DaVita Inc.
10/29/2026 | Press release | Distributed by Public on 10/29/2026 15:03
Quarterly Report for Quarter Ending September 30, 2026 (Form 10-Q)
Management's Discussion and Analysis of Financial Condition and Results of Operations.
Forward-looking statements
This Quarterly Report on Form 10-Q, including this Management's Discussion and Analysis of Financial Condition and Results of Operations, contains statements that are forward-looking statements within the meaning of the federal securities laws and as such are intended to be covered by the safe harbor for "forward-looking statements" provided by the Private Securities Litigation Reform Act of 1995. These forward-looking statements could include, among other things, statements about our balance sheet and liquidity, our expenses, revenues, billings and collections, patient census, the impact of the cybersecurity incident experienced by the Company in 2025 (cyber incident), the impact of federal government policy changes or shutdowns on our business, including with respect to federal funding and reimbursement rates of Medicare, Medicare Advantage (MA), Medicaid and other government programs, availability or cost of supplies, including without limitation the impact of evolving trade policies and tariffs and any reduction in clinical and other supplies due to any disruptions experienced by third party vendors, including with respect to our ability to provide home dialysis services, treatment volumes, mix expectation, such as the percentage or number of patients under commercial insurance, including potential impacts to such mix as a result of U.S. administration policies, 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, capital allocation plans, expenses, cost saving initiatives, other strategic initiatives, use of contract labor, government and commercial payment rates, expectations related to value-based care (VBC), integrated kidney care (IKC), MA plan enrollment and our international operations, 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 on the dialysis industry, and expectations regarding our share repurchase program. All statements in this report, 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" 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 report. 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:
•external conditions, including those related to general economic, political and global health conditions, including without limitation, the impact of global events and political or governmental volatility, including in the Middle East and Ukraine; the impact of the domestic political environment and related developments on the current healthcare marketplace, our patients and on our business; the impact of infectious diseases or other adverse conditions on our financial condition, the chronic kidney disease population and our patient population; supply chain challenges and disruptions, including without limitation with respect to certain key services, critical clinical supplies and equipment we obtain from third parties, and including any impacts on our supply chain and cost of supplies as a result of global events, natural disasters or evolving trade policies, including tariffs; the impact on our patients and industry of continued increased competition from dialysis providers and others, including new or potential entrants in the dialysis and pre-dialysis marketplace; the impact of new or innovative technologies, drugs, or other treatments, including our ability to successfully implement new technologies, treatments or therapies in our business such as those related to middle molecule toxin clearance; elevated teammate turnover or labor costs; and our ability to respond to challenging U.S. and global economic and marketplace conditions, including, among other things, our ability to successfully identify cost saving opportunities and execute on related strategic initiatives;
•the concentration of profits generated by higher-paying commercial payor plans for which there is continued downward pressure on average realized payment rates; our ability to negotiate and maintain contracts with these payors on competitive terms or at all; a reduction in the number or percentage of our patients under commercial plans, including, without limitation, as a result of healthcare, immigration or other policies implemented by the U.S. administration, continuing legislative, regulatory or other efforts to restrict or prohibit the use and/or availability of charitable premium assistance, or as a result of payors implementing restrictive plan designs or resulting from negotiations with large commercial payors that we have in the past, and currently are, conducting on a concurrent basis;
•risks arising from laws, regulations or requirements applicable to us or changes thereto, including, without limitation, the One Big Beautiful Bill Act and those related to trade policy, healthcare, charitable premium assistance, privacy, antitrust matters, and acquisition, merger, joint venture or similar transactions and/or labor matters, and potential impacts of changes in interpretation or enforcement thereof or related litigation impacting, among other things, coverage or reimbursement rates for our services or the number of patients enrolled in or that select higher-paying commercial plans, and the risk that we make incorrect assumptions about how our patients will respond to any such developments;
•our ability to successfully implement our strategies with respect to IKC and VBC initiatives that may be impacted by, among other things, changes to the Comprehensive Kidney Care Contracting model and home based dialysis, in the desired time frame and in a complex, dynamic and highly regulated environment;
•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 and adjustment methodologies;
•our reliance on significant suppliers, service providers and other third party vendors to provide key support to our business operations and enable our provision of services to patients, including, among others, suppliers of certain pharmaceuticals, administrative or other services or critical clinical products; and risks resulting from a closure, reduction, disruption or transition in the services or products provided to us by such suppliers, service providers and third party vendors, which may, among other things, increase our costs or expenses;
•our ability to successfully and cost-effectively maintain, operate or upgrade our information systems or those of third-party service providers upon which we rely and our ability to successfully and cost-effectively adopt or adapt to new technologies, treatments or therapies, including technologies that utilize artificial intelligence;
•legal and compliance risks, such as 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;
•noncompliance by us or our business associates with any privacy or security laws or any security breach by us or a third party, such as the cyber incident, including, among other things, any such non-compliance or breach involving the misappropriation, loss or other unauthorized use or disclosure of confidential information;
•our ability to attract, retain and motivate teammates, including key leadership personnel, our ability to manage potential disruptions to our business and operations, including potential work stoppages, and our ability to manage operating cost increases or productivity decreases that may be related to political unrest, legislative or other changes, union organizing activities, or volatility and uncertainty in the current challenging and highly competitive labor market that has experienced an ongoing nationwide shortage of skilled clinical personnel, among other things;
•changes in practice patterns, pricing, or reimbursement and payment policies or processes related to pharmaceuticals, medical equipment or supplies, 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 that, among other things, may erode our patient base and impact reimbursement rates;
•our ability to complete and successfully integrate and operate acquisitions, mergers, dispositions, joint ventures or other strategic transactions on terms favorable to us or at all; and our ability to continue to successfully expand our operations and services in markets outside the United States, or to businesses or products outside of dialysis services;
•the variability of our cash flows, including, without limitation, any extended billing or collections cycles that may be due to, among other things, defects or operational issues in our billing systems such as those experienced during the cyber incident, or defects or operational issues in the billing systems or services of third parties on which we rely; 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;
•the effects on us or others of natural or other disasters, public health crises or severe adverse weather events such as hurricanes, earthquakes, fires or flooding;
•factors that may impact our ability to repurchase stock under our share repurchase program and the timing of any such stock repurchases, as well as any use by us of a considerable amount of available funds to repurchase stock;
•our goals and disclosures related to sustainability matters, including, among other things, evolving regulatory requirements affecting environmental, social and governance standards, measurements and reporting requirements; and
•the other risk factors, trends and uncertainties set forth in our Annual Report on Form 10-K for the year ended December 31, 2025 (2025 10-K) and Quarterly Reports on Form 10-Q for the quarters ended March 31 and June 30, 2026, and the risks and uncertainties discussed in any subsequent reports that we file or furnish with the Securities and Exchange Commission (SEC) from time to time.
The following should be read in conjunction with our condensed consolidated financial statements.
