10-Q Filing

Astrana Health, Inc. CIK: 1083446 Q3 2021

Filing Information

Form Type	10-Q
Accession Number	`0001628280-21-022011`
Period End Date	20210930
Filing Date	20211105
Fiscal Year	2021
Fiscal Period	Q3
XBRL Instance	ameh-20210930_htm.xml

Filing Contents

This filing contains the following financial statements:

Balance Sheet 114 Income Statement 80 Cash Flow Statement 128 Stockholders Equity 61

Balance Sheet 114 line items

Line Item	Tag	Value	Unit	Period
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$103.19M	USD	Point-in-time
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$204.77M	USD	Point-in-time
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$166.08M	USD	Point-in-time
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$193.47M	USD	Point-in-time
Investments in marketable securities	`MarketableSecuritiesCurrent`	$67.69M	USD	Point-in-time
Investments in marketable securities	`MarketableSecuritiesCurrent`	$128.56M	USD	Point-in-time
Receivables, net	`AccountsReceivableNetCurrent`	$7.06M	USD	Point-in-time
Receivables, net	`AccountsReceivableNetCurrent`	$18.75M	USD	Point-in-time
Receivables, net related parties	`AccountsReceivableRelatedPartiesCurrent`	$49.26M	USD	Point-in-time
Receivables, net related parties	`AccountsReceivableRelatedPartiesCurrent`	$53.63M	USD	Point-in-time
Other receivables	`OtherReceivablesNetCurrent`	$4.30M	USD	Point-in-time
Other receivables	`OtherReceivablesNetCurrent`	$5.77M	USD	Point-in-time
Common stock, par value (in dollars per share)	`CommonStockParOrStatedValuePerShare`	$0.00	USD	Point-in-time
Prepaid expenses and other current assets	`PrepaidExpenseAndOtherAssetsCurrent`	$16.80M	USD	Point-in-time
Prepaid expenses and other current assets	`PrepaidExpenseAndOtherAssetsCurrent`	$11.73M	USD	Point-in-time
Common stock, par value (in dollars per share)	`CommonStockParOrStatedValuePerShare`	$0.00	USD	Point-in-time
Loan receivable related party	`NotesAndLoansReceivableNetCurrent`	$4.00M	USD	Point-in-time
Common stock, shares issued (in shares)	`CommonStockSharesIssued`	42.25M	shares	Point-in-time
Loan receivable related party	`NotesAndLoansReceivableNetCurrent`	-	USD	Point-in-time
Common stock, shares issued (in shares)	`CommonStockSharesIssued`	44.40M	shares	Point-in-time
Common stock, shares authorized (in shares)	`CommonStockSharesAuthorized`	100.00M	shares	Point-in-time
Total current assets	`AssetsCurrent`	$427.21M	USD	Point-in-time
Common stock, shares authorized (in shares)	`CommonStockSharesAuthorized`	100.00M	shares	Point-in-time
Total current assets	`AssetsCurrent`	$338.58M	USD	Point-in-time
Common stock, shares outstanding (in shares)	`CommonStockSharesOutstanding`	42.25M	shares	Point-in-time
Common stock, shares outstanding (in shares)	`CommonStockSharesOutstanding`	44.40M	shares	Point-in-time
Land, property, and equipment, net	`PropertyPlantAndEquipmentAndFinanceLeaseRightOfUseAssetAfterAccumulatedDepreciationAndAmortization`	$29.89M	USD	Point-in-time
Land, property, and equipment, net	`PropertyPlantAndEquipmentAndFinanceLeaseRightOfUseAssetAfterAccumulatedDepreciationAndAmortization`	$49.28M	USD	Point-in-time
Treasury shares (in shares)	`TreasuryStockCommonShares`	10.93M	shares	Point-in-time
Treasury shares (in shares)	`TreasuryStockCommonShares`	12.32M	shares	Point-in-time
Assets	`Assets`	$817.49M	USD	Point-in-time
Intangible assets, net	`IntangibleAssetsNetExcludingGoodwill`	$86.98M	USD	Point-in-time
Intangible assets, net	`IntangibleAssetsNetExcludingGoodwill`	$83.59M	USD	Point-in-time
Assets	`Assets`	$871.29M	USD	Point-in-time
Liabilities	`Liabilities`	$339.47M	USD	Point-in-time
Liabilities	`Liabilities`	$372.34M	USD	Point-in-time
Goodwill	`Goodwill`	$243.35M	USD	Point-in-time
Goodwill	`Goodwill`	$239.05M	USD	Point-in-time
Loans receivable	`NotesAndLoansReceivableNetNoncurrent`	$480.00K	USD	Point-in-time
Loans receivable	`NotesAndLoansReceivableNetNoncurrent`	$584.00K	USD	Point-in-time
Loans receivable related party	`NotesReceivableRelatedPartiesNoncurrent`	$4.14M	USD	Point-in-time
Loans receivable related party	`NotesReceivableRelatedPartiesNoncurrent`	-	USD	Point-in-time
Investments in other entities equity method	`EquityMethodInvestments`	$43.29M	USD	Point-in-time
Investments in other entities equity method	`EquityMethodInvestments`	$45.05M	USD	Point-in-time
Investments in privately held entities	`InvestmentInPrivatelyHeldEntityThatDoesNotReportNetAssetValue`	$37.08M	USD	Point-in-time
Investments in privately held entities	`InvestmentInPrivatelyHeldEntityThatDoesNotReportNetAssetValue`	$896.00K	USD	Point-in-time
Restricted cash	`RestrictedCashNoncurrent`	-	USD	Point-in-time
Restricted cash	`RestrictedCashNoncurrent`	$500.00K	USD	Point-in-time
Operating lease right-of-use assets	`OperatingLeaseRightOfUseAsset`	$16.13M	USD	Point-in-time
Operating lease right-of-use assets	`OperatingLeaseRightOfUseAsset`	$18.57M	USD	Point-in-time
Other assets	`OtherAssetsNoncurrent`	$18.91M	USD	Point-in-time
Other assets	`OtherAssetsNoncurrent`	$5.20M	USD	Point-in-time
Total noncurrent assets	`AssetsNoncurrent`	$478.91M	USD	Point-in-time
Total noncurrent assets	`AssetsNoncurrent`	$444.08M	USD	Point-in-time
Total assets	`Assets`	$817.49M	USD	Point-in-time
Total assets	`Assets`	$871.29M	USD	Point-in-time
Accounts payable and accrued expenses	`AccountsPayableAndAccruedLiabilitiesCurrent`	$57.51M	USD	Point-in-time
Accounts payable and accrued expenses	`AccountsPayableAndAccruedLiabilitiesCurrent`	$36.14M	USD	Point-in-time
Fiduciary accounts payable	`FiduciaryAccountsPayableCurrent`	$9.64M	USD	Point-in-time
