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CONSOLIDATED STATEMENTS OF CASH FLOWS ¥ in Thousands, $ in Thousands, $ in Thousands | 12 Months Ended
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Dec. 31, 2024 CNY (¥) | Dec. 31, 2024 USD ($) | Dec. 31, 2023 CNY (¥) | Dec. 31, 2022 CNY (¥)
CASH FLOWS FROM OPERATING ACTIVITIES |  |  |  |
Net loss | ¥ (652,075) | $ (89,333) | ¥ (531,021) | ¥ (768,990)
Adjustments to reconcile net loss to net cash generated from operating activities: |  |  |  |
Share-based compensation (note 24) |  |  | 0 | (5,919)
Depreciation of property, plant and equipment (note 10) | 84,775 | 11,614 | 82,124 | 88,692
Amortization of intangible assets (note 13) | 36,355 | 4,981 | 36,705 | 34,495
Amortization of land lease payments (note 11) | 9,627 | 1,319 | 9,625 | 9,627
Lease expense to reduce operating lease ROU | 22,578 | 3,093 | 26,683 | 19,322
Income from equity method investments | (12,696) | (1,739) | (20,789) | (17,647)
Change in fair value of derivative liability (note 22) | (166) | (23) | (5,207) | (1,015)
Changes in fair value of short-term investments | (7,290) | (999) | 0 | 0
(Gain) loss on disposal of long-lived assets | 13,110 | 1,796 | (62) | 3
Deferred tax expense (benefit) | (15,652) | (2,144) | (13,039) | (71,848)
Allowance for doubtful accounts, net | 128,196 | 17,563 | 64,712 | 5,400
Interest and consultation expenses | 193,199 | 26,468 | 165,669 | 120,357
(Gain) Loss on disposal of subsidiaries (note 4) | (48,497) | (6,644) | 638 | 61,546
Gain on sale of partial interests in an equity method investment | 120 | 16 | (37,498) | 0
Loss from agreements termination with a cooperative hospital |  |  | 0 | 204,250
Changes in operating assets and liabilities net of effects of acquisition and disposals: |  |  |  |
Accounts receivable | 12,018 | 1,646 | 36,454 | 644
Prepayments and other current assets | (335,657) | (45,986) | (149,738) | (130,156)
Inventories | 6,498 | 890 | 44,489 | (46,750)
Other non-current assets | (458) | (63) | 1,618 | (15)
Accounts payable | 93,052 | 12,748 | 15,779 | 113,743
Accrued expenses and other liabilities | 97,497 | 13,357 | 70,838 | 119,055
Deferred revenue | (3,089) | (423) | (41,179) | 57,168
Income tax payable | 101 | 14 | 705 | 818
Accrued unrecognized tax benefit | 35 | 5 | (15,830) | (6,539)
Operating lease liabilities | (19,330) | (2,647) | (18,147) | (2,935)
Net cash used in operating activities | (397,749) | (54,491) | (276,471) | (216,694)
CASH FLOWS FROM INVESTING ACTIVITIES |  |  |  |
Purchase of land use right |  |  | 0 | (215)
Investment in equity method investees |  |  | 0 | (2,300)
Investment in equity investments without readily determinable fair value |  |  | (100) | 0
Acquisitions of business, net of cash acquired |  |  | 0 | 0
Acquisitions of property, plant and equipment | (150,772) | (20,656) | (113,003) | (222,980)
Acquisitions of intangible assets | (10,160) | (1,392) | (4,211) | (818)
Deposits for the purchases of property, plant and equipment | (249,902) | (34,235) | (2,699) | (160,793)
Proceeds from disposal of property, plant and equipment |  |  | 310 | 5,635
Proceed from agreements termination with a cooperative hospital |  |  | 0 | 238,093
Proceeds from principal portion of direct financing leases |  |  | 0 | 7,536
Proceeds from disposal of subsidiaries | 9,057 | 1,241 | 0 | 0
Cash distribution from equity method investments | 10,000 | 1,370 | 12,022 | 5,101
Proceeds from disposal of certain percentage of an equity method investment |  |  | 60,000 | 0
Investment in a joint venture | (102,000) | (13,974) | 0 | 0
Proceeds from disposal of other investment | 27,664 | 3,790 | 0 | 0
Purchase of short - term investment | (204,607) | (28,031) | 0 | 0
Proceeds from disposal of short - term investment | 77,276 | 10,587 | 0 | 0
Redemption of available-for-sale debt securities |  |  | 0 | 11,949
Net cash used in investing activities | (593,444) | (81,300) | (47,681) | (118,792)
CASH FLOWS FROM FINANCING ACTIVITIES |  |  |  |
Proceeds from short-term bank borrowings | 504,699 | 69,143 | 337,695 | 217,470
Proceeds from long-term bank and other borrowings | 1,917,174 | 262,652 | 110,000 | 422,765
Borrowings from related parties (note 26) | 300,543 | 41,174 | 22,150 | 220,369
Repayment to related parties (note 26) | (335,359) | (45,944) | (61,777) | (82,915)
Repayment of short-term bank and other borrowings | (360,329) | (49,365) | (442,858) | (197,598)
Repayment of long-term bank and other borrowings | (1,391,219) | (190,596) | (7,561) | (197,003)
Purchase of subsidiary shares from noncontrolling interests |  |  | 0 | 0
Capital injection from a noncontrolling interests in a subsidiary |  | 0 | 300,004 | 0
Proceeds from initial public offering of Concord Healthcare Group Co., Ltd. | 510,522 | 69,941 |  | 0
Net cash generated from financing activities | 1,146,031 | 157,005 | 257,653 | 383,088
Effect of foreign exchange rate changes on cash and cash equivalent and restricted cash | (8,275) | (1,134) | (2,425) | (47,170)
Net increase (decrease) in cash | 146,563 | 20,080 | (68,924) | 432
Cash and cash equivalents and restricted cash at beginning of the year | 90,419 | 12,387 | 159,343 | 158,911
Cash and cash equivalents and restricted cash at end of the year | 236,982 | 32,467 | 90,419 | 159,343
Reconciliation of cash and cash equivalents and restricted cash to the consolidated balance sheets: |  |  |  |
Cash and cash equivalents | 216,224 | 29,623 | 58,139 | 158,283
Restricted cash, current portion | 20,758 | 2,844 | 32,280 | 1,060
Restricted cash, noncurrent portion |  |  |  | 0
Total cash and cash equivalents and restricted cash | 236,982 |  | 90,419 | 159,343
Supplemental schedule of major cash flows information: |  |  |  |
Income tax paid | (148) | (20) | (898) | (3,013)
Interest paid | (188,304) | (25,798) | (152,359) | (145,257)
Supplemental schedule of major non-cash activities: |  |  |  |
Acquisition of property, plant and equipment, construction in progress and other intangible assets through utilization of deposits | 79,644 | 10,911 | 5,812 | 257,440
Offset of Loan from a related party and Loan to a related party | ¥ 34,307 | $ 4,700 |  | 0
Acquisition of property, plant and equipment, construction in progress and other intangible assets included in accrued expense and other liabilities |  |  | ¥ 285,358 | ¥ 2,181

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