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0000927066false00009270662023-05-082023-05-08

 
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

 Form 8-K 

 CURRENT REPORT
 Pursuant to Section 13 or 15(d) of the
Securities Exchange Act of 1934
 
Date of Report (date of earliest event reported): May 8, 2023  


 
DAVITA INC.
(Exact name of registrant as specified in its charter)
 

DE 1-14106 51-0354549
(State or other jurisdiction
of incorporation)
(Commission File Number) (IRS Employer
Identification No.)
 
2000 16th Street
Denver, CO 80202
(Address of principal executive offices including Zip Code)
 
(720) 631-2100
(Registrant’s telephone number, including area code)
 
Not applicable
(Former name or former address, if changed since last report)
 
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
☐    Written communications pursuant to Rule 425 under the Securities Act (17 CFR 240.425)
☐    Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
☐    Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
☐    Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
Securities registered pursuant to Section 12(b) of the Act:
Title of each class:   Trading symbol(s): Name of each exchange on which registered:
Common Stock, $0.001 par value   DVA New York Stock Exchange
Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).
☐    Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐




Item 2.02. Results of Operations and Financial Condition.
 
On May 8, 2023, DaVita Inc. (the "Company") issued a press release announcing its financial results for the quarter ended March 31, 2023. A copy of the press release is furnished as Exhibit 99.1 to this report.
 
The information contained in this Item 2.02 (including Exhibit 99.1 attached hereto) is being furnished and shall not be deemed to be “filed” for the purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that section and shall not be incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly set forth by specific reference in such filing.
 
Item 9.01. Financial Statements and Exhibits.
 
(d) Exhibits.
 
Exhibit
Number
Description
Press Release dated May 8, 2023 announcing the registrant’s financial results for the quarter ended March 31, 2023.
104.0 Cover Page Interactive Data File - the cover page XBRL tags are embedded within the Inline XBRL document.




SIGNATURES
 
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
 
DAVITA INC.
Date: May 8, 2023
By: /s/ John D. Winstel
John D. Winstel
Chief Accounting Officer



EX-99.1 2 dva-33123ex991.htm EX-99.1 Document



Contact:        Investor Relations                    
DaVita Inc.
ir@davita.com
DaVita Inc. 1st Quarter 2023 Results
Denver, Colorado, May 8, 2023 — DaVita Inc. (NYSE: DVA) announced financial and operating results for the quarter ended March 31, 2023.
“In the first quarter, we performed well on our key metrics and our results benefited from an improving macro environment,” said Javier Rodriguez, CEO of DaVita Inc. “While some external uncertainty remains, 2023 is off to a strong start and the continuation of current trends would put us on a path to deliver strong results for the full year.”
Financial and operating highlights for the quarter ended March 31, 2023:
•Consolidated revenues were $2.873 billion.
•Operating income was $312 million and adjusted operating income was $352 million.
•Diluted earnings per share from continuing operations was $1.25 and adjusted diluted earnings per share from continuing operations was $1.58.
•Operating cash flow was $463 million and free cash flow was $265 million.
Three months ended
March 31, 2023 December 31, 2022 March 31, 2022
Net income attributable to DaVita Inc.:
(dollars in millions, except per share data)
Net income from continuing operations $ 116  $ 55  $ 162 
Diluted per share $ 1.25  $ 0.59  $ 1.61 
Adjusted net income from continuing operations(1)
$ 146  $ 102  $ 165 
Adjusted diluted per share(1)
$ 1.58  $ 1.11  $ 1.65 
Net income $ 116  $ 68  $ 162 
Diluted per share $ 1.25  $ 0.74  $ 1.61 
(1)For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 16.
Three months ended
March 31, 2023 December 31, 2022 March 31, 2022
Amount Margin Amount Margin Amount Margin
Operating income (dollars in millions)
Operating income $ 312  10.8  % $ 256  8.8  % $ 338  12.0  %
Adjusted operating income(1)(2)
$ 352  12.2  % $ 317  10.9  % $ 343  12.2  %
(1)For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 16.
(2)Adjusted operating income margin is adjusted operating income divided by consolidated revenues.
1


