v3.25.2
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2025
Jun. 30, 2024
Cash Flows from Operating Activities:    
Net income $ 90,873 $ 47,167
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization (inclusive of depreciation included in cost of service) 13,488 12,496
Non-cash compensation 14,749 16,184
Amortization and impairment of operating lease right of use assets 17,395 17,100
Gain on disposal of property and equipment (45) (19)
Gain on equity method investment (48,093) 0
Gain on termination of joint venture (3,568) 0
Deferred income taxes 16,395 6,577
Equity in earnings from equity method investments (3,435) (2,425)
Amortization of deferred debt issuance costs 442 495
Return on equity method investments 3,379 718
Impairment 883 0
Changes in operating assets and liabilities:    
Patient accounts receivable 554 (44,357)
Other current assets 3,576 3,127
Operating lease right of use assets (2,364) (2,069)
Other assets 48 370
Accounts payable (9,805) (1,693)
Accrued expenses (15,666) 7,095
Other long-term obligations (34) (573)
Operating lease liabilities (15,248) (14,429)
Net cash provided by operating activities 63,524 45,764
Cash Flows from Investing Activities:    
Proceeds from the sale of deferred compensation plan assets 27 21
Proceeds from the sale of property and equipment 19 0
Purchases of property and equipment (1,915) (4,055)
Investments in technology assets (426) (409)
Investment in equity method investee 0 (196)
Net cash used in investing activities (2,295) (4,639)
Cash Flows from Financing Activities:    
Proceeds from issuance of stock upon exercise of stock options 149 0
Shares withheld to pay taxes on non-cash compensation (6,005) (4,195)
Noncontrolling interest contributions 0 1,911
Noncontrolling interest distributions (1,260) (1,964)
Principal payments of long-term obligations (19,552) (18,382)
Debt Issuance Costs (499) 0
Net cash used in financing activities (27,167) (22,630)
Net increase in cash, cash equivalents and restricted cash 34,062 18,495
Cash, cash equivalents and restricted cash at beginning of period 303,242 138,863
Cash, cash equivalents and restricted cash at end of period 337,304 157,358
Supplemental Disclosures of Cash Flow Information:    
Cash paid for interest 12,359 15,507
Cash paid for income taxes, net of refunds received 25,330 18,393
Cash paid for operating lease liabilities 17,612 16,498
Cash paid for finance lease liabilities 8,302 7,111
Supplemental Disclosures of Non-Cash Activity:    
Right of use assets obtained in exchange for operating lease liabilities 20,381 10,947
Right of use assets obtained in exchange for finance lease liabilities 6,239 10,017
Reductions to right of use assets resulting from reductions to operating lease liabilities 75 168
Reductions to right of use assets resulting from reductions to finance lease liabilities $ 688 $ 1,119