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Interim Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
3 Months Ended
Mar. 31, 2020
Mar. 31, 2019
Cash Flows From Operating Activities:    
Net income/(loss) $ (26,816,000) $ 21,231,000
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 10,438,000 10,517,000
Equity in earnings of unconsolidated investments (2,811,000) (2,321,000)
Distributions from unconsolidated investments 2,349,000 31,000
Unrealized (gains)/losses on marketable equity securities 60,392,000 (6,838,000)
Gains on sale of restricted marketable debt securities (2,000) 0
Gain on acquisition of equity method investment (1,707,000) 0
Deferred income taxes 15,008,000 (1,603,000)
Stock–based compensation 466,000 424,000
Changes in operating assets and liabilities:    
Accounts receivable (6,212,000) (3,345,000)
Income tax receivable 2,560,000 0
Inventories (372,000) 517,000
Prepaid expenses and other assets (1,515,000) (1,008,000)
Trade accounts payable (1,408,000) (441,000)
Accrued payroll (21,343,000) (21,730,000)
Amounts due to third party payors 353,000 185,000
Accrued risk reserves 4,623,000 2,498,000
Other current liabilities 3,365,000 8,158,000
Other noncurrent liabilities (1,468,000) 102,000
Deferred revenue 1,870,000 2,018,000
Net cash provided by operating activities 7,754,000 11,601,000
Cash Flows From Investing Activities:    
Additions to property and equipment (6,628,000) (5,874,000)
Acquisition of equity method investment, net of cash acquired (6,648,000) 0
Investments in notes receivable (250,000) (312,000)
Investments in unconsolidated companies (125,000) (125,000)
Collections of notes receivable 376,000 353,000
Purchase of restricted marketable debt securities (6,360,000) (3,565,000)
Sale of restricted marketable debt securities 3,410,000 6,576,000
Net cash used in investing activities (16,225,000) (2,947,000)
Cash Flows From Financing Activities:    
Borrowings under credit facility 40,000,000 0
Principal payments under finance lease obligations (1,019,000) (959,000)
Dividends paid to common stockholders (7,968,000) (7,623,000)
Issuance of common shares 400,000 579,000
Repurchase of common shares (53,000) (872,000)
Equity contributed by noncontrolling entities 281,000 0
Net cash provided by (used in) financing activities 31,641,000 (8,875,000)
Net Increase (Decrease) in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents 23,170,000 (221,000)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period 61,010,000 54,920,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period 84,180,000 54,699,000
Balance Sheet Classifications:    
Cash and cash equivalents 69,492,000 38,194,000
Restricted Cash and Cash Equivalents 14,688,000 16,505,000
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents $ 84,180,000 $ 54,699,000