U.S. dialysis metrics:
Volume: Total U.S. dialysis treatments for the first quarter of 2023 were 7,117,427, or an average of 92,434 treatments per day, representing a per day increase of 0.9% compared to the fourth quarter of 2022. Normalized non-acquired treatment growth in the first quarter of 2023 compared to the first quarter of 2022 was 0.0%.
  Three months ended Quarter
change
Three months ended Year to date
change
  March 31,
2023
December 31,
2022
March 31,
2023
March 31,
2022
(dollars in millions, except per treatment data)
Revenue per treatment $ 366.14  $ 366.30  $ (0.16) $ 366.14  $ 361.35  $ 4.79 
Patient care costs per treatment $ 257.34  $ 257.60  $ (0.26) $ 257.34  $ 252.61  $ 4.73 
General and administrative $ 259  $ 283  $ (24) $ 259  $ 217  $ 42 
Primary drivers of the changes in the table above were as follows:
Revenue: The quarter change was primarily due to a seasonal decline from co-insurance and deductibles, partially offset by an increase in the Medicare base rate in 2023, favorable changes due to the continued shift to Medicare Advantage plans and a seasonal increase from hospital inpatient dialysis treatments. The year to date change was primarily driven by a net increase in the Medicare rate due to base rate in 2023 partially offset by reinstatement of 2% sequestration. The increase was also impacted by the continued shift to Medicare Advantage plans and increases in hospital inpatient dialysis revenues.
Patient care costs: The quarter change was primarily due to decreases in pharmaceutical costs, health benefit expenses, contract wages and insurance expense. These decreases were partially offset by increases in compensation expenses and fixed other direct operating expenses in our dialysis centers due to fewer number of treatments in the first quarter of 2023. Other drivers of this change include increases in center closure costs, as described below, and increases in costs related to management meetings. The year to date change was primarily due to increased compensation expenses including increased wage rates and headcount. Other drivers of the increase include other direct operating expenses associated with our dialysis centers as well as increases in center closure costs, as described below, and travel costs. These increases were partially offset by decreased pharmaceutical costs, contract wages and health benefit expenses.
General and administrative: The quarter change was primarily due to decreased professional fees, a refund received related to 2022 advocacy costs, seasonal decreases in other general and administrative costs, including IT costs and other purchased services as well as health benefit expenses. These decreases were partially offset by increased long-term incentive compensation expense. The year to date change was primarily due to increases in compensation expenses including increased wage rates and severance costs, as described below. Other drivers of this change include increased costs related to travel and management meetings, center closure costs, as described below, and higher IT-related costs. These increases were partially offset by refund received related to 2022 advocacy costs.
Certain items impacting the quarter operating results:
Closure costs. During the third quarter of 2022, we began a strategic review of our outpatient clinic capacity requirements and utilization, which have been impacted both by declines in our patient census in some markets due to the COVID-19 pandemic, as well as by our initiatives toward, and advances in, increasing the proportion of our home dialysis patients. This review has resulted in higher than normal charges for center capacity closures.
During the first quarter of 2023, we incurred charges for U.S. dialysis center closures of approximately $22.2 million, which increased our patient care costs by $12.6 million, our general and administrative expenses by $4.8 million and our depreciation and amortization expense by $4.8 million. These capacity closure costs included net losses on assets retired, lease costs, asset impairments and accelerated depreciation and amortization.
Severance costs and other. During the fourth quarter of 2022, we committed to a plan to increase efficiencies and cost savings in certain general and administrative support functions. As a result of this plan, we recognized expenses related to termination and other benefit commitments in our U.S. dialysis business, integrated kidney care (IKC) business and corporate administrative support of $16.9 million, 0.4 million $0.6 million, respectively, during the first quarter of 2023.
2


Financial and operating metrics:
Three months ended
March 31,
Twelve months ended
March 31,
2023 2022 2023 2022
Cash flow: (dollars in millions)
Operating cash flow $ 463  $ 322  $ 1,705  $ 2,099 
Free cash flow(1)
$ 265  $ 147  $ 935  $ 1,297 
(1)For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 16.
Three months ended March 31, 2023
Effective income tax rate on:
Income from continuing operations 20.5  %
Income from continuing operations attributable to DaVita Inc.(1)
27.5  %
Adjusted income from continuing operations attributable to DaVita Inc.(1)
27.0  %
(1)For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 16.
Center activity: As of March 31, 2023, we provided dialysis services to a total of approximately 246,000 patients at 3,058 outpatient dialysis centers, of which 2,707 centers were located in the United States and 351 centers were located in 11 countries outside of the United States. During the first quarter of 2023, we opened a total of three new dialysis centers and closed 20 dialysis centers in the United States. We also opened three dialysis centers and closed two dialysis centers outside of the United States during the first quarter of 2023.
Integrated kidney care (IKC): As of March 31, 2023, we had approximately 67,000 patients in risk-based integrated care arrangements representing approximately $5.2 billion in annualized medical spend. We also had an additional 15,000 patients in other integrated care arrangements; we do not include the medical spend for these patients in this annualized medical spend estimate. See additional description of these metrics at Note 2.

3


Outlook:
The following forward-looking measures and the underlying assumptions involve significant known and unknown risks and uncertainties, including those described below, and actual results may vary materially from these forward-looking measures. For example, the widespread impact of the COVID-19 pandemic continues to generate significant risk and uncertainty, and as a result, our future results could vary materially from the guidance provided below. We do not provide guidance for operating income or diluted net income per share attributable to DaVita Inc. on a basis consistent with United States generally accepted accounting principles (GAAP) nor a reconciliation of forward-looking non-GAAP financial measures to the most directly comparable GAAP financial measures on a forward-looking basis because we are unable to predict certain items contained in the GAAP measures without unreasonable efforts. These non-GAAP financial measures do not include certain items, including capacity closure charges, severance costs and foreign currency fluctuations, which may be significant. The guidance for our effective income tax rate on adjusted income attributable to DaVita Inc. also excludes the amount of third-party owners' income and related taxes attributable to non-tax paying entities.
Current 2023 guidance Prior 2023 guidance
Low High Low High
(dollars in millions, except per share data)
Adjusted operating income from continuing operations $1,475 $1,625 $1,400 $1,600
Adjusted diluted net income from continuing operations per share
 attributable to DaVita Inc.
$6.20 $7.30 $5.45 $6.95
Free cash flow $750 $1,000 $650 $900
We will be holding a conference call to discuss our results for the first quarter ended March 31, 2023, on May 8, 2023, at 5:00 p.m. Eastern Time. To join the conference call, please dial (877) 918-6630 from the U.S. or (517) 308-9042 from outside the U.S., and provide the operator the password 'Earnings'. This call is being webcast and can be accessed at the DaVita Investor Relations website investors.davita.com. A replay of the conference call will also be available at investors.davita.com for the following 30 days.
4


