DaVita (DVA) 10-K 12 Feb 21 2020 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) shares in Millions, $ in Billions	12 Months Ended
	Dec. 31, 2020	Jan. 29, 2021	Jun. 30, 2020
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2020
Current Fiscal Year End Date	--12-31
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
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Public Float			$ 9.7
Entity Common Stock, Shares Outstanding		109.4
Amendment Flag	false
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	FY
Entity Central Index Key	0000927066

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Statement [Abstract]
Dialysis patient service revenues before provision	$ 11,039,709	$ 10,918,421	$ 10,709,981
Provision for uncollectible accounts	(13,458)	(21,715)	(49,587)
Dialysis patient service revenues	11,026,251	10,896,706	10,660,394
Other revenues	524,353	491,773	744,457
Total revenues	11,550,604	11,388,479	11,404,851
Operating expenses and charges:
Patient care costs	7,988,613	7,914,485	8,195,513
General and administrative	1,247,584	1,103,312	1,135,454
Depreciation and amortization	630,435	615,152	591,035
Provision for uncollectible accounts	0	0	(7,300)
Equity investment (income) loss	(26,916)	(12,679)	4,484
Other asset impairments	0	0	17,338
Goodwill impairment charges	0	124,892	3,106
Loss (gain) on changes in ownership interest, net	16,252	0	(60,603)
Total operating expenses and charges	9,855,968	9,745,162	9,879,027
Operating income	1,694,636	1,643,317	1,525,824
Debt expense	(304,111)	(443,824)	(487,435)
Debt prepayment, refinancing and redemption charges	(89,022)	(33,402)	0
Other income, net	16,759	29,348	10,089
Income from continuing operations before income taxes	1,318,262	1,195,439	1,048,478
Income tax expense	313,932	279,628	258,400
Net income from continuing operations	1,004,330	915,811	790,078
Net (loss) income from discontinued operations, net of tax	(9,653)	105,483	(457,038)
Net income	994,677	1,021,294	333,040
Less: Net income attributable to noncontrolling interests	(221,035)	(210,313)	(173,646)
Net income attributable to DaVita Inc.	$ 773,642	$ 810,981	$ 159,394
Earnings per share attributable to DaVita Inc.:
Basic net income from continuing operations (in usd per share)	$ 6.54	$ 4.61	$ 3.66
Basic net income (in usd per share)	6.46	5.29	0.93
Diluted net income from continuing operations (in usd per share)	6.39	4.60	3.62
Diluted net income (in usd per share)	$ 6.31	$ 5.27	$ 0.92
Weighted average shares for earnings per share:
Basic shares (in shares)	119,797,000	153,181,000	170,786,000
Diluted shares (in shares)	122,623,000	153,812,000	172,365,000
Amounts attributable to DaVita Inc.:
Net income from continuing operations	$ 783,295	$ 706,832	$ 624,321
Net (loss) income from discontinued operations	(9,653)	104,149	(464,927)
Net income attributable to DaVita Inc.	$ 773,642	$ 810,981	$ 159,394

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Statement of Comprehensive Income [Abstract]
Net income	$ 994,677	$ 1,021,294	$ 333,040
Unrealized (losses) gains on interest rate cap agreements:
Unrealized (losses) gains	(16,346)	1,151	(133)
Reclassification into net income	5,313	6,377	6,286
Unrealized losses on foreign currency translation.
Unrealized losses on foreign currency translation	(7,623)	(20,102)	(45,944)
Other comprehensive loss	(18,656)	(12,574)	(39,791)
Total comprehensive income	976,021	1,008,720	293,249
Less: Comprehensive income attributable to noncontrolling interests	(221,035)	(210,313)	(173,646)
Comprehensive income attributable to DaVita Inc.	$ 754,986	$ 798,407	$ 119,603

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
ASSETS
Cash and cash equivalents	$ 324,958	$ 1,102,372
Restricted cash and equivalents	176,832	106,346
Short-term investments	20,101	11,572
Accounts receivable	1,824,282	1,795,598
Inventories	111,625	97,949
Other receivables	544,376	489,695
Prepaid and other current assets	76,387	66,866
Income tax receivable	70,163	19,772
Total current assets	3,148,724	3,690,170
Property and equipment, net of accumulated depreciation	3,521,824	3,473,384
Operating lease right-of-use assets	2,863,089	2,830,047
Intangible assets, net of accumulated amortization	166,585	135,684
Equity method and other investments	257,491	241,983
Long-term investments	32,193	36,519
Other long-term assets	79,501	115,972
Goodwill	6,919,109	6,787,635
Assets, Total	16,988,516	17,311,394
LIABILITIES AND EQUITY
Accounts payable	434,253	403,840
Other liabilities	810,529	756,174
Accrued compensation and benefits	685,555	695,052
Current portion of operating lease liabilities	369,497	343,912
Current portion of long-term debt	168,541	130,708
Income tax payable	7,768	42,412
Total current liabilities	2,476,143	2,372,098
Long-term operating lease liabilities	2,738,670	2,723,800
Long-term debt	7,917,263	7,977,526
Other long-term liabilities	150,060	160,809
Deferred income taxes	809,600	577,543
Total liabilities	14,091,736	13,811,776
Commitments and contingencies
Noncontrolling interests subject to put provisions	1,330,028	1,180,376
Equity:
Preferred stock ($0.001 par value, 5,000 shares authorized; none issued)	0	0
Common stock ($0.001 par value, 450,000 shares authorized; 109,933 and 125,843 shares issued and outstanding at December 31, 2020 and 2019, respectively)	110	126
Additional paid-in capital	597,073	749,043
Retained earnings	852,537	1,431,738
Accumulated other comprehensive loss	(66,154)	(47,498)
Total DaVita Inc. shareholders' equity	1,383,566	2,133,409
Noncontrolling interests not subject to put provisions	183,186	185,833
Total equity	1,566,752	2,319,242
Total liabilities and shareholders' equity	$ 16,988,516	$ 17,311,394

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2020	Dec. 31, 2019
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)	109,933,000	125,843,000
Common stock, shares outstanding (in shares)	109,933,000	125,843,000

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Cash flows from operating activities:
Net income	$ 994,677	$ 1,021,294	$ 333,040
Adjustments to Reconcile Net Income (Loss) to Cash Provided by (Used in) Operating Activities [Abstract]
Depreciation and amortization	630,435	615,152	591,035
Impairment charges	0	124,892	61,981
Valuation adjustment on disposal group	0	0	316,840
Debt prepayment, refinancing and redemption charges	86,957	33,402	0
Stock-based compensation expense	91,458	67,850	73,061
Deferred income taxes	240,848	41,723	273,660
Equity investment income, net	13,830	8,582	26,449
Loss (gain) on sales of business interests, net	24,248	23,022
Loss (gain) on sales of business interests, net			(85,699)
Other non-cash charges, net	747	49,579	82,374
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:
Accounts receivable	(21,087)	(79,957)	(81,176)
Inventories	(12,349)	10,158	73,505
Other receivables and other current assets	(79,277)	2,790	236,995
Other long-term assets	(6,123)	6,965	3,497
Accounts payable	37,200	(84,539)	(35,959)
Accrued compensation and benefits	(20,931)	(14,697)	84,165
Other current liabilities	105,637	181,940	(157,462)
Income taxes	(87,391)	95,645	(23,635)
Other long-term liabilities	(19,851)	(31,446)	(1,031)
Net Cash Provided by (Used in) Operating Activities, Total	1,979,028	2,072,355	1,771,640
Cash flows from investing activities:
Additions of property and equipment	(674,541)	(766,546)	(987,138)
Acquisitions	(182,013)	(100,861)	(183,156)
Proceeds from asset and business sales	50,139	3,877,392	150,205
Purchase of debt investments held-to-maturity	(150,701)	(101,462)	(5,963)
Purchase of other debt and equity investments	(3,757)	(5,458)	(8,448)
Proceeds from debt investments held-to-maturity	151,213	95,376	34,862
Proceeds from sale of other debt and equity investments	3,491	3,676	9,526
Purchase of equity method investments	(22,341)	(9,366)	(19,177)
Distributions from equity method investments	3,139	2,589	3,646
Net Cash Provided by (Used in) Investing Activities, Total	(825,371)	2,995,340	(1,005,643)
Cash flows from financing activities:
Borrowings	4,046,775	38,525,850	59,934,750
Payments on long-term debt	(4,110,304)	(40,520,722)	(59,234,946)
Debt Financing And Debt Redemption Costs	(105,848)	(85,319)	(5,027)
Purchase of treasury stock	(1,458,442)	(2,383,816)	(1,161,511)
Distributions to noncontrolling interests	(253,118)	(233,123)	(196,441)
Net (payments) receipts related to stock purchases and awards	(975)
Net (payments) receipts related to stock purchases and awards		11,382	13,577
Contributions from noncontrolling interests	42,966	57,317	52,311
Proceeds from sales of additional noncontrolling interests	0	0	15
Purchases of noncontrolling interests	(7,831)	(68,019)	(28,082)
Net cash used in financing activities	(1,846,777)	(4,696,450)	(625,354)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(13,808)	(1,760)	(3,350)
Less: Net increase (decrease) in cash, cash equivalents and restricted cash	(706,928)	369,485	137,293
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	1,208,718	415,420	518,920
Cash, cash equivalents and restricted cash of continuing operations at end of the year	501,790	1,208,718	415,420
Discontinued Operations
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash	0	(423,813)	240,793
Continuing Operations
Cash flows from financing activities:
Less: Net increase (decrease) in cash, cash equivalents and restricted cash	$ (706,928)	$ 793,298	$ (103,500)

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY - USD ($) $ in Thousands	Total	Total	TotalCumulative Effect, Period of Adoption, Adjustment	Non-controlling interests subject to put provisions	Non-controlling interests subject to put provisionsCumulative Effect, Period of Adoption, Adjustment	Common stock	Additional paid-in capital	Retained earnings	Retained earningsCumulative Effect, Period of Adoption, Adjustment	Treasury stock	Accumulated other comprehensive income (loss)	Accumulated other comprehensive income (loss)Cumulative Effect, Period of Adoption, Adjustment	Non-controlling interests not subject to put provisions	Non-controlling interests not subject to put provisionsCumulative Effect, Period of Adoption, Adjustment
Beginning Balance (in shares) at Dec. 31, 2017						182,462,000				0
Beginning balance at Dec. 31, 2017		$ 4,690,029	$ 0			$ 182	$ 1,042,899	$ 3,633,713	$ 8,368	$ 0	$ 13,235	$ (8,368)	$ 196,037
Temporary equity, beginning balance at Dec. 31, 2017				$ 1,011,360
Increase (Decrease) in Temporary Equity [Roll Forward]
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					68,115
Other comprehensive income	$ (39,791)	(39,791)									(39,791)
Stock purchase shares issued (in shares)						398,000
Stock purchase plan		17,398				$ 0	17,398
Stock award payment plan (in shares)						371,000
Stock award plan		(5,334)				$ 1	(5,335)
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		3,703,442	$ 39,876		$ (38)	$ 166	995,006	2,743,194	$ 39,876	$ 0	(34,924)		204,956	$ (6)
Ending Balance (in shares) at Dec. 31, 2018						166,387,000				0
Increase (Decrease) in Temporary Equity [Roll Forward]
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					66,900
Other comprehensive income	$ (12,574)	(12,574)									(12,574)
Stock purchase shares issued (in shares)						315,000
Stock purchase plan		16,570				$ 1	16,569
Stock award payment plan (in shares)						161,000
Stock award plan		(3,290)				$ 0	(3,290)
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	125,843,000					125,843,000				0
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income				141,879
Distributions				(163,175)
Contributions				30,154
Acquisitions and divestitures				(3,215)
Partial purchases				(7,771)
Fair value remeasurements				151,780
Temporary equity, ending balance at Dec. 31, 2020				$ 1,330,028
Comprehensive income:
Net income		773,642						773,642					79,156
Other comprehensive income	$ (18,656)	(18,656)									(18,656)
Stock purchase shares issued (in shares)						222,000
Stock purchase plan		17,148				$ 0	17,148
Stock award payment plan (in shares)						345,000
Stock award plan		(17,801)				$ 0	(17,801)
Stock-settled stock-based compensation expense		90,007					90,007
Changes in noncontrolling interest from:
Distributions													(89,943)
Contributions													12,812
Acquisitions and divestitures, noncontrolling interest													(248)
Partial purchases		4,364					4,364						(4,424)
Fair value remeasurements		(151,780)					(151,780)
Purchase of treasury stock (in shares)	(16,477,000)									(16,477,000)
Purchase of treasury stock	$ (1,446,767)	(1,446,767)								$ (1,446,767)
Retirement of treasury stock (in shares)						(16,477,000)				16,477,000
Retirement of treasury stock		0				$ (16)	(93,908)	(1,352,843)		$ 1,446,767
Ending balance at Dec. 31, 2020	$ 1,566,752	$ 1,383,566				$ 110	$ 597,073	$ 852,537		$ 0	$ (66,154)		$ 183,186
Ending Balance (in shares) at Dec. 31, 2020	109,933,000					109,933,000				0

Organization and Summary of Sig

Organization and Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2020
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, 2020, the Company operated or provided administrative services through a network of 2,816 U.S. outpatient dialysis centers in 46 states and the District of Columbia, serving a total of approximately 204,200 patients. In addition, as of December 31, 2020, the Company operated or provided administrative services to a total of 321 outpatient dialysis centers serving approximately 36,200 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 classifications have been conformed 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. The most significant assumptions and estimates underlying these consolidated financial statements and accompanying notes involve revenue recognition and accounts receivable, impairments of goodwill, accounting for income taxes, fair value estimates and loss contingencies. 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. 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 continued 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 businesses that the Company does not own or in which the Company owns a noncontrolling interest as well as revenues associated with the Company's non-dialysis ancillary services and strategic initiatives. Revenues associated with dialysis management services, integrated care services, clinical research programs, physician services, and ESRD seamless care organizations are estimated in the period services are provided. Revenues associated with pharmacy services until that business was closed in 2018 were estimated as prescriptions were filled and shipped to patients. Revenues associated with direct primary care until that business was sold in 2018 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 readily convertible to known amounts of cash that typically mature within three months or less at date of purchase. Restricted cash and equivalents Restricted cash and cash equivalents include funds held in trust to satisfy insurer and state regulatory requirements related to wholly-owned captive insurance companies that bear professional and general liability and workers' compensation risks for the Company as well as funds held in escrow for certain legal settlements pending finalization. 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 recorded at estimated fair value with changes in fair value recognized in current earnings within "Other income, net". These debt and equity investments are classified as "short-term investments" or "long-term investments" on the Company's consolidated balance sheet. See Note 5 for further details. 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. 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 majority of the Company’s facilities are leased under non-cancellable operating leases which contain renewal options. 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 increases or contain fixed escalation clauses. 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. The Company has elected the practical expedient to not separate lease components from non-lease components for its financing and operating leases. The Company has also elected the short-term lease recognition exemption and does not recognize right-of-use assets or lease liabilities for leases with a term of less than 12 months. Financing and operating right-of-use assets are recognized based on the net present value of lease payments over the lease term plus expected renewals as of 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. 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 expected 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. Amortizable intangibles Amortizable intangible assets include noncompetition agreements, hospital service contracts, and customer relationships arising from other service 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 and hospital acute service contracts over the contract term, and customer relationships from other service contracts over the remaining contract term plus expected renewal periods. 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. Costs to renew indefinite-lived intangible assets are expensed as incurred. 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. Equity investments without readily determinable fair values for which the Company does not maintain significant influence over the investee are carried either at estimated fair value or on the adjusted cost method, as determined on an investment-specific basis. The adjusted cost method represents the Company's cost for an investment, net of any other-than-temporary impairments, as adjusted for any subsequent observation of the investment's fair value. These equity method and adjusted cost method investments are classified as “Equity method and other investments” on the Company's consolidated balance sheet. See Note 9 for further details. 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 protection. 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, 2020, third parties held noncontrolling equity interests in 688 consolidated legal entities. Fair value estimates 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 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, 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 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 amend the impairment model to utilize an expected loss methodology in place of the incurred loss methodology for financial instruments and off-balance sheet credit exposures. The amendment requires entities to consider a broader range of information to estimate expected credit losses, which may result in earlier recognition of losses. The amendments in this ASU became effective for the Company beginning on January 1, 2020 and were applied using a modified retrospective basis. The adoption of ASU No. 2016-13 did not have a material impact on the Company's consolidated financial statements. 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 in this ASU 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 became effective for the Company beginning on January 1, 2020 and were applied on a prospective basis. The adoption of this ASU did not have a material impact on the Company’s consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-15, Intangibles-Goodwill and Other-Internal Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract . ASU No. 2018-15 aligns the requirements for capitalizing implementation costs incurred in a cloud computing arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The Company adopted this ASU as of January 1, 2020, using the prospective transition approach, which allows the Company to change the accounting method without restating prior periods or booking cumulative adjustments. The adoption of ASU No. 2018-15 did not have a material impact on the Company's consolidated financial statements. New standards not yet adopted 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 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 March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting . ASU No. 2020-04 provides optional expedients and exceptions for applying U.S. GAAP to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another rate that is expected to be discontinued. The amendments in this ASU were effective beginning on March 12, 2020, and the Company may elect to apply the amendments prospectively through December 31, 2022. 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, 2020
Text Block [Abstract]
Revenue from Contract with Customer	Revenue recognition and accounts receivable The Company's revenues by segment and primary payor source were as follows: Year ended December 31, 2020 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,048,043 $ $ 6,048,043 Medicaid and Managed Medicaid 744,862 744,862 Other government 455,897 380,584 836,481 Commercial 3,370,562 170,394 3,540,956 Other revenues: Medicare and Medicare Advantage 419,662 419,662 Medicaid and Managed Medicaid 1,227 1,227 Commercial 33,246 33,246 Other (1) 40,571 47,585 88,156 Eliminations of intersegment revenues (145,286) (16,743) (162,029) Total $ 10,514,649 $ 1,035,955 $ 11,550,604 (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, 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. The Company had no allowance for doubtful accounts related to performance obligations satisfied in years prior to January 1, 2018 as of December 31, 2020 and such allowance was $8,328 as of December 31, 2019. 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, no additional revenue was recognized during the year ended December 31, 2020 associated with performance obligations satisfied prior to January 1, 2018 and additional revenue of $37,274 was recognized during the year ended December 31, 2019 associated with performance obligations satisfied in years prior to 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, 2020 or 2019.

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2020
Earnings Per Share [Abstract]
Earnings Per Share	Earnings per share Basic earnings per share is calculated by dividing net income attributable to the Company by the weighted average number of common shares outstanding, reduced for 2018 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, 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, 2020 2019 2018 Net income (loss) attributable to DaVita Inc.: Continuing operations $ 783,295 $ 706,832 $ 624,321 Discontinued operations (9,653) 104,149 (464,927) Net income attributable to DaVita Inc. $ 773,642 $ 810,981 $ 159,394 Weighted average shares outstanding: During the period 119,797 153,181 171,886 Contingently returnable (1) — — (1,100) Basic shares 119,797 153,181 170,786 Contingently returnable (1) — — 1,100 Assumed incremental from stock plans 2,826 631 479 Diluted shares 122,623 153,812 172,365 Basic net income (loss) attributable to DaVita Inc.: Continuing operations per share $ 6.54 $ 4.61 $ 3.66 Discontinued operations per share (0.08) 0.68 (2.73) Basic net income per share attributable to DaVita Inc. $ 6.46 $ 5.29 $ 0.93 Diluted net income (loss) attributable to DaVita Inc.: Continuing operations per share $ 6.39 $ 4.60 $ 3.62 Discontinued operations per share (0.08) 0.67 (2.70) Diluted net income per share attributable to DaVita Inc. $ 6.31 $ 5.27 $ 0.92 Anti-dilutive stock-settled awards excluded from calculation (2) 2,301 5,936 5,295 (1) Shares previously held in escrow for the DaVita HealthCare Partners merger. (2) Shares associated with stock awards 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, 2020
Restricted Cash [Abstract]
Cash and Cash Equivalents Disclosure [Text Block]	Restricted cash and equivalentsThe Company had restricted cash and cash equivalents of $176,832 and $106,346 at December 31, 2020 and 2019, respectively. Approximately $92,286 of the balance at December 31, 2020 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 and $70,000 represents cash held in escrow to fund a previously announced legal settlement pending finalization. The remaining restricted cash and cash equivalents held at December 31, 2020 primarily represents cash pledged to third parties in connection with one of the Company's ancillary services.

