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DAVITA INC.

For the period ended Jun 30, 2026. Filed Aug 4, 2026.

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About this filing

A company's report for each of its first three quarters. The financial statements are not audited. It shows how the business has moved since the last annual report, and what management says changed.

Jun 30, 2026 · Filed Aug 4, 2026

DVA$191.35-1.8%Stored close · as of Nov 6, 2026

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Notes to Condensed Consolidated Financial Statements

Unless otherwise indicated in this Quarterly Report on Form 10-Q, "the Company", "we", "us", "our" and similar terms refer to DaVita Inc. and its consolidated subsidiaries.

  1. 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 revenues, expenses, assets, liabilities, contingencies, and noncontrolling interests subject to put provisions. The most significant estimates and assumptions underlying these financial statements and accompanying notes generally involve revenue recognition and accounts receivable, certain fair value estimates, accounting for income taxes, and loss contingencies. The results of operations reflected in these interim financial statements may not necessarily be indicative of annual operating results. 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, 2025 (2025 10-K). Prior period classifications conform to the current period presentation.

  1. Revenue recognition

The following tables summarize the Company's segment revenues by primary payor source:

Three months ended June 30, 2026 · Three months ended June 30, 2025
U.S. dialysis · Other — Ancillary services · Consolidated · U.S. dialysis · Other — Ancillary services · Consolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage$1,749,289$$1,749,289$1,659,607$$1,659,607
Medicaid and Managed Medicaid226,944226,944217,699217,699
Other government88,848236,377325,22583,104224,937308,041
Commercial940,228136,0521,076,280947,01591,2251,038,240
Other revenues:
Medicare and Medicare Advantage151,824151,824140,149140,149
Medicaid and Managed Medicaid————
Commercial6,2416,2418,3228,322
Other(1)6,51426,21532,7295,96621,05427,020
Eliminations of intersegment revenues(11,361)(3,087)(14,448)(16,716)(2,836)(19,552)
Total$3,000,462$553,622$3,554,084$2,896,675$482,851$3,379,526
Six months ended June 30, 2026 · Six months ended June 30, 2025
U.S. dialysis · Other — Ancillary services · Consolidated · U.S. dialysis · Other — Ancillary services · Consolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage$3,424,703$$3,424,703$3,268,625$$3,268,625
Medicaid and Managed Medicaid439,773439,773424,208424,208
Other government181,788484,556666,344159,850435,301595,151
Commercial1,894,471245,7162,140,1871,871,903178,4272,050,330
Other revenues:
Medicare and Medicare Advantage260,331260,331239,103239,103
Medicaid and Managed Medicaid——22
Commercial9,8899,88911,02311,023
Other(1)12,79053,82366,61311,97436,65448,628
Eliminations of intersegment revenues(31,833)(6,375)(38,208)(28,450)(5,565)(34,015)
Total$5,921,692$1,047,940$6,969,632$5,708,110$894,945$6,603,055

(1) Consists primarily of management service fees in the Company's U.S. dialysis business and research fees, management fees, and other non-patient service revenues in the Other - ancillary services businesses.

There are significant uncertainties associated with estimating revenue, many of which take several years to resolve. These estimates are subject to ongoing insurance coverage changes, geographic coverage differences, differing interpretations of contract coverage and other payor issues, as well as patient issues, including 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.

Measurements of revenue for the Company's integrated kidney care (IKC) risk-based arrangements are complex, sensitive to a number of key inputs, and require meaningful estimates for a number of factors, including but not limited to member alignment data, third-party medical claims expense, outcomes on various quality metrics, and ultimate risk adjustment factor scores. Information and other measurement limitations on these factors may constrain revenue recognition for a risk-based arrangement until a period after the Company's performance obligations have been met. For its IKC business, the Company recognized revenues for performance obligations satisfied in previous years of $98,491 and $95,911 during the six months ended June 30, 2026 and 2025, respectively. The delay in recognition of these amounts resulted predominantly from measurement limitations and recognition constraints on the Company's value-based care contracts with health plans, many of which are complex. Recognition of revenue from the Company's government Comprehensive Kidney Care Contracting program also has certain constraints for plan years 2025 and 2026.

