Document and Entity Information
Document and Entity Information - shares shares in Millions | 3 Months Ended | |
Mar. 31, 2017 | Apr. 28, 2017 | |
Document And Entity Information [Abstract] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Mar. 31, 2017 | |
Document Fiscal Year Focus | 2,017 | |
Document Fiscal Period Focus | Q1 | |
Trading Symbol | DVA | |
Entity Registrant Name | DAVITA INC. | |
Entity Central Index Key | 927,066 | |
Current Fiscal Year End Date | --12-31 | |
Entity Filer Category | Large Accelerated Filer | |
Entity Common Stock, Shares Outstanding | 197.4 |
CONSOLIDATED STATEMENTS OF INCO
CONSOLIDATED STATEMENTS OF INCOME (unaudited) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Income Statement [Abstract] | ||
Patient service revenues | $ 2,601,378 | $ 2,481,933 |
Less: Provision for uncollectible accounts | (112,983) | (109,205) |
Net patient service operating revenues | 2,488,395 | 2,372,728 |
Capitated revenues | 918,036 | 887,047 |
Other revenues | 290,852 | 321,361 |
Total net operating revenues | 3,697,283 | 3,581,136 |
Operating expenses and charges: | ||
Patient care costs and other costs | 2,722,820 | 2,582,333 |
General and administrative | 391,780 | 386,429 |
Depreciation and amortization | 190,206 | 169,355 |
Provision for uncollectible accounts | 1,910 | 2,517 |
Equity investment income | (3,935) | (1,387) |
Goodwill and asset impairment charges | 39,366 | 77,000 |
Gain on changes in ownership interests | (6,273) | 0 |
Gain on settlement | (526,827) | 0 |
Total operating expenses and charges | 2,809,047 | 3,216,247 |
Operating income | 888,236 | 364,889 |
Debt expense | (104,429) | (102,884) |
Other income, net | 4,243 | 2,976 |
Consolidated income before income taxes | 788,050 | 264,981 |
Income tax expense | 287,765 | 126,822 |
Net income | 500,285 | 138,159 |
Less: Net income attributable to noncontrolling interests | (52,588) | (40,725) |
Net income (loss) attributable to DaVita Inc. | $ 447,697 | $ 97,434 |
Earnings per share: | ||
Basic net income per share attributable to DaVita Inc. (usd per share) | $ 2.33 | $ 0.48 |
Diluted net income per share attributable to DaVita Inc. (usd per share) | $ 2.29 | $ 0.47 |
Weighted average shares for earnings per share: | ||
Basic (in shares) | 192,376,735 | 204,366,869 |
Diluted (in shares) | 195,281,014 | 207,928,096 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Statement of Comprehensive Income [Abstract] | ||
Net income (loss) | $ 500,285 | $ 138,159 |
Unrealized losses on interest rate cap and swap agreements: | ||
Unrealized losses on interest rate cap and swap agreements | (3,188) | (5,469) |
Reclassifications of net rate cap and swap agreements realized losses into net income | 1,265 | 465 |
Unrealized gains on investments: | ||
Unrealized gains on investments | 1,557 | 229 |
Reclassification of net investment realized gains into net income | (140) | (93) |
Unrealized gains on foreign currency translation: | ||
Foreign currency translation adjustments | 13,261 | 11,181 |
Other comprehensive income | 12,755 | 6,313 |
Total comprehensive income | 513,040 | 144,472 |
Less: comprehensive income attributable to the noncontrolling interests | (52,586) | (40,725) |
Comprehensive income (loss) attributable to DaVita Inc. | $ 460,454 | $ 103,747 |
CONSOLIDATED BALANCE SHEETS (un
CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 |
ASSETS | ||
Cash and cash equivalents | $ 1,472,232 | $ 913,187 |
Short-term investments | 313,265 | 310,198 |
Accounts receivable, less allowance of $242,462 and $252,056 | 1,900,561 | 1,917,302 |
Inventories | 174,159 | 164,858 |
Other receivables | 539,656 | 453,483 |
Prepaid and other current assets | 204,027 | 210,604 |
Income taxes receivable | 0 | 10,596 |
Total current assets | 4,603,900 | 3,980,228 |
Property and equipment, net of accumulated depreciation of $2,954,237 and $2,832,160 | 3,171,199 | 3,175,367 |
Intangible assets, net of accumulated amortization of $987,468 and $940,731 | 1,487,029 | 1,527,767 |
Equity investments | 521,848 | 502,389 |
Long-term investments | 108,368 | 103,679 |
Other long-term assets | 43,450 | 44,510 |
Goodwill | 9,452,470 | 9,407,317 |
Total assets | 19,388,264 | 18,741,257 |
LIABILITIES AND EQUITY | ||
Accounts payable | 464,790 | 522,415 |
Other liabilities | 783,806 | 856,847 |
Accrued compensation and benefits | 756,002 | 815,761 |
Medical payables | 389,681 | 336,381 |
Current portion of long-term debt | 170,217 | 165,041 |
Income tax payable | 249,081 | 0 |
Total current liabilities | 2,813,577 | 2,696,445 |
Long-term debt | 8,918,878 | 8,947,327 |
Other long-term liabilities | 504,380 | 465,358 |
Deferred income taxes | 830,990 | 809,128 |
Total liabilities | 13,067,825 | 12,918,258 |
Commitments and contingencies: | ||
Noncontrolling interests subject to put provisions | 979,848 | 973,258 |
Equity: | ||
Preferred stock ($0.001 par value, 5,000,000 shares authorized; none issued) | ||
Common stock ($0.001 par value, 450,000,000 shares authorized; 194,596,120 and 194,554,491 shares issued and outstanding, respectively) | 195 | 195 |
Additional paid-in capital | 1,058,610 | 1,027,182 |
Retained earnings | 4,158,010 | 3,710,313 |
Accumulated other comprehensive loss | (76,886) | (89,643) |
Total DaVita Inc. shareholders’ equity | 5,139,929 | 4,648,047 |
Noncontrolling interests not subject to put provisions | 200,662 | 201,694 |
Shareholders’ equity | 5,340,591 | 4,849,741 |
Total liabilities and shareholder’s equity | $ 19,388,264 | $ 18,741,257 |
CONSOLIDATED BALANCE SHEETS (u5
CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 |
Statement of Financial Position [Abstract] | ||
Accounts receivable, allowance | $ 242,462 | $ 252,056 |
Property and equipment, accumulated depreciation | 2,954,237 | 2,832,160 |
Intangible assets, accumulated amortization | $ 987,468 | $ 940,731 |
Preferred stock, par value (usd per share) | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized (in shares) | 5,000,000 | 5,000,000 |
Preferred stock, issued (in shares) | 0 | 0 |
Common stock, par value (usd per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (in shares) | 450,000,000 | 450,000,000 |
Common stock, shares issued (in shares) | 194,596,120 | 194,554,491 |
Common stock, shares outstanding (in shares) | 194,596,120 | 194,554,491 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Cash flows from operating activities: | ||
Net income | $ 500,285 | $ 138,159 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 190,206 | 169,355 |
Goodwill and asset impairment charges | 39,366 | 77,000 |
Stock-based compensation expense | 9,601 | 13,097 |
Deferred income taxes | 20,091 | 47,519 |
Equity investment income, net | 1,423 | 5,238 |
Other non-cash charges | 9,467 | 11,507 |
Changes in operating assets and liabilities, other than from acquisitions and divestitures: | ||
Accounts receivable | 16,168 | (78,097) |
Inventories | (8,909) | (4,924) |
Other receivables and other current assets | (84,511) | (75,326) |
Other long-term assets | (2,310) | (965) |
Accounts payable | (26,214) | 7,782 |
Accrued compensation and benefits | (62,825) | (32,909) |
Other current liabilities | (9,633) | 55,673 |
Income taxes | 258,490 | 76,685 |
Other long-term liabilities | 14,479 | 19,208 |
Net cash provided by (used in) operating activities | 865,174 | 429,002 |
Cash flows from investing activities: | ||
Additions of property and equipment | (214,535) | (173,187) |
Acquisitions | (77,236) | (405,154) |
Proceeds from asset and business sales | 46,612 | 4,657 |
Purchase of investments available for sale | (2,358) | (4,435) |
Purchase of investments held-to-maturity | (121,670) | (228,198) |
Proceeds from sale of investments available for sale | 4,025 | 5,155 |
Proceeds from investments held-to-maturity | 116,285 | 252,701 |
Purchase of equity investments | (1,135) | (5,850) |
Net cash used in investing activities | (250,012) | (554,311) |
Cash flows from financing activities: | ||
Borrowings | 12,803,015 | 13,098,553 |
Payments on long-term debt and other financing costs | (12,839,156) | (13,118,741) |
Purchase of treasury stock | 0 | (274,926) |
Distributions to noncontrolling interests | (43,316) | (50,409) |
Stock award exercises and other share issuances, net | 3,330 | 3,167 |
Contributions from noncontrolling interests | 17,989 | 10,190 |
Proceeds from sales of additional noncontrolling interests | 0 | 3,557 |
Purchase of noncontrolling interests | (799) | (4,300) |
Deferred financing costs | 0 | (188) |
Net cash (used in) provided by financing activities | (58,937) | (333,097) |
Effect of exchange rate changes on cash and cash equivalents | 2,820 | 717 |
Net increase (decrease) in cash | 559,045 | (457,689) |
Cash and cash equivalents at beginning of period | 913,187 | 1,499,116 |
Cash and cash equivalents at end of period | $ 1,472,232 | $ 1,041,427 |
CONSOLIDATED STATEMENTS OF EQUI
CONSOLIDATED STATEMENTS OF EQUITY (unaudited) - USD ($) $ in Thousands | Total | Total | TotalRestricted Stock Units | TotalStock Appreciation Rights | Non- controlling Interests subject to put provisions | Common stock | Common stockRestricted Stock Units | Common stockStock Appreciation Rights | Additional paid-in capital | Additional paid-in capitalRestricted Stock Units | Additional paid-in capitalStock Appreciation Rights | Retained earnings | Treasury stock | Treasury stockRestricted Stock Units | Treasury stockStock Appreciation Rights | Accumulated other comprehensive(loss) | Non-controlling interests not subject to put provisions |
Beginning balance at Dec. 31, 2015 | $ 4,870,780 | $ 864,066 | $ 217 | $ 1,118,326 | $ 4,356,835 | $ (544,772) | $ (59,826) | $ 213,392 | |||||||||
Beginning Balance (in shares) at Dec. 31, 2015 | 217,120,000 | (7,366,000) | |||||||||||||||
Comprehensive income: | |||||||||||||||||
Other comprehensive (loss) income | $ 6,313 | ||||||||||||||||
Beginning balance at Dec. 31, 2015 | 4,870,780 | 864,066 | $ 217 | 1,118,326 | 4,356,835 | $ (544,772) | (59,826) | 213,392 | |||||||||
Beginning Balance (in shares) at Dec. 31, 2015 | 217,120,000 | (7,366,000) | |||||||||||||||
Comprehensive income: | |||||||||||||||||
Net income | 879,874 | 99,834 | 879,874 | 53,374 | |||||||||||||
Other comprehensive (loss) income | (29,817) | (29,817) | 190 | ||||||||||||||
Stock purchase shares issued | 23,903 | $ 1 | 23,902 | ||||||||||||||
Stock purchase shares issued (in shares) | 438,000 | 0 | |||||||||||||||
Stock unit shares issued/settled | $ 0 | $ 0 | $ 0 | $ 0 | $ (19,815) | $ 36,685 | $ 19,815 | $ (36,685) | |||||||||
Stock unit shares issued/settled (in shares) | 4,000 | 218,000 | 276,000 | 513,000 | |||||||||||||
Stock-settled stock-based compensation expense | 37,970 | 37,970 | |||||||||||||||
Excess tax benefits from stock awards exercised | 13,251 | 13,251 | |||||||||||||||
Distributions to noncontrolling interests | (111,092) | (81,309) | |||||||||||||||
Contributions from noncontrolling interests | 33,517 | 14,073 | |||||||||||||||
Sales and assumptions of noncontrolling interests | 3,423 | 28,874 | 3,423 | 2,585 | |||||||||||||
Purchase of noncontrolling interests | (13,105) | (6,660) | (13,105) | (1,747) | |||||||||||||
Changes in fair value of noncontrolling interests | (65,855) | 65,855 | (65,855) | ||||||||||||||
Reclassifications and expirations of noncontrolling interests subject to puts | (1,136) | 1,136 | |||||||||||||||
Purchase of treasury stock | (1,072,377) | $ (1,072,377) | |||||||||||||||
Purchase of treasury stock (in shares) | (16,649,000) | ||||||||||||||||
Retirement of treasury stock | 0 | $ (23) | (34,230) | (1,526,396) | $ 1,560,649 | ||||||||||||
Retirement of treasury stock (in shares) | (23,226,000) | 23,226,000 | |||||||||||||||
Ending balance at Dec. 31, 2016 | $ 4,849,741 | 4,648,047 | 973,258 | $ 195 | 1,027,182 | 3,710,313 | $ 0 | (89,643) | 201,694 | ||||||||
Ending Balance (in shares) at Dec. 31, 2016 | 194,554,491 | 194,554,000 | 0 | ||||||||||||||
Comprehensive income: | |||||||||||||||||
Net income | 447,697 | 34,585 | 447,697 | 18,003 | |||||||||||||
Other comprehensive (loss) income | $ 12,755 | 12,757 | 12,757 | (2) | |||||||||||||
Stock unit shares issued/settled | $ 0 | $ 0 | $ 0 | $ 0 | $ 0 | $ 0 | $ 0 | $ 0 | |||||||||
Stock unit shares issued/settled (in shares) | 4,000 | 38,000 | 0 | 0 | |||||||||||||
Stock-settled stock-based compensation expense | 9,567 | 9,567 | |||||||||||||||
Distributions to noncontrolling interests | 0 | (25,957) | (17,359) | ||||||||||||||
Contributions from noncontrolling interests | 0 | 13,193 | 4,796 | ||||||||||||||
Sales and assumptions of noncontrolling interests | 0 | 7,347 | 0 | (6,388) | |||||||||||||
Purchase of noncontrolling interests | (423) | (294) | (423) | (82) | |||||||||||||
Changes in fair value of noncontrolling interests | 22,284 | (22,284) | 22,284 | ||||||||||||||
Ending balance at Mar. 31, 2017 | $ 5,340,591 | $ 5,139,929 | $ 979,848 | $ 195 | $ 1,058,610 | $ 4,158,010 | $ 0 | $ (76,886) | $ 200,662 | ||||||||
Ending Balance (in shares) at Mar. 31, 2017 | 194,596,120 | 194,596,000 | 0 |
Condensed consolidated interim
Condensed consolidated interim financial statements | 3 Months Ended |
Mar. 31, 2017 | |
Accounting Policies [Abstract] | |
Condensed consolidated interim financial statements | Condensed consolidated interim financial statements The condensed consolidated interim financial statements included in this report are prepared by the Company without audit. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and other long-lived assets, fair value estimates, accounting for income taxes, variable compensation accruals, consolidation of variable interest entities, purchase accounting valuation estimates, long-term incentive program compensation and medical liability claims. The results of operations for the three months ended March 31, 2017 are not necessarily indicative of the operating results for the full year. The condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2016 . Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these condensed consolidated financial statements were issued and has included all necessary adjustments and disclosures. |
Earnings per share
Earnings per share | 3 Months Ended |
Mar. 31, 2017 | |
Earnings Per Share [Abstract] | |
Earnings per share | Earnings per share Basic net income per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interests redemption rights in excess of fair value, by the weighted average number of common shares and vested stock units outstanding, net of shares held in escrow from the DaVita HealthCare Partner merger that under certain circumstances may be returned to the Company. Diluted net income per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units (under the treasury stock method) as well as contingently returnable shares held in escrow. The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share are as follows: Three months ended 2017 2016 Basic: Net income attributable to DaVita Inc. $ 447,697 $ 97,434 Weighted average shares outstanding during the period 194,571 206,561 Contingently returnable shares held in escrow from the DaVita HealthCare Partners merger (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 192,377 204,367 Basic net income per share attributable to DaVita Inc. $ 2.33 $ 0.48 Diluted: Net income attributable to DaVita Inc. $ 447,697 $ 97,434 Weighted average shares outstanding during the period 194,571 206,561 Assumed incremental shares from stock plans 710 1,367 Weighted average shares for diluted earnings per share calculation 195,281 207,928 Diluted net income per share attributable to DaVita Inc. $ 2.29 $ 0.47 Anti-dilutive potential common shares excluded from calculation (1) 3,427 2,273 (1) Shares associated with stock-settled stock appreciation rights that are excluded from the diluted denominator calculation because they are anti-dilutive under the treasury stock method. |
Accounts receivable
Accounts receivable | 3 Months Ended |
Mar. 31, 2017 | |
Receivables [Abstract] | |
Accounts receivable | Accounts receivable Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the ultimate collectability of accounts receivable, the Company analyzes its historical cash collection experience and trends for each of its government payors and commercial payors to estimate the adequacy of the allowance for doubtful accounts and the amount of the provision for uncollectible accounts. Management regularly updates its analysis based upon the most recent information available to determine its current provision for uncollectible accounts and the adequacy of its allowance for doubtful accounts. For receivables associated with dialysis patient services covered by Medicare, the Company receives 80% of the payment directly from Medicare as established under the government’s bundled payment system and determines an appropriate allowance for doubtful accounts and provision for uncollectible accounts on the remaining balance due depending upon the Company’s estimate of the amounts ultimately collectible from other secondary coverage sources or from the patients. For receivables associated with services to patients covered by commercial payors that are either based upon contractual terms or for non-contracted health plan coverage, the Company provides an allowance for doubtful accounts by recording a provision for uncollectible accounts based upon its historical collection experience, potential inefficiencies in its billing processes and for which collectability is determined to be unlikely. For receivables associated with the Company’s capitated health plans, the balances remain on the balance sheet for as long as the respective plan years are open, which varies by health plan, but is generally two years in length, with collections occurring on a periodic basis throughout the duration of the corresponding plan year. Approximately 1% of the Company’s net accounts receivable are associated with patient pay. The Company’s policy is to reserve 100% of the outstanding accounts receivable balances for dialysis services when those amounts due have been outstanding for more than three months and to reserve 100% of the outstanding accounts receivable balances for DaVita Medical Group's (DMG, formerly known as HealthCare Partners or HCP) services when those amounts due have been outstanding for more than twelve months and when the amount is not subject to a payment plan. During the three months ended March 31, 2017 , the Company’s allowance for doubtful accounts decreased by $9,594 . This was primarily due to a decrease in outstanding balances and an increase in write-offs of aged balances related to the U.S. dialysis and related lab business. There were no unusual transactions impacting the allowance for doubtful accounts. |
Investments in debt and equity
Investments in debt and equity securities | 3 Months Ended |
Mar. 31, 2017 | |
Investments, Debt and Equity Securities [Abstract] | |
Investments in debt and equity securities | Investments in debt and equity securities The Company classifies certain debt securities as held-to-maturity and records them at amortized cost based on the Company’s intentions and strategy concerning those investments. Equity securities that have readily determinable fair values, and certain other financial instruments that have readily determinable fair values or redemption values, are classified as available-for-sale and recorded at fair value. The Company’s investments in these securities and certain other financial instruments consist of the following: March 31, 2017 December 31, 2016 Held to Available Total Held to Available Total Certificates of deposit, commercial paper and $ 312,065 $ — $ 312,065 $ 256,827 $ — $ 256,827 Investments in mutual funds and common stock — 48,124 48,124 50,000 47,404 97,404 Cash surrender value of life insurance policies — 61,444 61,444 — 59,646 59,646 $ 312,065 $ 109,568 $ 421,633 $ 306,827 $ 107,050 $ 413,877 Short-term investments $ 312,065 $ 1,200 $ 313,265 $ 306,827 $ 3,371 $ 310,198 Long-term investments — 108,368 108,368 — 103,679 103,679 $ 312,065 $ 109,568 $ 421,633 $ 306,827 $ 107,050 $ 413,877 The cost of the certificates of deposit, commercial paper and money market funds at March 31, 2017 and December 31, 2016 approximates their fair value. As of March 31, 2017 and December 31, 2016 , the available-for-sale investments included $5,585 and $3,701 of gross pre-tax unrealized gains, respectively. During the three months ended March 31, 2017 , the Company recorded gross pre-tax unrealized gains of $2,113 , or $1,559 after tax, in other comprehensive income associated with changes in the fair value of these investments. During the three months ended March 31, 2017 , the Company sold investments in mutual funds and debt securities for net proceeds of $4,025 and recognized a pre-tax gain of $229 , or $140 after-tax, which was previously recorded in other comprehensive income. During the three months ended March 31, 2016 , the Company sold investments in mutual funds for net proceeds of $1,062 and recognized a pre-tax gain of $152 , or $93 after-tax, which was previously recorded in other comprehensive income. The investments in mutual funds classified as available-for-sale are held within a trust to fund existing obligations associated with several of the Company’s non-qualified deferred compensation plans. Investments in life insurance policies are carried at their cash surrender value, are held within trusts to fund existing obligations associated with certain of the Company’s non-qualified deferred compensation plans, and are principally classified as long-term to correspond with the long-term classification of the related plan liabilities. Certain DMG legal entities are required to maintain minimum cash balances in order to comply with regulatory requirements in conjunction with medical claim reserves. As of March 31, 2017 , this minimum cash balance was approximately $61,567 . |
Equity investments
Equity investments | 3 Months Ended |
Mar. 31, 2017 | |
Investments, Debt and Equity Securities [Abstract] | |
Equity investments | Equity investments Equity investments that do not have readily determinable fair values are carried on the cost or equity method, as applicable. The Company maintains equity method investments in nonconsolidated investees in both its Kidney Care and DMG lines of business, as well as minor cost method investments in private securities of certain other healthcare businesses. The Company classifies its non-marketable cost- or equity-method investments as equity investments on its balance sheet. Equity investments in nonconsolidated businesses were $521,848 and $502,389 at March 31, 2017 and December 31, 2016, respectively. The increase in equity investments was primarily due to an increase in the number of nonconsolidated entities. During the first quarters of 2017 and 2016, the Company recognized equity investment income of $3,935 and $1,387 , respectively, relating to equity investments in nonconsolidated businesses under the equity method of accounting. |
Goodwill
Goodwill | 3 Months Ended |
Mar. 31, 2017 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Goodwill | Goodwill Changes in goodwill by reportable segments were as follows: U.S. dialysis and related lab services DMG Other-ancillary services and strategic initiatives Consolidated total Balance at January 1, 2016 $ 5,629,183 $ 3,398,264 $ 267,032 $ 9,294,479 Acquisitions 75,295 248,901 123,632 447,828 Divestitures (12,891 ) (2,223 ) (29,645 ) (44,759 ) Goodwill impairment charges — (253,000 ) (28,415 ) (281,415 ) Foreign currency and other adjustments — — (8,816 ) (8,816 ) Balance at December 31, 2016 $ 5,691,587 $ 3,391,942 $ 323,788 $ 9,407,317 Acquisitions 46,569 14,989 17,171 78,729 Divestitures (14,110 ) (29 ) — (14,139 ) Goodwill impairment charges — — (24,198 ) (24,198 ) Foreign currency and other adjustments — — 4,761 4,761 Balance at March 31, 2017 $ 5,724,046 $ 3,406,902 $ 321,522 $ 9,452,470 Balance at March 31, 2017: Goodwill 5,724,046 3,848,671 380,044 9,952,761 Accumulated impairment charges — (441,769 ) (58,522 ) (500,291 ) $ 5,724,046 3,406,902 321,522 9,452,470 The Company elected to early adopt ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment effective for the quarter ended March 31, 2017. The amendments in this ASU simplify the test for goodwill impairment by eliminating the second step in the assessment. All goodwill impairment tests performed during the quarter ended March 31, 2017 were performed under this new guidance. Each of the Company’s operating segments described in Note 17 to these condensed consolidated financial statements represents an individual reporting unit for goodwill impairment testing purposes, except that each sovereign jurisdiction within the Company’s international operating segments is considered a separate reporting unit. Within the U.S. dialysis and related lab services operating segment, the Company considers each of its dialysis centers to constitute an individual business for which discrete financial information is available. However, since these dialysis centers have similar operating and economic characteristics, and the allocation of resources and significant investment decisions concerning these businesses are highly centralized and the benefits broadly distributed, the Company has aggregated these centers and deemed them to constitute a single reporting unit. The Company has applied a similar aggregation to the DMG operations in each region, to the vascular access service centers in its vascular access reporting unit, to the physician practices in its physician services and direct primary care reporting units, and to the dialysis centers within each international reporting unit. For the Company’s other operating segments, discrete business components below the operating segment level constitute individual reporting units. Based on continuing developments at the Company’s DMG and vascular access reporting units during the first quarter of 2017, the Company performed impairment assessments for certain at-risk reporting units. The Company has recognized goodwill impairment charges as shown and discussed below: Three months ended Reporting unit March 31, 2017 March 31, 2016 DMG Nevada $ — $ 77,000 Vascular access 24,198 — Total $ 24,198 $ 77,000 During the quarter ended December 31, 2016, the Company determined that circumstances indicated it had become more likely than not that the goodwill of its vascular access reporting unit had become impaired. These circumstances included changes in future governmental reimbursement and the Company’s expected ability to mitigate them. Specifically, on November 2, 2016, the Centers for Medicare and Medicaid Services (CMS) released the 2017 Physician Fee Schedule Final Rule and the Ambulatory Surgical Center Payment Final Rule which reflected significant changes in reimbursement structure for this business unit. Accordingly, the Company performed the required valuations to estimate the fair value of the net assets and implied goodwill of this reporting unit and recognized a goodwill impairment charge of $28,415 in the fourth quarter of 2016. During the quarter ended March 31, 2017, the Company recognized an incremental goodwill impairment charge of $24,198 at its vascular access reporting unit. This additional charge resulted primarily from changes in the Company’s outlook since the fourth quarter of 2016. The Company’s partners and operators have been evaluating potential changes in operations, including termination of their management services agreements and center closures, as a result of recent changes in Medicare reimbursement. These ongoing evaluations could lead to additional impairment charges in future quarters. During the quarter ended March 31, 2016, the Company recognized goodwill impairment charges of $77,000 at its DMG Nevada reporting unit. This charge resulted primarily from changes in expectations concerning government reimbursement and the Company’s expected ability to mitigate them, medical cost trends, and other market conditions. Further reductions in reimbursement rates, increases in medical cost or utilization trends, or other significant adverse changes in expected future cash flows or valuation assumptions could result in goodwill impairment charges in the future for the following reporting units, which remain at risk of goodwill impairment: Goodwill balance Carrying (1) Sensitivities Operating (2) Discount (3) Reporting unit DMG Nevada $ 261,204 14.0 % (2.7 )% (3.9 )% DMG Florida $ 447,073 10.5 % (1.6 )% (2.8 )% DMG New Mexico $ 70,926 4.9 % (1.5 )% (2.3 )% DMG Washington $ 245,576 2.0 % (1.7 )% (3.0 )% Vascular Access $ 10,498 0.0 % (1.7 )% (4.9 )% (1) Excess of estimated fair value of the reporting unit over carrying amount as of the latest assessment date. (2) Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date. (3) Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date. Except as described above, none of the Company’s various other reporting units were considered at risk of goodwill impairment as of March 31, 2017 . Since the dates of the Company’s last annual goodwill impairment tests, there have been certain developments, events, changes in operating performance and other changes in key circumstances that have affected the Company’s businesses. However, except as further described above, these did not cause management to believe it is more likely than not that the fair value of any of its reporting units would be less than their carrying amounts. |