Forward looking statements
DaVita Inc. and its representatives may from time to time make written and oral forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA), including statements in this release, filings with the Securities and Exchange Commission (SEC), reports to stockholders and in meetings with investors and analysts. All statements in this release, during the related presentation or other meetings, other than statements of historical fact, are forward-looking statements and as such are intended to be covered by the safe harbor for "forward-looking statements" provided by the PSLRA. These forward-looking statements could include, among other things, DaVita's response to and the expected future impacts of the coronavirus (COVID-19), including statements about our balance sheet and liquidity, our expenses and expense offsets, revenues, billings and collections, availability or cost of supplies, treatment volumes, mix expectation, such as the percentage or number of patients under commercial insurance, the availability, acceptance, impact, administration and efficacy of COVID-19 vaccines, treatments and therapies, the continuing impact on the U.S. and global economies, labor market conditions, and overall impact on our patients and teammates, as well as other statements regarding our future operations, financial condition and prospects, expenses, strategic initiatives, government and commercial payment rates, expectations related to value-based care, integrated kidney care, and Medicare Advantage (MA) plan enrollment and our ongoing stock repurchase program, and statements related to our guidance and expectations for future periods and the assumptions underlying any such projections. All statements in this release, other than statements of historical fact, are forward-looking statements. Without limiting the foregoing, statements including the words "expect," "intend," "will," "could," "plan," "anticipate," "believe," "forecast," "guidance," "outlook," "goals," and similar expressions are intended to identify forward-looking statements. These forward-looking statements are based on DaVita's current expectations and are based solely on information available as of the date of this release. DaVita undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of changed circumstances, new information, future events or otherwise, except as may be required by law. Actual future events and results could differ materially from any forward-looking statements due to numerous factors that involve substantial known and unknown risks and uncertainties. These risks and uncertainties include, among other things:
•the continuing impact of the COVID-19 pandemic, current macroeconomic and marketplace conditions, and global events, many of which are interrelated and which relate to, among other things, the impact of the COVID-19 pandemic on our patients, teammates, physician partners, suppliers, business, operations, reputation, financial condition and results of operations; the government's response to the ongoing pandemic, the pandemic's continuing impact on the U.S. and global economies, labor market conditions, interest rates, inflation and evolving monetary policies; the availability, acceptance, impact and efficacy of COVID-19 vaccines, treatments and therapies; further spread or resurgence of the virus, including as a result of the emergence of new strains of the virus; the impact of the pandemic on our revenues and non-acquired growth due to lower treatment volumes; COVID-19's impact on the chronic kidney disease (CKD) population and our patient population including on the mortality of these patients; any potential negative impact on our commercial mix or the number of our patients covered by commercial insurance plans; continued increased COVID-19-related costs; our ability to successfully implement cost savings initiatives; supply chain challenges and disruptions; and elevated teammate turnover and training costs and higher salary and wage expense, including, among other things, increased contract wages, driven in part by persisting labor market conditions and a high demand for our clinical personnel, any of which may also have the effect of heightening many of the other risks and uncertainties discussed below, and in many cases, the impact of the pandemic and the aforementioned global economic conditions on our business may persist even after the pandemic subsides;
•the concentration of profits generated by higher-paying commercial payor plans for which there is continued downward pressure on average realized payment rates; a reduction in the number or percentage of our patients under such plans, including, without limitation, as a result of restrictions or prohibitions on the use and/or availability of charitable premium assistance, which may result in the loss of revenues or patients, as a result of our making incorrect assumptions about how our patients will respond to any change in financial assistance from charitable organizations; or as a result of payors' implementing restrictive plan designs, including, without limitation, actions taken in response to the U.S. Supreme Court’s decision in Marietta Memorial Hospital Employee Health Benefit Plan, et al. v. DaVita Inc. et al. (Marietta); how and whether regulators and legislators will respond to the Marietta decision including, without limitation, whether they will issue regulatory guidance or adopt new legislation; how courts will interpret other anti-discriminatory provisions that may apply to restrictive plan designs; whether there could be other potential negative impacts of the Marietta decision; and the timing of each of these items;
•the extent to which the ongoing implementation of healthcare reform, or changes in or new legislation, regulations or guidance, enforcement thereof or related litigation result in a reduction in coverage or reimbursement rates for our services, a reduction in the number of patients enrolled in or that select higher-paying commercial plans, including for example MA plans or other material impacts to our business or operations; or our making incorrect assumptions about how our patients will respond to any such developments;
•risks arising from potential changes in laws, regulations or requirements applicable to us, such as potential and proposed federal and/or state legislation, regulation, ballot, executive action or other initiatives, including, without limitation, those related to healthcare and/or labor matters;
5


•our ability to attract, retain and motivate teammates and our ability to manage operating cost increases or productivity decreases whether due to union organizing activities, legislative or other changes, demand for labor, volatility and uncertainty in the labor market, the current challenging and highly competitive labor market conditions, or other reasons;
•U.S. and global economic and marketplace conditions, interest rates, inflation, unemployment, labor market conditions, and evolving monetary policies, and our ability to respond to these challenging conditions, including among other things our ability to successfully identify cost savings opportunities and to implement cost savings initiatives such as ongoing initiatives that increase our use of third party service providers to perform certain activities, initiatives that relate to clinic optimization and capacity utilization improvement, and procurement opportunities, among other things;
•our ability to successfully implement our strategies with respect to integrated kidney care and value-based care initiatives and home based dialysis in the desired time frame and in a complex, dynamic and highly regulated environment, including, among other things, maintaining our existing business; meeting growth expectations; recovering our investments; entering into agreements with payors, third party vendors and others on terms that are competitive and, as appropriate, prove actuarially sound; structuring operations, agreements and arrangements to comply with evolving rules and regulations; finding, training and retaining appropriate staff; and further developing our integrated care and other capabilities to provide competitive programs at scale;
•a reduction in government payment rates under the Medicare End Stage Renal Disease program, state Medicaid or other government-based programs and the impact of the Medicare Advantage benchmark structure;
•noncompliance by us or our business associates with any privacy or security laws or any security breach by us or a third party involving the misappropriation, loss or other unauthorized use or disclosure of confidential information;
•legal and compliance risks, such as our continued compliance with complex, and at times, evolving government regulations and requirements;
•the impact of the political environment and related developments on the current healthcare marketplace and on our business, including with respect to the Affordable Care Act, the exchanges and many other core aspects of the current healthcare marketplace, as well as the composition of the U.S. Supreme Court and the current presidential administration and congressional majority;
•changes in pharmaceutical practice patterns, reimbursement and payment policies and processes, or pharmaceutical pricing, including with respect to hypoxia inducible factors, among other things;
•our ability to develop and maintain relationships with physicians and hospitals, changing affiliation models for physicians, and the emergence of new models of care or other initiatives introduced by the government or private sector that, among other things, may erode our patient base and impact reimbursement rates;
•our ability to complete acquisitions, mergers, dispositions, joint ventures or other strategic transactions that we might announce or be considering, on terms favorable to us or at all, or to successfully integrate any acquired businesses, or to successfully operate any acquired businesses, joint ventures or other strategic transactions, or to successfully expand our operations and services in markets outside the United States, or to businesses or products outside of dialysis services;
•continued increased competition from dialysis providers and others, and other potential marketplace changes, including without limitation increased investment in and availability of funding to new entrants in the dialysis and pre-dialysis marketplace;
•the variability of our cash flows, including without limitation any extended billing or collections cycles; the risk that we may not be able to generate or access sufficient cash in the future to service our indebtedness or to fund our other liquidity needs; and the risk that we may not be able to refinance our indebtedness as it becomes due, on terms favorable to us or at all;
•factors that may impact our ability to repurchase stock under our stock repurchase program and the timing of any such stock repurchases, as well as our use of a considerable amount of available funds to repurchase stock;
•risks arising from the use of accounting estimates, judgments and interpretations in our financial statements;
•impairment of our goodwill, investments or other assets;
•our aspirations, goals and disclosures related to environmental, social and governance (ESG) matters, including, among other things, evolving regulatory requirements affecting ESG standards, measurements and reporting requirements; the availability of suppliers that can meet our sustainability standards; and our ability to recruit, develop and retain diverse talent in our labor markets; and
•the other risk factors, trends and uncertainties set forth in our Annual Report on Form 10-K for the year ended December 31, 2022 and the risks and uncertainties discussed in any subsequent reports that we file or furnish with the SEC from time to time.
The financial information presented in this release is unaudited and is subject to change as a result of subsequent events or adjustments, if any, arising prior to the filing of the Company's Quarterly Report on Form 10-Q for the quarter ended March 31, 2023.
6


