| Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 |
|---|---|---|---|---|---|---|---|---|---|
Cash flows from operating activities: | |||||||||
Net Loss | |||||||||
- | - | - | -7,462 | - | - | - | - | - | - |
Net Income (loss) | |||||||||
5,500 | -11,895 | -985 | - | -22,703 | -14,405 | -13,363 | -7,540 | -7,552 | -2,199 |
Income from discontinued operations, net of tax | |||||||||
626 | 74 | -1,679 | -13,428 | -4,892 | 23,783 | -1,255 | 5,846 | -1,158 | 174 |
Income (loss) from continuing operations | |||||||||
4,874 | -11,969 | 694 | 5,966 | -17,811 | -38,188 | -12,108 | -13,386 | -6,394 | -2,374 |
Adjustments to reconcile net income (loss) from continuing operations to net cash provided by operating activities: | |||||||||
Depreciation and amortization | |||||||||
3,438 | 4,634 | 4,868 | 5,296 | 7,345 | 7,393 | 6,918 | 6,538 | 3,359 | 1,261 |
Settlement agreements in excess of cash paid | |||||||||
- | - | -264 | 0 | - | - | - | - | - | - |
Warrants (cancelled) issued for services | |||||||||
- | - | - | - | -320 | 408 | 89 | 107 | 212 | 21 |
Stock-based compensation expense | |||||||||
92 | 176 | 267 | 1,133 | 942 | 1,155 | 1,097 | 891 | 806 | 818 |
Forfeiture (remeasurment) of liability based restricted stock | |||||||||
- | - | - | - | 75 | 0 | - | - | - | - |
Forfeiture (remeasurement) of liability based restricted stock | |||||||||
- | - | - | -75 | - | - | - | - | - | - |
Rent expense in excess of cash paid | |||||||||
308 | 368 | 578 | 896 | 162 | 209 | - | - | - | - |
Rent revenue in excess of cash received | |||||||||
-1,424 | -2,003 | -2,670 | - | - | - | - | - | - | - |
Rent revenue in excess of cash received | |||||||||
- | - | - | -2,498 | -1,211 | -21 | 274 | 430 | 700 | 201 |
Amortization of deferred financing costs, debt discounts and premiums | |||||||||
198 | 575 | 338 | - | - | - | - | - | - | - |
Loss on debt extinguishment | |||||||||
-2,458 | -5,234 | - | 185 | - | - | - | - | - | - |
Loss on legal settlement | |||||||||
- | - | - | - | - | - | 0 | - | - | - |
Loss on impairment (Note 6) | |||||||||
- | - | - | - | - | - | - | 0 | - | - |
Deferred tax expense | |||||||||
- | - | - | - | - | - | 87 | 104 | 7 | - |
Gain on disposal of assets | |||||||||
- | - | - | 8,750 | 0 | -7 | -10 | 2 | -111 | -1 |
Gain on disposal of assets | |||||||||
7,141 | - | - | - | - | - | - | - | - | - |
Amortization of deferred financing costs | |||||||||
- | - | - | 1,046 | 1,163 | 2,122 | 2,158 | 1,923 | 919 | 158 |
Amortization of debt discounts and premiums | |||||||||
- | - | - | - | - | -9 | 521 | 750 | 901 | 330 |
Derivative gain | |||||||||
- | - | - | - | - | - | 3,006 | -1,741 | 957 | -343 |
Loss on debt extinguishment | |||||||||
- | - | - | - | -680 | -1,803 | -109 | 500 | -141 | -228 |
Deferred tax benefit | |||||||||
0 | -38 | -188 | -163 | 102 | 98 | - | - | - | 20 |
Gain on acquisitions | |||||||||
- | - | - | - | - | - | - | - | 1,104 | 2,739 |
Bad debt (benefit) expense | |||||||||
-281 | 4,132 | 886 | 215 | 2,132 | 0 | 4,040 | 4,185 | 1,596 | 235 |
Non cash acquisition costs | |||||||||
- | - | - | - | - | - | - | - | 206 | - |
Other noncash expenses | |||||||||
- | - | - | - | - | - | - | -40 | -80 | -196 |