Medical payables
Medical payables | 3 Months Ended |
Mar. 31, 2017 | |
Health Care Organizations [Abstract] | |
Medical payables | Medical payables The following table includes estimates for the cost of professional medical services provided by non-employed physicians and other providers, as well as inpatient and other ancillary costs, other than California's non-global risk contracts. The Company does not include inpatient and other ancillary costs for non-global risk contracts held in California, as state regulation does not allow medical group entities to assume risk for inpatient services. Healthcare costs payable are included in medical payables in the condensed consolidated balance sheet. The following table shows the components of changes in health care costs payable for the three months ended March 31, 2017 : Three months ended March 31, 2017 Healthcare costs payable, beginning of the period $ 214,275 Add: Components of incurred health care costs Current year 467,683 Prior years 421 Total incurred health care costs 468,104 Less: Claims paid Current year 247,723 Prior years 172,693 Total claims paid 420,416 Healthcare costs payable, end of the period $ 261,963 The Company’s prior year estimates of healthcare costs payable resulted in medical claims being settled for different amounts than originally estimated. When significant increases (decreases) in prior-year health care cost estimates occur that the Company believes significantly impact its current year operating results, the Company discloses that amount as unfavorable (favorable) development of prior-year’s health care cost estimates. Actual claim payments for prior year services have not been materially different from the Company’s year-end estimates. |
Income taxes
Income taxes | 3 Months Ended |
Mar. 31, 2017 | |
Income Tax Disclosure [Abstract] | |
Income taxes | Income taxes As of March 31, 2017 , the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold was $26,399 , all of which would impact the Company’s effective tax rate if recognized. This balance represents an increase of $2,333 from the December 31, 2016 balance of $24,066 . The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. At March 31, 2017 and December 31, 2016 , the Company had approximately $2,776 and $2,595 , respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefits. |
Long-term debt
Long-term debt | 3 Months Ended |
Mar. 31, 2017 | |
Debt Disclosure [Abstract] | |
Long-term debt | Long-term debt Long-term debt was comprised of the following: March 31, 2017 December 31, 2016 Senior secured credit facilities: Term Loan A $ 843,750 $ 862,500 Term Loan B 3,403,750 3,412,500 Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 120,952 117,547 Capital lease obligations 296,505 299,682 Total debt principal outstanding 9,164,957 9,192,229 Discount and deferred financing costs (75,862 ) (79,861 ) 9,089,095 9,112,368 Less current portion (170,217 ) (165,041 ) $ 8,918,878 $ 8,947,327 Scheduled maturities of long-term debt at March 31, 2017 were as follows: 2017 (remainder of the year) 129,532 2018 167,855 2019 745,584 2020 70,157 2021 3,301,236 2022 1,277,759 Thereafter 3,472,834 During the first three months of 2017 , the Company made mandatory principal payments under its senior secured credit facilities totaling $18,750 on Term Loan A and $8,750 on Term Loan B. As of March 31, 2017, the Company maintains several active and forward interest rate cap agreements that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt, as described below. The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the term of the cap agreements. The cap agreements do not contain credit-risk contingent features. As of March 31, 2017 , the Company maintains several interest rate cap agreements that were entered into in November 2014 with notional amounts totaling $3,500,000 . These cap agreements became effective September 30, 2016 and have the economic effect of capping the LIBOR variable component of the Company’s interest rate at a maximum of 3.50% on an equivalent amount of the Company’s debt. The cap agreements expire on June 30, 2018 . As of March 31, 2017 , the total fair value of these cap agreements was an asset of approximately $14 . During the three months ended March 31, 2017 , the Company recognized debt expense of $2,070 from these caps. During the three months ended March 31, 2017 , the Company recorded a loss of $102 in other comprehensive income due to a decrease in the unrealized fair value of these cap agreements. As of March 31, 2017 , the Company also maintains several forward interest rate cap agreements that were entered into in October 2015 with notional amounts totaling $3,500,000 . These forward cap agreements will become effective June 29, 2018 and will have the economic effect of capping the LIBOR variable component of the Company’s interest rate at a maximum of 3.50% on an equivalent amount of its debt. These cap agreements expire on June 30, 2020 . As of March 31, 2017 , the total fair value of these cap agreements was an asset of approximately $4,698 . During the three months ended March 31, 2017 , the Company recorded a loss of $5,115 in other comprehensive income due to a decrease in the unrealized fair value of these forward cap agreements. The following table summarizes the Company’s derivative instruments as of March 31, 2017 and December 31, 2016 : March 31, 2017 December 31, 2016 Derivatives designated as hedging instruments Balance sheet location Fair value Balance sheet location Fair value Interest rate cap agreements Other long-term assets $ 4,712 Other long-term assets $ 9,929 The following table summarizes the effects of the Company’s interest rate cap and swap agreements for the three months ended March 31, 2017 and 2016 : Amount of losses Location of losses reclassified from accumulated OCI into income Amount of losses Three months ended Three months ended Derivatives designated as cash flow hedges 2017 2016 2017 2016 Interest rate swap agreements $ — $ (692 ) Debt expense $ — $ 151 Interest rate cap agreements (5,217 ) (8,259 ) Debt expense 2,070 610 Tax benefit (expense) 2,029 3,482 (805 ) (296 ) Total $ (3,188 ) $ (5,469 ) $ 1,265 $ 465 As of March 31, 2017 , the interest rate on the Company’s Term Loan B debt bears interest at LIBOR plus an interest rate margin of 2.75% . Term Loan B is subject to interest rate caps if LIBOR should rise above 3.50% . Term Loan A bears interest at LIBOR plus an interest rate margin of 2.00% . The capped portion of Term Loan A is $96,250 . In addition, the uncapped portion of Term Loan A, which is subject to the variability of LIBOR, is $747,500 . Interest rates on the Company’s senior notes are fixed by their terms. The Company’s weighted average effective interest rate on the senior secured credit facilities at end of the quarter was 3.95% , based on the current margins in effect of 2.00% for Term Loan A and 2.75% for Term Loan B, as of March 31, 2017 . The Company’s overall weighted average effective interest rate during the quarter ended March 31, 2017 was 4.55% and as of March 31, 2017 was 4.64% . As of March 31, 2017 , the Company’s interest rates are fixed on approximately 53.1% of its total debt. As of March 31, 2017 , the Company had undrawn revolving credit facilities totaling $1,000,000 , of which approximately $94,623 was committed for outstanding letters of credit. The remaining amount is unencumbered. In addition, the Company has approximately $1,286 of committed letters of credit outstanding related to DMG, which is backed by a certificate of deposit. |
Contingencies
Contingencies | 3 Months Ended |
Mar. 31, 2017 | |
Commitments and Contingencies Disclosure [Abstract] | |
Contingencies | Contingencies The majority of the Company’s revenues are from government programs and may be subject to adjustment as a result of: (i) examination by government agencies or contractors, for which the resolution of any matters raised may take extended periods of time to finalize; (ii) differing interpretations of government regulations by different Medicare contractors or regulatory authorities; (iii) differing opinions regarding a patient’s medical diagnosis or the medical necessity of services provided; and (iv) retroactive applications or interpretations of governmental requirements. In addition, the Company’s revenues from commercial payors may be subject to adjustment as a result of potential claims for refunds, as a result of government actions or as a result of other claims by commercial payors. The Company operates in a highly regulated industry and is a party to various lawsuits, claims, governmental investigations and audits (including investigations resulting from its obligation to self-report suspected violations of law) and other legal proceedings. The Company records accruals for certain legal proceedings and regulatory matters to the extent that the Company determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. As of December 31, 2016 and March 31, 2017, the Company’s total recorded accruals with respect to legal proceedings and regulatory matters, net of anticipated third party recoveries, were approximately $69,300 for both periods. 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 may be exacerbated by various factors, including that they may involve indeterminate claims for monetary damages or may involve fines, penalties or non-monetary remedies; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; are in the early stages of the proceedings; or result in a change of business practices. Further, there may be various levels of judicial review available to the Company in connection with any such proceeding. The following is a description of certain lawsuits, claims, governmental investigations and audits and other legal proceedings to which the Company is subject. Inquiries by the Federal Government and Certain Related Civil Proceedings Swoben Private Civil Suit : In April 2013, HealthCare Partners (HCP), now known as the Company’s DMG subsidiary, was one of several defendants served with a civil complaint filed by a former employee of SCAN Health Plan (SCAN), an HMO. On July 13, 2009, pursuant to the qui tam provisions of the federal False Claims Act (FCA) and the California False Claims Act, James M. Swoben, as relator, filed his initial qui tam action in the United States District Court for the Central District of California purportedly on behalf of the United States of America and the State of California against SCAN, and certain other defendants whose identities were under seal. The allegations in the complaint relate to alleged overpayments received from government healthcare programs. In 2009 and 2010, the relator twice amended his complaint and added additional defendants, and in November 2011, he filed his Third Amended Complaint under seal alleging violations of the federal FCA and the California False Claims Act, and added additional defendants, including HCP and certain health insurance companies (the defendant HMOs). The allegations in the complaint against HCP relate to patient diagnosis coding to determine reimbursement in the Medicare Advantage (MA) program, referred to as HCC and RAF scores. The complaint sought monetary damages and civil penalties as well as costs and expenses. The U.S. Department of Justice (DOJ) reviewed these allegations and in January 2013 declined to intervene in the case. HCP and the other defendants filed motions to dismiss the Third Amended Complaint, and the court dismissed with prejudice the claims and judgment was entered in September 2013. Upon the plaintiff’s appeal, a panel of the Ninth Circuit overturned the trial court’s ruling and vacated the dismissal of the case. The Company, with certain defendants, petitioned the Ninth Circuit for a rehearing, but in December 2016, the Ninth Circuit rejected the petition and determined the relator should be given an opportunity to amend the complaint, and remanded the case back to district court. In March 2017, the relator filed his Fourth Amended Complaint alleging that HCP and certain health insurance companies employed one-way retrospective reviews that were designed only to identify additional diagnoses that would be submitted to CMS for risk adjustment purposes, and thereby drive higher risk scores that would increase the capitated payments made by the federal government under the MA program. The Company disputes the allegations and intends to defend accordingly. 2015 U.S. Attorney Transportation Investigation : In February 2015, the Company announced that it received six administrative subpoenas from the OIG for medical records from six different dialysis centers in southern California operated by the Company. Specifically, each subpoena sought the medical records of a single patient of each respective dialysis center. In February 2016, the Company received four additional subpoenas for four additional dialysis centers in southern California. The subpoenas were similarly limited in scope to the subpoenas received in 2015. On February 8, 2017, the Company was served with a qui tam complaint in the U.S. District Court for the Central District of California. The Company has been advised by an attorney with the United States Attorney’s Office for the Central District of California that the qui tam is related to the investigation concerning the medical necessity of patient transportation, which was the basis for the subpoenas. The relator alleged that an ambulance company submitted false claims for patient transportation. Although the Company does not provide transportation nor does it bill for the transport of its dialysis patients, the relator alleged that two of its purported clinical staff caused the submission of a small number of those claims through improper certifications of medical necessity. The DOJ has declined to intervene. In April 2017, the court granted the Company's motion to dismiss the complaint without prejudice for failing to state a claim upon which relief can be granted. 2015 U.S. Office of Inspector General (OIG) Medicare Advantage Civil Investigation : In March 2015, JSA HealthCare Corporation (JSA), a subsidiary of DMG, received a subpoena from the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS). The Company has been advised by an attorney with the Civil Division of the DOJ in Washington, D.C. that the subpoena relates to an ongoing civil investigation concerning MA service providers’ risk adjustment practices and data, including identification and verification of patient diagnoses and factors used in making the diagnoses. The subpoena requests documents and information for the period from January 1, 2008 through December 31, 2013, for certain MA plans for which JSA provided services. It also requests information regarding JSA’s communications about patient diagnoses as they relate to certain MA plans generally, and more specifically as related to two Florida physicians with whom JSA previously contracted. The Company is producing the requested information and is cooperating with the government’s investigation. In addition to the subpoena described above, in June 2015, the Company received a subpoena from the OIG. This civil subpoena covers the period from January 1, 2008 through the present and seeks production of a wide range of documents relating to the Company’s and its subsidiaries’ (including DMG’s and its subsidiary JSA’s) provision of services to MA plans and related patient diagnosis coding and risk adjustment submissions and payments. The Company believes that the request is part of a broader industry investigation into MA patient diagnosis coding and risk adjustment practices and potential overpayments by the government. The information requested includes information relating to patient diagnosis coding practices for a number of conditions, including potentially improper historical DMG coding for a particular condition. With respect to that condition, the guidance related to that coding issue was discontinued following the Company’s November 1, 2012 acquisition of DMG, and the Company notified CMS in April 2015 of the coding practice and potential overpayments. In that regard, the Company has identified certain additional coding practices which may have been problematic and is in discussions with the DOJ about the scope and nature of a review of claims relating to those practices. The Company is cooperating with the government and is producing the requested information. In addition, the Company is continuing to review other DMG coding practices to determine whether there were any improper coding issues. In connection with the DMG merger, the Company has certain indemnification rights against the sellers and an escrow was established as security for the indemnification. The Company has submitted an indemnification claim against the sellers secured by the escrow for any and all liabilities incurred relating to these matters and intends to pursue recovery from the escrow. However, the Company can make no assurances that the indemnification and escrow will cover the full amount of the Company’s potential losses related to these matters. 2015 U.S. Department of Justice Vascular Access Investigation and Related Qui Tam Litigation : In November 2015, the Company announced that RMS Lifeline, Inc., a wholly-owned subsidiary of the Company that operates under the name Lifeline Vascular Access (Lifeline), received a Civil Investigative Demand (CID) from the DOJ. The CID relates to two vascular access centers in Florida that are part of Lifeline’s vascular access business. The CID covers the period from January 1, 2008 through the present. The Company acquired these two centers in December 2012. Based on the language of the CID, the DOJ appeared to be looking at whether angiograms performed at the two centers were medically unnecessary and therefore whether related claims filed with federal healthcare programs possibly violated the FCA. Lifeline does not perform dialysis services but instead provides vascular access management services for dialysis patients. The Company cooperated with the government and produced the requested information. The DOJ investigation was initiated pursuant to a complaint brought under the qui tam provisions of the FCA (the Complaint). The Complaint was originally filed under seal in August 2014 in the U.S. District Court, Middle District of Florida, United States ex. rel James Spafford v. DaVita HealthCare Partners, Inc., et al., Case Number 6:14-cv-1251-Orl-41DAB, naming several doctors along with the Company as defendants. In December 2015, a First Amended Complaint was filed under seal. In May 2016, the First Amended Complaint was unsealed. The First Amended Complaint alleges violations of the FCA due to the submission of claims to the government for allegedly medically unnecessary angiograms and angiography procedures at the two vascular access centers as well as employment-related claims. The Complaint covers alleged conduct dating from July 2008, prior to the Company’s acquisition of the centers, to the present. The DOJ declined to intervene. In January 2017, the Company finalized and executed a settlement agreement with the relator and the government for an immaterial amount, and in April 2017, the court dismissed the case with prejudice. 2016 U.S. Attorney Prescription Drug Investigation : In early February 2016, the Company announced that its pharmacy services’ wholly-owned subsidiary, DaVita Rx, received a CID from the U.S. Attorney’s Office for the Northern District of Texas. It appears the government is conducting an FCA investigation concerning allegations that DaVita Rx presented or caused to be presented false claims for payment to the government for prescription medications, as well as into the Company’s relationship with pharmaceutical manufacturers. The CID covers the period from January 1, 2006 through the present. In the spring of 2015, the Company initiated an internal compliance review of DaVita Rx during which it identified potential billing and operational issues, including potential write-offs and discounts of patient co-payment obligations, and credits to payors for returns of prescription drugs related to DaVita Rx. The Company notified the government in September 2015 that it was conducting this review of DaVita Rx and began providing regular updates of its review. Upon completion of its review, the Company filed a self-disclosure with the OIG in early February 2016 and has been working to address and update the practices it identified in the self-disclosure, some of which overlap with information requested by the U.S. Attorney’s Office. The Company does not know if the U.S. Attorney’s Office, which is part of the DOJ, knew when it served the CID on the Company that it was already in the process of developing a self-disclosure to the OIG. The OIG informed the Company in February 2016 that its submission was not accepted. They indicated that the OIG is not expressing an opinion regarding the conduct disclosed or the Company’s legal positions. The Company is cooperating with the government and is producing the requested information. Solari Post-Acquisition Matter : In 2016, HCP Nevada disclosed to the OIG for the HHS that proper procedures for clinical and eligibility determinations may not have been followed by Las Vegas Solari Hospice (Solari), which was acquired in March 2013 and sold in September 2016 by HCP Nevada. In June 2016, the Company was notified by the OIG that the disclosure submission had been accepted into the OIG’s Self Disclosure Protocol. HCP Nevada had previously made a disclosure and repayment of overpayments to National Government Services (NGS), the Medicare Administrative Contractor for HCP Nevada, for claims submitted by Solari to the federal government prior to DMG’s acquisition of Solari and claims made to the government post-acquisition for which the sellers had certain responsibilities pursuant to a management services agreement. The Company is cooperating with the government in this matter. 2017 U.S. Attorney American Kidney Fund Investigation : On January 4, 2017, the Company was served with an administrative subpoena for records by the United States Attorney’s Office, District of Massachusetts, relating to an investigation into possible federal health care offenses. The subpoena covers the period from January 1, 2007 through the present, and seeks documents relevant to charitable patient assistance organizations, particularly the American Kidney Fund, including documents related to efforts to provide patients with information concerning the availability of charitable assistance. The Company is cooperating with the government and is producing the requested information. Although the Company cannot predict whether or when proceedings might be initiated or when these matters may be resolved (other than as described above), it is not unusual for inquiries such as these to continue for a considerable period of time through the various phases of document and witness requests and on-going discussions with regulators. In addition to the inquiries and proceedings specifically identified above, the Company is frequently subject to other inquiries by state or federal government agencies and/or private civil qui tam complaints filed by relators. Negative findings or terms and conditions that the Company might agree to accept as part of a negotiated resolution of pending or future government inquiries or relator proceedings could result in, among other things, substantial financial penalties or awards against the Company, substantial payments made by the Company, harm to the Company’s reputation, required changes to the Company’s business practices, exclusion from future participation in the Medicare, Medicaid and other federal health care programs and, if criminal proceedings were initiated against the Company, possible criminal penalties, any of which could have a material adverse effect on the Company. Shareholder Claims Peace Officers’ Annuity and Benefit Fund of Georgia Securities Class Action Civil Suit : On February 1, 2017, the Peace Officers’ Annuity and Benefit Fund of Georgia filed a putative federal securities class action complaint in the U.S. District Court for the District of Colorado against the Company and certain executives. The complaint covers the time period of August 2015 to October 2016 and alleges, generally, that the Company and its executives violated federal securities laws concerning the Company’s financial results and revenue derived from patients who received charitable premium assistance from an industry-funded non-profit organization. The complaint further alleges that the process by which patients obtained commercial insurance and received charitable premium assistance was improper and “created a false impression of DaVita’s business and operational status and future growth prospects.” The Company disputes these allegations and intends to defend this action accordingly. Blackburn Shareholder Derivative Civil Suit : On February 10, 2017, Charles Blackburn filed a derivative shareholder lawsuit in the U.S. District Court for the District of Delaware against the Company, as nominal defendant, the Board of Directors and certain executives. The complaint covers the time period from 2015 to present and alleges, generally, breach of fiduciary duty, unjust enrichment and misrepresentations and/or failures to disclose certain information in violation of the federal securities laws in the Company’s 2016 proxy statement in connection with an alleged practice to direct patients with government-subsidized health insurance into private health insurance plans to maximize the Company’s profits. The Company disputes these allegations and intends to defend this action accordingly. On April 4, 2017, the court stayed this proceeding until the resolution of the Peace Officers’ Annuity and Benefit Fund of Georgia Securities Class Action Civil Suit, whether by dismissal with prejudice or entry of final judgment. Resolved Matters Vainer Private Civil Suit : As previously disclosed, the Company received a subpoena for documents from the OIG relating to the pharmaceutical products Zemplar, Hectorol, Venofer, Ferrlecit and erythropoietin (EPO), as well as other related matters, covering the period from January 2003 to December 2008. The Company subsequently learned that the allegations underlying this inquiry were made as part of a civil complaint filed by relators, Daniel Barbir and Dr. Alon Vainer, pursuant to the qui tam provisions of the federal FCA. The relators also alleged that the Company’s drug administration practices for the Company’s dialysis operations for Vitamin D and iron agents from 2003 through 2010 fraudulently created unnecessary waste, which was billed to and paid for by the government. In June 2015, the Company finalized the terms of the settlement with plaintiffs, including a settlement amount of $450,000 and attorney fees and other costs of $45,000 which was paid in 2015. 2011 U.S. Attorney Medicaid Investigation : In October 2011, the Company announced that it would be receiving a request for documents, which could include an administrative subpoena from the OIG. Subsequent to the Company’s announcement of this 2011 U.S. Attorney Medicaid Investigation, the Company received a request for documents in connection with the inquiry by the U.S. Attorney’s Office for the Eastern District of New York. The request related to payments for infusion drugs covered by Medicaid composite payments for dialysis. The Company cooperated with the government and produced the requested documents. In April 2014, the Company reached an agreement in principle with the government. In March 2016, the Company finalized and executed settlement agreements with the State of New York and the DOJ, including a settlement payment of an immaterial amount. Other Proceedings In addition to the foregoing, from time to time the Company is subject to other lawsuits, claims, governmental investigations and audits and legal proceedings that arise due to the nature of its business, including contractual disputes, such as with payors, suppliers and others, employee-related matters and professional and general liability claims. From time to time, the Company initiates litigation or other legal proceedings as a plaintiff arising out of contracts or other matters. In that regard, the Company had a pending lawsuit in the U.S. Court of Federal Claims against the federal government which was originally filed in May 2011. The lawsuit related to the U.S. Department of Veterans Affairs (VA) underpayment of dialysis services the Company provided from 2005 through 2011 to veterans pursuant to VA regulations. In the first quarter of 2017, we received a payment of $538,000 related to the settlement with the VA. Our consolidated entities recognized a net gain of $527,000 on this settlement. Our nonconsolidated and managed entities recognized a gain of $9,000 , of which our equity investment share was $3,000 . The net effect was a net increase of $530,000 to the Company's operating income. * * * Other than as described above, the Company cannot predict the ultimate outcomes of the various legal proceedings and regulatory matters to which the Company is or may be subject from time to time, including those described in this Note 10, or the timing of their resolution or the ultimate losses or impact of developments in those matters, which could have a material adverse effect on the Company’s revenues, earnings and cash flows. Further, any legal proceedings or regulatory matters involving the Company, whether meritorious or not, are time consuming, and often require management’s attention and result in significant legal expense, and may result in the diversion of significant operational resources, or otherwise harm the Company’s business, financial results or reputation. |