Fiduciary accounts payable	`FiduciaryAccountsPayableCurrent`	$8.83M	USD	Point-in-time
Medical liabilities	`LiabilityForClaimsAndClaimsAdjustmentExpense`	$42.87M	USD	Point-in-time
Medical liabilities	`LiabilityForClaimsAndClaimsAdjustmentExpense`	$50.33M	USD	Point-in-time
Medical liabilities	`LiabilityForClaimsAndClaimsAdjustmentExpense`	$58.73M	USD	Point-in-time
Medical liabilities	`LiabilityForClaimsAndClaimsAdjustmentExpense`	$57.45M	USD	Point-in-time
Income taxes payable	`AccruedIncomeTaxesCurrent`	$4.02M	USD	Point-in-time
Income taxes payable	`AccruedIncomeTaxesCurrent`	$4.22M	USD	Point-in-time
Dividend payable	`DividendsPayableCurrent`	$485.00K	USD	Point-in-time
Dividend payable	`DividendsPayableCurrent`	$556.00K	USD	Point-in-time
Finance lease liabilities	`FinanceLeaseLiabilityCurrent`	$110.00K	USD	Point-in-time
Finance lease liabilities	`FinanceLeaseLiabilityCurrent`	$102.00K	USD	Point-in-time
Operating lease liabilities	`OperatingLeaseLiabilityCurrent`	$2.66M	USD	Point-in-time
Operating lease liabilities	`OperatingLeaseLiabilityCurrent`	$3.18M	USD	Point-in-time
Current portion of long-term debt	`LongTermDebtCurrent`	$207.00K	USD	Point-in-time
Current portion of long-term debt	`LongTermDebtCurrent`	$10.89M	USD	Point-in-time
Total current liabilities	`LiabilitiesCurrent`	$116.76M	USD	Point-in-time
Total current liabilities	`LiabilitiesCurrent`	$114.99M	USD	Point-in-time
Deferred tax liability	`DeferredIncomeTaxLiabilitiesNet`	$10.96M	USD	Point-in-time
Deferred tax liability	`DeferredIncomeTaxLiabilitiesNet`	$19.59M	USD	Point-in-time
Finance lease liabilities, net of current portion	`FinanceLeaseLiabilityNoncurrent`	$311.00K	USD	Point-in-time
Finance lease liabilities, net of current portion	`FinanceLeaseLiabilityNoncurrent`	$221.00K	USD	Point-in-time
Operating lease liabilities, net of current portion	`OperatingLeaseLiabilityNoncurrent`	$13.86M	USD	Point-in-time
Operating lease liabilities, net of current portion	`OperatingLeaseLiabilityNoncurrent`	$15.87M	USD	Point-in-time
Long-term debt, net of current portion and deferred financing costs	`LongTermDebtNoncurrent`	$230.21M	USD	Point-in-time
Long-term debt, net of current portion and deferred financing costs	`LongTermDebtNoncurrent`	$182.81M	USD	Point-in-time
Other long-term liabilities	`OtherLiabilitiesNoncurrent`	$6.23M	USD	Point-in-time
Other long-term liabilities	`OtherLiabilitiesNoncurrent`	-	USD	Point-in-time
Total noncurrent liabilities	`LiabilitiesNoncurrent`	$257.35M	USD	Point-in-time
Total noncurrent liabilities	`LiabilitiesNoncurrent`	$222.71M	USD	Point-in-time
Total liabilities	`Liabilities`	$339.47M	USD	Point-in-time
Total liabilities	`Liabilities`	$372.34M	USD	Point-in-time
Commitments and contingencies (Note 12)	`CommitmentsAndContingencies`	-	USD	Point-in-time
Commitments and contingencies (Note 12)	`CommitmentsAndContingencies`	-	USD	Point-in-time
Noncontrolling interest in Allied Physicians of California, a Professional Medical Corporation	`TemporaryEquityCarryingAmountIncludingPortionAttributableToNoncontrollingInterests`	$114.24M	USD	Point-in-time
Noncontrolling interest in Allied Physicians of California, a Professional Medical Corporation	`TemporaryEquityCarryingAmountIncludingPortionAttributableToNoncontrollingInterests`	$91.50M	USD	Point-in-time
Common stock, $0.001 par value per share; 100,000,000 shares authorized, 44,397,050 and 42,249,137 shares issued and outstanding, excluding 10,925,702 and 12,323,164 treasury shares, as of September 30, 2021 and December 31, 2020, respectively	`CommonStockValue`	$42.00K	USD	Point-in-time
Common stock, $0.001 par value per share; 100,000,000 shares authorized, 44,397,050 and 42,249,137 shares issued and outstanding, excluding 10,925,702 and 12,323,164 treasury shares, as of September 30, 2021 and December 31, 2020, respectively	`CommonStockValue`	$44.00K	USD	Point-in-time
Additional paid-in capital	`AdditionalPaidInCapital`	$305.99M	USD	Point-in-time
Additional paid-in capital	`AdditionalPaidInCapital`	$261.01M	USD	Point-in-time
Retained earnings	`RetainedEarningsAccumulatedDeficit`	$129.86M	USD	Point-in-time
Retained earnings	`RetainedEarningsAccumulatedDeficit`	$69.77M	USD	Point-in-time
Total stockholders' equity, parent	`StockholdersEquity`	$435.90M	USD	Point-in-time
Total stockholders' equity, parent	`StockholdersEquity`	$330.82M	USD	Point-in-time
Noncontrolling interest	`MinorityInterest`	$87.00K	USD	Point-in-time
Noncontrolling interest	`MinorityInterest`	$4.42M	USD	Point-in-time
Total stockholders equity	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$192.34M	USD	Point-in-time
Total stockholders equity	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$229.42M	USD	Point-in-time
Total stockholders equity	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$404.58M	USD	Point-in-time
Total stockholders equity	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$207.85M	USD	Point-in-time
Total stockholders equity	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$197.96M	USD	Point-in-time
Total stockholders equity	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$330.91M	USD	Point-in-time
Total stockholders equity	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$349.69M	USD	Point-in-time
Total stockholders equity	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$440.32M	USD	Point-in-time
Total liabilities, mezzanine equity, and stockholders equity	`LiabilitiesAndStockholdersEquity`	$871.29M	USD	Point-in-time
Total liabilities, mezzanine equity, and stockholders equity	`LiabilitiesAndStockholdersEquity`	$817.49M	USD	Point-in-time

