American Renal Associates (ARA) Trailing 12-Month Cash Flow Statement

Cash Flow Summary

American Renal Associates Holdings (ARA) trailing twelve month cash flow statement covering six trailing twelve month periods to September 30, 2020, as reported to the SEC.

American Renal Associates Holdings generated $174.15M in cash from operations in the twelve months ended September 30, 2020, up 202.2% from $57.64M a year earlier.
That is 5.1 times its reported net income of $34.41M.
After spending $21.03M on capital expenditures, free cash flow was $153.13M.
Investing activities used $759K and financing activities used $97.06M.
American Renal Associates Holdings paid $18K in dividends.

A cash flow statement shows the cash that actually came in and went out, split between running the business, investing and financing.

Figures in USD thousands

						Sep'20	Jun'20	Mar'20	Dec'19	Sep'19	Jun'19
Operating activities
Net income
34,415	38,656	28,962	26,145	28,196	23,681	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net income						34,415	38,656	28,962	26,145	28,196	23,681	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation, amortization and impairment
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Depreciation, amortization and impairment						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Depreciation, amortization and impairment
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Depreciation, amortization and impairment						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Amortization of discounts, fees and deferred financing costs
3,180	3,237	3,149	2,825	2,675	2,197	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Amortization of discounts, fees and deferred financing costs						3,180	3,237	3,149	2,825	2,675	2,197	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Stock-based compensation
7,285	6,734	6,067	4,745	4,777	5,045	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Stock-based compensation						7,285	6,734	6,067	4,745	4,777	5,045	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Premium paid for interest rate cap agreements
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Premium paid for interest rate cap agreements						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Deferred taxes
251	1,833	1,557	121	13,726	7,949	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Deferred taxes						251	1,833	1,557	121	13,726	7,949	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Change in fair value of income tax receivable agreement
174	186	238	221	6,786	3,336	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Change in fair value of income tax receivable agreement						174	186	238	221	6,786	3,336	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash rent charges
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash rent charges						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash received on derivative settlement
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash received on derivative settlement						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash rent charges
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash rent charges						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Loss (gain) on disposal of assets
-1,918	-1,356	-1,351	-529	682	297	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Loss (gain) on disposal of assets						-1,918	-1,356	-1,351	-529	682	297	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Income Tax Receivable Agreement Income
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Income Tax Receivable Agreement Income						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other non-cash charges, net
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other non-cash charges, net						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Change in operating assets and liabilities, net of acquisitions:
Accounts receivable
-18,485	-15,868	2,519	2,624	4,679	2,656	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accounts receivable						-18,485	-15,868	2,519	2,624	4,679	2,656	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Inventories
126	766	669	-3,659	1,550	909	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Inventories						126	766	669	-3,659	1,550	909	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Prepaid expenses and other current assets
9,048	1,176	5,204	-2,072	9,814	11,799	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Prepaid expenses and other current assets						9,048	1,176	5,204	-2,072	9,814	11,799	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other assets
23,946	11,294	8,088	5,377	-6,211	-1,746	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other assets						23,946	11,294	8,088	5,377	-6,211	-1,746	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Right-of-use assets and operating lease liabilities
618	-603	-155	-2,067	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Right-of-use assets and operating lease liabilities						618	-603	-155	-2,067	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accounts payable
-15,729	-11,524	10,838	-9,543	4,031	4,799	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accounts payable						-15,729	-11,524	10,838	-9,543	4,031	4,799	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued compensation and benefits
3,920	2,910	2,673	2,609	2,984	3,946	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued compensation and benefits						3,920	2,910	2,673	2,609	2,984	3,946	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued expenses and other liabilities
112,421	94,375	-18,059	-28,134	-19,665	-12,669	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued expenses and other liabilities						112,421	94,375	-18,059	-28,134	-19,665	-12,669	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash provided by operating activities
174,153	182,035	62,492	38,821	57,636	55,673	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash provided by operating activities						174,153	182,035	62,492	38,821	57,636	55,673	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investing activities
Purchases of property, equipment and intangible assets
21,026	20,709	20,394	23,122	33,791	40,711	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchases of property, equipment and intangible assets						21,026	20,709	20,394	23,122	33,791	40,711	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from sale of clinics
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from sale of clinics						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from asset sales
