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Document and Entity Information - shares shares in Millions	3 Months Ended
Document and Entity Information - shares shares in Millions	Mar. 31, 2020	May 01, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2020
Document Transition Report	false
Entity File Number	1-14106
Entity Registrant Name	DAVITA INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	51-0354549
Entity Address, Address Line One	2000 16th Street
Entity Address, City or Town	Denver,
Entity Address, State or Province	CO
Entity Address, Postal Zip Code	80202
City Area Code	720
Local Phone Number	631-2100
Title of 12(b) Security	Common Stock, $0.001 par value
Trading Symbol	DVA
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		121.8
Amendment Flag	false
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Entity Central Index Key	0000927066
Current Fiscal Year End Date	--12-31

CONSOLIDATED STATEMENTS OF INCOME (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Statement [Abstract]
Dialysis patient service revenues	$ 2,713,281	$ 2,629,689
Other revenues	127,956	113,423
Total revenues	2,841,237	2,743,112
Operating expenses and charges:
Patient care costs	1,975,449	1,964,935
General and administrative	263,576	250,813
Depreciation and amortization	154,679	148,528
Equity investment income	(17,843)	(2,708)
Goodwill impairment charges	0	41,037
Total operating expenses and charges	2,375,861	2,402,605
Operating income	465,376	340,507
Debt expense	(88,603)	(131,519)
Debt refinancing charges	(2,948)	0
Other (loss) income, net	(4,350)	6,940
Income from continuing operations before income taxes	369,475	215,928
Income tax expense	91,560	56,746
Net income from continuing operations	277,915	159,182
Net income from discontinued operations, net of tax	9,980	30,305
Net income	287,895	189,487
Less: Net income attributable to noncontrolling interests	(48,302)	(40,198)
Net income attributable to DaVita Inc.	$ 239,593	$ 149,289
Earnings per share attributable to DaVita Inc.:
Basic net income from continuing operations per share	$ 1.84	$ 0.72
Basic net income per share	1.92	0.90
Diluted net income from continuing operations per share	1.81	0.72
Diluted net income per share	$ 1.89	$ 0.90
Weighted average shares for earnings per share:
Basic (in shares)	124,901,671	166,387,958
Diluted (in shares)	126,894,847	166,780,657
Amounts attributable to DaVita Inc.:
Net income from continuing operations	$ 229,613	$ 120,254
Net income from discontinued operations	9,980	29,035
Net income attributable to DaVita Inc.	$ 239,593	$ 149,289

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
Net income	$ 287,895	$ 189,487
Unrealized losses on interest rate cap agreements:
Unrealized losses	(13,018)	(580)
Reclassifications of net realized losses into net income	1,623	1,606
Unrealized losses on foreign currency translation:
Foreign currency translation adjustments	(81,632)	(13,653)
Other comprehensive loss	(93,027)	(12,627)
Total comprehensive income	194,868	176,860
Less: Comprehensive income attributable to noncontrolling interests	(48,302)	(40,198)
Comprehensive income attributable to DaVita Inc.	$ 146,566	$ 136,662

CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
ASSETS
Cash and cash equivalents	$ 1,381,764	$ 1,102,372
Restricted cash and equivalents	106,724	106,346
Short-term investments	9,376	11,572
Accounts receivable, net	1,820,132	1,795,598
Inventories	95,685	97,949
Other receivables	519,081	489,695
Prepaid and other current assets	59,853	66,866
Income tax receivable	31,324	19,772
Total current assets	4,023,939	3,690,170
Property and equipment, net of accumulated depreciation of $4,092,166 and $3,969,566, respectively	3,445,423	3,473,384
Operating lease right-of-use asset	2,847,776	2,830,047
Intangible assets, net of accumulated amortization of $84,643 and $81,922, respectively	117,953	135,684
Equity method and other investments	254,499	241,983
Long-term investments	34,657	36,519
Other long-term assets	94,030	115,972
Goodwill	6,778,023	6,787,635
Total assets	17,596,300	17,311,394
LIABILITIES AND EQUITY
Accounts payable	340,092	403,840
Other liabilities	757,784	756,174
Accrued compensation and benefits	596,999	695,052
Current portion of operating lease liabilities	356,033	343,912
Current portion of long-term debt	146,318	130,708
Income tax payable	23,520	42,412
Total current liabilities	2,220,746	2,372,098
Long-term operating lease liabilities	2,734,370	2,723,800
Long-term debt	8,442,136	7,977,526
Other long-term liabilities	161,940	160,809
Deferred income taxes	675,728	577,543
Total liabilities	14,234,920	13,811,776
Commitments and contingencies:
Noncontrolling interests subject to put provisions	1,228,036	1,180,376
Equity:
Preferred stock ($0.001 par value, 5,000,000 shares authorized; none issued)	0	0
Common stock ($0.001 par value, 450,000,000 shares authorized; 125,857,178 and 121,804,880 shares issued and outstanding at March 31, 2020, respectively and 125,842,853 shares issued and outstanding at December 31, 2019	126	126
Additional paid-in capital	720,053	749,043
Retained earnings	1,671,331	1,431,738
Treasury Stock, Value	(303,139)	0
Accumulated other comprehensive (loss) income	(140,525)	(47,498)
Total DaVita Inc. shareholders' equity	1,947,846	2,133,409
Noncontrolling interests not subject to put provisions	185,498	185,833
Total equity	2,133,344	2,319,242
Total liabilities and equity	$ 17,596,300	$ 17,311,394

CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Property and equipment, accumulated depreciation	$ 4,092,166	$ 3,969,566
Intangible assets, accumulated amortization	$ 84,643	$ 81,922
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)	125,857,178	125,842,853
Common stock, shares outstanding (in shares)	121,804,880	125,842,853
Treasury Stock, Common, Shares	4,052,298	0

CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Cash flows from operating activities:
Net income	$ 287,895	$ 189,487
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	154,679	148,528
Impairment charges	0	41,037
Debt refinancing charges	884	0
Stock-based compensation expense	19,870	12,110
Deferred income taxes	103,301	41,372
Equity investment loss, net	(9,482)	(337)
Other non-cash charges, net	5,055	1,720
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:
Accounts receivable	(32,966)	(132,292)
Inventories	1,835	3,324
Other receivables and other current assets	(24,965)	1,199
Other long-term assets	2,673	(1,997)
Accounts payable	(24,045)	(38,537)
Accrued compensation and benefits	(96,428)	(173,583)
Other current liabilities	3,982	17,236
Income taxes	(32,616)	32,502
Other long-term liabilities	709	(465)
Net cash provided by operating activities	360,381	141,304
Cash flows from investing activities:
Additions of property and equipment	(154,942)	(198,878)
Acquisitions	(34,107)	(11,274)
Proceeds from asset and business sales	31,518	13,903
Purchase of debt investments held-to-maturity	(5,049)	(209)
Purchase of other debt and equity investments	(2,633)	(3,290)
Proceeds from debt investments held-to-maturity	5,049	0
Proceeds from sale of other debt and equity investments	3,268	3,302
Purchase of equity method investments	(6,174)	(4,067)
Distributions from equity method investments	445	155
Net cash used in investing activities	(162,625)	(200,358)
Cash flows from financing activities:
Borrowings	570,779	17,133,464
Payments on long-term debt and other financing costs	(104,942)	(16,776,267)
Purchase of treasury stock	(321,798)	0
Distributions to noncontrolling interests	(58,131)	(44,230)
Stock award exercises and other share issuances, net	2,397	1,517
Contributions from noncontrolling interests	9,387	18,947
Purchases of noncontrolling interests	(700)	(8,480)
Net cash provided by financing activities	96,992	324,951
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(14,978)	(921)
Net increase in cash, cash equivalents and restricted cash	279,770	264,976
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	1,208,718	415,420
Cash, cash equivalents and restricted cash of continuing operations at end of the period	1,488,488	561,434
Discontinued Operations
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash	0	118,962
Continuing Operations
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash	$ 279,770	$ 146,014

CONSOLIDATED STATEMENTS OF EQUITY (unaudited) - USD ($) $ in Thousands	Total	Total	Total Restricted Stock Units	Total Stock Appreciation Rights	Non- controlling interests subject to put provisions	Common stock	Common stock Restricted Stock Units	Common stock Stock Appreciation Rights	Additional paid-in capital	Additional paid-in capital Restricted Stock Units	Additional paid-in capital Stock Appreciation Rights	Retained earnings	Treasury stock	Accumulated other comprehensive (loss) income	Non- controlling interests not subject to put provisions
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Cumulative effect of change in accounting principle		$ 39,876			$ (38)							$ 39,876			$ (6)
Temporary equity, start balance at Dec. 31, 2018					1,124,641
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income					25,389
Distributions					(27,565)
Contributions					6,415
Acquisitions and divestitures					1,762
Partial purchases					(1,967)
Fair value remeasurements					14,407
Temporary equity, ending balance at Mar. 31, 2019					1,143,044
Beginning balance at Dec. 31, 2018		3,703,442				$ 166			$ 995,006			2,743,194	$ 0	$ (34,924)	204,956
Beginning balance (in shares) at Dec. 31, 2018						166,387,000							0
Comprehensive income:
Net income attributable to DaVita Inc.	$ 149,289	149,289										149,289			14,809
Other comprehensive income (loss)	(12,627)	(12,627)												(12,627)
Stock unit shares issued (in shares)							9,000	0
Stock-settled SAR shares issued			$ (104)	$ 0						$ (104)
Stock-settled stock-based compensation expense		12,091							12,091
Changes in noncontrolling interest from:
Distributions															(16,665)
Contributions															12,532
Acquisitions and divestitures		0							0
Acquisitions and divestitures, non-controlling interest															0
Partial purchases		(2,206)							(2,206)						(4,307)
Fair value remeasurements		(14,407)							(14,407)
Ending balance at Mar. 31, 2019		3,875,354				$ 166			990,380			2,932,359	$ 0	(47,551)	211,319
Ending balance (in shares) at Mar. 31, 2019						166,396,000							0
Temporary equity, start balance at Dec. 31, 2019					1,180,376
Increase (Decrease) in Temporary Equity [Roll Forward]
Net income					32,176
Distributions					(37,566)
Contributions					5,283
Partial purchases					(255)
Fair value remeasurements					48,022
Temporary equity, ending balance at Mar. 31, 2020					$ 1,228,036
Beginning balance at Dec. 31, 2019	$ 2,319,242	2,133,409				$ 126			749,043			1,431,738	$ 0	(47,498)	185,833
Beginning balance (in shares) at Dec. 31, 2019	125,842,853					125,843,000							0
Comprehensive income:
Net income attributable to DaVita Inc.	$ 239,593	239,593										239,593			16,126
Other comprehensive income (loss)	(93,027)	(93,027)												(93,027)
Stock purchase shares issued		0
Stock unit shares issued (in shares)							8,000	6,000
Stock-settled SAR shares issued			$ (75)	$ (245)						$ (75)	$ (245)
Stock-settled stock-based compensation expense		19,797							19,797
Changes in noncontrolling interest from:
Distributions															(20,565)
Contributions															4,104
Partial purchases		(445)							(445)
Fair value remeasurements		(48,022)							(48,022)
Purchase of treasury stock (in shares)													(4,052,000)
Purchase of treasury stock		(303,139)											$ (303,139)
Ending balance at Mar. 31, 2020	$ 2,133,344	$ 1,947,846				$ 126			$ 720,053			$ 1,671,331	$ (303,139)	$ (140,525)	$ 185,498
Ending balance (in shares) at Mar. 31, 2020	121,804,880					125,857,000							(4,052,000)

Condensed consolidated interim financial statements Condensed consolidated interim financial statements	3 Months Ended
	Mar. 31, 2020
Text Block [Abstract]
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	Condensed consolidated interim financial statements The unaudited condensed consolidated interim financial statements included in this report are prepared by the Company. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these condensed consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, impairments of goodwill, accounting for income taxes, certain fair value estimates and loss contingencies. The results of operations for the three months ended March 31, 2020 are not necessarily indicative of the operating results for the full year. These 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, 2019 (10-K). 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 interim financial statements were issued and has included all necessary adjustments and disclosures.

Revenue Recognition Revenue Recognition

3 Months Ended

Mar. 31, 2020

Text Block [Abstract]

Revenue Recognition [Text Block]

Revenue recognition

The following table summarizes the Company's segment revenues by primary payor source:



	For the three months ended
	March 31, 2020									March 31, 2019
	U.S. dialysis			Other - Ancillary services			Consolidated			U.S. dialysis			Other - Ancillary services			Consolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage	$	1,502,222		$			$	1,502,222		$	1,493,516		$			$	1,493,516
Medicaid and Managed Medicaid	171,467						171,467			154,190						154,190
Other government	111,910			94,574			206,484			106,127			84,475			190,602
Commercial	825,582			39,467			865,049			788,413			33,388			821,801
Other revenues:
Medicare and Medicare Advantage				98,478			98,478						61,700			61,700
Medicaid and Managed Medicaid				366			366						6			6
Commercial				10,521			10,521						32,619			32,619
Other⁽¹⁾	5,442			17,602			23,044			4,905			17,750			22,655
Eliminations of intersegment revenues	(32,242		)	(4,152		)	(36,394		)	(30,641		)	(3,336		)	(33,977		)
Total	$	2,584,381		$	256,856		$	2,841,237		$	2,516,510		$	226,602		$	2,743,112


(1)	Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services.

The Company’s allowance for doubtful accounts related to performance obligations satisfied in years prior to January 1, 2018 was $4,422 and $8,328 as of March 31, 2020 and December 31, 2019, respectively.

There are significant uncertainties associated with estimating revenue, which generally take several years to resolve. These estimates are subject to ongoing insurance coverage changes, geographic coverage differences, differing interpretations of contract coverage and other payor issues, as well as patient issues including, without limitation, determination of applicable primary and secondary coverage, changes in patient insurance coverage and coordination of benefits. As these estimates are refined over time, both positive and negative adjustments to revenue are recognized in the current period.

Dialysis patient service revenues. Revenues are recognized based on the Company’s estimate of the transaction price the Company expects to collect as a result of satisfying its performance obligations. Dialysis patient service revenues are recognized in the period services are provided based on these estimates. Revenues consist primarily of payments from government and commercial health plans for dialysis services provided to patients. A usual and customary fee schedule is maintained for the Company’s dialysis treatments and related lab services; however, actual collectible revenue is normally recognized at a discount from the fee schedule.

Other revenues. Other revenues consist of fees for management and administrative support services provided to outpatient dialysis centers that the Company does not own or in which the Company owns a noncontrolling interest, revenues associated with the Company's non-dialysis ancillary services, and administrative and management support services to certain non-dialysis joint ventures in which the Company owns a noncontrolling interest.

Earnings per share (Notes)

3 Months Ended

Mar. 31, 2020

Earnings Per Share [Abstract]

Earnings Per Share [Text Block]

Earnings per share

Basic earnings per share is calculated by dividing net income attributable to the Company by the weighted average number of common shares outstanding. Weighted average common shares outstanding include restricted stock unit awards that are no longer subject to forfeiture because the recipients have satisfied either the explicit vesting terms or retirement eligibility requirements.

Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units as computed under the treasury stock method.

The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows:



	Three months ended March 31,
	2020		2019

Net income from continuing operations attributable to DaVita Inc.	$	229,613	$	120,254
Net income from discontinued operations attributable to DaVita Inc.	9,980		29,035
Net income attributable to DaVita Inc.	$	239,593	$	149,289

Weighted average shares - basic	124,902		166,388
Assumed incremental shares from stock plans	1,993		393
Weighted average shares - diluted	126,895		166,781

Basic net income attributable to DaVita Inc. from:
Continuing operations per share	$	1.84	$	0.72
Discontinued operations per share	0.08		0.18
Basic net income per share attributable to DaVita Inc.	$	1.92	$	0.90

Diluted net income attributable to DaVita Inc. from:
Continuing operations per share	$	1.81	$	0.72
Discontinued operations per share	0.08		0.18
Diluted net income per share attributable to DaVita Inc.	$	1.89	$	0.90

Anti-dilutive stock-settled awards excluded from calculations⁽¹⁾	3,207		6,150

(1)

Shares associated with stock-settled stock appreciation rights and performance stock units were excluded from the diluted denominator calculations because they are anti-dilutive under the treasury stock method.

Investments in debt and equity securities

3 Months Ended

Mar. 31, 2020

Investments, Debt and Equity Securities [Abstract]

Investments in debt and equity securities

Short-term and long-term investments

The Company’s short-term and long-term debt and equity investments consist of the following:



	March 31, 2020						December 31, 2019
	Debt securities		Equity securities		Total		Debt securities		Equity securities		Total
Certificates of deposit and other time deposits	$	8,190	$	—	$	8,190	$	8,140	$	—	$	8,140
Investments in mutual funds and common stock	—		35,843		35,843		—		39,951		39,951
	$	8,190	$	35,843	$	44,033	$	8,140	$	39,951	$	48,091
Short-term investments	$	8,190	$	1,186	$	9,376	$	8,140	$	3,432	$	11,572
Long-term investments	—		34,657		34,657		—		36,519		36,519
	$	8,190	$	35,843	$	44,033	$	8,140	$	39,951	$	48,091

Debt securities: The Company's short-term debt investments are principally bank certificates of deposit with contractual maturities longer than three months but shorter than one year. These debt securities are accounted for as held to maturity and recorded at amortized cost, which approximated their fair values at March 31, 2020 and December 31, 2019.

Equity securities: The Company's equity investments in mutual funds and common stock are held within a trust to fund existing obligations associated with several of the Company’s non-qualified deferred compensation plans. During the three months ended March 31, 2020, the Company recognized pre-tax net losses of $3,407 in other (loss) income associated with changes in the fair value of these equity securities, comprised of pre-tax realized gains of $293 and a net increase in unrealized losses of $3,700. During the three months ended March 31, 2019, the Company recognized pre-tax net gains of $1,893 in other (loss) income associated with changes in the fair value of these equity securities, comprised of pre-tax realized gains of $170 and a net increase in unrealized gains of $1,723.

Equity method and other investments

3 Months Ended

Mar. 31, 2020

Equity Method Investments and Joint Ventures [Abstract]

Equity method and other investments

The Company maintains equity method and minor adjusted cost method investments in the private securities of certain other healthcare and healthcare-related businesses. The Company classifies these investments as "Equity method and other investments" on its consolidated balance sheet.

The Company's equity method and other investments were comprised of the following:



	March 31, 2020		December 31, 2019
APAC joint venture	$	123,696	$	116,924
Other equity method partnerships	114,355		114,611
Adjusted cost method investments	16,448		10,448
	$	254,499	$	241,983

During the three months ended March 31, 2020 and 2019, the Company recognized equity investment income of $17,843 and $2,708, respectively, from equity method investments in nonconsolidated businesses.

Equity investments in nonconsolidated businesses over which the Company maintains significant influence, but which do not have readily determinable fair values, are carried on the equity method. The Company's largest equity method investment is its ownership interest in DaVita Care Pte. Ltd. (the APAC joint venture, or APAC JV), which is 75%-owned by the Company and 25%-owned by its other noncontrolling investor. As described in Note 9 to the Company's consolidated financial statements included in the 10-K, the Company does not consolidate the APAC JV.

The Company's other equity method investments include legal entities over which the Company has significant influence but in which it does not maintain a controlling financial interest. Almost all of these are U.S. partnerships in the form of limited liability companies. The Company's ownership interests in these partnerships vary, but typically range from 30% to 50%. During the three months ended March 31, 2020 and 2019, there were no meaningful impairments or other valuation adjustments recognized on these investments.

Goodwill

3 Months Ended

Mar. 31, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill

Changes in goodwill by reportable segments were as follows:



	U.S. dialysis			Other - Ancillary services			Consolidated
Balance at December 31, 2018	$	6,275,004		$	566,956		$	6,841,960
Acquisitions	18,089			72,137			90,226
Impairment charges	—			(124,892		)	(124,892		)
Foreign currency and other adjustments	(5,993		)	(13,666		)	(19,659		)
Balance at December 31, 2019	$	6,287,100		$	500,535		$	6,787,635
Acquisitions	2,839			23,931			26,770
Divestitures	(1,549		)	—			(1,549		)
Foreign currency and other adjustments	—			(34,833		)	(34,833		)
Balance at March 31, 2020	$	6,288,390		$	489,633		$	6,778,023

Goodwill	$	6,288,390		$	638,117		$	6,926,507
Accumulated impairment charges	—			(148,484		)	(148,484		)
	$	6,288,390		$	489,633		$	6,778,023

During the three months ended March 31, 2020, the Company did not recognize any goodwill impairment charges.

