DAVITA INC.
DAVITA INC.
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DaVita Inc. 2nd Quarter 2024 Results

  • 61
DaVita Inc. 2nd Quarter 2024 Results

PR Newswire

DENVER, Aug. 6, 2024 /PRNewswire/ -- DaVita Inc. (NYSE: DVA) announced financial and operating results for the quarter ended June 30, 2024.

"On behalf of all the teammates who provide life-saving care to our patients, I am grateful for the opportunity to report another positive quarter for DaVita," said Javier Rodriguez, CEO of DaVita Inc. "We continue to enhance our clinical capabilities while optimizing our revenue operations and cost structure."

Financial and operating highlights for the quarter ended June 30, 2024:

  • Consolidated revenues were $3.187 billion.
  • Operating income was $506 million.
  • Diluted earnings per share was $2.50 and adjusted diluted earnings per share was $2.59.
  • Operating cash flow was $799 million and free cash flow was $654 million.
  • Extended the maturity date for a portion of Term Loan B-1 in the aggregate principal amount of $1.64 billion.
  • Repurchased 2.7 million shares of our common stock at an average price paid of $140.14 per share.

 


Three months ended


Six months ended June 30,


June 30, 2024


March 31, 2024


2024


2023

Net income attributable to DaVita Inc.:

(dollars in millions, except per share data)

Net income

$               223


$               240


$               462


$               294

Diluted per share

$              2.50


$              2.65


$              5.15


$              3.17

Adjusted net income(1)

$               230


$               205


$               434


$               307

Adjusted diluted per share(1)

$              2.59


$              2.26


$              4.84


$              3.31









(1)

For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 15.

 


Three months ended

Six months ended June 30,


June 30, 2024


March 31, 2024


2024


2023


Amount


Margin


Amount


Margin


Amount


Margin


Amount


Margin

Operating income

(dollars in millions)

Operating income

$    506


15.9 %


$    484


15.8 %


$    990


15.8 %


$    717


12.2 %

Adjusted operating income(1)

$    506


15.9 %


$    449


14.6 %


$    955


15.3 %


$    740


12.6 %









(1)

For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 15.

U.S. dialysis metrics:

Volume: Total U.S. dialysis treatments for the second quarter of 2024 were 7,265,444, or an average of 93,147 treatments per day, representing a per day increase of 1.1% compared to the first quarter of 2024. Normalized non-acquired treatment growth in the second quarter of 2024 compared to the second quarter of 2023 was 0.4%.


Three months ended


Quarter

change


Six months ended


Year to date

change


June 30,
2024


March 31,
2024



June 30,
2024


June 30,
2023



(dollars in millions, except per treatment data)

Revenue per treatment

$          390.22


$          384.54


$         5.68


$        387.40


$        371.48


$          15.92

Patient care costs per treatment

$          255.25


$          255.13


$         0.12


$        255.19


$        254.94


$             0.25

General and administrative

$               282


$                275


$              7


$              556


$              538


$                18

Primary drivers of the changes in the table above were as follows:

Revenue: The quarter change was primarily due to a seasonal improvement from patients meeting their co-insurance and deductibles and normal annual rate increases, partially offset by unfavorable changes in payor mix. The year to date change was primarily driven by the increase in average reimbursement rates from normal annual rate increases including from Medicare, as well as revenue cycle improvements, favorable changes in mix and an increase in hospital inpatient dialysis rates.

Patient care costs: The quarter change was primarily due to increases in other direct operating expenses associated with our dialysis centers, health benefit expense, medical supplies expense, insurance costs and center closure costs, as described below. These increases were partially offset by decreased compensation expenses including seasonal decreases in payroll taxes, and decreased travel costs. Additionally, our fixed other direct operating expenses favorably impacted patient care costs per treatment due to increased treatments in the second quarter, as well as decreased professional fees and pharmaceutical unit costs. The year to date change was primarily due to increased compensation expenses, insurance costs, medical supplies expense and health benefits expense. These increases were partially offset by decreased contract wages, contributions to charitable organizations, other direct operating expenses associated with our dialysis centers and center closure costs. Patient care costs per treatment were also impacted by decreased IT-related costs, pharmaceutical unit costs, tax and license costs and professional fees. In addition, our fixed other direct operating expenses favorably impacted patient care costs per treatment due to increased treatments in 2024.

