we have put preparedness plans in place at our facilities to maintain continuity of operations , while also taking steps to keep employees and patients safe . in line with recommendations to reduce large gatherings and increase social distancing , we have , where practical , transitioned a large number of office-based employees to a remote work environment . in march 2020 , in response to the covid-19 pandemic , the coronavirus aid , relief , and economic security act ( “ cares act ” ) was signed into law . the cares act provides numerous tax provisions and other stimulus measures , including temporary changes regarding the prior and future utilization of net operating losses , temporary changes to the prior and future limitations on interest deductions , temporary suspension of certain payment requirements for the employer portion of social security taxes , technical corrections from prior tax legislation for tax depreciation of certain qualified improvement property , and the creation of certain payroll tax credits associated with the retention of employees . we have received a number of benefits under the cares act including , but not limited to : the cares act allowed for qualified healthcare providers to receive advanced payments under the existing medicare accelerated and advance payments program ( “ maapp funds ” ) during the covid-19 pandemic . under this program , healthcare providers could choose to receive advanced payments for future medicare services provided . we applied for and received approval to receive maap funds from centers for medicare & medicaid services ( “ cms ” ) in april 2020. we will record these payments as a liability until all performance obligations have been met as the payments were made on behalf of patients before services were provided . currently , maapp funds received are required to be applied to future medicare billings commencing in august 2021 , with all such remaining amounts required to be repaid by january 2024. beginning january 2024 , any unpaid balance will begin accruing interest . we currently intend to repay funds prior to august 2021. included in cash and cash equivalents and accrued liabilities at december 31 , 2020 is $ 14.1 million of maapp funds . we elected to defer depositing the employer 's share of social security taxes for payments due from march 27 , 2020 through december 31 , 2020 , interest-free and penalty-free . as of december 31 , 2020 , $ 4.2 million related to these deferred payments is included in accrued liabilities and $ 4.1 million is included in long term liabilities . the cares act provided additional waivers , reimbursement , grants and other funds to assist health care providers during the covid-19 pandemic , including $ 100.0 billion in appropriations for the public health and social services emergency fund , also referred to as the provider relief fund , to be used for preventing , preparing , and responding to the coronavirus , and for reimbursing eligible health care providers for lost revenues and health care related expenses that are attributable to covid-19 . through december 31 , 2020 , our consolidated subsidiaries received approximately $ 13.5 million of payments under the cares act ( “ relief funds ” ) . in accordance with gaap , these payments have been recorded as other income – relief funds . for the year ended december 31 , 2020 , we have recognized approximately $ 13.5 million , as other income – relief funds on the accompanying consolidated statements of income . these funds are not required to be repaid upon attestation and provided that we comply with certain terms and conditions regarding the use of such funds , which could change materially based on evolving grant compliance provisions and guidance provided by the u.s. department of health and human services . currently , we can attest to and comply with the terms and conditions . we will continue to monitor the evolving guidelines and may record adjustments as additional information is released . critical accounting policies critical accounting policies are those that have a significant impact on our results of operations and financial position involving significant estimates requiring our judgment . our critical accounting policies are : 26 revenue recognition . revenues are recognized in the period in which services are rendered . net patient revenues consists of revenues for physical therapy and occupational therapy clinics that provide pre-and post-operative care and treatment for orthopedic related disorders , sports-related injuries , preventative care , rehabilitation of injured workers and neurological-related injuries . net patient revenues ( patient revenues less estimated contractual adjustments ) are recognized at the estimated net realizable amounts from third-party payors , patients and others in exchange for services rendered when obligations under the terms of the contract are satisfied . there is an implied contract between us and the patient upon each patient visit . generally , this occurs as we provide physical and occupational therapy services , as each service provided is distinct and future services rendered are not dependent on previously rendered services . we have agreements with third-party payors that provide for payments to us at amounts different from our established rates . the allowance for estimated contractual adjustments is based on terms of payor contracts and historical collection and write-off experience . management contract revenues , which are included in other revenues in the consolidated statements of net income , are derived from contractual arrangements whereby we manage a clinic owned by a third party . we do not have any ownership interest in these clinics . typically , revenues are determined based on the number of visits