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v3.25.2

UNAUDITED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | 12 Months Ended
--- | --- | --- | ---
Jun. 30, 2025 | Jun. 30, 2024 | Jun. 30, 2025 | Jun. 30, 2024 | Dec. 31, 2024
OPERATING ACTIVITIES |  |  |  |  |
Net income including non-controlling interest | $ 17,720 | $ 11,712 | $ 31,188 | $ 23,329 |
Adjustments to reconcile net income including non-controlling interest to net cash provided by operating activities: |  |  |  |  |
Depreciation and amortization |  |  | 11,924 | 8,609 |
Provision for credit losses | 1,995 | 1,717 | 3,843 | 3,344 |
Equity-based awards compensation expense |  |  | 3,888 | 3,916 |
Amortization of debt issue costs |  |  | 210 | 210 |
Change in deferred income taxes |  |  | 7,279 | 770 |
Change in revaluation of put-right liability | 339 | 223 | 743 | 303 |
Change in fair value of contingent earn-out consideration | (790) | 4,046 | (5,612) | 3,434 |
Equity of earnings in unconsolidated affiliate | (401) | (248) | (794) | (519) |
Loss on sale of fixed assets |  |  | 438 | 51 |
Loss on sale of a partnership | 0 | 0 | 123 | 0 |
Changes in operating assets and liabilities: |  |  |  |  |
Patient accounts receivable, net |  |  | (10,232) | (5,110) |
Accounts receivable - other |  |  | 355 | (2,351) |
Other current and long term assets |  |  | (4,426) | (1,642) |
Accounts payable and accrued expenses |  |  | (7,914) | (1,481) |
Other long-term liabilities |  |  | (827) | 548 |
Net cash provided by operating activities |  |  | 30,186 | 33,411 |
INVESTING ACTIVITIES |  |  |  |  |
Purchase of fixed assets |  |  | (5,830) | (4,174) |
Purchase of majority interest in businesses, net of cash acquired |  |  | (6,890) | (38,695) |
Purchase of redeemable non-controlling interest, temporary equity |  |  | (8,427) | (6,230) |
Purchase of non controlling interest, permanent equity |  |  | (149) | (527) |
Proceeds from the sale of non-controlling interest, permanent equity |  |  | 9 | 26 |
Proceeds from the sale of partnership interest - redeemable non-controlling interest, temporary equity |  |  | 15 | 69 |
Repayment of notes receivable related to redeemable non-controlling interest |  |  | 346 | 375 |
Proceeds from the sale of partnership |  |  | 700 | 0 |
Distributions from unconsolidated affiliate |  |  | 664 | 532 |
Other |  |  | 228 | (131) |
Net cash (used in) investing activities |  |  | (19,334) | (48,755) |
FINANCING ACTIVITIES |  |  |  |  |
Proceeds from revolving facility |  |  | 73,500 | 0 |
Payments on revolving facility |  |  | (60,000) | 0 |
Distributions to non-controlling interest, permanent and temporary equity |  |  | (10,697) | (8,318) |
Cash dividends paid to shareholders |  |  | (13,678) | (13,264) |
Payments on term loan |  |  | (5,625) | (1,875) |
Principal payments on notes payable |  |  | (1,628) | (1,113) |
Net cash (used in) financing activities |  |  | (18,128) | (24,570) |
Net (decrease) in cash and cash equivalents |  |  | (7,276) | (39,914) |
Cash and cash equivalents - beginning of period |  |  | 41,362 | 152,825 | $ 152,825
Cash and cash equivalents - end of period | $ 34,086 | $ 112,911 | 34,086 | 112,911 | $ 41,362
Cash paid during the period for: |  |  |  |  |
Income taxes |  |  | 9,833 | 4,932 |
Interest paid |  |  | 4,683 | 3,708 |
Non-cash investing and financing transactions during the period: |  |  |  |  |
Purchase of businesses - seller financing portion |  |  | 0 | 955 |
Fair market value of initial contingent consideration related to purchase of businesses |  |  | 3,059 | 2,800 |
Offset of notes receivable associated with purchase of redeemable non-controlling interest |  |  | 254 | 75 |
Notes payable related to purchase of non-controlling interest, temporary equity |  |  | 0 | 22 |
Notes payable related to purchase of redeemable non-controlling interest, temporary equity |  |  | 89 | 0 |
Notes receivable related to sale of redeemable non-controlling interest, temporary equity |  |  | 660 | 402 |
Notes receivable related to the sale of non-controlling interest, permanent equity |  |  | $ 29 | $ 243 |

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