DAVITA INC.
CONSOLIDATED STATEMENTS OF INCOME
(unaudited)
(dollars and shares in thousands, except per share data)
Three months ended March 31,
  2023 2022
Dialysis patient service revenues $ 2,760,034  $ 2,716,281 
Other revenues 112,665  101,274 
Total revenues 2,872,699  2,817,555 
Operating expenses:    
Patient care costs 2,058,189  2,018,529 
General and administrative 331,614  294,820 
Depreciation and amortization 178,071  172,944 
Equity investment income, net (6,820) (7,046)
Total operating expenses 2,561,054  2,479,247 
Operating income 311,645  338,308 
Debt expense (100,774) (73,791)
Other income (loss), net 3,752  (1,786)
Income before income taxes 214,623  262,731 
Income tax expense 43,955  57,013 
Net income 170,668  205,718 
Less: Net income attributable to noncontrolling interests (55,121) (43,596)
Net income attributable to DaVita Inc. $ 115,547  $ 162,122 
Earnings per share attributable to DaVita Inc.:    
Basic net income $ 1.28  $ 1.68 
Diluted net income $ 1.25  $ 1.61 
Weighted average shares for earnings per share:
Basic shares 90,497  96,342 
Diluted shares 92,483  100,503 

7


DAVITA INC.
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(unaudited)
(dollars in thousands)
 
Three months ended March 31,
  2023 2022
Net income $ 170,668  $ 205,718 
Other comprehensive income, net of tax:
Unrealized (losses) gains on interest rate cap agreements:
Unrealized (losses) gains (3,539) 41,132 
Reclassifications of net realized (gains) losses into net income (15,742) 1,033 
Unrealized gains on foreign currency translation: 33,561  62,212 
Other comprehensive income 14,280  104,377 
Total comprehensive income 184,948  310,095 
Less: Comprehensive income attributable to noncontrolling interests (55,121) (43,596)
Comprehensive income attributable to DaVita Inc. $ 129,827  $ 266,499 

8


DAVITA INC.
CONSOLIDATED STATEMENTS OF CASH FLOW
(unaudited)
(dollars in thousands)
Three months ended March 31,
  2023 2022
Cash flows from operating activities:  
Net income $ 170,668  $ 205,718 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization 178,071  172,944 
Stock-based compensation expense 25,373  24,904 
Deferred income taxes (3,621) (41)
Equity investment loss, net 3,044  664 
Other non-cash charges, net 5,864  4,714 
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:
Accounts receivable 81,850  (66,270)
Inventories 2,758  849 
Other receivables and prepaid and other current assets 66,595  (17,966)
Other long-term assets (615) 3,520 
Accounts payable (20,535) 21,402 
Accrued compensation and benefits (74,144) (95,927)
Other current liabilities (6,486) 26,912 
Income taxes 39,251  52,473 
Other long-term liabilities (5,516) (11,701)
Net cash provided by operating activities 462,557  322,195 
Cash flows from investing activities:  
Additions of property and equipment (147,705) (123,108)
Acquisitions —  (5,166)
Proceeds from asset and business sales 13,474  11,353 
Purchase of debt investments held-to-maturity (25,000) (5,070)
Purchase of other debt and equity investments (4,643) (2,726)
Proceeds from debt investments held-to-maturity 50,258  5,070 
Proceeds from sale of other debt and equity investments 3,856  3,773 
Purchase of equity method investments (7,904) (2,962)
Distributions from equity method investments 1,120  470 
Net cash used in investing activities (116,544) (118,366)
Cash flows from financing activities:
Borrowings 611,829  354,285 
Payments on long-term debt (880,552) (398,990)
Deferred financing and debt redemption costs (7) — 
Purchase of treasury stock —  (236,232)
Distributions to noncontrolling interests (54,837) (65,452)
Net payments related to stock purchases and awards (7,902) (501)
Contributions from noncontrolling interests 4,725  4,929 
Proceeds from sales of additional noncontrolling interests 50,832  3,673 
Purchases of noncontrolling interests —  (3,283)
Net cash used in financing activities (275,912) (341,571)
Effect of exchange rate changes on cash, cash equivalents and restricted cash 2,307  3,363 
Net increase (decrease) in cash, cash equivalents and restricted cash 72,408  (134,379)
Cash, cash equivalents and restricted cash at beginning of the year 338,989  554,960 
Cash, cash equivalents and restricted cash at end of the period $ 411,397  $ 420,581 

