| Mar'20 | Dec'19 | Sep'19 | Jun'19 | Mar'19 | Dec'18 | Sep'18 | Jun'18 | Mar'18 | Dec'17 | Sep'17 | Jun'17 | Mar'17 | Dec'16 | Sep'16 | Jun'16 | Mar'16 | Dec'15 | Sep'15 | Jun'15 | Mar'15 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Cash flows from operating activities: | ||||||||||||||||||||
Net income (loss) | ||||||||||||||||||||
-79,501 | -31,641 | -75,192 | -16,477 | -38,606 | -19,920 | -53,886 | -25,941 | -98,487 | -26,023 | -28,554 | -30,575 | -27,205 | -90,092 | -6,452 | -243,966 | -4,687 | 781 | -4,075 | 2,205 | 5,824 |
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | ||||||||||||||||||||
Depreciation and amortization | ||||||||||||||||||||
12,218 | 13,446 | 15,028 | 14,500 | 14,639 | 15,979 | 16,612 | 17,142 | 18,261 | 18,714 | 20,735 | 20,586 | 22,120 | 26,434 | 28,234 | 31,463 | 31,157 | 32,674 | 31,488 | 32,141 | 31,698 |
Non-cash interest expense, net | ||||||||||||||||||||
2,381 | 3,255 | 2,306 | 2,380 | 1,939 | 2,339 | 1,860 | 2,723 | 1,811 | 2,547 | 1,793 | 700 | 730 | 510 | 1,257 | 729 | 0 | - | 0 | 0 | - |
Provision for (benefit from) deferred income taxes | ||||||||||||||||||||
37 | 633 | 71 | 31 | 90 | -176 | -1,129 | -511 | 536 | -21,750 | -642 | -346 | 601 | -4,807 | -4,081 | -47,451 | 0 | - | 0 | 0 | - |
Stock-based compensation expense | ||||||||||||||||||||
1,063 | 617 | 1,744 | 1,194 | 1,770 | 2,677 | 2,766 | 2,756 | 2,464 | 2,250 | 2,374 | 2,531 | 2,797 | 2,763 | 2,781 | 1,897 | 0 | - | 0 | 0 | - |
Impairment of long-lived assets and goodwill | ||||||||||||||||||||
12,000 | 0 | 8,010 | 25,950 | 8,860 | 4,940 | 32,438 | 0 | 39,760 | 25,820 | 5,261 | 12,900 | 3,300 | 41,470 | 0 | 250,400 | 0 | - | 0 | 0 | - |
Loss (gain) on sale of hospitals, net | ||||||||||||||||||||
-2,421 | -742 | -1,206 | -1,140 | 0 | -78 | -805 | -307 | -7,815 | 131 | -79 | 4,321 | 870 | -2,150 | 0 | 0 | 0 | - | - | - | - |
Non-cash portion of loss (gain) on hospital closures | ||||||||||||||||||||
1,608 | 23,897 | -11,781 | 0 | 567 | 12,788 | 0 | -1,089 | -5,305 | 0 | 0 | 0 | 0 | - | - | - | - | - | - | - | - |
Changes in reserves for self-insurance claims, net of payments | ||||||||||||||||||||
-595 | -31 | -119 | -29,963 | 4,160 | 4,675 | 4,623 | 4,355 | 6,025 | 6,266 | 4,999 | 7,042 | 4,212 | -105 | 11,208 | 8,901 | 7,990 | - | 0 | 0 | - |
Changes in reserves for legal, professional and settlement costs, net of payments | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | 0 | 0 | 0 | -3,651 | -991 | 0 | 4,642 | 0 | - | 0 | - | - |
Other non-cash expense (income), net | ||||||||||||||||||||
-187 | 734 | -3,237 | -116 | 1,372 | -572 | -380 | -56 | 49 | 48 | -233 | -47 | 42 | 42 | -54 | 33 | 554 | -1,183 | -705 | 1,137 | 371 |
Changes in operating assets and liabilities, net of acquisitions and divestitures: | ||||||||||||||||||||
Patient accounts receivable | ||||||||||||||||||||
-16,059 | 3,195 | -8,166 | -22,766 | 3,986 | 4,303 | -9,206 | -19,645 | -1,429 | -50,284 | -9,156 | 13,186 | 17,163 | -27,002 | 9,586 | -4,911 | 12,122 | -1,791 | 23,639 | -17,642 | 12,433 |
Due from and due to third-party payors, net | ||||||||||||||||||||
2,216 | 4,926 | -10,120 | -2,159 | 4,421 | -2,584 | -8,344 | -19,761 | -1,217 | -11,970 | 3,176 | -4,366 | -11,041 | -8,732 | 7,528 | 6,538 | -12,339 | - | 14,365 | - | - |
