant-date fair value of SSAR awards granted in the periods indicated is as follows: Year ended December 31, 2019 2018 2017 Expected term 4.0 4.2 4.2 Expected volatility 29.5 % 23.8 % 23.9 % Expected dividend yield — % — % — % Risk-free interest rate 2.2 % 2.9 % 1.7 %

Stockholder's equity (Tables)

Stockholder's equity (Tables)	12 Months Ended
	Dec. 31, 2019
Equity [Abstract]
Shares repurchases summary table	The following table summarizes our repurchases of our common stock during the years ended December 31, 2019 , 2018 and 2017 : 2019 2018 2017 Shares repurchased Amount paid Paid per share Shares repurchased Amount paid Paid per share Shares repurchased Amount paid Paid per share Tender Offer (1) 21,802 $ 1,234,154 $ 56.61 — $ — $ — — $ — $ — Open market 19,218 1,168,321 60.79 16,844 1,153,511 68.48 12,967 810,949 62.54 41,020 $ 2,402,475 $ 58.57 16,844 $ 1,153,511 $ 68.48 12,967 $ 810,949 $ 62.54 (1) The amount paid for shares repurchased associated with the Company's Tender Offer during the year ended December 31, 2019 includes the clearing price of $56.50 per share plus related fees and expenses of $2,343 .
Net effect of transfers from to noncontrolling interests on stock holders equity disclosure	The effects of changes in DaVita Inc.’s ownership interests in consolidated subsidiaries on the Company’s consolidated equity are as follows: Year ended December 31, 2019 2018 2017 Net income attributable to DaVita Inc. $ 810,981 $ 159,394 $ 663,618 Changes in paid-in capital for: Sales of noncontrolling interest — 79 (114 ) Purchase of noncontrolling interests (37,145 ) (17,897 ) (2,752 ) Net transfer in noncontrolling interests (37,145 ) (17,818 ) (2,866 ) Net income attributable to DaVita Inc. net of transfers in $ 773,836 $ 141,576 $ 660,752

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive (Loss) Income (Tables)	12 Months Ended
	Dec. 31, 2019
Statement of Comprehensive Income [Abstract]
Changes in Other Comprehensive (Loss) Income	Charges and credits to other comprehensive (loss) income have been as follows: Interest rate cap agreements Investment securities Foreign currency translation adjustments Accumulated other comprehensive (loss) income Balance at December 31, 2016 $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) Unrealized (losses) gains (8,897 ) 5,075 99,770 95,948 Related income tax 3,460 (1,368 ) — 2,092 (5,437 ) 3,707 99,770 98,040 Reclassification of income (loss) into net income 8,278 (360 ) — 7,918 Related income tax (3,220 ) 140 — (3,080 ) 5,058 (220 ) — 4,838 Balance at December 31, 2017 $ (12,408 ) $ 5,662 $ 19,981 $ 13,235 Cumulative effect of change in accounting principle (1) (2,706 ) (5,662 ) — (8,368 ) Unrealized losses (181 ) — (45,944 ) (46,125 ) Related income tax 48 — — 48 (133 ) — (45,944 ) (46,077 ) Reclassification of income into net income 8,466 — — 8,466 Related income tax (2,180 ) — — (2,180 ) 6,286 — — 6,286 Balance at December 31, 2018 $ (8,961 ) $ — $ (25,963 ) $ (34,924 ) Unrealized gains (losses) 1,566 — (20,102 ) (18,536 ) Related income tax (415 ) — — (415 ) 1,151 — (20,102 ) (18,951 ) Reclassification of income into net income 8,591 — — 8,591 Related income tax (2,214 ) — — (2,214 ) 6,377 — — 6,377 Balance at December 31, 2019 $ (1,433 ) $ — $ (46,065 ) $ (47,498 ) (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. See Note 5 for further details.

Acquisitions and Divestitures (

Acquisitions and Divestitures (Tables)	12 Months Ended
	Dec. 31, 2019
Business Acquisition [Line Items]
Pro Forma Summary of Results of Operations	The following summary, prepared on a pro forma basis, combines the results of operations as if all acquisitions within continuing operations in 2019 and 2018 had been consummated as of the beginning of 2018 , including the impact of certain adjustments such as amortization of intangibles, interest expense on acquisition financing and income tax effects. Year ended December 31, 2019 2018 (unaudited) Pro forma total revenues $ 11,416,498 $ 11,566,736 Pro forma net income from continuing operations attributable to $ 709,631 $ 640,112 Pro forma basic net income per share from continuing operations $ 4.63 $ 3.75 Pro forma diluted net income per share from continuing operations $ 4.61 $ 3.71
Reconciliation of Changes in Contingent Earn-Out Obligations	The following is a reconciliation of changes in liabilities for contingent earn-out obligations for the year ended December 31, 2019 : Balance at December 31, 2017 $ 6,388 Contingent earn-out obligations associated with acquisitions 1,246 Remeasurement of fair value (4,729 ) Payments of contingent earn-out obligations (297 ) Balance at December 31, 2018 $ 2,608 Contingent earn-out obligations associated with acquisitions 23,536 Remeasurement of fair value (784 ) Payments of contingent earn-out obligations (774 ) $ 24,586
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Aggregate Purchase Cost Allocations for Acquisitions	The following table summarizes the assets acquired and liabilities assumed in these transactions and recognized at their acquisition dates at estimated fair values, as well as the estimated fair value of noncontrolling interests assumed in these transactions: Year ended December 31, 2019 2018 2017 Current assets $ 6,713 $ 23,686 $ 14,366 Property and equipment 4,842 11,421 18,192 Amortizable intangible and other long-term assets 1,980 3,079 11,663 Indefinite-lived licenses 31,858 23,656 32,296 Goodwill 90,226 278,348 318,832 Deferred income taxes — — (210 ) Noncontrolling interests assumed (1,762 ) (80,291 ) (44,303 ) Liabilities assumed (7,159 ) (19,946 ) (15,846 ) $ 126,698 $ 239,953 $ 334,990
Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Aggregate Purchase Cost Allocations for Acquisitions	The following table summarizes the assets acquired and liabilities assumed in this transaction and recognized at the acquisition date at estimated fair values: Current assets, net of cash acquired $ 22,739 Property and equipment 36,295 Amortizable intangible and other long-term assets 11,547 Goodwill 298,200 Current liabilities (8,389 ) Long-term liabilities (479 ) $ 359,913

Held for Sale and Discontinue_2

Held for Sale and Discontinued Operations (Tables)	12 Months Ended
	Dec. 31, 2019
Discontinued Operations and Disposal Groups [Abstract]
Summary of Information Related to Assets Held For Sale and Discontinued Operations	The following table presents the financial results of discontinued operations related to DMG: Year ended December 31, 2019 2018 2017 Net revenues $ 2,713,059 $ 4,963,792 $ 4,676,213 Expenses 2,543,865 4,962,686 4,634,782 Goodwill and other asset impairment charges — 41,537 651,659 Valuation adjustment on disposal group — 316,840 — Income (loss) from discontinued operations before taxes 169,194 (357,271 ) (610,228 ) Loss on sale of discontinued operations before taxes (23,022 ) — — Income tax expense (benefit) 40,689 99,768 (364,856 ) Net income (loss) from discontinued operations, net of tax $ 105,483 (457,038 ) $ (245,372 )
Reconciliation of Cash Flows	The following table presents cash flows of discontinued operations related to DMG: Year ended December 31, 2019 2018 2017 Net cash provided by operating activities from discontinued operations $ 99,634 $ 290,684 $ 357,274 Net cash used in investing activities from discontinued operations $ (43,442 ) $ (57,382 ) $ (232,329 )

Fair Values of Financial Inst_2

Fair Values of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2019
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 measured at fair value on a recurring basis as of December 31, 2019 and 2018 : December 31, 2019 Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 39,951 $ 39,951 $ — $ — Interest rate cap agreements $ 24,452 $ — $ 24,452 $ — Liabilities Contingent earn-out obligations $ 24,586 $ — $ — $ 24,586 Temporary equity Noncontrolling interests subject to put provisions $ 1,180,376 $ — $ — $ 1,180,376 December 31, 2018 Assets Investments in equity securities $ 36,124 $ 36,124 $ — $ — Interest rate cap agreements $ 851 $ — $ 851 $ — Liabilities Contingent earn-out obligations $ 2,608 $ — $ — $ 2,608 Temporary equity Noncontrolling interests subject to put provisions $ 1,124,641 $ — $ — $ 1,124,641

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2019
Segment Reporting [Abstract]
Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes	The following is a summary of segment revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Year ended December 31, 2019 2018 2017 Segment revenues: (1) U.S. dialysis Patient service revenues: External sources $ 10,421,401 $ 10,274,046 $ 9,767,123 Intersegment revenues 131,199 92,950 55,176 Total U.S. dialysis revenues 10,552,600 10,366,996 9,822,299 Provision for uncollectible accounts (21,715 ) (50,927 ) (481,973 ) Net U.S. dialysis patient service revenues 10,530,885 10,316,069 9,340,326 Other revenues (2) External sources 30,895 19,880 19,739 Intersegment revenues 1,126 — — Total net U.S. dialysis revenues $ 10,562,906 $ 10,335,949 $ 9,360,065 Other - Ancillary services Net patient service revenues $ 497,021 $ 437,275 $ 323,156 Other external sources 460,877 724,577 1,248,589 Intersegment revenues 14,030 34,236 24,603 Total ancillary services $ 971,928 $ 1,196,088 $ 1,596,348 Total net segment revenues 11,534,834 11,532,037 10,956,413 Elimination of intersegment revenues (146,355 ) (127,186 ) (79,779 ) Consolidated revenues $ 11,388,479 $ 11,404,851 $ 10,876,634 Segment operating margin (loss): U.S. dialysis $ 1,924,826 $ 1,709,721 $ 2,297,198 Other - Ancillary services (189,174 ) (93,789 ) (439,477 ) Total segment margin 1,735,652 1,615,932 1,857,721 Reconciliation of segment operating margin to consolidated income from Corporate administrative support (92,335 ) (90,108 ) (44,966 ) Consolidated operating income 1,643,317 1,525,824 1,812,755 Debt expense (443,824 ) (487,435 ) (430,634 ) Debt prepayment, refinancing and redemption charges (33,402 ) — — Other income 29,348 10,089 17,665 Income from continuing operations before income taxes $ 1,195,439 $ 1,048,478 $ 1,399,786 (1) On January 1, 2018, the Company adopted 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. See Notes 1 and 2 for further discussion of the Company's adoption of Topic 606. (2) Includes management fee revenues from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling interest or which are wholly-owned by third parties.
Summary of Depreciation and Amortization Expense by Segment	Depreciation and amortization expense by reportable segment was as follows: Year ended December 31, 2019 2018 2017 U.S. dialysis $ 583,454 $ 558,810 $ 520,965 Other - Ancillary services 31,698 32,225 38,946 $ 615,152 $ 591,035 $ 559,911
Summary of Assets by Segment	Summary of assets by reportable segment was as follows: Year ended December 31, 2019 2018 Segment assets U.S. dialysis (including equity investments of $124,188 and $95,290, $ 15,778,880 $ 12,333,641 Other - Ancillary services (1) (including equity investments of $117,795 1,532,514 1,387,046 DMG - Discontinued operations (including equity investments of — 5,389,565 Consolidated assets $ 17,311,394 $ 19,110,252 (1) Includes approximately $154,572 and $136,052 in 2019 and 2018 , respectively, of net property and equipment related to the Company’s international operations.
Summary of Expenditures for Property and Equipment by Segment	Expenditures for property and equipment by reportable segment were as follows: Year ended December 31, 2019 2018 2017 U.S. dialysis $ 681,339 $ 856,108 $ 769,732 Other - Ancillary services 46,741 45,806 40,377 DMG - Discontinued operations 38,466 85,224 95,141 $ 766,546 $ 987,138 $ 905,250

Supplemental Cash Flow Inform_2

Supplemental Cash Flow Information (Tables)	12 Months Ended
	Dec. 31, 2019
Supplemental Cash Flow Elements [Abstract]
Supplemental Cash Flow Information	The table below provides supplemental cash flow information: Year ended December 31, 2019 2018 2017 Cash paid: Income taxes, net $ 157,983 $ 92,526 $ 387,159 Interest $ 473,176 $ 488,974 $ 424,547 Non-cash investing and financing activities: Fixed assets under financing lease obligations $ 18,953 $ 8,828 $ 48,378

Selected Quarterly Financial _2

Selected Quarterly Financial Data (unaudited) (Tables)	12 Months Ended
	Dec. 31, 2019
Quarterly Financial Information Disclosure [Abstract]
Selected Quarterly Financial Data (unaudited)	December 31, September 30, June 30, March 31, 2019 Total revenues $ 2,898,584 $ 2,904,078 $ 2,842,705 $ 2,743,112 Operating income $ 462,588 $ 378,336 $ 461,886 $ 340,507 Attributable to DaVita Inc.: Net income from continuing operations (1) $ 242,242 $ 150,113 $ 194,223 $ 120,254 Net (loss) income from discontinued operations 2,629 (6,843 ) 79,328 29,035 Net income $ 244,871 $ 143,270 $ 273,551 $ 149,289 Per share attributable to DaVita Inc.: Basic net income from continuing operations $ 1.87 $ 1.00 $ 1.17 $ 0.72 Basic net income (loss) from discontinued operations 0.02 (0.05 ) 0.47 0.18 Basic net income $ 1.89 $ 0.95 $ 1.64 $ 0.90 Diluted net income from continuing operations $ 1.86 $ 0.99 $ 1.16 $ 0.72 Diluted net income (loss) from discontinued operations 0.02 (0.04 ) 0.48 0.18 Diluted net income $ 1.88 $ 0.95 $ 1.64 $ 0.90 2018 Total revenues $ 2,821,124 $ 2,847,330 $ 2,886,953 $ 2,849,444 Operating income $ 387,908 $ 289,038 $ 438,192 $ 410,686 Attributable to DaVita Inc.: Net income from continuing operations (1) $ 160,332 $ 73,371 $ 199,603 $ 191,015 Net (loss) income from discontinued operations (310,104 ) (210,167 ) 67,673 (12,329 ) Net (loss) income $ (149,772 ) $ (136,796 ) $ 267,276 $ 178,686 Per share attributable to DaVita Inc.: Basic net income from continuing operations $ 0.97 $ 0.44 $ 1.16 $ 1.07 Basic net (loss) income from discontinued operations (1.87 ) (1.26 ) 0.40 (0.07 ) Basic net (loss) income $ (0.90 ) $ (0.82 ) $ 1.56 $ 1.00 Diluted net income from continuing operations $ 0.96 $ 0.44 $ 1.15 $ 1.05 Diluted net (loss) income from discontinued operations (1.86 ) (1.26 ) 0.38 (0.07 ) Diluted net (loss) income $ (0.90 ) $ (0.82 ) $ 1.53 $ 0.98 (1) The following table summarizes impairment charges, (gain) loss on changes in ownership interest, restructuring charges, and stock-based compensation modification charges and net acceleration of expense included in operating expenses and charges in 2019 and 2018 by quarter: Quarter ended Quarter ended December 31, September 30, June 30, March 31, December 31, September 30, June 30, March 31, Certain operating expenses and charges: Impairment charges $ 83,855 $ 41,037 $ 1,530 $ 12,088 $ 14,351 (Gain) loss on changes in $ (19,437 ) $ 1,506 $ (33,957 ) Restructuring charges $ 11,366 Stock-based compensation $ 23,470

