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0000927066false00009270662024-02-132024-02-13

 
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): February 13, 2024  


 
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 February 13, 2024, DaVita Inc. (the "Company") issued a press release announcing its financial results for the quarter ended December 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 February 13, 2024 announcing the registrant’s financial results for the quarter ended December 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: February 13, 2024
By: /s/    Christopher M. Berry
Christopher M. Berry
Chief Accounting Officer



EX-99.1 2 dva-123123ex991.htm EX-99.1 Document



Contact:        Investor Relations                    
DaVita Inc.
ir@davita.com
DaVita Inc. 4th Quarter 2023 Results
Denver, Colorado, February 13, 2024 — DaVita Inc. (NYSE: DVA) announced financial and operating results for the quarter and year ended December 31, 2023.

“As we reflect on the past year, our 2023 financial performance highlighted the resilience of our business,” said Javier Rodriguez, CEO of DaVita Inc. “The external challenges of recent years ultimately made us stronger, and with continued investment in our teammates, systems, and capabilities, we believe that we are well positioned for the years ahead. We enter 2024 with more confidence than we have had since the start of COVID in 2020.”
Financial and operating highlights for the quarter and year ended December 31, 2023:
•Consolidated revenues were $3.146 billion and $12.140 billion for the three months and year ended December 31, 2023, respectively.
•Operating income was $390 million and adjusted operating income was $415 million for the three months ended December 31, 2023. Operating income was $1,603 million and adjusted operating income was $1,734 million for year ended December 31, 2023.
•Diluted earnings per share from continuing operations was $1.62 and adjusted diluted earnings per share from continuing operations was $1.87 for three months ended December 31, 2023. Diluted earnings per share from continuing operations was $7.42 and adjusted diluted earnings per share from continuing operations was $8.47 for year ended December 31, 2023.
•Operating cash flow was $485 million and free cash flow was $258 million for the three months ended December 31, 2023. Operating cash flow was $2,059 million and free cash flow was $1,236 million for the year ended December 31, 2023.
•Repurchased 2,903,832 shares of our common stock at an average price paid of $97.82 per share.
Three months ended Year ended December 31,
December 31, 2023 September 30, 2023 2023 2022
Net income attributable to DaVita Inc.:
(dollars in millions, except per share data)
Net income from continuing operations $ 151  $ 247  $ 692  $ 547 
Diluted per share $ 1.62  $ 2.62  $ 7.42  $ 5.71 
Adjusted net income from continuing operations(1)
$ 173  $ 276  $ 789  $ 632 
Adjusted diluted per share(1)
$ 1.87  $ 2.94  $ 8.47  $ 6.60 
Net income $ 151  $ 247  $ 692  $ 560 
Diluted per share $ 1.62  $ 2.62  $ 7.42  $ 5.85 
        
(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 Year ended December 31,
December 31, 2023 September 30, 2023 2023 2022
Amount Margin Amount Margin Amount Margin Amount Margin
Operating income (dollars in millions)
Operating income $ 390  12.4  % $ 496  15.9  % $ 1,603  13.2  % $ 1,339  11.5  %
Adjusted operating income(1)
$ 415  $ 536  $ 1,734  $ 1,450 
(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.
1


U.S. dialysis metrics:
Volume: Total U.S. dialysis treatments for the fourth quarter of 2023 were 7,254,559, or an average of 92,533 treatments per day, representing a per day increase of 0.04% compared to the third quarter of 2023. Normalized non-acquired treatment growth in the fourth quarter of 2023 compared to the fourth quarter of 2022 was 0.7%.
  Three months ended Quarter
change
Year ended Year to date
change
  December 31,
2023
September 30,
2023
December 31,
2023
December 31,
2022
(dollars in millions, except per treatment data)
Revenue per treatment $ 386.31  $ 380.33  $ 5.98  $ 377.44  $ 365.24  $ 12.20 
Patient care costs per treatment $ 263.19  $ 250.08  $ 13.11  $ 255.78  $ 253.31  $ 2.47 
General and administrative $ 283  $ 281  $ $ 1,102  $ 1,038  $ 64 
Primary drivers of the changes in the table above were as follows:
Revenue: The quarter change was primarily due to the seasonal impact of increased hospital inpatient dialysis revenues and flu vaccines, revenue cycle improvements and other fluctuations. The year to date change was primarily driven by normal annual rate increases, including a net increase in Medicare rate, improved cash collections, and favorable changes in commercial and MA mix.
Patient care costs: The quarter change was primarily due to increases in other direct operating expenses associated with our dialysis centers, contributions to charitable organizations, health benefit expense, compensation expenses and pharmaceutical unit costs. The year to date change was primarily due to increases in compensation expenses, other direct operating expenses associated with our dialysis centers, medical supply costs, routine repairs and maintenance, health benefit expenses and professional fees, as well as increases in travel costs and center closure costs, as described below. These increases were partially offset by decreased pharmaceutical costs and contract wages.
General and administrative: The quarter change was primarily due to seasonal increases in purchased services and health benefit expense, as well as increases in contributions to our charitable foundation, professional fees, and long-term incentive compensation. These increases were partially offset by decreased compensation expenses. The year to date change was primarily due to increases in compensation expenses, decreases in gains recognized on the sale of our self-developed properties, as well as increases in IT-related costs, contributions to our charitable foundation, travel costs and long-term incentive compensation. These increases were partially offset by decreased advocacy costs and professional fees.
Certain items impacting the quarter and year:

Integrated kidney care (IKC). IKC revenues for the fourth quarter of 2023 increased compared to the third quarter of 2023 due to a net increase in shared savings recognized on our value-based care arrangements, partially offset by decreased revenues in our special needs plans. The increase in the fourth quarter of 2023 was primarily due to the lifting of certain revenue recognition constraints for some of our value-based care contracts with health plans, allowing us to recognize approximately $55 million in incremental shared savings revenues.
Closure costs. During 2023, we continued the 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 continuing review, which began in the third quarter of 2022, has resulted in higher than normal charges for center capacity closures over the last number of quarters. These capacity closure costs include net losses on assets retired, lease costs, asset impairments and accelerated depreciation and amortization.
During the three and twelve months ended December 31, 2023, we incurred charges for U.S. dialysis center closures of approximately $31.8 million and $99.1 million, respectively. For a breakdown of how these closure costs have impacted our income statement for respective periods, see Note 3 in our Non-GAAP reconciliations that follow.
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. This plan included additional charges of $0.4 million during the fourth quarter of 2023 and $28.5 million during the twelve months ended December 31, 2023.
2


Goodwill impairment and related items. During the quarter ended December 31, 2023, we recognized a non-cash goodwill charge of $26.1 million in our transplant software business. We also recognized a gain of $7.7 million due to a reduction in the estimated value of earn-out obligations from our original acquisition of this business.
Share repurchases. During the three months ended December 31, 2023, we repurchased 2,903,832 shares for $286 million, at an average price paid of $97.82 per share.
Subsequent to December 31, 2023 through February 12, 2024, the Company has repurchased 1,507,000 shares of our common stock for $164 million at an average price paid of $107.97 per share.

Financial and operating metrics:
Three months ended
December 31,
Twelve months ended
December 31,
2023 2022 2023 2022
Cash flow: (dollars in millions)
Operating cash flow $ 485  $ 344  $ 2,059  $ 1,565 
Free cash flow(1)
$ 258  $ 75  $ 1,236  $ 817 
(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 December 31, 2023 Year ended
December 31, 2023
Effective income tax rate on:
Income from continuing operations 20.2  % 18.7  %
Income from continuing operations attributable to DaVita Inc.(1)
29.0  % 24.3  %
Adjusted income from continuing operations attributable to DaVita Inc.(1)
26.7  % 24.0  %
(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 December 31, 2023, we provided dialysis services to a total of approximately 250,200 patients at 3,042 outpatient dialysis centers, of which 2,675 centers were located in the United States and 367 centers were located in 11 countries outside of the United States. During the fourth quarter of 2023, we opened a total of two new dialysis centers and closed 21 dialysis centers in the United States. We also acquired eight dialysis centers and closed one dialysis center outside of the United States during the fourth quarter of 2023.
IKC: As of December 31, 2023, we had approximately 58,000 patients in risk-based integrated care arrangements representing approximately $4.6 billion in annualized medical spend. We also had an additional 17,000 patients in other integrated care arrangements; we do not include the medical spend for these patients in this annualized medical spend estimate. For an additional description of these metrics, see Note 2: Integrated Care Metrics.
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, current macroeconomic and marketplace conditions, and global events continue 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 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 2024 guidance
Low High
(dollars in millions, except per share data)
Adjusted operating income $1,825 $1,975
Adjusted diluted net income per share attributable to DaVita Inc. $8.70 $9.80
Free cash flow $900 $1,150
We will be holding a conference call to discuss our results for the fourth quarter ended December 31, 2023, on February 13, 2024, 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, including statements about our balance sheet and liquidity, our expenses, revenues, billings and collections, availability or cost of supplies, treatment volumes, mix expectation, such as the percentage or number of patients under commercial insurance, current macroeconomic, marketplace and, 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, expectations regarding increased competition and marketplace changes, including those related to new or potential entrants in the dialysis and pre-dialysis marketplace and the potential impact of innovative technologies, drugs or other treatments, expectations regarding the impact of our continuing cost savings initiatives 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:
•current macroeconomic and marketplace conditions, global events and domestic political or governmental volatility, many of which are interrelated and which relate to, among other things, inflation, potential interest rate volatility, labor market conditions, wage pressure, evolving monetary policies, and the continuing impact of the COVID-19 pandemic on our patients, teammates, physician partners, suppliers, business, operations, reputation, financial condition and results of operations; the continuing 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; the potential impact of new or potential entrants in the dialysis and pre-dialysis marketplace and potential impact of innovative technologies, drugs, or other treatments on our patients and industry; 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, 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 as the pandemic continues to subside;
•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 continuing legislative efforts to restrict or prohibit the use and/or availability of charitable premium assistance, such as AB 290, 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
5