Company Overview
Our principal business is to provide dialysis and related lab services to patients in the United States, which we refer to as our U.S. dialysis business. We also operate our U.S. integrated kidney care (IKC) business, our U.S. other ancillary services, and our international operations, which we collectively refer to as our ancillary services, as well as our corporate administrative support functions. Our U.S. dialysis business is a leading provider of kidney dialysis services in the U.S. for patients suffering from chronic kidney failure, also known as end stage renal disease (ESRD) or end stage kidney disease (ESKD).
We assess our revenue and operating performance for our U.S. dialysis business based upon several principal metrics including, among others, treatment volume, revenue per treatment and patient care costs. Each of these metrics may be impacted by a number of factors that change from period to period and over time. For example, treatment volumes may be impacted by, among other things, mortality levels, missed treatment rates and admission rates. Revenue per treatment may be impacted by, among other things, rate changes, mix of patients with commercial plans and government programs as primary payor, timing of collections and seasonal factors such as patients meeting health plan co-insurance and deductibles. Patient care costs may be impacted by, among other things, labor market conditions and cost trends in pharmaceuticals and other medical supplies. We have set forth a discussion of certain of such factors below, and we believe that information related to changes in these metrics from period to period allows investors to assess the performance of the business.
We have been and expect to continue to be impacted by external conditions, including, but not limited to, those related to general economic, political and global health conditions and changing population or demographic trends. These conditions can impact our business in a variety of ways, including, among other things, by affecting our patient census, treatment volumes, revenues, results of operations and operating and other costs. Certain of these impacts could be further intensified by global events such as the ongoing conflicts in the Middle East and Ukraine that have continued to drive sociopolitical, geopolitical and economic uncertainty; severe weather events and other natural disasters; and the impact of healthcare, immigration, trade and other policies implemented by federal, state and local governments. These conditions are generally outside of our control, cannot reasonably be predicted and are interrelated or have interdependent complex consequences. As a result, the ultimate impact of these conditions on our business over time will depend on a myriad of future developments and is highly uncertain and difficult to predict. For additional discussion of general economic, marketplace and global health conditions that could impact our business, see Part I Item 1. "Business" and Part I Item 1A. "Risk Factors" in our 2025 10-K.
In the third quarter of 2026, treatment per day volumes increased compared to the third quarter of 2025 primarily driven by patient census increases that were partially offset by a slight increase in missed treatment rates. As noted above, treatment volumes may be impacted by a number of factors including mortality levels, and these levels may be influenced by several factors such as the impact of infectious diseases on our patient population. Adverse changes in mortality rates, particularly in the ESKD and CKD populations, could adversely impact treatment volumes, admission rates, future revenues and non-acquired growth, among other things, and the magnitude of these cumulative impacts could have a material adverse impact on our results of operations, financial condition and cash flows. For additional detail on these risks, see the discussion in Part I Item 1A. "Risk Factors" of our 2025 10-K. Mortality levels may also be influenced by the availability and use of vaccines, treatments and therapies. New technologies or treatments such as those that clear middle molecules from the blood may, among other things, reduce mortality as compared to standard dialysis treatments. Two current treatment pathways that provide middle molecule clearance are expanded hemodialysis (expanded HD) and hemodiafiltration (HDF). We have been working to expand patient access to these therapies as may be prescribed by their physician, and we expect to offer expanded HD to the vast majority of our eligible patients in November. As part of this initiative, we have dedicated resources to securing supply and training our clinical teammates, and we expect to incur costs associated with supplier transitions, among other things. For additional detail on middle molecule treatments, see the discussion in Part I Item 1. "Business" of our 2025 10-K.
Global economic conditions and political and regulatory developments, including, among other things, ongoing inflationary pressures and U.S., state and local administration policies and actions have increased, and may continue to increase, our expenses and may have an impact on our revenue per treatment. For example, the decision to let enhanced premium tax credits expire at the end of 2025 has had an adverse impact on enrollment in the Affordable Care Act exchanges and our commercial mix, which in turn adversely impacts our revenue per treatment, among other things. Future policy changes that further affect commercial, including exchange, enrollment could place additional pressure on our commercial mix and revenue per treatment. These global economic conditions and political and regulatory developments also continue to exert pressure on our staffing and labor costs, which have increased year over year due to, among other factors, the continuation of inflationary conditions. While the cumulative impact of any increased staffing, labor, and supply costs and other expenses could be material, we have experienced productivity improvements and we expect these efficiencies to continue throughout the year. Our industry has also experienced increased union organizing activities. For example, union petitions have been filed at a number of our clinics in California. We have had different results with elections and are in different stages with elections and legal challenges. For additional details on the risks related to rising labor costs and union organizing activities, see the discussion in Part I Item
1A. "Risk Factors" of our 2025 10-K under the headings, "Our business is labor intensive..." and "Global health conditions, changing population or demographic trends, severe weather events or natural disasters and general economic and political conditions..."
We have continued to invest in new technologies across our business to help modernize our technology platform and strengthen our capabilities. Over the past few years we have accelerated this investment while maintaining overall general and administrative cost discipline. In future periods, we expect to continue this overall cost discipline while decelerating the growth of the technology portion of that spend.
Legislative and Regulatory Developments
On October 20, 2026, the Department of Health and Human Services (HHS) released a 2026 Kidney Care National Plan (Plan) with three principles: (i) promote competition in the kidney marketplace; (ii) address structural impediments to transplantation; and (iii) move further upstream to prevent kidney deterioration. The Plan sets forth policy recommendations to achieve these ambitious policy principles. The Plan references and builds from the Executive Order "Advancing American Kidney Heath" issued in 2019 that directed HHS to undertake initiatives to prevent kidney failure, expand patient choice in dialysis modality and transplant access, and reform the transplant system. We will monitor Plan-related developments and guidance from HHS in order to evaluate the Plan's potential ultimate impact.
To the extent the Plan or other government action changes the complex and dynamic regulatory environment in which we operate or otherwise impacts the reimbursement ecosystem, such changes can alter the regulatory framework of the healthcare marketplace and shape the competitive landscape for our current dialysis and ancillary businesses as well as for comprehensive and integrated kidney care markets. Such changes may require us to shift strategic priorities and initiatives to successfully compete. Considerable uncertainty exists surrounding the continued development of the Plan and any potential regulatory or policy changes to the healthcare regulatory and legislative environment, including changes that may impact our operations, healthcare access or the availability and affordability of commercial insurance over time, among other things. For additional detail on risks associated with legal, regulatory or policy changes, see the discussion in Part I Item 1A. "Risk Factors" of our 2025 Form 10-K under the headings "Our business is subject to a complex set of governmental laws, regulations and other requirements...;" "We are subject to risks associated with our participation in government healthcare programs"; and "If we are unable to compete successfully…"
Financial Results
The discussion below includes analysis of our financial condition and results of operations for the three months ended September 30, 2026 compared to the three months ended June 30, 2026, and the year-to-date periods for the nine months ended September 30, 2026 compared to the nine months ended September 30, 2025.
