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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2024 | Dec. 31, 2023 | Dec. 31, 2022
OPERATING ACTIVITIES |  |  |
Net income including non-controlling interest | $ 45,600 | $ 37,220 | $ 43,407
Adjustments to reconcile net income including non-controlling interest to net cash provided by operating activities: |  |  |
Depreciation and amortization | 18,681 | 15,695 | 14,743
Provision for credit losses | 6,912 | 6,172 | 5,548
Equity-based awards compensation expense | 7,823 | 7,236 | 7,264
Amortization of debt issue costs | 422 | 420 | 305
Change in deferred income taxes | 5,365 | 4,490 | 4,309
Change in revaluation of put-right liability | 82 | (2,582) | 5
Change in fair value of contingent earn-out consideration | 219 | 1,550 | (2,520)
Equity of earnings in unconsolidated affiliate | (1,014) | (955) | (1,175)
Loss (gain) on sale of clinics and fixed assets | 836 | 166 | (643)
Impairment of goodwill and other intangible assets | 0 | 17,495 | 9,112
Impairment of assets held for sale | 2,418 | 0 | 0
Other | 0 | 0 | (83)
Changes in operating assets and liabilities: |  |  |
Increase in patient accounts receivable | (5,346) | (5,645) | (10,279)
Increase in accounts receivable - other | (6,548) | (356) | (307)
Increase in other current and long term assets | (818) | (197) | (5,940)
Decrease (increase) in accounts payable and accrued expenses | 1,713 | 15 | (7,755)
(Increase) decrease in other long-term liabilities | (1,405) | 1,254 | 2,546
Net cash provided by operating activities | 74,940 | 81,978 | 58,537
INVESTING ACTIVITIES |  |  |
Purchase of fixed assets | (9,186) | (9,294) | (8,248)
Purchase of majority interest in businesses, net of cash acquired | (133,087) | (26,582) | (59,788)
Purchase of redeemable non-controlling interest, temporary equity | (8,052) | (10,986) | (14,987)
Purchase of non controlling interest, permanent equity | (1,004) | (281) | (280)
Proceeds on sale of non-controlling interest, permanent equity | 26 | 102 | 0
Proceeds on sale of partnership interest - redeemable non-controlling interest, temporary equity | 79 | 875 | 402
Distributions from unconsolidated affiliate | 1,080 | 830 | 1,259
Proceeds on sale of partnership interest, clinics and fixed assets | 0 | 0 | 373
Other | 694 | 321 | 0
Net cash used in investing activities | (149,450) | (45,015) | (81,269)
FINANCING ACTIVITIES |  |  |
Proceeds from issuance of common stock pursuant to the secondary public offering, net of issuance costs | 0 | 163,646 | 0
Proceeds from revolving facility | 19,000 | 24,000 | 101,000
Distributions to non-controlling interest, permanent and temporary equity | (14,711) | (16,100) | (15,348)
Cash dividends paid to shareholders | (26,540) | (24,128) | (21,321)
Payments on revolving facility | (8,000) | (55,000) | (184,000)
Principal payments on notes payable | (2,952) | (4,400) | (930)
Payments on term loan | (3,750) | (3,750) | (1,875)
Proceeds from term loan | 0 | 0 | 150,000
Payment of deferred financing costs | 0 | 0 | (1,779)
Other | 0 | 0 | 12
Net cash (used in) provided by financing activities | (36,953) | 84,268 | 25,759
Net (decrease) increase in cash and cash equivalents | (111,463) | 121,231 | 3,027
Cash and cash equivalents - beginning of period | 152,825 | 31,594 | 28,567
Cash and cash equivalents - end of period | 41,362 | 152,825 | 31,594
Cash paid during the period for: |  |  |
Income taxes | 4,832 | 4,926 | 7,615
Interest paid | 7,209 | 8,655 | 5,687
Non-cash investing and financing transactions during the period: |  |  |
Purchase of businesses - seller financing portion | 2,060 | 1,815 | 1,574
Liabilities assumed associated with a purchase of a business | 670 | 524 | 0
Fair market value of initial contingent consideration related to purchase of businesses | 17,672 | 200 | 3,357
Notes payable related to purchase of redeemable non-controlling interest, temporary equity | 71 | 1,087 | 1,074
Notes payable related to purchase of non-controlling interest, permanent equity | 0 | 200 | 296
Notes receivable related to sale of redeemable non-controlling interest | 1,890 | 4,136 | 1,580
Notes receivable related to the sale of non-controlling interest, permanent equity | 282 | 458 | 0
Offset to notes receivable associated with purchase of redeemable non-controlling interest | 726 | 0 | 0
Issuance of restricted stock related to purchase of business | $ 1,500 | $ 0 | $ 0

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- Definition The amount of business acquisition cost of acquired entity debt issued (temporary equity) on the date of acquisition. + References No definition available. + Details
Name: | usph_NotesPayableRelatedToPurchaseOfRedeemableNonControllingInterestTemporaryEquity
Namespace Prefix: | usph_
Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | duration

X
- Definition Amount of cash inflow from a noncontrolling interest. Includes, permanent equity. + References No definition available. + Details
Name: | usph_NotesReceivableRelatedToSaleOfNonControllingInterestPermanentEquity
Namespace Prefix: | usph_
Data Type: | xbrli:monetaryItemType
Balance Type: | debit
Period Type: | duration

X
- Definition The amount of offset to notes receivable associated with purchase of redeemable non-controlling interest. + References No definition available. + Details
Name: | usph_OffsetToNotesReceivableAssociatedWithPurchaseOfRedeemableNonControllingInterest
Namespace Prefix: | usph_
Data Type: | xbrli:monetaryItemType
Balance Type: | debit
Period Type: | duration

X
- Definition The cash outflow associated with the acquisition of a redeemable non-controlling interest. + References No definition available. + Details
Name: | usph_PaymentsToAcquireRedeemableNonControllingInterest
Namespace Prefix: | usph_
Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | duration

X
- Definition The cash inflow associated with the sales of non-controlling interest-permanent. + References No definition available. + Details
Name: | usph_ProceedsFromSalesOfNonControllingInterestPermanent
Namespace Prefix: | usph_
Data Type: | xbrli:monetaryItemType
Balance Type: | debit
Period Type: | duration

X
- Definition Purchase of business - seller financing portion in noncash investing or financing activities. + References No definition available. + Details
Name: | usph_PurchaseOfBusinessSellerFinancingPortion
Namespace Prefix: | usph_
Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | duration