Short-term and long-term invest

Short-term and long-term investments	12 Months Ended
	Dec. 31, 2020
Investments, Debt and Equity Securities [Abstract]
Investments in Debt and Equity Securities	Short-term and long-term investments The Company’s short-term and long-term investments, consisting of debt instruments classified as held-to-maturity and equity investments with readily determinable fair values or redemption values, were as follows: December 31, 2020 December 31, 2019 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 8,217 $ — $ 8,217 $ 8,140 $ — $ 8,140 Investments in mutual funds and common stock — 44,077 44,077 — 39,951 39,951 $ 8,217 $ 44,077 $ 52,294 $ 8,140 $ 39,951 $ 48,091 Short-term investments $ 8,217 $ 11,884 $ 20,101 $ 8,140 $ 3,432 $ 11,572 Long-term investments — 32,193 32,193 — 36,519 36,519 $ 8,217 $ 44,077 $ 52,294 $ 8,140 $ 39,951 $ 48,091 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, 2020 and 2019.

Other Receivables Other Receiva

Other Receivables Other Receivables	12 Months Ended
	Dec. 31, 2020
Receivables [Abstract]
Other Receivables	Other receivables Other receivables were comprised of the following: December 31, 2020 2019 Supplier rebates and non-trade receivables $ 390,508 $ 351,650 Medicare bad debt claims 153,868 138,045 $ 544,376 $ 489,695

Property and Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2020
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment Property and equipment were comprised of the following: December 31, 2020 2019 Land $ 37,924 $ 36,480 Buildings 400,616 392,256 Leasehold improvements 3,865,729 3,545,224 Equipment and information systems, including internally developed software 3,081,298 2,880,645 New center and capital asset projects in progress 616,686 588,345 8,002,253 7,442,950 Less accumulated depreciation (4,480,429) (3,969,566) $ 3,521,824 $ 3,473,384 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. Depreciation expense on property and equipment was $616,626, $600,905, and $574,799 for 2020, 2019 and 2018, 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 $17,944, $27,322 and $25,978 for 2020, 2019 and 2018, 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, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Intangibles	Intangible assets Intangible assets other than goodwill were comprised of the following: December 31, 2020 2019 Indefinite-lived licenses $ 100,138 $ 90,209 Noncompetition agreements 84,022 103,510 Customer relationships and other 52,566 23,887 236,726 217,606 Less accumulated amortization (70,141) (81,922) $ 166,585 $ 135,684 Noncompetition agreements are generally amortized over three years to 10 years and customer relationships are principally amortized over 10 years to 20 years. Amortization expense from amortizable intangible assets was $13,809, $14,247, and $16,236 for 2020, 2019 and 2018, respectively. For the years ended December 31, 2020, 2019 and 2018, the Company recognized no impairment charges on any intangible assets other than the goodwill impairment charges discussed in Note 10. Noncompetition Customer relationships and other 2021 $ 10,274 $ 3,143 2022 6,680 3,139 2023 3,883 3,102 2024 1,714 2,851 2025 585 2,660 Thereafter 168 28,248 Total $ 23,304 $ 43,143

Equity Method and Other Investm

Equity Method and Other Investments	12 Months Ended
	Dec. 31, 2020
Investments, Debt and Equity Securities [Abstract]
Equity Method Investments and Joint Ventures Disclosure	Equity method and other investments The Company maintains equity method and other minor investments in the private securities of certain other healthcare and healthcare-related businesses, comprised as follows: December 31, 2020 2019 APAC joint venture $ 120,787 $ 116,924 Other equity method partnerships 107,599 114,611 Adjusted cost method and other investments 29,105 10,448 $ 257,491 $ 241,983 During 2020, 2019 and 2018, the Company recognized equity investment income (loss) of $26,916, $12,679 and $(4,484), 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). The Company holds a 75% voting and economic interest in the APAC JV and an unrelated noncontrolling investor holds the other 25% voting and economic interest in the joint venture. During 2019 the continuing third party noncontrolling investor made its final subscribed capital contribution to the joint venture and the other previous third party noncontrolling investor elected to exit 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 under the joint control of the Company and the APAC JV's unrelated noncontrolling investor. As a result, the Company does not consolidate the APAC JV. Prior to the transactions described above, 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. The Company's other equity method investments include 22 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. dialysis partnerships in the form of limited liability companies. The Company's ownership interests in these partnerships vary, but typically range from 30% to 50%.

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill Changes in the carrying value of goodwill by reportable segment were as follows: U.S. dialysis Other - Ancillary Consolidated 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 Acquisitions 24,377 105,680 130,057 Divestitures (1,549) (6,744) (8,293) Foreign currency and other adjustments — 9,710 9,710 Balance at December 31, 2020 $ 6,309,928 $ 609,181 $ 6,919,109 Balance at December 31, 2020: Goodwill $ 6,309,928 $ 745,732 $ 7,055,660 Accumulated impairment charges — (136,551) (136,551) $ 6,309,928 $ 609,181 $ 6,919,109 As dialysis treatments are an essential, life-sustaining service for patients who depend on them, the Company's operations have continued and are currently expected to continue throughout the novel coronavirus (COVID-19) pandemic. However, the ultimate impact of the dynamic and evolving COVID-19 pandemic on the Company will depend on future developments that are highly uncertain and difficult to predict, including among other things the severity and duration of the pandemic, further spread or resurgence of the virus, including as a result of the emergence of the new strains of the virus, its impact on the chronic kidney disease (CKD) patient population and the Company's patient population, the availability, acceptance, impact and efficacy of COVID-19 treatments, therapies and vaccines, the pandemic's continuing impact on the U.S. and global economies and unemployment, the responses of the Company's competitors to the pandemic and related changes in the marketplaces, and the timing, scope and effectiveness of governmental responses. While the Company does not currently expect a material adverse impact to its business as a result of this public health crisis, there can be no assurance that the COVID-19 pandemic will not have a material adverse impact on one or more of the Company's businesses. 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. 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 physician practices in its physician services reporting units, to the dialysis centers and other health operations within each international reporting unit, and to the vascular access service centers in its former vascular access services reporting unit. For the Company’s other operating segments, discrete business components below the operating segment level constitute individual reporting units. 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. During the year ended December 31, 2019, the Company recognized goodwill impairment charges of $119,476 in its Germany kidney care business. These charges resulted primarily from a decline in then current and expected future patient census and an increase in then current and expected future costs, including due to wage increases expected to result from legislation announced at that time. The changes in the Company's expectations were informed by developments in the business in response to evolving market conditions, including changes in the Company's expected timing and ability to mitigate them, and based on in-depth operating and strategic reviews completed by the Company's new Germany management team. During the year ended December 31, 2019 the Company also recognized a goodwill impairment charge of $5,416 in its German other health operations. Based on its 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 unit, which remains at risk of goodwill impairment as of December 31, 2020: Reporting unit Goodwill Carrying amount coverage (1) Sensitivities Operating income (2) Discount rate (3) Germany kidney care $ 322,736 2.3 % (1.5) % (10.1) % (1) Excess of estimated fair value of the reporting unit over its carrying amount as of the latest assessment date. (2) Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date. (3) Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date. Except as described above, none of the Company’s other reporting units were considered at risk of significant goodwill impairment as of December 31, 2020. 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 have not caused 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, 2020.

Other Liabilities

Other Liabilities	12 Months Ended
	Dec. 31, 2020
Other Liabilities Disclosure [Abstract]
Other Liabilities	Other liabilities Other liabilities were comprised of the following: December 31, 2020 2019 Payor refunds and retractions $ 371,183 $ 377,044 Insurance and self-insurance accruals 54,438 58,941 Accrued interest 30,066 54,899 Accrued non-income tax liabilities 39,075 36,285 Other 315,767 229,005 $ 810,529 $ 756,174

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2020
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 consolidated 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, 2020 2019 2018 Domestic $ 1,287,976 $ 1,307,299 $ 1,083,578 International 30,286 (111,860) (35,100) $ 1,318,262 $ 1,195,439 $ 1,048,478 Income tax expense for continuing operations consisted of the following: Year ended December 31, 2020 2019 2018 Current: Federal $ 47,171 $ 208,339 $ 140,064 State 21,442 58,026 32,990 International 17,481 15,545 7,557 Total current income tax 86,094 281,910 180,611 Deferred: Federal 198,623 44,263 52,034 State 27,206 (25,836) 21,096 International 2,009 (20,709) 4,659 Total deferred income tax 227,838 (2,282) 77,789 $ 313,932 $ 279,628 $ 258,400 Income taxes are allocated between continuing and discontinued operations as follows: Year ended December 31, 2020 2019 2018 Continuing operations $ 313,932 $ 279,628 $ 258,400 Discontinued operations 1,657 40,689 99,768 $ 315,589 $ 320,317 $ 358,168 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, 2020 2019 2018 Federal income tax rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 3.4 2.3 4.1 Change in International valuation allowance 1.5 1.3 0.9 Political advocacy costs 1.7 0.2 2.3 Nondeductible executive compensation 1.2 0.8 0.7 Unrecognized tax benefits 0.4 2.4 0.2 Other (0.6) 0.3 — Impact of noncontrolling interests primarily (4.8) (4.9) (4.6) Effective tax rate 23.8 % 23.4 % 24.6 % Deferred tax assets and liabilities arising from temporary differences for continuing operations were as follows: December 31, 2020 2019 Receivables $ 9,324 $ 19,095 Accrued liabilities 64,982 64,458 Operating lease liabilities 584,656 580,110 Net operating loss carryforwards 167,398 139,690 Other 62,110 55,108 Deferred tax assets 888,470 858,461 Valuation allowance (114,824) (91,925) Net deferred tax assets 773,646 766,536 Intangible assets (634,736) (563,914) Property and equipment (274,742) (162,628) Operating lease assets (532,082) (527,056) Investments in partnerships (101,996) (64,960) Other (39,690) (25,521) Deferred tax liabilities (1,583,246) (1,344,079) Net deferred tax liabilities $ (809,600) $ (577,543) At December 31, 2020, the Company had federal net operating loss carryforwards of approximately $99,657 that expire through 2036, although a substantial amount expire by 2029. The Company also had state net operating loss carryforwards of $488,070, some of which have an indefinite life, although a substantial amount expire by 2040 and international net operating loss carryforwards of $296,451, some of which will begin to expire in 2021 though the majority have an indefinite life. The Company has a state capital loss carryover of $297,748, the majority of which 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 $22,899 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, 2020. As a result of the passage of the Tax Cuts and Jobs Act (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, 2020 2019 Beginning balance $ 68,214 $ 40,382 Additions for tax positions related to current year 2,293 3,378 Additions for tax positions related to prior years 258 24,722 Reductions related to lapse of applicable statute (133) (268) Reductions related to settlements with taxing authorities (430) — Ending balance $ 70,202 $ 68,214 As of December 31, 2020, the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold is $70,202, of which $66,607 would impact the Company’s effective tax rate if recognized. This balance represents an increase of $1,988 from the December 31, 2019 balance of $68,214. The Company recognizes accrued interest and penalties related to unrecognized tax benefits in income tax expense. At December 31, 2020 and 2019, the Company had approximately $17,864 and $14,428, respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefit.

Long-Term Debt

Long-Term Debt	12 Months Ended
	Dec. 31, 2020
Debt Disclosure [Abstract]
Long-Term Debt	Long-term debt Long-term debt was comprised of the following: December 31, As of December 31, 2020 2020 2019 Maturity date Interest rate Estimated fair value (1) Senior Secured Credit Facilities: Term Loan A $ 1,684,375 $ 1,739,063 8/12/2024 LIBOR + 1.50% $ 1,675,953 Term Loan B-1 2,715,694 — 8/12/2026 LIBOR + 1.75% 2,702,115 Term Loan B — 2,743,125 8/12/2026 Revolving line of credit (2) 75,000 — 8/12/2024 ABR + 0.50% $ 75,000 Senior Notes: 4.625% Senior Notes 1,750,000 — 6/1/2030 4.625 % $ 1,859,375 3.75% Senior Notes 1,500,000 — 2/15/2031 3.75 % $ 1,522,500 5.125% Senior Notes — 1,750,000 7/15/2024 5.0% Senior Notes — 1,500,000 5/1/2025 Acquisition obligations and other notes payable (3) 164,160 180,352 2021-2036 4.88 % $ 164,160 Financing lease obligations (4) 274,292 268,534 2021-2038 5.1 % Total debt principal outstanding 8,163,521 8,181,074 Discount and deferred financing costs (5) (77,717) (72,840) 8,085,804 8,108,234 Less current portion (168,541) (130,708) $ 7,917,263 $ 7,977,526 (1) For the Company's senior secured credit facilities and senior notes, fair value estimates are based upon bid and ask quotes, typically a level 2 input. For acquisition obligations and other notes payable, the carrying values presented here approximate their estimated fair values, based on estimates of their present values using level 2 interest rate inputs. (2) The Company's interest rate for its revolving line of credit as of December 31, 2020 was based on an Alternate Base Rate (ABR or Prime Rate) plus 0.50%, or 3.75%. Effective January 6, 2021 this was converted to a LIBOR-based rate of LIBOR plus 1.50%. (3) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current fixed and LIBOR interest rate components in effect as of December 31, 2020. (4) Financing lease obligations are measured at their approximate present values at inception. The interest rate presented is the weighted average discount rate embedded in financing leases outstanding. The term of one ground lease runs to 2070, in addition to the other lease maturity dates presented in the table above. (5) As of December 31, 2020, the carrying amount of the Company's senior secured credit facilities includes a discount of $5,461 and deferred financing costs of $35,825 and the carrying amount of the Company's senior notes includes deferred financing costs of $36,431. As of December 31, 2019, the carrying amount of the Company's senior secured credit facilities included a discount of $6,457 and deferred financing costs of $45,444, and the carrying amount of the Company's senior notes included deferred financing costs of $20,939. Scheduled maturities of long-term debt at December 31, 2020 were as follows: 2021 $ 168,541 2022 $ 169,782 2023 $ 227,062 2024 $ 1,496,892 2025 $ 69,440 Thereafter $ 6,031,804 On February 13, 2020, the Company entered into an amendment (the Repricing Amendment) to refinance and reprice its senior secured Term Loan B with a senior 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 Term Loan A or the revolving line of credit. No additional debt was incurred, nor any additional proceeds received, by the Company in connection with the Repricing Amendment. The majority of the Company's Term Loan B debt was considered modified in this transaction. As a result, the Company recognized debt refinancing charges of $2,948 in the year ended December 31, 2020 comprised partially of fees incurred on this transaction and partially of deferred financing costs written off for the portion of debt considered extinguished and reborrowed. For the portion of the Term Loan B debt that was considered extinguished and reborrowed in this refinancing, the Company recognized $68,842 in constructive financing cash outflows and financing cash inflows on the statement of cash flows, even though no funds were actually paid or received. Another $55,895 of the debt considered extinguished in this refinancing represented a non-cash financing activity. During the year ended December 31, 2020, the Company made regularly scheduled mandatory principal payments under its senior secured credit facilities totaling $54,688 on Term Loan A and $27,431 on Term Loan B-1. On June 9, 2020, the Company issued $1,750,000 aggregate principal amount of 4.625% senior notes due 2030 (the 4.625% Senior Notes) in a private offering pursuant to Rule 144A and Regulation S under the Securities Act of 1933, as amended. The 4.625% Senior Notes pay interest on June 1 and December 1 of each year beginning December 1, 2020. The 4.625% Senior Notes are unsecured senior obligations and rank equally in right of payment with the Company's existing and future unsecured senior indebtedness. The 4.625% Senior Notes are guaranteed by each of the Company’s domestic subsidiaries that guarantee its senior secured credit facilities. The Company may redeem up to 40% of the aggregate principal amount of the 4.625% Senior Notes at any time prior to June 1, 2023 at 104.625% of the aggregate principal amount from the proceeds of one or more equity offerings, plus accrued and unpaid interest. In addition, the Company may redeem the 4.625% Senior Notes at any time prior to June 1, 2025 at a make-whole redemption price plus accrued and unpaid interest or, on and after such date, at certain redemption prices specified in the indenture governing these notes plus accrued and unpaid interest. The 4.625% Senior Notes contain restrictive covenants that limit the ability of the Company and its guarantors to, among other things, create certain liens, enter into certain sale/leaseback transactions, or merge, consolidate or sell all or substantially all of their assets. The 4.625% Senior Notes and related subsidiary guarantees do not have any registration or similar rights and are not expected to be registered for exchange on public markets. During the year ended December 31, 2020, the Company incurred $20,386 in fees, discounts and other professional expenses associated with this transaction that were capitalized and will amortize over the term of the 4.625% Senior Notes. On July 15, 2020, the Company used the net proceeds from these 4.625% Senior Notes, together with cash on hand, to redeem in full all $1,750,000 aggregate principal amount outstanding of its 5.125% Senior Notes plus accrued interest and redemption premium. The Company incurred debt redemption premium charges of $29,890 and deferred financing cost write-offs of $9,764 in connection with this redemption. On August 11, 2020, the Company issued $1,500,000 aggregate principal amount of 3.75% senior notes due 2031 (the 3.75% Senior Notes) in a private offering pursuant to Rule 144A and Regulation S under the Securities Act of 1933, as amended. The 3.75% Senior Notes pay interest on February 15 and August 15 of each year beginning February 15, 2021. The 3.75% Senior Notes are unsecured senior obligations and rank equally in right of payment with the Company's existing and future unsecured senior indebtedness. The 3.75% Senior Notes are guaranteed by each of the Company’s domestic subsidiaries that guarantee its senior secured credit facilities. The Company may redeem up to 40% of the aggregate principal amount of the 3.75% Senior Notes at any time prior to August 15, 2023 at 103.75% of the aggregate principal amount from the proceeds of one or more equity offerings, plus accrued and unpaid interest. In addition, the Company may redeem the 3.75% Senior Notes at any time prior to February 15, 2026 at a make-whole redemption price plus accrued and unpaid interest or, on and after such date, at certain redemption prices specified in the indenture governing these notes plus accrued and unpaid interest. The 3.75% Senior Notes contain restrictive covenants that limit the ability of the Company and its guarantors to, among other things, create certain liens, enter into certain sale/leaseback transactions, or merge, consolidate or sell all or substantially all of their assets. The 3.75% Senior Notes and related subsidiary guarantees do not have any registration or similar rights and are not expected to be registered for exchange on public markets. During the year ended December 31, 2020, the Company incurred $17,936 in fees, discounts and other professional expenses associated with this transaction that were capitalized and will amortize over the term of the 3.75% Senior Notes. On August 21, 2020, the Company used the net proceeds from these 3.75% Senior Notes, together with cash on hand, to redeem in full all $1,500,000 aggregate principal amount outstanding of its 5.0% Senior Notes plus accrued interest and redemption premium. The Company incurred debt redemption premium charges of $37,500 and deferred financing cost write-offs of $8,866 in connection with this redemption. The Company's 2015 interest rate cap agreements expired on June 30, 2020, at which time the Company's 2019 cap agreements became effective. As of December 31, 2020, 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 Term Loan B-1 and a portion of the Term Loan A. The remaining $900,069 outstanding principal balance of the Term Loan A and the $75,000 outstanding balance of the revolving line of credit are 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. The following table summarizes the Company’s interest rate cap agreements outstanding as of December 31, 2020 and December 31, 2019, which are classified in "Other long-term assets" on its consolidated balance sheet: Year ended December 31, December 31, 2020 2020 2019 Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI loss Fair value 2019 cap agreements $ 3,500,000 2.00% 6/30/2020 6/30/2024 $ 2,755 $ (21,781) $ 2,671 $ 24,452 2015 cap agreements $ 3,500,000 3.50% 6/29/2018 6/30/2020 $ 4,326 $ — $ — $ — The following table summarizes the effects of the Company’s interest rate cap agreements for the years ended December 31, 2020, 2019 and 2018: Amount of unrealized (losses) gains in OCI on interest rate cap agreements 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 2020 2019 2018 2020 2019 2018 Interest rate cap agreements $ (21,781) $ 1,566 $ (181) Debt expense $ 7,081 $ 8,591 $ 8,466 Related income tax 5,435 (415) 48 Related income tax (1,768) (2,214) (2,180) Total $ (16,346) $ 1,151 $ (133) $ 5,313 $ 6,377 $ 6,286 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 its senior secured credit facilities at the end of 2020 was 2.03%, based upon the current margins in effect for the Term Loan A, Term Loan B-1 and revolving line of credit as of December 31, 2020. The Company’s weighted average effective interest rate on all debt, including the effect of interest rate caps and amortization of debt discount, was 3.59% for the year ended December 31, 2020 and 3.06% as of December 31, 2020. As of December 31, 2020, the Company’s interest rates were fixed on approximately 44.4% of its total debt. As of December 31, 2020, the Company had $925,000 available and $75,000 drawn on its $1,000,000 revolving line of credit under its senior secured credit facilities. Credit available under this revolver is reduced by the amount of any letters of credit outstanding under this facility, but there were no such letters of credit outstanding as of December 31, 2020. The Company also had approximately $64,636 of outstanding letters of credit under a separate bilateral secured letter of credit facility as of December 31, 2020. Debt expense Debt expense consisted of interest expense of $282,932, $419,639 and $461,897 and the amortization and accretion of debt discounts and premiums, amortization of deferred financing costs and the amortization of interest rate cap agreements of $21,179, $24,185 and $25,538 for 2020, 2019 and 2018, respectively. These interest expense amounts are net of capitalized interest.