Noncontrolling interests subjec
Noncontrolling interests subject to put provisions and other commitments | 3 Months Ended |
Mar. 31, 2017 | |
Commitments and Contingencies Disclosure [Abstract] | |
Noncontrolling interests subject to put provisions and other commitments | Noncontrolling interests subject to put provisions and other commitments The Company has potential obligations to purchase the noncontrolling interests held by third parties in several of its majority-owned and other nonconsolidated entities. These obligations are in the form of put provisions and are exercisable at the third-party owners’ discretion within specified periods as outlined in each specific put provision. If these put provisions were exercised, the Company would be required to purchase the third-party owners’ equity interests at either the appraised fair market value or a predetermined multiple of earnings or cash flow attributable to the equity interests put to the Company, which is intended to approximate fair value. The methodology the Company uses to estimate the fair values of noncontrolling interests subject to put provisions assumes the higher of either a liquidation value of net assets or an average multiple of earnings, based on historical earnings, patient mix and other performance indicators that can affect future results, as well as other factors. The estimated fair values of the noncontrolling interests subject to put provisions is 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 interest obligations may be settled could vary significantly depending upon market conditions including potential purchasers’ access to the capital markets, which can impact the level of competition for dialysis and non-dialysis related businesses, the economic performance of these businesses and the restricted marketability of the third-party owners’ equity interests. The amount of noncontrolling interests subject to put provisions that employ a contractually predetermined multiple of earnings rather than fair value are immaterial. The Company has certain other potential commitments to provide operating capital to several dialysis centers that are wholly-owned by third parties or businesses in which the Company maintains a noncontrolling equity interest as well as to physician-owned vascular access clinics or medical practices that the Company operates under management and administrative services agreements of approximately $3,441 . Certain consolidated joint ventures are originally contractually scheduled to dissolve after terms ranging from 10 to 50 years. Accordingly, the noncontrolling interests in these partnerships are considered mandatorily redeemable instruments, for which the classification and measurement requirements have been indefinitely deferred. Future distributions upon dissolution of these entities would be valued below the related noncontrolling interest carrying balances in the consolidated balance sheet. |
Long-term incentive compensatio
Long-term incentive compensation | 3 Months Ended |
Mar. 31, 2017 | |
Disclosure of Compensation Related Costs, Share-based Payments [Abstract] | |
Long-term incentive compensation | Long-term incentive compensation Long-term incentive program (LTIP) compensation includes both stock-based awards (principally stock-settled stock appreciation rights, restricted stock units, and performance stock units) as well as long-term performance-based cash awards. Long-term incentive compensation expense, which was primarily general and administrative in nature, was attributed to the Company’s U.S. dialysis and related lab services business, DMG business, corporate administrative support, and the other ancillary services and strategic initiatives. The Company’s stock-based compensation awards are measured at their estimated fair values on the date of grant if settled in shares or at their estimated fair values at the end of each reporting period if settled in cash. The value of stock-based awards so measured is recognized as compensation expense on a cumulative straight-line basis over the vesting terms of the awards, adjusted for expected forfeitures. During the three months ended March 31, 2017 , the Company granted 244 stock-settled stock appreciation rights with an aggregate grant-date fair value of $3,453 and a weighted average expected life of approximately 4.1 years, and also granted 54 stock-settled restricted stock units with an aggregate grant-date fair value of $3,679 and a weighted-average expected life of approximately 2.5 years. For the three months ended March 31, 2017 and 2016 , the Company recognized $17,166 and $24,745 , respectively, in total LTIP expense, of which $9,601 and $13,097 , respectively, represented stock-based compensation expense for stock appreciation rights, restricted stock units, and discounted employee stock plan purchases, which are primarily included in general and administrative expense. The estimated tax benefits recorded for stock-based compensation for the three months ended March 31, 2017 and 2016 was $3,300 and $4,539 , respectively. As of March 31, 2017 , the Company had $91,479 of total estimated but unrecognized compensation expense for outstanding LTIP awards, including $60,244 related to stock-based compensation arrangements under the Company’s equity compensation and employee stock purchase plans. The Company expects to recognize the performance-based cash component of these LTIP costs over a weighted average remaining period of 1.0 year and the stock-based component of these LTIP costs over a weighted average remaining period of 1.3 years. For the three months ended March 31, 2017 and 2016 , the Company received $1,091 and $8,668 , respectively, in actual tax benefits upon the exercise of stock awards. |
Comprehensive income
Comprehensive income | 3 Months Ended |
Mar. 31, 2017 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | Comprehensive income For the three months ended March 31, 2017 For the three months ended March 31, 2016 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) $ (10,925 ) $ 1,361 $ (50,262 ) $ (59,826 ) Unrealized (losses) (5,217 ) 2,113 13,261 10,157 (8,951 ) 342 11,181 2,572 Related income tax 2,029 (554 ) — 1,475 3,482 (113 ) — 3,369 (3,188 ) 1,559 13,261 11,632 (5,469 ) 229 11,181 5,941 Reclassification 2,070 (229 ) — 1,841 761 (152 ) — 609 Related income tax (expense) benefit (805 ) 89 — (716 ) (296 ) 59 — (237 ) 1,265 (140 ) — 1,125 465 (93 ) — 372 Ending balance $ (13,952 ) $ 3,594 $ (66,528 ) $ (76,886 ) $ (15,929 ) $ 1,497 $ (39,081 ) $ (53,513 ) The reclassification of net cap and swap realized losses into income are recorded as debt expense in the corresponding consolidated statements of income. See Note 9 to these condensed consolidated financial statements for further details. The reclassification of net investment realized gains into income are recorded in other income in the corresponding consolidated statements of income. See Note 4 to these condensed consolidated financial statements for further details. |
Acquisitions and divestitures
Acquisitions and divestitures | 3 Months Ended |
Mar. 31, 2017 | |
Business Combinations [Abstract] | |
Acquisitions and divestitures | Acquisitions and divestitures Other routine acquisitions During the three months ended March 31, 2017 , the Company acquired dialysis and other businesses consisting of 12 dialysis centers located in the U.S., three dialysis centers located outside the U.S., and two other medical businesses for a total of $77,236 in net cash, $2,205 in deferred purchase price obligations, and $1,495 in earn-outs and liabilities assumed. The assets and liabilities for all of these acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s condensed consolidated financial statements, as are their operating results, from the designated effective dates of the acquisitions. Certain income tax amounts are pending final evaluation and quantification of any pre-acquisition tax contingencies. In addition, valuation of medical claims liabilities and certain other working capital items relating to 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: Current assets $ 1,123 Property and equipment 5,604 Amortizable intangible and other long-term assets 6,173 Goodwill 78,729 Noncontrolling interests assumed (8,052 ) Deferred income taxes (2,194 ) Liabilities assumed (447 ) Aggregate purchase price $ 80,936 Amortizable intangible assets acquired during the first three months of 2017 had weighted-average estimated useful lives of five years. The majority of the intangible assets acquired during the first three months of 2017 relate to non-compete agreements having a weighted-average useful life and amortization period of five years. The total amount of goodwill deductible for tax purposes associated with these acquisitions was approximately $69,691 . Contingent earn-out obligations The Company has several contingent earn-out obligations associated with acquisitions that could result in the Company paying the former owners of acquired companies a total of up to $13,754 if certain EBITDA, operating income performance targets or quality margins are met primarily over the next one to seven years. Contingent earn-out obligations are remeasured to fair value at each reporting date until the contingencies are resolved with changes in the liability due to the re-measurement recorded in earnings. See Note 16 to these condensed consolidated financial statements for further details. As of March 31, 2017 , the Company has estimated the fair value of these contingent earn-out obligations to be $8,565 , of which a total of $4,653 is included in other liabilities and the remaining $3,912 is included in other long-term liabilities in the Company’s condensed consolidated balance sheet. The following is a reconciliation of changes in the contingent earn-out obligations for the three months ended March 31, 2017 : Beginning balance, January 1, 2017 $ 9,977 Contingent earn-out obligations associated with acquisitions 1,053 Remeasurement of fair value for contingent earn-out obligations 102 Payments on contingent earn-out obligations (2,567 ) $ 8,565 |
Variable interest entities
Variable interest entities | 3 Months Ended |
Mar. 31, 2017 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Variable interest entities | Variable interest entities The Company relies on the operating activities of certain legal entities that it does not directly own or control, but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are subject to the consolidation guidance applicable to variable interest entities (VIEs). Under U.S. generally accepted accounting principles (GAAP), VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. The Company has determined that substantially all of the legal entities it is associated with that qualify as VIEs must be included in its consolidated financial statements. The Company manages these entities and provides operating and capital funding as necessary for these entities to accomplish their operational and strategic objectives. A number of these entities are subject to nominee ownership transfer restriction agreements that effectively transfer the majority of the economic risks and rewards of their ownership to the Company. In other cases, the Company’s management agreements with these entities include both financial terms and protective and participating rights to the entities’ operating, strategic and non-clinical governance decisions which transfer substantial powers over and economic responsibility for the entities to the Company. In some cases, such entities are subject to broad exclusivity or noncompetition restrictions that benefit the Company. Further, in some cases, the Company has contractual arrangements with the nominee owners that effectively indemnify these parties from the economic losses from, or entitle the Company to the economic benefits of, these entities. The analyses upon which these consolidation determinations rest are complex, involve uncertainties, and require significant judgment on various matters, some of which could be subject to different interpretations. At March 31, 2017 , these condensed consolidated financial statements include total assets of VIEs of $751,805 and total liabilities and noncontrolling interests of VIEs to third parties of $411,822 . The Company also sponsors certain deferred compensation plans whose trusts qualify as VIEs and the Company consolidates each of these plans as their primary beneficiary. The assets of these plans are recorded in short-term or long-term investments with matching offsetting liabilities recorded in accrued compensation and benefits and other long-term liabilities. See Note 4 to these condensed consolidated financial statements for disclosures on the assets of these consolidated non-qualified deferred compensation plans. |
Fair value of financial instrum
Fair value of financial instruments | 3 Months Ended |
Mar. 31, 2017 | |
Fair Value Disclosures [Abstract] | |
Fair value of financial instruments | Fair value of financial instruments The Company measures the fair value of certain assets, liabilities and noncontrolling interests subject to put provisions (temporary equity) based upon certain valuation techniques that include observable or unobservable inputs and assumptions that market participants would use in pricing these assets, liabilities, temporary equity and commitments. The Company also has classified certain assets, liabilities and temporary equity that are measured at fair value into the appropriate fair value hierarchy levels as defined by the Financial Accounting Standards Board (FASB). The following table summarizes the Company’s assets, liabilities and temporary equity measured at fair value on a recurring basis as of March 31, 2017 : Total Quoted prices in Significant other Significant Assets Available-for-sale securities $ 48,124 $ 48,124 $ — $ — Cash surrender value of life insurance policies $ 61,444 $ — $ 61,444 $ — Interest rate cap agreements $ 4,712 $ — $ 4,712 $ — Funds on deposit with third parties $ 79,459 $ 79,459 $ — $ — Liabilities Contingent earn-out obligations $ 8,565 $ — $ — $ 8,565 Temporary equity Noncontrolling interests subject to put provisions $ 979,848 $ — $ — $ 979,848 Available-for-sale securities represent investments in various open-ended registered investment companies, or mutual funds, and are recorded at estimated fair value based upon quoted prices reported by each mutual fund. See Note 4 to these condensed consolidated financial statements for further discussion. Investments in life insurance policies are carried at their cash surrender value which approximates their fair value. See Note 4 to these condensed consolidated financial statements for further discussion. The interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 9 to these condensed consolidated financial statements for further discussion. The funds on deposit with third parties represent funds held with various third parties as required by regulation or contract and invested by those parties in various investments, which are measured at estimated fair value based primarily on quoted market prices. The estimated fair value measurements of contingent earn-out obligations are primarily based on unobservable inputs including projected EBITDA, estimated probability of achieving gross margins or quality margins of certain medical procedures and the estimated probability of earn-out payments being made using an option pricing technique and a simulation model for expected EBITDA and operating income. In addition, a probability adjusted model was used to estimate the fair value amounts of the quality margins. The estimated fair value of these contingent earn-out obligations are remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company credit risk adjusted rate that is used to discount obligations to present value. See Note 11 to these condensed consolidated financial statements for a discussion of the Company’s methodology for estimating the fair value of noncontrolling interests subject to put obligations. Other financial instruments consist primarily of cash, accounts receivable, accounts payable, other accrued liabilities and debt. The balances of the non-debt financial instruments are presented in the condensed consolidated financial statements at March 31, 2017 at their approximate fair values due to the short-term nature of their settlements. The carrying balance of the Company’s senior secured credit facilities totaled $4,171,638 as of March 31, 2017 , and the fair value was approximately $4,300,460 based upon quoted market prices, a level 2 input. The carrying balance of the Company’s senior notes was $4,500,000 as of March 31, 2017 and their fair value was approximately $4,568,650 , based upon quoted market prices, a level 2 input. |
Segment Reporting
Segment Reporting | 3 Months Ended |
Mar. 31, 2017 | |
Segment Reporting [Abstract] | |
Segment reporting | Segment reporting The Company operates two major divisions, DaVita Kidney Care (Kidney Care) and DaVita Medical Group (DMG). The Kidney Care division is comprised of the Company’s U.S. dialysis and related lab services business, various ancillary services and strategic initiatives, including its international operations, and the Company’s corporate administrative support. The Company’s U.S. dialysis and related lab services business is its largest line of business, and is a leading provider of kidney dialysis services in the U.S. for patients suffering from chronic kidney failure, also known as ESRD. The Company’s DMG division is a patient- and physician-focused integrated healthcare delivery and management company with over two decades of providing coordinated outcomes-based medical care in a cost-effective manner. The Company’s ancillary services and strategic initiatives consist primarily of pharmacy services, disease management services, vascular access services, clinical research programs, physician services, direct primary care and the Company’s international dialysis operations. 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 DMG operations in each region, each of its ancillary services and strategic initiatives, and its consolidated international kidney care and other healthcare operations in the European and Middle Eastern, Latin America, and Asia Pacific markets, and under the Saudi Ministry of Health charter. The U.S. dialysis and related lab services business and the DMG business each qualify as separately reportable segments, and all of the other ancillary services and strategic initiatives operating segments, including the international operating segments, have been combined and disclosed in the other segments category. The Company’s operating segment financial information included in this report is prepared on the internal management reporting basis that the chief operating decision maker uses to allocate resources and assess the financial performance of the operating segments. For internal management reporting, segment operations include direct segment operating expenses but exclude corporate administrative support costs, which consist primarily of indirect labor, benefits and long-term incentive based compensation of certain departments which provide support to all of the Company’s various operating lines of business. These corporate administrative support costs are reduced by internal management fees received from the Company’s ancillary lines of businesses. The following is a summary of segment net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes: Three months ended 2017 2016 Segment net revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,348,901 $ 2,313,663 Intersegment revenues 23,760 14,308 Total dialysis and related lab services revenues 2,372,661 2,327,971 Less: Provision for uncollectible accounts (106,770 ) (104,751 ) Net dialysis and related lab services patient service revenues 2,265,891 2,223,220 Other revenues (1) 5,303 3,973 Total net dialysis and related lab services revenues 2,271,194 2,227,193 DMG DMG revenues: Capitated revenues 889,686 866,019 Net patient service revenues 178,971 112,433 Other revenues (2) 18,269 10,335 Intersegment capitated and other revenues 59 71 Total net DMG revenues 1,086,985 988,858 Other—Ancillary services and strategic initiatives Net patient service revenues 67,293 51,383 Capitated revenues 28,350 21,028 Other external sources 267,280 307,053 Intersegment revenues 15,302 11,827 Total ancillary services and strategic initiatives revenues 378,225 391,291 Total net segment revenues 3,736,404 3,607,342 Elimination of intersegment revenues (39,121 ) (26,206 ) Consolidated net revenues $ 3,697,283 $ 3,581,136 Segment operating margin (loss): U.S. dialysis and related lab services (3) $ 944,740 $ 440,055 DMG 12,308 (57,145 ) Other—Ancillary services and strategic initiatives (58,220 ) (11,100 ) Total segment operating margin 898,828 371,810 Reconciliation of segment operating margin to consolidated income before Corporate administrative support (10,592 ) (6,921 ) Consolidated operating income 888,236 364,889 Debt expense (104,429 ) (102,884 ) Other income, net 4,243 2,976 Consolidated income before income taxes $ 788,050 $ 264,981 (1) Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment. (2) Includes medical consulting service fees and management fees for providing management and administrative services to unconsolidated joint ventures, as well as revenue related to the maintenance of existing physician networks. (3) U.S. dialysis and related lab services operating income includes the net gain on the settlement with the VA. Depreciation and amortization expense by reportable segment is as follows: Three months ended 2017 2016 U.S. dialysis and related lab services $ 125,029 $ 116,537 DMG 57,323 46,263 Ancillary services and strategic initiatives 7,854 6,555 $ 190,206 $ 169,355 Summary of assets by reportable segment is as follows: Subsequent to issuance of the Company’s fiscal year 2016 consolidated financial statements and their inclusion in its Annual Report on Form 10-K filed with the Securities and Exchange Commission on February 24, 2017 (the “2016 10-K”), the Company determined that it had misstated its disclosure of segment assets at December 31, 2016 in Note 25 to those consolidated financial statements. This misstatement resulted in an overstatement of “U.S. dialysis and related lab services” segment assets of $338,963 and a corresponding understatement of “Other - ancillary services and strategic initiatives” segment assets of the same amount. The Company performed an assessment of the materiality of this misstatement and concluded that this misstatement as originally disclosed was not materially misleading in its 2016 consolidated financial statements taken as a whole. The Company therefore has not amended its financial statements filed on its 2016 10-K to correct this misstatement, but has provided the corrected disclosure here. March 31, 2017 December 31, 2016 Segment assets U.S. dialysis and related lab services (including equity $ 11,744,695 $ 11,099,137 DMG (including equity investments of $12,579 and $10,350, 6,209,369 6,213,091 Other—Ancillary services and strategic initiatives (including 1,434,200 1,429,029 Consolidated assets $ 19,388,264 $ 18,741,257 Expenditures for property and equipment by reportable segment is as follows: Three months ended 2017 2016 U.S. dialysis and related lab services $ 173,528 $ 133,450 DMG 27,788 20,145 Ancillary services and strategic initiatives 13,219 19,592 $ 214,535 $ 173,187 |
Changes in DaVita Inc.'s Owners
Changes in DaVita Inc.'s Ownership Interest in Consolidated Subsidiaries | 3 Months Ended |
Mar. 31, 2017 | |
Noncontrolling Interest [Abstract] | |
Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries | Changes in DaVita Inc.’s ownership interest in consolidated subsidiaries The effects of changes in DaVita Inc.’s ownership interest on the Company’s equity are as follows: Three months ended 2017 2016 Net income attributable to DaVita Inc. $ 447,697 $ 97,434 Increase in paid-in capital for sales of noncontrolling interests — 885 Decrease in paid-in capital for the purchase of noncontrolling (423 ) (3,337 ) Net transfers to noncontrolling interests (423 ) (2,452 ) Net income attributable to DaVita Inc., net of transfers to $ 447,274 $ 94,982 |
New Accounting Standards
New Accounting Standards | 3 Months Ended |
Mar. 31, 2017 | |
Accounting Changes and Error Corrections [Abstract] | |