Consolidating Financial State_2

Consolidating Financial Statements (Tables)	12 Months Ended
	Dec. 31, 2019
Condensed Financial Information Disclosure [Abstract]
Consolidating Statements of Income	Consolidating Statements of Income For year ended December 31, 2019 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Dialysis patient service revenues $ — $ 6,961,825 $ 4,226,402 $ (269,806 ) $ 10,918,421 Less: Provision for uncollectible accounts — (15,296 ) (6,419 ) — (21,715 ) Net dialysis patient service revenues — 6,946,529 4,219,983 (269,806 ) 10,896,706 Other revenues 804,684 601,394 171,856 (1,086,161 ) 491,773 Total revenues 804,684 7,547,923 4,391,839 (1,355,967 ) 11,388,479 Operating expenses and charges 642,717 6,631,471 3,826,941 (1,355,967 ) 9,745,162 Operating income 161,967 916,452 564,898 — 1,643,317 Debt expense (482,074 ) (183,272 ) (53,043 ) 241,163 (477,226 ) Other income, net 309,623 7,314 46,306 (333,895 ) 29,348 Income tax (benefit) expense (2,616 ) 263,563 18,681 — 279,628 Equity earnings in subsidiaries 818,849 429,628 — (1,248,477 ) — Net income from continuing operations 810,981 906,559 539,480 (1,341,209 ) 915,811 Net income from discontinued operations, net of tax — — 12,751 92,732 105,483 Net income 810,981 906,559 552,231 (1,248,477 ) 1,021,294 Less: Net income attributable to noncontrolling — — — (210,313 ) (210,313 ) Net income attributable to DaVita Inc. $ 810,981 $ 906,559 $ 552,231 $ (1,458,790 ) $ 810,981 Consolidating Statements of Income - (continued) For year ended December 31, 2018 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Dialysis patient service revenues $ — $ 6,834,865 $ 4,096,666 $ (221,550 ) $ 10,709,981 Less: Provision for uncollectible accounts — (34,977 ) (14,610 ) — (49,587 ) Net dialysis patient service revenues — 6,799,888 4,082,056 (221,550 ) 10,660,394 Other revenues 799,230 488,086 558,079 (1,100,938 ) 744,457 Total revenues 799,230 7,287,974 4,640,135 (1,322,488 ) 11,404,851 Operating expenses and charges 646,640 6,551,328 4,003,547 (1,322,488 ) 9,879,027 Operating income 152,590 736,646 636,588 — 1,525,824 Debt expense (491,749 ) (201,496 ) (43,414 ) 249,224 (487,435 ) Other income, net 418,839 3,430 29,132 (441,312 ) 10,089 Income tax expense 23,482 155,372 79,546 — 258,400 Equity earnings in subsidiaries 103,196 388,737 — (491,933 ) — Net income from continuing operations 159,394 771,945 542,760 (684,021 ) 790,078 Net loss from discontinued operations, net of tax — — (649,126 ) 192,088 (457,038 ) Net income (loss) 159,394 771,945 (106,366 ) (491,933 ) 333,040 Less: Net income attributable to noncontrolling — — — (173,646 ) (173,646 ) Net income (loss) attributable to DaVita Inc. $ 159,394 $ 771,945 $ (106,366 ) $ (665,579 ) $ 159,394 For year ended December 31, 2017 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Dialysis patient service revenues $ — $ 6,417,574 $ 3,848,172 $ (172,076 ) $ 10,093,670 Less: Provision for uncollectible accounts — (322,085 ) (170,447 ) 7,168 (485,364 ) Net dialysis patient service — 6,095,489 3,677,725 (164,908 ) 9,608,306 Other revenues 793,751 408,460 1,080,832 (1,014,715 ) 1,268,328 Total net revenues 793,751 6,503,949 4,758,557 (1,179,623 ) 10,876,634 Operating expenses and charges 527,942 5,331,545 4,384,015 (1,179,623 ) 9,063,879 Operating income 265,809 1,172,404 374,542 — 1,812,755 Debt expense (426,149 ) (200,953 ) (43,490 ) 239,958 (430,634 ) Other income, net 411,731 5,979 23,657 (423,702 ) 17,665 Income tax expense 65,965 210,068 47,826 — 323,859 Equity earnings in subsidiaries 478,192 460,261 — (938,453 ) — Net income from continuing operations 663,618 1,227,623 306,883 (1,122,197 ) 1,075,927 Net loss from discontinued operations, net of tax — — (429,116 ) 183,744 (245,372 ) Net income (loss) 663,618 1,227,623 (122,233 ) (938,453 ) 830,555 Less: Net income attributable to noncontrolling — — — (166,937 ) (166,937 ) Net income (loss) attributable to DaVita Inc. $ 663,618 $ 1,227,623 $ (122,233 ) $ (1,105,390 ) $ 663,618
Consolidating Statements of Comprehensive Income	Consolidating Statements of Comprehensive Income For the year ended December 31, 2019 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Net income $ 810,981 $ 906,559 $ 552,231 $ (1,248,477 ) $ 1,021,294 Other comprehensive income (loss) 7,528 — (20,102 ) — (12,574 ) Total comprehensive income 818,509 906,559 532,129 (1,248,477 ) 1,008,720 Less: Comprehensive income attributable to — — — (210,313 ) (210,313 ) Comprehensive income attributable to DaVita Inc. $ 818,509 $ 906,559 $ 532,129 $ (1,458,790 ) $ 798,407 For the year ended December 31, 2018 Net income (loss) $ 159,394 $ 771,945 $ (106,366 ) $ (491,933 ) $ 333,040 Other comprehensive income (loss) 6,153 — (45,944 ) — (39,791 ) Total comprehensive income (loss) 165,547 771,945 (152,310 ) (491,933 ) 293,249 Less: Comprehensive income attributable to — — — (173,646 ) (173,646 ) Comprehensive income (loss) attributable to DaVita Inc. $ 165,547 $ 771,945 $ (152,310 ) $ (665,579 ) $ 119,603 For the year ended December 31, 2017 Net income (loss) $ 663,618 $ 1,227,623 $ (122,233 ) $ (938,453 ) $ 830,555 Other comprehensive income (loss) 3,106 — 99,770 — 102,876 Total comprehensive income (loss) 666,724 1,227,623 (22,463 ) (938,453 ) 933,431 Less: Comprehensive income attributable to — — — (166,935 ) (166,935 ) Comprehensive income (loss) attributable to DaVita Inc. $ 666,724 $ 1,227,623 $ (22,463 ) $ (1,105,388 ) $ 766,496
Consolidating Balance Sheets	Consolidating Balance Sheets As of December 31, 2019 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Cash and cash equivalents $ 758,241 $ 532 $ 343,599 $ — $ 1,102,372 Restricted cash and equivalents 14,499 — 91,847 — 106,346 Accounts receivable, net — 1,189,301 606,297 — 1,795,598 Other current assets 76,787 548,553 102,410 (41,896 ) 685,854 Total current assets 849,527 1,738,386 1,144,153 (41,896 ) 3,690,170 Property and equipment, net 543,932 1,589,417 1,344,543 (4,508 ) 3,473,384 Operating lease right-of-use assets 109,415 1,656,145 1,084,552 (20,065 ) 2,830,047 Intangible assets, net 362 31,569 103,753 — 135,684 Investments in and advances to affiliates, net 10,813,991 7,611,402 3,051,208 (21,476,601 ) — Other long-term assets and investments 102,779 133,698 176,315 (18,318 ) 394,474 Goodwill — 4,812,972 1,974,663 — 6,787,635 Total assets $ 12,420,006 $ 17,573,589 $ 8,879,187 $ (21,561,388 ) $ 17,311,394 Current liabilities $ 379,286 $ 1,327,378 $ 666,470 $ (1,036 ) $ 2,372,098 Intercompany payables 1,381,863 3,051,208 2,615,151 (7,048,222 ) — Long-term operating lease liabilities 136,123 1,567,776 1,039,145 (19,244 ) 2,723,800 Long-term debt and other long-term liabilities 7,741,725 674,558 364,102 (64,507 ) 8,715,878 Noncontrolling interests subject to put provisions 647,600 — — 532,776 1,180,376 Total DaVita Inc. shareholders' equity 2,133,409 10,952,669 3,475,710 (14,428,379 ) 2,133,409 Noncontrolling interests not subject to put — — 718,609 (532,776 ) 185,833 Total equity 2,133,409 10,952,669 4,194,319 (14,961,155 ) 2,319,242 Total liabilities and equity $ 12,420,006 $ 17,573,589 $ 8,879,187 $ (21,561,388 ) $ 17,311,394 Consolidating Balance Sheets - (continued) As of December 31, 2018 DaVita Inc. Guarantor Subsidiaries Non- Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Cash and cash equivalents $ 60,653 $ 1,232 $ 261,153 $ — $ 323,038 Restricted cash and equivalents 1,005 12,048 79,329 — 92,382 Accounts receivable, net — 1,204,122 654,486 — 1,858,608 Other current assets 37,185 565,974 157,407 — 760,566 Current assets held for sale — — 5,389,565 — 5,389,565 Total current assets 98,843 1,783,376 6,541,940 — 8,424,159 Property and equipment, net 491,462 1,584,321 1,317,886 — 3,393,669 Intangible assets, net 153 42,896 75,797 — 118,846 Investments in and advances to affiliates, net 13,522,198 6,196,801 2,498,545 (22,217,544 ) — Other long-term assets and investments 53,385 90,037 188,196 — 331,618 Goodwill — 4,806,939 2,035,021 — 6,841,960 Total assets $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252 Current liabilities $ 1,945,943 $ 1,217,526 $ 483,933 $ — $ 3,647,402 Current liabilities held for sale — — 1,243,759 — 1,243,759 Total current liabilities 1,945,943 1,217,526 1,727,692 — 4,891,161 Intercompany payables — 2,498,545 6,161,292 (8,659,837 ) — Long-term debt and other long-term liabilities 7,918,581 687,443 580,028 — 9,186,052 Noncontrolling interests subject to put provisions 598,075 — — 526,566 1,124,641 Total DaVita Inc. shareholders' equity 3,703,442 10,100,856 3,456,851 (13,557,707 ) 3,703,442 Noncontrolling interests not subject to put — — 731,522 (526,566 ) 204,956 Total equity 3,703,442 10,100,856 4,188,373 (14,084,273 ) 3,908,398 Total liabilities and equity $ 14,166,041 $ 14,504,370 $ 12,657,385 $ (22,217,544 ) $ 19,110,252
Consolidating Statements of Cash Flows	Consolidating Statements of Cash Flow For the year ended December 31, 2019 DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated Cash flows from operating activities: Net income $ 810,981 $ 906,559 $ 552,231 $ (1,248,477 ) $ 1,021,294 Changes in operating assets and liabilities and (602,288 ) (73,356 ) 478,228 1,248,477 1,051,061 Net cash provided by operating activities 208,693 833,203 1,030,459 — 2,072,355 Cash flows from investing activities: Additions of property and equipment, net (145,378 ) (310,032 ) (311,136 ) — (766,546 ) Acquisitions — (11,851 ) (89,010 ) — (100,861 ) Proceeds from asset sales, net of cash divested 3,824,516 1,777 51,099 — 3,877,392 Investments and other items (4,606 ) (6,676 ) (3,363 ) — (14,645 ) Net cash provided by (used in) investing activities 3,674,532 (326,782 ) (352,410 ) — 2,995,340 Cash flows from financing activities: Long-term debt and related financing costs, net (2,052,197 ) (10,481 ) (17,513 ) — (2,080,191 ) Intercompany borrowing 1,267,138 (455,405 ) (811,733 ) — — Other items (2,387,084 ) (53,283 ) (175,892 ) — (2,616,259 ) Net cash used in financing activities (3,172,143 ) (519,169 ) (1,005,138 ) — (4,696,450 ) Effect of exchange rate changes on cash — — (1,760 ) — (1,760 ) Net increase (decrease) in cash, cash equivalents and restricted cash 711,082 (12,748 ) (328,849 ) — 369,485 Less: Net increase in cash, cash equivalents and — — (423,813 ) — (423,813 ) Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations 711,082 (12,748 ) 94,964 — 793,298 Cash, cash equivalents and restricted cash of 61,658 13,280 340,482 — 415,420 Cash, cash equivalents and restricted cash of $ 772,740 $ 532 $ 435,446 $ — $ 1,208,718 Consolidating Statements of Cash Flow - (continued) For the year ended December 31, 2018 DaVita Inc. Guarantor Non-Guarantor Consolidating Consolidated Cash flows from operating activities: Net income $ 159,394 $ 771,945 $ (106,366 ) $ (491,933 ) $ 333,040 Changes in operating assets and liabilities and (86,070 ) (150,976 ) 1,183,713 491,933 1,438,600 Net cash provided by operating activities 73,324 620,969 1,077,347 — 1,771,640 Cash flows from investing activities: Additions of property and equipment, net (175,787 ) (425,008 ) (386,343 ) — (987,138 ) Acquisitions — (42,987 ) (140,169 ) — (183,156 ) Proceeds from asset and business sales, net of cash — 55,184 95,021 — 150,205 Investments and other items 30,962 (8,286 ) (8,230 ) — 14,446 Net cash used in investing activities (144,825 ) (421,097 ) (439,721 ) — (1,005,643 ) Cash flows from financing activities: Long-term debt and related financing costs, net 725,889 (8,874 ) (22,238 ) — 694,777 Intercompany borrowing 404,897 (168,224 ) (236,673 ) — — Other items (1,147,934 ) (29,457 ) (142,740 ) — (1,320,131 ) Net cash used in financing activities (17,148 ) (206,555 ) (401,651 ) — (625,354 ) Effect of exchange rate changes on cash — — (3,350 ) — (3,350 ) Net (decrease) increase in cash, cash equivalents and restricted cash (88,649 ) (6,683 ) 232,625 — 137,293 Less: Net decrease in cash, cash equivalents — — 240,793 — 240,793 Net decrease in cash, cash equivalents and restricted cash from continuing operations (88,649 ) (6,683 ) (8,168 ) — (103,500 ) Cash, cash equivalents and restricted cash of 150,307 19,963 348,650 — 518,920 Cash, cash equivalents and restricted cash of $ 61,658 $ 13,280 $ 340,482 $ — $ 415,420 Consolidating Statements of Cash Flow - (continued) For the year ended December 31, 2017 DaVita Inc. Guarantor Subsidiaries Non-Guarantor Subsidiaries Consolidating Adjustments Consolidated Total Cash flows from operating activities: Net income $ 663,618 $ 1,227,623 $ (122,233 ) $ (938,453 ) $ 830,555 Changes in operating assets and liabilities and (533,300 ) (739,023 ) 1,416,481 938,453 1,082,611 Net cash provided by operating activities 130,318 488,600 1,294,248 — 1,913,166 Cash flows from investing activities: Additions of property and equipment, net (155,972 ) (348,292 ) (400,986 ) — (905,250 ) Acquisitions — (528,588 ) (275,291 ) — (803,879 ) Proceeds from asset sales — 25,989 66,347 — 92,336 Investments and other items 211,619 (3,526 ) 43,968 — 252,061 Net cash provided by (used in) investing activities 55,647 (854,417 ) (565,962 ) — (1,364,732 ) Cash flows from financing activities: Long-term debt and related financing costs, net 173,529 (8,186 ) (10,495 ) — 154,848 Intercompany borrowing 22,589 382,452 (405,041 ) — — Other items (781,697 ) (2,205 ) (137,203 ) — (921,105 ) Net cash (used in) provided by financing activities (585,579 ) 372,061 (552,739 ) — (766,257 ) Effect of exchange rate changes on cash — — 254 — 254 Net (decrease) increase in cash, cash equivalents and restricted cash (399,614 ) 6,244 175,801 — (217,569 ) Less: Net decrease in cash, cash equivalents and restricted cash from discontinued operations — — (53,026 ) — (53,026 ) Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations (399,614 ) 6,244 228,827 — (164,543 ) Cash, cash equivalents and restricted cash of 549,921 13,719 119,823 — 683,463 Cash, cash equivalents and restricted cash of $ 150,307 $ 19,963 $ 348,650 $ — $ 518,920

