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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 6 Months Ended
--- | ---
Jun. 30, 2022 | Jun. 30, 2021
Cash flows from operating activities: |  |
Net income | $ 58.1 | $ 19.6
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 55.4 | 50.9
Non-cash interest expense, net | 12.4 | 5.7
Equity-based compensation expense | 8.0 | 9.3
Loss on disposals and deconsolidations, net | 1.0 | 0.1
Loss on debt extinguishment | 0.0 | 9.6
Deferred income taxes | 4.9 | (3.2)
Equity in earnings of unconsolidated affiliates, net of distributions received | (0.4) | (0.4)
Non-cash lease expense | 17.1 | 20.0
Changes in operating assets and liabilities, net of acquisitions and divestitures: |  |
Accounts receivable | 5.4 | (3.1)
Medicare accelerated payments and deferred governmental grants | (40.2) | (28.8)
DOJ settlement payments | 0.0 | (32.2)
Other operating assets and liabilities | 0.2 | 5.0
Net cash provided by operating activities | 121.9 | 52.5
Cash flows from investing activities: |  |
Purchases of property and equipment | (40.6) | (28.0)
Payments for acquisitions, net of cash acquired | (74.9) | (15.2)
Proceeds from disposals of facilities and other assets | 0.0 | 2.5
Purchases of equity investments | (65.8) | 0.0
Proceeds from sales of equity investments | 11.5 | 0.0
Other investing activities | (11.6) | 0.0
Net cash used in investing activities | (181.4) | (40.7)
Cash flows from financing activities: |  |
Principal payments on long-term debt | (33.3) | (309.4)
Borrowings of long-term debt | 12.4 | 283.1
Payments of debt issuance costs | 0.0 | (8.7)
Payment of premium on debt extinguishment | 0.0 | (2.4)
Proceeds from equity offering | 0.0 | 260.9
Payments of equity offering costs | 0.0 | (12.7)
Payment of preferred dividends | 0.0 | (5.1)
Distributions to non-controlling interest holders | (75.2) | (63.4)
(Payments) receipts related to ownership transactions with non-controlling interest holders | (4.0) |
(Payments) receipts related to ownership transactions with non-controlling interest holders |  | 3.4
Other financing activities | (2.9) | (10.9)
Net cash (used in) provided by financing activities | (103.0) | 134.8
Net (decrease) increase in cash and cash equivalents | (162.5) | 146.6
Cash and cash equivalents at beginning of period | 389.9 | 318.2
Cash and cash equivalents at end of period | $ 227.4 | $ 464.8

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