Leases

Leases	12 Months Ended
	Dec. 31, 2020
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 which range in terms from five years to 20 years and which contain renewal options of five years to ten years at the fair rental value at the time of renewal. Certain of the Company's leases are subject to periodic consumer price increases or contain fixed escalation clauses. See Note 1 for further information on how the Company accounts for leases. As of December 31, 2020 and December 31, 2019, assets recorded under finance leases were $275,389 and $247,246, respectively, and accumulated amortization associated with finance leases was $49,345 and $27,193, 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 20 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: Year ended December 31, Lease cost 2020 2019 Operating lease cost (1) : Fixed lease expense $ 541,090 $ 526,352 Variable lease expense 122,729 119,740 Financing lease cost: Amortization of leased assets 24,720 23,724 Interest on lease liabilities 14,421 14,932 Net lease cost $ 702,960 $ 684,748 (1) Includes short-term lease expense and sublease income, which are immaterial. Other information related to leases was as follows: Year ended December 31, Lease term and discount rate 2020 2019 Weighted average remaining lease term (years): Operating leases 8.7 9.0 Finance leases 10.5 10.2 Weighted average discount rate: Operating leases 3.8 % 4.1 % Finance leases 5.1 % 5.4 % Year ended December 31, Other information 2020 2019 Gains on sale leasebacks, net $ 34,301 $ 20,833 Cash paid for amounts included in the Operating cash flows for operating leases $ 661,318 $ 637,655 Operating cash flows for finance leases $ 20,981 $ 22,257 Financing cash flows for finance leases $ 24,780 $ 25,692 Net operating lease assets obtained in exchange $ 401,559 $ 432,074 Future minimum lease payments under non-cancellable leases as of December 31, 2020 are as follows: Operating leases Finance leases 2021 $ 480,439 $ 35,039 2022 504,789 35,124 2023 464,023 35,645 2024 412,419 35,669 2025 361,447 35,539 Thereafter 1,437,965 174,907 Total future minimum lease payments 3,661,082 351,923 Less portion representing interest (552,915) (77,631) Present value of lease liabilities $ 3,108,167 $ 274,292 Rent expense under all operating leases for 2020, 2019, and 2018 was $663,819, $646,092 and $596,117, 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, 2020
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 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. The Company maintains 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, 2020, 2019 and 2018, the Company accrued matching contributions totaling approximately $70,180, $64,988 and $67,807, respectively. Prior to 2018, the Company did not provide matching contributions for its 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 2020, 2019 and 2018 were $3,637, $1,751 and $3,090, 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 2020, 2019 and 2018 the Company distributed $3,139, $2,730 and $4,652, 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, 2020 and 2019, the total fair value of assets held in these plans' trusts was $43,844 and $39,527, respectively. The assets of these plans are recorded at fair value with changes in fair value recorded in "Other income, net". 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, 2020
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 (which frequently arise from qui tam suits) and audits (including, without limitation, investigations or other actions resulting from its obligation to self-report suspected violations of law) and other legal proceedings, including, without limitation, those described below. 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, 2020 and December 31, 2019, 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. Certain Governmental Inquiries and 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 government's investigation covers the period from January 1, 2006 through December 31, 2018. In December 2017, the Company finalized and executed a settlement agreement that resolved certain of the issues in the government's investigation and 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 is ongoing with respect to issues related to DaVita Rx's historic relationships with certain pharmaceutical manufacturers, 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 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. In May 2020, the Company sold its interest in Lifeline, but the Company retained certain liabilities of the Lifeline business, including those related 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. On February 24, 2020, the Company and DaVita Labs filed a motion to dismiss the amended complaint. On June 25, 2020, the court denied the motion to dismiss. The Company and DaVita Labs answered the complaint on July 23, 2020. The Company and DaVita Labs dispute these allegations and intend to defend this action accordingly. 2020 U.S. Attorney New Jersey Investigation : In March 2020, the U.S. Attorney’s Office, District of New Jersey served the Company with a subpoena and a CID relating to an investigation being conducted by that office and the U.S. Attorney’s Office, Eastern District of Pennsylvania. The subpoena and CID request information on several topics, including certain of the Company’s joint venture arrangements with physicians and physician groups, medical director agreements, and compliance with its five-year Corporate Integrity Agreement, the term of which expired October 22, 2019. The Company is cooperating with the government in this investigation. 2020 California Department of Insurance Investigation : In April 2020, the California Department of Insurance (CDI) sent the Company an Investigative Subpoena relating to an investigation being conducted by that office. CDI issued a superseding subpoena in September 2020. The subpoena, as revised, requests information on a number of topics, including but not limited to the Company’s communications with patients about insurance plans and financial assistance from the American Kidney Fund (AKF), analyses of the potential impact of patients’ decisions to change insurance providers, and documents relating to donations or contributions to the AKF. The Company is cooperating with CDI in this investigation. 2020 Department of Justice Investigation : In October 2020, the Company received a CID from the Department of Justice pursuant to a False Claims Act investigation concerning allegations that DaVita Medical Group (DMG) may have submitted undocumented or unsupported diagnosis codes in connection with Medicare Advantage beneficiaries. The CID covers the period from January 1, 2015 through June 19, 2019, the date the Company completed the divestiture of DMG to Collaborative Care Holdings, LLC. The Company is cooperating with the government in this investigation. * * * 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, many of which relate to 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 court denied the motion to dismiss. The Company answered the complaint on May 28, 2019. On January 31, 2020, the plaintiffs filed a motion for class certification and the Company filed its opposition on June 29, 2020. While the Company continues to dispute the allegations, in July 2020, it reached an agreement in principle to resolve this matter without admitting to any liability. Settlement of this matter on the agreed terms is expected to be covered primarily with insurance proceeds, with the Company contributing an amount that would not have a material impact on the Company’s consolidated financial position, results of operations or cash flows. A motion for preliminary approval of the settlement was granted by the court on October 27, 2020. The settlement is subject to, among other things, final approval by the court. 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. While the defendants continue to dispute the allegations, in July 2020, an agreement in principle was reached to resolve this matter without admitting to any liability. The Company’s Board of Directors (Board) approved the settlement on October 20, 2020. The court granted a motion for final approval of the settlement on January 27, 2021 and approved the settlement on January 29, 2021. As part of the settlement, the Company agreed to certain corporate governance policies, but will not make any financial contribution towards the settlement. 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, 2020
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 also has certain potential commitments to provide working capital funding, if necessary, to certain nonconsolidated dialysis businesses that the Company manages and in which the Company owns a noncontrolling equity interest or which are wholly-owned by third parties of approximately $8,663. 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 agreements with various suppliers to purchase established amounts of dialysis equipment, parts, and supplies. As of December 31, 2020, the remaining minimum purchase commitments under these arrangements were approximately $542,061, $540,715, $179,869, and $92,075 for the years 2021, 2022, 2023, and 2024, 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, 2020.

Long-term Incentive Compensatio

Long-term Incentive Compensation and Shareholders’ Equity	12 Months Ended
	Dec. 31, 2020
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) as well as 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 LTIP 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 as a liability. Shares issued upon exercise or, when applicable, vesting of stock awards, are issued from authorized but unissued shares. Long-term incentive compensation plans On June 11, 2020, the Company’s stockholders approved the DaVita Inc. 2020 Incentive Award Plan (the 2020 Plan). Prior to June 11, 2020 stock-based awards were granted under the DaVita Healthcare Partners Inc. 2011 Incentive Award Plan (the 2011 Plan). The 2011 Plan was terminated with respect to any new awards upon stockholder approval of the 2020 Plan. At the time the 2020 Plan was approved there were 8,730 shares of common stock available for issuance under the 2020 Plan, consisting of 5,000 newly authorized shares and 3,730 shares that were available for issuance under the 2011 Plan as of the effective date of the 2020 Plan and which became available for grant under the 2020 Plan, pursuant to the terms of the 2020 Plan. The 2020 Plan is the Company’s current 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 2020 Plan provides for the grant of stock appreciation rights, nonqualified stock options, incentive stock options, restricted stock units, restricted stock, performance stock awards, dividend equivalents, stock payments, deferred stock unit awards, deferred stock awards and performance cash awards. The 2020 Plan mandates a maximum award term of 10 years for stock appreciation rights and stock options and stipulates that awards of these types be granted with a base or exercise price per share of not less than the fair market value of the Company's common stock on the date of grant. Shares available under the 2020 Plan are also stated on a full value share basis rather than on an option-equivalent basis. The 2020 Plan therefore provides that shares available for issuance under the plan are reduced by one share available for every four shares underlying stock appreciation rights and stock options, and are reduced by one share available for every one share underlying stock-based awards other than stock appreciation rights and stock options. At December 31, 2020, there were 8,074 shares available for future grants under the 2020 Plan. The Company’s stock units awarded under the 2020 Plan generally vest over 36 months to 48 months from the date of grant. As of December 31, 2020, no stock appreciation rights have been awarded under the 2020 Plan. The 2011 Plan was the Company’s prior omnibus equity compensation plan and authorized 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 mandated a maximum award term of five years and stipulated 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 required 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 stock appreciation rights and stock units awarded under the 2011 Plan generally vest over 36 months to 48 months from the date of grant. A combined summary of the status of the Company’s stock-settled awards under both the 2020 Plan and 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, 2020 Stock appreciation rights Stock units Awards Weighted Weighted Awards Weighted Outstanding at beginning of year 6,953 $ 64.10 3,160 Granted 2,765 $ 68.58 1,027 Added by performance factor 19 Exercised/Vested (894) $ 72.13 (351) Expired (494) $ 83.61 — Canceled (246) $ 61.36 (318) Outstanding at end of period 8,084 $ 63.64 3.0 3,537 1.8 Exercisable at end of period 987 $ 69.56 1.0 — — Weighted-average fair value of grants: 2020 $ 26.70 $ 77.83 2019 $ 14.04 $ 50.58 2018 $ 16.24 $ 66.23 Awards Outstanding Weighted average exercise price Awards exercisable Weighted average exercise price Range of SSARs base prices $50.01–$60.00 2,263 $ 52.53 2 $ 57.88 $60.01–$70.00 5,165 $ 66.99 610 $ 65.95 $70.01–$80.00 656 $ 75.60 375 $ 75.50 Total 8,084 $ 63.64 987 $ 69.56 For the years ended December 31, 2020, 2019, and 2018, the aggregate intrinsic value of stock-based awards exercised was $49,258, $11,475 and $31,045, respectively. At December 31, 2020, the aggregate intrinsic value of stock-based awards outstanding was $853,803 and the aggregate intrinsic value of stock awards exercisable was $47,208. 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. 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 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, 2020 2019 2018 Expected term 4.8 4.0 4.2 Expected volatility 28.2 % 29.5 % 23.8 % Expected dividend yield — % — % — % Risk-free interest rate 1.5 % 2.2 % 2.9 % 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 the Company's 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 modified Dutch auction tender offer for its shares in 2019 (2019 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 2020, 2019 and 2018 purchase periods were $17,148, $16,569 and $17,398, respectively. Shares purchased pursuant to the plan’s 2020, 2019 and 2018 purchase periods were 222, 315 and 398, respectively. At December 31, 2020, there were 6,189 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 2020, 2019 and 2018, respectively: expected volatility of 40.4%, 28.8% and 24.2%; risk-free interest rates of 1.0%, 2.6% and 1.9%, and no dividends. Using these assumptions, the weighted average estimated per share fair value of each purchase right was $22.06, $13.80 and $17.45 for 2020, 2019 and 2018, respectively. Long-term incentive compensation expense and proceeds For the years ended December 31, 2020, 2019 and 2018, the Company recognized $99,643, $118,513 and $85,759, respectively, in total LTIP expense, of which $91,458, $63,705 and $73,582, respectively, was stock-based compensation expense for stock appreciation rights, stock units and discounted employee stock purchase plan purchases, which are primarily included in general and administrative expenses. The estimated tax benefits recorded for stock-based compensation in 2020, 2019 and 2018 were $11,775, $9,186 and $13,591, respectively. As of December 31, 2020, there was $189,713 of total estimated but unrecognized stock-based compensation expense under the Company’s equity compensation and employee stock purchase plans. The Company expects to recognize this expense over a weighted average remaining period of 1.4 years. The Company no longer has outstanding long-term performance-based cash awards in its principal U.S. dialysis business as the performance and accrual period for these awards ended December 31, 2019 with a final payout of $66,302 in 2020. 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 for stock-settled stock appreciation rights 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, 2020, 2019 and 2018, the Company received $8,957, $2,251 and $7,988, respectively, in actual tax benefits upon the exercise or vesting 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, 2020
Equity [Abstract]
Stockholder's equity	Shareholders’ equity Stock repurchases The following table summarizes the Company's repurchases of its common stock during the years ended December 31, 2020, 2019 and 2018: 2020 2019 2018 Open market repurchases Shares 8,495 19,218 16,844 Amounts paid $ 741,850 $ 1,168,321 $ 1,153,511 Average paid per share $ 87.32 $ 60.79 $ 68.48 Tender offers (1) Shares 7,982 21,802 Amounts paid $ 704,917 $ 1,234,154 Average paid per share $ 88.32 $ 56.61 Total Shares 16,477 41,020 16,844 Amounts paid $ 1,446,767 $ 2,402,475 $ 1,153,511 Average paid per share $ 87.80 $ 58.57 $ 68.48 (1) The aggregate amounts paid for shares repurchased pursuant to the Company's 2020 and 2019 tender offers for its shares during the years ended December 31, 2020 and 2019, include their clearing prices of $88.00 and $56.50 per share, respectively, plus related fees and expenses of $2,529 and $2,343, respectively . Subsequent to December 31, 2020 through February 10, 2021, the Company has repurchased 1,063 shares of its common stock for $123,282 at an average cost of $115.98 per share. Effective as of the close of business on November 4, 2019, the Board terminated all remaining prior share repurchase authorizations available to the Company and approved a new share repurchase authorization of $2,000,000. Effective on December 10, 2020, the Board terminated all remaining prior share repurchase authorizations available to the Company under the aforementioned November 4, 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 10, 2021, the Company has a total of $1,806,674 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, 2020 and December 31, 2019. 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 for director nominations and stockholder proposals and granting the Company's Board of Directors 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, prohibits 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. The provisions described above may discourage, delay or prevent an acquisition of the Company at a price that stockholders may find attractive. 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 were as follows: Year ended December 31, 2020 2019 2018 Net income attributable to DaVita Inc. $ 773,642 $ 810,981 $ 159,394 Changes in paid-in capital for: Purchases of noncontrolling interests 4,364 (37,145) (17,897) Sales of noncontrolling interest — — 79 Net transfers in noncontrolling interests 4,364 (37,145) (17,818) Net income attributable to DaVita Inc. net of transfers in $ 778,006 $ 773,836 $ 141,576 The Company acquired additional ownership interests in several existing majority-owned partnerships for $7,831, $68,019, and $28,082 in 2020, 2019, and 2018, respectively.

Accumulated Other Comprehensive

Accumulated Other Comprehensive (Loss) Income	12 Months Ended
	Dec. 31, 2020
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 Investment Foreign currency Accumulated other 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 (loss) 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) Unrealized losses (21,781) — (7,080) (28,861) Related income tax 5,435 — (543) 4,892 (16,346) — (7,623) (23,969) Reclassification of income into net income 7,081 — — 7,081 Related income tax (1,768) — — (1,768) 5,313 — — 5,313 Balance at December 31, 2020 $ (12,466) $ — $ (53,688) $ (66,154) (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. 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.

Acquisitions and Divestitures

Acquisitions and Divestitures	12 Months Ended
	Dec. 31, 2020
Business Combinations [Abstract]
Acquisitions and Divestitures	Acquisitions and divestitures Routine acquisitions During 2020, the Company acquired eight dialysis centers in the U.S. and 66 dialysis centers outside the U.S. for a total of $182,013 in net cash, earn-outs of $14,042 and deferred purchase price and liabilities assumed of $20,415. The Company also recognized a non-cash gain of $1,821. 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, 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 of $34,394. In one of these 2018 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 its prior interest upon consolidation. 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, as are their operating results, from the designated effective dates of the acquisitions. The initial purchase price allocations for these transactions have been recorded at estimated fair values based on information available to management and will be finalized when certain information arranged to be obtained has been received. For several of the 2020 acquisitions, certain income tax amounts are pending final evaluation and quantification of any pre-acquisition tax contingencies. In addition, valuation of intangibles, leases 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, 2020 2019 2018 Current assets $ 23,607 $ 6,713 $ 23,686 Property and equipment 37,457 4,842 11,421 Customer relationships 34,625 — — Noncompetition agreements and other long-term assets 10,168 1,980 3,079 Indefinite-lived licenses 22,136 31,858 23,656 Goodwill 130,057 90,226 278,348 Deferred income taxes (3,962) — — Liabilities assumed (34,068) (7,159) (19,946) Noncontrolling interests assumed (1,729) (1,762) (80,291) $ 218,291 $ 126,698 $ 239,953 The following summarizes weighted-average estimated useful lives of amortizable intangible assets acquired during 2020, 2019 and 2018, as well as goodwill deductible for tax purposes associated with these acquisitions: Year ended December 31, 2020 2019 2018 Weighted-average estimated useful lives: Customer relationships 18 Noncompetition agreements 5 6 6 Goodwill deductible for tax purposes $ 94,318 $ 88,517 $ 165,013 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 2020 and 2019 had been consummated as of the beginning of 2019, including the impact of certain adjustments such as amortization of intangibles, interest expense on acquisition financing and income tax effects. Year ended December 31, 2020 2019 (unaudited) Pro forma total revenues $ 11,636,416 $ 11,570,086 Pro forma net income from continuing operations attributable to $ 789,473 $ 718,928 Pro forma basic net income per share from continuing operations $ 6.59 $ 4.69 Pro forma diluted net income per share from continuing operations $ 6.44 $ 4.67 Sale of RMS Lifeline The Company divested its vascular access business, RMS Lifeline, Inc., effective May 1, 2020 and recognized a loss on sale of approximately $16,252. 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 $42,378 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, 2020, the Company estimated the fair value of these contingent earn-out obligations to be $30,248, of which a total of $13,025 is included in other current liabilities, and the remaining $17,223 is included in other long-term liabilities in the Company’s consolidated balance sheet. The following is a reconciliation of changes in contingent earn-out liabilities for the years ended December 31, 2020 and 2019: Year ended December 31, 2020 2019 Beginning balance $ 24,586 $ 2,608 Acquisitions 14,042 23,536 Foreign currency translation (3,688) (905) Fair value remeasurements (2,630) 121 Payments or other settlements (2,062) (774) Ending balance $ 30,248 $ 24,586

Held for Sale and Discontinued

Held for Sale and Discontinued Operations	12 Months Ended
	Dec. 31, 2020
Discontinued Operations and Disposal Groups [Abstract]
Held for Sale and Discontinued Operations	Discontinued operations previously held for sale 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 was 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. Those estimated net proceeds included $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. At close of the DMG sale, the Company's ultimate net sale proceeds remained subject to resolution of certain post-closing purchase price adjustments described in the equity purchase agreement. In the fourth quarter of 2020, the Company and Optum reached agreement on the final purchase price for the DMG sale, which resulted in an additional payment by the Company to Optum of $47,000 and an additional loss on sale of $17,976. In the first quarter of 2020, the Company recognized $9,980 in additional tax benefits under the Coronavirus Aid, Relief and Economic Security Act related to its period of DMG ownership, which were also recognized as an adjustment to the Company's loss on sale of the DMG business. Under the equity purchase agreement, the Company also has certain continuing 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 continuing uncertainties and the amounts of such payments could be significant to the Company. The following table presents the financial results of discontinued operations related to DMG: Year ended December 31, 2020 2019 2018 Net revenues $ — $ 2,713,059 $ 4,963,792 Expenses — 2,543,865 4,962,686 Goodwill and other asset impairment charges — — 41,537 Valuation adjustment on disposal group — — 316,840 Income (loss) from discontinued operations before taxes — 169,194 (357,271) Loss on sale of discontinued operations before taxes (7,996) (23,022) — Income tax expense 1,657 40,689 99,768 Net (loss) income from discontinued operations, net of tax $ (9,653) $ 105,483 $ (457,038) The following table presents cash flows of discontinued operations related to DMG: Year ended December 31, 2020 2019 2018 Net cash provided by operating activities from discontinued operations $ — $ 99,634 $ 290,684 Net cash used in investing activities from discontinued operations $ — $ (43,442) $ (57,382) DMG acquisitions

Variable Interest Entities

Variable Interest Entities	12 Months Ended
	Dec. 31, 2020
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 either because they are (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, 2020, these consolidated financial statements include total assets of VIEs above of $310,190 and total liabilities and noncontrolling interests of these VIEs to third parties of $216,632.