During the three months ended March 31, 2019, the Company recognized a $41,037 goodwill impairment charge in its Germany kidney care business. This charge resulted primarily from a change in relevant discount rates, as well as a decline in current and expected future patient census and an increase in the first quarter of 2019 and expected future costs, principally due to wage increases expected to result from recently announced legislation.

Developments, events, changes in operating performance and other changes in circumstances since the dates of the Company’s last annual goodwill impairment assessments have not caused management to believe it is more likely than not that the fair values of any of the Company's reporting units would be less than their respective carrying amounts as of March 31, 2020. Except as described in Note 10 to the 10-K, none of the Company's various other reporting units were considered at risk of significant goodwill impairment as of March 31, 2020.

As dialysis treatments are an essential, life-sustaining service for patients who depend on them, the Company's operations have continued and are currently expected to continue during the novel coronavirus (COVID-19) pandemic. However, the ultimate impact of the dynamic and rapidly evolving COVID-19 pandemic on the Company will depend on future developments that are highly uncertain and difficult to predict, including among other things the severity and duration of the pandemic, the impact on our patient population, the pandemic’s impact on the U.S. and global economies and unemployment, and the timing, scope and effectiveness of governmental responses. While the Company does not currently expect a material adverse impact to its business as a result of this public health crisis, there can be no assurance that the COVID-19 pandemic will not have a material adverse impact on one or more of the Company's businesses.

Income taxes	3 Months Ended
Income taxes	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Income taxes	Income taxes As of March 31, 2020, the Company’s total liability for unrecognized tax benefits relating to tax positions that do not meet the more-likely-than-not threshold was $68,602, of which $64,356 would impact the Company's effective tax rate if recognized. The total balance increased $388 from the December 31, 2019 balance of $68,214. The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense. At March 31, 2020 and December 31, 2019, the Company had approximately $15,249 and $14,428, respectively, accrued for interest and penalties related to unrecognized tax benefits, net of federal tax benefits.

Long-term debt

3 Months Ended

Mar. 31, 2020

Debt Disclosure [Abstract]

Long-term debt

Long-term debt was comprised of the following:



								As of March 31, 2020
	March 31, 2020			December 31, 2019			Maturity date	Interest rate		Estimated fair value⁽¹⁾
Senior Secured Credit Facilities:
Term Loan A	$	1,728,125		$	1,739,063		8/12/2024	LIBOR + 1.50%		$	1,659,000
Term Loan B-1⁽²⁾	2,736,267			—			8/12/2026	LIBOR + 1.75%		$	2,640,498
Term Loan B⁽²⁾	—			2,743,125			8/12/2026	LIBOR + 2.25%		$	—
Revolving line of credit	500,000			—			8/12/2024	LIBOR + 1.50%		$	500,000
Senior Notes:
5 1/8% Senior Notes	1,750,000			1,750,000			7/15/2024	5.125	%	$	1,743,525
5% Senior Notes	1,500,000			1,500,000			5/1/2025	5.00	%	$	1,497,900
Acquisition obligations and other notes payable⁽³⁾	167,727			180,352			2020-2027	4.71	%	$	167,727
Financing lease obligations⁽⁴⁾	275,092			268,534			2020-2036	5.31	%
Total debt principal outstanding	8,657,211			8,181,074
Discount and deferred financing costs⁽⁵⁾	(68,757		)	(72,840		)
	8,588,454			8,108,234
Less current portion	(146,318		)	(130,708		)
	$	8,442,136		$	7,977,526


(1)	Fair value estimates are based upon bid and ask quotes for the Company's senior secured credit facilities and senior notes, typically a level 2 input. The carrying values of acquisition obligations and other notes payable presented here approximate their estimated fair values, based on estimates of their current present values using level 2 interest rate inputs.


(2)	On February 13, 2020, the Company entered into an amendment to its credit agreement governing its senior secured credit facilities to refinance the Term Loan B with a $2,743,125 secured Term Loan B-1.


(3)	The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current interest rate in effect and assuming no changes to the LIBOR based interest rates.


(4)	Financing lease obligations are measured at their approximate present value at inception. The interest rate presented is the weighted average discount rate embedded in financing leases outstanding.

(5)

As of March 31, 2020, the carrying amount of the Company’s senior secured credit facilities and senior notes include a discount of $6,207 and deferred financing costs of $42,420; and deferred financing costs of $20,130, respectively. As of December 31, 2019, the carrying amount of the Company’s senior secured credit facilities and senior notes include a discount of $6,457 and deferred financing costs of $45,444; and deferred financing costs of $20,939, respectively.

Scheduled maturities of long-term debt at March 31, 2020 were as follows:



2020 (remainder of the year)	$	95,359
2021	$	170,056
2022	$	172,376
2023	$	224,727
2024	$	3,671,586
2025	$	61,951
Thereafter	$	4,261,156

On February 13, 2020, the Company entered into an amendment to refinance its senior secured Term Loan B (Repricing Amendment) with a secured Term Loan B-1 that bears interest at a rate equal to LIBOR plus an applicable margin of 1.75% and matures on August 12, 2026. The Repricing Amendment did not change the interest rate on the Term Loan A or the revolving line of credit. No additional debt was incurred, nor any additional proceeds received, by the Company in connection with the Repricing Amendment. As a result of this transaction, the Company recognized debt refinancing charges of $2,948 in the three months ended March 31, 2020. The majority of the Company's Term Loan B debt was considered a modification, therefore

these charges primarily represent fees incurred on this transaction, as well as the write off and capitalization of deferred financing costs associated with the portion of debt considered extinguished. For the portion of the Term Loan B debt that was considered extinguished and reborrowed in this refinancing, the Company recognized $68,842 in constructive financing cash outflows and financing cash inflows on the statement of cash flows, even though no funds were actually paid or received. Another $55,895 of the debt considered extinguished in this refinancing represented a non-cash financing activity.

During the first three months of 2020, the Company made regularly scheduled mandatory principal payments under its senior secured credit facilities totaling $10,938 on Term Loan A and $6,858 on Term Loan B-1.

As of March 31, 2020, the Company maintains several interest rate cap agreements that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt, including all of the Term Loan B-1 and a portion of the Term Loan A. The remaining $1,464,392 outstanding principal balance of the Term Loan A and the revolving line of credit are subject to LIBOR-based interest rate volatility. The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the terms of the cap agreements. These cap agreements do not contain credit-risk contingent features.

In August 2019, the Company entered into several forward interest rate cap agreements with a notional amount of $3,500,000 that have the economic effect of capping the Company's maximum exposure to LIBOR variable interest rate changes on specific portions of the Company's floating rate debt (2019 cap agreements). These 2019 cap agreements are designated as cash flow hedges and, as a result, changes in their fair values are reported in other comprehensive income. These 2019 cap agreements do not contain credit-risk contingent features, and become effective on June 30, 2020.

The following table summarizes the Company’s interest rate cap agreements outstanding as of March 31, 2020 and December 31, 2019, which are classified in "Other long-term assets" on its consolidated balance sheet:



						Three months ended March 31, 2020				Fair value
	Notional amount		LIBOR maximum rate	Effective date	Expiration date	Debt expense		Recorded OCI loss		March 31, 2020		December 31, 2019
2015 cap agreements	$	3,500,000	3.50%	6/29/2018	6/30/2020	$	2,163	$	—	$	—	$	—
2019 cap agreements	$	3,500,000	2.00%	6/30/2020	6/30/2024			$	17,346	$	7,106	$	24,452

The following table summarizes the effects of the Company’s interest rate cap agreements for the three months ended March 31, 2020 and 2019:



	Amount of unrecognized losses in OCI on interest rate cap agreements						Income statement location	Reclassification from accumulated other comprehensive loss into net income
	Three months ended March 31,							Three months ended March 31,
Derivatives designated as cash flow hedges	2020			2019				2020			2019
Interest rate cap agreements	$	(17,346	)	$	(781	)	Debt expense	$	2,163		$	2,163
Related income tax	4,328			201			Related income tax	(540		)	(557		)
Total	$	(13,018	)	$	(580	)		$	1,623		$	1,606

See Note 14 to these condensed consolidated financial statements for further details on amounts recorded and reclassified from accumulated other comprehensive loss.

The Company’s weighted average effective interest rate on the senior secured credit facilities at the end of the first quarter of 2020 was 2.78%, based on the current margins in effect for the Term Loan A, Term Loan B-1 and revolving line of credit as of March 31, 2020, as described above.

The Company’s overall weighted average effective interest rate for the three months ended March 31, 2020 was 4.35%, and as of March 31, 2020 was 3.75%.

As of March 31, 2020, the Company’s interest rates are fixed on approximately 41.83% of its total debt.

As of March 31, 2020, the Company had $500,000 drawn on its $1,000,000 revolving line of credit under its senior secured credit facilities. The Company also has approximately $57,705 of outstanding letters of credit under a separate bilateral secured letter of credit facility.

Leases Leases

3 Months Ended

Mar. 31, 2020

Leases [Abstract]

Leases of Lessee Disclosure [Text Block]

Leases

The majority of the Company’s facilities are leased under non-cancellable operating leases ranging in terms from five years to fifteen years and which contain renewal options of five years to ten years at the fair rental value at the time of renewal.

As of March 31, 2020 and December 31, 2019, assets recorded under finance leases were $257,750 and $247,246, respectively, and accumulated amortization associated with finance leases was $33,318 and $27,193, respectively, included in property and equipment, net, on the Company's consolidated balance sheet.

The components of lease expense were as follows:



Lease cost	Three months ended March 31, 2020		Three months ended March 31, 2019
Operating lease cost⁽¹⁾:
Fixed lease expense	$	134,733	$	128,110
Variable lease expense	30,059		28,571
Financing lease cost:
Amortization of leased assets	6,077		5,826
Interest on lease liabilities	3,603		3,775
Net lease cost	$	174,472	$	166,282


(1)	Includes short-term lease expense and sublease income, which are immaterial.

Other information related to leases was as follows:



Other information	Three months ended March 31, 2020		Three months ended March 31, 2019
Gains on sale leasebacks, net	$	9,489	$	3,987
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	162,828	$	153,587
Operating cash flows from finance leases	$	5,178	$	5,661
Financing cash flows from finance leases	$	4,180	$	5,344
Net operating lease assets obtained in exchange for new or modified operating lease liabilities	$	101,473	$	45,034



Lease term and discount rate	March 31, 2020
Weighted average remaining lease term (years):
Operating leases	8.9
Finance leases	10.2
Weighted average discount rate:
Operating leases	4.0	%
Finance leases	5.3	%

Future minimum lease payments under non-cancellable leases as of March 31, 2020 were as follows:



	Operating leases			Finance leases
2020 (remainder of the year)	$	344,537		$	30,291
2021	505,417			34,177
2022	472,643			34,621
2023	426,485			34,700
2024	372,190			34,725
2025	320,079			34,549
Thereafter	1,248,317			153,800
Total future minimum lease payments	$	3,689,668		$	356,863
Less portion representing interest	(599,265		)	(81,771		)
Present value of lease liabilities	$	3,090,403		$	275,092

Contingencies	3 Months Ended
Contingencies	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Contingencies	Contingencies The majority of the Company’s revenues are from government programs and may be subject to adjustment as a result of: (i) examination by government agencies or contractors, for which the resolution of any matters raised may take extended periods of time to finalize; (ii) differing interpretations of government regulations by different Medicare contractors or regulatory authorities; (iii) differing opinions regarding a patient’s medical diagnosis or the medical necessity of services provided; and (iv) retroactive applications or interpretations of governmental requirements. In addition, the Company’s revenues from commercial payors may be subject to adjustment as a result of potential claims for refunds, as a result of government actions or as a result of other claims by commercial payors. The Company operates in a highly regulated industry and is a party to various lawsuits, demands, claims, qui tam suits, governmental investigations and audits (including, without limitation, investigations or other actions resulting from its obligation to self-report suspected violations of law) and other legal proceedings. The Company records accruals for certain legal proceedings and regulatory matters to the extent that the Company determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. As of March 31, 2020 and December 31, 2019, the Company’s total recorded accruals with respect to legal proceedings and regulatory matters, net of anticipated third party recoveries, were immaterial. While these accruals reflect the Company’s best estimate of the probable loss for those matters as of the dates of those accruals, the recorded amounts may differ materially from the actual amount of the losses for those matters, and any anticipated third party recoveries for any such losses may not ultimately be recoverable. Additionally, in some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal proceedings and regulatory matters, which also may be impacted by various factors, including, without limitation, that they may involve indeterminate claims for monetary damages or may involve fines, penalties or non-monetary remedies; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; are in the early stages of the proceedings; or may result in a change of business practices. Further, there may be various levels of judicial review available to the Company in connection with any such proceeding. The following is a description of certain lawsuits, claims, governmental investigations and audits and other legal proceedings to which the Company is subject. Governmental Inquiries and Certain Related Proceedings 2016 U.S. Attorney Texas Investigation: In February 2016, DaVita Rx, LLC (DaVita Rx), a wholly-owned subsidiary of the Company, received a Civil Investigative Demand (CID) from the U.S. Attorney’s Office, Northern District of Texas. The government is conducting a federal False Claims Act (FCA) investigation concerning allegations that DaVita Rx presented or caused to be presented false claims for payment to the government for prescription medications, as well as an investigation into the Company’s relationships with pharmaceutical manufacturers. The CID covers the period from January 1, 2006 through the present. In connection with the Company’s ongoing efforts working with the government, the Company learned that a qui tam complaint had been filed covering some of the issues in the CID and practices that had been identified by the Company in a self-disclosure filed with the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) in February 2016. In December 2017, the Company finalized and executed a settlement agreement with the government and relators in the qui tam matter that included total monetary consideration of $63,700, as previously disclosed, of which $41,500 was an incremental cash payment and $22,200 was for amounts previously refunded, and all of which was previously accrued. The government’s investigation into certain of the Company's relationships with pharmaceutical manufacturers is ongoing, and in July 2018 the OIG served the Company with a subpoena seeking additional documents and information relating to those relationships. The Company is continuing to cooperate with the government in this investigation. 2017 U.S. Attorney Massachusetts Investigation: In January 2017, the Company was served with an administrative subpoena for records by the U.S. Attorney’s Office, District of Massachusetts, relating to an investigation into possible federal health care offenses. The subpoena covered the period from January 1, 2007 to the present, and sought documents relevant to charitable patient assistance organizations, particularly the American Kidney Fund (AKF), including documents related to efforts to provide patients with information concerning the availability of charitable assistance. The Department of Justice notified the court on July 23, 2019 of its decision to elect not to intervene in the matter of U.S. ex rel. David Gonzalez v. DaVita Healthcare Partners, et al. The complaint then was unsealed in the U.S. District Court, District of Massachusetts by order entered on August 1, 2019. The Department of Justice has confirmed that the complaint, which alleges violations of the FCA and various state false claims acts, was the basis of its investigation initiated in January 2017. The Company has not been served with the complaint. 2017 U.S. Attorney Colorado Investigation: In November 2017, the U.S. Attorney’s Office, District of Colorado informed the Company of an investigation it was conducting into possible federal healthcare offenses involving DaVita Kidney Care, as well as several of the Company’s wholly-owned subsidiaries. In addition to DaVita Kidney Care, the matter currently includes an investigation into DaVita Rx, DaVita Laboratory Services, Inc. (DaVita Labs), and RMS Lifeline Inc. (Lifeline). In each of August 2018 and May 2019, the Company received a CID pursuant to the FCA from the U.S. Attorney's Office relating to this investigation. The Company is continuing to cooperate with the government in this investigation. 2018 U.S. Attorney Florida Investigation: In March 2018, DaVita Labs received two CIDs from the U.S. Attorney’s Office, Middle District of Florida that were identical in nature but directed to the two different labs. According to the face of the CIDs, the U.S. Attorney’s Office is conducting an investigation as to whether the Company’s subsidiary submitted claims for blood, urine, and fecal testing, where there were insufficient test validation or stability studies to ensure accurate results, in violation of the FCA. In October 2018, DaVita Labs received a subpoena from the OIG in connection with this matter requesting certain patient records linked to clinical laboratory tests. On September 30, 2019, the U.S. Attorney’s Office notified the U.S. District Court, Middle District of Florida, of its decision not to elect to intervene at this time in the matter of U.S. ex rel. Lorne Holland, et al. v. DaVita Healthcare Partners, Inc., et al. The court then unsealed the complaint, which alleges violations of the FCA, by order dated the same day. In January 2020, the private party relators served the Company and DaVita Labs with an amended complaint. On February 24, 2020, the Company and DaVita Labs filed a motion to dismiss the amended complaint. The Company and DaVita Labs dispute these allegations and intend to defend this action accordingly. 2020 U.S. Attorney New Jersey Investigation: In March 2020, the U.S. Attorney’s Office, District of New Jersey served the Company with a subpoena and a CID relating to an investigation being conducted by that office and the U.S. Attorney’s Office, Eastern District of Pennsylvania. The subpoena and CID request information on several topics, including certain of the Company’s joint venture arrangements with physicians and physician groups, medical director agreements, and compliance with the Corporate Integrity Agreement. The Company is cooperating with the government in this investigation. 2020 California Department of Insurance Investigation: In April 2020, the California Department of Insurance sent the Company a Investigative Subpoena relating to an investigation being conducted by that office. The subpoena requests information on a number of topics, including but not limited to the Company’s communications with patients about insurance plans and financial assistance from the American Kidney Fund (AKF), analyses of the potential impact of patients’ decisions to change insurance providers, and documents relating to donations or contributions to the AKF. The Company is cooperating with the California Department of Insurance in this investigation. * * * Although the Company cannot predict whether or when proceedings might be initiated or when these matters may be resolved (other than as may be described above), it is not unusual for inquiries such as these to continue for a considerable period of time through the various phases of document and witness requests and on-going discussions with regulators and to develop over the course of time. In addition to the inquiries and proceedings specifically identified above, the Company frequently is subject to other inquiries by state or federal government agencies and/or private civil qui tam complaints filed by relators. Negative findings or terms and conditions that the Company might agree to accept as part of a negotiated resolution of pending or future government inquiries or relator proceedings could result in, among other things, substantial financial penalties or awards against the Company, substantial payments made by the Company, harm to the Company’s reputation, required changes to the Company’s business practices, exclusion from future participation in the Medicare, Medicaid and other federal health care programs and, if criminal proceedings were initiated against the Company, members of its board of directors or management, possible criminal penalties, any of which could have a material adverse effect on the Company. Shareholder and Derivative Claims Peace Officers’ Annuity and Benefit Fund of Georgia Securities Class Action Civil Suit: On February 1, 2017, the Peace Officers’ Annuity and Benefit Fund of Georgia filed a putative federal securities class action complaint in the U.S. District Court for the District of Colorado against the Company and certain executives. The complaint covers the time period of August 2015 to October 2016 and alleges, generally, that the Company and its executives violated federal securities laws concerning the Company’s financial results and revenue derived from patients who received charitable premium assistance from an industry-funded non-profit organization. The complaint further alleges that the process by which patients obtained commercial insurance and received charitable premium assistance was improper and "created a false impression of DaVita’s business and operational status and future growth prospects." In November 2017, the court appointed the lead plaintiff and an amended complaint was filed on January 12, 2018. On March 27, 2018, the Company and various individual defendants filed a motion to dismiss. On March 28, 2019, the U.S. District Court for the District of Colorado denied the motion to dismiss. The Company answered the complaint on May 28, 2019. On January 31, 2020, the plaintiffs filed a motion for class certification that the Company intends to oppose. The Company disputes these allegations and intends to defend this action accordingly. In re DaVita Inc. Stockholder Derivative Litigation: On August 15, 2017, the U.S. District Court for the District of Delaware consolidated three previously disclosed shareholder derivative lawsuits: the Blackburn Shareholder action filed on February 10, 2017, the Gabilondo Shareholder action filed on May 30, 2017, and the City of Warren Police and Fire Retirement System Shareholder action filed on June 9, 2017. The complaint covers the time period from 2015 to present and alleges, generally, breach of fiduciary duty, unjust enrichment, abuse of control, gross mismanagement, corporate waste, and misrepresentations and/or failures to disclose certain information in violation of the federal securities laws in connection with an alleged practice to direct patients with government-subsidized health insurance into private health insurance plans to maximize the Company’s profits. An amended complaint was filed in September 2017, and on December 18, 2017, the Company filed a motion to dismiss and a motion to stay proceedings in the alternative. On April 25, 2019, the court denied the Company's motion to dismiss. The Company answered the complaint on May 28, 2019. The Company disputes these allegations and intends to defend this action accordingly. Other Proceedings In addition to the foregoing, from time to time the Company is subject to other lawsuits, demands, claims, governmental investigations and audits and legal proceedings that arise due to the nature of its business, including, without limitation, contractual disputes, such as with payors, suppliers and others, employee-related matters and professional and general liability claims. From time to time, the Company also initiates litigation or other legal proceedings as a plaintiff arising out of contracts or other matters. * * * Other than as may be described above, the Company cannot predict the ultimate outcomes of the various legal proceedings and regulatory matters to which the Company is or may be subject from time to time, including those described in this Note 10 to these condensed consolidated financial statements, or the timing of their resolution or the ultimate losses or impact of developments in those matters, which could have a material adverse effect on the Company’s revenues, earnings and cash flows. Further, any legal proceedings or regulatory matters involving the Company, whether meritorious or not, are time consuming, and often require management’s attention and result in significant legal expense, and may result in the diversion of significant operational resources, or otherwise harm the Company’s business, results of operations, financial condition, cash flows or reputation.