General and administrative: The quarter change was primarily due to increased compensation expense, professional fees, center closure costs, as described below, and long-term incentive compensation, partially offset by decreased advocacy costs. The year to date change was primarily due to increased advocacy costs, IT-related costs, compensation expenses, professional fees and center closure costs, as described below. These increases were partially offset by decreased severance costs, as described below.

Certain items impacting the quarter:

Closure costs. During the third quarter of 2023, we continued the strategic review of our outpatient clinic capacity requirements and utilization, which both have been impacted by declines in our patient census in some markets due to the COVID-19 pandemic. 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 several quarters. These capacity closure costs include net losses on assets retired, lease termination costs, asset impairments and accelerated depreciation and amortization.

During the three months ended and six months ended June 30, 2024, we incurred charges for U.S. dialysis center closures of approximately $15.3 million and $29.9 million, respectively. During the three months ended June 30, 2024 these center closures increased our patient care costs by $6.5 million, our general and administrative expenses by $8.7 million and our depreciation and amortization expense by $0.1 million. During the six months ended June 30, 2024, these center closures increased our patient care costs by $9.8 million, our general and administrative expenses by $15.8 million and our depreciation and amortization expense by $4.3 million.

In connection with a comment letter from the Securities and Exchange Commission Staff, beginning in the second quarter of 2024, we have updated the presentation of our non-GAAP measures to no longer exclude center closure costs for all periods presented as well as for our current full-year 2024 guidance. To facilitate comparisons, prior periods shown herein now conform to this revised presentation, except as may otherwise be indicated.

Debt transactions. In May 2024, we entered into the Fourth Amendment to our senior secured credit agreement. The Fourth Amendment extends the maturity date for a portion of our Term Loan B-1 in the aggregate principal amount of $1,640 million.

Change Healthcare. During the first half of 2024, we experienced delays in claims processing as a result of the Change Healthcare outage. As a result, we applied for and received interest-free funding from UnitedHealth Group under the Temporary Funding Assistance Program. As of June 30, 2024 we have $393 million outstanding under this program. Amounts provided under this program are subject to repayment within 45 business days from a future date to be mutually agreed to by Change Healthcare and the Company.

Share repurchases. During the three months ended June 30, 2024, we repurchased 2.7 million shares for $376 million, at an average price paid of $140.14 per share.

Subsequent to June 30, 2024 through August 2, 2024, the Company has repurchased 1.1 million shares of our common stock for $159 million at an average price paid of $138.81 per share.

Financial and operating metrics:


Three months ended

June 30,


Twelve months ended

June 30,


2024


2023


2024


2023

Cash flow:

(dollars in millions)

Operating cash flow

$               799


$               450


$           1,810


$           1,967

Free cash flow(1)

$               654


$               260


$           1,038


$           1,100









(1)

For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 15.

 


Three months ended
June 30, 2024


Six months ended

June 30, 2024

Effective income tax rate on:




Income

19.3 %


18.5 %

Income attributable to DaVita Inc.(1)

24.2 %


22.9 %

Adjusted income attributable to DaVita Inc.(1)

24.3 %


24.3 %









(1)

For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 15.

Center activity: As of June 30, 2024, we provided dialysis services to a total of approximately 265,100 patients at 3,124 outpatient dialysis centers, of which 2,672 centers were located in the United States and 452 centers were located in 13 countries outside of the United States. During the second quarter of 2024, we acquired and opened a total of 10 and closed three dialysis centers in the United States. We also acquired 24, opened three and closed two dialysis centers outside of the United States during the second quarter of 2024.

Integrated kidney care (IKC): As of June 30, 2024, we had approximately 71,300 patients in risk-based integrated care arrangements representing approximately $5.4 billion in annualized medical spend. We also had an additional 15,200 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 footnote 7 in the "Supplemental Financial Data" table below.

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. 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 current non-GAAP financial measures do not include certain items, including gains on changes in ownership interest 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.

Additionally, in connection with a comment letter from the Securities and Exchange Commission Staff, beginning in the second quarter of 2024, we no longer exclude center closure costs from our 2024 guidance. Accordingly, under the revised presentation, our current 2024 guidance no longer excludes approximately $60 million in center closure costs. Prior 2024 guidance shown below is as of May 2, 2024, and therefore is shown under the prior presentation methodology.


Current 2024 guidance


Prior 2024 guidance


Low


High


Low


High


(dollars in millions, except per share data)

Adjusted operating income

$1,910


$2,010


$1,875


$1,975

Adjusted diluted net income per share attributable to DaVita Inc.