Fair Values of Financial Instru

Fair Values of Financial Instruments	12 Months Ended
	Dec. 31, 2020
Fair Value Disclosures [Abstract]
Fair Values of Financial Instruments	Fair values of financial instruments The Company measures the fair value of certain assets, liabilities, and noncontrolling interests subject to put provisions (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 assets, liabilities and temporary equity that are measured at fair value on a recurring basis into the appropriate fair value hierarchy levels as defined by the 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, 2020 and 2019: December 31, 2020 Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 44,077 $ 44,077 $ — $ — Interest rate cap agreements $ 2,671 $ — $ 2,671 $ — Liabilities Contingent earn-out obligations $ 30,248 $ — $ — $ 30,248 Temporary equity Noncontrolling interests subject to put provisions $ 1,330,028 $ — $ — $ 1,330,028 December 31, 2019 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 For reconciliations of changes in contingent earn-out obligations and noncontrolling interests subject to put provisions during the year ended at December 31, 2020 and 2019, see Note 21 and the consolidated statement of equity, respectively. 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. The estimated fair value of noncontrolling interests subject to put provisions is based principally on the higher of either estimated liquidation value of net assets or a multiple of earnings for each subject dialysis partnership, based on historical earnings, revenue mix, and other performance indicators that can affect future results. The multiples used for these valuations are derived from observed ownership transactions for dialysis businesses between unrelated parties in the U.S. in recent years, and the specific valuation multiple applied to each dialysis partnership is principally determined by its recent and expected revenue mix and contribution margin. As of December 31, 2020, an increase or decrease in the weighted average multiple used in these valuations of one times EBITDA would change the estimated fair value of these noncontrolling interests by approximately $160,000. 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 financial instruments other than debt and lease liabilities are presented in the consolidated financial statements at December 31, 2020 and 2019 at their approximate fair values due to the short-term nature of their settlements.

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2020
Segment Reporting [Abstract]
Segment Reporting	Segment reporting The Company's operations are comprised of its U.S. dialysis and related lab services business (its U.S. dialysis business), its various ancillary services and strategic initiatives, including its international operations (collectively, its ancillary services), 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 APAC 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, 2020 2019 2018 Segment revenues: U.S. dialysis Patient service revenues: External sources $ 10,488,731 $ 10,421,401 $ 10,274,046 Intersegment revenues 144,091 131,199 92,950 U.S. dialysis revenues before provision 10,632,822 10,552,600 10,366,996 Provision for uncollectible accounts (13,458) (21,715) (50,927) U.S. dialysis patient service revenues 10,619,364 10,530,885 10,316,069 Other revenues (1) External sources 39,376 30,895 19,880 Intersegment revenues 1,195 1,126 — Total U.S. dialysis revenues $ 10,659,935 $ 10,562,906 $ 10,335,949 Other - Ancillary services Net patient service revenues 550,978 497,021 437,275 Other external sources 484,977 460,877 724,577 Intersegment revenues 16,743 14,030 34,236 Total ancillary services 1,052,698 971,928 1,196,088 Total net segment revenues 11,712,633 11,534,834 11,532,037 Elimination of intersegment revenues (162,029) (146,355) (127,186) Consolidated revenues $ 11,550,604 $ 11,388,479 $ 11,404,851 Segment operating margin (loss): U.S. dialysis $ 1,917,604 $ 1,924,826 $ 1,709,721 Other - Ancillary services (2) (76,261) (189,174) (93,789) Total segment margin 1,841,343 1,735,652 1,615,932 Reconciliation of segment operating margin to consolidated income from Corporate administrative support (146,707) (92,335) (90,108) Consolidated operating income 1,694,636 1,643,317 1,525,824 Debt expense (304,111) (443,824) (487,435) Debt prepayment, refinancing and redemption charges (89,022) (33,402) — Other income 16,759 29,348 10,089 Income from continuing operations before income taxes $ 1,318,262 $ 1,195,439 $ 1,048,478 - (1) Includes management fee revenues from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling interest or which are wholly-owned by third parties. (2) Includes equity investment income of $5,866, $9,366, and $24,866 in 2020, 2019 and 2018, respectively. Depreciation and amortization expense by reportable segment was as follows: Year ended December 31, 2020 2019 2018 U.S. dialysis $ 594,552 $ 583,454 $ 558,810 Other - Ancillary services 35,883 31,698 32,225 $ 630,435 $ 615,152 $ 591,035 Summary of assets by reportable segment was as follows: Year ended December 31, 2020 2019 Segment assets U.S. dialysis (1) $ 15,344,647 $ 15,778,880 Other - Ancillary services (2) 1,643,869 1,532,514 Consolidated assets $ 16,988,516 $ 17,311,394 (1) Includes equity method and other investments of $122,974 and $124,188 in 2020 and 2019, respectively. (2) Includes equity method and other investments of $134,517 and 117,795 in 2020 and 2019, respectively and includes approximately $181,137 and $154,572 in 2020 and 2019, 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, 2020 2019 2018 U.S. dialysis 646,870 $ 681,339 $ 856,108 Other - Ancillary services 27,671 46,741 45,806 DMG - Discontinued operations — 38,466 85,224 $ 674,541 $ 766,546 $ 987,138

Supplemental Cash Flow Informat

Supplemental Cash Flow Information	12 Months Ended
	Dec. 31, 2020
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, 2020 2019 2018 Cash paid: Income taxes, net $ 154,850 $ 157,983 $ 92,526 Interest $ 326,165 $ 473,176 $ 488,974 Non-cash investing and financing activities: Fixed assets under financing lease obligations $ 22,042 $ 18,953 $ 8,828

Selected Quarterly Financial Da

Selected Quarterly Financial Data (unaudited)	12 Months Ended
	Dec. 31, 2020
Quarterly Financial Information Disclosure [Abstract]
Selected Quarterly Financial Data (unaudited)	Selected quarterly financial data (unaudited) December 31, September 30, June 30, March 31, 2020 Total revenues $ 2,905,322 $ 2,924,066 $ 2,879,979 $ 2,841,237 Operating income $ 381,671 $ 437,669 $ 409,920 $ 465,376 Attributable to DaVita Inc.: Net income from continuing operations (1) $ 193,406 $ 158,674 $ 201,602 $ 229,613 Net (loss) income from discontinued operations (19,633) — — 9,980 Net income $ 173,773 $ 158,674 $ 201,602 $ 239,593 Per share attributable to DaVita Inc.: Basic net income from continuing operations $ 1.73 $ 1.31 $ 1.65 $ 1.84 Basic net (loss) income from discontinued operations (0.17) — — 0.08 Basic net income $ 1.56 $ 1.31 $ 1.65 $ 1.92 Diluted net income from continuing operations $ 1.67 $ 1.28 $ 1.62 $ 1.81 Diluted net (loss) income from discontinued operations (0.17) — — 0.08 Diluted net income $ 1.50 $ 1.28 $ 1.62 $ 1.89 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 (1) The following table summarizes impairment charges, loss on changes in ownership interest, and a legal settlement included in operating expenses and charges in 2020 and 2019 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 Impairment charges $ 83,855 $ 41,037 Loss on changes in $ 16,252 Accruals for legal matters $ 35,000

SCHEDULE II-VALUATION AND QUALI

SCHEDULE II-VALUATION AND QUALIFYING ACCOUNTS	12 Months Ended
	Dec. 31, 2020
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
SCHEDULE II-VALUATION AND QUALIFYING ACCOUNTS	DAVITA INC. SCHEDULE II—VALUATION AND QUALIFYING ACCOUNTS Balance at Acquisitions Amounts Amounts written off Balance Description (dollars in thousands) Allowance for uncollectible accounts: Year ended December 31, 2020 $ 8,328 $ — $ 13,458 $ 21,786 $ — 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

Organization and Summary of S_2

Organization and Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2020
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 classifications have been conformed 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. The most significant assumptions and estimates underlying these consolidated financial statements and accompanying notes involve revenue recognition and accounts receivable, impairments of goodwill, accounting for income taxes, fair value estimates and loss contingencies. 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. 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 continued 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 businesses that the Company does not own or in which the Company owns a noncontrolling interest as well as revenues associated with the Company's non-dialysis ancillary services and strategic initiatives. Revenues associated with dialysis management services, integrated care services, clinical research programs, physician services, and ESRD seamless care organizations are estimated in the period services are provided. Revenues associated with pharmacy services until that business was closed in 2018 were estimated as prescriptions were filled and shipped to patients. Revenues associated with direct primary care until that business was sold in 2018 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 continued 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 readily convertible to known amounts of cash that typically mature within three months or less at date of purchase.
Restricted cash and equivalents	Restricted cash and equivalents Restricted cash and cash equivalents include funds held in trust to satisfy insurer and state regulatory requirements related to wholly-owned captive insurance companies that bear professional and general liability and workers' compensation risks for the Company as well as funds held in escrow for certain legal settlements pending finalization.
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 recorded at estimated fair value with changes in fair value recognized in current earnings within "Other income, net". These debt and equity investments are classified as "short-term investments" or "long-term investments" on the Company's consolidated balance sheet. See Note 5 for further details.
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 equipmentProperty 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. 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 majority of the Company’s facilities are leased under non-cancellable operating leases which contain renewal options. 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 increases or contain fixed escalation clauses. 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. The Company has elected the practical expedient to not separate lease components from non-lease components for its financing and operating leases. The Company has also elected the short-term lease recognition exemption and does not recognize right-of-use assets or lease liabilities for leases with a term of less than 12 months. Financing and operating right-of-use assets are recognized based on the net present value of lease payments over the lease term plus expected renewals as of 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. 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 expected lease term.
Amortizable intangibles	Amortizable intangibles Amortizable intangible assets include noncompetition agreements, hospital service contracts, and customer relationships arising from other service 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 and hospital acute service contracts over the contract term, and customer relationships from other service contracts over the remaining contract term plus expected renewal periods. 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. Costs to renew indefinite-lived intangible assets are expensed as incurred.
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. Equity investments without readily determinable fair values for which the Company does not maintain significant influence over the investee are carried either at estimated fair value or on the adjusted cost method, as determined on an investment-specific basis. The adjusted cost method represents the Company's cost for an investment, net of any other-than-temporary impairments, as adjusted for any subsequent observation of the investment's fair value. These equity method and adjusted cost method investments are classified as “Equity method and other investments” on the Company's consolidated balance sheet. See Note 9 for further details. 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-insuranceThe 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 protection. The Company is also predominantly self-insured with respect to employee medical and other health benefits. The Company records insurance liabilities for the professional and general liability, workers’ compensation, and employee health benefit risks that it retains and estimates its liability for those risks using third party actuarial calculations that are based upon historical claims experience and expectations for future claims.
Income taxes	Income taxes Federal and state income taxes are computed at currently enacted tax rates less tax credits using the asset and liability method. Deferred taxes are adjusted both for items that do not currently have tax consequences and for the cumulative effect of any changes in tax rates from those previously used to determine deferred tax assets or liabilities. Tax provisions include amounts that are currently payable, changes in deferred tax assets and liabilities that arise because of temporary differences between the timing of when items of income and expense are recognized for financial reporting and income tax purposes, changes in the recognition of tax positions and any changes in the valuation allowance caused by a change in judgment about the realizability of the related deferred tax assets. A valuation allowance is established when necessary to reduce deferred tax assets to amounts expected to be realized. The Company uses a recognition threshold of more-likely-than-not and a measurement attribute on all tax positions taken or expected to be taken in a tax return in order to be recognized in the financial statements. Once the recognition threshold is met, the tax position is then measured to determine the actual amount of benefit to recognize in the financial statements.
Stock-based compensation	Stock-based compensation The Company’s stock-based compensation 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 interestsNoncontrolling interests represent third-party equity ownership interests in entities which are consolidated by the Company for financial statement reporting purposes. Noncontrolling interests subject to put provisions The Company has potential obligations to purchase the equity interests held by third parties in 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 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.
New accounting standards	New accounting standards New standards recently 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 amend the impairment model to utilize an expected loss methodology in place of the incurred loss methodology for financial instruments and off-balance sheet credit exposures. The amendment requires entities to consider a broader range of information to estimate expected credit losses, which may result in earlier recognition of losses. The amendments in this ASU became effective for the Company beginning on January 1, 2020 and were applied using a modified retrospective basis. The adoption of ASU No. 2016-13 did not have a material impact on the Company's consolidated financial statements. 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 in this ASU 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 became effective for the Company beginning on January 1, 2020 and were applied on a prospective basis. The adoption of this ASU did not have a material impact on the Company’s consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-15, Intangibles-Goodwill and Other-Internal Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract . ASU No. 2018-15 aligns the requirements for capitalizing implementation costs incurred in a cloud computing arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The Company adopted this ASU as of January 1, 2020, using the prospective transition approach, which allows the Company to change the accounting method without restating prior periods or booking cumulative adjustments. The adoption of ASU No. 2018-15 did not have a material impact on the Company's consolidated financial statements. New standards not yet adopted 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 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 March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting . ASU No. 2020-04 provides optional expedients and exceptions for applying U.S. GAAP to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another rate that is expected to be discontinued. The amendments in this ASU were effective beginning on March 12, 2020, and the Company may elect to apply the amendments prospectively through December 31, 2022. 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 by the weighted average number of common shares outstanding, reduced for 2018 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, 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, 2020 and 2019.
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 LTIP 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 either because they are (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.

Revenue Recognition and Account

Revenue Recognition and Accounts Receivable Segment revenue by major payor (Tables)	12 Months Ended
	Dec. 31, 2020
Disaggregation of Revenue [Abstract]
Disaggregation of Revenue	The Company's revenues by segment and primary payor source were as follows: Year ended December 31, 2020 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,048,043 $ $ 6,048,043 Medicaid and Managed Medicaid 744,862 744,862 Other government 455,897 380,584 836,481 Commercial 3,370,562 170,394 3,540,956 Other revenues: Medicare and Medicare Advantage 419,662 419,662 Medicaid and Managed Medicaid 1,227 1,227 Commercial 33,246 33,246 Other (1) 40,571 47,585 88,156 Eliminations of intersegment revenues (145,286) (16,743) (162,029) Total $ 10,514,649 $ 1,035,955 $ 11,550,604 (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, 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.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2020
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, 2020 2019 2018 Net income (loss) attributable to DaVita Inc.: Continuing operations $ 783,295 $ 706,832 $ 624,321 Discontinued operations (9,653) 104,149 (464,927) Net income attributable to DaVita Inc. $ 773,642 $ 810,981 $ 159,394 Weighted average shares outstanding: During the period 119,797 153,181 171,886 Contingently returnable (1) — — (1,100) Basic shares 119,797 153,181 170,786 Contingently returnable (1) — — 1,100 Assumed incremental from stock plans 2,826 631 479 Diluted shares 122,623 153,812 172,365 Basic net income (loss) attributable to DaVita Inc.: Continuing operations per share $ 6.54 $ 4.61 $ 3.66 Discontinued operations per share (0.08) 0.68 (2.73) Basic net income per share attributable to DaVita Inc. $ 6.46 $ 5.29 $ 0.93 Diluted net income (loss) attributable to DaVita Inc.: Continuing operations per share $ 6.39 $ 4.60 $ 3.62 Discontinued operations per share (0.08) 0.67 (2.70) Diluted net income per share attributable to DaVita Inc. $ 6.31 $ 5.27 $ 0.92 Anti-dilutive stock-settled awards excluded from calculation (2) 2,301 5,936 5,295 (1) Shares previously held in escrow for the DaVita HealthCare Partners merger. (2) Shares associated with stock awards 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, 2020
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	The Company’s short-term and long-term investments, consisting of debt instruments classified as held-to-maturity and equity investments with readily determinable fair values or redemption values, were as follows: December 31, 2020 December 31, 2019 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 8,217 $ — $ 8,217 $ 8,140 $ — $ 8,140 Investments in mutual funds and common stock — 44,077 44,077 — 39,951 39,951 $ 8,217 $ 44,077 $ 52,294 $ 8,140 $ 39,951 $ 48,091 Short-term investments $ 8,217 $ 11,884 $ 20,101 $ 8,140 $ 3,432 $ 11,572 Long-term investments — 32,193 32,193 — 36,519 36,519 $ 8,217 $ 44,077 $ 52,294 $ 8,140 $ 39,951 $ 48,091

Other Receivables (Tables)

Other Receivables (Tables)	12 Months Ended
	Dec. 31, 2020
Receivables [Abstract]
Schedule of Other Receivables	Other receivables were comprised of the following: December 31, 2020 2019 Supplier rebates and non-trade receivables $ 390,508 $ 351,650 Medicare bad debt claims 153,868 138,045 $ 544,376 $ 489,695

Property and Equipment (Tables)

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2020
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment were comprised of the following: December 31, 2020 2019 Land $ 37,924 $ 36,480 Buildings 400,616 392,256 Leasehold improvements 3,865,729 3,545,224 Equipment and information systems, including internally developed software 3,081,298 2,880,645 New center and capital asset projects in progress 616,686 588,345 8,002,253 7,442,950 Less accumulated depreciation (4,480,429) (3,969,566) $ 3,521,824 $ 3,473,384

Intangibles (Tables)

Intangibles (Tables)	12 Months Ended
	Dec. 31, 2020
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, 2020 2019 Indefinite-lived licenses $ 100,138 $ 90,209 Noncompetition agreements 84,022 103,510 Customer relationships and other 52,566 23,887 236,726 217,606 Less accumulated amortization (70,141) (81,922) $ 166,585 $ 135,684
Scheduled Amortization Charges from Intangible Assets and Liabilities	Scheduled amortization expenses from amortizable intangible assets as of December 31, 2020 were as follows: Noncompetition Customer relationships and other 2021 $ 10,274 $ 3,143 2022 6,680 3,139 2023 3,883 3,102 2024 1,714 2,851 2025 585 2,660 Thereafter 168 28,248 Total $ 23,304 $ 43,143

Equity Method and Other Inves_2

Equity Method and Other Investmetns Equity Method and Other Investments (Tables)	12 Months Ended
	Dec. 31, 2020
Equity Method Investments and Joint Ventures [Abstract]
Equity Method Investments	The Company maintains equity method and other minor investments in the private securities of certain other healthcare and healthcare-related businesses, comprised as follows: December 31, 2020 2019 APAC joint venture $ 120,787 $ 116,924 Other equity method partnerships 107,599 114,611 Adjusted cost method and other investments 29,105 10,448 $ 257,491 $ 241,983

Goodwill (Tables)

Goodwill (Tables)	12 Months Ended
	Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in Carrying Value of Goodwill by Reportable Segments	Changes in the carrying value of goodwill by reportable segment were as follows: U.S. dialysis Other - Ancillary Consolidated 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 Acquisitions 24,377 105,680 130,057 Divestitures (1,549) (6,744) (8,293) Foreign currency and other adjustments — 9,710 9,710 Balance at December 31, 2020 $ 6,309,928 $ 609,181 $ 6,919,109 Balance at December 31, 2020: Goodwill $ 6,309,928 $ 745,732 $ 7,055,660 Accumulated impairment charges — (136,551) (136,551) $ 6,309,928 $ 609,181 $ 6,919,109
Schedule of Reporting Units Goodwill Balances	Reporting unit Goodwill Carrying amount coverage (1) Sensitivities Operating income (2) Discount rate (3) Germany kidney care $ 322,736 2.3 % (1.5) % (10.1) % (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, 2020
Other Liabilities Disclosure [Abstract]
Schedule of Other Liabilities	Other liabilities were comprised of the following: December 31, 2020 2019 Payor refunds and retractions $ 371,183 $ 377,044 Insurance and self-insurance accruals 54,438 58,941 Accrued interest 30,066 54,899 Accrued non-income tax liabilities 39,075 36,285 Other 315,767 229,005 $ 810,529 $ 756,174