Income Statement 80 line items

Line Item	Tag	Value	Unit	Period
Total revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$227.12M	USD	1 Quarter
Total revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$180.12M	USD	1 Quarter
Total revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$510.40M	USD	3 Qtrs
Total revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$578.82M	USD	3 Qtrs
Cost of services, excluding depreciation and amortization	`CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization`	$424.30M	USD	3 Qtrs
Cost of services, excluding depreciation and amortization	`CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization`	$147.47M	USD	1 Quarter
Cost of services, excluding depreciation and amortization	`CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization`	$402.11M	USD	3 Qtrs
Cost of services, excluding depreciation and amortization	`CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization`	$121.82M	USD	1 Quarter
General and administrative expenses	`GeneralAndAdministrativeExpense`	$39.66M	USD	3 Qtrs
General and administrative expenses	`GeneralAndAdministrativeExpense`	$16.27M	USD	1 Quarter
General and administrative expenses	`GeneralAndAdministrativeExpense`	$21.81M	USD	1 Quarter
General and administrative expenses	`GeneralAndAdministrativeExpense`	$45.48M	USD	3 Qtrs
Depreciation and amortization	`CostOfGoodsAndServicesSoldDepreciationAndAmortization`	$14.00M	USD	3 Qtrs
Depreciation and amortization	`CostOfGoodsAndServicesSoldDepreciationAndAmortization`	$13.11M	USD	3 Qtrs
Depreciation and amortization	`CostOfGoodsAndServicesSoldDepreciationAndAmortization`	$4.67M	USD	1 Quarter
Depreciation and amortization	`CostOfGoodsAndServicesSoldDepreciationAndAmortization`	$4.67M	USD	1 Quarter
Total expenses	`CostsAndExpenses`	$455.77M	USD	3 Qtrs
Total expenses	`CostsAndExpenses`	$142.77M	USD	1 Quarter
Total expenses	`CostsAndExpenses`	$482.88M	USD	3 Qtrs
Total expenses	`CostsAndExpenses`	$173.96M	USD	1 Quarter
Income from operations	`OperatingIncomeLoss`	$95.93M	USD	3 Qtrs
Income from operations	`OperatingIncomeLoss`	$37.36M	USD	1 Quarter
Income from operations	`OperatingIncomeLoss`	$54.63M	USD	3 Qtrs
Income from operations	`OperatingIncomeLoss`	$53.16M	USD	1 Quarter
Income (loss) from equity method investments	`IncomeLossFromEquityMethodInvestments`	$132.00K	USD	1 Quarter
Income (loss) from equity method investments	`IncomeLossFromEquityMethodInvestments`	$403.00K	USD	1 Quarter
Income (loss) from equity method investments	`IncomeLossFromEquityMethodInvestments`	$-3.68M	USD	3 Qtrs
Income (loss) from equity method investments	`IncomeLossFromEquityMethodInvestments`	$3.29M	USD	3 Qtrs
Gain on sale of equity method investment	`EquityMethodInvestmentRealizedGainLossOnDisposal`	$2.19M	USD	1 Quarter
Gain on sale of equity method investment	`EquityMethodInvestmentRealizedGainLossOnDisposal`	$2.19M	USD	3 Qtrs
Gain on sale of equity method investment	`EquityMethodInvestmentRealizedGainLossOnDisposal`	$99.65M	USD	3 Qtrs
Gain on sale of equity method investment	`EquityMethodInvestmentRealizedGainLossOnDisposal`	-	USD	1 Quarter
Interest expense	`InterestExpense`	$2.47M	USD	1 Quarter
Interest expense	`InterestExpense`	$4.34M	USD	3 Qtrs
Interest expense	`InterestExpense`	$967.00K	USD	1 Quarter
Interest expense	`InterestExpense`	$8.01M	USD	3 Qtrs
Interest income	`InvestmentIncomeInterest`	$752.00K	USD	1 Quarter
Interest income	`InvestmentIncomeInterest`	$420.00K	USD	1 Quarter
Interest income	`InvestmentIncomeInterest`	$2.54M	USD	3 Qtrs
Interest income	`InvestmentIncomeInterest`	$1.33M	USD	3 Qtrs
Unrealized (loss) gain on investments	`UnrealizedGainLossOnInvestments`	$22.83M	USD	3 Qtrs