related to healthcare, antitrust matters, including, among others, restrictive covenants and acquisition, merger, joint venture or similar transactions and/or labor matters;
•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, which continue to increase in the dialysis industry, 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;
•our ability to respond to challenging U.S. and global economic and marketplace conditions, including among other things our ability to successfully identify cost savings opportunities and to invest in and 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 or renewing 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 MA 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, and with additional laws that may apply to our operations as we expand geographically or enter into new lines of business, including through acquisitions or joint ventures;
•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 oral phosphate binders, 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, to successfully integrate any acquired businesses, to successfully operate any acquired businesses, joint ventures or other strategic transactions, 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 Quarterly Reports on Form 10-Q for the quarters ended March 31, June 30, and September 30, 2023, 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 Annual Report on Form 10-K for the quarter ended December 31, 2023.
6


DAVITA INC.
CONSOLIDATED STATEMENTS OF INCOME
(unaudited)
(dollars and shares in thousands, except per share data)
Three months ended December 31, Year ended December 31,
  2023 2022 2023 2022
Dialysis patient service revenues $ 2,972,272  $ 2,803,590  $ 11,574,941  $ 11,176,464 
Other revenues 173,475  113,298  565,206  433,430 
Total revenues 3,145,747  2,916,888  12,140,147  11,609,894 
Operating expenses:    
Patient care costs 2,138,369  2,088,681  8,319,717  8,209,553 
General and administrative 401,471  379,711  1,473,984  1,355,197 
Depreciation and amortization 195,277  194,068  745,443  732,602 
Equity investment income, net (5,362) (1,824) (27,864) (26,520)
Goodwill impairment charges 26,083  —  26,083  — 
Total operating expenses 2,755,838  2,660,636  10,537,363  10,270,832 
Operating income 389,909  256,252  1,602,784  1,339,062 
Debt expense (96,190) (100,962) (398,551) (357,019)
Debt extinguishment and modification costs —  —  (7,962) — 
Other loss, net (4,652) (7,797) (19,177) (15,765)
Income from continuing operations before income taxes 289,067  147,493  1,177,094  966,278 
Income tax expense 58,495  34,330  220,116  198,087 
Net income from continuing operations 230,572  113,163  956,978  768,191 
Net income from discontinued operations, net of tax —  13,452  —  13,452 
Net income 230,572  126,615  956,978  781,643 
Less: Net income attributable to noncontrolling interests (79,907) (58,512) (265,443) (221,243)
Net income attributable to DaVita Inc. $ 150,665  $ 68,103  $ 691,535  $ 560,400 
Earnings per share attributable to DaVita Inc.:    
Basic net income from continuing operations $ 1.67  $ 0.61  $ 7.62  $ 5.88 
Basic net income $ 1.67  $ 0.76  $ 7.62  $ 6.03 
Diluted net income from continuing operations $ 1.62  $ 0.59  $ 7.42  $ 5.71 
Diluted net income $ 1.62  $ 0.74  $ 7.42  $ 5.85 
Weighted average shares for earnings per share:
Basic shares 90,353  90,122  90,790  92,992 
Diluted shares 92,782  91,910  93,182  95,834 
Amounts attributable to DaVita Inc.:
Net income from continuing operations $ 150,665  $ 54,651  $ 691,535  $ 546,948 
Net income from discontinued operations —  13,452  —  13,452 
Net income attributable to DaVita Inc. $ 150,665  $ 68,103  $ 691,535  $ 560,400 

