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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended
--- | --- | ---
Mar. 31, 2022 | Mar. 31, 2021 | Dec. 31, 2021
OPERATING ACTIVITIES: |  |  |
Net income | $ 32,901 | $ 45,394 |
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Depreciation and amortization | 29,724 | 29,214 |
Non-cash impairment charges | 0 | 2,754 |
Deferred income tax provision (benefit) | 3,544 | (1,234) |
Share-based compensation | 6,291 | 6,334 |
Amortization of debt issuance costs and expenses associated with debt refinancing | 1,724 | 1,721 |
Non-cash lease expense | (17) | 1,522 |
Loss on disposal of property and equipment | 712 | (2) |
Gain from the sale of business | 0 | (42,876) |
Change in fair value of contingent consideration and others | (765) | 281 |
Changes in assets and liabilities: |  |  |
Accounts receivable | (3,116) | 16,756 |
Inventories | (11,561) | (2,332) |
Prepaid expenses and other current assets | (5,046) | (3,574) |
Other non-current assets | 2,283 | 10,419 |
Accounts payable, accrued expenses and other current liabilities | (9,754) | 14,449 |
Contract liabilities | 0 | (83) |
Other non-current liabilities | (2,576) | (9,662) |
Net cash provided by operating activities | 44,344 | 69,081 |
INVESTING ACTIVITIES: |  |  |
Purchases of property and equipment | (9,325) | (6,675) |
Proceeds from sale of Extremity Orthopedics business | 0 | 191,736 |
Acquired in-process research and development milestone | (4,742) | 0 |
Cash paid for business acquisitions, net of cash acquired | 0 | (302,627) |
Net cash used in investing activities | (14,067) | (117,566) |
FINANCING ACTIVITIES: |  |  |
Proceeds from borrowings of long-term indebtedness | 11,250 | 600 |
Payments on debt | (11,750) | (2,200) |
Purchases of treasury stock | (125,000) | 0 |
Proceeds from exercised stock options | 1,239 | 2,222 |
Cash taxes paid in net equity settlement | (9,204) | (3,637) |
Net cash used in financing activities | (133,465) | (3,015) |
Effect of exchange rate changes on cash and cash equivalents | (3,168) | (9,690) |
Net decrease in cash and cash equivalents | (106,356) | (61,190) |
Cash and cash equivalents at beginning of period | 513,448 | 470,166 | $ 470,166
Cash and cash equivalents at end of period | $ 407,092 | $ 408,976 | $ 513,448

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