Other commitments	3 Months Ended
Other commitments	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Noncontrolling interests subject to put provisions and other commitments	Other commitments The Company has certain other potential commitments to provide operating capital to a number of dialysis centers that are wholly-owned by third parties or businesses in which the Company maintains a noncontrolling equity interest as well as to physician-owned vascular access clinics or medical practices that the Company operates under management and administrative services agreements of approximately $9,460.

Long-term incentive compensation	3 Months Ended
Long-term incentive compensation	Mar. 31, 2020
Share-based Payment Arrangement [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 is primarily general and administrative in nature, is attributed to the Company’s U.S. dialysis business, corporate administrative support, and ancillary services. The Company’s stock-based compensation expense for stock-settled awards is measured at the estimated fair value of awards on the date of grant and recognized on a cumulative straight-line basis over the vesting terms of the awards unless the stock awards are based on non-market based performance metrics, in which case expense is adjusted for the expected ultimate shares to be issued as of the end of each reporting period. Stock-based compensation expense for cash-settled awards is based on their estimated fair values as of the end of each reporting period. The expense for all stock-based awards is recognized net of expected forfeitures. During the three months ended March 31, 2020, the Company granted 950 restricted and performance stock units with an aggregate grant-date fair value of $72,648 and a weighted-average expected life of approximately 3.5 years and 2,765 stock-settled stock appreciation rights with an aggregate grant-date fair value of $73,833 and a weighted-average expected life of approximately 4.8 years. For the three months ended March 31, 2020 and 2019, the Company recognized $25,594 and $13,107, respectively, in total LTIP expense, of which $19,870 and $10,301, respectively, represented stock-based compensation expense for stock appreciation rights, restricted stock units, performance 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, 2020 and 2019 was $2,584 and $1,495, respectively. As of March 31, 2020, the Company had $247,420 in total estimated but unrecognized stock-based compensation expense under the Company’s equity compensation and employee stock purchase plans. The Company expects to recognize this expense over a weighted average remaining period of 1.7 years. The Company no longer has outstanding long-term performance-based cash awards in its principal U.S. dialysis business as the performance and accrual period for these awards ended December 31, 2019 with a final payout of $66,302 in 2020. For the three months ended March 31, 2020 and 2019, the Company recognized $199 and $151, respectively, in actual tax benefits upon the settlement of stock awards. On November 4, 2019, the independent members of the Company’s Board of Directors (Board) approved an award of 2,500 premium-priced stock-settled stock appreciation rights (Premium-Priced Award) to the Company’s Chief Executive Officer (CEO), which award was subject to stockholder approval of a related amendment to the Company's 2011 Incentive Award Plan (2011 Plan). The Company's stockholders approved such amendment to the 2011 Plan on January 23, 2020, authorizing the grant to the Company's CEO. Since stockholder approval occurred in 2020, subsequent to the Board approval, this award had both a service inception and grant date of January 23, 2020 for accounting purposes. The base price of the Premium-Priced Award is $67.80 per share, which is a 20% premium to the clearing price of the Company's 2019 modified Dutch auction tender offer. The award vests 50% on each of November 4, 2022 and November 4, 2023, and expires on November 4, 2024. The award includes a requirement that the CEO hold any shares acquired upon exercise of this award, net of shares used to cover related taxes, until November 4, 2024 (that is, for the full term of the award), subject to lapse of the holding period upon a change in control of the Company or due to the CEO's death or termination due to disability.

Share repurchases

3 Months Ended

Mar. 31, 2020

Equity [Abstract]

Share repurchases

The following table summarizes the Company's repurchases of its common stock during the three months ended March 31, 2020 and 2019:



	Three months ended March 31, 2020					Three months ended March 31, 2019
	Shares repurchased	Amount paid		Average paid per share		Shares repurchased	Amount paid		Average paid per share
Open market repurchases	4,052	$	303,139	$	74.81	—	$	—	$	—

The Company did not repurchase any shares subsequent to March 31, 2020 through May 4, 2020.

Effective as of the close of business on November 4, 2019, the Board terminated all remaining prior share repurchase authorizations available to the Company and approved a new share repurchase authorization of $2,000,000. As of May 4, 2020, the Company had a total of $1,400,356 available under the current repurchase authorization for additional share repurchases. Although this share repurchase authorization does not have an expiration date, the Company remains subject to share repurchase limitations, including under the terms of its current senior secured credit facilities and the indentures governing its senior notes.

Accumulated other comprehensive (loss) income

3 Months Ended

Mar. 31, 2020

Statement of Comprehensive Income [Abstract]

Comprehensive income

Accumulated other comprehensive loss



	For the three months ended March 31, 2020									For the three months ended March 31, 2019
	Interest rate cap agreements			Foreign currency translation adjustments			Accumulated other comprehensive loss			Interest rate cap agreements			Foreign currency translation adjustments			Accumulated other comprehensive loss
Beginning balance	$	(1,433	)	$	(46,065	)	$	(47,498	)	$	(8,961	)	$	(25,963	)	$	(34,924	)
Unrealized losses	(17,346		)	(81,632		)	(98,978		)	(781		)	(13,653		)	(14,434		)
Related income tax	4,328			—			4,328			201			—			201
	(13,018		)	(81,632		)	(94,650		)	(580		)	(13,653		)	(14,233		)
Reclassification into net income	2,163			—			2,163			2,163			—			2,163
Related income tax	(540		)	—			(540		)	(557		)	—			(557		)
	1,623			—			1,623			1,606			—			1,606
Ending balance	$	(12,828	)	$	(127,697	)	$	(140,525	)	$	(7,935	)	$	(39,616	)	$	(47,551	)

The reclassification of net cap realized losses into income are recorded as debt expense in the corresponding consolidated statements of income. See Note 8 to these condensed consolidated financial statements for further details.

Acquisitions and divestitures

3 Months Ended

Mar. 31, 2020

Business Combinations [Abstract]

Acquisitions and divestitures

During the three months ended March 31, 2020, the Company acquired dialysis businesses consisting of two dialysis centers located in the U.S. and 22 dialysis centers located outside the U.S. for a total of $34,107 in net cash, $875 in deferred purchase price obligations, and $5,007 in earn-out obligations and assumed liabilities. The assets and liabilities for these acquisitions were recorded at their estimated fair values at the dates of the acquisitions and are included in the Company’s condensed consolidated financial statements, as are their operating results, from the designated effective dates of the acquisitions.

The initial purchase price allocations for these transactions have been recorded at estimated fair values based on the best information available to management and will be finalized when certain information arranged to be obtained has been received. In particular, certain income tax amounts are pending final evaluation and quantification of pre-acquisition tax contingencies and filing of final tax returns. In addition, valuation of certain working capital items, fixed assets and intangibles are pending final audits and related valuation reports.

The following table summarizes the assets acquired and liabilities assumed in these transactions at their estimated acquisition date fair values:



Current assets	$	7,412
Property and equipment	8,892
Intangible and other long-term assets	6,107
Goodwill	26,770
Deferred income taxes	1,513
Current liabilities	(10,705		)
	$	39,989

Amortizable intangible assets acquired during the three months ended March 31, 2020 primarily represent non-compete agreements which had weighted-average estimated useful lives of approximately four years. The total estimated amount of goodwill deductible for tax purposes associated with these acquisitions was approximately $11,241.

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 $31,723 if certain performance targets or quality margins are met primarily over the next one year to five years. As of March 31, 2020, the estimated fair values of these contingent earn-out obligations is $22,386, of which $4,579 is included in other current liabilities and the remaining $17,807 is included in other long-term liabilities in the Company’s consolidated balance sheet.

The following is a reconciliation of changes in contingent earn-out obligations for the three months ended March 31, 2020:



Balance at December 31, 2019	$	24,586
Contingent earn-out obligations associated with acquisitions	2,672
Foreign currency translation adjustment for contingent earn-out obligations	(4,874		)
Remeasurement of fair value for contingent earn-out obligations	2
Balance at March 31, 2020	$	22,386

Held for Sale and Discontinued Operations Held for Sale and Discontinued Operations

3 Months Ended

Mar. 31, 2020

Held for Sale and Discontinued Operations [Abstract]

Disposal Groups, Including Discontinued Operations, Disclosure [Text Block]

Discontinued operations previously held for sale

DaVita Medical Group

On June 19, 2019, the Company completed the sale of its DaVita Medical Group (DMG) business to Optum, a subsidiary of UnitedHealth Group Inc., for an aggregate purchase price of $4,340,000, prior to certain closing and post-closing adjustments specified in the related equity purchase agreement dated as of December 5, 2017, as amended as of September 20, 2018 and as of December 11, 2018 (as amended, the equity purchase agreement).

The Company recorded a preliminary estimated pre-tax net loss of approximately $23,022 on the sale of its DMG business in 2019. This preliminary net loss was based on initial estimates of the Company's expected aggregate proceeds from the sale, net of transaction costs and obligations, as well as the estimated values of DMG net assets sold as of the closing date. These estimated net proceeds included $4,465,476 in cash received from Optum at closing, or $3,824,509 net of cash and restricted cash included in the DMG net assets sold. During the three months ended March 31, 2020, the Company recognized $9,980 in additional tax benefits under the Coronavirus Aid, Relief, and Economic Security (CARES) Act related to its period of DMG ownership, which have been recognized as an adjustment to the Company's loss on sale of the DMG business.

The ultimate net proceeds from the DMG sale, as well as the value of its previously held for sale net assets sold, remain subject to estimate revisions and post-closing adjustments pursuant to the equity purchase agreement, which could be material. The Company continues to work with Optum concerning what, if any, net working capital adjustment or other potential adjustments to the purchase price are appropriate, via the process set forth in the equity purchase agreement. Under the equity purchase agreement, the Company also has certain indemnification obligations that could require payments to the buyer relating

to the Company's previous ownership and operation of the DMG business. Potential payments under these provisions, if any, remain subject to significant uncertainties and could have a material adverse effect on the net proceeds ultimately retained by the Company or the total amount of its loss on the sale of this business.

The following table presents the financial results of discontinued operations related to DMG:



	Three months ended March 31,
	2020		2019
Revenues	$	—	$	1,382,281
Expenses	—		1,338,153
Income from discontinued operations before taxes	—		44,128
Income tax expense	—		13,823
Gain (loss) on sale of discontinued operations, net of tax	9,980		—
Net income from discontinued operations, net of tax	$	9,980	$	30,305

The following table presents cash flows of discontinued operations related to DMG:



	Three months ended March 31,
	2020		2019
Net cash provided by operating activities from discontinued operations	$	—	$	68,240
Net cash used in investing activities from discontinued operations	$	—	$	(22,809	)

Variable interest entities	3 Months Ended
Variable interest entities	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Variable interest entities	Variable interest entities (VIEs) At March 31, 2020, these condensed consolidated financial statements include total assets of VIEs of $320,505 and total liabilities and noncontrolling interests of VIEs to third parties of $234,915. There have been no material changes in the nature of the Company's arrangements with VIEs or its judgments concerning them from those described in Note 23 to the Company's consolidated financial statements included in the 10-K.

Fair value of financial instruments

3 Months Ended

Mar. 31, 2020

Fair Value Disclosures [Abstract]

Fair value of financial instruments

Fair values of financial instruments

The Company measures the fair value of certain assets, liabilities and noncontrolling interests subject to put provisions (redeemable equity interests classified as temporary equity) based upon certain valuation techniques that include observable or unobservable inputs and assumptions that market participants would use in pricing these assets, liabilities, temporary equity and commitments. The Company has also classified certain assets, liabilities and temporary equity that are measured at fair value into the appropriate fair value hierarchy levels as defined by the Financial Accounting Standards Board (FASB).

The following table summarizes the Company’s assets, liabilities and temporary equity that are measured at fair value on a recurring basis as of March 31, 2020:



	Total		Quoted prices in active markets for identical assets (Level 1)		Significant other observable inputs (Level 2)		Significant unobservable inputs (Level 3)
Assets
Investments in equity securities	$	35,843	$	35,843	$	—	$	—
Interest rate cap agreements	$	7,106	$	—	$	7,106	$	—
Liabilities
Contingent earn-out obligations	$	22,386	$	—	$	—	$	22,386
Temporary equity
Noncontrolling interests subject to put provisions	$	1,228,036	$	—	$	—	$	1,228,036

For reconciliations of changes in contingent earn-out obligations and noncontrolling interests subject to put provisions during the three months ended March 31, 2020, see Note 15 and the consolidated statement of equity, respectively.

Investments in equity securities represent investments in various open-ended registered investment companies (mutual funds) and common stock and are recorded at fair value estimated based on reported market prices or redemption prices, as applicable. See Note 4 to these condensed consolidated financial statements for further discussion.

Interest rate cap agreements are recorded at fair value estimated from valuation models utilizing the income approach and commonly accepted valuation techniques that use inputs from closing prices for similar assets and liabilities in active markets as well as other relevant observable market inputs at quoted intervals such as current interest rates, forward yield curves, implied volatility and credit default swap pricing. The Company does not believe the ultimate amount that could be realized upon settlement of these interest rate cap agreements would be materially different from the fair value estimates currently reported. See Note 8 to these condensed consolidated financial statements for further discussion.

The estimated fair value measurements of contingent earn-out obligations are primarily based on unobservable inputs, including projected earnings before interest, taxes, depreciation, and amortization (EBITDA) and revenue. The estimated fair value of these contingent earn-out obligations is remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company's credit risk adjusted rate that is used to discount obligations to present value. See Note 15 to these condensed consolidated financial statements for further discussion.

The estimated fair value of noncontrolling interests subject to put provisions is based principally on the higher of either estimated liquidation value of net assets or a multiple of earnings for each subject dialysis partnership, based on historical earnings, revenue mix, and other performance indicators that can affect future results. The multiples used for these valuations are derived from observed ownership transactions for dialysis businesses between unrelated parties in the U.S. in recent years, and the specific valuation multiple applied to each dialysis partnership is principally determined by its recent and expected revenue mix and contribution margin. As of March 31, 2020, an increase or decrease in the weighted average multiple used in these valuations of one times EBITDA would change the estimated fair value of these noncontrolling interests by approximately $150,000. See Note 17 to the Company's consolidated financial statements included in the 10-K for further discussion of the Company’s methodology for estimating the fair value of noncontrolling interests subject to put obligations.

The Company's fair value estimates for its senior secured credit facilities and senior notes are based upon bid and ask quotes for these instruments, typically a level 2 input. See Note 8 to these condensed consolidated financial statements for further discussion of the Company's debt.

Other financial instruments consist primarily of cash and cash equivalents, restricted cash and cash equivalents, accounts receivable, accounts payable, other accrued liabilities, lease liabilities and debt. The balances of financial instruments other than debt and lease liabilities are presented in these condensed consolidated financial statements at March 31, 2020 at their approximate fair values due to the short-term nature of their settlements.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Segment reporting

3 Months Ended

Mar. 31, 2020

Segment Reporting [Abstract]

Segment Reporting Disclosure

Segment reporting

The Company’s operations are comprised of its U.S. dialysis and related lab services business, its various ancillary services and strategic initiatives, including its international operations, and its corporate administrative support.

On June 19, 2019, the Company completed the sale of its DMG division to Optum, a subsidiary of UnitedHealth Group Inc. As a result of this transaction, DMG's results of operations have been reported as discontinued operations for all periods presented.

The Company’s separate operating segments include its U.S. dialysis and related lab services business, each of its ancillary services and strategic initiatives, its kidney care operations in each foreign sovereign jurisdiction, its other health operations in each foreign sovereign jurisdiction, and its equity method investment in the APAC JV. The U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other ancillary services and strategic initiatives operating segments, including the international operating segments, have been combined and disclosed in the other segments category. See Note 25 to the Company's consolidated financial statements included in the 10-K for further description of how the Company determines and measures results for its operating segments.

The following is a summary of segment net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:



	Three months ended March 31,
	2020			2019
Segment revenues:
U.S. dialysis
Dialysis patient service revenues:
External sources	$	2,579,240		$	2,511,826
Intersegment revenues	31,941			30,420
U.S. dialysis patient service revenues	2,611,181			2,542,246
Other revenues⁽¹⁾:
External sources	5,141			4,684
Intersegment revenues	301			221
Total U.S. dialysis revenues	2,616,623			2,547,151
Other—Ancillary services
Dialysis patient service revenues, net	134,041			117,863
Other external sources	122,815			108,739
Intersegment revenues	4,152			3,336
Total ancillary services revenues	261,008			229,938
Total net segment revenues	2,877,631			2,777,089
Elimination of intersegment revenues	(36,394		)	(33,977		)
Consolidated revenues	$	2,841,237		$	2,743,112
Segment operating margin (loss):
U.S. dialysis	$	491,607		$	416,981
Other—Ancillary services	(2,646		)	(57,630		)
Total segment operating margin	488,961			359,351
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:
Corporate administrative support	(23,585		)	(18,844		)
Consolidated operating income	465,376			340,507
Debt expense	(88,603		)	(131,519		)
Debt refinancing charges	(2,948		)	—
Other income, net	(4,350		)	6,940
Consolidated income from continuing operations before income taxes	$	369,475		$	215,928


(1)	Includes management fee revenue from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling equity investment or which are wholly-owned by third parties.

A summary of assets by reportable segment was as follows:



	March 31, 2020		December 31, 2019
U.S. dialysis (including equity investments of $130,144 and $124,188, respectively)	$	16,075,622	$	15,778,880
Other—Ancillary services (including equity investments of $124,355 and $117,795, respectively)	1,520,678		1,532,514
Consolidated assets	$	17,596,300	$	17,311,394

Depreciation and amortization expense by reportable segment was as follows:



	Three months ended March 31,
	2020		2019
U.S. dialysis	$	146,300	$	140,780
Other—Ancillary services	8,379		7,748
	$	154,679	$	148,528

Expenditures for property and equipment by reportable segment were as follows:



	Three months ended March 31,
	2020		2019
U.S. dialysis	$	148,763	$	170,548
Other—Ancillary services	6,179		8,578
DMG—Discontinued operations	—		19,752
	$	154,942	$	198,878

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries

3 Months Ended

Mar. 31, 2020

Noncontrolling Interest [Abstract]

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries

Changes in DaVita Inc.’s ownership interests in consolidated subsidiaries

The effects of changes in DaVita Inc.’s ownership interests in consolidated subsidiaries on the Company’s consolidated equity were as follows:



	Three months ended March 31,
	2020			2019
Net income attributable to DaVita Inc.	$	239,593		$	149,289
Changes in paid-in capital for:
Purchases of noncontrolling interests	(445		)	(2,206		)
Net transfers to noncontrolling interests	(445		)	(2,206		)
Net income attributable to DaVita Inc., net of transfers to noncontrolling interests	$	239,148		$	147,083

New accounting standards	3 Months Ended
New accounting standards	Mar. 31, 2020
Accounting Changes and Error Corrections [Abstract]
New accounting standards	New accounting standards New standards recently adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The amendments in this ASU amend the impairment model to utilize an expected loss methodology in place of the incurred loss methodology for financial instruments and off-balance sheet credit exposures. The amendment requires entities to consider a broader range of information to estimate expected credit losses, which may result in earlier recognition of losses. The amendments in this ASU became effective for the Company beginning on January 1, 2020 and were applied using a modified retrospective basis. The adoption of ASU No. 2016-13 did not have a material impact on the Company's consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework -Changes to the Disclosure Requirements for Fair Value Measurement. The applicable amendments in this ASU remove requirements for disclosures concerning transfers between fair value measurement levels 1, 2 and 3 and disclosures concerning valuation processes for level 3 fair value measurements. The applicable amendments in this ASU also add a requirement to separately disclose the changes in unrealized gains and losses included in other comprehensive income for the reporting period for level 3 items measured at fair value on a recurring basis, and require disclosure of the range and weighted average of significant unobservable inputs used to develop level 3 fair value measurements. The amendments in this ASU became effective for the Company beginning on January 1, 2020 and were applied on a prospective basis. The adoption of this ASU did not have a material impact on the Company’s consolidated financial statements when adopted January 1, 2020. In August 2018, the FASB issued ASU No. 2018-15, Intangibles-Goodwill and Other-Internal Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract. ASU No. 2018-15 aligns the requirements for capitalizing implementation costs incurred in a cloud computing arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The Company adopted this ASU as of January 1, 2020, using the prospective transition approach, which allows the Company to change the accounting method without restating prior periods or booking cumulative adjustments. The adoption of ASU No. 2018-15 did not have a material impact on the Company's consolidated financial statements. New standards not yet adopted In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. ASU No. 2019-12 attempts to simplify aspects of accounting for franchise taxes and enacted changes in tax laws or rates, and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. ASU No. 2019-12 is effective for public business entities for fiscal years beginning after December 15, 2020, including interim periods within that fiscal year. Early adoption is permitted for all entities. The Company is currently assessing the effect this guidance may have on its consolidated financial statements. In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. ASU No. 2020-04 provides optional expedients and exceptions for applying U.S. generally accepted accounting principles (GAAP) to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another rate that is expected to be discontinued. The amendments in this ASU were effective beginning on March 12, 2020, and the Company may elect to apply the amendments prospectively through December 31, 2022. The Company is currently assessing the effect this guidance may have on its consolidated financial statements.