Customer contract assets. The carrying value of customer contract assets, which are included in contract assets and other receivables and other long-term assets on the Company’s consolidated balance sheet, was $399,165 and $310,541 as of June 30, 2026 and December 31, 2025, respectively.

  1. Earnings per share

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

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

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

Three months ended June 30,Six months ended June 30,
2026202520262025
Net income attributable to DaVita Inc.$265,397$199,337$462,927$362,254
Weighted average shares outstanding:
Basic shares64,78175,94366,07877,646
Assumed incremental from stock plans1,3111,4191,3981,663
Diluted shares66,09277,36267,47679,309
Basic net income per share attributable to DaVita Inc.$4.10$2.62$7.01$4.67
Diluted net income per share attributable to DaVita Inc.$4.02$2.58$6.86$4.57
Anti-dilutive stock-settled awards excluded from calculation(1)102266247226

(1)Shares associated with stock plans excluded from the diluted denominator calculation because they were anti-dilutive under the treasury stock method.

  1. Short-term and long-term investments

The Company’s short-term and long-term investments, consisting of debt instruments classified as held-to-maturity and equity investments with readily determinable fair values or redemption values, were as follows:

June 30, 2026December 31, 2025
DebtsecuritiesEquitysecuritiesTotalDebtsecuritiesEquitysecuritiesTotal
Certificates of deposit, bonds and other$16,414$—$16,414$24,320$—$24,320
Investments in mutual funds—41,86541,865—40,94940,949
$16,414$41,865$58,279$24,320$40,949$65,269
Short-term investments$16,414$3,500$19,914$19,903$4,400$24,303
Long-term investments—38,36538,3654,41736,54940,966
$16,414$41,865$58,279$24,320$40,949$65,269
  1. Goodwill

Changes in the carrying value of goodwill by reportable segment were as follows:

U.S. dialysisOther — Ancillary servicesConsolidated
Balance at December 31, 2024$6,517,220$857,996$7,375,216
Acquisitions10,39661,28871,684
Foreign currency and other adjustments—98,19598,195
Balance at December 31, 20256,527,6161,017,4797,545,095
Acquisitions21,92812,68034,608
Foreign currency and other adjustments—11,26311,263
Balance at June 30, 2026$6,549,544$1,041,422$7,590,966
Balance at June 30, 2026:
Goodwill6,549,5441,194,8257,744,369
Accumulated impairment charges—(153,403)(153,403)
$6,549,544$1,041,422$7,590,966

The Company didnot recognize any goodwill impairment charges during the six months ended June 30, 2026 and 2025.

The Company performed various annual impairment assessments during the six months ended June 30, 2026, with no impairment indicated. None of the Company's various reporting units were considered at risk of significant goodwill impairment as of June 30, 2026.

  1. Long-term debt

Long-term debt comprised the following:

June 30, 2026December 31, 2025Maturity dateInterest rateEstimated fair value(1)
Senior Secured Credit Facilities:
Term Loan A-2(2)$1,975,000$2,000,00011/24/2030SOFR + 1.50%$1,970,063
Term Loan B-22,357,9101,868,5595/9/2031SOFR + 1.75%$2,352,015
Revolving line of credit(2)65,000—11/24/2030SOFR + 1.50%$65,000
Senior Notes:
4.625% Senior Notes2,750,0002,750,0006/1/20304.625%$2,653,750
3.75% Senior Notes1,500,0001,500,0002/15/20313.75%$1,385,625
6.875% Senior Notes1,000,0001,000,0009/1/20326.875%$1,028,750
6.75% Senior Notes1,000,0001,000,0007/15/20336.75%$1,028,750
Acquisition obligations and other notes payable(3)39,46340,9042026-20384.67%$39,463
Financing lease obligations(4)160,143185,1202027-20394.30%
Total debt principal outstanding10,847,51610,344,583
Discount, premium and deferred financing costs(66,503)(71,394)
10,781,01310,273,189
Less current portion(117,177)(109,201)
$10,663,836$10,163,988

(1)See Note 11 for discussion of the Company's fair value estimates.

