Quarterly report pursuant to Section 13 or 15(d)

CONSOLIDATED STATEMENTS OF CASH FLOWS

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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2021
Sep. 30, 2020
Cash flows from operating activities    
Net income $ 68,603 $ 109,412
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 13,105 14,004
Amortization of debt issuance costs 900 1,004
Share-based compensation 4,322 2,558
Unrealized (gain) loss from investment in equity securities (22,826) 23
Loss (income) from equity method investments 3,680 (3,291)
Gain on sale of equity method investment (2,193) (99,647)
Impairment of beneficial interest 15,723 0
Loss on interest rate swaps 1,069 0
Deferred tax 6,847 (6,137)
Other 189 0
Changes in operating assets and liabilities, net of business combinations:    
Receivables, net (10,686) (6,953)
Receivables, net – related parties (4,367) 6,618
Other receivables (1,477) 12,898
Prepaid expenses and other current assets 5,064 (1,804)
Right-of-use assets 2,440 2,601
Other assets (954) (5,090)
Accounts payable and accrued expenses 14,362 12,644
Fiduciary accounts payable (815) 1,958
Medical liabilities (7,633) (1,566)
Income taxes payable (300) 11,642
Operating lease liabilities (2,528) (2,110)
Net cash provided by operating activities 82,525 48,764
Cash flows from investing activities    
Payments for business acquisition, net of cash acquired (2,575) 0
Proceeds from repayment of loans receivable – related parties 41 16,500
Purchases of marketable securities (1,009) (1,793)
Purchase of investment – equity method (13,384) (500)
Proceeds from sale of equity method investment 6,375 52,743
Purchases of property and equipment (16,420) (553)
Cash received from consolidation of VIE 3,322 0
Proceeds from sale of marketable securities 1,106 0
Net cash (used in) provided by investing activities (22,544) 66,397
Cash flows from financing activities    
Dividends paid (31,089) (50,133)
Repayment of long-term debt (238,254) (7,125)
Payment of finance lease obligations (81) (78)
Proceeds from the exercise of stock options and warrants 6,601 6,552
Repurchase of shares (5,739) (1,559)
Distribution to noncontrolling interest (75) 0
Proceeds from sale of noncontrolling interest 48 0
Borrowings on revolver 180,000 0
Proceeds from sale of shares 40,133 0
Payment of debt issuance costs (727) 0
Net cash used in financing activities (49,183) (52,343)
Net increase in cash, cash equivalents, and restricted cash 10,798 62,818
Cash, cash equivalents, and restricted cash, beginning of period 193,970 104,010
Cash, cash equivalents, and restricted cash, end of period 204,768 166,828
Supplementary disclosures of cash flow information:    
Cash paid for income taxes 24,800 37,900
Cash paid for interest 3,330 6,961
Supplemental disclosures of non-cash investing and financing activities    
Dividend declared included in dividend payable 71 485
Preferred shares received from sale of equity investment 0 36,179
Cancellation of restricted stock awards 334 0
Deferred tax liability adjustment to goodwill 1,786 0
Deferred tax liability adjustment related to warrant exercises 0 473
Reconciliation of cash, cash equivalents, and restricted cash    
Cash and cash equivalents 204,768 166,082
Restricted cash - noncurrent 0 746
Cash, cash equivalents, restricted cash total $ 204,768 $ 166,828