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CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands | 9 Months Ended
--- | ---
Sep. 30, 2018 | Sep. 30, 2017
OPERATING ACTIVITIES |  |
Net income including non-controlling interests | $ 35,169 | $ 19,018
Adjustments to reconcile net income including non-controlling interests to net cash provided by operating activities: |  |
Depreciation and amortization | 7,335 | 7,269
Provision for doubtful accounts | 3,102 | 2,716
Equity-based awards compensation expense | 4,453 | 3,410
Loss on sale and disposal of fixed assets | 128 | 83
Deferred income taxes | (3,099) | 291
Changes in operating assets and liabilities: |  |
Increase in patient accounts receivable | (1,092) | (1,914)
Increase in accounts receivable - other | (3,954) | (4,736)
Decrease (increase) in other assets | 233 | (787)
Increase in accounts payable and accrued expenses | 9,742 | 8,126
Increase in mandatorily redeemable non-controlling interests | 0 | 7,069
Increase in other liabilities | 1,988 | 286
Net cash provided by operating activities | 54,005 | 40,831
INVESTING ACTIVITIES |  |
Purchase of fixed assets | (5,307) | (5,576)
Purchase of businesses, net of cash acquired | (16,303) | (33,740)
Purchase of non-controlling interest | (272) | 0
Proceeds on sale of fixed assets | 2 | 67
Net cash used in investing activities | (21,880) | (39,249)
FINANCING ACTIVITIES |  |
Distributions to non-controlling interests, permanent and temporary equity | (10,470) | (3,698)
Cash dividends paid to shareholders | (8,746) | (7,547)
Proceeds from revolving line of credit | 79,000 | 63,000
Payments on revolving line of credit | (79,000) | (53,000)
Payments to settle mandatorily redeemable non-controlling interests | (265) | (2,230)
Principal payments on notes payable | (2,294) | (776)
Other | (42) | 40
Net cash used in financing activities | (21,817) | (4,211)
Net increase in cash and cash equivalents | 10,308 | (2,629)
Cash and cash equivalents - beginning of period | 21,933 | 20,047
Cash and cash equivalents - end of period | 32,241 | 17,418
Cash paid during the period for: |  |
Income taxes | 8,957 | 8,059
Interest | 1,705 | 1,616
Non-cash investing and financing transactions during the period: |  |
Purchase of business - seller financing portion | $ 950 | $ 1,650

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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://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -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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Balance Type: | credit
Period Type: | duration

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- Definition The cash outflow for a borrowing supported by a written promise to pay an obligation. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&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://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585 + Details
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- References No definition available. + Details
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Balance Type: | na
Period Type: | duration

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- Definition Amount of increase (decrease) in mandatorily redeemable non-controlling interests. + References No definition available. + Details
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Data Type: | xbrli:monetaryItemType
Balance Type: | debit
Period Type: | duration

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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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Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | duration