Consolidated results of operations
The following tables summarize our revenues, operating income (loss) and adjusted operating income (loss) by line of business. See the discussion of our results for each line of business following the tables. When multiple drivers are identified in the following discussion of results, they are listed in order of magnitude:
| Three months ended | Q3 2026 vs. Q2 2026 | ||||||||||||||||||||||
|
September 30, 2026 |
June 30, 2026 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Revenues: | |||||||||||||||||||||||
| U.S. dialysis | $ | 3,050 | $ | 3,012 | $ | 38 | 1.3 | % | |||||||||||||||
| Other - Ancillary services | 552 | 557 | (5) | (0.9) | % | ||||||||||||||||||
| Elimination of intersegment revenues | (24) | (14) | (10) | (71.4) | % | ||||||||||||||||||
| Total consolidated revenues | $ | 3,578 | $ | 3,554 | $ | 24 | 0.7 | % | |||||||||||||||
| Operating income (loss): | |||||||||||||||||||||||
| U.S. dialysis | $ | 544 | $ | 538 | $ | 6 | 1.1 | % | |||||||||||||||
| Other - Ancillary services | (19) | 57 | (76) | (133.3) | % | ||||||||||||||||||
| Corporate administrative support | (26) | (16) | (10) | (62.5) | % | ||||||||||||||||||
| Operating income | $ | 499 | $ | 579 | $ | (80) | (13.8) | % | |||||||||||||||
|
Adjusted operating income (loss)(1):
|
|||||||||||||||||||||||
| U.S. dialysis | $ | 544 | $ | 538 | $ | 6 | 1.1 | % | |||||||||||||||
| Other - Ancillary services | 44 | 57 | (13) | (22.8) | % | ||||||||||||||||||
| Corporate administrative support | (26) | (16) | (10) | (62.5) | % | ||||||||||||||||||
| Adjusted operating income | $ | 561 | $ | 579 | $ | (18) | (3.1) | % | |||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
| Nine months ended | YTD Q3 2026 vs. YTD Q3 2025 | ||||||||||||||||||||||
|
September 30, 2026 |
September 30, 2025 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Revenues: | |||||||||||||||||||||||
| U.S. dialysis | $ | 9,004 | $ | 8,717 | $ | 287 | 3.3 | % | |||||||||||||||
| Other - Ancillary services | 1,606 | 1,355 | 251 | 18.5 | % | ||||||||||||||||||
| Elimination of intersegment revenues | (62) | (49) | (13) | (26.5) | % | ||||||||||||||||||
| Total consolidated revenues | $ | 10,548 | $ | 10,023 | $ | 525 | 5.2 | % | |||||||||||||||
| Operating income (loss): | |||||||||||||||||||||||
| U.S. dialysis | $ | 1,588 | $ | 1,529 | $ | 59 | 3.9 | % | |||||||||||||||
| Other - Ancillary services | 44 | 55 | (11) | (20.0) | % | ||||||||||||||||||
| Corporate administrative support | (72) | (101) | 29 | 28.7 | % | ||||||||||||||||||
| Operating income | $ | 1,560 | $ | 1,483 | $ | 77 | 5.2 | % | |||||||||||||||
|
Adjusted operating income (loss)(1):
|
|||||||||||||||||||||||
| U.S. dialysis | $ | 1,588 | $ | 1,554 | $ | 34 | 2.2 | % | |||||||||||||||
| Other - Ancillary services | 106 | 55 | 51 | 92.7 | % | ||||||||||||||||||
| Corporate administrative support | (72) | (101) | 29 | 28.7 | % | ||||||||||||||||||
| Adjusted operating income | $ | 1,622 | $ | 1,508 | $ | 114 | 7.6 | % | |||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
(1)For a reconciliation of adjusted operating income (loss) by reportable segment, see the "Reconciliations of Non-GAAP measures" section below.
U.S. dialysis results of operations
Treatment volume:
| Three months ended | Q3 2026 vs. Q2 2026 | ||||||||||||||||||||||
|
September 30, 2026 |
June 30, 2026 |
Amount | Percent | ||||||||||||||||||||
| Dialysis treatments | 7,329,644 | 7,226,600 | 103,044 | 1.4 | % | ||||||||||||||||||
| Treatment days | 79.0 | 78.0 | 1.0 | 1.3 | % | ||||||||||||||||||
| Average treatments per day | 92,780 | 92,649 | 131 | 0.1 | % | ||||||||||||||||||
|
Number of normalized treatment days(1)
|
79.2 | 78.0 | 1.2 | 1.5 | % | ||||||||||||||||||
| Average treatments per normalized day | 92,546 | 92,649 | (103) | (0.1) | % | ||||||||||||||||||
|
Normalized non-acquired treatment growth(2)
|
0.4 | % | 0.3 | % | |||||||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
(1)Normalized treatment days reflect treatment days adjusted to normalize for the mix of days of the week in a given period.
(2)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.
| Nine months ended | YTD Q3 2026 vs. YTD Q3 2025 | ||||||||||||||||||||||
|
September 30, 2026 |
September 30, 2025 |
Amount | Percent | ||||||||||||||||||||
| Dialysis treatments | 21,585,769 | 21,469,460 | 116,309 | 0.5 | % | ||||||||||||||||||
| Treatment days | 233.7 | 233.7 | - | - | % | ||||||||||||||||||
| Average treatments per day | 92,365 | 91,868 | 497 | 0.5 | % | ||||||||||||||||||
|
Number of normalized treatment days(1)
|
233.7 | 233.7 | - | - | % | ||||||||||||||||||
| Average treatments per normalized day | 92,365 | 91,868 | 497 | 0.5 | % | ||||||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
(1)Normalized treatment days reflect treatment days adjusted to normalize for the mix of days of the week in a given quarter.
Our U.S. dialysis operating revenues and expenses are directly driven by treatment volume. The increase in our U.S. dialysis treatments for the third quarter of 2026 from the second quarter of 2026 was primarily driven by an increase in treatment days. The increase in our U.S. dialysis treatments for the nine months ended September 30, 2026 from the nine months ended September 30, 2025 was primarily driven by an increase in patient count.
Revenues:
| Three months ended | Q3 2026 vs. Q2 2026 | ||||||||||||||||||||||
|
September 30, 2026 |
June 30, 2026 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions, except per treatment data) | |||||||||||||||||||||||
| Total revenues | $ | 3,050 | $ | 3,012 | $ | 38 | 1.3 | % | |||||||||||||||
| Average patient service revenue per treatment | $ | 415.25 | $ | 415.87 | $ | (0.62) | (0.1) | % | |||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
| Nine months ended | YTD Q3 2026 vs. YTD Q3 2025 | ||||||||||||||||||||||
|
September 30, 2026 |
September 30, 2025 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions, except per treatment data) | |||||||||||||||||||||||
| Total revenues | $ | 9,004 | $ | 8,717 | $ | 287 | 3.3 | % | |||||||||||||||
| Average patient service revenue per treatment | $ | 416.22 | $ | 405.15 | $ | 11.07 | 2.7 | % | |||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
U.S. dialysis average patient service revenue per treatment for the third quarter of 2026 decreased compared to the second quarter of 2026 primarily driven by normal fluctuations partially offset by increases in average reimbursement rates and improvements in payor mix.
