| Dec'19 | Dec'18 | Dec'17 | Mar'17 | Dec'16 | Mar'16 | Mar'15 | Jan'14 | Jan'13 | Jan'12 |
|---|---|---|---|---|---|---|---|---|---|
Cash flows from operating activities | |||||||||
Net income | |||||||||
17,673 | 60,267 | 45,824 | -8,681 | 10,019 | -8,173 | -1,347 | -4,558 | -8,904 | -720 |
Adjustments to reconcile net income to net cash provided by operating activities: | |||||||||
Depreciation and amortization | |||||||||
18,753 | 19,303 | 19,075 | 645 | 18,114 | 351 | 334 | 31 | 20 | 12 |
Loss on disposal of property and equipment | |||||||||
0 | -41 | 0 | -6 | - | -476 | - | - | - | - |
Impairment of goodwill and intangible assets | |||||||||
1,994 | 3,798 | 2,431 | 68 | 324 | 207 | 0 | - | - | - |
Provision for doubtful accounts | |||||||||
-1,363 | 3,887 | 0 | 385 | - | 435 | 64 | 0 | 74 | 118 |
Share-based compensation | |||||||||
1,546 | 1,441 | 2,743 | 1,106 | 1,954 | 1,103 | 1,258 | 2,157 | 2,061 | - |
Gain on loan assumption | |||||||||
2,250 | 0 | 0 | - | - | - | - | - | - | - |
Unrealized (gain) loss from investment in equity securities | |||||||||
9 | -25 | 86 | - | 0 | - | - | - | - | - |
Gain on deconsolidation of variable interest entity | |||||||||
- | - | - | 242 | - | 0 | - | - | - | - |
Loss on debt extinguishment | |||||||||
- | - | - | 0 | - | -266 | 0 | 24 | 0 | - |
Issuance of shares for services | |||||||||
- | - | - | - | - | - | - | - | - | 152 |
Non-cash stock option expense | |||||||||
- | - | - | - | - | - | - | - | - | 29 |
Amortization of deferred financing costs | |||||||||
- | - | - | 44 | - | 94 | 121 | 255 | 89 | 37 |
Write-off of capitalized offering costs | |||||||||
- | - | - | 0 | - | 513 | 0 | - | - | - |
Amortization adjustment to debt discount | |||||||||
- | - | - | 0 | - | -29 | 400 | 136 | 670 | 0 |
Gain on settlement of preexisting note receivable from ApolloMed | |||||||||
0 | 0 | 921 | - | 0 | - | - | - | - | - |
Gain (Loss) on Investments | |||||||||
0 | 0 | 13,697 | - | 0 | - | - | - | - | - |
Change in fair value of derivative instrument | |||||||||
0 | 0 | -44 | 1,633 | 1,722 | -408 | 833 | 0 | - | - |
Income (Loss) from Equity Method Investments | |||||||||
-6,900 | -8,125 | -1,112 | - | 4,748 | - | - | - | - | - |
Deferred tax | |||||||||
-6,800 | -8,345 | -20,675 | 40 | -3,009 | -127 | -51 | 0 | - | - |
Gain on sale of marketable securities | |||||||||
- | - | - | - | - | - | 49 | 0 | - | - |
Loss on disposal of assets | |||||||||
- | - | - | - | - | - | 0 | - | - | - |
Loss on change in fair value of warrant and derivative liabilities | |||||||||
- | - | - | - | - | - | - | - | 5,853 | 120 |
Impairment loss | |||||||||
- | - | - | - | - | - | - | - | - | 210 |
Changes in operating assets and liabilities, net of acquisition amounts: | |||||||||
Receivable, net | |||||||||
-10,713 | 263 | -4,108 | 2,780 | -8,703 | 27 | 912 | -72 | 548 | -407 |
Receivable, net – related parties | |||||||||
1,435 | 28,363 | -6,593 | - | - | - | - | - | - | - |
Other receivable | |||||||||
15,079 | 0 | 0 | -113 | - | -283 | 188 | 0 | - | - |
Due to officers | |||||||||
- | - | - | - | - | - | - | - | -12 | 14 |
Due from affiliates | |||||||||
- | - | - | -2 | - | -15 | -55 | -4 | -5 | -1 |
Prepaid expenses and other current assets | |||||||||
2,755 | 2,813 | -1,260 | 10 | 172 | 92 | 118 | -19 | 23 | -22 |