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2020
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, 2020 2019 2018 Domestic $ 1,287,976 $ 1,307,299 $ 1,083,578 International 30,286 (111,860) (35,100) $ 1,318,262 $ 1,195,439 $ 1,048,478
Components of Income Tax Expense (Benefit)	Income tax expense for continuing operations consisted of the following: Year ended December 31, 2020 2019 2018 Current: Federal $ 47,171 $ 208,339 $ 140,064 State 21,442 58,026 32,990 International 17,481 15,545 7,557 Total current income tax 86,094 281,910 180,611 Deferred: Federal 198,623 44,263 52,034 State 27,206 (25,836) 21,096 International 2,009 (20,709) 4,659 Total deferred income tax 227,838 (2,282) 77,789 $ 313,932 $ 279,628 $ 258,400
Schedule of Allocation of Income Tax Expense (Benefit)	Income taxes are allocated between continuing and discontinued operations as follows: Year ended December 31, 2020 2019 2018 Continuing operations $ 313,932 $ 279,628 $ 258,400 Discontinued operations 1,657 40,689 99,768 $ 315,589 $ 320,317 $ 358,168
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, 2020 2019 2018 Federal income tax rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 3.4 2.3 4.1 Change in International valuation allowance 1.5 1.3 0.9 Political advocacy costs 1.7 0.2 2.3 Nondeductible executive compensation 1.2 0.8 0.7 Unrecognized tax benefits 0.4 2.4 0.2 Other (0.6) 0.3 — Impact of noncontrolling interests primarily (4.8) (4.9) (4.6) Effective tax rate 23.8 % 23.4 % 24.6 %
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, 2020 2019 Receivables $ 9,324 $ 19,095 Accrued liabilities 64,982 64,458 Operating lease liabilities 584,656 580,110 Net operating loss carryforwards 167,398 139,690 Other 62,110 55,108 Deferred tax assets 888,470 858,461 Valuation allowance (114,824) (91,925) Net deferred tax assets 773,646 766,536 Intangible assets (634,736) (563,914) Property and equipment (274,742) (162,628) Operating lease assets (532,082) (527,056) Investments in partnerships (101,996) (64,960) Other (39,690) (25,521) Deferred tax liabilities (1,583,246) (1,344,079) Net deferred tax liabilities $ (809,600) $ (577,543)
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, 2020 2019 Beginning balance $ 68,214 $ 40,382 Additions for tax positions related to current year 2,293 3,378 Additions for tax positions related to prior years 258 24,722 Reductions related to lapse of applicable statute (133) (268) Reductions related to settlements with taxing authorities (430) — Ending balance $ 70,202 $ 68,214

Long-Term Debt (Tables)

Long-Term Debt (Tables)	12 Months Ended
	Dec. 31, 2020
Debt Disclosure [Abstract]
Long-term Debt	Long-term debt Long-term debt was comprised of the following: December 31, As of December 31, 2020 2020 2019 Maturity date Interest rate Estimated fair value (1) Senior Secured Credit Facilities: Term Loan A $ 1,684,375 $ 1,739,063 8/12/2024 LIBOR + 1.50% $ 1,675,953 Term Loan B-1 2,715,694 — 8/12/2026 LIBOR + 1.75% 2,702,115 Term Loan B — 2,743,125 8/12/2026 Revolving line of credit (2) 75,000 — 8/12/2024 ABR + 0.50% $ 75,000 Senior Notes: 4.625% Senior Notes 1,750,000 — 6/1/2030 4.625 % $ 1,859,375 3.75% Senior Notes 1,500,000 — 2/15/2031 3.75 % $ 1,522,500 5.125% Senior Notes — 1,750,000 7/15/2024 5.0% Senior Notes — 1,500,000 5/1/2025 Acquisition obligations and other notes payable (3) 164,160 180,352 2021-2036 4.88 % $ 164,160 Financing lease obligations (4) 274,292 268,534 2021-2038 5.1 % Total debt principal outstanding 8,163,521 8,181,074 Discount and deferred financing costs (5) (77,717) (72,840) 8,085,804 8,108,234 Less current portion (168,541) (130,708) $ 7,917,263 $ 7,977,526 (1) For the Company's senior secured credit facilities and senior notes, fair value estimates are based upon bid and ask quotes, typically a level 2 input. For acquisition obligations and other notes payable, the carrying values presented here approximate their estimated fair values, based on estimates of their present values using level 2 interest rate inputs. (2) The Company's interest rate for its revolving line of credit as of December 31, 2020 was based on an Alternate Base Rate (ABR or Prime Rate) plus 0.50%, or 3.75%. Effective January 6, 2021 this was converted to a LIBOR-based rate of LIBOR plus 1.50%. (3) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current fixed and LIBOR interest rate components in effect as of December 31, 2020. (4) Financing lease obligations are measured at their approximate present values at inception. The interest rate presented is the weighted average discount rate embedded in financing leases outstanding. The term of one ground lease runs to 2070, in addition to the other lease maturity dates presented in the table above. (5) As of December 31, 2020, the carrying amount of the Company's senior secured credit facilities includes a discount of $5,461 and deferred financing costs of $35,825 and the carrying amount of the Company's senior notes includes deferred financing costs of $36,431. As of December 31, 2019, the carrying amount of the Company's senior secured credit facilities included a discount of $6,457 and deferred financing costs of $45,444, and the carrying amount of the Company's senior notes included deferred financing costs of $20,939.
Scheduled Maturities of Long-term Debt	Scheduled maturities of long-term debt at December 31, 2020 were as follows: 2021 $ 168,541 2022 $ 169,782 2023 $ 227,062 2024 $ 1,496,892 2025 $ 69,440 Thereafter $ 6,031,804
Derivative Instruments	The following table summarizes the Company’s interest rate cap agreements outstanding as of December 31, 2020 and December 31, 2019, which are classified in "Other long-term assets" on its consolidated balance sheet: Year ended December 31, December 31, 2020 2020 2019 Notional amount LIBOR maximum rate Effective date Expiration date Debt expense Recorded OCI loss Fair value 2019 cap agreements $ 3,500,000 2.00% 6/30/2020 6/30/2024 $ 2,755 $ (21,781) $ 2,671 $ 24,452 2015 cap agreements $ 3,500,000 3.50% 6/29/2018 6/30/2020 $ 4,326 $ — $ — $ —
Effects of Interest Rate Swap and Cap Agreements	The following table summarizes the effects of the Company’s interest rate cap agreements for the years ended December 31, 2020, 2019 and 2018: Amount of unrealized (losses) gains in OCI on interest rate cap agreements 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 2020 2019 2018 2020 2019 2018 Interest rate cap agreements $ (21,781) $ 1,566 $ (181) Debt expense $ 7,081 $ 8,591 $ 8,466 Related income tax 5,435 (415) 48 Related income tax (1,768) (2,214) (2,180) Total $ (16,346) $ 1,151 $ (133) $ 5,313 $ 6,377 $ 6,286

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2020
Leases [Abstract]
Lease Expense Components	The components of lease expense were as follows: Year ended December 31, Lease cost 2020 2019 Operating lease cost (1) : Fixed lease expense $ 541,090 $ 526,352 Variable lease expense 122,729 119,740 Financing lease cost: Amortization of leased assets 24,720 23,724 Interest on lease liabilities 14,421 14,932 Net lease cost $ 702,960 $ 684,748
Leases Other Information	Other information related to leases was as follows: Year ended December 31, Lease term and discount rate 2020 2019 Weighted average remaining lease term (years): Operating leases 8.7 9.0 Finance leases 10.5 10.2 Weighted average discount rate: Operating leases 3.8 % 4.1 % Finance leases 5.1 % 5.4 % Year ended December 31, Other information 2020 2019 Gains on sale leasebacks, net $ 34,301 $ 20,833 Cash paid for amounts included in the Operating cash flows for operating leases $ 661,318 $ 637,655 Operating cash flows for finance leases $ 20,981 $ 22,257 Financing cash flows for finance leases $ 24,780 $ 25,692 Net operating lease assets obtained in exchange $ 401,559 $ 432,074
Schedule Of Minimum Lease Payments	Future minimum lease payments under non-cancellable leases as of December 31, 2020 are as follows: Operating leases Finance leases 2021 $ 480,439 $ 35,039 2022 504,789 35,124 2023 464,023 35,645 2024 412,419 35,669 2025 361,447 35,539 Thereafter 1,437,965 174,907 Total future minimum lease payments 3,661,082 351,923 Less portion representing interest (552,915) (77,631) Present value of lease liabilities $ 3,108,167 $ 274,292

Long-term Incentive Compensat_2

Long-term Incentive Compensation and Shareholders’ Equity (Tables)	12 Months Ended
	Dec. 31, 2020
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 both the 2020 Plan and 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, 2020 Stock appreciation rights Stock units Awards Weighted Weighted Awards Weighted Outstanding at beginning of year 6,953 $ 64.10 3,160 Granted 2,765 $ 68.58 1,027 Added by performance factor 19 Exercised/Vested (894) $ 72.13 (351) Expired (494) $ 83.61 — Canceled (246) $ 61.36 (318) Outstanding at end of period 8,084 $ 63.64 3.0 3,537 1.8 Exercisable at end of period 987 $ 69.56 1.0 — — Weighted-average fair value of grants: 2020 $ 26.70 $ 77.83 2019 $ 14.04 $ 50.58 2018 $ 16.24 $ 66.23
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 2,263 $ 52.53 2 $ 57.88 $60.01–$70.00 5,165 $ 66.99 610 $ 65.95 $70.01–$80.00 656 $ 75.60 375 $ 75.50 Total 8,084 $ 63.64 987 $ 69.56
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, 2020 2019 2018 Expected term 4.8 4.0 4.2 Expected volatility 28.2 % 29.5 % 23.8 % Expected dividend yield — % — % — % Risk-free interest rate 1.5 % 2.2 % 2.9 %

Stockholder's equity (Tables)

Stockholder's equity (Tables)	12 Months Ended
	Dec. 31, 2020
Equity [Abstract]
Shares repurchases summary table	The following table summarizes the Company's repurchases of its common stock during the years ended December 31, 2020, 2019 and 2018: 2020 2019 2018 Open market repurchases Shares 8,495 19,218 16,844 Amounts paid $ 741,850 $ 1,168,321 $ 1,153,511 Average paid per share $ 87.32 $ 60.79 $ 68.48 Tender offers (1) Shares 7,982 21,802 Amounts paid $ 704,917 $ 1,234,154 Average paid per share $ 88.32 $ 56.61 Total Shares 16,477 41,020 16,844 Amounts paid $ 1,446,767 $ 2,402,475 $ 1,153,511 Average paid per share $ 87.80 $ 58.57 $ 68.48 (1) The aggregate amounts paid for shares repurchased pursuant to the Company's 2020 and 2019 tender offers for its shares during the years ended December 31, 2020 and 2019, include their clearing prices of $88.00 and $56.50 per share, respectively, plus related fees and expenses of $2,529 and $2,343, respectively .
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 were as follows: Year ended December 31, 2020 2019 2018 Net income attributable to DaVita Inc. $ 773,642 $ 810,981 $ 159,394 Changes in paid-in capital for: Purchases of noncontrolling interests 4,364 (37,145) (17,897) Sales of noncontrolling interest — — 79 Net transfers in noncontrolling interests 4,364 (37,145) (17,818) Net income attributable to DaVita Inc. net of transfers in $ 778,006 $ 773,836 $ 141,576

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive (Loss) Income (Tables)	12 Months Ended
	Dec. 31, 2020
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 Investment Foreign currency Accumulated other 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 (loss) 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) Unrealized losses (21,781) — (7,080) (28,861) Related income tax 5,435 — (543) 4,892 (16,346) — (7,623) (23,969) Reclassification of income into net income 7,081 — — 7,081 Related income tax (1,768) — — (1,768) 5,313 — — 5,313 Balance at December 31, 2020 $ (12,466) $ — $ (53,688) $ (66,154)

Acquisitions and Divestitures (

Acquisitions and Divestitures (Tables)	12 Months Ended
	Dec. 31, 2020
Business Combinations [Abstract]
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, 2020 2019 2018 Current assets $ 23,607 $ 6,713 $ 23,686 Property and equipment 37,457 4,842 11,421 Customer relationships 34,625 — — Noncompetition agreements and other long-term assets 10,168 1,980 3,079 Indefinite-lived licenses 22,136 31,858 23,656 Goodwill 130,057 90,226 278,348 Deferred income taxes (3,962) — — Liabilities assumed (34,068) (7,159) (19,946) Noncontrolling interests assumed (1,729) (1,762) (80,291) $ 218,291 $ 126,698 $ 239,953
Schedule of other information related to acquired intangibles and goodwill	The following summarizes weighted-average estimated useful lives of amortizable intangible assets acquired during 2020, 2019 and 2018, as well as goodwill deductible for tax purposes associated with these acquisitions: Year ended December 31, 2020 2019 2018 Weighted-average estimated useful lives: Customer relationships 18 Noncompetition agreements 5 6 6 Goodwill deductible for tax purposes $ 94,318 $ 88,517 $ 165,013
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 2020 and 2019 had been consummated as of the beginning of 2019, including the impact of certain adjustments such as amortization of intangibles, interest expense on acquisition financing and income tax effects. Year ended December 31, 2020 2019 (unaudited) Pro forma total revenues $ 11,636,416 $ 11,570,086 Pro forma net income from continuing operations attributable to $ 789,473 $ 718,928 Pro forma basic net income per share from continuing operations $ 6.59 $ 4.69 Pro forma diluted net income per share from continuing operations $ 6.44 $ 4.67
Reconciliation of Changes in Contingent Earn-Out Obligations	The following is a reconciliation of changes in contingent earn-out liabilities for the years ended December 31, 2020 and 2019: Year ended December 31, 2020 2019 Beginning balance $ 24,586 $ 2,608 Acquisitions 14,042 23,536 Foreign currency translation (3,688) (905) Fair value remeasurements (2,630) 121 Payments or other settlements (2,062) (774) Ending balance $ 30,248 $ 24,586

Held for Sale and Discontinue_2

Held for Sale and Discontinued Operations (Tables)	12 Months Ended
	Dec. 31, 2020
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, 2020 2019 2018 Net revenues $ — $ 2,713,059 $ 4,963,792 Expenses — 2,543,865 4,962,686 Goodwill and other asset impairment charges — — 41,537 Valuation adjustment on disposal group — — 316,840 Income (loss) from discontinued operations before taxes — 169,194 (357,271) Loss on sale of discontinued operations before taxes (7,996) (23,022) — Income tax expense 1,657 40,689 99,768 Net (loss) income from discontinued operations, net of tax $ (9,653) $ 105,483 $ (457,038)
Reconciliation of Cash Flows	The following table presents cash flows of discontinued operations related to DMG: Year ended December 31, 2020 2019 2018 Net cash provided by operating activities from discontinued operations $ — $ 99,634 $ 290,684 Net cash used in investing activities from discontinued operations $ — $ (43,442) $ (57,382)

Fair Values of Financial Inst_2

Fair Values of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2020
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, 2020 and 2019: December 31, 2020 Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 44,077 $ 44,077 $ — $ — Interest rate cap agreements $ 2,671 $ — $ 2,671 $ — Liabilities Contingent earn-out obligations $ 30,248 $ — $ — $ 30,248 Temporary equity Noncontrolling interests subject to put provisions $ 1,330,028 $ — $ — $ 1,330,028 December 31, 2019 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

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2020
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, 2020 2019 2018 Segment revenues: U.S. dialysis Patient service revenues: External sources $ 10,488,731 $ 10,421,401 $ 10,274,046 Intersegment revenues 144,091 131,199 92,950 U.S. dialysis revenues before provision 10,632,822 10,552,600 10,366,996 Provision for uncollectible accounts (13,458) (21,715) (50,927) U.S. dialysis patient service revenues 10,619,364 10,530,885 10,316,069 Other revenues (1) External sources 39,376 30,895 19,880 Intersegment revenues 1,195 1,126 — Total U.S. dialysis revenues $ 10,659,935 $ 10,562,906 $ 10,335,949 Other - Ancillary services Net patient service revenues 550,978 497,021 437,275 Other external sources 484,977 460,877 724,577 Intersegment revenues 16,743 14,030 34,236 Total ancillary services 1,052,698 971,928 1,196,088 Total net segment revenues 11,712,633 11,534,834 11,532,037 Elimination of intersegment revenues (162,029) (146,355) (127,186) Consolidated revenues $ 11,550,604 $ 11,388,479 $ 11,404,851 Segment operating margin (loss): U.S. dialysis $ 1,917,604 $ 1,924,826 $ 1,709,721 Other - Ancillary services (2) (76,261) (189,174) (93,789) Total segment margin 1,841,343 1,735,652 1,615,932 Reconciliation of segment operating margin to consolidated income from Corporate administrative support (146,707) (92,335) (90,108) Consolidated operating income 1,694,636 1,643,317 1,525,824 Debt expense (304,111) (443,824) (487,435) Debt prepayment, refinancing and redemption charges (89,022) (33,402) — Other income 16,759 29,348 10,089 Income from continuing operations before income taxes $ 1,318,262 $ 1,195,439 $ 1,048,478 - (1) Includes management fee revenues from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling interest or which are wholly-owned by third parties. (2) Includes equity investment income of $5,866, $9,366, and $24,866 in 2020, 2019 and 2018, respectively.
Summary of Depreciation and Amortization Expense by Segment	Depreciation and amortization expense by reportable segment was as follows: Year ended December 31, 2020 2019 2018 U.S. dialysis $ 594,552 $ 583,454 $ 558,810 Other - Ancillary services 35,883 31,698 32,225 $ 630,435 $ 615,152 $ 591,035
Summary of Assets by Segment	Summary of assets by reportable segment was as follows: Year ended December 31, 2020 2019 Segment assets U.S. dialysis (1) $ 15,344,647 $ 15,778,880 Other - Ancillary services (2) 1,643,869 1,532,514 Consolidated assets $ 16,988,516 $ 17,311,394 (1) Includes equity method and other investments of $122,974 and $124,188 in 2020 and 2019, respectively. (2) Includes equity method and other investments of $134,517 and 117,795 in 2020 and 2019, respectively and includes approximately $181,137 and $154,572 in 2020 and 2019, 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, 2020 2019 2018 U.S. dialysis 646,870 $ 681,339 $ 856,108 Other - Ancillary services 27,671 46,741 45,806 DMG - Discontinued operations — 38,466 85,224 $ 674,541 $ 766,546 $ 987,138

Supplemental Cash Flow Inform_2

Supplemental Cash Flow Information (Tables)	12 Months Ended
	Dec. 31, 2020
Supplemental Cash Flow Elements [Abstract]
Supplemental Cash Flow Information	The table below provides supplemental cash flow information: Year ended December 31, 2020 2019 2018 Cash paid: Income taxes, net $ 154,850 $ 157,983 $ 92,526 Interest $ 326,165 $ 473,176 $ 488,974 Non-cash investing and financing activities: Fixed assets under financing lease obligations $ 22,042 $ 18,953 $ 8,828

Selected Quarterly Financial _2

Selected Quarterly Financial Data (unaudited) (Tables)	12 Months Ended
	Dec. 31, 2020
Quarterly Financial Information Disclosure [Abstract]
Selected Quarterly Financial Data (unaudited)	December 31, September 30, June 30, March 31, 2020 Total revenues $ 2,905,322 $ 2,924,066 $ 2,879,979 $ 2,841,237 Operating income $ 381,671 $ 437,669 $ 409,920 $ 465,376 Attributable to DaVita Inc.: Net income from continuing operations (1) $ 193,406 $ 158,674 $ 201,602 $ 229,613 Net (loss) income from discontinued operations (19,633) — — 9,980 Net income $ 173,773 $ 158,674 $ 201,602 $ 239,593 Per share attributable to DaVita Inc.: Basic net income from continuing operations $ 1.73 $ 1.31 $ 1.65 $ 1.84 Basic net (loss) income from discontinued operations (0.17) — — 0.08 Basic net income $ 1.56 $ 1.31 $ 1.65 $ 1.92 Diluted net income from continuing operations $ 1.67 $ 1.28 $ 1.62 $ 1.81 Diluted net (loss) income from discontinued operations (0.17) — — 0.08 Diluted net income $ 1.50 $ 1.28 $ 1.62 $ 1.89 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 (1) The following table summarizes impairment charges, loss on changes in ownership interest, and a legal settlement included in operating expenses and charges in 2020 and 2019 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 Impairment charges $ 83,855 $ 41,037 Loss on changes in $ 16,252 Accruals for legal matters $ 35,000

SEC Schedule, Article 12-09, Va

SEC Schedule, Article 12-09, Valuation and Qualifying Accounts (Tables)	12 Months Ended
	Dec. 31, 2020
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
SEC Schedule, 12-09, Schedule of Valuation and Qualifying Accounts Disclosure	DAVITA INC. SCHEDULE II—VALUATION AND QUALIFYING ACCOUNTS Balance at Acquisitions Amounts Amounts written off Balance Description (dollars in thousands) Allowance for uncollectible accounts: Year ended December 31, 2020 $ 8,328 $ — $ 13,458 $ 21,786 $ — 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

Organization and Summary of S_3

Organization and Summary of Significant Accounting Policies - Additional Information (Details)	12 Months Ended
	Dec. 31, 2020clinicpatientstateentitycountry
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Medicare Payment Rate Established By Statute Or Regulation For The Portion Of Payment Rates Paid By The Government Payor	80.00%
Number of legal entities that third parties held noncontrolling equity interests | entity	688
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	2,816
Number of states where dialysis centers are located | state	46
Number of patients served | patient	204,200
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	321
Number of patients served | patient	36,200
Number of countries in which dialysis centers located | country	10

