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m a r - 2 0 0 5 + + + b b - % 2 f - - + + + + + + + + + + + + + + b b - % 2 f - - 2 8 - j a n - 2 0 0 4 + + + b b % 2 f - - + + + + + + + + + + + + + + + b b % 2 f - - % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d % 3 d r a t i o n a l e t h e + r a t i n g + o n + d e n v e r - b a s e d + d a v i t a + i n c % 2 c + a + d i a l y s i s + s e r v i c e + p r o v i d e r % 2 c + r e f l e c t s + % 0 9 % 0 a i t s + % 2 2 f a i r % 2 2 + b u s i n e s s + r i s k + p r o f i l e + a n d + % 2 2 a g g r e s s i v e % 2 2 + f i n a n c i a l + r i s k + p r o f i l e + % 0 9 % 0 a s t a n d a r d + % 2 6 + p o o r % 2 7 s + r a t i n g s + s e r v i c e s % 2 7 + v i e w + o f + d a v i t a % 2 7 s + b u s i n e s s + o v e r w h e l m i n g l y + % 0 9 % 0 a r e f l e c t s + i t s + d e p e n d e n c e + o n + t h e + t r e a t m e n t + o f + a + s i n g l e + d i s e a s e + a n d + i t s + e x p o s u r e + % 0 9 % 0 a t o + p o t e n t i a l + a d v e r s e + c h a n g e s + i n + p a y o r + m i x + a n d + r e i m b u r s e m e n t + i t s + f a i r + b u s i n e s s + % 0 9 % 0 a r i s k + p r o f i l e + a l s o + r e c o g n i z e s + p o s i t i v e + a t t r i b u t e s + o f + t h e + s e c t o r % 2 c + s u c h + a s + s t e a d y + % 0 9 % 0 a d e m a n d + f r o m + p a t i e n t s + w i t h + e n d - s t a g e + r e n a l + d i s e a s e + f o r + e s s e n t i a l + d i a l y s i s + % 0 9 % 0 a t r e a t m e n t s % 2 c + f a v o r a b l e + d e m o g r a p h i c + t r e n d s % 2 c + a n d + r e l a t i v e l y + l o w + i n v e s t m e n t + % 0 9 % 0 a r e q u i r e m e n t s w e + e x p e c t + d a v i t a % 2 7 s + r e v e n u e s + t o + g r o w + a b o u t + 1 0 % 2 5 + i n + 2 0 1 2 % 2 c + i n c o r p o r a t i n g + t h e + % 0 9 % 0 a s e p t e m b e r + 2 0 1 1 + a c q u i s i t i o n + o f + d s i + r e n a l + i n c % 2 c + a n d + a t + a + m i d - s i n g l e - d i g i t + a n n u a l + % 0 9 % 0 a r a t e + t h e r e a f t e r + w e + e x p e c t + t r e a t m e n t + g r o w t h + a t + d a v i t a % 2 7 s + e x i s t i n g + c e n t e r s + t o + % 0 9 % 0 a s l i g h t l y + e x c e e d + t h e + 3 5 % 2 5 + t o + 4 0 % 2 5 + a n n u a l + g r o w t h + i n + t o t a l + u s + d i a l y s i s + % 0 9 % 0 a p a t i e n t s % 2 c + w i t h + i n c r e m e n t a l + r e v e n u e + g r o w t h + c o m i n g + f r o m + n e w l y + o p e n e d + a n d + % 0 9 % 0 a a c q u i r e d + c l i n i c s + w e + e x p e c t + d a v i t a % 2 7 s + p r o f i t + m a r g i n s + t o + r e m a i n + s t a b l e % 2 c + % 0 9 % 0 a s u p p o r t i n g + c o n t i n u e d + g e n e r a t i o n + o f + r o b u s t + d i s c r e t i o n a r y + c a s h + f l o w + % 2 8 d c f % 2 9 p a y o r + m i x + i s + a n + i m p o r t a n t + c r e d i t + c o n s i d e r a t i o n + f o r + u s + d i a l y s i s + s e r v