DaVita (DVA) 10-K 13 Feb 25 2024 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) shares in Millions, $ in Billions	12 Months Ended
	Dec. 31, 2024	Jan. 31, 2025	Jun. 30, 2024
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2024
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			$ 11.8
Entity Common Stock, Shares Outstanding		80
Amendment Flag	false
Document Financial Statement Error Correction [Flag]	false
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Entity Central Index Key	0000927066

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2024
Auditor [Abstract]
Auditor Name	KPMG LLP
Auditor Location	Seattle, WA, USA
Auditor Firm ID	185

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Statement [Abstract]
Dialysis patient service revenues	$ 12,260,375	$ 11,574,941	$ 11,176,464
Other revenues	555,175	565,206	433,430
Total revenues	12,815,550	12,140,147	11,609,894
Operating expenses:
Patient care costs	8,598,521	8,319,717	8,209,553
General and administrative	1,538,341	1,473,984	1,355,197
Depreciation and amortization	723,860	745,443	732,602
Equity investment income, net	(26,189)	(27,864)	(26,520)
Goodwill impairment charges	0	26,083	0
Gain on changes in ownership interests	(109,466)	0	0
Total operating expenses	10,725,067	10,537,363	10,270,832
Operating income	2,090,483	1,602,784	1,339,062
Debt expense	(470,469)	(398,551)	(357,019)
Debt prepayment, extinguishment and modification costs	(19,813)	(7,962)	0
Other loss, net	(69,808)	(19,177)	(15,765)
Income from continuing operations before income taxes	1,530,393	1,177,094	966,278
Income tax expense	279,656	220,116	198,087
Net income from continuing operations	1,250,737	956,978	768,191
Net income from discontinued operations, net of tax	0	0	13,452
Net income	1,250,737	956,978	781,643
Less: Net income attributable to noncontrolling interests	(314,395)	(265,443)	(221,243)
Net income attributable to DaVita Inc.	$ 936,342	$ 691,535	$ 560,400
Earnings per share attributable to DaVita Inc.:
Basic net income from continuing operations	$ 11.02	$ 7.62	$ 5.88
Basic net income	11.02	7.62	6.03
Diluted net income from continuing operations	10.73	7.42	5.71
Diluted net income	$ 10.73	$ 7.42	$ 5.85
Weighted average shares for earnings per share:
Basic shares (in shares)	84,991,000	90,790,000	92,992,000
Diluted shares (in shares)	87,274,000	93,182,000	95,834,000
Amounts attributable to DaVita Inc.:
Net income from continuing operations	$ 936,342	$ 691,535	$ 546,948
Net income from discontinued operations	0	0	13,452
Net (loss) income attributable to DaVita Inc.	$ 936,342	$ 691,535	$ 560,400

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 1,250,737	$ 956,978	$ 781,643
Unrealized gains on interest rate cap agreements:
Unrealized gains	7,250	6,895	108,669
Reclassification of net realized gains into net income	(43,660)	(77,727)	(8,806)
Unrealized gains on defined benefit plans	46	0	0
Unrealized losses on foreign currency translation.
Unrealized (losses) gains	(207,861)	87,934	(29,802)
Reclassification of net realized gains into net income	(14,487)	0	0
Other comprehensive loss	(258,712)	17,102	70,061
Total comprehensive income	992,025	974,080	851,704
Less: Comprehensive income attributable to noncontrolling interests	(314,395)	(265,443)	(221,243)
Comprehensive income attributable to DaVita Inc.	$ 677,630	$ 708,637	$ 630,461

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
ASSETS
Cash and cash equivalents	$ 794,933	$ 380,063
Restricted cash and equivalents	84,892	84,571
Short-term investments	51,064	11,610
Accounts receivable	2,146,975	1,986,856
Inventories	134,559	143,105
Other receivables	383,166	422,669
Prepaid and other current assets	122,948	102,645
Income tax receivable	27,535	6,387
Total current assets	3,746,072	3,137,906
Property and equipment, net of accumulated depreciation	2,940,916	3,073,533
Operating lease right-of-use assets	2,393,558	2,501,364
Intangible assets, net of accumulated amortization	197,431	203,224
Equity method and other investments	336,684	545,848
Long-term investments	33,660	47,890
Other long-term assets	261,731	271,253
Goodwill	7,375,216	7,112,560
Assets, Total	17,285,268	16,893,578
LIABILITIES AND EQUITY
Accounts payable	547,200	514,533
Other liabilities	934,145	828,878
Accrued compensation and benefits	800,484	752,598
Current portion of operating lease liabilities	410,411	394,399
Current portion of long-term debt	270,867	123,299
Income tax payable	10,303	28,507
Total current liabilities	2,973,410	2,642,214
Long-term operating lease liabilities	2,209,655	2,330,389
Long-term debt	9,175,903	8,268,334
Other long-term liabilities	169,588	183,074
Deferred income taxes	665,361	726,217
Total liabilities	15,193,917	14,150,228
Commitments and contingencies
Noncontrolling interests subject to put provisions	1,695,483	1,499,288
Equity:
Preferred Stock, Value, Issued	0	0
Common Stock, Value, Issued	90	89
Additional paid-in capital	286,270	509,804
Retained earnings	1,534,630	598,288
Treasury Stock, Value	(1,389,072)	0
Accumulated other comprehensive loss	(310,796)	(52,084)
Total DaVita Inc. shareholders' equity	121,122	1,056,097
Noncontrolling interests not subject to put provisions	274,746	187,965
Total equity	395,868	1,244,062
Total liabilities and shareholders' equity	$ 17,285,268	$ 16,893,578
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)	90,369,000	88,824,000

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2024	Dec. 31, 2023
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 outstanding (in shares)	80,536,000	88,824,000
Treasury Stock, Common, Shares	9,833,000	0

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities:
Net income	$ 1,250,737	$ 956,978	$ 781,643
Adjustments to Reconcile Net Income (Loss) to Cash Provided by (Used in) Operating Activities [Abstract]
Depreciation and amortization	723,860	745,443	732,602
Impairment charges	0	26,083	0
Loss on extinguishment of debt	12,527	7,132	0
Stock-based compensation expense	102,788	112,375	95,427
Deferred income taxes	(57,840)	(39,354)	(75,669)
Equity investment loss, net	115,839	64,777	8,773
Gain on changes in ownership interests	(109,466)	0	0
Other non-cash losses and (gains), net	13,414	(8,938)	21,693
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:
Accounts receivable	(29,766)	172,361	(148,394)
Inventories	17,942	(32,132)	(757)
Other current assets	36,801	(43,437)	27,533
Other long-term assets	(67,031)	(5,792)	(50,549)
Accounts payable	1,699	26,890	87,481
Accrued compensation and benefits	14,687	56,209	34,536
Other current liabilities	46,733	27,082	89,955
Income taxes	(44,214)	1,570	(24,103)
Other long-term liabilities	(6,672)	(8,216)	(15,601)
Net Cash Provided by (Used in) Operating Activities, Total	2,022,038	2,059,031	1,564,570
Cash flows from investing activities:
Additions of property and equipment	(555,443)	(567,985)	(603,429)
Acquisitions	246,068	26,394	57,308
Proceeds from asset and business sales	25,862	30,610	117,582
Purchase of debt investments held-to-maturity	(15,319)	(37,180)	(129,803)
Purchase of other debt and equity investments	(9,140)	(9,566)	(3,590)
Proceeds from debt investments held-to-maturity	22,638	99,639	71,125
Proceeds from sale of other debt and equity investments	4,566	10,365	3,781
Purchase of equity method investments	(5,205)	(276,202)	(31,885)
Distributions from equity method investments	6,680	4,913	3,962
Payments to Acquire Other Investments	0	0	(782)
Net Cash Provided by (Used in) Investing Activities, Total	(771,429)	(771,800)	(630,347)
Cash flows from financing activities:
Borrowings	6,624,310	2,468,341	2,393,116
Payments on long-term debt	(5,515,213)	(3,020,956)	(2,404,395)
Deferred and debt related financing costs	(50,874)	(69,791)	(3)
Purchase of treasury stock	(1,385,932)	(272,219)	(802,228)
Distributions to noncontrolling interests	(337,042)	(280,938)	(267,946)
Net proceeds from issuance of common stock under employee stock plans	20,453	16,900	18,577
Payment, Tax Withholding, Share-Based Payment Arrangement	(134,040)	(65,012)	(55,944)
Contributions from noncontrolling interests	14,499	14,773	14,797
Proceeds from sales of additional noncontrolling interests	860	50,962	3,673
Purchases of noncontrolling interests	(53,958)	(12,555)	(20,775)
Net cash used in financing activities	(816,937)	(1,170,495)	(1,121,128)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(18,481)	8,909	(29,066)
Less: Net increase (decrease) in cash, cash equivalents and restricted cash	415,191	125,645	(215,971)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	464,634	338,989	554,960
Cash, cash equivalents and restricted cash of continuing operations at end of the year	$ 879,825	$ 464,634	$ 338,989

CONSOLIDATED STATEMENTS OF EQUI

CONSOLIDATED STATEMENTS OF EQUITY - USD ($) $ in Thousands	Total	Non-controlling interests subject to put provisions	Total	Common stock	Additional paid-in capital	Retained earnings	Treasury Stock, Common	Accumulated other comprehensive income (loss)	Non-controlling interests not subject to put provisions
Beginning Balance (in shares) at Dec. 31, 2021				97,289,000			0
Beginning balance at Dec. 31, 2021			$ 755,508	$ 97	$ 540,321	$ 354,337	$ 0	$ (139,247)	$ 180,640
Temporary equity, beginning balance at Dec. 31, 2021		$ 1,434,832
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income		151,379
Distributions		(176,957)
Contributions		10,962
Acquisitions and divestitures		2,392
Partial purchases		(11,670)
Fair value remeasurements		(62,487)
Other		457
Temporary equity, ending balance at Dec. 31, 2022		1,348,908
Comprehensive income:
Net income			560,400			560,400			69,864
Other comprehensive loss	$ 70,061		70,061					70,061
Stock purchase shares issued (in shares)				285,000
Stock purchase plan			18,061	$ 0	18,061
Stock award payment plan (in shares)				932,000
Stock award plans			55,920	$ 1	55,921
Stock-settled stock-based compensation expense			95,230		95,230
Changes in noncontrolling interest from:
Distributions									(90,989)
Contributions									3,835
Acquisitions and divestitures			939		939
Acquisitions and divestitures									866
Partial purchases			(6,586)		(6,586)				193
Fair value remeasurements			62,487		62,487
Purchase of treasury stock (in shares)							(8,095,000)
Purchase of treasury stock			(787,854)				$ (787,854)
Retirement of treasury stock (in shares)				8,095,000			8,095,000
Retirement of treasury stock			0	$ 8	47,596	740,250	$ 787,854
Other			0						(457)
Ending balance at Dec. 31, 2022			712,326	$ 90	606,935	174,487	$ 0	(69,186)	163,566
Ending Balance (in shares) at Dec. 31, 2022				90,411,000			0
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income		176,789
Distributions		(184,044)
Contributions		12,878
Acquisitions and divestitures		181
Partial purchases		(5,296)
Fair value remeasurements		149,872
Temporary equity, ending balance at Dec. 31, 2023		1,499,288
Comprehensive income:
Net income			691,535			691,535			88,654
Other comprehensive loss	17,102		17,102					17,102
Stock purchase shares issued (in shares)				231,000
Stock purchase plan			18,213	$ 0	18,213
Stock award payment plan (in shares)				1,086,000
Stock award plans			65,012	$ 2	65,014
Stock-settled stock-based compensation expense			109,813		109,813
Changes in noncontrolling interest from:
Distributions									(96,894)
Contributions									1,895
Acquisitions and divestitures			13,077		13,077				30,776
Partial purchases			(5,375)		(5,375)				(32)
Fair value remeasurements			(149,872)		(149,872)
Purchase of treasury stock (in shares)							(2,904,000)
Purchase of treasury stock			(285,710)				$ (285,710)
Retirement of treasury stock (in shares)				2,904,000			2,904,000
Retirement of treasury stock			0	$ 3	17,973	267,734	$ 285,710
Ending balance at Dec. 31, 2023	$ 1,244,062		1,056,097	$ 89	509,804	598,288	$ 0	(52,084)	187,965
Ending Balance (in shares) at Dec. 31, 2023	88,824,000			88,824,000			0
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income		214,986
Distributions		(226,389)
Contributions		11,639
Acquisitions and divestitures		38,806
Partial purchases		(49,265)
Fair value remeasurements		206,418
Temporary equity, ending balance at Dec. 31, 2024		$ 1,695,483
Comprehensive income:
Net income			936,342			936,342			99,409
Other comprehensive loss	$ (258,712)		(258,712)					(258,712)
Stock purchase shares issued (in shares)				184,000
Stock purchase plan			20,441		20,441
Stock award payment plan (in shares)				1,361,000
Stock award plans			134,040	$ 1	134,041
Stock-settled stock-based compensation expense			99,095		99,095
Changes in noncontrolling interest from:
Distributions									(110,653)
Contributions									2,860
Acquisitions and divestitures			491		491				95,024
Partial purchases			3,102		(3,102)				141
Fair value remeasurements			(206,418)		(206,418)
Purchase of treasury stock (in shares)							(9,833,000)
Purchase of treasury stock			(1,389,072)				$ (1,389,072)
Ending balance at Dec. 31, 2024	$ 395,868		$ 121,122	$ 90	$ 286,270	$ 1,534,630	$ (1,389,072)	$ (310,796)	$ 274,746
Ending Balance (in shares) at Dec. 31, 2024	80,536,000			90,369,000			(9,833,000)

Organization and Summary of Sig

Organization and Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Organization and Summary of Significant Accounting Policies	Organization and summary of significant accounting policies Organization The Company's operations are composed of its dialysis and related lab services to patients in the United States (its U.S. dialysis business), its U.S. integrated kidney care (IKC) business, its U.S. other ancillary services and its international operations (collectively, its ancillary services), as well as its corporate administrative support functions. 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 or end stage kidney disease (ESRD or ESKD). As of December 31, 2024, the Company operated or provided administrative services through a network of 2,657 U.S. outpatient dialysis centers in 46 states and the District of Columbia, serving a total of approximately 200,800 patients. In addition, as of December 31, 2024, the Company operated or provided administrative services to a total of 509 outpatient dialysis centers serving approximately 80,300 patients located in 13 countries outside of the U.S. The Company’s U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other operating segments 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 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). 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, certain fair value estimates, accounting for income taxes and loss contingencies. Specific estimating risks and contingencies are further addressed within these notes to the consolidated financial statements. Revenues 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. The Company maintains a usual and customary fee schedule for its dialysis treatments and related lab services; however, actual collectible revenue is normally recognized at a discount from this fee schedule. The majority of the Company's revenues are paid from government programs, principally Medicare, Medicare Advantage and Medicaid. 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. Medicare Advantage revenues are reimbursed at negotiated contract rates that are generally higher than Medicare fee-for-service rates, but which generally have a slower payment cycle than Medicare fee-for-service payments, and some of which are subject to certain quality or performance adjustments. Medicare Advantage revenues are subject to meaningful estimating risk based on factors similar to those described for commercial health plans below. 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 earned under government programs are subject to significant estimating risk, as they can be subject to adjustment as a result of examination by government agencies or contractors, differing interpretations of applicable regulations by different Medicare contractors or regulatory authorities, differing opinions regarding a patient's diagnosis or the medical necessity of patient services, or retroactive applications or interpretations of governmental requirements. In addition to government programs, the Company also earns revenues that are paid by commercial health plans. 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. Some of the Company's commercial revenue contracts are also subject to certain quality or performance adjustments. 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. As described above, there are significant risks associated with estimating dialysis patient service revenue, whether paid from governmental or commercial sources, many of which take several years to resolve. These estimates are subject to examinations by or differing interpretations among government contractors or agencies or other regulatory authorities, retroactive application of interpretations, commercial insurance coverage changes, geographic coverage differences, differing interpretations of commercial contract coverage and other payor- and patient-specific issues, including determination of applicable primary and secondary coverage, changes in patient insurance coverage and coordination of benefits. As the Company's revenue estimates are refined over time, both positive and negative adjustments to revenue are recognized in the current period. Other revenues Other revenues consist of revenues earned by the Company's non-dialysis ancillary services as well as fees for management and administrative services to outpatient dialysis businesses that the Company does not consolidate. Other revenues are estimated and recognized in the period the Company's performance obligations are met, subject to applicable measurement constraints. The Company's IKC revenues include revenues earned under risk-based arrangements, including value-based care (VBC) arrangements. Under its VBC arrangements, the Company assumes full or shared financial risk for the total medical cost of care for patients below or above a benchmark. The benchmarks against which the Company incurs profit or loss on these contracts are typically based on the underlying premiums paid to the insuring entity (the Company's counterparty), with adjustments where applicable, or on trended and adjusted medical cost targets. For some of the Company's risk-based arrangements (such as its special needs plans), the Company acts as a principal with respect to all medical services provided to the patient by effectively hosting or sponsoring the entire arrangement, and as a result recognizes revenue and expense for all medical services provided to covered patients. However, under its VBC arrangements (including VBC contracts with health plans and via direct government programs), the Company provides health monitoring and care coordination services to patients but does not control or direct the medical services that patients receive from third party providers. As a result, the Company does not include third party medical costs in its reported revenues and expenses for its VBC arrangements, but rather recognizes revenue only for the estimated amount of shared savings or shared losses or related revenues that are directly earned or incurred by the Company, and ultimately paid to or by the Company, under the arrangement. Measurements of revenue for the Company's IKC risk-based arrangements are complex, sensitive to a number of key inputs, and require meaningful estimates for a number of factors, including but not limited to member alignment data, third-party medical claims expense, outcomes on various quality metrics, and ultimate risk adjustment factor (RAF) scores. Information and other measurement limitations on these factors may constrain revenue recognition for a risk-based arrangement until a period after the Company's performance obligations have been met. Other (loss) income, net Other (loss) income includes interest income on cash and cash equivalents and short- and long-term investments, equity investment (loss) income on equity method investments other than dialysis partnerships, realized and unrealized gains and losses recognized on other investments, impairments 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. 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 (loss) 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 4 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 and purchase volume levels from the manufacturer and related data submission. Property and equipment The Company capitalizes expenditures to purchase property and equipment, improvements thereon, leasehold improvements, and qualifying software costs, as well as costs to replace, extend the life of or improve the functionality of existing capital assets, where such purchases and costs have an expected benefit period of more than one year. All other expenditures related to capital assets are expensed as incurred (i.e., as repairs and maintenance expense). 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. Property and equipment assets are reviewed for possible impairment whenever significant events or changes in circumstances indicate that an impairment may have occurred. Property and equipment impairment assessments are performed at a location or market level, as applicable, based on the specific cash flows they support or protect. If the Company commits to a plan to dispose of a long-lived asset before the end of its previously estimated useful life, cash flow estimates are revised accordingly, and the Company records an asset impairment, if applicable, or accelerates depreciation over the revised estimated useful life. Upon sale or retirement of long-lived assets, the cost and related accumulated depreciation or amortization are removed from the balance sheet and any resulting gain or loss is included in current operating expenses. Leases The Company leases substantially all of its 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 lease right-of-use assets and related lease liabilities when renewal is considered reasonably certain at the commencement date. The Company's leases are generally subject to fixed escalation clauses or contain consumer price index increases. 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. For short-term leases with a term of less than 12 months, the Company does not recognize lease right-of-use assets or lease liabilities and instead recognizes short-term lease costs as rent expense directly as incurred. Financing and operating lease liabilities are measured at the net present value of lease payments over the lease term 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. Accretion of interest on finance lease liabilities is included in debt expense. 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. Both amortization of operating lease right-of-use assets and interest accretion on operating lease liabilities are recorded to rent expense over the lease term. Rent expenses are included in patient care costs or general and administrative expense, as applicable, based on the business unit or corporate function for which the space is leased. The Company evaluates its lease right-of-use assets for impairments in a similar manner to long-lived assets, as described above in Property and equipment . 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: noncompetition 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. Amortizable intangible asset impairment assessments are performed on a location, market or business unit basis, as applicable, based on the specific cash flows they support or protect. 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 unless the fair value option is elected. Equity investments without readily determinable fair values for which the Company does not maintain significant influence over the investee are carried either on the adjusted cost method or at estimated fair value, as determined on an investment-specific basis. The adjusted cost method represents the Company's cost for an investment, net of any impairments, as adjusted for any subsequent observable price changes. These equity investments are classified as equity method and other investments on the Company's consolidated balance sheet. See Note 8 for further details. Equity method 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. Income and expense from nonconsolidated dialysis partnerships accounted for as equity method investments are recorded within equity investment income, net. For ownership interests accounted for as equity method investments other than dialysis partnerships, income and expense are included on up to a one quarter lag in other (loss) income, net. 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. The Company operates multiple reporting units. The Company's annual impairment assessment is performed in the third quarter for its U.S. dialysis reporting unit and at various points throughout the year for its other reporting units. In addition to these annual impairment assessments, the Company performs impairment assessments at intervening periods when a reporting unit is considered at risk of significant goodwill impairment. In performing these assessments, the Company may first assess goodwill for impairment qualitatively as determined appropriate. If goodwill is more likely than not impaired, the Company is required to perform a quantitative assessment. 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 recent good-faith offer prices received for the subject business that would be acceptable to the Company. An impairment charge is recognized when and to the extent a reporting unit's carrying amount is determined to exceed its fair value after taking into account the effect of deferred taxes arising from the impairment. See Note 9 for further details. Self-insurance The Company predominantly self-insures its professional and general liability, workers' compensation and automobile risks, and a portion of its employment liability practice 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, automobile, employee health benefit and portion of employment liability practice 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, state and foreign 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. 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. 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 Secured Overnight Financing Rate (SOFR) 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 12 for further details. Noncontrolling interests Noncontrolling interests represent third-party equity interests in entities which are consolidated by the Company for financial statement reporting purposes. As of December 31, 2024, third parties held direct or indirect noncontrolling equity interests in 728 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 criticality of a particular fair value estimate to the Company's consolidated financial statements depends upon the nature and size of the item being measured, the extent of uncertainties involved and the nature and magnitude or potential effect of assumptions and judgments required. Certain fair value estimates can involve significant uncertainties and require significant judgment on various matters, some of which could be subject to reasonable disagreement. 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 classified its assets, liabilities and temporary equity into the fair value hierarchy levels defined by the Financial Accounting Standards Board (FASB) reflecting their differing degrees of uncertainty. See Note 23 for further details. New accounting standards New standards recently adopted In November 2023, the FASB issued Accounting Standards Update (ASU) 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures , which expands reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. The guidance also requires disclosure of the chief operating decision maker's (CODM) position for each segment and detail of how the CODM uses financial reporting to assess their segment’s performance. The amendments in this ASU became effective for the Company beginning January 1, 2024. See Note 24 for further discussion of the Company's reportable segments. New standards not yet adopted In December 2023, the Financial Accounting Standards Board issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures , which expands income tax disclosure requirements to include additional information related to the rate reconciliation of effective tax rates to statutory rates, as well as additional disaggregation of taxes paid in both U.S. and foreign jurisdictions. The amendments in the ASU also remove disclosures related to certain unrecognized tax benefits and deferred taxes. ASU 2023-09 is effective for fiscal years beginning after December 15, 2024. The amendments may be applied prospectively or retrospectively, and early adoption is permitted. The Company intends to adopt this ASU for the fiscal year ended December 31, 2025 and is still assessing the effect this guidance may have on its consolidated financial statement disclosures. In November 2024, the Financial Accounting Standards Board issued ASU 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures, which requires disaggregated disclosure of income statement expenses, including purchases of inventory, employee compensation, depreciation, and amortization. The amendments in this ASU are effective for fiscal years beginning after December 15, 2026. The amendments in this ASU may be applied prospectively or retrospectively, and early adoption is permitted. 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, 2024
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, 2024 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,374,882 $ $ 6,374,882 Medicaid and Managed Medicaid 863,947 863,947 Other government 343,705 717,735 1,061,440 Commercial 3,783,827 248,026 4,031,853 Other revenues: Medicare and Medicare Advantage 463,731 463,731 Medicaid and Managed Medicaid 740 740 Commercial 21,396 21,396 Other (1) 24,356 58,862 83,218 Eliminations of intersegment revenues (71,747) (13,910) (85,657) Total $ 11,318,970 $ 1,496,580 $ 12,815,550 Year ended December 31, 2023 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,100,183 $ $ 6,100,183 Medicaid and Managed Medicaid 833,744 833,744 Other government 354,304 500,137 854,441 Commercial 3,623,516 251,279 3,874,795 Other revenues: Medicare and Medicare Advantage 460,991 460,991 Medicaid and Managed Medicaid 1,733 1,733 Commercial 32,329 32,329 Other (1) 25,251 52,754 78,005 Eliminations of intersegment revenues (88,222) (7,852) (96,074) Total $ 10,848,776 $ 1,291,371 $ 12,140,147 Year ended December 31, 2022 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,041,496 $ $ 6,041,496 Medicaid and Managed Medicaid 759,579 759,579 Other government 336,991 464,921 801,912 Commercial 3,437,306 223,216 3,660,522 Other revenues: Medicare and Medicare Advantage 345,340 345,340 Medicaid and Managed Medicaid 1,546 1,546 Commercial 22,211 22,211 Other (1) 24,437 44,092 68,529 Eliminations of intersegment revenues (87,035) (4,206) (91,241) Total $ 10,512,774 $ 1,097,120 $ 11,609,894 (1) Consists primarily of management service fees in the Company's U.S. dialysis business and research fees, management fees, and other non-patient service revenues in the Other - ancillary services businesses. The majority of the Company's non-patient service revenues from Medicare and Medicare Advantage, Medicaid and Managed Medicaid, and commercial sources represent risk-based revenues earned by the Company's U.S. IKC business. For its IKC business, the Company recognized revenues for performance obligations satisfied in previous years of $116,336, $94,361, and $34,600 during the years ended December 31, 2024, 2023 and 2022, respectively. The delay in recognition of these amounts resulted predominantly from measurement limitations and recognition constraints on both the Company's VBC contracts with health plans, many of which are complex and relatively new arrangements, as well as its government Comprehensive Kidney Care Contracting (CKCC) program. The Company's revenue recognition for its government CKCC program also remains heavily constrained for plan year 2024. See Note 1 "Other revenues" for a description of the Company's accounting for these value-based care arrangements. No single commercial payor accounted for more than 10% of consolidated revenues or consolidated accounts receivable for the periods presented in these consolidated financial statements or at their period-ends, respectively. Dialysis services accounts receivable and other receivables from Medicare, including Medicare Advantage plans, and Medicaid, including managed Medicaid plans, were approximately $833,464 and $817,045 as of December 31, 2024 and 2023, respectively. Approximately 23% and 19% of the Company’s U.S. dialysis accounts receivable balances as of December 31, 2024 and 2023, respectively, were more than six months old. There were no significant balances over one year old at December 31, 2024. The Company's accounts receivable are principally due from Medicare and Medicaid programs and commercial insurance plans.

