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v3.23.1

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 3 Months Ended
--- | ---
Mar. 31, 2023 | Mar. 31, 2022
Cash flows from operating activities: |  |
Net income | $ 1.2 | $ 42.8
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 33.7 | 27.4
Non-cash lease expense | 9.0 | 8.6
Non-cash interest expense, net | 6.5 | 6.1
Equity-based compensation expense | 4.2 | 3.7
Net loss (gain) on disposals, consolidations and deconsolidations | 10.5 | (0.1)
Deferred income taxes | (1.8) | 1.0
Equity in earnings of unconsolidated affiliates, net of distributions received | (0.2) | (0.9)
Changes in operating assets and liabilities, net of acquisitions and divestitures: |  |
Accounts receivable | 8.8 | 2.0
Medicare accelerated payments and deferred governmental grants | (1.2) | (18.0)
Other operating assets and liabilities | 3.8 | 7.2
Net cash provided by operating activities | 74.5 | 79.8
Cash flows from investing activities: |  |
Purchases of property and equipment | (24.3) | (18.2)
Payments for acquisitions, net of cash acquired | (40.7) | (31.1)
Proceeds from disposals of facilities and other assets | 8.0 | 0.0
Purchases of equity investments | (9.6) | 0.0
Proceeds from sales of equity investments | 0.0 | 11.5
Other investing activities | (4.1) | (9.3)
Net cash used in investing activities | (70.7) | (47.1)
Cash flows from financing activities: |  |
Principal payments on long-term debt | (15.9) | (17.0)
Borrowings of long-term debt | 15.9 | 11.9
Payments of debt issuance costs | (1.3) | 0.0
Distributions to non-controlling interest holders | (41.9) | (36.2)
Receipts (payments) related to ownership transactions with non-controlling interest holders | 5.1 | (3.1)
Other financing activities | (3.1) | 0.7
Net cash used in financing activities | (41.2) | (43.7)
Net decrease in cash and cash equivalents | (37.4) | (11.0)
Cash and cash equivalents at beginning of period | 282.9 | 389.9
Cash and cash equivalents at end of period | $ 245.5 | $ 378.9

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