$9.25


$10.05


$9.00


$9.80

Free cash flow

$950


$1,200


$900


$1,150

We will be holding a conference call to discuss our results for the second quarter ended June 30, 2024, on August 6, 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.

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, statements about our balance sheet and liquidity, our expenses, revenues, billings and collections, patient census, availability or cost of supplies, treatment volumes, mix expectation, such as the percentage or number of patients under commercial insurance, the effects of the recent Change Healthcare (CHC) cybersecurity outage on us and our operations, 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), Medicare Advantage (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, expectations regarding the impact of our continuing cost savings initiatives and our 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, including, without limitation, the impact of global events and political or governmental volatility; the impact of the domestic political environment and related developments on the current healthcare marketplace and on our business; the continuing impact of the COVID-19 pandemic on our operations, reputation, financial condition and the chronic kidney disease (CKD) population and our patient population; 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; supply chain challenges and disruptions, including without limitation with respect to certain of our equipment and clinical supplies; elevated teammate turnover or labor costs; the impact of continued increased competition from dialysis providers and others; 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 to invest in and implement cost saving initiatives;
  • 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 commercial plans, including, without limitation, as a result of continuing legislative efforts to restrict or prohibit the use and/or availability of charitable premium assistance, or as a result of payors' implementing restrictive plan designs;
  • risks arising from potential changes in or new laws, regulations or requirements applicable to us, including, without limitation, those related to healthcare, antitrust matters, including, among others, non-competes and other restrictive covenants, and acquisition, merger, joint venture or similar transactions and/or labor matters, and potential impacts of changes in 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 attract, retain and motivate teammates and our ability to manage operating cost increases or productivity decreases whether due to union organizing activities, legislative or other changes, demand for labor, volatility and uncertainty in the labor market, the current challenging and highly competitive labor market conditions, or other reasons;
  • our ability to successfully implement our strategies with respect to IKC and VBC initiatives 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;
  • 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 recent cyberattack on CHC, including, among other things, any such non-compliance or breach involving the misappropriation, loss or other unauthorized use or disclosure of confidential information;
  • 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;
  • 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 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, such as, among others, CHC and suppliers of certain pharmaceuticals or critical clinical products;
  • 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 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 including, without limitation, due to defects or operational issues in our billing systems or in the billing systems or services of third parties on which we rely, such as the operational issues at CHC resulting from a recent cyberattack; 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 any use by us of a considerable amount of available funds to repurchase stock;
  • 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; and
  • the other risk factors, trends and uncertainties set forth in our Annual Report on Form 10-K for the year ended December 31, 2023 and Quarterly Report on Form 10-Q for the quarter ended March 31, 2024, and the risks and uncertainties discussed in any subsequent reports that we file or furnish with the SEC from time to time.

The financial information presented in this release is unaudited and is subject to change as a result of subsequent events or adjustments, if any, arising prior to the filing of the Company's Quarterly Report on Form 10-Q for the quarter ended June 30, 2024.

 

DAVITA INC.

CONSOLIDATED STATEMENTS OF INCOME

(unaudited)

(dollars and shares in thousands, except per share data)



Three months ended June 30,


Six months ended June 30,


2024


2023


2024


2023

Dialysis patient service revenues

$        3,061,102


$        2,890,685


$      6,002,634


$      5,650,719

Other revenues

125,620


109,684


254,643


222,349

Total revenues

3,186,722


3,000,369


6,257,277


5,873,068

Operating expenses:








Patient care costs

2,142,299


2,055,844


4,221,275


4,114,033

General and administrative

367,845


364,016


730,325


695,630

Depreciation and amortization

175,661


183,672


362,744


361,743

Equity investment income, net

(5,481)


(8,454)


(12,163)


(15,274)

Gain on changes in ownership interest



(35,147)


Total operating expenses

2,680,324


2,595,078


5,267,034


5,156,132

Operating income

506,398


405,291


990,243


716,936

Debt expense

(97,747)


(103,507)


(197,165)


(204,281)

Debt prepayment, extinguishment and modification costs

(9,732)


(7,962)


(9,732)


(7,962)

Other (loss) income, net

(27,479)


1,373


(40,120)


5,125

Income before income taxes

371,440


295,195


743,226


509,818

Income tax expense

71,688


48,818


137,494


92,773

Net income

299,752


246,377


605,732


417,045

Less: Net income attributable to noncontrolling interests

(77,076)


(67,686)


(143,407)


(122,807)

Net income attributable to DaVita Inc.