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2024
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. 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 as computed under the treasury stock method. The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows: Year ended December 31, 2024 2023 2022 Net income attributable to DaVita Inc.: Continuing operations $ 936,342 $ 691,535 $ 546,948 Discontinued operations — — 13,452 Net income attributable to DaVita Inc. $ 936,342 $ 691,535 $ 560,400 Weighted average shares outstanding: Basic shares 84,991 90,790 92,992 Assumed incremental from stock plans 2,283 2,392 2,842 Diluted shares 87,274 93,182 95,834 Basic net income attributable to DaVita Inc.: Continuing operations per share $ 11.02 $ 7.62 $ 5.88 Discontinued operations per share — — 0.15 Basic net income per share attributable to DaVita Inc. $ 11.02 $ 7.62 $ 6.03 Diluted net income attributable to DaVita Inc.: Continuing operations per share $ 10.73 $ 7.42 $ 5.71 Discontinued operations per share — — 0.14 Diluted net income per share attributable to DaVita Inc. $ 10.73 $ 7.42 $ 5.85 Anti-dilutive stock-settled awards excluded from calculation (1) 103 531 1,058 (1) 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 invest

Short-term and long-term investments	12 Months Ended
	Dec. 31, 2024
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, 2024 December 31, 2023 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 44,158 $ — $ 44,158 $ 22,109 $ — $ 22,109 Investments in mutual funds and common stock — 40,566 40,566 — 37,391 37,391 $ 44,158 $ 40,566 $ 84,724 $ 22,109 $ 37,391 $ 59,500 Short-term investments $ 44,158 $ 6,906 $ 51,064 $ 7,110 $ 4,500 $ 11,610 Long-term investments — 33,660 33,660 14,999 32,891 47,890 $ 44,158 $ 40,566 $ 84,724 $ 22,109 $ 37,391 $ 59,500 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. Typically, the Company's long-term debt investments are bank time deposits with contractual maturities longer 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, 2024 and 2023. Equity securities: Substantially all of the Company's short-term and long-term equity investments are held within a trust to fund existing obligations associated with the Company’s non-qualified deferred compensation plans.

Other Receivables Other Receiva

Other Receivables Other Receivables	12 Months Ended
	Dec. 31, 2024
Receivables [Abstract]
Other Receivables	Other receivables Other receivables comprised the following: December 31, 2024 2023 Customer contract assets: Medicare bad debt claims $ 107,129 $ 107,444 IKC risk-based arrangements 143,942 127,442 Supplier rebates and non-trade receivables 132,095 187,783 383,166 $ 422,669

Property and Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2024
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment Property and equipment comprised the following: December 31, 2024 2023 Land $ 50,172 $ 35,216 Buildings 428,994 436,460 Leasehold improvements 4,180,747 4,058,987 Equipment and information systems, including internally developed software 4,410,395 4,125,235 New center and capital asset projects in progress 133,311 177,149 9,203,619 8,833,047 Less accumulated depreciation (6,262,703) (5,759,514) $ 2,940,916 $ 3,073,533 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, including internally developed software, principally three years to 15 years. Depreciation expense on property and equipment was $716,396, $736,474 and $721,133 for 2024, 2023 and 2022, 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 $7,978, $9,178 and $12,677 for 2024, 2023 and 2022, respectively.

Intangibles

Intangibles	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Intangibles	Intangible assets Intangible assets other than goodwill comprised the following: December 31, 2024 2023 Indefinite-lived licenses $ 146,025 $ 153,983 Noncompetition agreements 22,234 31,090 Customer relationships and other 61,580 56,596 229,839 241,669 Accumulated amortization: Noncompetition agreements (13,982) (23,680) Customer relationships and other (18,426) (14,765) $ 197,431 $ 203,224 Noncompetition agreements are generally amortized over four years to 10 years and customer relationships are principally amortized over 10 years to 20 years. The weighted average renewal or extension period of customer relationships was three years and two years as of December 31, 2024 and 2023, respectively. Amortization expense from amortizable intangible assets was $7,464, $8,969, and $11,469 for 2024, 2023 and 2022, respectively. For the years ended December 31, 2024, 2023 and 2022, the Company recognized no impairment charges on any intangible assets other than goodwill. See Note 9 for further information regarding goodwill. Scheduled amortization expenses from amortizable intangible assets as of December 31, 2024 were as follows: Noncompetition Customer relationships and other 2025 $ 2,301 $ 4,031 2026 1,598 4,047 2027 1,157 3,871 2028 956 3,784 2029 427 3,780 Thereafter 1,813 23,641 Total $ 8,252 $ 43,154

Equity Method and Other Investm

Equity Method and Other Investments	12 Months Ended
	Dec. 31, 2024
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 as follows: December 31, 2024 2023 Mozarc Medical Holding LLC $ 215,706 $ 324,711 APAC joint venture — 98,865 Other equity method partnerships 99,246 107,282 Adjusted cost method and other investments 21,732 14,990 $ 336,684 $ 545,848 During 2024, 2023 and 2022, the Company recognized equity investment income of $26,189, $27,864 and $26,520, respectively, from its equity method investments in nonconsolidated dialysis partnerships. The Company also recognized equity investment losses from other equity method investments of $112,696, $59,508 and $4,703 in other loss, net during 2024, 2023 and 2022, respectively. Effective April 1, 2023, the Company formed a new, independent kidney care-focused medical device company (Mozarc Medical Holding LLC, or Mozarc) with Medtronic, Inc. (Medtronic). The Company holds a 50% voting equity interest in Mozarc and Medtronic holds the other 50% voting equity interest. The Company does not maintain a controlling financial interest in Mozarc and accounts for this investment on the equity method, with equity method income or loss recognized in other loss, net, on a one-month lag. The Company's investment in Mozarc was recorded at a cumulative measured cost of $370,740, which includes the value of contingent consideration payable to Medtronic of $86,200. As of December 31, 2024, the book value of the Company's contingent consideration payable to Medtronic approximates its estimated fair value, which is based on level 3 inputs. The Company also holds a 75% voting and economic interest in DaVita Care Pte. Ltd. (the APAC joint venture, or APAC JV) and an unrelated noncontrolling investor holds the other 25% voting and economic interest in the joint venture. Prior to November 1, 2024, the Company did not control or consolidate the APAC JV as a result of substantive participating rights retained by the unrelated investor over certain key operating decisions for the joint venture. Effective November 1, 2024, the third-party rights that blocked the Company's ultimate unilateral operating control of this business were removed, resulting in the Company's consolidation of this business. See Note 20 for further information. The Company's other equity method investments include 17 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, and are often subject to blocking rights on certain key operating decisions held by outside investors, but mostly range from 30% to 65%. There were no significant investment impairments or other valuation adjustments for the years ended December 31, 2024 and 2023. For the year ended December 31, 2022, the Company recognized impairments and other valuation adjustments on the Company's adjusted cost method and other investments of $20,154 in other loss, net.

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill Changes in the carrying amount of goodwill by reportable segment were as follows: U.S. dialysis Other - Ancillary Consolidated Balance at December 31, 2022 $ 6,416,825 $ 659,785 $ 7,076,610 Acquisitions — 25,723 25,723 Impairment charges — (26,083) (26,083) Foreign currency and other adjustments — 36,310 36,310 Balance at December 31, 2023 $ 6,416,825 $ 695,735 $ 7,112,560 Acquisitions 102,082 246,987 349,069 Divestitures (1,687) (1,506) (3,193) Foreign currency and other adjustments — (83,220) (83,220) Balance at December 31, 2024 $ 6,517,220 $ 857,996 $ 7,375,216 Balance at December 31, 2024: Goodwill $ 6,517,220 $ 999,817 $ 7,517,037 Accumulated impairment charges — (141,821) (141,821) $ 6,517,220 $ 857,996 $ 7,375,216 Substantially all of the Company’s operating segments described in Note 24 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 dialysis centers within each of its international reporting units. For the Company’s other operating segments, discrete business components below the operating segment level constitute individual reporting units. The Company performed various annual impairment assessments during the year ended December 31, 2024, with no impairment indicated. None of the Company’s reporting units were considered at risk of significant goodwill impairment as of December 31, 2024. During the year ended December 31, 2023, the Company performed its annual impairment assessment of its transplant software reporting unit and recognized a goodwill impairment charge of $26,083 in that reporting unit, or $19,575 net of tax. This charge resulted from a reduction in estimated fair value for the business driven primarily from the business not achieving its revenue targets, with reduced revenue expectations for future years, as well as an increase in the risk-free rate. After this impairment charge, the transplant software reporting unit had a goodwill balance of $14,424 remaining.

Other Liabilities

Other Liabilities	12 Months Ended
	Dec. 31, 2024
Other Liabilities Disclosure [Abstract]
Other Liabilities	Other liabilities Other liabilities comprised the following: December 31, 2024 2023 Payor refunds and retractions $ 484,459 $ 448,589 Insurance and self-insurance accruals 83,038 74,337 Accrued interest 60,541 35,914 Accrued non-income tax liabilities 59,007 47,391 Other 247,100 222,647 $ 934,145 $ 828,878

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2024
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, 2024 2023 2022 Domestic $ 1,374,571 $ 1,100,420 $ 926,604 International 155,822 76,674 39,674 $ 1,530,393 $ 1,177,094 $ 966,278 Income tax expense for continuing operations consisted of the following: Year ended December 31, 2024 2023 2022 Current: Federal $ 253,504 $ 200,070 $ 201,932 State 52,410 38,370 55,593 International 31,532 21,008 16,253 Total current income tax 337,446 259,448 273,778 Deferred: Federal (47,715) (40,234) (66,400) State (2,855) 367 (12,289) International (7,220) 535 2,998 Total deferred income tax (57,790) (39,332) (75,691) $ 279,656 $ 220,116 $ 198,087 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, 2024 2023 2022 Federal income tax rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 3.4 2.6 3.8 Equity compensation (1.1) (1.1) (1.6) Nondeductible executive compensation 0.7 1.2 1.1 Political advocacy costs 0.3 0.2 2.2 Unrecognized tax benefits (0.5) (1.1) (1.1) Change in international valuation allowance 0.1 0.8 1.2 Credits (1.2) (1.2) (1.2) Other 0.3 1.9 1.1 Impact of noncontrolling interests primarily (4.7) (5.6) (6.0) Effective tax rate 18.3 % 18.7 % 20.5 % Deferred tax assets and liabilities arising from temporary differences for continuing operations were as follows: December 31, 2024 2023 Receivables $ 37,630 $ 23,075 Accrued liabilities 74,419 81,281 Operating lease liabilities 508,729 533,859 Net operating loss carryforwards 161,371 183,216 Investments in partnerships 4,108 — Other 54,600 52,142 Deferred tax assets 840,857 873,573 Valuation allowance (107,952) (113,237) Net deferred tax assets 732,905 760,336 Intangible assets (757,797) (731,024) Property and equipment (63,726) (127,191) Operating lease assets (464,455) (486,864) Investments in partnerships — (19,119) Other (66,035) (87,918) Deferred tax liabilities (1,352,013) (1,452,116) Net deferred tax liabilities $ (619,108) $ (691,780) Reported as: Deferred tax liabilities $ (665,361) $ (726,217) Deferred tax assets (included in Other long-term assets) 46,253 34,437 $ (619,108) $ (691,780) At December 31, 2024, the Company had federal net operating loss carryforwards of approximately $44,248 that expire through 2036, although a substantial amount expire by 2029. The Company also had state net operating loss carryforwards of $555,691, some of which have an indefinite life, while a substantial amount expire by 2044. Additionally, the Company had international net operating loss carryforwards of $410,313, some of which will begin to expire in 2026, though the majority have an indefinite life. The Company has a state capital loss carryover of $9,653, the majority of which will expire in 2025. 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 decrease of $5,285 in the valuation allowance is primarily due to unutilized state capital losses that expired in the current year. The Company remains indefinitely reinvested in several of the foreign jurisdictions in which it operates as of December 31, 2024. As a result of the passage of the Tax Cuts and Jobs Act (2017 Tax Act), the Company does not expect any significant taxes to be incurred if such earnings were 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, 2024 2023 Beginning balance $ 47,379 $ 63,985 Additions for tax positions related to current year 3,866 4,088 Adjustments for tax positions related to prior years (1,452) (7,273) Reductions related to lapse of applicable statute (8,309) (5,428) Reductions related to settlements with taxing authorities — (7,993) Ending balance $ 41,484 $ 47,379 As of December 31, 2024, the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold is $41,484. Of this balance, $27,336 would impact the Company’s effective tax rate if recognized. The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. We recognized a benefit of $679 and $138 related to interest and penalties net of federal tax benefit within tax expense in 2024 and 2023, respectively. At December 31, 2024 and December 31, 2023, the Company had approximately $5,846 and $6,525, respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefit. The Company and its subsidiaries are under examination in various state, local and foreign tax jurisdictions. In 2022, the Company was able to reach a settlement with the IRS for tax years 2014-2015. Subsequent to the settlement, the Company filed a 2014 refund claim with respect to a contested issue that was included in the IRS examination. During 2023 the IRS denied the refund claim and the Company has until September 2025 to appeal. Except for the 2014 refund claim, the Company is no longer subject to U.S. federal examinations prior to 2021.

Long-Term Debt

Long-Term Debt	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Long-Term Debt	Long-term debt Long-term debt comprised the following: December 31, As of December 31, 2024 2024 2023 Maturity date Interest rate Estimated fair value (1) Senior Secured Credit Facilities: Term Loan A-1 $ 2,259,295 $ 1,234,375 4/28/2028 Base +1.75% (2) $ 2,256,471 Term Loan B-1 — 2,603,786 $ — Extended Term Loan B-1 1,636,150 5/9/2031 SOFR + 2.00% $ 1,638,195 Revolving line of credit — — 4/28/2028 Base +1.75% (2) $ — Senior Notes: 4.625% Senior Notes 2,750,000 2,750,000 6/1/2030 4.625 % $ 2,533,438 3.75% Senior Notes 1,500,000 1,500,000 2/15/2031 3.75 % $ 1,301,250 6.875% Senior Notes 1,000,000 9/1/2032 6.875 % $ 1,007,500 Acquisition obligations and other notes payable (3) 56,483 102,328 2025-2038 5.58 % $ 56,483 Financing lease obligations (4) 216,401 255,491 2025-2039 4.58 % CHC temporary funding assistance (5) 92,777 — % $ 92,777 Total debt principal outstanding 9,511,106 8,445,980 Discount, premium and deferred financing costs (6) (64,336) (54,347) 9,446,770 8,391,633 Less current portion (270,867) (123,299) $ 9,175,903 $ 8,268,334 (1) For the Company's senior secured credit facilities, fair value estimates are based on bid and ask quotes, a level 2 input. For the Company's senior notes, fair value estimates are based on market level 1 inputs. For acquisition obligations and other notes payable, the carrying values presented here approximate their estimated fair values, based on estimates of their present values typically using level 2 interest rate inputs. For the CHC temporary funding assistance, the carrying value presented here approximates the estimated fair value based on the short-term nature of settlement. (2) The Company's senior secured credit facilities bear interest at Term SOFR, plus an interest rate margin, with certain portions also subject to a credit spread adjustment (CSA). Term SOFR plus CSA is referred to as "Base" in the table above. The Term Loan A-1 and revolving line of credit bear a CSA of 0.10%. (3) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current fixed and variable interest rate components in effect as of December 31, 2024. (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. (5) The Change Healthcare (CHC) temporary funding assistance, as described below, is interest-free and amounts provided under this program are subject to repayment at a future date to be mutually agreed to by the parties. The balance is included in the Company's current portion of long-term debt as of December 31, 2024. (6) As of December 31, 2024, the carrying amount of the Company's senior secured credit facilities has been reduced by a discount of $8,084 and deferred financing costs of $28,879, and the carrying amount of the Company's senior notes has been reduced by deferred financing costs of $37,612 and increased by a debt premium of $10,239. As of December 31, 2023, the carrying amount of the Company's senior secured credit facilities was reduced by a discount of $2,487 and deferred financing costs of $32,498, and the carrying amounts of the Company's senior notes was reduced by deferred financing costs of $31,491 and increased by a debt premium of $12,129. Scheduled maturities of long-term debt at December 31, 2024 were as follows: 2025 $ 270,867 2026 $ 174,693 2027 $ 202,674 2028 $ 1,922,275 2029 $ 39,993 Thereafter $ 6,900,604 Senior Secured Credit Facilities On May 9, 2024 (the Fourth Amendment Effective Date), the Company entered into the Fourth Amendment (the Fourth Amendment) to its senior secured credit agreement dated as of August 12, 2019 (as amended, restated, supplemented or otherwise modified from time to time, the Credit Agreement). The Fourth Amendment modified the Credit Agreement to, among other things, extend the maturity date for a portion of its Term Loan B-1 in the aggregate principal amount of $911,598 and extend an additional incremental principal amount of $728,653 (together, referred to as the Extended Term Loan B-1). The Company used the incremental proceeds from the Extended Term Loan B-1 to prepay a proportionate amount of the principal balance still outstanding on its Term Loan B-1. The Extended Term Loan B-1 bears interest at the Company’s option, based on (i) the Base Rate (as defined below) plus the Applicable Margin (as defined below), or (ii) the forward-looking term rate based on the secured overnight financing rate that is published by CME Group Benchmark Administration Limited (Term SOFR) plus the Applicable Margin. The "Base Rate" is defined as the highest of (i) the Federal Funds Rate, as published by the Federal Reserve Bank of New York, plus 0.50%, (ii) the prime commercial lending rate of Wells Fargo as established from time to time and (iii) Term SOFR for an interest period of one month plus 1.00%; provided that if Term SOFR or the Base Rate is less than 0.00% such rate shall be deemed to be 0.00% for purposes of the Credit Agreement. The "Applicable Margin" for the Extended Term Loan B-1 is 2.00% in the case of Term SOFR loans, and 1.00% in the case of Base Rate loans. The Extended Term Loan B-1 requires quarterly principal payments beginning on December 31, 2024 of 0.25% of the aggregate principal amount of the Extended Term Loan B-1 outstanding on the Fourth Amendment Effective Date, with the balance due on May 9, 2031. As a result of the Fourth Amendment transaction described above, the Company recognized debt prepayment, extinguishment and modification costs of $9,732 in the second quarter of 2024 composed partially of fees incurred for this transaction and partially of deferred financing costs and original issue discount written off for the portion of debt considered extinguished and reborrowed as a result of the Fourth Amendment. For the portion of the debt that was considered extinguished and reborrowed, the Company recognized constructive financing cash outflows and financing cash inflows on the statement of cash flows of $6,302 and $728,653 for the Extended Term Loan B-1, respectively, and constructive financing cash outflows of $722,351 for the prepayment of a portion of Term Loan B-1, even though no funds were actually paid or received. Another $13,282 of the debt considered extinguished related to the Extended Term Loan B-1 represented a non-cash financing activity. On August 13, 2024, the Company entered into the Sixth Amendment (the Sixth Amendment) to the Credit Agreement. The Sixth Amendment modified the Credit Agreement to extend an additional incremental principal amount of $1,100,000 on its Term Loan A-1 (together with the existing Term Loan A-1 balance, referred to as the Increased Term Loan A-1). The Sixth Amendment also incorporated the provisions of the Fifth Amendment to the Credit Agreement, dated as of August 7, 2024, which removed a cap on the amount of incremental term "A" loans the Company can incur under the Credit Agreement. The Company used a portion of the net proceeds from this transaction along with the net proceeds from the issuance of 6.875% Senior Notes due 2032, described below, to prepay the remainder of the balance outstanding on its Term Loan B-1 maturing 2026 in the amount of $949,819, the balance outstanding on its revolving line of credit and related accrued interest and fees. The remaining borrowings added cash to the balance sheet for general corporate purposes. The Increased Term Loan A-1 bears interest at Term SOFR, plus a CSA of 0.10% and an interest rate margin which is subject to adjustment depending upon the Company's leverage ratio under the Credit Agreement, and which can range from 1.25% to 2.25%, provided that this adjusted rate shall never be less than 0.00%. The Increased Term Loan A-1 requires amortizing quarterly principal payments that began on September 30, 2024 of $29,728 per quarter through June 30, 2027, and $44,591 per quarter from September 30, 2027 through March 31, 2028, with the balance due on April 28, 2028. As a result of the Sixth Amendment transaction described above, the Company recognized debt prepayment, extinguishment and modification costs of $10,081 in the third quarter of 2024 composed partially of fees incurred for this transaction and partially of deferred financing costs and original issue discount written off for the extinguishment of the Term Loan B-1. Additionally, $861,282 of the debt considered extinguished and reborrowed related to the Increased Term Loan A-1 represented a non-cash financing activity. Borrowings under the Company's senior secured credit facilities are guaranteed and secured by substantially all of DaVita Inc.'s and certain of the Company’s domestic subsidiaries' assets and rank senior to all unsecured indebtedness. Borrowings under the Term Loan A-1, Extended Term Loan B-1 and revolving line of credit rank equal in priority for that security and related subsidiary guarantees. The Credit Agreement contains certain customary affirmative and negative covenants such as various restrictions or limitations on permitted amounts of investments (including acquisitions), share repurchases, payment of dividends, and redemptions and incurrence of other indebtedness. Many of these restrictions and limitations will not apply as long as the Company’s leverage ratio calculated in accordance with the Credit Agreement is below 4.00:1.00. In addition, the Credit Agreement requires compliance with a maximum leverage ratio covenant, tested quarterly, of 5.00:1.00 through June 30, 2026 and 4.50:1.00 thereafter (subject to an increase to 5.00:1.00 during the four fiscal quarters following a material acquisition). In addition to the prepayments described above, during 2024, the Company made regularly scheduled and other principal payments under its senior secured credit facilities totaling $75,080 on Term Loan A-1, $13,716 on Term Loan B-1 and $4,101 on Extended Term Loan B-1. As of December 31, 2024, the Company had undrawn capacity on the revolving line of credit under its senior secured credit facilities of $1,500,000. Credit available under this revolving line of credit is reduced by the amount of any letters of credit outstanding thereunder, of which there were none as of December 31, 2024. The Company also had letters of credit of approximately $161,496 outstanding under a separate bilateral secured letter of credit facility as of December 31, 2024. The Company's 2019 interest rate cap agreements expired on June 30, 2024 and a portion of the Company's 2023 cap agreements became effective on or prior to June 30, 2024. As of December 31, 2024, the effective portion of the Company's 2023 interest rate cap agreements had the economic effect of capping the Company's maximum exposure to SOFR variable interest rate changes on equivalent amounts of the Company's floating rate debt, including all of Extended Term Loan B-1 and a portion of Term Loan A-1. The remaining $395,445 outstanding principal balance of Term Loan A-1 is subject to SOFR-based interest rate volatility. These cap agreements are designated as cash flow hedges and, as a result, changes in their fair values are reported in other comprehensive income. The original premiums paid for the caps are amortized to debt expense utilizing the effective interest rate method over the term of each cap agreement starting from its effective date. These cap agreements do not contain credit risk-contingent features. Senior Notes On August 13, 2024, the Company issued $1,000,000 aggregate principal amount of 6.875% senior notes due 2032 (the 6.875% Senior Notes) in a private offering pursuant to Rule 144A and Regulation S under the Securities Act of 1933, as amended. The 6.875% Senior Notes pay interest on March 1 and September 1 of each year beginning March 1, 2025 and mature on September 1, 2032. The 6.875% Senior Notes are unsecured senior obligations and rank equally in right of payment with the Company's existing and future unsecured senior indebtedness. The 6.875% 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 6.875% Senior Notes at any time prior to September 1, 2027 at 106.875% of the aggregate principal amount from the proceeds of one or more equity offerings, plus accrued and unpaid interest. On and after September 1, 2027, the Company may at its option redeem the 6.875% Senior Notes, in whole or from time to time in part, at certain redemption prices specified in the indenture governing these notes plus accrued and unpaid interest. If the Company experiences certain change of control events, the Company must offer to repurchase all of the 6.875% Senior Notes (unless otherwise redeemed) at a price equal to 101% of the principal amount thereof, plus accrued and unpaid interest. The 6.875% Senior Notes contain restrictive covenants that limit the ability of the Company and the subsidiary guarantors of the 6.875% Senior Notes to, among other things and subject to certain exceptions and qualifications, create certain liens, enter into certain sale/leaseback transactions, or merge with or into, or convey, transfer or lease all or substantially all of their assets. The 6.875% 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. As of December 31, 2024, the Company incurred $11,421 in fees and other professional expenses associated with this transaction that were capitalized and will amortize over the term of the 6.875% Senior Notes. All of the Company's outstanding senior notes, including the 6.875% Senior Notes (collectively, the Senior Notes), are unsecured obligations, rank equally in right of payment with the Company’s existing and future unsecured senior indebtedness and require semi-annual interest payments. The Company may redeem some or all of the Senior Notes at any time on or after certain specific dates and at certain specific redemption prices as outlined in the indenture governing each series of Senior Notes. Interest rates on the Senior Notes are fixed by their terms. Change Healthcare On March 1, 2024, Change Healthcare (CHC), a subsidiary of UnitedHealth Group, launched a temporary assistance funding program (CHC Funding) to help bridge the gap in short-term cash flow needs for providers impacted by the disruption of CHC's services. Under the program, CHC provides funding to providers for amounts that would otherwise have been received (with certain limitations), but for the disruption in processing electronic claims as a result of the outage. Amounts provided under this program are subject to repayment at a future date to be mutually agreed to by CHC and the Company. CHC has restored claims submission functionality and the Company has resumed claims submissions and billing processes through CHC’s information technology systems. Through a combination of CHC's platform and certain alternate billing processes, the Company is current on its primary claims submissions, but does continue to see delays in collections with some payors. As of December 31, 2024, the remaining CHC Funding amount outstanding was $92,777. Subsequent to December 31, 2024, the Company made a payment for a portion of the CHC Funding amount, leaving a remaining balance outstanding of $70,000 as of February 13, 2025. Interest rate cap agreements During 2024 the Company entered into several forward interest rate cap agreements, described below, that have the economic effect of capping the Company's exposure to SOFR variable interest rate changes on specific portions of the Company's floating rate debt (2024 cap agreements). These 2024 cap agreements are designated as cash flow hedges and, as a result, changes in their fair values will be reported in other comprehensive income. These 2024 cap agreements do not contain credit-risk contingent features, and become effective and expire as described in the table below. The following table summarizes the Company’s interest rate cap agreements outstanding as of December 31, 2024: Notional amount effective Year cap agreements executed Initial notional amount SOFR maximum rate Approximate effective date Maturity date 2024 2025 2026 2027 2023 $ 1,000,000 3.75% 6/30/2024 12/31/2025 $ 1,000,000 $ 500,000 2023 $ 1,000,000 4.00% (1) 6/30/2024 12/31/2025 $ 1,000,000 $ 750,000 2023 $ 1,000,000 4.75% (2) 6/30/2024 12/31/2025 $ 1,000,000 $ 750,000 2023 $ 500,000 5.00% (3) 6/30/2024 12/31/2026 $ 500,000 $ 500,000 $ 500,000 2023 $ 250,000 4.50% 12/31/2024 12/31/2025 $ 250,000 2023 $ 750,000 4.00% 12/31/2024 12/31/2026 $ 750,000 $ 500,000 2024 $ 1,750,000 4.50% (4) 12/31/2025 12/31/2027 $ 1,750,000 $ 1,000,000 2024 $ 750,000 4.00% (5) 12/31/2025 12/31/2027 $ 750,000 $ 500,000 Total notional coverage $ 3,500,000 $ 3,500,000 $ 3,500,000 $ 1,500,000 Weighted average strike rate 4.29 % 4.02 % 4.32 % 4.58 % (1) Effective January 1, 2025, the maximum rate of 4.00% decreased to 3.75% for these interest rate caps. (2) Effective January 1, 2025, the maximum rate of 4.75% decreased to 4.00% for these interest rate caps. (3) Effective January 1, 2025, the maximum rate of 5.00% decreased to 4.50% for these interest rate caps. (4) Effective December 31, 2026, the maximum rate of 4.50% increases to 4.75% for these interest rate caps. (5) Effective December 31, 2026, the maximum rate of 4.00% increases to 4.25% for these interest rate caps. The following table summarizes the effects of the Company’s interest rate cap agreements for the years ended December 31, 2024, 2023 and 2022: Amount of unrealized gains (losses) in OCI on interest rate cap agreements Location in Consolidated Statements of Income Reclassification from accumulated other comprehensive income into net income Year ended December 31, Year ended December 31, Derivatives designated as cash flow hedges 2024 2023 2022 2024 2023 2022 Interest rate cap agreements $ 9,662 $ 9,186 $ 144,793 Debt expense $ (58,175) $ (103,567) $ (11,732) Related income tax (2,412) (2,291) (36,124) Related income tax 14,515 25,840 2,926 Total $ 7,250 $ 6,895 $ 108,669 $ (43,660) $ (77,727) $ (8,806) The fair value of the Company's interest rate cap agreements, which are classified in other long-term assets on its consolidated balance sheet, were $30,062 and $79,805 for the years ended December 31, 2024 and December 31, 2023, respectively. See Note 19 for further details on amounts recorded and reclassified from accumulated other comprehensive (loss) income and recorded as debt expense (offset) related to the Company’s interest rate cap agreements for the year ended December 31, 2024. As a result of the variable rate cap from the Company's 2023 interest rate cap agreements, the Company’s weighted average effective interest rate on its senior secured credit facilities at the end of December 31, 2024 was 6.91%, based on the current margins in effect for its senior secured credit facilities as of December 31, 2024, as detailed in the table above. The Company’s weighted average effective interest rate on all debt, including the effect of interest rate caps and amortization of debt discount, was 5.07% for the year ended December 31, 2024 and 5.68% as of December 31, 2024. As of December 31, 2024, the Company’s interest rates were fixed and economically fixed on approximately 59% and 96% of its total debt, respectively. Debt expense Debt expense consisted of interest expense of $435,203, $373,951 and $339,247 and the amortization and accretion of debt discounts and premiums, amortization of deferred financing costs, costs for the undrawn portion of the revolving line of credit and the amortization of interest rate cap agreements of $35,266, $24,600 and $17,772 for 2024, 2023 and 2022, respectively. These interest expense amounts are net of capitalized interest.