Condensed consolidating financial statements

3 Months Ended

Mar. 31, 2020

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Condensed consolidating financial statements

The following information is presented in accordance with Rule 3-10 of Regulation S-X. The operating and investing activities of the separate legal entities included in the Company’s condensed consolidated financial statements are fully interdependent and integrated. Revenues and operating expenses of the separate legal entities include intercompany charges for management and other administrative services. The Company’s senior notes are guaranteed by a substantial majority of its domestic subsidiaries as measured by revenue, income and assets. The subsidiary guarantors have guaranteed the senior notes on a joint and several basis. However, a subsidiary guarantor will be released from its obligations under its guarantee of the senior notes and the indentures governing the senior notes if, in general, there is a sale or other disposition of all or substantially all of the assets of such subsidiary guarantor, including by merger or consolidation, or a sale or other disposition of all of the equity interests in such subsidiary guarantor held by the Company and its restricted subsidiaries, as defined in the indentures; such subsidiary guarantor is designated by the Company as an unrestricted subsidiary, as defined in the indentures, or otherwise ceases to be a restricted subsidiary of the Company, in each case in accordance with the indentures; or such subsidiary guarantor no longer guarantees any other indebtedness, as defined in the indentures, of the Company or any of its restricted subsidiaries, except for guarantees that are contemporaneously released. The senior notes are not guaranteed by certain of the Company’s domestic subsidiaries, any of the Company’s foreign subsidiaries, or any entities that do not constitute subsidiaries within the meaning of the indentures, such as corporations in which the Company holds capital stock with less than a majority of the voting power, joint ventures and partnerships in which the Company holds less than a majority of the equity or voting interests, non-owned entities and third parties. Contemporaneously with the Company entering into its $5,500,000 senior secured credit agreement (the New Credit Agreement) on August 12, 2019 and pursuant to the indentures governing the Company’s senior notes, certain subsidiaries of the Company were released from their guarantees of the Company's senior notes such that, after that release, the remaining subsidiary guarantors of the senior notes were the same subsidiaries

guaranteeing the New Credit Agreement. The following condensed consolidating financial statements have been prepared for all periods presented based on the current subsidiary guarantors and non-guarantors stipulated in the New Credit Agreement.

Condensed Consolidating Statements of Operations



For the three months ended March 31, 2020	DaVita Inc.			Guarantor subsidiaries			Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Patient service revenues	$	—		$	1,729,740		$	1,050,877		$	(67,336	)	$	2,713,281
Other revenues	197,283			156,860			41,428			(267,615		)	127,956
Total net revenues	197,283			1,886,600			1,092,305			(334,951		)	2,841,237
Operating expenses	154,651			1,640,821			915,340			(334,951		)	2,375,861
Operating income	42,632			245,779			176,965			—			465,376
Debt expense	(91,362		)	(59,093		)	(11,337		)	70,241			(91,551		)
Other income (loss), net	62,453			805			2,633			(70,241		)	(4,350		)
Income tax expense	3,424			80,975			7,161			—			91,560
Equity earnings in subsidiaries	229,294			98,795			—			(328,089		)	—
Net income from continuing operations	239,593			205,311			161,100			(328,089		)	277,915
Net income from discontinued operations, net of tax	—			—			9,980			—			9,980
Net income	239,593			205,311			171,080			(328,089		)	287,895
Less: Net income attributable to noncontrolling interests	—			—			—			(48,302		)	(48,302		)
Net income attributable to DaVita Inc.	$	239,593		$	205,311		$	171,080		$	(376,391	)	$	239,593



For the three months ended March 31, 2019	DaVita Inc.			Guarantor subsidiaries			Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Patient service revenues	$	—		$	1,706,593		$	986,373		$	(63,277	)	$	2,629,689
Other revenues	188,836			146,117			34,909			(256,439		)	113,423
Total net revenues	188,836			1,852,710			1,021,282			(319,716		)	2,743,112
Operating expenses and charges	143,659			1,634,285			944,377			(319,716		)	2,402,605
Operating income	45,177			218,425			76,905			—			340,507
Debt expense	(133,595		)	(50,650		)	(12,549		)	65,275			(131,519		)
Other income, net	110,198			648			11,060			(114,966		)	6,940
Income tax expense	7,026			44,027			5,693			—			56,746
Equity earnings in subsidiaries	134,535			64,375			—			(198,910		)	—
Net income from continuing operations	149,289			188,771			69,723			(248,601		)	159,182
Net (loss) income from discontinued operations, net of tax	—			—			(19,386		)	49,691			30,305
Net income	149,289			188,771			50,337			(198,910		)	189,487
Less: Net income attributable to noncontrolling interests	—			—			—			(40,198		)	(40,198		)
Net income attributable to DaVita Inc.	$	149,289		$	188,771		$	50,337		$	(239,108	)	$	149,289

Condensed Consolidating Statements of Comprehensive Income



For the three months ended March 31, 2020	DaVita Inc.			Guarantor subsidiaries		Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Net income	$	239,593		$	205,311	$	171,080		$	(328,089	)	$	287,895
Other comprehensive loss	(11,395		)	—		(81,632		)	—			(93,027		)
Total comprehensive income	228,198			205,311		89,448			(328,089		)	194,868
Less: Comprehensive income attributable to noncontrolling interest	—			—		—			(48,302		)	(48,302		)
Comprehensive income attributable to DaVita Inc.	$	228,198		$	205,311	$	89,448		$	(376,391	)	$	146,566



For the three months ended March 31, 2019	DaVita Inc.		Guarantor subsidiaries		Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Net income	$	149,289	$	188,771	$	50,337		$	(198,910	)	$	189,487
Other comprehensive income (loss)	1,026		—		(13,653		)	—			(12,627		)
Total comprehensive income	150,315		188,771		36,684			(198,910		)	176,860
Less: Comprehensive income attributable to noncontrolling interest	—		—		—			(40,198		)	(40,198		)
Comprehensive income attributable to DaVita Inc.	$	150,315	$	188,771	$	36,684		$	(239,108	)	$	136,662

Condensed Consolidating Balance Sheets



As of March 31, 2020	DaVita Inc.		Guarantor subsidiaries		Non- Guarantor subsidiaries		Consolidating adjustments			Consolidated total
Cash and cash equivalents	$	1,075,965	$	411	$	305,388	$	—		$	1,381,764
Restricted cash and equivalents	14,540		—		92,184		—			106,724
Accounts receivable, net	—		1,184,686		635,446		—			1,820,132
Other current assets	86,786		556,210		100,357		(28,034		)	715,319
Total current assets	1,177,291		1,741,307		1,133,375		(28,034		)	4,023,939
Property and equipment, net	555,409		1,555,662		1,336,966		(2,614		)	3,445,423
Operating lease right-of-use assets	107,620		1,643,765		1,114,378		(17,987		)	2,847,776
Intangible assets, net	340		28,766		88,847		—			117,953
Investments in and advances to affiliates, net	10,961,209		7,869,131		3,099,564		(21,929,904		)	—
Other long-term assets and investments	85,777		130,528		187,405		(20,524		)	383,186
Goodwill	—		4,812,207		1,965,816		—			6,778,023
Total assets	$	12,887,646	$	17,781,366	$	8,926,351	$	(21,999,063	)	$	17,596,300
Current liabilities	$	365,783	$	1,172,340	$	683,608	$	(985	)	$	2,220,746
Intercompany liabilities, net	1,534,892		3,099,564		2,693,572		(7,328,028		)	—
Long-term operating leases liabilities	133,926		1,554,717		1,062,852		(17,125		)	2,734,370
Long-term debt and other long-term liabilities	8,209,577		786,685		334,591		(51,049		)	9,279,804
Noncontrolling interests subject to put provisions	695,622		—		—		532,414			1,228,036
Total DaVita Inc. shareholders' equity	1,947,846		11,168,060		3,433,816		(14,601,876		)	1,947,846
Noncontrolling interests not subject to put provisions	—		—		717,912		(532,414		)	185,498
Total equity	1,947,846		11,168,060		4,151,728		(15,134,290		)	2,133,344
Total liabilities and equity	$	12,887,646	$	17,781,366	$	8,926,351	$	(21,999,063	)	$	17,596,300



As of December 31, 2019	DaVita Inc.		Guarantor subsidiaries		Non- Guarantor subsidiaries		Consolidating adjustments			Consolidated total
Cash and cash equivalents	$	758,241	$	532	$	343,599	$	—		$	1,102,372
Restricted cash and equivalents	14,499		—		91,847		—			106,346
Accounts receivable, net	—		1,189,301		606,297		—			1,795,598
Other current assets	76,787		548,553		102,410		(41,896		)	685,854
Total current assets	849,527		1,738,386		1,144,153		(41,896		)	3,690,170
Property and equipment, net	543,932		1,589,417		1,344,543		(4,508		)	3,473,384
Operating lease right-of-use assets	109,415		1,656,145		1,084,552		(20,065		)	2,830,047
Intangible assets, net	362		31,569		103,753		—			135,684
Investments in and advances to affiliates, net	10,813,991		7,611,402		3,051,208		(21,476,601		)	—
Other long-term assets and investments	102,779		133,698		176,315		(18,318		)	394,474
Goodwill	—		4,812,972		1,974,663		—			6,787,635
Total assets	$	12,420,006	$	17,573,589	$	8,879,187	$	(21,561,388	)	$	17,311,394
Current liabilities	$	379,286	$	1,327,378	$	666,470	$	(1,036	)	$	2,372,098
Intercompany payables	1,381,863		3,051,208		2,615,151		(7,048,222		)	—
Long-term operating lease liabilities	136,123		1,567,776		1,039,145		(19,244		)	2,723,800
Long-term debt and other long-term liabilities	7,741,725		674,558		364,102		(64,507		)	8,715,878
Noncontrolling interests subject to put provisions	647,600		—		—		532,776			1,180,376
Total DaVita Inc. shareholders' equity	2,133,409		10,952,669		3,475,710		(14,428,379		)	2,133,409
Noncontrolling interests not subject to put provisions	—		—		718,609		(532,776		)	185,833
Total equity	2,133,409		10,952,669		4,194,319		(14,961,155		)	2,319,242
Total liabilities and equity	$	12,420,006	$	17,573,589	$	8,879,187	$	(21,561,388	)	$	17,311,394

Condensed Consolidating Statements of Cash Flows



For the three months ended March 31, 2020	DaVita Inc.			Guarantor subsidiaries			Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Cash flows provided by operating activities:
Net income	$	239,593		$	205,311		$	171,080		$	(328,089	)	$	287,895
Changes in operating assets and liabilities and non-cash items included in net income	(182,332		)	(71,454		)	(1,817		)	328,089			72,486
Net cash provided by operating activities	57,261			133,857			169,263			—			360,381
Cash flows used in investing activities:
Additions of property and equipment	(52,714		)	(41,144		)	(61,084		)	—			(154,942		)
Acquisitions	—			(984		)	(33,123		)	—			(34,107		)
Proceeds from asset and business sales	—			4,180			27,338			—			31,518
Proceeds (purchases) from investment sales and other items, net	452			271			(5,817		)	—			(5,094		)
Net cash used in investing activities	(52,262		)	(37,677		)	(72,686		)	—			(162,625		)
Cash flows provided by (used in) financing activities:
Long-term debt and related financing costs, net	481,856			(2,462		)	(13,557		)	—			465,837
Intercompany borrowings (payments)	153,029			(95,857		)	(57,172		)	—			—
Other items	(322,119		)	2,018			(48,744		)	—			(368,845		)
Net cash provided by (used in) financing activities	312,766			(96,301		)	(119,473		)	—			96,992
Effect of exchange rate changes on cash, cash equivalents and restricted cash	—			—			(14,978		)	—			(14,978		)
Net increase (decrease) in cash, cash equivalents and restricted cash	317,765			(121		)	(37,874		)	—			279,770
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	772,740			532			435,446			—			1,208,718
Cash, cash equivalents and restricted cash of continuing operations at end of the period	$	1,090,505		$	411		$	397,572		$	—		$	1,488,488



For the three months ended March 31, 2019	DaVita Inc.			Guarantor subsidiaries			Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Cash flows provided by (used in) operating activities:
Net income	$	149,289		$	188,771		$	50,337		$	(198,910	)	$	189,487
Changes in operating assets and liabilities and non-cash items included in net income	(124,409		)	(289,332		)	166,648			198,910			(48,183		)
Net cash provided by (used in) operating activities	24,880			(100,561		)	216,985			—			141,304
Cash flows used in investing activities:
Additions of property and equipment	(38,942		)	(76,529		)	(83,407		)	—			(198,878		)
Acquisitions	—			—			(11,274		)	—			(11,274		)
Proceeds from asset and business sales	—			2,270			11,633			—			13,903
Proceeds (purchases) from investment sales and other items, net	1,804			(3,878		)	(2,035		)	—			(4,109		)
Net cash used in investing activities	(37,138		)	(78,137		)	(85,083		)	—			(200,358		)
Cash flows provided by financing activities:
Long-term debt and related financing costs, net	365,133			(2,364		)	(5,572		)	—			357,197
Intercompany (payments) borrowings	(220,697		)	188,870			31,827			—			—
Other items	1,517			(8,427		)	(25,336		)	—			(32,246		)
Net cash provided by financing activities	145,953			178,079			919			—			324,951
Effect of exchange rate changes on cash, cash equivalents and restricted cash	—			—			(921		)	—			(921		)
Net increase (decrease) in cash, cash equivalents and restricted cash	133,695			(619		)	131,900			—			264,976
Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations	—			—			118,962			—			118,962
Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations	133,695			(619		)	12,938			—			146,014
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	61,658			13,280			340,482			—			415,420
Cash, cash equivalents and restricted cash of continuing operations at end of the period	$	195,353		$	12,661		$	353,420		$	—		$	561,434

Subsequent events (Notes)	3 Months Ended
Subsequent events (Notes)	Mar. 31, 2020
Subsequent Events [Abstract]
Subsequent events	ubsequent events In March 2020, the World Health Organization declared the outbreak of COVID-19 a pandemic, and the virus continues to spread throughout the world. As a caregiving organization, the Company is exposed to and will continue to be impacted by the effects of the COVID-19 pandemic. The Company has continued to provide essential, life-sustaining care for its patients during this public health crisis. The Company has also maintained business process continuity during the pandemic by enabling most back office teammates to work remotely, and as of the date of this report has not experienced any material issues in billing or cash collections. This transition combined with the Company's balance sheet has helped the Company to avoid any material deterioration of its liquidity position as a result of the COVID-19 crisis at this time. The Company is closely monitoring the impact of the pandemic and the resulting economic downturn on all aspects of its business, including the impact on its patients, teammates, physician partners, suppliers, vendors and other business partners. We expect that the long-term impact of this public health crisis on the Company will be driven primarily by the severity and duration of the pandemic, the impact on our patient population, the pandemic’s impact on the U.S. and global economies and unemployment, and the timing, scope and effectiveness of federal, state and local governmental responses. At this time, the Company cannot reasonably estimate the ultimate impact the COVID-19 pandemic will have on its business, financial condition, results of operations, cash flows and liquidity, but the adverse impact could be material. Under the CARES Act, in April 2020 the government distributed approximately $250,000 to the Company and its joint venture partners from the Public Health and Social Services Emergency Fund. These funds were only to be used for healthcare related expenses or lost revenues attributable to COVID-19. At this time, the Company has elected not to accept the funds available to it through this government financial support. The Company’s initial receipt of these payments constitutes a subsequent event and therefore had no effect on the Company's reported financial results or financial condition for the three months ended March 31, 2020.

Condensed consolidated interim financial statements Condensed consolidaed interim financial statements (Policies)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Condensed consolidated interim financial statements	The unaudited condensed consolidated interim financial statements included in this report are prepared by the Company. In the opinion of management, all adjustments necessary for a fair presentation of the results of operations are reflected in these condensed consolidated interim financial statements. All significant intercompany accounts and transactions have been eliminated. The preparation of these financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, impairments of goodwill, accounting for income taxes, certain fair value estimates and loss contingencies. The results of operations for the three months ended March 31, 2020 are not necessarily indicative of the operating results for the full year. These 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, 2019 (10-K). 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 interim financial statements were issued and has included all necessary adjustments and disclosures.
Earnings Per Share	Basic earnings per share is calculated by dividing net income attributable to the Company by the weighted average number of common shares outstanding. Weighted average common shares outstanding include restricted stock unit awards that are no longer subject to forfeiture because the recipients have satisfied either the explicit vesting terms or retirement eligibility requirements. Diluted earnings per share includes the dilutive effect of outstanding stock-settled stock appreciation rights and unvested stock units as computed under the treasury stock method.
Short-term and Long-term Investments	Debt securities: The Company's short-term debt investments are principally bank certificates of deposit with contractual maturities longer than three months but shorter than one year. These debt securities are accounted for as held to maturity and recorded at amortized cost, which approximated their fair values at March 31, 2020 and December 31, 2019. Equity securities: The Company's equity investments in mutual funds and common stock are held within a trust to fund existing obligations associated with several of the Company’s non-qualified deferred compensation plans.
Income Taxes	The Company recognizes accrued interest and penalties related to unrecognized tax benefits in its income tax expense.
Long-term debt	The cap agreements are designated as cash flow hedges and, as a result, changes in the fair values of these cap agreements are reported in other comprehensive income. The amortization of the original cap premium is recognized as a component of debt expense on a straight-line basis over the terms of the cap agreements.
Long-term incentive compensation	The Company’s stock-based compensation expense for stock-settled awards is measured at the estimated fair value of awards on the date of grant and recognized on a cumulative straight-line basis over the vesting terms of the awards unless the stock awards are based on non-market based performance metrics, in which case expense is adjusted for the expected ultimate shares to be issued as of the end of each reporting period. Stock-based compensation expense for cash-settled awards is based on their estimated fair values as of the end of each reporting period. The expense for all stock-based awards is recognized net of expected forfeitures.
Accumulated other comprehensive Income	The reclassification of net cap realized losses into income are recorded as debt expense in the corresponding consolidated statements of income.
Fair Value of Financial Instruments	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 8 to these condensed consolidated financial statements for further discussion. The estimated fair value measurements of contingent earn-out obligations are primarily based on unobservable inputs, including projected earnings before interest, taxes, depreciation, and amortization (EBITDA) and revenue. The estimated fair value of these contingent earn-out obligations is remeasured as of each reporting date and could fluctuate based upon any significant changes in key assumptions, such as changes in the Company's credit risk adjusted rate that is used to discount obligations to present value.
New Accounting Standards	New standards recently adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The amendments in this ASU amend the impairment model to utilize an expected loss methodology in place of the incurred loss methodology for financial instruments and off-balance sheet credit exposures. The amendment requires entities to consider a broader range of information to estimate expected credit losses, which may result in earlier recognition of losses. The amendments in this ASU became effective for the Company beginning on January 1, 2020 and were applied using a modified retrospective basis. The adoption of ASU No. 2016-13 did not have a material impact on the Company's consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework -Changes to the Disclosure Requirements for Fair Value Measurement. The applicable amendments in this ASU remove requirements for disclosures concerning transfers between fair value measurement levels 1, 2 and 3 and disclosures concerning valuation processes for level 3 fair value measurements. The applicable amendments in this ASU also add a requirement to separately disclose the changes in unrealized gains and losses included in other comprehensive income for the reporting period for level 3 items measured at fair value on a recurring basis, and require disclosure of the range and weighted average of significant unobservable inputs used to develop level 3 fair value measurements. The amendments in this ASU became effective for the Company beginning on January 1, 2020 and were applied on a prospective basis. The adoption of this ASU did not have a material impact on the Company’s consolidated financial statements when adopted January 1, 2020. In August 2018, the FASB issued ASU No. 2018-15, Intangibles-Goodwill and Other-Internal Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract. ASU No. 2018-15 aligns the requirements for capitalizing implementation costs incurred in a cloud computing arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The Company adopted this ASU as of January 1, 2020, using the prospective transition approach, which allows the Company to change the accounting method without restating prior periods or booking cumulative adjustments. The adoption of ASU No. 2018-15 did not have a material impact on the Company's consolidated financial statements. New standards not yet adopted In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. ASU No. 2019-12 attempts to simplify aspects of accounting for franchise taxes and enacted changes in tax laws or rates, and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. ASU No. 2019-12 is effective for public business entities for fiscal years beginning after December 15, 2020, including interim periods within that fiscal year. Early adoption is permitted for all entities. The Company is currently assessing the effect this guidance may have on its consolidated financial statements. In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. ASU No. 2020-04 provides optional expedients and exceptions for applying U.S. generally accepted accounting principles (GAAP) to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another rate that is expected to be discontinued. The amendments in this ASU were effective beginning on March 12, 2020, and the Company may elect to apply the amendments prospectively through December 31, 2022. The Company is currently assessing the effect this guidance may have on its consolidated financial statements.