Unrealized (loss) gain on investments	`UnrealizedGainLossOnInvestments`	-	USD	1 Quarter
Unrealized (loss) gain on investments	`UnrealizedGainLossOnInvestments`	$-60.94M	USD	1 Quarter
Unrealized (loss) gain on investments	`UnrealizedGainLossOnInvestments`	-	USD	3 Qtrs
Other income (expense)	`OtherNonoperatingIncomeExpense`	$-14.08M	USD	3 Qtrs
Other income (expense)	`OtherNonoperatingIncomeExpense`	$1.51M	USD	3 Qtrs
Other income (expense)	`OtherNonoperatingIncomeExpense`	$130.00K	USD	1 Quarter
Other income (expense)	`OtherNonoperatingIncomeExpense`	$500.00K	USD	1 Quarter
Total other (expense) income, net	`NonoperatingIncomeExpense`	$4.25M	USD	3 Qtrs
Total other (expense) income, net	`NonoperatingIncomeExpense`	$98.99M	USD	3 Qtrs
Total other (expense) income, net	`NonoperatingIncomeExpense`	$-1.18M	USD	1 Quarter
Total other (expense) income, net	`NonoperatingIncomeExpense`	$-58.66M	USD	1 Quarter
(Loss) income before (benefit from) provision for income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$-5.50M	USD	1 Quarter
(Loss) income before (benefit from) provision for income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$153.62M	USD	3 Qtrs
(Loss) income before (benefit from) provision for income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$36.17M	USD	1 Quarter
(Loss) income before (benefit from) provision for income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$100.18M	USD	3 Qtrs
(Benefit from) provision for income taxes	`IncomeTaxExpenseBenefit`	$31.57M	USD	3 Qtrs
(Benefit from) provision for income taxes	`IncomeTaxExpenseBenefit`	$44.20M	USD	3 Qtrs
(Benefit from) provision for income taxes	`IncomeTaxExpenseBenefit`	$-120.00K	USD	1 Quarter
(Benefit from) provision for income taxes	`IncomeTaxExpenseBenefit`	$10.75M	USD	1 Quarter
Net (loss) income	`ProfitLoss`	$109.41M	USD	3 Qtrs
Net (loss) income	`ProfitLoss`	$68.60M	USD	3 Qtrs
Net (loss) income	`ProfitLoss`	$-5.38M	USD	1 Quarter
Net (loss) income	`ProfitLoss`	$25.42M	USD	1 Quarter
Net (loss) income attributable to noncontrolling interest	`NetIncomeLossAttributableToNoncontrollingInterest`	$-39.66M	USD	1 Quarter
Net (loss) income attributable to noncontrolling interest	`NetIncomeLossAttributableToNoncontrollingInterest`	$81.60M	USD	3 Qtrs
Net (loss) income attributable to noncontrolling interest	`NetIncomeLossAttributableToNoncontrollingInterest`	$8.52M	USD	3 Qtrs
Net (loss) income attributable to noncontrolling interest	`NetIncomeLossAttributableToNoncontrollingInterest`	$8.71M	USD	1 Quarter
Net income attributable to Apollo Medical Holdings, Inc.	`NetIncomeLoss`	$60.09M	USD	3 Qtrs
Net income attributable to Apollo Medical Holdings, Inc.	`NetIncomeLoss`	$16.71M	USD	1 Quarter
Net income attributable to Apollo Medical Holdings, Inc.	`NetIncomeLoss`	$27.81M	USD	3 Qtrs
Net income attributable to Apollo Medical Holdings, Inc.	`NetIncomeLoss`	$34.28M	USD	1 Quarter
Earnings per share basic (in dollars per share)	`EarningsPerShareBasic`	$0.46	USD	1 Quarter
Earnings per share basic (in dollars per share)	`EarningsPerShareBasic`	$0.77	USD	1 Quarter
Earnings per share basic (in dollars per share)	`EarningsPerShareBasic`	$0.77	USD	3 Qtrs
Earnings per share basic (in dollars per share)	`EarningsPerShareBasic`	$1.38	USD	3 Qtrs
Earnings per share diluted (in dollars per share)	`EarningsPerShareDiluted`	$0.74	USD	1 Quarter
Earnings per share diluted (in dollars per share)	`EarningsPerShareDiluted`	$0.45	USD	1 Quarter
Earnings per share diluted (in dollars per share)	`EarningsPerShareDiluted`	$1.33	USD	3 Qtrs
Earnings per share diluted (in dollars per share)	`EarningsPerShareDiluted`	$0.75	USD	3 Qtrs

