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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2022
Jun. 30, 2021
OPERATING ACTIVITIES    
Net income including non-controlling interest and earnings from unconsolidated affiliates, net $ 27,238 $ 29,358
Adjustments to reconcile net income including non-controlling interest to net cash provided by operating activities:    
Depreciation and amortization 7,298 5,484
Provision for credit losses 2,856 2,564
Equity-based awards compensation expense 3,660 3,405
Deferred income taxes 4,307 3,160
Loss on revaluation of put-right liability 14 0
(Gain) loss on sale of clinics and fixed assets (614) 106
Earnings in unconsolidated affiliate (679) 0
Changes in operating assets and liabilities:    
Increase in patient accounts receivable (7,459) (5,325)
(Increase) decrease in accounts receivable - other (2,862) 129
(Increase) decrease in other assets 230 (255)
Decrease in accounts payable and accrued expenses (3,891) (3,672)
(Decrease) increase in other long-term liabilities (2,587) 602
Net cash provided by operating activities 27,511 35,556
INVESTING ACTIVITIES    
Purchase of fixed assets (4,569) (3,301)
Purchase of majority interest in businesses, net of cash acquired (11,799) (20,402)
Purchase of redeemable non-controlling interest, temporary equity (8,648) (9,536)
Purchase of non-controlling interest, permanent equity (156) 0
Proceeds on sales of partnership interest, clinics and fixed assets 740 (168)
Distributions from unconsolidated affiliate 548 0
Proceeds on sales of redeemable non-controlling interest-temporary 344 32
Net cash used in investing activities (23,540) (33,375)
FINANCING ACTIVITIES    
Distributions to non-controlling interest, permanent and temporary equity (7,202) (9,398)
Cash dividends paid to shareholders (10,659) (9,028)
Proceeds from revolving line of credit 61,000 128,000
Proceeds from term loan 150,000 0
Payments on revolving line of credit (175,000) (106,000)
Principal payments on notes payable (338) (4,207)
(Payment) receipt of Medicare Accelerated and Advance Funds 0 (14,054)
Payment of deferred financing costs (1,779) 0
Other 12 7
Net cash used in financing activities 16,034 (14,680)
Net decrease in cash and cash equivalents 20,005 (12,499)
Cash and cash equivalents - beginning of period 28,567 32,918
Cash and cash equivalents - end of period 48,572 20,419
Cash paid during the period for:    
Income taxes 4,524 6,967
Interest paid 1,319 741
Non-cash investing and financing transactions during the period:    
Purchase of businesses - seller financing portion 374 550
Purchase of businesses - contingent consideration 0 1,000
Notes payable related to purchase of redeemable non-controlling interest, temporary equity 948 0
Notes payable due to purchase of non-controlling interest, permanent equity 296 0
Notes receivable related to sale of partnership interest 0 287
Notes receivable related to sale of partnership interest - redeemable non-controlling interest $ 1,476 $ 0