Revenue Recognition Segment revenue by major payor (Tables)

3 Months Ended

Mar. 31, 2020

Revenues by major payor [Abstract]

Schedule of Revenue Sources, Health Care Organization [Table Text Block]

The following table summarizes the Company's segment revenues by primary payor source:



	For the three months ended
	March 31, 2020									March 31, 2019
	U.S. dialysis			Other - Ancillary services			Consolidated			U.S. dialysis			Other - Ancillary services			Consolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage	$	1,502,222		$			$	1,502,222		$	1,493,516		$			$	1,493,516
Medicaid and Managed Medicaid	171,467						171,467			154,190						154,190
Other government	111,910			94,574			206,484			106,127			84,475			190,602
Commercial	825,582			39,467			865,049			788,413			33,388			821,801
Other revenues:
Medicare and Medicare Advantage				98,478			98,478						61,700			61,700
Medicaid and Managed Medicaid				366			366						6			6
Commercial				10,521			10,521						32,619			32,619
Other⁽¹⁾	5,442			17,602			23,044			4,905			17,750			22,655
Eliminations of intersegment revenues	(32,242		)	(4,152		)	(36,394		)	(30,641		)	(3,336		)	(33,977		)
Total	$	2,584,381		$	256,856		$	2,841,237		$	2,516,510		$	226,602		$	2,743,112

(1)

Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services.

Earnings per share Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2020

Earnings Per Share [Abstract]

Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]

The reconciliations of the numerators and denominators used to calculate basic and diluted earnings per share were as follows:



	Three months ended March 31,
	2020		2019

Net income from continuing operations attributable to DaVita Inc.	$	229,613	$	120,254
Net income from discontinued operations attributable to DaVita Inc.	9,980		29,035
Net income attributable to DaVita Inc.	$	239,593	$	149,289

Weighted average shares - basic	124,902		166,388
Assumed incremental shares from stock plans	1,993		393
Weighted average shares - diluted	126,895		166,781

Basic net income attributable to DaVita Inc. from:
Continuing operations per share	$	1.84	$	0.72
Discontinued operations per share	0.08		0.18
Basic net income per share attributable to DaVita Inc.	$	1.92	$	0.90

Diluted net income attributable to DaVita Inc. from:
Continuing operations per share	$	1.81	$	0.72
Discontinued operations per share	0.08		0.18
Diluted net income per share attributable to DaVita Inc.	$	1.89	$	0.90

Anti-dilutive stock-settled awards excluded from calculations⁽¹⁾	3,207		6,150

(1)

Investments in debt and equity securities (Tables)

3 Months Ended

Mar. 31, 2020

Investments, Debt and Equity Securities [Abstract]

Investments

The Company’s short-term and long-term debt and equity investments consist of the following:



	March 31, 2020						December 31, 2019
	Debt securities		Equity securities		Total		Debt securities		Equity securities		Total
Certificates of deposit and other time deposits	$	8,190	$	—	$	8,190	$	8,140	$	—	$	8,140
Investments in mutual funds and common stock	—		35,843		35,843		—		39,951		39,951
	$	8,190	$	35,843	$	44,033	$	8,140	$	39,951	$	48,091
Short-term investments	$	8,190	$	1,186	$	9,376	$	8,140	$	3,432	$	11,572
Long-term investments	—		34,657		34,657		—		36,519		36,519
	$	8,190	$	35,843	$	44,033	$	8,140	$	39,951	$	48,091

Equity method and other investments Equity Method and Other Investments (Tables)

3 Months Ended

Mar. 31, 2020

Equity Method Investments and Joint Ventures [Abstract]

Equity Method Investments

The Company's equity method and other investments were comprised of the following:



	March 31, 2020		December 31, 2019
APAC joint venture	$	123,696	$	116,924
Other equity method partnerships	114,355		114,611
Adjusted cost method investments	16,448		10,448
	$	254,499	$	241,983

Goodwill (Tables)

3 Months Ended

Mar. 31, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Changes in Goodwill by Reportable Segments [Text Block]

Changes in goodwill by reportable segments were as follows:



	U.S. dialysis			Other - Ancillary services			Consolidated
Balance at December 31, 2018	$	6,275,004		$	566,956		$	6,841,960
Acquisitions	18,089			72,137			90,226
Impairment charges	—			(124,892		)	(124,892		)
Foreign currency and other adjustments	(5,993		)	(13,666		)	(19,659		)
Balance at December 31, 2019	$	6,287,100		$	500,535		$	6,787,635
Acquisitions	2,839			23,931			26,770
Divestitures	(1,549		)	—			(1,549		)
Foreign currency and other adjustments	—			(34,833		)	(34,833		)
Balance at March 31, 2020	$	6,288,390		$	489,633		$	6,778,023

Goodwill	$	6,288,390		$	638,117		$	6,926,507
Accumulated impairment charges	—			(148,484		)	(148,484		)
	$	6,288,390		$	489,633		$	6,778,023

Long-term debt (Tables)

3 Months Ended

Mar. 31, 2020

Debt Disclosure [Abstract]

Long-term Debt

Long-term debt was comprised of the following:



								As of March 31, 2020
	March 31, 2020			December 31, 2019			Maturity date	Interest rate		Estimated fair value⁽¹⁾
Senior Secured Credit Facilities:
Term Loan A	$	1,728,125		$	1,739,063		8/12/2024	LIBOR + 1.50%		$	1,659,000
Term Loan B-1⁽²⁾	2,736,267			—			8/12/2026	LIBOR + 1.75%		$	2,640,498
Term Loan B⁽²⁾	—			2,743,125			8/12/2026	LIBOR + 2.25%		$	—
Revolving line of credit	500,000			—			8/12/2024	LIBOR + 1.50%		$	500,000
Senior Notes:
5 1/8% Senior Notes	1,750,000			1,750,000			7/15/2024	5.125	%	$	1,743,525
5% Senior Notes	1,500,000			1,500,000			5/1/2025	5.00	%	$	1,497,900
Acquisition obligations and other notes payable⁽³⁾	167,727			180,352			2020-2027	4.71	%	$	167,727
Financing lease obligations⁽⁴⁾	275,092			268,534			2020-2036	5.31	%
Total debt principal outstanding	8,657,211			8,181,074
Discount and deferred financing costs⁽⁵⁾	(68,757		)	(72,840		)
	8,588,454			8,108,234
Less current portion	(146,318		)	(130,708		)
	$	8,442,136		$	7,977,526


(1)	Fair value estimates are based upon bid and ask quotes for the Company's senior secured credit facilities and senior notes, typically a level 2 input. The carrying values of acquisition obligations and other notes payable presented here approximate their estimated fair values, based on estimates of their current present values using level 2 interest rate inputs.


(2)	On February 13, 2020, the Company entered into an amendment to its credit agreement governing its senior secured credit facilities to refinance the Term Loan B with a $2,743,125 secured Term Loan B-1.


(3)	The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current interest rate in effect and assuming no changes to the LIBOR based interest rates.


(4)	Financing lease obligations are measured at their approximate present value at inception. The interest rate presented is the weighted average discount rate embedded in financing leases outstanding.

(5)

Scheduled Maturities of Long-term Debt

Scheduled maturities of long-term debt at March 31, 2020 were as follows:



2020 (remainder of the year)	$	95,359
2021	$	170,056
2022	$	172,376
2023	$	224,727
2024	$	3,671,586
2025	$	61,951
Thereafter	$	4,261,156

Schedule of Derivative Instruments



						Three months ended March 31, 2020				Fair value
	Notional amount		LIBOR maximum rate	Effective date	Expiration date	Debt expense		Recorded OCI loss		March 31, 2020		December 31, 2019
2015 cap agreements	$	3,500,000	3.50%	6/29/2018	6/30/2020	$	2,163	$	—	$	—	$	—
2019 cap agreements	$	3,500,000	2.00%	6/30/2020	6/30/2024			$	17,346	$	7,106	$	24,452

Effects of Interest Rate Swap and Cap Agreements

The following table summarizes the effects of the Company’s interest rate cap agreements for the three months ended March 31, 2020 and 2019:



	Amount of unrecognized losses in OCI on interest rate cap agreements						Income statement location	Reclassification from accumulated other comprehensive loss into net income
	Three months ended March 31,							Three months ended March 31,
Derivatives designated as cash flow hedges	2020			2019				2020			2019
Interest rate cap agreements	$	(17,346	)	$	(781	)	Debt expense	$	2,163		$	2,163
Related income tax	4,328			201			Related income tax	(540		)	(557		)
Total	$	(13,018	)	$	(580	)		$	1,623		$	1,606

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 1A
-URI http://asc.fasb.org/extlink&oid=114775744&loc=d3e28541-108399

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 6
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21506-112644

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08.(e),(f))
-URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=114775744&loc=d3e28551-108399

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 7
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+ Details

- Definition

Tabular disclosure of pertinent information about a derivative or group of derivatives on a disaggregated basis, such as for individual instruments, or small groups of similar instruments. May include a combination of the type of instrument, risks being hedged, notional amount, hedge designation, related hedged item, inception date, maturity date, or other relevant item.

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+ Details

Leases Leases (Tables)

3 Months Ended

Mar. 31, 2020

Leases [Abstract]

Lease Expense Components

The components of lease expense were as follows:



Lease cost	Three months ended March 31, 2020		Three months ended March 31, 2019
Operating lease cost⁽¹⁾:
Fixed lease expense	$	134,733	$	128,110
Variable lease expense	30,059		28,571
Financing lease cost:
Amortization of leased assets	6,077		5,826
Interest on lease liabilities	3,603		3,775
Net lease cost	$	174,472	$	166,282

(1)

Includes short-term lease expense and sublease income, which are immaterial.

Leases Other Information

Other information related to leases was as follows:



Other information	Three months ended March 31, 2020		Three months ended March 31, 2019
Gains on sale leasebacks, net	$	9,489	$	3,987
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	162,828	$	153,587
Operating cash flows from finance leases	$	5,178	$	5,661
Financing cash flows from finance leases	$	4,180	$	5,344
Net operating lease assets obtained in exchange for new or modified operating lease liabilities	$	101,473	$	45,034



Lease term and discount rate	March 31, 2020
Weighted average remaining lease term (years):
Operating leases	8.9
Finance leases	10.2
Weighted average discount rate:
Operating leases	4.0	%
Finance leases	5.3	%

Schedule Of Minimum Lease Payments

Future minimum lease payments under non-cancellable leases as of March 31, 2020 were as follows:



	Operating leases			Finance leases
2020 (remainder of the year)	$	344,537		$	30,291
2021	505,417			34,177
2022	472,643			34,621
2023	426,485			34,700
2024	372,190			34,725
2025	320,079			34,549
Thereafter	1,248,317			153,800
Total future minimum lease payments	$	3,689,668		$	356,863
Less portion representing interest	(599,265		)	(81,771		)
Present value of lease liabilities	$	3,090,403		$	275,092

Share repurchases Share Repurchases (Tables)

3 Months Ended

Mar. 31, 2020

Treasury Stock, Value [Abstract]

Class of Treasury Stock [Table Text Block]

The following table summarizes the Company's repurchases of its common stock during the three months ended March 31, 2020 and 2019:



	Three months ended March 31, 2020					Three months ended March 31, 2019
	Shares repurchased	Amount paid		Average paid per share		Shares repurchased	Amount paid		Average paid per share
Open market repurchases	4,052	$	303,139	$	74.81	—	$	—	$	—

Accumulated other comprehensive (loss) income (Tables)

3 Months Ended

Mar. 31, 2020

Statement of Comprehensive Income [Abstract]

Comprehensive income



	For the three months ended March 31, 2020									For the three months ended March 31, 2019
	Interest rate cap agreements			Foreign currency translation adjustments			Accumulated other comprehensive loss			Interest rate cap agreements			Foreign currency translation adjustments			Accumulated other comprehensive loss
Beginning balance	$	(1,433	)	$	(46,065	)	$	(47,498	)	$	(8,961	)	$	(25,963	)	$	(34,924	)
Unrealized losses	(17,346		)	(81,632		)	(98,978		)	(781		)	(13,653		)	(14,434		)
Related income tax	4,328			—			4,328			201			—			201
	(13,018		)	(81,632		)	(94,650		)	(580		)	(13,653		)	(14,233		)
Reclassification into net income	2,163			—			2,163			2,163			—			2,163
Related income tax	(540		)	—			(540		)	(557		)	—			(557		)
	1,623			—			1,623			1,606			—			1,606
Ending balance	$	(12,828	)	$	(127,697	)	$	(140,525	)	$	(7,935	)	$	(39,616	)	$	(47,551	)

Acquisitions and divestitures (Tables)

3 Months Ended

Mar. 31, 2020

Business Acquisition [Line Items]

Schedule of Business Acquisitions by Acquisition, Contingent Consideration

The following is a reconciliation of changes in contingent earn-out obligations for the three months ended March 31, 2020:



Balance at December 31, 2019	$	24,586
Contingent earn-out obligations associated with acquisitions	2,672
Foreign currency translation adjustment for contingent earn-out obligations	(4,874		)
Remeasurement of fair value for contingent earn-out obligations	2
Balance at March 31, 2020	$	22,386

Dialysis and other businesses

Business Acquisition [Line Items]

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]

The following table summarizes the assets acquired and liabilities assumed in these transactions at their estimated acquisition date fair values:



Current assets	$	7,412
Property and equipment	8,892
Intangible and other long-term assets	6,107
Goodwill	26,770
Deferred income taxes	1,513
Current liabilities	(10,705		)
	$	39,989

Held for Sale and Discontinued Operations (Tables)

3 Months Ended

Mar. 31, 2020

Discontinued Operations and Disposal Groups [Abstract]

Disposal Groups, Including Discontinued Operations [Table Text Block]

The following table presents the financial results of discontinued operations related to DMG:



	Three months ended March 31,
	2020		2019
Revenues	$	—	$	1,382,281
Expenses	—		1,338,153
Income from discontinued operations before taxes	—		44,128
Income tax expense	—		13,823
Gain (loss) on sale of discontinued operations, net of tax	9,980		—
Net income from discontinued operations, net of tax	$	9,980	$	30,305

The following table presents cash flows of discontinued operations related to DMG:



	Three months ended March 31,
	2020		2019
Net cash provided by operating activities from discontinued operations	$	—	$	68,240
Net cash used in investing activities from discontinued operations	$	—	$	(22,809	)

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

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+ Details

Fair value of financial instruments (Tables)

3 Months Ended

Mar. 31, 2020

Fair Value Disclosures [Abstract]

Assets, Liabilities and Temporary Equity Measured at Fair Value on a Recurring Basis

The following table summarizes the Company’s assets, liabilities and temporary equity that are measured at fair value on a recurring basis as of March 31, 2020:



	Total		Quoted prices in active markets for identical assets (Level 1)		Significant other observable inputs (Level 2)		Significant unobservable inputs (Level 3)
Assets
Investments in equity securities	$	35,843	$	35,843	$	—	$	—
Interest rate cap agreements	$	7,106	$	—	$	7,106	$	—
Liabilities
Contingent earn-out obligations	$	22,386	$	—	$	—	$	22,386
Temporary equity
Noncontrolling interests subject to put provisions	$	1,228,036	$	—	$	—	$	1,228,036

Segment reporting (Tables)

3 Months Ended

Mar. 31, 2020

Segment Reporting [Abstract]

Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes

The following is a summary of segment net revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:



	Three months ended March 31,
	2020			2019
Segment revenues:
U.S. dialysis
Dialysis patient service revenues:
External sources	$	2,579,240		$	2,511,826
Intersegment revenues	31,941			30,420
U.S. dialysis patient service revenues	2,611,181			2,542,246
Other revenues⁽¹⁾:
External sources	5,141			4,684
Intersegment revenues	301			221
Total U.S. dialysis revenues	2,616,623			2,547,151
Other—Ancillary services
Dialysis patient service revenues, net	134,041			117,863
Other external sources	122,815			108,739
Intersegment revenues	4,152			3,336
Total ancillary services revenues	261,008			229,938
Total net segment revenues	2,877,631			2,777,089
Elimination of intersegment revenues	(36,394		)	(33,977		)
Consolidated revenues	$	2,841,237		$	2,743,112
Segment operating margin (loss):
U.S. dialysis	$	491,607		$	416,981
Other—Ancillary services	(2,646		)	(57,630		)
Total segment operating margin	488,961			359,351
Reconciliation of segment operating margin to consolidated income from continuing operations before income taxes:
Corporate administrative support	(23,585		)	(18,844		)
Consolidated operating income	465,376			340,507
Debt expense	(88,603		)	(131,519		)
Debt refinancing charges	(2,948		)	—
Other income, net	(4,350		)	6,940
Consolidated income from continuing operations before income taxes	$	369,475		$	215,928

(1)

Includes management fee revenue from providing management and administrative services to dialysis ventures in which the Company owns a noncontrolling equity investment or which are wholly-owned by third parties.

