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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 3 Months Ended
--- | ---
Mar. 31, 2023 | Mar. 31, 2022
CASH FLOWS FROM OPERATING ACTIVITIES |  |
Net (loss) income | $ (14,283) | $ 8,363
Adjustments to reconcile net (loss) income to net cash provided by operating activities: |  |
Depreciation and amortization | 31,315 | 27,118
Amortization of operating lease right-of-use assets | 15,699 | 16,802
Equity in earnings of joint ventures, net of dividends | (1,835) | (2,517)
Amortization of deferred financing costs and loan discount | 746 | 648
Loss on sale and disposal of equipment and other | 579 | 1,128
Amortization of cash flow hedge, net of taxes | 922 | 923
Non-cash change in fair value of interest rate hedge | 4,093 | (20,819)
Stock-based compensation | 12,185 | 11,102
Change in fair value of contingent consideration | 2,335 | (501)
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions: |  |
Accounts receivable | (9,997) | (23,904)
Other current assets | (1,691) | (4,065)
Other assets | (2,726) | (1,417)
Deferred taxes | 942 | 1,387
Operating lease liability | (15,080) | (15,859)
Deferred revenue | 335 | (4,519)
Accounts payable, accrued expenses and other | 9,077 | 7,031
Net cash provided by operating activities | 32,616 | 901
CASH FLOWS FROM INVESTING ACTIVITIES |  |
Purchase of imaging centers and other acquisitions | (9,644) | (25,123)
Purchase of property and equipment | (55,915) | (36,558)
Proceeds from sale of equipment | 3 | 117
Net cash used in investing activities | (65,556) | (61,564)
CASH FLOWS FROM FINANCING ACTIVITIES |  |
Principal payments on notes and leases payable | (184) | 0
Payments on term loan debt | (3,688) | (3,313)
Proceeds from issuance of common stock upon exercise of options | 51 | 0
Net cash used in financing activities | (3,821) | (3,313)
EFFECT OF EXCHANGE RATE CHANGES ON CASH | (229) | 83
NET DECREASE IN CASH AND CASH EQUIVALENTS | (36,990) | (63,893)
CASH AND CASH EQUIVALENTS, beginning of period | 127,834 | 134,606
CASH AND CASH EQUIVALENTS, end of period | 90,844 | 70,713
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION |  |
Cash paid during the period for interest | 21,471 | 7,448
Cash paid during the period for income taxes | $ 40 | $ 34

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- Definition The amount of expense charged against earnings by an Entity to record deferred gains and losses on hedge instruments. Examples include gain on economic hedges, amortization of gain on designated fair value hedge and so forth. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI https://asc.fasb.org/extlink&oid=126954810&loc=d3e3602-108585 + Details
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