New accounting standards | New accounting standards In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers , which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. In July 2015, the FASB issued ASU 2015-14, Revenue from Contracts with Customers (Topic 606): Deferral of Effective Date . This guidance approves a one-year deferral of the effective date of ASU 2014-09. The ASU now permits the Company to adopt this standard effective January 1, 2018. Early application is permitted as of January 1, 2017. In March, April, and May 2016, the FASB issued ASU 2016-08, ASU 2016-10, ASU 2016-11, and ASU 2016-12, Revenue from Contracts with Customers (Topic 606) , each of which amends the guidance in ASU 2014-09. When they become effective, these ASUs will replace most existing revenue recognition guidance in GAAP. The Company has assembled an internal revenue task force that meets regularly to discuss and evaluate the overall impact this guidance will have on various revenue streams in the condensed consolidated financial statements and related disclosures. The Company is continuing to evaluate the impact this guidance will have on its consolidated financial statements. The Company expects to adopt these ASU’s effective January 1, 2018 retrospectively with the cumulative effect of initially applying it recognized at the date of initial application (the cumulative effect method). In January 2016, the FASB issued ASU No. 2016-01, Financial Statements - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities. The amendments in this ASU revise accounting related to (i) the classification and measurement of investments in equity securities and (ii) the presentation of certain fair value changes for financial liabilities at fair value. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied through a cumulative effect adjustment to the statement of financial position. Early adoption is permitted under certain circumstances. The adoption of this ASU is not expected to have a material impact on the Company’s condensed consolidated financial statements when adopted on January 1, 2018. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in this ASU revise the accounting related to lessee accounting. Under the new guidance, lessees will be required to recognize a lease liability and a right-of-use asset for substantially all leases with lease terms in excess of twelve months. The new lease guidance also simplifies the accounting for sale and leaseback transactions primarily because lessees must recognize lease assets and lease liabilities. The amendments in this ASU are effective for the Company beginning on January 1, 2019 and are to be applied through a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements. Early adoption is permitted. The Company has assembled an internal lease task force that meets regularly to discuss and evaluate the overall impact of this guidance on its condensed consolidated financial statements and related disclosures, as well as the expected timing of adoption. The Company believes that the new standard will have a material impact on its condensed consolidated balance sheet but will not have a material impact on its results of operations or liquidity. The Company expects to adopt this ASU on January 1, 2019, and continues to evaluate the effect that the implementation of this ASU will have on its condensed consolidated financial statements and related disclosures. In March 2016, the FASB issued ASU No. 2016-07, Investments - Equity Method and Joint Ventures (Topic 323): Simplifying the Transition to the Equity Method of Accounting. The amendments in this ASU eliminate the requirement that when an investment qualifies for use of the equity method as a result of an increase in the level of ownership interest or degree of influence, an investor must adjust the investment, results of operations, and retained earnings retroactively on a step-by-step basis as if the equity method had been in effect during all previous periods that the investment had been held. The amendments in this ASU were effective for the Company beginning on January 1, 2017 and was applied prospectively. The adoption of this ASU did not have a material impact on the Company’s condensed consolidated financial statements. In March 2016, the FASB issued ASU No. 2016-09, Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting . The changes required by this ASU involve several aspects of the accounting for share-based payment transactions, including income tax consequences, classification of awards as either equity or liabilities, classification on the statement of cash flows, and an election on estimating forfeitures. The amendments in this ASU were effective for the Company beginning January 1, 2017. The method of adoption differs for each of the topics covered by the ASU. The primary effect of this ASU for the Company is the presentation of excess tax benefits or deficiencies as a component of income tax expense within the Company's condensed consolidated statement of income rather than within additional paid-in capital on its condensed consolidated balance sheet. In addition, these excess tax benefits or deficiencies are presented as an operating activity on the condensed consolidated statement of cash flows rather than as a financing activity. The Company elected to apply the presentation requirements for cash flows related to excess tax benefits prospectively. Additionally, the Company has elected to continue to estimate forfeitures expected to occur in determining the amount of compensation cost to be recognized each period. The new standard may cause volatility in the Company’s effective tax rates and diluted earnings per share due to the tax effects related to share-based payments being recorded within the Company’s condensed consolidated statement of income, including a potential increase in the Company’s provision for income taxes if a significant number of outstanding stock awards are exercised at recent levels of the Company’s stock price. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments . The amendments in this ASU clarify how certain cash receipts and cash payments should be classified on the statement of cash flows. The new standard is effective for the Company beginning January 1, 2018 and should be applied retrospectively to all periods presented. The Company has not yet determined the effect that adoption of this ASU will have on its condensed consolidated financial statements. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory . The amendments in this ASU allow entities to recognize the income tax consequences of an intra-entity transfer of an asset other than inventory when the transfer occurs. The current guidance does not allow recognition until the asset has been sold to an outside party. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied on a modified retrospective basis. The Company has not yet determined the effect that adoption of this ASU will have on its condensed consolidated financial statements. In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment . The amendments in this ASU simplify the test for goodwill impairment by eliminating the second step in testing for goodwill impairment. The amendments in this new ASU are effective for the Company January 1, 2020 and are to be applied on a prospective basis. Early adoption is permitted after January 1, 2017. The Company early adopted this ASU as of January 1, 2017. |
Condensed Consolidating Financi
Condensed Consolidating Financial Statements | 3 Months Ended |
Mar. 31, 2017 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Condensed consolidating financial statements | Condensed consolidating financial statements The following information is presented in accordance with Rule 3-10 of Regulation S-X. The operating and investing activities of the separate legal entities included in the Company’s condensed consolidated financial statements are fully interdependent and integrated. Revenues and operating expenses of the separate legal entities include intercompany charges for management and other administrative services. The Company’s senior notes are guaranteed by substantially all of its domestic subsidiaries. The subsidiary guarantors have guaranteed the senior notes on a joint and several basis. However, a subsidiary guarantor will be released from its obligations under its guarantee of the senior notes and the indentures governing the senior notes if, in general, there is a sale or other disposition of all or substantially all of the assets of such subsidiary guarantor, including by merger or consolidation, or a sale or other disposition of all of the equity interests in such subsidiary guarantor held by the Company and its restricted subsidiaries, as defined in the indentures; such subsidiary guarantor is designated by the Company as an unrestricted subsidiary, as defined in the indentures, or otherwise ceases to be a restricted subsidiary of the Company, in each case in accordance with the indentures; or such subsidiary guarantor no longer guarantees any other indebtedness, as defined in the indentures, of the Company or any of its restricted subsidiaries, except for guarantees that are contemporaneously released. The senior notes are not guaranteed by certain of the Company’s domestic subsidiaries, any of the Company’s foreign subsidiaries, or any entities that do not constitute subsidiaries within the meaning of the indentures, such as corporations in which the Company holds capital stock with less than a majority of the voting power, joint ventures and partnerships in which the Company holds less than a majority of the equity or voting interests, non-owned entities and third parties. Condensed Consolidating Statements of Income Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended March 31, 2017 DaVita Inc. Patient services revenues $ — $ 1,553,356 $ 1,098,752 $ (50,730 ) $ 2,601,378 Less: Provision for uncollectible accounts — (62,281 ) (50,702 ) — (112,983 ) Net patient service revenues — 1,491,075 1,048,050 (50,730 ) 2,488,395 Capitated revenues — 463,627 454,954 (545 ) 918,036 Other revenues 221,386 477,675 35,637 (443,846 ) 290,852 Total net revenues 221,386 2,432,377 1,538,641 (495,121 ) 3,697,283 Operating expenses and charges 131,910 1,880,155 1,292,103 (495,121 ) 2,809,047 Operating income 89,476 552,222 246,538 — 888,236 Debt expense (102,664 ) (91,401 ) (13,716 ) 103,352 (104,429 ) Other income, net 100,337 3,537 3,721 (103,352 ) 4,243 Income tax expense 34,093 221,421 32,251 — 287,765 Equity earnings in subsidiaries 394,641 151,704 — (546,345 ) — Net income 447,697 394,641 204,292 (546,345 ) 500,285 Less: Net income attributable to noncontrolling interests — — — (52,588 ) (52,588 ) Net income attributable to DaVita Inc. $ 447,697 $ 394,641 $ 204,292 $ (598,933 ) $ 447,697 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2016 DaVita Inc. Patient service revenues $ — $ 1,653,312 $ 868,037 $ (39,416 ) $ 2,481,933 Less: Provision for uncollectible accounts — (58,813 ) (50,392 ) — (109,205 ) Net patient service revenues — 1,594,499 817,645 (39,416 ) 2,372,728 Capitated revenues — 467,001 420,173 (127 ) 887,047 Other revenues 186,975 485,316 27,521 (378,451 ) 321,361 Total net revenues 186,975 2,546,816 1,265,339 (417,994 ) 3,581,136 Operating expenses 122,273 2,377,630 1,134,338 (417,994 ) 3,216,247 Operating income 64,702 169,186 131,001 — 364,889 Debt expense (101,101 ) (92,173 ) (11,514 ) 101,904 (102,884 ) Other income 98,560 4,336 1,984 (101,904 ) 2,976 Income tax expense 35,146 73,254 18,422 — 126,822 Equity earnings in subsidiaries 70,419 62,324 — (132,743 ) — Net income 97,434 70,419 103,049 (132,743 ) 138,159 Less: Net income attributable to noncontrolling interests — — — (40,725 ) (40,725 ) Net income attributable to DaVita Inc. $ 97,434 $ 70,419 $ 103,049 $ (173,468 ) $ 97,434 Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Net income $ 447,697 $ 394,641 $ 204,292 $ (546,345 ) $ 500,285 Other comprehensive (loss) income (506 ) — 13,261 — 12,755 Total comprehensive income 447,191 394,641 217,553 (546,345 ) 513,040 Less: Comprehensive income attributable to — — — (52,586 ) (52,586 ) Comprehensive income attributable to DaVita Inc. $ 447,191 $ 394,641 $ 217,553 $ (598,931 ) $ 460,454 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2016 DaVita Inc. Net income $ 97,434 $ 70,419 $ 103,049 $ (132,743 ) $ 138,159 Other comprehensive (loss) income (4,868 ) — 11,181 — 6,313 Total comprehensive income 92,566 70,419 114,230 (132,743 ) 144,472 Less: comprehensive income attributable to the — — — (40,725 ) (40,725 ) Comprehensive income attributable to DaVita Inc. $ 92,566 $ 70,419 $ 114,230 $ (173,468 ) $ 103,747 Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of March 31, 2017 DaVita Inc. Cash and cash equivalents $ 1,078,071 $ 74,633 $ 319,528 $ — $ 1,472,232 Accounts receivable, net — 1,216,764 683,797 — 1,900,561 Other current assets 339,626 814,917 76,564 — 1,231,107 Total current assets 1,417,697 2,106,314 1,079,889 — 4,603,900 Property and equipment, net 347,805 1,664,888 1,158,506 — 3,171,199 Intangible assets, net 421 1,448,086 38,522 — 1,487,029 Investments in subsidiaries 10,231,471 2,334,152 — (12,565,623 ) — Intercompany receivables 2,840,305 — 1,158,246 (3,998,551 ) — Other long-term assets and investments 45,042 87,414 541,210 — 673,666 Goodwill — 7,858,841 1,593,629 — 9,452,470 Total assets $ 14,882,741 $ 15,499,695 $ 5,570,002 $ (16,564,174 ) $ 19,388,264 Current liabilities $ 557,557 $ 1,697,937 $ 558,083 $ — $ 2,813,577 Intercompany payables — 2,337,683 1,660,868 (3,998,551 ) — Long-term debt and other long-term liabilities 8,599,938 1,232,604 421,706 — 10,254,248 Noncontrolling interests subject to put provisions 585,317 — — 394,531 979,848 Total DaVita Inc. shareholder's equity 5,139,929 10,231,471 2,334,152 (12,565,623 ) 5,139,929 Noncontrolling interests not subject to put provisions — — 595,193 (394,531 ) 200,662 Total equity 5,139,929 10,231,471 2,929,345 (12,960,154 ) 5,340,591 Total liabilities and equity $ 14,882,741 $ 15,499,695 $ 5,570,002 $ (16,564,174 ) $ 19,388,264 Guarantor Non- Consolidating Consolidated As of December 31, 2016 DaVita Inc. Cash and cash equivalents $ 549,921 $ 59,192 $ 304,074 $ — $ 913,187 Accounts receivable, net — 1,215,232 702,070 — 1,917,302 Other current assets 277,911 736,727 135,101 — 1,149,739 Total current assets 827,832 2,011,151 1,141,245 — 3,980,228 Property and equipment, net 337,200 1,689,798 1,148,369 — 3,175,367 Intangible assets, net 487 1,491,057 36,223 — 1,527,767 Investments in subsidiaries 9,717,728 2,002,660 — (11,720,388 ) — Intercompany receivables 3,250,692 — 866,955 (4,117,647 ) — Other long-term assets and investments 39,994 86,710 523,874 — 650,578 Goodwill — 7,838,984 1,568,333 — 9,407,317 Total assets $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Current liabilities $ 303,840 $ 1,865,193 $ 527,412 $ — $ 2,696,445 Intercompany payables — 2,322,124 1,795,523 (4,117,647 ) — Long-term debt and other long-term liabilities 8,614,445 1,215,315 392,053 — 10,221,813 Noncontrolling interests subject to put provisions 607,601 — — 365,657 973,258 Total DaVita Inc. shareholder's equity 4,648,047 9,717,728 2,002,660 (11,720,388 ) 4,648,047 Noncontrolling interests not subject to put provisions — — 567,351 (365,657 ) 201,694 Total equity 4,648,047 9,717,728 2,570,011 (12,086,045 ) 4,849,741 Total liabilities and equity $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 447,697 $ 394,641 $ 204,292 $ (546,345 ) $ 500,285 Changes in operating assets and liabilities and non-cash items included in net income (149,767 ) (131,683 ) 99,994 546,345 364,889 Net cash provided by operating activities 297,930 262,958 304,286 — 865,174 Cash flows from investing activities: Additions of property and equipment, net (30,580 ) (133,909 ) (50,046 ) — (214,535 ) Acquisitions — (70,237 ) (6,999 ) — (77,236 ) Proceeds from asset and business sales — 46,612 — — 46,612 (Purchases) proceeds from investment sales and other items, net (54,150 ) (1,976 ) 51,273 — (4,853 ) Net cash used in investing activities (84,730 ) (159,510 ) (5,772 ) — (250,012 ) Cash flows from financing activities: Long-term debt and related financing costs, net (27,504 ) (4,616 ) (4,021 ) — (36,141 ) Intercompany borrowing (payments) 339,124 (82,592 ) (256,532 ) — — Other items 3,330 (799 ) (25,327 ) — (22,796 ) Net cash provided by (used in) financing activities 314,950 (88,007 ) (285,880 ) — (58,937 ) Effect of exchange rate changes on cash — — 2,820 — 2,820 Net increase in cash and cash equivalents 528,150 15,441 15,454 — 559,045 Cash and cash equivalents at beginning of period 549,921 59,192 304,074 — 913,187 Cash and cash equivalents at end of period $ 1,078,071 $ 74,633 $ 319,528 $ — $ 1,472,232 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2016 DaVita Inc. Cash flows from operating activities: Net income $ 97,434 $ 70,419 $ 103,049 $ (132,743 ) $ 138,159 Changes in operating assets and liabilities and non-cash (18,699 ) 217,405 (40,606 ) 132,743 290,843 Net cash provided by operating activities 78,735 287,824 62,443 — 429,002 Cash flows from investing activities: Additions of property and equipment, net (16,865 ) (86,055 ) (70,267 ) — (173,187 ) Acquisitions — (400,093 ) (5,061 ) — (405,154 ) Proceeds from asset and business sales — 4,657 — — 4,657 (Purchases) proceeds from investment sales and other 23,387 (7,438 ) 3,424 — 19,373 Net cash provided by (used in) investing activities 6,522 (488,929 ) (71,904 ) — (554,311 ) Cash flows from financing activities: Long-term debt and related financing costs, net (21,247 ) (1,977 ) (1,347 ) — (24,571 ) Intercompany borrowing (payments) (315,986 ) 167,702 148,284 — — Other items (267,551 ) (756 ) (40,219 ) — (308,526 ) Net cash provided by (used in) financing activities (604,784 ) 164,969 106,718 — (333,097 ) Effect of exchange rate changes on cash — — 717 — 717 Net increase in cash and cash equivalents (519,527 ) (36,136 ) 97,974 — (457,689 ) Cash and cash equivalents at beginning of period 1,186,636 109,357 203,123 — 1,499,116 Cash and cash equivalents at end of period $ 667,109 $ 73,221 $ 301,097 $ — $ 1,041,427 |
Supplemental Data
Supplemental Data | 3 Months Ended |
Mar. 31, 2017 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Supplemental data | Supplemental data The following information is presented as supplemental data as required by the indentures governing the Company’s senior notes. Condensed Consolidating Statements of Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2017 Patient service operating revenues $ 2,601,378 $ 133,537 $ — $ 2,467,841 Less: Provision for uncollectible accounts (112,983 ) (3,725 ) — (109,258 ) Net patient service operating revenues 2,488,395 129,812 — 2,358,583 Capitated revenues 918,036 384,262 — 533,774 Other revenues 290,852 9,851 — 281,001 Total net operating revenues 3,697,283 523,925 — 3,173,358 Operating expenses 2,809,047 500,390 (166 ) 2,308,823 Operating income 888,236 23,535 166 864,535 Debt expense, including refinancing charges (104,429 ) (1,450 ) — (102,979 ) Other income 4,243 35 — 4,208 Income tax expense 287,765 18,594 66 269,105 Net income (loss) 500,285 3,526 100 496,659 Less: Net income attributable to noncontrolling interests (52,588 ) — — (52,588 ) Net income (loss) attributable to DaVita Inc. $ 447,697 $ 3,526 $ 100 $ 444,071 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2017 Net income (loss) $ 500,285 $ 3,526 $ 100 $ 496,659 Other comprehensive loss 12,755 — — 12,755 Total comprehensive income (loss) 513,040 3,526 100 509,414 Less: comprehensive income attributable to the noncontrolling (52,586 ) — — (52,586 ) Comprehensive income (loss) attributable to DaVita Inc. $ 460,454 $ 3,526 $ 100 $ 456,828 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of March 31, 2017 Cash and cash equivalents $ 1,472,232 $ 99,086 $ — $ 1,373,146 Accounts receivable, net 1,900,561 202,006 — 1,698,555 Other current assets 1,231,107 14,819 — 1,216,288 Total current assets 4,603,900 315,911 — 4,287,989 Property and equipment, net 3,171,199 1,268 — 3,169,931 Amortizable intangibles, net 1,487,029 4,576 — 1,482,453 Other long-term assets 673,666 81,419 2,880 589,367 Goodwill 9,452,470 16,796 — 9,435,674 Total assets $ 19,388,264 $ 419,970 $ 2,880 $ 18,965,414 Current liabilities $ 2,813,577 $ 204,998 $ — $ 2,608,579 Payables to parent — 61,723 2,880 (64,603 ) Long-term debt and other long-term liabilities 10,254,248 45,226 — 10,209,022 Noncontrolling interests subject to put provisions 979,848 — — 979,848 Total DaVita Inc. shareholders’ equity 5,139,929 108,023 — 5,031,906 Noncontrolling interests not subject to put provisions 200,662 — — 200,662 Shareholders’ equity 5,340,591 108,023 — 5,232,568 Total liabilities and shareholder’s equity $ 19,388,264 $ 419,970 $ 2,880 $ 18,965,414 (1) After elimination of the unrestricted subsidiaries and the physician groups. Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2017 Cash flows from operating activities: Net income $ 500,285 $ 3,526 $ 100 $ 496,659 Changes in operating and intercompany assets and liabilities 364,889 (14,847 ) (100 ) 379,836 Net cash provided by (used in) operating activities 865,174 (11,321 ) — 876,495 Cash flows from investing activities: Additions of property and equipment (214,535 ) (10 ) — (214,525 ) Acquisitions and divestitures, net (77,236 ) — — (77,236 ) Proceeds from discontinued operations 46,612 — — 46,612 Investments and other items (4,853 ) (946 ) — (3,907 ) Net cash used in investing activities (250,012 ) (956 ) — (249,056 ) Cash flows from financing activities: Long-term debt (36,141 ) — — (36,141 ) Intercompany — 6,672 — (6,672 ) Other items (22,796 ) — — (22,796 ) Net cash (used in) provided by financing activities (58,937 ) 6,672 — (65,609 ) Effect of exchange rate changes on cash 2,820 — — 2,820 Net increase (decrease) in cash 559,045 (5,605 ) — 564,650 Cash and cash equivalents at beginning of period 913,187 104,691 — 808,496 Cash and cash equivalents at end of period $ 1,472,232 $ 99,086 $ — $ 1,373,146 |
Subsequent events (Notes)
Subsequent events (Notes) | 3 Months Ended |
Mar. 31, 2017 | |
Subsequent Events [Abstract] | |
Subsequent events | Subsequent events On May 1, 2017, the Company completed its acquisition of 100% of the interest in Colorado-based Renal Ventures Management, LLC (Renal Ventures) for approximately $360,000 in cash, subject to certain post-closing adjustments. Renal Ventures operates 38 outpatient dialysis centers in six states. As a part of this transaction, the Company was required to divest seven outpatient dialysis centers. |
Condensed consolidated interi30
Condensed consolidated interim financial statements (Policies) | 3 Months Ended |
Mar. 31, 2017 | |
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items] | |
Condensed consolidated interim financial statements | The condensed consolidated interim financial statements included in this report are prepared by the Company without audit. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, contingencies, impairments of goodwill and other long-lived assets, fair value estimates, accounting for income taxes, variable compensation accruals, consolidation of variable interest entities, purchase accounting valuation estimates, long-term incentive program compensation and medical liability claims. The results of operations for the three months ended March 31, 2017 are not necessarily indicative of the operating results for the full year. The condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2016 . Prior year balances and amounts have been reclassified to conform to the current year presentation. The Company has evaluated subsequent events through the date these condensed consolidated financial statements were issued and has included all necessary adjustments and disclosures. |
Earnings per share | Basic net income per share is calculated by dividing net income attributable to the Company, adjusted for any change in noncontrolling interests redemption rights in excess of fair value, by the weighted average number of common shares and vested stock units outstanding, net of shares held in escrow from the DaVita HealthCare Partner merger that under certain circumstances may be returned to the Company. Diluted net income per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units (under the treasury stock method) as well as contingently returnable shares held in escrow. |
Accounts receivable | Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the ultimate collectability of accounts receivable, the Company analyzes its historical cash collection experience and trends for each of its government payors and commercial payors to estimate the adequacy of the allowance for doubtful accounts and the amount of the provision for uncollectible accounts. Management regularly updates its analysis based upon the most recent information available to determine its current provision for uncollectible accounts and the adequacy of its allowance for doubtful accounts. For receivables associated with dialysis patient services covered by Medicare, the Company receives 80% of the payment directly from Medicare as established under the government’s bundled payment system and determines an appropriate allowance for doubtful accounts and provision for uncollectible accounts on the remaining balance due depending upon the Company’s estimate of the amounts ultimately collectible from other secondary coverage sources or from the patients. For receivables associated with services to patients covered by commercial payors that are either based upon contractual terms or for non-contracted health plan coverage, the Company provides an allowance for doubtful accounts by recording a provision for uncollectible accounts based upon its historical collection experience, potential inefficiencies in its billing processes and for which collectability is determined to be unlikely. For receivables associated with the Company’s capitated health plans, the balances remain on the balance sheet for as long as the respective plan years are open, which varies by health plan, but is generally two years in length, with collections occurring on a periodic basis throughout the duration of the corresponding plan year. Approximately 1% of the Company’s net accounts receivable are associated with patient pay. The Company’s policy is to reserve 100% of the outstanding accounts receivable balances for dialysis services when those amounts due have been outstanding for more than three months and to reserve 100% of the outstanding accounts receivable balances for DaVita Medical Group's (DMG, formerly known as HealthCare Partners or HCP) services when those amounts due have been outstanding for more than twelve months and when the amount is not subject to a payment plan. |
Investments in debt and equity securities | The investments in mutual funds classified as available-for-sale are held within a trust to fund existing obligations associated with several of the Company’s non-qualified deferred compensation plans. The Company classifies certain debt securities as held-to-maturity and records them at amortized cost based on the Company’s intentions and strategy concerning those investments. Equity securities that have readily determinable fair values, and certain other financial instruments that have readily determinable fair values or redemption values, are classified as available-for-sale and recorded at fair value. |
Income taxes | The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. |
Long-term debt | the Company maintains several active and forward interest rate cap agreements that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt, as described below. The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the term of the cap agreements. The cap agreements do not contain credit-risk contingent features. |
Long-term incentive compensation | The Company’s stock-based compensation awards are measured at their estimated fair values on the date of grant if settled in shares or at their estimated fair values at the end of each reporting period if settled in cash. The value of stock-based awards so measured is recognized as compensation expense on a cumulative straight-line basis over the vesting terms of the awards, adjusted for expected forfeitures. |
Comprehensive income | The reclassification of net cap and swap realized losses into income are recorded as debt expense in the corresponding consolidated statements of income. See Note 9 to these condensed consolidated financial statements for further details. The reclassification of net investment realized gains into income are recorded in other income in the corresponding consolidated statements of income. See Note 4 to these condensed consolidated financial statements for further details. |
Variable interest entities | The Company also sponsors certain deferred compensation plans whose trusts qualify as VIEs and the Company consolidates each of these plans as their primary beneficiary. The assets of these plans are recorded in short-term or long-term investments with matching offsetting liabilities recorded in accrued compensation and benefits and other long-term liabilities. The analyses upon which these consolidation determinations rest are complex, involve uncertainties, and require significant judgment on various matters, some of which could be subject to different interpretations. The Company relies on the operating activities of certain legal entities that it does not directly own or control, but over which it has indirect influence and of which it is considered the primary beneficiary. These entities are subject to the consolidation guidance applicable to variable interest entities (VIEs). Under U.S. generally accepted accounting principles (GAAP), VIEs typically include entities for which (i) the entity’s equity is not sufficient to finance its activities without additional subordinated financial support; (ii) the equity holders as a group lack the power to direct the activities that most significantly influence the entity’s economic performance, the obligation to absorb the entity’s expected losses, or the right to receive the entity’s expected returns; or (iii) the voting rights of some investors are not proportional to their obligations to absorb the entity’s losses. |
Fair value of financial instruments | Available-for-sale securities represent investments in various open-ended registered investment companies, or mutual funds, and are recorded at estimated fair value based upon quoted prices reported by each mutual fund. See Note 4 to these condensed consolidated financial statements for further discussion. Investments in life insurance policies are carried at their cash surrender value which approximates their fair value. See Note 4 to these condensed consolidated financial statements for further discussion. The interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 9 to these condensed consolidated financial statements for further discussion. The funds on deposit with third parties represent funds held with various third parties as required by regulation or contract and invested by those parties in various investments, which are measured at estimated fair value based primarily on quoted market prices. The estimated fair value measurements of contingent earn-out obligations are primarily based on unobservable inputs including projected EBITDA, estimated probability of achieving gross margins or quality margins of certain medical procedures and the estimated probability of earn-out payments being made using an option pricing technique and a simulation model for expected EBITDA and operating income. In addition, a probability adjusted model was used to estimate the fair value amounts of the quality margins. The estimated fair value of these contingent earn-out obligations are 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. |