Cash Flow Statement 128 line items

Line Item	Tag	Value	Unit	Period
Net income	`ProfitLoss`	$109.41M	USD	3 Qtrs
Net income	`ProfitLoss`	$68.60M	USD	3 Qtrs
Net income	`ProfitLoss`	$-5.38M	USD	1 Quarter
Net income	`ProfitLoss`	$25.42M	USD	1 Quarter
Depreciation and amortization	`DepreciationDepletionAndAmortization`	$14.00M	USD	3 Qtrs
Depreciation and amortization	`DepreciationDepletionAndAmortization`	$13.11M	USD	3 Qtrs
Amortization of debt issuance costs	`AmortizationOfFinancingCosts`	$1.00M	USD	3 Qtrs
Amortization of debt issuance costs	`AmortizationOfFinancingCosts`	$900.00K	USD	3 Qtrs
Share-based compensation	`ShareBasedCompensation`	$2.56M	USD	3 Qtrs
Share-based compensation	`ShareBasedCompensation`	$4.32M	USD	3 Qtrs
Unrealized (gain) loss from investment in equity securities	`UnrealizedGainLossFromInvestmentInEquitySecurities`	$22.83M	USD	3 Qtrs
Unrealized (gain) loss from investment in equity securities	`UnrealizedGainLossFromInvestmentInEquitySecurities`	$-23.00K	USD	3 Qtrs
Loss (income) from equity method investments	`IncomeLossFromEquityMethodInvestments`	$132.00K	USD	1 Quarter
Loss (income) from equity method investments	`IncomeLossFromEquityMethodInvestments`	$403.00K	USD	1 Quarter
Loss (income) from equity method investments	`IncomeLossFromEquityMethodInvestments`	$-3.68M	USD	3 Qtrs
Loss (income) from equity method investments	`IncomeLossFromEquityMethodInvestments`	$3.29M	USD	3 Qtrs
Gain on sale of equity method investment	`EquityMethodInvestmentRealizedGainLossOnDisposal`	$2.19M	USD	1 Quarter
Gain on sale of equity method investment	`EquityMethodInvestmentRealizedGainLossOnDisposal`	$2.19M	USD	3 Qtrs
Gain on sale of equity method investment	`EquityMethodInvestmentRealizedGainLossOnDisposal`	$99.65M	USD	3 Qtrs
Gain on sale of equity method investment	`EquityMethodInvestmentRealizedGainLossOnDisposal`	-	USD	1 Quarter
Impairment of beneficial interest	`AssetImpairmentCharges`	$15.72M	USD	3 Qtrs
Impairment of beneficial interest	`AssetImpairmentCharges`	-	USD	3 Qtrs
Loss on interest rate swaps	`DerivativeLossOnDerivative`	-	USD	3 Qtrs
Loss on interest rate swaps	`DerivativeLossOnDerivative`	$1.07M	USD	3 Qtrs
Deferred tax	`DeferredIncomeTaxesAndTaxCredits`	$6.85M	USD	3 Qtrs
Deferred tax	`DeferredIncomeTaxesAndTaxCredits`	$-6.14M	USD	3 Qtrs
Other	`ProceedsFromOtherOperatingActivities`	-	USD	3 Qtrs
Other	`ProceedsFromOtherOperatingActivities`	$189.00K	USD	3 Qtrs
Receivables, net	`IncreaseDecreaseInAccountsReceivable`	$10.69M	USD	3 Qtrs
Receivables, net	`IncreaseDecreaseInAccountsReceivable`	$6.95M	USD	3 Qtrs
Receivables, net related parties	`IncreaseDecreaseInDueFromRelatedParties`	$-6.62M	USD	3 Qtrs
Receivables, net related parties	`IncreaseDecreaseInDueFromRelatedParties`	$4.37M	USD	3 Qtrs
Other receivables	`IncreaseDecreaseInOtherReceivables`	$1.48M	USD	3 Qtrs
Other receivables	`IncreaseDecreaseInOtherReceivables`	$-12.90M	USD	3 Qtrs
Prepaid expenses and other current assets	`IncreaseDecreaseInPrepaidExpensesAndOtherCurrentAssets`	$-5.06M	USD	3 Qtrs
Prepaid expenses and other current assets	`IncreaseDecreaseInPrepaidExpensesAndOtherCurrentAssets`	$1.80M	USD	3 Qtrs
Right-of-use assets	`IncreaseDecreaseInOperatingLeaseAssets`	$2.60M	USD	3 Qtrs
Right-of-use assets	`IncreaseDecreaseInOperatingLeaseAssets`	$2.44M	USD	3 Qtrs
Other assets	`IncreaseDecreaseInOtherOperatingAssets`	$954.00K	USD	3 Qtrs
Other assets	`IncreaseDecreaseInOtherOperatingAssets`	$5.09M	USD	3 Qtrs
Accounts payable and accrued expenses	`IncreaseDecreaseInAccountsPayableAndAccruedLiabilities`	$14.36M	USD	3 Qtrs
Accounts payable and accrued expenses	`IncreaseDecreaseInAccountsPayableAndAccruedLiabilities`	$12.64M	USD	3 Qtrs
Fiduciary accounts payable	`IncreaseDecreaseInOtherAccountsPayable`	$-815.00K	USD	3 Qtrs
Fiduciary accounts payable	`IncreaseDecreaseInOtherAccountsPayable`	$1.96M	USD	3 Qtrs
Medical liabilities	`IncreaseDecreaseInMedicalLiabilities`	$-7.63M	USD	3 Qtrs
Medical liabilities	`IncreaseDecreaseInMedicalLiabilities`	$-1.57M	USD	3 Qtrs
Income taxes payable	`IncreaseDecreaseInAccruedIncomeTaxesPayable`	$-300.00K	USD	3 Qtrs
