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UNAUDITED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 3 Months Ended
--- | ---
Mar. 31, 2024 | Mar. 31, 2023
OPERATING ACTIVITIES |  |
Net income including non-controlling interest | $ 11,617 | $ 11,427
Adjustments to reconcile net income including non-controlling interest to net cash provided by operating activities: |  |
Depreciation and amortization | 4,095 | 3,788
Provision for credit losses | 1,627 | 1,512
Equity-based awards compensation expense | 1,997 | 1,806
Amortization of debt issue costs | 106 | 106
Change in deferred income taxes | 1,943 | 221
Change in revaluation of put-right liability | 80 | 149
Change in fair value of contingent earn-out consideration | (612) | 698
Equity of earnings in unconsolidated affiliate | (271) | (274)
Loss on sale of fixed assets | 5 | 0
Other | 0 | 19
Changes in operating assets and liabilities: |  |
Increase in patient accounts receivable | (5,124) | (5,999)
Increase in accounts receivable - other | (3,985) | (796)
(Decrease) increase in other current and long term assets | (433) | 1,897
Decrease in accounts payable and accrued expenses | (6,678) | (1,846)
Increase (decrease) in other long-term liabilities | 52 | (1,359)
Net cash provided by operating activities | 4,419 | 11,349
INVESTING ACTIVITIES |  |
Purchase of fixed assets | (1,838) | (2,059)
Purchase of majority interest in businesses, net of cash acquired | (15,971) | (5,796)
Purchase of redeemable non-controlling interest, temporary equity | (2,702) | (5,178)
Purchase of non controlling interest, permanent equity | (498) | 0
Proceeds on sale of non-controlling interest, permanent equity | 23 | 0
Proceeds on sale of partnership interest - redeemable non-controlling interest, temporary equity | 67 | 107
Distributions from unconsolidated affiliate | 367 | 245
Other | 88 | 0
Net cash used in investing activities | (20,464) | (12,681)
FINANCING ACTIVITIES |  |
Proceeds from revolving facility | 0 | 7,000
Distributions to non-controlling interest, permanent and temporary equity | (3,160) | (3,297)
Principal payments on notes payable | (392) | (422)
Payments on term loan | (938) | (938)
Net cash (used in) provided by financing activities | (4,490) | 2,343
Net (decrease) increase in cash and cash equivalents | (20,535) | 1,011
Cash and cash equivalents - beginning of period | 152,825 | 31,594
Cash and cash equivalents - end of period | 132,290 | 32,605
Cash paid during the period for: |  |
Income taxes | 367 | 442
Interest paid | 1,844 | 1,377
Non-cash investing and financing transactions during the period: |  |
Purchase of interest in businesses - seller financing portion | 500 | 360
Notes payable related to purchase of redeemable non-controlling interest, temporary equity | 0 | 611
Offset of notes receivable associated with purchase of redeemable non-controlling interest | 75 | 0
Notes receivable related to sale of redeemable non-controlling interest, temporary equity | 315 | 532
Notes receivable related to the sale of non-controlling interest, permanent equity | 243 | 0
Dividends payable to USPH shareholders | $ 6,630 | $ 5,617

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