Leases

Leases	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Leases Disclosure	Leases The Company leases substantially all of its dialysis facilities. The majority of the Company’s facilities are leased under non-cancellable operating leases which range in terms from five years to 15 years and which contain renewal options of five years to 10 years at the fair rental value at the time of renewal. The Company's leases are generally subject to fixed escalation clauses or contain consumer price index increases. See Note 1 for further information on how the Company accounts for leases. As of December 31, 2024 and December 31, 2023, assets recorded under finance leases 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. Substantially all of 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 10 years to 15 years and containing renewal options of five years to 15 years at the fair rental value at the time of renewal. The components of lease expense were as follows: Year ended December 31, Lease cost 2024 2023 2022 Operating lease cost (1) : Fixed lease expense $ 557,591 $ 556,844 $ 552,194 Variable lease expense 131,539 135,990 127,621 Financing lease cost: Amortization of leased assets 28,262 26,964 27,079 Interest on lease liabilities 10,885 11,724 12,776 Net lease cost $ 728,277 $ 731,522 $ 719,670 (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 2024 2023 2022 Weighted average remaining lease term (years): Operating leases 7.2 7.6 8.2 Finance leases 7.9 8.5 9.4 Weighted average discount rate: Operating leases 4.1 % 4.0 % 3.6 % Finance leases 4.6 % 4.6 % 4.5 % Year ended December 31, Other information 2024 2023 2022 Gains on sale leasebacks, net $ 2,260 $ 3,387 $ 28,005 Cash paid for amounts included in the Operating cash flows for operating leases $ 719,339 $ 708,162 $ 696,291 Operating cash flows for finance leases $ 18,599 $ 19,246 $ 20,103 Financing cash flows for finance leases $ 29,592 $ 26,455 $ 24,329 Net operating lease assets obtained in exchange $ 286,022 $ 269,564 $ 278,108 Future minimum lease payments under non-cancellable leases as of December 31, 2024 are as follows: Operating leases Finance leases 2025 $ 508,420 $ 36,557 2026 517,309 38,694 2027 453,895 37,421 2028 385,211 33,854 2029 310,332 24,862 Thereafter 863,739 82,400 Total future minimum lease payments 3,038,906 253,788 Less portion representing interest (418,840) (37,387) Present value of lease liabilities $ 2,620,066 $ 216,401 Rent expense under all operating leases for 2024, 2023 and 2022 was $689,130, $692,834 and $679,815, 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 reduce the carrying value of right-of-use assets and are amortized to rent expense over the term of the lease. Finance lease obligations are included in long-term debt. See Note 12 for further details on long-term debt.

Employee Benefit Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2024
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, 2024, 2023 and 2022, the Company accrued matching contributions totaling approximately $79,006, $73,725 and $70,084, respectively. The Company also maintains a voluntary compensation deferral plan, the Deferred Compensation Plan. 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 2024, 2023 and 2022 were $2,521, $2,695 and $3,573, 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 2024, 2023 and 2022 the Company distributed $4,511, $3,899 and $3,731, 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, 2024 and 2023, the total fair value of assets held in these plans' trusts was $39,527 and $36,936, respectively. The assets of these plans are recorded at fair value with changes in fair value recorded in other loss, net. See Note 4 for further details. Any fair value changes to the corresponding liability balance are recorded as compensation expense.

Contingencies

Contingencies	12 Months Ended
	Dec. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Contingencies	Contingencies The Company operates in a highly regulated industry and is a party to, or has the potential to be a party to, various lawsuits, demands, claims, qui tam suits, governmental investigations and audits (including, without limitation, investigations or other actions resulting from its obligation to self-report suspected violations of law) and other legal proceedings, 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. Excluding amounts stated below, as of December 31, 2024 and December 31, 2023, 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 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 included an investigation into DaVita Rx, DaVita Laboratory Services, Inc. (DaVita Labs), and RMS Lifeline Inc. (Lifeline). In each of August 2018, May 2019, and July 2021, the Company received a Civil Investigative Demand (CID) pursuant to the False Claims Act from the U.S. Attorney's Office relating to this investigation. On May 6, 2024, the Company finalized and executed a settlement agreement with the government and the relator in a qui tam matter that included a settlement amount of $34,487 for this matter. On May 7, 2024, the government notified the U.S. District Court, District of Colorado of its decision to intervene for purposes of settlement in the matter of U.S. ex rel. Kogod v. DaVita Inc., et al . The government and the relator agreed to voluntarily dismiss all substantive claims in the matter, and, on July 18, 2024, the District Court dismissed all claims except for the relator’s statutory claim for expenses, attorney’s fees, and costs. On December 10, 2024, the parties signed an agreement to resolve the remaining claim for relator’s statutory claim for expenses, attorney’s fees, and costs for an immaterial amount. On December 20, 2024, the parties filed a stipulation of dismissal with the District Court on the remaining claim and the District Court ordered the relator’s claim withdrawn. 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. In November 2022, the Company learned that, on April 1, 2022, the U.S. Attorney’s Office for the District of New Jersey notified the U.S. District Court for the District of New Jersey of its decision not to elect to intervene in the matter of U.S. ex rel. Doe v. DaVita Inc. and filed a Stipulation of Dismissal. On April 13, 2022, the U.S. District Court for the District of New Jersey dismissed the case without prejudice. On October 12, 2022, the U.S. Attorney’s Office for the Eastern District of Pennsylvania notified the U.S. District Court, Eastern District of Pennsylvania, of its decision not to elect to intervene at this time in the matter of U.S. ex rel. Bayne v. DaVita Inc., et al. The court then unsealed an amended complaint, which alleges violations of federal and state False Claims Acts, by order dated October 14, 2022. On November 8, 2023, the private party relator filed a fourth amended complaint. On November 29, 2023, the Company filed a motion to dismiss the fourth amended complaint. 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 and an additional subpoena in September 2021. Those subpoenas request 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 continuing to cooperate with CDI in this investigation. 2023 District of Columbia Office of Attorney General Investigation : In January 2023, the Office of the Attorney General for the District of Columbia issued a CID to the Company in connection with an antitrust investigation into the AKF. The CID covers the period from January 1, 2016 to the present. The CID requests information on a number of topics, including but not limited to the Company’s communications with the AKF, documents relating to donations to the AKF, and communications with patients, providers, and insurers regarding the AKF. The Company is cooperating with the government in this investigation. 2024 Federal Trade Commission Investigation : In April 2024, the Company received from the Federal Trade Commission (FTC) two CIDs in connection with an industry investigation under Section 5 of the Federal Trade Commission Act regarding the acquisition of medical director services and provision of dialysis services. The CIDs cover the period from January 1, 2016 to the present and generally seek information relating to restrictive covenants, such as non-competes, with physicians. 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 ongoing 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. Negative findings or terms and conditions that the Company might agree to accept 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, an impact on the Company's various relationships and/or contracts related to the Company's business, 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. Other Proceedings 2021 Antitrust Indictment and Putative Class Action Suit : On July 14, 2021, an indictment was returned by a grand jury in the U.S. District Court, District of Colorado against the Company and its former chief executive officer in the matter of U.S. v. DaVita Inc., et al. alleging that purported agreements entered into by DaVita's former chief executive officer not to solicit senior-level employees violated Section 1 of the Sherman Act. On April 15, 2022, a jury returned a verdict in the Company’s favor, acquitting both the Company and its former chief executive officer on all counts. On April 20, 2022, the court entered judgments of acquittal and closed the case. On August 9, 2021, DaVita Inc. and its former chief executive officer were added as defendants in a consolidated putative class action complaint in the matter of In re Outpatient Medical Center Employee Antitrust Litigation in the U.S. District Court, Northern District of Illinois. This class action complaint asserts that the defendants violated Section 1 of the Sherman Act and seeks to bring an action on behalf of certain groups of individuals employed by the Company. On October 27, 2024, the plaintiffs filed a Third Amended Complaint, seeking to bring an action on behalf of certain groups of individuals employed by the Company between March 2008 and January 2021, to which the Company responded on December 20, 2024. The Company disputes the allegations in the class action complaint, as well as the asserted violations of the Sherman Act, and intends to defend this action accordingly. Additionally, 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 15, 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, may impact the Company's various relationships and/or contracts related to the Company's business 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, 2024
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. 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 The Company has agreements with various suppliers to purchase established amounts of dialysis equipment, parts, pharmaceuticals and supplies. As of December 31, 2024, the remaining minimum purchase commitments under these arrangements were approximately $559,952, $547,079, $547,031, $564,134 and $414,491 for the years 2025, 2026, 2027, 2028 and 2029, 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. 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 $7,131. Other than the letters of credit disclosed in Note 12 to these consolidated financial statements, and the arrangements as described above, the Company has no off balance sheet financing arrangements as of December 31, 2024.

Stock-based compensation

Stock-based compensation	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Long-term Incentive Compensation and Shareholders’ Equity	Stock-based compensation Stock-based compensation Stock-based compensation consists primarily of stock-settled stock appreciation rights, restricted stock units and performance stock units. Stock-based compensation, 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. See Note 1 "Organization and summary of significant accounting policies" for more information on how the Company measures and recognizes stock-based compensation expense. Long-term incentive compensation plans The DaVita Inc. 2020 Incentive Award 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 stated on a full value share 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, 2024, there were 4,969 shares available for future grants under the 2020 Plan. The Company’s stock awards granted under the 2020 Plan generally vest over 36 months to 48 months from the date of grant. A summary of the status of the Company’s stock-settled awards, including base shares for stock-settled stock appreciation rights (SSARs) and stock-settled stock unit awards is as follows: Year ended December 31, 2024 Stock appreciation rights Stock units Awards Weighted Weighted Awards Weighted Outstanding at beginning of year 3,471 $ 67.40 3,223 Granted — 827 Added by performance factor 16 Exercised/Vested (3,200) $ 63.99 (628) Canceled (3) $ 75.95 (292) Outstanding at end of period 268 $ 108.02 1.63 3,146 1.96 Exercisable at end of period 72 $ 102.48 1.01 — — Weighted-average fair value of grants: 2024 $ 142.36 2023 $ 77.61 2022 $ 35.13 $ 107.60 Awards Outstanding Weighted average exercise price Awards exercisable Weighted average exercise price Range of SSARs base prices $70.01–$80.00 14 $ 75.95 14 $ 75.95 $100.01–$110.00 124 $ 108.93 58 $ 108.93 $110.01–$120.00 130 $ 110.63 — Total 268 $ 108.02 72 $ 102.48 For the years ended December 31, 2024, 2023 and 2022, the aggregate intrinsic value of stock-based awards exercised was $323,681, $168,500 and $149,442, respectively. At December 31, 2024, the aggregate intrinsic value of stock-based awards outstanding was $490,209 and the aggregate intrinsic value of stock awards exercisable was $3,394. 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. No SSAR awards were granted during the years ended December 31, 2024 or 2023. A summary of the weighted average valuation inputs described above used for estimating the grant-date fair value of SSAR awards granted during the year end December 31, 2022 were as follows: Expected term 4.5 Expected volatility 34.3 % Expected dividend yield — % Risk-free interest rate 2.1 % The Company estimates expected forfeitures based upon historical experience with separate groups of employees that have exhibited similar forfeiture behavior in the past. Stock-based compensation expense is recorded only for awards that are expected to vest. Employee stock purchase plan The Employee Stock Purchase Plan entitles qualifying employees to purchase up to $25 of the Company’s common stock during each calendar year. The amounts used to purchase stock are accumulated through payroll withholdings or through optional lump sum payments made in advance of the first day of the purchase right period. This compensatory plan allows employees to purchase stock for the lesser of 100% of its fair market value on the first day of the purchase right period or 85% of its fair market value on the last day of the purchase right period. Purchase right periods begin on January 1 and July 1, and end on December 31. Contributions used to purchase the Company’s common stock under this plan for the 2024, 2023 and 2022 purchase periods were $20,441, $18,213 and $18,061, respectively. Shares purchased pursuant to the plan’s 2024, 2023 and 2022 purchase periods were 184, 231 and 285, respectively. At December 31, 2024, there were 5,286 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 2024, 2023 and 2022, respectively: expected volatility of 32.6%, 41.3% and 31.7%; risk-free interest rates of 4.8%, 4.9% and 1.3%; and no dividends. Using these assumptions, the weighted average estimated per share fair value of each purchase right was $31.78, $25.25 and $26.50 for 2024, 2023 and 2022, respectively. Stock-based compensation expense and proceeds For the years ended December 31, 2024, 2023 and 2022, the Company recognized $102,788, $112,375 and $95,427 in 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 2024, 2023 and 2022 were $16,398, $16,536 and $14,723, respectively. As of December 31, 2024, there was $146,350 of total estimated but unrecognized stock-based compensation expense under the Company’s equity compensation plans. The Company expects to recognize this expense over a weighted average remaining period of 1.2 years. For the years ended December 31, 2024, 2023 and 2022, the Company received $27,531, $25,629 and $24,805, 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, 2024
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, 2024, 2023 and 2022: 2024 2023 2022 Open market repurchases Shares 9,833 2,904 8,095 Amounts paid (1) $ 1,389,072 $ 285,710 $ 787,854 Average price paid per share (2) $ 140.06 $ 97.82 $ 97.30 (1) Includes commissions and the 1% excise tax imposed on certain stock repurchases made after December 31, 2022 by the Inflation Reduction Act of 2022. The excise tax is recorded as part of the cost basis of treasury stock repurchased and, as such, is included in stockholders’ equity. (2) Excludes commissions and the excise tax described above. The Company repurchased 779 shares of its common stock for $124,665 at an average price paid of $158.48 per share subsequent to December 31, 2024 through February 13, 2025, inclusive of the shares repurchased from Berkshire Inc. as discussed below. As of December 31, 2024, the Company is authorized to make share repurchases pursuant to a September 5, 2024 Board authorized repurchase plan of $2,000,000. This authorization allows the Company 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, trading plans pursuant to Rule 10b5-1 or Rule 10b-18, or any combination of the foregoing, depending upon market conditions and other considerations. As of February 13, 2025, the Company has a total of $1,811,069, excluding excise taxes, available under the current 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 its senior secured credit facilities. Berkshire share repurchase agreement On April 30, 2024, the Company entered into an agreement (the share repurchase agreement) with Berkshire Hathaway Inc. on behalf of itself and its affiliates (collectively, Berkshire). Under the share repurchase agreement, at any time Berkshire beneficially owns at least 45.0% of the issued and outstanding common stock of the Company in the aggregate, the Company will repurchase from Berkshire, and Berkshire will sell to the Company, on a quarterly basis, a number of shares of common stock sufficient to return Berkshire’s aggregate beneficial ownership to 45.0% of the Company's issued and outstanding common stock. The per share price the Company will pay Berkshire for any such share repurchase will be the volume-weighted average price per share paid by the Company for any shares of common stock repurchased by the Company from public stockholders pursuant to the Company’s share repurchase program during the applicable repurchase period. Under this agreement, repurchases of common stock by the Company from Berkshire will occur on the date that is two business days prior to the date of the Company’s regular quarterly or annual investor call to publicly report earnings; however, if at any time the Company determines that Berkshire beneficially owns or will beneficially own shares of common stock representing more than 49.5% of the issued and outstanding common stock in the aggregate, such determination will trigger immediate share repurchases under this agreement. As of December 31, 2024, Berkshire beneficially owned less than 45.0% of the issued and outstanding common stock of the Company and, as a result, no repurchase obligation existed at such date. Subsequent to December 31, 2024, through February 13, 2025, the Company's open market share repurchases caused Berkshire to beneficially own greater then 45.0%. As such, on February 11, 2025 the Company repurchased 203 shares of common stock from Berkshire for $32,001 at an average price paid of $156.01 per share. Berkshire standstill agreement Berkshire remains subject to a standstill agreement with the Company, as amended and restated as of February 9, 2022 (the standstill agreement). The standstill agreement currently restricts Berkshire’s actions with respect to acquiring additional shares of the Company’s common stock, and for any matter presented to Company stockholders, the standstill agreement requires Berkshire to vote any shares it beneficially holds in excess of 40% of the then-outstanding voting stock of the Company in accordance with the recommendation of the Board of Directors of the Company (Board). The standstill agreement also restricts Berkshire from taking certain actions, including, among other things, actions relating to stockholder proposals and actions seeking to control or influence the Board, management or policies of the Company. The standstill agreement provisions vary depending on Berkshire’s ownership levels and in the event of certain specified leadership changes at Berkshire. The standstill agreement may be terminated by Berkshire at any time it ceases to beneficially own more than 15% of the Company's then-outstanding common stock, and terminates automatically if the Company enters into or publicly announces a plan to enter into a definitive agreement concerning a transaction involving all or a controlling portion of the Company's equity securities or all, or substantially all, of the Company's assets. 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, 2024 2023 2022 Net income attributable to DaVita Inc. $ 936,342 $ 691,535 $ 560,400 Changes in paid-in capital for: Purchases of noncontrolling interests (3,102) (5,375) (6,586) Sales of noncontrolling interest 491 13,077 939 Net transfers in noncontrolling interests (2,611) 7,702 (5,647) Net income attributable to DaVita Inc. net of transfers in $ 933,731 $ 699,237 $ 554,753 The Company acquired additional ownership interests in several existing majority-owned partnerships for $53,958, $12,555 and $20,775 in 2024, 2023 and 2022, respectively.

Accumulated Other Comprehensive

Accumulated Other Comprehensive (Loss) Income	12 Months Ended
	Dec. 31, 2024
Statement of Comprehensive Income [Abstract]
Other Comprehensive (Loss) Income	Accumulated other comprehensive loss Charges and credits to other comprehensive (loss) income have been as follows: Interest rate cap agreements (1) Defined benefit plans Foreign currency Accumulated other Balance at December 31, 2021 $ (1,178) $ — $ (138,069) $ (139,247) Unrealized gains (losses) 144,793 — (30,554) 114,239 Related income tax (36,124) — 752 (35,372) 108,669 — (29,802) 78,867 Reclassification of income into net income (11,732) — — (11,732) Related income tax 2,926 — — 2,926 (8,806) — — (8,806) Balance at December 31, 2022 $ 98,685 $ — $ (167,871) $ (69,186) Unrealized gains 9,186 — 89,055 98,241 Related income tax (2,291) — (1,121) (3,412) 6,895 — 87,934 94,829 Reclassification of income into net income (103,567) — — (103,567) Related income tax 25,840 — — 25,840 (77,727) — — (77,727) Balance at December 31, 2023 $ 27,853 $ — $ (79,937) $ (52,084) Unrealized gains (losses) 9,662 46 (207,906) (198,198) Related income tax (2,412) — 45 (2,367) 7,250 46 (207,861) (200,565) Reclassification of income into net income (58,175) — (15,252) (73,427) Related income tax 14,515 — 765 15,280 (43,660) — (14,487) (58,147) Balance at December 31, 2024 $ (8,557) $ 46 $ (302,285) $ (310,796) (1) The reclassification of net interest rate cap realized losses into income are recorded as debt expense in the corresponding consolidated statements of income. See Note 12 for further details.

Acquisitions and Divestitures

Acquisitions and Divestitures	12 Months Ended
	Dec. 31, 2024
Business Combinations [Abstract]
Acquisitions and Divestitures	Acquisitions and divestitures Acquisition of DaVita Care Pte. Ltd. Effective November 1, 2024, the Company acquired control of DaVita Care Pte. Ltd. (DVC), previously referred to as the Company's APAC joint venture, through a change in control rights for no cash consideration. See Note 8 for more information. In connection with this acquisition, the Company recognized a non-cash gain of $59,067 on its previously held equity interests in the acquiree and realized a related foreign currency gain of $15,252 from foreign currency translation adjustments on this investment which were previously classified in accumulated other comprehensive loss. The Company estimated the fair value of its previously held equity interests of $114,744 using appraisals developed with an independent third party valuation firm. The following table summarizes the assets acquired and liabilities assumed in this transaction and recognized at the acquisition date at estimated fair values, as well as the estimated fair value of noncontrolling interests assumed in this transaction: Year ended December 31, 2024 Cash $ 34,818 Other current assets $ 44,810 Property and equipment 22,651 Other long-term assets 37,682 Indefinite-lived licenses 15,114 Goodwill 127,207 Liabilities assumed (54,708) Noncontrolling interests assumed (112,830) $ 114,744 Other international and routine acquisitions During 2024, 2023 and 2022, the Company acquired other dialysis and related businesses for consideration paid in cash. As part of these other international and routine transactions in 2024, the Company acquired a controlling interest in a previously nonconsolidated U.S. dialysis partnership for which it recognized a non-cash gain of $35,147 on its prior investment upon consolidation. The Company estimated the fair value of its previously held equity interest in this business using appraisals developed with independent third party valuation firms. Aggregate consideration – DVC and all other acquisitions Aggregate consideration for both the DaVita Care Pte. Ltd. acquisition and all other international and routine acquisitions described above has been as follows: Year ended December 31, 2024 2023 2022 Cash paid $ 329,187 $ 27,648 $ 59,271 Contingent purchase price and liabilities assumed 50,384 19,801 19,337 Fair value of previously held equity interests 182,270 — — Aggregate consideration $ 561,841 $ 47,449 $ 78,608 Number of dialysis centers acquired — U.S. 12 — 5 Number of dialysis centers acquired — International 198 12 11 Purchase price allocations — DVC and all other acquisitions The assets and liabilities for these acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s consolidated financial statements, as are their operating results, from the designated effective dates of the acquisitions. The initial purchase price allocations for these transactions have been recorded at estimated fair values based on information available to management and will be finalized when certain information arranged to be obtained has been received. For several of the 2024 acquisitions, certain income tax amounts are pending final evaluation and quantification of any pre-acquisition tax contingencies. In addition, valuation of contingent earn-outs, intangibles, fixed assets, leases and certain 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, 2024 2023 2022 Cash $ 83,119 $ 1,254 $ 1,963 Other current assets 249,738 6,128 6,389 Property and equipment 94,951 4,130 7,481 Right-of-use lease assets and other long-term assets 97,591 785 1,066 Indefinite-lived licenses 22,725 15,789 19,610 Goodwill 349,069 25,723 49,047 Liabilities assumed (201,704) (6,179) (6,081) Noncontrolling interests assumed (133,648) (181) (867) $ 561,841 $ 47,449 $ 78,608 The amount of goodwill related to these acquisitions recognized or adjusted in 2024, 2023 and 2022 that is deductible for local tax purposes was $54,810, $17,836 and $49,047, respectively. Pro forma financial information (unaudited) The following summary, prepared on a pro forma basis, combines the results of operations as if all acquisitions in 2024 and 2023 had been consummated as of the beginning of 2023, including the impact of certain adjustments such as amortization of intangibles, interest expense on acquisition financing and income tax effects. Year ended December 31, 2024 2023 (unaudited) Pro forma total revenues $ 13,073,083 $ 12,625,223 Pro forma net income attributable to DaVita Inc. $ 952,836 $ 732,265 Pro forma basic net income per share attributable to DaVita Inc. $ 11.21 $ 8.07 Pro forma diluted net income per share attributable to DaVita Inc. $ 10.92 $ 7.86

Held for Sale and Discontinued

Held for Sale and Discontinued Operations	12 Months Ended
	Dec. 31, 2024
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 prior DMG business to Optum, a subsidiary of UnitedHealth Group Inc. At close, the Company's ultimate net proceeds from this sale remained subject to resolution of certain post-closing adjustments. Shortly after December 31, 2022, Optum made an additional purchase price payment of $13,452 to the Company after resolution of one such post-closing matter, which represented a contingent gain to the Company for the fourth quarter of 2022. The Company recognized no DMG operating, financing or investing cash flows for the years ended December 31, 2024, 2023 and 2022. 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.