Income taxes payable	`IncreaseDecreaseInAccruedIncomeTaxesPayable`	$11.64M	USD	3 Qtrs
Operating lease liabilities	`IncreaseDecreaseInOperatingLeaseLiability`	$-2.11M	USD	3 Qtrs
Operating lease liabilities	`IncreaseDecreaseInOperatingLeaseLiability`	$-2.53M	USD	3 Qtrs
Net cash provided by operating activities	`NetCashProvidedByUsedInOperatingActivities`	$82.53M	USD	3 Qtrs
Net cash provided by operating activities	`NetCashProvidedByUsedInOperatingActivities`	$48.76M	USD	3 Qtrs
Payments for business acquisition, net of cash acquired	`PaymentsToAcquireBusinessesNetOfCashAcquired`	-	USD	3 Qtrs
Payments for business acquisition, net of cash acquired	`PaymentsToAcquireBusinessesNetOfCashAcquired`	$2.58M	USD	3 Qtrs
Proceeds from repayment of loans receivable related parties	`ProceedsFromCollectionOfLongtermLoansToRelatedParties`	$41.00K	USD	3 Qtrs
Proceeds from repayment of loans receivable related parties	`ProceedsFromCollectionOfLongtermLoansToRelatedParties`	$16.50M	USD	3 Qtrs
Purchases of marketable securities	`PaymentsToAcquireMarketableSecurities`	$1.01M	USD	3 Qtrs
Purchases of marketable securities	`PaymentsToAcquireMarketableSecurities`	$1.79M	USD	3 Qtrs
Purchase of investment equity method	`PaymentsToAcquireEquityMethodInvestments`	$500.00K	USD	3 Qtrs
Purchase of investment equity method	`PaymentsToAcquireEquityMethodInvestments`	$13.38M	USD	3 Qtrs
Proceeds from sale of equity method investment	`ProceedsFromSaleOfEquityMethodInvestments`	$52.74M	USD	3 Qtrs
Proceeds from sale of equity method investment	`ProceedsFromSaleOfEquityMethodInvestments`	$6.38M	USD	3 Qtrs
Purchases of property and equipment	`PaymentsToAcquirePropertyPlantAndEquipment`	$553.00K	USD	3 Qtrs
Purchases of property and equipment	`PaymentsToAcquirePropertyPlantAndEquipment`	$16.42M	USD	3 Qtrs
Cash received from consolidation of VIE	`ProceedsFromCashReceivedFromConsolidationOfVariableInterestEntity`	$3.32M	USD	3 Qtrs
Cash received from consolidation of VIE	`ProceedsFromCashReceivedFromConsolidationOfVariableInterestEntity`	-	USD	3 Qtrs
Proceeds from sale of marketable securities	`ProceedsFromSaleAndMaturityOfMarketableSecurities`	$1.11M	USD	3 Qtrs
Proceeds from sale of marketable securities	`ProceedsFromSaleAndMaturityOfMarketableSecurities`	-	USD	3 Qtrs
Net cash (used in) provided by investing activities	`NetCashProvidedByUsedInInvestingActivities`	$-22.54M	USD	3 Qtrs
Net cash (used in) provided by investing activities	`NetCashProvidedByUsedInInvestingActivities`	$66.40M	USD	3 Qtrs
Dividends paid	`PaymentsOfDividends`	$50.13M	USD	3 Qtrs
Dividends paid	`PaymentsOfDividends`	$31.09M	USD	3 Qtrs
Repayment of long-term debt	`RepaymentsOfLongTermDebt`	$238.25M	USD	3 Qtrs
Repayment of long-term debt	`RepaymentsOfLongTermDebt`	$7.12M	USD	3 Qtrs
Payment of finance lease obligations	`FinanceLeasePrincipalPayments`	$78.00K	USD	3 Qtrs
Payment of finance lease obligations	`FinanceLeasePrincipalPayments`	$81.00K	USD	3 Qtrs
Proceeds from the exercise of stock options and warrants	`ProceedsFromWarrantExercises`	$6.60M	USD	3 Qtrs
Proceeds from the exercise of stock options and warrants	`ProceedsFromWarrantExercises`	$6.55M	USD	3 Qtrs
Repurchase of shares	`PaymentsForRepurchaseOfCommonStock`	$1.56M	USD	3 Qtrs
Repurchase of shares	`PaymentsForRepurchaseOfCommonStock`	$5.74M	USD	3 Qtrs
Distribution to noncontrolling interest	`PaymentsToMinorityShareholders`	$75.00K	USD	3 Qtrs
Distribution to noncontrolling interest	`PaymentsToMinorityShareholders`	-	USD	3 Qtrs
Proceeds from sale of noncontrolling interest	`ProceedsFromSaleOfNoncontrollingInterest`	-	USD	3 Qtrs
Proceeds from sale of noncontrolling interest	`ProceedsFromSaleOfNoncontrollingInterest`	$48.00K	USD	3 Qtrs
Borrowings on revolver	`ProceedsFromLinesOfCredit`	-	USD	3 Qtrs
Borrowings on revolver	`ProceedsFromLinesOfCredit`	$180.00M	USD	3 Qtrs
Proceeds from sale of shares	`ProceedsFromIssuanceOfCommonStock`	-	USD	3 Qtrs
Proceeds from sale of shares	`ProceedsFromIssuanceOfCommonStock`	$40.13M	USD	3 Qtrs
Payment of debt issuance costs	`PaymentsOfDebtIssuanceCosts`	-	USD	3 Qtrs
Payment of debt issuance costs	`PaymentsOfDebtIssuanceCosts`	$727.00K	USD	3 Qtrs