(2)Outstanding Term Loan A-2 and revolving line of credit balances are due on November 24, 2030, unless any of the 4.625% senior notes due 2030 (the 4.625% Senior Notes) remain outstanding 91 days prior to the 4.625% Senior Notes maturity date, in which case the outstanding Term Loan A-2 and revolving line of credit balances become due at that 91 day date (March 2, 2030).

(3)The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current fixed and variable interest rate components in effect as of June 30, 2026.

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

Scheduled maturities of long-term debt at June 30, 2026 were as follows:

2026 (remainder of the year)$62,283
2027$114,026
2028$160,808
2029$144,566
2030$4,554,268
2031$3,764,157
Thereafter$2,047,408

On June 8, 2026 (the Ninth Amendment Effective Date), the Company entered into the Ninth Amendment (the Ninth Amendment) to the Credit Agreement. The Ninth Amendment modified the Credit Agreement to extend an additional incremental principal amount of $500,000 on its Term Loan B-2. The Company used the net proceeds from this transaction to repay a portion of the balance outstanding on its revolving line of credit and related accrued interest and fees. The Term Loan B-2 requires quarterly principal payments that began on June 30, 2026 of 0.25% of the aggregate principal amount of the Term Loan B-2 outstanding on the Ninth Amendment Effective Date, with the balance due on May 9, 2031. As a result of the Ninth Amendment, the Company recognized debt extinguishment and modification costs of $2,035 in the second quarter of 2026 comprised of fees incurred for this transaction.

During the first six months of 2026, the Company made regularly scheduled principal payments under its senior secured credit facilities totaling $25,000 on Term Loan A-2 and $10,649 on Term Loan B-2.

As of June 30, 2026, the effective portion of the Company's interest rate cap agreements, as detailed in the table below, have the economic effect of capping the Company's maximum exposure to SOFR variable interest rate changes on equivalent amounts of the Company's floating rate debt, including all of Term Loan B-2 and a portion of Term Loan A-2. The remaining $832,910 outstanding principal balance of Term Loan A-2 and $65,000 balance outstanding on the revolving line of credit are subject to SOFR-based interest rate volatility. The Company's interest rate cap agreements are designated as cash flow hedges and, as a result, changes in their fair values are reported in other comprehensive income. The original premiums paid for the caps are amortized to debt expense on a straight-line basis over the term of each cap agreement starting from its effective date. These cap agreements do not contain credit risk-contingent features.

The following table summarizes the Company’s interest rate cap agreements outstanding as of June 30, 2026:

Year cap agreements executed · Initial notional amount · SOFR maximum rate · Approximate effective date · Maturity date · Notional amount effectivethrough December 31
2026 · 2027 · 2028 · 2029
2023$500,0004.50%6/30/202412/31/2026$500,000
2023$750,0004.00%12/31/202412/31/2026$500,000
2024$1,750,0004.50%(1)12/31/202512/31/2027$1,750,000$1,000,000
2024$750,0004.00%(2)12/31/202512/31/2027$750,000$500,000
2025$1,000,0004.50%(3)12/31/202612/31/2028$1,000,000$750,000
2025$1,000,0004.25%(4)12/31/202612/31/2028$1,000,000$1,000,000
2025$1,750,0004.25%12/31/202712/31/2028$1,750,000
2025$1,000,0004.50%12/31/202812/31/2029$1,000,000
2026$750,0004.75%12/31/202812/31/2029$750,000
Total notional coverage$3,500,000$3,500,000$3,500,000$1,750,000
Weighted average strike rate4.32%4.46%4.43%4.61%

(1)Effective December 31, 2026, the maximum rate of 4.50% increases to 4.75% for these interest rate caps.

(2)Effective December 31, 2026, the maximum rate of 4.00% increases to 4.25% for these interest rate caps.

(3)Effective December 31, 2027, the maximum rate of 4.50% increases to 4.75% for these interest rate caps.

(4)Effective December 31, 2027, the maximum rate of 4.25% increases to 4.50% for these interest rate caps.

See Note 9 for further details on amounts reclassified from accumulated other comprehensive loss and recorded as debt expense (offset) related to the Company’s interest rate cap agreements for the three and six months ended June 30, 2026 and 2025. See Note 11 for discussion of the Company's fair value estimates.