Variable Interest Entities

Variable Interest Entities	12 Months Ended
	Dec. 31, 2024
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 the VIEs the Company consolidates are either U.S. dialysis partnerships encumbered by guaranteed debt, U.S. dialysis limited partnerships, U.S. integrated kidney care subsidiaries, non-U.S. subsidiaries that are structurally dependent on subordinated debt, 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. Also, certain wholly-owned entities employed in the Company's integrated kidney care business constitute VIEs since by design these entities require additional subordinated financial support. The Company believes it has the most power over these entities' most significant activities and the Company is fully exposed to all or almost all of their expected losses. The Company therefore consolidates these wholly-owned entities as its subsidiaries. Finally, some of the Company's business units rely on the operating activities of certain nominee-owned 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 subject to transfer restriction, management and other agreements that effectively transfer substantial ultimate 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. In addition to the consolidated entities described above, the Company maintains minor equity method or other venture capital investments in certain development-stage investees which qualify as VIEs based on their capitalization. The Company has concluded that it is not the primary beneficiary of any of these investees. For the VIEs described above, these consolidated financial statements include total assets of $577,585 and total liabilities and noncontrolling interests to third parties of $249,900 at December 31, 2024. The Company also sponsors certain non-qualified deferred compensation plans whose trusts qualify as VIEs and the Company consolidates these plans as their primary beneficiary. The assets of these plans are recorded in short-term or long-term investments with related liabilities recorded in accrued compensation and benefits and other long-term liabilities. See Notes 4 and 14 for disclosures concerning the assets of these consolidated non-qualified deferred compensation plans.

Fair Values of Financial Instru

Fair Values of Financial Instruments	12 Months Ended
	Dec. 31, 2024
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, 2024 and 2023: December 31, 2024 Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 40,566 $ 40,566 Interest rate cap agreements $ 30,062 $ 30,062 Liabilities Contingent earn-out obligations for acquisitions $ 13,542 $ 13,542 Temporary equity Noncontrolling interests subject to put provisions $ 1,695,483 $ 1,695,483 December 31, 2023 Assets Investments in equity securities $ 37,391 $ 37,391 Interest rate cap agreements $ 79,805 $ 79,805 Liabilities Contingent earn-out obligations for acquisitions $ 23,088 $ 23,088 Temporary equity Noncontrolling interests subject to put provisions $ 1,499,288 $ 1,499,288 Investments in equity securities represent investments in various open-ended registered investment companies (mutual funds) and common stocks and are recorded at fair value estimated based on reported market prices or redemption prices, as applicable. See Note 4 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 12 for further discussion. As of December 31, 2024, the Company had contingent earn-out obligations associated with business acquisitions that could result in the Company paying the former owners a total of up to approximately $24,580 if certain performance targets or quality margins are met over the next one year to five years. The estimated fair value measurements of these contingent earn-out obligations are primarily based on unobservable inputs, including projected earnings before interest, taxes, depreciation, and amortization (EBITDA), revenue and key performance indicators. 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. 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, 2024, 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 $225,000. See Note 16 for a discussion of the Company’s methodology for estimating the fair values of noncontrolling interests subject to put obligations and the reconciliation of changes on the consolidated statements of equity. The Company's fair value estimates for its senior secured credit facilities are based upon quoted bid and ask prices for these instruments, a level 2 input. For the Company's senior notes, fair value estimates are based on level 1 market inputs. See Note 12 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, 2024 and 2023 at their approximate fair values due to the short-term nature of their settlements.

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2024
Segment Reporting [Abstract]
Segment Reporting	Segment reporting The Company's operating divisions are composed of its U.S. dialysis and related lab services business (its U.S. dialysis business), its U.S. integrated kidney care business, its U.S. other ancillary services and its international operations (collectively, its ancillary services), as well as its corporate administrative support functions. See Note 1 "Organization" for a summary description of the Company's businesses. The Company’s operating segments have been defined based on the separate financial information that is regularly produced and reviewed by the Company’s chief operating decision maker in making decisions about allocating resources to and assessing the financial performance of the Company’s various operating lines of business. The chief operating decision maker for the Company is its Chief Executive Officer. The Company’s separate operating segments include its U.S. dialysis and related lab services business, its U.S. integrated kidney care business, its U.S. other ancillary services, its operations in each foreign sovereign jurisdiction, and, until its reconsolidation in the fourth quarter of 2024, the Company's equity method investment in its Asia Pacific joint venture (APAC JV). The U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other 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 assess the financial performance of and allocate resources among 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 more than one of the Company’s various operating lines of business. The chief operating decision maker uses segment operating margin to assess segment profitability and resource allocation. The chief operating decision maker does not review total assets by segment to make decisions regarding resources; therefore, the total assets by segment disclosure has not been included. The following is a summary of segment revenues, segment operating margin, and a reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Year ended December 31, 2024 2023 2022 Segment revenues: U.S. dialysis Patient service revenues: External sources $ 11,294,614 $ 10,823,525 $ 10,488,327 Intersegment revenues 71,747 88,222 87,045 U.S. dialysis patient service revenues 11,366,361 10,911,747 10,575,372 Other revenues External sources 24,356 25,251 24,447 Intersegment revenues — — (10) Total U.S. dialysis revenues 11,390,717 10,936,998 10,599,809 Other - Ancillary services Patient service revenues 965,761 751,416 688,137 Other external sources 530,819 539,955 408,983 Intersegment revenues 13,910 7,852 4,206 Total ancillary services 1,510,490 1,299,223 1,101,326 Total net segment revenues 12,901,207 12,236,221 11,701,135 Elimination of intersegment revenues (85,657) (96,074) (91,241) Consolidated revenues $ 12,815,550 $ 12,140,147 $ 11,609,894 Significant segment expenses: U.S. dialysis Patient care costs $ 7,497,576 $ 7,394,640 $ 7,334,415 General and administrative 1,173,990 1,102,072 1,037,552 Depreciation and amortization 661,181 695,674 690,949 Other segment items (1) (63,037) (29,966) (28,417) U.S. dialysis segment expenses 9,269,710 9,162,420 9,034,499 Other - Ancillary services expenses 1,427,833 1,307,970 1,197,905 Segment operating margin: U.S. dialysis $ 2,121,007 1,774,578 1,565,310 Other - Ancillary services (2) 82,657 (8,747) (96,579) Total segment margin 2,203,664 1,765,831 1,468,731 Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Corporate administrative support (113,181) (163,047) (129,669) Consolidated operating income 2,090,483 1,602,784 1,339,062 Debt expense (470,469) (398,551) (357,019) Debt prepayment, extinguishment and modification costs (19,813) (7,962) — Other loss, net (69,808) (19,177) (15,765) Income from continuing operations before income taxes $ 1,530,393 $ 1,177,094 $ 966,278 (1) Other segment items for our U.S. dialysis segment include equity income from nonconsolidated joint ventures and a gain on changes in ownership interest. (2) Segment operating margin (loss) for Other - Ancillary services includes equity investment loss of $1,701, $2,103 and $1,898 in 2024, 2023 and 2022, respectively. Depreciation and amortization expense by reportable segment was as follows: Year ended December 31, 2024 2023 2022 U.S. dialysis $ 661,181 $ 695,674 $ 690,949 Other - Ancillary services 62,679 49,769 41,653 $ 723,860 $ 745,443 $ 732,602 Expenditures for property and equipment by reportable segment were as follows: Year ended December 31, 2024 2023 2022 U.S. dialysis $ 469,799 $ 501,149 $ 533,600 Other - Ancillary services 85,644 66,836 69,829 $ 555,443 $ 567,985 $ 603,429 The Company's international operations include approximately $317,488 and $240,742 in 2024 and 2023, respectively, of net property and equipment.
Net Property and Equipment International Operations	The Company's international operations include approximately $317,488 and $240,742 in 2024 and 2023, respectively, of net property and equipment.

Supplemental Cash Flow Informat

Supplemental Cash Flow Information	12 Months Ended
	Dec. 31, 2024
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, 2024 2023 2022 Cash paid: Income taxes, net $ 387,940 $ 268,091 $ 344,430 Interest, net $ 423,360 $ 387,661 $ 350,999 Non-cash investing and financing activities: Fixed assets under financing lease obligations $ 11,327 $ 13,269 $ 1,928

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net (loss) income attributable to DaVita Inc.	$ 936,342	$ 691,535	$ 560,400

Insider Trading Arrangements

Insider Trading Arrangements	12 Months Ended
	Dec. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Cybersecurity Risk Management a

Cybersecurity Risk Management and Strategy Disclosure	12 Months Ended
	Dec. 31, 2024
Cybersecurity Risk Management, Strategy, and Governance [Line Items]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	Item 1C. Cybersecurity Risk Management and Strategy Information security risks have significantly increased in recent years in part because of the proliferation of new technologies, the increasing use of the Internet and telecommunications technologies to conduct our operations, and the increased sophistication and activities of organized crime, hackers, terrorists and other external parties, including, among others, foreign state agents. Our business and operations rely on the secure and continuous processing, transmission and storage of confidential, proprietary and other information in our computer systems and networks, including, but not limited to, sensitive personal information, such as PHI, social security numbers, and/or credit card information of our patients, teammates, physicians, business partners and others. Our business and operations also rely on certain critical IT vendors that support such processing, transmission and storage (which have become more relevant and important given the information security issues and risks that are intensified through our increased use of remote work arrangements). To manage risks to our Company, including information and security risks, our Board oversees our enterprise-wide approach to risk management with a fundamental belief that the key components of risk management are: • Identifying potential risks that we face; • Assessing the likelihood and potential impact of the risks; • Adopting strategies and controls designed to manage the risks; • Reporting on a regular basis regarding the assessment and management of the risks; • Monitoring these potential risks on a regular basis; and • Evaluating whether there are new potential risks to assess. Under our Enterprise Risk Management (ERM) process, the Company evaluates risks to the enterprise on short, intermediate and long-term bases. The ERM Committee, a group comprised of members of senior management, meet on a regular basis to oversee the performance of these risk management functions. We assess risks using a probability-magnitude lens, with shorter and intermediate term risks generally given greater weight. We prioritize mitigating activities on shorter and intermediate term risks, but also use risk analyses and oversight to proactively incorporate mitigating activities into our long-term strategy. The ERM process reflects a Company-wide effort designed to identify, assess, manage, report and monitor enterprise risks and risk areas. This effort includes the Company's Enterprise Risk Services (Internal Audit), Sarbanes-Oxley (SOX), Compliance Audit, legal and IT security teams, among others. The identification and evaluation of cybersecurity threats and risks is integrated into this ERM process. The ERM process is incorporated into our disclosure controls and procedures. Representatives of each of our ERM, Internal Audit, legal and compliance teams sit on the Company’s management Disclosure Committee, which is responsible for, among other things, the design and establishment of disclosure controls and procedures to help ensure the timeliness, accuracy and completeness of corporate disclosure. Our IT security and privacy teams, who are responsible for assessing cybersecurity threats and risks, in turn maintain policies and procedures designed to ensure appropriate escalation of cybersecurity incidents to meet external disclosure requirements. Our Chief Information Officer (CIO) and Chief Information Security Officer (CISO) regularly meet and coordinate with our Chief Privacy Officer (CPO). Each of the CIO, CISO and CPO also advise members of the Disclosure Committee, including our Chief Legal and Public Affairs Officer (CLO), on disclosure matters on an as-needed basis. With respect to assessing privacy, data and cybersecurity risks, the Company adopts a hybrid approach that primarily aligns with the National Institute of Standards and Technology (NIST) Cybersecurity Framework, including the guidance set forth in the NIST HIPAA Security Rule Cybersecurity Guide, while also evaluating against certain elements of the ISO 27001 and 27005 standards that management believes provide additional levels of guidance or structure. We regularly evaluate the Company’s cybersecurity and privacy processes and procedures, both through regular audits by our Internal Audit and IT security teams, as well as regular retention of outside advisors under direction of our IT security team. Among other things, the IT security team oversees an external third party review at least every two years that evaluates the readiness of the entire Company against the NIST Cybersecurity Framework and provides an assessment that measures Capability Maturity Model Integration levels. Additionally, our CISO engages in regular consultations, typically monthly, with third-party cybersecurity advisors. Among other things, these sessions provide the Company with a broader review of the external cybersecurity environment, helping us to stay current on emerging or developing security approaches and risks. Among other initiatives, our CISO and the Company’s IT security team actively participate in industry conferences and maintain memberships to resources such as the Health Information Sharing and Analysis Center (Health-ISAC), a trusted community of critical infrastructure owners and operators within the Health Care and Public Health sector which, among other things, allows the Company to monitor email updates and alerts coordinated with the U.S. Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency. In order to maintain awareness of privacy, data and cybersecurity risks, the Company incorporates these topics into its annual compliance training materials that are mandatory for all teammates and new hires, and among other things cover HIPAA privacy and security requirements. We maintain policies and have established processes involving our IT security, privacy and legal teams that assess potential cybersecurity risks associated with our retention and use of third-party service providers. These policies and procedures are generally aligned with the NIST Cybersecurity Framework. Prior to retaining or renewing a third-party vendor, the Company policy requires a risk assessment of such potential new vendor or new engagement through a collaborative process among the Company’s IT security, privacy, insurance and legal teams, among others. Potential vendor engagements also are reviewed to assess a range of other considerations and contractual terms and conditions, including, among other things, a potential vendor’s liability insurance limits, scope and coverage of cyber insurance and privacy data protections. Our IT SOX team also conducts annual SOX reviews for those vendors that are considered in scope for SOX controls. All finalized vendor engagements are considered by Internal Audit as part of our ordinary course risk assessment and audit planning.
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Processes Integrated [Text Block]	To manage risks to our Company, including information and security risks, our Board oversees our enterprise-wide approach to risk management with a fundamental belief that the key components of risk management are: • Identifying potential risks that we face; • Assessing the likelihood and potential impact of the risks; • Adopting strategies and controls designed to manage the risks; • Reporting on a regular basis regarding the assessment and management of the risks; • Monitoring these potential risks on a regular basis; and • Evaluating whether there are new potential risks to assess. Under our Enterprise Risk Management (ERM) process, the Company evaluates risks to the enterprise on short, intermediate and long-term bases. The ERM Committee, a group comprised of members of senior management, meet on a regular basis to oversee the performance of these risk management functions. We assess risks using a probability-magnitude lens, with shorter and intermediate term risks generally given greater weight. We prioritize mitigating activities on shorter and intermediate term risks, but also use risk analyses and oversight to proactively incorporate mitigating activities into our long-term strategy. The ERM process reflects a Company-wide effort designed to identify, assess, manage, report and monitor enterprise risks and risk areas. This effort includes the Company's Enterprise Risk Services (Internal Audit), Sarbanes-Oxley (SOX), Compliance Audit, legal and IT security teams, among others. The identification and evaluation of cybersecurity threats and risks is integrated into this ERM process. The ERM process is incorporated into our disclosure controls and procedures. Representatives of each of our ERM, Internal Audit, legal and compliance teams sit on the Company’s management Disclosure Committee, which is responsible for, among other things, the design and establishment of disclosure controls and procedures to help ensure the timeliness, accuracy and completeness of corporate disclosure. Our IT security and privacy teams, who are responsible for assessing cybersecurity threats and risks, in turn maintain policies and procedures designed to ensure appropriate escalation of cybersecurity incidents to meet external disclosure requirements. Our Chief Information Officer (CIO) and Chief Information Security Officer (CISO) regularly meet and coordinate with our Chief Privacy Officer (CPO). Each of the CIO, CISO and CPO also advise members of the Disclosure Committee, including our Chief Legal and Public Affairs Officer (CLO), on disclosure matters on an as-needed basis. With respect to assessing privacy, data and cybersecurity risks, the Company adopts a hybrid approach that primarily aligns with the National Institute of Standards and Technology (NIST) Cybersecurity Framework, including the guidance set forth in the NIST HIPAA Security Rule Cybersecurity Guide, while also evaluating against certain elements of the ISO 27001 and 27005 standards that management believes provide additional levels of guidance or structure. We regularly evaluate the Company’s cybersecurity and privacy processes and procedures, both through regular audits by our Internal Audit and IT security teams, as well as regular retention of outside advisors under direction of our IT security team. Among other things, the IT security team oversees an external third party review at least every two years that evaluates the readiness of the entire Company against the NIST Cybersecurity Framework and provides an assessment that measures Capability Maturity Model Integration levels. Additionally, our CISO engages in regular consultations, typically monthly, with third-party cybersecurity advisors. Among other things, these sessions provide the Company with a broader review of the external cybersecurity environment, helping us to stay current on emerging or developing security approaches and risks. Among other initiatives, our CISO and the Company’s IT security team actively participate in industry conferences and maintain memberships to resources such as the Health Information Sharing and Analysis Center (Health-ISAC), a trusted community of critical infrastructure owners and operators within the Health Care and Public Health sector which, among other things, allows the Company to monitor email updates and alerts coordinated with the U.S. Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency. In order to maintain awareness of privacy, data and cybersecurity risks, the Company incorporates these topics into its annual compliance training materials that are mandatory for all teammates and new hires, and among other things cover HIPAA privacy and security requirements. We maintain policies and have established processes involving our IT security, privacy and legal teams that assess potential cybersecurity risks associated with our retention and use of third-party service providers. These policies and procedures are generally aligned with the NIST Cybersecurity Framework. Prior to retaining or renewing a third-party vendor, the Company policy requires a risk assessment of such potential new vendor or new engagement through a collaborative process among the Company’s IT security, privacy, insurance and legal teams, among others. Potential vendor engagements also are reviewed to assess a range of other considerations and contractual terms and conditions, including, among other things, a potential vendor’s liability insurance limits, scope and coverage of cyber insurance and privacy data protections. Our IT SOX team also conducts annual SOX reviews for those vendors that are considered in scope for SOX controls. All finalized vendor engagements are considered by Internal Audit as part of our ordinary course risk assessment and audit planning.
Cybersecurity Risk Management Third Party Engaged [Flag]	true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]	true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]	false
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Text Block]	Cybersecurity Risks and the Impact on our Company Due to the continuously evolving series of laws and regulations related to cybersecurity, data protection and privacy that are applicable to our business, as well as the associated risks from cybersecurity threats, we have expended significant resources in order to protect our information systems and data. We regularly review, monitor and implement multiple layers of security measures through technology, processes and our people. We utilize security technologies designed to protect and maintain the integrity of our information systems and data, and our defenses are monitored and routinely tested internally and by external parties. Despite these efforts, our facilities and systems and those of our third-party service providers may be vulnerable to privacy and security incidents; security attacks and breaches; acts of vandalism or theft; computer viruses and other malicious code; coordinated attacks by a variety of actors, including, among others, activist entities or state sponsored cyberattacks; emerging cybersecurity risks; cyber risk related to connected devices; misplaced or lost data; programming and/or human errors; or other similar events that could impact the security, reliability and availability of our systems. Internal or external parties have attempted to, and will continue to attempt to, circumvent our security systems, and we have in the past, and expect that we will in the future, defend against, experience, and respond to attacks on our network including, without limitation, reconnaissance probes, denial of service attempts, malicious software attacks including ransomware or other attacks intended to render our internal operating systems or data unavailable, and phishing attacks or business email compromise. While we have experienced cybersecurity incidents in the past, to date none have had a material impact on our business, results of operations, financial condition and cash flows. Cybersecurity requires ongoing investment and diligence against evolving threats and in the context of new or developing technologies. For further information regarding the risks we face from cybersecurity threats and how our business strategy, results of operations, and financial condition could be materially affected by such risks, see Part I Item IA. " Risk Factors " under the heading, " Privacy and information security laws are complex …".
Cybersecurity Risk Board of Directors Oversight [Text Block]	Board Oversight As part of its oversight responsibilities, the Audit Committee monitors privacy, data and cybersecurity as specific risk areas. The Audit Committee also works with the Compliance and Quality Committee to oversee enterprise risks with healthcare and anti-corruption requirements, and those requirements include certain privacy, data and cybersecurity aspects. Both Mr. Schechter, a member of the Audit Committee, and Ms. Schoppert, a member of the Audit Committee, hold a CERT Certificate in Cybersecurity Oversight. The Audit Committee engages in regular discussions with management on privacy, data, and cybersecurity risk exposures, receiving quarterly reports from the ERM team and the CIO. On a periodic basis, the full Board of Directors also receives these reports from the ERM team and the CIO. The CPO and/or CLO periodically reports to the Audit Committee about the Company’s privacy program, and Internal Audit reports to the Audit Committee quarterly, providing the Audit Committee with results from any privacy, data, or cybersecurity audits. Among other things, the Company’s privacy team actively develops and implements policies designed to comply with the requirements of privacy laws in the countries where the Company operates. Working with Internal Audit and the CIO, the privacy team assesses the nature and potential severity of privacy risks within DaVita and guides the organization in taking steps to help mitigate such risks. The Audit Committee also oversees the Company's negotiation of any cybersecurity insurance. Currently, the Company maintains a cybersecurity risk insurance policy providing coverage for certain cybersecurity breaches among other specified risks.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]	The ERM Committee, a group comprised of members of senior management, meet on a regular basis to oversee the performance of these risk management functions.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]	The Audit Committee engages in regular discussions with management on privacy, data, and cybersecurity risk exposures, receiving quarterly reports from the ERM team and the CIO. On a periodic basis, the full Board of Directors also receives these reports from the ERM team and the CIO. The CPO and/or CLO periodically reports to the Audit Committee about the Company’s privacy program, and Internal Audit reports to the Audit Committee quarterly, providing the Audit Committee with results from any privacy, data, or cybersecurity audits.
Cybersecurity Risk Role of Management [Text Block]	Management As referenced above, our IT security team, in consultation with our privacy team, is primarily responsible for frontline assessments and management of day-to-day risks from cybersecurity threats, including the monitoring and detection of cybersecurity incidents and the execution of DaVita's cybersecurity and privacy incident response plans, as needed. Pursuant to the plan, the teams are responsible for assessing and classifying cybersecurity incidents and coordinating the response to such incidents, including managing both internal and external reporting obligations and remediation efforts. Our key personnel responsible for privacy and cybersecurity expertise include our CIO, CISO and CPO. Their qualifications include expertise in international privacy laws, compliance, global IT strategy, and security responsibilities, helping to ensure a comprehensive approach to risk management. Our CISO has more than two decades of experience in information technology risk and compliance and holds a Certified Chief Information Security Officer certification from EC-Council, a Certified Information Security Manager certification from ISACA and a certification from the Massachusetts Institute of Technology on AI management in healthcare. Our CPO is a Certified Information Privacy Professional and a Certified Compliance and Ethics Professional, and has more than two decades of experience in creating and implementing privacy and data protection programs that enable multinational organizations to respect and protect personal data and execute mission critical business strategies. Our IT security team also operates a 24x7 security operations center through a managed service provider. This dedicated center, alongside active monitoring of the dark web for DaVita-related data, and our use of both internal and external tools, is designed to ensure proactive detection, prevention and remediation of cybersecurity incidents. We inform and develop this integrated approach through our ongoing internal and external evaluations and risk assessments of our IT security program as described above.
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]	The Audit Committee engages in regular discussions with management on privacy, data, and cybersecurity risk exposures, receiving quarterly reports from the ERM team and the CIO. On a periodic basis, the full Board of Directors also receives these reports from the ERM team and the CIO. The CPO and/or CLO periodically reports to the Audit Committee about the Company’s privacy program, and Internal Audit reports to the Audit Committee quarterly, providing the Audit Committee with results from any privacy, data, or cybersecurity audits.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	Our key personnel responsible for privacy and cybersecurity expertise include our CIO, CISO and CPO. Their qualifications include expertise in international privacy laws, compliance, global IT strategy, and security responsibilities, helping to ensure a comprehensive approach to risk management. Our CISO has more than two decades of experience in information technology risk and compliance and holds a Certified Chief Information Security Officer certification from EC-Council, a Certified Information Security Manager certification from ISACA and a certification from the Massachusetts Institute of Technology on AI management in healthcare. Our CPO is a Certified Information Privacy Professional and a Certified Compliance and Ethics Professional, and has more than two decades of experience in creating and implementing privacy and data protection programs that enable multinational organizations to respect and protect personal data and execute mission critical business strategies.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]	The CPO and/or CLO periodically reports to the Audit Committee about the Company’s privacy program, and Internal Audit reports to the Audit Committee quarterly, providing the Audit Committee with results from any privacy, data, or cybersecurity audits.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag]	false