9


DAVITA INC.
CONSOLIDATED BALANCE SHEETS
(unaudited)
(dollars and shares in thousands, except per share data)
  March 31, 2023 December 31, 2022
ASSETS    
Cash and cash equivalents $ 317,132  $ 244,086 
Restricted cash and equivalents 94,265  94,903 
Short-term investments 49,965  77,693 
Accounts receivable 2,057,809  2,132,070 
Inventories 106,770  109,122 
Other receivables 324,405  413,976 
Prepaid and other current assets 89,393  78,839 
Income tax receivable —  4,603 
Total current assets 3,039,739  3,155,292 
Property and equipment, net of accumulated depreciation of $5,395,966 and $5,265,372, respectively
3,216,373  3,256,397 
Operating lease right-of-use assets 2,617,018  2,666,242 
Intangible assets, net of accumulated amortization of $40,945 and $49,772, respectively
186,758  182,687 
Equity method and other investments 241,747  231,108 
Long-term investments 44,520  44,329 
Other long-term assets 291,321  315,587 
Goodwill 7,090,311  7,076,610 
  $ 16,727,787  $ 16,928,252 
LIABILITIES AND EQUITY    
Accounts payable $ 447,969  $ 479,780 
Other liabilities 796,742  802,469 
Accrued compensation and benefits 618,931  692,654 
Current portion of operating lease liabilities 394,607  395,401 
Current portion of long-term debt 242,193  231,404 
Income tax payable 64,651  18,039 
Total current liabilities 2,565,093  2,619,747 
Long-term operating lease liabilities 2,455,144  2,503,068 
Long-term debt 8,417,532  8,692,617 
Other long-term liabilities 100,229  105,233 
Deferred income taxes 771,087  782,787 
Total liabilities 14,309,085  14,703,452 
Commitments and contingencies
Noncontrolling interests subject to put provisions 1,398,829  1,348,908 
Equity:    
Preferred stock ($0.001 par value, 5,000 shares authorized; none issued)
—  — 
Common stock ($0.001 par value, 450,000 shares authorized; 90,650 and 90,411 shares issued
 and outstanding at March 31, 2023 and December 31, 2022, respectively)
91  90 
Additional paid-in capital 590,251  606,935 
Retained earnings 290,034  174,487 
Accumulated other comprehensive loss (54,906) (69,186)
Total DaVita Inc. shareholders' equity 825,470  712,326 
Noncontrolling interests not subject to put provisions 194,403  163,566 
Total equity 1,019,873  875,892 
  $ 16,727,787  $ 16,928,252 

10


DAVITA INC.
SUPPLEMENTAL FINANCIAL DATA
(unaudited)
(dollars in millions and shares in thousands, except per treatment data)
Three months ended
March 31,
2023
December 31,
2022
March 31,
2022
1. Consolidated business metrics:
Operating margin 10.8  % 8.8  % 12.0  %
Adjusted operating margin excluding certain items(1)(2)
12.2  % 10.9  % 12.2  %
General and administrative expenses as a percent of consolidated revenues(3)
11.5  % 13.0  % 10.5  %
Effective income tax rate on income from continuing operations
20.5  % 23.3  % 21.7  %
Effective income tax rate on income from continuing operations
 attributable to DaVita Inc.(1)
27.5  % 38.5  % 26.0  %
Effective income tax rate on adjusted income from continuing operations
 attributable to DaVita Inc.(1)
27.0  % 31.7  % 26.0  %
2. Summary of financial results:
Revenues:
U.S. dialysis patient services and other
$ 2,612  $ 2,658  $ 2,575 
Other—Ancillary services
Integrated kidney care 98  102  87 
Other U.S. ancillary
International dialysis patient service and other
179  177  173 
284  285  265 
Eliminations
(23) (27) (22)
Total consolidated revenues
$ 2,873  $ 2,917  $ 2,818 
Operating income (loss):
U.S. dialysis
$ 361  $ 335  $ 406 
Other—Ancillary services
Integrated kidney care (37) (34) (37)
Other U.S. ancillary (3) (1) (3)
International(4)
15  (4)
(25) (40) (32)
Corporate administrative support expenses
(25) (38) (36)
Total consolidated operating income
$ 312  $ 256  $ 338 

11


DAVITA INC.
SUPPLEMENTAL FINANCIAL DATA - continued
(unaudited)
(dollars in millions and shares in thousands, except per treatment data)
Three months ended
March 31,
2023
December 31,
2022
March 31,
2022
3. Summary of reportable segment financial results and metrics:
U.S. dialysis
Financial results
Revenue:
Dialysis patient service revenues
$ 2,606  $ 2,652  $ 2,569 
Other revenues
Total operating revenues
2,612  2,658  2,575 
Operating expenses:
Patient care costs
1,832  1,865  1,796 
General and administrative
259  283  217 
Depreciation and amortization
167  184  162 
Equity investment income
(6) (8) (6)
Total operating expenses
2,251  2,324  2,169 
Segment operating income $ 361  $ 335  $ 406 
Reconciliation for non-GAAP measure:
Closure charges 22  35 
Severance and other costs 17  17  — 
Adjusted segment operating income(1)
$ 400  $ 387  $ 411 
Metrics
Volume:
Treatments 7,117,427  7,239,660  7,109,788 
Number of treatment days 77.0  79.0  77.0 
Average treatments per day 92,434  91,641  92,335 
Per day year-over-year increase (decrease) 0.1  % (2.9) % (2.4) %
Normalized year-over-year non-acquired treatment growth(5)
—  % (2.1) % (1.9) %
Operating net revenues:
Average patient service revenue per treatment $ 366.14  $ 366.30  $ 361.35 
Expenses:
Patient care costs per treatment
$ 257.34  $ 257.60  $ 252.61 
General and administrative expenses per treatment $ 36.39  $ 39.07  $ 30.50 
Depreciation and amortization expense per treatment $ 23.46  $ 25.36  $ 22.79 
Accounts receivable:
Receivables
$ 1,769  $ 1,899  $ 1,837 
DSO
62  66  65 
12


