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Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019
CASH FLOWS FROM OPERATING ACTIVITIES |  |  |
NET (LOSS) INCOME | $ (8,347) | $ 4,172 | $ 8,006
Adjustments to reconcile net (loss) income to net cash provided by operating activities: |  |  |
Depreciation | 30,192 | 25,904 | 20,346
Amortization of intangibles | 23,160 | 9,817 | 9,925
Non-cash stock-based compensation | 22,458 | 10,212 | 10,000
Non-cash operating lease expense | 8,716 | 6,168 | 5,635
Amortization of convertible debt discount | 2,563 | 4,358 | 0
Amortization of debt issuance costs | 178 | 165 | 390
Loss on debt extinguishment | 0 | 1,400 | 1,018
Loss on termination of cash flow hedge | 0 | 3,506 | 0
Gain on investment in and loan receivable from non-consolidated affiliate, net | (109,260) | (3,955) | 0
Interest on loan receivable from non-consolidated affiliate | (391) | 0 | 0
Write off of COVID-19 PCR testing inventory and equipment | 6,061 | 0 | 0
Other non-cash items | 2,547 | 1,460 | 472
Changes in assets and liabilities, net: |  |  |
Accounts receivable, net | (4,691) | (12,601) | (17,301)
Inventories | 1,634 | (15,197) | (5,754)
Prepaid lease asset | (4,788) | (20,229) | 0
Prepaid and other assets | (1,906) | (9,750) | (367)
Accounts payable, operating lease liabilities, deferred taxes, accrued and other liabilities | 5,151 | (3,970) | (9,001)
Net cash (used in) provided by operating activities | (26,723) | 1,460 | 23,369
CASH FLOWS FROM INVESTING ACTIVITIES |  |  |
Purchases of marketable securities | (196,791) | (73,101) | 0
Proceeds from sales and maturities of marketable securities | 62,970 | 5,356 | 0
Purchases of property and equipment | (64,142) | (29,096) | (20,029)
Business acquisitions, net of cash acquired | (419,404) | (37,000) | 0
Investment in non-consolidated affiliate | 0 | (25,600) | 0
Loan receivable from non-consolidated affiliate | (15,000) | 0 | 0
Acquisition working capital adjustment | 0 | 0 | 399
Net cash used in investing activities | (632,367) | (159,441) | (19,630)
CASH FLOWS FROM FINANCING ACTIVITIES |  |  |
Repayment of revolving credit facility | 0 | 0 | (5,000)
Repayment of equipment financing obligations | (3,047) | (5,615) | (7,201)
Proceeds from term loan | 0 | 0 | 100,000
Repayment of term loan | 0 | (97,540) | (99,250)
Cash flow hedge termination | 0 | (3,317) | 0
Payments of debt issuance costs for term loan | 0 | 0 | (1,059)
Issuance of common stock, net | 15,080 | 20,310 | 11,202
Proceeds from issuance of convertible debt, net of issuance costs | 334,410 | 194,466 | 0
Premiums paid for capped call transactions | (29,291) | 0 | 0
Proceeds from equity offering, net of issuance costs | 408,133 | 127,293 | 160,774
Net cash provided by financing activities | 725,285 | 235,597 | 159,466
Net change in cash and cash equivalents | 66,195 | 77,616 | 163,205
Cash and cash equivalents, beginning of year | 250,632 | 173,016 | 9,811
Cash, cash equivalents and restricted cash, end of year | 316,827 | 250,632 | 173,016
Cash and cash equivalents | 316,827 | 228,713 | 173,016
Restricted cash | 0 | 21,919 | 0
Supplemental disclosure of cash flow information: |  |  |
Interest paid | 3,065 | 2,926 | 4,775
Income taxes paid, net | 148 | 246 | 319
Supplemental disclosure of non-cash investing and financing information: |  |  |
Fair value of common stock issued to fund acquisition | 29,174 | 0 | 0
Working capital adjustment related to acquisition | 0 | 0 | 1,977
Equipment acquired under financing obligations | 0 | 428 | 4,283
Property and equipment included in accounts payable | $ 1,315 | $ 2,007 | $ 1,034

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