[3] The company primarily treats end-stage renal disease (ESRD), which requires patients to undergo dialysis 3 times per week for the rest of their lives.

[10] In 2000, the company pleaded guilty to billing Medicare for unnecessary medical tests and to paying kickbacks for lab business and paid a $486 million fine.

[15][16] In 2013, the company acquired Shiel Medical Laboratory, expanding services to New York City metro area.

[18][19] In March 2019, the company paid $231 million to the United States Department of Justice and the U.S. Securities and Exchange Commission to settle allegations of civil bribery to obtain business in 13 countries, including Angola, Saudi Arabia, Morocco, and Spain.

In March 2023, the company was certified by the monitor that its compliance program is reasonably designed and implemented to detect and prevent violations of the U.S. Foreign Corrupt Practices Act (FCPA).