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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 3 Months Ended
--- | ---
Mar. 31, 2024 | Mar. 31, 2023
Cash Flows from Operating Activities |  |
Net income (loss) | $ (29,581) | $ (44,563)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: |  |
Depreciation and amortization, net | 88,384 | 86,874
Asset impairment | 1,708 | 0
Equity in (earnings) loss of unconsolidated ventures | 0 | 577
Amortization of entrance fees | 0 | (508)
Proceeds from deferred entrance fee revenue | 0 | 324
Deferred income tax (benefit) provision | (425) | 244
Operating lease expense adjustment | (13,089) | (10,805)
Change in fair value of derivatives | (3,087) | 904
Loss (gain) on sale of assets, net | (704) | 0
Non-cash stock-based compensation expense | 3,273 | 3,104
Property and casualty insurance income | (2,626) | (3,295)
Changes in operating assets and liabilities: |  |
Accounts receivable, net | (1,253) | 3,143
Prepaid expenses and other assets, net | 1,708 | (7,602)
Prepaid insurance premiums financed with notes payable | (23,319) | (19,305)
Trade accounts payable and accrued expenses | (25,109) | (1,386)
Refundable fees and deferred revenue | 2,725 | 14,092
Operating lease assets and liabilities for lessor capital expenditure reimbursements | 249 | 2,244
Net cash provided by (used in) operating activities | (1,146) | 24,042
Cash Flows from Investing Activities |  |
Purchase of marketable securities | 0 | (49,674)
Sale and maturities of marketable securities | 30,000 | 30,000
Capital expenditures, net of related payables | (44,399) | (49,700)
Proceeds from sale of assets, net | 849 | 0
Property and casualty insurance proceeds | 2,642 | 6,422
Purchase of interest rate cap instruments | (629) | (212)
Proceeds from interest rate cap instruments | 4,659 | 1,212
Other | (68) | (67)
Net cash provided by (used in) investing activities | (6,946) | (62,019)
Cash Flows from Financing Activities |  |
Proceeds from debt | 80,923 | 25,519
Repayment of debt and financing lease obligations | (20,502) | (23,322)
Payment of financing costs, net of related payables | (2,934) | (346)
Payments of employee taxes for withheld shares | (3,397) | (1,680)
Net cash provided by (used in) financing activities | 54,090 | 171
Net increase (decrease) in cash, cash equivalents, and restricted cash | 45,998 | (37,806)
Cash, cash equivalents, and restricted cash at beginning of period | 349,668 | 474,548
Cash, cash equivalents, and restricted cash at end of period | $ 395,666 | $ 436,742

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