$           222,676


$           178,691


$         462,325


$         294,238









Earnings per share attributable to DaVita Inc.:








Basic net income

$                 2.56


$                 1.96


$               5.29


$               3.24

Diluted net income

$                 2.50


$                 1.91


$               5.15


$               3.17









Weighted average shares for earnings per share:








Basic shares

86,899


90,984


87,337


90,742

Diluted shares

88,950


93,418


89,749


92,952

 

DAVITA INC.

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME

(unaudited)

 (dollars in thousands)



Three months ended June 30,


Six months ended June 30,


2024


2023


2024


2023

Net income

$         299,752


$         246,377


$         605,732


$         417,045

Other comprehensive (loss) income, net of tax:








Unrealized gains on interest rate cap agreements:








Unrealized gains

5,919


24,849


19,236


21,310

Reclassifications of net realized gains into net income

(22,041)


(18,956)


(43,669)


(34,698)

Unrealized (losses) gains on foreign currency translation:

(78,853)


41,961


(118,573)


75,522

Other comprehensive (loss) income

(94,975)


47,854


(143,006)


62,134

Total comprehensive income

204,777


294,231


462,726


479,179

Less: Comprehensive income attributable to noncontrolling interests

(77,076)


(67,686)


(143,407)


(122,807)

Comprehensive income attributable to DaVita Inc.

$         127,701


$         226,545


$         319,319


$         356,372

 

DAVITA INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS

(unaudited)

(dollars in thousands)



Six months ended June 30,


2024


2023

Cash flows from operating activities:




Net income

$          605,732


$          417,045

Adjustments to reconcile net income to net cash provided by operating activities:




Depreciation and amortization

362,744


361,743

Loss on extinguishment of debt

2,445


7,132

Stock-based compensation expense

48,832


55,197

Deferred income taxes

(28,643)


(16,178)

Equity investment loss, net

54,748


14,571

Gain on changes in ownership interest

(35,147)


Other non-cash losses and (gains), net

16,570


(5,160)

Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:




Accounts receivable

(193,093)


141,503

Inventories

22,422


(116)

Other current assets

(13,898)


33,182

Other long-term assets

(3,367)


(607)

Accounts payable

(38,998)


(40,615)

Accrued compensation and benefits

(122,817)


(68,800)

Other current liabilities

1,219


17,242

Income taxes

(8,097)


5,200

Other long-term liabilities

(6,642)


(8,675)

Net cash provided by operating activities

664,010


912,664

Cash flows from investing activities:




Additions of property and equipment

(245,740)


(272,204)

Acquisitions

(157,783)


(2,575)

Proceeds from asset and business sales

12,779


21,198

Purchase of debt investments held-to-maturity

(309)


(30,419)

Purchase of other debt and equity investments

(3,411)


(6,366)

Proceeds from debt investments held-to-maturity

7,082


94,414

Proceeds from sale of other debt and equity investments

4,564


3,873

Purchase of equity method investments

(700)


(273,336)

Distributions from equity method investments

6,554


1,758

Net cash used in investing activities

(376,964)


(463,657)

Cash flows from financing activities:




Borrowings

3,275,533


2,136,873

Payments on long-term debt

(2,661,145)


(2,347,120)

Deferred and debt related financing costs

(19,993)


(45,009)

Purchase of treasury stock

(612,614)


Distributions to noncontrolling interests

(107,210)


(124,178)

Net payments related to stock purchases and awards

(86,277)


(43,612)

Contributions from noncontrolling interests

7,621


6,946

Proceeds from sales of additional noncontrolling interests

860


50,962

Purchases of noncontrolling interests

(40,751)


(7,610)

Net cash used in financing activities

(243,976)


(372,748)

Effect of exchange rate changes on cash, cash equivalents and restricted cash

(4,458)


6,922

Net increase in cash, cash equivalents and restricted cash

38,612


83,181

Cash, cash equivalents and restricted cash at beginning of the year

464,634


338,989

Cash, cash equivalents and restricted cash at end of the period

$          503,246


$          422,170

 

DAVITA INC.