Organization and Summary of S_2

Organization and Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2024
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 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). 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, certain fair value estimates, accounting for income taxes 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 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. The Company maintains a usual and customary fee schedule for its dialysis treatments and related lab services; however, actual collectible revenue is normally recognized at a discount from this fee schedule. The majority of the Company's revenues are paid from government programs, principally Medicare, Medicare Advantage and Medicaid. 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. Medicare Advantage revenues are reimbursed at negotiated contract rates that are generally higher than Medicare fee-for-service rates, but which generally have a slower payment cycle than Medicare fee-for-service payments, and some of which are subject to certain quality or performance adjustments. Medicare Advantage revenues are subject to meaningful estimating risk based on factors similar to those described for commercial health plans below. 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 earned under government programs are subject to significant estimating risk, as they can be subject to adjustment as a result of examination by government agencies or contractors, differing interpretations of applicable regulations by different Medicare contractors or regulatory authorities, differing opinions regarding a patient's diagnosis or the medical necessity of patient services, or retroactive applications or interpretations of governmental requirements. In addition to government programs, the Company also earns revenues that are paid by commercial health plans. 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. Some of the Company's commercial revenue contracts are also subject to certain quality or performance adjustments. 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. As described above, there are significant risks associated with estimating dialysis patient service revenue, whether paid from governmental or commercial sources, many of which take several years to resolve. These estimates are subject to examinations by or differing interpretations among government contractors or agencies or other regulatory authorities, retroactive application of interpretations, commercial insurance coverage changes, geographic coverage differences, differing interpretations of commercial contract coverage and other payor- and patient-specific issues, including determination of applicable primary and secondary coverage, changes in patient insurance coverage and coordination of benefits. As the Company's revenue estimates are refined over time, both positive and negative adjustments to revenue are recognized in the current period. Other revenues Other revenues consist of revenues earned by the Company's non-dialysis ancillary services as well as fees for management and administrative services to outpatient dialysis businesses that the Company does not consolidate. Other revenues are estimated and recognized in the period the Company's performance obligations are met, subject to applicable measurement constraints. The Company's IKC revenues include revenues earned under risk-based arrangements, including value-based care (VBC) arrangements. Under its VBC arrangements, the Company assumes full or shared financial risk for the total medical cost of care for patients below or above a benchmark. The benchmarks against which the Company incurs profit or loss on these contracts are typically based on the underlying premiums paid to the insuring entity (the Company's counterparty), with adjustments where applicable, or on trended and adjusted medical cost targets. For some of the Company's risk-based arrangements (such as its special needs plans), the Company acts as a principal with respect to all medical services provided to the patient by effectively hosting or sponsoring the entire arrangement, and as a result recognizes revenue and expense for all medical services provided to covered patients. However, under its VBC arrangements (including VBC contracts with health plans and via direct government programs), the Company provides health monitoring and care coordination services to patients but does not control or direct the medical services that patients receive from third party providers. As a result, the Company does not include third party medical costs in its reported revenues and expenses for its VBC arrangements, but rather recognizes revenue only for the estimated amount of shared savings or shared losses or related revenues that are directly earned or incurred by the Company, and ultimately paid to or by the Company, under the arrangement. Measurements of revenue for the Company's IKC risk-based arrangements are complex, sensitive to a number of key inputs, and require meaningful estimates for a number of factors, including but not limited to member alignment data, third-party medical claims expense, outcomes on various quality metrics, and ultimate risk adjustment factor (RAF) scores. Information and other measurement limitations on these factors may constrain revenue recognition for a risk-based arrangement until a period after the Company's performance obligations have been met.
Other income	Other (loss) income, net Other (loss) income includes interest income on cash and cash equivalents and short- and long-term investments, equity investment (loss) income on equity method investments other than dialysis partnerships, realized and unrealized gains and losses recognized on other investments, impairments 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.
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 (loss) 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 4 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 and purchase volume levels from the manufacturer and related data submission.
Property and equipment	Property and equipment The Company capitalizes expenditures to purchase property and equipment, improvements thereon, leasehold improvements, and qualifying software costs, as well as costs to replace, extend the life of or improve the functionality of existing capital assets, where such purchases and costs have an expected benefit period of more than one year. All other expenditures related to capital assets are expensed as incurred (i.e., as repairs and maintenance expense). 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. Property and equipment assets are reviewed for possible impairment whenever significant events or changes in circumstances indicate that an impairment may have occurred. Property and equipment impairment assessments are performed at a location or market level, as applicable, based on the specific cash flows they support or protect. If the Company commits to a plan to dispose of a long-lived asset before the end of its previously estimated useful life, cash flow estimates are revised accordingly, and the Company records an asset impairment, if applicable, or accelerates depreciation over the revised estimated useful life. Upon sale or retirement of long-lived assets, the cost and related accumulated depreciation or amortization are removed from the balance sheet and any resulting gain or loss is included in current operating expenses.
Leases	Leases The Company leases substantially all of its 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 lease right-of-use assets and related lease liabilities when renewal is considered reasonably certain at the commencement date. The Company's leases are generally subject to fixed escalation clauses or contain consumer price index increases. 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. For short-term leases with a term of less than 12 months, the Company does not recognize lease right-of-use assets or lease liabilities and instead recognizes short-term lease costs as rent expense directly as incurred. Financing and operating lease liabilities are measured at the net present value of lease payments over the lease term 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. Accretion of interest on finance lease liabilities is included in debt expense. 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. Both amortization of operating lease right-of-use assets and interest accretion on operating lease liabilities are recorded to rent expense over the lease term. Rent expenses are included in patient care costs or general and administrative expense, as applicable, based on the business unit or corporate function for which the space is leased. The Company evaluates its lease right-of-use assets for impairments in a similar manner to long-lived assets, as described above in Property and equipment .
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: noncompetition 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. Amortizable intangible asset impairment assessments are performed on a location, market or business unit basis, as applicable, based on the specific cash flows they support or protect.
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 unless the fair value option is elected. Equity investments without readily determinable fair values for which the Company does not maintain significant influence over the investee are carried either on the adjusted cost method or at estimated fair value, as determined on an investment-specific basis. The adjusted cost method represents the Company's cost for an investment, net of any impairments, as adjusted for any subsequent observable price changes. These equity investments are classified as equity method and other investments on the Company's consolidated balance sheet. See Note 8 for further details. Equity method 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. Income and expense from nonconsolidated dialysis partnerships accounted for as equity method investments are recorded within equity investment income, net. For ownership interests accounted for as equity method investments other than dialysis partnerships, income and expense are included on up to a one quarter lag in other (loss) income, net.
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. The Company operates multiple reporting units. The Company's annual impairment assessment is performed in the third quarter for its U.S. dialysis reporting unit and at various points throughout the year for its other reporting units. In addition to these annual impairment assessments, the Company performs impairment assessments at intervening periods when a reporting unit is considered at risk of significant goodwill impairment. In performing these assessments, the Company may first assess goodwill for impairment qualitatively as determined appropriate. If goodwill is more likely than not impaired, the Company is required to perform a quantitative assessment. 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 recent good-faith offer prices received for the subject business that would be acceptable to the Company. An impairment charge is recognized when and to the extent a reporting unit's carrying amount is determined to exceed its fair value after taking into account the effect of deferred taxes arising from the impairment. See Note 9 for further details.
Self insurance	Self-insurance
Income taxes	Income taxes Federal, state and foreign income taxes are computed at currently enacted tax rates less tax credits using the asset and liability method. Deferred taxes are adjusted both for items that do not currently have tax consequences and for the cumulative effect of any changes in tax rates from those previously used to determine deferred tax assets or liabilities. Tax provisions include amounts that are currently payable, changes in deferred tax assets and liabilities that arise because of temporary differences between the timing of when items of income and expense are recognized for financial reporting and income tax purposes, changes in the recognition of tax positions and any changes in the valuation allowance caused by a change in judgment about the realizability of the related deferred tax assets. A valuation allowance is established when necessary to reduce deferred tax assets to amounts expected to be realized. The Company uses a recognition threshold of more-likely-than-not and a measurement attribute on all tax positions taken or expected to be taken in a tax return in order to be recognized in the financial statements. Once the recognition threshold is met, the tax position is then measured to determine the actual amount of benefit to recognize in the financial statements. The Company accounts for income taxes under the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the 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.
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. 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.
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 Secured Overnight Financing Rate (SOFR) 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 12 for further details.
Noncontrolling interests	Noncontrolling interests Noncontrolling interests represent third-party equity interests in entities which are consolidated by the Company for financial statement reporting purposes. As of December 31, 2024, third parties held direct or indirect noncontrolling equity interests in 728 consolidated legal entities. 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. The criticality of a particular fair value estimate to the Company's consolidated financial statements depends upon the nature and size of the item being measured, the extent of uncertainties involved and the nature and magnitude or potential effect of assumptions and judgments required. Certain fair value estimates can involve significant uncertainties and require significant judgment on various matters, some of which could be subject to reasonable disagreement. 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 classified its assets, liabilities and temporary equity into the fair value hierarchy levels defined by the Financial Accounting Standards Board (FASB) reflecting their differing degrees of uncertainty. See Note 23 for further details.
New accounting standards	New accounting standards New standards recently adopted In November 2023, the FASB issued Accounting Standards Update (ASU) 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures , which expands reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. The guidance also requires disclosure of the chief operating decision maker's (CODM) position for each segment and detail of how the CODM uses financial reporting to assess their segment’s performance. The amendments in this ASU became effective for the Company beginning January 1, 2024. See Note 24 for further discussion of the Company's reportable segments. New standards not yet adopted In December 2023, the Financial Accounting Standards Board issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures , which expands income tax disclosure requirements to include additional information related to the rate reconciliation of effective tax rates to statutory rates, as well as additional disaggregation of taxes paid in both U.S. and foreign jurisdictions. The amendments in the ASU also remove disclosures related to certain unrecognized tax benefits and deferred taxes. ASU 2023-09 is effective for fiscal years beginning after December 15, 2024. The amendments may be applied prospectively or retrospectively, and early adoption is permitted. The Company intends to adopt this ASU for the fiscal year ended December 31, 2025 and is still assessing the effect this guidance may have on its consolidated financial statement disclosures. In November 2024, the Financial Accounting Standards Board issued ASU 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures, which requires disaggregated disclosure of income statement expenses, including purchases of inventory, employee compensation, depreciation, and amortization. The amendments in this ASU are effective for fiscal years beginning after December 15, 2026. The amendments in this ASU may be applied prospectively or retrospectively, and early adoption is permitted. 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. 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 as computed under the treasury stock method.
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. Typically, the Company's long-term debt investments are bank time deposits with contractual maturities longer 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, 2024 and 2023. Equity securities: Substantially all of the Company's short-term and long-term equity investments are held within a trust to fund existing obligations associated with the Company’s non-qualified deferred compensation plans.
Other Comprehensive (Loss) Income	The reclassification of net interest rate 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 the VIEs the Company consolidates are either U.S. dialysis partnerships encumbered by guaranteed debt, U.S. dialysis limited partnerships, U.S. integrated kidney care subsidiaries, non-U.S. subsidiaries that are structurally dependent on subordinated debt, 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. Also, certain wholly-owned entities employed in the Company's integrated kidney care business constitute VIEs since by design these entities require additional subordinated financial support. The Company believes it has the most power over these entities' most significant activities and the Company is fully exposed to all or almost all of their expected losses. The Company therefore consolidates these wholly-owned entities as its subsidiaries. Finally, some of the Company's business units rely on the operating activities of certain nominee-owned 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 subject to transfer restriction, management and other agreements that effectively transfer substantial ultimate 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. In addition to the consolidated entities described above, the Company maintains minor equity method or other venture capital investments in certain development-stage investees which qualify as VIEs based on their capitalization. The Company has concluded that it is not the primary beneficiary of any of these investees.

Revenue Recognition and Account

Revenue Recognition and Accounts Receivable Segment revenue by major payor (Tables)	12 Months Ended
	Dec. 31, 2024
Disaggregation of Revenue [Abstract]
Disaggregation of Revenue	The Company's revenues by segment and primary payor source were as follows: Year ended December 31, 2024 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,374,882 $ $ 6,374,882 Medicaid and Managed Medicaid 863,947 863,947 Other government 343,705 717,735 1,061,440 Commercial 3,783,827 248,026 4,031,853 Other revenues: Medicare and Medicare Advantage 463,731 463,731 Medicaid and Managed Medicaid 740 740 Commercial 21,396 21,396 Other (1) 24,356 58,862 83,218 Eliminations of intersegment revenues (71,747) (13,910) (85,657) Total $ 11,318,970 $ 1,496,580 $ 12,815,550 Year ended December 31, 2023 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,100,183 $ $ 6,100,183 Medicaid and Managed Medicaid 833,744 833,744 Other government 354,304 500,137 854,441 Commercial 3,623,516 251,279 3,874,795 Other revenues: Medicare and Medicare Advantage 460,991 460,991 Medicaid and Managed Medicaid 1,733 1,733 Commercial 32,329 32,329 Other (1) 25,251 52,754 78,005 Eliminations of intersegment revenues (88,222) (7,852) (96,074) Total $ 10,848,776 $ 1,291,371 $ 12,140,147 Year ended December 31, 2022 U.S. dialysis Other - Ancillary services Consolidated Patient service revenues: Medicare and Medicare Advantage $ 6,041,496 $ $ 6,041,496 Medicaid and Managed Medicaid 759,579 759,579 Other government 336,991 464,921 801,912 Commercial 3,437,306 223,216 3,660,522 Other revenues: Medicare and Medicare Advantage 345,340 345,340 Medicaid and Managed Medicaid 1,546 1,546 Commercial 22,211 22,211 Other (1) 24,437 44,092 68,529 Eliminations of intersegment revenues (87,035) (4,206) (91,241) Total $ 10,512,774 $ 1,097,120 $ 11,609,894 (1) Consists primarily of management service fees in the Company's U.S. dialysis business and research fees, management fees, and other non-patient service revenues in the Other - ancillary services businesses.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2024
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, 2024 2023 2022 Net income attributable to DaVita Inc.: Continuing operations $ 936,342 $ 691,535 $ 546,948 Discontinued operations — — 13,452 Net income attributable to DaVita Inc. $ 936,342 $ 691,535 $ 560,400 Weighted average shares outstanding: Basic shares 84,991 90,790 92,992 Assumed incremental from stock plans 2,283 2,392 2,842 Diluted shares 87,274 93,182 95,834 Basic net income attributable to DaVita Inc.: Continuing operations per share $ 11.02 $ 7.62 $ 5.88 Discontinued operations per share — — 0.15 Basic net income per share attributable to DaVita Inc. $ 11.02 $ 7.62 $ 6.03 Diluted net income attributable to DaVita Inc.: Continuing operations per share $ 10.73 $ 7.42 $ 5.71 Discontinued operations per share — — 0.14 Diluted net income per share attributable to DaVita Inc. $ 10.73 $ 7.42 $ 5.85 Anti-dilutive stock-settled awards excluded from calculation (1) 103 531 1,058 (1) 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, 2024
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, 2024 December 31, 2023 Debt Equity Total Debt Equity Total Certificates of deposit and other time deposits $ 44,158 $ — $ 44,158 $ 22,109 $ — $ 22,109 Investments in mutual funds and common stock — 40,566 40,566 — 37,391 37,391 $ 44,158 $ 40,566 $ 84,724 $ 22,109 $ 37,391 $ 59,500 Short-term investments $ 44,158 $ 6,906 $ 51,064 $ 7,110 $ 4,500 $ 11,610 Long-term investments — 33,660 33,660 14,999 32,891 47,890 $ 44,158 $ 40,566 $ 84,724 $ 22,109 $ 37,391 $ 59,500

Other Receivables (Tables)

Other Receivables (Tables)	12 Months Ended
	Dec. 31, 2024
Receivables [Abstract]
Schedule of Other Receivables	Other receivables comprised the following: December 31, 2024 2023 Customer contract assets: Medicare bad debt claims $ 107,129 $ 107,444 IKC risk-based arrangements 143,942 127,442 Supplier rebates and non-trade receivables 132,095 187,783 383,166 $ 422,669

Property and Equipment (Tables)

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2024
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment comprised the following: December 31, 2024 2023 Land $ 50,172 $ 35,216 Buildings 428,994 436,460 Leasehold improvements 4,180,747 4,058,987 Equipment and information systems, including internally developed software 4,410,395 4,125,235 New center and capital asset projects in progress 133,311 177,149 9,203,619 8,833,047 Less accumulated depreciation (6,262,703) (5,759,514) $ 2,940,916 $ 3,073,533

Intangibles (Tables)

Intangibles (Tables)	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets other than Goodwill	Intangible assets other than goodwill comprised the following: December 31, 2024 2023 Indefinite-lived licenses $ 146,025 $ 153,983 Noncompetition agreements 22,234 31,090 Customer relationships and other 61,580 56,596 229,839 241,669 Accumulated amortization: Noncompetition agreements (13,982) (23,680) Customer relationships and other (18,426) (14,765) $ 197,431 $ 203,224
Scheduled Amortization Charges from Intangible Assets and Liabilities	Scheduled amortization expenses from amortizable intangible assets as of December 31, 2024 were as follows: Noncompetition Customer relationships and other 2025 $ 2,301 $ 4,031 2026 1,598 4,047 2027 1,157 3,871 2028 956 3,784 2029 427 3,780 Thereafter 1,813 23,641 Total $ 8,252 $ 43,154

Equity Method and Other Inves_2

Equity Method and Other Investmetns Equity Method and Other Investments (Tables)	12 Months Ended
	Dec. 31, 2024
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 as follows: December 31, 2024 2023 Mozarc Medical Holding LLC $ 215,706 $ 324,711 APAC joint venture — 98,865 Other equity method partnerships 99,246 107,282 Adjusted cost method and other investments 21,732 14,990 $ 336,684 $ 545,848

Goodwill (Tables)

Goodwill (Tables)	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in Carrying Value of Goodwill by Reportable Segments	Changes in the carrying amount of goodwill by reportable segment were as follows: U.S. dialysis Other - Ancillary Consolidated Balance at December 31, 2022 $ 6,416,825 $ 659,785 $ 7,076,610 Acquisitions — 25,723 25,723 Impairment charges — (26,083) (26,083) Foreign currency and other adjustments — 36,310 36,310 Balance at December 31, 2023 $ 6,416,825 $ 695,735 $ 7,112,560 Acquisitions 102,082 246,987 349,069 Divestitures (1,687) (1,506) (3,193) Foreign currency and other adjustments — (83,220) (83,220) Balance at December 31, 2024 $ 6,517,220 $ 857,996 $ 7,375,216 Balance at December 31, 2024: Goodwill $ 6,517,220 $ 999,817 $ 7,517,037 Accumulated impairment charges — (141,821) (141,821) $ 6,517,220 $ 857,996 $ 7,375,216

Other Liabilities (Tables)

Other Liabilities (Tables)	12 Months Ended
	Dec. 31, 2024
Other Liabilities Disclosure [Abstract]
Schedule of Other Liabilities	Other liabilities comprised the following: December 31, 2024 2023 Payor refunds and retractions $ 484,459 $ 448,589 Insurance and self-insurance accruals 83,038 74,337 Accrued interest 60,541 35,914 Accrued non-income tax liabilities 59,007 47,391 Other 247,100 222,647 $ 934,145 $ 828,878

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2024
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, 2024 2023 2022 Domestic $ 1,374,571 $ 1,100,420 $ 926,604 International 155,822 76,674 39,674 $ 1,530,393 $ 1,177,094 $ 966,278
Components of Income Tax Expense (Benefit)	Income tax expense for continuing operations consisted of the following: Year ended December 31, 2024 2023 2022 Current: Federal $ 253,504 $ 200,070 $ 201,932 State 52,410 38,370 55,593 International 31,532 21,008 16,253 Total current income tax 337,446 259,448 273,778 Deferred: Federal (47,715) (40,234) (66,400) State (2,855) 367 (12,289) International (7,220) 535 2,998 Total deferred income tax (57,790) (39,332) (75,691) $ 279,656 $ 220,116 $ 198,087
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, 2024 2023 2022 Federal income tax rate 21.0 % 21.0 % 21.0 % State income taxes, net of federal benefit 3.4 2.6 3.8 Equity compensation (1.1) (1.1) (1.6) Nondeductible executive compensation 0.7 1.2 1.1 Political advocacy costs 0.3 0.2 2.2 Unrecognized tax benefits (0.5) (1.1) (1.1) Change in international valuation allowance 0.1 0.8 1.2 Credits (1.2) (1.2) (1.2) Other 0.3 1.9 1.1 Impact of noncontrolling interests primarily (4.7) (5.6) (6.0) Effective tax rate 18.3 % 18.7 % 20.5 %
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, 2024 2023 Receivables $ 37,630 $ 23,075 Accrued liabilities 74,419 81,281 Operating lease liabilities 508,729 533,859 Net operating loss carryforwards 161,371 183,216 Investments in partnerships 4,108 — Other 54,600 52,142 Deferred tax assets 840,857 873,573 Valuation allowance (107,952) (113,237) Net deferred tax assets 732,905 760,336 Intangible assets (757,797) (731,024) Property and equipment (63,726) (127,191) Operating lease assets (464,455) (486,864) Investments in partnerships — (19,119) Other (66,035) (87,918) Deferred tax liabilities (1,352,013) (1,452,116) Net deferred tax liabilities $ (619,108) $ (691,780) Reported as: Deferred tax liabilities $ (665,361) $ (726,217) Deferred tax assets (included in Other long-term assets) 46,253 34,437 $ (619,108) $ (691,780)
Schedule of Unrecognized Tax Benefits Roll Forward	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, 2024 2023 Beginning balance $ 47,379 $ 63,985 Additions for tax positions related to current year 3,866 4,088 Adjustments for tax positions related to prior years (1,452) (7,273) Reductions related to lapse of applicable statute (8,309) (5,428) Reductions related to settlements with taxing authorities — (7,993) Ending balance $ 41,484 $ 47,379

Long-Term Debt (Tables)

Long-Term Debt (Tables)	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Long-term Debt	Long-term debt comprised the following: December 31, As of December 31, 2024 2024 2023 Maturity date Interest rate Estimated fair value (1) Senior Secured Credit Facilities: Term Loan A-1 $ 2,259,295 $ 1,234,375 4/28/2028 Base +1.75% (2) $ 2,256,471 Term Loan B-1 — 2,603,786 $ — Extended Term Loan B-1 1,636,150 5/9/2031 SOFR + 2.00% $ 1,638,195 Revolving line of credit — — 4/28/2028 Base +1.75% (2) $ — Senior Notes: 4.625% Senior Notes 2,750,000 2,750,000 6/1/2030 4.625 % $ 2,533,438 3.75% Senior Notes 1,500,000 1,500,000 2/15/2031 3.75 % $ 1,301,250 6.875% Senior Notes 1,000,000 9/1/2032 6.875 % $ 1,007,500 Acquisition obligations and other notes payable (3) 56,483 102,328 2025-2038 5.58 % $ 56,483 Financing lease obligations (4) 216,401 255,491 2025-2039 4.58 % CHC temporary funding assistance (5) 92,777 — % $ 92,777 Total debt principal outstanding 9,511,106 8,445,980 Discount, premium and deferred financing costs (6) (64,336) (54,347) 9,446,770 8,391,633 Less current portion (270,867) (123,299) $ 9,175,903 $ 8,268,334 (1) For the Company's senior secured credit facilities, fair value estimates are based on bid and ask quotes, a level 2 input. For the Company's senior notes, fair value estimates are based on market level 1 inputs. For acquisition obligations and other notes payable, the carrying values presented here approximate their estimated fair values, based on estimates of their present values typically using level 2 interest rate inputs. For the CHC temporary funding assistance, the carrying value presented here approximates the estimated fair value based on the short-term nature of settlement. (2) The Company's senior secured credit facilities bear interest at Term SOFR, plus an interest rate margin, with certain portions also subject to a credit spread adjustment (CSA). Term SOFR plus CSA is referred to as "Base" in the table above. The Term Loan A-1 and revolving line of credit bear a CSA of 0.10%. (3) The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current fixed and variable interest rate components in effect as of December 31, 2024. (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. (5) The Change Healthcare (CHC) temporary funding assistance, as described below, is interest-free and amounts provided under this program are subject to repayment at a future date to be mutually agreed to by the parties. The balance is included in the Company's current portion of long-term debt as of December 31, 2024. (6) As of December 31, 2024, the carrying amount of the Company's senior secured credit facilities has been reduced by a discount of $8,084 and deferred financing costs of $28,879, and the carrying amount of the Company's senior notes has been reduced by deferred financing costs of $37,612 and increased by a debt premium of $10,239. As of December 31, 2023, the carrying amount of the Company's senior secured credit facilities was reduced by a discount of $2,487 and deferred financing costs of $32,498, and the carrying amounts of the Company's senior notes was reduced by deferred financing costs of $31,491 and increased by a debt premium of $12,129.
Scheduled Maturities of Long-term Debt	Scheduled maturities of long-term debt at December 31, 2024 were as follows: 2025 $ 270,867 2026 $ 174,693 2027 $ 202,674 2028 $ 1,922,275 2029 $ 39,993 Thereafter $ 6,900,604
Derivative Instruments	The following table summarizes the Company’s interest rate cap agreements outstanding as of December 31, 2024: Notional amount effective Year cap agreements executed Initial notional amount SOFR maximum rate Approximate effective date Maturity date 2024 2025 2026 2027 2023 $ 1,000,000 3.75% 6/30/2024 12/31/2025 $ 1,000,000 $ 500,000 2023 $ 1,000,000 4.00% (1) 6/30/2024 12/31/2025 $ 1,000,000 $ 750,000 2023 $ 1,000,000 4.75% (2) 6/30/2024 12/31/2025 $ 1,000,000 $ 750,000 2023 $ 500,000 5.00% (3) 6/30/2024 12/31/2026 $ 500,000 $ 500,000 $ 500,000 2023 $ 250,000 4.50% 12/31/2024 12/31/2025 $ 250,000 2023 $ 750,000 4.00% 12/31/2024 12/31/2026 $ 750,000 $ 500,000 2024 $ 1,750,000 4.50% (4) 12/31/2025 12/31/2027 $ 1,750,000 $ 1,000,000 2024 $ 750,000 4.00% (5) 12/31/2025 12/31/2027 $ 750,000 $ 500,000 Total notional coverage $ 3,500,000 $ 3,500,000 $ 3,500,000 $ 1,500,000 Weighted average strike rate 4.29 % 4.02 % 4.32 % 4.58 % (1) Effective January 1, 2025, the maximum rate of 4.00% decreased to 3.75% for these interest rate caps. (2) Effective January 1, 2025, the maximum rate of 4.75% decreased to 4.00% for these interest rate caps. (3) Effective January 1, 2025, the maximum rate of 5.00% decreased to 4.50% for these interest rate caps. (4) Effective December 31, 2026, the maximum rate of 4.50% increases to 4.75% for these interest rate caps. (5) Effective December 31, 2026, the maximum rate of 4.00% increases to 4.25% for these interest rate caps.
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, 2024, 2023 and 2022: Amount of unrealized gains (losses) in OCI on interest rate cap agreements Location in Consolidated Statements of Income Reclassification from accumulated other comprehensive income into net income Year ended December 31, Year ended December 31, Derivatives designated as cash flow hedges 2024 2023 2022 2024 2023 2022 Interest rate cap agreements $ 9,662 $ 9,186 $ 144,793 Debt expense $ (58,175) $ (103,567) $ (11,732) Related income tax (2,412) (2,291) (36,124) Related income tax 14,515 25,840 2,926 Total $ 7,250 $ 6,895 $ 108,669 $ (43,660) $ (77,727) $ (8,806)

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Lease Expense Components	The components of lease expense were as follows: Year ended December 31, Lease cost 2024 2023 2022 Operating lease cost (1) : Fixed lease expense $ 557,591 $ 556,844 $ 552,194 Variable lease expense 131,539 135,990 127,621 Financing lease cost: Amortization of leased assets 28,262 26,964 27,079 Interest on lease liabilities 10,885 11,724 12,776 Net lease cost $ 728,277 $ 731,522 $ 719,670 (1)
Lease Other Information	Other information related to leases was as follows: Year ended December 31, Lease term and discount rate 2024 2023 2022 Weighted average remaining lease term (years): Operating leases 7.2 7.6 8.2 Finance leases 7.9 8.5 9.4 Weighted average discount rate: Operating leases 4.1 % 4.0 % 3.6 % Finance leases 4.6 % 4.6 % 4.5 % Year ended December 31, Other information 2024 2023 2022 Gains on sale leasebacks, net $ 2,260 $ 3,387 $ 28,005 Cash paid for amounts included in the Operating cash flows for operating leases $ 719,339 $ 708,162 $ 696,291 Operating cash flows for finance leases $ 18,599 $ 19,246 $ 20,103 Financing cash flows for finance leases $ 29,592 $ 26,455 $ 24,329 Net operating lease assets obtained in exchange $ 286,022 $ 269,564 $ 278,108
Schedule Of Minimum Lease Payments	Future minimum lease payments under non-cancellable leases as of December 31, 2024 are as follows: Operating leases Finance leases 2025 $ 508,420 $ 36,557 2026 517,309 38,694 2027 453,895 37,421 2028 385,211 33,854 2029 310,332 24,862 Thereafter 863,739 82,400 Total future minimum lease payments 3,038,906 253,788 Less portion representing interest (418,840) (37,387) Present value of lease liabilities $ 2,620,066 $ 216,401