Right-of-use assets | |||||||||
2,479 | - | - | - | - | - | - | - | - | - |
Deferred financing costs | |||||||||
- | - | - | 0 | - | 43 | 0 | - | - | - |
Other assets | |||||||||
572 | -2 | 220 | 8 | 63 | -3 | 106 | 27 | -7 | 0 |
Accounts payable and accrued expenses | |||||||||
-4,883 | -22,669 | -3,687 | 3,653 | 1,927 | 1,024 | 851 | 455 | 764 | 70 |
Fiduciary accounts payable | |||||||||
488 | 0 | 0 | - | - | - | - | - | - | - |
Deferred rent liability | |||||||||
- | - | - | 53 | - | 57 | 0 | - | - | - |
Capitation incentives payable | |||||||||
0 | -21,500 | 1,878 | - | 5,182 | - | - | - | - | - |
Medical liabilities | |||||||||
-2,391 | 4,134 | 5,661 | -902 | 2,945 | 1,410 | 249 | 0 | - | - |
Income taxes payable | |||||||||
-7,092 | 8,423 | 388 | - | -17,540 | - | - | - | - | - |
Operating lease liabilities | |||||||||
-2,243 | - | - | - | - | - | - | - | - | - |
Proceeds from sale of ACC assets | |||||||||
- | - | - | 0 | - | 15 | 0 | - | - | - |
Decrease in cash and cash equivalents resulting from deconsolidation of variable interest entities | |||||||||
- | - | - | 858 | - | 0 | - | - | - | - |
Increase in cash on consolidation of variable interest entity | |||||||||
- | - | - | - | - | - | 271 | 0 | - | - |
Proceeds from sale of marketable securities | |||||||||
- | - | - | - | - | - | 438 | 0 | - | - |
Net cash provided by operating activities | |||||||||
13,673 | 25,496 | 51,833 | -8,139 | 21,913 | -1,839 | - | - | 57 | -385 |
Net cash provided by (used in) operating activities | |||||||||
- | - | - | - | - | - | -271 | -1,478 | - | - |
Cash flows from investing activities | |||||||||
Cash acquired from Merger | |||||||||
0 | 0 | 37,112 | - | 0 | - | - | - | - | - |
Cash received from consolidation of VIE | |||||||||
0 | 0 | -228 | - | 0 | - | - | - | - | - |
Purchases of marketable securities | |||||||||
115,402 | 9 | 5 | - | 10 | - | - | - | - | - |
Proceeds from loan receivable | |||||||||
0 | 0 | 200 | - | 0 | - | - | - | - | - |
Advances on loans receivable | |||||||||
- | - | - | - | 0 | - | - | - | - | - |
Advances on loans receivable | |||||||||
11,425 | 7,500 | 10,000 | - | 200 | - | - | - | - | - |
Proceeds from Equity Method Investment, Distribution, Return of Capital | |||||||||
240 | 607 | 1,240 | - | 2,000 | - | - | - | - | - |
Proceeds on sale of investments in a privately held entity | |||||||||
0 | 0 | 25 | - | - | - | - | - | - | - |
Change in restricted cash | |||||||||
- | - | - | 235 | 0 | 0 | - | - | - | - |
Payments to Acquire Businesses, Net of Cash Acquired | |||||||||
49,402 | 0 | 0 | - | - | - | 3,356 | 250 | -14 | -164 |
Purchases of investments in privately held entities | |||||||||
491 | 405 | 0 | - | - | - | - | - | - | - |
Proceeds on sale of investments - cost method | |||||||||
- | - | - | - | 0 | - | - | - | - | - |
Purchases of investments - cost method | |||||||||
- | - | - | - | 5,000 | - | - | - | - | - |
Payments to Acquire Equity Method Investments | |||||||||
3,108 | 16,706 | 0 | - | 2,440 | - | - | - | - | - |
Purchases of property and equipment | |||||||||
1,041 | 1,170 | 2,084 | 297 | 3,306 | 262 | 44 | 22 | 45 | 7 |
Net cash (used in) provided by investing activities | |||||||||
-180,630 | -25,182 | 26,716 | -1,391 | -8,956 | -247 | - | - | -31 | 157 |