New accounting standards | In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers , which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. In July 2015, the FASB issued ASU 2015-14, Revenue from Contracts with Customers (Topic 606): Deferral of Effective Date . This guidance approves a one-year deferral of the effective date of ASU 2014-09. The ASU now permits the Company to adopt this standard effective January 1, 2018. Early application is permitted as of January 1, 2017. In March, April, and May 2016, the FASB issued ASU 2016-08, ASU 2016-10, ASU 2016-11, and ASU 2016-12, Revenue from Contracts with Customers (Topic 606) , each of which amends the guidance in ASU 2014-09. When they become effective, these ASUs will replace most existing revenue recognition guidance in GAAP. The Company has assembled an internal revenue task force that meets regularly to discuss and evaluate the overall impact this guidance will have on various revenue streams in the condensed consolidated financial statements and related disclosures. The Company is continuing to evaluate the impact this guidance will have on its consolidated financial statements. The Company expects to adopt these ASU’s effective January 1, 2018 retrospectively with the cumulative effect of initially applying it recognized at the date of initial application (the cumulative effect method). In January 2016, the FASB issued ASU No. 2016-01, Financial Statements - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities. The amendments in this ASU revise accounting related to (i) the classification and measurement of investments in equity securities and (ii) the presentation of certain fair value changes for financial liabilities at fair value. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied through a cumulative effect adjustment to the statement of financial position. Early adoption is permitted under certain circumstances. The adoption of this ASU is not expected to have a material impact on the Company’s condensed consolidated financial statements when adopted on January 1, 2018. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The amendments in this ASU revise the accounting related to lessee accounting. Under the new guidance, lessees will be required to recognize a lease liability and a right-of-use asset for substantially all leases with lease terms in excess of twelve months. The new lease guidance also simplifies the accounting for sale and leaseback transactions primarily because lessees must recognize lease assets and lease liabilities. The amendments in this ASU are effective for the Company beginning on January 1, 2019 and are to be applied through a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements. Early adoption is permitted. The Company has assembled an internal lease task force that meets regularly to discuss and evaluate the overall impact of this guidance on its condensed consolidated financial statements and related disclosures, as well as the expected timing of adoption. The Company believes that the new standard will have a material impact on its condensed consolidated balance sheet but will not have a material impact on its results of operations or liquidity. The Company expects to adopt this ASU on January 1, 2019, and continues to evaluate the effect that the implementation of this ASU will have on its condensed consolidated financial statements and related disclosures. In March 2016, the FASB issued ASU No. 2016-07, Investments - Equity Method and Joint Ventures (Topic 323): Simplifying the Transition to the Equity Method of Accounting. The amendments in this ASU eliminate the requirement that when an investment qualifies for use of the equity method as a result of an increase in the level of ownership interest or degree of influence, an investor must adjust the investment, results of operations, and retained earnings retroactively on a step-by-step basis as if the equity method had been in effect during all previous periods that the investment had been held. The amendments in this ASU were effective for the Company beginning on January 1, 2017 and was applied prospectively. The adoption of this ASU did not have a material impact on the Company’s condensed consolidated financial statements. In March 2016, the FASB issued ASU No. 2016-09, Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting . The changes required by this ASU involve several aspects of the accounting for share-based payment transactions, including income tax consequences, classification of awards as either equity or liabilities, classification on the statement of cash flows, and an election on estimating forfeitures. The amendments in this ASU were effective for the Company beginning January 1, 2017. The method of adoption differs for each of the topics covered by the ASU. The primary effect of this ASU for the Company is the presentation of excess tax benefits or deficiencies as a component of income tax expense within the Company's condensed consolidated statement of income rather than within additional paid-in capital on its condensed consolidated balance sheet. In addition, these excess tax benefits or deficiencies are presented as an operating activity on the condensed consolidated statement of cash flows rather than as a financing activity. The Company elected to apply the presentation requirements for cash flows related to excess tax benefits prospectively. Additionally, the Company has elected to continue to estimate forfeitures expected to occur in determining the amount of compensation cost to be recognized each period. The new standard may cause volatility in the Company’s effective tax rates and diluted earnings per share due to the tax effects related to share-based payments being recorded within the Company’s condensed consolidated statement of income, including a potential increase in the Company’s provision for income taxes if a significant number of outstanding stock awards are exercised at recent levels of the Company’s stock price. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments . The amendments in this ASU clarify how certain cash receipts and cash payments should be classified on the statement of cash flows. The new standard is effective for the Company beginning January 1, 2018 and should be applied retrospectively to all periods presented. The Company has not yet determined the effect that adoption of this ASU will have on its condensed consolidated financial statements. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory . The amendments in this ASU allow entities to recognize the income tax consequences of an intra-entity transfer of an asset other than inventory when the transfer occurs. The current guidance does not allow recognition until the asset has been sold to an outside party. The amendments in this ASU are effective for the Company beginning on January 1, 2018 and are to be applied on a modified retrospective basis. The Company has not yet determined the effect that adoption of this ASU will have on its condensed consolidated financial statements. In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment . The amendments in this ASU simplify the test for goodwill impairment by eliminating the second step in testing for goodwill impairment. The amendments in this new ASU are effective for the Company January 1, 2020 and are to be applied on a prospective basis. Early adoption is permitted after January 1, 2017. The Company early adopted this ASU as of January 1, 2017. |
Put Obligation Fair Value Estimate of Noncontrolling Interest | |
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items] | |
Noncontrolling interests subject to put provisions and other commitments | The Company has potential obligations to purchase the noncontrolling interests held by third parties in several of its majority-owned and other nonconsolidated entities. These obligations are in the form of put provisions and are exercisable at the third-party owners’ discretion within specified periods as outlined in each specific put provision. If these put provisions were exercised, the Company would be required to purchase the third-party owners’ equity interests at either the appraised fair market value or a predetermined multiple of earnings or cash flow attributable to the equity interests put to the Company, which is intended to approximate fair value. The methodology the Company uses to estimate the fair values of noncontrolling interests subject to put provisions assumes the higher of either a liquidation value of net assets or an average multiple of earnings, based on historical earnings, patient mix and other performance indicators that can affect future results, as well as other factors. The estimated fair values of the noncontrolling interests subject to put provisions is 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 interest obligations may be settled could vary significantly depending upon market conditions including potential purchasers’ access to the capital markets, which can impact the level of competition for dialysis and non-dialysis related businesses, the economic performance of these businesses and the restricted marketability of the third-party owners’ equity interests. The amount of noncontrolling interests subject to put provisions that employ a contractually predetermined multiple of earnings rather than fair value are immaterial. |
Earnings per share (Tables)
Earnings per share (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Earnings Per Share [Abstract] | |
Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Earnings Per Share | The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share are as follows: Three months ended 2017 2016 Basic: Net income attributable to DaVita Inc. $ 447,697 $ 97,434 Weighted average shares outstanding during the period 194,571 206,561 Contingently returnable shares held in escrow from the DaVita HealthCare Partners merger (2,194 ) (2,194 ) Weighted average shares for basic earnings per share calculation 192,377 204,367 Basic net income per share attributable to DaVita Inc. $ 2.33 $ 0.48 Diluted: Net income attributable to DaVita Inc. $ 447,697 $ 97,434 Weighted average shares outstanding during the period 194,571 206,561 Assumed incremental shares from stock plans 710 1,367 Weighted average shares for diluted earnings per share calculation 195,281 207,928 Diluted net income per share attributable to DaVita Inc. $ 2.29 $ 0.47 Anti-dilutive potential common shares excluded from calculation (1) 3,427 2,273 (1) Shares associated with stock-settled stock appreciation rights that are excluded from the diluted denominator calculation because they are anti-dilutive under the treasury stock method. |
Investments in debt and equit32
Investments in debt and equity securities (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Investments, Debt and Equity Securities [Abstract] | |
Investments | The Company’s investments in these securities and certain other financial instruments consist of the following: March 31, 2017 December 31, 2016 Held to Available Total Held to Available Total Certificates of deposit, commercial paper and $ 312,065 $ — $ 312,065 $ 256,827 $ — $ 256,827 Investments in mutual funds and common stock — 48,124 48,124 50,000 47,404 97,404 Cash surrender value of life insurance policies — 61,444 61,444 — 59,646 59,646 $ 312,065 $ 109,568 $ 421,633 $ 306,827 $ 107,050 $ 413,877 Short-term investments $ 312,065 $ 1,200 $ 313,265 $ 306,827 $ 3,371 $ 310,198 Long-term investments — 108,368 108,368 — 103,679 103,679 $ 312,065 $ 109,568 $ 421,633 $ 306,827 $ 107,050 $ 413,877 |
Goodwill (Tables)
Goodwill (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Changes in Goodwill by Reportable Segments | Changes in goodwill by reportable segments were as follows: U.S. dialysis and related lab services DMG Other-ancillary services and strategic initiatives Consolidated total Balance at January 1, 2016 $ 5,629,183 $ 3,398,264 $ 267,032 $ 9,294,479 Acquisitions 75,295 248,901 123,632 447,828 Divestitures (12,891 ) (2,223 ) (29,645 ) (44,759 ) Goodwill impairment charges — (253,000 ) (28,415 ) (281,415 ) Foreign currency and other adjustments — — (8,816 ) (8,816 ) Balance at December 31, 2016 $ 5,691,587 $ 3,391,942 $ 323,788 $ 9,407,317 Acquisitions 46,569 14,989 17,171 78,729 Divestitures (14,110 ) (29 ) — (14,139 ) Goodwill impairment charges — — (24,198 ) (24,198 ) Foreign currency and other adjustments — — 4,761 4,761 Balance at March 31, 2017 $ 5,724,046 $ 3,406,902 $ 321,522 $ 9,452,470 Balance at March 31, 2017: Goodwill 5,724,046 3,848,671 380,044 9,952,761 Accumulated impairment charges — (441,769 ) (58,522 ) (500,291 ) $ 5,724,046 3,406,902 321,522 9,452,470 |
Schedule of Goodwill and Indefinite Lived Intangible Asset Impairment Charges | e Company has recognized goodwill impairment charges as shown and discussed below: Three months ended Reporting unit March 31, 2017 March 31, 2016 DMG Nevada $ — $ 77,000 Vascular access 24,198 — Total $ 24,198 $ 77,000 |
Schedule of Reporting Units Goodwill Balances | Further reductions in reimbursement rates, increases in medical cost or utilization trends, or other significant adverse changes in expected future cash flows or valuation assumptions could result in goodwill impairment charges in the future for the following reporting units, which remain at risk of goodwill impairment: Goodwill balance Carrying (1) Sensitivities Operating (2) Discount (3) Reporting unit DMG Nevada $ 261,204 14.0 % (2.7 )% (3.9 )% DMG Florida $ 447,073 10.5 % (1.6 )% (2.8 )% DMG New Mexico $ 70,926 4.9 % (1.5 )% (2.3 )% DMG Washington $ 245,576 2.0 % (1.7 )% (3.0 )% Vascular Access $ 10,498 0.0 % (1.7 )% (4.9 )% (1) Excess of estimated fair value of the reporting unit over carrying amount as of the latest assessment date. (2) Potential impact on estimated fair value of a sustained, long-term reduction of 3% in operating income as of the latest assessment date. (3) Potential impact on estimated fair value of an increase in discount rates of 100 basis points as of the latest assessment date. |
Medical payables (Tables)
Medical payables (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Health Care Organizations [Abstract] | |
Components of Changes in Health Care Costs Payable | The following table shows the components of changes in health care costs payable for the three months ended March 31, 2017 : Three months ended March 31, 2017 Healthcare costs payable, beginning of the period $ 214,275 Add: Components of incurred health care costs Current year 467,683 Prior years 421 Total incurred health care costs 468,104 Less: Claims paid Current year 247,723 Prior years 172,693 Total claims paid 420,416 Healthcare costs payable, end of the period $ 261,963 |
Long-term debt (Tables)
Long-term debt (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Debt Disclosure [Abstract] | |
Long-term Debt | Long-term debt was comprised of the following: March 31, 2017 December 31, 2016 Senior secured credit facilities: Term Loan A $ 843,750 $ 862,500 Term Loan B 3,403,750 3,412,500 Senior notes 4,500,000 4,500,000 Acquisition obligations and other notes payable 120,952 117,547 Capital lease obligations 296,505 299,682 Total debt principal outstanding 9,164,957 9,192,229 Discount and deferred financing costs (75,862 ) (79,861 ) 9,089,095 9,112,368 Less current portion (170,217 ) (165,041 ) $ 8,918,878 $ 8,947,327 |
Scheduled Maturities of Long-term Debt | Scheduled maturities of long-term debt at March 31, 2017 were as follows: 2017 (remainder of the year) 129,532 2018 167,855 2019 745,584 2020 70,157 2021 3,301,236 2022 1,277,759 Thereafter 3,472,834 |
Derivative Instruments | The following table summarizes the Company’s derivative instruments as of March 31, 2017 and December 31, 2016 : March 31, 2017 December 31, 2016 Derivatives designated as hedging instruments Balance sheet location Fair value Balance sheet location Fair value Interest rate cap agreements Other long-term assets $ 4,712 Other long-term assets $ 9,929 |
Effects of Interest Rate Swap and Cap Agreements | December 31, 2016 : March 31, 2017 December 31, 2016 Derivatives designated as hedging instruments Balance sheet location Fair value Balance sheet location Fair value Interest rate cap agreements Other long-term assets $ 4,712 Other long-term assets $ 9,929 The following table summarizes the effects of the Company’s interest rate cap and swap agreements for the three months ended March 31, 2017 and 2016 : Amount of losses Location of losses reclassified from accumulated OCI into income Amount of losses Three months ended Three months ended Derivatives designated as cash flow hedges 2017 2016 2017 2016 Interest rate swap agreements $ — $ (692 ) Debt expense $ — $ 151 Interest rate cap agreements (5,217 ) (8,259 ) Debt expense 2,070 610 Tax benefit (expense) 2,029 3,482 (805 ) (296 ) Total $ (3,188 ) $ (5,469 ) $ 1,265 $ 465 |
Comprehensive income (Tables)
Comprehensive income (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Statement of Comprehensive Income [Abstract] | |
Comprehensive income | For the three months ended March 31, 2017 For the three months ended March 31, 2016 Interest Investment Foreign Accumulated Interest Investment Foreign Accumulated Beginning balance $ (12,029 ) $ 2,175 $ (79,789 ) $ (89,643 ) $ (10,925 ) $ 1,361 $ (50,262 ) $ (59,826 ) Unrealized (losses) (5,217 ) 2,113 13,261 10,157 (8,951 ) 342 11,181 2,572 Related income tax 2,029 (554 ) — 1,475 3,482 (113 ) — 3,369 (3,188 ) 1,559 13,261 11,632 (5,469 ) 229 11,181 5,941 Reclassification 2,070 (229 ) — 1,841 761 (152 ) — 609 Related income tax (expense) benefit (805 ) 89 — (716 ) (296 ) 59 — (237 ) 1,265 (140 ) — 1,125 465 (93 ) — 372 Ending balance $ (13,952 ) $ 3,594 $ (66,528 ) $ (76,886 ) $ (15,929 ) $ 1,497 $ (39,081 ) $ (53,513 ) |
Acquisitions and divestitures (
Acquisitions and divestitures (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Business Acquisition [Line Items] | |
Reconciliation of Changes in Contingent Earn-Out Obligations | The following is a reconciliation of changes in the contingent earn-out obligations for the three months ended March 31, 2017 : Beginning balance, January 1, 2017 $ 9,977 Contingent earn-out obligations associated with acquisitions 1,053 Remeasurement of fair value for contingent earn-out obligations 102 Payments on contingent earn-out obligations (2,567 ) $ 8,565 |
Dialysis businesses and other businesses | |
Business Acquisition [Line Items] | |
Aggregate Purchase Cost Allocations for Acquisitions | The following table summarizes the assets acquired and liabilities assumed in these transactions and recognized at their acquisition dates at estimated fair values: Current assets $ 1,123 Property and equipment 5,604 Amortizable intangible and other long-term assets 6,173 Goodwill 78,729 Noncontrolling interests assumed (8,052 ) Deferred income taxes (2,194 ) Liabilities assumed (447 ) Aggregate purchase price $ 80,936 |
Fair value of financial instr38
Fair value of financial instruments (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
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 March 31, 2017 : Total Quoted prices in Significant other Significant Assets Available-for-sale securities $ 48,124 $ 48,124 $ — $ — Cash surrender value of life insurance policies $ 61,444 $ — $ 61,444 $ — Interest rate cap agreements $ 4,712 $ — $ 4,712 $ — Funds on deposit with third parties $ 79,459 $ 79,459 $ — $ — Liabilities Contingent earn-out obligations $ 8,565 $ — $ — $ 8,565 Temporary equity Noncontrolling interests subject to put provisions $ 979,848 $ — $ — $ 979,848 |
Segment Reporting (Tables)
Segment Reporting (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Segment Reporting [Abstract] | |
Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes | The following is a summary of segment net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes: Three months ended 2017 2016 Segment net revenues: U.S. dialysis and related lab services Patient service revenues: External sources $ 2,348,901 $ 2,313,663 Intersegment revenues 23,760 14,308 Total dialysis and related lab services revenues 2,372,661 2,327,971 Less: Provision for uncollectible accounts (106,770 ) (104,751 ) Net dialysis and related lab services patient service revenues 2,265,891 2,223,220 Other revenues (1) 5,303 3,973 Total net dialysis and related lab services revenues 2,271,194 2,227,193 DMG DMG revenues: Capitated revenues 889,686 866,019 Net patient service revenues 178,971 112,433 Other revenues (2) 18,269 10,335 Intersegment capitated and other revenues 59 71 Total net DMG revenues 1,086,985 988,858 Other—Ancillary services and strategic initiatives Net patient service revenues 67,293 51,383 Capitated revenues 28,350 21,028 Other external sources 267,280 307,053 Intersegment revenues 15,302 11,827 Total ancillary services and strategic initiatives revenues 378,225 391,291 Total net segment revenues 3,736,404 3,607,342 Elimination of intersegment revenues (39,121 ) (26,206 ) Consolidated net revenues $ 3,697,283 $ 3,581,136 Segment operating margin (loss): U.S. dialysis and related lab services (3) $ 944,740 $ 440,055 DMG 12,308 (57,145 ) Other—Ancillary services and strategic initiatives (58,220 ) (11,100 ) Total segment operating margin 898,828 371,810 Reconciliation of segment operating margin to consolidated income before Corporate administrative support (10,592 ) (6,921 ) Consolidated operating income 888,236 364,889 Debt expense (104,429 ) (102,884 ) Other income, net 4,243 2,976 Consolidated income before income taxes $ 788,050 $ 264,981 (1) Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment. (2) Includes medical consulting service fees and management fees for providing management and administrative services to unconsolidated joint ventures, as well as revenue related to the maintenance of existing physician networks. (3) U.S. dialysis and related lab services operating income includes the net gain on the settlement with the VA. |
Summary of Depreciation and Amortization Expense by Reportable Segment | Depreciation and amortization expense by reportable segment is as follows: Three months ended 2017 2016 U.S. dialysis and related lab services $ 125,029 $ 116,537 DMG 57,323 46,263 Ancillary services and strategic initiatives 7,854 6,555 $ 190,206 $ 169,355 |
Summary of Assets by Reportable Segment | Summary of assets by reportable segment is as follows: Subsequent to issuance of the Company’s fiscal year 2016 consolidated financial statements and their inclusion in its Annual Report on Form 10-K filed with the Securities and Exchange Commission on February 24, 2017 (the “2016 10-K”), the Company determined that it had misstated its disclosure of segment assets at December 31, 2016 in Note 25 to those consolidated financial statements. This misstatement resulted in an overstatement of “U.S. dialysis and related lab services” segment assets of $338,963 and a corresponding understatement of “Other - ancillary services and strategic initiatives” segment assets of the same amount. The Company performed an assessment of the materiality of this misstatement and concluded that this misstatement as originally disclosed was not materially misleading in its 2016 consolidated financial statements taken as a whole. The Company therefore has not amended its financial statements filed on its 2016 10-K to correct this misstatement, but has provided the corrected disclosure here. March 31, 2017 December 31, 2016 Segment assets U.S. dialysis and related lab services (including equity $ 11,744,695 $ 11,099,137 DMG (including equity investments of $12,579 and $10,350, 6,209,369 6,213,091 Other—Ancillary services and strategic initiatives (including 1,434,200 1,429,029 Consolidated assets $ 19,388,264 $ 18,741,257 |
Summary of Expenditures for Property and Equipment by Reportable Segment | Expenditures for property and equipment by reportable segment is as follows: Three months ended 2017 2016 U.S. dialysis and related lab services $ 173,528 $ 133,450 DMG 27,788 20,145 Ancillary services and strategic initiatives 13,219 19,592 $ 214,535 $ 173,187 |
Changes in DaVita Inc.'s Owne40
Changes in DaVita Inc.'s Ownership Interest in Consolidated Subsidiaries (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Noncontrolling Interest [Abstract] | |
Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity | The effects of changes in DaVita Inc.’s ownership interest on the Company’s equity are as follows: Three months ended 2017 2016 Net income attributable to DaVita Inc. $ 447,697 $ 97,434 Increase in paid-in capital for sales of noncontrolling interests — 885 Decrease in paid-in capital for the purchase of noncontrolling (423 ) (3,337 ) Net transfers to noncontrolling interests (423 ) (2,452 ) Net income attributable to DaVita Inc., net of transfers to $ 447,274 $ 94,982 |
Condensed Consolidating Finan41