CONSOLIDATED BALANCE SHEETS

(unaudited)

(dollars and shares in thousands, except per share data)



June 30, 2024


December 31, 2023

ASSETS




Cash and cash equivalents

$             416,493


$             380,063

Restricted cash and equivalents

86,753


84,571

Short-term investments

20,693


11,610

Accounts receivable

2,303,119


1,986,856

Inventories

126,765


143,105

Other receivables

420,623


422,669

Prepaid and other current assets

83,106


102,645

Income tax receivable

9,373


6,387

Total current assets

3,466,925


3,137,906

Property and equipment, net of accumulated depreciation of $6,058,826 and $5,759,514, respectively

2,982,222


3,073,533

Operating lease right-of-use assets

2,457,565


2,501,364

Intangible assets, net of accumulated amortization of $38,752 and $38,445, respectively

191,483


203,224

Equity method and other investments

453,709


545,848

Long-term investments

31,779


47,890

Other long-term assets

240,490


271,253

Goodwill

7,201,399


7,112,560


$        17,025,572


$        16,893,578

LIABILITIES AND EQUITY




Accounts payable

$             493,534


$             514,533

Other liabilities

888,358


828,878

Accrued compensation and benefits

644,865


752,598

Current portion of operating lease liabilities

404,820


394,399

Current portion of long-term debt

537,991


123,299

Income tax payable

25,222


28,507

Total current liabilities

2,994,790


2,642,214

Long-term operating lease liabilities

2,281,372


2,330,389

Long-term debt

8,451,562


8,268,334

Other long-term liabilities

179,010


183,074

Deferred income taxes

693,982


726,217

Total liabilities

14,600,716


14,150,228

Commitments and contingencies




Noncontrolling interests subject to put provisions

1,574,840


1,499,288

Equity:




Preferred stock ($0.001 par value, 5,000 shares authorized; none issued)


Common stock ($0.001 par value, 450,000 shares authorized; 89,855 and 85,081 shares issued

 and outstanding at June 30, 2024, respectively, and 88,824 shares issued and outstanding at

 December 31, 2023)

90


89

Additional paid-in capital

383,235


509,804

Retained earnings

1,060,613


598,288

Treasury stock (4,774 and zero shares, respectively)

(615,948)


Accumulated other comprehensive loss

(195,090)


(52,084)

Total DaVita Inc. shareholders' equity

632,900


1,056,097

Noncontrolling interests not subject to put provisions

217,116


187,965

Total equity

850,016


1,244,062


$        17,025,572


$        16,893,578

 

DAVITA INC.

SUPPLEMENTAL FINANCIAL DATA

(unaudited)
(dollars in millions and shares in thousands, except per treatment and patient data)



Three months ended


Six months ended
June 30, 2024


June 30,
2024


March 31,
2024


1. Consolidated business metrics:






Operating margin

15.9 %


15.8 %


15.8 %

Adjusted operating margin excluding certain items(2)

15.9 %


14.6 %


15.3 %

General and administrative expenses as a percent of consolidated revenues(1)

11.5 %


11.8 %


11.7 %

Effective income tax rate on income

19.3 %


17.7 %


18.5 %

Effective income tax rate on income attributable to DaVita Inc.(2)

24.2 %


21.5 %


22.9 %

Effective income tax rate on adjusted income attributable to DaVita Inc.(2)

24.3 %


24.3 %


24.3 %







2. Summary of financial results:






Revenues:






U.S. dialysis patient services and other

$     2,841


$     2,756


$        5,597

Other—Ancillary services






Integrated kidney care

114


116


230

Other U.S. ancillary

7


6


13

International dialysis patient service and other

242


219


461


362


342


704

Eliminations

(17)


(27)


(44)

Total consolidated revenues

$     3,187


$     3,071


$        6,257

Operating income (loss):






U.S. dialysis

$         550


$         526


$        1,076

Other—Ancillary services






Integrated kidney care

(34)


(26)


(60)

Other U.S. ancillary

(2)


(2)


(3)

International(3)

17


16


33


(19)


(12)


(30)

Corporate administrative support expenses

(25)


(30)


(56)

Total consolidated operating income

$         506


$         484


$           990

 

DAVITA INC.

SUPPLEMENTAL FINANCIAL DATA - continued

(unaudited)

(dollars in millions and shares in thousands, except per treatment and patient data)



Three months ended


Six months ended
June 30, 2024


June 30,
2024


March 31,
2024


3. Summary of reportable segment financial results and metrics:






U.S. dialysis






Financial results






Revenue:






Dialysis patient service revenues

$     2,835


$     2,750


$        5,585

Other revenues

6


6


12

Total operating revenues

2,841


2,756


5,597

Operating expenses:






Patient care costs

1,855


1,825


3,679

General and administrative

282


275


556

Depreciation and amortization

160


173


333

Equity investment income

(6)


(6)


(12)

Gain on changes in ownership interests


(35)