Net cash used in financing activities	`NetCashProvidedByUsedInFinancingActivities`	$-52.34M	USD	3 Qtrs
Net cash used in financing activities	`NetCashProvidedByUsedInFinancingActivities`	$-49.18M	USD	3 Qtrs
Net increase in cash, cash equivalents, and restricted cash	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect`	$10.80M	USD	3 Qtrs
Net increase in cash, cash equivalents, and restricted cash	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect`	$62.82M	USD	3 Qtrs
Cash, cash equivalents, and restricted cash, beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$204.77M	USD	Point-in-time
Cash, cash equivalents, and restricted cash, beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$166.83M	USD	Point-in-time
Cash, cash equivalents, and restricted cash, beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$193.97M	USD	Point-in-time
Cash, cash equivalents, and restricted cash, beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$104.01M	USD	Point-in-time
Cash, cash equivalents, and restricted cash, end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$204.77M	USD	Point-in-time
Cash, cash equivalents, and restricted cash, end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$166.83M	USD	Point-in-time
Cash, cash equivalents, and restricted cash, end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$193.97M	USD	Point-in-time
Cash, cash equivalents, and restricted cash, end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$104.01M	USD	Point-in-time
Cash paid for income taxes	`IncomeTaxesPaid`	$37.90M	USD	3 Qtrs
Cash paid for income taxes	`IncomeTaxesPaid`	$24.80M	USD	3 Qtrs
Cash paid for interest	`InterestPaidNet`	$6.96M	USD	3 Qtrs
Cash paid for interest	`InterestPaidNet`	$3.33M	USD	3 Qtrs
Dividend declared included in dividend payable	`DividendsPayableCurrentAndNoncurrent`	$485.00K	USD	Point-in-time
Dividend declared included in dividend payable	`DividendsPayableCurrentAndNoncurrent`	$71.00K	USD	Point-in-time
Preferred shares received from sale of equity investment	`NoncashOrPartNoncashDivestitureAmountOfConsiderationReceived1`	$36.18M	USD	3 Qtrs
Preferred shares received from sale of equity investment	`NoncashOrPartNoncashDivestitureAmountOfConsiderationReceived1`	-	USD	3 Qtrs
Cancellation of restricted stock awards	`CancellationOfRestrictedStockAwards`	$334.00K	USD	3 Qtrs
Cancellation of restricted stock awards	`CancellationOfRestrictedStockAwards`	-	USD	3 Qtrs
Deferred tax liability adjustment to goodwill	`DeferredTaxLiabilitiesAdjustedToGoodwill`	$1.79M	USD	3 Qtrs
Deferred tax liability adjustment to goodwill	`DeferredTaxLiabilitiesAdjustedToGoodwill`	-	USD	3 Qtrs
Deferred tax liability adjustment related to warrant exercises	`DeferredTaxLiabilitiesWarrantsExercised`	-	USD	3 Qtrs
Deferred tax liability adjustment related to warrant exercises	`DeferredTaxLiabilitiesWarrantsExercised`	$473.00K	USD	3 Qtrs
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$103.19M	USD	Point-in-time
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$204.77M	USD	Point-in-time
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$166.08M	USD	Point-in-time
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$193.47M	USD	Point-in-time
Restricted cash - noncurrent	`RestrictedCashEquivalentsNoncurrent`	$746.00K	USD	Point-in-time
Restricted cash - noncurrent	`RestrictedCashEquivalentsNoncurrent`	$75.00K	USD	Point-in-time
Restricted cash - noncurrent	`RestrictedCashEquivalentsNoncurrent`	-	USD	Point-in-time
Restricted cash - noncurrent	`RestrictedCashEquivalentsNoncurrent`	-	USD	Point-in-time
Cash, cash equivalents, restricted cash total	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$204.77M	USD	Point-in-time
Cash, cash equivalents, restricted cash total	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$166.83M	USD	Point-in-time
Cash, cash equivalents, restricted cash total	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$193.97M	USD	Point-in-time
Cash, cash equivalents, restricted cash total	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$104.01M	USD	Point-in-time