Revenue Recognition and Accou_2

Revenue Recognition and Accounts Receivable Revenue Recognition Segment Revenue by Payor (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Disaggregation of Revenue [Line Items]
Patient service revenues									$ 11,039,709	$ 10,918,421	$ 10,709,981
Other revenues									524,353	491,773	744,457
Total revenues	$ 2,905,322	$ 2,924,066	$ 2,879,979	$ 2,841,237	$ 2,898,584	$ 2,904,078	$ 2,842,705	$ 2,743,112	11,550,604	11,388,479	11,404,851
Revenue disaggregation table footnote
Provision for uncollectible accounts									13,458	21,715	49,587
Intersegment Elimination
Disaggregation of Revenue [Line Items]
Total revenues									(162,029)	(146,355)	(127,186)
Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Patient service revenues									6,048,043	6,129,697	6,063,891
Other revenues									419,662	264,538	492,812
Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Patient service revenues									744,862	669,089	628,766
Other revenues									1,227	606	44,246
Other Government Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									836,481	798,775	782,593
Commercial Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									3,540,956	3,430,345	3,278,094
Other revenues									33,246	130,823	90,890
Other
Disaggregation of Revenue [Line Items]
Other revenues									88,156	110,961	150,745
U.S. dialysis
Disaggregation of Revenue [Line Items]
Total revenues									10,514,649	10,430,581	10,242,999
U.S. dialysis | Intersegment Elimination
Disaggregation of Revenue [Line Items]
Total revenues									(145,286)	(132,325)	(92,950)
U.S. dialysis | Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Patient service revenues									6,048,043	6,129,697	6,063,891
U.S. dialysis | Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Patient service revenues									744,862	669,089	628,766
U.S. dialysis | Other Government Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									455,897	446,010	446,999
U.S. dialysis | Commercial Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									3,370,562	3,286,089	3,176,413
U.S. dialysis | Other
Disaggregation of Revenue [Line Items]
Other revenues									40,571	32,021	19,880
Other - Ancillary services
Disaggregation of Revenue [Line Items]
Total revenues									1,035,955	957,898	1,161,852
Other - Ancillary services | Intersegment Elimination
Disaggregation of Revenue [Line Items]
Total revenues									(16,743)	(14,030)	(34,236)
Other - Ancillary services | Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Other revenues									419,662	264,538	492,812
Other - Ancillary services | Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Other revenues									1,227	606	44,246
Other - Ancillary services | Other Government Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									380,584	352,765	335,594
Other - Ancillary services | Commercial Payors
Disaggregation of Revenue [Line Items]
Patient service revenues									170,394	144,256	101,681
Other revenues									33,246	130,823	90,890
Other - Ancillary services | Other
Disaggregation of Revenue [Line Items]
Other revenues									$ 47,585	$ 78,940	$ 130,865

Revenue Recognition and Accou_3

Revenue Recognition and Accounts Receivable - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable	$ 1,824,282	$ 1,795,598
Medicare bad debt claims
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable	$ 1,101,837	$ 1,038,248
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	0
Concentration risk percentage	10.00%	10.00%
Accounts receivable	$ 0
Percentage Of Accounts Receivable Six Months Or More Past Due	17.00%	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	$ 0	$ 37,274
Accounts Receivable
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, allowance	$ 0	$ 8,328

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, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Numerators:
Net income from continuing operations	$ 193,406	$ 158,674	$ 201,602	$ 229,613	$ 242,242	$ 150,113	$ 194,223	$ 120,254	$ 783,295	$ 706,832	$ 624,321
Discontinued operations	(19,633)	0	0	9,980	2,629	(6,843)	79,328	29,035	(9,653)	104,149	(464,927)
Net income attributable to DaVita Inc.	$ 173,773	$ 158,674	$ 201,602	$ 239,593	$ 244,871	$ 143,270	$ 273,551	$ 149,289	$ 773,642	$ 810,981	$ 159,394
Weighted Average Number of Shares Outstanding Reconciliation [Abstract]
Weighted average shares outstanding during the period (in shares)									119,797,000	153,181,000	171,886,000
Weighted average contingently returnable shares (in shares)									0	0	(1,100,000)
Weighted average shares - basic (in shares)									119,797,000	153,181,000	170,786,000
Weighted average contingently returnable shares attributable to dilutive effect (shares)									0	0	1,100,000
Assumed incremental shares from stock plans (in shares)									2,826,000	631,000	479,000
Weighted average shares - diluted (in shares)									122,623,000	153,812,000	172,365,000
Basic net income (loss) attributable to DaVita Inc.:
Income (Loss) from Continuing Operations, Per Basic Share	$ 1.73	$ 1.31	$ 1.65	$ 1.84	$ 1.87	$ 1	$ 1.17	$ 0.72	$ 6.54	$ 4.61	$ 3.66
Basic net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)	(0.17)	0	0	0.08	0.02	(0.05)	0.47	0.18	(0.08)	0.68	(2.73)
Basic net income per share attributable to DaVita Inc. (in usd per share)	1.56	1.31	1.65	1.92	1.89	0.95	1.64	0.90	6.46	5.29	0.93
Diluted net income (loss) attributable to DaVita Inc.:
Diluted net income from continuing operations per share attributable to DaVita Inc. (in usd per share)	1.67	1.28	1.62	1.81	1.86	0.99	1.16	0.72	6.39	4.60	3.62
Diluted net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)	(0.17)	0	0	0.08	0.02	(0.04)	0.48	0.18	(0.08)	0.67	(2.70)
Diluted net income per share attributable to DaVita Inc. (in usd per share)	$ 1.50	$ 1.28	$ 1.62	$ 1.89	$ 1.88	$ 0.95	$ 1.64	$ 0.90	$ 6.31	$ 5.27	$ 0.92
Anti-dilutive stock-settled awards excluded from calculation (in shares)									2,301,000	5,936,000	5,295,000

Restricted Cash and Equivalents

Restricted Cash and Equivalents - Additional Information (Details) $ in Thousands	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Restricted Cash and Cash Equivalents Items [Line Items]
Restricted cash and equivalents	$ 176,832	$ 106,346
Assets Held-in-trust, Current	92,286
Pending legal settlements
Restricted Cash and Cash Equivalents Items [Line Items]
Assets Held-in-trust, Current	$ 70,000
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, 2020	Dec. 31, 2019
Investment Holdings [Line Items]
Debt securities	$ 8,217	$ 8,140
Equity securities, FV-NI	44,077	39,951
Total	52,294	48,091
Debt securities, short-term investments	8,217	8,140
Total, short-term investments	20,101	11,572
Debt securities, long-term investments	0	0
Total, long-term investments	32,193	36,519
Certificates of deposit and other time deposits
Investment Holdings [Line Items]
Debt securities	8,217	8,140
Equity securities, FV-NI	0	0
Total	8,217	8,140
Investments in mutual funds and common stock
Investment Holdings [Line Items]
Debt securities	0	0
Equity securities, FV-NI	44,077	39,951
Total	44,077	39,951
Short-term Investments
Investment Holdings [Line Items]
Equity securities, FV-NI	11,884	3,432
Other long-term Investments
Investment Holdings [Line Items]
Equity securities, FV-NI	$ 32,193	$ 36,519

Short-term and long-term inve_3

Short-term and long-term investments - Additional Information (Details) - Investments in mutual funds and common stock - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Debt and Equity Securities, FV-NI [Line Items]
Equity Securities, FV-NI, Gain (Loss)	$ 3,818	$ 4,383
Equity Securities, FV-NI, Realized Gain (Loss)	1,941	1,459
Net Increase (Decrease) In Unrealized Gains On Equity Securities	$ 1,877	$ 2,924

Other Receivables (Details)

Other Receivables (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	$ 544,376	$ 489,695
Supplier rebates and non-trade receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	390,508	351,650
Medicare bad debt claims
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	$ 153,868	$ 138,045

Property and Equipment (Details

Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Property, Plant and Equipment [Abstract]
Land	$ 37,924	$ 36,480
Buildings	400,616	392,256
Leasehold improvements	3,865,729	3,545,224
Equipment and information systems, including internally developed software	3,081,298	2,880,645
New center and capital asset projects in progress	616,686	588,345
Property, plant and equipment, gross, total	8,002,253	7,442,950
Less accumulated depreciation	(4,480,429)	(3,969,566)
Property and equipment, net	$ 3,521,824	$ 3,473,384

Property and Equipment - Additi

Property and Equipment - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Depreciation expense on property and equipment	$ 616,626	$ 600,905	$ 574,799
Capitalized interest	17,944	27,322	25,978
Other asset impairments	$ 0	$ 0	17,338
Pharmacy Business
Property, Plant and Equipment [Line Items]
Other asset impairments			$ 17,338
Buildings | Minimum
Property, Plant and Equipment [Line Items]
Property, and equipment useful lives	25 years
Buildings | Maximum
Property, Plant and Equipment [Line Items]
Property, and equipment useful lives	40 years
Leasehold Improvements | Minimum
Property, Plant and Equipment [Line Items]
Property, and equipment useful lives	10 years
Equipment and Information Systems | Minimum
Property, Plant and Equipment [Line Items]
Property, and equipment useful lives	3 years
Equipment and Information Systems | Maximum
Property, Plant and Equipment [Line Items]
Property, and equipment useful lives	15 years

Intangibles - Amortizable Intan

Intangibles - Amortizable Intangible Assets Other Than Goodwill (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Indefinite-lived licenses	$ 100,138	$ 90,209
Noncompetition agreements	84,022	103,510
Customer relationships and other	52,566	23,887
Intangible assets, gross (excluding goodwill)	236,726	217,606
Less accumulated amortization	(70,141)	(81,922)
Total intangible assets	$ 166,585	$ 135,684

Intangibles - Scheduled Amortiz

Intangibles - Scheduled Amortization Charges from Intangible Assets and Liabilities (Details) $ in Thousands	Dec. 31, 2020USD ($)
Noncompetition agreements
Expected Amortization Expense [Line Items]
2021	$ 10,274
2022	6,680
2023	3,883
2024	1,714
2025	585
Thereafter	168
Total	23,304
Customer relationships and other
Expected Amortization Expense [Line Items]
2021	3,143
2022	3,139
2023	3,102
2024	2,851
2025	2,660
Thereafter	28,248
Total	$ 43,143

Intangibles - Additional Inform

Intangibles - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Amortization expense from amortizable intangible assets, other than lease agreements	$ 13,809	$ 14,247	$ 16,236
Impairment of Intangible Assets (Excluding Goodwill)	$ 0	$ 0	$ 0
Noncompetition agreements | Minimum
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Remaining Amortization Period	3 years
Noncompetition agreements | Maximum
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Remaining Amortization Period	10 years
Customer Relationships | Minimum
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Remaining Amortization Period	10 years
Customer Relationships | Maximum
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Remaining Amortization Period	20 years

Equity Method and Other Inves_3

Equity Method and Other Investmetns Equity Method and Other Investments (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	$ 257,491	$ 241,983
APAC JV - Deconsolidated Noncontrolling Entity
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	120,787	116,924
Adjusted cost method investments
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	29,105	10,448
Other equity method partnerships
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	$ 107,599	$ 114,611

Equity Method and Other Inves_4

Equity Method and Other Investments - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Noncontrolling Interest [Line Items]
Equity investment (loss) income	$ 26,916	$ 12,679	$ (4,484)
Equity method investment, significant impairments and other valuation adjustments	$ 0	0	$ 0
Company and Restricted Subsidiaries(1)
Noncontrolling Interest [Line Items]
Voting Interest, in percents			60.00%
Ownership percentage by Parent	75.00%
APAC JV - Deconsolidated Noncontrolling Entity
Noncontrolling Interest [Line Items]
Voting Interest, in percents			40.00%
Ownership percentage by Parent			73.30%
Current economic interest in the APAC JV, Owned by Noncontrolling Investors	25.00%		26.70%
Minimum | Company and Restricted Subsidiaries(1)
Noncontrolling Interest [Line Items]
Ownership percentage by Parent	30.00%
Maximum | Company and Restricted Subsidiaries(1)
Noncontrolling Interest [Line Items]
Ownership percentage by Parent	50.00%
Equity method investments in nonconsolidated businesses
Noncontrolling Interest [Line Items]
Equity investment (loss) income	$ 26,916	$ 12,679	$ (4,484)
Number of partnerships	22

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, 2020	Dec. 31, 2019	Dec. 31, 2018
Goodwill [Roll Forward]
Beginning balance		$ 6,787,635	$ 6,841,960
Acquisitions		130,057	90,226
Goodwill, Written off Related to Sale of Business Unit		(8,293)
Impairment charges		0	(124,892)	$ (3,106)
Foreign currency and other adjustments		9,710	(19,659)
Ending balance		6,919,109	6,787,635	6,841,960
Goodwill		7,055,660
Accumulated impairment charges		(136,551)
U.S. dialysis
Goodwill [Roll Forward]
Beginning balance		6,287,100	6,275,004
Acquisitions		24,377	18,089
Goodwill, Written off Related to Sale of Business Unit		(1,549)
Impairment charges			0
Foreign currency and other adjustments		0	(5,993)
Ending balance		6,309,928	6,287,100	6,275,004
Goodwill		6,309,928
Accumulated impairment charges		0
Other - Ancillary services
Goodwill [Roll Forward]
Beginning balance		500,535	566,956
Acquisitions		105,680	72,137
Goodwill, Written off Related to Sale of Business Unit		(6,744)
Impairment charges	$ (83,855)		(124,892)
Foreign currency and other adjustments		9,710	(13,666)
Ending balance		609,181	$ 500,535	$ 566,956
Goodwill		745,732
Accumulated impairment charges		$ (136,551)

Goodwill - Schedule of Reportin

Goodwill - Schedule of Reporting Units Goodwill Balances (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Goodwill [Line Items]
Goodwill	$ 6,919,109	$ 6,787,635	$ 6,841,960
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	$ 322,736
Carrying amount coverage	2.30%
Sensitivities, Operating Income	(1.50%)
Sensitivities, Discount rate	(10.10%)

Goodwill - Additional Informati

Goodwill - Additional Information (Details) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2019USD ($)	Dec. 31, 2020USD ($)segment	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Goodwill [Line Items]
Goodwill impairment charges		$ 0	$ 124,892	$ 3,106
Other reporting units
Goodwill [Line Items]
Number of Operating Segments | segment		0
GERMANY | Kidney Care
Goodwill [Line Items]
Goodwill impairment charges	$ 41,037		119,476
GERMANY | Other reporting units
Goodwill [Line Items]
Goodwill impairment charges			$ 5,416

Other Liabilities (Details)

Other Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Other Liabilities Disclosure [Abstract]
Payor refunds and retractions	$ 371,183	$ 377,044
Insurance and self-insurance accruals	54,438	58,941
Accrued interest	30,066	54,899
Accrued non-income tax liabilities	39,075	36,285
Other	315,767	229,005
Other liabilities	$ 810,529	$ 756,174

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Domestic	$ 1,287,976	$ 1,307,299	$ 1,083,578
International	30,286	(111,860)	(35,100)
Income (Loss) from Continuing Operations before Equity Method Investments, Income Taxes, Noncontrolling Interest, Total	$ 1,318,262	$ 1,195,439	$ 1,048,478

Income Taxes - Components of In

Income Taxes - Components of Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Current:
Federal	$ 47,171	$ 208,339	$ 140,064
State	21,442	58,026	32,990
International	17,481	15,545	7,557
Total current income tax	86,094	281,910	180,611
Deferred:
Federal	198,623	44,263	52,034
State	27,206	(25,836)	21,096
International	2,009	(20,709)	4,659
Total deferred income tax	227,838	(2,282)	77,789
Continuing operations	$ 313,932	$ 279,628	$ 258,400

Income Taxes Income Taxes - All

Income Taxes Income Taxes - Allocation of Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Continuing operations	$ 313,932	$ 279,628	$ 258,400
Discontinued operations	1,657	40,689	99,768
Income tax (benefit) expense from continuing and discontinued operations	$ 315,589	$ 320,317	$ 358,168

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, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Federal income tax rate	21.00%	21.00%	21.00%
State income taxes, net of federal benefit	3.40%	2.30%	4.10%
Change in International valuation allowance	1.50%	1.30%	0.90%
Political advocacy costs	1.70%	0.20%	2.30%
Nondeductible executive compensation	1.20%	0.80%	0.70%
Unrecognized tax benefits	0.40%	2.40%	0.20%
Other	(0.60%)	0.30%	0.00%
Impact of noncontrolling interests primarily attributable to non-tax paying entities	(4.80%)	(4.90%)	(4.60%)
Effective tax rate	23.80%	23.40%	24.60%

Income Taxes - Deferred Tax and

Income Taxes - Deferred Tax and Liabilities Arising from Temporary Differences (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Receivables	$ 9,324	$ 19,095
Accrued liabilities	64,982	64,458
Operating lease liabilities	584,656	580,110
Net operating loss carryforwards	167,398	139,690
Other	62,110	55,108
Deferred tax assets	888,470	858,461
Valuation allowance	(114,824)	(91,925)
Net deferred tax assets	773,646	766,536
Intangible assets	(634,736)	(563,914)
Property and equipment	(274,742)	(162,628)
Operating lease assets	(532,082)	(527,056)
Investments in partnerships	(101,996)	(64,960)
Other	(39,690)	(25,521)
Deferred tax liabilities	(1,583,246)	(1,344,079)
Net deferred tax liabilities	$ (809,600)	$ (577,543)

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, 2020	Dec. 31, 2019
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Beginning balance	$ 68,214	$ 40,382
Additions for tax positions related to current year	2,293	3,378
Additions for tax positions related to prior years	258	24,722
Reductions related to lapse of applicable statute	(133)	(268)
Reductions related to settlements with taxing authorities	(430)	0
Ending balance	$ 70,202	$ 68,214

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Taxes [Line Items]
Increase in valuation allowance related to changes in the estimated tax benefit of foreign and state operating losses	$ 22,899
Liability for unrecognized tax benefits	70,202	$ 68,214	$ 40,382
Unrecognized tax benefits that would impact effective tax rate	66,607
Increase in liability for unrecognized tax benefits	1,988
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits	17,864	$ 14,428
Capital Loss Carryforward
Income Taxes [Line Items]
State capital loss carryforward, amount	$ 297,748
State capital loss carryforward, expiration date	Dec. 31, 2024
Domestic Tax Authority
Income Taxes [Line Items]
Net operating loss carryforwards	$ 99,657
Operating loss carryforwards, expiration date	Dec. 31, 2036
Domestic Tax Authority | Tax Year 2029
Income Taxes [Line Items]
Operating loss carryforwards, expiration date	Dec. 31, 2029
State
Income Taxes [Line Items]
Net operating loss carryforwards	$ 488,070
Operating loss carryforwards, expiration date	Dec. 31, 2040
Foreign Tax Authority
Income Taxes [Line Items]
Net operating loss carryforwards	$ 296,451
Operating loss carryforwards, expiration date	Dec. 31, 2021