U.S. dialysis average patient service revenue per treatment for the nine months ended September 30, 2026 increased compared to the nine months ended September 30, 2025 primarily driven by Medicare base rate and other annual rate increases and other normal fluctuations, partially offset by unfavorable changes in payor mix.
On October 28, 2026, Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare ESRD Prospective Payment System (PPS) rate and policies for calendar year 2027. CMS estimates that the overall impact of the proposed rule will increase ESRD freestanding facilities' average reimbursement by 2.7% in 2027 which includes a proposed increase to account for the incorporation of phosphate binders into the ESRD PPS base rate, and is also subject to quarterly updates of the post Transitional Drug Add-on Payment Adjustment reimbursement of certain pharmaceuticals.
Operating expenses and charges:
| Three months ended | Q3 2026 vs. Q2 2026 | ||||||||||||||||||||||
|
September 30, 2026 |
June 30, 2026 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions, except per treatment data) | |||||||||||||||||||||||
| Patient care costs | $ | 2,054 | $ | 2,005 | $ | 49 | 2.4 | % | |||||||||||||||
| General and administrative | 316 | 331 | (15) | (4.5) | % | ||||||||||||||||||
| Depreciation and amortization | 144 | 146 | (2) | (1.4) | % | ||||||||||||||||||
| Equity investment income | (8) | (8) | - | - | % | ||||||||||||||||||
| Total operating expenses and charges | $ | 2,506 | $ | 2,474 | $ | 32 | 1.3 | % | |||||||||||||||
| Patient care costs per treatment | $ | 280.22 | $ | 277.40 | $ | 2.82 | 1.0 | % | |||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
| Nine months ended | YTD Q3 2026 vs. YTD Q3 2025 | ||||||||||||||||||||||
|
September 30, 2026 |
September 30, 2025 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions, except per treatment data) | |||||||||||||||||||||||
| Patient care costs | $ | 6,028 | $ | 5,823 | $ | 205 | 3.5 | % | |||||||||||||||
| General and administrative | 967 | 917 | 50 | 5.5 | % | ||||||||||||||||||
| Depreciation and amortization | 446 | 470 | (24) | (5.1) | % | ||||||||||||||||||
| Equity investment income | (25) | (22) | (3) | (13.6) | % | ||||||||||||||||||
| Total operating expenses and charges | $ | 7,416 | $ | 7,188 | $ | 228 | 3.2 | % | |||||||||||||||
| Patient care costs per treatment | $ | 279.24 | $ | 271.23 | $ | 8.01 | 3.0 | % | |||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
Charges impacting operating income - Cybersecurity incident-related charges. During the second quarter of 2025, we experienced a cybersecurity incident that impacted certain elements of our network and resulted in a temporary disruption of our operations. As a result of our efforts to remediate the incident and restore systems with the assistance of third-party cybersecurity professionals, we incurred general and administrative charges of approximately $12 million during the third quarter of 2025. During the nine months ended September 30, 2025, we incurred patient care costs of approximately $1 million and general and administrative expenses of approximately $24 million related to the incident. These costs do not include the impact related to business interruption on our results.
Patient care costs. U.S. dialysis patient care costs per treatment for the third quarter of 2026 increased from the second quarter of 2026 primarily due to increased medical supplies expenses.
U.S. dialysis patient care costs per treatment for the nine months ended September 30, 2026 increased from the nine months ended September 30, 2025 primarily due to increased compensation expenses, including increased wage rates, as well as increases in medical supplies expense, insurance costs and health benefits expense.
General and administrative expenses. U.S. dialysis general and administrative expenses in the third quarter of 2026 decreased from the second quarter of 2026 primarily due to decreased professional fees.
U.S. dialysis general and administrative expenses for the nine months ended September 30, 2026 increased from the nine months ended September 30, 2025 due to increases in IT-related costs and compensation expenses, including increased wage rates, partially offset by costs related to the cybersecurity incident, as described above.
Depreciation and amortization. U.S. dialysis depreciation and amortization expenses in the third quarter of 2026 decreased compared to the second quarter of 2026 primarily due to lower depreciation expense in the third quarter for certain leasehold improvements.
U.S. dialysis depreciation and amortization expenses for the nine months ended September 30, 2026 compared to the nine months ended September 30, 2025 decreased primarily due to fully depreciated assets.
Equity investment income. U.S. dialysis equity investment income for the third quarter of 2026 was flat compared to the second quarter of 2026. Equity investment income for the nine months ended September 30, 2026 increased compared to the nine months ended September 30, 2025 due to increased profitability at certain nonconsolidated dialysis partnerships.
Operating income:
| Three months ended | Q3 2026 vs. Q2 2026 | ||||||||||||||||||||||
|
September 30, 2026 |
June 30, 2026 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Operating income | $ | 544 | $ | 538 | $ | 6 | 1.1 | % | |||||||||||||||
| Nine months ended | YTD Q3 2026 vs. YTD Q3 2025 | ||||||||||||||||||||||
|
September 30, 2026 |
September 30, 2025 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Operating income | $ | 1,588 | $ | 1,529 | $ | 59 | 3.9 | % | |||||||||||||||
|
Adjusted operating income(1)
|
$ | 1,588 | $ | 1,554 | $ | 34 | 2.2 | % | |||||||||||||||
(1)For a reconciliation of adjusted operating income by reportable segment, see the "Reconciliations of Non-GAAP measures" section below.
U.S. dialysis operating income for the third quarter of 2026 increased compared to the second quarter of 2026 as a result of all factors discussed above.
For the nine months ended September 30, 2026, U.S. dialysis operating income and adjusted operating income both increased compared to the nine months ended September 30, 2025, due to the factors discussed above. Operating income was impacted by the cybersecurity incident-related charges in 2025, as described above.
Other-Ancillary services
Our other operations include ancillary services that are primarily aligned with our core business of providing dialysis services to our network of patients. As of September 30, 2026, these consisted principally of our U.S. IKC business, certain U.S. other ancillary businesses (including our clinical research programs, transplant software business, medical device company and venture investment group), and our international operations.
As of September 30, 2026, DaVita IKC provided integrated care and disease management services to approximately 80,800 patients in risk-based integrated care arrangements and to an additional 3,100 patients in other integrated care arrangements. We also expect to incorporate additional service offerings to our business and pursue additional strategic initiatives in the future as circumstances warrant, which could include, among other things, healthcare services not related to kidney disease.
For a discussion of the risks related to IKC and our ancillary services, see the discussion in the risk factors in Part I Item 1A. "Risk Factors" of our 2025 10-K under the heading, "We invest in strategic and operational initiatives to maintain our business and expand our capabilities in a complex, evolving and highly regulated environment..."
As of September 30, 2026, our international dialysis business owned or operated 598 outpatient dialysis centers located in 14 countries outside of the United States.