(35)

Total operating expenses

2,291


2,230


4,521

Segment operating income

$         550


$         526


$        1,076

Reconciliation for non-GAAP measure:






Gain on changes in ownership interest


(35)


(35)

Adjusted segment operating income(2)

$         550


$         491


$        1,041

Metrics






Volume:






Treatments

7,265,444


7,151,512


14,416,956

Number of treatment days

78.0


77.6


155.6

Average treatments per day

93,147


92,159


92,654

Per day year-over-year increase (decrease)

0.5 %


(0.3) %


0.1 %

Normalized year-over-year non-acquired treatment growth(4)

0.4 %


0.4 %



Operating net revenues:






Average patient service revenue per treatment

$   390.22


$   384.54


$     387.40

Expenses:






Patient care costs per treatment

$   255.25


$   255.13


$     255.19

General and administrative expenses per treatment

$     38.79


$     38.39


$        38.59

Depreciation and amortization expense per treatment

$     22.08


$     24.17


$        23.12

Accounts receivable:






Receivables

$     1,812


$     2,180



DSO

59


73









4. IKC metrics:






Patients per integrated care arrangement type:






Risk-based

71,300


68,600



Other

15,200


14,200



Annualized aggregate risk based spend(7)

$     5,400


$     5,300



 

DAVITA INC.

SUPPLEMENTAL FINANCIAL DATA - continued

(unaudited)

(dollars in millions and shares in thousands, except per treatment and patient data)



Three months ended


Six months ended
June 30, 2024


June 30,
2024


March 31,
2024


5. Cash flow:






Operating cash flow

$         799


$       (135)


$               664

Operating cash flow, last twelve months

$     1,810


$     1,462



Free cash flow(2)

$         654


$       (327)


$               327

Free cash flow, last twelve months(2)

$     1,038


$         645



Capital expenditures:






Maintenance

$           86


$           85


$               171

Development

$           39


$           36


$                 74

Acquisition expenditures

$           53


$         105


$               158

Proceeds from sale of self-developed properties

$             6


$             3


$                   9

6. Debt and capital structure:






Total debt(5)

$     9,048


$     9,179



Net debt, net of cash and cash equivalents(5)

$     8,632


$     8,834



Leverage ratio(6)

3.10x


3.29x



Weighted average effective interest rate:






During the quarter

4.27 %


4.51 %



At end of the quarter

4.33 %


4.69 %



On the senior secured credit facilities at end of the quarter

4.62 %


4.88 %



Debt with fixed and capped rates as a percentage of total debt:






Debt with rates fixed by its terms

55 %


50 %



Debt with rates fixed by its terms or capped by cap agreements

93 %


88 %



Amount spent on share repurchases

$         376


$         240


$               616

Number of shares repurchased

2,655


2,119


4,774


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. Adjusted operating income margin is adjusted operating income divided by consolidated revenues.

(3)

The reported operating income for the three months ended June 30, 2024 and March 31, 2024, and for six months ended June 30, 2024 includes foreign currency gains (losses) embedded in equity method income recognized from our Asia Pacific joint venture of approximately $0.4, $1.5 and $1.9, 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 June 30, 2024 and March 31, 2024 presented exclude approximately $58.6 and $51.3, 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)

This is a non-GAAP measure. See "Calculation of Leverage Ratio" in non-GAAP reconciliations.

(7)

Integrated care metrics: 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 SNPs), 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.

DAVITA INC.
RECONCILIATIONS FOR NON-GAAP MEASURES
(unaudited)
(dollars in millions)

Calculation of the Leverage Ratio

Under our amended senior secured credit facilities (the Amended Credit Agreement) dated May 9, 2024 and our prior senior secured credit facilities, 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 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


June 30,
2024


March 31,
2024

Net income attributable to DaVita Inc.

$                   860


$                   816

Income taxes

265


242

Interest expense

348


353

Depreciation and amortization

746


754

Impairment charges

26


26

Net income attributable to noncontrolling interests

286


277

Stock-settled stock-based compensation

103


108

Debt extinguishment and modification costs

10


8

Expected cost savings and expense reductions

16


23

Severance and other related costs

5


10

Other

116


67

"Consolidated EBITDA"

$               2,781


$               2,683






June 30,
2024


March 31,
2024

Total debt, excluding debt discount and other deferred financing costs(1)

$               9,048


$               9,179

Less: Cash and cash equivalents including short-term investments(2)

(432)


(352)

Consolidated net debt

$               8,616


$               8,827

Last twelve months "Consolidated EBITDA"

$               2,781


$               2,683

Leverage ratio

3.10x


3.29x

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 June 30, 2024 and March 31, 2024 presented exclude approximately $58.6 and $51.3, 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.

