| Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | |
|---|---|---|---|---|---|---|
Operating activities | ||||||
Net loss | ||||||
26,145 | 22,467 | 58,136 | 101,666 | 93,077 | 82,406 | |
Adjustments to reconcile net income to cash provided by operating activities: | ||||||
Depreciation, amortization and impairment | ||||||
43,765 | 39,802 | 37,634 | 33,862 | 31,846 | 28,527 | |
Amortization of discounts, fees and deferred financing costs | ||||||
2,825 | 1,981 | 2,031 | 2,595 | 2,888 | 2,822 | |
Loss on early extinguishment of debt | ||||||
0 | 0 | -526 | -4,708 | 0 | - | |
Stock-based compensation | ||||||
4,745 | 5,721 | 15,872 | 40,285 | 1,400 | 1,017 | |
Premium paid for interest rate cap agreements | ||||||
0 | 0 | 1,186 | 0 | 0 | - | |
Excess tax benefits from stock option exercises | ||||||
- | - | - | - | 4,147 | - | |
Deferred taxes | ||||||
121 | 2,350 | 11,299 | -18,570 | 5,003 | 10,017 | |
Income Tax Receivable, Changes In Fair Value, Gain (Loss) | ||||||
221 | 2,673 | 7,234 | - | - | - | |
Non-cash rent charges | ||||||
- | - | - | 2,191 | 917 | 3,033 | |
Loss on disposal of assets | ||||||
- | - | - | - | 0 | - | |
Gain on sale of assets | ||||||
- | - | - | - | 0 | - | |
Loss (gain) on disposal of assets | ||||||
-529 | -80 | 27 | -857 | - | - | |
Income Tax Receivable Agreement Income | ||||||
- | - | - | 1,286 | 0 | - | |
Payment related to income tax receivable agreement | ||||||
- | - | - | - | 0 | - | |
Other non-cash charges, net | ||||||
- | - | - | -473 | -86 | 300 | |
Other non-cash charges, net | ||||||
-317 | -119 | -1,217 | - | - | - | |
Change in operating assets and liabilities, net of acquisitions: | ||||||
Accounts receivable | ||||||
2,624 | -13,118 | -17,568 | 21,221 | 5,987 | 1,690 | |
Inventories | ||||||
-3,659 | 6,799 | -11 | 385 | -538 | 376 | |
Prepaid expenses and other current assets | ||||||
-2,072 | 2,340 | 6,353 | 4,768 | 843 | 5,389 | |
Other assets | ||||||
5,377 | 5,712 | 1,325 | 219 | 966 | 796 | |
Right-of-use assets and operating lease liabilities | ||||||
-2,067 | 0 | 0 | - | - | - | |
Accounts payable | ||||||
-9,543 | 25,661 | 2,294 | 8,556 | 519 | -5,326 | |
Accrued compensation and benefits | ||||||
2,609 | 5,602 | -118 | 6,599 | 4,032 | 1,368 | |
Accrued expenses and other liabilities | ||||||
-28,134 | 7,027 | -1,797 | 16,863 | 5,232 | 2,946 | |
Cash provided by (used in) operating activities | ||||||
38,821 | 106,404 | 128,548 | 172,206 | 133,595 | 118,259 | |
Investing activities | ||||||
Purchases of property, equipment and intangible assets | ||||||
23,122 | 44,960 | 36,073 | 61,432 | 46,273 | 39,849 | |
Proceeds from asset sales | ||||||
9,400 | 2,502 | 2,325 | 0 | 0 | - | |
Cash paid for acquisitions | ||||||
6,590 | 388 | 1,555 | 4,507 | 2,642 | 5,086 | |
Cash used in investing activities | ||||||
-20,312 | -42,846 | -35,303 | -65,939 | -48,915 | -44,935 | |
Financing activities | ||||||
Proceeds from issuance of common stock sold in initial public offering, net of underwriting discounts and offering expense | ||||||
- | - | - | 175,254 | 0 | - | |
Net proceeds from issuance of long-term debt | ||||||