Due to and due from third-party payors, net | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | -17,218 | - |
Inventories, prepaid expenses and other current assets | ||||||||||||||||||||
-512 | -6,546 | -5,726 | 5,143 | -4,911 | -22,738 | 7,353 | 1,519 | -1,290 | 1,351 | -9,756 | -8,942 | 16,674 | -13,632 | 14,689 | -5,103 | 2,589 | 1,854 | -12,794 | -4,127 | 7,067 |
Accounts payable and accrued liabilities | ||||||||||||||||||||
29,772 | -35,681 | 44,793 | -28,930 | 20,146 | -36,254 | 12,108 | -19,301 | 9,587 | -4,033 | -12,002 | -36,773 | 38,065 | -5,181 | -2,505 | 36,072 | -7,626 | 12,304 | -20,540 | -16,073 | -54,635 |
Long-term assets and liabilities, net | ||||||||||||||||||||
1,467 | 6,210 | 11,721 | 117 | -515 | -640 | -1,560 | 3,368 | -443 | -1,666 | 268 | -606 | -1,265 | 1,155 | -880 | 9,334 | -489 | 3,916 | -371 | -223 | -3,334 |
Net cash provided by (used in) operating activities | ||||||||||||||||||||
-8,737 | -55,710 | 25,156 | -10,394 | 8,078 | -3,431 | 28,334 | 17,194 | -2,593 | 66,181 | 9,744 | -27,481 | 18,526 | 20,320 | -427 | 36,796 | 24,397 | 37,454 | -17,261 | 56,346 | -33,650 |
Cash flows from investing activities: | ||||||||||||||||||||
Capital expenditures for property and equipment | ||||||||||||||||||||
10,306 | 13,597 | 7,720 | 9,819 | 8,292 | 10,987 | 9,576 | 10,791 | 14,528 | 10,863 | 11,525 | 15,925 | 23,217 | 23,472 | 23,241 | 20,367 | 12,840 | 25,694 | 13,351 | 10,471 | 9,939 |
Capital expenditures for software | ||||||||||||||||||||
1,683 | 2,846 | 1,843 | 2,326 | 1,191 | 1,135 | 483 | 531 | 513 | 724 | 3,005 | 1,663 | 1,506 | 2,011 | 1,454 | 1,278 | 2,526 | - | 2,802 | 1,664 | - |
Proceeds from other asset sales | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | 858 | - | - | - | - |
Acquisitions, net of cash acquired | ||||||||||||||||||||
0 | 34 | 76 | 0 | 455 | 0 | 63 | 26 | 32 | 0 | 33 | 1,887 | 0 | - | 26 | 0 | - | - | 4,854 | 2,012 | - |
Proceeds from the sale of hospitals | ||||||||||||||||||||
990 | 1 | 40,992 | 11,741 | 0 | 1,678 | 0 | 507 | 38,663 | 2,841 | 9,084 | 15,874 | 4,282 | 13,746 | 0 | 0 | 0 | - | - | - | - |
Purchases of and costs to develop information technology | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | 997 |
Proceeds from sale of property and equipment | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | 0 | 2,917 | 100 |
Other investing activities, net | ||||||||||||||||||||
-334 | -314 | -3,643 | 2,112 | -1,729 | 748 | -10 | -52 | -197 | 0 | 0 | 0 | 0 | -884 | 346 | -492 | -52 | 2,025 | 70 | 1,867 | 1,425 |
Net cash provided by (used in) investing activities | ||||||||||||||||||||
-10,665 | -16,162 | 34,996 | -2,516 | -8,209 | -11,192 | -10,112 | -10,789 | 23,787 | -8,746 | -5,479 | -3,601 | -20,441 | -12,470 | -25,067 | -21,153 | -14,456 | -32,157 | -21,077 | -13,097 | -12,261 |
Cash flows from financing activities: | ||||||||||||||||||||
Borrowings under revolving credit facilities | ||||||||||||||||||||
129,000 | 175,000 | 138,000 | 175,000 | 152,000 | 122,000 | 121,000 | 115,000 | 132,000 | 75,000 | 131,000 | 130,000 | 172,000 | - | - | - | - | - | - | - | - |
Repayments under revolving credit facilities | ||||||||||||||||||||
80,000 | 103,000 | 155,000 | 149,000 | 150,000 | 108,000 | 135,000 | 119,000 | 114,000 | 120,000 | 136,000 | 158,000 | 94,000 | - | - | - | - | - | - | - | - |
