The company increased its international presence by 142 centers, demonstrating a commitment to global expansion. This expansion is likely to drive future revenue growth and market diversification.

A strategic review of outpatient clinic capacity resulted in $72.4 million in closure costs, indicating efforts to optimize operations and reduce underperforming assets. This may lead to improved efficiency and profitability in the long term.

The company repurchased 9,832,705 shares of its common stock for $1.389 billion, signaling confidence in its financial position and future prospects. This action also reduces the number of outstanding shares, potentially increasing earnings per share.

The company has implemented cost savings initiatives designed to help mitigate these cost and volume pressures.

The company is committed to promoting a safe and compliant environment for teammates, particularly in clinical settings.

Management has designed and implemented a corporate compliance program as part of our commitment to comply fully with applicable criminal, civil and administrative laws and regulations.

The company notes that it is impacted by external conditions, including those related to general economic, marketplace and global health conditions, many of which are interrelated, including, among other things, inflation, interest rate volatility, labor market conditions, wage pressure, supply chain challenges, increased mortality rates of our patients and other ESKD and CKD patients, and the potential application of innovative technologies, drugs or other treatments.

The company notes that it is subject to a complex set of governmental laws, regulations and other requirements that impact us, including potential changes thereto.

The company notes that it is subject to changes in federal and state legislation or regulations.

The company notes that in our U.S. dialysis business, we continue to face intense competition from large and medium-sized providers, among others, which compete directly with us for limited acquisition targets, for individual patients who may choose to dialyze with us and to engage physicians qualified to provide required medical director services.

The company notes that in our U.S. dialysis business, we also compete with new dialysis providers, individual nephrologists and former medical directors or physicians that have opened their own dialysis units or facilities.

The company notes that in the integrated care market, we face competition from other dialysis providers who, similar to DaVita, may be seeking to expand arrangements with payors, physicians and hospitals. We also face competition from non-traditional providers and others in this space, who have made a number of announcements, initiatives and capital raises in areas along the full continuum of kidney care from CKD to dialysis to transplant.

U.S. dialysis patient care costs per treatment increased primarily due to increased compensation expenses, including increased wage rates, as well as increases in health benefit expense and medical supply costs.

The company is working to improve its supply chain, as noted in the risk factors.

The company is working to improve its information systems, as noted in the risk factors.

The company notes that healthcare companies, including our Company and certain of our third-party service providers, strategic partners, consultants or contractors, are increasingly incorporating self-learning or artificial intelligence features into information technology capabilities.

The company notes that federal and state laws governing the use of artificial intelligence and machine learning technologies are evolving. As the regulation of these technologies matures, we may face additional compliance costs and legal risk to our operations.

The company is working to improve its information systems, as noted in the risk factors.

The company repurchased 9,832,705 shares of its common stock for $1,389 million, signaling confidence in its financial position and future prospects.

As of February 13, 2025, the Company has a total of $1.811 billion, excluding excise taxes, available under the current repurchase authorization for additional share repurchases.

During 2024 the Company entered into several forward interest rate cap agreements, described below, that have the economic effect of capping the Company's exposure to SOFR variable interest rate changes on specific portions of the Company's floating rate debt.

The company notes that our goals and disclosures related to ESG matters expose us to numerous risks, including without limitation risks to our reputation and stock price.

The company notes that we have a longstanding program relating to environmental, social and governance (ESG) issues and have engaged with key stakeholders to develop ESG focus areas and to set ESG-related goals, many of which are aspirational.

The company notes that if we are not able to adequately recognize and respond to the rapid and ongoing developments and governmental and social expectations relating to ESG matters, this failure could result in missed corporate opportunities, additional regulatory, social or other scrutiny of us, the imposition of unexpected costs, or damage to our reputation with governments, patients, teammates, third parties and the communities in which we operate, which in turn could have a material adverse effect on our business, financial condition, cash flows and results of operations and could cause the market value of our common stock to decline.

The company notes that we continue to be impacted by external conditions, including those related to general economic, marketplace and global health conditions, many of which are interrelated, including, among other things, inflation, interest rate volatility, labor market conditions, wage pressure, supply chain challenges, increased mortality rates of our patients and other ESKD and CKD patients, and the potential application of innovative technologies, drugs or other treatments.

The company notes that we are, and may in the future be, subject to investigations and audits by governmental agencies, private civil qui tam complaints filed by relators and other lawsuits, demands, claims, legal proceedings and/or other actions alleging our failure to comply with a rule, regulation, law or practice of medicine.

The company notes that the healthcare sector, including the dialysis industry, is regularly subject to negative publicity, including as a result of governmental investigations, adverse media coverage and political debate surrounding the U.S. healthcare system, among other things.