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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019
Cash flows from operating activities |  |  |
Net income | $ 49,294 | $ 122,320 | $ 17,673
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Depreciation and amortization | 17,517 | 18,350 | 18,280
Amortization of debt issuance cost | 1,078 | 1,347 | 473
Other | 189 | 0 | 0
Loss of disposal of property and equipment | 0 | 91 | 0
Impairment of goodwill and intangible assets | 0 | 0 | 1,994
Provision for doubtful accounts | 0 | 0 | (1,363)
Share-based compensation | 6,745 | 3,383 | 1,547
Gain on sale of equity method investment | (2,193) | (99,839) | 0
Gain on consolidation of equity method investment | (2,752) | 0 | 0
Gain on contingent equity securities | (4,270) | 0 | 0
Gain on loan assumption | 0 | 0 | (2,250)
Unrealized loss (gain) from investment in equity securities | 10,845 | 11 | (9)
Gain from investment in warrants | (1,145) |  | 0
Loss in interest rate swaps | 1,071 | 0 | 0
Impairment of beneficial interest | 15,723 | 0 | 0
Loss (income) from equity method investments, net | 4,306 | (3,694) | 6,901
Deferred tax | (5,952) | (6,620) | (6,801)
Changes in operating assets and liabilities, net of acquisition amounts: |  |  |
Receivable, net | (1,518) | 4,134 | 10,714
Receivable, net – related parties | (20,116) | (1,123) | (1,435)
Other receivable | (5,351) | 12,589 | (15,079)
Prepaid expenses and other current assets | 2,708 | (6,432) | (2,756)
Right-of-use assets | 3,133 | 3,325 | 2,480
Other assets | (1,529) | (5,530) | (572)
Accounts payable and accrued expenses | 3,217 | 8,204 | (4,883)
Fiduciary accounts payable | 892 | 7,615 | 488
Medical liabilities | 5,279 | (8,691) | (2,392)
Income taxes payable | (3,621) | (304) | (7,093)
Operating lease liabilities | (3,215) | (2,973) | (2,244)
Net cash provided by operating activities | 70,335 | 46,163 | 13,673
Cash flows from investing activities |  |  |
Purchases of marketable securities | (28,000) | (1,793) | (115,402)
Proceeds from sale of marketable securities | 67,612 | 50,625 | 0
Proceeds from repayment of loans receivable - related parties | 56 | 16,500 | 0
Advances on loans receivable | 0 | (145) | (11,425)
Dividends received from equity method investments | 0 | 0 | 240
Proceeds from sale of fixed assets | 0 | 50 | 0
Payments for business acquisition, net of cash acquired | (2,585) | (11,354) | (49,403)
Purchases of investments in privately held entities | 0 | 0 | (491)
Proceeds from sale of equity method investment | 6,375 | 52,743 | 0
Purchases of investments – equity method | (13,622) | (9,969) | (3,108)
Purchases of property and equipment | (19,223) | (1,164) | (1,042)
Cash recorded from consolidation of VIE | 5,927 | 0 | 0
Net cash provided by (used in) investing activities | 16,540 | 95,493 | (180,631)
Cash flows from financing activities |  |  |
Dividends paid | (31,089) | (51,319) | (61,717)
Repayment of term loan | 0 | (9,500) | 0
Change in non-controlling interest capital | 48 | 0 | 28
Borrowings on long-term debt | 569 | 0 | 250,000
Borrowings on line of credit | 180,000 | 0 | 39,600
Repayments on long-term debt | (201) | 0 | (2,375)
Repayments on bank loan and lines of credit | (238,125) | 0 | (52,640)
Payment of capital lease obligations | (208) | (105) | (102)
Proceeds from exercise of stock options and warrants | 9,061 | 10,802 | 3,123
Proceeds from sale of shares | 40,134 | 0 | 0
Proceeds from common stock offering | 0 | 0 | 755
Repurchase of common shares | (5,739) | (537) | (7,570)
Distribution to non-controlling interest | (1,471) | (1,037) | 0
Cost of debt and equity issuances | (727) | 0 | (5,771)
Net cash (used in) provided by financing activities | (47,748) | (51,696) | 163,331
Net increase (decrease) in cash, cash equivalents, and restricted cash | 39,127 | 89,960 | (3,627)
Cash, cash equivalents, and restricted cash, beginning of year | 193,970 | 104,010 | 107,637
Cash, cash equivalents and restricted cash, end of year | 233,097 | 193,970 | 104,010
Supplemental disclosures of cash flow information |  |  |
Cash paid for income taxes | 37,201 | 62,002 | 20,200
Cash paid for interest | 4,158 | 8,510 | 4,258
Supplemental disclosures of non-cash investing and financing activities |  |  |
Issuance of financing obligation for business combinations | 12,706 | 0 | 0
Cashless exercise of warrants | 0 | 599 | 0
Cancellation of Restricted Stock Awards | 334 | 0 | 0
Dividend declared included in dividend payable | 71 | 485 | 271
Reclassification of liability for equity shares | 0 | 0 | 1,185
Deferred tax liability adjustment related to warrant exercises | 0 | 690 | 0
Preferred shares received from sale of equity method investment | 0 | 36,179 | 0
Beneficial interest acquired from sale of equity method investment | 0 | 15,723 | 0
Reconciliation of cash, cash equivalents, and restricted cash |  |  |
Cash and cash equivalents | 233,097 | 193,470 | 103,189
Restricted cash – long-term - letters of credit | 0 | 500 | 746
Restricted cash – short-term | 0 | 0 | 75
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows | 233,097 | 193,970 | 104,010
Affiliated Entity | APC |  |  |
Supplemental disclosures of non-cash investing and financing activities |  |  |
APC stock issued in exchange for AMG | $ 0 | $ 0 | $ 414

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