As a result of the variable rate cap from the Company's 2023 interest rate cap agreements, the Company’s weighted average effective interest rate on its senior secured credit facilities at the end of the second quarter of 2026 was 5.76%, based on the current margins in effect for its senior secured credit facilities as of June 30, 2026, as detailed in the table above.

The Company’s weighted average effective interest rate on all debt, including the effect of interest rate caps and amortization of debt discount, premium and deferred financing costs was 5.43% as of June 30, 2026.

As of June 30, 2026, the Company had $1,435,000 available and $65,000 drawn on its $1,500,000 revolving line of credit under its senior secured credit facilities. Credit available under this revolving line of credit is reduced by the amount of any letters of credit outstanding under the facility, of which there were none as of June 30, 2026. The Company also had letters of credit of approximately $188,482 outstanding under a separate bilateral secured letter of credit facility as of June 30, 2026.

  1. Commitments and contingencies

The Company operates in a highly regulated industry and is a party to, or has the potential to be a party to, various lawsuits, demands, claims, qui tam suits, governmental investigations and audits (including, without limitation, investigations or other actions resulting from its obligation to self-report suspected violations of law) and other legal proceedings, including, without limitation, those described below. The Company records accruals for certain legal proceedings and regulatory matters to the extent that the Company determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. As of June 30, 2026 and December 31, 2025, each of the Company’s recorded accruals with respect to legal proceedings and regulatory matters were immaterial. While these accruals reflect the Company’s best estimate of the probable loss for those matters as of the dates of those accruals, the recorded amounts may differ materially from the actual amount of the losses for those matters, and any anticipated third party recoveries for any such losses may not ultimately be recoverable. Additionally, in some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal proceedings and regulatory matters, which also may be impacted by various factors, including, without limitation, that they may involve indeterminate claims for monetary damages or may involve fines, penalties or non-monetary remedies; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; are in the early stages of the proceedings; or may result in a change of business practices. Further, there may be various levels of judicial review available to the Company in connection with any such proceeding.

The following is a description of certain lawsuits, claims, governmental investigations and audits and other legal proceedings to which the Company is subject.

Certain Governmental Inquiries and Related Proceedings

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 Civil Investigative Demand (CID) relating to an investigation being conducted by that office and the U.S. Attorney’s Office, Eastern District of Pennsylvania. The subpoena and CID request information on several topics, including certain of the Company’s joint venture arrangements with physicians and physician groups, medical director agreements, and compliance with its five-year Corporate Integrity Agreement, the term of which expired October 22, 2019. In November 2022, the Company learned that, on April 1, 2022, the U.S. Attorney’s Office for the District of New Jersey notified the U.S. District Court for the District of New Jersey of its decision not to elect to intervene in the matter of U.S. ex rel. Doe v. DaVita Inc. and filed a Stipulation of Dismissal. On April 13, 2022, the U.S. District Court for the District of New Jersey dismissed the case without prejudice. On October 12, 2022, the U.S. Attorney’s Office for the Eastern District of Pennsylvania notified the U.S. District Court, Eastern District of Pennsylvania, of its decision not to elect to intervene at this time in the matter of U.S. ex rel. Bayne v. DaVita Inc., et al. The court then unsealed an amended complaint, which alleges violations of federal and state False Claims Acts, by order dated October 14, 2022. On November 8, 2023, the private party relator filed a fourth amended complaint. On November 29, 2023, the Company filed a motion to dismiss the fourth amended complaint. On April 29, 2025, the Court denied the Company’s motion to dismiss. On July 21, 2025, the Company answered the complaint. The Company disputes the allegations in the complaint and intends to defend this action accordingly.

2020 California Department of Insurance Investigation: In April 2020, the California Department of Insurance (CDI) sent the Company an Investigative Subpoena relating to an investigation being conducted by that office. CDI issued a superseding subpoena in September 2020 and an additional subpoena in September 2021. Those subpoenas request information on a number of topics, including but not limited to the Company’s communications with patients about insurance plans and financial assistance from the American Kidney Fund (AKF), analyses of the potential impact of patients’ decisions to change insurance providers, and documents relating to donations or contributions to the AKF. The Company is continuing to cooperate with CDI in this investigation.