Organization and Summary of S_3

Organization and Summary of Significant Accounting Policies - Additional Information (Details) $ in Thousands	Jan. 01, 2019USD ($)	Dec. 31, 2019patientstatecountryclinicentity	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of legal entities that third parties held noncontrolling equity interests | entity		672
Minimum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Lessee, Operating Lease, Term of Contract		5 years
Lessee, Operating Lease, Renewal Term		5 years
Minimum | Noncompetition agreements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period		3 years
Minimum | Buildings
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		25 years
Minimum | Leasehold Improvements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		10 years
Minimum | Equipment and Information Systems
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		3 years
Maximum
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Lessee, Operating Lease, Term of Contract		15 years
Lessee, Operating Lease, Renewal Term		10 years
Maximum | Noncompetition agreements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Amortization period		10 years
Maximum | Buildings
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		40 years
Maximum | Equipment and Information Systems
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Property, and equipment useful lives		15 years
Accounting Standards Update 2016-02 | Lease Assets
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification	$ 2,783,784
Accounting Standards Update 2016-02 | Lease Liabilities
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification	3,001,354
Retained earnings
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Cumulative Effect of New Accounting Principle in Period of Adoption			$ 39,876	$ 8,368
Cash Flow Effect | Accounting Standards Update 2016-02
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification	$ 0
United States
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of dialysis centers that the company operated or provided administrative services | clinic		2,753
Number of states where dialysis centers are located | state		46
Number of patients served | patient		206,900
International Operations
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of dialysis centers that the company operated or provided administrative services | clinic		259
Number of patients served | patient		28,700
Number of countries in which dialysis centers located | country		10

Revenue Recognition and Accou_2

Revenue Recognition and Accounts Receivable - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net	$ 1,795,598,000	$ 1,858,608,000
Medicare bad debt claims
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net	$ 1,038,248,000	$ 1,080,561,000
Accounts Receivable
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Accounts Receivable Period Outstanding	1 year
Patient Services Customer Concentration Risk | Accounts Receivable
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Number of concentration risk customers	0
Concentration risk percentage	10.00%
Accounts receivable, net	$ 0
Percentage Of Accounts Receivable Six Months Or More Past Due	18.00%
Accounts Receivable Period Outstanding	6 months	6 months
Difference between Revenue Guidance in Effect before and after Topic 606
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Contract with Customer, Performance Obligation Satisfied in Previous Period	$ 37,274,000	$ 88,495,000
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification		36,000,000
Accounts Receivable
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, allowance	$ 8,328,000	$ 52,924,000

Revenue Recognition and Accou_3

Revenue Recognition and Accounts Receivable Revenue Recognition Segment Revenue by Payor (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Disaggregation of Revenue [Line Items]
Patient service revenues									$ 10,918,421	$ 10,709,981	$ 10,093,670
Other revenues									491,773	744,457	1,268,328
Total revenues	$ 2,898,584	$ 2,904,078	$ 2,842,705	$ 2,743,112	$ 2,821,124	$ 2,847,330	$ 2,886,953	$ 2,849,444	11,388,479	11,404,851	10,876,634
Revenue disaggregation table footnote
Provision for uncollectible accounts									21,715	49,587	485,364
Intersegment Elimination
Disaggregation of Revenue [Line Items]
Total revenues									(146,355)	(127,186)	(79,779)
Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Patient service revenues									6,129,697	6,063,891	5,253,012
Other revenues									264,538	492,812	902,289
Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Patient service revenues									669,089	628,766	606,827
Other revenues									606	44,246	71,426
Other Government Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									798,775	782,593	622,218
Commercial Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									3,430,345	3,278,094	3,181,425
Other revenues									130,823	90,890	116,503
Other
Disaggregation of Revenue [Line Items]
Other revenues									110,961	150,745	202,713
U.S. dialysis
Disaggregation of Revenue [Line Items]
Total revenues									10,430,581	10,242,999	9,304,889
U.S. dialysis | Intersegment Elimination
Disaggregation of Revenue [Line Items]
Total revenues									(132,325)	(92,950)	(55,176)
U.S. dialysis | Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Patient service revenues									6,129,697	6,063,891	5,253,012
U.S. dialysis | Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Patient service revenues									669,089	628,766	606,827
U.S. dialysis | Other Government Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									446,010	446,999	362,567
U.S. dialysis | Commercial Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									3,286,089	3,176,413	3,117,920
U.S. dialysis | Other
Disaggregation of Revenue [Line Items]
Other revenues									32,021	19,880	19,739
Other - Ancillary services
Disaggregation of Revenue [Line Items]
Total revenues									957,898	1,161,852	1,571,745
Other - Ancillary services | Intersegment Elimination
Disaggregation of Revenue [Line Items]
Total revenues									(14,030)	(34,236)	(24,603)
Other - Ancillary services | Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Other revenues									264,538	492,812	902,289
Other - Ancillary services | Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Other revenues									606	44,246	71,426
Other - Ancillary services | Other Government Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									352,765	335,594	259,651
Other - Ancillary services | Commercial Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									144,256	101,681	63,505
Other revenues									130,823	90,890	116,503
Other - Ancillary services | Other
Disaggregation of Revenue [Line Items]
Other revenues									$ 78,940	$ 130,865	$ 182,974

Earnings Per Share - Reconcilia

Earnings Per Share - Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Net Income Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Numerators:
Net income from continuing operations	$ 242,242	$ 150,113	$ 194,223	$ 120,254	$ 160,332	$ 73,371	$ 199,603	$ 191,015	$ 706,832	$ 624,321	$ 901,277
Net income (loss) from discontinued operations attributable to DaVita Inc.	2,629	(6,843)	79,328	29,035	(310,104)	(210,167)	67,673	(12,329)	104,149	(464,927)	(237,659)
Net (loss) income attributable to DaVita Inc.	$ 244,871	$ 143,270	$ 273,551	$ 149,289	$ (149,772)	$ (136,796)	$ 267,276	$ 178,686	$ 810,981	$ 159,394	$ 663,618
Basic:
Weighted average shares outstanding during the period (in shares)									153,181,000	171,886,000	190,820,000
Weighted average contingently returnable shares previously held in escrow for DaVitaHealthCare Partners merger (in shares)									0	(1,100,000)	(2,194,000)
Weighted average shares for basic earnings per share calculation (in shares)									153,180,908	170,785,999	188,625,559
Basic net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	$ 1.87	$ 1	$ 1.17	$ 0.72	$ 0.97	$ 0.44	$ 1.16	$ 1.07	$ 4.61	$ 3.66	$ 4.78
Basic net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)	0.02	(0.05)	0.47	0.18	(1.87)	(1.26)	0.40	(0.07)	0.68	(2.73)	(1.26)
Basic net income per share attributable to DaVita Inc. (in usd per share)	1.89	0.95	1.64	0.90	(0.90)	(0.82)	1.56	1	$ 5.29	$ 0.93	$ 3.52
Diluted:
Weighted average shares outstanding during the period (in shares)									153,181,000	171,886,000	190,820,000
Assumed incremental shares from stock plans (in shares)									631,000	479,000	529,000
Weighted average shares for diluted earnings per share calculation (in shares)									153,812,064	172,364,581	191,348,533
Diluted net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	1.86	0.99	1.16	0.72	0.96	0.44	1.15	1.05	$ 4.60	$ 3.62	$ 4.71
Diluted net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)	0.02	(0.04)	0.48	0.18	(1.86)	(1.26)	0.38	(0.07)	0.67	(2.70)	(1.24)
Diluted net income per share attributable to DaVita Inc. (in usd per share)	$ 1.88	$ 0.95	$ 1.64	$ 0.90	$ (0.90)	$ (0.82)	$ 1.53	$ 0.98	$ 5.27	$ 0.92	$ 3.47
Anti-dilutive stock-settled awards excluded from calculation (in shares)									5,936,000	5,295,000	4,350,000

Restricted Cash and Equivalents

Restricted Cash and Equivalents - Additional Information (Details) $ in Thousands	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Restricted Cash and Cash Equivalents Items [Line Items]
Restricted cash and equivalents	$ 106,346	$ 92,382
Assets Held-in-trust, Current	$ 91,847
Number Of Businesses	20
Other - Ancillary services
Restricted Cash and Cash Equivalents Items [Line Items]
Number Of Businesses	1

Short-term and long-term inve_2

Short-term and long-term investments (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Investment Holdings [Line Items]
Debt securities	$ 8,140	$ 2,235
Equity securities, FV-NI	39,951	36,124
Total	48,091	38,359
Debt securities, short-term investments	8,140	2,235
Total, short-term investments	11,572	2,935
Debt securities, long-term investments	0	0
Total, long-term investments	36,519	35,424
Certificates of deposit and other time deposits
Investment Holdings [Line Items]
Debt securities	8,140	2,235
Equity securities, FV-NI	0	0
Total	8,140	2,235
Investments in mutual funds and common stock
Investment Holdings [Line Items]
Debt securities	0	0
Equity securities, FV-NI	39,951	36,124
Total	39,951	36,124
Short-term Investments
Investment Holdings [Line Items]
Equity securities, FV-NI	3,432	700
Other long-term Investments
Investment Holdings [Line Items]
Equity securities, FV-NI	$ 36,519	$ 35,424

Short-term and long-term inve_3

Short-term and long-term investments - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Jan. 01, 2018
Investments in mutual funds and common stock
Debt and Equity Securities, FV-NI [Line Items]
Equity Securities, FV-NI, Gain (Loss)	$ 4,383	$ (1,208)
Equity Securities, FV-NI, Realized Gain	1,459	4,490
Net Increase (Decrease) In Unrealized Gains On Equity Securities	$ 2,924	$ (5,698)
Investment securities
Debt and Equity Securities, FV-NI [Line Items]
Cumulative Effect of New Accounting Principle in Period of Adoption			$ 5,662

Other Receivables (Details)

Other Receivables (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	$ 489,695	$ 469,796
Supplier rebates and non-trade receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	351,650	334,156
Medicare bad debt claims
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	$ 138,045	$ 135,640

Property and Equipment (Details

Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Abstract]
Land	$ 36,480	$ 37,384
Buildings	392,256	467,181
Leasehold improvements	3,545,224	3,164,943
Equipment and information systems, including internally developed software	2,880,645	2,586,564
New center and capital asset projects in progress	588,345	661,695
Property, plant and equipment, gross, total	7,442,950	6,917,767
Less accumulated depreciation	(3,969,566)	(3,524,098)
Property and equipment, net	$ 3,473,384	$ 3,393,669

Property and Equipment - Additi

Property and Equipment - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Depreciation expense on property and equipment	$ 600,905	$ 574,799	$ 544,129
Capitalized interest	27,322	25,978	19,176
Investment and other asset impairments	$ 0	17,338	$ 295,234
Pharmacy Business
Property, Plant and Equipment [Line Items]
Investment and other asset impairments		$ 17,338

Intangibles - Amortizable Intan

Intangibles - Amortizable Intangible Assets Other Than Goodwill (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Noncompetition agreements	$ 103,510	$ 107,726
Indefinite-lived licenses	90,209	59,885
Other	23,887	31,801
Intangible assets, gross (excluding goodwill)	217,606	199,412
Less accumulated amortization	(81,922)	(80,566)
Total intangible assets	$ 135,684	$ 118,846

Intangibles - Additional Inform

Intangibles - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense from amortizable intangible assets, other than lease agreements	$ 14,247	$ 16,236	$ 15,782
Amortization of lease agreement intangible assets and liabilities		(296)	(203)
Impairment of Intangible Assets (Excluding Goodwill)	$ 0	0	$ 0
Amortizable intangible lease liabilities		5,930
Lease agreements, accumulated amortization		$ 4,362

Intangibles - Scheduled Amortiz

Intangibles - Scheduled Amortization Charges from Intangible Assets and Liabilities (Details) $ in Thousands	Dec. 31, 2019USD ($)
Noncompetition agreements
Expected Amortization Expense [Line Items]
2020	$ 11,470
2021	9,703
2022	6,141
2023	3,118
2024	1,429
Thereafter	525
Total	32,386
Other
Expected Amortization Expense [Line Items]
2020	1,779
2021	1,335
2022	1,330
2023	1,294
2024	1,046
Thereafter	6,305
Total	$ 13,089

Equity Method and Other Inves_3

Equity Method and Other Investmetns Equity Method and Other Investments (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	$ 241,983	$ 224,611
Adjusted cost method investments
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	10,448	12,386
Other equity method partnerships
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	114,611	83,052
APAC JV - Deconsolidated Noncontrolling Entity
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	$ 116,924	$ 129,173

Equity Method and Other Inves_4

Equity Method and Other Investments - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Noncontrolling Interest [Line Items]
Equity investment (loss) income		$ 12,679	$ (4,484)	$ (8,640)
Number of partnerships		20
Equity method investment, significant impairments and other valuation adjustments		$ 0	0
APAC JV - Deconsolidated Noncontrolling Entity
Noncontrolling Interest [Line Items]
Equity investment (loss) income	$ 1,530	$ 12,679	$ (4,484)	(8,640)
Voting Interest, in percents	40.00%	25.00%	40.00%
Ownership percentage by Parent	73.30%		73.30%
Current economic interest in the APAC JV, Owned by Noncontrolling Investors	26.70%		26.70%
Non-cash non-taxable loss				$ 280,066
Company and Restricted Subsidiaries(1)
Noncontrolling Interest [Line Items]
Voting Interest, in percents	60.00%	75.00%	60.00%
Minimum
Noncontrolling Interest [Line Items]
Ownership percentage by Parent		30.00%
Maximum
Noncontrolling Interest [Line Items]
Ownership percentage by Parent		50.00%

Goodwill - Changes in Carrying

Goodwill - Changes in Carrying Value of Goodwill by Reportable Segments (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Sep. 30, 2019	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Goodwill [Roll Forward]
Beginning balance		$ 6,841,960	$ 6,610,279
Acquisitions		90,226	278,348
Divestitures			(15,497)
Impairment charges		(124,892)	(3,106)	$ (36,196)
Foreign currency and other adjustments		(19,659)	(28,064)
Ending balance		6,787,635	6,841,960	6,610,279
Goodwill		6,940,970
Accumulated impairment charges		(153,335)
U.S. dialysis
Goodwill [Roll Forward]
Beginning balance		6,275,004	6,144,761
Acquisitions		18,089	130,574
Divestitures			(331)
Impairment charges		0	0
Foreign currency and other adjustments		(5,993)	0
Ending balance		6,287,100	6,275,004	6,144,761
Goodwill		6,287,100
Accumulated impairment charges		0
Other - Ancillary services
Goodwill [Roll Forward]
Beginning balance		566,956	465,518
Acquisitions		72,137	147,774
Divestitures			(15,166)
Impairment charges	$ (83,855)	(124,892)	(3,106)
Foreign currency and other adjustments		(13,666)	(28,064)
Ending balance		500,535	$ 566,956	$ 465,518
Goodwill		653,870
Accumulated impairment charges		$ (153,335)

Goodwill - Schedule of Reportin

Goodwill - Schedule of Reporting Units Goodwill Balances (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Goodwill [Line Items]
Goodwill	$ 6,787,635	$ 6,841,960	$ 6,610,279
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%
Kidney Care | GERMANY
Goodwill [Line Items]
Goodwill	$ 295,151
Carrying amount coverage	0.00%
Sensitivities, Operating Income	(1.30%)
Sensitivities, Discount rate	(11.00%)
Kidney Care | BRAZIL
Goodwill [Line Items]
Goodwill	$ 88,551
Carrying amount coverage	4.40%
Sensitivities, Operating Income	(2.80%)
Sensitivities, Discount rate	(7.00%)

