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Interim Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
9 Months Ended
Sep. 30, 2022
Sep. 30, 2021
Cash Flows From Operating Activities:    
Net income $ 14,403,000 $ 123,092,000
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 30,011,000 30,521,000
Equity in earnings of unconsolidated investments (498,000) (5,320,000)
Distributions from unconsolidated investments 439,000 6,314,000
Unrealized losses on marketable equity securities 11,479,000 23,227,000
(Gains)/losses on sale of marketable securities 756,000 (941,000)
Gain on acquisition of equity method investment 0 (95,202,000)
Recovery of notes receivable (3,728,000) 0
Deferred income taxes (4,977,000) 5,428,000
Stock–based compensation 1,980,000 1,905,000
Changes in operating assets and liabilities:    
Accounts receivable (2,879,000) 1,195,000
Inventories 1,284,000 85,000
Prepaid expenses and other assets (11,484,000) (1,685,000)
Trade accounts payable (3,045,000) 8,329,000
Accrued payroll (29,356,000) (3,480,000)
Amounts due to third party payors (2,099,000) 100,000
Accrued risk reserves 5,662,000 4,287,000
Provider relief funds (8,927,000) (16,068,000)
Contract liabilities (14,884,000) (24,240,000)
Other current liabilities 4,014,000 2,110,000
Other noncurrent liabilities (1,297,000) (1,930,000)
Net cash provided by/(used in) operating activities (3,192,000) 46,871,000
Cash Flows From Investing Activities:    
Purchases of property and equipment (24,563,000) (25,774,000)
Acquisition of equity method investment, net of cash acquired 0 (28,713,000)
Investments in unconsolidated companies and notes receivable (2,000,000) (350,000)
Proceeds from the sale of property and equipment 4,175,000 0
Collections of notes receivable 4,181,000 8,620,000
Purchases of marketable securities (28,717,000) (95,749,000)
Proceeds from sale of marketable securities 38,114,000 89,129,000
Net cash used in investing activities (8,810,000) (52,837,000)
Cash Flows From Financing Activities:    
Principal payments under finance lease obligations (3,495,000) (3,292,000)
Dividends paid to common stockholders (25,830,000) (24,010,000)
Noncontrolling interest contributions 250,000 0
Issuance of common shares 1,281,000 2,405,000
Repurchase of common shares (6,907,000) (278,000)
Entrance fee refunds (840,000) (594,000)
Net cash used in financing activities (35,541,000) (25,769,000)
Net Decrease in Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents (47,543,000) (31,735,000)
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Beginning of Period 119,743,000 158,502,000
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, End of Period 72,200,000 126,767,000
Balance Sheet Classifications:    
Cash and cash equivalents 44,515,000 112,462,000
Restricted Cash and Cash Equivalents 27,685,000 14,305,000
Total Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents $ 72,200,000 $ 126,767,000