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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2022
Mar. 31, 2021
OPERATING ACTIVITIES    
Net income including non-controlling interest and earnings from unconsolidated affiliates, net $ 11,982 $ 11,886
Adjustments to reconcile net income including non-controlling interest to net cash provided by operating activities:    
Depreciation and amortization 3,824 2,681
Provision for credit losses 1,305 1,200
Equity-based awards compensation expense 1,846 1,651
Deferred income taxes 2,132 2,181
Gain on revaluation of put-right liability (603) 0
Earnings in unconsolidated affiliate (339) 0
Other 93 96
Changes in operating assets and liabilities:    
Increase in patient accounts receivable (4,676) (4,688)
(Increase) decrease in accounts receivable - other (2,145) 220
(Increase) decrease in other assets (735) 221
Increase in accounts payable and accrued expenses 1,445 3,969
Decrease in other long-term liabilities (2,480) (1,743)
Net cash provided by operating activities 11,649 17,674
INVESTING ACTIVITIES    
Purchase of fixed assets (2,528) (1,608)
Purchase of majority interest in businesses, net of cash acquired (11,242) (11,747)
Purchase of redeemable non-controlling interest - temporary equity (2,211) 0
Purchase of non-controlling interest, permanent equity (99) 0
Proceeds on sales of partnership interest, clinics and fixed assets 4 152
Distributions from unconsolidated affiliate 132 0
Sales of non-controlling interest-permanent 0 0
Net cash used in investing activities (15,944) (13,203)
FINANCING ACTIVITIES    
Distributions to non-controlling interest, permanent and temporary equity (3,711) (5,265)
Cash dividends paid to shareholders 0 0
Proceeds from revolving line of credit 35,000 60,000
Payments on revolving line of credit (31,000) (60,000)
Principal payments on notes payable (332) (145)
(Payment) receipt of Medicare Accelerated and Advance Funds 0 (14,054)
Other 0 12
Net cash used in financing activities (43) (19,452)
Net decrease in cash and cash equivalents (4,338) (14,981)
Cash and cash equivalents - beginning of period 28,567 32,918
Cash and cash equivalents - end of period 24,229 17,937
Cash paid during the period for:    
Income taxes 81 62
Interest paid 525 298
Non-cash investing and financing transactions during the period:    
Purchase of businesses - seller financing portion 300 300
Notes payable related to purchase of redeemable non-controlling interest, temporary equity 246 4,829
Notes payable due to purchase of non-controlling interest, permanent equity 296 0
Notes receivable related to sale of partnership interest - redeemable non-controlling interest 0 287
Dividends payable to USPH shareholders $ 5,327 $ 4,514