Condensed Consolidating Financial Statements (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Condensed Consolidating Statements of Income | Condensed Consolidating Statements of Income Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended March 31, 2017 DaVita Inc. Patient services revenues $ — $ 1,553,356 $ 1,098,752 $ (50,730 ) $ 2,601,378 Less: Provision for uncollectible accounts — (62,281 ) (50,702 ) — (112,983 ) Net patient service revenues — 1,491,075 1,048,050 (50,730 ) 2,488,395 Capitated revenues — 463,627 454,954 (545 ) 918,036 Other revenues 221,386 477,675 35,637 (443,846 ) 290,852 Total net revenues 221,386 2,432,377 1,538,641 (495,121 ) 3,697,283 Operating expenses and charges 131,910 1,880,155 1,292,103 (495,121 ) 2,809,047 Operating income 89,476 552,222 246,538 — 888,236 Debt expense (102,664 ) (91,401 ) (13,716 ) 103,352 (104,429 ) Other income, net 100,337 3,537 3,721 (103,352 ) 4,243 Income tax expense 34,093 221,421 32,251 — 287,765 Equity earnings in subsidiaries 394,641 151,704 — (546,345 ) — Net income 447,697 394,641 204,292 (546,345 ) 500,285 Less: Net income attributable to noncontrolling interests — — — (52,588 ) (52,588 ) Net income attributable to DaVita Inc. $ 447,697 $ 394,641 $ 204,292 $ (598,933 ) $ 447,697 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2016 DaVita Inc. Patient service revenues $ — $ 1,653,312 $ 868,037 $ (39,416 ) $ 2,481,933 Less: Provision for uncollectible accounts — (58,813 ) (50,392 ) — (109,205 ) Net patient service revenues — 1,594,499 817,645 (39,416 ) 2,372,728 Capitated revenues — 467,001 420,173 (127 ) 887,047 Other revenues 186,975 485,316 27,521 (378,451 ) 321,361 Total net revenues 186,975 2,546,816 1,265,339 (417,994 ) 3,581,136 Operating expenses 122,273 2,377,630 1,134,338 (417,994 ) 3,216,247 Operating income 64,702 169,186 131,001 — 364,889 Debt expense (101,101 ) (92,173 ) (11,514 ) 101,904 (102,884 ) Other income 98,560 4,336 1,984 (101,904 ) 2,976 Income tax expense 35,146 73,254 18,422 — 126,822 Equity earnings in subsidiaries 70,419 62,324 — (132,743 ) — Net income 97,434 70,419 103,049 (132,743 ) 138,159 Less: Net income attributable to noncontrolling interests — — — (40,725 ) (40,725 ) Net income attributable to DaVita Inc. $ 97,434 $ 70,419 $ 103,049 $ (173,468 ) $ 97,434 Condensed Consolidating Statements of Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2017 Patient service operating revenues $ 2,601,378 $ 133,537 $ — $ 2,467,841 Less: Provision for uncollectible accounts (112,983 ) (3,725 ) — (109,258 ) Net patient service operating revenues 2,488,395 129,812 — 2,358,583 Capitated revenues 918,036 384,262 — 533,774 Other revenues 290,852 9,851 — 281,001 Total net operating revenues 3,697,283 523,925 — 3,173,358 Operating expenses 2,809,047 500,390 (166 ) 2,308,823 Operating income 888,236 23,535 166 864,535 Debt expense, including refinancing charges (104,429 ) (1,450 ) — (102,979 ) Other income 4,243 35 — 4,208 Income tax expense 287,765 18,594 66 269,105 Net income (loss) 500,285 3,526 100 496,659 Less: Net income attributable to noncontrolling interests (52,588 ) — — (52,588 ) Net income (loss) attributable to DaVita Inc. $ 447,697 $ 3,526 $ 100 $ 444,071 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Comprehensive Income | Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Net income $ 447,697 $ 394,641 $ 204,292 $ (546,345 ) $ 500,285 Other comprehensive (loss) income (506 ) — 13,261 — 12,755 Total comprehensive income 447,191 394,641 217,553 (546,345 ) 513,040 Less: Comprehensive income attributable to — — — (52,586 ) (52,586 ) Comprehensive income attributable to DaVita Inc. $ 447,191 $ 394,641 $ 217,553 $ (598,931 ) $ 460,454 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2016 DaVita Inc. Net income $ 97,434 $ 70,419 $ 103,049 $ (132,743 ) $ 138,159 Other comprehensive (loss) income (4,868 ) — 11,181 — 6,313 Total comprehensive income 92,566 70,419 114,230 (132,743 ) 144,472 Less: comprehensive income attributable to the — — — (40,725 ) (40,725 ) Comprehensive income attributable to DaVita Inc. $ 92,566 $ 70,419 $ 114,230 $ (173,468 ) $ 103,747 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2017 Net income (loss) $ 500,285 $ 3,526 $ 100 $ 496,659 Other comprehensive loss 12,755 — — 12,755 Total comprehensive income (loss) 513,040 3,526 100 509,414 Less: comprehensive income attributable to the noncontrolling (52,586 ) — — (52,586 ) Comprehensive income (loss) attributable to DaVita Inc. $ 460,454 $ 3,526 $ 100 $ 456,828 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Balance Sheets | Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of March 31, 2017 DaVita Inc. Cash and cash equivalents $ 1,078,071 $ 74,633 $ 319,528 $ — $ 1,472,232 Accounts receivable, net — 1,216,764 683,797 — 1,900,561 Other current assets 339,626 814,917 76,564 — 1,231,107 Total current assets 1,417,697 2,106,314 1,079,889 — 4,603,900 Property and equipment, net 347,805 1,664,888 1,158,506 — 3,171,199 Intangible assets, net 421 1,448,086 38,522 — 1,487,029 Investments in subsidiaries 10,231,471 2,334,152 — (12,565,623 ) — Intercompany receivables 2,840,305 — 1,158,246 (3,998,551 ) — Other long-term assets and investments 45,042 87,414 541,210 — 673,666 Goodwill — 7,858,841 1,593,629 — 9,452,470 Total assets $ 14,882,741 $ 15,499,695 $ 5,570,002 $ (16,564,174 ) $ 19,388,264 Current liabilities $ 557,557 $ 1,697,937 $ 558,083 $ — $ 2,813,577 Intercompany payables — 2,337,683 1,660,868 (3,998,551 ) — Long-term debt and other long-term liabilities 8,599,938 1,232,604 421,706 — 10,254,248 Noncontrolling interests subject to put provisions 585,317 — — 394,531 979,848 Total DaVita Inc. shareholder's equity 5,139,929 10,231,471 2,334,152 (12,565,623 ) 5,139,929 Noncontrolling interests not subject to put provisions — — 595,193 (394,531 ) 200,662 Total equity 5,139,929 10,231,471 2,929,345 (12,960,154 ) 5,340,591 Total liabilities and equity $ 14,882,741 $ 15,499,695 $ 5,570,002 $ (16,564,174 ) $ 19,388,264 Guarantor Non- Consolidating Consolidated As of December 31, 2016 DaVita Inc. Cash and cash equivalents $ 549,921 $ 59,192 $ 304,074 $ — $ 913,187 Accounts receivable, net — 1,215,232 702,070 — 1,917,302 Other current assets 277,911 736,727 135,101 — 1,149,739 Total current assets 827,832 2,011,151 1,141,245 — 3,980,228 Property and equipment, net 337,200 1,689,798 1,148,369 — 3,175,367 Intangible assets, net 487 1,491,057 36,223 — 1,527,767 Investments in subsidiaries 9,717,728 2,002,660 — (11,720,388 ) — Intercompany receivables 3,250,692 — 866,955 (4,117,647 ) — Other long-term assets and investments 39,994 86,710 523,874 — 650,578 Goodwill — 7,838,984 1,568,333 — 9,407,317 Total assets $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Current liabilities $ 303,840 $ 1,865,193 $ 527,412 $ — $ 2,696,445 Intercompany payables — 2,322,124 1,795,523 (4,117,647 ) — Long-term debt and other long-term liabilities 8,614,445 1,215,315 392,053 — 10,221,813 Noncontrolling interests subject to put provisions 607,601 — — 365,657 973,258 Total DaVita Inc. shareholder's equity 4,648,047 9,717,728 2,002,660 (11,720,388 ) 4,648,047 Noncontrolling interests not subject to put provisions — — 567,351 (365,657 ) 201,694 Total equity 4,648,047 9,717,728 2,570,011 (12,086,045 ) 4,849,741 Total liabilities and equity $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of March 31, 2017 Cash and cash equivalents $ 1,472,232 $ 99,086 $ — $ 1,373,146 Accounts receivable, net 1,900,561 202,006 — 1,698,555 Other current assets 1,231,107 14,819 — 1,216,288 Total current assets 4,603,900 315,911 — 4,287,989 Property and equipment, net 3,171,199 1,268 — 3,169,931 Amortizable intangibles, net 1,487,029 4,576 — 1,482,453 Other long-term assets 673,666 81,419 2,880 589,367 Goodwill 9,452,470 16,796 — 9,435,674 Total assets $ 19,388,264 $ 419,970 $ 2,880 $ 18,965,414 Current liabilities $ 2,813,577 $ 204,998 $ — $ 2,608,579 Payables to parent — 61,723 2,880 (64,603 ) Long-term debt and other long-term liabilities 10,254,248 45,226 — 10,209,022 Noncontrolling interests subject to put provisions 979,848 — — 979,848 Total DaVita Inc. shareholders’ equity 5,139,929 108,023 — 5,031,906 Noncontrolling interests not subject to put provisions 200,662 — — 200,662 Shareholders’ equity 5,340,591 108,023 — 5,232,568 Total liabilities and shareholder’s equity $ 19,388,264 $ 419,970 $ 2,880 $ 18,965,414 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Cash Flows | Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 447,697 $ 394,641 $ 204,292 $ (546,345 ) $ 500,285 Changes in operating assets and liabilities and non-cash items included in net income (149,767 ) (131,683 ) 99,994 546,345 364,889 Net cash provided by operating activities 297,930 262,958 304,286 — 865,174 Cash flows from investing activities: Additions of property and equipment, net (30,580 ) (133,909 ) (50,046 ) — (214,535 ) Acquisitions — (70,237 ) (6,999 ) — (77,236 ) Proceeds from asset and business sales — 46,612 — — 46,612 (Purchases) proceeds from investment sales and other items, net (54,150 ) (1,976 ) 51,273 — (4,853 ) Net cash used in investing activities (84,730 ) (159,510 ) (5,772 ) — (250,012 ) Cash flows from financing activities: Long-term debt and related financing costs, net (27,504 ) (4,616 ) (4,021 ) — (36,141 ) Intercompany borrowing (payments) 339,124 (82,592 ) (256,532 ) — — Other items 3,330 (799 ) (25,327 ) — (22,796 ) Net cash provided by (used in) financing activities 314,950 (88,007 ) (285,880 ) — (58,937 ) Effect of exchange rate changes on cash — — 2,820 — 2,820 Net increase in cash and cash equivalents 528,150 15,441 15,454 — 559,045 Cash and cash equivalents at beginning of period 549,921 59,192 304,074 — 913,187 Cash and cash equivalents at end of period $ 1,078,071 $ 74,633 $ 319,528 $ — $ 1,472,232 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2016 DaVita Inc. Cash flows from operating activities: Net income $ 97,434 $ 70,419 $ 103,049 $ (132,743 ) $ 138,159 Changes in operating assets and liabilities and non-cash (18,699 ) 217,405 (40,606 ) 132,743 290,843 Net cash provided by operating activities 78,735 287,824 62,443 — 429,002 Cash flows from investing activities: Additions of property and equipment, net (16,865 ) (86,055 ) (70,267 ) — (173,187 ) Acquisitions — (400,093 ) (5,061 ) — (405,154 ) Proceeds from asset and business sales — 4,657 — — 4,657 (Purchases) proceeds from investment sales and other 23,387 (7,438 ) 3,424 — 19,373 Net cash provided by (used in) investing activities 6,522 (488,929 ) (71,904 ) — (554,311 ) Cash flows from financing activities: Long-term debt and related financing costs, net (21,247 ) (1,977 ) (1,347 ) — (24,571 ) Intercompany borrowing (payments) (315,986 ) 167,702 148,284 — — Other items (267,551 ) (756 ) (40,219 ) — (308,526 ) Net cash provided by (used in) financing activities (604,784 ) 164,969 106,718 — (333,097 ) Effect of exchange rate changes on cash — — 717 — 717 Net increase in cash and cash equivalents (519,527 ) (36,136 ) 97,974 — (457,689 ) Cash and cash equivalents at beginning of period 1,186,636 109,357 203,123 — 1,499,116 Cash and cash equivalents at end of period $ 667,109 $ 73,221 $ 301,097 $ — $ 1,041,427 Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2017 Cash flows from operating activities: Net income $ 500,285 $ 3,526 $ 100 $ 496,659 Changes in operating and intercompany assets and liabilities 364,889 (14,847 ) (100 ) 379,836 Net cash provided by (used in) operating activities 865,174 (11,321 ) — 876,495 Cash flows from investing activities: Additions of property and equipment (214,535 ) (10 ) — (214,525 ) Acquisitions and divestitures, net (77,236 ) — — (77,236 ) Proceeds from discontinued operations 46,612 — — 46,612 Investments and other items (4,853 ) (946 ) — (3,907 ) Net cash used in investing activities (250,012 ) (956 ) — (249,056 ) Cash flows from financing activities: Long-term debt (36,141 ) — — (36,141 ) Intercompany — 6,672 — (6,672 ) Other items (22,796 ) — — (22,796 ) Net cash (used in) provided by financing activities (58,937 ) 6,672 — (65,609 ) Effect of exchange rate changes on cash 2,820 — — 2,820 Net increase (decrease) in cash 559,045 (5,605 ) — 564,650 Cash and cash equivalents at beginning of period 913,187 104,691 — 808,496 Cash and cash equivalents at end of period $ 1,472,232 $ 99,086 $ — $ 1,373,146 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Supplemental Data (Tables)
Supplemental Data (Tables) | 3 Months Ended |
Mar. 31, 2017 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Condensed Consolidating Statements of Income | Condensed Consolidating Statements of Income Guarantor subsidiaries Non- Guarantor subsidiaries Consolidating adjustments Consolidated total For The Three Months Ended March 31, 2017 DaVita Inc. Patient services revenues $ — $ 1,553,356 $ 1,098,752 $ (50,730 ) $ 2,601,378 Less: Provision for uncollectible accounts — (62,281 ) (50,702 ) — (112,983 ) Net patient service revenues — 1,491,075 1,048,050 (50,730 ) 2,488,395 Capitated revenues — 463,627 454,954 (545 ) 918,036 Other revenues 221,386 477,675 35,637 (443,846 ) 290,852 Total net revenues 221,386 2,432,377 1,538,641 (495,121 ) 3,697,283 Operating expenses and charges 131,910 1,880,155 1,292,103 (495,121 ) 2,809,047 Operating income 89,476 552,222 246,538 — 888,236 Debt expense (102,664 ) (91,401 ) (13,716 ) 103,352 (104,429 ) Other income, net 100,337 3,537 3,721 (103,352 ) 4,243 Income tax expense 34,093 221,421 32,251 — 287,765 Equity earnings in subsidiaries 394,641 151,704 — (546,345 ) — Net income 447,697 394,641 204,292 (546,345 ) 500,285 Less: Net income attributable to noncontrolling interests — — — (52,588 ) (52,588 ) Net income attributable to DaVita Inc. $ 447,697 $ 394,641 $ 204,292 $ (598,933 ) $ 447,697 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2016 DaVita Inc. Patient service revenues $ — $ 1,653,312 $ 868,037 $ (39,416 ) $ 2,481,933 Less: Provision for uncollectible accounts — (58,813 ) (50,392 ) — (109,205 ) Net patient service revenues — 1,594,499 817,645 (39,416 ) 2,372,728 Capitated revenues — 467,001 420,173 (127 ) 887,047 Other revenues 186,975 485,316 27,521 (378,451 ) 321,361 Total net revenues 186,975 2,546,816 1,265,339 (417,994 ) 3,581,136 Operating expenses 122,273 2,377,630 1,134,338 (417,994 ) 3,216,247 Operating income 64,702 169,186 131,001 — 364,889 Debt expense (101,101 ) (92,173 ) (11,514 ) 101,904 (102,884 ) Other income 98,560 4,336 1,984 (101,904 ) 2,976 Income tax expense 35,146 73,254 18,422 — 126,822 Equity earnings in subsidiaries 70,419 62,324 — (132,743 ) — Net income 97,434 70,419 103,049 (132,743 ) 138,159 Less: Net income attributable to noncontrolling interests — — — (40,725 ) (40,725 ) Net income attributable to DaVita Inc. $ 97,434 $ 70,419 $ 103,049 $ (173,468 ) $ 97,434 Condensed Consolidating Statements of Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2017 Patient service operating revenues $ 2,601,378 $ 133,537 $ — $ 2,467,841 Less: Provision for uncollectible accounts (112,983 ) (3,725 ) — (109,258 ) Net patient service operating revenues 2,488,395 129,812 — 2,358,583 Capitated revenues 918,036 384,262 — 533,774 Other revenues 290,852 9,851 — 281,001 Total net operating revenues 3,697,283 523,925 — 3,173,358 Operating expenses 2,809,047 500,390 (166 ) 2,308,823 Operating income 888,236 23,535 166 864,535 Debt expense, including refinancing charges (104,429 ) (1,450 ) — (102,979 ) Other income 4,243 35 — 4,208 Income tax expense 287,765 18,594 66 269,105 Net income (loss) 500,285 3,526 100 496,659 Less: Net income attributable to noncontrolling interests (52,588 ) — — (52,588 ) Net income (loss) attributable to DaVita Inc. $ 447,697 $ 3,526 $ 100 $ 444,071 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Comprehensive Income | Condensed Consolidating Statements of Comprehensive Income Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Net income $ 447,697 $ 394,641 $ 204,292 $ (546,345 ) $ 500,285 Other comprehensive (loss) income (506 ) — 13,261 — 12,755 Total comprehensive income 447,191 394,641 217,553 (546,345 ) 513,040 Less: Comprehensive income attributable to — — — (52,586 ) (52,586 ) Comprehensive income attributable to DaVita Inc. $ 447,191 $ 394,641 $ 217,553 $ (598,931 ) $ 460,454 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2016 DaVita Inc. Net income $ 97,434 $ 70,419 $ 103,049 $ (132,743 ) $ 138,159 Other comprehensive (loss) income (4,868 ) — 11,181 — 6,313 Total comprehensive income 92,566 70,419 114,230 (132,743 ) 144,472 Less: comprehensive income attributable to the — — — (40,725 ) (40,725 ) Comprehensive income attributable to DaVita Inc. $ 92,566 $ 70,419 $ 114,230 $ (173,468 ) $ 103,747 Condensed Consolidating Statements of Comprehensive Income Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2017 Net income (loss) $ 500,285 $ 3,526 $ 100 $ 496,659 Other comprehensive loss 12,755 — — 12,755 Total comprehensive income (loss) 513,040 3,526 100 509,414 Less: comprehensive income attributable to the noncontrolling (52,586 ) — — (52,586 ) Comprehensive income (loss) attributable to DaVita Inc. $ 460,454 $ 3,526 $ 100 $ 456,828 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Balance Sheets | Condensed Consolidating Balance Sheets Guarantor Non- Consolidating Consolidated As of March 31, 2017 DaVita Inc. Cash and cash equivalents $ 1,078,071 $ 74,633 $ 319,528 $ — $ 1,472,232 Accounts receivable, net — 1,216,764 683,797 — 1,900,561 Other current assets 339,626 814,917 76,564 — 1,231,107 Total current assets 1,417,697 2,106,314 1,079,889 — 4,603,900 Property and equipment, net 347,805 1,664,888 1,158,506 — 3,171,199 Intangible assets, net 421 1,448,086 38,522 — 1,487,029 Investments in subsidiaries 10,231,471 2,334,152 — (12,565,623 ) — Intercompany receivables 2,840,305 — 1,158,246 (3,998,551 ) — Other long-term assets and investments 45,042 87,414 541,210 — 673,666 Goodwill — 7,858,841 1,593,629 — 9,452,470 Total assets $ 14,882,741 $ 15,499,695 $ 5,570,002 $ (16,564,174 ) $ 19,388,264 Current liabilities $ 557,557 $ 1,697,937 $ 558,083 $ — $ 2,813,577 Intercompany payables — 2,337,683 1,660,868 (3,998,551 ) — Long-term debt and other long-term liabilities 8,599,938 1,232,604 421,706 — 10,254,248 Noncontrolling interests subject to put provisions 585,317 — — 394,531 979,848 Total DaVita Inc. shareholder's equity 5,139,929 10,231,471 2,334,152 (12,565,623 ) 5,139,929 Noncontrolling interests not subject to put provisions — — 595,193 (394,531 ) 200,662 Total equity 5,139,929 10,231,471 2,929,345 (12,960,154 ) 5,340,591 Total liabilities and equity $ 14,882,741 $ 15,499,695 $ 5,570,002 $ (16,564,174 ) $ 19,388,264 Guarantor Non- Consolidating Consolidated As of December 31, 2016 DaVita Inc. Cash and cash equivalents $ 549,921 $ 59,192 $ 304,074 $ — $ 913,187 Accounts receivable, net — 1,215,232 702,070 — 1,917,302 Other current assets 277,911 736,727 135,101 — 1,149,739 Total current assets 827,832 2,011,151 1,141,245 — 3,980,228 Property and equipment, net 337,200 1,689,798 1,148,369 — 3,175,367 Intangible assets, net 487 1,491,057 36,223 — 1,527,767 Investments in subsidiaries 9,717,728 2,002,660 — (11,720,388 ) — Intercompany receivables 3,250,692 — 866,955 (4,117,647 ) — Other long-term assets and investments 39,994 86,710 523,874 — 650,578 Goodwill — 7,838,984 1,568,333 — 9,407,317 Total assets $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Current liabilities $ 303,840 $ 1,865,193 $ 527,412 $ — $ 2,696,445 Intercompany payables — 2,322,124 1,795,523 (4,117,647 ) — Long-term debt and other long-term liabilities 8,614,445 1,215,315 392,053 — 10,221,813 Noncontrolling interests subject to put provisions 607,601 — — 365,657 973,258 Total DaVita Inc. shareholder's equity 4,648,047 9,717,728 2,002,660 (11,720,388 ) 4,648,047 Noncontrolling interests not subject to put provisions — — 567,351 (365,657 ) 201,694 Total equity 4,648,047 9,717,728 2,570,011 (12,086,045 ) 4,849,741 Total liabilities and equity $ 14,173,933 $ 15,120,360 $ 5,284,999 $ (15,838,035 ) $ 18,741,257 Condensed Consolidating Balance Sheets Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) As of March 31, 2017 Cash and cash equivalents $ 1,472,232 $ 99,086 $ — $ 1,373,146 Accounts receivable, net 1,900,561 202,006 — 1,698,555 Other current assets 1,231,107 14,819 — 1,216,288 Total current assets 4,603,900 315,911 — 4,287,989 Property and equipment, net 3,171,199 1,268 — 3,169,931 Amortizable intangibles, net 1,487,029 4,576 — 1,482,453 Other long-term assets 673,666 81,419 2,880 589,367 Goodwill 9,452,470 16,796 — 9,435,674 Total assets $ 19,388,264 $ 419,970 $ 2,880 $ 18,965,414 Current liabilities $ 2,813,577 $ 204,998 $ — $ 2,608,579 Payables to parent — 61,723 2,880 (64,603 ) Long-term debt and other long-term liabilities 10,254,248 45,226 — 10,209,022 Noncontrolling interests subject to put provisions 979,848 — — 979,848 Total DaVita Inc. shareholders’ equity 5,139,929 108,023 — 5,031,906 Noncontrolling interests not subject to put provisions 200,662 — — 200,662 Shareholders’ equity 5,340,591 108,023 — 5,232,568 Total liabilities and shareholder’s equity $ 19,388,264 $ 419,970 $ 2,880 $ 18,965,414 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Condensed Consolidating Statements of Cash Flows | Condensed Consolidating Statements of Cash Flows Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2017 DaVita Inc. Cash flows from operating activities: Net income $ 447,697 $ 394,641 $ 204,292 $ (546,345 ) $ 500,285 Changes in operating assets and liabilities and non-cash items included in net income (149,767 ) (131,683 ) 99,994 546,345 364,889 Net cash provided by operating activities 297,930 262,958 304,286 — 865,174 Cash flows from investing activities: Additions of property and equipment, net (30,580 ) (133,909 ) (50,046 ) — (214,535 ) Acquisitions — (70,237 ) (6,999 ) — (77,236 ) Proceeds from asset and business sales — 46,612 — — 46,612 (Purchases) proceeds from investment sales and other items, net (54,150 ) (1,976 ) 51,273 — (4,853 ) Net cash used in investing activities (84,730 ) (159,510 ) (5,772 ) — (250,012 ) Cash flows from financing activities: Long-term debt and related financing costs, net (27,504 ) (4,616 ) (4,021 ) — (36,141 ) Intercompany borrowing (payments) 339,124 (82,592 ) (256,532 ) — — Other items 3,330 (799 ) (25,327 ) — (22,796 ) Net cash provided by (used in) financing activities 314,950 (88,007 ) (285,880 ) — (58,937 ) Effect of exchange rate changes on cash — — 2,820 — 2,820 Net increase in cash and cash equivalents 528,150 15,441 15,454 — 559,045 Cash and cash equivalents at beginning of period 549,921 59,192 304,074 — 913,187 Cash and cash equivalents at end of period $ 1,078,071 $ 74,633 $ 319,528 $ — $ 1,472,232 Guarantor Non- Consolidating Consolidated For The Three Months Ended March 31, 2016 DaVita Inc. Cash flows from operating activities: Net income $ 97,434 $ 70,419 $ 103,049 $ (132,743 ) $ 138,159 Changes in operating assets and liabilities and non-cash (18,699 ) 217,405 (40,606 ) 132,743 290,843 Net cash provided by operating activities 78,735 287,824 62,443 — 429,002 Cash flows from investing activities: Additions of property and equipment, net (16,865 ) (86,055 ) (70,267 ) — (173,187 ) Acquisitions — (400,093 ) (5,061 ) — (405,154 ) Proceeds from asset and business sales — 4,657 — — 4,657 (Purchases) proceeds from investment sales and other 23,387 (7,438 ) 3,424 — 19,373 Net cash provided by (used in) investing activities 6,522 (488,929 ) (71,904 ) — (554,311 ) Cash flows from financing activities: Long-term debt and related financing costs, net (21,247 ) (1,977 ) (1,347 ) — (24,571 ) Intercompany borrowing (payments) (315,986 ) 167,702 148,284 — — Other items (267,551 ) (756 ) (40,219 ) — (308,526 ) Net cash provided by (used in) financing activities (604,784 ) 164,969 106,718 — (333,097 ) Effect of exchange rate changes on cash — — 717 — 717 Net increase in cash and cash equivalents (519,527 ) (36,136 ) 97,974 — (457,689 ) Cash and cash equivalents at beginning of period 1,186,636 109,357 203,123 — 1,499,116 Cash and cash equivalents at end of period $ 667,109 $ 73,221 $ 301,097 $ — $ 1,041,427 Condensed Consolidating Statements of Cash Flows Consolidated Total Physician Groups Unrestricted Subsidiaries Company and Restricted Subsidiaries (1) For The Three Months Ended March 31, 2017 Cash flows from operating activities: Net income $ 500,285 $ 3,526 $ 100 $ 496,659 Changes in operating and intercompany assets and liabilities 364,889 (14,847 ) (100 ) 379,836 Net cash provided by (used in) operating activities 865,174 (11,321 ) — 876,495 Cash flows from investing activities: Additions of property and equipment (214,535 ) (10 ) — (214,525 ) Acquisitions and divestitures, net (77,236 ) — — (77,236 ) Proceeds from discontinued operations 46,612 — — 46,612 Investments and other items (4,853 ) (946 ) — (3,907 ) Net cash used in investing activities (250,012 ) (956 ) — (249,056 ) Cash flows from financing activities: Long-term debt (36,141 ) — — (36,141 ) Intercompany — 6,672 — (6,672 ) Other items (22,796 ) — — (22,796 ) Net cash (used in) provided by financing activities (58,937 ) 6,672 — (65,609 ) Effect of exchange rate changes on cash 2,820 — — 2,820 Net increase (decrease) in cash 559,045 (5,605 ) — 564,650 Cash and cash equivalents at beginning of period 913,187 104,691 — 808,496 Cash and cash equivalents at end of period $ 1,472,232 $ 99,086 $ — $ 1,373,146 (1) After elimination of the unrestricted subsidiaries and the physician groups. |
Reconciliations of Numerators a
Reconciliations of Numerators and Denominators Used to Calculate Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | ||
Mar. 31, 2017 | Mar. 31, 2016 | ||
Basic: | |||
Net income attributable to DaVita Inc. | $ 447,697 | $ 97,434 | |
Weighted average shares outstanding during the period | 194,571,000 | 206,561,000 | |
Contingently returnable shares held in escrow for the DaVita HealthCare Partners merger (in shares) | (2,194,000) | (2,194,000) | |
Weighted average shares for basic earnings per share calculation (in shares) | 192,376,735 | 204,366,869 | |
Basic net income per share attributable to DaVita Inc. (usd per share) | $ 2.33 | $ 0.48 | |
Diluted: | |||
Net income attributable to DaVita Inc. | $ 447,697 | $ 97,434 | |
Weighted average shares outstanding during the period | 194,571,000 | 206,561,000 | |
Assumed incremental shares from stock plans (in shares) | 710,000 | 1,367,000 | |
Weighted average shares for diluted earnings per share calculation (in shares) | 195,281,014 | 207,928,096 | |
Diluted net income per share attributable to DaVita Inc. (usd per share) | $ 2.29 | $ 0.47 | |
Anti-dilutive potential common shares excluded from calculation (in shares) | [1] | 3,427,000 | 2,273,000 |
[1] | Shares associated with stock-settled stock appreciation rights that are excluded from the diluted denominator calculation because they are anti-dilutive under the treasury stock method. |
Accounts Receivable - Additiona
Accounts Receivable - Additional Information (Detail) $ in Thousands | 3 Months Ended |
Mar. 31, 2017USD ($) | |
Accounts Notes And Loans Receivable [Line Items] | |
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy | 100.00% |
Account receivable outstanding, number of months | 3 months |
Decrease in allowance for doubtful accounts | $ (9,594) |
Government-based Programs, Medicare and Medicaid | Accounts Receivable | |
Accounts Notes And Loans Receivable [Line Items] | |
Percentage of accounts receivable due | 80.00% |
Health Care Patient | Accounts Receivable | |
Accounts Notes And Loans Receivable [Line Items] | |
Percentage of accounts receivable due | 1.00% |
DMG | |
Accounts Notes And Loans Receivable [Line Items] | |
Percentage of outstanding patient accounts receivables to be reserved as per Company's policy | 100.00% |
Account receivable outstanding, number of months | 12 months |
Investments (Detail)
Investments (Detail) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 |
Investment Holdings [Line Items] | ||
Held to maturity | $ 312,065 | $ 306,827 |
Available for sale | 109,568 | 107,050 |
Total | 421,633 | 413,877 |
Held to maturity, short-term investments | 312,065 | 306,827 |
Available for sale, short-term investments | 1,200 | 3,371 |
Total, short-term investments | 313,265 | 310,198 |
Held to maturity, long-term investments | 0 | 0 |
Available for sale, long-term investments | 108,368 | 103,679 |
Total, long-term investments | 108,368 | 103,679 |
Certificates of deposit, commercial paper and money market funds due within one year | ||
Investment Holdings [Line Items] | ||
Held to maturity | 312,065 | 256,827 |
Total | 312,065 | 256,827 |
Investments in mutual funds and common stock | ||
Investment Holdings [Line Items] | ||
Held to maturity | 0 | 50,000 |
Available for sale, equity securities | 48,124 | 47,404 |
Total | 48,124 | 97,404 |
Cash surrender value of life insurance policies | ||
Investment Holdings [Line Items] | ||
Held to maturity | 0 | 0 |
Available for sale, equity securities | 61,444 | 59,646 |
Total | $ 61,444 | $ 59,646 |
Investments in Debt and Equit46
Investments in Debt and Equity Securities - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2017 | Mar. 31, 2016 | Dec. 31, 2016 | |
Schedule Of Trading Securities And Other Trading Assets [Line Items] | |||
Available for sale investments gross pre-tax unrealized gain (loss) | $ 5,585 | $ 3,701 | |
Unrealized gains on investments | 1,557 | $ 229 | |
Proceeds from sale of mutual funds and debt securities | 4,025 | ||
Pre tax reclassification of net investment realized gain (loss) into net income | (229) | (152) | |
Reclassification of net investment realized gain (loss) into net income, net tax | (140) | (93) | |
Proceeds from sale of investments available for sale | $ 1,062 | ||
HealthCare Partners (HCP) | |||
Schedule Of Trading Securities And Other Trading Assets [Line Items] | |||
Required minimum cash balance | 61,567 | ||
Certificates of deposit, commercial paper and money market funds due within one year | |||
Schedule Of Trading Securities And Other Trading Assets [Line Items] | |||
Other Comprehensive Income (Loss), Unrealized Holding Gain (Loss) on Securities Arising During Period, before Tax | 2,113 | ||
Unrealized gains on investments | $ 1,559 |
Equity investments Additional (
Equity investments Additional (Details) - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2017 | Mar. 31, 2016 | Dec. 31, 2016 | |
Investments, Debt and Equity Securities [Abstract] | |||
Equity investments in nonconsolidated businesses | $ 521,848 | $ 502,389 | |
Equity investment income | $ 3,935 | $ 1,387 |
Changes in Goodwill by Reportab
Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | ||
Mar. 31, 2017 | Mar. 31, 2016 | Dec. 31, 2016 | Mar. 31, 2017 | |
Goodwill [Roll Forward] | ||||
Beginning balance | $ 9,407,317 | $ 9,294,479 | $ 9,294,479 | |
Acquisitions | 78,729 | 447,828 | ||
Divestitures | (14,139) | (44,759) | ||
Goodwill impairment charges | (24,198) | (77,000) | (281,415) | |
Foreign currency and other adjustments | 4,761 | (8,816) | ||
Ending balance | 9,452,470 | 9,407,317 | ||
Goodwill | $ 9,952,761 | |||
Accumulated impairment charges | (500,291) | |||
Goodwill, net | 9,407,317 | 9,294,479 | 9,294,479 | 9,452,470 |
U.S. dialysis and related lab services | ||||
Goodwill [Roll Forward] | ||||
Beginning balance | 5,691,587 | 5,629,183 | 5,629,183 | |
Acquisitions | 46,569 | 75,295 | ||
Divestitures | (14,110) | (12,891) | ||
Ending balance | 5,724,046 | 5,691,587 | ||
Goodwill | 5,724,046 | |||
Accumulated impairment charges | 0 | |||
Goodwill, net | 5,691,587 | 5,629,183 | 5,629,183 | 5,724,046 |
DMG | ||||
Goodwill [Roll Forward] | ||||
Beginning balance | 3,391,942 | 3,398,264 | 3,398,264 | |
Acquisitions | 14,989 | 248,901 | ||
Divestitures | (29) | (2,223) | ||
Goodwill impairment charges | 0 | (253,000) | ||
Ending balance | 3,406,902 | 3,391,942 | ||
Goodwill | 3,848,671 | |||
Accumulated impairment charges | (441,769) | |||
Goodwill, net | 3,391,942 | 3,398,264 | 3,398,264 | 3,406,902 |
Ancillary services and strategic initiatives | ||||
Goodwill [Roll Forward] | ||||
Beginning balance | 323,788 | 267,032 | 267,032 | |
Acquisitions | 17,171 | 123,632 | ||
Divestitures | 0 | (29,645) | ||
Goodwill impairment charges | (24,198) | (28,415) | ||
Foreign currency and other adjustments | 4,761 | (8,816) | ||
Ending balance | 321,522 | 323,788 | ||
Goodwill | 380,044 | |||
Accumulated impairment charges | (58,522) | |||
Goodwill, net | $ 323,788 | $ 267,032 | $ 267,032 | $ 321,522 |
Goodwill Schedule of Goodwill a
Goodwill Schedule of Goodwill and Indefinite-Lived Intangible Asset Impairment Charges (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | ||
