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UNAUDITED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 6 Months Ended
--- | ---
Jun. 30, 2024 | Jun. 30, 2023
OPERATING ACTIVITIES |  |
Net income including non-controlling interest | $ 23,329 | $ 26,291
Adjustments to reconcile net income including non-controlling interest to net cash provided by operating activities: |  |
Depreciation and amortization | 8,609 | 7,615
Provision for credit losses | 3,344 | 3,075
Equity-based awards compensation expense | 3,916 | 3,592
Amortization of debt issue costs | 210 | 210
Change in deferred income taxes | 770 | 1,799
Change in revaluation of put-right liability | 303 | 199
Change in fair value of contingent earn-out consideration | 3,434 | (10)
Equity of earnings in unconsolidated affiliate | (519) | (600)
Loss on sale of fixed assets | 51 | 63
Changes in operating assets and liabilities: |  |
Increase in patient accounts receivable | (5,110) | (5,341)
Increase in accounts receivable - other | (2,351) | (85)
(Increase) decrease in other current and long term assets | (1,642) | 593
(Decrease) increase in accounts payable and accrued expenses | (1,481) | 1,125
Increase in other long-term liabilities | 548 | 253
Net cash provided by operating activities | 33,411 | 38,779
INVESTING ACTIVITIES |  |
Purchase of fixed assets | (4,174) | (4,523)
Purchase of majority interest in businesses, net of cash acquired | (38,695) | (8,040)
Purchase of redeemable non-controlling interest, temporary equity | (6,230) | (7,804)
Purchase of non controlling interest, permanent equity | (527) | (39)
Proceeds on sale of non-controlling interest, permanent equity | 26 | 0
Proceeds on sale of partnership interest - redeemable non-controlling interest | 69 | 237
Distributions from unconsolidated affiliate | 532 | 502
Proceeds on sale of fixed assets | 0 | 7
Other | 244 | 0
Net cash used in investing activities | (48,755) | (19,660)
FINANCING ACTIVITIES |  |
Proceeds from revolving facility | 0 | 24,000
Proceeds from issuance of common stock pursuant to the secondary public offering, net of issuance costs | 0 | 163,655
Distributions to non-controlling interest, permanent and temporary equity | (8,318) | (8,431)
Cash dividends paid to shareholders | (13,264) | (11,238)
Principal payments on notes payable | (1,113) | (1,086)
Payments on term loan | (1,875) | (1,875)
Payments on revolving facility | 0 | (55,000)
Net cash (used in) provided by financing activities | (24,570) | 110,025
Net (decrease) increase in cash and cash equivalents | (39,914) | 129,144
Cash and cash equivalents - beginning of period | 152,825 | 31,594
Cash and cash equivalents - end of period | 112,911 | 160,738
Cash paid during the period for: |  |
Income taxes | 4,932 | 1,241
Interest paid | 3,708 | 4,011
Non-cash investing and financing transactions during the period: |  |
Purchase of interest in businesses - seller financing portion | 955 | 360
Deferred payments related to purchase of interest in business | 0 | 180
Fair market value of initial contingent consideration related to purchase of interest of businesses | 2,800 | 200
Offset of notes receivable associated with purchase of redeemable non-controlling interest | 75 | 0
Notes payable related to purchase of non-controlling interest, temporary equity | 22 | 0
Notes payable related to purchase of redeemable non-controlling interest, temporary equity | 0 | 621
Notes receivable related to sale of redeemable non-controlling interest, temporary equity | 402 | 2,687
Notes receivable related to the sale of non-controlling interest, permanent equity | $ 243 | $ 0

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