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, 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.

In connection with a comment letter from the Securities and Exchange Commission Staff, beginning in the second quarter of 2024, we have updated the presentation of our non-GAAP measures to no longer exclude center closure costs for all periods presented. To facilitate comparisons, the non-GAAP measures presented for prior periods also have been conformed to the presentation of the non-GAAP measures for the current period.

These non-GAAP or "adjusted" measures are presented because management believes these measures are useful adjuncts to GAAP results. However, these non-GAAP measures should not be considered alternatives to the corresponding measures determined under GAAP. 

Specifically, management uses adjusted measures of operating expenses for its U.S. dialysis business, adjusted U.S. dialysis patient care costs per treatment, adjusted operating income, adjusted net income 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, 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 or liquidity under GAAP and should not be considered in isolation from, nor as substitutes for, their most comparable GAAP measures.

The following reconciliations of the non-GAAP financial measures presented in this press release to their most comparable GAAP measures.

DAVITA INC.

RECONCILIATIONS FOR NON-GAAP MEASURES - continued

(unaudited)

(dollars in millions, except per share data)


Adjusted net income and adjusted diluted net income per share attributable to DaVita Inc.:



Three months ended

Six months ended


June 30,
2024


March 31,
2024


June 30,
2024


June 30,
2023


Dollars


Per share


Dollars


Per share


Dollars


Per share


Dollars


Per share

Consolidated:
















Net income attributable to DaVita Inc.

$   223


$   2.50


$   240


$   2.65


$   462


$   5.15


$   294


$   3.17

Gain on changes in ownership interest(1)



(35)


(0.39)


(35)


(0.39)



Severance and other costs(2)







23


0.25

Debt prepayment and refinancing charges(3)

10


0.11




10


0.11


8


0.09

Other income - Mozarc gain(4)







(14)


(0.15)

Related income tax

(2)


(0.03)




(2)


(0.03)


(4)


(0.05)

Adjusted net income attributable to DaVita Inc.(5)

$   230


$   2.59


$   205


$   2.26


$   434


$   4.84


$   307


$   3.31


Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.

 

Adjusted operating income:



Three months ended June 30, 2024


U.S.

dialysis


Ancillary services


Corporate

administration





U.S. IKC


U.S. Other


International


Total



Consolidated

Operating income (loss)

$       550


$        (34)


$           (2)


$          17


$      (19)


$           (25)


$        506

Adjusted operating income (loss)(5)

$       550


$        (34)


$           (2)


$          17


$      (19)


$           (25)


$        506


Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.



Three months ended March 31, 2024


U.S.

dialysis


Ancillary services


Corporate

administration





U.S. IKC


U.S. Other


International


Total



Consolidated

Operating income (loss)

$       526


$        (26)


$           (2)


$          16


$      (12)


$           (30)


$        484

Gain on changes in ownership interest(1)

(35)







(35)

Adjusted operating income (loss)(5)

$       491


$        (26)


$           (2)


$          16


$      (12)


$           (30)


$        449


Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.



Six months ended June 30, 2024


U.S.

dialysis


Ancillary services


Corporate

administration





U.S. IKC


U.S. Other


International


Total



Consolidated

Operating income (loss)

$    1,076


$        (60)


$           (3)


$          33


$      (30)


$           (56)


$        990

Gain on changes in ownership interest(1)

(35)







(35)

Adjusted operating income (loss)(5)

$    1,041


$        (60)


$           (3)


$          33


$      (30)


$           (56)


$        955


Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.



Six months ended June 30, 2023


U.S.

dialysis


Ancillary services


Corporate

administration





U.S. IKC


U.S. Other


International


Total



Consolidated

Operating income (loss)

$       822


$        (77)


$           (5)


$          35


$      (46)


$           (58)


$        717

Severance and other costs(2)

22






1


23

Adjusted operating income (loss)(5)

$       844


$        (76)


$           (5)


$          35


$      (46)


$           (57)


$        740


Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.

 

DAVITA INC.

RECONCILIATIONS FOR NON-GAAP MEASURES - continued

(unaudited)

(dollars in millions, except per share data)



Three months ended


Six months ended

June 30, 2024


June 30,
2024


March 31,
2024


Effective income tax rates on income attributable to DaVita Inc.:






Income before income taxes

$       371


$       372


$       743

Noncontrolling owners' income primarily attributable to non-tax paying entities

(78)


(66)


(144)

Income before income taxes attributable to DaVita Inc.

