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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) | 9 Months Ended
--- | ---
Sep. 30, 2019 | Sep. 30, 2018
CASH FLOWS FROM OPERATING ACTIVITIES |  |
Net income | $ 10,760,000 | $ 6,786,000
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 60,193,000 | 53,422,000
Amortization of operating lease right-of-use assets | 49,948,000 |
Equity in earnings of joint ventures | (6,072,000) | (9,547,000)
Distributions from joint ventures | 3,924,000 | 21,783,000
Amortization of deferred financing costs and loan discount | 3,103,000 | 2,924,000
Loss (gain) on sale and disposal of equipment and other | 1,990,000 | (2,204,000)
Stock-based compensation | 6,963,000 | 6,557,000
Other noncash items included in cost of operations | (559,000) | 0
Change in fair value of contingent consideration | (1,749,000) | 0
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions: |  |
Accounts receivable | (3,467,000) | (9,641,000)
Other current assets | (1,569,000) | (5,680,000)
Other assets | (5,770,000) | (1,209,000)
Deferred taxes | (4,230,000) | 1,531,000
Operating lease liability | (49,721,000) |
Deferred rent | 0 | 2,397,000
Deferred revenue | (490,000) | 353,000
Accounts payable, accrued expenses and other | 19,349,000 | 20,386,000
Net cash provided by operating activities | 82,603,000 | 87,858,000
CASH FLOWS FROM INVESTING ACTIVITIES |  |
Purchase of imaging facilities | (27,150,000) | (17,393,000)
Equity investments at fair value | (143,000) | (2,200,000)
Purchase of property and equipment | (68,269,000) | (62,595,000)
Proceeds from sale of equipment | 760,000 | 2,587,000
Proceeds from the sale of equity interests in a joint venture | 132,000 | 0
Nulogix return of capital | 792,000 | 0
Equity contributions in existing and purchase of interest in joint ventures | (103,000) | (2,000,000)
Net cash used in investing activities | (93,981,000) | (81,601,000)
CASH FLOWS FROM FINANCING ACTIVITIES |  |
Principal payments on notes and leases payable | (4,778,000) | (4,374,000)
Payments on term loan debt | (29,918,000) | (24,810,000)
Proceeds from debt issuance | 97,144,000 | 0
Distributions paid to noncontrolling interests | (1,818,000) | (913,000)
Proceeds from sale of noncontrolling interest | 5,275,000 | 0
Contribution from noncontrolling partner | 750,000 | 0
Proceeds from revolving credit facility | 251,200,000 | 44,000,000
Purchase of noncontrolling interests | 0 | (200,000)
Payments on revolving credit facility | (279,200,000) | (44,000,000)
Proceeds from issuance of common stock upon exercise of options | 50,000 | 10,000
Net cash provided by (used in) financing activities | 38,705,000 | (30,287,000)
EFFECT OF EXCHANGE RATE CHANGES ON CASH | (28,000) | (65,000)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS | 27,299,000 | (24,095,000)
CASH AND CASH EQUIVALENTS, beginning of period | 10,389,000 | 51,322,000
CASH AND CASH EQUIVALENTS, end of period | 37,688,000 | 27,227,000
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION |  |
Cash paid during the period for interest | 36,058,000 | 27,136,000
Equipment acquired and leasehold improvements | 14,100,000 | 14,200,000
Capital lease debt | $ 0 | $ 4,000,000

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- Definition The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3213-108585 + Details
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- Definition Amount of cash outflow to a noncontrolling interest. Includes, but not limited to, reduction of noncontrolling interest ownership. Excludes dividends paid to the noncontrolling interest. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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- Definition The cash inflow associated with the amount received by a corporation from a shareholder during the period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3255-108585 + Details
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- Definition The cash inflow from the sale of an investment interest in a joint venture that the reporting entity has not previously accounted for using consolidation or the equity method of accounting. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3179-108585 + Details
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- Definition Amount of distribution received from equity method investee for return of investment, classified as investing activities. Excludes distribution for return on investment, classified as operating activities. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 21D -URI http://asc.fasb.org/extlink&oid=109223946&loc=SL94080555-108585 Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3179-108585 + Details
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- Definition The cash inflow during the period from additional borrowings in aggregate debt. Includes proceeds from short-term and long-term debt. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3255-108585 + Details
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- Definition Amount of cash inflow from issuance of shares under share-based compensation arrangement. Issuance includes, but is not limited to, exercise of stock options and similar instruments. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2A -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109197908&loc=SL79508275-113901 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3255-108585 + Details
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- Definition Amount of cash inflow from contractual arrangement with the lender, including but not limited to, letter of credit, standby letter of credit and revolving credit arrangements. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3255-108585 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.4-08.(f)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690 + Details
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- Definition The cash inflow from the sale of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3179-108585 + Details
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- Definition Aggregate cash proceeds received from a combination of transactions in which noncurrent assets are sold, which may include the sale of a business, an investment in an affiliate (including an equity method investee), property, plant and equipment and intangible assets. Excludes sales of trading, available-for-sale, and held-to-maturity securities. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3179-108585 + Details
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- Definition The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 220 -SubTopic 10 -Section 45 -Paragraph 1A -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=114867106&loc=SL7669619-108580 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1A -Subparagraph (a)(1) -URI http://asc.fasb.org/extlink&oid=109239629&loc=SL4573702-111684 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 220 -SubTopic 10 -Section 45 -Paragraph 1B -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=114867106&loc=SL7669625-108580 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1A -Subparagraph (c)(1) -URI http://asc.fasb.org/extlink&oid=109239629&loc=SL4573702-111684 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8736-108599 Reference 6: http://www.xbrl.org/2003/role/exampleRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 55 -Paragraph 4J -URI http://asc.fasb.org/extlink&oid=84234705&loc=SL4591551-111686 Reference 7: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3000-108585 Reference 8: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 45 -Paragraph 19 -URI http://asc.fasb.org/extlink&oid=108774443&loc=SL4569616-111683 Reference 9: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8933-108599 Reference 10: http://www.xbrl.org/2003/role/exampleRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 55 -Paragraph 4K -URI http://asc.fasb.org/extlink&oid=84234705&loc=SL4591552-111686 + Details
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- Definition The cash outflow during the period from the repayment of aggregate short-term and long-term debt. Excludes payment of capital lease obligations. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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- Definition Amount of cash outflow for payment of an obligation from a lender, including but not limited to, letter of credit, standby letter of credit and revolving credit arrangements. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.4-08.(f)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690 + Details
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- Definition The cash outflow associated with security instruments that either represent a creditor or an ownership relationship with the holder of the investment security with a maturity of beyond one year or normal operating cycle, if longer. Includes repayments of (a) debt, (b) capital lease obligations, (c) mandatory redeemable capital securities, and (d) any combination of (a), (b), or (c). + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a),(b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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- Definition The aggregate amount of noncash, equity-based employee remuneration. This may include the value of stock or unit options, amortization of restricted stock or units, and adjustment for officers' compensation. As noncash, this element is an add back when calculating net cash generated by operating activities using the indirect method. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585 + Details
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