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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018
CASH FLOWS FROM OPERATING ACTIVITIES |  |  |
Net (loss) income | $ (1,749) | $ 23,440 | $ 38,133
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Depreciation and amortization | 86,795 | 80,607 | 72,899
Amortization of operating lease right-of-use assets | 67,915 | 66,842 | 0
Equity in earnings of joint ventures, net of dividends | 1,577 | 248 | 13,469
Amortization and write off of deferred financing costs and loan discount | 4,413 | 4,184 | 3,898
Loss (gain) on sale and disposal of equipment and other | 1,200 | 2,383 | (2,054)
Gain on extinguishment of debt | (4,047) | 0 | 0
Gain on re-measurement of pre-existing interest | 0 | (768) | (39,539)
Loss on impairment | 4,170 | 0 | 3,937
Amortization of cash flow hedge | 3,448 | 0 | 0
Non-cash change in fair value of interest rate hedge | 2,528 | 0 | 0
Stock-based compensation | 12,405 | 8,730 | 7,662
Other non cash item in other expenses | 242 | (371) | 0
Change in value of contingent consideration | 0 | (3,123) | 1,749
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions: |  |  |
Accounts receivable | 25,206 | (17,482) | 2,145
Other current assets | 6,588 | (3,557) | (9,248)
Other assets | (5,425) | (2,326) | (1,687)
Deferred taxes | (611) | (3,888) | (6,935)
Operating lease liability | (53,906) | (66,831) | 0
Deferred rent | 0 | 0 | 6,312
Deferred revenue | 37,941 | (1,082) | (208)
Accounts payable, accrued expenses and other liabilities | 45,069 | 17,316 | 26,221
Net cash provided by operating activities | 233,759 | 104,322 | 116,754
CASH FLOWS FROM INVESTING ACTIVITIES |  |  |
Purchase of imaging facilities | (31,265) | (27,150) | (73,192)
Equity investments at fair value | 0 | (143) | (2,200)
Purchase of property and equipment | (94,172) | (74,153) | (72,180)
Proceeds from sale of equipment | 828 | 1,160 | 2,575
Proceeds from the sale of equity interests in a joint venture | 0 | 132 | 0
Proceeds from sale of internal use software | 0 | 0 | 248
Nulogix return of capital | 0 | 792 | 0
Equity contributions in existing and purchase of interest in joint ventures | (1,635) | (103) | (2,000)
Net cash used in investing activities | (126,244) | (99,465) | (146,749)
CASH FLOWS FROM FINANCING ACTIVITIES |  |  |
Principal payments on notes and leases payable | (3,562) | (6,494) | (6,072)
Payments on term loan debt | (43,296) | (40,742) | (33,830)
Additional deferred finance costs on revolving loan amendment | (741) | 0 | 0
Proceeds from debt issuance, net of issuance costs | 0 | 97,144 | 0
Proceeds from paycheck protection program loans | 4,023 | 0 | 0
Distributions paid to noncontrolling interests | (1,985) | (3,057) | (1,427)
Proceeds from sale of noncontrolling interest | 0 | 5,275 | 0
Contributions from noncontrolling partners | 0 | 750 | 2,640
Proceeds from revolving credit facility | 250,900 | 261,200 | 204,300
Payments on revolving credit facility | (250,900) | (289,200) | (176,300)
Purchase of noncontrolling interests | 0 | 0 | (200)
Proceeds from issuance of common stock upon exercise of options | 0 | 75 | 20
Net cash (used in) provided by financing activities | (45,561) | 24,951 | (10,869)
EFFECT OF EXCHANGE RATE CHANGES ON CASH | (101) | (32) | (69)
NET INCREASE (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS | 61,853 | 29,776 | (40,933)
CASH AND CASH EQUIVALENTS, beginning of period | 40,165 | 10,389 | 51,322
CASH AND CASH EQUIVALENTS, end of period | 102,018 | 40,165 | 10,389
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION |  |  |
Cash paid during the period for interest | 39,521 | 46,254 | 37,016
Cash paid during the period for income taxes | 5,069 | 5,884 | 4,933
Equipment acquired and leasehold improvements | 52,000 | 51,700 | 47,800
Capital lease debt | 20 | 100 | 6,700
Gain (loss) on equity method investment |  | (134) |
Contingent consideration liability adjustment | 0 | (3,123) | 1,749
Noncontrolling Interests |  |  |
CASH FLOWS FROM OPERATING ACTIVITIES |  |  |
Net (loss) income | 13,091 | 8,684 | 5,890
Radnet, Inc. Stockholders' Equity |  |  |
CASH FLOWS FROM OPERATING ACTIVITIES |  |  |
Net (loss) income | $ (14,840) | 14,756 | 32,243
Variable Interest Entity, Not Primary Beneficiary | Medical Arts Radiology |  |  |
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Change in value of contingent consideration |  |  | 1,700
Contingent consideration liability adjustment |  |  | $ 1,700
Business consideration liability adjustment recorded amount |  | $ 2,400 |

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- Definition Amount of cash inflow (outflow) from investing activities, including discontinued operations. Investing activity cash flows include making and collecting loans and acquiring and disposing of debt or equity instruments and property, plant, and equipment and other productive assets. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 24 -URI http://asc.fasb.org/extlink&oid=121586364&loc=d3e3521-108585 + Details
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- Definition Amount of cash inflow (outflow) from operating activities, including discontinued operations. Operating activity cash flows include transactions, adjustments, and changes in value not defined as investing or financing activities. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 25 -URI http://asc.fasb.org/extlink&oid=121586364&loc=d3e3536-108585 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 24 -URI http://asc.fasb.org/extlink&oid=121586364&loc=d3e3521-108585 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -URI http://asc.fasb.org/extlink&oid=121586364&loc=d3e3602-108585 + Details
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- Definition The cash outflow paid to third parties in connection with debt origination, which will be amortized over the remaining maturity period of the associated long-term debt. + 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 (e) -URI http://asc.fasb.org/extlink&oid=121586364&loc=d3e3291-108585 + Details
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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=121586364&loc=d3e3213-108585 + Details
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- Definition The cash outflow associated with the investment in or advances to an entity in which the reporting entity shares control of the entity with another party or group. + 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 (b) -URI http://asc.fasb.org/extlink&oid=121586364&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=121586364&loc=d3e3291-108585 + 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=121586364&loc=d3e3255-108585 + Details
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