Ancillary services results of operations
| Three months ended | Q3 2026 vs. Q2 2026 | ||||||||||||||||||||||
|
September 30, 2026 |
June 30, 2026 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Revenues: | |||||||||||||||||||||||
| U.S. IKC | $ | 144 | $ | 162 | $ | (18) | (11.1) | % | |||||||||||||||
| U.S. other ancillary | 10 | 9 | 1 | 11.1 | % | ||||||||||||||||||
| International | 398 | 386 | 12 | 3.1 | % | ||||||||||||||||||
| Total ancillary services revenues | $ | 552 | $ | 557 | $ | (5) | (0.9) | % | |||||||||||||||
| Operating (loss) income | |||||||||||||||||||||||
| U.S. IKC | $ | 4 | $ | 40 | $ | (36) | (90.0) | % | |||||||||||||||
| U.S. other ancillary | (6) | (8) | 2 | 25.0 | % | ||||||||||||||||||
| International | (16) | 25 | (41) | (164.0) | % | ||||||||||||||||||
| Total ancillary services operating income | $ | (19) | $ | 57 | $ | (76) | (133.3) | % | |||||||||||||||
|
Adjusted operating (loss) income(1):
|
|||||||||||||||||||||||
| U.S. IKC | $ | 4 | $ | 40 | $ | (36) | (90.0) | % | |||||||||||||||
| U.S. other ancillary | (6) | (8) | 2 | 25.0 | % | ||||||||||||||||||
| International | 46 | 25 | 21 | 84.0 | % | ||||||||||||||||||
| Total ancillary services adjusted operating income | $ | 44 | $ | 57 | $ | (13) | (22.8) | % | |||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
(1)For a reconciliation of adjusted operating income by reportable segment, see the "Reconciliations of Non-GAAP measures" section below.
| Nine months ended | YTD Q3 2026 vs. YTD Q3 2025 | ||||||||||||||||||||||
|
September 30, 2026 |
September 30, 2025 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Revenues: | |||||||||||||||||||||||
| U.S. IKC | $ | 422 | $ | 352 | $ | 70 | 19.9 | % | |||||||||||||||
| U.S. other ancillary | 29 | 24 | 5 | 20.8 | % | ||||||||||||||||||
| International | 1,156 | 979 | 177 | 18.1 | % | ||||||||||||||||||
| Total ancillary services revenues | $ | 1,606 | $ | 1,355 | $ | 251 | 18.5 | % | |||||||||||||||
| Operating income (loss): | |||||||||||||||||||||||
| U.S. IKC | $ | 24 | $ | (24) | $ | 48 | 200.0 | % | |||||||||||||||
| U.S. other ancillary | (20) | (14) | (6) | (42.9) | % | ||||||||||||||||||
| International | 40 | 93 | (53) | (57.0) | % | ||||||||||||||||||
| Total ancillary services operating income | $ | 44 | $ | 55 | $ | (11) | (20.0) | % | |||||||||||||||
|
Adjusted operating income (loss)(1):
|
|||||||||||||||||||||||
| U.S. IKC | $ | 24 | $ | (24) | $ | 48 | 200.0 | % | |||||||||||||||
| U.S. other ancillary | (20) | (14) | (6) | (42.9) | % | ||||||||||||||||||
| International | 102 | 93 | 9 | 9.7 | % | ||||||||||||||||||
| Total ancillary services adjusted operating income | $ | 106 | $ | 55 | $ | 51 | 92.7 | % | |||||||||||||||
Certain columns, rows or percentages may not sum due to the presentation of rounded numbers.
(1)For a reconciliation of adjusted operating income by reportable segment, see the "Reconciliations of Non-GAAP measures" section below.
Charges impacting operating income - Goodwill and other asset impairment charges. During the third quarter of 2026, we recognized goodwill and other asset impairment charges of $62 million related to our business in China. These charges resulted from a reduction in the estimated fair value of the business driven primarily by adverse reimbursement rate changes and corresponding operating developments across non-renal hospital services.
Operating (loss) income and adjusted operating (loss) income
IKC operating income for the third quarter of 2026 decreased compared to the second quarter of 2026 primarily driven by a net decrease in shared savings. IKC operating income for the nine months ended September 30, 2026 compared to operating loss for the nine months ended September 30, 2025 was impacted by a net increase in shared savings, partially offset by decreased revenues from, and increased medical claims expense related to, our special needs plans.
U.S. other ancillary services operating loss for the third quarter of 2026 remained relatively flat compared to the second quarter of 2026. U.S. other ancillary services operating loss for the nine months ended September 30, 2026 increased compared to the nine months ended September 30, 2025 primarily due to increased operating losses in our medical device company and a reduction of the earn-out obligations related to our transplant software business in the first quarter of 2025.
International operating results were impacted by goodwill and other asset impairment charges incurred in the third quarter of 2026, as described above. International operating income and adjusted operating income for the third quarter of 2026 compared to the second quarter of 2026 were impacted by increased treatment days in the third quarter, a gain on sale of divested centers recognized in the third quarter compared to a loss recognized in the second quarter and average reimbursement rate increases in certain countries. International operating income and adjusted operating income for the nine months ended September 30, 2026 compared to the nine months ended September 30, 2025 were impacted by non-acquired and acquired treatment growth and average reimbursement rate increases in certain countries, partially offset by favorable changes in the fair value of contingent consideration associated with a prior acquisition recognized in the second quarter of 2025.
Corporate administrative support
| Three months ended | Q3 2026 vs. Q2 2026 | ||||||||||||||||||||||
|
September 30, 2026 |
June 30, 2026 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Corporate administrative support | $ | (26) | $ | (16) | $ | (10) | (62.5) | % | |||||||||||||||
| Nine months ended | YTD Q3 2026 vs. YTD Q3 2025 | ||||||||||||||||||||||
|
September 30, 2026 |
September 30, 2025 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Corporate administrative support | $ | (72) | $ | (101) | $ | 29 | 28.7 | % | |||||||||||||||
Corporate administrative support expenses for the third quarter of 2026 compared to the second quarter of 2026 increased primarily due to increased professional fees. Corporate administrative support expenses for the nine months ended September 30, 2026 compared to the nine months ended September 30, 2025 decreased primarily due to decreased long-term incentive compensation and professional fees.
Corporate-level charges
| Three months ended | Q3 2026 vs. Q2 2026 | ||||||||||||||||||||||
|
September 30, 2026 |
June 30, 2026 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Debt expense | $ | 150 | $ | 150 | $ | - | - | % | |||||||||||||||
| Debt extinguishment and modification costs | $ | - | $ | 2 | $ | (2) | (100.0) | % | |||||||||||||||
|
Weighted average effective interest rate(1)
|
5.54 | % | 5.43 | % | 0.11 | % | |||||||||||||||||
| Other income, net | $ | 9 | $ | 8 | $ | 1 | 12.5 | % | |||||||||||||||
| Effective income tax rate | 24.9 | % | 21.1 | % | 3.8 | % | |||||||||||||||||
|
Effective income tax rate attributable to DaVita Inc.(2)
|
28.7 | % | 25.6 | % | 3.1 | % | |||||||||||||||||
| Net income attributable to noncontrolling interests | $ | 46 | $ | 78 | $ | (32) | (41.0) | % | |||||||||||||||
(1)Represents our overall weighted average effective interest rate on all debt, including the effect of interest rate caps and amortization of debt discount, premium and deferred financing charges as of the dates presented.
