The centers are worried because the “direct patient care services costs” listed in the ballot measure do not include administrative costs such as payroll, human resources and legal expenses, nor payment for medical directors to oversee the clinics. All of those costs would have to come out of the 15 percent, translating into minuscule profit or none at all, Estrada said. About 70 percent of the centers in California are owned by two large companies: DaVita Kidney Care and Fresenius Medical Care. They operate most of the dialysis clinics in the nation, and both turn healthy profits. DaVita, for example, recorded net income of $1 billion last year.