Changes in operating assets and liabilities: | |||||||||
Accounts receivable | |||||||||
-465 | 497 | -182 | 545 | 2,220 | -369 | 3,567 | 12,973 | 9,334 | 6,398 |
Prepaid expenses | |||||||||
- | - | -283 | - | - | - | - | - | - | - |
Prepaid expenses and other assets | |||||||||
-400 | -898 | - | -672 | 2,156 | 653 | 25 | -90 | -522 | 772 |
Other assets | |||||||||
- | - | 76 | - | - | 554 | 57 | -330 | 179 | -6 |
Accounts payable, and accrued expenses and other | |||||||||
- | - | 665 | -1,361 | - | - | - | - | - | - |
Accounts payable and accrued expenses | |||||||||
-339 | 1,235 | - | - | -1,550 | 1,946 | 4,285 | 11,408 | 8,936 | 7,052 |
Other liabilities | |||||||||
- | 334 | 168 | -199 | 1,090 | - | - | - | - | - |
Net cash provided by operating activities—continuing operations | |||||||||
3,048 | 3,079 | 5,995 | 1,598 | -11,727 | -23,915 | 825 | 1,676 | 542 | -1,407 |
Net cash used in operating activities—discontinued operations | |||||||||
-652 | -1,731 | -850 | -5,007 | -6,079 | 17,780 | 4,238 | -229 | 1,450 | 191 |
Net cash provided by operating activities | |||||||||
2,396 | 1,348 | 5,145 | -3,409 | -17,806 | -6,135 | 5,063 | 1,447 | 1,992 | -1,216 |
Cash flow from investing activities: | |||||||||
Proceeds from disposal of lease assets, net | |||||||||
1,192 | - | - | - | - | - | - | - | - | - |
Proceeds from the sale of property and equipment, net | |||||||||
2,687 | - | - | 18,370 | 0 | - | - | 3 | - | - |
Change in net cash investments | |||||||||
- | - | 44 | -7,263 | 3,950 | -5,744 | 6,111 | 3,284 | -1,070 | - |
Purchase of real estate, net | |||||||||
- | - | 1,375 | 0 | - | - | - | - | - | - |
Purchase of property and equipment | |||||||||
58 | 338 | 846 | 1,500 | 1,799 | 4,139 | 4,520 | 5,615 | 4,245 | 1,131 |
Escrow deposits for acquisitions | |||||||||
- | - | - | - | - | - | - | - | - | 1,725 |
Lease deposits | |||||||||
- | - | - | - | - | - | - | - | 15 | 1,670 |
Change in restricted cash and investments | |||||||||
- | - | - | - | - | - | - | - | - | 134 |
Acquisitions | |||||||||
- | - | - | - | - | - | - | 61,901 | 57,582 | 9,693 |
Proceeds from the sale of property and equipment | |||||||||
- | - | - | - | - | - | 3,240 | 0 | - | - |
Net cash provided by (used in) investing activities—continuing operations | |||||||||
3,821 | -338 | -2,265 | 24,133 | -5,749 | 1,605 | -7,391 | -70,797 | -60,772 | -14,354 |
Net cash provided by investing activities—discontinued operations | |||||||||
- | - | - | 0 | 15,594 | -1,489 | 4,268 | 11,635 | -218 | -9 |
Net cash provided (used in) by investing activities | |||||||||
3,821 | -338 | -2,265 | 24,133 | 9,845 | 116 | -3,123 | -59,162 | -60,990 | -14,363 |
Cash flows from financing activities: | |||||||||
Proceeds from debt issuance | |||||||||
- | 2,397 | - | - | - | - | - | - | - | - |
Proceeds from debt | |||||||||
- | - | - | 9,809 | 22,757 | 25,716 | 7,332 | 92,476 | 51,864 | 8,827 |
Proceeds from convertible debt | |||||||||
- | - | - | - | 2,049 | 6,055 | - | - | - | - |
Proceeds from stock issuances, net | |||||||||
- | - | - | - | - | - | - | - | - | 6,109 |
Repayment on notes payable | |||||||||
3,036 | 2,076 | 3,609 | 16,284 | 25,652 | 24,905 | 8,442 | 30,075 | 2,053 | 737 |