Goodwill - Additional Informati

Goodwill - Additional Information (Details) $ in Thousands	3 Months Ended		12 Months Ended
	Sep. 30, 2019USD ($)	Mar. 31, 2019USD ($)	Dec. 31, 2019USD ($)segment	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)
Goodwill [Line Items]
Goodwill impairment charges			$ 124,892	$ 3,106	$ 36,196
Goodwill			6,787,635	6,841,960	6,610,279
Goodwill, Subsequent Recognition of Deferred Tax Asset			26,634
Goodwill, Impairment Loss, Net of Tax			$ 98,258
Other reporting units
Goodwill [Line Items]
Number of Operating Segments | segment			0
Other - Ancillary services
Goodwill [Line Items]
Goodwill impairment charges	$ 83,855		$ 124,892	3,106
Goodwill			500,535	566,956	465,518
Vascular access
Goodwill [Line Items]
Goodwill impairment charges					34,696
Goodwill					0
International Operations
Goodwill [Line Items]
Goodwill impairment charges					$ 1,500
GERMANY | Other reporting units
Goodwill [Line Items]
Goodwill impairment charges			5,416	$ 3,106
Goodwill, Subsequent Recognition of Deferred Tax Asset			1,013
GERMANY | Kidney Care
Goodwill [Line Items]
Goodwill impairment charges	$ 78,439	$ 41,037
Goodwill			295,151
Goodwill, Subsequent Recognition of Deferred Tax Asset			$ 25,621

Other Liabilities (Details)

Other Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Other Liabilities Disclosure [Abstract]
Payor refunds and retractions	$ 377,044	$ 302,244
Insurance and self-insurance accruals	58,941	58,569
Accrued interest	54,899	82,827
Accrued non-income tax liabilities	36,285	28,663
Other	229,005	123,547
Other liabilities	$ 756,174	$ 595,850

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Domestic	$ 1,307,299	$ 1,083,578	$ 1,725,822
International	(111,860)	(35,100)	(326,036)
Income from continuing operations before income taxes	$ 1,195,439	$ 1,048,478	$ 1,399,786

Income Taxes - Components of In

Income Taxes - Components of Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Current:
Federal	$ 208,339	$ 140,064	$ 330,191
State	58,026	32,990	47,228
International	15,545	7,557	3,422
Total current income tax	281,910	180,611	380,841
Deferred:
Federal	44,263	52,034	(98,760)
State	(25,836)	21,096	37,347
International	(20,709)	4,659	4,431
Total deferred income tax	(2,282)	77,789	(56,982)
Continuing operations	$ 279,628	$ 258,400	$ 323,859

Income Taxes Income Taxes - All

Income Taxes Income Taxes - Allocation of Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Continuing operations	$ 279,628	$ 258,400	$ 323,859
Discontinued operations	40,689	99,768	(364,856)
Income tax (benefit) expense from continuing and discontinued operations	$ 320,317	$ 358,168	$ (40,997)

Income Taxes - Reconciliation B

Income Taxes - Reconciliation Between U.S. Federal Income Tax Rate and Our Effective Tax Rate From Continuing Operations (Details)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Federal income tax rate	21.00%	21.00%	35.00%
State income taxes, net of federal benefit	2.30%	4.10%	3.70%
Change in International valuation allowance	1.30%	0.90%	0.40%
Gain on APAC JV ownership changes	0.00%	0.00%	(0.20%)
Political advocacy costs	0.20%	2.30%	0.00%
APAC investment impairment	0.00%	0.00%	6.40%
Impact of 2017 Tax Act	0.00%	(0.10%)	(20.50%)
Unrecognized tax benefits	2.40%	0.20%	0.10%
Other	1.10%	0.80%	1.50%
Impact of noncontrolling interests primarily attributable to non-tax paying entities	(4.90%)	(4.60%)	(3.30%)
Effective tax rate	23.40%	24.60%	23.10%

Income Taxes - Deferred Tax and

Income Taxes - Deferred Tax and Liabilities Arising from Temporary Differences (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Receivables	$ 19,095	$ 19,327
Accrued liabilities	64,458	106,506
Operating lease liabilities	580,110	0
Net operating loss carryforwards	139,690	117,511
Other	55,108	36,712
Deferred tax assets	858,461	280,056
Valuation allowance	(91,925)	(70,474)
Net deferred tax assets	766,536	209,582
Intangible assets	(563,914)	(555,822)
Property and equipment	(162,628)	(118,008)
Operating lease assets	(527,056)	0
Investments in partnerships	(64,960)	(67,354)
Other	(25,521)	(30,934)
Deferred tax liabilities	(1,344,079)	(772,118)
Net deferred tax liabilities	$ (577,543)	$ (562,536)

Income Taxes - Reconciliation o

Income Taxes - Reconciliation of Beginning and Ending Liability for Unrecognized Tax Benefits that Do Not Meet More-Likely-Than-Not Threshold (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Beginning balance	$ 40,382	$ 32,776
Additions for tax positions related to current year	3,378	6,111
Additions for tax positions related to prior years	24,722	4,134
Reductions related to lapse of applicable statute	(268)	(338)
Reductions related to settlements with taxing authorities	0	(2,301)
Ending balance	$ 68,214	$ 40,382

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Taxes [Line Items]
Increase in valuation allowance related to changes in the estimated tax benefit of foreign and state operating losses	$ 21,451
Liability for unrecognized tax benefits	68,214	$ 40,382	$ 32,776
Unrecognized tax benefits that would impact effective tax rate	63,968
Increase in liability for unrecognized tax benefits	27,832
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits	14,428	$ 9,019
Domestic Tax Authority
Income Taxes [Line Items]
Net operating loss carryforwards	$ 111,322
Operating loss carryforwards, expiration date	Dec. 31, 2036
State
Income Taxes [Line Items]
Net operating loss carryforwards	$ 434,030
Operating loss carryforwards, expiration date	Dec. 31, 2039
Foreign Tax Authority
Income Taxes [Line Items]
Net operating loss carryforwards	$ 224,197
Operating loss carryforwards, expiration date	Dec. 31, 2021
Capital Loss Carryforward
Income Taxes [Line Items]
State capital loss carryforward, amount	$ 188,823
State capital loss carryforward, expiration date	Dec. 31, 2024
Tax Year 2028 | Domestic Tax Authority
Income Taxes [Line Items]
Operating loss carryforwards, expiration date	Dec. 31, 2028

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Thousands	Feb. 13, 2020	May 06, 2019	Jun. 30, 2019	Dec. 31, 2019	Aug. 12, 2019	Dec. 31, 2018
Senior Notes:
Debt interest rate during period				5.01%
Acquisition obligations, other notes payable, and financing lease obligations
Financing lease obligations				$ 268,534
Long-term debt, weighted average interest rate, at point in time				4.46%
Long-term debt totals:
Total debt principal outstanding				$ 8,181,074		$ 10,154,216
Discount and deferred financing costs				(72,840)		(52,000)
Carrying amount of long-term debt, net of unamortized discounts				8,108,234		10,102,216
Less current portion				(130,708)		(1,929,369)
Total long-term debt				7,977,526		8,172,847
Debt Instrument, footnotes to the table
Long-Term Debt Maturity Extension Term		6 months
Senior Notes 5.125 Percent Due 2024
Senior Notes:
Senior Notes				$ 1,750,000		1,750,000
Debt interest rate during period				5.125%
Debt Instrument, Maturity Date				Jul. 15, 2024
Debt Instrument, Fair Value Disclosure				$ 1,789,375
Senior Notes 5.0 Percent Due 2025
Senior Notes:
Senior Notes				$ 1,500,000		1,500,000
Debt interest rate during period				5.00%
Debt Instrument, Maturity Date				May 1, 2025
Debt Instrument, Fair Value Disclosure				$ 1,538,700
Senior Notes 5.75% due 2022
Senior Notes:
Senior Notes				$ 0		1,250,000
Debt Instrument, Maturity Date				Aug. 15, 2022
Acquisition obligations and other notes payable
Acquisition obligations, other notes payable, and financing lease obligations
Acquisition obligations and other notes payable				$ 180,352		183,979
Debt instrument, maturity date, description				2019-2027
Long-term debt, weighted average interest rate, at point in time				5.35%
Acquisition obligations and other notes payable, fair value				$ 180,352
Financing Lease
Acquisition obligations, other notes payable, and financing lease obligations
Financing lease obligations				$ 268,534		282,737
Debt instrument, maturity date, description				2019-2036
Finance lease, weighted average discount rate, percent				5.39%
Financing lease liability, fair value				$ 268,534
Prior revolving line of credit
Senior Secured Credit Facilities:
Secured Debt				$ 0		175,000
Senior Notes:
Debt Instrument, Maturity Date				Dec. 24, 2019
Debt Instrument, Fair Value Disclosure				$ 0
Prior revolving line of credit | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument, footnotes to the table
LIBOR plus interest margin			2.00%
New revolving line of credit
Senior Notes:
Debt Instrument, Maturity Date				Aug. 12, 2024
Debt Instrument, footnotes to the table
Maximum borrowing capacity on revolving credit facilities				$ 1,000,000	$ 1,000,000
New revolving line of credit | London Interbank Offered Rate (LIBOR)
Debt Instrument, footnotes to the table
LIBOR plus interest margin				1.50%
New Term Loan A
Senior Secured Credit Facilities:
Secured Debt				$ 1,739,063	1,750,000	0
Debt Instrument, Description of Variable Rate Basis				LIBOR + 1.50%
Senior Notes:
Debt Instrument, Maturity Date				Aug. 12, 2024
Debt Instrument, Fair Value Disclosure				$ 1,739,063
New Term Loan A | London Interbank Offered Rate (LIBOR)
Debt Instrument, footnotes to the table
LIBOR plus interest margin				1.50%
New Term Loan A | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument, footnotes to the table
LIBOR plus interest margin				1.00%
New Term Loan B
Senior Secured Credit Facilities:
Secured Debt				$ 2,743,125	$ 2,750,000	0
Debt Instrument, Description of Variable Rate Basis				LIBOR + 2.25%
Senior Notes:
Debt Instrument, Maturity Date				Aug. 12, 2026
Debt Instrument, Fair Value Disclosure				$ 2,770,556
New Term Loan B | Subsequent Event
Senior Secured Credit Facilities:
Secured Debt	$ 2,743,125
New Term Loan B | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument, footnotes to the table
LIBOR plus interest margin				2.25%
Prior Term Loan A
Senior Secured Credit Facilities:
Secured Debt				$ 0		675,000
Senior Notes:
Debt Instrument, Maturity Date				Dec. 24, 2019
Debt Instrument, Fair Value Disclosure				$ 0
Prior Term Loan A | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument, footnotes to the table
LIBOR plus interest margin			2.00%
Prior Term Loan A-2
Senior Secured Credit Facilities:
Secured Debt				$ 0		995,000
Senior Notes:
Debt Instrument, Maturity Date				Dec. 24, 2019
Debt Instrument, Fair Value Disclosure				$ 0
Prior Term Loan A-2 | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument, footnotes to the table
LIBOR plus interest margin			1.00%
Prior Term Loan B
Senior Secured Credit Facilities:
Secured Debt				$ 0		3,342,500
Senior Notes:
Debt Instrument, Maturity Date				Jun. 24, 2021
Debt Instrument, Fair Value Disclosure				$ 0
Prior Term Loan B | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument, footnotes to the table
LIBOR plus interest margin			2.75%
New Term Loan B-1 | Subsequent Event
Senior Notes:
Debt Instrument, Maturity Date	Aug. 12, 2026
Debt Instrument, footnotes to the table
Debt Instrument Agreement Date	Feb. 13, 2020
New Term Loan B-1 | London Interbank Offered Rate (LIBOR) | Subsequent Event | Minimum
Debt Instrument, footnotes to the table
LIBOR plus interest margin	1.75%
Senior Secured Credit Facilities
Debt Instrument, footnotes to the table
Debt Instrument, Unamortized Discount				6,457		6,104
Deferred Offering Costs				45,444		12,580
Senior Notes
Debt Instrument, footnotes to the table
Deferred Offering Costs				$ 20,939		$ 33,316

Long-Term Debt - Scheduled Matu

Long-Term Debt - Scheduled Maturities of Long-term Debt (Details) $ in Thousands	Dec. 31, 2019USD ($)
Debt Disclosure [Abstract]
2020	$ 130,708
2021	153,110
2022	168,951
2023	224,437
2024	3,172,298
Thereafter	$ 4,331,570

Long-Term Debt - Derivative Ins

Long-Term Debt - Derivative Instruments (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Interest Rate Cap Agreements Effective June 29, 2018
Derivative [Line Items]
Derivative, effective date	Jun. 29, 2018
Derivative, expiration date	Jun. 30, 2020
Interest Rate Cap Agreements Member Effective June 30, 2019
Derivative [Line Items]
Derivative, effective date	Jun. 30, 2020
Derivative, expiration date	Jun. 30, 2024
Term Loan Facility | Interest Rate Cap Agreements Effective June 29, 2018 | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000,000
LIBOR plus interest margin	3.50%
Term Loan Facility | Interest Rate Cap Agreements Member Effective June 30, 2019 | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000,000
LIBOR plus interest margin	2.00%
Cash Flow Hedging
Derivative [Line Items]
Amount of debt expense reclassified from accumulated OCI into income	$ 6,377,000	$ 6,286,000	$ 5,058,000
Amount of unrealized gains (losses) in OCI on interest rate cap and swap agreements	1,151,000	(133,000)	$ (5,437,000)
Debt Expense | Cash Flow Hedging | Interest Rate Cap Agreements Effective June 29, 2018
Derivative [Line Items]
Amount of debt expense reclassified from accumulated OCI into income	8,654,000
Amount of unrealized gains (losses) in OCI on interest rate cap and swap agreements	(851,000)
Debt Expense | Cash Flow Hedging | Interest Rate Cap Agreements Member Effective June 30, 2019
Derivative [Line Items]
Amount of unrealized gains (losses) in OCI on interest rate cap and swap agreements	2,417,000
Other long-term assets | Interest Rate Cap Agreements Effective June 29, 2018
Derivative [Line Items]
Derivative asset, fair value, gross asset	0	$ 851,000
Other long-term assets | Interest Rate Cap Agreements Member Effective June 30, 2019
Derivative [Line Items]
Derivative asset, fair value, gross asset	$ 24,452,000

Long-Term Debt - Effects of Int

Long-Term Debt - Effects of Interest Rate Swap and Cap Agreements (Details) - Cash Flow Hedging - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized gains (losses) in OCI on interest rate cap and swap agreements	$ 1,151	$ (133)	$ (5,437)
Reclassification from accumulated other comprehensive income into net income	6,377	6,286	5,058
Tax benefit (expense)
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized gains (losses) in OCI on interest rate cap and swap agreements	(415)	48	3,460
Reclassification from accumulated other comprehensive income into net income	(2,214)	(2,180)	(3,220)
Interest rate cap agreements | Debt Expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized gains (losses) in OCI on interest rate cap and swap agreements	1,566	(181)	(8,897)
Reclassification from accumulated other comprehensive income into net income	$ 8,591	$ 8,466	$ 8,278