Borrowings (repayments) of revolving credit facilities, net | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | - | - | - | - | 0 | 0 | 0 | - | - | - | - |
Borrowings of long-term debt | ||||||||||||||||||||
11 | 94 | 0 | 25 | 161 | -52 | 90 | 55 | 12 | 129 | 175 | 72 | 0 | 725 | 36 | 1,255,500 | 20 | 87 | 150 | 75 | 60 |
Repayments of long-term debt | ||||||||||||||||||||
515 | 39,862 | 445 | 12,130 | 1,833 | 10,117 | 354 | 30,820 | 627 | 22,678 | 4,670 | 4,738 | 7,109 | 7,780 | 3,165 | 3,188 | 1,089 | 568 | 259 | 340 | 396 |
Increase in Due to Parent, net | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | - | - | - | -387 | 0 | 31,669 | -6,486 | 216,026 | 37,488 | -42,939 | 52,200 |
Increase (decrease) in receivables facility, net | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | 951 | -2,854 | - |
Payments of debt issuance costs | ||||||||||||||||||||
- | - | 0 | 0 | - | 0 | 0 | 0 | 2,268 | 0 | 181 | 2,891 | 47 | 7 | 1,136 | 28,003 | 0 | - | 0 | 0 | - |
Payments on purchase contracts | ||||||||||||||||||||
701 | - | 374 | - | 0 | - | 0 | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
Cancellation of restricted stock awards for payroll tax withholdings on vested shares | ||||||||||||||||||||
157 | - | 24 | - | 461 | - | 36 | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
Cash paid to Parent related to the Spin-off | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | - | - | - | - | 0 | 1,217,336 | - | - | 0 | 0 | - |
Cancellation of restricted stock awards for payroll tax withholdings on vested shares | ||||||||||||||||||||
- | - | - | 103 | - | - | - | 1,309 | 634 | - | 14 | 461 | 1,028 | 1 | 39 | -27 | 0 | - | 0 | 0 | - |
Cash distributions to noncontrolling investors | ||||||||||||||||||||
0 | 1,056 | 143 | 333 | 1,223 | 54 | 678 | 0 | 803 | 0 | 0 | 37 | 3,814 | 22 | 181 | 163 | 2,484 | 101 | 100 | 1,292 | 130 |
Decrease in indebtedness of receivables facility, net | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | -2,333 |
Purchases of shares from noncontrolling investors | ||||||||||||||||||||
- | - | - | - | - | - | - | - | - | - | 1,244 | - | - | 1 | 88 | 0 | 12 | - | 214 | 722 | - |
Net cash provided by (used in) financing activities | ||||||||||||||||||||
47,638 | 30,586 | -17,986 | 13,459 | -1,356 | 3,760 | -14,978 | -36,074 | 13,680 | -67,554 | -10,934 | -36,055 | 66,002 | -7,473 | -4,573 | 38,506 | -10,051 | -5,095 | 38,016 | -48,072 | 49,401 |
Net change in cash, cash equivalents and restricted cash | ||||||||||||||||||||
28,236 | -41,286 | 42,166 | 549 | -1,487 | -10,863 | 3,244 | -29,669 | 34,874 | -10,119 | -6,669 | -67,137 | 64,087 | 377 | -30,067 | 54,149 | -110 | 202 | -322 | -4,823 | 3,490 |
Supplemental cash flow information: | ||||||||||||||||||||
Interest payments, net | ||||||||||||||||||||
18,243 | 42,713 | 7,663 | 42,846 | 18,215 | 42,612 | 18,702 | 41,224 | 17,487 | 46,048 | 13,105 | 51,104 | 15,468 | 39,131 | 15,432 | 8,894 | 27,452 | - | 24,549 | 23,828 | - |
Income tax payments, net | ||||||||||||||||||||
0 | 203 | 0 | 189 | 0 | 67 | 46 | 341 | 146 | -143 | 311 | 28 | 0 | -34 | 0 | 34 | 0 | - | 0 | 0 | - |
Non-cash purchases of property and equipment under finance lease obligations | ||||||||||||||||||||
128 | - | - | - | 79 | - | - | - | 0 | - | 0 | 54 | - | 58 | 1,401 | 3,097 | 2,023 | - | - | - | - |