Summary of Assets by Reportable Segment

A summary of assets by reportable segment was as follows:



	March 31, 2020		December 31, 2019
U.S. dialysis (including equity investments of $130,144 and $124,188, respectively)	$	16,075,622	$	15,778,880
Other—Ancillary services (including equity investments of $124,355 and $117,795, respectively)	1,520,678		1,532,514
Consolidated assets	$	17,596,300	$	17,311,394

Summary of Depreciation and Amortization Expense by Reportable Segment

Depreciation and amortization expense by reportable segment was as follows:



	Three months ended March 31,
	2020		2019
U.S. dialysis	$	146,300	$	140,780
Other—Ancillary services	8,379		7,748
	$	154,679	$	148,528

Summary of Expenditures for Property and Equipment by Reportable Segment

Expenditures for property and equipment by reportable segment were as follows:



	Three months ended March 31,
	2020		2019
U.S. dialysis	$	148,763	$	170,548
Other—Ancillary services	6,179		8,578
DMG—Discontinued operations	—		19,752
	$	154,942	$	198,878

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries (Tables)

3 Months Ended

Mar. 31, 2020

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 interests in consolidated subsidiaries on the Company’s consolidated equity were as follows:



	Three months ended March 31,
	2020			2019
Net income attributable to DaVita Inc.	$	239,593		$	149,289
Changes in paid-in capital for:
Purchases of noncontrolling interests	(445		)	(2,206		)
Net transfers to noncontrolling interests	(445		)	(2,206		)
Net income attributable to DaVita Inc., net of transfers to noncontrolling interests	$	239,148		$	147,083

Condensed Consolidating financial statements (Tables)

3 Months Ended

Mar. 31, 2020

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Condensed Consolidating Statements of Operations



For the three months ended March 31, 2020	DaVita Inc.			Guarantor subsidiaries			Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Patient service revenues	$	—		$	1,729,740		$	1,050,877		$	(67,336	)	$	2,713,281
Other revenues	197,283			156,860			41,428			(267,615		)	127,956
Total net revenues	197,283			1,886,600			1,092,305			(334,951		)	2,841,237
Operating expenses	154,651			1,640,821			915,340			(334,951		)	2,375,861
Operating income	42,632			245,779			176,965			—			465,376
Debt expense	(91,362		)	(59,093		)	(11,337		)	70,241			(91,551		)
Other income (loss), net	62,453			805			2,633			(70,241		)	(4,350		)
Income tax expense	3,424			80,975			7,161			—			91,560
Equity earnings in subsidiaries	229,294			98,795			—			(328,089		)	—
Net income from continuing operations	239,593			205,311			161,100			(328,089		)	277,915
Net income from discontinued operations, net of tax	—			—			9,980			—			9,980
Net income	239,593			205,311			171,080			(328,089		)	287,895
Less: Net income attributable to noncontrolling interests	—			—			—			(48,302		)	(48,302		)
Net income attributable to DaVita Inc.	$	239,593		$	205,311		$	171,080		$	(376,391	)	$	239,593



For the three months ended March 31, 2019	DaVita Inc.			Guarantor subsidiaries			Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Patient service revenues	$	—		$	1,706,593		$	986,373		$	(63,277	)	$	2,629,689
Other revenues	188,836			146,117			34,909			(256,439		)	113,423
Total net revenues	188,836			1,852,710			1,021,282			(319,716		)	2,743,112
Operating expenses and charges	143,659			1,634,285			944,377			(319,716		)	2,402,605
Operating income	45,177			218,425			76,905			—			340,507
Debt expense	(133,595		)	(50,650		)	(12,549		)	65,275			(131,519		)
Other income, net	110,198			648			11,060			(114,966		)	6,940
Income tax expense	7,026			44,027			5,693			—			56,746
Equity earnings in subsidiaries	134,535			64,375			—			(198,910		)	—
Net income from continuing operations	149,289			188,771			69,723			(248,601		)	159,182
Net (loss) income from discontinued operations, net of tax	—			—			(19,386		)	49,691			30,305
Net income	149,289			188,771			50,337			(198,910		)	189,487
Less: Net income attributable to noncontrolling interests	—			—			—			(40,198		)	(40,198		)
Net income attributable to DaVita Inc.	$	149,289		$	188,771		$	50,337		$	(239,108	)	$	149,289

Condensed Consolidating Statements of Comprehensive Income



For the three months ended March 31, 2020	DaVita Inc.			Guarantor subsidiaries		Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Net income	$	239,593		$	205,311	$	171,080		$	(328,089	)	$	287,895
Other comprehensive loss	(11,395		)	—		(81,632		)	—			(93,027		)
Total comprehensive income	228,198			205,311		89,448			(328,089		)	194,868
Less: Comprehensive income attributable to noncontrolling interest	—			—		—			(48,302		)	(48,302		)
Comprehensive income attributable to DaVita Inc.	$	228,198		$	205,311	$	89,448		$	(376,391	)	$	146,566



For the three months ended March 31, 2019	DaVita Inc.		Guarantor subsidiaries		Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Net income	$	149,289	$	188,771	$	50,337		$	(198,910	)	$	189,487
Other comprehensive income (loss)	1,026		—		(13,653		)	—			(12,627		)
Total comprehensive income	150,315		188,771		36,684			(198,910		)	176,860
Less: Comprehensive income attributable to noncontrolling interest	—		—		—			(40,198		)	(40,198		)
Comprehensive income attributable to DaVita Inc.	$	150,315	$	188,771	$	36,684		$	(239,108	)	$	136,662

Condensed Consolidating Balance Sheets



As of March 31, 2020	DaVita Inc.		Guarantor subsidiaries		Non- Guarantor subsidiaries		Consolidating adjustments			Consolidated total
Cash and cash equivalents	$	1,075,965	$	411	$	305,388	$	—		$	1,381,764
Restricted cash and equivalents	14,540		—		92,184		—			106,724
Accounts receivable, net	—		1,184,686		635,446		—			1,820,132
Other current assets	86,786		556,210		100,357		(28,034		)	715,319
Total current assets	1,177,291		1,741,307		1,133,375		(28,034		)	4,023,939
Property and equipment, net	555,409		1,555,662		1,336,966		(2,614		)	3,445,423
Operating lease right-of-use assets	107,620		1,643,765		1,114,378		(17,987		)	2,847,776
Intangible assets, net	340		28,766		88,847		—			117,953
Investments in and advances to affiliates, net	10,961,209		7,869,131		3,099,564		(21,929,904		)	—
Other long-term assets and investments	85,777		130,528		187,405		(20,524		)	383,186
Goodwill	—		4,812,207		1,965,816		—			6,778,023
Total assets	$	12,887,646	$	17,781,366	$	8,926,351	$	(21,999,063	)	$	17,596,300
Current liabilities	$	365,783	$	1,172,340	$	683,608	$	(985	)	$	2,220,746
Intercompany liabilities, net	1,534,892		3,099,564		2,693,572		(7,328,028		)	—
Long-term operating leases liabilities	133,926		1,554,717		1,062,852		(17,125		)	2,734,370
Long-term debt and other long-term liabilities	8,209,577		786,685		334,591		(51,049		)	9,279,804
Noncontrolling interests subject to put provisions	695,622		—		—		532,414			1,228,036
Total DaVita Inc. shareholders' equity	1,947,846		11,168,060		3,433,816		(14,601,876		)	1,947,846
Noncontrolling interests not subject to put provisions	—		—		717,912		(532,414		)	185,498
Total equity	1,947,846		11,168,060		4,151,728		(15,134,290		)	2,133,344
Total liabilities and equity	$	12,887,646	$	17,781,366	$	8,926,351	$	(21,999,063	)	$	17,596,300



As of December 31, 2019	DaVita Inc.		Guarantor subsidiaries		Non- Guarantor subsidiaries		Consolidating adjustments			Consolidated total
Cash and cash equivalents	$	758,241	$	532	$	343,599	$	—		$	1,102,372
Restricted cash and equivalents	14,499		—		91,847		—			106,346
Accounts receivable, net	—		1,189,301		606,297		—			1,795,598
Other current assets	76,787		548,553		102,410		(41,896		)	685,854
Total current assets	849,527		1,738,386		1,144,153		(41,896		)	3,690,170
Property and equipment, net	543,932		1,589,417		1,344,543		(4,508		)	3,473,384
Operating lease right-of-use assets	109,415		1,656,145		1,084,552		(20,065		)	2,830,047
Intangible assets, net	362		31,569		103,753		—			135,684
Investments in and advances to affiliates, net	10,813,991		7,611,402		3,051,208		(21,476,601		)	—
Other long-term assets and investments	102,779		133,698		176,315		(18,318		)	394,474
Goodwill	—		4,812,972		1,974,663		—			6,787,635
Total assets	$	12,420,006	$	17,573,589	$	8,879,187	$	(21,561,388	)	$	17,311,394
Current liabilities	$	379,286	$	1,327,378	$	666,470	$	(1,036	)	$	2,372,098
Intercompany payables	1,381,863		3,051,208		2,615,151		(7,048,222		)	—
Long-term operating lease liabilities	136,123		1,567,776		1,039,145		(19,244		)	2,723,800
Long-term debt and other long-term liabilities	7,741,725		674,558		364,102		(64,507		)	8,715,878
Noncontrolling interests subject to put provisions	647,600		—		—		532,776			1,180,376
Total DaVita Inc. shareholders' equity	2,133,409		10,952,669		3,475,710		(14,428,379		)	2,133,409
Noncontrolling interests not subject to put provisions	—		—		718,609		(532,776		)	185,833
Total equity	2,133,409		10,952,669		4,194,319		(14,961,155		)	2,319,242
Total liabilities and equity	$	12,420,006	$	17,573,589	$	8,879,187	$	(21,561,388	)	$	17,311,394

Condensed Consolidating Statements of Cash Flows



For the three months ended March 31, 2020	DaVita Inc.			Guarantor subsidiaries			Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Cash flows provided by operating activities:
Net income	$	239,593		$	205,311		$	171,080		$	(328,089	)	$	287,895
Changes in operating assets and liabilities and non-cash items included in net income	(182,332		)	(71,454		)	(1,817		)	328,089			72,486
Net cash provided by operating activities	57,261			133,857			169,263			—			360,381
Cash flows used in investing activities:
Additions of property and equipment	(52,714		)	(41,144		)	(61,084		)	—			(154,942		)
Acquisitions	—			(984		)	(33,123		)	—			(34,107		)
Proceeds from asset and business sales	—			4,180			27,338			—			31,518
Proceeds (purchases) from investment sales and other items, net	452			271			(5,817		)	—			(5,094		)
Net cash used in investing activities	(52,262		)	(37,677		)	(72,686		)	—			(162,625		)
Cash flows provided by (used in) financing activities:
Long-term debt and related financing costs, net	481,856			(2,462		)	(13,557		)	—			465,837
Intercompany borrowings (payments)	153,029			(95,857		)	(57,172		)	—			—
Other items	(322,119		)	2,018			(48,744		)	—			(368,845		)
Net cash provided by (used in) financing activities	312,766			(96,301		)	(119,473		)	—			96,992
Effect of exchange rate changes on cash, cash equivalents and restricted cash	—			—			(14,978		)	—			(14,978		)
Net increase (decrease) in cash, cash equivalents and restricted cash	317,765			(121		)	(37,874		)	—			279,770
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	772,740			532			435,446			—			1,208,718
Cash, cash equivalents and restricted cash of continuing operations at end of the period	$	1,090,505		$	411		$	397,572		$	—		$	1,488,488



For the three months ended March 31, 2019	DaVita Inc.			Guarantor subsidiaries			Non- Guarantor subsidiaries			Consolidating adjustments			Consolidated total
Cash flows provided by (used in) operating activities:
Net income	$	149,289		$	188,771		$	50,337		$	(198,910	)	$	189,487
Changes in operating assets and liabilities and non-cash items included in net income	(124,409		)	(289,332		)	166,648			198,910			(48,183		)
Net cash provided by (used in) operating activities	24,880			(100,561		)	216,985			—			141,304
Cash flows used in investing activities:
Additions of property and equipment	(38,942		)	(76,529		)	(83,407		)	—			(198,878		)
Acquisitions	—			—			(11,274		)	—			(11,274		)
Proceeds from asset and business sales	—			2,270			11,633			—			13,903
Proceeds (purchases) from investment sales and other items, net	1,804			(3,878		)	(2,035		)	—			(4,109		)
Net cash used in investing activities	(37,138		)	(78,137		)	(85,083		)	—			(200,358		)
Cash flows provided by financing activities:
Long-term debt and related financing costs, net	365,133			(2,364		)	(5,572		)	—			357,197
Intercompany (payments) borrowings	(220,697		)	188,870			31,827			—			—
Other items	1,517			(8,427		)	(25,336		)	—			(32,246		)
Net cash provided by financing activities	145,953			178,079			919			—			324,951
Effect of exchange rate changes on cash, cash equivalents and restricted cash	—			—			(921		)	—			(921		)
Net increase (decrease) in cash, cash equivalents and restricted cash	133,695			(619		)	131,900			—			264,976
Less: Net increase in cash, cash equivalents and restricted cash from discontinued operations	—			—			118,962			—			118,962
Net increase (decrease) in cash, cash equivalents and restricted cash from continuing operations	133,695			(619		)	12,938			—			146,014
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	61,658			13,280			340,482			—			415,420
Cash, cash equivalents and restricted cash of continuing operations at end of the period	$	195,353		$	12,661		$	353,420		$	—		$	561,434

Revenue Recognition Segment Revenue by Payor (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Disaggregation of Revenue [Line Items]
Other revenues	$ 127,956	$ 113,423
Total revenues	2,841,237	2,743,112
Elimination of intersegment revenues
Disaggregation of Revenue [Line Items]
Total revenues	(36,394)	(33,977)
Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Patient service revenues	1,502,222	1,493,516
Other revenues	98,478	61,700
Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Patient service revenues	171,467	154,190
Other revenues	366	6
Other Government Payors
Disaggregation of Revenue [Line Items]
Patient service revenues	206,484	190,602
Commercial Payors
Disaggregation of Revenue [Line Items]
Patient service revenues	865,049	821,801
Other revenues	10,521	32,619
Other
Disaggregation of Revenue [Line Items]
Other revenues	23,044	22,655
U.S. dialysis and related lab services
Disaggregation of Revenue [Line Items]
Total revenues	2,584,381	2,516,510
U.S. dialysis and related lab services \| Elimination of intersegment revenues
Disaggregation of Revenue [Line Items]
Total revenues	(32,242)	(30,641)
U.S. dialysis and related lab services \| Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Patient service revenues	1,502,222	1,493,516
U.S. dialysis and related lab services \| Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Patient service revenues	171,467	154,190
U.S. dialysis and related lab services \| Other Government Payors
Disaggregation of Revenue [Line Items]
Patient service revenues	111,910	106,127
U.S. dialysis and related lab services \| Commercial Payors
Disaggregation of Revenue [Line Items]
Patient service revenues	825,582	788,413
U.S. dialysis and related lab services \| Other
Disaggregation of Revenue [Line Items]
Other revenues	5,442	4,905
Other—Ancillary services
Disaggregation of Revenue [Line Items]
Total revenues	256,856	226,602
Other—Ancillary services \| Elimination of intersegment revenues
Disaggregation of Revenue [Line Items]
Total revenues	(4,152)	(3,336)
Other—Ancillary services \| Medicare and Medicare Advantage
Disaggregation of Revenue [Line Items]
Other revenues	98,478	61,700
Other—Ancillary services \| Medicaid and Managed Medicaid
Disaggregation of Revenue [Line Items]
Other revenues	366	6
Other—Ancillary services \| Other Government Payors
Disaggregation of Revenue [Line Items]
Patient service revenues	94,574	84,475
Other—Ancillary services \| Commercial Payors
Disaggregation of Revenue [Line Items]
Patient service revenues	39,467	33,388
Other revenues	10,521	32,619
Other—Ancillary services \| Other
Disaggregation of Revenue [Line Items]
Other revenues	$ 17,602	$ 17,750

Revenue Recognition Revenue Recognition (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Revenue Recognition [Abstract]
Allowance for doubtful accounts	$ 4,422	$ 8,328

Earnings per share Earnings per share - Reconciliation of numberators and denominators used to calculate basic and diluted earnings per share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Numerators:
Net income from continuing operations attributable to DaVita Inc.	$ 229,613	$ 120,254
Net income from discontinued operations attributable to DaVita Inc.	9,980	29,035
Net income (loss) attributable to DeVita Inc. for earnings per share calculation	$ 239,593	$ 149,289
Weighted average shares outstanding during period	124,902,000	166,388,000
Assumed incremental shares from stock plans	1,993,000	393,000
Weighted average shares for diluted earnings per share calculation	126,894,847	166,780,657
Basic:
Basic net income from continuing operations per share	$ 1.84	$ 0.72
Basic net income (loss) from discontinued operations per share	0.08	0.18
Basic net income per share attributable to DaVita Inc.	1.92	0.90
Diluted:
Diluted net income from continuing operations per share	1.81	0.72
Diluted net income from discontinued operations per share	0.08	0.18
Diluted net income per share attributable to DaVita Inc.	$ 1.89	$ 0.90
Anti-dilutive stock-settled awards excluded from calculation	3,207,000	6,150,000

Investments in debt and equity securities (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Investment Holdings [Line Items]
Debt securities	$ 8,190	$ 8,140
Investments in equity securities	35,843	39,951
Total	44,033	48,091
Debt securities, short-term investments	8,190	8,140
Total, short-term investments	9,376	11,572
Debt securities, long-term investments	0	0
Total, long-term investments	34,657	36,519
Certificates of deposit and other time deposits
Investment Holdings [Line Items]
Debt securities	8,190	8,140
Investments in equity securities	0	0
Total	8,190	8,140
Investments in mutual funds and common stock
Investment Holdings [Line Items]
Debt securities	0	0
Investments in equity securities	35,843	39,951
Total	35,843	39,951
Short-term Investments
Investment Holdings [Line Items]
Investments in equity securities	1,186	3,432
Long-term Investments
Investment Holdings [Line Items]
Investments in equity securities	$ 34,657	$ 36,519

Investments in debt and equity securities - Additional Information (Detail) - Investments in mutual funds and common stock - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Pre-tax Net Gain (Loss) recognized in Income Statement	$ (3,407)	$ 1,893
Pre-tax Realized Gain (Loss) on Securities Arising During Period	293	170
Net Increase Decrease In Unrealized Gains On Equity Securities	$ (3,700)	$ 1,723

Equity method and other investments Equity Method and Other Investments (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	$ 254,499	$ 241,983
Adjusted cost method investments
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	16,448	10,448
Other equity method partnerships
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	114,355	114,611
APAC JV - Deconsolidated Noncontrolling Entity
Schedule of Equity Method Investments [Line Items]
Equity method and other investments	$ 123,696	$ 116,924

Equity method and other investments - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Noncontrolling Interest [Line Items]
Equity investment income (loss)	$ 17,843	$ 2,708
Valuation Adjustment	$ 0	$ 0
Parent Company
Noncontrolling Interest [Line Items]
Ownership interest percentage by parent	75.00%
Parent Company \| Minimum
Noncontrolling Interest [Line Items]
Ownership interest percentage by parent	30.00%
Parent Company \| Maximum
Noncontrolling Interest [Line Items]
Ownership interest percentage by parent	50.00%
APAC JV - Deconsolidated Noncontrolling Entity
Noncontrolling Interest [Line Items]
Current economic interest in the APAC JV, Owned by Noncontrolling Investors	25.00%

Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Goodwill [Roll Forward]
Beginning balance	$ 6,787,635	$ 6,841,960	$ 6,841,960
Acquisitions	26,770		90,226
Impairment charges	0	(41,037)	(124,892)
Foreign currency and other adjustments	(34,833)		(19,659)
Divestitures	(1,549)
Ending balance	6,778,023		6,787,635
Goodwill, before accumulated impairment charges	6,926,507
Accumulated impairment charges	(148,484)
Ending balance	6,778,023		6,787,635
U.S. dialysis and related lab services
Goodwill [Roll Forward]
Beginning balance	6,287,100	6,275,004	6,275,004
Acquisitions	2,839		18,089
Impairment charges			0
Foreign currency and other adjustments	0		(5,993)
Divestitures	(1,549)
Ending balance	6,288,390		6,287,100
Goodwill, before accumulated impairment charges	6,288,390
Accumulated impairment charges	0
Ending balance	6,288,390		6,287,100
Other—Ancillary services and strategic initiatives
Goodwill [Roll Forward]
Beginning balance	500,535	$ 566,956	566,956
Acquisitions	23,931		72,137
Impairment charges			(124,892)
Foreign currency and other adjustments	(34,833)		(13,666)
Divestitures	0
Ending balance	489,633		500,535
Goodwill, before accumulated impairment charges	638,117
Accumulated impairment charges	(148,484)
Ending balance	$ 489,633		$ 500,535

Goodwill - Narrative (Details) $ in Thousands	3 Months Ended		12 Months Ended
Goodwill - Narrative (Details) $ in Thousands	Mar. 31, 2020 USD ($) segment	Mar. 31, 2019 USD ($)	Dec. 31, 2019 USD ($)
Goodwill [Line Items]
Goodwill impairment charges	$ 0	$ 41,037	$ 124,892
Other Reporting Units
Goodwill [Line Items]
Number of Reportable Segments \| segment	0
GERMANY \| Kidney Care
Goodwill [Line Items]
Goodwill impairment charges		$ 41,037

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Liability for unrecognized tax benefits	$ 68,602	$ 68,214
Unrecognized tax benefits that would impact effective tax rate	64,356
Increase in liability for unrecognized tax benefits	388
Accrued interest and penalties related to unrecognized tax benefits, net of federal tax benefits	$ 15,249	$ 14,428