2023 District of Columbia Office of Attorney General Investigation: In January 2023, the Office of the Attorney General for the District of Columbia issued a CID to the Company in connection with an antitrust investigation into the AKF. The CID covers the period from January 1, 2016 to the present. The CID requests information on a number of topics, including but not limited to the Company’s communications with the AKF, documents relating to donations to the AKF, and communications with patients, providers, and insurers regarding the AKF. The Company is cooperating with the government in this investigation.

2024 Federal Trade Commission Investigation: In April 2024, the Company received from the Federal Trade Commission (FTC) two CIDs in connection with an industry investigation under Section 5 of the Federal Trade Commission Act regarding the acquisition of medical director services and provision of dialysis services. The CIDs cover the period from January 1, 2016 to the present and generally seek information relating to restrictive covenants, such as non-competes, with physicians. The Company is cooperating with the government in this investigation.

Although the Company cannot predict whether or when proceedings might be initiated or when these matters may be resolved (other than as may be described above), it is not unusual for inquiries such as these to continue for a considerable period of time through the various phases of document and witness requests and ongoing discussions with regulators and to develop over the course of time. In addition to the inquiries and proceedings specifically identified above, the Company frequently is subject to other inquiries by state or federal government agencies. Negative findings or terms and conditions that the Company might agree to accept could result in, among other things, substantial financial penalties or awards against the Company, substantial payments made by the Company, harm to the Company’s reputation, required changes to the Company’s business practices, an impact on the Company's various relationships and/or contracts related to the Company's business, exclusion from future participation in the Medicare, Medicaid and other federal health care programs and, if criminal proceedings were initiated against the Company, members of its board of directors or management, possible criminal penalties, any of which could have a material adverse effect on the Company.

Other Proceedings

2021 Antitrust Indictment and Putative Class Action Suit: On July 14, 2021, an indictment was returned by a grand jury in the U.S. District Court, District of Colorado against the Company and its former chief executive officer in the matter of U.S. v. DaVita Inc., et al. alleging that purported agreements entered into by DaVita's former chief executive officer not to solicit senior-level employees violated Section 1 of the Sherman Act. On April 15, 2022, a jury returned a verdict in the Company’s favor, acquitting both the Company and its former chief executive officer on all counts. On April 20, 2022, the court entered judgments of acquittal and closed the case. On August 9, 2021, DaVita Inc. and its former chief executive officer were added as defendants in a consolidated putative class action complaint in the matter of In re Outpatient Medical Center Employee Antitrust Litigation in the U.S. District Court, Northern District of Illinois. This class action complaint asserts that the defendants violated Section 1 of the Sherman Act and seeks to bring an action on behalf of certain groups of individuals employed by the Company. On October 27, 2024, the plaintiffs filed a Third Amended Complaint, seeking to bring an action on behalf of certain groups of individuals employed by the Company between March 2008 and January 2021, to which the Company responded on December 20, 2024. On September 15, 2025, the plaintiffs filed a motion to certify the class. On June 10, 2026, the Court denied the plaintiffs’ motion for class certification. The Company disputes the allegations in the class action complaint, as well as the asserted violations of the Sherman Act, and intends to defend this action accordingly.

Additionally, from time to time the Company is subject to other lawsuits, demands, claims, governmental investigations and audits and legal proceedings that arise due to the nature of its business, including, without limitation, contractual disputes, such as with payors, suppliers and others, employee-related matters and professional and general liability claims. From time to time, the Company also initiates litigation or other legal proceedings as a plaintiff arising out of contracts or other matters.

Other than as may be described above, the Company cannot predict the ultimate outcomes of the various legal proceedings and regulatory matters to which the Company is or may be subject from time to time, including those described in this Note 7, or the timing of their resolution or the ultimate losses or impact of developments in those matters, which could have a material adverse effect on the Company’s revenues, earnings and cash flows. Further, any legal proceedings or regulatory matters involving the Company, whether meritorious or not, are time consuming, and often require management’s attention and result in significant legal expense, and may result in the diversion of significant operational resources, may impact the Company's various relationships and/or contracts related to the Company's business or otherwise harm the Company’s business, results of operations, financial condition, cash flows or reputation.

