v3.26.1
UNAUDITED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended 12 Months Ended
Jun. 30, 2026
Jun. 30, 2025
Jun. 30, 2026
Jun. 30, 2025
Dec. 31, 2025
OPERATING ACTIVITIES          
Net income including non-controlling interest $ 14,898 $ 17,720 $ 23,054 $ 31,188  
Adjustments to reconcile net income including non-controlling interest to net cash provided by operating activities:          
Depreciation and amortization     11,935 11,924  
Provision for credit losses 2,120 1,995 4,124 3,843  
Equity-based awards compensation expense     5,479 3,888  
Amortization of debt issuance costs     212 210  
Change in deferred income taxes     5,232 7,279  
Change in revaluation of put-right liability 168 339 (195) 743  
Change in fair value of contingent earn-out consideration 992 (790) 2,989 (5,612)  
Equity of earnings in unconsolidated affiliate (408) (401) (772) (794)  
Loss on sale of clinics and fixed assets     302 438  
Loss on sale of a partnership 0 0 0 123  
Loss on extinguishment of debt 124 0 124 0  
Changes in operating assets and liabilities:          
Patient accounts receivable, net     (9,047) (10,232)  
Accounts receivable - other     (2,962) 355  
Other current and long term assets     74 (4,426)  
Accounts payable and accrued expenses     (1,410) (7,914)  
Other long-term liabilities     (961) (827)  
Net cash provided by operating activities     38,178 30,186  
INVESTING ACTIVITIES          
Purchase of fixed assets     (10,737) (5,830)  
Purchase of majority interest in businesses, net of cash acquired     (21,133) (6,890)  
Purchase of redeemable non-controlling interest, temporary equity     (6,531) (8,427)  
Purchase of non controlling interest, permanent equity     (8,973) (149)  
Proceeds on sale of non-controlling interest, permanent equity     50 9  
Repayment of notes receivable related to sales of redeemable non-controlling interest     396 346  
Proceeds on sale of partnership interest - redeemable non-controlling interest, temporary equity     221 15  
Distributions from unconsolidated affiliate     335 664  
Proceeds on sale of partnership interest, clinics and fixed assets     0 700  
Other     165 228  
Net cash (used in) investing activities     (46,207) (19,334)  
FINANCING ACTIVITIES          
Payment of debt issuance costs     (2,214) 0  
Proceeds from revolving facility     153,262 73,500  
Payments on revolving facility     (137,762) (60,000)  
Distributions to non-controlling interest, permanent and temporary equity     (12,326) (10,697)  
Cash dividends paid to shareholders     (13,871) (13,678)  
Proceeds from term loan     45,625 0  
Payments on term loan     (1,875) (5,625)  
Principal payments on notes payable     (617) (1,628)  
Payment for taxes related to net settlement of equity awards     (51) 0  
Repurchases of common stock     (19,233) 0  
Payment of contingent consideration     (13,592) 0  
Net cash (used in) financing activities     (2,654) (18,128)  
Net (decrease) in cash and cash equivalents     (10,683) (7,276)  
Cash and cash equivalents - beginning of period     35,570 41,362 $ 41,362
Cash and cash equivalents - end of period $ 24,887 $ 34,086 24,887 34,086 $ 35,570
Cash paid during the period for:          
Income taxes     4,769 9,833  
Interest paid     6,589 4,683  
Non-cash investing and financing transactions during the period:          
Purchase of businesses - seller financing portion     500 0  
Fair market value of initial contingent consideration related to purchase of businesses     0 3,059  
Notes payable related to purchase of redeemable non-controlling interest, temporary equity     78 89  
Notes receivable related to sale of redeemable non-controlling interest, temporary equity     3,649 660  
Notes receivable related to the sale of non-controlling interest, permanent equity     527 29  
Offset to notes receivable associated with purchase of redeemable non-controlling interest     $ 72 $ 254