Repayment on bonds payable | |||||||||
344 | 95 | 90 | 85 | 0 | 2,994 | - | - | - | - |
Debt extinguishment, forbearance and issuance costs, net of refunds | |||||||||
1,251 | -130 | - | - | - | - | - | - | - | - |
Repayment on convertible debt | |||||||||
- | - | 7,700 | 0 | 6,849 | 4,094 | - | - | - | - |
Debt issuance costs, net of refunds | |||||||||
- | - | 62 | - | - | - | - | - | - | - |
Proceeds from lines of credit | |||||||||
- | - | - | - | 28,310 | 69,874 | 105,034 | 365 | 6,734 | 1,828 |
Repayment of lines of credit | |||||||||
- | - | - | - | 34,944 | 71,590 | 105,665 | - | - | - |
Debt issuance costs | |||||||||
- | - | - | 315 | 598 | 1,044 | 864 | 3,063 | 618 | 1,134 |
Exercise of warrants and options | |||||||||
- | - | - | - | 1,791 | 3,257 | 67 | 137 | 6,795 | 331 |
Proceeds from stock issuances | |||||||||
- | - | - | - | - | - | - | 3,779 | - | - |
Proceeds from preferred stock issuances, net | |||||||||
- | - | 977 | 6,780 | 34,323 | 0 | 11,283 | 9,159 | - | - |
Repurchase of common stock | |||||||||
- | - | - | - | - | -50 | - | - | - | - |
Repurchase of common stock | |||||||||
- | - | 186 | 523 | 0 | - | - | - | - | - |
Repurchase of preferred stock | |||||||||
- | - | - | 48 | 0 | - | - | - | - | - |
Dividends paid on common stock | |||||||||
- | - | - | - | 3,276 | 0 | - | - | - | - |
Preferred stock offering costs | |||||||||
- | - | - | - | - | - | 0 | - | - | - |
Dividends on preferred stock | |||||||||
- | - | 5,702 | 7,335 | 5,208 | 2,584 | 1,564 | 156 | - | - |
Net cash (used in) provided by financing activities—continuing operations | |||||||||
-4,631 | 356 | -16,372 | -8,001 | 12,703 | -2,359 | 7,181 | 72,622 | 62,722 | 15,222 |
Net cash used in financing activities—discontinued operations | |||||||||
-34 | -239 | -658 | -1,398 | -12,757 | -261 | -5,684 | -6,154 | -271 | -212 |
Net cash (used in) provided by financing activities | |||||||||
-4,665 | 117 | -17,030 | -9,399 | -54 | -2,620 | 1,497 | 66,468 | 62,451 | 15,010 |
Net change in cash and restricted cash | |||||||||
1,552 | 1,127 | -14,150 | - | - | - | - | - | - | - |
Net change in cash and cash equivalents | |||||||||
- | - | - | 11,325 | -8,015 | -8,639 | 3,437 | 8,753 | 3,453 | -569 |
Cash decrease due to deconsolidation of variable interest entities | |||||||||
- | - | - | - | - | - | - | 180 | - | - |
Supplemental Disclosure of Cash Flow Information: | |||||||||
Cash interest paid | |||||||||
4,809 | 5,220 | 3,781 | - | - | - | - | - | - | - |
Interest paid | |||||||||
- | - | - | 6,126 | 8,367 | 9,859 | 10,420 | 9,673 | 6,091 | 1,953 |
Cash income taxes paid | |||||||||
- | - | 29 | 0 | 8 | 33 | 0 | 0 | 197 | - |
Supplemental disclosure of non-cash Activities: | |||||||||
Non-cash payments of short-term debt | |||||||||
24,637 | - | - | - | - | - | - | - | - | - |
Non-cash payments of long-term debt | |||||||||
- | 8,744 | - | - | - | - | - | - | - | - |
Non-cash payments of convertible debt | |||||||||
- | 1,500 | - | - | - | - | - | - | - | - |
Non-cash payments of professional liability settlements from financing | |||||||||
- | 2,371 | - | - | - | - | - | - | - | - |
Non-cash debt extinguishment, issuance costs and prepayment penalties | |||||||||