Mar. 31, 2017 | Dec. 31, 2016 | Mar. 31, 2016 | Dec. 31, 2016 | |
Goodwill [Line Items] | ||||
Total goodwill impairment charges | $ 24,198 | $ 77,000 | $ 281,415 | |
DMG | ||||
Goodwill [Line Items] | ||||
Total goodwill impairment charges | 0 | $ 253,000 | ||
Vascular access | ||||
Goodwill [Line Items] | ||||
Total goodwill impairment charges | 24,198 | $ 28,415 | 0 | |
NEVADA | DMG | ||||
Goodwill [Line Items] | ||||
Total goodwill impairment charges | $ 0 | $ 77,000 |
Goodwill Schedule of Reporting
Goodwill Schedule of Reporting Units Goodwill Balances (Details) - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | |
Goodwill [Line Items] | |||
Percentage Change In Discount Rate Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment | 1.00% | ||
Percentage Change In Operating Income Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment | 3.00% | ||
Goodwill | $ 9,452,470 | $ 9,407,317 | $ 9,294,479 |
DMG | |||
Goodwill [Line Items] | |||
Goodwill | 3,406,902 | $ 3,391,942 | $ 3,398,264 |
DMG | NEVADA | |||
Goodwill [Line Items] | |||
Goodwill | $ 261,204 | ||
Carrying amount coverage | 14.00% | ||
Sensitivities, operating income | (2.70%) | ||
Sensitivities, discount rate | (3.90%) | ||
DMG | FLORIDA | |||
Goodwill [Line Items] | |||
Goodwill | $ 447,073 | ||
Carrying amount coverage | 10.50% | ||
Sensitivities, operating income | (1.60%) | ||
Sensitivities, discount rate | (2.80%) | ||
DMG | NEW MEXICO | |||
Goodwill [Line Items] | |||
Goodwill | $ 70,926 | ||
Carrying amount coverage | 4.90% | ||
Sensitivities, operating income | (1.50%) | ||
Sensitivities, discount rate | (2.30%) | ||
DMG | WASHINGTON | |||
Goodwill [Line Items] | |||
Goodwill | $ 245,576 | ||
Carrying amount coverage | 2.00% | ||
Sensitivities, operating income | (1.70%) | ||
Sensitivities, discount rate | (3.00%) | ||
Vascular access | |||
Goodwill [Line Items] | |||
Goodwill | $ 10,498 | ||
Carrying amount coverage | 0.00% | ||
Sensitivities, operating income | (1.70%) | ||
Sensitivities, discount rate | (4.90%) |
Goodwill Goodwill Narrative (De
Goodwill Goodwill Narrative (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | ||
Mar. 31, 2017 | Dec. 31, 2016 | Mar. 31, 2016 | Dec. 31, 2016 | |
Goodwill [Line Items] | ||||
Total goodwill impairment charges | $ 24,198 | $ 77,000 | $ 281,415 | |
DMG | ||||
Goodwill [Line Items] | ||||
Total goodwill impairment charges | 0 | $ 253,000 | ||
Vascular access | ||||
Goodwill [Line Items] | ||||
Total goodwill impairment charges | 24,198 | $ 28,415 | 0 | |
NEVADA | DMG | ||||
Goodwill [Line Items] | ||||
Total goodwill impairment charges | $ 0 | $ 77,000 |
Components of Changes in Medica
Components of Changes in Medical Payables (Detail) $ in Thousands | 3 Months Ended |
Mar. 31, 2017USD ($) | |
Health Care Costs Payable [Roll Forward] | |
Health care costs payable, beginning of the period | $ 336,381 |
Less: Claims paid | |
Health care costs payable, end of the period | 389,681 |
Healthcare Cost | |
Health Care Costs Payable [Roll Forward] | |
Health care costs payable, beginning of the period | 214,275 |
Add: Components of incurred health care costs | |
Current year | 467,683 |
Prior years | 421 |
Total incurred health care costs | 468,104 |
Less: Claims paid | |
Current year | 247,723 |
Prior years | 172,693 |
Total claims paid | 420,416 |
Health care costs payable, end of the period | $ 261,963 |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Dec. 31, 2016 | |
Income Tax Disclosure [Abstract] | ||
Liability for unrecognized tax benefits | $ 26,399 | $ 24,066 |
Increase in liability for unrecognized tax benefits | (2,333) | |
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits | $ 2,776 | $ 2,595 |
Long-term Debt (Detail)
Long-term Debt (Detail) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 |
Debt Instrument [Line Items] | ||
Senior notes | $ 4,500,000 | $ 4,500,000 |
Acquisition obligations and other notes payable | 120,952 | 117,547 |
Capital lease obligations | 296,505 | 299,682 |
Total debt principal outstanding | 9,164,957 | 9,192,229 |
Discount and deferred financing costs | (75,862) | (79,861) |
Carrying Amount of Long-Term Debt, Net of Unamortized Discount or Premium, Current and Noncurrent, Total | 9,089,095 | 9,112,368 |
Less current portion | (170,217) | (165,041) |
Long-term debt | 8,918,878 | 8,947,327 |
Term Loan A | ||
Debt Instrument [Line Items] | ||
Senior Secured Credit Facilities | 843,750 | 862,500 |
Term Loan B | ||
Debt Instrument [Line Items] | ||
Senior Secured Credit Facilities | $ 3,403,750 | $ 3,412,500 |
Scheduled Maturities of Long-te
Scheduled Maturities of Long-term Debt (Detail) $ in Thousands | Mar. 31, 2017USD ($) |
Debt Disclosure [Abstract] | |
2017 (remainder of the year) | $ 129,532 |
2,018 | 167,855 |
2,019 | 745,584 |
2,020 | 70,157 |
2,021 | 3,301,236 |
2,022 | 1,277,759 |
Thereafter | $ 3,472,834 |
Long-term Debt - Additional Inf
Long-term Debt - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2017 | Mar. 31, 2016 | Dec. 31, 2016 | |
Debt Instrument [Line Items] | |||
Unrealized losses on interest rate cap and swap agreements | $ (3,188) | $ (5,469) | |
Weighted average effective interest rate | 4.64% | ||
Weighted average effective interest rate | 4.55% | ||
Fixed interest rate | 53.08% | ||
DMG | |||
Debt Instrument [Line Items] | |||
Letters of credit outstanding | $ 1,286 | ||
Revolving Credit Facility | |||
Debt Instrument [Line Items] | |||
Undrawn revolving credit facilities | 1,000,000 | ||
Letter of Credit | |||
Debt Instrument [Line Items] | |||
Letters of credit outstanding | 94,623 | ||
Interest Rate Cap Agreements Effective September 30, 2016 | |||
Debt Instrument [Line Items] | |||
Interest rate agreements, notional amount | $ 3,500,000 | ||
Derivative, effective date | Sep. 30, 2016 | ||
Derivative, expiration date | Jun. 30, 2018 | ||
Fair value of assets | $ 14 | ||
Debt expense recognized | 2,070 | ||
Unrealized losses on interest rate cap and swap agreements | 102 | ||
Interest Rate Cap Agreements Effective June 29, 2018 | |||
Debt Instrument [Line Items] | |||
Interest rate agreements, notional amount | $ 3,500,000 | ||
Derivative, effective date | Jun. 29, 2018 | ||
Derivative, expiration date | Jun. 30, 2020 | ||
Fair value of assets | $ 4,698 | ||
Unrealized losses on interest rate cap and swap agreements | $ 5,115 | ||
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective September 30, 2016 | |||
Debt Instrument [Line Items] | |||
LIBOR cap rate | 3.50% | ||
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective June 29, 2018 | |||
Debt Instrument [Line Items] | |||
LIBOR cap rate | 3.50% | ||
Term Loan A | |||
Debt Instrument [Line Items] | |||
Debt instrument, annual principal payment | $ 18,750 | ||
Senior Secured Credit Facilities | $ 843,750 | $ 862,500 | |
Term Loan A | London Interbank Offered Rate (LIBOR) | |||
Debt Instrument [Line Items] | |||
Debt instrument, variable interest rate margin | 2.00% | ||
Term Loan B | |||
Debt Instrument [Line Items] | |||
Debt instrument, annual principal payment | $ 8,750 | ||
Senior Secured Credit Facilities | $ 3,403,750 | $ 3,412,500 | |
Term Loan B | London Interbank Offered Rate (LIBOR) | |||
Debt Instrument [Line Items] | |||
Debt instrument, variable interest rate margin | 2.75% | ||
Term Loan B | London Interbank Offered Rate (LIBOR) | Maximum | |||
Debt Instrument [Line Items] | |||
Debt instrument, variable interest rate margin | 3.50% | ||
Term Loan A subject to interest rate caps | |||
Debt Instrument [Line Items] | |||
Senior Secured Credit Facilities | $ 96,250 | ||
Term Loan A subject to uncapped portion of variability of LIBOR | |||
Debt Instrument [Line Items] | |||
Senior Secured Credit Facilities | $ 747,500 | ||
Senior Secured Credit Facilities | |||
Debt Instrument [Line Items] | |||
Weighted average effective interest rate | 3.95% |
Derivative Instruments (Detail)
Derivative Instruments (Detail) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 |
Designated as Hedging Instrument | Interest rate cap agreements | Other long-term assets | ||
Derivative [Line Items] | ||
Derivative assets, Fair value | $ 4,712 | $ 9,929 |
Effects of Interest Rate Swap a
Effects of Interest Rate Swap and Cap Agreements (Detail) - Cash Flow Hedging - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Derivative Instruments Gain Loss [Line Items] | ||
Amount of gains (losses) recognized in OCI on interest rate swap and cap agreements | $ (3,188) | $ (5,469) |
Amount of losses reclassified from accumulated OCI into income | 1,265 | 465 |
Tax benefit | ||
Derivative Instruments Gain Loss [Line Items] | ||
Amount of gains (losses) recognized in OCI on interest rate swap and cap agreements | 2,029 | 3,482 |
Amount of losses reclassified from accumulated OCI into income | (805) | (296) |
Interest rate swap agreements | Debt Expense (Including Refinancing Charges) | ||
Derivative Instruments Gain Loss [Line Items] | ||
Amount of gains (losses) recognized in OCI on interest rate swap and cap agreements | 0 | (692) |
Amount of losses reclassified from accumulated OCI into income | 0 | 151 |
Interest rate cap agreements | Debt Expense (Including Refinancing Charges) | ||
Derivative Instruments Gain Loss [Line Items] | ||
Amount of gains (losses) recognized in OCI on interest rate swap and cap agreements | (5,217) | (8,259) |
Amount of losses reclassified from accumulated OCI into income | $ 2,070 | $ 610 |
Contingencies - Additional Info
Contingencies - Additional Information (Detail) $ in Thousands | 1 Months Ended | 3 Months Ended | ||||
Mar. 31, 2017USD ($) | Jun. 30, 2015USD ($) | Dec. 31, 2012Entity | Mar. 31, 2017USD ($) | Mar. 31, 2016USD ($) | Dec. 31, 2016USD ($) | |
Other Commitments [Line Items] | ||||||
Loss contingency liability | $ 69,300 | |||||
Gain on litigation settlement | $ 526,827 | $ 0 | ||||
Dialysis businesses and other businesses | ||||||
Other Commitments [Line Items] | ||||||
Number of businesses acquired | Entity | 2 | |||||
Vainer Private Civil Suit | ||||||
Other Commitments [Line Items] | ||||||
Litigation settlement amount | $ (450,000) | |||||
Legal fees | $ 45,000 | |||||
US Department Of Veterans Affairs Suit | ||||||
Other Commitments [Line Items] | ||||||
Litigation settlement amount | $ 538,000 | |||||
Gain on litigation settlement | 527,000 | |||||
Noncontrolling Interest | US Department Of Veterans Affairs Suit | ||||||
Other Commitments [Line Items] | ||||||
Gain on litigation settlement | 9,000 | |||||
Operating Income (Loss) | US Department Of Veterans Affairs Suit | ||||||
Other Commitments [Line Items] | ||||||
Gain on litigation settlement | 530,000 | |||||
Equity Method Investments | Noncontrolling Interest | US Department Of Veterans Affairs Suit | ||||||
Other Commitments [Line Items] | ||||||
Gain on litigation settlement | $ 3,000 |
Noncontrolling Interests Subj60
Noncontrolling Interests Subject to Put Provisions and Other Commitments - Additional Information (Detail) $ in Thousands | 3 Months Ended |
Mar. 31, 2017USD ($) | |
Minimum | |
Other Commitments [Line Items] | |
Scheduled dissolution term of joint ventures | 10 years |
Maximum | |
Other Commitments [Line Items] | |
Scheduled dissolution term of joint ventures | 50 years |
Commitments to provide operating capital | |
Other Commitments [Line Items] | |
Other potential commitments to provide operating capital to several dialysis centers | $ 3,441 |
Long-term Incentive Compensat61
Long-term Incentive Compensation - Additional Information (Detail) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Long-term incentive program (LTIP) expense | $ 17,166 | $ 24,745 |
Stock-based compensation expense | 9,601 | 13,097 |
Estimated tax benefits recorded for stock-based compensation | 3,300 | 4,539 |
Unrecognized compensation cost related to outstanding LTIP awards | 91,479 | |
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans | $ 60,244 | |
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under performance-based cash component of LTIP costs, weighted average remaining period (in years) | 1 year | |
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under stock-based component of LTIP costs, weighted average remaining period (in years) | 1 year 3 months 24 days | |
Tax benefits from stock award exercises | $ 1,091 | $ 8,668 |
Stock Appreciation Rights | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock granted (in shares) | 244 | |
Aggregate grant-date fair value | $ 3,453 | |
Weighted-average expected life (in years) | 4 years 1 month 12 days | |
Restricted Stock Units | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock granted (in shares) | 54 | |
Aggregate grant-date fair value | $ 3,679 | |
Weighted-average expected life (in years) | 2 years 5 months 24 days |
Comprehensive Income (Detail)
Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||
Beginning balance | $ 4,849,741 | |
Ending balance | 5,340,591 | |
Interest rate swaps and cap agreements | ||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||
Beginning balance | (12,029) | $ (10,925) |
Unrealized (losses) gains | (5,217) | (8,951) |
Related income tax benefit (expense) | 2,029 | 3,482 |
Unrealized (losses) gains net | (3,188) | (5,469) |
Reclassification from accumulated other comprehensive income into net income | 2,070 | 761 |
Related income tax (expense) benefit | (805) | (296) |
Reclassification from accumulated other comprehensive income into net income net of tax | 1,265 | 465 |
Ending balance | (13,952) | (15,929) |
Investment securities | ||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||
Beginning balance | 2,175 | 1,361 |
Unrealized (losses) gains | 2,113 | 342 |
Related income tax benefit (expense) | (554) | (113) |
Unrealized (losses) gains net | 1,559 | 229 |
Reclassification from accumulated other comprehensive income into net income | (229) | (152) |
Related income tax (expense) benefit | 89 | 59 |
Reclassification from accumulated other comprehensive income into net income net of tax | (140) | (93) |
Ending balance | 3,594 | 1,497 |
Foreign currency translation adjustments | ||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||
Beginning balance | (79,789) | (50,262) |
Unrealized (losses) gains | 13,261 | 11,181 |
Unrealized (losses) gains net | 13,261 | 11,181 |
Reclassification from accumulated other comprehensive income into net income | 0 | 0 |
Reclassification from accumulated other comprehensive income into net income net of tax | 0 | 0 |
Ending balance | (66,528) | (39,081) |
Accumulated other comprehensive (loss) income | ||
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward] | ||
Beginning balance | (89,643) | (59,826) |
Unrealized (losses) gains | 10,157 | 2,572 |
Related income tax benefit (expense) | 1,475 | 3,369 |
Unrealized (losses) gains net | 11,632 | 5,941 |
Reclassification from accumulated other comprehensive income into net income | 1,841 | 609 |
Related income tax (expense) benefit | (716) | (237) |
Reclassification from accumulated other comprehensive income into net income net of tax | 1,125 | 372 |
Ending balance | $ (76,886) | $ (53,513) |
Acquisitions and divestitures -
Acquisitions and divestitures - Additional Information (Detail) $ in Thousands | 1 Months Ended | 3 Months Ended | ||
Dec. 31, 2012Entity | Mar. 31, 2017USD ($)Clinic | Mar. 31, 2016USD ($) | Dec. 31, 2016USD ($) | |
Business Acquisition [Line Items] | ||||
Cash paid to acquire businesses | $ 77,236 | $ 405,154 | ||
Contingent earn-out obligations associated with acquisitions | $ 13,754 | |||
Amortizable intangible assets acquired, weighted-average estimated useful lives | 5 years | |||
Business Combination, Contingent Consideration, Liability | $ 8,565 | $ 9,977 | ||
Other Accrued Liabilities | ||||
Business Acquisition [Line Items] | ||||
Business Combination, Contingent Consideration, Liability | 4,653 | |||
Other long-term liabilities | ||||
Business Acquisition [Line Items] | ||||
Business Combination, Contingent Consideration, Liability | 3,912 | |||
Other companies | ||||
Business Acquisition [Line Items] | ||||
Business Combination, Contingent Consideration, Liability | $ 8,565 | |||
Minimum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins | ||||
Business Acquisition [Line Items] | ||||
Earn-out consideration payment period | 1 year | |||
Maximum | Other companies | EBITDA or Operating Income Performance Targets or Quality Margins | ||||
Business Acquisition [Line Items] | ||||
Earn-out consideration payment period | 7 years | |||
Dialysis businesses and other businesses | ||||
Business Acquisition [Line Items] | ||||
Number of businesses acquired | Entity | 2 | |||
Cash paid to acquire businesses | $ 77,236 | |||
Deferred purchase price obligations | 2,205 | |||
Contingent earn-out obligations associated with acquisitions | 1,495 | |||
Goodwill deductible for tax purposes associated with acquisitions | $ 69,691 | |||
Noncompete Agreements | ||||
Business Acquisition [Line Items] | ||||
Amortizable intangible assets acquired, weighted-average estimated useful lives | 5 years | |||
U.S. dialysis and related lab services | Dialysis businesses and other businesses | ||||
Business Acquisition [Line Items] | ||||
Number of businesses acquired | Clinic | 12 | |||
Foreign Dialysis Centers | Dialysis businesses and other businesses | ||||
Business Acquisition [Line Items] | ||||
Number of businesses acquired | Clinic | 3 | |||
Other Medical Businesses | Dialysis businesses and other businesses | ||||
Business Acquisition [Line Items] | ||||
Number of businesses acquired | Clinic | 2 |
Aggregate Purchase Cost Allocat
Aggregate Purchase Cost Allocations for Acquisitions (Detail) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 |
Business Acquisition [Line Items] | |||
Goodwill | $ 9,452,470 | $ 9,407,317 | $ 9,294,479 |
Dialysis businesses and other businesses | |||
Business Acquisition [Line Items] | |||
Current assets | 1,123 | ||
Property and equipment | 5,604 | ||
Amortizable intangible and other long-term assets | 6,173 | ||
Goodwill | 78,729 | ||
Noncontrolling interests assumed | (8,052) | ||
Deferred income taxes | (2,194) | ||
Liabilities assumed | (447) | ||
Aggregate purchase price | $ 80,936 |
Reconciliation of Changes in Co
Reconciliation of Changes in Contingent Earn-Out Obligations (Detail) $ in Thousands | 3 Months Ended |
Mar. 31, 2017USD ($) | |
Contingent Earn-Out Obligations [Roll Forward] | |
Beginning balance, January 1, 2017 | $ 9,977 |
Contingent earn-out obligations associated with acquisitions | 1,053 |
Remeasurement of fair value for contingent earn-out obligations | 102 |
Payments on contingent earn-out obligations | (2,567) |
Ending balance | $ 8,565 |
Variable Interest Entities - Ad
Variable Interest Entities - Additional Information (Detail) $ in Thousands | Mar. 31, 2017USD ($) |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Asset | $ 751,805 |
Liabilities | $ 411,822 |
Assets, Liabilities and Tempora
Assets, Liabilities and Temporary Equity Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 |
Assets | ||
Available-for-sale securities | $ 109,568 | $ 107,050 |
Liabilities | ||
Contingent earn-out obligations | 8,565 | $ 9,977 |
Fair Value, Measurements, Recurring | ||
Assets | ||
Available-for-sale securities | 48,124 | |
Cash surrender value of life insurance policies | 61,444 | |
Funds on deposit with third parties | 79,459 | |
Liabilities | ||
Contingent earn-out obligations | 8,565 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 979,848 | |
Fair Value, Measurements, Recurring | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | 4,712 | |
Fair Value, Measurements, Recurring | Level 1 | ||
Assets | ||
Available-for-sale securities | 48,124 | |
Cash surrender value of life insurance policies | 0 | |
Funds on deposit with third parties | 79,459 | |
Liabilities | ||
Contingent earn-out obligations | 0 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 0 | |
Fair Value, Measurements, Recurring | Level 1 | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | 0 | |
Fair Value, Measurements, Recurring | Level 2 | ||
Assets | ||
Available-for-sale securities | 0 | |
Cash surrender value of life insurance policies | 61,444 | |
Funds on deposit with third parties | 0 | |
Liabilities | ||
Contingent earn-out obligations | 0 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 0 | |
Fair Value, Measurements, Recurring | Level 2 | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | 4,712 | |
Fair Value, Measurements, Recurring | Level 3 | ||
Assets | ||
Available-for-sale securities | 0 | |
Cash surrender value of life insurance policies | 0 | |
Funds on deposit with third parties | 0 | |
Liabilities | ||
Contingent earn-out obligations | 8,565 | |
Temporary equity | ||
Noncontrolling interests subject to put provisions | 979,848 | |
Fair Value, Measurements, Recurring | Level 3 | Interest rate cap agreements | ||
Assets | ||
Interest rate cap agreements | $ 0 |
Fair Value of Financial Instr68
Fair Value of Financial Instruments - Additional Information (Detail) $ in Thousands | Mar. 31, 2017USD ($) |
Estimate of Fair Value Measurement | Senior Secured Credit Facilities | |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | |
Long-term debt, fair value | $ 4,300,460 |
Estimate of Fair Value Measurement | Senior Notes | |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | |
Long-term debt, fair value | 4,568,650 |
Reported Value Measurement | Senior Secured Credit Facilities | |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | |
Long-term debt, fair value | 4,171,638 |
Reported Value Measurement | Senior Notes | |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | |
Long-term debt, fair value | $ 4,500,000 |
Segment Reporting - Additional
Segment Reporting - Additional Information (Detail) | 3 Months Ended |
Mar. 31, 2017Segment | |
Segment Reporting [Abstract] | |
Number of operating segments | 2 |
Summary of Segment Net Revenues
Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes (Detail) - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2017 | Mar. 31, 2016 | ||
Segment Reporting Information [Line Items] | |||
Patient service revenues | $ 2,601,378 | $ 2,481,933 | |
Less: Provision for uncollectible accounts | (112,983) | (109,205) | |
Net dialysis and related lab services patient service revenues | 2,488,395 | 2,372,728 | |
Other revenues | 290,852 | 321,361 | |
Total net operating revenues | 3,697,283 | 3,581,136 | |
Capitated revenues | 918,036 | 887,047 | |
Operating income (loss) | 888,236 | 364,889 | |
Corporate administrative support | (10,592) | (6,921) | |
Debt expense | (104,429) | (102,884) | |
Other income, net | 4,243 | 2,976 | |
Consolidated income before income taxes | 788,050 | 264,981 | |
Operating Segments | |||
Segment Reporting Information [Line Items] | |||
Total net operating revenues | 3,736,404 | 3,607,342 | |
Operating income (loss) | 898,828 | 371,810 | |
Operating Segments | U.S. dialysis and related lab services | |||
Segment Reporting Information [Line Items] | |||
Patient service revenues | 2,372,661 | 2,327,971 | |
Less: Provision for uncollectible accounts | (106,770) | (104,751) | |
Net dialysis and related lab services patient service revenues | 2,265,891 | 2,223,220 | |
Other revenues | [1] | 5,303 | 3,973 |
Total net operating revenues | 2,271,194 | 2,227,193 | |
Operating income (loss) | [2] | 944,740 | 440,055 |
Operating Segments | U.S. dialysis and related lab services | External Sources | |||
Segment Reporting Information [Line Items] | |||
Patient service revenues | 2,348,901 | 2,313,663 | |
Operating Segments | U.S. dialysis and related lab services | Intersubsegment Eliminations | |||
Segment Reporting Information [Line Items] | |||
Patient service revenues | 23,760 | 14,308 | |
Operating Segments | DMG | |||
Segment Reporting Information [Line Items] | |||
Net dialysis and related lab services patient service revenues | 178,971 | 112,433 | |
Other revenues | [3] | 18,269 | 10,335 |
Total net operating revenues | 1,086,985 | 988,858 | |
Capitated revenues | 889,686 | 866,019 | |
Operating income (loss) | 12,308 | (57,145) | |
Operating Segments | DMG | Intersubsegment Eliminations | |||
Segment Reporting Information [Line Items] | |||
Other revenues | 59 | 71 | |
Operating Segments | Ancillary services and strategic initiatives | |||
Segment Reporting Information [Line Items] | |||
Net dialysis and related lab services patient service revenues | 67,293 | 51,383 | |
Other revenues | 267,280 | 307,053 | |
Total net operating revenues | 378,225 | 391,291 | |
Capitated revenues | 28,350 | 21,028 | |
Operating income (loss) | (58,220) | (11,100) | |
Operating Segments | Ancillary services and strategic initiatives | Intersubsegment Eliminations | |||
Segment Reporting Information [Line Items] | |||
Total net operating revenues | 15,302 | 11,827 | |
Intersegment Elimination | |||
Segment Reporting Information [Line Items] | |||
Total net operating revenues | $ (39,121) | $ (26,206) | |
[1] | (1)Includes management fees for providing management and administrative services to dialysis centers that are wholly-owned by third parties and legal entities in which the Company owns a noncontrolling equity investment. | ||
[2] | U.S. dialysis and related lab services operating income includes the net gain on the settlement with the VA. | ||
[3] | Includes medical consulting service fees and management fees for providing management and administrative services to unconsolidated joint ventures, as well as revenue related to the maintenance of existing physician networks. |
Summary of Depreciation and Amo
Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Segment Reporting Information [Line Items] | ||
Depreciation and amortization | $ 190,206 | $ 169,355 |
U.S. dialysis and related lab services | ||
Segment Reporting Information [Line Items] | ||
Depreciation and amortization | 125,029 | 116,537 |
DMG | ||
Segment Reporting Information [Line Items] | ||
Depreciation and amortization | 57,323 | 46,263 |
Ancillary services and strategic initiatives | ||
Segment Reporting Information [Line Items] | ||
Depreciation and amortization | $ 7,854 | $ 6,555 |
Summary of Assets by Segment (D
Summary of Assets by Segment (Detail) - USD ($) $ in Thousands | Mar. 31, 2017 | Feb. 25, 2017 | Dec. 31, 2016 |
ASSETS | |||
Total assets | $ 19,388,264 | $ 18,741,257 | |
U.S. dialysis and related lab services | |||
ASSETS | |||
Total assets | 11,744,695 | $ 338,963 | 11,099,137 |
DMG | |||
ASSETS | |||
Total assets | 6,209,369 | 6,213,091 | |
Ancillary services and strategic initiatives | |||
ASSETS | |||
Total assets | $ 1,434,200 | $ 1,429,029 |
Summary of Assets by Segment (P
Summary of Assets by Segment (Parenthetical) (Detail) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 |
Segment Reporting Information [Line Items] | ||
Equity investments | $ 521,848 | $ 502,389 |
U.S. dialysis and related lab services | ||
Segment Reporting Information [Line Items] | ||
Equity investments | 85,769 | 66,924 |
DMG | ||
Segment Reporting Information [Line Items] | ||
Equity investments | 12,579 | 10,350 |
Ancillary services and strategic initiatives | ||
Segment Reporting Information [Line Items] | ||
Equity investments | $ 423,500 | $ 425,115 |
Summary of Expenditures for Pro
Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Segment Reporting Information [Line Items] | ||
Expenditures for property and equipment | $ 214,535 | $ 173,187 |
U.S. dialysis and related lab services | ||
Segment Reporting Information [Line Items] | ||
Expenditures for property and equipment | 173,528 | 133,450 |
DMG | ||
Segment Reporting Information [Line Items] | ||
Expenditures for property and equipment | 27,788 | 20,145 |
Ancillary services and strategic initiatives | ||
Segment Reporting Information [Line Items] | ||
Expenditures for property and equipment | $ 13,219 | $ 19,592 |
Effects of Changes in DaVita In
Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | ||
Net income attributable to DaVita Inc. | $ 447,697 | $ 97,434 |
Net transfers to noncontrolling interests | (423) | (2,452) |
Net income attributable to DaVita Inc., net of transfers to noncontrolling interests | 447,274 | 94,982 |
Additional paid-in capital | ||
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items] | ||
Increase in paid-in capital for sales of noncontrolling interests | 0 | 885 |
Decrease in paid-in capital for the purchase of noncontrolling interests and adjustments to ownership interest | $ (423) | $ (3,337) |
Condensed Consolidating Stateme
Condensed Consolidating Statements of Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Condensed Income Statements Captions [Line Items] | ||
Patient service revenues | $ 2,601,378 | $ 2,481,933 |
Less: Provision for uncollectible accounts | (112,983) | (109,205) |
Net patient service operating revenues | 2,488,395 | 2,372,728 |