Long-term debt (Detail) - USD ($) $ in Thousands		3 Months Ended
Long-term debt (Detail) - USD ($) $ in Thousands	Feb. 13, 2020	Mar. 31, 2020	Dec. 31, 2019
Senior Notes
Debt interest rate during period		4.35%
Acquisition obligations, other notes payable, and financing lease obligations
Financing lease obligations		$ 275,092
Long-term debt, weighted average interest rate, at point in time		3.75%
Total debt principal outstanding		$ 8,657,211	$ 8,181,074
Discount and deferred financing costs		(68,757)	(72,840)
Carrying amount of long-term debt, net of unamortized discounts		8,588,454	8,108,234
Less current portion		(146,318)	(130,708)
Total long-term debt		8,442,136	7,977,526
Senior Notes Five Point One Two Five Percent Due Twenty Twenty Four
Senior Notes
Senior Notes		$ 1,750,000	1,750,000
Debt interest rate during period		5.125%
Debt Instrument, Maturity Date		Jul. 15, 2024
Debt Instrument, Fair Value Disclosure		$ 1,743,525
Debt Instrument, table footnotes
Debt Instrument, Maturity Date		Jul. 15, 2024
Senior Notes Five Point Zero Percent Due Twenty Twenty Five
Senior Notes
Senior Notes		$ 1,500,000	1,500,000
Debt interest rate during period		5.00%
Debt Instrument, Maturity Date		May 01, 2025
Debt Instrument, Fair Value Disclosure		$ 1,497,900
Debt Instrument, table footnotes
Debt Instrument, Maturity Date		May 01, 2025
Acquisition obligations and other notes payable
Acquisition obligations, other notes payable, and financing lease obligations
Acquisition obligations and other notes payable		$ 167,727	180,352
Debt instrument, maturity date, description		2020-2027
Long-term debt, weighted average interest rate, at point in time		4.71%
Acquisition obligations and other notes payable, fair value		$ 167,727
Financing lease obligations
Acquisition obligations, other notes payable, and financing lease obligations
Financing lease obligations		$ 275,092	268,534
Debt instrument, maturity date, description		2020-2036
Finance lease, weighted average discount rate, percent		5.31%
Financing lease liability, fair value
Revolving line of credit
Senior Secured Credit Facilities
Secured Debt		$ 500,000	0
Debt Instrument, Description of Variable Rate Basis		LIBOR + 1.50%
Senior Notes
Debt Instrument, Maturity Date		Aug. 12, 2024
Debt Instrument, Fair Value Disclosure		$ 500,000
Debt Instrument, table footnotes
Debt Instrument, Maturity Date		Aug. 12, 2024
Term Loan A
Senior Secured Credit Facilities
Secured Debt		$ 1,728,125	1,739,063
Debt Instrument, Description of Variable Rate Basis		LIBOR + 1.50%
Senior Notes
Debt Instrument, Maturity Date		Aug. 12, 2024
Debt Instrument, Fair Value Disclosure		$ 1,659,000
Debt Instrument, table footnotes
Debt Instrument, Maturity Date		Aug. 12, 2024
Term Loan B-1
Senior Secured Credit Facilities
Secured Debt	$ 2,743,125	$ 2,736,267	0
Debt Instrument, Description of Variable Rate Basis		LIBOR + 1.75%
Senior Notes
Debt Instrument, Maturity Date	Aug. 12, 2026
Debt Instrument, Fair Value Disclosure		$ 2,640,498
Debt Instrument, table footnotes
Debt Instrument Agreement Date	Feb. 13, 2020
Debt Instrument, Maturity Date	Aug. 12, 2026
Term Loan B-1 \| London Interbank Offered Rate (LIBOR)
Debt Instrument, table footnotes
LIBOR plus interest rate margin	1.75%
Term Loan B
Senior Secured Credit Facilities
Secured Debt		$ 0	2,743,125
Debt Instrument, Description of Variable Rate Basis		LIBOR + 2.25%
Senior Notes
Debt Instrument, Maturity Date		Aug. 12, 2026
Debt Instrument, Fair Value Disclosure		$ 0
Debt Instrument, table footnotes
Debt Instrument, Maturity Date		Aug. 12, 2026
Senior Secured Credit Facilities
Acquisition obligations, other notes payable, and financing lease obligations
Long-term debt, weighted average interest rate, at point in time		2.78%
Debt Instrument, table footnotes
Debt Instrument, Unamortized Discount		$ 6,207	6,457
Deferred Offering Costs		42,420	45,444
Senior Notes
Debt Instrument, table footnotes
Deferred Offering Costs		$ 20,130	$ 20,939

Long-term debt - Scheduled Maturities of Long-term Debt (Detail) $ in Thousands	Mar. 31, 2020 USD ($)
Debt Disclosure [Abstract]
2020 (remainder of the year)	$ 95,359
2021	170,056
2022	172,376
2023	224,727
2024	3,671,586
2025	61,951
Thereafter	$ 4,261,156

Long-term debt Schedule of Derivative Instruments (Details) - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Interest Rate Cap Agreements Effective June 29, 2018
Derivative [Line Items]
Derivative, effective date	Jun. 29, 2018
Derivative, expiration date	Jun. 30, 2020
Interest Rate Cap Agreements Effective June 30, 2020
Derivative [Line Items]
Derivative, effective date	Jun. 30, 2020
Derivative, expiration date	Jun. 30, 2024
Term Loan Facility \| Interest Rate Cap Agreements Effective June 29, 2018 \| Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000,000
LIBOR plus interest rate margin	3.50%
Term Loan Facility \| Interest Rate Cap Agreements Effective June 30, 2020 \| Maximum
Derivative [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000,000
LIBOR plus interest rate margin	2.00%
Cash Flow Hedging
Derivative [Line Items]
Amount of debt expense reclassified from accumulated OCI into income	$ 1,623,000	$ 1,606,000
Amount of unrecognized losses in OCI on interest rate cap agreements	(13,018,000)	$ (580,000)
Debt Expense \| Cash Flow Hedging \| Interest Rate Cap Agreements Effective June 29, 2018
Derivative [Line Items]
Amount of debt expense reclassified from accumulated OCI into income	2,163,000
Amount of unrecognized losses in OCI on interest rate cap agreements	0
Debt Expense \| Cash Flow Hedging \| Interest Rate Cap Agreements Effective June 30, 2020
Derivative [Line Items]
Amount of unrecognized losses in OCI on interest rate cap agreements	17,346,000
Other Long-term Assets \| Interest Rate Cap Agreements Effective June 29, 2018
Derivative [Line Items]
Derivative asset, fair value, gross asset	0		$ 0
Other Long-term Assets \| Interest Rate Cap Agreements Effective June 30, 2020
Derivative [Line Items]
Derivative asset, fair value, gross asset	$ 7,106,000		$ 24,452,000

Long-term debt - Effects of Interest Rate Swap and Cap Agreements (Detail) - Cash Flow Hedging - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Derivative Instruments Gain Loss [Line Items]
Amount of unrecognized losses in OCI on interest rate cap agreements	$ (13,018)	$ (580)
Reclassification from accumulated other comprehensive loss into net income	1,623	1,606
Related income tax
Derivative Instruments Gain Loss [Line Items]
Amount of unrecognized losses in OCI on interest rate cap agreements	4,328	201
Reclassification from accumulated other comprehensive loss into net income	(540)	(557)
Interest rate cap agreements \| Debt Expense
Derivative Instruments Gain Loss [Line Items]
Amount of unrecognized losses in OCI on interest rate cap agreements	(17,346)	(781)
Reclassification from accumulated other comprehensive loss into net income	$ 2,163	$ 2,163

Long-term debt - Additional Information (Detail) - USD ($)		3 Months Ended
	Feb. 13, 2020	Mar. 31, 2020	Mar. 31, 2019
Debt Instrument [Line Items]
Debt refinancing charges		$ 2,948,000	$ 0
Weighted average effective interest rate at quarter end		3.75%
Weighted average effective interest rate during quarter		4.35%
Percentage of debt instruments bearing fixed interest rate		41.83%
Letters of credit outstanding		$ 57,705,000
Revolving line of credit
Debt Instrument [Line Items]
Debt Instrument, Maturity Date		Aug. 12, 2024
Maximum borrowing capacity on the revolving credit facilities		$ 1,000,000,000
Term Loan B-1
Debt Instrument [Line Items]
Debt Instrument Agreement Date	Feb. 13, 2020
Debt Instrument, Maturity Date	Aug. 12, 2026
Additional Debt Principal Amount Due To New Agreement	$ 0
Debt refinancing charges		2,948,000
Noncash Financing Outflows Related To Extinguishment Of Long Term Debt		55,895,000
Debt Instrument, Periodic Payment, Principal		$ 6,858,000
Term Loan B-1 \| London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest rate margin	1.75%
Term Loan B
Debt Instrument [Line Items]
Debt Instrument, Maturity Date		Aug. 12, 2026
Cash outflows from extinguishment of secured debt		$ 68,842,000
Cash inflows from reborrowing of secured debt		$ 68,842,000
Term Loan A
Debt Instrument [Line Items]
Debt Instrument, Maturity Date		Aug. 12, 2024
Debt Instrument, Periodic Payment, Principal		$ 10,938,000
Term Loan A and Revolver subject to uncapped portion of variability of LIBOR
Debt Instrument [Line Items]
Line of credit outstanding principal balance		$ (1,464,392,000)
Senior Secured Credit Facilities
Debt Instrument [Line Items]
Weighted average effective interest rate at quarter end		2.78%

Leases Lease Expense Components (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating lease cost:
Fixed lease expense	$ 134,733	$ 128,110
Variable lease expense	30,059	28,571
Finance lease cost:
Amortization of leased assets	6,077	5,826
Interest on lease liabilities	3,603	3,775
Net Lease Cost	$ 174,472	$ 166,282

Leases Leases Other Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Leases other information
Gains on sale leasebacks, net	$ 9,489	$ 3,987
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows from operating leases	162,828	153,587
Operating cash flows from finance leases	5,178	5,661
Financing cash flows from finance leases	4,180	5,344
Net operating lease assets obtained in exchange for new or modified operating lease liabilities	$ 101,473	$ 45,034
Leases term and discount rate
Operating Lease, Weighted Average Remaining Lease Term	8 years 10 months 24 days
Finance Lease, Weighted Average Remaining Lease Term	10 years 2 months 12 days
Operating Lease, Weighted Average Discount Rate, Percent	4.00%
Finance Lease
Leases term and discount rate
Finance Lease, Weighted Average Discount Rate, Percent	5.31%

Leases Schedule of Minimum Lease Payments (Details) $ in Thousands	Mar. 31, 2020 USD ($)
Operating leases
2020 (remainder of the year)	$ 344,537
2021	505,417
2022	472,643
2023	426,485
2024	372,190
2025	320,079
Thereafter	1,248,317
Total future minimum lease payments, operating leases	3,689,668
Less portion representing interest, operating lease liabilities	(599,265)
Present value of lease liabilities, operating leases	3,090,403
Finance leases
2020 (remainder of the year)	30,291
2021	34,177
2022	34,621
2023	34,700
2024	34,725
2025	34,549
Thereafter	153,800
Total future minimum lease payments	356,863
Less portion representing interest, finance lease liabilities	(81,771)
Present value of lease liabilities, finance leases	$ 275,092

Leases Leases - Additional Information (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Lessee, Lease, Description [Line Items]
Finance Lease, Right-of-Use Asset	$ 257,750	$ 247,246
Finance Lease Accumulated Depreciation	$ 33,318	$ 27,193
Minimum
Lessee, Lease, Description [Line Items]
Lessee, Operating Lease, Term of Contract	5 years
Lessee, Operating Lease, Renewal Term	5 years
Maximum
Lessee, Lease, Description [Line Items]
Lessee, Operating Lease, Term of Contract	15 years
Lessee, Operating Lease, Renewal Term	10 years

Contingencies - Additional Information (Detail) $ in Thousands		1 Months Ended
	Aug. 15, 2017	Dec. 31, 2017 USD ($)
US Attorney Prescription Drug Investigation
Other Commitments [Line Items]
Litigation Settlement, Amount Awarded to Other Party		$ 63,700
Stockholder Derivative Litigation
Other Commitments [Line Items]
Loss Contingency Number of Previously Disclosed Lawsuits Consolidated Into One	3
Incremental Cash Portion \| US Attorney Prescription Drug Investigation
Other Commitments [Line Items]
Litigation Settlement, Amount Awarded to Other Party		41,500
Cash Paid For Portion Previously Refunded \| US Attorney Prescription Drug Investigation
Other Commitments [Line Items]
Litigation Settlement, Amount Awarded to Other Party		$ 22,200

Other commitments - additional information (Detail) $ in Thousands	Mar. 31, 2020 USD ($)
Commitments to provide operating capital
Other Commitments [Line Items]
Other potential commitments to provide operating capital to several dialysis centers	$ 9,460

Long-term incentive compensation - Additional Information (Detail) $ / shares in Units, shares in Thousands, $ in Thousands			3 Months Ended
	Jan. 23, 2020 $ / shares	Nov. 04, 2019 shares	Mar. 31, 2020 USD ($) shares	Mar. 31, 2019 USD ($)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Long-term incentive program (LTIP) expense			$ 25,594	$ 13,107
Stock-based compensation expense			19,870	12,110
Estimated tax benefits recorded for stock-based compensation			2,584	1,495
Compensation cost related to LTIP awards			66,302
Unrecognized compensation cost related to nonvested stock-based compensation arrangements under equity compensation and stock purchase plans			$ 247,420
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 8 months 12 days
Longterm Incentive Compensation cash awards, number of awards outstanding			0
Share-based Payment Arrangement, Expense, Tax Benefit			$ 199	151
Restricted and Performance Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock-settled awards granted (in shares) \| shares			950
Aggregate grant-date fair value			$ 72,648
Weighted-average expected life (in years)			3 years 6 months
Stock Appreciation Rights
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock-settled awards granted (in shares) \| shares			2,765
Aggregate grant-date fair value			$ 73,833
Weighted-average expected life (in years)			4 years 9 months 18 days
Premium Priced Stock-Settled Stock Appreciation Rights
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock-settled awards granted (in shares) \| shares		2,500
Premium Priced Award Base Price Per Share \| $ / shares	$ 67.80
Premium To The Tender Offer Share Purchase Price	20.00%
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Date	Nov. 04, 2024
Share-based Compensation Arrangement by Share-based Payment Award, Award Requisite Holding Period, End Date	Nov. 04, 2024
Premium Priced Stock-Settled Stock Appreciation Rights \| Vesting period, tranche one
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage	50.00%
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Date	Nov. 04, 2023
Premium Priced Stock-Settled Stock Appreciation Rights \| Vesting period, tranche two
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Rights, Percentage	50.00%
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Date	Nov. 04, 2022
General and Administrative Expense
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock-based compensation expense			$ 19,870	$ 10,301

Share repurchases Share Repurchase Tender Offer (Details) - Open Market Purchases - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)	4,052	0
Value of treasury stock acquired	$ 303,139	$ 0
Treasury stock acquired, average cost per share	$ 74.81	$ 0

Share repurchases (Details) - USD ($) $ in Thousands	1 Months Ended
Share repurchases (Details) - USD ($) $ in Thousands	May 04, 2020	Nov. 04, 2019
Equity, Class of Treasury Stock [Line Items]
Terminated Remaining Prior Share Repurchases Authorized, Amount		$ 246,373
Stock Repurchase Program, Authorized Amount		$ 2,000,000
Subsequent Event
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock (in shares)	0
Stock Repurchase Program, Remaining Authorized Repurchase Amount	$ 1,400,356

Accumulated other comprehensive (loss) income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	$ 2,319,242
Ending balance	2,133,344
Interest rate cap agreements
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(1,433)	$ (8,961)
Unrealized (losses) gains	(17,346)	(781)
Related income tax benefit	4,328	201
Unrealized (losses) gains net	(13,018)	(580)
Reclassification into net income	2,163	2,163
Related income	(540)	(557)
Reclassification from accumulated other comprehensive income into net income net of tax	1,623	1,606
Ending balance	(12,828)	(7,935)
Foreign currency translation adjustments
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(46,065)	(25,963)
Unrealized (losses) gains	(81,632)	(13,653)
Related income tax benefit	0	0
Unrealized (losses) gains net	(81,632)	(13,653)
Reclassification into net income	0	0
Related income	0	0
Reclassification from accumulated other comprehensive income into net income net of tax	0	0
Ending balance	(127,697)	(39,616)
Accumulated other comprehensive (loss) income
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(47,498)	(34,924)
Unrealized (losses) gains	(98,978)	(14,434)
Related income tax benefit	4,328	201
Unrealized (losses) gains net	(94,650)	(14,233)
Reclassification into net income	2,163	2,163
Related income	(540)	(557)
Reclassification from accumulated other comprehensive income into net income net of tax	1,623	1,606
Ending balance	$ (140,525)	$ (47,551)

Acquisitions and divestitures - Aggregate Purchase Cost Allocations for Acquisitions (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill	$ 6,778,023	$ 6,787,635	$ 6,841,960
Dialysis and other businesses
Business Acquisition [Line Items]
Current assets	7,412
Property and equipment	8,892
Intangible and other long-term assets	6,107
Goodwill	26,770
Deferred income taxes	1,513
Current liabilities	(10,705)
Aggregate purchase price	$ 39,989

Acquisitions and divestitures Contingent Earn-out obligations (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020 USD ($)
Business Combination, Contingent Consideration Arrangements [Abstract]
Contingent Earn-out Obligations, Beginning balance	$ 24,586
Contingent earn-out obligations associated with acquisitions	2,672
Foreign Currency Translation Adjustment For Contingent Earn Out Obligations	(4,874)
Remeasurement of fair value for contingent earn-out obligations	2
Contingent Earn-out Obligations, Ending balance	$ 22,386

Acquisitions and divestitures - Additional Information (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2020 USD ($) clinic	Mar. 31, 2019 USD ($)
Business Acquisition [Line Items]
Cash paid to acquire businesses	$ 34,107	$ 11,274
Other accrued liabilities
Business Acquisition [Line Items]
Contingent earn-out obligations	4,579
Other long-term liabilities
Business Acquisition [Line Items]
Contingent earn-out obligations	17,807
Other companies
Business Acquisition [Line Items]
Contingent earn-out obligations	$ 22,386
Minimum \| Other companies \| EBITDA or Operating Income Performance Targets or Quality Margins
Business Acquisition [Line Items]
Earn-out consideration payment period	1 year
Maximum
Business Acquisition [Line Items]
Contingent earn-out obligations and liabilities assumed associated with acquisitions	$ 31,723
Maximum \| Other companies \| EBITDA or Operating Income Performance Targets or Quality Margins
Business Acquisition [Line Items]
Earn-out consideration payment period	5 years
Noncompete Agreements
Business Acquisition [Line Items]
Amortizable intangible assets acquired, weighted-average estimated useful lives	4 years
Dialysis and other businesses
Business Acquisition [Line Items]
Cash paid to acquire businesses	$ 34,107
Deferred purchase price obligations	875
Contingent earn-out obligations and liabilities assumed associated with acquisitions	5,007
Goodwill deductible for tax purposes associated with acquisitions	$ 11,241
U.S. dialysis and related lab services \| Dialysis and other businesses
Business Acquisition [Line Items]
Number of businesses acquired \| clinic	2
Foreign Dialysis Centers \| Dialysis and other businesses
Business Acquisition [Line Items]
Number of businesses acquired \| clinic	22

Held for Sale and Discontinued Operations Schedule of Financial Results of DMG's Discontinued Operations (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net (loss) income from discontinued operations, net of tax	$ 9,980	$ 30,305
DMG held for sale \| Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenues	0	1,382,281
Expenses	0	1,338,153
(Loss) income from discontinued operations before taxes	0	44,128
Income tax expense	0	13,823
Coronavirus Aid Relief And Economic Security Act Additional Tax Benefit \| DMG held for sale \| Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain (Loss) on Disposition of Business	$ 9,980	$ 0

Held for Sale and Discontinued Operations Schedule of Cash Flows of Discontinued Operations Related to DMG (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Discontinued Operations and Disposal Groups [Abstract]
Net cash provided by operating activities from discontinued operations	$ 0	$ 68,240
Net cash used in investing activities from discontinued operations	$ 0	$ (22,809)

Held for Sale and Discontinued Operations Additional Information (Details) - USD ($) $ in Thousands			3 Months Ended		12 Months Ended
	Jun. 19, 2019	Dec. 05, 2017	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from Divestiture of Businesses	$ 4,465,476
Proceeds from Divestiture of Businesses, Net of Cash Divested	$ 3,824,509
Discontinued Operations, Held-for-sale \| DMG held for sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Business acquisition, Effective date of divestiture	Jun. 19, 2019
Purchase and Sale Agreement, Aggregate purchase price	$ 4,340,000
Business Acquisition, Date of Acquisition Agreement		Dec. 05, 2017
Gain (Loss) On Disposition Of Business Interests Before Tax					$ (23,022)
Coronavirus Aid Relief And Economic Security Act Additional Tax Benefit \| Discontinued Operations, Held-for-sale \| DMG held for sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain (Loss) on Disposition of Business			$ 9,980	$ 0

Variable interest entities - Additional Information (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Assets	$ 17,596,300	$ 17,311,394
Liabilities	14,234,920	$ 13,811,776
Variable Interest Entity
Assets	320,505
Liabilities	$ 234,915

Fair value of financial instruments - Assets, Liabilities and Temporary Equity Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Assets
Investments in equity securities	$ 35,843	$ 39,951
Fair Value, Measurements, Recurring
Assets
Investments in equity securities	35,843
Liabilities
Contingent earn-out obligations	22,386
Temporary equity
Noncontrolling interests subject to put provisions	1,228,036
Fair Value, Measurements, Recurring \| Interest rate cap agreements
Assets
Interest rate cap agreements	7,106
Fair Value, Measurements, Recurring \| Quoted prices in active markets for identical assets (Level 1)
Assets
Investments in equity securities	35,843
Liabilities
Contingent earn-out obligations	0
Temporary equity
Noncontrolling interests subject to put provisions	0
Fair Value, Measurements, Recurring \| Quoted prices in active markets for identical assets (Level 1) \| Interest rate cap agreements
Assets
Interest rate cap agreements	0
Fair Value, Measurements, Recurring \| Significant other observable inputs (Level 2)
Assets
Investments in equity securities	0
Liabilities
Contingent earn-out obligations	0
Temporary equity
Noncontrolling interests subject to put provisions	0
Fair Value, Measurements, Recurring \| Significant other observable inputs (Level 2) \| Interest rate cap agreements
Assets
Interest rate cap agreements	7,106
Fair Value, Measurements, Recurring \| Significant unobservable inputs (Level 3)
Assets
Investments in equity securities	0
Liabilities
Contingent earn-out obligations	22,386
Temporary equity
Noncontrolling interests subject to put provisions	1,228,036
Fair Value, Measurements, Recurring \| Significant unobservable inputs (Level 3) \| Interest rate cap agreements
Assets
Interest rate cap agreements	$ 0