(2)For a reconciliation of our effective income tax rate attributable to DaVita Inc., see the "Reconciliations of Non-GAAP measures" section below.
| Nine months ended | YTD Q3 2026 vs. YTD Q3 2025 | ||||||||||||||||||||||
|
September 30, 2026 |
September 30, 2025 |
Amount | Percent | ||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||
| Debt expense | $ | 445 | $ | 432 | $ | 13 | 3.0 | % | |||||||||||||||
| Debt extinguishment and modification costs | $ | 2 | $ | 5 | $ | (3) | (60.0) | % | |||||||||||||||
|
Weighted average effective interest rate(1)
|
5.54 | % | 5.70 | % | (0.16) | % | |||||||||||||||||
| Other income (loss), net | $ | 22 | $ | (82) | $ | 104 | 126.8 | % | |||||||||||||||
| Effective income tax rate | 21.8 | % | 22.4 | % | (0.6) | % | |||||||||||||||||
|
Effective income tax rate attributable to DaVita Inc.(2)
|
26.5 | % | 29.6 | % | (3.1) | % | |||||||||||||||||
| Net income attributable to noncontrolling interests | $ | 202 | $ | 235 | $ | (33) | (14.0) | % | |||||||||||||||
(1)Represents our overall weighted average effective interest rate on all debt, including the effect of interest rate caps and amortization of debt discount, premium and deferred financing charges as of the dates presented.
(2)For a reconciliation of our effective income tax rate attributable to DaVita Inc., see the "Reconciliations of Non-GAAP measures" section below.
Debt expense
Debt expense for the third quarter of 2026 remained relatively flat compared to the second quarter of 2026. Debt expense for the nine months ended September 30, 2026 compared to the nine months ended September 30, 2025 increased primarily due to an increase in our long-term debt balance related to the issuance of the 6.75% senior notes due 2033 in the second quarter of 2025, partially offset by decreased weighted average effective interest rates.
Debt extinguishment and modification costs
The three months ended June 30, 2026 and nine months ended September 30, 2026 included debt extinguishment and modification costs of $2 million composed of fees incurred in connection with the Term Loan B-2 incremental transaction that occurred in June 2026. Comparatively, the nine months ended September 30, 2025 included debt extinguishment and modification costs of $5 million composed partially of fees incurred in connection with the Term Loan B-2 transaction and partially of deferred financing costs and original issue discount written off for the extinguishment of Term Loan B-1 and partial repayment of Term Loan A-1.
Other income (loss), net
Other income for the third quarter of 2026 decreased compared to the second quarter of 2026, primarily due to gains on foreign currency transactions, partially offset by decreased net income on investments. Other income for the nine months ended September 30, 2026 compared to other loss for the nine months ended September 30, 2025 was impacted by equity investment losses at Mozarc Medical Holding LLC recognized in 2025.
Provision for income taxes
The effective income tax rate and the effective income tax rate attributable to DaVita Inc. increased for the third quarter of 2026 compared to the second quarter of 2026 primarily due to a non-deductible goodwill impairment charge recognized in the third quarter and benefits recognized in the second quarter related to the purchase of renewable energy credits.
The effective income tax rate and the effective income tax rate attributable to DaVita Inc. for the nine months ended September 30, 2026 decreased compared to the nine months ended September 30, 2025 primarily due to the write-down of a 2014 tax refund claim recognized in the second quarter of 2025, partially offset by a non-deductible goodwill impairment charge recognized in the third quarter of 2026.
Net income attributable to noncontrolling interests
The decrease in net income attributable to noncontrolling interests for the third quarter of 2026 compared to the second quarter of 2026, and for the nine months ended September 30, 2026 compared to the nine months ended September 30, 2025, was driven primarily by $34 million of goodwill and other asset impairments attributable to minority interests in our China business, as described above, partially offset by increased profitability at certain U.S. dialysis partnerships.
U.S. dialysis accounts receivable
Our U.S. dialysis accounts receivable balances at September 30, 2026 and December 31, 2025 were $1.684 billion and $1.610 billion, respectively, representing approximately 51 days and 49 days of revenue outstanding (DSO), respectively. The increase in DSO is primarily due to timing of collections. Our DSO calculation is based on the current quarter's average revenues per day. There were no significant changes from the second quarter of 2026 to the third quarter of 2026 in the carrying value of accounts receivable outstanding over one year old.
Liquidity and capital resources
The following table summarizes our major sources and uses of cash, cash equivalents and restricted cash:
| Nine months ended September 30, | YTD Q3 2026 vs. YTD Q3 2025 | ||||||||||||||||||||||
| 2026 | 2025 | Amount | Percent | ||||||||||||||||||||
| (dollars in millions and shares in thousands) | |||||||||||||||||||||||
| Net cash provided by operating activities: | |||||||||||||||||||||||
| Net income | $ | 888 | $ | 748 | $ | 140 | 18.7 | % | |||||||||||||||
| Non-cash items in net income | 763 | 807 | (44) | (5.5) | % | ||||||||||||||||||
| Other working capital changes | (279) | (194) | (85) | (43.8) | % | ||||||||||||||||||
| Other | (42) | (14) | (28) | (200.0) | % | ||||||||||||||||||
| $ | 1,330 | $ | 1,346 | $ | (16) | (1.2) | % | ||||||||||||||||
| Net cash used in investing activities: | |||||||||||||||||||||||
|
Maintenance capital expenditures(1)
|
$ | (309) | $ | (304) | $ | (5) | (1.6) | % | |||||||||||||||
|
Development capital expenditures(2)
|
(122) | (126) | 4 | 3.2 | % | ||||||||||||||||||
| Acquisition expenditures | (42) | (118) | 76 | 64.4 | % | ||||||||||||||||||
| Proceeds from sale of self-developed properties | 13 | 29 | (16) | (55.2) | % | ||||||||||||||||||
| Other | (293) | 28 | (321) | (1,146.4) | % | ||||||||||||||||||
| $ | (753) | $ | (492) | $ | (261) | (53.0) | % | ||||||||||||||||
| Net cash used in financing activities: | |||||||||||||||||||||||
| Debt issuances, net | $ | 490 | $ | 788 | $ | (298) | (37.8) | % | |||||||||||||||
| Deferred and debt-related financing costs | (11) | (26) | 15 | 57.7 | % | ||||||||||||||||||
| Distributions to noncontrolling interests | (244) | (233) | (11) | (4.7) | % | ||||||||||||||||||
| Contributions from noncontrolling interests | 5 | 4 | 1 | 25.0 | % | ||||||||||||||||||
| Stock award exercises and other share issuances | (54) | (16) | (38) | (237.5) | % | ||||||||||||||||||
| Share repurchases | (870) | (1,464) | 594 | 40.6 | % | ||||||||||||||||||
| Other | (71) | (13) | (58) | (446.2) | % | ||||||||||||||||||
| $ | (755) | $ | (960) | $ | 205 | 21.4 | % | ||||||||||||||||
| Total number of shares repurchased | 5,837 | 10,001 | (4,164) | (41.6) | % | ||||||||||||||||||
|
Free cash flow(3)
|
$ | 672 | $ | 716 | $ | (44) | (6.1) | % | |||||||||||||||
Certain columns or rows may not sum due to the presentation of rounded numbers.
