|
CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
|
12 Months Ended |
|
Dec. 31, 2014
|
Dec. 31, 2013
|
Dec. 31, 2012
|
| Cash flows from operating activities |
|
|
|
| Net income |
$ 157,149,000 |
$ 54,598,000 |
$ 74,365,000 |
| Loss from discontinued operations |
9,355,000 |
9,330,000 |
4,895,000 |
| Adjustments to reconcile net income to net cash provided by operating activities |
|
|
|
| Provision for doubtful accounts |
14,051,000 |
14,208,000 |
12,736,000 |
| Depreciation and amortization |
52,663,000 |
41,450,000 |
39,953,000 |
| Amortization of deferred issuance costs |
2,954,000 |
3,891,000 |
2,980,000 |
| Impairment of long-lived assets |
610,000 |
0 |
435,000 |
| Realized (gain) loss on sale of investments |
(7,633,000) |
12,330,000 |
7,100,000 |
| (Gain) loss on disposal of assets |
(232,000) |
123,000 |
(307,000) |
| Equity in net income of nonconsolidated affiliates |
(32,564,000) |
(23,364,000) |
(16,767,000) |
| Distributions from nonconsolidated affiliates |
50,773,000 |
50,505,000 |
38,652,000 |
| Deferred income tax |
8,556,000 |
15,410,000 |
7,385,000 |
| Stock compensation |
4,126,000 |
2,724,000 |
1,719,000 |
| Change in fair value and loss on de-designation of interest rate swap |
485,000 |
8,314,000 |
|
| Loss on extinguishment of debt |
|
10,333,000 |
|
| Payment of deferred interest |
|
(14,785,000) |
|
| Debt call premium paid |
|
(5,000,000) |
|
| (Increase) decrease in assets, net of business combinations |
|
|
|
| Accounts receivable |
(18,692,000) |
(20,000,000) |
(10,048,000) |
| Other assets |
(66,709,000) |
8,230,000 |
(24,314,000) |
| (Decrease) increase in liabilities, net of business combinations |
|
|
|
| Accounts payable |
4,709,000 |
3,679,000 |
(810,000) |
| Accrued payroll |
2,404,000 |
6,143,000 |
(1,138,000) |
| Accrued interest |
(213,000) |
(13,263,000) |
(560,000) |
| Other liabilities |
34,261,000 |
9,064,000 |
33,849,000 |
| Other, net |
(722,000) |
(251,000) |
(1,767,000) |
| Net cash (used in) provided by operating activities of discontinued operations |
(4,750,000) |
(8,085,000) |
2,834,000 |
| Net cash provided by operating activities |
210,581,000 |
165,584,000 |
171,192,000 |
| Cash flows from investing activities |
|
|
|
| Capital expenditures |
(37,304,000) |
(36,838,000) |
(28,445,000) |
| Proceeds from sale of business |
2,711,000 |
1,276,000 |
10,198,000 |
| Proceeds from sale of investment |
|
|
4,335,000 |
| Proceeds from disposal of assets |
1,302,000 |
5,880,000 |
474,000 |
| Proceeds from sale of equity interests of nonconsolidated affiliates |
2,344,000 |
4,587,000 |
14,980,000 |
| Proceeds from sale of equity interests of consolidated affiliates in deconsolidation transactions |
2,375,000 |
2,069,000 |
4,251,000 |
| Decrease in cash related to conversion of consolidated affiliates to equity interests |
(30,000) |
(116,000) |
(1,034,000) |
| Net change in restricted cash |
1,062,000 |
1,886,000 |
(3,936,000) |
| Net settlements on interest rate swap |
(1,539,000) |
(2,921,000) |
(6,081,000) |
| Business acquisitions, net of cash acquired 2014 - $2,527; 2013 - $6,131; 2012 - $4,386 |
(122,165,000) |
(54,499,000) |
(2,796,000) |
| Purchase of equity interests in nonconsolidated affiliates |
(36,032,000) |
(766,000) |
(14,521,000) |
| Purchase of equity interests in deconsolidation transaction |
|
|
(1,576,000) |
| Return of equity method investments in nonconsolidated affiliates |
2,555,000 |
2,592,000 |
|
| Other |
(3,791,000) |
|
|
| Net cash provided by investing activities of discontinued operations |
|
16,000 |
2,347,000 |
| Net cash used in investing activities |
(188,512,000) |
(76,834,000) |
(21,804,000) |
| Cash flows from financing activities |
|
|
|
| Borrowings under line of credit arrangements and long-term debt, net of issuance costs |
35,646,000 |
417,678,000 |
4,010,000 |
| Payment of debt acquisition costs |
|
(5,700,000) |
|
| Proceeds from issuance of shares pursuant to IPO, net of offering costs |
|
171,877,000 |
|
| Principal payments on line of credit arrangements and long-term debt |
(31,083,000) |
(527,634,000) |
(8,865,000) |
| Principal payments under capital lease obligations |
(8,225,000) |
(7,552,000) |
(6,189,000) |
| Distributions to noncontrolling interests of consolidated affiliates |
(113,432,000) |
(102,975,000) |
(94,163,000) |
| Contributions from noncontrolling interests of consolidated affiliates |
17,452,000 |
4,758,000 |
22,000 |
| Proceeds from sale of equity interests of consolidated affiliates |
5,593,000 |
7,864,000 |
7,596,000 |
| Repurchase of equity interests of consolidated affiliates |
(8,726,000) |
(5,612,000) |
(6,500,000) |
| Distributions to unit holders |
|
(74,900,000) |
|
| Proceeds from teammate equity plans |
5,820,000 |
453,000 |
|
| Other |
(2,189,000) |
|
|
| Net cash provided by financing activities of discontinued operations |
|
|
2,004,000 |
| Net cash used in financing activities |
(99,144,000) |
(121,743,000) |
(102,085,000) |
| Change in cash and cash equivalents |
(77,075,000) |
(32,993,000) |
47,303,000 |
| Cash and cash equivalents at beginning of period |
85,829,000 |
118,618,000 |
71,212,000 |
| Cash and cash equivalents of discontinued operations at beginning of period |
14,000 |
178,000 |
169,000 |
| Less: Cash and cash equivalents of discontinued operations at end of period |
(37,000) |
26,000 |
(66,000) |
| Cash and cash equivalents at end of period |
8,731,000 |
85,829,000 |
118,618,000 |
| Supplemental cash flow information |
|
|
|
| Cash paid during the year for interest |
31,173,000 |
62,167,000 |
56,848,000 |
| Cash paid during the year for income taxes |
753,000 |
493,000 |
475,000 |
| Supplemental schedule of noncash investing and financing activities |
|
|
|
| Property and equipment acquired through capital leases and installment purchases |
9,722,000 |
21,329,000 |
7,714,000 |
| Goodwill attributable to sale of surgery centers |
752,000 |
10,062,000 |
9,066,000 |
| Net investment in consolidated affiliates that became equity method facilities |
1,848,000 |
5,356,000 |
712,000 |
| Noncontrolling interest associated with conversion of consolidated affiliates to equity method affiliates |
3,886,000 |
747,000 |
3,019,000 |
| Contributions (non-cash) from noncontrolling interests of consolidated affiliates |
5,225,000 |
|
|
| Accrued capital expenditures at end of period |
3,457,000 |
2,341,000 |
2,713,000 |
| Conversion of equity method affiliate to consolidated affiliate financed through the issuance of debt |
|
|
7,221,000 |
| Equity interest purchase in nonconsolidated affiliates via withheld distributions |
|
|
10,462,000 |
| Debt to equity conversion of nonconsolidated affiliate |
|
|
$ 5,027,000 |