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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