(1)Maintenance capital expenditures represent capital expenditures to maintain the productive capacity of the business and include those made for investments in information technology, dialysis center renovations, capital asset replacements, and any other capital expenditures that are not development or acquisition expenditures.
(2)Development capital expenditures principally represent capital expenditures (other than acquisition expenditures) made to expand the productive capacity of the business and include those for new U.S. and international dialysis center developments, dialysis center expansions and relocations, and new or expanded contracted hospital operations.
(3)For a reconciliation of our free cash flow, see the "Reconciliations of Non-GAAP measures" section below.
Consolidated cash flows
Consolidated cash flows from operating activities during the nine months ended September 30, 2026 decreased compared to the nine months ended September 30, 2025. The decrease was principally from changes in working capital items partially offset by an increase in operating results.
Free cash flow during the nine months ended September 30, 2026 decreased as compared to the nine months ended September 30, 2025 primarily due to a decrease in net cash provided by operating activities, as described above, as well as a decrease in proceeds from sale of self-developed properties and an increase in distributions to noncontrolling interest.
Significant sources of cash during the period included the incurrence of an incremental Term Loan B-2 tranche in the aggregate principal amount of $500 million and net draws on our revolving line of credit of $80 million. Significant uses of cash included regularly scheduled principal payments under our senior secured credit facilities totaling approximately $38 million on our Term Loan A-2 and $17 million on Term Loan B-2, as well as additional required payments under other debt arrangements. In addition, during the nine months ended September 30, 2026 we used cash to repurchase 5.8 million shares of our common stock.
By comparison, the same period in 2025 included the refinancing of Term Loan B-1 with a secured Term Loan B-2 facility in the aggregate principal amount of $1,878 million and issuance of the 6.75% Senior Notes in the amount of $1,000 million. Significant uses of cash during the nine months ended September 30, 2025 included the pay-off of the remaining principal balance outstanding on our Term Loan B-1 in the amount of $1,628 million, principal prepayment on our Term Loan A-1 in the amount of $250 million and repayment of $93 million in interest-free funding made available by UnitedHealth Group and its affiliates following the cybersecurity breach that affected Change Healthcare, a subsidiary of UnitedHealth Group, during the first quarter of 2025, regularly scheduled principal payments under our senior secured credit facilities totaling approximately $59 million on our Term Loan A-1, $8 million on Term Loan B-1 and $5 million on Term Loan B-2, as well as additional required payments under other debt arrangements. We also recognized financing cash outflows of $12 million in deferred financing costs related to the 6.75% Senior Notes transaction, as well as $13 million in cap premium fees for our 2025 forward interest rate cap agreements. In addition, during the nine months ended September 30, 2025 we used cash to repurchase 10.0 million shares of our common stock.
Dialysis center footprint
The table below shows the footprint of our dialysis operations by number of dialysis centers owned or operated:
| U.S. | International | ||||||||||||||||||||||
| Nine months ended September 30, | |||||||||||||||||||||||
| 2026 | 2025 | 2026 | 2025 | ||||||||||||||||||||
| Number of centers operated at beginning of period | 2,657 | 2,657 | 585 | 509 | |||||||||||||||||||
| Acquired centers | 10 | 2 | 15 | 59 | |||||||||||||||||||
| Developed centers | 7 | 12 | 3 | 6 | |||||||||||||||||||
|
Net change in non-owned managed or administered centers(1)
|
2 | - | 6 | 27 | |||||||||||||||||||
|
Sold and closed centers(2)
|
(2) | (3) | (8) | (13) | |||||||||||||||||||
|
Closed centers(3)
|
(3) | (6) | (3) | (3) | |||||||||||||||||||
| Number of centers operated at end of period | 2,671 | 2,662 | 598 | 585 | |||||||||||||||||||
(1)Represents the change in the number of dialysis centers which we manage or provide administrative services to but in which we own a noncontrolling equity interest or which are wholly-owned by third parties.
(2)Represents dialysis centers that were sold and/or closed for which the majority of patients were not retained.
(3)Represents dialysis centers that were closed for which the majority of patients were retained and transferred to one of our other existing outpatient dialysis centers.
Available liquidity
As of September 30, 2026, we had $1.42 billion available and $80 million drawn on our $1.5 billion revolving line of credit under our senior secured credit facilities. Credit available under this revolving line of credit is reduced by the amount of any letters of credit outstanding thereunder, of which there were none as of September 30, 2026. We separately had approximately $185 million in letters of credit outstanding under a separate bilateral secured letter of credit facility.
See Note 7 to the condensed consolidated financial statements for components of our long-term debt and their interest rates.
We believe that our cash flow from operations and other sources of liquidity, including from amounts available under our senior secured credit facilities and our access to the capital markets, will be sufficient to fund our scheduled debt service under the terms of our debt agreements and other obligations for the foreseeable future, including the next 12 months. From time to time, depending on market conditions, our capital requirements and the availability of financing, among other things, we may seek to refinance our existing debt and may incur additional indebtedness. Our primary recurrent sources of liquidity are cash from operations and cash from borrowings, which are subject to general, economic, financial, competitive, regulatory and other factors that are beyond our control, as described in Part I Item 1A. "Risk Factors" of our 2025 10-K.
Reconciliations of Non-GAAP measures
The following tables provide reconciliations of adjusted operating income (loss) to operating income (loss) as presented on a U.S. generally accepted accounting principles (GAAP) basis for our U.S. dialysis reportable segment as well as for our U.S. IKC business, our U.S. other ancillary services, our international business, and for our total ancillary services which combines them and is disclosed as our other segments category, in addition to our corporate administrative support.
These non-GAAP or "adjusted" measures are presented because management believes these measures are useful adjuncts to, but not alternatives for, our GAAP results. Specifically, management uses adjusted operating income (loss) 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 this non-GAAP measure is also 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. We also believe this presentation enhances a user's understanding of our normal operating income by excluding certain items which we do not believe are indicative of our ordinary results of operations.
In addition, our effective income tax rate on income attributable to DaVita Inc. excludes noncontrolling owners' income, which primarily relates to non-tax paying entities. We believe this adjusted effective income tax rate is 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, our free cash flow represents net cash provided by operating activities less distributions to noncontrolling interests, development capital expenditures, and maintenance capital expenditures; 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 under GAAP and should not be considered in isolation from, nor as substitutes for, their most comparable GAAP measures.