Long-Term Debt - Additional inf

Long-Term Debt - Additional information (Detail) shares in Thousands	Feb. 13, 2020USD ($)	Jun. 19, 2019	Feb. 20, 2020USD ($)shares	Sep. 30, 2019USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2019	Dec. 31, 2019USD ($)shares	Dec. 31, 2018USD ($)shares	Dec. 31, 2017USD ($)shares	Aug. 12, 2019USD ($)
Annual principal payments
2020							$ 130,708,000
2021							153,110,000
2022							168,951,000
2023							224,437,000
2024							$ 3,172,298,000
Long-term Debt, Percentage Bearing Fixed Interest, Percentage Rate							44.29%
Long-term debt, weighted average interest rate, at point in time							4.46%
Long-term debt, weighted average effective interest rate during period							5.01%
Debt prepayment, refinancing, and redemption charges				$ 21,242,000	$ 12,160,000		$ 33,402,000	$ 0	$ 0
Purchase of treasury stock							$ (2,402,475,000)	$ (1,153,511,000)	$ (810,949,000)
Repurchase of common stock (in shares) | shares							41,020	16,844	12,967
Letters of Credit Outstanding, Amount							$ 59,705,000
Interest Expense, Debt							419,639,000	$ 461,897,000	$ 406,341,000
Amortization of Debt Issuance Costs							$ 24,185,000	25,538,000	24,293,000
Interest Rate Cap Agreements Member Effective June 30, 2019
Annual principal payments
Derivative, effective date							Jun. 30, 2020
Senior Notes 5.75% due 2022
Debt Instrument [Line Items]
Early Repayment of Senior Debt							$ 1,267,565,000
Annual principal payments
Debt Instrument, Maturity Date							Aug. 15, 2022
Senior Secured Credit Facilities
Annual principal payments
Long-term debt, weighted average interest rate, at point in time							3.93%
Tender Offer
Annual principal payments
Purchase of treasury stock							$ (1,234,154,000)	$ 0	$ 0
Repurchase of common stock (in shares) | shares							21,802	0	0
Maximum | Term Loan Facility | Interest Rate Cap Agreements Member Effective June 30, 2019
Debt Instrument [Line Items]
LIBOR plus interest margin							2.00%
Annual principal payments
Notional amounts of interest rate agreements							$ 3,500,000,000
Revolving Credit Facility
Debt Instrument [Line Items]
Secured Debt							$ 0	$ 175,000,000
Annual principal payments
Debt Instrument, Maturity Date							Dec. 24, 2019
Revolving Credit Facility | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument [Line Items]
LIBOR plus interest margin						2.00%
New revolving line of credit
Debt Instrument [Line Items]
Maximum borrowing capacity on revolving credit facilities							$ 1,000,000,000			$ 1,000,000,000
Annual principal payments
Debt Instrument, Maturity Date							Aug. 12, 2024
New revolving line of credit | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest margin							1.50%
Incremental Revolving Line Of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity on revolving credit facilities										$ 1,500,000,000
Incremental Revolving Line Of Credit | Maximum
Debt Instrument [Line Items]
Required Leverage Ratio Covenant										3.50
Letter of Credit
Annual principal payments
Letters of Credit Outstanding, Amount							$ 13,055,000
Prior Term Loan A
Debt Instrument [Line Items]
Early Repayment of Senior Debt							647,424,000
Secured Debt							0	675,000,000
Annual principal payments
Debt instrument, annual principal payment							$ 27,576,000
Debt Instrument, Maturity Date							Dec. 24, 2019
Prior Term Loan A | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument [Line Items]
LIBOR plus interest margin						2.00%
Prior Term Loan A-2
Debt Instrument [Line Items]
Early Repayment of Senior Debt							$ 995,000,000
Secured Debt							$ 0	995,000,000
Annual principal payments
Debt Instrument, Maturity Date							Dec. 24, 2019
Prior Term Loan A-2 | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument [Line Items]
LIBOR plus interest margin						1.00%
Prior Term Loan B
Debt Instrument [Line Items]
Early Repayment of Senior Debt							$ 2,823,447,000
Secured Debt							0	3,342,500,000
Annual principal payments
Debt instrument, annual principal payment							$ 17,500,000
Debt Instrument, Maturity Date							Jun. 24, 2021
Prior Term Loan B | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument [Line Items]
LIBOR plus interest margin						2.75%
New Credit Agreement
Debt Instrument [Line Items]
Secured Debt										$ 5,500,000,000
New Credit Agreement | Maximum
Debt Instrument [Line Items]
Required Leverage Ratio Covenant										4
Required Leverage Ratio Covenant Through Year Four										5
Required Leverage Ratio Covenant After Year Four										4.50
New Term Loan A
Debt Instrument [Line Items]
Secured Debt							$ 1,739,063,000	0		$ 1,750,000,000
Annual principal payments
2019							10,937,000
2020							54,689,000
2021							87,500,000
2022							98,437,000
2023							142,187,000
2024							1,356,250,000
Debt instrument, annual principal payment							$ 10,937,000
Debt Instrument, Maturity Date							Aug. 12, 2024
New Term Loan A | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest margin							1.50%
New Term Loan A | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument [Line Items]
LIBOR plus interest margin							1.00%
New Term Loan A | London Interbank Offered Rate (LIBOR) | Maximum
Debt Instrument [Line Items]
LIBOR plus interest margin							2.00%
New Term Loan B
Debt Instrument [Line Items]
Secured Debt							$ 2,743,125,000	$ 0		$ 2,750,000,000
Annual principal payments
2019							6,875,000
2020							27,500,000
2021							27,500,000
2022							27,500,000
2023							27,500,000
2024							27,500,000
2025							27,500,000
2026							2,578,125,000
Debt instrument, annual principal payment							$ 6,875,000
Debt Instrument, Maturity Date							Aug. 12, 2026
New Term Loan B | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument [Line Items]
LIBOR plus interest margin							2.25%
Prior Term Loan B and Prior Revolving Line Of Credit
Debt Instrument [Line Items]
Early Repayment of Senior Debt							$ 1,153,274,000
New Term Loan A subject to uncapped portion of variability of LIBOR
Annual principal payments
Long-term Line of Credit							$ 982,188,000
Discontinued Operations, Held-for-sale | DMG - Held for sale
Debt Instrument [Line Items]
Business acquisition, effective date of acquisition		Jun. 19, 2019
Subsequent Event
Annual principal payments
Purchase of treasury stock			$ (21,794,000)
Repurchase of common stock (in shares) | shares			291
Subsequent Event | New Term Loan B
Debt Instrument [Line Items]
Secured Debt	$ 2,743,125,000
Subsequent Event | New Term Loan B-1
Annual principal payments
Debt Instrument Agreement Date	Feb. 13, 2020
Additional Debt Principal Amount Due To New Agreement	$ 0
Proceeds From New Agreement On Secured Debt	$ 0
Debt Instrument, Maturity Date	Aug. 12, 2026
Subsequent Event | New Term Loan B-1 | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument [Line Items]
LIBOR plus interest margin	1.75%

Leases Lease Expense Components

Leases Lease Expense Components (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Operating lease cost:
Fixed lease expense	$ 526,352
Variable lease expense	119,740
Financing lease cost:
Amortization of leased assets	23,724
Interest on lease liabilities	14,932
Net lease cost	$ 684,748

Leases Leases Other Information

Leases Leases Other Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Leases term and discount rate
Operating Lease, Weighted Average Remaining Lease Term	9 years
Finance Lease, Weighted Average Remaining Lease Term	10 years 2 months 12 days
Operating Lease, Weighted Average Discount Rate, Percent	4.10%
Leases Other Information [Abstract]
Sale and Leaseback Transaction, Gain (Loss), Net	$ 20,833
Cash paid for amounts included in the measurement of lease liabilities:
Operating Lease, Payments	637,655
Finance Lease, Interest Payment on Liability	22,257
Finance Lease, Principal Payments	25,692
Net Operating Lease Assets Obtained In Exchange For Lease Liabilities	$ 432,074
Finance Lease
Leases term and discount rate
Finance lease, weighted average discount rate, percent	5.39%

Leases - Future Minimum Lease P

Leases - Future Minimum Lease Payments Under Non-Cancelable Operating and Capital Leases (Details) $ in Thousands	Dec. 31, 2019USD ($)
Operating leases
2020	$ 462,131
2021	489,799
2022	454,753
2023	409,655
2024	358,009
Thereafter	1,510,665
Total future minimum lease payments due under operating leases	3,685,012
Less portion representing interest, operating lease liabilities	(617,300)
Present value of lease liabilities, operating leases	3,067,712
Finance leases
2020	37,624
2021	33,267
2022	33,677
2023	33,825
2024	33,841
Thereafter	178,434
Total future minimum payments due under finance leases	350,668
Less portion representing interest, financing lease liabilities	(82,134)
Present value of lease liabilities, finance leases	$ 268,534

Leases - Additional Information

Leases - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Leases Disclosure [Line Items]
Finance Lease, Right-of-Use Asset	$ 247,246	$ 367,164
Finance Lease Accumulated Depreciation	27,193	131,971
Rent expense under all operating leases	$ 646,092	$ 596,117	$ 530,748
Minimum
Leases Disclosure [Line Items]
Lessee, Operating Lease, Term of Contract	5 years
Lessee, Operating Lease, Renewal Term	5 years
Maximum
Leases Disclosure [Line Items]
Lessee, Operating Lease, Term of Contract	15 years
Lessee, Operating Lease, Renewal Term	10 years

Employee Benefit Plans - Additi

Employee Benefit Plans - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Defined Benefit Plan Disclosure [Line Items]
Employer matching contribution, percent of match	50.00%
Employer matching contribution, percent of employees' gross wages	6.00%
Defined Benefit Plan, Benefit Obligation, Benefits Paid	$ 64,988	$ 67,807
DaVita Voluntary Deferral Plan
Defined Benefit Plan Disclosure [Line Items]
Maximum percentage of employees' base salary to be maintained into deferral account	50.00%
Non-qualified deferred compensation plan, contributions	$ 1,751	3,090	$ 4,497
Non-qualified deferred compensation plan, distributions	2,730	4,652	$ 2,789
DaVita Voluntary Deferral Plan | Rabbi trusts
Defined Benefit Plan Disclosure [Line Items]
Total fair value of assets held in trust	$ 39,527	$ 36,124
Minimum
Defined Benefit Plan Disclosure [Line Items]
Voluntary Deferral Plan Contribution Cash Payout Period After Individuals Retirement Date	1 year
Voluntary Deferral Plan Contribution Cash Payout Period After Deferral Election	3 years
Maximum
Defined Benefit Plan Disclosure [Line Items]
Voluntary Deferral Plan Contribution Cash Payout Period After Individuals Retirement Date	2 years
Voluntary Deferral Plan Contribution Cash Payout Period After Deferral Election	4 years

Contingencies - Additional Info

Contingencies - Additional Information (Details) - US Attorney Prescription Drug Investigation $ in Thousands	1 Months Ended
	Dec. 31, 2017USD ($)
Other Commitments [Line Items]
Litigation settlement amount awarded to other party	$ 63,700
Incremental Cash Portion
Other Commitments [Line Items]
Litigation settlement amount awarded to other party	41,500
Cash Paid For Portion Previously Refunded
Other Commitments [Line Items]
Litigation settlement amount awarded to other party	$ 22,200

Noncontrolling Interests Subj_2

Noncontrolling Interests Subject to Put Provisions and Other Commitments - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Commitments And Contingencies Disclosure [Line Items]
Purchase Obligation, Due in Next Twelve Months	$ 399,042
Purchase Obligation, Due in Second Year	312,119
Purchase Obligation, Due in Third Year	$ 312,101
EPO
Commitments And Contingencies Disclosure [Line Items]
Long term purchase commitment, expiration date	Dec. 31, 2022
Dialysis Equipment, Parts and Supplies
Commitments And Contingencies Disclosure [Line Items]
Long term purchase commitment, expiration date	Dec. 31, 2020
Hemodialysis Supplies
Commitments And Contingencies Disclosure [Line Items]
Long term purchase commitment, expiration date	Dec. 31, 2022
Minimum
Commitments And Contingencies Disclosure [Line Items]
Scheduled dissolution term of joint ventures	10 years
Minimum | EPO
Commitments And Contingencies Disclosure [Line Items]
Long-term purchase commitment, percentage of quantity required to be purchased	90.00%
Maximum
Commitments And Contingencies Disclosure [Line Items]
Scheduled dissolution term of joint ventures	50 years
Commitments to Provide Operating Capital
Commitments And Contingencies Disclosure [Line Items]
Other potential commitments to provide operating capital to several dialysis centers	$ 9,669

Long-term Incentive Compensat_3

Long-term Incentive Compensation and Shareholders’ Equity - Summary of Status of Awards Under Stock-Based Compensation Plans and Agreements (Details) - $ / shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Stock appreciation rights
Awards
Outstanding at beginning of year (in shares)	6,163,000
Granted (in shares)	2,389,000
Exercised (in shares)	(20,000)
Expired (in shares)	(1,058,000)
Canceled (in shares)	(521,000)
Outstanding at end of period (in shares)	6,953,000	6,163,000
Exercisable at end of period (in shares)	1,254,000
Weighted-average fair value of grants	$ 14.04	$ 16.24	$ 14.51
Weighted average exercise price
Outstanding at beginning of year (USD per share)	69.90
Granted (USD per share)	52.45
Exercised (USD per share)	64.17
Expired (USD per share)	70.97
Canceled (USD per share)	65.23
Outstanding at end of period (USD per share)	64.10	$ 69.90
Exercisable at end of period (USD per share)	$ 77.68
Weighted average remaining contractual life
Outstanding at end of period (1)	3 years
Exercisable at end of period	1 year 1 month 6 days
Stock units
Awards
Outstanding at beginning of year (in shares)	1,860,000
Granted (in shares)	1,961,000
Exercised (in shares)	(225,000)
Expired (in shares)	0
Canceled (in shares)	(436,000)
Outstanding at end of period (in shares)	3,160,000	1,860,000
Exercisable at end of period (in shares)	0
Weighted-average fair value of grants (USD per share)	$ 50.58	$ 66.23	$ 65.73
Weighted average remaining contractual life
Outstanding at end of period (1)	2 years 3 months 18 days
Exercisable at end of period	0 years
Performance stock units | Share-based Payment Arrangement, Tranche One
Awards
Granted (in shares)	8

Long-term Incentive Compensat_4

Long-term Incentive Compensation and Shareholders’ Equity - Summary of Range of Exercise Prices (Details)	12 Months Ended
	Dec. 31, 2019$ / sharesshares
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	6,953,000
Weighted average exercise price (USD per share)	$ 64.10
Awards exercisable (in shares) | shares	1,254,000
Weighted average exercise price (USD per share)	$ 77.68
$50.01–$60.00
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	2,400,000
Weighted average exercise price (USD per share)	$ 52.63
Awards exercisable (in shares) | shares	0
Weighted average exercise price (USD per share)	$ 0
Range of exercise prices, lower range (USD per share)	50.01
Range of exercise prices, upper range (USD per share)	$ 60
$60.01–$70.00
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	3,069,000
Weighted average exercise price (USD per share)	$ 66.16
Awards exercisable (in shares) | shares	186,000
Weighted average exercise price (USD per share)	$ 65.92
Range of exercise prices, lower range (USD per share)	60.01
Range of exercise prices, upper range (USD per share)	$ 70
$70.01–$80.00
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	925,000
Weighted average exercise price (USD per share)	$ 75.28
Awards exercisable (in shares) | shares	509,000
Weighted average exercise price (USD per share)	$ 75.50
Range of exercise prices, lower range (USD per share)	70.01
Range of exercise prices, upper range (USD per share)	$ 80
$80.01–$90.00
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	559,000
Weighted average exercise price (USD per share)	$ 83.59
Awards exercisable (in shares) | shares	559,000
Weighted average exercise price (USD per share)	$ 83.59
Range of exercise prices, lower range (USD per share)	80.01
Range of exercise prices, upper range (USD per share)	$ 90

Long-term Incentive Compensat_5

Long-term Incentive Compensation and Shareholders Equity - Summary of Weighted Average Valuation Inputs (Details) - Stock Options and Stock Appreciation Rights	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	4 years	4 years 2 months 12 days	4 years 2 months 12 days
Expected volatility	29.50%	23.80%	23.90%
Expected dividend yield	0.00%	0.00%	0.00%
Risk-free interest rate	2.20%	2.90%	1.70%

