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v3.23.3

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 9 Months Ended
--- | ---
Sep. 30, 2023 | Sep. 30, 2022
Cash flows from operating activities |  |
Net income | $ 57,943 | $ 46,624
Adjustments to reconcile net income to net cash provided by (used in) operating activities: |  |
Depreciation and amortization | 12,846 | 13,480
Amortization of debt issuance cost | 711 | 703
Share-based compensation | 13,364 | 10,477
Gain on sale of equity securities | 0 | (2,272)
Unrealized loss on investments | 6,898 | 21,894
Income from equity method investments | (3,104) | (4,397)
Unrealized gain on interest rate swaps | (1,022) | (4,302)
Deferred tax | (3,936) | (3,054)
Other | 0 | 901
Changes in operating assets and liabilities, net of business combinations: |  |
Receivables, net | (46,261) | (58,325)
Receivables, net – related parties | (21,801) | (21,832)
Other receivables | 2,303 | (31,988)
Prepaid expenses and other current assets | (1,246) | 3,228
Loan receivable, non-current | (40) | 0
Right-of-use assets | 5,223 | 2,843
Other assets | (180) | (682)
Accounts payable and accrued expenses | (1,119) | 765
Fiduciary accounts payable | (1,808) | (4,029)
Medical liabilities | 10,108 | 37,491
Income taxes payable/receivable | 25,154 | (10,395)
Operating lease liabilities | (5,215) | (3,059)
Other long-term liabilities | 109 | 3,118
Net cash provided by (used in) operating activities | 48,927 | (2,811)
Cash flows from investing activities |  |
Payments for business and asset acquisitions, net of cash acquired | (4,674) | (5,614)
Proceeds from repayment of loans receivable – related parties | 2,200 | 4,051
Purchase of marketable securities | (2,125) | (1,750)
Issuance of loan receivable | (25,000) | 0
Purchase of investments - privately held | (2,000) | 0
Purchase of investments - equity method | (325) | 0
Purchases of property and equipment | (21,472) | (22,054)
Proceeds from sale of marketable securities | 0 | 6,438
Distribution from investment - equity method | 0 | 400
Contribution to investment - equity method | (700) | (1,785)
Net cash used in investing activities | (54,096) | (20,314)
Cash flows from financing activities |  |
Dividends paid | (2,266) | (12,676)
Repayment of long-term debt | (461) | (3,714)
Payment of finance lease obligations | (505) | (417)
Proceeds from the exercise of stock options and warrants | 1,250 | 2,784
Repurchase of shares | (9,689) | (9,648)
Proceeds from sale of non-controlling interest | 0 | 67
Purchase of non-controlling interest | (50) | (4,338)
Borrowings on loans | 3,149 | 1,986
Net cash used in financing activities | (8,572) | (25,956)
Net decrease in cash and cash equivalents | (13,741) | (49,081)
Cash and cash equivalents beginning of period | 288,027 | 233,097
Cash and cash equivalents end of period | 274,286 | 184,016
Supplementary disclosures of cash flow information |  |
Cash paid for income taxes | 7,881 | 41,811
Cash paid for interest | 9,670 | 4,386
Supplemental disclosures of non-cash investing and financing activities |  |
Right-of-use assets obtained in exchange for operating lease liabilities | 6,626 | 0
Tax impact from APC dividends to APC Shareholders | 3,076 | 0
Fixed asset obtained in exchange for finance lease liabilities | 0 | 398
Common stock issued in business combination | 0 | 1,000
Mortgage loan | 0 | 16,275
Cashless exercise of warrants | 0 | 694
Reconciliation of cash, cash equivalents, and restricted cash |  |
Cash and cash equivalents | 273,941 | 184,016
Restricted cash | 345 | 0
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows | $ 274,286 | $ 184,016

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