7


DAVITA INC.
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(unaudited)
(dollars in thousands)
Three months ended December 31, Year ended December 31,
  2023 2022 2023 2022
Net income $ 230,572  $ 126,615  $ 956,978  $ 781,643 
Other comprehensive income, net of tax:
Unrealized (losses) gains on interest rate cap agreements:
Unrealized (losses) gains (21,411) 13,008  6,895  108,669 
Reclassifications of net realized gains into net income (21,831) (11,905) (77,727) (8,806)
Unrealized gains (losses) on foreign currency translation: 60,056  65,262  87,934  (29,802)
Other comprehensive income 16,814  66,365  17,102  70,061 
Total comprehensive income 247,386  192,980  974,080  851,704 
Less: Comprehensive income attributable to noncontrolling interests (79,907) (58,512) (265,443) (221,243)
Comprehensive income attributable to DaVita Inc. $ 167,479  $ 134,468  $ 708,637  $ 630,461 

8


DAVITA INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(unaudited)
(dollars in thousands)
Year ended December 31,
  2023 2022
Cash flows from operating activities:  
Net income $ 956,978  $ 781,643 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization 745,443  732,602 
Impairment charges 26,083  — 
Loss on extinguishment of debt 7,132  — 
Stock-based compensation expense 112,375  95,427 
Deferred income taxes (39,354) (75,669)
Equity investment loss, net 64,777  8,773 
Other non-cash charges, net (8,938) 21,693 
Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:
Accounts receivable 172,361  (148,394)
Inventories (32,132) (757)
Other current assets (43,437) 27,533 
Other long-term assets (5,792) (50,549)
Accounts payable 26,890  87,481 
Accrued compensation and benefits 56,209  34,536 
Other current liabilities 27,082  89,955 
Income taxes 1,570  (24,103)
Other long-term liabilities (8,216) (15,601)
Net cash provided by operating activities 2,059,031  1,564,570 
Cash flows from investing activities:  
Additions of property and equipment (567,985) (603,429)
Acquisitions (26,394) (57,308)
Proceeds from asset and business sales 30,610  117,582 
Purchase of debt investments held-to-maturity (37,180) (129,803)
Purchase of other debt and equity investments (9,566) (3,590)
Proceeds from debt investments held-to-maturity 99,639  71,125 
Proceeds from sale of other debt and equity investments 10,365  3,781 
Purchase of equity method investments (276,202) (31,885)
Distributions from equity method investments 4,913  3,962 
Other —  (782)
Net cash used in investing activities (771,800) (630,347)
Cash flows from financing activities:
Borrowings 2,468,341  2,393,116 
Payments on long-term debt (3,020,956) (2,404,395)
Deferred and debt related financing costs (69,791) (3)
Purchase of treasury stock (272,219) (802,228)
Distributions to noncontrolling interests (280,938) (267,946)
Net payments related to stock purchases and awards (48,112) (37,367)
Contributions from noncontrolling interests 14,773  14,797 
Proceeds from sales of additional noncontrolling interests 50,962  3,673 
Purchases of noncontrolling interests (12,555) (20,775)
Net cash used in financing activities (1,170,495) (1,121,128)
Effect of exchange rate changes on cash, cash equivalents and restricted cash 8,909  (29,066)
Net increase (decrease) in cash, cash equivalents and restricted cash 125,645  (215,971)
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 $ 464,634  $ 338,989 
9


DAVITA INC.
CONSOLIDATED BALANCE SHEETS
(unaudited)
(dollars and shares in thousands, except per share data)
  December 31, 2023 December 31, 2022
ASSETS    
Cash and cash equivalents $ 380,063  $ 244,086 
Restricted cash and equivalents 84,571  94,903 
Short-term investments 11,610  77,693 
Accounts receivable 1,986,856  2,132,070 
Inventories 143,105  109,122 
Other receivables 422,669  413,976 
Prepaid and other current assets 102,645  78,839 
Income tax receivable 6,387  4,603 
Total current assets 3,137,906  3,155,292 
Property and equipment, net of accumulated depreciation of $5,759,514 and $5,265,372, respectively
3,073,533  3,256,397 
Operating lease right-of-use assets 2,501,364  2,666,242 
Intangible assets, net of accumulated amortization of $38,445 and $49,772, respectively
203,224  182,687 
Equity method and other investments 545,848  231,108 
Long-term investments 47,890  44,329 
Other long-term assets 271,253  315,587 
Goodwill 7,112,560  7,076,610 
  $ 16,893,578  $ 16,928,252 
LIABILITIES AND EQUITY    
Accounts payable $ 514,533  $ 479,780 
Other liabilities 828,878  802,469 
Accrued compensation and benefits 752,598  692,654 
Current portion of operating lease liabilities 394,399  395,401 
Current portion of long-term debt 123,299  231,404 
Income tax payable 28,507  18,039 
Total current liabilities 2,642,214  2,619,747 
Long-term operating lease liabilities 2,330,389  2,503,068 
Long-term debt 8,268,334  8,692,617 
Other long-term liabilities 183,074  105,233 
Deferred income taxes 726,217  782,787 
Total liabilities 14,150,228  14,703,452 
Commitments and contingencies
Noncontrolling interests subject to put provisions 1,499,288  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; 88,824 and 90,411 shares issued
 and outstanding at December 31, 2023 and December 31, 2022, respectively)
89  90 
Additional paid-in capital 509,804  606,935 
Retained earnings 598,288  174,487 
Accumulated other comprehensive loss (52,084) (69,186)
Total DaVita Inc. shareholders' equity 1,056,097  712,326 
Noncontrolling interests not subject to put provisions 187,965  163,566 
Total equity 1,244,062  875,892 
  $ 16,893,578  $ 16,928,252 