Stock-based compensation and Sh

Stock-based compensation and Shareholders’ Equity (Tables)	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Summary of Status of Awards Under Stock-Based Compensation Plans and Agreements	A summary of the status of the Company’s stock-settled awards, including base shares for stock-settled stock appreciation rights (SSARs) and stock-settled stock unit awards is as follows: Year ended December 31, 2024 Stock appreciation rights Stock units Awards Weighted Weighted Awards Weighted Outstanding at beginning of year 3,471 $ 67.40 3,223 Granted — 827 Added by performance factor 16 Exercised/Vested (3,200) $ 63.99 (628) Canceled (3) $ 75.95 (292) Outstanding at end of period 268 $ 108.02 1.63 3,146 1.96 Exercisable at end of period 72 $ 102.48 1.01 — — Weighted-average fair value of grants: 2024 $ 142.36 2023 $ 77.61 2022 $ 35.13 $ 107.60
Summary of Range of Exercise Prices	Awards Outstanding Weighted average exercise price Awards exercisable Weighted average exercise price Range of SSARs base prices $70.01–$80.00 14 $ 75.95 14 $ 75.95 $100.01–$110.00 124 $ 108.93 58 $ 108.93 $110.01–$120.00 130 $ 110.63 — Total 268 $ 108.02 72 $ 102.48
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 during the year end December 31, 2022 were as follows: Expected term 4.5 Expected volatility 34.3 % Expected dividend yield — % Risk-free interest rate 2.1 %

Stockholder's equity (Tables)

Stockholder's equity (Tables)	12 Months Ended
	Dec. 31, 2024
Equity [Abstract]
Shares repurchases summary table	The following table summarizes the Company's repurchases of its common stock during the years ended December 31, 2024, 2023 and 2022: 2024 2023 2022 Open market repurchases Shares 9,833 2,904 8,095 Amounts paid (1) $ 1,389,072 $ 285,710 $ 787,854 Average price paid per share (2) $ 140.06 $ 97.82 $ 97.30 (1) Includes commissions and the 1% excise tax imposed on certain stock repurchases made after December 31, 2022 by the Inflation Reduction Act of 2022. The excise tax is recorded as part of the cost basis of treasury stock repurchased and, as such, is included in stockholders’ equity. (2) Excludes commissions and the excise tax described above.
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, 2024 2023 2022 Net income attributable to DaVita Inc. $ 936,342 $ 691,535 $ 560,400 Changes in paid-in capital for: Purchases of noncontrolling interests (3,102) (5,375) (6,586) Sales of noncontrolling interest 491 13,077 939 Net transfers in noncontrolling interests (2,611) 7,702 (5,647) Net income attributable to DaVita Inc. net of transfers in $ 933,731 $ 699,237 $ 554,753

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive (Loss) Income (Tables)	12 Months Ended
	Dec. 31, 2024
Statement of Comprehensive Income [Abstract]
Changes in Other Comprehensive (Loss) Income	Charges and credits to other comprehensive (loss) income have been as follows: Interest rate cap agreements (1) Defined benefit plans Foreign currency Accumulated other Balance at December 31, 2021 $ (1,178) $ — $ (138,069) $ (139,247) Unrealized gains (losses) 144,793 — (30,554) 114,239 Related income tax (36,124) — 752 (35,372) 108,669 — (29,802) 78,867 Reclassification of income into net income (11,732) — — (11,732) Related income tax 2,926 — — 2,926 (8,806) — — (8,806) Balance at December 31, 2022 $ 98,685 $ — $ (167,871) $ (69,186) Unrealized gains 9,186 — 89,055 98,241 Related income tax (2,291) — (1,121) (3,412) 6,895 — 87,934 94,829 Reclassification of income into net income (103,567) — — (103,567) Related income tax 25,840 — — 25,840 (77,727) — — (77,727) Balance at December 31, 2023 $ 27,853 $ — $ (79,937) $ (52,084) Unrealized gains (losses) 9,662 46 (207,906) (198,198) Related income tax (2,412) — 45 (2,367) 7,250 46 (207,861) (200,565) Reclassification of income into net income (58,175) — (15,252) (73,427) Related income tax 14,515 — 765 15,280 (43,660) — (14,487) (58,147) Balance at December 31, 2024 $ (8,557) $ 46 $ (302,285) $ (310,796)

Acquisitions and Divestitures (

Acquisitions and Divestitures (Tables)	12 Months Ended
	Dec. 31, 2024
Business Combinations [Abstract]
Schedule of Components of Routine Acquisitions	During 2024, 2023 and 2022, the Company acquired other dialysis and related businesses for consideration paid in cash. As part of these other international and routine transactions in 2024, the Company acquired a controlling interest in a previously nonconsolidated U.S. dialysis partnership for which it recognized a non-cash gain of $35,147 on its prior investment upon consolidation. The Company estimated the fair value of its previously held equity interest in this business using appraisals developed with independent third party valuation firms. Aggregate consideration – DVC and all other acquisitions Aggregate consideration for both the DaVita Care Pte. Ltd. acquisition and all other international and routine acquisitions described above has been as follows: Year ended December 31, 2024 2023 2022 Cash paid $ 329,187 $ 27,648 $ 59,271 Contingent purchase price and liabilities assumed 50,384 19,801 19,337 Fair value of previously held equity interests 182,270 — — Aggregate consideration $ 561,841 $ 47,449 $ 78,608 Number of dialysis centers acquired — U.S. 12 — 5 Number of dialysis centers acquired — International 198 12 11
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, 2024 2023 2022 Cash $ 83,119 $ 1,254 $ 1,963 Other current assets 249,738 6,128 6,389 Property and equipment 94,951 4,130 7,481 Right-of-use lease assets and other long-term assets 97,591 785 1,066 Indefinite-lived licenses 22,725 15,789 19,610 Goodwill 349,069 25,723 49,047 Liabilities assumed (201,704) (6,179) (6,081) Noncontrolling interests assumed (133,648) (181) (867) $ 561,841 $ 47,449 $ 78,608
Schedule of other information related to acquired intangibles and goodwill	The amount of goodwill related to these acquisitions recognized or adjusted in 2024, 2023 and 2022 that is deductible for local tax purposes was $54,810, $17,836 and $49,047, respectively.
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 in 2024 and 2023 had been consummated as of the beginning of 2023, including the impact of certain adjustments such as amortization of intangibles, interest expense on acquisition financing and income tax effects. Year ended December 31, 2024 2023 (unaudited) Pro forma total revenues $ 13,073,083 $ 12,625,223 Pro forma net income attributable to DaVita Inc. $ 952,836 $ 732,265 Pro forma basic net income per share attributable to DaVita Inc. $ 11.21 $ 8.07 Pro forma diluted net income per share attributable to DaVita Inc. $ 10.92 $ 7.86

Fair Values of Financial Inst_2

Fair Values of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2024
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, 2024 and 2023: December 31, 2024 Total Quoted prices in Significant other Significant Assets Investments in equity securities $ 40,566 $ 40,566 Interest rate cap agreements $ 30,062 $ 30,062 Liabilities Contingent earn-out obligations for acquisitions $ 13,542 $ 13,542 Temporary equity Noncontrolling interests subject to put provisions $ 1,695,483 $ 1,695,483 December 31, 2023 Assets Investments in equity securities $ 37,391 $ 37,391 Interest rate cap agreements $ 79,805 $ 79,805 Liabilities Contingent earn-out obligations for acquisitions $ 23,088 $ 23,088 Temporary equity Noncontrolling interests subject to put provisions $ 1,499,288 $ 1,499,288

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2024
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, and a reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Year ended December 31, 2024 2023 2022 Segment revenues: U.S. dialysis Patient service revenues: External sources $ 11,294,614 $ 10,823,525 $ 10,488,327 Intersegment revenues 71,747 88,222 87,045 U.S. dialysis patient service revenues 11,366,361 10,911,747 10,575,372 Other revenues External sources 24,356 25,251 24,447 Intersegment revenues — — (10) Total U.S. dialysis revenues 11,390,717 10,936,998 10,599,809 Other - Ancillary services Patient service revenues 965,761 751,416 688,137 Other external sources 530,819 539,955 408,983 Intersegment revenues 13,910 7,852 4,206 Total ancillary services 1,510,490 1,299,223 1,101,326 Total net segment revenues 12,901,207 12,236,221 11,701,135 Elimination of intersegment revenues (85,657) (96,074) (91,241) Consolidated revenues $ 12,815,550 $ 12,140,147 $ 11,609,894 Significant segment expenses: U.S. dialysis Patient care costs $ 7,497,576 $ 7,394,640 $ 7,334,415 General and administrative 1,173,990 1,102,072 1,037,552 Depreciation and amortization 661,181 695,674 690,949 Other segment items (1) (63,037) (29,966) (28,417) U.S. dialysis segment expenses 9,269,710 9,162,420 9,034,499 Other - Ancillary services expenses 1,427,833 1,307,970 1,197,905 Segment operating margin: U.S. dialysis $ 2,121,007 1,774,578 1,565,310 Other - Ancillary services (2) 82,657 (8,747) (96,579) Total segment margin 2,203,664 1,765,831 1,468,731 Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes: Corporate administrative support (113,181) (163,047) (129,669) Consolidated operating income 2,090,483 1,602,784 1,339,062 Debt expense (470,469) (398,551) (357,019) Debt prepayment, extinguishment and modification costs (19,813) (7,962) — Other loss, net (69,808) (19,177) (15,765) Income from continuing operations before income taxes $ 1,530,393 $ 1,177,094 $ 966,278 (1) Other segment items for our U.S. dialysis segment include equity income from nonconsolidated joint ventures and a gain on changes in ownership interest. (2) Segment operating margin (loss) for Other - Ancillary services includes equity investment loss of $1,701, $2,103 and $1,898 in 2024, 2023 and 2022, respectively.
Summary of Depreciation and Amortization Expense by Segment	Depreciation and amortization expense by reportable segment was as follows: Year ended December 31, 2024 2023 2022 U.S. dialysis $ 661,181 $ 695,674 $ 690,949 Other - Ancillary services 62,679 49,769 41,653 $ 723,860 $ 745,443 $ 732,602
Summary of Expenditures for Property and Equipment by Segment	Expenditures for property and equipment by reportable segment were as follows: Year ended December 31, 2024 2023 2022 U.S. dialysis $ 469,799 $ 501,149 $ 533,600 Other - Ancillary services 85,644 66,836 69,829 $ 555,443 $ 567,985 $ 603,429

Supplemental Cash Flow Inform_2

Supplemental Cash Flow Information (Tables)	12 Months Ended
	Dec. 31, 2024
Supplemental Cash Flow Elements [Abstract]
Supplemental Cash Flow Information	The table below provides supplemental cash flow information: Year ended December 31, 2024 2023 2022 Cash paid: Income taxes, net $ 387,940 $ 268,091 $ 344,430 Interest, net $ 423,360 $ 387,661 $ 350,999 Non-cash investing and financing activities: Fixed assets under financing lease obligations $ 11,327 $ 13,269 $ 1,928

Organization and Summary of S_3

Organization and Summary of Significant Accounting Policies - Additional Information (Details)	12 Months Ended
	Dec. 31, 2024 patient entity country clinic state
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%
Number of legal entities that third parties held noncontrolling equity interests | entity	728
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	2,657
Number of states where dialysis centers are located | state	46
Number of patients served | patient	200,800
International Operations
Organization, Consolidation and Presentation of Financial Statements Disclosure [Line Items]
Number of dialysis centers that the company operated or provided administrative services | clinic	509
Number of patients served | patient	80,300
Number of countries in which dialysis centers located | country	13

Revenue Recognition and Accou_2

Revenue Recognition and Accounts Receivable Revenue Recognition Segment Revenue by Payor (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenue Recognition
Other revenues	$ 555,175	$ 565,206	$ 433,430
Total revenue net of intersegment revenue	$ 12,815,550	$ 12,140,147	11,609,894
Accounts Receivable
Revenue Recognition
Percentage Of Accounts Receivable Six Months Or More Past Due	23%	19%
Intersegment Elimination
Revenue Recognition
Eliminations of intersegment revenues	$ (85,657)	$ (96,074)	(91,241)
Medicare and Medicare Advantage
Revenue Recognition
Patient service revenues	6,374,882	6,100,183	6,041,496
Other revenues	463,731	460,991	345,340
Medicaid and Managed Medicaid
Revenue Recognition
Patient service revenues	863,947	833,744	759,579
Other revenues	740	1,733	1,546
Other Government Payors
Revenue Recognition
Patient service revenues	1,061,440	854,441	801,912
Commercial Payors
Revenue Recognition
Patient service revenues	4,031,853	3,874,795	3,660,522
Other revenues	21,396	32,329	22,211
Other
Revenue Recognition
Other revenues	83,218	78,005	68,529
U.S. dialysis
Revenue Recognition
Total revenue net of intersegment revenue	11,318,970	10,848,776	10,512,774
U.S. dialysis | Intersegment Elimination
Revenue Recognition
Eliminations of intersegment revenues	(71,747)	(88,222)	(87,035)
U.S. dialysis | Medicare and Medicare Advantage
Revenue Recognition
Patient service revenues	6,374,882	6,100,183	6,041,496
U.S. dialysis | Medicaid and Managed Medicaid
Revenue Recognition
Patient service revenues	863,947	833,744	759,579
U.S. dialysis | Other Government Payors
Revenue Recognition
Patient service revenues	343,705	354,304	336,991
U.S. dialysis | Commercial Payors
Revenue Recognition
Patient service revenues	3,783,827	3,623,516	3,437,306
U.S. dialysis | Other
Revenue Recognition
Other revenues	24,356	25,251	24,437
Other - Ancillary services
Revenue Recognition
Total revenue net of intersegment revenue	1,496,580	1,291,371	1,097,120
Other - Ancillary services | Intersegment Elimination
Revenue Recognition
Eliminations of intersegment revenues	(13,910)	(7,852)	(4,206)
Other - Ancillary services | Medicare and Medicare Advantage
Revenue Recognition
Other revenues	463,731	460,991	345,340
Other - Ancillary services | Medicaid and Managed Medicaid
Revenue Recognition
Other revenues	740	1,733	1,546
Other - Ancillary services | Other Government Payors
Revenue Recognition
Patient service revenues	717,735	500,137	464,921
Other - Ancillary services | Commercial Payors
Revenue Recognition
Patient service revenues	248,026	251,279	223,216
Other revenues	21,396	32,329	22,211
Other - Ancillary services | Other
Revenue Recognition
Other revenues	$ 58,862	$ 52,754	$ 44,092

Revenue Recognition and Accou_3

Revenue Recognition and Accounts Receivable - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Revenue Recognition
Accounts receivable	$ 2,146,975	$ 1,986,856
Contract with Customer, Performance Obligation Satisfied in Previous Period	116,336	94,361	$ 34,600
Medicare bad debt claims
Revenue Recognition
Accounts receivable	833,464	$ 817,045
Accounts Receivable
Revenue Recognition
Accounts receivable	$ 0
Percentage Of Accounts Receivable Six Months Or More Past Due	23%	19%
Accounts Receivable Period Outstanding	6 months	6 months
Accounts Receivable, Noncurrent, Threshold Period Past Due	1 year
Customer Concentration Risk | Accounts Receivable | Third-Party Payor
Revenue Recognition
Number of concentration risk customers	0	0
Concentration risk percentage	10%	10%

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	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Net income attributable to DaVita Inc.:
Net income from continuing operations	$ 936,342	$ 691,535	$ 546,948
Net income from discontinued operations	0	0	13,452
Net income attributable to DaVita Inc.	$ 936,342	$ 691,535	$ 560,400
Weighted average shares outstanding:
Weighted average shares outstanding during the period (in shares)	84,991,000	90,790,000	92,992,000
Assumed incremental shares from stock plans (in shares)	2,283,000	2,392,000	2,842,000
Weighted average shares - diluted (in shares)	87,274,000	93,182,000	95,834,000
Basic net income attributable to DaVita Inc.:
Basic net income from continuing operations	$ 11.02	$ 7.62	$ 5.88
Basic net income from discontinued operations per share attributable to DaVita Inc.	0	0	0.15
Basic net income per share attributable to DaVita Inc.	11.02	7.62	6.03
Diluted net income attributable to DaVita Inc.:
Diluted net income from continuing operations per share attributable to DaVita Inc.	10.73	7.42	5.71
Diluted net income from discontinued operations per share attributable to DaVita Inc.	0	0	0.14
Diluted net income per share attributable to DaVita Inc.	$ 10.73	$ 7.42	$ 5.85
Anti-dilutive stock-settled awards excluded from calculation (in shares)	103,000	531,000	1,058,000

Short-term and long-term inve_2

Short-term and long-term investments (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Investment Holdings [Line Items]
Debt securities	$ 44,158	$ 22,109
Equity securities, FV-NI	40,566	37,391
Total	84,724	59,500
Debt securities, short-term investments	44,158	7,110
Total Short-term investments	51,064	11,610
Debt securities, long-term investments	0	14,999
Total Long-term investments	33,660	47,890
Equity Securities, FV-NI	40,566	37,391
Certificates of deposit and other time deposits
Investment Holdings [Line Items]
Debt securities	44,158	22,109
Equity securities, FV-NI	0	0
Total	44,158	22,109
Investments in mutual funds and common stock
Investment Holdings [Line Items]
Debt securities	0	0
Equity securities, FV-NI	40,566	37,391
Total	40,566	37,391
Short-term Investments
Investment Holdings [Line Items]
Equity securities, FV-NI	6,906	4,500
Other long-term Investments
Investment Holdings [Line Items]
Equity Securities, FV-NI, Noncurrent	$ 33,660	$ 32,891

Other Receivables (Details)

Other Receivables (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	$ 383,166	$ 422,669
Supplier rebates and non-trade receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	132,095	187,783
Medicare bad debt claims
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	107,129	107,444
IKC VBC arrangements
Accounts, Notes, Loans and Financing Receivable [Line Items]
Other receivables	$ 143,942	$ 127,442

Property and Equipment (Details

Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Abstract]
Land	$ 50,172	$ 35,216
Buildings	428,994	436,460
Leasehold improvements	4,180,747	4,058,987
Equipment and information systems, including internally developed software	4,410,395	4,125,235
New center and capital asset projects in progress	133,311	177,149
Property, plant and equipment, gross, total	9,203,619	8,833,047
Less accumulated depreciation	(6,262,703)	(5,759,514)
Property and equipment, net	$ 2,940,916	$ 3,073,533

Property and Equipment - Additi

Property and Equipment - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Depreciation expense on property and equipment	$ 716,396	$ 736,474	$ 721,133
Capitalized interest	$ 7,978	$ 9,178	$ 12,677
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 | Maximum
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, 2024	Dec. 31, 2023
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Indefinite-lived licenses	$ 146,025	$ 153,983
Finite-Lived Intangible Assets [Line Items]
Noncompetition agreements	22,234	31,090
Customer relationships and other	61,580	56,596
Intangible assets, gross (excluding goodwill)	229,839	241,669
Total intangible assets Net	197,431	203,224
Noncompete Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Accumulated Amortization	(13,982)	(23,680)
Customer relationships and other
Finite-Lived Intangible Assets [Line Items]
Accumulated Amortization	$ (18,426)	$ (14,765)

Intangibles - Scheduled Amortiz

Intangibles - Scheduled Amortization Charges from Intangible Assets and Liabilities (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Noncompete Agreements [Member]
Expected Amortization Expense [Line Items]
2025	$ 2,301
2026	1,598
2027	1,157
2028	956
2029	427
Thereafter	1,813
Total	8,252
Customer relationships and other
Expected Amortization Expense [Line Items]
2025	4,031
2026	4,047
2027	3,871
2028	3,784
2029	3,780
Thereafter	23,641
Total	$ 43,154

Intangibles - Additional Inform

Intangibles - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Amortization expense from amortizable intangible assets, other than lease agreements	$ 7,464	$ 8,969	$ 11,469
Impairment of Intangible Assets (Excluding Goodwill)	$ 0	$ 0	$ 0
Noncompete Agreements [Member] | Minimum
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Remaining Amortization Period	4 years
Noncompete Agreements [Member] | Maximum
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Remaining Amortization Period	10 years
Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Acquired Finite-lived Intangible Asset, Weighted-Average Period before Renewal or Extension	3 years	2 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	Apr. 01, 2023	Dec. 31, 2024	Dec. 31, 2023
Schedule of Equity Method Investments [Line Items]
Equity method and other investments		$ 336,684	$ 545,848
Mozarc Medical Holding LLC
Schedule of Equity Method Investments [Line Items]
Transaction Agreement Effective Closing Date	Apr. 01, 2023
Fair value of Contingent Consideration payable to Medtronic	$ 86,200
Equity Method Investment, Cumulative measured cost	$ 370,740
Mozarc Medical Holding LLC
Schedule of Equity Method Investments [Line Items]
Equity method and other investments		215,706	324,711
Voting Equity Interest by the Company	50%
Voting Equity Interest in Mozarc, Owned by Medtronic	50%
APAC joint venture
Schedule of Equity Method Investments [Line Items]
Equity method and other investments		$ 0	98,865
Voting Equity Interest by the Company		75%
Current economic interest in the APAC JV, Owned by Other Noncontrolling Investors		25%
Adjusted cost method and other investments
Schedule of Equity Method Investments [Line Items]
Equity method and other investments		$ 21,732	14,990
Other equity method partnerships
Schedule of Equity Method Investments [Line Items]
Equity method and other investments		$ 99,246	$ 107,282

Equity Method and Other Inves_4

Equity Method and Other Investments - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Equity Method Investment income from equity method investments
Equity investment income (loss) from equity method investments in nonconsolidated dialysis partnerships.	$ 26,189	$ 27,864	$ 26,520
Minimum | Company and Restricted Subsidiaries
Equity Method Investment income from equity method investments
Ownership percentage by the Company	30%
Maximum | Company and Restricted Subsidiaries
Equity Method Investment income from equity method investments
Ownership percentage by the Company	65%
Other Nonoperating Income (Expense)
Equity Method Investment income from equity method investments
Equity method investment, significant impairments and other valuation adjustments	$ 0	0	20,154
Equity investment income (loss) from other equity method investments	(112,696)	(59,508)	(4,703)
Equity Method Investments In Nonconsolidated Dialysis Partnerships
Equity Method Investment income from equity method investments
Equity investment income (loss) from equity method investments in nonconsolidated dialysis partnerships.	$ 26,189	$ 27,864	$ 26,520
Number of equity method investments	17

Goodwill - Changes in Carrying

Goodwill - Changes in Carrying Value of Goodwill by Reportable Segments (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Goodwill [Roll Forward]
Beginning balance	$ 7,112,560	$ 7,076,610
Acquisitions	349,069	25,723
Goodwill, Written off Related to Sale of Business Unit	(3,193)
Impairment charges	0	(26,083)	$ 0
Foreign currency and other adjustments	(83,220)	36,310
Ending balance	7,375,216	7,112,560	7,076,610
Goodwill	7,517,037
Accumulated impairment charges	(141,821)
Transplant Software Reporting Unit
Goodwill [Roll Forward]
Beginning balance	14,424
Impairment charges		(26,083)
Ending balance		14,424
U.S. dialysis
Goodwill [Roll Forward]
Beginning balance	6,416,825	6,416,825
Acquisitions	102,082	0
Goodwill, Written off Related to Sale of Business Unit	(1,687)
Impairment charges		0
Foreign currency and other adjustments	0	0
Ending balance	6,517,220	6,416,825	6,416,825
Goodwill	6,517,220
Accumulated impairment charges	0
Other - Ancillary services
Goodwill [Roll Forward]
Beginning balance	695,735	659,785
Acquisitions	246,987	25,723
Goodwill, Written off Related to Sale of Business Unit	(1,506)
Impairment charges		(26,083)
Foreign currency and other adjustments	(83,220)	36,310
Ending balance	857,996	$ 695,735	$ 659,785
Goodwill	999,817
Accumulated impairment charges	$ (141,821)

Goodwill - Schedule of Reportin

Goodwill - Schedule of Reporting Units Goodwill Balances (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) Segments	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Goodwill [Line Items]
Goodwill	$ 7,375,216	$ 7,112,560	$ 7,076,610
Impairment charges	$ 0	(26,083)	$ 0
Other reporting units
Goodwill [Line Items]
Number of operating segments that were considered at risk of significant goodwill impairment | Segments	0
Transplant Software Reporting Unit
Goodwill [Line Items]
Goodwill		14,424
Goodwill, Impairment Loss, Net of Tax		19,575
Impairment charges		$ (26,083)

Goodwill - Additional Informati

Goodwill - Additional Information (Details)	12 Months Ended
	Dec. 31, 2024 Segments
Other reporting units
Goodwill [Line Items]
Number of operating segments that were considered at risk of significant goodwill impairment	0

Other Liabilities (Details)

Other Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Other Liabilities Disclosure [Abstract]
Payor refunds and retractions	$ 484,459	$ 448,589
Insurance and self-insurance accruals	83,038	74,337
Accrued interest	60,541	35,914
Accrued non-income tax liabilities	59,007	47,391
Other	247,100	222,647
Other liabilities	$ 934,145	$ 828,878

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Domestic	$ 1,374,571	$ 1,100,420	$ 926,604
International	155,822	76,674	39,674
Income from continuing operations before income taxes	$ 1,530,393	$ 1,177,094	$ 966,278

Income Taxes - Components of In

Income Taxes - Components of Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Current:
Federal	$ 253,504	$ 200,070	$ 201,932
State	52,410	38,370	55,593
International	31,532	21,008	16,253
Total current income tax	337,446	259,448	273,778
Deferred:
Federal	(47,715)	(40,234)	(66,400)
State	(2,855)	367	(12,289)
International	(7,220)	535	2,998
Total deferred income tax	(57,790)	(39,332)	(75,691)
Income Tax Expense (Benefit), Total	$ 279,656	$ 220,116	$ 198,087