i c e + % 0 9 % 0 a c o m p a n i e s + m e d i c a r e + d o e s + n o t + f u l l y + r e i m b u r s e + d i a l y s i s + p r o v i d e r s + f o r + t r e a t m e n t + % 0 9 % 0 a c o s t % 2 c + a n d + g o v e r n m e n t + p r o g r a m s + % 2 8 m a i n l y + m e d i c a r e + a n d + m e d i c a r e + a d v a n t a g e % 2 9 + p a y + f o r + % 0 9 % 0 a a b o u t + 9 0 % 2 5 + o f + t h e + t r e a t m e n t s + d a v i t a + p r o v i d e s + d a v i t a + l o s e s + m o n e y + o n + e a c h + % 0 9 % 0 a m e d i c a r e + t r e a t m e n t + t h u s % 2 c + t h e + p e r c e n t + o f + t r e a t m e n t s + t h a t + c o m m e r c i a l + i n s u r e r s + % 0 9 % 0 a c o v e r % 2 c + t h e + c o m m e r c i a l + i n s u r e r s % 2 7 + p r i c i n g % 2 c + a n d + e f f i c i e n t + m a n a g e m e n t + p r a c t i c e s + % 0 9 % 0 a a r e + i m p o r t a n t + i n + r e c e n t + y e a r s % 2 c + d a v i t a + h a s + e x p e r i e n c e d + s o m e + e r o s i o n + i n + t h e + % 0 9 % 0 a p e r c e n t + o f + r e v e n u e + f r o m + p r i v a t e + p a y o r s % 2 c + m o s t + l i k e l y + b e c a u s e + o f + h i g h + % 0 9 % 0 a u n e m p l o y m e n t + a n d + i m p r o v e d + p a t i e n t + m o r t a l i t y + % 2 8 c o m m e r c i a l + i n s u r a n c e + d o e s + n o t + % 0 9 % 0 a c o v e r + m o r e + t h a n + 3 3 + m o n t h s + o f + t r e a t m e n t s % 2 9 + m o r e o v e r + d a v i t a + h a s + e x p e r i e n c e d + % 0 9 % 0 a d o w n w a r d + p r e s s u r e + o n + i t s + r e a l i z e d + p a y m e n t + r a t e s + f r o m + c o m m e r c i a l + p a y o r s + i n + % 0 9 % 0 a 2 0 1 1 % 2 c + c o m m e r c i a l + i n s u r e r s + a c c o u n t e d + f o r + 3 4 % 2 5 + o f + d a v i t a % 2 7 s + d i a l y s i s + r e v e n u e % 2 c + d o w n + % 0 9 % 0 a f r o m + 3 5 % 2 5 + i n + 2 0 0 8 % 2 c + b u t + o n l y + 1 1 % 2 5 + o f + 2 0 1 1 + t r e a t m e n t s + w e r e + c o v e r e d + b y + c o m m e r c i a l + % 0 9 % 0 a p a y o r s + % 2 8 1 0 % 2 5 + a t + t h e + e n d + o f + t h e + y e a r % 2 9 + w e + e x p e c t + c o m m e r c i a l + p a y o r s + w i l l + c o n t i n u e + % 0 9 % 0 a t o + b e + v e r y + a g g r e s s i v e + i n + t h e i r + n e g o t i a t i o n s + w i t h + d i a l y s i s - s e r v i c e + p r o v i d e r s i n + a d d i t i o n + t o + r e i m b u r s e m e n t + p r e s s u r e + f r o m + c o m m e r c i a l + p a y o r s % 2 c + m a j o r + c h a n g e s + i n + % 0 9 % 0 a m e d i c a r e + r e i m b u r s e m e n t + a r e + u n d e r w a y + a + k e y + f e a t u r e + o f + t h i s + n e w + r e g i m e % 2 c + w h i c h + % 0 9 % 0 a b e g a n + i n + 2 0 1 1 % 2 c + i s + a + b u n d l e d + p a y m e n t % 2 c + r e p l a c i n g + s e p a r a t e + r e i m b u r s e m e n t s + f o r + % 0 9 % 0 a s e r v i c e s + a n d + i n j e c t e d + p h a r m a c e u t i