Long-term Incentive Compensat_6

Long-term Incentive Compensation and Shareholders’ Equity - Additional Information (Details)	Dec. 31, 2019USD ($)shares	Nov. 04, 2019$ / sharesshares	Jul. 01, 2019	Jan. 01, 2019	Sep. 30, 2018USD ($)	Dec. 31, 2019USD ($)$ / sharesshares	Dec. 31, 2018USD ($)$ / sharesshares	Dec. 31, 2017USD ($)$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate intrinsic value of stock awards exercised						$ 11,475,000	$ 31,045,000	$ 34,895,000
Aggregate intrinsic value of stock awards outstanding	$ 319,486,000					319,486,000
Aggregate intrinsic value of stock awards exercisable	1,783,000					1,783,000
Payments of ordinary dividends, common stock						0
Employee stock purchase plan
Share-based awards, fair value assumptions, expected dividend						0	0	0
Long-term incentive program (LTIP) expense						118,513,000	85,759,000	61,978,000
Stock-based compensation expense						67,850,000	73,061,000	35,092,000
Estimated tax benefits recorded for stock-based compensation						9,186,000	13,591,000	7,717,000
Unrecognized compensation cost related to outstanding LTIP awards	147,267,000					147,267,000
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans	$ 136,818,000					$ 136,818,000
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under performance-based cash component of LTIP costs, weighted average remaining period (in years)						7 months 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 6 months
Share-based Payment Arrangement, Plan Modification, Incremental Cost					$ 23,470,000		14,704,000
Share-based Payment Arrangement, Accelerated Cost							9,727,000
Share-based Payment Arrangement, Expense, Tax Benefit						$ 2,251,000	7,988,000	13,473,000
Stock award exercises and other share issuances, net						0	0	0
General and Administrative Expense
Employee stock purchase plan
Stock-based compensation expense						$ 63,705,000	73,582,000	34,431,000
Premium priced stock-settled stock appreciation rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock granted | shares		2,500,000
Premium Priced Award Base Price Per Share | $ / shares		$ 67.80
Premium To The Tender Offer Share Purchase Price		20.00%
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Date		Nov. 4, 2024
Share-based Compensation Arrangement by Share-based Payment Award, Award Requisite Holding Period, End Date		Nov. 4, 2024
Employee stock purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for future grants | shares	6,411,000					6,411,000
Employee stock purchase plan
Employee entitlement for purchase of the Company's common stock during each calendar year						$ 25,000
Stock purchase price as percentage of fair market value	85.00%		100.00%	100.00%
Contributions used to purchase shares, employee-related current liabilities	$ 16,569,000					$ 16,569,000	$ 17,398,000	$ 22,131,000
Stock issued for employee stock purchase plans | shares						315,000	398,000	360,000
Expected volatility Rate						28.80%	24.20%	22.70%
Risk-free interest rate						2.60%	1.90%	1.30%
Weighted average fair value | $ / shares						$ 13.80	$ 17.45	$ 15.19
Share-based Payment Arrangement, Tranche One | Premium priced stock-settled stock appreciation rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage		50.00%
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Date		Nov. 4, 2022
Share-based Payment Arrangement, Tranche Two | Premium priced stock-settled stock appreciation rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage		50.00%
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Date		Nov. 4, 2023
Stock Incentive Plan 2011
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Terms of award (in years)						5 years
Full share awards to shares available, conversion ratio						3.5
Shares available for future grants | shares	15,547,000					15,547,000
Stock Incentive Plan 2011 | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period						36 months
Stock Incentive Plan 2011 | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period						48 months

Stock Repurchases Tender Offer

Stock Repurchases Tender Offer (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	2 Months Ended	12 Months Ended
	Feb. 20, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Jul. 11, 2018
Equity, Class of Treasury Stock [Line Items]
Stock Repurchase Program, Remaining Authorized Repurchase Amount					$ 110,001
Repurchase of common stock (in shares)		41,020	16,844	12,967
Value of treasury stock acquired		$ 2,402,475	$ 1,153,511	$ 810,949
Treasury stock acquired, average cost per share		$ 58.57	$ 68.48	$ 62.54
Tender Offer
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)		21,802	0	0
Value of treasury stock acquired		$ 1,234,154	$ 0	$ 0
Treasury stock acquired, average cost per share		$ 56.61	$ 0	$ 0
Treasury Stock, Shares Repurchases, Table Footnotes:
Treasury Stock Acquired, Average Cost Per Share, Clearing Price		$ 56.50
Share Repurchase Fees And Expenses		$ 2,343
Open Market Purchases
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)		19,218	16,844	12,967
Value of treasury stock acquired		$ 1,168,321	$ 1,153,511	$ 810,949
Treasury stock acquired, average cost per share		$ 60.79	$ 68.48	$ 62.54
Subsequent Event
Equity, Class of Treasury Stock [Line Items]
Stock Repurchase Program, Remaining Authorized Repurchase Amount	$ 1,681,701
Repurchase of common stock (in shares)	291
Value of treasury stock acquired	$ 21,794
Treasury stock acquired, average cost per share	$ 74.92

Shareholder's equity Effects of

Shareholder's equity Effects of Changes in DaVita Inc's Ownership Interest (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Nov. 04, 2019	Jul. 17, 2019
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Net (loss) income attributable to DaVita Inc.	$ 244,871	$ 143,270	$ 273,551	$ 149,289	$ (149,772)	$ (136,796)	$ 267,276	$ 178,686	$ 810,981	$ 159,394	$ 663,618
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Changes, Net [Abstract]
Stock Repurchase Program, Authorized Amount												$ 2,000,000	$ 2,000,000
Additional paid-in capital
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Changes, Net [Abstract]
Increase (Decrease) In Paid-In Capital for Sales of Noncontrolling Interests									0	79	(114)
Partial purchases									(37,145)	(17,897)	(2,752)
Noncontrolling Interest, Period Increase (Decrease)									(37,145)	(17,818)	(2,866)
Stock Repurchase Program, Authorized Amount	$ 773,836				$ 141,576				$ 773,836	$ 141,576	$ 660,752

Shareholder's equity (Details)

Shareholder's equity (Details) - USD ($) $ / shares in Units, $ in Thousands	2 Months Ended	12 Months Ended
	Feb. 20, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Nov. 04, 2019	Jul. 17, 2019	Jul. 11, 2018
Stock repurchases
Repurchase of common stock (in shares)		41,020,000	16,844,000	12,967,000
Value of treasury stock acquired		$ 2,402,475	$ 1,153,511	$ 810,949
Treasury stock acquired, average cost per share		$ 58.57	$ 68.48	$ 62.54
Stock Repurchase Program, Additional Authorized Amount							$ 1,389,999
Stock Repurchase Program, Remaining Authorized Repurchase Amount							$ 110,001
Stock Repurchase Program, Authorized Amount					$ 2,000,000	$ 2,000,000
Terminated Remaining Prior Share Repurchases Authorized, Amount					$ 246,373	$ 1,005,605
Charter documents and Delaware law:
Preferred stock, shares authorized (in shares)		5,000,000	5,000,000
Period During Which The Company Is Subject To Section 203 Of The Delaware General Corporation Law Limitation		3 years
Payments to Noncontrolling Interests		$ 68,019	$ 28,082	$ 5,357
Subsequent Event
Stock repurchases
Repurchase of common stock (in shares)	291,000
Value of treasury stock acquired	$ 21,794
Treasury stock acquired, average cost per share	$ 74.92
Stock Repurchase Program, Remaining Authorized Repurchase Amount	$ 1,681,701

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive (Loss) Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Jan. 01, 2018
Comprehensive Income (Loss) [Line Items]
Beginning balance	$ 3,703,442
Ending balance	2,133,409	$ 3,703,442
Interest rate cap agreements
Comprehensive Income (Loss) [Line Items]
Beginning balance	(8,961)	(12,408)	$ (12,029)
Cumulative Effect of New Accounting Principle in Period of Adoption				$ (2,706)
Unrealized (losses) gains	1,566	(181)	(8,897)
Related income tax	(415)	48	3,460
Unrealized (losses) gains net	1,151	(133)	(5,437)
Reclassification from accumulated other comprehensive losses (income) into net income	8,591	8,466	8,278
Related income tax	(2,214)	(2,180)	(3,220)
Reclassification from accumulated other comprehensive income into net income net of tax	6,377	6,286	5,058
Ending balance	(1,433)	(8,961)	(12,408)
Investment securities
Comprehensive Income (Loss) [Line Items]
Beginning balance	0	5,662	2,175
Cumulative Effect of New Accounting Principle in Period of Adoption				(5,662)
Unrealized (losses) gains	0	0	5,075
Related income tax	0	0	(1,368)
Unrealized (losses) gains net	0	0	3,707
Reclassification from accumulated other comprehensive losses (income) into net income	0	0	(360)
Related income tax	0	0	140
Reclassification from accumulated other comprehensive income into net income net of tax	0	0	(220)
Ending balance	0	0	5,662
Foreign currency translation adjustments
Comprehensive Income (Loss) [Line Items]
Beginning balance	(25,963)	19,981	(79,789)
Cumulative Effect of New Accounting Principle in Period of Adoption				0
Unrealized (losses) gains	(20,102)	(45,944)	99,770
Related income tax	0	0	0
Unrealized (losses) gains net	(20,102)	(45,944)	99,770
Reclassification from accumulated other comprehensive losses (income) into net income	0	0	0
Related income tax	0	0	0
Reclassification from accumulated other comprehensive income into net income net of tax	0	0	0
Ending balance	(46,065)	(25,963)	19,981
Accumulated other comprehensive (loss) income
Comprehensive Income (Loss) [Line Items]
Beginning balance	(34,924)	13,235	(89,643)
Cumulative Effect of New Accounting Principle in Period of Adoption				$ (8,368)
Unrealized (losses) gains	(18,536)	(46,125)	95,948
Related income tax	(415)	48	2,092
Unrealized (losses) gains net	(18,951)	(46,077)	98,040
Reclassification from accumulated other comprehensive losses (income) into net income	8,591	8,466	7,918
Related income tax	(2,214)	(2,180)	(3,080)
Reclassification from accumulated other comprehensive income into net income net of tax	6,377	6,286	4,838
Ending balance	$ (47,498)	$ (34,924)	$ 13,235

Acquisitions and Divestitures -

Acquisitions and Divestitures - Aggregate Purchase Cost Allocations for Acquisitions (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill	$ 6,787,635	$ 6,841,960	$ 6,610,279
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Current assets	6,713	23,686	14,366
Property and equipment	4,842	11,421	18,192
Amortizable intangible and other long-term assets	1,980	3,079	11,663
Indefinite-lived licenses	31,858	23,656	32,296
Goodwill	90,226	278,348	318,832
Deferred income taxes	0	0	(210)
Noncontrolling interests assumed	(1,762)	(80,291)	(44,303)
Liabilities assumed	(7,159)	(19,946)	(15,846)
Aggregate purchase price	$ 126,698	$ 239,953	$ 334,990

Acquisitions and Divestitures_2

Acquisitions and Divestitures - Assets Acquired and Liabilities Assumed and Recognized at Acquisition Dates at Estimated Fair Values (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill	$ 6,787,635	$ 6,841,960	$ 6,610,279
Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Current assets, net of cash acquired	22,739
Property and equipment	36,295
Amortizable intangible and other long-term assets	11,547
Goodwill	298,200
Current liabilities	(8,389)
Long-term liabilities	(479)
Aggregate purchase price	$ 359,913

Acquisitions and Divestitures_3

Acquisitions and Divestitures - Pro Forma Summary of Results of Operation (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Business Combinations [Abstract]
Pro forma total revenues	$ 11,416,498	$ 11,566,736
Pro forma net income from continuing operations attributable to DaVita Inc.	$ 709,631	$ 640,112
Pro forma basic net income per share from continuing operations attributable to DaVita Inc.	$ 4.63	$ 3.75
Pro forma diluted net income per share from continuing operations attributable to DaVita Inc.	$ 4.61	$ 3.71

Acquisitions and Divestitures_4

Acquisitions and Divestitures - Reconciliation of Changes in Contingent Earn-Out Obligations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Business Combinations [Abstract]
Beginning balance	$ 2,608	$ 6,388
Contingent earn-out obligations associated with acquisitions	23,536	1,246
Remeasurement of fair value	(784)	(4,729)
Payments of contingent earn-out obligations	(774)	(297)
Ending balance	$ 24,586	$ 2,608

Acquisitions and Divestitures_5

Acquisitions and Divestitures - Additional Information (Details) $ in Thousands	Jun. 19, 2019USD ($)	May 01, 2017USD ($)patientstateclinicoutpatient_dialysis_center	Dec. 31, 2019USD ($)clinic	Dec. 31, 2018USD ($)clinic	Dec. 31, 2017USD ($)clinic
Business Acquisition [Line Items]
Cash paid to acquire business			$ 100,861	$ 183,156	$ 803,879
Contingent earn-out obligations associated with acquisitions			23,536	1,246
Non-cash gain on acquiring additional ownership in business acquisition				28,152
Proceeds from divestiture of business	$ 4,465,476
Contingent earn-out obligations			33,889
Fair value of contingent earn-out consideration			24,586	2,608	6,388
Other accrued liabilities
Business Acquisition [Line Items]
Fair value of contingent earn-out consideration			6,712
Other long-term liabilities
Business Acquisition [Line Items]
Fair value of contingent earn-out consideration			17,874
Other companies
Business Acquisition [Line Items]
Fair value of contingent earn-out consideration			$ 24,586
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			5 years
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Cash paid to acquire business			$ 98,836	176,161	308,550
Contingent earn-out obligations associated with acquisitions			23,536	1,246	2,692
Deferred Purchase price and liabilities assumed			$ 4,326	$ 34,394	$ 23,748
Amortizable intangible assets acquired, weighted-average estimated useful lives			6 years	6 years	7 years
Goodwill deductible for tax purposes associated with acquisitions			$ 88,517	$ 165,013	$ 237,363
Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Cash paid to acquire business		$ 359,913
Amortizable intangible assets acquired, weighted-average estimated useful lives			5 years
Goodwill deductible for tax purposes associated with acquisitions			$ 298,200
Ownership interest percentage		100.00%
Number of dialysis clinic patients | patient		2,600
Number of states where dialysis centers are located | state		6
Proceeds from divestiture of business		$ 21,219
Business acquisition, transaction costs					$ 11,950
Operating Dialysis Center
Business Acquisition [Line Items]
Number of businesses divested | outpatient_dialysis_center		3
Operating Dialysis Center | Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Number of businesses acquired | clinic		36
Number of businesses divested | outpatient_dialysis_center		3
New Center Under Construction | Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Number of businesses acquired | clinic		1
Number of businesses divested | outpatient_dialysis_center		1
Home Dialysis Clinic | Renal Ventures Limited, LLC
Business Acquisition [Line Items]
Number of businesses acquired | clinic		1
U S Dialysis And Related Lab Services | Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Number of businesses acquired | clinic			7	18	30
Foreign Dialysis Centers | Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Number of businesses acquired | clinic			16	28	68

Held for Sale and Discontinue_3

Held for Sale and Discontinued Operations Financial results for discontinued operations related to DMG (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Goodwill and other asset impairment charges	$ 124,892	$ 3,106	$ 36,196
Valuation adjustment on disposal group	0	316,840	0
Income (Loss) from Discontinued Operations, Net of Tax, Including Portion Attributable to Noncontrolling Interest	105,483	(457,038)	(245,372)
DMG - Held for sale | Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net revenues	2,713,059	4,963,792	4,676,213
Expenses	2,543,865	4,962,686	4,634,782
Goodwill and other asset impairment charges	0	41,537	651,659
Valuation adjustment on disposal group	0	316,840	0
Income (loss) from discontinued operations before taxes	169,194	(357,271)	(610,228)
Loss on sale of discontinued operations before taxes	(23,022)	0	0
Income tax expense (benefit)	$ 40,689	$ 99,768	$ (364,856)

Held for Sale and Discontinue_4

Held for Sale and Discontinued Operations Cash Flows of discontinued operations related to DMG (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Discontinued Operations and Disposal Groups [Abstract]
Net cash provided by operating activities from discontinued operations	$ 99,634	$ 290,684	$ 357,274
Net cash used in investing activities from discontinued operations	$ (43,442)	$ (57,382)	$ (232,329)