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from asset sales						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash paid for acquisitions
-	-	-	6,590	6,978	6,978	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash paid for acquisitions						-	-	-	6,590	6,978	6,978	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash provided by (used in) investing activities
-759	-14,609	-14,294	-20,312	-34,469	-44,387	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash provided by (used in) investing activities						-759	-14,609	-14,294	-20,312	-34,469	-44,387	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Financing activities
Proceeds from revolving credit facility and term loans, net of discounts and fees
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from revolving credit facility and term loans, net of discounts and fees						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds on term loans, net of discounts and fees
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds on term loans, net of discounts and fees						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments on long-term debt
88,244	81,081	53,545	54,069	71,508	80,299	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments on long-term debt						88,244	81,081	53,545	54,069	71,508	80,299	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments on capital lease obligations
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments on capital lease obligations						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Dividends and dividend equivalents paid
18	36	44	50	56	79	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Dividends and dividend equivalents paid						18	36	44	50	56	79	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from exercise of stock options
924	1,155	94	10	294	1,069	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from exercise of stock options						924	1,155	94	10	294	1,069	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Common stock repurchases for tax withholdings of net settlement of equity awards
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Common stock repurchases for tax withholdings of net settlement of equity awards						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Repurchase of vested restricted stock awards withheld on net share settlement
436	460	457	368	362	392	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Repurchase of vested restricted stock awards withheld on net share settlement						436	460	457	368	362	392	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of deferred offering costs
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of deferred offering costs						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Common stock repurchases for tax withholdings of net settlement equity awards
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Common stock repurchases for tax withholdings of net settlement equity awards						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Distributions to noncontrolling interests
65,023	64,319	68,985	62,987	56,078	58,400	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Distributions to noncontrolling interests						65,023	64,319	68,985	62,987	56,078	58,400	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Contributions from noncontrolling interests
-158	-1,912	-874	-	1,268	1,644	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Contributions from noncontrolling interests						-158	-1,912	-874	-	1,268	1,644	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchases of equity of noncontrolling interests
17,387	1,211	8,276	8,499	8,841	8,460	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchases of equity of noncontrolling interests						17,387	1,211	8,276	8,499	8,841	8,460	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Sales of additional noncontrolling interests
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Sales of additional noncontrolling interests						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash (used in) provided by financing activities
-97,063	-88,778	-50,690	-39,315	-24,939	-10,693	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash (used in) provided by financing activities						-97,063	-88,778	-50,690	-39,315	-24,939	-10,693	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
(Decrease) increase in cash and restricted cash
76,331	78,648	-2,492	-20,806	-1,772	593	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
(Decrease) increase in cash and restricted cash						76,331	78,648	-2,492	-20,806	-1,772	593	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Supplemental Disclosure of Cash Flow Information
Cash paid for income taxes
2,214	2,152	2,162	2,159	1,488	1,283	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash paid for income taxes						2,214	2,152	2,162	2,159	1,488	1,283	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash paid for interest
26,541	33,183	36,410	34,152	33,703	33,131	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash paid for interest						26,541	33,183	36,410	34,152	33,703	33,131	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash paid for interest
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Cash paid for interest						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Supplemental Disclosure of Non-Cash Financing Activities
Contributions from noncontrolling interests in the form of a receivable
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Contributions from noncontrolling interests in the form of a receivable						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash equity impacts of the sale or closure of clinics
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash equity impacts of the sale or closure of clinics						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash equity contributions
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash equity contributions						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued offering expense
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued offering expense						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Change in liability accrued for dividend equivalent payments
14	25	37	45	54	66	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Change in liability accrued for dividend equivalent payments						14	25	37	45	54	66	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Liability established for IPO Put liability (Note 5)
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Liability established for IPO Put liability (Note 5)						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx