CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2022	Mar. 31, 2021
CASH FLOWS FROM OPERATING ACTIVITIES
Net (loss) income	$ 8,363	$ 13,775
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	27,118	22,656
Amortization of operating lease right-of-use assets	16,802	17,863
Equity in earnings of joint ventures, net of dividends	(2,517)	(2,285)
Amortization of deferred financing costs and loan discount	648	1,147
Loss (gain) on sale and disposal of equipment and other	1,128	(1,307)
Amortization of cash flow hedge, net of taxes	923	925
Non-cash change in fair value of interest rate hedge	(20,819)	(11,245)
Stock-based compensation	11,102	8,248
Change in fair value of contingent consideration	(501)	200
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:
Accounts receivable	(23,904)	(17,493)
Other current assets	(4,065)	(4,308)
Other assets	(1,417)	(3,507)
Deferred taxes	1,387	3,133
Operating lease liability	(15,859)	(18,291)
Deferred revenue	(4,519)	1,416
Accounts payable, accrued expenses and other	7,031	17,157
Net cash (used in) provided by operating activities	901	28,084
CASH FLOWS FROM INVESTING ACTIVITIES
Purchase of imaging centers and other acquisitions	(25,123)	(57,075)
Purchase of property and equipment	(36,558)	(30,424)
Proceeds from sale of equipment	117	151
Net cash used in investing activities	(61,564)	(87,348)
CASH FLOWS FROM FINANCING ACTIVITIES
Principal payments on notes and leases payable	0	(827)
Payments on term loan debt	(3,313)	(10,824)
Proceeds from revolving credit facility	0	87,100
Payments on revolving credit facility	0	(87,100)
Net cash used in financing activities	(3,313)	(11,651)
EFFECT OF EXCHANGE RATE CHANGES ON CASH	83	(12)
NET DECREASE IN CASH AND CASH EQUIVALENTS	(63,893)	(70,927)
CASH AND CASH EQUIVALENTS, beginning of period	134,606	102,018
CASH AND CASH EQUIVALENTS, end of period	70,713	31,091
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid during the period for interest	7,448	8,267
Cash paid during the period for income taxes	$ 34	$ 24

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