Net cash used in investing activities | |||||||||
- | - | - | - | - | - | -3,200 | -272 | - | - |
Cash flows from financing activities | |||||||||
Repayment of bank loan and lines of credit | |||||||||
- | - | - | - | 600 | - | - | - | - | - |
Dividends paid | |||||||||
61,717 | 17,758 | 10,447 | - | 26,659 | - | - | - | - | - |
Proceeds from notes and line of credit payable | |||||||||
- | - | - | - | - | - | - | - | 594 | - |
Principal payments on lines of credit | |||||||||
- | - | - | 150 | - | 1,006 | 0 | 0 | 0 | - |
Contributions by noncontrolling interest | |||||||||
- | - | - | - | - | - | 725 | - | - | - |
Change in noncontrolling interest capital | |||||||||
27 | 27 | 0 | - | 1,124 | - | - | 0 | - | - |
Borrowings on long-term debt | |||||||||
250,000 | 8,000 | 5,000 | - | - | - | - | - | - | - |
Borrowings on line of credit | |||||||||
39,600 | 0 | 0 | 112 | 0 | 0 | 1,000 | 2,811 | - | - |
Proceeds from notes payable | |||||||||
- | - | - | 400 | - | 100 | 0 | - | - | 150 |
Principal payments on notes payable | |||||||||
- | - | - | 400 | - | 6,527 | 936 | 530 | - | - |
Advances by NMM to ApolloMed prior to the Merger | |||||||||
0 | 0 | -9,000 | - | 0 | - | - | - | - | - |
Repayments on long-term debt | |||||||||
2,375 | 0 | 0 | - | - | - | - | - | - | - |
Repayments on bank loan, and lines of credit | |||||||||
52,640 | 495 | 0 | - | - | - | - | - | - | - |
Principal payments on bank loan | |||||||||
- | - | - | - | 1,477 | - | - | - | - | - |
Payment of capital lease obligations | |||||||||
101 | 98 | 102 | - | 181 | - | - | - | - | - |
Payment of medical clinic acquisition notes payable | |||||||||
- | - | - | - | - | - | - | 0 | - | - |
Repayments on convertible notes | |||||||||
- | - | - | 0 | - | 470 | 0 | 707 | - | - |
Proceeds from exercise of stock options included in liabilities | |||||||||
0 | 0 | 425 | - | 0 | - | - | - | - | - |
Proceeds from the exercise of stock options and warrants | |||||||||
- | - | - | - | 260 | - | - | - | 15 | 0 |
Payment to noncontrolling interest for equity interest | |||||||||
- | - | - | 0 | - | -251 | -0 | - | - | - |
Proceeds from exercise of stock options and warrants | |||||||||
3,123 | 3,996 | 164 | - | - | - | - | - | - | - |
Increase in restricted cash | |||||||||
- | - | - | - | 0 | - | 510 | 0 | - | - |
Proceeds from issuance of convertible note payable | |||||||||
- | - | - | 4,990 | - | 0 | 2,000 | 220 | - | - |
Borrowings on line of credit and long-term debt | |||||||||
- | - | - | 5,000 | - | 0 | - | - | - | - |
Proceeds from issuance of common stock | |||||||||
- | - | - | - | - | - | - | - | 0 | - |
Proceeds from issuance of convertible notes payable | |||||||||
- | - | - | - | - | - | - | - | 880 | 0 |
Cash payments in connection with convertible note redemption | |||||||||
- | - | - | - | - | - | - | - | 0 | - |
Debt issuance costs | |||||||||
- | - | - | - | - | - | 533 | 258 | 104 | 0 |
Proceeds from common stock offering | |||||||||
754 | 200 | 2,160 | 0 | 10,903 | 200 | 0 | 730 | - | - |
Distributions to non-controlling interest shareholder | |||||||||
- | - | - | 1,200 | - | 702 | 600 | 240 | 400 | 154 |
Proceeds from exercise of warrants and vested restricted stock | |||||||||
- | - | - | 172 | - | 0 | - | - | - | - |
Repurchase of common shares | |||||||||