conducted at the clinic and recognized at the point in time when services are performed . costs , typically salaries for our employees , are recorded when incurred . story_separator_special_tag : replace_table_token_9_th for 2020 , our net income attributable to shareholders , in accordance with gaap , was $ 35.2 million as compared to $ 40.0 million for the comparable period of 2019. inclusive of the charge for revaluation of non-controlling interest , net of tax , used to compute diluted earnings per share in accordance with gaap , earnings per share was $ 2.48 per share for 2020 and $ 2.45 per share for 2019. for both 2020 and 2019 , in accordance with current accounting guidance , the revaluation of redeemable non-controlling interest , net of tax , is not included in net income but rather charged directly to retained earnings ; however , the charge for this change is included in the earnings per basic and diluted share calculation . see table below ( in thousands , except per share data ) . replace_table_token_10_th for 2020 , our operating results ( as defined below ) , including relief funds ( defined below ) , was $ 38.4 million , or $ 2.99 per diluted share , as compared to $ 36.0 million , or $ 2.82 per diluted share in 2019. for 2020 , our operating results , excluding relief funds , was $ 30.6 million , or $ 2.39 per diluted share , as compared to $ 36.0 million , or $ 2.82 per diluted share in 2019. operating results , a non-generally accepted accounting principle ( “ gaap ” ) measure , equals net income attributable to our shareholders per the consolidated statements of net income plus charges incurred for closure costs , less gain on the sale of partnership interests and clinics , less allocated non-controlling interests , excludes expenses incurred for the transition to our new chief financial officer , all net of tax . the earnings per share from operating results also excludes the impact of the revaluation of redeemable non-controlling interest . see table below for a detailed computation ( in thousands , except per share data ) : 31 replace_table_token_11_th for 2020 , the company 's adjusted ebitda was $ 70.0 million compared to $ 72.8 million in 2019. for 2020 , the company 's adjusted ebitda , excluding relief funds , was $ 56.5 million . adjusted ebitda is defined as earnings before interest income , interest expense – debt and other , taxes , depreciation , amortization , derecognition of goodwill and equity-based awards compensation expense . see reconciliation of adjusted ebitda to net income attributable to our shareholders in the following table ( in thousands ) : 32 replace_table_token_12_th the above tables reconcile net income attributable to our shareholders calculated in accordance with gaap to adjusted ebitda and operating results , non-gaap measures defined above . we believe that operating results , which eliminates certain items described above that can be subject to volatility and unusual costs , is one of the principal measures to evaluate and monitor financial performance period over period . we also believe that operating results is useful information for investors to use in comparing the company 's period-to-period results as well as for comparing with other similar businesses . we believe adjusted ebitda is useful information for investors in comparing the company 's period-to-period results as well as comparing with similar businesses which report adjusted ebitda as defined by their company . operating results and adjusted ebitda are not measures of financial performance under gaap . operating results and adjusted ebitda should not be considered in isolation or as an alternative to , or substitute for , net income attributable to our shareholders presented in the consolidated financial statements . net patient revenues net patient revenues from physical therapy operations decreased approximately 13.8 % or $ 60.0 million to $ 373.3 million in 2020 from $ 433.3 million in 2019. included in net patient revenues above are revenues related to clinics sold or closed in 2020 and 2019 of $ 4.4 million in 2020 and $ 28.6 million in 2019. during 2020 , the company sold its interest in 14 clinics and closed 34 clinics . during 2019 , the company sold its interest in a partnership which include 30 clinics and closed 11 clinics . for comparison purposes , adjusted for revenue from the clinics sold or closed , net patient revenues from physical therapy operations was approximately $ 369.0 million in 2020 , inclusive of $ 9.7 million related to new clinics and $ 404.8 million in 2019. net patient revenues related to mature clinics decreased by $ 45.5 million in 2020 compared to 2019. the reduction is largely attributable to the adverse effects of the covid-19 pandemic . see table below for a detail of net patient revenues from physical therapy operations ( in thousands ) : replace_table_token_13_th including all clinics operational during 2020 and 2019 , the average net patient revenue per visit was $ 105.66 and $ 105.90 respectively . total patient visits were 3,533,371 in 2020 and 4,091,967 in 2019. the reduction is largely attributable to the adverse effects of the covid-19 pandemic . 33 net patient revenues are based on established billing rates less allowances and discounts for patients covered by contractual programs and workers ' compensation . net patient revenues reflect contractual and other adjustments , which we evaluate monthly , relating to patient discounts from certain payors . payments received under these contractual programs and workers ' compensation are based on predetermined rates and are generally less than the established billing rates of the clinics . other revenues other revenues , consisting primarily of revenues from our industrial injury prevention business and management fees revenue , increased by $ 1.0 million , from $ 48.6 million in 2019 to $ 49.6 million in 2020. revenues from management contracts were $ 8.4 million for 2020 as compared to $ 8.7 million for 2019. revenue from our industrial injury prevention business increased 4.6 % to $ 39.2 million in 2020 compared to $ 37.5 million