  1. Shareholders' equity

Stock-based compensation

During the six months ended June 30, 2026, the Company granted 727 stock-settled restricted and performance stock units with an aggregate grant-date fair value of $116,627. Additionally, the Company granted 98 stock-settled stock appreciation rights with an aggregate grant-date fair value of $5,460.

As of June 30, 2026, the Company had $195,359 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 1.4 years.

Share repurchases

The following table summarizes the Company's common stock repurchases during the three and six months ended June 30, 2026:

Three months ended June 30, 2026Six months ended June 30, 2026
Shares repurchasedAmount paid(1)Average amount(2)Shares repurchasedAmount paid(1)Average amount(2)
Open market repurchases:1,018$165,605$161.082,364$368,529$154.71
Berkshire repurchases:1,220182,865$149.842,879382,805$132.97
Total repurchases:2,238$348,470$154.955,243$751,334$142.77

(1)Includes commissions and excise tax, as applicable. The excise tax is recorded as part of the cost basis of treasury shares repurchased and, as such, is included in stockholders’ equity.

(2)Excludes commissions and excise tax.

Berkshire share repurchase agreement

Pursuant to the April 30, 2024 share repurchase agreement with Berkshire Hathaway Inc. on behalf of itself and its affiliates (collectively, Berkshire), the Company had a repurchase obligation at June 30, 2026 to purchase shares from Berkshire for $36,513 in the aggregate, recorded as a payable and classified as due to related party on the Company's consolidated balance sheet. On July 31, 2026, the Company settled the Berkshire repurchase obligation in total for 183 shares of common stock for $36,513, at an average price paid of $199.55 per share.

See Note 18 to the Company's consolidated financial statements included in the 2025 10-K for further discussion of the Company’s relationship with Berkshire and the share repurchase agreement.

Share repurchase authorizations

The Company is authorized to make share repurchases pursuant to prior Board authorizations. This authorization allows the Company to make purchases from time to time in the open market or in privately negotiated transactions, including without limitation, through accelerated share repurchase transactions, derivative transactions, tender offers, Rule 10b5-1 plans or any combination of the foregoing, depending upon market conditions and other considerations.

As of July 31, 2026, the Company has a total of $1,372,960, excluding excise taxes, available under current authorizations for additional share repurchases. Although these share repurchase authorizations do not have an expiration date, the Company remains subject to share repurchase limitations, including under the terms of its senior secured credit facilities.

  1. Accumulated other comprehensive loss
Three months ended June 30, 2026Six months ended June 30, 2026
Interestrate capagreementsForeigncurrencytranslationadjustmentsAccumulatedothercomprehensivelossInterestrate capagreementsForeigncurrencytranslationadjustmentsAccumulatedothercomprehensiveloss
Beginning balance$(14,367)$(72,592)$(86,959)$(22,398)$(100,385)$(122,783)
Unrealized gains3,72922,73226,46110,59650,52561,121
Related income tax(930)—(930)(2,643)—(2,643)
2,79922,73225,5317,95350,52558,478
Reclassification into net income3,834—3,8347,667—7,667
Related income tax(957)—(957)(1,913)—(1,913)
2,877—2,8775,754—5,754
Ending balance$(8,691)$(49,860)$(58,551)$(8,691)$(49,860)$(58,551)
Three months ended June 30, 2025Six months ended June 30, 2025
Defined benefit pension planInterestrate capagreementsForeigncurrencytranslationadjustmentsAccumulatedothercomprehensivelossDefined benefit pension planInterestrate capagreementsForeigncurrencytranslationadjustmentsAccumulatedothercomprehensiveloss
Beginning balance$46$(15,585)$(211,429)$(226,968)$46$(8,557)$(302,285)$(310,796)
Unrealized (losses) gains—(8,533)94,00185,468—(19,906)184,857164,951
Related income tax—2,128—2,128—4,966—4,966
—(6,405)94,00187,596—(14,940)184,857169,917
Reclassification into net income—2,043—2,043—4,052—4,052
Related income tax—(509)—(509)—(1,011)—(1,011)
—1,534—1,534—3,041—3,041
Ending balance$46$(20,456)$(117,428)$(137,838)$46$(20,456)$(117,428)$(137,838)

The interest rate cap agreement net realized losses reclassified into net income are recorded as debt expense in the corresponding consolidated statements of income. See Note 6 for further details.

