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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015
OPERATING ACTIVITIES |  |  |
Net income including non-controlling interests | $ 27,724 | $ 26,268 | $ 26,489
Adjustments to reconcile net income including non-controlling interests to net cash provided by operating activities: |  |  |
Depreciation and amortization | 9,710 | 8,779 | 7,952
Provision for doubtful accounts | 3,672 | 4,040 | 4,170
Equity-based awards compensation expense | 5,032 | 4,962 | 4,491
Excess tax benefit from equity-based rewards | 0 | 0 | (947)
Deferred income tax | (4,864) | 2,979 | 5,953
Other | 621 | 152 | 264
Changes in operating assets and liabilities: |  |  |
Increase in patient accounts receivable | (3,447) | (3,275) | (5,519)
Increase in accounts receivable - other | (3,022) | (400) | (852)
Decrease (increase) in other assets | 2,086 | (1,399) | (1,375)
Increase (decrease) in accounts payable and accrued expenses | 6,979 | 2,994 | (7,011)
Increase in mandatorily redeemable non-controlling interests | 11,579 | 5,598 | 2,509
Increase in other liabilities | 456 | 352 | 1,396
Net cash provided by operating activities | 56,526 | 51,050 | 37,520
INVESTING ACTIVITIES |  |  |
Purchase of fixed assets | (7,095) | (8,260) | (6,263)
Purchase of businesses, net of cash acquired | (36,682) | (23,623) | (18,965)
Sale of non-controlling interest, net of purchases | 121 | (670) | (968)
Proceeds on sale of fixed assets | 81 | 61 | 71
Net cash used in investing activities | (43,575) | (32,492) | (26,125)
FINANCING ACTIVITIES |  |  |
Distributions to non-controlling interests | (5,572) | (5,718) | (5,892)
Cash dividends paid to shareholders - funded | (10,066) | (8,510) | (7,449)
Proceeds from revolving line of credit | 93,000 | 168,000 | 103,000
Payments on revolving line of credit | (85,000) | (166,000) | (93,500)
Payments to settle mandatorily redeemable non-controlling interests | (2,361) | (1,262) | (6,115)
Principal payments on notes payable | (1,227) | (800) | (884)
Tax benefit from equity-based rewards | 0 | 0 | 947
Other | 161 | 1 | 5
Net cash used in financing activities | (11,065) | (14,289) | (9,888)
Net increase in cash and cash equivalents | 1,886 | 4,269 | 1,507
Cash and cash equivalents - beginning of period | 20,047 | 15,778 | 14,271
Cash and cash equivalents - end of period | 21,933 | 20,047 | 15,778
Cash paid during the period for: |  |  |
Income taxes | 8,543 | 10,584 | 7,779
Interest | 2,113 | 784 | 884
Non-cash investing and financing transactions during the period: |  |  |
Purchase of business - seller financing portion | 2,150 | 1,000 | 1,800
Acquisition of non-controlling interest - seller financing portion | 0 | 387 | 0
Payment to settle redeemable non-controlling interest - financing portion | 0 | 127 | 3,077
Receivable from sale of non-controlling interests | $ 0 | $ (138) | $ 0

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- Definition Amount of expense related to write-down of receivables to the amount expected to be collected. Includes, but is not limited to, accounts receivable and notes receivable. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 45 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=82913815&loc=SL49130534-203044 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 225 -SubTopic 10 -Section S99 -Paragraph 2 -Subparagraph (SX 210.5-03.5) -URI http://asc.fasb.org/extlink&oid=63488584&loc=d3e20235-122688 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3602-108585 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 4 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=82913847&loc=SL49130543-203045 + Details
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- Definition Amount of cash outflow for payment of an obligation from a lender, including but not limited to, letter of credit, standby letter of credit and revolving credit arrangements. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3291-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.4-08.(f)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690 + Details
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- Definition The cash outflow for a borrowing supported by a written promise to pay an obligation. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3291-108585 + Details
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- Definition The aggregate amount of noncash, equity-based employee remuneration. This may include the value of stock or unit options, amortization of restricted stock or units, and adjustment for officers' compensation. As noncash, this element is an add back when calculating net cash generated by operating activities using the indirect method. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3602-108585 + Details
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- Definition Acquisition of non-controlling interest - seller financing portion in noncash investing or financing activities. + References No definition available. + Details
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- Definition Amount of increase (decrease) in mandatorily redeemable non-controlling interests. + References No definition available. + Details
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- Definition The amount of payment to settle redeemable non-controlling interest related to financing portion during the period. + References No definition available. + Details
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- Definition Purchase of business - seller financing portion in noncash investing or financing activities. + References No definition available. + Details
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