7,569 | 5,047 | 3,175 | - | 517 | - | - | 0 | - | - |
Cost of debt and equity issuances | |||||||||
5,771 | 0 | 0 | - | - | - | - | - | - | - |
Net cash used in financing activities | |||||||||
- | - | - | - | - | - | 1,655 | 2,025 | - | - |
Net cash used in financing activities | |||||||||
163,330 | -11,176 | -14,975 | 8,924 | -17,147 | 6,342 | - | - | 986 | -4 |
Net (decrease) increase in cash, cash equivalents and restricted cash | |||||||||
-3,626 | -10,863 | 63,574 | - | - | - | - | - | - | - |
Supplemental disclosures of cash flow information | |||||||||
Interest paid | |||||||||
- | - | - | - | - | - | 768 | 247 | 160 | 129 |
Cash paid for income taxes | |||||||||
20,200 | 23,642 | 24,362 | 30 | 29,366 | 176 | 32 | 19 | 9 | 2 |
Cash paid for interest | |||||||||
4,257 | 462 | 51 | 23 | 61 | 521 | - | - | - | - |
Supplemental disclosures of non-cash investing and financing activities | |||||||||
Cashless exercise of stock options | |||||||||
0 | 0 | 0 | - | - | - | - | - | - | - |
APC stock issued in exchange for AMG | |||||||||
- | - | - | 0 | 5,155 | 1,312 | 0 | - | - | 280 |
Reclassification of APS noncontrolling interest to equity | |||||||||
0 | 2,832 | 0 | - | - | - | - | - | - | - |
Deferred tax liability adjusted to goodwill | |||||||||
6,334 | 1,110 | 0 | - | 977 | - | - | - | - | - |
Reclassification of liability for equity shares | |||||||||
1,185 | 0 | 0 | - | - | - | - | - | - | - |
Purchase price adjustment for acceleration of vested stock options | |||||||||
0 | 868 | 0 | - | - | - | - | - | - | - |
Conversion of loan receivable to investment in Accountable Health Care, IPA | |||||||||
0 | 5,000 | 0 | - | - | - | - | - | - | - |
Purchase price adjustment for acceleration of vested stock options | |||||||||
0 | 868 | 0 | - | - | - | - | - | - | - |
Conversion of loan receivable to investment in Accountable Health Care, IPA | |||||||||
0 | 5,000 | 0 | - | - | - | - | - | - | - |
Reclassification of dividends related to share repurchase | |||||||||
0 | 4,216 | 0 | - | - | - | - | - | - | - |
Reclassification of APS noncontrolling interest to equity related to purchase of additional shares | |||||||||
0 | 2,832 | 0 | - | - | - | - | - | - | - |
Equipment purchased with capital lease | |||||||||
- | - | - | - | 186 | - | - | - | - | - |
Dividends declared included in dividends payable and restricted cash | |||||||||
- | - | - | - | 0 | - | - | - | - | - |
Adjustment of Warrants Granted for Services | |||||||||
0 | 0 | 5,294 | - | 0 | - | - | - | - | - |
Issuance of common stock upon conversion of debt and accrued interest | |||||||||
0 | 0 | 5,376 | - | 0 | - | - | - | - | - |
Convertible note warrant | |||||||||
- | - | - | - | - | - | 487 | 50 | - | - |
Convertible note conversion feature | |||||||||
- | - | - | - | - | - | 578 | 0 | 0 | - |
Acquisition related warrant consideration | |||||||||
- | - | - | - | - | - | 132 | 0 | - | - |
Acquisition related consideration fair value of units issued by consolidated subsidiary | |||||||||
- | - | - | - | - | - | 274 | 0 | - | - |
Acquisition related deferred tax liability | |||||||||
- | - | - | - | - | - | 218 | 0 | - | - |
Pre-acquisition net equity of noncontrolling interest in variable interest entity | |||||||||
- | - | - | - | - | - | 191 | 0 | - | - |