$       294


$       305


$       599

Income tax expense

$         72


$         66


$       137

Income tax attributable to noncontrolling interests



(1)

Income tax expense attributable to DaVita Inc.

$         71


$         66


$       137

Effective income tax rate on income attributable to DaVita Inc.

24.2 %


21.5 %


22.9 %







Effective income tax rate on adjusted income attributable to DaVita Inc.:






Income before income taxes

$       371


$       372


$       743

Gain on changes in ownership interest(1)


(35)


(35)

Debt prepayment and refinancing charges(3)

10



10

Noncontrolling owners' income primarily attributable to non-tax paying entities

(78)


(66)


(144)

Adjusted income before income taxes attributable to DaVita Inc.(5)

$       304


$       270


$       574

Income tax expense

$         72


$         66


$       137

Plus income tax related to:






Debt prepayment and refinancing charges(3)

2



2

Less income tax related to:






Noncontrolling interests



(1)

Income tax on adjusted income attributable to DaVita Inc.(5)

$         74


$         66


$       139

Effective income tax rate on adjusted income attributable to DaVita Inc.(5)

24.3 %


24.3 %


24.3 %


Certain columns, rows or percentages may not sum or recalculate due to the presentation of rounded numbers.

 

Free cash flow:



Three months ended


Six months ended

June 30, 2024


June 30,
2024


March 31,
2024


June 30,
2023


Net cash provided by (used in) operating activities

$           799


$         (135)


$           450


$              664

Adjustments to reconcile net cash provided by operating activities to

 free cash flow:








Distributions to noncontrolling interests

(30)


(77)


(69)


(107)

Contributions from noncontrolling interests

4


4


2


8

Maintenance capital expenditures(6)

(86)


(85)


(86)


(171)

Development capital expenditures(7)

(39)


(36)


(39)


(74)

Proceeds from sale of self-developed properties

6


3


2


9

Free cash flow

$           654


$         (327)


$           260


$              327


Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.

 

DAVITA INC.

RECONCILIATIONS FOR NON-GAAP MEASURES - continued

(unaudited)

(dollars in millions, except per share data)


Free cash flow (continued):


Twelve months ended


June 30,
2024


March 31,
2024


June 30,
2023

Net cash provided by operating activities

$        1,810


$        1,462


$        1,967

Adjustments to reconcile net cash provided by operating activities to free cash flow:






Distributions to noncontrolling interests

(264)


(303)


(274)

Contributions from noncontrolling interests

15


14


13

Maintenance capital expenditures(6)

(383)


(383)


(445)

Development capital expenditures(7)

(158)


(159)


(165)

Proceeds from sale of self-developed properties

18


14


4

Free cash flow

$        1,038


$           645


$        1,100


Certain columns or rows may not sum or recalculate due to the presentation of rounded numbers.









(1)

Represents a non-cash gain recognized on the acquisition of a controlling financial interest in a previously nonconsolidated dialysis partnership. This gain to mark the investment to fair value prior to consolidation does not represent a normal and recurring cost of operating our business or generating revenues and may obscure analysis of underlying trends and financial performance.

(2)

Includes severance and other termination costs related to a prior strategic restructuring initiative and associated transition of certain general and administrative support functions to a third party.

(3)

Represents the non-cash write-off of debt refinancing costs associated with the Company's senior secured credit agreement. Costs associated with refinancing the Company's debt are not indicative of normal debt expense and may obscure analysis of underlying trends and financial performance. See additional discussion under "Debt transactions" above.

(4)

Represents a non-cash gain recognized on rights contributed to Mozarc Medical Holding LLC (Mozarc) upon its formation. This gain to mark these rights to fair value prior to contribution to Mozarc does not represent a normal and recurring cost of operating our business or generating revenues and may obscure analysis of underlying trends and financial performance.

(5)

In connection with the conclusion of a comment letter from the Securities and Exchange Commission Staff in July 2024, beginning in the second quarter of 2024, we have updated our non-GAAP measures to no longer exclude center closure costs for all periods presented. To facilitate comparisons, the non-GAAP measures presented for prior periods also have been conformed to the presentation of the non-GAAP measures for the current period.

(6)

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.

(7)

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.

 

Contact:

Investor Relations


DaVita Inc.


[email protected]

 

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