Fair value of financial instruments Fair Value of Financial Instruments (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020 USD ($)
Fair Value Disclosures [Abstract]
Potential Increase Decrease In Fair Value Of Noncontrolling Interests Due To Change In Weighted Average EBITDA Multiple	$ 150,000

Segment reporting - 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, 2020	Mar. 31, 2019
Segment Reporting Information [Line Items]
U.S. dialysis and related lab services patient service revenues	$ 2,713,281	$ 2,629,689
Other revenues	127,956	113,423
Total revenues	2,841,237	2,743,112
Operating income (loss)	465,376	340,507
Corporate administrative support	(23,585)	(18,844)
Debt expense	(88,603)	(131,519)
Debt refinancing charges	(2,948)	0
Other (loss) income, net	(4,350)	6,940
Income from continuing operations before income taxes	369,475	215,928
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Total revenues	2,584,381	2,516,510
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Total revenues	256,856	226,602
Operating Segments
Segment Reporting Information [Line Items]
Total revenues	2,877,631	2,777,089
Operating income (loss)	488,961	359,351
Operating Segments \| U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
U.S. dialysis and related lab services patient service revenues	2,611,181	2,542,246
Total revenues	2,616,623	2,547,151
Operating income (loss)	491,607	416,981
Operating Segments \| U.S. dialysis and related lab services \| External Sources
Segment Reporting Information [Line Items]
Dialysis patient service revenues	2,579,240	2,511,826
Other revenues	5,141	4,684
Operating Segments \| U.S. dialysis and related lab services \| Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues	31,941	30,420
Other revenues	301	221
Operating Segments \| Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Dialysis patient service revenues	134,041	117,863
Other revenues	122,815	108,739
Total revenues	261,008	229,938
Operating income (loss)	(2,646)	(57,630)
Operating Segments \| Other—Ancillary services and strategic initiatives \| Intersubsegment Eliminations
Segment Reporting Information [Line Items]
Dialysis patient service revenues	4,152	3,336
Intersegment Elimination
Segment Reporting Information [Line Items]
Total revenues	(36,394)	(33,977)
Intersegment Elimination \| U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Total revenues	(32,242)	(30,641)
Intersegment Elimination \| Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Total revenues	$ (4,152)	$ (3,336)

Segment reporting - Summary of Assets by Segment (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
ASSETS
Total assets	$ 17,596,300	$ 17,311,394
U.S. dialysis and related lab services
ASSETS
Total assets	16,075,622	15,778,880
Other—Ancillary services and strategic initiatives
ASSETS
Total assets	$ 1,520,678	$ 1,532,514

Segment reporting - Summary of Assets by Segment (Phantom) (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Segment Reporting Information [Line Items]
Equity method and other investments	$ 254,499	$ 241,983
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Equity method and other investments	130,144	124,188
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Equity method and other investments	$ 124,355	$ 117,795

Segment reporting - Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 154,679	$ 148,528
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Depreciation and amortization	146,300	140,780
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 8,379	$ 7,748

Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 154,942	$ 198,878
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	148,763	170,548
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	6,179	8,578
DMG held for sale
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 0	$ 19,752

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

Changes in DaVita Inc.'s ownership interest in consolidated subsidiaries - Effects of Changes in DaVita Inc's Ownership Interest on Company's Equity (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Change Due to Net Income Attributable to Parent and Effects of Changes, Net [Abstract]
Net income attributable to DaVita Inc.	$ 239,593	$ 149,289
Changes in paid-in capital for:
Purchases of noncontrolling interests	(445)	(2,206)
Net transfers to noncontrolling interests	(445)	(2,206)
Net income attributable to DaVita Inc., net of transfers to noncontrolling interests	$ 239,148	$ 147,083

Condensed consolidating financial statements - Condensed Consolidating Statements of Operations (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Condensed Income Statements Captions [Line Items]
Dialysis patient service revenues	$ 2,713,281	$ 2,629,689
Other revenues	127,956	113,423
Total revenues	2,841,237	2,743,112
Operating expenses	2,375,861	2,402,605
Operating income	465,376	340,507
Debt expense	(91,551)	(131,519)
Other (loss) income, net	(4,350)	6,940
Income tax expense	91,560	56,746
Equity earnings in subsidiaries	0	0
Net income from continuing operations	277,915	159,182
Net income from discontinued operations, net of tax	9,980	30,305
Net income	287,895	189,487
Less: Net income attributable to noncontrolling interests	(48,302)	(40,198)
Net income attributable to DaVita Inc.	239,593	149,289
Consolidating adjustments
Condensed Income Statements Captions [Line Items]
Dialysis patient service revenues	(67,336)	(63,277)
Other revenues	(267,615)	(256,439)
Total revenues	(334,951)	(319,716)
Operating expenses	(334,951)	(319,716)
Operating income	0	0
Debt expense	70,241	65,275
Other (loss) income, net	(70,241)	(114,966)
Income tax expense	0	0
Equity earnings in subsidiaries	(328,089)	(198,910)
Net income from continuing operations	(328,089)	(248,601)
Net income from discontinued operations, net of tax	0	49,691
Net income	(328,089)	(198,910)
Less: Net income attributable to noncontrolling interests	(48,302)	(40,198)
Net income attributable to DaVita Inc.	(376,391)	(239,108)
DaVita Inc. \| Reportable Legal Entities
Condensed Income Statements Captions [Line Items]
Dialysis patient service revenues	0	0
Other revenues	197,283	188,836
Total revenues	197,283	188,836
Operating expenses	154,651	143,659
Operating income	42,632	45,177
Debt expense	(91,362)	(133,595)
Other (loss) income, net	62,453	110,198
Income tax expense	3,424	7,026
Equity earnings in subsidiaries	229,294	134,535
Net income from continuing operations	239,593	149,289
Net income from discontinued operations, net of tax	0	0
Net income	239,593	149,289
Less: Net income attributable to noncontrolling interests	0	0
Net income attributable to DaVita Inc.	239,593	149,289
Guarantor subsidiaries \| Reportable Legal Entities
Condensed Income Statements Captions [Line Items]
Dialysis patient service revenues	1,729,740	1,706,593
Other revenues	156,860	146,117
Total revenues	1,886,600	1,852,710
Operating expenses	1,640,821	1,634,285
Operating income	245,779	218,425
Debt expense	(59,093)	(50,650)
Other (loss) income, net	805	648
Income tax expense	80,975	44,027
Equity earnings in subsidiaries	98,795	64,375
Net income from continuing operations	205,311	188,771
Net income from discontinued operations, net of tax	0	0
Net income	205,311	188,771
Less: Net income attributable to noncontrolling interests	0	0
Net income attributable to DaVita Inc.	205,311	188,771
Non- Guarantor subsidiaries \| Reportable Legal Entities
Condensed Income Statements Captions [Line Items]
Dialysis patient service revenues	1,050,877	986,373
Other revenues	41,428	34,909
Total revenues	1,092,305	1,021,282
Operating expenses	915,340	944,377
Operating income	176,965	76,905
Debt expense	(11,337)	(12,549)
Other (loss) income, net	2,633	11,060
Income tax expense	7,161	5,693
Equity earnings in subsidiaries	0	0
Net income from continuing operations	161,100	69,723
Net income from discontinued operations, net of tax	9,980	(19,386)
Net income	171,080	50,337
Less: Net income attributable to noncontrolling interests	0	0
Net income attributable to DaVita Inc.	$ 171,080	$ 50,337

Condensed consolidating financial statements - Condensed Consolidating Statements of Comprehensive Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Condensed Financial Statements Captions [Line Items]
Net income	$ 287,895	$ 189,487
Other comprehensive income	(93,027)	(12,627)
Total comprehensive income	194,868	176,860
Less: Comprehensive income attributable to noncontrolling interests	(48,302)	(40,198)
Comprehensive income attributable to DaVita Inc.	146,566	136,662
Consolidating adjustments
Condensed Financial Statements Captions [Line Items]
Net income	(328,089)	(198,910)
Other comprehensive income	0	0
Total comprehensive income	(328,089)	(198,910)
Less: Comprehensive income attributable to noncontrolling interests	(48,302)	(40,198)
Comprehensive income attributable to DaVita Inc.	(376,391)	(239,108)
DaVita Inc. \| Reportable Legal Entities
Condensed Financial Statements Captions [Line Items]
Net income	239,593	149,289
Other comprehensive income	(11,395)	1,026
Total comprehensive income	228,198	150,315
Less: Comprehensive income attributable to noncontrolling interests	0	0
Comprehensive income attributable to DaVita Inc.	228,198	150,315
Guarantor subsidiaries \| Reportable Legal Entities
Condensed Financial Statements Captions [Line Items]
Net income	205,311	188,771
Other comprehensive income	0	0
Total comprehensive income	205,311	188,771
Less: Comprehensive income attributable to noncontrolling interests	0	0
Comprehensive income attributable to DaVita Inc.	205,311	188,771
Non- Guarantor subsidiaries \| Reportable Legal Entities
Condensed Financial Statements Captions [Line Items]
Net income	171,080	50,337
Other comprehensive income	(81,632)	(13,653)
Total comprehensive income	89,448	36,684
Less: Comprehensive income attributable to noncontrolling interests	0	0
Comprehensive income attributable to DaVita Inc.	$ 89,448	$ 36,684

Condensed consolidating financial statements - Condensed Consolidating Balance Sheets (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	$ 1,381,764	$ 1,102,372
Restricted cash and equivalents	106,724	106,346
Accounts receivable, net	1,820,132	1,795,598
Other current assets	715,319	685,854
Total current assets	4,023,939	3,690,170
Property and equipment, net	3,445,423	3,473,384
Operating lease right-of-use asset	2,847,776	2,830,047
Intangible assets, net	117,953	135,684
Investments in and advances to affiliates, net	0	0
Other long-term assets and investments	383,186	394,474
Goodwill	6,778,023	6,787,635	$ 6,841,960
Total assets	17,596,300	17,311,394
Current liabilities	2,220,746	2,372,098
Intercompany liabilities, net	0	0
Long-term operating lease liabilities	2,734,370	2,723,800
Long-term debt and other long-term liabilities	9,279,804	8,715,878
Noncontrolling interests subject to put provisions	1,228,036	1,180,376
Total DaVita Inc. shareholders' equity	1,947,846	2,133,409
Noncontrolling interests not subject to put provisions	185,498	185,833
Total equity	2,133,344	2,319,242
Total liabilities and equity	17,596,300	17,311,394
Consolidating adjustments
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	0	0
Restricted cash and equivalents	0	0
Accounts receivable, net	0	0
Other current assets	(28,034)	(41,896)
Total current assets	(28,034)	(41,896)
Property and equipment, net	(2,614)	(4,508)
Operating lease right-of-use asset	(17,987)	(20,065)
Intangible assets, net	0	0
Investments in and advances to affiliates, net	(21,929,904)	(21,476,601)
Other long-term assets and investments	(20,524)	(18,318)
Goodwill	0	0
Total assets	(21,999,063)	(21,561,388)
Current liabilities	(985)	(1,036)
Intercompany liabilities, net	(7,328,028)	(7,048,222)
Long-term operating lease liabilities	(17,125)	(19,244)
Long-term debt and other long-term liabilities	(51,049)	(64,507)
Noncontrolling interests subject to put provisions	532,414	532,776
Total DaVita Inc. shareholders' equity	(14,601,876)	(14,428,379)
Noncontrolling interests not subject to put provisions	(532,414)	(532,776)
Total equity	(15,134,290)	(14,961,155)
Total liabilities and equity	(21,999,063)	(21,561,388)
DaVita Inc. \| Reportable Legal Entities
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	1,075,965	758,241
Restricted cash and equivalents	14,540	14,499
Accounts receivable, net	0	0
Other current assets	86,786	76,787
Total current assets	1,177,291	849,527
Property and equipment, net	555,409	543,932
Operating lease right-of-use asset	107,620	109,415
Intangible assets, net	340	362
Investments in and advances to affiliates, net	10,961,209	10,813,991
Other long-term assets and investments	85,777	102,779
Goodwill	0	0
Total assets	12,887,646	12,420,006
Current liabilities	365,783	379,286
Intercompany liabilities, net	1,534,892	1,381,863
Long-term operating lease liabilities	133,926	136,123
Long-term debt and other long-term liabilities	8,209,577	7,741,725
Noncontrolling interests subject to put provisions	695,622	647,600
Total DaVita Inc. shareholders' equity	1,947,846	2,133,409
Noncontrolling interests not subject to put provisions	0	0
Total equity	1,947,846	2,133,409
Total liabilities and equity	12,887,646	12,420,006
Guarantor subsidiaries \| Reportable Legal Entities
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	411	532
Restricted cash and equivalents	0	0
Accounts receivable, net	1,184,686	1,189,301
Other current assets	556,210	548,553
Total current assets	1,741,307	1,738,386
Property and equipment, net	1,555,662	1,589,417
Operating lease right-of-use asset	1,643,765	1,656,145
Intangible assets, net	28,766	31,569
Investments in and advances to affiliates, net	7,869,131	7,611,402
Other long-term assets and investments	130,528	133,698
Goodwill	4,812,207	4,812,972
Total assets	17,781,366	17,573,589
Current liabilities	1,172,340	1,327,378
Intercompany liabilities, net	3,099,564	3,051,208
Long-term operating lease liabilities	1,554,717	1,567,776
Long-term debt and other long-term liabilities	786,685	674,558
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholders' equity	11,168,060	10,952,669
Noncontrolling interests not subject to put provisions	0	0
Total equity	11,168,060	10,952,669
Total liabilities and equity	17,781,366	17,573,589
Non- Guarantor subsidiaries \| Reportable Legal Entities
Condensed Balance Sheet Statements Captions [Line Items]
Cash and cash equivalents	305,388	343,599
Restricted cash and equivalents	92,184	91,847
Accounts receivable, net	635,446	606,297
Other current assets	100,357	102,410
Total current assets	1,133,375	1,144,153
Property and equipment, net	1,336,966	1,344,543
Operating lease right-of-use asset	1,114,378	1,084,552
Intangible assets, net	88,847	103,753
Investments in and advances to affiliates, net	3,099,564	3,051,208
Other long-term assets and investments	187,405	176,315
Goodwill	1,965,816	1,974,663
Total assets	8,926,351	8,879,187
Current liabilities	683,608	666,470
Intercompany liabilities, net	2,693,572	2,615,151
Long-term operating lease liabilities	1,062,852	1,039,145
Long-term debt and other long-term liabilities	334,591	364,102
Noncontrolling interests subject to put provisions	0	0
Total DaVita Inc. shareholders' equity	3,433,816	3,475,710
Noncontrolling interests not subject to put provisions	717,912	718,609
Total equity	4,151,728	4,194,319
Total liabilities and equity	$ 8,926,351	$ 8,879,187

Condensed consolidating financial statements - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Cash flows from operating activities:
Net income	$ 287,895	$ 189,487
Changes in operating assets and liabilities and non-cash items included in net income	72,486	(48,183)
Net cash provided by operating activities	360,381	141,304
Cash flows from investing activities:
Additions of property and equipment	(154,942)	(198,878)
Acquisitions	(34,107)	(11,274)
Proceeds from asset and business sales	31,518	13,903
Purchases from investment sales and other items, net	(5,094)	(4,109)
Net cash used in investing activities	(162,625)	(200,358)
Cash flows from financing activities:
Long-term debt and related financing costs, net	465,837	357,197
Intercompany borrowings (payments)	0	0
Other items	(368,845)	(32,246)
Net cash provided by financing activities	96,992	324,951
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(14,978)	(921)
Net increase in cash, cash equivalents and restricted cash	279,770	264,976
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	1,208,718	415,420
Cash, cash equivalents and restricted cash of continuing operations at end of the period	1,488,488	561,434
Consolidating adjustments
Cash flows from operating activities:
Net income	(328,089)	(198,910)
Changes in operating assets and liabilities and non-cash items included in net income	328,089	198,910
Net cash provided by operating activities	0	0
Cash flows from investing activities:
Additions of property and equipment	0	0
Acquisitions	0	0
Proceeds from asset and business sales	0	0
Purchases from investment sales and other items, net	0	0
Net cash used in investing activities	0	0
Cash flows from financing activities:
Long-term debt and related financing costs, net	0	0
Intercompany borrowings (payments)	0	0
Other items	0	0
Net cash provided by financing activities	0	0
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0
Net increase in cash, cash equivalents and restricted cash	0	0
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	0	0
Cash, cash equivalents and restricted cash of continuing operations at end of the period	0	0
DaVita Inc. \| Reportable Legal Entities
Cash flows from operating activities:
Net income	239,593	149,289
Changes in operating assets and liabilities and non-cash items included in net income	(182,332)	(124,409)
Net cash provided by operating activities	57,261	24,880
Cash flows from investing activities:
Additions of property and equipment	(52,714)	(38,942)
Acquisitions	0	0
Proceeds from asset and business sales	0	0
Purchases from investment sales and other items, net	452	1,804
Net cash used in investing activities	(52,262)	(37,138)
Cash flows from financing activities:
Long-term debt and related financing costs, net	481,856	365,133
Intercompany borrowings (payments)	153,029	(220,697)
Other items	(322,119)	1,517
Net cash provided by financing activities	312,766	145,953
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0
Net increase in cash, cash equivalents and restricted cash	317,765	133,695
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	772,740	61,658
Cash, cash equivalents and restricted cash of continuing operations at end of the period	1,090,505	195,353
Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from operating activities:
Net income	205,311	188,771
Changes in operating assets and liabilities and non-cash items included in net income	(71,454)	(289,332)
Net cash provided by operating activities	133,857	(100,561)
Cash flows from investing activities:
Additions of property and equipment	(41,144)	(76,529)
Acquisitions	(984)	0
Proceeds from asset and business sales	4,180	2,270
Purchases from investment sales and other items, net	271	(3,878)
Net cash used in investing activities	(37,677)	(78,137)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(2,462)	(2,364)
Intercompany borrowings (payments)	(95,857)	188,870
Other items	2,018	(8,427)
Net cash provided by financing activities	(96,301)	178,079
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0
Net increase in cash, cash equivalents and restricted cash	(121)	(619)
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	532	13,280
Cash, cash equivalents and restricted cash of continuing operations at end of the period	411	12,661
Non- Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from operating activities:
Net income	171,080	50,337
Changes in operating assets and liabilities and non-cash items included in net income	(1,817)	166,648
Net cash provided by operating activities	169,263	216,985
Cash flows from investing activities:
Additions of property and equipment	(61,084)	(83,407)
Acquisitions	(33,123)	(11,274)
Proceeds from asset and business sales	27,338	11,633
Purchases from investment sales and other items, net	(5,817)	(2,035)
Net cash used in investing activities	(72,686)	(85,083)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(13,557)	(5,572)
Intercompany borrowings (payments)	(57,172)	31,827
Other items	(48,744)	(25,336)
Net cash provided by financing activities	(119,473)	919
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(14,978)	(921)
Net increase in cash, cash equivalents and restricted cash	(37,874)	131,900
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	435,446	340,482
Cash, cash equivalents and restricted cash of continuing operations at end of the period	397,572	353,420
Discontinued Operations
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash	0	118,962
Discontinued Operations \| Consolidating adjustments
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash		0
Discontinued Operations \| DaVita Inc. \| Reportable Legal Entities
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash		0
Discontinued Operations \| Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash		0
Discontinued Operations \| Non- Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash		118,962
Continuing Operations
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash	$ 279,770	146,014
Continuing Operations \| Consolidating adjustments
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash		0
Continuing Operations \| DaVita Inc. \| Reportable Legal Entities
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash		133,695
Continuing Operations \| Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash		(619)
Continuing Operations \| Non- Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from financing activities:
Net increase in cash, cash equivalents and restricted cash		$ 12,938

Condensed consolidating financial statements Additional Information (Details) $ in Thousands	Aug. 12, 2019 USD ($)
New Credit Agreement
Debt Instrument [Line Items]
Secured Debt	$ 5,500,000

Subsequent events Additional Information (Details) $ in Thousands	1 Months Ended
	Apr. 30, 2020 USD ($)
Subsequent Event
Subsequent Event [Line Items]
Available Funds through the Provider Relief Fund under CARES Act	$ 250,000