Issuance of common stock on conversion of 8% warrants and notes | |||||||||
- | - | - | 0 | - | 3,060 | 0 | - | - | - |
Issuance of common stock in connection with conversion of 9% notes payable and accrued interest | |||||||||
- | - | - | 0 | - | 553 | 0 | - | - | - |
Change in noncontrolling interest ownership | |||||||||
- | - | - | 0 | - | 338 | 0 | - | - | - |
Tenant improvement allowance | |||||||||
- | - | - | 0 | - | 659 | 0 | - | - | - |
Note receivable related to sale of ACC asset | |||||||||
- | - | - | 0 | - | 51 | 0 | - | - | - |
Reclassification of liability for unissued common shares payable to equity | |||||||||
0 | 0 | 1,237 | - | 0 | - | - | - | - | - |
Non-cash purchase consideration for acquisition | |||||||||
0 | 0 | 61,092 | - | - | - | - | - | - | - |
Reclassification of fiduciary cash to payable | |||||||||
- | - | - | 0 | 1,313 | 100 | 0 | - | - | - |
Reconciliation of cash, cash equivalents, and restricted cash | |||||||||
Net change in cash and cash equivalents | |||||||||
- | - | - | -605 | -4,190 | 4,255 | -1,817 | 274 | 1,012 | -232 |
Reclassification of derivative liability to equity | |||||||||
- | - | - | 1,177 | - | 0 | - | - | - | - |
Relative fair value of warrant included in debt discount | |||||||||
- | - | - | 6 | - | 0 | - | - | - | - |
Reclassification of mezzanine equity to permanent equity | |||||||||
- | - | - | 7,077 | - | 0 | - | - | - | - |
Reclassification of noncontrolling interest to due to acquisition of BAHA noncontrolling interest | |||||||||
- | - | - | 183 | - | 0 | - | - | - | - |
Warrants issuable for debt guarantee | |||||||||
- | - | - | 161 | - | 0 | - | - | - | - |
NNA term loan discount | |||||||||
- | - | - | - | - | - | - | 0 | - | - |
Shares issued in connection with convertible notes redemption | |||||||||
- | - | - | - | - | - | - | 864 | 0 | - |
Fair value of warrant liabilities | |||||||||
- | - | - | - | - | - | - | 0 | - | - |
NNA shares issuance discount | |||||||||
- | - | - | - | - | - | - | 0 | - | - |
Warrants issued in connection with convertible note issuance | |||||||||
- | - | - | - | - | - | - | - | 387 | 0 |
Shares issuable and issued for deferred financing costs | |||||||||
- | - | - | - | - | - | - | 45 | 198 | 0 |
Warrants and derivative reclassified from liabilities to stockholders' deficit | |||||||||
- | - | - | - | - | - | - | - | 6,626 | 0 |
Contingent consideration payable | |||||||||
- | - | - | - | - | - | - | - | - | 367 |
Shares Issuable For Services | |||||||||
- | - | - | - | - | - | - | - | 159 | 90 |
Notes payable issued in connection with medical clinic acquisitions | |||||||||
- | - | - | - | - | - | - | 299 | 0 | - |
Settlement of stock issuable liability with issuance of shares | |||||||||
- | - | - | - | - | - | - | 159 | 0 | - |
Fair value of embedded conversion feature reacquired in connection with convertible notes redemption | |||||||||
- | - | - | - | - | - | - | 509 | - | - |
Preferred stock | |||||||||
Non-cash purchase consideration for acquisition | |||||||||
0 | 0 | 19,118 | - | - | - | - | - | - | - |
NMM | |||||||||
Non-cash purchase consideration for acquisition | |||||||||
0 | 0 | 5,129 | - | - | - | - | - | - | - |
Unvested stock compensation | |||||||||
Non-cash purchase consideration for acquisition | |||||||||
0 | 0 | 187 | - | - | - | - | - | - | - |