c a l s + t h e + b u n d l e d + r e i m b u r s e m e n t + c o n t r i b u t e d + % 0 9 % 0 a t o + a + 2 % 2 5 + d e c l i n e + i n + d a v i t a % 2 7 s + r e v e n u e + p e r + t r e a t m e n t + i n + 2 0 1 1 + o r a l + d r u g s + a r e + % 0 9 % 0 a s l a t e d + t o + b e + a d d e d + t o + t h e + b u n d l e + i n + 2 0 1 4 % 2 c + w h i c h + c o u l d + p l a c e + f u r t h e r + p r e s s u r e + % 0 9 % 0 a o n + p r o f i t a b i l i t y + t h e + m e d i c a r e + b a s e + r e i m b u r s e m e n t + r a t e + r o s e + 2 1 % 2 5 + i n + 2 0 1 2 % 2 c + % 0 9 % 0 a w h i c h + w e + b e l i e v e + m a y + n o t + c o v e r + d a v i t a % 2 7 s + c o s t + i n c r e a s e s + t h e + 2 0 1 1 + b u d g e t + % 0 9 % 0 a c o n t r o l + a c t + w i l l + r e s u l t + i n + a + 2 % 2 5 + a c r o s s - t h e - b o a r d + c u t + % 2 8 s e q u e s t r a t i o n % 2 9 + i n + % 0 9 % 0 a m e d i c a r e + r e i m b u r s e m e n t + i n + 2 0 1 3 + u n l e s s + t h e + l a w + i s + a m e n d e d + w e + e s t i m a t e + t h i s + % 0 9 % 0 a c o u l d + r e d u c e + d a v i t a % 2 7 s + 2 0 1 3 + r e v e n u e + a n d + e b i t d a + b y + a b o u t + % 2 4 1 0 0 + m i l l i o n + b e g i n n i n g + % 0 9 % 0 a i n + 2 0 1 2 % 2 c + m e d i c a r e + r e i m b u r s e m e n t s + w i l l + b e + p a r t l y + l i n k e d + t o + c l i n i c a l + o u t c o m e s + % 0 9 % 0 a f o r + p a t i e n t s % 2 c + p r i m a r i l y + a n e m i a + m a n a g e m e n t + a + b r o a d e r + a r r a y + o f + p e r f o r m a n c e + % 0 9 % 0 a m e t r i c s + w i l l + b e + a d d e d + i n + 2 0 1 4 + w e + b e l i e v e + d a v i t a + c o u l d + b e n e f i t + f r o m + t h i s + % 0 9 % 0 a q u a l i t y + i n c e n t i v e + p r o g r a m + o v e r a l l % 2 c + w e + b e l i e v e + t h e + c o m b i n e d + e f f e c t s + o f + % 0 9 % 0 a m e d i c a r e + c h a n g e s + i n + 2 0 1 2 + a n d + b e y o n d + a r e + n o t + l i k e l y + t o + s i g n i f i c a n t l y + a f f e c t + % 0 9 % 0 a d a v i t a % 2 7 s + c r e d i t + m e t r i c s a s + o f + d e c + 3 1 % 2 c + 2 0 1 1 % 2 c + d a v i t a + s e r v e d + a p p r o x i m a t e l y + 1 4 2 % 2 c 0 0 0 + p a t i e n t s + t h r o u g h + a + % 0 9 % 0 a n e t w o r k + o f + a b o u t + 1 % 2 c 8 0 0 + o u t p a t i e n t + c e n t e r s + a n d + 9 0 0 + h o s p i t a l s + s i m i l a r + t o + s o m e + % 0 9 % 0 a o t h e r + h e a l t h + c a r e + f i r m s + w i t h + a + % 2 2 f a i r % 2 2 + b u s i n e s s + r i s k + p r o f i l e % 2 c + d a v i t a + h a s + a + % 0 9 % 0 a s t r o n g + p o s i t i o n + i n + a + r e l a t i v e l y + n a r r o w + b u s i n e s s + w i t h + c o n s i d e r a b l e + r i s k s + % 0 9 % 0 a d a v i t a + a n d + f r e s e n i u s % 2 c + e a c h + w i t h + a b o u t + 3 0 % 2 5 + t o + 3 5 % 2 5 + o f + t h e + u + s + d i a l y s i s + m a r k e t % 2 c + % 0 9 % 0 a a r e + b y + f a r + t h e + l e a d i n g + p l a y e r s + t h e + r e m a i n d e r + o f + t h e + m a r k e t + i s + f a i r l y + % 0 9 % 0 a f r a g m e n t e d % 2 c + a l t h o u g h + c o n s o l i d a t i o n + i s + o c c u r r i n g + d a v i t a % 2 7 s + s i z e + a n d + g e o g r a p h i c + % 0 9 % 0 a d i v e r s i t y + g i v e + i t + a d v a n t a g e s + o v e r + s m a l l e r + c o m p e t i t o r s + b e c a u s e + i t + c a n + m o r e + % 0 9 % 0 a e a s i l y + u n d e r t a k e + i n c r e a s e d + s p e n d i n g + f o r + i n f o r m a t i o n + t e c h n o l o g y + i n f r a s t r u c t u r e + % 0 9 % 0 a a n d + i t + h a s + l e v e r a g e + t o + n e g o t i a t e + w i t h + l a r g e + c o m m e r c i a l + p a y o r s + a n d + s u p p l i e r s + % 0 9 % 0 a d a v i t a + a n d + % 2 7 b b % 2 b % 2 7 - r a t e d + f r e s e n i u s + s e + % 2 6 + c o + k g a a + h a v e + h a d + s i m i l a r + r e t u r n s + o n + % 0 9 % 0 a c a p i t a l + a n d + e b i t d a + m a r g i n s + w e + v i e w + f r e s e n i u s % 2 7 + b u s i n e s s + r i s k + m o r e + f a v o r a b l y + % 0 9 % 0 a b e c a u s e + i t + i s + s u b s t a n t i a l l y + m o r e + d i v e r s e % 2 c + b o t h + g e o g r a p h i c a l l y + a n d + i n + t h e + r a n g e + % 0 9 % 0 a o f + s e r v i c e s + a n d + p r o d u c t s + i t + o f f e r s d a v i t a % 2 7 s + e b i t d a + m a r g i n + h a s + b e e n + q u i t e + s t a b l e + f o r + a t + l e a s t + s i x + y e a r s % 2 c + d e s p i t e + % 0 9 % 0 a p r i c e + p r e s s u r e + f r o m + t h i r d - p a r t y + p a y o r s + a n d + c h a n g e s + i n + t h e + m e d i c a r e + % 0 9 % 0 a r e i m b u r s e m e n t + s c h e m e + w e + e x p e c t + t h i s + m e a s u r e + t o + r e m a i n + a r o u n d + 1 9 % 2 5 + t o + 2 0 % 2 5 + % 2 8 a s + % 0 9 % 0 a r e p o r t e d % 2 9 + i n + t h e + y e a r s + a h e a d % 2 c + r e f l e c t i n g + d a v i t a % 2 7 s + d e m o n s t r a t e d + a b i l i t y + t o + % 0 9 % 0 a m a n a g e + i t s + c o s t s % 2 c + i n t e g r a t e + a c q u i s i t i o n s % 2 c + a n d + a d a p t + t o + e v o l v i n g + t h i r d - p a r t y + % 0 9 % 0 a r e i m b u r s e m e n t + p r o f i t a b i l i t y + b e n e f i t e d + f r o m + r e d u c e d + d r u g + u t i l i z a t i o n + i n + 2 0 1 0 + % 0 9 % 0 a a n d + 2 0 1 1 % 2 c + b u t + w e + a s s u m e + u t i l i z a t i o n + h a s + s t a b i l i z e d + o u r + b a s e - c a s e + f o r e c a s t + % 0 9 % 0 a i n d i c a t e s + r e t u r n + o n + c a p i t a l + w i l l + r e m a i n + i n + t h e + 1 3 % 2 5 + t o + 1 4 % 2 5 + r a n g e a s + o f + d e c + 3 1 % 2 c + 2 0 1 1 % 2 c + a d j u s t e d + d e b t + t o + e b i t d a + w a s + 3 9 x + o u r + a d j u s t m e n t s + i n c l u d e + % 0 9 % 0 a t h e + c a p i t a l i z a t i o n + o f + o p e r a