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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 9 Months Ended
--- | ---
Sep. 30, 2022 | Sep. 30, 2021
CASH FLOWS FROM OPERATING ACTIVITIES |  |
Net income | $ 28,640 | $ 43,005
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 85,209 | 71,272
Amortization of operating lease right-of-use assets | 51,573 | 55,880
Equity in earnings of joint ventures, net of dividends | (8,350) | (8,259)
Amortization of deferred financing costs and loan discount | 1,943 | 2,608
Loss (gain) on sale and disposal of equipment and other | 962 | (279)
Loss on extinguishment of debt | 0 | 1,496
Amortization of cash flow hedge, net of taxes | 2,771 | 2,765
Non-cash change in fair value of interest rate swaps | (39,576) | (14,149)
Stock-based compensation | 19,112 | 21,566
Change in fair value of contingent consideration | (329) | 891
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions: |  |
Accounts receivable | (36,686) | (23,237)
Other current assets | (4,934) | 3,358
Other assets | 3,738 | (4,998)
Deferred taxes | 8,955 | 10,124
Operating lease liability | (49,597) | (55,035)
Deferred revenue | (7,809) | (19,438)
Accounts payable, accrued expenses and other | 37,148 | 12,725
Net cash provided by operating activities | 92,770 | 100,295
CASH FLOWS FROM INVESTING ACTIVITIES |  |
Purchase of imaging centers and other acquisitions | (26,009) | (70,108)
Purchase of property and equipment | (98,606) | (88,478)
Proceeds from sale of equipment | 3,008 | 521
Equity contributions in existing and purchase of interest in joint ventures | (1,441) | (1,441)
Net cash used in investing activities | (123,048) | (159,506)
CASH FLOWS FROM FINANCING ACTIVITIES |  |
Principal payments on notes and leases payable | 0 | (3,302)
Payments on term loan debt | (9,938) | (616,217)
Proceeds from debt refinancing, net of issuing costs | 0 | 716,369
Proceeds from sale of economic interest in majority owned subsidiary, net of taxes | 0 | 11,602
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 | (9,938) | 108,478
EFFECT OF EXCHANGE RATE CHANGES ON CASH | 616 | (32)
NET (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS | (39,600) | 49,235
CASH AND CASH EQUIVALENTS, beginning of period | 134,606 | 102,018
CASH AND CASH EQUIVALENTS, end of period | 95,006 | 151,253
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION |  |
Cash paid during the period for interest | 30,251 | 21,408
Cash paid during the period for income taxes | $ 560 | $ 1,913

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