Capitated revenues | 918,036 | 887,047 |
Other revenues | 290,852 | 321,361 |
Total net operating revenues | 3,697,283 | 3,581,136 |
Operating expenses and charges | 2,809,047 | 3,216,247 |
Operating income | 888,236 | 364,889 |
Interest and Debt Expense | 104,429 | 102,884 |
Other income, net | 4,243 | 2,976 |
Income tax expense | 287,765 | 126,822 |
Equity (loss) earnings in subsidiaries | 0 | 0 |
Net income | 500,285 | 138,159 |
Less: Net income attributable to noncontrolling interests | (52,588) | (40,725) |
Net income (loss) attributable to DaVita Inc. | 447,697 | 97,434 |
Consolidating adjustments | ||
Condensed Income Statements Captions [Line Items] | ||
Patient service revenues | (50,730) | (39,416) |
Less: Provision for uncollectible accounts | 0 | 0 |
Net patient service operating revenues | (50,730) | (39,416) |
Capitated revenues | (545) | (127) |
Other revenues | (443,846) | (378,451) |
Total net operating revenues | (495,121) | (417,994) |
Operating expenses and charges | (495,121) | (417,994) |
Operating income | 0 | 0 |
Interest and Debt Expense | (103,352) | (101,904) |
Other income, net | (103,352) | (101,904) |
Income tax expense | 0 | 0 |
Equity (loss) earnings in subsidiaries | (546,345) | (132,743) |
Net income | (546,345) | (132,743) |
Less: Net income attributable to noncontrolling interests | (52,588) | (40,725) |
Net income (loss) attributable to DaVita Inc. | (598,933) | (173,468) |
DaVita Inc. | Reportable Legal Entities | ||
Condensed Income Statements Captions [Line Items] | ||
Patient service revenues | 0 | 0 |
Less: Provision for uncollectible accounts | 0 | 0 |
Net patient service operating revenues | 0 | 0 |
Capitated revenues | 0 | 0 |
Other revenues | 221,386 | 186,975 |
Total net operating revenues | 221,386 | 186,975 |
Operating expenses and charges | 131,910 | 122,273 |
Operating income | 89,476 | 64,702 |
Interest and Debt Expense | 102,664 | 101,101 |
Other income, net | 100,337 | 98,560 |
Income tax expense | 34,093 | 35,146 |
Equity (loss) earnings in subsidiaries | 394,641 | 70,419 |
Net income | 447,697 | 97,434 |
Less: Net income attributable to noncontrolling interests | 0 | 0 |
Net income (loss) attributable to DaVita Inc. | 447,697 | 97,434 |
Guarantor subsidiaries | Reportable Legal Entities | ||
Condensed Income Statements Captions [Line Items] | ||
Patient service revenues | 1,553,356 | 1,653,312 |
Less: Provision for uncollectible accounts | (62,281) | (58,813) |
Net patient service operating revenues | 1,491,075 | 1,594,499 |
Capitated revenues | 463,627 | 467,001 |
Other revenues | 477,675 | 485,316 |
Total net operating revenues | 2,432,377 | 2,546,816 |
Operating expenses and charges | 1,880,155 | 2,377,630 |
Operating income | 552,222 | 169,186 |
Interest and Debt Expense | 91,401 | 92,173 |
Other income, net | 3,537 | 4,336 |
Income tax expense | 221,421 | 73,254 |
Equity (loss) earnings in subsidiaries | 151,704 | 62,324 |
Net income | 394,641 | 70,419 |
Less: Net income attributable to noncontrolling interests | 0 | 0 |
Net income (loss) attributable to DaVita Inc. | 394,641 | 70,419 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||
Condensed Income Statements Captions [Line Items] | ||
Patient service revenues | 1,098,752 | 868,037 |
Less: Provision for uncollectible accounts | (50,702) | (50,392) |
Net patient service operating revenues | 1,048,050 | 817,645 |
Capitated revenues | 454,954 | 420,173 |
Other revenues | 35,637 | 27,521 |
Total net operating revenues | 1,538,641 | 1,265,339 |
Operating expenses and charges | 1,292,103 | 1,134,338 |
Operating income | 246,538 | 131,001 |
Interest and Debt Expense | 13,716 | 11,514 |
Other income, net | 3,721 | 1,984 |
Income tax expense | 32,251 | 18,422 |
Equity (loss) earnings in subsidiaries | 0 | 0 |
Net income | 204,292 | 103,049 |
Less: Net income attributable to noncontrolling interests | 0 | 0 |
Net income (loss) attributable to DaVita Inc. | $ 204,292 | $ 103,049 |
Condensed Consolidating State77
Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Condensed Financial Statements Captions [Line Items] | ||
Net income | $ 500,285 | $ 138,159 |
Other comprehensive (loss) income | 12,755 | 6,313 |
Total comprehensive income | 513,040 | 144,472 |
Less: comprehensive income attributable to the noncontrolling interests | (52,586) | (40,725) |
Comprehensive income (loss) attributable to DaVita Inc. | 460,454 | 103,747 |
Consolidating adjustments | ||
Condensed Financial Statements Captions [Line Items] | ||
Net income | (546,345) | (132,743) |
Other comprehensive (loss) income | 0 | 0 |
Total comprehensive income | (546,345) | (132,743) |
Less: comprehensive income attributable to the noncontrolling interests | (52,586) | (40,725) |
Comprehensive income (loss) attributable to DaVita Inc. | (598,931) | (173,468) |
DaVita Inc. | Reportable Legal Entities | ||
Condensed Financial Statements Captions [Line Items] | ||
Net income | 447,697 | 97,434 |
Other comprehensive (loss) income | (506) | (4,868) |
Total comprehensive income | 447,191 | 92,566 |
Less: comprehensive income attributable to the noncontrolling interests | 0 | 0 |
Comprehensive income (loss) attributable to DaVita Inc. | 447,191 | 92,566 |
Guarantor subsidiaries | Reportable Legal Entities | ||
Condensed Financial Statements Captions [Line Items] | ||
Net income | 394,641 | 70,419 |
Other comprehensive (loss) income | 0 | 0 |
Total comprehensive income | 394,641 | 70,419 |
Less: comprehensive income attributable to the noncontrolling interests | 0 | 0 |
Comprehensive income (loss) attributable to DaVita Inc. | 394,641 | 70,419 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||
Condensed Financial Statements Captions [Line Items] | ||
Net income | 204,292 | 103,049 |
Other comprehensive (loss) income | 13,261 | 11,181 |
Total comprehensive income | 217,553 | 114,230 |
Less: comprehensive income attributable to the noncontrolling interests | 0 | 0 |
Comprehensive income (loss) attributable to DaVita Inc. | $ 217,553 | $ 114,230 |
Condensed Consolidating Balance
Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 | Mar. 31, 2016 | Dec. 31, 2015 |
Condensed Balance Sheet Statements Captions [Line Items] | ||||
Cash and cash equivalents | $ 1,472,232 | $ 913,187 | $ 1,041,427 | $ 1,499,116 |
Accounts receivable, net | 1,900,561 | 1,917,302 | ||
Other current assets | 1,231,107 | 1,149,739 | ||
Total current assets | 4,603,900 | 3,980,228 | ||
Property and equipment, net | 3,171,199 | 3,175,367 | ||
Amortizable intangibles, net | 1,487,029 | 1,527,767 | ||
Investments in subsidiaries | 0 | 0 | ||
Intercompany receivables | 0 | 0 | ||
Other long-term assets and investments | 673,666 | 650,578 | ||
Goodwill | 9,452,470 | 9,407,317 | 9,294,479 | |
Total assets | 19,388,264 | 18,741,257 | ||
Current liabilities | 2,813,577 | 2,696,445 | ||
Intercompany payables | 0 | 0 | ||
Long-term debt and other long-term liabilities | 10,254,248 | 10,221,813 | ||
Noncontrolling interests subject to put provisions | 979,848 | 973,258 | ||
Total DaVita Inc. shareholder's equity | 5,139,929 | 4,648,047 | ||
Noncontrolling interests not subject to put provisions | 200,662 | 201,694 | ||
Shareholders’ equity | 5,340,591 | 4,849,741 | ||
Total liabilities and equity | 19,388,264 | 18,741,257 | ||
Consolidating adjustments | ||||
Condensed Balance Sheet Statements Captions [Line Items] | ||||
Cash and cash equivalents | 0 | 0 | 0 | 0 |
Accounts receivable, net | 0 | 0 | ||
Other current assets | 0 | 0 | ||
Total current assets | 0 | 0 | ||
Property and equipment, net | 0 | 0 | ||
Amortizable intangibles, net | 0 | 0 | ||
Investments in subsidiaries | (12,565,623) | (11,720,388) | ||
Intercompany receivables | (3,998,551) | (4,117,647) | ||
Other long-term assets and investments | 0 | 0 | ||
Goodwill | 0 | 0 | ||
Total assets | (16,564,174) | (15,838,035) | ||
Current liabilities | 0 | 0 | ||
Intercompany payables | (3,998,551) | (4,117,647) | ||
Long-term debt and other long-term liabilities | 0 | 0 | ||
Noncontrolling interests subject to put provisions | 394,531 | 365,657 | ||
Total DaVita Inc. shareholder's equity | (12,565,623) | (11,720,388) | ||
Noncontrolling interests not subject to put provisions | (394,531) | (365,657) | ||
Shareholders’ equity | (12,960,154) | (12,086,045) | ||
Total liabilities and equity | (16,564,174) | (15,838,035) | ||
DaVita Inc. | Reportable Legal Entities | ||||
Condensed Balance Sheet Statements Captions [Line Items] | ||||
Cash and cash equivalents | 1,078,071 | 549,921 | 667,109 | 1,186,636 |
Accounts receivable, net | 0 | 0 | ||
Other current assets | 339,626 | 277,911 | ||
Total current assets | 1,417,697 | 827,832 | ||
Property and equipment, net | 347,805 | 337,200 | ||
Amortizable intangibles, net | 421 | 487 | ||
Investments in subsidiaries | 10,231,471 | 9,717,728 | ||
Intercompany receivables | 2,840,305 | 3,250,692 | ||
Other long-term assets and investments | 45,042 | 39,994 | ||
Goodwill | 0 | 0 | ||
Total assets | 14,882,741 | 14,173,933 | ||
Current liabilities | 557,557 | 303,840 | ||
Intercompany payables | 0 | 0 | ||
Long-term debt and other long-term liabilities | 8,599,938 | 8,614,445 | ||
Noncontrolling interests subject to put provisions | 585,317 | 607,601 | ||
Total DaVita Inc. shareholder's equity | 5,139,929 | 4,648,047 | ||
Noncontrolling interests not subject to put provisions | 0 | 0 | ||
Shareholders’ equity | 5,139,929 | 4,648,047 | ||
Total liabilities and equity | 14,882,741 | 14,173,933 | ||
Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Balance Sheet Statements Captions [Line Items] | ||||
Cash and cash equivalents | 74,633 | 59,192 | 73,221 | 109,357 |
Accounts receivable, net | 1,216,764 | 1,215,232 | ||
Other current assets | 814,917 | 736,727 | ||
Total current assets | 2,106,314 | 2,011,151 | ||
Property and equipment, net | 1,664,888 | 1,689,798 | ||
Amortizable intangibles, net | 1,448,086 | 1,491,057 | ||
Investments in subsidiaries | 2,334,152 | 2,002,660 | ||
Intercompany receivables | 0 | 0 | ||
Other long-term assets and investments | 87,414 | 86,710 | ||
Goodwill | 7,858,841 | 7,838,984 | ||
Total assets | 15,499,695 | 15,120,360 | ||
Current liabilities | 1,697,937 | 1,865,193 | ||
Intercompany payables | 2,337,683 | 2,322,124 | ||
Long-term debt and other long-term liabilities | 1,232,604 | 1,215,315 | ||
Noncontrolling interests subject to put provisions | 0 | 0 | ||
Total DaVita Inc. shareholder's equity | 10,231,471 | 9,717,728 | ||
Noncontrolling interests not subject to put provisions | 0 | 0 | ||
Shareholders’ equity | 10,231,471 | 9,717,728 | ||
Total liabilities and equity | 15,499,695 | 15,120,360 | ||
Non- Guarantor subsidiaries | Reportable Legal Entities | ||||
Condensed Balance Sheet Statements Captions [Line Items] | ||||
Cash and cash equivalents | 319,528 | 304,074 | $ 301,097 | $ 203,123 |
Accounts receivable, net | 683,797 | 702,070 | ||
Other current assets | 76,564 | 135,101 | ||
Total current assets | 1,079,889 | 1,141,245 | ||
Property and equipment, net | 1,158,506 | 1,148,369 | ||
Amortizable intangibles, net | 38,522 | 36,223 | ||
Investments in subsidiaries | 0 | 0 | ||
Intercompany receivables | 1,158,246 | 866,955 | ||
Other long-term assets and investments | 541,210 | 523,874 | ||
Goodwill | 1,593,629 | 1,568,333 | ||
Total assets | 5,570,002 | 5,284,999 | ||
Current liabilities | 558,083 | 527,412 | ||
Intercompany payables | 1,660,868 | 1,795,523 | ||
Long-term debt and other long-term liabilities | 421,706 | 392,053 | ||
Noncontrolling interests subject to put provisions | 0 | 0 | ||
Total DaVita Inc. shareholder's equity | 2,334,152 | 2,002,660 | ||
Noncontrolling interests not subject to put provisions | 595,193 | 567,351 | ||
Shareholders’ equity | 2,929,345 | 2,570,011 | ||
Total liabilities and equity | $ 5,570,002 | $ 5,284,999 |
Condensed Consolidating State79
Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2017 | Mar. 31, 2016 | |
Cash flows from operating activities: | ||
Net income (loss) | $ 500,285 | $ 138,159 |
Changes in operating assets and liabilities and non-cash items included in net income | 364,889 | 290,843 |
Net cash provided by (used in) operating activities | 865,174 | 429,002 |
Cash flows from investing activities: | ||
Additions of property and equipment | (214,535) | (173,187) |
Acquisitions | (77,236) | (405,154) |
Proceeds from asset and business sales | 46,612 | 4,657 |
(Purchases) proceeds from investment sales and other items, net | (4,853) | 19,373 |
Net cash used in investing activities | (250,012) | (554,311) |
Cash flows from financing activities: | ||
Long-term debt and related financing costs, net | (36,141) | (24,571) |
Intercompany borrowing (payments) | 0 | 0 |
Other items | (22,796) | (308,526) |
Net cash (used in) provided by financing activities | (58,937) | (333,097) |
Effect of exchange rate changes on cash | 2,820 | 717 |
Net increase (decrease) in cash | 559,045 | (457,689) |
Cash and cash equivalents at beginning of period | 913,187 | 1,499,116 |
Cash and cash equivalents at end of period | 1,472,232 | 1,041,427 |
Consolidating adjustments | ||
Cash flows from operating activities: | ||
Net income (loss) | (546,345) | (132,743) |
Changes in operating assets and liabilities and non-cash items included in net income | 546,345 | 132,743 |
Net cash provided by (used in) operating activities | 0 | 0 |
Cash flows from investing activities: | ||
Additions of property and equipment | 0 | 0 |
Acquisitions | 0 | 0 |
Proceeds from asset and business sales | 0 | 0 |
(Purchases) proceeds from investment sales and other items, net | 0 | 0 |
Net cash used in investing activities | 0 | 0 |
Cash flows from financing activities: | ||
Long-term debt and related financing costs, net | 0 | 0 |
Intercompany borrowing (payments) | 0 | 0 |
Other items | 0 | 0 |
Net cash (used in) provided by financing activities | 0 | 0 |
Effect of exchange rate changes on cash | 0 | 0 |
Net increase (decrease) in cash | 0 | 0 |
Cash and cash equivalents at beginning of period | 0 | 0 |
Cash and cash equivalents at end of period | 0 | 0 |
DaVita Inc. | Reportable Legal Entities | ||
Cash flows from operating activities: | ||
Net income (loss) | 447,697 | 97,434 |
Changes in operating assets and liabilities and non-cash items included in net income | (149,767) | (18,699) |
Net cash provided by (used in) operating activities | 297,930 | 78,735 |
Cash flows from investing activities: | ||
Additions of property and equipment | (30,580) | (16,865) |
Acquisitions | 0 | |
Proceeds from asset and business sales | 0 | 0 |
(Purchases) proceeds from investment sales and other items, net | (54,150) | 23,387 |
Net cash used in investing activities | (84,730) | 6,522 |
Cash flows from financing activities: | ||
Long-term debt and related financing costs, net | (27,504) | (21,247) |
Intercompany borrowing (payments) | 339,124 | (315,986) |
Other items | 3,330 | (267,551) |
Net cash (used in) provided by financing activities | 314,950 | (604,784) |
Effect of exchange rate changes on cash | 0 | 0 |
Net increase (decrease) in cash | 528,150 | (519,527) |
Cash and cash equivalents at beginning of period | 549,921 | 1,186,636 |
Cash and cash equivalents at end of period | 1,078,071 | 667,109 |
Guarantor subsidiaries | Reportable Legal Entities | ||
Cash flows from operating activities: | ||
Net income (loss) | 394,641 | 70,419 |
Changes in operating assets and liabilities and non-cash items included in net income | (131,683) | 217,405 |
Net cash provided by (used in) operating activities | 262,958 | 287,824 |
Cash flows from investing activities: | ||
Additions of property and equipment | (133,909) | (86,055) |
Acquisitions | (70,237) | (400,093) |
Proceeds from asset and business sales | 46,612 | 4,657 |
(Purchases) proceeds from investment sales and other items, net | (1,976) | (7,438) |
Net cash used in investing activities | (159,510) | (488,929) |
Cash flows from financing activities: | ||
Long-term debt and related financing costs, net | (4,616) | (1,977) |
Intercompany borrowing (payments) | (82,592) | 167,702 |
Other items | (799) | (756) |
Net cash (used in) provided by financing activities | (88,007) | 164,969 |
Effect of exchange rate changes on cash | 0 | 0 |
Net increase (decrease) in cash | 15,441 | (36,136) |
Cash and cash equivalents at beginning of period | 59,192 | 109,357 |
Cash and cash equivalents at end of period | 74,633 | 73,221 |
Non- Guarantor subsidiaries | Reportable Legal Entities | ||
Cash flows from operating activities: | ||
Net income (loss) | 204,292 | 103,049 |
Changes in operating assets and liabilities and non-cash items included in net income | 99,994 | (40,606) |
Net cash provided by (used in) operating activities | 304,286 | 62,443 |
Cash flows from investing activities: | ||
Additions of property and equipment | (50,046) | (70,267) |
Acquisitions | (6,999) | (5,061) |
Proceeds from asset and business sales | 0 | 0 |
(Purchases) proceeds from investment sales and other items, net | 51,273 | 3,424 |
Net cash used in investing activities | (5,772) | (71,904) |
Cash flows from financing activities: | ||
Long-term debt and related financing costs, net | (4,021) | (1,347) |
Intercompany borrowing (payments) | (256,532) | 148,284 |
Other items | (25,327) | (40,219) |
Net cash (used in) provided by financing activities | (285,880) | 106,718 |
Effect of exchange rate changes on cash | 2,820 | 717 |
Net increase (decrease) in cash | 15,454 | 97,974 |
Cash and cash equivalents at beginning of period | 304,074 | 203,123 |
Cash and cash equivalents at end of period | $ 319,528 | $ 301,097 |
Supplemental Data - Condensed C
Supplemental Data - Condensed Consolidating Statements of Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2017 | Mar. 31, 2016 | ||
Condensed Income Statements Captions [Line Items] | |||
Patient service operating revenues | $ 2,601,378 | $ 2,481,933 | |
Less: Provision for uncollectible accounts | (112,983) | (109,205) | |
Net patient service operating revenues | 2,488,395 | 2,372,728 | |
Capitated revenues | 918,036 | 887,047 | |
Other revenues | 290,852 | 321,361 | |
Total net operating revenues | 3,697,283 | 3,581,136 | |
Operating expenses | 2,809,047 | 3,216,247 | |
Operating income | 888,236 | 364,889 | |
Debt expense, including refinancing charges | (104,429) | ||
Other income | 4,243 | 2,976 | |
Income tax expense | 287,765 | 126,822 | |
Net income (loss) | 500,285 | 138,159 | |
Less: Net income attributable to noncontrolling interests | (52,588) | (40,725) | |
Net income (loss) attributable to DaVita Inc. | 447,697 | $ 97,434 | |
Physician Groups | |||
Condensed Income Statements Captions [Line Items] | |||
Patient service operating revenues | 133,537 | ||
Less: Provision for uncollectible accounts | (3,725) | ||
Net patient service operating revenues | 129,812 | ||
Capitated revenues | 384,262 | ||
Other revenues | 9,851 | ||
Total net operating revenues | 523,925 | ||
Operating expenses | 500,390 | ||
Operating income | 23,535 | ||
Debt expense, including refinancing charges | (1,450) | ||
Other income | 35 | ||
Income tax expense | 18,594 | ||
Net income (loss) | 3,526 | ||
Net income (loss) attributable to DaVita Inc. | 3,526 | ||
Unrestricted Subsidiaries | |||
Condensed Income Statements Captions [Line Items] | |||
Operating expenses | (166) | ||
Operating income | 166 | ||
Income tax expense | 66 | ||
Net income (loss) | 100 | ||
Net income (loss) attributable to DaVita Inc. | 100 | ||
Company and Restricted Subsidiaries(1) | |||
Condensed Income Statements Captions [Line Items] | |||
Patient service operating revenues | [1] | 2,467,841 | |
Less: Provision for uncollectible accounts | [1] | (109,258) | |
Net patient service operating revenues | [1] | 2,358,583 | |
Capitated revenues | [1] | 533,774 | |
Other revenues | [1] | 281,001 | |
Total net operating revenues | [1] | 3,173,358 | |
Operating expenses | [1] | 2,308,823 | |
Operating income | [1] | 864,535 | |
Debt expense, including refinancing charges | [1] | (102,979) | |
Other income | [1] | 4,208 | |
Income tax expense | [1] | 269,105 | |
Net income (loss) | [1] | 496,659 | |
Less: Net income attributable to noncontrolling interests | [1] | (52,588) | |
Net income (loss) attributable to DaVita Inc. | [1] | $ 444,071 | |
[1] | After elimination of the unrestricted subsidiaries and the physician groups. |
Supplemental Data - Condensed81
Supplemental Data - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2017 | Mar. 31, 2016 | ||
Condensed Financial Statements Captions [Line Items] | |||
Net income (loss) | $ 500,285 | $ 138,159 | |
Other comprehensive loss | 12,755 | 6,313 | |
Total comprehensive income | 513,040 | 144,472 | |
Less: comprehensive income attributable to the noncontrolling interests | (52,586) | (40,725) | |
Comprehensive income (loss) attributable to DaVita Inc. | 460,454 | $ 103,747 | |
Physician Groups | |||
Condensed Financial Statements Captions [Line Items] | |||
Net income (loss) | 3,526 | ||
Total comprehensive income | 3,526 | ||
Comprehensive income (loss) attributable to DaVita Inc. | 3,526 | ||
Unrestricted Subsidiaries | |||
Condensed Financial Statements Captions [Line Items] | |||
Net income (loss) | 100 | ||
Total comprehensive income | 100 | ||
Comprehensive income (loss) attributable to DaVita Inc. | 100 | ||
Company and Restricted Subsidiaries | |||
Condensed Financial Statements Captions [Line Items] | |||
Net income (loss) | [1] | 496,659 | |
Other comprehensive loss | [1] | 12,755 | |
Total comprehensive income | [1] | 509,414 | |
Less: comprehensive income attributable to the noncontrolling interests | [1] | (52,586) | |
Comprehensive income (loss) attributable to DaVita Inc. | [1] | $ 456,828 | |
[1] | After elimination of the unrestricted subsidiaries and the physician groups. |
Supplemental Data - Condensed82
Supplemental Data - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands | Mar. 31, 2017 | Dec. 31, 2016 | Mar. 31, 2016 | Dec. 31, 2015 | |
Condensed Balance Sheet Statements Captions [Line Items] | |||||
Cash and cash equivalents | $ 1,472,232 | $ 913,187 | $ 1,041,427 | $ 1,499,116 | |
Accounts receivable, net | 1,900,561 | 1,917,302 | |||
Other current assets | 1,231,107 | 1,149,739 | |||
Total current assets | 4,603,900 | 3,980,228 | |||
Property and equipment, net | 3,171,199 | 3,175,367 | |||
Amortizable intangibles, net | 1,487,029 | 1,527,767 | |||
Other long-term assets | 673,666 | 650,578 | |||
Goodwill | 9,452,470 | 9,407,317 | $ 9,294,479 | ||
Total assets | 19,388,264 | 18,741,257 | |||
Current liabilities | 2,813,577 | 2,696,445 | |||
Long-term debt and other long-term liabilities | 10,254,248 | 10,221,813 | |||
Noncontrolling interests subject to put provisions | 979,848 | 973,258 | |||
Total DaVita Inc. shareholders’ equity | 5,139,929 | 4,648,047 | |||
Noncontrolling interests not subject to put provisions | 200,662 | 201,694 | |||
Shareholders’ equity | 5,340,591 | 4,849,741 | |||
Total liabilities and shareholder’s equity | 19,388,264 | 18,741,257 | |||
Physician Groups | |||||
Condensed Balance Sheet Statements Captions [Line Items] | |||||
Cash and cash equivalents | 99,086 | 104,691 | |||
Accounts receivable, net | 202,006 | ||||
Other current assets | 14,819 | ||||
Total current assets | 315,911 | ||||
Property and equipment, net | 1,268 | ||||
Amortizable intangibles, net | 4,576 | ||||
Other long-term assets | 81,419 | ||||
Goodwill | 16,796 | ||||
Total assets | 419,970 | ||||
Current liabilities | 204,998 | ||||
Payables to parent | 61,723 | ||||
Long-term debt and other long-term liabilities | 45,226 | ||||
Total DaVita Inc. shareholders’ equity | 108,023 | ||||
Shareholders’ equity | 108,023 | ||||
Total liabilities and shareholder’s equity | 419,970 | ||||
Unrestricted Subsidiaries | |||||
Condensed Balance Sheet Statements Captions [Line Items] | |||||
Other long-term assets | 2,880 | ||||
Total assets | 2,880 | ||||
Payables to parent | 2,880 | ||||
Total liabilities and shareholder’s equity | 2,880 | ||||
Company and Restricted Subsidiaries | |||||
Condensed Balance Sheet Statements Captions [Line Items] | |||||
Cash and cash equivalents | [1] | 1,373,146 | $ 808,496 | ||
Accounts receivable, net | [1] | 1,698,555 | |||
Other current assets | [1] | 1,216,288 | |||
Total current assets | [1] | 4,287,989 | |||
Property and equipment, net | [1] | 3,169,931 | |||
Amortizable intangibles, net | [1] | 1,482,453 | |||
Other long-term assets | [1] | 589,367 | |||
Goodwill | [1] | 9,435,674 | |||
Total assets | [1] | 18,965,414 | |||
Current liabilities | [1] | 2,608,579 | |||
Payables to parent | [1] | (64,603) | |||
Long-term debt and other long-term liabilities | [1] | 10,209,022 | |||
Noncontrolling interests subject to put provisions | [1] | 979,848 | |||
Total DaVita Inc. shareholders’ equity | [1] | 5,031,906 | |||
Noncontrolling interests not subject to put provisions | [1] | 200,662 | |||
Shareholders’ equity | [1] | 5,232,568 | |||
Total liabilities and shareholder’s equity | [1] | $ 18,965,414 | |||
[1] | After elimination of the unrestricted subsidiaries and the physician groups. |
Supplemental Data - Condensed83
Supplemental Data - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2017 | Mar. 31, 2016 | ||
Cash flows from operating activities: | |||
Net income (loss) | $ 500,285 | $ 138,159 | |
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | 364,889 | 290,843 | |
Net cash provided by (used in) operating activities | 865,174 | 429,002 | |
Cash flows from investing activities: | |||
Additions of property and equipment | (214,535) | (173,187) | |
Acquisitions and divestitures, net | (77,236) | ||
Proceeds from discontinued operations | 46,612 | 4,657 | |
Investments and other items | (4,853) | 19,373 | |
Net cash used in investing activities | (250,012) | (554,311) | |
Cash flows from financing activities: | |||
Long-term debt | (36,141) | (24,571) | |
Intercompany | 0 | 0 | |
Other items | (22,796) | (308,526) | |
Net cash (used in) provided by financing activities | (58,937) | (333,097) | |
Effect of exchange rate changes on cash | 2,820 | 717 | |
Net increase (decrease) in cash | 559,045 | (457,689) | |
Cash and cash equivalents at beginning of period | 913,187 | 1,499,116 | |
Cash and cash equivalents at end of period | 1,472,232 | $ 1,041,427 | |
Physician Groups | |||
Cash flows from operating activities: | |||
Net income (loss) | 3,526 | ||
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | (14,847) | ||
Net cash provided by (used in) operating activities | (11,321) | ||
Cash flows from investing activities: | |||
Additions of property and equipment | (10) | ||
Investments and other items | (946) | ||
Net cash used in investing activities | (956) | ||
Cash flows from financing activities: | |||
Long-term debt | 0 | ||
Intercompany | 6,672 | ||
Net cash (used in) provided by financing activities | 6,672 | ||
Net increase (decrease) in cash | (5,605) | ||
Cash and cash equivalents at beginning of period | 104,691 | ||
Cash and cash equivalents at end of period | 99,086 | ||
Unrestricted Subsidiaries | |||
Cash flows from operating activities: | |||
Net income (loss) | 100 | ||
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | (100) | ||
Company and Restricted Subsidiaries | |||
Cash flows from operating activities: | |||
Net income (loss) | [1] | 496,659 | |
Changes in operating and intercompany assets and liabilities and non-cash items included in net income | [1] | 379,836 | |
Net cash provided by (used in) operating activities | [1] | 876,495 | |
Cash flows from investing activities: | |||
Additions of property and equipment | [1] | (214,525) | |
Acquisitions and divestitures, net | [1] | (77,236) | |
Proceeds from discontinued operations | [1] | 46,612 | |
Investments and other items | [1] | (3,907) | |
Net cash used in investing activities | [1] | (249,056) | |
Cash flows from financing activities: | |||
Long-term debt | [1] | (36,141) | |
Intercompany | [1] | (6,672) | |
Other items | [1] | (22,796) | |
Net cash (used in) provided by financing activities | [1] | (65,609) | |
Effect of exchange rate changes on cash | [1] | 2,820 | |
Net increase (decrease) in cash | [1] | 564,650 | |
Cash and cash equivalents at beginning of period | [1] | 808,496 | |
Cash and cash equivalents at end of period | [1] | $ 1,373,146 | |
[1] | After elimination of the unrestricted subsidiaries and the physician groups. |
Subsequent events (Details)
Subsequent events (Details) $ in Thousands | May 01, 2017USD ($)Clinic | Mar. 31, 2017USD ($) | Mar. 31, 2016USD ($) |
Subsequent Event [Line Items] | |||
Purchase price | $ | $ 77,236 | $ 405,154 | |
Renal Ventures Limited L L C | Subsequent Event | |||
Subsequent Event [Line Items] | |||
Interest acquired, percentage | 100.00% | ||
Purchase price | $ | $ 360,000 | ||
Number of businesses acquired | Clinic | 38 | ||
Number of states in which dialysis clinics acquired | 6 | ||
Number of businesses divested | Clinic | 7 |