DAVITA INC.
SUPPLEMENTAL FINANCIAL DATA - continued
(unaudited)
(dollars in millions and shares in thousands, except per treatment data)
Three months ended
March 31,
2023
December 31,
2022
March 31,
2022
4. Cash flow:
Operating cash flow $ 463  $ 344  $ 322 
Operating cash flow, last twelve months $ 1,705  $ 1,565  $ 2,099 
Free cash flow(1)
$ 265  $ 75  $ 147 
Free cash flow, last twelve months(1)
$ 935  $ 817  $ 1,297 
Capital expenditures:
Routine maintenance/IT/other
$ 109  $ 147  $ 84 
Development and relocations
$ 39  $ 47  $ 39 
Acquisition expenditures
$ —  $ 13  $
Proceeds from sale of self-developed properties $ —  $ $
5. Debt and capital structure:
Total debt(6)
$ 8,701  $ 8,969  $ 8,927 
Net debt, net of cash and cash equivalents(6)
$ 8,384  $ 8,724  $ 8,599 
Leverage ratio(7)
3.89x 4.03x 3.50x
Weighted average effective interest rate:
During the quarter
4.55  % 4.49  % 3.35  %
At end of the quarter
4.53  % 4.52  % 3.52  %
On the senior secured credit facilities at end of the quarter 4.60  % 4.59  % 2.54  %
Debt with fixed and capped rates as a percentage of total debt:
Debt with rates fixed by its terms
53  % 51  % 52  %
Debt with rates fixed by its terms or capped by cap agreements 93  % 90  % 91  %
Amount spent on share repurchases $ —  $ —  $ 233 
Number of shares repurchased —  —  2,104 
Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.
(1)These are non-GAAP financial measures. For a reconciliation of these non-GAAP financial measures to their most comparable measure calculated and presented in accordance with GAAP, and for a definition of adjusted amounts, see attached reconciliation schedules.
(2)Adjusted operating income margin is adjusted operating income divided by consolidated revenues.
(3)General and administrative expenses include certain corporate support, long-term incentive compensation and advocacy costs.
(4)The reported operating income for the three months ended March 31, 2023, December 31, 2022 and March 31, 2022 includes foreign currency (losses) gains embedded in equity method income recognized from our Asia Pacific joint venture of approximately $(0.7), $(5.0) and $0.3, respectively.
(5)Normalized non-acquired treatment growth reflects year-over-year growth in treatment volume, adjusted to exclude acquisitions and other similar transactions, and further adjusted to normalize for the number and mix of treatment days in a given quarter versus the prior year quarter.
(6)The debt amounts as of March 31, 2023, December 31, 2022 and March 31, 2022 presented exclude approximately $41.5, $44.5 and $53.6, respectively, of debt discount, premium and other deferred financing costs related to our senior secured credit facilities and senior notes in effect or outstanding at that time.
(7)See Note 1: Calculation of the Leverage Ratio on page 14.
13


DAVITA INC.
SUPPLEMENTAL FINANCIAL DATA-continued
(unaudited)
(dollars in millions)
Note 1: Calculation of the Leverage Ratio
Under our senior secured credit facilities (the Credit Agreement) dated August 12, 2019, the leverage ratio is defined as (a) all funded debt plus the face amount of all letters of credit issued, minus unrestricted cash and cash equivalents (including short-term investments) not to exceed $750 divided by (b) "Consolidated EBITDA." The leverage ratio determines the interest rate margin payable by the Company for its Term Loan A and revolving line of credit under the Credit Agreement by establishing the margin over the base interest rate (LIBOR) that is applicable. The calculation below is based on the last twelve months of "Consolidated EBITDA," as of the end of the reported period and pro forma for acquisitions or divestitures that occurred during the period, and "Consolidated net debt" at the end of the reported period, each as defined in the Credit Agreement. The Company’s management believes the presentation of "Consolidated EBITDA" is useful to investors to enhance their understanding of the Company’s leverage ratio under its Credit Agreement. The leverage ratio calculated by the Company is a non-GAAP measure and should not be considered a substitute for the ratio of total debt to operating income, determined in accordance with GAAP. The Company’s calculation of its leverage ratio might not be calculated in the same manner as, and thus might not be comparable to, similarly titled measures of other companies.
Twelve months ended
March 31,
2023
December 31,
2022
March 31,
2022
Net income from continuing operations attributable to DaVita Inc. $ 500  $ 547  $ 903 
Income taxes 185  198  279 
Interest expense 350  326  268 
Depreciation and amortization 738  733  688 
Noncontrolling interests and equity investment income, net 233  221  223 
Stock-settled stock-based compensation 95  95  102 
Other 81  55  20 
"Consolidated EBITDA" $ 2,182  $ 2,175  $ 2,481 
March 31,
2023
December 31,
2022
March 31,
2022
Total debt, excluding debt discount and other deferred financing costs(1)
$ 8,701  $ 8,969  $ 8,927 
Letters of credit issued 151  109  108 
8,853  9,077  9,035 
Less: Cash and cash equivalents including short-term investments(2)
(364) (318) (344)
Consolidated net debt $ 8,489  $ 8,759  $ 8,691 
Last twelve months "Consolidated EBITDA" $ 2,182  $ 2,175  $ 2,481 
Leverage ratio 3.89x 4.03x 3.50x
Maximum leverage ratio permitted under the Credit Agreement 5.00x 5.00x 5.00x
Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.
(1)The debt amounts as of March 31, 2023, December 31, 2022 and March 31, 2022 presented exclude approximately $41.5, $44.5 and $53.6, respectively, of debt discount, premium and other deferred financing costs related to our senior secured credit facilities and senior notes in effect or outstanding at that time.
(2)This excludes amounts not readily convertible to cash related to the Company's non-qualified deferred compensation plans for all periods presented. The Credit Agreement limits the amount deducted for cash and cash equivalents, including short-term investments, to the lesser of all unrestricted cash and cash equivalents, including short-term investments of the Company or $750.
14


