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Leases
9 Months Ended
Sep. 30, 2023
Leases [Abstract]  
Leases Leases
The Company currently leases office facilities and equipment for its practices under noncancelable operating and finance lease agreements expiring on various dates through 2038. Certain of the leases contain renewal options which are exercisable at the Company’s discretion. These renewal options are considered in determining the lease term if it is reasonably certain that the Company will exercise such options. Additionally, the Company leases certain other office and medical equipment under month-to-month lease agreements. 
Right-of-use assets and lease liabilities consist of the following at September 30, 2023 and December 31, 2022:
As of September 30,
2023
As of December 31,
2022
Assets
Operating lease right-of-use assets, net$46,138 $43,724 
Finance lease right-of-use assets, net (included in property and equipment, net)2,791 1,998 
Total right-of-use assets$48,929 $45,722 
Liabilities
Current
Current portion of operating lease liabilities$7,123 $9,177 
Current portion of finance lease liabilities (included in accrued other)630 425 
Long-term7,753 9,602 
Long-term operating lease liabilities42,261 37,224 
Long-term finance lease liabilities (included in other long-term liabilities)2,126 1,619 
Total lease liabilities$52,140 $48,445 
The components of lease costs recognized in the condensed consolidated statements of operations and comprehensive loss consist of the following for the three and nine month periods ended September 30, 2023 and 2022 and are included in selling, general, and administrative expenses unless otherwise noted:
Three Months Ended September 30,Nine Months Ended
September 30,
2023202220232022
Operating lease costs$2,820 $3,161 $8,361 $9,297 
Finance lease costs
Amortization of finance lease right-of-use assets122185354 413 
Interest on finance lease liabilities (included in interest expense)351979 60 
Variable lease costs5608621,742 2,232 
Total lease costs$3,537 $4,227 $10,536 $12,002 
The following table reconciles the undiscounted cash flows expected to be paid in each of the next five years and thereafter recorded in the condensed consolidated balance sheets for operating and finance leases as of September 30, 2023:
Operating
Lease
Finance
Leases
2023 (remainder of year after September 30, 2023)$1,679 $188 
202410,940 753 
20259,830 731 
20269,413 492 
20278,194 428 
Thereafter24,154 528 
Total lease payments64,210 3,120 
Less: amount representing interest(14,826)(364)
Present value of lease liabilities49,384 2,756 
Less: current portion of lease liabilities(7,123)(630)
Long-term lease liabilities, net of current portion$42,261 $2,126 
The weighted-average remaining lease term as of September 30, 2023 and December 31, 2022 was 7.01 years and 5.68 years for operating leases and 5.00 years and 5.37 years for finance leases, respectively. The weighted-average discount rate as of September 30, 2023 and December 31, 2022 was 6.56% and 4.88% for operating leases and 5.12% and 3.60% for finance leases, respectively.
The cash paid for amounts included in the measurement of lease liabilities for the nine months ended September 30, 2023 and 2022 is as follows:
Nine Months Ended
September 30,
20232022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$7,678 $9,788 
Operating cash flows from finance leases79 60 
Financing cash flows from finance leases387 321 
ROU assets obtained in exchange for new operating lease liabilities9,862 9,771 
ROU assets obtained in exchange for new finance lease liabilities1,103 
At September 30, 2023, the Company had entered into two sixty-month finance leases for medical equipment that had not yet commenced. The future commitments related to these leases are approximately $3.8 million and the Company expects to take control of the leased assets early in the fourth quarter.
Leases Leases
The Company currently leases office facilities and equipment for its practices under noncancelable operating and finance lease agreements expiring on various dates through 2038. Certain of the leases contain renewal options which are exercisable at the Company’s discretion. These renewal options are considered in determining the lease term if it is reasonably certain that the Company will exercise such options. Additionally, the Company leases certain other office and medical equipment under month-to-month lease agreements. 
Right-of-use assets and lease liabilities consist of the following at September 30, 2023 and December 31, 2022:
As of September 30,
2023
As of December 31,
2022
Assets
Operating lease right-of-use assets, net$46,138 $43,724 
Finance lease right-of-use assets, net (included in property and equipment, net)2,791 1,998 
Total right-of-use assets$48,929 $45,722 
Liabilities
Current
Current portion of operating lease liabilities$7,123 $9,177 
Current portion of finance lease liabilities (included in accrued other)630 425 
Long-term7,753 9,602 
Long-term operating lease liabilities42,261 37,224 
Long-term finance lease liabilities (included in other long-term liabilities)2,126 1,619 
Total lease liabilities$52,140 $48,445 
The components of lease costs recognized in the condensed consolidated statements of operations and comprehensive loss consist of the following for the three and nine month periods ended September 30, 2023 and 2022 and are included in selling, general, and administrative expenses unless otherwise noted:
Three Months Ended September 30,Nine Months Ended
September 30,
2023202220232022
Operating lease costs$2,820 $3,161 $8,361 $9,297 
Finance lease costs
Amortization of finance lease right-of-use assets122185354 413 
Interest on finance lease liabilities (included in interest expense)351979 60 
Variable lease costs5608621,742 2,232 
Total lease costs$3,537 $4,227 $10,536 $12,002 
The following table reconciles the undiscounted cash flows expected to be paid in each of the next five years and thereafter recorded in the condensed consolidated balance sheets for operating and finance leases as of September 30, 2023:
Operating
Lease
Finance
Leases
2023 (remainder of year after September 30, 2023)$1,679 $188 
202410,940 753 
20259,830 731 
20269,413 492 
20278,194 428 
Thereafter24,154 528 
Total lease payments64,210 3,120 
Less: amount representing interest(14,826)(364)
Present value of lease liabilities49,384 2,756 
Less: current portion of lease liabilities(7,123)(630)
Long-term lease liabilities, net of current portion$42,261 $2,126 
The weighted-average remaining lease term as of September 30, 2023 and December 31, 2022 was 7.01 years and 5.68 years for operating leases and 5.00 years and 5.37 years for finance leases, respectively. The weighted-average discount rate as of September 30, 2023 and December 31, 2022 was 6.56% and 4.88% for operating leases and 5.12% and 3.60% for finance leases, respectively.
The cash paid for amounts included in the measurement of lease liabilities for the nine months ended September 30, 2023 and 2022 is as follows:
Nine Months Ended
September 30,
20232022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$7,678 $9,788 
Operating cash flows from finance leases79 60 
Financing cash flows from finance leases387 321 
ROU assets obtained in exchange for new operating lease liabilities9,862 9,771 
ROU assets obtained in exchange for new finance lease liabilities1,103 
At September 30, 2023, the Company had entered into two sixty-month finance leases for medical equipment that had not yet commenced. The future commitments related to these leases are approximately $3.8 million and the Company expects to take control of the leased assets early in the fourth quarter.