10


DAVITA INC.
SUPPLEMENTAL FINANCIAL DATA
(unaudited)
(dollars in millions and shares in thousands, except per treatment data)
Three months ended Year ended December 31, 2023
December 31,
2023
September 30,
2023
1. Consolidated business metrics:
Operating margin 12.4  % 15.9  % 13.2  %
General and administrative expenses as a percent of consolidated revenues(1)
12.8  % 12.1  % 12.1  %
Effective income tax rate on income
20.2  % 18.2  % 18.7  %
Effective income tax rate on income attributable to DaVita Inc.(2)
29.0  % 21.8  % 24.3  %
Effective income tax rate on adjusted income attributable to DaVita Inc.(2)
26.7  % 22.1  % 24.0  %
2. Summary of financial results:
Revenues:
U.S. dialysis patient services and other
$ 2,809  $ 2,785  $ 10,937 
Other—Ancillary services
Integrated kidney care 160  158  511 
Other U.S. ancillary 25 
International dialysis patient service and other
194  200  763 
361  363  1,299 
Eliminations
(24) (27) (96)
Total consolidated revenues
$ 3,146  $ 3,121  $ 12,140 
Operating income (loss):
U.S. dialysis
$ 444  $ 509  $ 1,775 
Other—Ancillary services
Integrated kidney care 27  11  (39)
Other U.S. ancillary (19) (2) (25)
International(3)
19  55 
10  28  (9)
Corporate administrative support expenses
(63) (41) (163)
Total consolidated operating income
$ 390  $ 496  $ 1,603 

11


DAVITA INC.
SUPPLEMENTAL FINANCIAL DATA - continued
(unaudited)
(dollars in millions and shares in thousands, except per treatment data)
Three months ended Year ended December 31, 2023
December 31,
2023
September 30,
2023
3. Summary of reportable segment financial results and metrics:
U.S. dialysis
Financial results
Revenue:
Dialysis patient service revenues
$ 2,802  $ 2,779  $ 10,912 
Other revenues
25 
Total operating revenues
2,809  2,785  10,937 
Operating expenses:
Patient care costs
1,909  1,827  7,395 
General and administrative
283  281  1,102 
Depreciation and amortization
181  176  696 
Equity investment income
(8) (8) (30)
Total operating expenses
2,365  2,276  9,162 
Segment operating income $ 444  $ 509  $ 1,775 
Reconciliation for non-GAAP measure:
Closure charges 32  24  99 
Severance and other costs —  27 
Adjusted segment operating income(2)
$ 476  $ 537  $ 1,900 
Metrics
Volume:
Treatments 7,254,559  7,306,948  28,910,177 
Number of treatment days 78.4  79.0  312.4 
Average treatments per day 92,533  92,493  92,542 
Per day year-over-year increase (decrease) 1.0  % (0.4) % —  %
Normalized year-over-year non-acquired treatment growth(4)
0.7  % 0.5  %
Operating net revenues:
Average patient service revenue per treatment $ 386.31  $ 380.33  $ 377.44 
Expenses:
Patient care costs per treatment
$ 263.19  $ 250.08  $ 255.78 
General and administrative expenses per treatment $ 39.06  $ 38.40  $ 38.12 
Depreciation and amortization expense per treatment $ 24.94  $ 24.08  $ 24.06 
Accounts receivable:
Receivables
$ 1,632  $ 1,708 
DSO
54  57 
12