Held for Sale and Discontinue_5

Held for Sale and Discontinued Operations - Additional Information (Details) $ in Thousands	Jun. 19, 2019USD ($)	Dec. 05, 2017	Jun. 18, 2019USD ($)clinic	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of DMG division	$ 4,465,476
Proceeds from Divestiture of Businesses, Net of Cash Divested	$ 3,824,509
Payments to Acquire Businesses, Gross				$ 100,861	$ 183,156	$ 803,879
Series of individually immaterial business acquisitions
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Payments to Acquire Businesses, Gross				98,836	176,161	308,550
DMG Acquisitions | Series of individually immaterial business acquisitions
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of businesses acquired | clinic			2
Payments to Acquire Businesses, Gross			$ 2,025		6,995	135,416
Business combination, deferred purchase price			$ 212		1,142	1,038
Business combination, deferred purchase price and liabilities assumed						10,145
Discontinued Operations, Held-for-sale | DMG - Held for sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Business acquisition, effective date of acquisition	Jun. 19, 2019
Purchase And Sale Agreement Aggregate Purchase Price	$ 4,340,000
Business Acquisition, Date of Acquisition Agreement		Dec. 5, 2017
Loss on sale of discontinued operations before taxes				$ (23,022)	$ 0	$ 0

Variable Interest Entities - Ad

Variable Interest Entities - Additional Information (Details) $ in Thousands	Dec. 31, 2019USD ($)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Total assets of VIEs	$ 319,691
Total liabilities of VIEs	$ 231,586

Fair Values of Financial Inst_3

Fair Values of Financial Instruments - Assets, Liabilities and Temporary Equity Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Assets
Investments in equity securities	$ 39,951	$ 36,124
Liabilities
Contingent earn-out obligations	33,889
Fair Value, Measurements, Recurring
Assets
Investments in equity securities	39,951	36,124
Liabilities
Contingent earn-out obligations	24,586	2,608
Temporary equity
Noncontrolling interests subject to put provisions	1,180,376	1,124,641
Fair Value, Measurements, Recurring | Interest rate cap agreements
Assets
Interest rate cap agreements	24,452	851
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1)
Assets
Investments in equity securities	39,951	36,124
Liabilities
Contingent earn-out obligations	0	0
Temporary equity
Noncontrolling interests subject to put provisions	0	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	0
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2)
Assets
Investments in equity securities	0	0
Liabilities
Contingent earn-out obligations	0	0
Temporary equity
Noncontrolling interests subject to put provisions	0	0
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2) | Interest rate cap agreements
Assets
Interest rate cap agreements	24,452
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3)
Assets
Investments in equity securities	0	0
Liabilities
Contingent earn-out obligations	24,586	2,608
Temporary equity
Noncontrolling interests subject to put provisions	1,180,376	1,124,641
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | Interest rate cap agreements
Assets
Interest rate cap agreements	$ 0	$ 0

Segment Reporting - Summary of

Segment Reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income from Continuing Operations Before Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Segment Reporting Information [Line Items]
Dialysis patient service revenues									$ 10,918,421	$ 10,709,981	$ 10,093,670
Provision for uncollectible accounts									(21,715)	(49,587)	(485,364)
Net dialysis patient service revenues									10,896,706	10,660,394	9,608,306
Other revenues									491,773	744,457	1,268,328
Total revenues	$ 2,898,584	$ 2,904,078	$ 2,842,705	$ 2,743,112	$ 2,821,124	$ 2,847,330	$ 2,886,953	$ 2,849,444	11,388,479	11,404,851	10,876,634
Operating income	$ 462,588	378,336	461,886	$ 340,507	$ 387,908	$ 289,038	$ 438,192	$ 410,686	1,643,317	1,525,824	1,812,755
Corporate administrative support									(92,335)	(90,108)	(44,966)
Debt expense									(443,824)	(487,435)	(430,634)
Debt prepayment, refinancing and redemption charges		$ (21,242)	$ (12,160)						(33,402)	0	0
Other income									29,348	10,089	17,665
Income from continuing operations before income taxes									1,195,439	1,048,478	1,399,786
U.S. dialysis
Segment Reporting Information [Line Items]
Total revenues									10,430,581	10,242,999	9,304,889
Other - Ancillary services
Segment Reporting Information [Line Items]
Total revenues									957,898	1,161,852	1,571,745
Operating Segments
Segment Reporting Information [Line Items]
Total revenues									11,534,834	11,532,037	10,956,413
Operating income									1,735,652	1,615,932	1,857,721
Operating Segments | U.S. dialysis
Segment Reporting Information [Line Items]
Dialysis patient service revenues									10,552,600	10,366,996	9,822,299
Provision for uncollectible accounts									(21,715)	(50,927)	(481,973)
Net dialysis patient service revenues									10,530,885	10,316,069	9,340,326
Total revenues									10,562,906	10,335,949	9,360,065
Operating income									1,924,826	1,709,721	2,297,198
Operating Segments | U.S. dialysis | External Sources
Segment Reporting Information [Line Items]
Dialysis patient service revenues									10,421,401	10,274,046	9,767,123
Other revenues									30,895	19,880	19,739
Operating Segments | U.S. dialysis | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues									131,199	92,950	55,176
Other revenues									1,126	0	0
Operating Segments | Other - Ancillary services
Segment Reporting Information [Line Items]
Dialysis patient service revenues									497,021	437,275	323,156
Other revenues									460,877	724,577	1,248,589
Total revenues									971,928	1,196,088	1,596,348
Operating income									(189,174)	(93,789)	(439,477)
Operating Segments | Other - Ancillary services | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues									14,030	34,236	24,603
Intersegment Elimination
Segment Reporting Information [Line Items]
Total revenues									(146,355)	(127,186)	(79,779)
Intersegment Elimination | U.S. dialysis
Segment Reporting Information [Line Items]
Total revenues									(132,325)	(92,950)	(55,176)
Intersegment Elimination | Other - Ancillary services
Segment Reporting Information [Line Items]
Total revenues									$ (14,030)	$ (34,236)	$ (24,603)

Segment Reporting - Summary o_2

Segment Reporting - Summary of Depreciation and Amortization Expense by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 615,152	$ 591,035	$ 559,911
U.S. dialysis
Segment Reporting Information [Line Items]
Depreciation and amortization	583,454	558,810	520,965
Other - Ancillary services
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 31,698	$ 32,225	$ 38,946

Segment Reporting - Summary o_3

Segment Reporting - Summary of Assets by Segment (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
ASSETS
Consolidated assets	$ 17,311,394	$ 19,110,252
Equity method and other investments	241,983	224,611
Property and equipment, net	3,473,384	3,393,669
U.S. dialysis
ASSETS
Consolidated assets	15,778,880	12,333,641
Equity method and other investments	124,188	95,290
Other - Ancillary services
ASSETS
Consolidated assets	1,532,514	1,387,046
Equity method and other investments	117,795	129,321
DMG - Held for sale
ASSETS
Consolidated assets	0	5,389,565
Equity method and other investments	0	4,833
International | Other - Ancillary services
ASSETS
Property and equipment, net	$ 154,572	$ 136,052

Segment Reporting - Summary o_4

Segment Reporting - Summary of Expenditures for Property and Equipment by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 766,546	$ 987,138	$ 905,250
U.S. dialysis
Segment Reporting Information [Line Items]
Expenditures for property and equipment	681,339	856,108	769,732
Other - Ancillary services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	46,741	45,806	40,377
DMG - Held for sale
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 38,466	$ 85,224	$ 95,141

Segment Reporting - Additional

Segment Reporting - Additional Information (Details)	Jun. 19, 2019
DMG - Held for sale | Discontinued Operations, Held-for-sale
Segment Reporting Information [Line Items]
Business acquisition, effective date of acquisition	Jun. 19, 2019

Supplemental Cash Flow Inform_3

Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Cash paid:
Income taxes, net	$ 157,983	$ 92,526	$ 387,159
Interest	473,176	488,974	424,547
Non-cash investing and financing activities:
Fixed assets under financing lease obligations	$ 18,953	$ 8,828	$ 48,378

Selected Quarterly Financial _3

Selected Quarterly Financial Data (unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Selected quarterly financial information:
Net revenues	$ 2,898,584	$ 2,904,078	$ 2,842,705	$ 2,743,112	$ 2,821,124	$ 2,847,330	$ 2,886,953	$ 2,849,444	$ 11,388,479	$ 11,404,851	$ 10,876,634
Operating income	462,588	378,336	461,886	340,507	387,908	289,038	438,192	410,686	1,643,317	1,525,824	1,812,755
Amounts attributable to DaVita Inc.:
Net income from continuing operations	242,242	150,113	194,223	120,254	160,332	73,371	199,603	191,015	706,832	624,321	901,277
Net income (loss) from discontinued operations	2,629	(6,843)	79,328	29,035	(310,104)	(210,167)	67,673	(12,329)	104,149	(464,927)	(237,659)
Net (loss) income attributable to DaVita Inc.	$ 244,871	$ 143,270	$ 273,551	$ 149,289	$ (149,772)	$ (136,796)	$ 267,276	$ 178,686	$ 810,981	$ 159,394	$ 663,618
Earnings per share attributable to DaVita Inc.:
Basic net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	$ 1.87	$ 1	$ 1.17	$ 0.72	$ 0.97	$ 0.44	$ 1.16	$ 1.07	$ 4.61	$ 3.66	$ 4.78
Basic net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)	0.02	(0.05)	0.47	0.18	(1.87)	(1.26)	0.40	(0.07)	0.68	(2.73)	(1.26)
Basic net income per share attributable to DaVita Inc. (in usd per share)	1.89	0.95	1.64	0.90	(0.90)	(0.82)	1.56	1	5.29	0.93	3.52
Diluted net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	1.86	0.99	1.16	0.72	0.96	0.44	1.15	1.05	4.60	3.62	4.71
Diluted net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)	0.02	(0.04)	0.48	0.18	(1.86)	(1.26)	0.38	(0.07)	0.67	(2.70)	(1.24)
Diluted net income per share attributable to DaVita Inc. (in usd per share)	$ 1.88	$ 0.95	$ 1.64	$ 0.90	$ (0.90)	$ (0.82)	$ 1.53	$ 0.98	$ 5.27	$ 0.92	$ 3.47
Footnotes to Selected Quarterly Financial Information:
Goodwill impairment charges									$ 124,892	$ 3,106	$ 36,196
Equity investment (loss) income									12,679	(4,484)	(8,640)
Equity Loss And Asset Impairment						$ 12,088
Goodwill and Intangible Asset Impairment							$ 14,351		124,892	61,981	981,589
Business combination, equity interest in acquiree, remeasurement gain (loss), net					$ (19,437)
Share-based Payment Arrangement, Plan Modification, Incremental Cost						23,470				14,704
APAC JV - Deconsolidated Noncontrolling Entity
Footnotes to Selected Quarterly Financial Information:
Equity investment (loss) income					$ 1,530				12,679	(4,484)	(8,640)
Paladina
Footnotes to Selected Quarterly Financial Information:
Equity Method Investment, Realized Gain (Loss) on Disposal						1,506	$ (33,957)
Pharmacy
Footnotes to Selected Quarterly Financial Information:
Restructuring Charges						$ 11,366
Other - Ancillary services
Selected quarterly financial information:
Net revenues									957,898	1,161,852	$ 1,571,745
Footnotes to Selected Quarterly Financial Information:
Goodwill impairment charges		$ 83,855							$ 124,892	$ 3,106
GERMANY | Kidney Care
Footnotes to Selected Quarterly Financial Information:
Goodwill impairment charges		$ 78,439		$ 41,037

Consolidating Financial State_3

Consolidating Financial Statements - Consolidating Statements of Income (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Condensed Income Statements, Captions [Line Items]
Dialysis patient service revenues									$ 10,918,421	$ 10,709,981	$ 10,093,670
Provision for uncollectible accounts									(21,715)	(49,587)	(485,364)
Net dialysis patient service revenues									10,896,706	10,660,394	9,608,306
Other revenues									491,773	744,457	1,268,328
Total revenues	$ 2,898,584	$ 2,904,078	$ 2,842,705	$ 2,743,112	$ 2,821,124	$ 2,847,330	$ 2,886,953	$ 2,849,444	11,388,479	11,404,851	10,876,634
Operating expenses and charges									9,745,162	9,879,027	9,063,879
Operating income	462,588	378,336	461,886	340,507	387,908	289,038	438,192	410,686	1,643,317	1,525,824	1,812,755
Debt expense, including debt prepayment, refinancing and redemption charges									(477,226)	(487,435)	(430,634)
Other income, net									29,348	10,089	17,665
Income tax expense									279,628	258,400	323,859
Equity earnings in subsidiaries									0	0	0
Net income from continuing operations									915,811	790,078	1,075,927
Net income (loss) from discontinuing operations, net of tax									105,483	(457,038)	(245,372)
Net income									1,021,294	333,040	830,555
Less: Net income attributable to noncontrolling interests									(210,313)	(173,646)	(166,937)
Net (loss) income attributable to DaVita Inc.	$ 244,871	$ 143,270	$ 273,551	$ 149,289	$ (149,772)	$ (136,796)	$ 267,276	$ 178,686	810,981	159,394	663,618
Reportable Legal Entites | DaVita Inc.
Condensed Income Statements, Captions [Line Items]
Dialysis patient service revenues									0	0	0
Provision for uncollectible accounts									0	0	0
Net dialysis patient service revenues									0	0	0
Other revenues									804,684	799,230	793,751
Total revenues									804,684	799,230	793,751
Operating expenses and charges									642,717	646,640	527,942
Operating income									161,967	152,590	265,809
Debt expense, including debt prepayment, refinancing and redemption charges									(482,074)	(491,749)	(426,149)
Other income, net									309,623	418,839	411,731
Income tax expense									(2,616)	23,482	65,965
Equity earnings in subsidiaries									818,849	103,196	478,192
Net income from continuing operations									810,981	159,394	663,618
Net income (loss) from discontinuing operations, net of tax									0	0	0
Net income									810,981	159,394	663,618
Less: Net income attributable to noncontrolling interests									0	0	0
Net (loss) income attributable to DaVita Inc.									810,981	159,394	663,618
Reportable Legal Entites | Guarantor Subsidiaries
Condensed Income Statements, Captions [Line Items]
Dialysis patient service revenues									6,961,825	6,834,865	6,417,574
Provision for uncollectible accounts									(15,296)	(34,977)	(322,085)
Net dialysis patient service revenues									6,946,529	6,799,888	6,095,489
Other revenues									601,394	488,086	408,460
Total revenues									7,547,923	7,287,974	6,503,949
Operating expenses and charges									6,631,471	6,551,328	5,331,545
Operating income									916,452	736,646	1,172,404
Debt expense, including debt prepayment, refinancing and redemption charges									(183,272)	(201,496)	(200,953)
Other income, net									7,314	3,430	5,979
Income tax expense									263,563	155,372	210,068
Equity earnings in subsidiaries									429,628	388,737	460,261
Net income from continuing operations									906,559	771,945	1,227,623
Net income (loss) from discontinuing operations, net of tax									0	0	0
Net income									906,559	771,945	1,227,623
Less: Net income attributable to noncontrolling interests									0	0	0
Net (loss) income attributable to DaVita Inc.									906,559	771,945	1,227,623
Reportable Legal Entites | Non- Guarantor Subsidiaries
Condensed Income Statements, Captions [Line Items]
Dialysis patient service revenues									4,226,402	4,096,666	3,848,172
Provision for uncollectible accounts									(6,419)	(14,610)	(170,447)
Net dialysis patient service revenues									4,219,983	4,082,056	3,677,725
Other revenues									171,856	558,079	1,080,832
Total revenues									4,391,839	4,640,135	4,758,557
Operating expenses and charges									3,826,941	4,003,547	4,384,015
Operating income									564,898	636,588	374,542
Debt expense, including debt prepayment, refinancing and redemption charges									(53,043)	(43,414)	(43,490)
Other income, net									46,306	29,132	23,657
Income tax expense									18,681	79,546	47,826
Equity earnings in subsidiaries									0	0	0
Net income from continuing operations									539,480	542,760	306,883
Net income (loss) from discontinuing operations, net of tax									12,751	(649,126)	(429,116)
Net income									552,231	(106,366)	(122,233)
Less: Net income attributable to noncontrolling interests									0	0	0
Net (loss) income attributable to DaVita Inc.									552,231	(106,366)	(122,233)
Consolidating Adjustments
Condensed Income Statements, Captions [Line Items]
Dialysis patient service revenues									(269,806)	(221,550)	(172,076)
Provision for uncollectible accounts									0	0	7,168
Net dialysis patient service revenues									(269,806)	(221,550)	(164,908)
Other revenues									(1,086,161)	(1,100,938)	(1,014,715)
Total revenues									(1,355,967)	(1,322,488)	(1,179,623)
Operating expenses and charges									(1,355,967)	(1,322,488)	(1,179,623)
Operating income									0	0	0
Debt expense, including debt prepayment, refinancing and redemption charges									241,163	249,224	239,958
Other income, net									(333,895)	(441,312)	(423,702)
Income tax expense									0	0	0
Equity earnings in subsidiaries									(1,248,477)	(491,933)	(938,453)
Net income from continuing operations									(1,341,209)	(684,021)	(1,122,197)
Net income (loss) from discontinuing operations, net of tax									92,732	192,088	183,744
Net income									(1,248,477)	(491,933)	(938,453)
Less: Net income attributable to noncontrolling interests									(210,313)	(173,646)	(166,937)
Net (loss) income attributable to DaVita Inc.									$ (1,458,790)	$ (665,579)	$ (1,105,390)