t i n g + l e a s e s % 3 b + w e + a d d + s t o c k + c o m p e n s a t i o n + e x p e n s e + t o + % 0 9 % 0 a e b i t d a % 3 b + a n d + w e + d e d u c t + n e t + i n c o m e + a t t r i b u t a b l e + t o + n o n c o n t r o l l i n g + i n t e r e s t s + % 0 9 % 0 a % 2 8 n c i s % 2 9 + f r o m + e b i t d a + w h e n + m e a s u r i n g + d e b t + l e v e r a g e + w e + e x p e c t + a d j u s t e d + l e v e r a g e + % 0 9 % 0 a t o + r e m a i n + a b o v e + 3 5 x + a n d + i t + m a y + t e m p o r a r i l y + e x c e e d + 4 0 x + f o r + a c q u i s i t i o n s + % 0 9 % 0 a a n d % 2 f o r + s h a r e + r e p u r c h a s e s + w e + p r o j e c t + t h e + a d j u s t e d + f u n d s + f r o m + o p e r a t i o n s + % 2 8 f f o % 2 9 + % 0 9 % 0 a t o + d e b t + r a t i o + w i l l + r e m a i n + a p p r o x i m a t e l y + 2 0 % 2 5 + g i v e n + o u r + e x p e c t a t i o n s + f o r + % 0 9 % 0 a a c q u i s i t i o n s + a n d + s h a r e h o l d e r + r e t u r n s % 2 c + w e + d o + n o t + e x p e c t + d e b t + r e d u c t i o n l i q u i d i t y d a v i t a % 2 7 s + l i q u i d i t y + i s + s t r o n g % 2 c + u n d e r p i n n e d + b y + i t s + c o n s i s t e n t + a n d + s u b s t a n t i a l + % 0 9 % 0 a g e n e r a t i o n + o f + d c f + a f t e r + d i s t r i b u t i o n s + t o + n c i s + i n t e r n a l l y + g e n e r a t e d + f u n d s + % 0 9 % 0 a e a s i l y + f i n a n c e + c a p i t a l + e x p e n d i t u r e s + a n d + m o d e s t + w o r k i n g + c a p i t a l + r e q u i r e m e n t s + % 0 9 % 0 a w e + e x p e c t + e x c e s s + c a s h + f l o w + t o + b e + a p p l i e d + o p p o r t u n i s t i c a l l y + t o + a + m i x + o f + % 0 9 % 0 a a c q u i s i t i o n s + a n d + s h a r e + r e p u r c h a s e s + w e + a s s u m e + t h e + c o m b i n a t i o n + o f + s t o c k + % 0 9 % 0 a b u y - b a c k s + a n d + a c q u i s i t i o n s + w i l l + b e + r o u g h l y + % 2 4 4 0 0 + m i l l i o n + t o + % 2 4 5 0 0 + m i l l i o n + o r + % 0 9 % 0 a m o r e + a n n u a l l y % 2 c + c o m p a r e d + w i t h + % 2 4 1 4 + b i l l i o n + i n + 2 0 1 1 o u r + v i e w + o f + d a v i t a % 2 7 s + l i q u i d i t y + p r o f i l e + i n c o r p o r a t e s + t h e + f o l l o w i n g + a s s u m p t i o n s + % 0 9 % 0 a a n d + e x p e c t a t i o n s % 3 a - - + w e + e x p e c t + s o u r c e s + o f + l i q u i d i t y % 2 c + m a i n l y + f f o % 2 c + t o + e x c e e d + u s e s + b y + a b o u t + % 0 9 % 0 a 1 5 x + o v e r + t h e + n e x t + 1 2 + m o n t h s + w e + a s s u m e + a b o u t + % 2 4 3 1 0 + m i l l i o n + o f + c a p i t a l + s p e n d i n g + % 0 9 % 0 a a n d + a + % 2 4 1 3 0 + m i l l i o n + w o r k i n g + c a p i t a l + i n c r e a s e + i n + 2 0 1 2 - - + w e + e x p e c t + t h a t + n e t + s o u r c e s + w o u l d + b e + p o s i t i v e % 2 c + e v e n + w i t h + a