DAVITA INC.
SUPPLEMENTAL FINANCIAL DATA - continued
(unaudited)
(dollars in millions and shares in thousands, except per treatment data)
Three months ended Year ended December 31, 2023
December 31,
2023
September 30,
2023
4. Cash flow:
Operating cash flow $ 485  $ 661  $ 2,059 
Operating cash flow, last twelve months $ 2,059  $ 1,918 
Free cash flow(2)
$ 258  $ 453  $ 1,236 
Free cash flow, last twelve months(2)
$ 1,236  $ 1,054 
Capital expenditures:
Routine maintenance/IT/other
$ 119  $ 93  $ 406 
Development and relocations
$ 40  $ 44  $ 162 
Acquisition expenditures
$ 18  $ $ 26 
Proceeds from sale of self-developed properties $ $ $ 11 
5. Debt and capital structure:
Total debt(5)
$ 8,446  $ 8,451 
Net debt, net of cash and cash equivalents(5)
$ 8,066  $ 8,002 
Leverage ratio(6)
3.15x 3.27x
Weighted average effective interest rate:
During the quarter
4.45  % 4.61  %
At end of the quarter
4.42  % 4.56  %
On the senior secured credit facilities at end of the quarter 4.39  % 4.70  %
Debt with fixed and capped rates as a percentage of total debt:
Debt with rates fixed by its terms
54  % 54  %
Debt with rates fixed by its terms or capped by cap agreements 96  % 95  %
Amount spent on share repurchases $ 286  $ 286 
Number of shares repurchased 2,904  2,904 
Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.
(1)General and administrative expenses include certain corporate support, long-term incentive compensation and advocacy costs.
(2)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.
(3)The reported operating income for the three months ended December 31, 2023 and September 30, 2023 and for the twelve months ended December 31, 2023 includes foreign currency (losses) gains embedded in equity method income recognized from our Asia Pacific joint venture of approximately $(2.5), $0.4 and $(1.6), respectively.
(4)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.
(5)The debt amounts as of December 31, 2023 and September 30, 2023 presented exclude approximately $54.3 and $57.5, 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.
(6)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 amended senior secured credit facilities (the Amended Credit Agreement) dated April 28, 2023 the leverage ratio is defined as (a) all funded debt, 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-1 and new revolving line of credit under the Amended Credit Agreement by establishing the margin over the base interest rate (SOFR plus credit spread adjustment) that is applicable. The calculation below is based on the last 12 months of "Consolidated EBITDA" and "Consolidated net debt" at the end of each reported period, each as defined in the credit agreement. The calculation of "Consolidated EBITDA" below sets forth, among other things, certain pro forma adjustments described in the Amended Credit Agreement, including pro forma adjustments for acquisitions or divestitures that occurred during the period and certain projected net cost savings, expense reductions and cost synergies. These pro forma adjustments are determined according to specified criteria set forth in the Amended Credit Agreement, and as a result, the total adjustments calculated may not be comparable to the Company's estimates for other purposes, including as operating performance measures. 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 the Amended Credit Agreement and should not be evaluated for any other purpose. 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
December 31,
2023
September 30,
2023
Net income from continuing operations attributable to DaVita Inc. $ 692  $ 596 
Income taxes 220  196 
Interest expense 355  362 
Depreciation and amortization 745  744 
Impairment charges 26  — 
Net income attributable to noncontrolling interests 265  244 
Stock-settled stock-based compensation 110  98 
Debt extinguishment and modification costs
Expected cost savings and expense reductions 33  65 
Severance and other related costs 28  54 
Other 72  81 
"Consolidated EBITDA" $ 2,555  $ 2,447 
December 31,
2023
September 30,
2023
Total debt, excluding debt discount and other deferred financing costs(1)
$ 8,446  $ 8,451 
Less: Cash and cash equivalents including short-term investments(2)
(387) (457)
Consolidated net debt $ 8,059  $ 7,994 
Last twelve months "Consolidated EBITDA" $ 2,555  $ 2,447 
Leverage ratio 3.15x 3.27x
Maximum leverage ratio permitted under the Credit Agreement 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 December 31, 2023 and September 30, 2023 presented exclude approximately $54.3 and $57.5, 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 Amended 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 our special needs plans), as well as the aggregate estimated benchmark amount above or below which we will incur profit or loss from 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, but not limited to, impairment charges, (gain) loss on ownership changes, capacity closure charges, restructuring charges, accruals for legal matters, and debt extinguishment and modification costs; and (ii) the term "effective income tax rate on adjusted income 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.
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 attributable to DaVita Inc. and adjusted diluted net income per share 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 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 - continued
(unaudited)
(dollars in millions, except per share data)
Note 3:    Adjusted net income and adjusted diluted net income per share attributable to DaVita Inc.
Three months ended Year ended
December 31,
2023
September 30,
2023
December 31,
2023
December 31,
2022
Dollars Per share Dollars Per share Dollars Per share Dollars Per share
Consolidated:
Net income from continuing operations
 attributable to DaVita Inc.
$ 151  $ 1.62  $ 247  $ 2.62  $ 692  $ 7.42  $ 547  $ 5.71 
IKC adjustment (55) (0.59) (55) (0.59)
Goodwill impairment 26  0.28  26  0.28 
Earn-out revaluation (8) (0.08) (8) (0.08)
Legal accrual 29  0.31  11  0.12  40  0.43 
Other income - Mozarc gain (1) (0.01) (15) (0.16)
Debt extinguishment and modification costs 0.09 
Closure charges impacting:
 Patient care costs 0.06  0.05  28  0.30  21  0.22 
 General and administrative 0.05  0.04  21  0.22  22  0.23 
 Depreciation and amortization 22  0.24  16  0.17  51  0.54  46  0.48 
Total closure charges 32  0.34  24  0.26  99  1.06  88  0.92 
Severance and other costs —  —  0.05  28  0.31  23  0.24 
Related income tax (2) (0.02) (10) (0.11) (27) (0.29) (26) (0.27)
Adjusted net income from continuing
 operations attributable to DaVita Inc.
$ 173  $ 1.87  $ 276  $ 2.94  $ 789  $ 8.47  $ 632  $ 6.60 
Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.
17