1,036 | 1,238 | - | - | - | - | - | - | - | - |
Non-cash surrender of security deposit | |||||||||
140 | - | - | - | - | - | - | - | - | - |
Non-cash payments of professional liability settlements from prior insurer | |||||||||
- | 2,850 | - | - | - | - | - | - | - | - |
Net payments through escrow | |||||||||
25,813 | 16,703 | - | - | - | - | - | - | - | - |
Non-cash proceeds from sale of property and equipment | |||||||||
25,813 | - | - | - | - | - | - | - | - | - |
Non-cash proceeds from financing | |||||||||
- | 13,853 | - | - | - | - | - | - | - | - |
Non-cash proceeds from prior insurer for professional liability settlements | |||||||||
- | 2,850 | - | - | - | - | - | - | - | - |
Net proceeds through escrow | |||||||||
25,813 | 16,703 | - | - | - | - | - | - | - | - |
Non-cash proceeds from debt to purchase real estate | |||||||||
- | - | 4,125 | 0 | 680 | - | - | - | - | - |
Non-cash deferred financing | |||||||||
- | 4,202 | - | - | - | - | - | - | - | - |
Surrender of security deposit | |||||||||
- | 305 | 500 | 0 | - | - | - | - | - | - |
Settlement agreements in excess of cash paid | |||||||||
- | - | -264 | - | - | - | - | - | - | - |
Non-cash proceeds from financing of South Carolina Medicaid audit repayment | |||||||||
- | - | 385 | 0 | - | - | - | - | - | - |
Repayment on notes payable - sale of Arkansas Facilities | |||||||||
- | - | - | 35,176 | - | - | - | - | - | - |
Settlement agreements in excess of cash paid | |||||||||
- | - | -264 | 0 | - | - | - | - | - | - |
Issuance of seller note | |||||||||
- | - | - | 3,000 | 0 | - | - | - | - | - |
Repayment on notes payable - sale of Arkansas Facilities | |||||||||
- | - | - | 35,176 | 0 | - | - | - | - | - |
Notes repaid by setoff of amounts owed to the Company by noteholders | |||||||||
- | - | - | - | 5,651 | 0 | - | - | - | - |
Issuance of vendor-financed insurance | |||||||||
250 | 198 | 198 | 0 | - | - | - | - | - | - |
Non-cash proceeds from finance lease to purchase fixed assets | |||||||||
26 | - | - | - | - | - | - | - | - | - |
Surrender of security deposit | |||||||||
- | 305 | 500 | 0 | - | - | - | - | - | - |
Non-cash proceeds from financing of South Carolina Medicaid audit repayment | |||||||||
- | - | 385 | 0 | - | - | - | - | - | - |
2011 Notes surrendered and cancelled in payment for 2014 Notes | |||||||||
- | - | - | - | - | 445 | 0 | 11,056 | 3,150 | 28,914 |
Land received in settlement of note receivable | |||||||||
- | - | - | - | - | 640 | 0 | - | - | 750 |
Conversion of debt to equity | |||||||||
- | - | - | - | - | 6,930 | - | 0 | 150 | - |
Warrants issued in conjunction with convertible debt offering | |||||||||
- | - | - | - | - | 87 | 9 | 756 | 330 | - |
Cancellation of insurance premium financing | |||||||||
- | - | - | - | 721 | 14 | 80 | 0 | 6,441 | - |
Gain on extinguishment of exit fee note | |||||||||
- | - | - | 185 | 0 | - | - | - | - | - |
Gain on extinguishment of exit fee note | |||||||||
- | - | - | 185 | - | - | - | - | - | - |
Cashless exercise of warrants | |||||||||
- | - | - | 135 | 0 | - | - | - | - | - |
Discounts on debt for bifurcated derivative and detachable warrants | |||||||||
- | - | - | - | - | - | - | - | - | 2,963 |