0 | 0 | 267,564 | 60,000 | 0 | - | |
Cash paid for financing costs | ||||||
0 | 0 | 3,914 | 1,350 | 0 | - | |
Proceeds on term loans, net of discounts and fees | ||||||
78,299 | 82,389 | 49,921 | 70,590 | 44,163 | 33,538 | |
Payments on long-term debt | ||||||
54,069 | 90,428 | 327,331 | 275,243 | 24,891 | 21,245 | |
Payments on capital lease obligations | ||||||
- | - | - | - | 5 | 57 | |
Dividends and dividend equivalents paid | ||||||
50 | 332 | 8,729 | 30,241 | 0 | - | |
Proceeds from exercise of stock options | ||||||
10 | 1,398 | 2,380 | 170 | 124 | - | |
Proceeds from issuance of common stock | ||||||
- | - | - | - | 727 | 4,669 | |
Common stock repurchases for tax withholdings of net settlement of equity awards | ||||||
0 | 417 | 0 | 356 | 193 | 48 | |
Repurchase of vested restricted stock awards withheld on net share settlement | ||||||
368 | 421 | 0 | 0 | - | - | |
Excess tax benefits from stock option exercises | ||||||
- | - | - | - | 4,147 | - | |
Payments of deferred offering costs | ||||||
- | - | - | - | 5,026 | - | |
Distributions to noncontrolling interests | ||||||
62,987 | 70,960 | 79,478 | 94,468 | 79,125 | 68,235 | |
Contributions from noncontrolling interests | ||||||
0 | 229 | 66 | 227 | 1,836 | 1,309 | |
Contributions from noncontrolling interests | ||||||
8,349 | 7,739 | 6,522 | 7,470 | 7,235 | 5,933 | |
Purchases of equity of noncontrolling interests | ||||||
8,499 | 9,066 | 29,540 | 8,397 | 4,159 | 583 | |
Increase in cash | ||||||
- | - | - | - | - | 28,605 | |
Cash provided by financing activities | ||||||
-39,315 | -79,869 | -122,539 | -96,344 | -55,167 | -44,719 | |
(Decrease) increase in cash and restricted cash | ||||||
-20,806 | -16,311 | -29,294 | 9,923 | 29,513 | - | |
Supplemental Disclosure of Cash Flow Information | ||||||
Non-cash equity impacts of the sale or closure of clinics | ||||||
1,702 | 610 | -19 | - | - | - | |
Non-cash equity contributions | ||||||
4,655 | 0 | 0 | - | - | - | |
Cash paid for income taxes | ||||||
2,159 | 2,635 | 1,885 | 16,095 | 6,915 | 3,238 | |
Cash paid for interest | ||||||
34,152 | 30,504 | 26,812 | 32,499 | - | - | |
Cash paid for interest | ||||||
- | - | - | - | 42,339 | 41,320 | |
Supplemental Disclosure of Non-Cash Financing Activities | ||||||
Contributions from noncontrolling interests in the form of a receivable | ||||||
25 | 148 | 0 | 15 | 529 | 657 | |
Liability accrued for initial fair value of Tax Receivable Agreement | ||||||
- | - | - | 23,400 | - | - | |
Tax Receivable Agreement | ||||||
- | - | - | - | 0 | - | |
Dividends declared not paid | ||||||
- | - | - | 26,232 | 0 | - | |
Assets acquired under capital lease obligations | ||||||
0 | 6,168 | 0 | 0 | - | - | |
Change in liability accrued for dividend equivalent payments | ||||||
45 | -478 | 2,880 | 6,688 | - | - | |
Liability accrued for purchases of noncontrolling interests | ||||||
0 | 0 | 3,696 | 0 | 0 | - | |
Liability for accrued dividend equivalent payments, net | ||||||
- | - | - | - | 0 | - | |
Non-cash portion of long-term debt refinancing | ||||||
0 | 0 | 167,808 | 0 | 0 | - | |