DAVITA INC.
RECONCILIATIONS FOR NON-GAAP MEASURES - continued
(unaudited)
(dollars in millions, except per share data)
Note 4:    Adjusted operating income
Three months ended December 31, 2023
U.S.
dialysis
Ancillary services Corporate
administration
U.S. IKC U.S. Other International Total Consolidated
Operating income (loss) $ 444  $ 27  $ (19) $ $ 10  $ (63) $ 390 
Closure charges impacting:
Patient care costs
General and administrative
Depreciation and amortization 22  22 
Total closure charges 32  32 
Severance and other costs —  — 
Legal accrual 29  29 
IKC adjustment (55) (55) (55)
Earn-out revaluation (8) (8) (8)
Goodwill impairment 26  26  26 
Adjusted operating income (loss) $ 476  $ (28) $ —  $ $ (27) $ (34) $ 415 
Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.
Three months ended September 30, 2023
U.S.
dialysis
Ancillary services Corporate
administration
U.S. IKC U.S. Other International Total Consolidated
Operating income (loss) $ 509  $ 11  $ (2) $ 19  $ 28  $ (41) $ 496 
Closure charges impacting:
Patient care costs
General and administrative
Depreciation and amortization 16  16 
Total closure charges 24  24 
Severance and other costs — 
Legal accrual 11  11 
Adjusted operating income (loss) $ 537  $ 11  $ (2) $ 19  $ 28  $ (30) $ 536 
Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.
18


DAVITA INC.
RECONCILIATIONS FOR NON-GAAP MEASURES - continued
(unaudited)
(dollars in millions, except per share data)
Year ended December 31, 2023
U.S.
dialysis
Ancillary services Corporate
administration
U.S. IKC U.S. Other International Total Consolidated
Operating income (loss) $ 1,775  $ (39) $ (25) $ 55  $ (9) $ (163) $ 1,603 
Closure charges impacting:
Patient care costs 28  28 
General and administrative 21  21 
Depreciation and amortization 51  51 
Total closure charges 99  99 
Severance and other costs 27  —  —  28 
Legal accrual 40  40 
IKC adjustment (55) (55) (55)
Earn-out revaluation (8) (8) (8)
Goodwill impairment 26  26  26 
Adjusted operating income (loss) $ 1,900  $ (93) $ (7) $ 55  $ (45) $ (122) $ 1,734 
Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.
Year ended December 31, 2022
U.S.
dialysis
Ancillary services Corporate
administration
U.S. IKC U.S. Other International Total Consolidated
Operating income (loss) $ 1,565  $ (125) $ (9) $ 37  $ (97) $ (130) $ 1,339 
Closure charges impacting:
Patient care costs 21  21 
General and administrative 19  22 
Depreciation and amortization 46  46 
Total closure charges 86  88 
Severance and other costs 17  —  23 
Adjusted operating income (loss) $ 1,668  $ (124) $ (9) $ 44  $ (89) $ (129) $ 1,450 
Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.
19


