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v3.25.4

Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2025 | Dec. 31, 2024 | Dec. 31, 2023
Operating activities |  |  |
Net income | $ 214,533 | $ 296,704 | $ 299,731
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Distributions from unconsolidated subsidiaries | 52,970 | 39,178 | 23,417
Depreciation and amortization | 140,303 | 203,894 | 208,742
Provision for expected credit losses | 2,362 | 4,279 | 1,030
Equity in earnings of unconsolidated subsidiaries | (54,521) | (60,228) | (40,813)
Loss on extinguishment of debt | 0 | 19,038 | 175
(Gain) loss on sale or disposal of assets | 8 | (1,063) | (57)
Stock compensation expense | 16,702 | 100,670 | 43,809
Amortization of debt discount, premium and issuance costs | 3,136 | 2,963 | 2,647
Deferred income taxes | 30,652 | (32,434) | (16,119)
Changes in operating assets and liabilities, net of effects of business combinations: |  |  |
Accounts receivable | (45,185) | (95,845) | 1,156
Other current assets | 413 | 18,072 | (29,374)
Other assets | (8,808) | 12,933 | 10,031
Accounts payable | (854) | (16,789) | (6,412)
Accrued expenses | (5,244) | 26,492 | 84,095
Net cash provided by operating activities | 346,467 | 517,864 | 582,058
Investing activities |  |  |
Business combinations, net of cash acquired | (9,197) | (13,097) | (29,567)
Purchases of property, equipment, and other assets | (229,225) | (222,177) | (229,200)
Investment in businesses | (1,455) | 0 | (9,873)
Proceeds from sales and exchanges of assets and sale of business | 23,391 | 4,263 | 163
Net cash used in investing activities | (216,486) | (231,011) | (268,477)
Financing activities |  |  |
Borrowings on revolving facilities | 1,290,000 | 1,240,000 | 905,000
Payments on revolving facilities | (1,295,000) | (1,415,000) | (1,070,000)
Proceeds from term loans, net of issuance costs | 0 | 1,880,052 | 2,092,232
Payments on term loans | (10,500) | (2,092,485) | (2,113,952)
Payment on senior notes, including call premium | 0 | (1,237,764) | 0
Proceeds from senior notes, net of issuance costs | 0 | 1,176,598 | 0
Borrowings of other debt | 101,218 | 24,892 | 31,399
Principal payments on other debt | (34,328) | (65,280) | (46,946)
Dividends paid to common stockholders | (31,435) | (64,617) | (63,904)
Repurchase of common stock | (100,077) | (37,905) | (12,759)
Decrease in overdrafts | (9,052) | (4,471) | (1,687)
Proceeds from issuance of non-controlling interests | 15,904 | 15,713 | 22,935
Distributions to and purchases of non-controlling interests | (89,882) | (60,001) | (63,531)
Purchase of membership interests of Concentra Group Holdings Parent | 0 | 0 | (6,268)
Proceeds from Concentra initial public offering | 0 | 511,198 | 0
Cash transferred to Concentra at separation | 0 | (182,095) | 0
Net cash used in financing activities | (163,152) | (311,165) | (327,481)
Net decrease in cash and cash equivalents | (33,171) | (24,312) | (13,900)
Cash and cash equivalents at beginning of period | 59,694 | 84,006 | 97,906
Cash and cash equivalents at end of period | 26,523 | 59,694 | 84,006
Supplemental information: |  |  |
Cash paid for interest, excluding amounts received of $82,818 and $68,069 under the interest rate cap contract for the years ended December 31, 2023 and 2024, respectively. | 120,624 | 256,229 | 272,261
Cash paid for taxes | 26,022 | 133,187 | 88,510
Non-cash investing and financing activities: |  |  |
Liabilities for purchases of property and equipment | $ 36,268 | $ 21,784 | $ 18,403

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