n + u n l i k e l y + % 0 9 % 0 a 3 0 % 2 5 + d r o p + i n + e b i t d a + m o r e o v e r % 2 c + d a v i t a + c o u l d + c u r t a i l + s h a r e + r e p u r c h a s e s + a n d + % 0 9 % 0 a a c q u i s i t i o n s + i f + l i q u i d i t y + w a s + c o n s t r a i n e d - - + a s + o f + d e c + 3 1 % 2 c + 2 0 1 1 % 2 c + d a v i t a + h a d + % 2 4 3 9 4 + m i l l i o n + o f + c a s h + a n d + % 2 4 2 9 8 + m i l l i o n + % 0 9 % 0 a o f + f u n d s + a v a i l a b l e + f r o m + a + % 2 4 3 5 0 + m i l l i o n + r e v o l v i n g + c r e d i t + f a c i l i t y % 2 c + a f t e r + % 0 9 % 0 a d e d u c t i n g + % 2 4 5 2 + m i l l i o n + c o m m i t t e d + f o r + l e t t e r s + o f + c r e d i t - - + a s + o f + d e c + 3 1 % 2 c + 2 0 1 1 % 2 c + t h e r e + w a s + s u b s t a n t i a l + h e a d r o o m + u n d e r + d a v i t a % 2 7 s + % 0 9 % 0 a l o a n + c o v e n a n t s + a n d + w e + e x p e c t + t h i s + t o + c o n t i n u e r e c o v e r y + a n a l y s i s o u r + r a t i n g + o n + d a v i t a % 2 7 s + s e n i o r + s e c u r e d + d e b t + i s + % 2 7 b b % 2 7 % 2 c + o n e + n o t c h + a b o v e + t h e + % 0 9 % 0 a c o r p o r a t e + c r e d i t + r a t i n g % 2 c + a n d + o u r + r a t i n g + o n + i t s + s e n i o r + u n s e c u r e d + d e b t + i s + % 2 7 b % 2 7 % 2 c + % 0 9 % 0 a t w o + n o t c h e s + b e l o w + t h e + c o r p o r a t e + c r e d i t + r a t i n g + o u r + r e c o v e r y + r a t i n g + o n + t h e + % 0 9 % 0 a s e n i o r + s e c u r e d + d e b t + i s + % 2 7 2 % 2 7 % 2 c + i n d i c a t i n g + o u r + e x p e c t a t i o n + f o r + s u b s t a n t i a l + % 2 8 7 0 % 2 5 + t o + % 0 9 % 0 a 9 0 % 2 5 % 2 9 + r e c o v e r y + o f + p r i n c i p a l % 2 c + a n d + o u r + r e c o v e r y + r a t i n g + o n + t h e + s e n i o r + u n s e c u r e d + % 0 9 % 0 a d e b t + i s + % 2 7 6 % 2 7 % 2 c + i n d i c a t i n g + o u r + e x p e c t a t i o n + f o r + n e g l i g i b l e + % 2 8 0 + t o + 1 0 % 2 5 % 2 9 + r e c o v e r y + o f + % 0 9 % 0 a p r i n c i p a l % 2 c + b o t h + i n + t h e + e v e n t + o f + p a y m e n t + d e f a u l t + f o r + o u r + c o m p l e t e + r e c o v e r y + % 0 9 % 0 a a n a l y s i s % 2 c + p l e a s e + s e e + t h e + r e c o v e r y + r e p o r t + o n + d a v i t a + i n c % 2 c + t o + b e + p u b l i s h e d + % 0 9 % 0 a f o l l o w i n g + t h i s + r e p o r t + o n + r a t i n g s d i r e c t o u t l o o k o u r + o u t l o o k + o n + d a v i t a + i s + s t a b l e + w e + b e l i e v e + t h e + c o m p a n y + w i l l + c o n t i n u e + t o + % 0 9 % 0 a g e n e r a t e + s t r o n g + c a s h + f l o w + f r o m + i t s + p o s i t i o n + a s + a + m a r k e t + l e a d e r + i n + t h e + d i a l y s i s + % 0 9 % 0 a s e r v i c e + s e c t o r % 2 c + a n d + i t + i s + w e l l - 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