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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended
--- | --- | ---
Mar. 31, 2021 | Mar. 31, 2020 | Dec. 31, 2020
OPERATING ACTIVITIES: |  |  |
Net income | $ 45,394 | $ 9,180 |
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Depreciation and amortization | 29,214 | 29,151 |
Non-cash impairment charges | 2,754 | 0 |
Deferred income tax (benefit) provision | (1,234) | 5,068 |
Share-based compensation | 6,334 | 3,750 |
Amortization of debt issuance costs and expenses associated with debt refinancing | 1,721 | 4,246 |
Non-cash lease expense | 1,522 | 178 |
Accretion of bond issuance discount | 0 | 2,529 |
Loss on disposal of property and equipment | (2) | 374 |
Gain from the sale of business | (42,876) | 0 |
Change in fair value of contingent consideration and others | 281 | (1,051) |
Changes in assets and liabilities: |  |  |
Accounts receivable | 16,756 | 28,301 |
Inventories | (2,332) | (26,236) |
Prepaid expenses and other current assets | (3,574) | 4,683 |
Other non-current assets | 10,419 | 3,000 |
Accounts payable, accrued expenses and other current liabilities | 14,449 | (40,413) |
Contract liabilities | (83) | 338 |
Other non-current liabilities | (9,662) | (2,284) |
Net cash provided by operating activities | 69,081 | 20,814 |
INVESTING ACTIVITIES: |  |  |
Purchases of property and equipment | (6,675) | (16,519) |
Proceeds from sale of Extremity Orthopedics business | 191,736 | 0 |
Proceeds from sale of property and equipment | 0 | 34 |
Cash (paid) provided for business acquisitions, net of cash acquired | (302,627) | 0 |
Acquired in-process research and development | 0 | (5,000) |
Net cash used in investing activities | (117,566) | (21,485) |
FINANCING ACTIVITIES: |  |  |
Proceeds from borrowings of long-term indebtedness | 600 | 113,200 |
Payments on debt | (2,200) | (344,200) |
Purchase of option hedge on convertible notes | 0 | (104,248) |
Proceeds from convertible notes issuance | 0 | 575,000 |
Proceeds from sale of stock purchase warrants | 0 | 44,562 |
Payment of debt issuance costs | 0 | (20,264) |
Purchases of treasury stock | 0 | (100,000) |
Proceeds from exercised stock options | 2,222 | 2,303 |
Cash taxes paid in net equity settlement | (3,637) | (4,348) |
Net cash (used) provided by financing activities | (3,015) | 162,005 |
Effect of exchange rate changes on cash and cash equivalents | (9,690) | (2,533) |
Net increase in cash and cash equivalents | (61,190) | 158,801 |
Cash and cash equivalents at beginning of period | 470,166 | 198,911 | $ 198,911
Cash and cash equivalents at end of period | $ 408,976 | $ 357,712 | $ 470,166

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