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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
3 Months Ended 12 Months Ended
Mar. 31, 2020
Mar. 31, 2019
Dec. 31, 2019
Cash Flows from Operating Activities:      
Net income $ 32,046 $ 31,573  
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 5,338 2,895  
Non-cash compensation 5,909 6,615  
401(k) employer match 3,291 2,379  
Amortization and impairment of operating lease right of use assets 9,058 8,345  
Loss (gain) on disposal of property and equipment 55 (4)  
Write-off of other comprehensive income (15) 0  
Deferred income taxes 1,228 3,269  
Equity in earnings from equity method investments (477) (1,216)  
Amortization of deferred debt issuance costs/debt discount 220 213  
Return on equity investment 2,369 725  
Changes in operating assets and liabilities, net of impact of acquisitions:      
Patient accounts receivable (25,459) (22,333)  
Other current assets (5,756) (10,635)  
Other assets 417 (338)  
Accounts payable (2,673) (11,140)  
Accrued expenses (13,627) 18,838  
Other long-term obligations 3,060 (144)  
Operating lease liabilities (8,132) (8,139)  
Operating lease right of use assets (817) (844)  
Net cash provided by operating activities 6,035 20,059  
Cash Flows from Investing Activities:      
Proceeds from sale of deferred compensation plan assets 16 208  
Proceeds from the sale of property and equipment 12 65  
Purchases of property and equipment (1,434) (1,198)  
Investments in equity method investees 0 (120)  
Acquisitions of businesses, net of cash acquired (69,349) (327,867)  
Net cash used in investing activities (70,755) (328,912)  
Cash Flows from Financing Activities:      
Proceeds from issuance of stock upon exercise of stock options 1,184 356  
Proceeds from issuance of stock to employee stock purchase plan 860 782  
Shares withheld upon stock vesting (4,050) (2,688)  
Noncontrolling interest distribution (360) (366)  
Proceeds from borrowings under term loan 0 175,000  
Proceeds from borrowings under revolving line of credit 187,500 161,500  
Repayments of borrowings under revolving line of credit (37,500) (34,000)  
Principal payments of long-term obligations (1,592) (559)  
Debt issuance costs 0 (847)  
Net cash provided by financing activities 146,042 299,178  
Net increase (decrease) in cash, cash equivalents and restricted cash 81,322 (9,675)  
Cash, cash equivalents and restricted cash at beginning of period 96,490 20,229 $ 20,229
Cash, cash equivalents and restricted cash at end of period 177,812 10,554 $ 96,490
Supplemental Disclosures of Cash Flow Information:      
Cash paid for interest 1,755 725  
Cash paid for income taxes, net of refunds received 5,272 404  
Cash paid for operating lease liabilities 8,949 8,983  
Cash paid for finance lease liabilities 499 384  
Supplemental Disclosures of Non-Cash Activity:      
Right of use assets obtained in exchange for operating lease liabilities 6,437 91,743  
Right of use assets obtained in exchange for finance lease liabilities 254 808  
Reductions to right of use assets resulting from reductions to operating lease liabilities $ 159 $ 625