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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands | 6 Months Ended
--- | ---
Jun. 30, 2020 | Jun. 30, 2019
CASH FLOWS FROM OPERATING ACTIVITIES |  |
Net (loss) income | $ (22,958) | $ 5,668
Adjustments to reconcile net loss to net cash provided by operating activities: |  |
Depreciation and amortization | 43,289 | 39,703
Amortization of operating lease right-of-use assets | 34,094 | 32,937
Equity in earnings of joint ventures | (2,900) | (4,117)
Distributions from joint ventures | 0 | 3,438
Amortization of deferred financing costs and loan discount | 2,163 | 2,021
(Gain) loss on sale and disposal of equipment and other | 202 | 1,073
Amortization of cash flow hedge | 892 | 0
Non-cash change in fair value of interest rate hedge | 3,843 | 0
Stock-based compensation | 8,078 | 5,582
Other non-cash items included in cost of operations | 0 | (559)
Change in fair value of contingent consideration | (97) | (1,953)
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions: |  |
Accounts receivable | 29,018 | (12,042)
Other current assets | 9,884 | 4,331
Other assets | (4,257) | 2,069
Deferred taxes | (11,678) | (3,542)
Operating lease liability | (30,182) | (32,268)
Deferred revenue | 44,384 | (666)
Accounts payable, accrued expenses and other | 27,690 | 2,860
Net cash provided by operating activities | 131,465 | 44,535
CASH FLOWS FROM INVESTING ACTIVITIES |  |
Purchase of imaging facilities and other acquisitions | (4,188) | (27,149)
Equity investments at fair value | 0 | (143)
Purchase of property and equipment | (64,193) | (50,342)
Proceeds from sale of equipment | 779 | 760
Proceeds from the sale of equity interests in a joint venture | 0 | 132
Equity contributions in existing and purchase of interest in joint ventures | 0 | (103)
Net cash used in investing activities | (67,602) | (76,845)
CASH FLOWS FROM FINANCING ACTIVITIES |  |
Principal payments on notes and leases payable | (1,814) | (3,320)
Payments on term loan debt | (21,648) | (19,469)
Proceeds from debt issuance, net of issuing costs | 0 | 97,144
Proceeds from Payment Protection Program | 4,023 | 0
Proceeds from sale of noncontrolling interest | 0 | 5,275
Contribution from noncontrolling partner | 0 | 750
Proceeds from revolving credit facility | 250,900 | 236,200
Payments on revolving credit facility | (250,900) | (264,200)
Proceeds from issuance of common stock upon exercise of options | 0 | 50
Net cash (used in) provided by financing activities | (19,439) | 52,430
EFFECT OF EXCHANGE RATE CHANGES ON CASH | (6) | (5)
NET INCREASE IN CASH AND CASH EQUIVALENTS | 44,418 | 20,115
CASH AND CASH EQUIVALENTS, beginning of period | 40,165 | 10,389
CASH AND CASH EQUIVALENTS, end of period | 84,583 | 30,504
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION |  |
Cash paid during the period for interest | 22,826 | 23,292
Equipment acquired and leasehold improvements | $ 31,800 | 14,000
Distribution to noncontrolling interests |  | $ 1,818

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- Definition The cash outflow for acquisition of buildings (properties) whether for investment or use. + 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=118932676&loc=d3e3213-108585 + Details
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- Definition The cash outflow associated with the purchase of all investments (debt, security, other) 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 13 -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3213-108585 + Details
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- Definition Amount of cash outflow from the acquisition of or improvements to long-lived, physical assets used to produce goods and services and not intended for resale, classified as other. + 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=118932676&loc=d3e3213-108585 + 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=118932676&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=118932676&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=118932676&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=118932676&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=118932676&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=118932676&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=118930883&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=118930883&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=116874947&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=118932676&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=116874947&loc=SL4591552-111686 + 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=118932676&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 Amount of cash outflow for debt, mandatory redeemable security, and principal payment for finance lease obligation. + 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=118932676&loc=d3e3291-108585 + Details
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