v3.23.1
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2023
Mar. 31, 2022
Cash flows from operating activities    
Net income $ 14,307 $ 12,073
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 4,292 4,374
Amortization of debt issuance cost 237 237
Share-based compensation 3,445 3,055
Unrealized loss on investments 5,755 10,556
Income from equity method investments (2,484) (1,433)
Unrealized loss (gain) on interest rate swaps 637 (1,593)
Deferred tax 790 1,985
Changes in operating assets and liabilities, net of business combinations:    
Receivables, net (26,373) (44,673)
Receivables, net – related parties (9,730) (6,865)
Other receivables (94) (3,613)
Prepaid expenses and other current assets (506) 4,171
Right-of-use assets 2,013 672
Other assets (23) 2,016
Accounts payable and accrued expenses (4,517) 3,735
Fiduciary accounts payable 911 (4,229)
Medical liabilities 17,141 39,974
Income taxes payable 4,007 4,241
Operating lease liabilities (2,088) (645)
Net Cash Provided by (Used in) Operating Activities, Total 7,720 24,038
Cash flows from investing activities    
Payments for business acquisition, net of cash acquired 0 (999)
Proceeds from repayment of loans receivable – related parties 2,141 19
Purchase of marketable securities (1,000) (21)
Purchase of investment – equity method (325) 0
Purchases of property and equipment (6,027) (17,489)
Deposit for purchase of property (8,824) 0
Distribution from investment - equity method 0 200
Contribution to investment - equity method 0 (1,435)
Net cash used in investing activities (14,035) (19,725)
Cash flows from financing activities    
Dividends paid (120) (1,178)
Repayment of long-term debt (153) (52)
Payment of finance lease obligations (154) (141)
Proceeds from the exercise of stock options and warrants 1,250 1,573
Repurchase of shares 0 (230)
Repurchase of treasury shares (9,539) 0
Proceeds from sale of non-controlling interest 0 38
Purchase of non-controlling interest 0 (200)
Borrowings on loans 1,617 722
Net cash (used in) provided by financing activities (7,099) 532
Net (decrease) increase in cash and cash equivalents (13,414) 4,845
Cash and cash equivalents beginning of period 288,027 233,097
Cash and cash equivalents end of period 274,613 237,942
Supplementary disclosures of cash flow information    
Cash paid for interest 2,991 845
Supplemental disclosures of non-cash investing and financing activities    
Non-cash business acquisition 3,844 0
Fixed asset obtained in exchange for finance lease liabilities 0 398
Common stock issued in business combination $ 0 $ 1,000

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