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v3.22.2.2

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 9 Months Ended
--- | ---
Sep. 30, 2022 | Sep. 30, 2021
Cash flows from operating activities: |  |
Net income | $ 63.7 | $ 27.8
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 85.2 | 76.1
Non-cash interest expense, net | 19.0 | 12.0
Equity-based compensation expense | 13.0 | 13.4
Loss on disposals and deconsolidations, net | 3.2 | 2.0
Loss on debt extinguishment | 0.0 | 9.1
Deferred income taxes | 12.4 | (2.3)
Equity in earnings of unconsolidated affiliates, net of distributions received | (0.5) | 0.2
Non-cash lease expense | 26.8 | 30.3
Changes in operating assets and liabilities, net of acquisitions and divestitures: |  |
Accounts receivable | 3.4 | (18.4)
Medicare accelerated payments and deferred governmental grants | (53.7) | (48.5)
DOJ settlement payments | 0.0 | (32.2)
Other operating assets and liabilities | (20.9) | (2.1)
Net cash provided by operating activities | 151.6 | 67.4
Cash flows from investing activities: |  |
Purchases of property and equipment | (57.9) | (43.5)
Payments for acquisitions, net of cash acquired | (82.6) | (101.0)
Proceeds from disposals of facilities and other assets | 0.0 | 2.5
Purchases of equity investments | (95.1) | 0.0
Proceeds from sales of equity investments | 11.5 | 0.0
Other investing activities | (11.6) | 0.3
Net cash used in investing activities | (235.7) | (141.7)
Cash flows from financing activities: |  |
Principal payments on long-term debt | (81.5) | (328.4)
Borrowings of long-term debt | 51.2 | 293.0
Payments of debt issuance costs | 0.0 | (11.7)
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 | (110.5) | (97.5)
(Payments) receipts related to ownership transactions with non-controlling interest holders | (3.9) |
(Payments) receipts related to ownership transactions with non-controlling interest holders |  | 2.4
Other financing activities | (6.3) | (14.4)
Net cash (used in) provided by financing activities | (151.0) | 86.5
Net (decrease) increase in cash and cash equivalents | (235.1) | 12.2
Cash and cash equivalents at beginning of period | 389.9 | 318.2
Cash and cash equivalents at end of period | $ 154.8 | $ 330.4

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