v3.24.2
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2024
Jun. 30, 2023
Cash Flows from Operating Activities:    
Net income (loss) $ 47,167 $ (55,572)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:    
Depreciation and amortization (inclusive of depreciation included in cost of service) 12,496 11,893
Non-cash compensation 16,184 12,381
Amortization and impairment of operating lease right of use assets 17,100 16,971
(Gain) loss on disposal of property and equipment (19) 356
Loss on personal care divestiture 0 2,186
Merger termination fee 0 106,000
Deferred income taxes 6,577 8,104
Equity in earnings from equity method investments (2,425) (8,114)
Amortization of deferred debt issuance costs 495 495
Return on equity method investments 718 2,753
Changes in operating assets and liabilities, net of impact of acquisitions:    
Patient accounts receivable (44,357) 7,862
Other current assets 3,127 1,689
Operating lease right of use assets (2,069) (1,937)
Other assets 370 244
Accounts payable (1,693) (4,731)
Accrued expenses 7,095 4,775
Other long-term obligations (573) (3,179)
Operating lease liabilities (14,429) (15,456)
Net cash provided by operating activities 45,764 86,720
Cash Flows from Investing Activities:    
Proceeds from the sale of deferred compensation plan assets 21 25
Proceeds from the sale of property and equipment 0 100
Purchases of property and equipment (4,055) (2,744)
Investments in technology assets (409) (6,667)
Investment in equity method investee (196) 0
Proceeds from personal care divestiture 0 47,787
Acquisitions of businesses, net of cash acquired 0 (350)
Net cash (used in) provided by investing activities (4,639) 38,151
Cash Flows from Financing Activities:    
Proceeds from issuance of stock upon exercise of stock options 0 75
Proceeds from issuance of stock under employee stock purchase plan 0 1,754
Shares withheld to pay taxes on non-cash compensation (4,195) (3,488)
Noncontrolling interest contributions 1,911 376
Noncontrolling interest distributions (1,964) (712)
Purchase of noncontrolling interest 0 (800)
Proceeds from borrowings under revolving line of credit 0 23,000
Repayments of borrowings under revolving line of credit 0 (23,000)
Principal payments of long-term obligations (18,382) (60,993)
Payment of accrued contingent consideration 0 (4,055)
Net cash used in financing activities (22,630) (67,843)
Net increase in cash, cash equivalents and restricted cash 18,495 57,028
Cash, cash equivalents and restricted cash at beginning of period 138,863 54,133
Cash, cash equivalents and restricted cash at end of period 157,358 111,161
Supplemental Disclosures of Cash Flow Information:    
Cash paid for interest 15,507 13,031
Cash paid for income taxes, net of refunds received 18,393 15,820
Cash paid for operating lease liabilities 16,498 17,394
Cash paid for finance lease liabilities 7,111 5,321
Supplemental Disclosures of Non-Cash Activity:    
Right of use assets obtained in exchange for operating lease liabilities 10,947 14,802
Right of use assets obtained in exchange for finance lease liabilities 10,017 27,944
Reductions to right of use assets resulting from reductions to operating lease liabilities 168 15,135
Reductions to right of use assets resulting from reductions to finance lease liabilities $ 1,119 $ 894