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Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash flows from operating activities    
Net loss $ (29,363) $ (40,797)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities    
Depreciation and amortization 7,459 6,368
Amortization of debt issuance costs 609 570
Amortization of postcombination compensation 875 0
Provision for income taxes 2,894 0
Equity in (gain) loss of affiliate (153) 251
Amortization of operating right-of-use assets [1] 6,390 6,194
Changes in fair value adjustments of warrants and derivative liabilities (1,634) 9,334
Equity-based compensation and NCI rebalancing 12,913 4,875
Loss (gain) on sale and abandonment of property and equipment 2,135 (2)
Bargain purchase gain on acquisition of physician practice (1,040) 0
Deferred taxes (324) 75
Changes in operating assets and liabilities, net of business combinations:    
Patient accounts receivable, net 1,140 (4,941)
Inventories [2] (2,225) (1,367)
Prepaid expenses and other current assets (4,851) (775)
Other receivables (25,700) (8,546)
Other assets (5,847) (2,107)
Accounts payable [3] 26,395 13,889
Accrued compensation related costs 6,130 8,744
Accrued other (4,751) 6,290
Operating lease liabilities [4] (4,241) (5,625)
Other long-term liabilities (3,680) 1,410
Net cash provided by (used in) operating activities (16,869) (6,160)
Cash flows from investing activities    
Purchases of property and equipment and intangible assets (14,628) (9,527)
Proceeds from disposals of property and equipment 141 5
Acquisition of physician practices, net of cash acquired (6,712) 0
Purchases of marketable securities (18,850) (20,824)
Proceeds from sales of marketable securities 54,736 4,933
Issuance of notes receivable - related parties (560) 0
Collections on notes receivable - related parties 682 740
Net cash provided by (used) in investing activities 14,809 (24,673)
Cash flows from financing activities    
Issuance of redeemable convertible Class C Units 0 64,996
Class A and A-1 preferred returns 0 (9,481)
Repayments on long-term debt (2,520) 0
Contribution from noncontrolling interest 0 134
Repurchases of Class A Common Stock (368) 0
Payment of tax withholding obligation on net RSU settlement (3,258) 0
Repayments on finance lease liabilities (901) (387)
Cash paid for debt financing costs 0 (446)
Cash paid for offering costs on Class C issuance 0 (750)
Proceeds from reverse recapitalization 0 1,494
Net cash (used in) provided by financing activities (7,047) 55,560
Net increase in cash and cash equivalents (9,107) 24,727
Beginning of period 28,539 26,926
End of period 19,432 51,653
Supplemental noncash investing and financing activities    
Right-of-use assets and lease liabilities removed in termination of lease 0 1,254
Promissory note issued in connection with acquisition of physician practices (6,550) 0
Promissory note issued in connection with asset acquisition (1,569) 0
Changes in accounts payable for capital additions to property and equipment 361 0
Noncash consideration paid by assumption of note for purchase of physician practice   0
Contribution from noncontrolling interest (380) 0
Unpaid offering costs relating to the reverse recapitalization 0 2,745
Deemed dividend for Series A Preferred Stock extinguishment $ 0 $ 2,089
[1] Includes related party amortization of operating right-of-use assets of $1,505 and $1,601 for the nine months ended September 30, 2024 and 2023, respectively.
[2] Includes changes in related party balances of ($4,462) and $(1,299) for the nine months ended September 30, 2024 and 2023, respectively.
[3] Includes changes in related party balances of $22,801 and $10,627 for the nine months ended September 30, 2024 and 2023, respectively.
[4] Includes changes in related party balances of ($1,766) and ($1,835) for the nine months ended September 30, 2024 and 2023, respectively.