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Variable Interest Entities (VIEs) - Eliminated Upon Consolidation Included In Accompanying Consolidated Balance Sheets (Details) - USD ($)
$ in Thousands
Dec. 31, 2022
Sep. 30, 2022
Jun. 30, 2022
Mar. 31, 2022
Dec. 31, 2021
Sep. 30, 2021
Jun. 30, 2021
Mar. 31, 2021
Dec. 31, 2020
Current assets                  
Cash and cash equivalents $ 288,027       $ 233,097       $ 193,470
Investment in marketable securities 5,567       53,417        
Receivables, net 49,631       10,608        
Receivables, net – related party 65,147       69,376        
Income taxes receivable (restated) 0       5,678   $ 1,426    
Other receivables 1,834       9,647        
Prepaid expenses and other current assets 14,798       18,637        
Loans receivable 996       0        
Loans receivable — related parties 2,125       4,000        
Total current assets 428,125 $ 445,785 $ 468,085 $ 445,423 404,460   471,976    
Non-current assets                  
Intangible assets, net 76,861       82,807        
Goodwill 269,053 250,860 246,688 245,757 246,416 $ 236,730 232,431 $ 232,431 232,430
Income taxes receivable, non-current 15,943 15,943 15,943 15,943 15,943 6,483 6,483 6,483  
Investments in other entities – equity method 40,299       41,715        
Operating lease right-of-use assets 20,444       15,441        
Other assets 6,056       5,928        
Total non-current assets 538,088 509,111 499,347 477,236 462,901 443,942 423,741 472,866  
Total assets 966,213 [1] 954,896 967,432 922,659 867,361 [1] 871,154 895,717 843,141  
Current liabilities                  
Accounts payable and accrued expenses 49,562       43,951        
Fiduciary accounts payable 8,065       10,534        
Medical liabilities 81,255       55,783       $ 50,330
Dividend payable 664       556        
Finance lease liabilities 594       486        
Operating lease liabilities 3,572       2,629        
Operating lease liabilities 619       780        
Total current liabilities 148,610     155,542 114,719 115,173 125,873 122,553  
Non-current liabilities                  
Deferred tax liability 14,217 24,985 30,920 30,888 30,135 27,833 31,695 17,383  
Finance lease liabilities, net of current portion 1,275       973        
Operating lease liabilities, net of current portion 19,915       13,198        
Long-term debt, net of current portion 203,389       182,917        
Other long-term liabilities 20,260       14,777        
Total non-current liabilities 259,056 254,173 261,647 241,425 242,000 230,955 230,357 259,744  
Total liabilities 407,666 [1] $ 410,364 $ 446,885 $ 396,967 356,719 [1] $ 346,128 $ 356,230 $ 382,297  
Variable Interest Entity, Primary Beneficiary                  
Current assets                  
Cash and cash equivalents 97,669       161,762        
Investment in marketable securities 4,543       49,066        
Receivables, net 11,503       7,251        
Receivables, net – related party 62,190       62,180        
Income taxes receivable (restated) 8,580       5,855        
Other receivables 1,236       1,833        
Prepaid expenses and other current assets 9,289       11,734        
Loans receivable 22       0        
Loans receivable — related parties 2,125       4,000        
Amounts due from affiliates 30,340       6,598        
Total current assets 227,497       310,279        
Non-current assets                  
Land, property and equipment, net 106,486       49,547        
Intangible assets, net 53,964       58,282        
Goodwill 111,539       103,034        
Income taxes receivable, non-current 15,943       15,943        
Loans receivable – related parties 0       89        
Investments in other entities – equity method 27,561       41,715        
Investment in a privately held entity 405       405        
Investment in affiliates 304,755       802,821        
Operating lease right-of-use assets 6,503       4,953        
Other assets 4,169       3,219        
Total non-current assets 631,325       1,080,008        
Total assets 858,822       1,390,287        
Current liabilities                  
Accounts payable and accrued expenses 23,632       11,591        
Fiduciary accounts payable 7,853       10,534        
Medical liabilities 48,100       44,000        
Dividend payable 638       556        
Finance lease liabilities 594       110        
Operating lease liabilities 1,800       1,250        
Operating lease liabilities 619       780        
Total current liabilities 83,236       68,821        
Non-current liabilities                  
Deferred tax liability 4,591       5,144        
Finance lease liabilities, net of current portion 1,275       193        
Operating lease liabilities, net of current portion 7,484       3,950        
Long-term debt, net of current portion 26,645       7,114        
Other long-term liabilities 8,542       9,614        
Total non-current liabilities 48,537       26,015        
Total liabilities $ 131,773       $ 94,836        
[1] The Company’s consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The consolidated balance sheets include total assets that can be used only to settle obligations of the Company’s consolidated VIEs totaling $523.7 million and $580.9 million as of December 31, 2022 and December 31, 2021, respectively, and total liabilities of the Company’s consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $131.8 million and $94.8 million as of December 31, 2022 and December 31, 2021, respectively. These VIE balances do not include $304.8 million of investment in affiliates and $30.3 million of amounts due from affiliates as of December 31, 2022 and $802.8 million of investment in affiliates and $6.6 million of amounts due from affiliates as of December 31, 2021 as these are eliminated upon consolidation and not presented within the consolidated balance sheets. See Note 19 – “Variable Interest Entities (VIEs)” for further detail.