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CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Cash flows from operating activities:    
Income from continuing operations $ 36,271 $ 69,375
Income from discontinued operations, net of tax   901
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 22,366 3,461
Amortization and write-off of deferred loan costs 3,256 1,101
Amortization of debt discount 2,593 4,140
Share-based employee compensation expense 15,266 4,913
Gain on sale of TPHS business   (1,304)
Deferred income taxes 10,489 23,812
Increase in accounts receivable, net (1,407) (12,181)
Decrease in inventory 14,775  
Decrease in other current assets 3,608 1,544
Decrease in accounts payable (9,917) (1,285)
Decrease in accrued salaries and benefits (592) (10,626)
Decrease in other current liabilities (14,138) (11,235)
Increase in deferred revenue 345  
Other 1,908 1,912
Net cash flows provided by operating activities 84,823 74,528
Cash flows from investing activities:    
Acquisition of property and equipment (15,354) (6,456)
Proceeds from sale of MeYou Health   1,416
Business acquisitions, net of cash acquired (1,062,818)  
Net cash flows used in investing activities (1,078,172) (5,040)
Cash flows from financing activities:    
Proceeds from issuance of long-term debt 1,505,245 173,350
Payments of long-term debt (478,479) (271,923)
Proceeds from settlement of cash convertible notes hedges   141,246
Payments related to settlement of cash conversion derivative   (141,246)
Payments related to tax withholding for share-based compensation (1,464) (2,083)
Exercise of stock options 701 1,521
Deferred loan costs (30,189)  
Change in cash overdraft and other 2,471 2,887
Net cash flows provided by (used in) financing activities 998,285 (96,248)
Effect of exchange rate changes on cash (12) (37)
Net increase in cash and cash equivalents 4,924 (26,797)
Cash and cash equivalents, beginning of period 1,933 28,440
Cash and cash equivalents, end of period $ 6,857 $ 1,643