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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 6 Months Ended
--- | ---
Jun. 30, 2022 | Jun. 30, 2021
CASH FLOWS FROM OPERATING ACTIVITIES |  |
Net (loss) income | $ 22,194 | $ 21,862
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 55,980 | 46,667
Amortization of operating lease right-of-use assets | 34,055 | 36,834
Equity in earnings of joint ventures, net of dividends | (5,266) | (5,406)
Amortization of deferred financing costs and loan discount | 1,295 | 1,959
Loss (gain) on sale and disposal of equipment and other | 1,209 | (2,874)
Loss on extinguishment of debt | 0 | 1,496
Amortization of cash flow hedge, net of taxes | 1,847 | 1,845
Non-cash change in fair value of interest rate swaps | (27,125) | (11,280)
Stock-based compensation | 15,795 | 17,145
Change in fair value of contingent consideration | (1,287) | 1,292
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions: |  |
Accounts receivable | (30,566) | (28,156)
Other current assets | (709) | 2,963
Other assets | 1,282 | (4,997)
Deferred taxes | 4,732 | 5,297
Operating lease liability | (32,219) | (36,564)
Deferred revenue | (7,565) | (7,147)
Accounts payable, accrued expenses and other | 32,092 | 17,765
Net cash provided by operating activities | 65,744 | 58,701
CASH FLOWS FROM INVESTING ACTIVITIES |  |
Purchase of imaging centers and other acquisitions | (26,009) | (64,918)
Purchase of property and equipment | (72,659) | (53,799)
Proceeds from sale of equipment | 4,121 | 500
Equity contributions in existing and purchase of interest in joint ventures | (1,441) | (1,441)
Net cash used in investing activities | (95,988) | (119,658)
CASH FLOWS FROM FINANCING ACTIVITIES |  |
Principal payments on notes and leases payable | 0 | (3,304)
Payments on term loan debt | (6,625) | (613,279)
Proceeds from debt refinancing, net of issuing costs | 0 | 716,369
Proceeds from revolving credit facility | 0 | 128,300
Payments on revolving credit facility | 0 | (128,300)
Proceeds from issuance of common stock upon exercise of options | 0 | 26
Net cash (used in) provided by financing activities | (6,625) | 99,812
EFFECT OF EXCHANGE RATE CHANGES ON CASH | 1,433 | (21)
NET (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS | (35,436) | 38,834
CASH AND CASH EQUIVALENTS, beginning of period | 134,606 | 102,018
CASH AND CASH EQUIVALENTS, end of period | 99,170 | 140,852
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION |  |
Cash paid during the period for interest | 19,687 | 13,774
Cash paid during the period for income taxes | $ 126 | $ 1,471

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