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Details) - USD ($)	Dec. 31, 2020	Aug. 21, 2020	Aug. 11, 2020	Jul. 15, 2020	Jun. 09, 2020	Feb. 13, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Senior Notes:
Debt interest rate during period								3.59%
Acquisition obligations, other notes payable, and financing lease obligations
Financing lease obligations	$ 274,292,000							$ 274,292,000
Long-term debt, weighted average interest rate, at point in time	3.06%							3.06%
Long-term debt totals:
Total debt principal outstanding	$ 8,163,521,000							$ 8,163,521,000	$ 8,181,074,000
Discount and deferred financing costs	(77,717,000)							(77,717,000)	(72,840,000)
Carrying amount of long-term debt, net of unamortized discounts	8,085,804,000							8,085,804,000	8,108,234,000
Less current portion	(168,541,000)							(168,541,000)	(130,708,000)
Total long-term debt	7,917,263,000							7,917,263,000	7,977,526,000
Senior Notes 4.625% due 2030
Senior Notes:
Senior Notes	1,750,000,000				$ 1,750,000,000			$ 1,750,000,000	0
Debt Instrument, Maturity Date								Jun. 1, 2030
Debt interest rate during period					4.625%			4.625%
Debt Instrument, Fair Value Disclosure	1,859,375,000							$ 1,859,375,000
Debt Instrument, footnotes to the table
Debt Instrument Redeemed Outstanding Principal Amount				$ 1,750,000,000
Senior Notes 3.75% due 2031
Senior Notes:
Senior Notes	1,500,000,000		$ 1,500,000,000					$ 1,500,000,000	0
Debt Instrument, Maturity Date								Feb. 15, 2031
Debt interest rate during period			3.75%					3.75%
Debt Instrument, Fair Value Disclosure	1,522,500,000							$ 1,522,500,000
Senior Notes 5.125 % due 2024
Senior Notes:
Senior Notes	0							$ 0	1,750,000,000
Debt Instrument, Maturity Date								Jul. 15, 2024
Debt interest rate during period				5.125%
Senior Notes 5.0 % due 2025
Senior Notes:
Senior Notes	0							$ 0	1,500,000,000
Debt Instrument, Maturity Date								May 1, 2025
Debt interest rate during period		5.00%
Debt Instrument, footnotes to the table
Debt Instrument Redeemed Outstanding Principal Amount		$ 1,500,000,000
Acquisition obligations and other notes payable
Acquisition obligations, other notes payable, and financing lease obligations
Acquisition obligations and other notes payable	$ 164,160,000							$ 164,160,000	180,352,000
Debt instrument, maturity date, description								2021-2036
Long-term debt, weighted average interest rate, at point in time	4.88%							4.88%
Acquisition obligations and other notes payable, fair value	$ 164,160,000							$ 164,160,000
Financing Lease
Acquisition obligations, other notes payable, and financing lease obligations
Financing lease obligations	$ 274,292,000							$ 274,292,000	$ 268,534,000
Debt instrument, maturity date, description								2021-2038
Finance lease, weighted average discount rate, percent	5.10%							5.10%	5.40%
Revolving line of credit
Senior Secured Credit Facilities:
Secured Debt	$ 75,000,000							$ 75,000,000	$ 0
Debt Instrument, Description of Variable Rate Basis								ABR + 0.50%
Senior Notes:
Debt Instrument, Maturity Date								Aug. 12, 2024
Debt Instrument, Fair Value Disclosure	$ 75,000,000							$ 75,000,000
Revolving line of credit | Base Rate
Senior Notes:
Debt interest rate during period	3.75%
Debt Instrument, footnotes to the table
LIBOR plus interest margin	0.50%
Revolving line of credit | London Interbank Offered Rate (LIBOR) | Subsequent Event
Debt Instrument, footnotes to the table
LIBOR plus interest margin							1.50%
Term Loan A
Senior Secured Credit Facilities:
Secured Debt	$ 1,684,375,000							$ 1,684,375,000	1,739,063,000
Debt Instrument, Description of Variable Rate Basis								LIBOR + 1.50%
Senior Notes:
Debt Instrument, Maturity Date								Aug. 12, 2024
Debt Instrument, Fair Value Disclosure	1,675,953,000							$ 1,675,953,000
Term Loan B-1
Senior Secured Credit Facilities:
Secured Debt	2,715,694,000							$ 2,715,694,000	0
Debt Instrument, Description of Variable Rate Basis								LIBOR + 1.75%
Senior Notes:
Debt Instrument, Maturity Date						Aug. 12, 2026		Aug. 12, 2026
Debt Instrument, Fair Value Disclosure	2,702,115,000							$ 2,702,115,000
Term Loan B-1 | London Interbank Offered Rate (LIBOR)
Debt Instrument, footnotes to the table
LIBOR plus interest margin						1.75%
Term Loan B
Senior Secured Credit Facilities:
Secured Debt	0							$ 0	2,743,125,000
Senior Notes:
Debt Instrument, Maturity Date								Aug. 12, 2026
Senior Secured Credit Facilities
Debt Instrument, footnotes to the table
Debt Instrument, Unamortized Discount	5,461,000							$ 5,461,000	6,457,000
Deferred Offering Costs	35,825,000							35,825,000	45,444,000
Senior Notes
Debt Instrument, footnotes to the table
Deferred Offering Costs	$ 36,431,000							$ 36,431,000	$ 20,939,000

Long-Term Debt - Scheduled Matu

Long-Term Debt - Scheduled Maturities of Long-term Debt (Details) $ in Thousands	Dec. 31, 2020USD ($)
Debt Disclosure [Abstract]
2021	$ 168,541
2022	169,782
2023	227,062
2024	1,496,892
2025	69,440
Thereafter	$ 6,031,804

Long-Term Debt - Derivative Ins

Long-Term Debt - Derivative Instruments (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Cash Flow Hedging
Derivative [Line Items]
Amount of debt expense reclassified from accumulated OCI into income	$ 5,313,000	$ 6,377,000	$ 6,286,000
Amount of unrealized gains (losses) in OCI on interest rate cap and swap agreements	$ (16,346,000)	1,151,000	$ (133,000)
2019 Interest Rate Cap Agreements Effective June 30, 2020
Derivative [Line Items]
Derivative, effective date	Jun. 30, 2020
Derivative, expiration date	Jun. 30, 2024
2019 Interest Rate Cap Agreements Effective June 30, 2020 | Other long-term assets
Derivative [Line Items]
Derivative asset, fair value, gross asset	$ 2,671,000
2019 Interest Rate Cap Agreements Effective June 30, 2020 | Cash Flow Hedging | Debt Expense
Derivative [Line Items]
Amount of debt expense reclassified from accumulated OCI into income	2,755,000
Amount of unrealized gains (losses) in OCI on interest rate cap and swap agreements	(21,781,000)
2019 Interest Rate Cap Agreements Effective June 30, 2020 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000,000
LIBOR plus interest margin	2.00%
2015 Interest Rate Cap Agreements Effective June 29, 2018
Derivative [Line Items]
Derivative, effective date	Jun. 29, 2018
Derivative, expiration date	Jun. 30, 2020
2015 Interest Rate Cap Agreements Effective June 29, 2018 | Other long-term assets
Derivative [Line Items]
Derivative asset, fair value, gross asset	$ 0	$ 0
2015 Interest Rate Cap Agreements Effective June 29, 2018 | Cash Flow Hedging | Debt Expense
Derivative [Line Items]
Amount of debt expense reclassified from accumulated OCI into income	4,326,000
Amount of unrealized gains (losses) in OCI on interest rate cap and swap agreements	0
2015 Interest Rate Cap Agreements Effective June 29, 2018 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000,000
LIBOR plus interest margin	3.50%

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, 2020	Dec. 31, 2019	Dec. 31, 2018
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized (losses) gains in OCI on interest rate cap agreements	$ (16,346)	$ 1,151	$ (133)
Reclassification from accumulated other comprehensive income into net income	5,313	6,377	6,286
Related income tax benefit (expense)
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized (losses) gains in OCI on interest rate cap agreements	5,435	(415)	48
Reclassification from accumulated other comprehensive income into net income	(1,768)	(2,214)	(2,180)
Interest rate cap agreements | Debt Expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized (losses) gains in OCI on interest rate cap agreements	(21,781)	1,566	(181)
Reclassification from accumulated other comprehensive income into net income	$ 7,081	$ 8,591	$ 8,466

Long-Term Debt - Additional inf

Long-Term Debt - Additional information (Detail) - USD ($)	Aug. 21, 2020	Aug. 11, 2020	Jul. 15, 2020	Jun. 09, 2020	Feb. 13, 2020	Jun. 30, 2020	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Aug. 12, 2019
Debt Instrument [Line Items]
Debt prepayment, refinancing and redemption charges							$ 86,957,000	$ 33,402,000	$ 0
Long-term debt, weighted average effective interest rate during period							3.59%
Long-term debt, weighted average interest rate, at point in time							3.06%
Long-term Debt, Percentage Bearing Fixed Interest, Percentage Rate							44.40%
Interest Expense, Debt							$ 282,932,000	419,639,000	461,897,000
Amortization of Debt Issuance Costs							$ 21,179,000	24,185,000	$ 25,538,000
2015 Interest Rate Cap Agreements Effective June 29, 2018
Debt Instrument [Line Items]
Derivative, Maturity Date							Jun. 30, 2020
Senior Notes 4.625% due 2030
Debt Instrument [Line Items]
Debt Instrument, Maturity Date							Jun. 1, 2030
Senior Notes				$ 1,750,000,000			$ 1,750,000,000	0
Long-term debt, weighted average effective interest rate during period				4.625%			4.625%
Debt Instrument, Date of First Required Payment				Dec. 1, 2020
Debt Instrument, Redemption Price, Percentage of Principal Amount Redeemed				40.00%
Debt Instrument, Redemption Price, Percentage				104.625%
Debt Instrument, Fee Amount				$ 20,386,000
Debt Instrument Redeemed Outstanding Principal Amount			$ 1,750,000,000
Senior Notes 5.125 % due 2024
Debt Instrument [Line Items]
Debt Instrument, Maturity Date							Jul. 15, 2024
Senior Notes							$ 0	1,750,000,000
Long-term debt, weighted average effective interest rate during period			5.125%
Debt Refinancing Call Premium Redemption Charge Incurred Upon Redemption Of Senior Notes			$ 29,890,000
Write off of Deferred Debt Issuance Cost			$ 9,764,000
Senior Notes 3.75% due 2031
Debt Instrument [Line Items]
Debt Instrument, Maturity Date							Feb. 15, 2031
Senior Notes		$ 1,500,000,000					$ 1,500,000,000	0
Long-term debt, weighted average effective interest rate during period		3.75%					3.75%
Debt Instrument, Date of First Required Payment		Feb. 15, 2021
Debt Instrument, Redemption Price, Percentage of Principal Amount Redeemed		40.00%
Debt Instrument, Redemption Price, Percentage		103.75%
Debt Instrument, Fee Amount		$ 17,936,000
Senior Notes 5.0 % due 2025
Debt Instrument [Line Items]
Debt Instrument, Maturity Date							May 1, 2025
Senior Notes							$ 0	1,500,000,000
Long-term debt, weighted average effective interest rate during period	5.00%
Debt Instrument Redeemed Outstanding Principal Amount	$ 1,500,000,000
Debt Refinancing Call Premium Redemption Charge Incurred Upon Redemption Of Senior Notes	37,500,000
Write off of Deferred Debt Issuance Cost	$ 8,866,000
Senior Secured Credit Facilities
Debt Instrument [Line Items]
Long-term debt, weighted average interest rate, at point in time							2.03%
Revolving Credit Facility
Debt Instrument [Line Items]
Debt Instrument, Maturity Date							Aug. 12, 2024
Secured Debt							$ 75,000,000	0
Line of Credit Facility, Remaining Borrowing Capacity							925,000,000
Maximum borrowing capacity on revolving credit facilities										$ 1,000,000,000
Letter of Credit
Debt Instrument [Line Items]
Letters of Credit Outstanding, Amount							$ 64,636,000
Term Loan B-1
Debt Instrument [Line Items]
Debt Instrument, Issuance Date					Feb. 13, 2020
Debt Instrument, Maturity Date					Aug. 12, 2026		Aug. 12, 2026
Additional Debt Principal Amount Due To Repricing Agreement					$ 0
Proceeds From Repricing Agreement On Secured Debt					$ 0
Debt prepayment, refinancing and redemption charges							$ 2,948,000
Noncash Financing Outflows Related To Extinguishment Of Long Term Debt							55,895,000
Debt Instrument, Periodic Payment, Principal							27,431,000
Secured Debt							$ 2,715,694,000	0
Term Loan B-1 | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest margin					1.75%
Term Loan B
Debt Instrument [Line Items]
Debt Instrument, Maturity Date							Aug. 12, 2026
Repayments of Secured Debt						$ 68,842,000
Secured Debt							$ 0	2,743,125,000
Term Loan A
Debt Instrument [Line Items]
Debt Instrument, Maturity Date							Aug. 12, 2024
Debt Instrument, Periodic Payment, Principal							$ 54,688,000
Long-term Line of Credit							900,069,000
Secured Debt							$ 1,684,375,000	$ 1,739,063,000

Leases Lease Expense Components

Leases Lease Expense Components (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Operating lease cost:
Fixed lease expense	$ 541,090	$ 526,352
Variable lease expense	122,729	119,740
Financing lease cost:
Amortization of leased assets	24,720	23,724
Interest on lease liabilities	14,421	14,932
Net lease cost	$ 702,960	$ 684,748

Leases Leases Other Information

Leases Leases Other Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Leases term and discount rate
Operating Lease, Weighted Average Remaining Lease Term	8 years 8 months 12 days	9 years
Finance Lease, Weighted Average Remaining Lease Term	10 years 6 months	10 years 2 months 12 days
Operating Lease, Weighted Average Discount Rate, Percent	3.80%	4.10%
Leases Other Information [Abstract]
Sale and Leaseback Transaction, Gain (Loss), Net	$ 34,301	$ 20,833
Cash paid for amounts included in the measurement of lease liabilities:
Operating Lease, Payments	661,318	637,655
Finance Lease, Interest Payment on Liability	20,981	22,257
Finance Lease, Principal Payments	24,780	25,692
Net Operating Lease Assets Obtained In Exchange For Lease Liabilities	$ 401,559	$ 432,074
Finance Lease
Leases term and discount rate
Finance lease, weighted average discount rate, percent	5.10%	5.40%

Leases - Future Minimum Lease P

Leases - Future Minimum Lease Payments Under Non-Cancelable Operating and Capital Leases (Details) $ in Thousands	Dec. 31, 2020USD ($)
Operating leases
2021	$ 480,439
2022	504,789
2023	464,023
2024	412,419
2025	361,447
Thereafter	1,437,965
Total future minimum lease payments due under operating leases	3,661,082
Less portion representing interest, operating lease liabilities	(552,915)
Present value of lease liabilities, operating leases	3,108,167
Finance leases
2021	35,039
2022	35,124
2023	35,645
2024	35,669
2025	35,539
Thereafter	174,907
Total future minimum payments due under finance leases	351,923
Less portion representing interest, financing lease liabilities	(77,631)
Financing lease obligations	$ 274,292

Leases - Additional Information

Leases - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Leases Disclosure [Line Items]
Finance Lease, Right-of-Use Asset	$ 275,389	$ 247,246
Finance Lease Accumulated Depreciation	49,345	27,193
Rent expense under all operating leases	$ 663,819	$ 646,092	$ 596,117
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	20 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, 2020	Dec. 31, 2019	Dec. 31, 2018
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	$ 70,180	$ 64,988	$ 67,807
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
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	$ 3,637	1,751	3,090
Deferred compensation plan, distributions	3,139	2,730	$ 4,652
DaVita Voluntary Deferral Plan | Rabbi trusts
Defined Benefit Plan Disclosure [Line Items]
Total fair value of assets held in trust	$ 43,844	$ 39,527

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, 2020USD ($)
Commitments And Contingencies Disclosure [Line Items]
Purchase Obligation, Due in Next Twelve Months	$ 542,061
Purchase Obligation, Due in Second Year	540,715
Purchase Obligation, Due in Third Year	179,869
Purchase Obligation, to be Paid, Year Four	92,075
Off -Balance Sheet Financing Arrangements	$ 0
EPO
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	$ 8,663

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, 2020	Dec. 31, 2019	Dec. 31, 2018
Stock Appreciation Rights (SARs)
Awards
Outstanding at beginning of year (in shares)	6,953,000
Granted (in shares)	2,765,000
Exercised (in shares)	(894,000)
Expired (in shares)	(494,000)
Canceled (in shares)	(246,000)
Outstanding at end of period (in shares)	8,084,000	6,953,000
Exercisable at end of period (in shares)	987,000
Weighted-average fair value of grants	$ 26.70	$ 14.04	$ 16.24
Weighted average exercise price
Outstanding at beginning of year (USD per share)	64.10
Granted (USD per share)	68.58
Exercised (USD per share)	72.13
Expired (USD per share)	83.61
Canceled (USD per share)	61.36
Outstanding at end of period (USD per share)	63.64	$ 64.10
Exercisable at end of period (USD per share)	$ 69.56
Weighted average remaining contractual life
Outstanding at end of period	3 years
Exercisable at end of period	1 year
Stock units
Awards
Outstanding at beginning of year (in shares)	3,160,000
Granted (in shares)	1,027,000
Added by performance factor (in shares)	19,000
Exercised (in shares)	(351,000)
Expired (in shares)	0
Canceled (in shares)	(318,000)
Outstanding at end of period (in shares)	3,537,000	3,160,000
Exercisable at end of period (in shares)	0
Weighted-average fair value of grants (USD per share)	$ 77.83	$ 50.58	$ 66.23
Weighted average remaining contractual life
Outstanding at end of period	1 year 9 months 18 days
Exercisable at end of period	0 years

Long-term Incentive Compensat_4

Long-term Incentive Compensation and Shareholders’ Equity - Summary of Range of Exercise Prices (Details)	12 Months Ended
	Dec. 31, 2020$ / sharesshares
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	8,084,000
Weighted average exercise price (USD per share)	$ 63.64
Awards exercisable (in shares) | shares	987,000
Weighted average exercise price (USD per share)	$ 69.56
$50.01–$60.00
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	2,263,000
Weighted average exercise price (USD per share)	$ 52.53
Awards exercisable (in shares) | shares	2,000
Weighted average exercise price (USD per share)	$ 57.88
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	5,165,000
Weighted average exercise price (USD per share)	$ 66.99
Awards exercisable (in shares) | shares	610,000
Weighted average exercise price (USD per share)	$ 65.95
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	656,000
Weighted average exercise price (USD per share)	$ 75.60
Awards exercisable (in shares) | shares	375,000
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

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, 2020	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	4 years 9 months 18 days	4 years	4 years 2 months 12 days
Expected volatility	28.20%	29.50%	23.80%
Expected dividend yield	0.00%	0.00%	0.00%
Risk-free interest rate	1.50%	2.20%	2.90%

Long-term Incentive Compensat_6

Long-term Incentive Compensation and Shareholders’ Equity - Additional Information (Details)	Dec. 31, 2020USD ($)shares	Jul. 01, 2020	Jan. 01, 2020	Nov. 04, 2019$ / sharesshares	Dec. 31, 2020USD ($)$ / sharesshares	Dec. 31, 2019USD ($)$ / sharesshares	Dec. 31, 2018USD ($)$ / sharesshares	Jun. 11, 2020shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate intrinsic value of stock awards exercised					$ 49,258,000	$ 11,475,000	$ 31,045,000
Aggregate intrinsic value of stock awards outstanding	$ 853,803,000				853,803,000
Aggregate intrinsic value of stock awards exercisable	47,208,000				47,208,000
Payments of ordinary dividends, common stock					0	0	0
Employee stock purchase plan
Share-based awards, fair value assumptions, expected dividend					0
Long-term incentive program (LTIP) expense					99,643,000	118,513,000	85,759,000
Stock-based compensation expense					91,458,000	67,850,000	73,061,000
Estimated tax benefits recorded for stock-based compensation					11,775,000	9,186,000	13,591,000
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans	189,713,000				$ 189,713,000
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under stock-based component of LTIP costs, weighted average remaining period (in years)					1 year 4 months 24 days
Longterm Incentive Compensation Cash Awards, Number Of Awards Outstanding	$ 0				$ 0
Longterm Incentive Program Awards Compensation Cost Related To Long-Term Performance-Based Cash Awards					66,302,000
Share-based Payment Arrangement, Plan Modification, Incremental Cost							14,704,000
Share-based Payment Arrangement, Accelerated Cost							9,727,000
Share-based Payment Arrangement, Expense, Tax Benefit					8,957,000	2,251,000	7,988,000
Stock award exercises and other share issuances, net					0	0	0
General and Administrative Expense
Employee stock purchase plan
Stock-based compensation expense					$ 91,458,000	63,705,000	73,582,000
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	6,189,000				6,189,000
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	$ 17,148,000				$ 17,148,000	$ 16,569,000	$ 17,398,000
Stock issued for employee stock purchase plans | shares					222,000	315,000	398,000
Expected volatility Rate					40.40%	28.80%	24.20%
Risk-free interest rate					1.00%	2.60%	1.90%
Weighted average fair value | $ / shares					$ 22.06	$ 13.80	$ 17.45
Stock Appreciation Rights (SARs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock appreciation awards granted | shares					2,765,000
Employee stock purchase plan
Weighted average fair value | $ / shares					$ 26.70	$ 14.04	$ 16.24
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 2020 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for future grants | shares	8,074,000				8,074,000			8,730,000
Number of shares authorized under the plan | shares								5,000,000
Stockbased Compensation Number Of Shares Available For Issuance Reduced By One Share Available For Every Four Shares Underlying SARS And Stock Options | shares					1
Stockbased Compensation Number Of Shares Underlying SARS And Stock Options, For One Full Share Available For Issuance | shares					4
Stockbased Compensation Number Of Shares Available For Issuance Reduced By One Share Available For Every One Share Underlying Other Full Share Type Of Award | shares					1
Stock-based Compensation Number Of Shares Underlying Full Share Types Of Stock-based Awards, For One Full Share Available For Issuance | shares					1
Stock Incentive 2020 Plan | Stock Appreciation Rights (SARs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock appreciation awards granted | shares					0
Stock Incentive 2020 Plan | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period					36 months
Stock Incentive 2020 Plan | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Terms of award (in years)					10 years
Vesting period					48 months
Stock Incentive 2011 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for future grants | shares								3,730,000
Terms of award (in years)					5 years
Full share awards to shares available, conversion ratio					3.5
Stock Incentive 2011 Plan | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period					36 months
Stock Incentive 2011 Plan | 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	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)	16,477	41,020	16,844
Value of treasury stock acquired	$ 1,446,767	$ 2,402,475	$ 1,153,511
Treasury stock acquired, average cost per share	$ 87.80	$ 58.57	$ 68.48
Open Market Purchases
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)	8,495	19,218	16,844
Value of treasury stock acquired	$ 741,850	$ 1,168,321	$ 1,153,511
Treasury stock acquired, average cost per share	$ 87.32	$ 60.79	$ 68.48
Tender Offer
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)	7,982	21,802
Value of treasury stock acquired	$ 704,917	$ 1,234,154
Treasury stock acquired, average cost per share	$ 88.32	$ 56.61
Treasury Stock, Shares Repurchases, Table Footnotes:
Treasury Stock Acquired, Average Cost Per Share, Clearing Price	$ 88	$ 56.50
Share Repurchase Fees And Expenses	$ 2,529	$ 2,343