There were no non-GAAP adjustments for the three months ended June 30, 2026.
| Three months ended September 30, 2026 | |||||||||||||||||||||||||||||||||||||||||
| U.S. dialysis | Ancillary services | Corporate administration | Consolidated | ||||||||||||||||||||||||||||||||||||||
| U.S. IKC | U.S. Other | International | Total | ||||||||||||||||||||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||||||||||||||||||||
| Operating income (loss) | $ | 544 | $ | 4 | $ | (6) | $ | (16) | $ | (19) | $ | (26) | $ | 499 | |||||||||||||||||||||||||||
|
Goodwill and other asset impairments(1)
|
- | - | - | 62 | 62 | - | 62 | ||||||||||||||||||||||||||||||||||
| Adjusted operating income (loss) | $ | 544 | $ | 4 | $ | (6) | $ | 46 | $ | 44 | $ | (26) | $ | 561 | |||||||||||||||||||||||||||
| Nine months ended September 30, 2026 | |||||||||||||||||||||||||||||||||||||||||
| U.S. dialysis | Ancillary services | Corporate administration | Consolidated | ||||||||||||||||||||||||||||||||||||||
| U.S. IKC | U.S. Other | International | Total | ||||||||||||||||||||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||||||||||||||||||||
| Operating income (loss) | $ | 1,588 | $ | 24 | $ | (20) | $ | 40 | $ | 44 | $ | (72) | $ | 1,560 | |||||||||||||||||||||||||||
|
Goodwill and other asset impairments(1)
|
- | - | - | 62 | 62 | - | 62 | ||||||||||||||||||||||||||||||||||
| Adjusted operating income (loss) | $ | 1,588 | $ | 24 | $ | (20) | $ | 102 | $ | 106 | $ | (72) | $ | 1,622 | |||||||||||||||||||||||||||
| Nine months ended September 30, 2025 | |||||||||||||||||||||||||||||||||||||||||
| U.S. dialysis | Ancillary services | Corporate administration | Consolidated | ||||||||||||||||||||||||||||||||||||||
| U.S. IKC | U.S. Other | International | Total | ||||||||||||||||||||||||||||||||||||||
| (dollars in millions) | |||||||||||||||||||||||||||||||||||||||||
| Operating income (loss) | $ | 1,529 | $ | (24) | $ | (14) | $ | 93 | $ | 55 | $ | (101) | $ | 1,483 | |||||||||||||||||||||||||||
|
Cybersecurity incident-related charges(2)
|
25 | - | - | - | - | - | 25 | ||||||||||||||||||||||||||||||||||
| Adjusted operating income (loss) | $ | 1,554 | $ | (24) | $ | (14) | $ | 93 | $ | 55 | $ | (101) | $ | 1,508 | |||||||||||||||||||||||||||
Certain columns or rows in the above tables may not sum due to the presentation of rounded numbers.
(1)Represents non-cash goodwill and other asset impairment charges related to our business in China. These charges are excluded from our non-GAAP metrics because they do not occur in or reflect the ordinary course of our ongoing business, are inherently unpredictable and are non-cash amounts, the exclusion of which facilitates comparison of historical, current and forecasted financial results.
(2)Represents charges recognized to remediate a cybersecurity incident and restore systems during the second quarter of 2025. We have excluded these charges from our non-GAAP metrics as we do not believe they are indicative of our ordinary results of operations. See additional discussion above under the heading "Cybersecurity incident-related charges" within "U.S. dialysis results of operations".
| Three months ended | Nine months ended | ||||||||||||||||||||||
|
September 30, 2026 |
June 30, 2026 |
September 30, 2026 |
September 30, 2025 |
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| (dollars in millions) | |||||||||||||||||||||||
| Income before income taxes | $ | 359 | $ | 435 | $ | 1,135 | $ | 964 | |||||||||||||||
| Noncontrolling owners' income primarily attributable to non-tax paying entities | (46) | (78) | (202) | (236) | |||||||||||||||||||
| Income before income taxes attributable to DaVita Inc. | $ | 313 | $ | 357 | $ | 933 | $ | 729 | |||||||||||||||
| Income tax expense | $ | 89 | $ | 92 | $ | 247 | $ | 216 | |||||||||||||||
| Income tax benefit (expense) attributable to noncontrolling interests | 1 | (1) | - | - | |||||||||||||||||||
| Income tax expense attributable to DaVita Inc. | $ | 90 | $ | 91 | $ | 247 | $ | 216 | |||||||||||||||
| Effective income tax rate on income attributable to DaVita Inc. | 28.7 | % | 25.6 | % | 26.5 | % | 29.6 | % | |||||||||||||||
Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.
| Nine months ended | |||||||||||
|
September 30, 2026 |
September 30, 2025 |
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| (dollars in millions) | |||||||||||
| Net cash provided by operating activities | $ | 1,330 | $ | 1,346 | |||||||
| Adjustments to reconcile net cash provided by operating activities to free cash flow: | |||||||||||
| Distributions to noncontrolling interests | (244) | (233) | |||||||||
| Contributions from noncontrolling interests | 5 | 4 | |||||||||
| Maintenance capital expenditures | (309) | (304) | |||||||||
| Development capital expenditures | (122) | (126) | |||||||||
| Proceeds from sale of self-developed properties | 13 | 29 | |||||||||
| Free cash flow | $ | 672 | $ | 716 | |||||||
Certain columns or rows may not sum due to the presentation of rounded numbers.
Off-balance sheet arrangements and aggregate contractual obligations
In addition to the debt obligations and operating lease liabilities reflected on our balance sheet, we have certain potential commitments associated with letters of credit, working capital funding or other financing, if necessary, to certain nonconsolidated businesses that we manage and in which we own a noncontrolling equity interest or which are wholly-owned by third parties. We also have agreed to future investments in particular equity method and other investments if certain milestones are achieved or capital calls are made, as applicable. For additional information, see Note 16 to the consolidated financial statements included in our 2025 10-K.
We also have potential obligations to purchase the noncontrolling interests held by third parties in many of our majority-owned dialysis partnerships and other nonconsolidated entities. These obligations are in the form of put provisions that are exercisable at the third-party owners' discretion within specified periods as outlined in each specific put provision. For additional information on these obligations and how we measure and report them, see Note 12 to the condensed consolidated financial statements included in this report and Notes 16 and 23 to the consolidated financial statements included in our 2025 10-K.
For information on the maturities and other terms of our long-term debt and outstanding letters of credit, see Note 7 to the condensed consolidated financial statements.
As of September 30, 2026, we have outstanding purchase agreements with various suppliers to purchase set amounts of dialysis equipment, parts, pharmaceuticals, supplies and technology services. If we fail to meet the minimum purchase commitments under these contracts during any year, we are required to pay the difference to the supplier, as described further in Note 16 to the consolidated financial statements included in our 2025 10-K.
New Accounting Standards
See discussion of new accounting standards in Note 14 to the condensed consolidated financial statements.
DaVita Inc. published this content on October 29, 2026, and is solely responsible for the information contained herein. Distributed via EDGAR on October 29, 2026 at 21:04 UTC. If you believe the information included in the content is inaccurate or outdated and requires editing or removal, please contact us at [email protected]