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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands | 9 Months Ended
--- | ---
Sep. 30, 2020 | Sep. 30, 2019
CASH FLOWS FROM OPERATING ACTIVITIES |  |
Net (loss) income | $ (12,734) | $ 10,760
Adjustments to reconcile net (loss) income to net cash provided by operating activities: |  |
Depreciation and amortization | 64,536 | 60,193
Amortization of operating lease right-of-use assets | 50,769 | 49,948
Equity in earnings of joint ventures | 530 | (2,148)
Amortization of deferred financing costs and loan discount | 3,266 | 3,103
Loss on sale and disposal of equipment and other | 543 | 1,990
Amortization of cash flow hedge | 2,204 | 0
Non-cash change in fair value of interest rate hedge | 4,523 | 0
Stock-based compensation | 10,144 | 6,963
Other non-cash items included in cost of operations | 0 | (559)
Change in fair value of contingent consideration | (145) | (1,749)
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions: |  |
Accounts receivable | 17,380 | (3,467)
Other current assets | 13,522 | (1,569)
Other assets | (700) | (5,770)
Deferred taxes | (7,640) | (4,230)
Operating lease liability | (43,351) | (49,721)
Deferred revenue | 44,530 | (490)
Accounts payable, accrued expenses and other | 22,966 | 19,349
Net cash provided by operating activities | 170,343 | 82,603
CASH FLOWS FROM INVESTING ACTIVITIES |  |
Purchase of imaging facilities and other acquisitions | (10,125) | (27,150)
Equity investments at fair value | 0 | (143)
Purchase of property and equipment | (77,303) | (68,269)
Proceeds from sale of equipment | 779 | 760
Proceeds from the sale of equity interests in a joint venture | 0 | 132
Nulogix return of capital | 0 | 792
Equity contributions in existing and purchase of interest in joint ventures | (1,631) | (103)
Net cash used in investing activities | (88,280) | (93,981)
CASH FLOWS FROM FINANCING ACTIVITIES |  |
Principal payments on notes and leases payable | (2,704) | (4,778)
Payments on term loan debt | (32,472) | (29,918)
Additional deferred finance costs on revolving loan amendment | (741) | 0
Proceeds from debt issuance, net of issuing costs | 0 | 97,144
Proceeds from Payment Protection Program | 4,023 | 0
Distributions paid to noncontrolling interests | (601) | (1,818)
Proceeds from sale of noncontrolling interest | 0 | 5,275
Contribution from noncontrolling partner | 0 | 750
Proceeds from revolving credit facility | 250,900 | 251,200
Payments on revolving credit facility | (250,900) | (279,200)
Proceeds from issuance of common stock upon exercise of options | 0 | 50
Net cash (used in) provided by financing activities | (32,495) | 38,705
EFFECT OF EXCHANGE RATE CHANGES ON CASH | 6 | (28)
NET INCREASE IN CASH AND CASH EQUIVALENTS | 49,574 | 27,299
CASH AND CASH EQUIVALENTS, beginning of period | 40,165 | 10,389
CASH AND CASH EQUIVALENTS, end of period | 89,739 | 37,688
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION |  |
Cash paid during the period for interest | 31,210 | 36,058
Equipment acquired and leasehold improvements | $ 28,100 | $ 14,100

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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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