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, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Net (loss) income attributable to DaVita Inc.	$ 173,773	$ 158,674	$ 201,602	$ 239,593	$ 244,871	$ 143,270	$ 273,551	$ 149,289	$ 773,642	$ 810,981	$ 159,394
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	0	79
Purchase of noncontrolling interests									4,364	(37,145)	(17,897)
Purchase of noncontrolling interests									4,364
Noncontrolling Interest, Period Increase (Decrease)									4,364	(37,145)	(17,818)
Net Income Attributable To Parent Net Of Transfers To Noncontrolling Interests.									$ 778,006	$ 773,836	$ 141,576

Shareholder's equity (Details)

Shareholder's equity (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	12 Months Ended
	Feb. 10, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 10, 2020	Nov. 04, 2019
Stock repurchases
Repurchase of common stock (in shares)		16,477,000	41,020,000	16,844,000
Value of treasury stock acquired		$ 1,446,767	$ 2,402,475	$ 1,153,511
Treasury stock acquired, average cost per share		$ 87.80	$ 58.57	$ 68.48
Stock Repurchase Program, Authorized Amount					$ 2,000,000	$ 2,000,000
Terminated Remaining Prior Share Repurchases Authorized, Amount					$ 329,302	$ 246,373
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		$ 7,831	$ 68,019	$ 28,082
Treasury stock
Stock repurchases
Repurchase of common stock (in shares)		16,477,000	41,020,000	16,844,000
Value of treasury stock acquired		$ 1,446,767	$ 2,402,475	$ 1,153,511
Retirement of treasury stock (in shares)		16,477,000	41,020,000	16,844,000
Subsequent Event
Stock repurchases
Repurchase of common stock (in shares)	1,063,000
Value of treasury stock acquired	$ 123,282
Treasury stock acquired, average cost per share	$ 115.98
Stock Repurchase Program, Remaining Authorized Repurchase Amount	$ 1,806,674

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive (Loss) Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Comprehensive Income (Loss) [Line Items]
Beginning balance	$ 2,133,409
Ending balance	1,383,566	$ 2,133,409
Interest rate cap agreements
Comprehensive Income (Loss) [Line Items]
Beginning balance	(1,433)	(8,961)	$ (12,408)
Unrealized (losses) gains	(21,781)	1,566	(181)
Related income tax	5,435	(415)	48
Unrealized (losses) gains net	(16,346)	1,151	(133)
Reclassification from accumulated other comprehensive losses (income) into net income	7,081	8,591	8,466
Related income tax	(1,768)	(2,214)	(2,180)
Reclassification from accumulated other comprehensive income into net income net of tax	5,313	6,377	6,286
Ending balance	(12,466)	(1,433)	(8,961)
Interest rate cap agreements | Cumulative Effect, Period of Adoption, Adjustment
Comprehensive Income (Loss) [Line Items]
Cumulative effect of change in accounting principle				$ (2,706)
Investment securities
Comprehensive Income (Loss) [Line Items]
Beginning balance	0	0	5,662
Unrealized (losses) gains	0	0	0
Related income tax	0	0	0
Unrealized (losses) gains net	0	0	0
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	0	0	0
Investment securities | Cumulative Effect, Period of Adoption, Adjustment
Comprehensive Income (Loss) [Line Items]
Cumulative effect of change in accounting principle				(5,662)
Foreign currency translation adjustments
Comprehensive Income (Loss) [Line Items]
Beginning balance	(46,065)	(25,963)	19,981
Unrealized (losses) gains	(7,080)	(20,102)	(45,944)
Related income tax	(543)	0	0
Unrealized (losses) gains net	(7,623)	(20,102)	(45,944)
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	(53,688)	(46,065)	(25,963)
Foreign currency translation adjustments | Cumulative Effect, Period of Adoption, Adjustment
Comprehensive Income (Loss) [Line Items]
Cumulative effect of change in accounting principle				0
Accumulated other comprehensive (loss) income
Comprehensive Income (Loss) [Line Items]
Beginning balance	(47,498)	(34,924)	13,235
Unrealized (losses) gains	(28,861)	(18,536)	(46,125)
Related income tax	4,892	(415)	48
Unrealized (losses) gains net	(23,969)	(18,951)	(46,077)
Reclassification from accumulated other comprehensive losses (income) into net income	7,081	8,591	8,466
Related income tax	(1,768)	(2,214)	(2,180)
Reclassification from accumulated other comprehensive income into net income net of tax	5,313	6,377	6,286
Ending balance	$ (66,154)	$ (47,498)	$ (34,924)
Accumulated other comprehensive (loss) income | Cumulative Effect, Period of Adoption, Adjustment
Comprehensive Income (Loss) [Line Items]
Cumulative effect of change in accounting principle				$ (8,368)

Acquisitions - Assets acquired

Acquisitions - Assets acquired and liabilities assumed (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill	$ 6,919,109	$ 6,787,635	$ 6,841,960
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Current assets	23,607	6,713	23,686
Property and equipment	37,457	4,842	11,421
Customer relationships	34,625	0	0
Noncompetition agreements and other long-term assets	10,168	1,980	3,079
Indefinite-lived licenses	22,136	31,858	23,656
Goodwill	130,057	90,226	278,348
Deferred income taxes	(3,962)	0	0
Liabilities Assumed	(34,068)	(7,159)	(19,946)
Noncontrolling interests assumed	(1,729)	(1,762)	(80,291)
Aggregate purchase price	$ 218,291	$ 126,698	$ 239,953

Schedule Of Other Information R

Schedule Of Other Information Related To Acquired Intangibles and Goodwill (Details) - Series of individually immaterial business acquisitions - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill deductible for tax purposes associated with acquisitions	$ 94,318	$ 88,517	$ 165,013
Customer Relationships
Business Acquisition [Line Items]
Amortizable intangible assets acquired, weighted-average estimated useful lives	18 years
Noncompetition agreements
Business Acquisition [Line Items]
Amortizable intangible assets acquired, weighted-average estimated useful lives	5 years	6 years	6 years

Acquisitions and Divestitures -

Acquisitions and Divestitures - Pro Forma Summary of Results of Operation (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Business Combinations [Abstract]
Pro forma total revenues	$ 11,636,416	$ 11,570,086
Pro forma net income from continuing operations attributable to DaVita Inc.	$ 789,473	$ 718,928
Pro forma basic net income per share from continuing operations attributable to DaVita Inc.	$ 6.59	$ 4.69
Pro forma diluted net income per share from continuing operations attributable to DaVita Inc.	$ 6.44	$ 4.67

Acquisitions and Divestitures_2

Acquisitions and Divestitures - Reconciliation of Changes in Contingent Earn-Out Obligations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Business Combinations [Abstract]
Beginning balance	$ 24,586	$ 2,608
Acquisitions	14,042	23,536
Foreign currency translation	(3,688)	(905)
Fair value remeasurements	(2,630)	121
Payments or other settlements	(2,062)	(774)
Ending balance	$ 30,248	$ 24,586

Acquisitions and Divestitures_3

Acquisitions and Divestitures - Additional Information (Details) $ in Thousands	May 01, 2020USD ($)	Jun. 30, 2020USD ($)	Dec. 31, 2020USD ($)clinic	Dec. 31, 2019USD ($)clinic	Dec. 31, 2018USD ($)clinic
Business Acquisition [Line Items]
Cash paid to acquire business			$ 182,013	$ 100,861	$ 183,156
Business combination contingent consideration acquisitions, earn-outs			14,042	23,536
Non-cash gain on acquiring additional ownership in business acquisition					28,152
Contingent earn-out obligations			42,378
Fair value of contingent earn-out consideration			30,248	24,586	2,608
RMS Lifeline
Business Acquisition [Line Items]
Gain (Loss) on Divestiture	$ 16,252	$ 16,252
Other Long-term Liabilities
Business Acquisition [Line Items]
Fair value of contingent earn-out consideration			17,223
Other Current Liabilities
Business Acquisition [Line Items]
Fair value of contingent earn-out consideration			13,025
Other companies
Business Acquisition [Line Items]
Fair value of contingent earn-out consideration			$ 30,248
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			$ 182,013	98,836	176,161
Business combination contingent consideration acquisitions, earn-outs			14,042	23,536	1,246
Deferred Purchase price and liabilities assumed			20,415	$ 4,326	$ 34,394
Non-cash gain on acquiring additional ownership in business acquisition			$ 1,821
U S Dialysis And Related Lab Services | Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Number of businesses acquired | clinic			8	7	18
Foreign Dialysis Centers | Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Number of businesses acquired | clinic			66	16	28

Held for Sale and Discontinue_3

Held for Sale and Discontinued Operations Financial results for discontinued operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Goodwill and other asset impairment charges	$ 0	$ 124,892	$ 3,106
Valuation adjustment on disposal group	0	0	316,840
Loss on sale of discontinued operations before taxes	(24,248)	(23,022)
Net (loss) income from discontinued operations, net of tax	(9,653)	105,483	(457,038)
DMG - discontinued operations | Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net revenues	0	2,713,059	4,963,792
Expenses	0	2,543,865	4,962,686
Goodwill and other asset impairment charges	0	0	41,537
Valuation adjustment on disposal group	0	0	316,840
Income (loss) from discontinued operations before taxes	0	169,194	(357,271)
Loss on sale of discontinued operations before taxes	(7,996)	(23,022)	0
Income tax expense	$ 1,657	$ 40,689	$ 99,768

Held for Sale and Discontinue_4

Held for Sale and Discontinued Operations Cash Flows of discontinued operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Discontinued Operations and Disposal Groups [Abstract]
Net cash provided by operating activities from discontinued operations	$ 0	$ 99,634	$ 290,684
Net cash used in investing activities from discontinued operations	$ 0	$ (43,442)	$ (57,382)

Held for Sale and Discontinue_5

Held for Sale and Discontinued Operations - Additional Information (Details) $ in Thousands	Jun. 19, 2019USD ($)	Dec. 05, 2017	Dec. 31, 2020USD ($)	Mar. 31, 2020USD ($)	Jun. 18, 2019USD ($)clinic	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Loss on sale of discontinued operations before taxes						$ (24,248)	$ (23,022)
Proceeds from sale of DMG division	$ 4,465,476
Proceeds from Divestiture of Businesses, Net of Cash Divested	$ 3,824,509
Gain (Loss) on Disposition of Business						(16,252)	0	$ 60,603
Payments to Acquire Businesses, Gross						182,013	100,861	183,156
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						182,013	98,836	176,161
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
Business combination, deferred purchase price					$ 212			1,142
Discontinued Operations, Held-for-sale | DMG - discontinued operations
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						$ (7,996)	$ (23,022)	$ 0
Additional Payment To The Buyer Related To The Final Agreement On The Purchase Price			$ 47,000
Gain (Loss) on Disposition of Business			$ (17,976)
Discontinued Operations, Held-for-sale | DMG - discontinued operations | Coronavirus Aid Relief And Economic Security Act Additional Tax Benefit Member [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain (Loss) on Disposition of Business				$ 9,980

Variable Interest Entities - Ad

Variable Interest Entities - Additional Information (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Variable Interest Entity
Assets	$ 16,988,516	$ 17,311,394
Liabilities	14,091,736	$ 13,811,776
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity
Assets	310,190
Liabilities	$ 216,632

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, 2020	Dec. 31, 2019
Assets
Investments in equity securities	$ 44,077	$ 39,951
Liabilities
Contingent earn-out obligations	42,378
Fair Value, Measurements, Recurring
Assets
Investments in equity securities	44,077	39,951
Liabilities
Contingent earn-out obligations	30,248	24,586
Temporary equity
Noncontrolling interests subject to put provisions	1,330,028	1,180,376
Fair Value, Measurements, Recurring | Interest rate cap agreements
Assets
Interest rate cap agreements	2,671	24,452
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1)
Assets
Investments in equity securities	44,077	39,951
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	2,671	24,452
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3)
Assets
Investments in equity securities	0	0
Liabilities
Contingent earn-out obligations	30,248	24,586
Temporary equity
Noncontrolling interests subject to put provisions	1,330,028	1,180,376
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | Interest rate cap agreements
Assets
Interest rate cap agreements	$ 0	$ 0

Fair Values of Financial Inst_4

Fair Values of Financial Instruments (Details) $ in Thousands	Dec. 31, 2020USD ($)
Fair Value Disclosures [Abstract]
Potential Increase Decrease In Fair Value Of Noncontrolling Interests Due To Change In Weighted Average EBITDA Multiple	$ 160

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, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision									$ 11,039,709	$ 10,918,421	$ 10,709,981
Provision for uncollectible accounts									(13,458)	(21,715)	(49,587)
Dialysis patient service revenues									11,026,251	10,896,706	10,660,394
Other revenues									524,353	491,773	744,457
Total revenues	$ 2,905,322	$ 2,924,066	$ 2,879,979	$ 2,841,237	$ 2,898,584	$ 2,904,078	$ 2,842,705	$ 2,743,112	11,550,604	11,388,479	11,404,851
Operating income	$ 381,671	$ 437,669	$ 409,920	$ 465,376	$ 462,588	$ 378,336	$ 461,886	$ 340,507	1,694,636	1,643,317	1,525,824
Corporate administrative support									(146,707)	(92,335)	(90,108)
Debt expense									(304,111)	(443,824)	(487,435)
Debt prepayment, refinancing and redemption charges									(89,022)	(33,402)	0
Other income									16,759	29,348	10,089
Income (Loss) from Continuing Operations before Equity Method Investments, Income Taxes, Noncontrolling Interest, Total									1,318,262	1,195,439	1,048,478
Segment Reporting Information footnote:
Equity investment (loss) income									26,916	12,679	(4,484)
U.S. dialysis
Segment Reporting Information [Line Items]
Total revenues									10,514,649	10,430,581	10,242,999
Other - Ancillary services
Segment Reporting Information [Line Items]
Total revenues									1,035,955	957,898	1,161,852
Operating Segments
Segment Reporting Information [Line Items]
Total revenues									11,712,633	11,534,834	11,532,037
Operating income									1,841,343	1,735,652	1,615,932
Operating Segments | U.S. dialysis
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision									10,632,822	10,552,600	10,366,996
Provision for uncollectible accounts									(13,458)	(21,715)	(50,927)
Dialysis patient service revenues									10,619,364	10,530,885	10,316,069
Total revenues									10,659,935	10,562,906	10,335,949
Operating income									1,917,604	1,924,826	1,709,721
Operating Segments | U.S. dialysis | External Sources
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision									10,488,731	10,421,401	10,274,046
Other revenues									39,376	30,895	19,880
Operating Segments | U.S. dialysis | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision									144,091	131,199	92,950
Other revenues									1,195	1,126	0
Operating Segments | Other - Ancillary services
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision									550,978	497,021	437,275
Other revenues									484,977	460,877	724,577
Total revenues									1,052,698	971,928	1,196,088
Operating income									(76,261)	(189,174)	(93,789)
Segment Reporting Information footnote:
Equity investment (loss) income									5,866	9,366	24,866
Operating Segments | Other - Ancillary services | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues before provision									16,743	14,030	34,236
Intersegment Elimination
Segment Reporting Information [Line Items]
Total revenues									(162,029)	(146,355)	(127,186)
Intersegment Elimination | U.S. dialysis
Segment Reporting Information [Line Items]
Total revenues									(145,286)	(132,325)	(92,950)
Intersegment Elimination | Other - Ancillary services
Segment Reporting Information [Line Items]
Total revenues									$ (16,743)	$ (14,030)	$ (34,236)

Segment Reporting - Summary o_2

Segment Reporting - Summary of Depreciation and Amortization Expense by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 630,435	$ 615,152	$ 591,035
U.S. dialysis
Segment Reporting Information [Line Items]
Depreciation and amortization	594,552	583,454	558,810
Other - Ancillary services
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 35,883	$ 31,698	$ 32,225

Segment Reporting - Summary o_3

Segment Reporting - Summary of Assets by Segment (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
ASSETS
Assets	$ 16,988,516	$ 17,311,394
Equity method and other investments	257,491	241,983
Property and equipment, net of accumulated depreciation	3,521,824	3,473,384
U.S. dialysis
ASSETS
Assets	15,344,647	15,778,880
Equity method and other investments	122,974	124,188
Other - Ancillary services
ASSETS
Assets	1,643,869	1,532,514
Equity method and other investments	134,517	117,795
International | Other - Ancillary services
ASSETS
Property and equipment, net of accumulated depreciation	$ 181,137	$ 154,572

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, 2020	Dec. 31, 2019	Dec. 31, 2018
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 674,541	$ 766,546	$ 987,138
U.S. dialysis
Segment Reporting Information [Line Items]
Expenditures for property and equipment	646,870	681,339	856,108
Other - Ancillary services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	27,671	46,741	45,806
DMG - discontinued operations
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 0	$ 38,466	$ 85,224

Segment Reporting - Additional

Segment Reporting - Additional Information (Details)	Jun. 19, 2019
DMG - discontinued operations | 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, 2020	Dec. 31, 2019	Dec. 31, 2018
Cash paid:
Income taxes, net	$ 154,850	$ 157,983	$ 92,526
Interest	326,165	473,176	488,974
Non-cash investing and financing activities:
Fixed assets under financing lease obligations	$ 22,042	$ 18,953	$ 8,828

Selected Quarterly Financial _3

Selected Quarterly Financial Data (unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands	May 01, 2020	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Selected quarterly financial information:
Total revenues		$ 2,905,322	$ 2,924,066	$ 2,879,979	$ 2,841,237	$ 2,898,584	$ 2,904,078	$ 2,842,705	$ 2,743,112	$ 11,550,604	$ 11,388,479	$ 11,404,851
Operating income		381,671	437,669	409,920	465,376	462,588	378,336	461,886	340,507	1,694,636	1,643,317	1,525,824
Amounts attributable to DaVita Inc.:
Net income from continuing operations		193,406	158,674	201,602	229,613	242,242	150,113	194,223	120,254	783,295	706,832	624,321
Net (loss) income from discontinued operations		(19,633)	0	0	9,980	2,629	(6,843)	79,328	29,035	(9,653)	104,149	(464,927)
Net income attributable to DaVita Inc.		$ 173,773	$ 158,674	$ 201,602	$ 239,593	$ 244,871	$ 143,270	$ 273,551	$ 149,289	$ 773,642	$ 810,981	$ 159,394
Earnings per share attributable to DaVita Inc.:
Income (Loss) from Continuing Operations, Per Basic Share		$ 1.73	$ 1.31	$ 1.65	$ 1.84	$ 1.87	$ 1	$ 1.17	$ 0.72	$ 6.54	$ 4.61	$ 3.66
Basic net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)		(0.17)	0	0	0.08	0.02	(0.05)	0.47	0.18	(0.08)	0.68	(2.73)
Basic net income per share attributable to DaVita Inc. (in usd per share)		1.56	1.31	1.65	1.92	1.89	0.95	1.64	0.90	6.46	5.29	0.93
Diluted net income from continuing operations per share attributable to DaVita Inc. (in usd per share)		1.67	1.28	1.62	1.81	1.86	0.99	1.16	0.72	6.39	4.60	3.62
Diluted net loss from discontinued operations per share attributable to DaVita Inc. (in usd per share)		(0.17)	0	0	0.08	0.02	(0.04)	0.48	0.18	(0.08)	0.67	(2.70)
Diluted net income per share attributable to DaVita Inc. (in usd per share)		$ 1.50	$ 1.28	$ 1.62	$ 1.89	$ 1.88	$ 0.95	$ 1.64	$ 0.90	$ 6.31	$ 5.27	$ 0.92
Footnotes to Selected Quarterly Financial Information:
Goodwill impairment charges										$ 0	$ 124,892	$ 3,106
RMS Lifeline
Footnotes to Selected Quarterly Financial Information:
Gain (Loss) on Divestiture	$ 16,252			$ 16,252
Pending legal settlements
Footnotes to Selected Quarterly Financial Information:
Loss Contingency, Estimate of Possible Loss				$ 35,000
Other - Ancillary services
Selected quarterly financial information:
Total revenues										$ 1,035,955	957,898	$ 1,161,852
Footnotes to Selected Quarterly Financial Information:
Goodwill impairment charges							$ 83,855				124,892
Kidney Care | GERMANY
Footnotes to Selected Quarterly Financial Information:
Goodwill impairment charges									$ 41,037		$ 119,476

SCHEDULE II - VALUATION AND QUA

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS (Details) - Allowance for uncollectible Accounts - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at beginning of year	$ 8,328	$ 52,924	$ 218,399
Acquisitions	0	0	0
Amounts charged to income	13,458	21,715	42,287
Amounts written off	21,786	66,311	207,762
Balance at end of year	$ 0	$ 8,328	$ 52,924