XML 15 R6.htm IDEA: XBRL DOCUMENT v3.22.1
Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2022
Mar. 31, 2021
Cash flows from operating activities:    
Net (loss) income $ (21,188) $ 17,642
loss (Income) from discontinued operations 247 (12,290)
Adjustments to reconcile net income (loss) to net cash from operating activities:    
Depreciation and amortization 8,769 8,031
Amortization of premiums, discounts and issuance costs 577 994
Loss on early extinguishment of debt 57,016 14,532
Stock-based compensation expense 4,435 3,717
Deferred income taxes 2,389 (16,016)
Other (605) (638)
Changes in assets and liabilities:    
Accounts receivable (20,152) (11,633)
Prepaid expenses and other current assets 16,212 47,799
Other long-term assets 863 (90)
Accounts payable and accrued expenses (159,271) (106,937)
Increase in income tax receivable 17,216 (18,501)
Long-term professional liabilities 2,684 (916)
Other liabilities 877 (24,620)
Net cash used in operating activities – continuing operations (89,931) (98,926)
Net cash (used in) provided by operating activities - discontinued operations (7,551) 16,738
Net cash (used in) provided by operating activities (97,482) (82,188)
Cash flows from investing activities:    
Acquisition payments, net of cash acquired (25,667) (5,957)
Purchases of investments (1,272) (5,138)
Proceeds from maturities or sales of investments 7,712 7,433
Purchases of property and equipment (7,145) (9,052)
Other 99
Net cash provided by (used in) investing activities - continuing operations (26,273) (12,714)
Net cash provided by investing activities-discontinued operations 2,350
Net cash provided by (used in) investing activities (26,273) (10,364)
Cash flows from financing activities:    
Borrowings on credit agreement 248,500
Payments on credit agreement (99,500)
Redemption of senior notes, including call premium (1,046,880) (759,848)
Proceeds from senior notes and term loan 650,000
Payments for financing costs (7,924)
Payment on Finance lease obligation (747) (672)
Proceeds from issuance of common stock 1,174 1,042
Repurchases of common stock (1,166) (1,994)
Other 86 (189)
Net cash (used in) provided from financing activities - continuing operations (256,457) (761,661)
Net cash used in financing activities (256,457) (761,661)
Net (decrease) increase in cash and cash equivalents (380,212) (854,213)
Cash and Cash Equivalents, at Carrying Value, Beginning Balance 387,391 1,123,843
Cash and cash equivalents at end of period $ 7,179 $ 269,630