  1. Variable interest entities (VIEs)

At June 30, 2026, these condensed consolidated financial statements include total assets of VIEs of $619,318 and total liabilities and noncontrolling interests of VIEs to third parties of $214,273. There have beenno material changes in the nature of the Company's arrangements with VIEs or its judgments concerning them from those described in Note 22 to the Company's consolidated financial statements included in the 2025 10-K.

  1. Fair values of financial instruments

The Company measures the fair value of certain assets 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, temporary equity and commitments. The Company has also classified assets and temporary equities that are measured at fair value on a recurring basis into the appropriate fair value hierarchy levels as defined by the Financial Accounting Standards Board (FASB).

The following table summarizes the Company’s assets and temporary equities measured at fair value on a recurring basis as of June 30, 2026:

TotalQuoted prices inactive marketsfor identical assets(Level 1)Significant otherobservable inputs(Level 2)Significantunobservableinputs(Level 3)
Assets:
Investments in equity securities$41,865$41,865
Interest rate cap agreements$25,035$25,035
Temporary equity:
Noncontrolling interests subject to put provisions$1,561,416$1,561,416

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

Interest rate cap agreements, which are classified in other long-term assets on the Company's consolidated balance sheet, 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 6 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 June 30, 2026, an increase or decrease in the weighted average multiple used in these valuations of one times EBITDA would change the estimated fair value of these noncontrolling interests by approximately $225,000. See Notes 16 and 23 to the Company's consolidated financial statements included in the 2025 10-K for further discussion of the Company’s methodology for estimating the fair value of noncontrolling interests subject to put obligations. For a reconciliation of changes in noncontrolling interests subject to put provisions for the three and six months ended June 30, 2026, see the consolidated statements of equity.

The Company's fair value estimates for its senior secured credit facilities are based upon quoted bid and ask prices for these instruments, a level 2 input. For the Company's senior notes, fair value estimates are based on market level 1 inputs. For acquisition obligations and other notes payable, the carrying values presented approximate their estimated fair values, based on estimates of their present values typically using level 2 interest rate inputs. See Note 6 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, investments in debt securities, accounts payable, other accrued liabilities and lease liabilities. The balances of financial instruments other than lease liabilities are presented in these condensed consolidated financial statements at June 30, 2026 at their approximate fair values due to the short-term nature of their settlements.

  1. Segment reporting

The Company’s separate operating segments include its U.S. dialysis and related lab services business (its U.S. dialysis business), its U.S. integrated kidney care business, its U.S. other ancillary services and its operations in each foreign jurisdiction (collectively, its ancillary services). The Company also maintains a corporate administrative support function.

The Company’s operating segments have been defined based on the separate financial information that is regularly produced and reviewed by the Company’s chief operating decision maker, its Chief Executive Officer, in making decisions about allocating resources to and assessing the financial performance of the Company’s various operating lines of business. The chief operating decision maker does not review total assets by segment to make decisions regarding resources; therefore, the total assets by segment disclosure has not been included.

Currently, the U.S. dialysis and related lab services business qualifies as a separately reportable segment, and all other operating segments have been combined and disclosed in the other segments category. See Note 24 to the Company's consolidated financial statements included in the 2025 10-K for further description of how the Company determines and measures results for its operating segments.