Consolidating Financial State_4

Consolidating Financial Statements - Consolidating Statements of Comprehensive Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Condensed Financial Statements, Captions [Line Items]
Net income (loss)	$ 1,021,294	$ 333,040	$ 830,555
Other comprehensive income (loss)	(12,574)	(39,791)	102,876
Total comprehensive income	1,008,720	293,249	933,431
Less: Comprehensive income attributable to noncontrolling interests	(210,313)	(173,646)	(166,935)
Comprehensive income attributable to DaVita Inc.	798,407	119,603	766,496
Reportable Legal Entites | DaVita Inc.
Condensed Financial Statements, Captions [Line Items]
Net income (loss)	810,981	159,394	663,618
Other comprehensive income (loss)	7,528	6,153	3,106
Total comprehensive income	818,509	165,547	666,724
Less: Comprehensive income attributable to noncontrolling interests	0	0	0
Comprehensive income attributable to DaVita Inc.	818,509	165,547	666,724
Reportable Legal Entites | Guarantor Subsidiaries
Condensed Financial Statements, Captions [Line Items]
Net income (loss)	906,559	771,945	1,227,623
Other comprehensive income (loss)	0	0	0
Total comprehensive income	906,559	771,945	1,227,623
Less: Comprehensive income attributable to noncontrolling interests	0	0	0
Comprehensive income attributable to DaVita Inc.	906,559	771,945	1,227,623
Reportable Legal Entites | Non- Guarantor Subsidiaries
Condensed Financial Statements, Captions [Line Items]
Net income (loss)	552,231	(106,366)	(122,233)
Other comprehensive income (loss)	(20,102)	(45,944)	99,770
Total comprehensive income	532,129	(152,310)	(22,463)
Less: Comprehensive income attributable to noncontrolling interests	0	0	0
Comprehensive income attributable to DaVita Inc.	532,129	(152,310)	(22,463)
Consolidating Adjustments
Condensed Financial Statements, Captions [Line Items]
Net income (loss)	(1,248,477)	(491,933)	(938,453)
Other comprehensive income (loss)	0	0	0
Total comprehensive income	(1,248,477)	(491,933)	(938,453)
Less: Comprehensive income attributable to noncontrolling interests	(210,313)	(173,646)	(166,935)
Comprehensive income attributable to DaVita Inc.	$ (1,458,790)	$ (665,579)	$ (1,105,388)

Consolidating Financial State_5

Consolidating Financial Statements - Consolidating Balance Sheets (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	$ 1,102,372	$ 323,038
Restricted cash and equivalents	106,346	92,382
Accounts receivable, net	1,795,598	1,858,608
Other current assets	685,854	760,566
Current assets held for sale, net	0	5,389,565
Total current assets	3,690,170	8,424,159
Property and equipment, net	3,473,384	3,393,669
Operating lease right-of-use assets	2,830,047	0
Intangible assets, net	135,684	118,846
Investments in and advances to affiliates, net	0	0
Other long-term assets and investments	394,474	331,618
Goodwill	6,787,635	6,841,960	$ 6,610,279
Total assets	17,311,394	19,110,252
Current liabilities	2,372,098	3,647,402
Current liabilities held for sale	0	1,243,759
Total current liabilities	2,372,098	4,891,161
Intercompany payables	0	0
Long-term operating lease liabilities	2,723,800	0
Long-term debt and other long-term liabilities	8,715,878	9,186,052
Noncontrolling interests subject to put provisions	1,180,376	1,124,641
Total DaVita Inc. shareholders' equity	2,133,409	3,703,442
Noncontrolling interests not subject to put provisions	185,833	204,956
Total equity	2,319,242	3,908,398
Total liabilities and equity	17,311,394	19,110,252
Reportable Legal Entites | DaVita Inc.
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	758,241	60,653
Restricted cash and equivalents	14,499	1,005
Accounts receivable, net	0	0
Other current assets	76,787	37,185
Current assets held for sale, net		0
Total current assets	849,527	98,843
Property and equipment, net	543,932	491,462
Operating lease right-of-use assets	109,415
Intangible assets, net	362	153
Investments in and advances to affiliates, net	10,813,991	13,522,198
Other long-term assets and investments	102,779	53,385
Goodwill	0	0
Total assets	12,420,006	14,166,041
Current liabilities	379,286	1,945,943
Current liabilities held for sale		0
Total current liabilities		1,945,943
Intercompany payables	1,381,863	0
Long-term operating lease liabilities	136,123
Long-term debt and other long-term liabilities	7,741,725	7,918,581
Noncontrolling interests subject to put provisions	647,600	598,075
Total DaVita Inc. shareholders' equity	2,133,409	3,703,442
Noncontrolling interests not subject to put provisions	0	0
Total equity	2,133,409	3,703,442
Total liabilities and equity	12,420,006	14,166,041
Reportable Legal Entites | Guarantor Subsidiaries
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	532	1,232
Restricted cash and equivalents	0	12,048
Accounts receivable, net	1,189,301	1,204,122
Other current assets	548,553	565,974
Current assets held for sale, net		0
Total current assets	1,738,386	1,783,376
Property and equipment, net	1,589,417	1,584,321
Operating lease right-of-use assets	1,656,145
Intangible assets, net	31,569	42,896
Investments in and advances to affiliates, net	7,611,402	6,196,801
Other long-term assets and investments	133,698	90,037
Goodwill	4,812,972	4,806,939
Total assets	17,573,589	14,504,370
Current liabilities	1,327,378	1,217,526
Current liabilities held for sale		0
Total current liabilities		1,217,526
Intercompany payables	3,051,208	2,498,545
Long-term operating lease liabilities	1,567,776
Long-term debt and other long-term liabilities	674,558	687,443
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholders' equity	10,952,669	10,100,856
Noncontrolling interests not subject to put provisions	0	0
Total equity	10,952,669	10,100,856
Total liabilities and equity	17,573,589	14,504,370
Reportable Legal Entites | Non- Guarantor Subsidiaries
Condensed Balance Sheet Statements, Captions [Line Items]
Cash and cash equivalents	343,599	261,153
Restricted cash and equivalents	91,847	79,329
Accounts receivable, net	606,297	654,486
Other current assets	102,410	157,407
Current assets held for sale, net		5,389,565
Total current assets	1,144,153	6,541,940
Property and equipment, net	1,344,543	1,317,886
Operating lease right-of-use assets	1,084,552
Intangible assets, net	103,753	75,797
Investments in and advances to affiliates, net	3,051,208	2,498,545
Other long-term assets and investments	176,315	188,196
Goodwill	1,974,663	2,035,021
Total assets	8,879,187	12,657,385
Current liabilities	666,470	483,933
Current liabilities held for sale		1,243,759
Total current liabilities		1,727,692
Intercompany payables	2,615,151	6,161,292
Long-term operating lease liabilities	1,039,145
Long-term debt and other long-term liabilities	364,102	580,028
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholders' equity	3,475,710	3,456,851
Noncontrolling interests not subject to put provisions	718,609	731,522
Total equity	4,194,319	4,188,373
Total liabilities and equity	8,879,187	12,657,385
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	(41,896)	0
Current assets held for sale, net		0
Total current assets	(41,896)	0
Property and equipment, net	(4,508)	0
Operating lease right-of-use assets	(20,065)
Intangible assets, net	0	0
Investments in and advances to affiliates, net	(21,476,601)	(22,217,544)
Other long-term assets and investments	(18,318)	0
Goodwill	0	0
Total assets	(21,561,388)	(22,217,544)
Current liabilities	(1,036)	0
Current liabilities held for sale		0
Total current liabilities		0
Intercompany payables	(7,048,222)	(8,659,837)
Long-term operating lease liabilities	(19,244)
Long-term debt and other long-term liabilities	(64,507)	0
Noncontrolling interests subject to put provisions	532,776	526,566
Total DaVita Inc. shareholders' equity	(14,428,379)	(13,557,707)
Noncontrolling interests not subject to put provisions	(532,776)	(526,566)
Total equity	(14,961,155)	(14,084,273)
Total liabilities and equity	$ (21,561,388)	$ (22,217,544)

Consolidating Financial State_6

Consolidating Financial Statements - Consolidating Statements of Cash Flows (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Cash flows from operating activities:
Net income	$ 1,021,294	$ 333,040	$ 830,555
Changes in operating assets and liabilities and non-cash items included in net income	1,051,061	1,438,600	1,082,611
Net cash provided by operating activities	2,072,355	1,771,640	1,913,166
Cash flows from investing activities:
Additions of property and equipment, net	(766,546)	(987,138)	(905,250)
Acquisitions	(100,861)	(183,156)	(803,879)
Proceeds from asset sales, net of cash divested	3,877,392	150,205	92,336
Investments and other items	(14,645)	14,446	252,061
Net cash provided by (used in) investing activities	2,995,340	(1,005,643)	(1,364,732)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(2,080,191)	694,777	154,848
Intercompany borrowing	0	0	0
Other items	(2,616,259)	(1,320,131)	(921,105)
Net cash used in financing activities	(4,696,450)	(625,354)	(766,257)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(1,760)	(3,350)	254
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	369,485	137,293	(217,569)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	415,420	518,920	683,463
Cash, cash equivalents and restricted cash of continuing operations at end of the year	1,208,718	415,420	518,920
Reportable Legal Entites | DaVita Inc.
Cash flows from operating activities:
Net income	810,981	159,394	663,618
Changes in operating assets and liabilities and non-cash items included in net income	(602,288)	(86,070)	(533,300)
Net cash provided by operating activities	208,693	73,324	130,318
Cash flows from investing activities:
Additions of property and equipment, net	(145,378)	(175,787)	(155,972)
Acquisitions	0	0	0
Proceeds from asset sales, net of cash divested	3,824,516	0	0
Investments and other items	(4,606)	30,962	211,619
Net cash provided by (used in) investing activities	3,674,532	(144,825)	55,647
Cash flows from financing activities:
Long-term debt and related financing costs, net	(2,052,197)	725,889	173,529
Intercompany borrowing	1,267,138	404,897	22,589
Other items	(2,387,084)	(1,147,934)	(781,697)
Net cash used in financing activities	(3,172,143)	(17,148)	(585,579)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0	0
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	711,082	(88,649)	(399,614)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	61,658	150,307	549,921
Cash, cash equivalents and restricted cash of continuing operations at end of the year	772,740	61,658	150,307
Reportable Legal Entites | Guarantor Subsidiaries
Cash flows from operating activities:
Net income	906,559	771,945	1,227,623
Changes in operating assets and liabilities and non-cash items included in net income	(73,356)	(150,976)	(739,023)
Net cash provided by operating activities	833,203	620,969	488,600
Cash flows from investing activities:
Additions of property and equipment, net	(310,032)	(425,008)	(348,292)
Acquisitions	(11,851)	(42,987)	(528,588)
Proceeds from asset sales, net of cash divested	1,777	55,184	25,989
Investments and other items	(6,676)	(8,286)	(3,526)
Net cash provided by (used in) investing activities	(326,782)	(421,097)	(854,417)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(10,481)	(8,874)	(8,186)
Intercompany borrowing	(455,405)	(168,224)	382,452
Other items	(53,283)	(29,457)	(2,205)
Net cash used in financing activities	(519,169)	(206,555)	372,061
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0	0
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	(12,748)	(6,683)	6,244
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	13,280	19,963	13,719
Cash, cash equivalents and restricted cash of continuing operations at end of the year	532	13,280	19,963
Reportable Legal Entites | Non- Guarantor Subsidiaries
Cash flows from operating activities:
Net income	552,231	(106,366)	(122,233)
Changes in operating assets and liabilities and non-cash items included in net income	478,228	1,183,713	1,416,481
Net cash provided by operating activities	1,030,459	1,077,347	1,294,248
Cash flows from investing activities:
Additions of property and equipment, net	(311,136)	(386,343)	(400,986)
Acquisitions	(89,010)	(140,169)	(275,291)
Proceeds from asset sales, net of cash divested	51,099	95,021	66,347
Investments and other items	(3,363)	(8,230)	43,968
Net cash provided by (used in) investing activities	(352,410)	(439,721)	(565,962)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(17,513)	(22,238)	(10,495)
Intercompany borrowing	(811,733)	(236,673)	(405,041)
Other items	(175,892)	(142,740)	(137,203)
Net cash used in financing activities	(1,005,138)	(401,651)	(552,739)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(1,760)	(3,350)	254
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	(328,849)	232,625	175,801
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	340,482	348,650	119,823
Cash, cash equivalents and restricted cash of continuing operations at end of the year	435,446	340,482	348,650
Consolidating Adjustments
Cash flows from operating activities:
Net income	(1,248,477)	(491,933)	(938,453)
Changes in operating assets and liabilities and non-cash items included in net income	1,248,477	491,933	938,453
Net cash provided by operating activities	0	0	0
Cash flows from investing activities:
Additions of property and equipment, net	0	0	0
Acquisitions	0	0	0
Proceeds from asset sales, net of cash divested	0	0	0
Investments and other items	0	0	0
Net cash provided by (used in) investing activities	0	0	0
Cash flows from financing activities:
Long-term debt and related financing costs, net	0	0	0
Intercompany borrowing	0	0	0
Other items	0	0	0
Net cash used in financing activities	0	0	0
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0	0
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	0	0	0
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	0	0	0
Cash, cash equivalents and restricted cash of continuing operations at end of the year	0	0	0
Discontinued Operations
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	(423,813)	240,793	(53,026)
Discontinued Operations | Reportable Legal Entites | DaVita Inc.
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	0	0	0
Discontinued Operations | Reportable Legal Entites | Guarantor Subsidiaries
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	0	0	0
Discontinued Operations | Reportable Legal Entites | Non- Guarantor Subsidiaries
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	(423,813)	240,793	(53,026)
Discontinued Operations | Consolidating Adjustments
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	0	0	0
Continuing Operations
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	793,298	(103,500)	(164,543)
Continuing Operations | Reportable Legal Entites | DaVita Inc.
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	711,082	(88,649)	(399,614)
Continuing Operations | Reportable Legal Entites | Guarantor Subsidiaries
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	(12,748)	(6,683)	6,244
Continuing Operations | Reportable Legal Entites | Non- Guarantor Subsidiaries
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	94,964	(8,168)	228,827
Continuing Operations | Consolidating Adjustments
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash from discontinued operations	$ 0	$ 0	$ 0

SCHEDULE II - VALUATION AND QUA

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS (Details) - Allowance for uncollectible Accounts - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at beginning of year	$ 52,924	$ 218,399	$ 238,897
Acquisitions	0	0	0
Amounts charged to income	21,715	42,287	478,365
Amounts written off	66,311	207,762	498,863
Balance at end of year	$ 8,328	$ 52,924	$ 218,399