Stockholders Equity 61 line items

Line Item	Tag	Value	Unit	Period
Equity, beginning balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$192.34M	USD	Point-in-time
Equity, beginning balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$229.42M	USD	Point-in-time
Equity, beginning balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$404.58M	USD	Point-in-time
Equity, beginning balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$207.85M	USD	Point-in-time
Equity, beginning balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$197.96M	USD	Point-in-time
Equity, beginning balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$330.91M	USD	Point-in-time
Equity, beginning balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$349.69M	USD	Point-in-time
Equity, beginning balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$440.32M	USD	Point-in-time
Net (loss) income	`NetIncomeLossIncludingPortionAttributableToNoncontrollingInterestAndTemporaryEquity`	$13.70M	USD	1 Quarter
Net (loss) income	`NetIncomeLossIncludingPortionAttributableToNoncontrollingInterestAndTemporaryEquity`	$16.90M	USD	1 Quarter
Net (loss) income	`NetIncomeLossIncludingPortionAttributableToNoncontrollingInterestAndTemporaryEquity`	$34.97M	USD	1 Quarter
Net (loss) income	`NetIncomeLossIncludingPortionAttributableToNoncontrollingInterestAndTemporaryEquity`	$4.15M	USD	1 Quarter
Net (loss) income	`NetIncomeLossIncludingPortionAttributableToNoncontrollingInterestAndTemporaryEquity`	$7.33M	USD	1 Quarter
Net (loss) income	`NetIncomeLossIncludingPortionAttributableToNoncontrollingInterestAndTemporaryEquity`	$12.67M	USD	1 Quarter
Purchase of noncontrolling interest	`MinorityInterestDecreaseFromRedemptions`	-	USD	1 Quarter
Purchase of noncontrolling interest	`MinorityInterestDecreaseFromRedemptions`	-	USD	1 Quarter
Purchase of noncontrolling interest	`MinorityInterestDecreaseFromRedemptions`	$75.00K	USD	1 Quarter
Purchase of noncontrolling interest	`MinorityInterestDecreaseFromRedemptions`	-	USD	1 Quarter
Cancellation of restricted stock awards	`StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures`	$236.00K	USD	1 Quarter
Cancellation of restricted stock awards	`StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures`	$189.00K	USD	1 Quarter
Cancellation of restricted stock awards	`StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures`	-	USD	1 Quarter
Cancellation of restricted stock awards	`StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures`	$144.00K	USD	1 Quarter
Shares issued for vesting of restricted stock awards	`StockIssuedDuringPeriodValueRestrictedStockAwardGross`	-	USD	1 Quarter
Shares issued for vesting of restricted stock awards	`StockIssuedDuringPeriodValueRestrictedStockAwardGross`	-	USD	1 Quarter
Shares issued for vesting of restricted stock awards	`StockIssuedDuringPeriodValueRestrictedStockAwardGross`	-	USD	1 Quarter
Shares issued for exercise of options and warrants	`StockIssuedDuringThePeriodValueOfExerciseOfOptionAndWarrants`	$1.78M	USD	1 Quarter
Shares issued for exercise of options and warrants	`StockIssuedDuringThePeriodValueOfExerciseOfOptionAndWarrants`	$561.00K	USD	1 Quarter
Shares issued for exercise of options and warrants	`StockIssuedDuringThePeriodValueOfExerciseOfOptionAndWarrants`	$4.02M	USD	1 Quarter
Shares issued for exercise of options and warrants	`StockIssuedDuringThePeriodValueOfExerciseOfOptionAndWarrants`	$4.26M	USD	1 Quarter
Shares issued for exercise of options and warrants	`StockIssuedDuringThePeriodValueOfExerciseOfOptionAndWarrants`	$2.28M	USD	1 Quarter
Shares issued for exercise of options and warrants	`StockIssuedDuringThePeriodValueOfExerciseOfOptionAndWarrants`	$722.00K	USD	1 Quarter
Shares issued for cashless exercise of warrants	`StockIssuedDuringPeriodValueCashlessWarrantsExercised`	-	USD	1 Quarter
Purchase of treasury shares	`TreasuryStockValueAcquiredParValueMethod`	$2.95M	USD	1 Quarter
Purchase of treasury shares	`TreasuryStockValueAcquiredParValueMethod`	$2.45M	USD	1 Quarter
Purchase of treasury shares	`TreasuryStockValueAcquiredParValueMethod`	$342.00K	USD	1 Quarter
Purchase of treasury shares	`TreasuryStockValueAcquiredParValueMethod`	$301.00K	USD	1 Quarter
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$1.56M	USD	1 Quarter
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$1.35M	USD	1 Quarter
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$648.00K	USD	1 Quarter
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$1.42M	USD	1 Quarter
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$1.06M	USD	1 Quarter
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$852.00K	USD	1 Quarter
Sale of shares by noncontrolling interest	`StockIssuedDuringPeriodValueAcquisitions`	$40.13M	USD	1 Quarter
Investment in noncontrolling interest	`NoncontrollingInterestIncreaseFromBusinessCombination`	$3.77M	USD	1 Quarter
Investment in noncontrolling interest	`NoncontrollingInterestIncreaseFromBusinessCombination`	$500.00K	USD	1 Quarter
Noncontrolling interest capital charge	`NoncontrollingInterestIncreaseFromCapitalCharge`	$10.00K	USD	1 Quarter
Dividends	`MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders`	-	USD	1 Quarter
Dividends	`MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders`	-	USD	1 Quarter
Dividends	`MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders`	$347.00K	USD	1 Quarter
Dividends	`MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders`	-	USD	1 Quarter
Dividends	`MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders`	$1.16M	USD	1 Quarter
Sales of noncontrolling interest	`NoncontrollingInterestIncreaseFromSaleOfParentEquityInterest`	$37.00K	USD	1 Quarter
Sales of noncontrolling interest	`NoncontrollingInterestIncreaseFromSaleOfParentEquityInterest`	-	USD	1 Quarter
Equity, ending balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$192.34M	USD	Point-in-time
Equity, ending balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$229.42M	USD	Point-in-time
Equity, ending balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$404.58M	USD	Point-in-time
Equity, ending balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$207.85M	USD	Point-in-time
Equity, ending balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$197.96M	USD	Point-in-time
Equity, ending balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$330.91M	USD	Point-in-time
Equity, ending balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$349.69M	USD	Point-in-time
Equity, ending balance	`StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest`	$440.32M	USD	Point-in-time

Data is extracted from SEC EDGAR XBRL filings. Values shown are as reported in the filing.