DAVITA INC.
INTEGRATED CARE METRICS
(unaudited)
Note 2:    Integrated Care Metrics
Our integrated kidney care (IKC) business is party to a variety of risk-based integrated care and disease management arrangements, including value-based care (VBC) contracts under which we assume full or shared financial risk for the total medical cost of care for patients below or above a benchmark.
The aggregate amount of medical spend associated with risk-based integrated care arrangements that we disclose includes both medical costs included in our reported expenses for certain risk-based arrangements (such as its special needs plans), as well as the aggregate estimated benchmark amount above or below which we will incur profit or loss on for VBC arrangements under which third-party medical costs are not included in our reported results. This metric is an annualization of our estimate of this amount for the most recent quarter.
A number of our VBC contracts are subject to complex or novel patient attribution mechanics and benchmark adjustments, some of which are based on information not reported to us until periods after we report our quarterly results. As a result, our estimates of our patients under, and the dollar amount of, our value-based contracts remain subject to estimation uncertainty.
15


DAVITA INC.
RECONCILIATIONS FOR NON-GAAP MEASURES
(unaudited)
Note on Non-GAAP Financial Measures
As used in this press release, the term "adjusted" refers to non-GAAP measures as follows, each as reconciled to its most comparable GAAP measure as presented in the non-GAAP reconciliations in the notes to this press release: (i) for income and expense measures, the term "adjusted" refers to operating performance measures that exclude certain items such as impairment charges, (gain) loss on ownership changes, capacity closure charges, restructuring charges, accruals for legal matters and debt prepayment and refinancing charges; and (ii) the term "effective income tax rate on adjusted income from continuing operations attributable to DaVita Inc." represents the Company’s effective tax rate excluding applicable non-GAAP items and the tax associated with them as well as noncontrolling owners’ income, which primarily relates to non-tax paying entities. Note that the non-GAAP measures presented for prior periods below have been conformed to the non-GAAP measures presented for the current period.
These non-GAAP or "adjusted" measures are presented because management believes these measures are useful adjuncts to GAAP results. However, these non-GAAP measures should not be considered alternatives to the corresponding measures determined under GAAP. 
Specifically, management uses adjusted measures of operating expenses for its U.S. dialysis business, adjusted U.S. dialysis patient care costs per treatment, adjusted operating income, adjusted net income from continuing operations attributable to DaVita Inc. and adjusted diluted net income per share from continuing operations attributable to DaVita Inc. to compare and evaluate our performance period over period and relative to competitors, to analyze the underlying trends in our business, to establish operational budgets and forecasts and for incentive compensation purposes. We believe these non-GAAP measures also are useful to investors and analysts in evaluating our performance over time and relative to competitors, as well as in analyzing the underlying trends in our business. Furthermore, we believe these presentations enhance a user's understanding of our normal consolidated results by excluding certain items which we do not believe are indicative of our ordinary results of operations. As a result, adjusting for these amounts allows for comparison to our normalized prior period results.
The effective income tax rate on adjusted income from continuing operations attributable to DaVita Inc. excludes noncontrolling owners' income and certain non-deductible and other charges which we do not believe are indicative of our ordinary results. Accordingly, we believe these adjusted effective income tax rates are useful to management, investors and analysts in evaluating our performance and establishing expectations for income taxes incurred on our ordinary results attributable to DaVita Inc.
Finally, free cash flow represents net cash provided by operating activities less distributions to noncontrolling interests and all capital expenditures (including development capital expenditures, routine maintenance and information technology); plus contributions from noncontrolling interests and proceeds from the sale of self-developed properties. Management uses this measure to assess our ability to fund acquisitions and meet our debt service obligations and we believe this measure is equally useful to investors and analysts as an adjunct to cash flows from operating activities and other measures under GAAP.
It is important to bear in mind that these non-GAAP "adjusted" measures are not measures of financial performance or liquidity under GAAP and should not be considered in isolation from, nor as substitutes for, their most comparable GAAP measures.
The following Notes 3 through 7 provide reconciliations of the non-GAAP financial measures presented in this press release to their most comparable GAAP measures.
16


DAVITA INC.
RECONCILIATIONS FOR NON-GAAP MEASURES
(unaudited)
(dollars in millions, except per share data)

Note 3:    Adjusted net income from continuing operations and adjusted diluted net income from continuing operations per share attributable to DaVita Inc.
Three months ended
March 31,
2023
December 31,
2022
March 31,
2022
Dollars Per share Dollars Per share Dollars Per share
Consolidated:
Net income from continuing operations
 attributable to DaVita Inc.
$ 116  $ 1.25  $ 55  $ 0.59  $ 162  $ 1.61 
Closure charges impacting:
 Patient care costs 13  0.14  0.07  0.03 
 General and administrative: 0.05  0.09  0.01 
 Depreciation and amortization 0.05  24  0.26  —  — 
Total closure charges 22  0.24  38  0.42  0.04 
Severance and other costs 18  0.19  23  0.25  —  — 
Related income tax (10) (0.11) (13) (0.15) (1) (0.01)
Adjusted net income from continuing operations
 attributable to DaVita Inc.
$ 146  $ 1.58  $ 102  $ 1.11  $ 165  $ 1.65 
Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.
17


