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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2022
Mar. 31, 2021
Cash flows from operating activities    
Net income $ 12,073 $ 14,458
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 4,374 4,197
Amortization of debt issuance cost 237 351
Share-based compensation 3,055 1,346
Unrealized loss (gain) from investment in equity securities 10,556 (9)
(Income) loss from equity method investments (1,433) 677
Unrealized gain on interest rate swaps (1,593) 0
Deferred tax 1,985 (921)
Changes in operating assets and liabilities, net of business combinations:    
Receivables, net (44,673) (9,390)
Receivables, net – related parties (6,865) (17,612)
Other receivables (3,613) (223)
Prepaid expenses and other current assets 4,171 7,165
Right-of-use assets 672 836
Other assets 2,016 (192)
Accounts payable and accrued expenses 3,735 3,915
Fiduciary accounts payable (4,229) (2,771)
Medical liabilities 39,974 1,149
Income taxes payable 4,241 7,835
Operating lease liabilities (645) (859)
Net cash provided by operating activities 24,038 9,952
Cash flows from investing activities    
Payments for business acquisition, net of cash acquired and shares issued (999) 0
Proceeds from repayment of loans receivable – related parties 19 16
Purchases of marketable securities (21) (332)
Purchases of property and equipment (17,489) (98)
Proceeds from sale of marketable securities 0 1,106
Distribution from investment - equity method 200 0
Contribution to investment - equity method (1,435) 0
Net cash (used in) provided by investing activities (19,725) 692
Cash flows from financing activities    
Dividends paid (1,178) (4)
Repayment of long-term debt (52) (2,434)
Payment of finance lease obligations (141) (27)
Proceeds from the exercise of stock options and warrants 1,573 4,256
Repurchase of shares (230) (342)
Distribution to non-controlling interest 0 (225)
Proceeds from sale of non-controlling interest 38 38
Purchase of non-controlling interest (200) 0
Borrowings on loans 722 0
Net cash provided by financing activities 532 1,262
Net increase in cash, cash equivalents, and restricted cash 4,845 11,906
Cash, cash equivalents, and restricted cash, beginning of period 233,097 193,970
Cash, cash equivalents, and restricted cash, end of period 237,942 205,876
Supplementary disclosures of cash flow information:    
Cash paid for income taxes 0 40
Cash paid for interest 845 1,277
Supplemental disclosures of non-cash investing and financing activities    
Fixed asset obtained in exchange for finance lease liabilities 398 0
Common stock issued in business combination 1,000 0
Reconciliation of cash, cash equivalents, and restricted cash    
Cash and cash equivalents 237,942  
Cash, cash equivalents, restricted cash total $ 237,942 $ 205,876