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

Three months ended June 30,Six months ended June 30,
2026202520262025
Segment revenues:
U.S. dialysis
Patient service revenues:
External sources$2,993,948$2,890,709$5,908,902$5,696,136
Intersegment revenues11,36116,71631,83328,450
U.S. dialysis patient service revenues3,005,3092,907,4255,940,7355,724,586
Other revenues
External sources6,5145,96612,79011,974
Total U.S. dialysis revenues3,011,8232,913,3915,953,5255,736,560
Other—Ancillary services
Patient service revenues372,429316,162730,272613,728
Other external sources181,193166,689317,668281,217
Intersegment revenues3,0872,8366,3755,565
Total ancillary services556,709485,6871,054,315900,510
Total net segment revenues3,568,5323,399,0787,007,8406,637,070
Elimination of intersegment revenues(14,448)(19,552)(38,208)(34,015)
Consolidated revenues$3,554,084$3,379,526$6,969,632$6,603,055
Significant segment expenses:
U.S. dialysis
Patient care costs$2,004,694$1,928,462$3,973,750$3,841,890
General and administrative330,892312,089650,664594,768
Depreciation and amortization146,461156,782301,631313,681
Other segment items(1)(8,200)(6,786)(16,464)(12,396)
U.S. dialysis segment expenses2,473,8472,390,5474,909,5814,737,943
Segment operating margin:
U.S. dialysis537,976522,8441,043,944998,617
Other—Ancillary services(2)57,05056,71462,88253,906
Total segment operating margin595,026579,5581,106,8261,052,523
Reconciliation of segment operating income to consolidated income before income taxes:
Corporate administrative support(16,025)(41,717)(45,933)(75,745)
Consolidated operating income579,001537,8411,060,893976,778
Debt expense(150,256)(146,062)(295,387)(281,117)
Debt extinguishment and modification costs(2,035)—(2,035)—
Other income (loss), net8,300(22,851)12,773(40,400)
Income before income taxes$435,010$368,928$776,244$655,261

(1)Other segment items for the Company's U.S. dialysis segment include equity income from nonconsolidated joint ventures for all periods presented.

(2)Includes depreciation and amortization of $21,347 and $17,923 for the three months ended June 30, 2026 and 2025, respectively, and $44,006 and $37,474 for the six months ended June 30, 2026 and 2025, respectively.

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

Six months ended June 30,
20262025
U.S. dialysis$229,523$216,902
Other—Ancillary services42,31347,447
$271,836$264,349
  1. New accounting standards

New standards not yet adopted

In November 2024, the Financial Accounting Standards Board issued ASU 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures, which requires disaggregated disclosure of income statement expenses, including purchases of inventory, employee compensation, depreciation, and amortization. The amendments in this ASU are effective for fiscal years beginning after December 15, 2026 and interim reporting periods beginning after December 15, 2027. The amendments in this ASU may be applied prospectively or retrospectively, and early adoption is permitted. The Company is currently assessing the effect this guidance may have on its consolidated financial statements.

In September 2025, the Financial Accounting Standards Board issued ASU 2025-06, Intangibles—Goodwill and Other—Internal-Use software (Subtopic 350-40), which requires capitalization of software costs when management has authorized and committed to funding a software project and it is probable that the project will be completed and used as intended. The amendments in this ASU are effective for fiscal years beginning after December 15, 2027 and interim reporting periods within those annual reporting periods. The amendments in the ASU may be applied prospectively or retrospectively, and early adoption is permitted. The Company is currently assessing the effect this guidance may have on its consolidated financial statements.

In May 2026, the Financial Accounting Standards Board issued ASU 2026-02, Environmental Credits and Environmental Credit Obligations (Topic 818), which requires environmental credits intended for compliance or exchange to be recognized as assets and initially measured at cost, while costs for credits intended for voluntary use are expensed as incurred. Additionally, the guidance establishes impairment assessment models based on intended use and requires environmental credit obligation liabilities to be recognized based on the credits needed to settle the obligation. The amendments in this ASU are effective for fiscal years beginning after December 15, 2027 and interim reporting periods within those annual reporting periods. The amendments in this ASU must be applied using a modified retrospective approach, and early adoption is permitted. The Company is currently assessing the effect this guidance may have on its consolidated financial statements.

  1. Subsequent events

Elara Caring

On February 2, 2026, the Company signed a definitive agreement to acquire a noncontrolling minority interest in Elara Caring, a leading national provider of skilled home health, hospice, behavioral health, and personal care services, which closed effective July 20, 2026. At the closing, the Company made a cash payment of $200,000, subject to certain customary post-closing adjustments.

Forward Interest Rate Cap Agreements

On July 7, 2026, the Company entered into several forward interest rate cap agreements with an aggregate notional amount of $750,000 that have the economic effect of capping the Company's exposure to Secured Overnight Financing Rate (SOFR) variable interest rate changes on specific portions of the Company's floating rate debt. These cap agreements are designated as cash flow hedges and, as a result, changes in their fair values will be reported in other comprehensive income. These cap agreements do not contain credit-risk contingent features, and become effective on December 29, 2028 and expire on December 31, 2029.

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