DAVITA INC.
RECONCILIATIONS FOR NON-GAAP MEASURES - continued
(unaudited)
(dollars in millions, except per share data)
Note 5:    Adjusted U.S. dialysis expense measures
Three months ended
December 31, 2023 September 30, 2023
GAAP Non-GAAP adjustment Adjusted GAAP Non-GAAP adjustment Adjusted
(dollars in millions)
U.S. dialysis
Treatments 7,254,559  7,254,559  7,306,948  7,306,948 
Operating expenses:
Patient care costs $ 1,909  $ (5) $ 1,904  $ 1,827  $ (4) $ 1,823 
General and administrative 283  (5) 278  281  (8) 273 
Depreciation and amortization 181  (22) 159  176  (16) 160 
Equity investment income (8) (8) (8) (8)
Total operating expenses $ 2,365  $ (32) $ 2,333  $ 2,276  $ (28) $ 2,248 
Patient care costs per treatment(1)
$ 263.19  $ 262.45  $ 250.08  $ 249.48 
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.
20


DAVITA INC.
RECONCILIATIONS FOR NON-GAAP MEASURES - continued
(unaudited)
(dollars in millions)
Note 6:    Effective income tax rates on income attributable to DaVita Inc.
Three months ended Year ended
December 31, 2023
December 31,
2023
September 30,
2023
Income from continuing operations before income taxes $ 289  $ 378  $ 1,177 
Noncontrolling owners’ income primarily attributable to non-tax paying entities (77) (63) (263)
Income from continuing operations before income taxes attributable to DaVita Inc. $ 212  $ 315  $ 914 
Income tax expense for continuing operations $ 58  $ 69  $ 220 
Income tax attributable to noncontrolling interests — 
Income tax expense for continuing operations attributable to DaVita Inc. $ 61  $ 69  $ 222 
Effective income tax rate on income from continuing operations attributable to
 DaVita Inc.
29.0  % 21.8  % 24.3  %

The effective income tax rate on adjusted income attributable to DaVita Inc. is computed as follows:
Three months ended Year ended
December 31, 2023
December 31,
2023
September 30,
2023
Income before income taxes $ 289  $ 378  $ 1,177 
IKC adjustment (55) (55)
Goodwill impairment 26  26 
Earn-out revaluation (8) (8)
Legal accrual 29  11  40 
Other income - Mozarc gain (1) (15)
Debt extinguishment and modification costs
Closure charges 32  24  99 
Severance and other costs —  28 
Noncontrolling owners’ income primarily attributable to non-tax paying entities (77) (63) (263)
Adjusted income before income taxes attributable to DaVita Inc. $ 236  $ 355  $ 1,038 
Income tax expense $ 58  $ 69  $ 220 
Plus income tax related to:
IKC adjustment (14) (14)
Goodwill impairment
Earn-out revaluation (2) (2)
Legal accrual
Other income - Mozarc gain —  (4)
Debt extinguishment and modification costs
Closure charges 25 
Severance and other costs — 
Less income tax related to:
Noncontrolling interests — 
Income tax on adjusted income attributable to DaVita Inc. $ 63  $ 79  $ 249 
Effective income tax rate on adjusted income attributable to DaVita Inc. 26.7  % 22.1  % 24.0  %
Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.
21


DAVITA INC.
RECONCILIATIONS FOR NON-GAAP MEASURES - continued
(unaudited)
(dollars in millions, except per share data)
Note 7:    Free cash flow
Three months ended
December 31,
2023
September 30,
2023
December 31,
2022
Net cash provided by operating activities $ 485  $ 661  $ 344 
Adjustments to reconcile net cash provided by operating activities to free cash flow:
Distributions to noncontrolling interests (78) (79) (79)
Contributions from noncontrolling interests
Expenditures for routine maintenance and information technology (119) (93) (147)
Expenditures for development and relocations (40) (44) (47)
Proceeds from sale of self-developed properties
Free cash flow $ 258  $ 453  $ 75 
Twelve months ended
December 31,
2023
September 30,
2023
December 31,
2022
Net cash provided by operating activities $ 2,059  $ 1,918  $ 1,565 
Adjustments to reconcile net cash provided by operating activities to free cash flow:
Distributions to noncontrolling interests (281) (283) (268)
Contributions from noncontrolling interests 15  15  15 
Expenditures for routine maintenance and information technology (406) (434) (431)
Expenditures for development and relocations (162) (169) (172)
Proceeds from sale of self-developed properties 11  109 
Free cash flow $ 1,236  $ 1,054  $ 817 
Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.
22