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, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Federal income tax rate	21%	21%	21%
State income taxes, net of federal benefit	3.40%	2.60%	3.80%
Equity compensation	(1.10%)	(1.10%)	(1.60%)
Nondeductible executive compensation	0.70%	1.20%	1.10%
Political advocacy costs	0.30%	0.20%	2.20%
Unrecognized tax benefits	(0.50%)	(1.10%)	(1.10%)
Change in international valuation allowance	0.10%	0.80%	1.20%
Credits	(1.20%)	(1.20%)	(1.20%)
Other	0.30%	1.90%	1.10%
Impact of noncontrolling interests primarily attributable to non-tax paying entities	(4.70%)	(5.60%)	(6.00%)
Effective tax rate	18.30%	18.70%	20.50%

Income Taxes - Deferred Tax and

Income Taxes - Deferred Tax and Liabilities Arising from Temporary Differences (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Income Taxes [Line Items]
Receivables	$ 37,630	$ 23,075
Accrued liabilities	74,419	81,281
Operating lease liabilities	508,729	533,859
Net operating loss carryforwards	161,371	183,216
Investments in partnerships	4,108	0
Other	54,600	52,142
Deferred tax assets	840,857	873,573
Valuation allowance	(107,952)	(113,237)
Net deferred tax assets	732,905	760,336
Intangible assets	(757,797)	(731,024)
Property and equipment	(63,726)	(127,191)
Operating lease assets	(464,455)	(486,864)
Investments in partnerships	0	(19,119)
Other	(66,035)	(87,918)
Deferred tax liabilities	(1,352,013)	(1,452,116)
Net deferred tax liabilities	(619,108)	(691,780)
Deferred tax liabilities
Income Taxes [Line Items]
Net deferred tax liabilities	(665,361)	(726,217)
Other long-term assets
Income Taxes [Line Items]
Net deferred tax assets	$ 46,253	$ 34,437

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, 2024	Dec. 31, 2023
Unrecognized Tax Benefits [Roll Forward]
Beginning balance	$ 47,379	$ 63,985
Additions for tax positions related to current year	3,866	4,088
Adjustments for tax positions related to prior years	(1,452)	(7,273)
Reductions related to lapse of applicable statute	(8,309)	(5,428)
Reductions related to settlements with taxing authorities	0	(7,993)
Ending balance	$ 41,484	$ 47,379

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Taxes [Line Items]
Income tax expense	$ 279,656	$ 220,116	$ 198,087
Liability for unrecognized tax benefits	41,484	47,379	$ 63,985
Unrecognized tax benefits that would impact effective tax rate	27,336
Unrecognized tax expense (benefit), income tax penalties and interest expense, net of federal tax benefits	(679)	(138)
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits	5,846	$ 6,525
Indefinite Life Net Operating Losses
Income Taxes [Line Items]
Increase (decrease) in valuation allowance related to changes in the estimated tax benefit	(5,285)
Capital Loss Carryforward
Income Taxes [Line Items]
State capital loss carryforward, amount	$ 9,653
State capital loss carryforward, expiration date	Dec. 31, 2025
Domestic Tax Jurisdiction
Income Taxes [Line Items]
Net operating loss carryforwards	$ 44,248
Operating loss carryforwards, expiration date	Dec. 31, 2036
Domestic Tax Jurisdiction | Tax Year 2029
Income Taxes [Line Items]
Operating loss carryforwards, expiration date	Dec. 31, 2029
State
Income Taxes [Line Items]
Net operating loss carryforwards	$ 555,691
Operating loss carryforwards, expiration date	Dec. 31, 2044
Foreign Tax Jurisdiction
Income Taxes [Line Items]
Net operating loss carryforwards	$ 410,313
Operating loss carryforwards, expiration date	Dec. 31, 2026

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Thousands				3 Months Ended		12 Months Ended
	Aug. 13, 2024	Aug. 07, 2024	May 09, 2024	Sep. 30, 2024	Jun. 30, 2024	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Feb. 13, 2025
Long-term debt disclosure
Long-term debt, weighted average interest rate, at point in time						5.68%
Financing lease obligations						$ 216,401
Long-term debt totals:
Total debt principal outstanding						9,511,106	$ 8,445,980
Discount, premium and deferred financing costs						(64,336)	(54,347)
Carrying amount of long-term debt, net of unamortized discounts, premiums and deferred financing costs						9,446,770	8,391,633
Less current portion						(270,867)	(123,299)
Total long-term debt						9,175,903	8,268,334
Debt Instrument, footnotes to the table
Debt prepayment, extinguishment and modification costs				$ 10,081	$ 9,732	$ 19,813	7,962	$ 0
Debt, Weighted Average Interest Rate						5.07%
Senior Notes 4.625% due 2030
Senior Notes:
Senior Notes						$ 2,750,000	2,750,000
Long-term debt disclosure
Debt Instrument, Maturity Date						Jun. 01, 2030
Debt, interest rate at a point in time.						4.625%
Debt Instrument, Fair Value Disclosure						$ 2,533,438
Senior Notes 3.75% due 2031
Senior Notes:
Senior Notes						$ 1,500,000	1,500,000
Long-term debt disclosure
Debt Instrument, Maturity Date						Feb. 15, 2031
Debt, interest rate at a point in time.						3.75%
Debt Instrument, Fair Value Disclosure						$ 1,301,250
Senior Notes 6.875% due 2032
Senior Notes:
Senior Notes	$ 1,000,000					$ 1,000,000
Long-term debt disclosure
Debt Instrument, Maturity Date	Sep. 01, 2032					Sep. 01, 2032
Debt, interest rate at a point in time.	6.875%					6.875%
Debt Instrument, Fair Value Disclosure						$ 1,007,500
Debt Instrument, footnotes to the table
Debt Instrument, Payment Terms	The 6.875% Senior Notes pay interest on March 1 and September 1 of each year beginning March 1, 2025 and mature on September 1, 2032
Debt Instrument, Date of First Required Payment	Mar. 01, 2025
Debt Instrument, Redemption, Description	The Company may redeem up to 40% of the aggregate principal amount of the 6.875% Senior Notes at any time prior to September 1, 2027 at 106.875% of the aggregate principal amount from the proceeds of one or more equity offerings, plus accrued and unpaid interest.
Debt Instrument, Fee Amount	$ 11,421
Debt Instrument, Redemption Price, Percentage Any time Prior to September 1, 2027	106.875%
Debt Instrument, Redemption Price, if change of control	101%
Acquisition obligations and other notes payable
Long-term debt disclosure
Long-term debt, weighted average interest rate, at point in time						5.58%
Acquisition obligations and other notes payable						$ 56,483	102,328
Acquisition obligations and other notes payable, fair value						$ 56,483
Debt instrument, maturity date, description						2025-2038
Financing lease obligations
Long-term debt disclosure
Financing lease obligations						$ 216,401	$ 255,491
Finance lease, weighted average discount rate, percent						4.58%	4.58%	4.51%
Debt instrument, maturity date, description						2025-2039
Change Healthcare Temporary Funding Assistance
Long-term debt disclosure
Debt, interest rate at a point in time.						0%
Debt Instrument, footnotes to the table
CHC Temporary Funding Assistance						$ 92,777
CHC Temporary Funding Assistance, Fair Value						92,777
Change Healthcare Temporary Funding Assistance | Subsequent Event
Debt Instrument, footnotes to the table
CHC Temporary Funding Assistance									$ 70,000
Revolving line of credit
Senior Secured Credit Facilities:
Secured Debt						$ 0	$ 0
Long-term debt disclosure
Debt Instrument, Maturity Date						Apr. 28, 2028
Line of Credit Facility, Fair Value of Amount Outstanding						$ 0
Debt Instrument, footnotes to the table
Maximum borrowing capacity on revolving credit facilities						$ 1,500,000
Term Loan A-1 and Revolver | SOFR
Debt Instrument, footnotes to the table
Debt Instrument, Description of Variable Rate Basis						Base + 1.75%
Term Loan A-1 and Revolver | Adjusted Rate
Debt Instrument, footnotes to the table
Debt Instrument, Basis Spread on Variable Rate						0.10%
Term Loan A-1
Senior Secured Credit Facilities:
Secured Debt						$ 2,259,295	1,234,375
Long-term debt disclosure
Debt Instrument, Maturity Date						Apr. 28, 2028
Debt Instrument, Fair Value Disclosure						$ 2,256,471
Debt Instrument, footnotes to the table
Secured Debt Outstanding Principal Balance Subject To SOFR						395,445
Debt Instrument, Periodic Payment, Principal						75,080
Increased Term Loan A-1
Long-term debt disclosure
Debt Instrument, Maturity Date	Apr. 28, 2028
Debt Instrument, footnotes to the table
Debt Instrument, Payment Terms	The Increased Term Loan A-1 requires amortizing quarterly principal payments that began on September 30, 2024 of $29,728 per quarter through June 30, 2027, and $44,591 per quarter from September 30, 2027 through March 31, 2028, with the balance due on April 28, 2028.
Debt Instrument, Maturity Date Range, Start	Sep. 30, 2024
Debt Instrument, Effective Date	Aug. 13, 2024	Aug. 07, 2024
Debt Instrument, Description		The Sixth Amendment also incorporated the provisions of the Fifth Amendment to the Credit Agreement, dated as of August 7, 2024, which removed a cap on the amount of incremental term "A" loans the Company can incur under the Credit Agreement.
Debt Instrument, Date of First Required Payment	Sep. 30, 2024
Debt Instrument, Maturity Date Range, End	Apr. 28, 2028
Other Significant Noncash Financing Activity				$ 861,282
Debt Instrument, Periodic Payment Terms, Balloon Payment to be Paid						$ 1,828,245
Debt Instrument, Frequency of Periodic Payment	quarterly
Proceeds from Issuance of Debt	$ 1,100,000
Debt Instrument, Quarterly Payment Through June 30, 2027	29,728
Debt Instrument, Quarterly Payment From September 30, 2027 Through March 31, 2028	$ 44,591
Increased Term Loan A-1 | Minimum
Debt Instrument, footnotes to the table
Debt Instrument, Variable Rate	0%
Increased Term Loan A-1 | SOFR | Minimum
Debt Instrument, footnotes to the table
Debt Instrument, Basis Spread on Variable Rate	1.25%
Increased Term Loan A-1 | SOFR | Maximum
Debt Instrument, footnotes to the table
Debt Instrument, Basis Spread on Variable Rate	2.25%
Increased Term Loan A-1 | Adjusted Rate
Debt Instrument, footnotes to the table
Debt Instrument, Basis Spread on Variable Rate						0.10%
Term Loan B-1
Senior Secured Credit Facilities:
Secured Debt						$ 0	2,603,786
Long-term debt disclosure
Debt Instrument, Fair Value Disclosure						0
Debt Instrument, footnotes to the table
Constructive Financing Cash Outflow					722,351
Repayments of Debt	$ 949,819				728,653
Debt Instrument, Periodic Payment, Principal						13,716
Extended Term Loan B-1
Senior Secured Credit Facilities:
Secured Debt						$ 1,636,150
Long-term debt disclosure
Debt Instrument, Maturity Date			May 09, 2031			May 09, 2031
Debt Instrument, Fair Value Disclosure						$ 1,638,195
Debt Instrument, footnotes to the table
Debt Instrument, Payment Terms			The Extended Term Loan B-1 requires quarterly principal payments beginning on December 31, 2024 of 0.25% of the aggregate principal amount of the Extended Term Loan B-1 outstanding on the Fourth Amendment Effective Date, with the balance due on May 9, 2031.
Debt Instrument, Maturity Date Range, Start			Dec. 31, 2024
Constructive Financing Cash Outflow					6,302
Constructive Financing Cash Inflow					728,653
Debt Instrument, Effective Date			May 09, 2024
Debt Instrument, Date of First Required Payment			Dec. 31, 2024
Debt Instrument, Maturity Date Range, End			May 09, 2031
Other Significant Noncash Financing Activity					13,282
Debt Instrument, Periodic Payment Terms, Balloon Payment to be Paid						1,533,635
Debt Instrument, Frequency of Periodic Payment			quarterly
Secured Debt, Extended Maturity			$ 911,598
Debt Instrument, Increase (Decrease), Net					$ 728,653
Debt Instrument, Quarterly Payment, % of Beginning Balance Outstanding			0.25%
Debt Instrument, Periodic Payment, Principal						$ 4,101
Extended Term Loan B-1 | Minimum
Debt Instrument, footnotes to the table
Debt Instrument, Variable Rate			0%
Extended Term Loan B-1 | SOFR
Debt Instrument, footnotes to the table
Debt Instrument, Description of Variable Rate Basis						SOFR + 2.00%
Extended Term Loan B-1 | SOFR | SOFR Loans
Debt Instrument, footnotes to the table
Debt Instrument, Basis Spread on Variable Rate			2%
Extended Term Loan B-1 | Adjusted Rate | Base Rate Loans
Debt Instrument, footnotes to the table
Debt Instrument, Basis Spread on Variable Rate			1%
Extended Term Loan B-1 | Fed Funds Effective Rate Overnight Index Swap Rate | Maximum | Base Rate Loans
Debt Instrument, footnotes to the table
Debt Instrument, Basis Spread on Variable Rate			0.50%
Extended Term Loan B-1 | 1-Month SOFR | Maximum | Base Rate Loans
Debt Instrument, footnotes to the table
Debt Instrument, Basis Spread on Variable Rate			1%
Extended Term Loan B-1 | Prime Rate | Maximum | Base Rate Loans
Debt Instrument, footnotes to the table
Debt Instrument, Description of Variable Rate Basis			prime commercial lending rate
Senior Notes
Debt Instrument, footnotes to the table
Deferred Financing Costs						$ 37,612	31,491
Debt Instrument, Unamortized Premium						$ 10,239	12,129
Senior Secured Credit Facilities
Long-term debt disclosure
Long-term debt, weighted average interest rate, at point in time						6.91%
Debt Instrument, footnotes to the table
Debt Instrument, Unamortized Discount						$ 8,084	2,487
Deferred Financing Costs						$ 28,879	$ 32,498

Long-Term Debt - Scheduled Matu

Long-Term Debt - Scheduled Maturities of Long-term Debt (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Debt Disclosure [Abstract]
2025	$ 270,867
2026	174,693
2027	202,674
2028	1,922,275
2029	39,993
Thereafter	$ 6,900,604

Long-Term Debt - Derivative Ins

Long-Term Debt - Derivative Instruments (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2026	Jan. 01, 2025
2019 Interest Rate Cap Agreements Effective June 30, 2020
Derivative [Line Items]
Derivative, contractual maturity date	Jun. 30, 2024
2023 Interest Rate Cap Agreements 3.75% Effective June 30 2024
Derivative [Line Items]
Derivative, effective date	Jun. 30, 2024
Derivative, contractual maturity date	Dec. 31, 2025
Notional Amount Amortizable By December 31, 2024	$ 500,000
Notional Amount Amortizable By Maturity Date	500,000
2023 Interest Rate Cap Agreements 3.75% Effective June 30 2024 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 1,000,000
Derivative, Fixed Interest Rate	3.75%
2023 Interest Rate Cap Agreements 4.00% Effective June 30 2024
Derivative [Line Items]
Derivative, effective date	Jun. 30, 2024
Derivative, contractual maturity date	Dec. 31, 2025
Notional Amount Amortizable By December 31, 2024	$ 250,000
Notional Amount Amortizable By Maturity Date	750,000
2023 Interest Rate Cap Agreements 4.00% Effective June 30 2024 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 1,000,000
Derivative, Fixed Interest Rate	4%
2023 Interest Rate Cap Agreements 4.00% Effective June 30 2024 | Term Loan Facility | Maximum | Subsequent Event
Derivative [Line Items]
Derivative, Fixed Interest Rate			3.75%
2023 Interest Rate Cap Agreements 4.75% Effective June 30 2024
Derivative [Line Items]
Derivative, effective date	Jun. 30, 2024
Derivative, contractual maturity date	Dec. 31, 2025
Notional Amount Amortizable By December 31, 2024	$ 250,000
Notional Amount Amortizable By Maturity Date	750,000
2023 Interest Rate Cap Agreements 4.75% Effective June 30 2024 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 1,000,000
Derivative, Fixed Interest Rate	4.75%
2023 Interest Rate Cap Agreements 4.75% Effective June 30 2024 | Term Loan Facility | Maximum | Subsequent Event
Derivative [Line Items]
Derivative, Fixed Interest Rate			4%
2023 Interest Rate Cap Agreements 5.00% Effective June 30 2024
Derivative [Line Items]
Derivative, effective date	Jun. 30, 2024
Derivative, contractual maturity date	Dec. 31, 2026
Notional Amount Amortizable By Maturity Date	$ 500,000
2023 Interest Rate Cap Agreements 5.00% Effective June 30 2024 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 500,000
Derivative, Fixed Interest Rate	5%
2023 Interest Rate Cap Agreements 5.00% Effective June 30 2024 | Term Loan Facility | Maximum | Subsequent Event
Derivative [Line Items]
Derivative, Fixed Interest Rate			4.50%
2023 Interest Rate Cap Agreements 4.50% Effective December 31 2024
Derivative [Line Items]
Derivative, effective date	Dec. 31, 2024
Derivative, contractual maturity date	Dec. 31, 2025
Notional Amount Amortizable By Maturity Date	$ 250,000
2023 Interest Rate Cap Agreements 4.50% Effective December 31 2024 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 250,000
Derivative, Fixed Interest Rate	4.50%
2023 Interest Rate Cap Agreements 4.00% Effective December 31 2024
Derivative [Line Items]
Derivative, effective date	Dec. 31, 2024
Derivative, contractual maturity date	Dec. 31, 2026
Notional Amount Amortizable By December 31, 2025	$ 250,000
Notional Amount Amortizable By Maturity Date	500,000
2023 Interest Rate Cap Agreements 4.00% Effective December 31 2024 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 750,000
Derivative, Fixed Interest Rate	4%
2024 Interest Rate Cap Agreements 4.50% Effective December 31 2025
Derivative [Line Items]
Derivative, effective date	Dec. 31, 2025
Derivative, contractual maturity date	Dec. 31, 2027
Notional Amount Amortizable By December 31, 2026	$ 750,000
Notional Amount Amortizable By Maturity Date	1,000,000
2024 Interest Rate Cap Agreements 4.50% Effective December 31 2025 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 1,750,000
Derivative, Fixed Interest Rate	4.50%
2024 Interest Rate Cap Agreements 4.50% Effective December 31 2025 | Term Loan Facility | Maximum | Subsequent Event
Derivative [Line Items]
Derivative, Fixed Interest Rate		4.75%
2024 Interest Rate Cap Agreements 4.00% Effective December 31 2025
Derivative [Line Items]
Derivative, effective date	Dec. 31, 2025
Derivative, contractual maturity date	Dec. 31, 2027
Notional Amount Amortizable By December 31, 2026	$ 250,000
Notional Amount Amortizable By Maturity Date	500,000
2024 Interest Rate Cap Agreements 4.00% Effective December 31 2025 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 750,000
Derivative, Fixed Interest Rate	4%
2024 Interest Rate Cap Agreements 4.00% Effective December 31 2025 | Term Loan Facility | Maximum | Subsequent Event
Derivative [Line Items]
Derivative, Fixed Interest Rate		4.25%
Total Notional Amount Effective Through December 31, 2024 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000
Total Notional Amount Effective Through December 31, 2024 | Term Loan Facility | Weighted Average
Derivative [Line Items]
Derivative, Average Fixed Interest Rate	4.29%
Total Notional Amount Effective Through December 31, 2025 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000
Total Notional Amount Effective Through December 31, 2025 | Term Loan Facility | Weighted Average
Derivative [Line Items]
Derivative, Average Fixed Interest Rate	4.02%
Total Notional Amount Effective Through December 31, 2026 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000
Total Notional Amount Effective Through December 31, 2026 | Term Loan Facility | Weighted Average
Derivative [Line Items]
Derivative, Average Fixed Interest Rate	4.32%
Total Notional Amount Effective Through December 31, 2027 | Term Loan Facility | Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 1,500,000
Total Notional Amount Effective Through December 31, 2027 | Term Loan Facility | Weighted Average
Derivative [Line Items]
Derivative, Average Fixed Interest Rate	4.58%

Long-Term Debt - Effects of Int

Long-Term Debt - Effects of Interest Rate Swap and Cap Agreements (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized gains (losses) in OCI on interest rate cap agreements	$ 7,250	$ 6,895	$ 108,669
Cash Flow Hedging
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized gains (losses) in OCI on interest rate cap agreements	7,250	6,895	108,669
Reclassification from accumulated other comprehensive income into net income	(43,660)	(77,727)	(8,806)
Income Tax Related To Cash Flow Hedges | Cash Flow Hedging
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized gains (losses) in OCI on interest rate cap agreements	(2,412)	(2,291)	(36,124)
Reclassification from accumulated other comprehensive income into net income	$ 14,515	25,840	2,926
Derivative Instrument, Gain (Loss) Reclassified from AOCI into Income, Effective Portion, Statement of Income or Comprehensive Income [Extensible Enumeration]	Income tax expense
Interest Rate Cap | Cash Flow Hedging
Derivative Instruments, Gain (Loss) [Line Items]
Amount of unrealized gains (losses) in OCI on interest rate cap agreements	$ 9,662	9,186	144,793
Reclassification from accumulated other comprehensive income into net income	$ (58,175)	(103,567)	$ (11,732)
Derivative Instrument, Gain (Loss) Reclassified from AOCI into Income, Effective Portion, Statement of Income or Comprehensive Income [Extensible Enumeration]	Interest and Debt Expense
Other long-term assets | Interest Rate Cap
Derivative [Line Items]
Derivative Asset, Fair Value, Gross Asset	$ 30,062	$ 79,805

Long-Term Debt - Additional inf

Long-Term Debt - Additional information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Debt Instrument [Line Items]
Letters of Credit Outstanding, Amount	$ 0
Long-term Debt, Percentage Bearing Fixed Interest, Percentage Rate	59%
Interest Expense, Debt	$ 435,203	$ 373,951	$ 339,247
Amortization of Debt Discounts, Premiums and Deferred Financing Costs	$ 35,266	$ 24,600	$ 17,772
Long Term Debt Percentage Bearing Economically Fixed Interest Rate	96%
Secured Letter of Credit
Debt Instrument [Line Items]
Letters of Credit Outstanding, Amount	$ 161,496
New Credit Agreement - Amended | Maximum
Debt Instrument [Line Items]
Leverage Ratio Covenant	4
Leverage Ratio Covenant Through Jun 30, 2026	5
Leverage Ratio Covenant after Jun 30, 2026	4.50
Leverage Ratio Covenant after Jun 30, 2026 - Subject to Increase during four fiscal quarters following a material acquisition	5
Term Loan A-1 and Revolver | Adjusted Rate
Debt Instrument [Line Items]
SOFR Plus Interest Rate Margin	0.10%

Leases Lease Expense Components

Leases Lease Expense Components (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Operating lease cost:
Fixed lease expense	$ 557,591	$ 556,844	$ 552,194
Variable lease expense	131,539	135,990	127,621
Operating Lease, Cost	689,130	692,834	679,815
Financing lease cost:
Amortization of leased assets	28,262	26,964	27,079
Interest on lease liabilities	10,885	11,724	12,776
Net lease cost	$ 728,277	$ 731,522	$ 719,670

Leases Leases Other Information

Leases Leases Other Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Leases term and discount rate
Operating Lease, Weighted Average Remaining Lease Term	7 years 2 months 12 days	7 years 7 months 6 days	8 years 2 months 12 days
Finance Lease, Weighted Average Remaining Lease Term	7 years 10 months 24 days	8 years 6 months	9 years 4 months 24 days
Operating Lease, Weighted Average Discount Rate, Percent	4.10%	4%	3.60%
Leases Other Information [Abstract]
Sale and Leaseback Transaction, Gain (Loss), Net	$ 2,260	$ 3,387	$ 28,005
Cash paid for amounts included in the measurement of lease liabilities:
Operating Lease, Payments	719,339	708,162	696,291
Finance Lease, Interest Payment on Liability	18,599	19,246	20,103
Finance Lease, Principal Payments	29,592	26,455	24,329
Net Operating Lease Assets Obtained In Exchange For Lease Liabilities	$ 286,022	$ 269,564	$ 278,108
Finance Lease
Leases term and discount rate
Finance lease, weighted average discount rate, percent	4.58%	4.58%	4.51%

Leases - Future Minimum Lease P

Leases - Future Minimum Lease Payments Under Non-Cancelable Operating and Capital Leases (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Operating leases
2025	$ 508,420
2026	517,309
2027	453,895
2028	385,211
2029	310,332
Thereafter	863,739
Total future minimum lease payments due under operating leases	3,038,906
Less portion representing interest, operating lease liabilities	(418,840)
Present value of lease liabilities, operating leases	$ 2,620,066
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	Current portion of operating lease liabilities, Long-term operating lease liabilities
Finance leases
2025	$ 36,557
2026	38,694
2027	37,421
2028	33,854
2029	24,862
Thereafter	82,400
Total future minimum payments due under finance leases	253,788
Less portion representing interest, financing lease liabilities	(37,387)
Financing lease obligations	$ 216,401
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration]	Long-term debt, Current portion of long-term debt

Leases - Additional Information

Leases - Additional Information (Details) - USD ($) $ in Thousands		12 Months Ended
	Dec. 31, 2024	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Leases Disclosure [Line Items]
Finance Lease, Right-of-Use Asset	$ 309,363	$ 309,363	$ 322,844
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Property and equipment, net of accumulated depreciation	Property and equipment, net of accumulated depreciation	Property and equipment, net of accumulated depreciation
Finance Lease Accumulated Depreciation	$ 139,071	$ 139,071	$ 122,286
Rent Expense, Operating Leases		689,130	692,834	$ 679,815
Operating Lease
Leases Disclosure [Line Items]
Rent Expense, Operating Leases		$ 689,130	$ 692,834	$ 679,815
Minimum
Leases Disclosure [Line Items]
Lessee, Operating Lease, Term of Contract	5 years	5 years
Lessee, Operating Lease, Renewal Term	5 years	5 years
Sale Leaseback Transaction, Lease Term		10 years
Sale Leaseback Transaction, Renewal Lease Term	5 years
Maximum
Leases Disclosure [Line Items]
Lessee, Operating Lease, Term of Contract	15 years	15 years
Lessee, Operating Lease, Renewal Term	10 years	10 years
Sale Leaseback Transaction, Lease Term		15 years
Sale Leaseback Transaction, Renewal Lease Term	15 years

Employee Benefit Plans - Additi

Employee Benefit Plans - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Defined Benefit Plan Disclosure [Line Items]
Employer matching contribution, percent of match	50%
Defined Benefit Plan, Benefit Obligation, Benefits Paid	$ 79,006	$ 73,725	$ 70,084
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]
Employer matching contribution, percent of employees' gross wages	6%
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
Deferred Compensation Plan
Defined Benefit Plan Disclosure [Line Items]
Maximum percentage of employees' base salary to be maintained into deferral account	50%
Non-qualified deferred compensation plan, contributions	$ 2,521	2,695	3,573
Deferred compensation plan, distributions	4,511	3,899	$ 3,731
Deferred Compensation Plan | Rabbi trusts
Defined Benefit Plan Disclosure [Line Items]
Total fair value of assets held in trust	$ 39,527	$ 36,936