Note 4:    Adjusted operating income
Three months ended
March 31,
2023
December 31,
2022
March 31,
2022
Consolidated:
Operating income $ 312  $ 256  $ 338 
Closure charges impacting:
 Patient care costs 13 
 General and administrative:
 Depreciation and amortization 24  — 
Total closure charges 22  38 
Severance and other costs 18  23  — 
Adjusted operating income $ 352  $ 317  $ 343 

Three months ended
March 31,
2023
December 31,
2022
March 31,
2022
Consolidated:
U.S. dialysis:
Segment operating income $ 361  $ 335  $ 406 
Closure charges 22  35 
Severance and other costs 17  17  — 
Adjusted U.S. dialysis operating income 400  387  411 
Other - Ancillary services:
U.S.
Integrated kidney care (37) (34) (37)
Other U.S. ancillary (3) (1) (3)
Segment operating loss (40) (36) (41)
Severance and other costs —  —  — 
Adjusted operating loss (39) (35) (41)
International
Segment operating income 15  (4)
Closure charges —  — 
Severance and other costs —  — 
Adjusted operating income 15 
Other - Ancillary services operating loss (24) (32) (32)
Corporate administrative support expenses:
Segment expenses (25) (38) (36)
Severance and other costs — 
Adjusted Corporate administrative support expenses (24) (38) (36)
Adjusted operating income $ 352  $ 317  $ 343 
Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.

18


Note 5:    Adjusted U.S. dialysis expense measures

Three months ended
March 31, 2023 December 31, 2022
GAAP Non-GAAP adjustment Adjusted GAAP Non-GAAP adjustment Adjusted
(dollars in millions)
U.S. dialysis
Treatments 7,117,427  —  7,117,427  7,239,660  —  7,239,660 
Operating expenses:
Patient care costs $ 1,832  $ (13) $ 1,819  $ 1,865  $ (6) $ 1,859 
General and administrative 259  (22) 237  283  (22) 261 
Depreciation and amortization 167  (5) 162  184  (24) 160 
Equity investment income (6) —  (6) (8) —  (8)
Total operating expenses $ 2,251  $ (39) $ 2,212  $ 2,324  $ (52) $ 2,271 
Patient care costs per treatment $ 257.34  $ 255.56  $ 257.60  $ 256.74 
Certain columns, rows, per treatment amounts or percentages may not sum or recalculate due to the presentation of rounded numbers.
(1)Patient care costs per treatment and adjusted patient care costs per treatment are patient care costs or adjusted patient care costs divided by number of U.S. dialysis treatments, respectively.
19


DAVITA INC.
RECONCILIATIONS FOR NON-GAAP MEASURES - continued
(unaudited)
(dollars in millions)
Note 6:    Effective income tax rates on income from continuing operations attributable to DaVita Inc.
Three months ended
March 31,
2023
December 31,
2022
March 31,
2022
Income from continuing operations before income taxes $ 215  $ 147  $ 263 
Noncontrolling owners’ income primarily attributable to non-tax paying entities (55) (59) (44)
Income from continuing operations before income taxes attributable to DaVita Inc. $ 159  $ 89  $ 219 
Income tax expense for continuing operations $ 44  $ 34  $ 57 
Income tax attributable to noncontrolling interests —  —  — 
Income tax expense for continuing operations attributable to DaVita Inc. $ 44  $ 34  $ 57 
Effective income tax rate on income from continuing operations attributable to
 DaVita Inc.
27.5  % 38.5  % 26.0  %
The effective income tax rate on adjusted income from continuing operations attributable to DaVita Inc. is computed as follows:
Three months ended
March 31,
2023
December 31,
2022
March 31,
2022
Income from continuing operations before income taxes $ 215  $ 147  $ 263 
Closure charges impacting:
 Patient care costs 13 
 General and administrative:
 Depreciation and amortization 24  — 
Severance and other costs 18  23  — 
Noncontrolling owners’ income primarily attributable to non-tax paying entities (55) (59) (44)
Adjusted income from continuing operations before income taxes attributable to
 DaVita Inc.
$ 200  $ 150  $ 223 
Income tax expense $ 44  $ 34  $ 57 
Plus income tax related to:
Closure charges impacting:
 Patient care costs
 General and administrative: — 
 Depreciation and amortization — 
Severance and other costs — 
Less income tax related to:
Noncontrolling interests —  —  — 
Income tax on adjusted income from continuing operations attributable to DaVita Inc. $ 54  $ 48  $ 58 
Effective income tax rate on adjusted income from continuing operations attributable
 to DaVita Inc.
27.0  % 31.7  % 26.0  %
Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.





20



Note 7:    Free cash flow
Three months ended
March 31,
2023
December 31,
2022
March 31,
2022
Net cash provided by operating activities $ 463  $ 344  $ 322 
Adjustments to reconcile net cash provided by operating activities to free cash flow:
Distributions to noncontrolling interests (55) (79) (65)
Contributions from noncontrolling interests
Expenditures for routine maintenance and information technology (109) (147) (84)
Expenditures for development and relocations (39) (47) (39)
Proceeds from sale of self-developed properties — 
Free cash flow $ 265  $ 75  $ 147 
Twelve months ended
March 31,
2023
December 31,
2022
March 31,
2022
Net cash provided by operating activities $ 1,705  $ 1,565  $ 2,099 
Adjustments to reconcile net cash provided by operating activities to free cash flow:
Distributions to noncontrolling interests (257) (268) (256)
Contributions from noncontrolling interests 15  15  26 
Expenditures for routine maintenance and information technology (455) (431) (416)
Expenditures for development and relocations (173) (172) (204)
Proceeds from sale of self-developed properties 100  109  48 
Free cash flow $ 935  $ 817  $ 1,297 
Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.
21