Contingencies (Details)

Contingencies (Details) - USD ($) $ in Thousands		12 Months Ended
	Oct. 22, 2019	Dec. 31, 2024
Loss Contingencies [Line Items]
Corporate Integrity Agreement Expiration Date	Oct. 22, 2019
2017 U S Attorney Colorado Investigation
Loss Contingencies [Line Items]
Litigation Settlement, Amount Awarded to Other Party		$ 34,487

Noncontrolling Interests Subj_2

Noncontrolling Interests Subject to Put Provisions and Other Commitments - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)
Commitments And Contingencies Disclosure [Line Items]
Purchase Obligation, Due in Next Twelve Months	$ 559,952
Purchase Obligation, Due in Second Year	547,079
Purchase Obligation, Due in Third Year	547,031
Purchase Obligation, to be Paid, Year Four	564,134
Purchase Obligation, to be Paid, Year Five	414,491
Off -Balance Sheet Financing Arrangements	$ 0
Minimum
Commitments And Contingencies Disclosure [Line Items]
Scheduled dissolution term of joint ventures	10 years
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 nonconsolidated dialysis centers	$ 7,131

Long-term Incentive Compensatio

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, 2024	Dec. 31, 2023	Dec. 31, 2022
Stock Appreciation Rights (SARs)
Awards
Outstanding at beginning of year (in shares)	3,471,000
Granted (in shares)	0
Exercised/ Vested (in shares)	(3,200,000)
Canceled (in shares)	(3,000)
Outstanding at end of period (in shares)	268,000	3,471,000
Exercisable at end of period (in shares)	72,000
Weighted-average fair value of grants			$ 35.13
Weighted average exercise price
Outstanding at beginning of year (USD per share)	67.40
Granted (USD per share)
Exercised (USD per share)	63.99
Canceled (USD per share)	75.95
Outstanding at end of period (USD per share)	108.02	$ 67.40
Exercisable at end of period (USD per share)	$ 102.48
Weighted average remaining contractual life
Outstanding at end of period	1 year 7 months 17 days
Exercisable at end of period	1 year 3 days
Stock units
Awards
Outstanding at beginning of year (in shares)	3,223,000
Granted (in shares)	827,000
Added by performance factor (in shares)	16,000
Exercised/ Vested (in shares)	(628,000)
Canceled (in shares)	(292,000)
Outstanding at end of period (in shares)	3,146,000	3,223,000
Exercisable at end of period (in shares)	0
Weighted-average fair value of grants (USD per share)	$ 142.36	$ 77.61	$ 107.60
Weighted average remaining contractual life
Outstanding at end of period	1 year 11 months 15 days
Exercisable at end of period	0 years

Long-term Incentive Compensat_2

Long-term Incentive Compensation and Shareholders’ Equity - Summary of Range of Exercise Prices (Details)	12 Months Ended
	Dec. 31, 2024 $ / shares shares
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	268,000
Weighted average exercise price (USD per share)	$ 108.02
Awards exercisable (in shares) | shares	72,000
Weighted average exercise price (USD per share)	$ 102.48
Range One [Member]
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Range of exercise prices, lower range (USD per share)	50.01
Range of exercise prices, upper range (USD per share)	60
Range Two [Member]
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
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	14,000
Weighted average exercise price (USD per share)	$ 75.95
Awards exercisable (in shares) | shares	14,000
Weighted average exercise price (USD per share)	$ 75.95
Range of exercise prices, lower range (USD per share)	70.01
Range of exercise prices, upper range (USD per share)	$ 80
$100.01–$110.00
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	124,000
Weighted average exercise price (USD per share)	$ 108.93
Awards exercisable (in shares) | shares	58,000
Weighted average exercise price (USD per share)	$ 108.93
Range of exercise prices, lower range (USD per share)	100.01
Range of exercise prices, upper range (USD per share)	$ 110
$110.01–$120.00
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Awards outstanding (in shares) | shares	130,000
Weighted average exercise price (USD per share)	$ 110.63
Awards exercisable (in shares) | shares	0
Weighted average exercise price (USD per share)
Range of exercise prices, lower range (USD per share)	110.01
Range of exercise prices, upper range (USD per share)	$ 120

Long-term Incentive Compensat_3

Long-term Incentive Compensation and Shareholders Equity - Summary of Weighted Average Valuation Inputs (Details) - Stock-settled Stock Appreciation Rights	12 Months Ended
	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	4 years 6 months
Expected volatility	34.30%
Expected dividend yield	0%
Risk-free interest rate	2.10%

Long-term Incentive Compensat_4

Long-term Incentive Compensation and Shareholders’ Equity - Additional Information (Details) - USD ($)				12 Months Ended
	Dec. 31, 2024	Jan. 01, 2024	Jul. 01, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate intrinsic value of stock awards exercised				$ 323,681,000	$ 168,500,000	$ 149,442,000
Aggregate intrinsic value of stock awards outstanding	$ 490,209,000			490,209,000
Aggregate intrinsic value of stock awards exercisable	3,394,000			3,394,000
Payments of ordinary dividends, common stock				0	0	0
Stock-based compensation expense				102,788,000	112,375,000	95,427,000
Estimated tax benefits recorded for stock-based compensation				16,398,000	16,536,000	14,723,000
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans	$ 146,350,000			$ 146,350,000
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 2 months 12 days
Share-based Payment Arrangement, Expense, Tax Benefit				$ 27,531,000	25,629,000	24,805,000
Cash proceeds from stock option exercises				$ 0	0	0
Employee stock purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for future grants	5,286,000			5,286,000
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%	100%	100%
Contributions used to purchase shares, employee-related current liabilities	$ 20,441,000			$ 20,441,000	$ 18,213,000	$ 18,061,000
Stock issued for employee stock purchase plans				184,000	231,000	285,000
Expected volatility Rate				32.60%	41.30%	31.70%
Risk-free interest rate				4.80%	4.90%	1.30%
Share-based awards, fair value assumptions, expected dividend				$ 0	$ 0	$ 0
Weighted average fair value				$ 31.78	$ 25.25	$ 26.50
Stock Incentive 2020 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based Compensation Number Of Shares Available For Issuance Reduced By One Share Available For Every Four Shares Underlying SARS And Stock Options				1
Stock-based Compensation Number Of Shares Underlying SARS And Stock Options, For One Full Share Available For Issuance				4
Stock-based Compensation Number Of Shares Available For Issuance Reduced By One Share Available For Every One Share Underlying Other Full Share Type Of Award				1
Stock-based Compensation Number Of Shares Underlying Full Share Types Of Stock-based Awards, For One Full Share Available For Issuance				1
Shares available for future grants	4,969,000			4,969,000
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 Repurchases Tender Offer

Stock Repurchases Tender Offer (Details) - Open Market Purchases - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)	9,833	2,904	8,095
Value of treasury stock acquired	$ 1,389,072	$ 285,710	$ 787,854
Treasury stock acquired, average cost per share	$ 140.06	$ 97.82	$ 97.30

Shareholder's equity Effects of

Shareholder's equity Effects of Changes in DaVita Inc's Ownership Interest (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Net (loss) income attributable to DaVita Inc.	$ 936,342	$ 691,535	$ 560,400
Additional paid-in capital
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Changes, Net [Abstract]
Purchase of noncontrolling interests	(3,102)	(5,375)	(6,586)
Sale of noncontrolling interest	491	13,077
Sale of noncontrolling interest			939
Noncontrolling Interest, Period Increase (Decrease)	(2,611)	7,702	(5,647)
Net Income Attributable To Parent Net Of Transfers To Noncontrolling Interests.	$ 933,731	$ 699,237	$ 554,753

Shareholder's equity (Details)

Shareholder's equity (Details) - USD ($) $ / shares in Units, $ in Thousands	2 Months Ended	12 Months Ended
	Feb. 13, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Sep. 05, 2024	Dec. 10, 2020
Stock repurchases
Terminated Remaining Prior Share Repurchases Authorized, Amount						$ 329,302
Share Repurchase Program, Authorized, Amount					$ 2,000,000
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		$ 53,958	$ 12,555	$ 20,775
Open Market Purchases
Stock repurchases
Repurchase of common stock (in shares)		9,833,000	2,904,000	8,095,000
Value of treasury stock acquired		$ 1,389,072	$ 285,710	$ 787,854
Treasury stock acquired, average cost per share		$ 140.06	$ 97.82	$ 97.30
Treasury Stock, Common
Stock repurchases
Repurchase of common stock (in shares)		9,833,000	2,904,000	8,095,000
Value of treasury stock acquired		$ 1,389,072	$ 285,710	$ 787,854
Retirement of treasury stock (in shares)			2,904,000	8,095,000
Subsequent Event
Stock repurchases
Repurchase of common stock (in shares)	779,000
Value of treasury stock acquired	$ 124,665
Treasury stock acquired, average cost per share	$ 158.48
Share Repurchase Program, Remaining Authorized, Amount	$ 1,811,069

Related Party Transactions (Det

Related Party Transactions (Details) - Berkshire			12 Months Ended
	Feb. 13, 2025	Dec. 31, 2024	Dec. 31, 2024
Equity, Class of Treasury Stock [Line Items]
Berkshire Share Repurchase Agreement			Berkshire share repurchase agreement On April 30, 2024, the Company entered into an agreement (the share repurchase agreement) with Berkshire Hathaway Inc. on behalf of itself and its affiliates (collectively, Berkshire). Under the share repurchase agreement, at any time Berkshire beneficially owns at least 45.0% of the issued and outstanding common stock of the Company in the aggregate, the Company will repurchase from Berkshire, and Berkshire will sell to the Company, on a quarterly basis, a number of shares of common stock sufficient to return Berkshire’s aggregate beneficial ownership to 45.0% of the Company's issued and outstanding common stock. The per share price the Company will pay Berkshire for any such share repurchase will be the volume-weighted average price per share paid by the Company for any shares of common stock repurchased by the Company from public stockholders pursuant to the Company’s share repurchase program during the applicable repurchase period. Under this agreement, repurchases of common stock by the Company from Berkshire will occur on the date that is two business days prior to the date of the Company’s regular quarterly or annual investor call to publicly report earnings; however, if at any time the Company determines that Berkshire beneficially owns or will beneficially own shares of common stock representing more than 49.5% of the issued and outstanding common stock in the aggregate, such determination will trigger immediate share repurchases under this agreement. As of December 31, 2024, Berkshire beneficially owned less than 45.0% of the issued and outstanding common stock of the Company and, as a result, no repurchase obligation existed at such date. Subsequent to December 31, 2024, through February 13, 2025, the Company's open market share repurchases caused Berkshire to beneficially own greater then 45.0%. As such, on February 11, 2025 the Company repurchased 203 shares of common stock from Berkshire for $32,001 at an average price paid of $156.01 per share. Berkshire standstill agreement Berkshire remains subject to a standstill agreement with the Company, as amended and restated as of February 9, 2022 (the standstill agreement). The standstill agreement currently restricts Berkshire’s actions with respect to acquiring additional shares of the Company’s common stock, and for any matter presented to Company stockholders, the standstill agreement requires Berkshire to vote any shares it beneficially holds in excess of 40% of the then-outstanding voting stock of the Company in accordance with the recommendation of the Board of Directors of the Company (Board). The standstill agreement also restricts Berkshire from taking certain actions, including, among other things, actions relating to stockholder proposals and actions seeking to control or influence the Board, management or policies of the Company. The standstill agreement provisions vary depending on Berkshire’s ownership levels and in the event of certain specified leadership changes at Berkshire.
Related Party Transaction, Description of Transaction			Berkshire beneficially owns at least 45.0%
Related Party Transaction, Description of Transaction 1			Berkshire beneficially owns or will beneficially own shares of common stock representing more than 49.5% of the issued and outstanding common stock in the aggregate, such determination will trigger immediate share repurchases under this agreement.
Related Party Transaction, Description of Transaction 2		As of December 31, 2024, Berkshire beneficially owned less than 45.0% of the issued and outstanding common stock of the Company and, as a result, no repurchase obligation existed at such date.
Repurchase Agreement, Date			Apr. 30, 2024
Related Party Transaction, Terms and Manner of Settlement			two business days prior to the date of the Company’s regular quarterly or annual investor call to publicly report earnings
Subsequent Event
Equity, Class of Treasury Stock [Line Items]
Related Party Transaction, Description of Transaction 2	Subsequent to December 31, 2024, through February 13, 2025, the Company's open market share repurchases caused Berkshire to beneficially own greater then 45.0%. As such, on February 11, 2025 the Company repurchased 203 shares of common stock from Berkshire for $32,001 at an average price paid of $156.01 per share.

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive (Loss) Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Comprehensive Income (Loss) [Line Items]
Beginning Balance of AOCI	$ (52,084)
Ending Balance of AOCI	(310,796)	$ (52,084)
Interest rate cap agreements
Comprehensive Income (Loss) [Line Items]
Beginning Balance of AOCI	27,853	98,685	$ (1,178)
Unrealized gains (losses)	9,662	9,186	144,793
Related income tax	(2,412)	(2,291)	(36,124)
Unrealized (losses) gains net	7,250	6,895	108,669
Reclassification from accumulated other comprehensive income (losses) into net income	(58,175)	(103,567)	(11,732)
Related income tax	14,515	25,840	2,926
Reclassification from accumulated other comprehensive income (loss) into net income net of tax	(43,660)	(77,727)	(8,806)
Ending Balance of AOCI	(8,557)	27,853	98,685
Foreign currency translation adjustments
Comprehensive Income (Loss) [Line Items]
Beginning Balance of AOCI	(79,937)	(167,871)	(138,069)
Unrealized gains (losses)	(207,906)	89,055	(30,554)
Related income tax	45	(1,121)	752
Unrealized (losses) gains net	(207,861)	87,934	(29,802)
Reclassification from accumulated other comprehensive income (losses) into net income	(15,252)	0	0
Related income tax	765	0	0
Reclassification from accumulated other comprehensive income (loss) into net income net of tax	(14,487)	0	0
Ending Balance of AOCI	(302,285)	(79,937)	(167,871)
Accumulated other comprehensive (loss) income
Comprehensive Income (Loss) [Line Items]
Beginning Balance of AOCI	(52,084)	(69,186)	(139,247)
Unrealized gains (losses)	(198,198)	98,241	114,239
Related income tax	(2,367)	(3,412)	(35,372)
Unrealized (losses) gains net	(200,565)	94,829	78,867
Reclassification from accumulated other comprehensive income (losses) into net income	(73,427)	(103,567)	(11,732)
Related income tax	15,280	25,840	2,926
Reclassification from accumulated other comprehensive income (loss) into net income net of tax	(58,147)	(77,727)	(8,806)
Ending Balance of AOCI	(310,796)	(52,084)	(69,186)
Accumulated Defined Benefit Plans Adjustment Including Portion Attributable to Noncontrolling Interest
Comprehensive Income (Loss) [Line Items]
Beginning Balance of AOCI	0	0	0
Unrealized gains (losses)	46	0	0
Related income tax	0	0	0
Unrealized (losses) gains net	46	0	0
Reclassification from accumulated other comprehensive income (losses) into net income	0	0	0
Related income tax	0	0	0
Reclassification from accumulated other comprehensive income (loss) into net income net of tax	0	0	0
Ending Balance of AOCI	$ 46	$ 0	$ 0

Acquisitions - Components of Ro

Acquisitions - Components of Routine Acquisitions (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) Clinic	Dec. 31, 2023 USD ($) Clinic	Dec. 31, 2022 USD ($) Clinic
Business Acquisition [Line Items]
Gain on changes in ownership interest	$ 109,466	$ 0	$ 0
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Cash paid to acquire business	329,187	27,648	59,271
Contingent purchase price and liabilities assumed	50,384	19,801	19,337
Fair Value of Previously Held Equity Interests	182,270	0	0
Aggregate purchase cost recognized	561,841	$ 47,449	$ 78,608
Series of individually immaterial business acquisitions | Non-Cash Gain
Business Acquisition [Line Items]
Gain on changes in ownership interest	$ 35,147
Series of individually immaterial business acquisitions | U.S. dialysis
Business Acquisition [Line Items]
Number of businesses acquired | Clinic	12	0	5
Series of individually immaterial business acquisitions | Foreign Dialysis Centers
Business Acquisition [Line Items]
Number of businesses acquired | Clinic	198	12	11
DaVita Care Pte. Ltd.
Business Acquisition [Line Items]
Fair Value of Previously Held Equity Interests	$ 114,744
Aggregate purchase cost recognized	114,744
DaVita Care Pte. Ltd. | Non-Cash Gain
Business Acquisition [Line Items]
Gain on changes in ownership interest	$ 59,067

Acquisitions - Assets acquired

Acquisitions - Assets acquired and liabilities assumed (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Goodwill	$ 7,375,216	$ 7,112,560	$ 7,076,610
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Cash and Cash Equivalents	83,119	1,254	1,963
Other current assets	249,738	6,128	6,389
Property and equipment	94,951	4,130	7,481
Other long-term assets	97,591	785	1,066
Indefinite-lived licenses	22,725	15,789	19,610
Goodwill	349,069	25,723	49,047
Liabilities Assumed	(201,704)	(6,179)	(6,081)
Noncontrolling interests assumed	(133,648)	(181)	(867)
Aggregate purchase price	561,841	$ 47,449	$ 78,608
DaVita Care Pte. Ltd.
Business Acquisition [Line Items]
Cash and Cash Equivalents	34,818
Other current assets	44,810
Property and equipment	22,651
Other long-term assets	37,682
Indefinite-lived licenses	15,114
Goodwill	127,207
Liabilities Assumed	(54,708)
Noncontrolling interests assumed	(112,830)
Aggregate purchase price	$ 114,744

Schedule Of Other Information R

Schedule Of Other Information Related To Acquired Intangibles and Goodwill (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Goodwill deductible for tax purposes associated with acquisitions	$ 54,810	$ 17,836	$ 49,047

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, 2024	Dec. 31, 2023
Business Combinations [Abstract]
Pro forma total revenues	$ 13,073,083	$ 12,625,223
Pro forma net income attributable to DaVita Inc.	$ 952,836	$ 732,265
Pro forma basic net income per share attributable to DaVita Inc.	$ 11.21	$ 8.07
Pro forma diluted net income per share attributable to DaVita Inc.	$ 10.92	$ 7.86

Acquisitions and Divestitures_2

Acquisitions and Divestitures - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Gain on changes in ownership interest	$ 109,466	$ 0	$ 0
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Contingent earn-out obligations for acquisitions	$ 24,580
DaVita Care Pte. Ltd.
Business Acquisition [Line Items]
Business Acquisition, Name of Acquired Entity	DaVita Care Pte. Ltd.
Business Acquisition, Effective Date of Acquisition	Nov. 01, 2024
DaVita Care Pte. Ltd. | Foreign Currency Gain (Loss) Translation Adjustments
Business Acquisition [Line Items]
Gain on changes in ownership interest	$ 15,252
Other companies | Performance Targets or Quality Margins | Minimum
Business Acquisition [Line Items]
Earn-out consideration payment period	1 year
Other companies | Performance Targets or Quality Margins | Maximum
Business Acquisition [Line Items]
Earn-out consideration payment period	5 years

Held for Sale and Discontinue_2

Held for Sale and Discontinued Operations - Additional Information (Details) - DMG - discontinued operations - USD ($) $ in Thousands		12 Months Ended
	Jun. 19, 2019	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash Provided by (Used in) Operating Activities, Discontinued Operations		$ 0	$ 0	$ 0
Cash Provided by (Used in) Financing Activities, Discontinued Operations		0	0	0
Cash Provided by (Used in) Investing Activities, Discontinued Operations		$ 0	$ 0	0
Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Business Sale, Effective Date Of Sale	Jun. 19, 2019
Gain on disposition of business, additional purchase price payment				$ 13,452

Variable Interest Entities - Ad

Variable Interest Entities - Additional Information (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Variable Interest Entity
Assets	$ 17,285,268	$ 16,893,578
Liabilities	15,193,917	$ 14,150,228
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity
Assets	577,585
Liabilities	$ 249,900

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, 2024	Dec. 31, 2023
Assets
Investments in equity securities	$ 40,566	$ 37,391
Fair Value, Measurements, Recurring
Assets
Investments in equity securities	40,566	37,391
Liabilities
Contingent earn-out obligations for acquisitions	13,542	23,088
Temporary equity
Noncontrolling interests subject to put provisions	1,695,483	1,499,288
Fair Value, Measurements, Recurring | Interest Rate Cap
Assets
Interest rate cap agreements	30,062	79,805
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1)
Assets
Investments in equity securities	40,566	37,391
Liabilities
Contingent earn-out obligations for acquisitions
Temporary equity
Noncontrolling interests subject to put provisions
Fair Value, Measurements, Recurring | Quoted prices in active markets for identical assets (Level 1) | Interest Rate Cap
Assets
Interest rate cap agreements
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2)
Assets
Investments in equity securities
Liabilities
Contingent earn-out obligations for acquisitions
Temporary equity
Noncontrolling interests subject to put provisions
Fair Value, Measurements, Recurring | Significant other observable inputs (Level 2) | Interest Rate Cap
Assets
Interest rate cap agreements	30,062	79,805
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3)
Assets
Investments in equity securities
Liabilities
Contingent earn-out obligations for acquisitions	13,542	23,088
Temporary equity
Noncontrolling interests subject to put provisions	1,695,483	1,499,288
Fair Value, Measurements, Recurring | Significant unobservable inputs (Level 3) | Interest Rate Cap
Assets
Interest rate cap agreements

Fair Values of Financial Inst_4

Fair Values of Financial Instruments (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Fair Value Disclosures [Abstract]
Potential Increase Decrease In Fair Value Of Noncontrolling Interests Due To Change In Weighted Average EBITDA Multiple	$ 225,000

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
	Sep. 30, 2024	Jun. 30, 2024	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Segment Reporting Information [Line Items]
Other revenues			$ 555,175	$ 565,206	$ 433,430
Total revenues			12,815,550	12,140,147	11,609,894
Operating Income (Loss)			2,090,483	1,602,784	1,339,062
Corporate administrative support			(113,181)	(163,047)	(129,669)
Debt expense			(470,469)	(398,551)	(357,019)
Debt prepayment, extinguishment and modification costs	$ (10,081)	$ (9,732)	(19,813)	(7,962)	0
Other loss, net			(69,808)	(19,177)	(15,765)
Income from continuing operations before income taxes			1,530,393	1,177,094	966,278
Segment Reporting Information footnote:
Equity investment income (loss) from equity method investments in nonconsolidated dialysis partnerships.			26,189	27,864	26,520
Patient care costs			8,598,521	8,319,717	8,209,553
General and administrative			1,538,341	1,473,984	1,355,197
Operating expenses and charges			10,725,067	10,537,363	10,270,832
Depreciation and amortization			723,860	745,443	732,602
Property and equipment, net of accumulated depreciation			2,940,916	3,073,533
Other - Ancillary services
Segment Reporting Information footnote:
Depreciation and amortization			62,679	49,769	41,653
Operating Segments
Segment Reporting Information [Line Items]
Total revenues			12,901,207	12,236,221	11,701,135
Operating Income (Loss)			2,203,664	1,765,831	1,468,731
Operating Segments | U.S. dialysis
Segment Reporting Information [Line Items]
Operating Income (Loss)			2,121,007	1,774,578	1,565,310
Segment Reporting Information footnote:
Patient care costs			7,497,576	7,394,640	7,334,415
General and administrative			1,173,990	1,102,072	1,037,552
Segment Reporting, Other Segment Item, Amount			(63,037)	(29,966)	(28,417)
Operating expenses and charges			9,269,710	9,162,420	9,034,499
Depreciation and amortization			661,181	695,674	690,949
Operating Segments | Other - Ancillary services
Segment Reporting Information [Line Items]
Operating Income (Loss)			82,657	(8,747)	(96,579)
Segment Reporting Information footnote:
Equity investment income (loss) from equity method investments in nonconsolidated dialysis partnerships.			(1,701)	(2,103)	(1,898)
Operating expenses and charges			1,427,833	1,307,970	1,197,905
Operating Segments | U S Dialysis And Related Lab Services with Intersegment
Segment Reporting Information [Line Items]
Dialysis patient service revenues			11,366,361	10,911,747	10,575,372
Total revenues			11,390,717	10,936,998	10,599,809
Operating Segments | U S Dialysis And Related Lab Services with Intersegment | External Sources
Segment Reporting Information [Line Items]
Dialysis patient service revenues			11,294,614	10,823,525	10,488,327
Other revenues			24,356	25,251	24,447
Operating Segments | U S Dialysis And Related Lab Services with Intersegment | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues			71,747	88,222	87,045
Other revenues			0	0	(10)
Operating Segments | Other Operating Segments with Intersegment
Segment Reporting Information [Line Items]
Dialysis patient service revenues			965,761	751,416	688,137
Other revenues			530,819	539,955	408,983
Total revenues			1,510,490	1,299,223	1,101,326
Operating Segments | Other Operating Segments with Intersegment | Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues			13,910	7,852	4,206
Intersegment Elimination
Segment Reporting Information [Line Items]
Total revenues			$ (85,657)	$ (96,074)	$ (91,241)

Segment Reporting - Summary o_2

Segment Reporting - Summary of Depreciation and Amortization Expense by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 723,860	$ 745,443	$ 732,602
Other - Ancillary services
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 62,679	$ 49,769	$ 41,653

Segment Reporting - Summary o_3

Segment Reporting - Summary of Expenditures for Property and Equipment by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Segment Reporting Information [Line Items]
Segment, Expenditure, Addition to Long-Lived Assets	$ 555,443	$ 567,985	$ 603,429
U.S. dialysis
Segment Reporting Information [Line Items]
Segment, Expenditure, Addition to Long-Lived Assets	469,799	501,149	533,600
Other - Ancillary services
Segment Reporting Information [Line Items]
Segment, Expenditure, Addition to Long-Lived Assets	$ 85,644	$ 66,836	$ 69,829

Segment Reporting - Summary o_4

Segment Reporting - Summary of Assets by Segment (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
ASSETS
Assets	$ 17,285,268	$ 16,893,578
Equity method and other investments	336,684	545,848
Property and equipment, net of accumulated depreciation	2,940,916	3,073,533
Other - Ancillary services | International
ASSETS
Property and equipment, net of accumulated depreciation	$ 317,488	$ 240,742

Supplemental Cash Flow Inform_3

Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash paid:
Income taxes, net	$ 387,940	$ 268,091	$ 344,430
Interest, net	423,360	387,661	350,999
Non-cash investing and financing activities:
Fixed assets under financing lease obligations	$ 11,327	$ 13,269	$ 1,928