liquidity and capital resources we believe that our business is generating sufficient cash flow from operating activities to allow us to meet our short-term and long-term cash requirements , other than those with respect to future significant acquisitions . at december 31 , 2020 , we had $ 32.9 million in cash and cash equivalents compared to $ 23.5 million at december 31 , 2019. although the start-up costs associated with opening new clinics and our planned capital expenditures are significant , we believe that our cash and cash equivalents and availability under our amended credit agreement are sufficient to fund the working capital needs of our operating subsidiaries , future clinic development and acquisitions and investments through at least december 2021. significant acquisitions would likely require financing under our amended credit agreement . effective december 5 , 2013 , we entered into an amended and restated credit agreement with a commitment for a $ 125.0 million revolving credit facility . this agreement was amended in august 2015 , january 2016 , march 2017 and november 2017 ( hereafter referred to as “ amended credit agreement ” ) . the amended credit agreement is unsecured and has loan covenants , including requirements that we comply with a consolidated fixed charge coverage ratio and consolidated leverage ratio . proceeds from the amended credit agreement may be used for working capital , acquisitions , purchases of our common stock , dividend payments to our common stockholders , capital expenditures and other corporate purposes . the pricing grid is based on our consolidated leverage ratio with the applicable spread over libor ranging from 1.25 % to 2.0 % or the applicable spread over the base rate ranging from 0.1 % to 1 % . fees under the amended credit agreement include an unused commitment fee ranging from 0.25 % to 0.3 % depending on our consolidated leverage ratio and the amount of funds outstanding under the amended credit agreement .


 Write a concise suspicious activity report of the following text delimited by triple backquotes. Return your response as a formal report which covers the key points highlighting the location,dates,entity names and account holder information in chronological order of the text.
     ```liquidity and capital resources we believe that our business is generating sufficient cash flow from operating activities to allow us to meet our short-term and long-term cash requirements , other than those with respect to future significant acquisitions . at december 31 , 2020 , we had $ 32.9 million in cash and cash equivalents compared to $ 23.5 million at december 31 , 2019. although the start-up costs associated with opening new clinics and our planned capital expenditures are significant , we believe that our cash and cash equivalents and availability under our amended credit agreement are sufficient to fund the working capital needs of our operating subsidiaries , future clinic development and acquisitions and investments through at least december 2021. significant acquisitions would likely require financing under our amended credit agreement . effective december 5 , 2013 , we entered into an amended and restated credit agreement with a commitment for a $ 125.0 million revolving credit facility . this agreement was amended in august 2015 , january 2016 , march 2017 and november 2017 ( hereafter referred to as “ amended credit agreement ” ) . the amended credit agreement is unsecured and has loan covenants , including requirements that we comply with a consolidated fixed charge coverage ratio and consolidated leverage ratio . proceeds from the amended credit agreement may be used for working capital , acquisitions , purchases of our common stock , dividend payments to our common stockholders , capital expenditures and other corporate purposes . the pricing grid is based on our consolidated leverage ratio with the applicable spread over libor ranging from 1.25 % to 2.0 % or the applicable spread over the base rate ranging from 0.1 % to 1 % . fees under the amended credit agreement include an unused commitment fee ranging from 0.25 % to 0.3 % depending on our consolidated leverage ratio and the amount of funds outstanding under the amended credit agreement .
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 Suspicious Activity Report : we have put preparedness plans in place at our facilities to maintain continuity of operations , while also taking steps to keep employees and patients safe . in line with recommendations to reduce large gatherings and increase social distancing , we have , where practical , transitioned a large number of office-based employees to a remote work environment . in march 2020 , in response to the covid-19 pandemic , the coronavirus aid , relief , and economic security act ( “ cares act ” ) was signed into law . the cares act provides numerous tax provisions and other stimulus measures , including temporary changes regarding the prior and future utilization of net operating losses , temporary changes to the prior and future limitations on interest deductions , temporary suspension of certain payment requirements for the employer portion of social security taxes , technical corrections from prior tax legislation for tax depreciation of certain qualified improvement property , and the creation of certain payroll tax credits associated with the retention of employees . we have received a number of benefits under the cares act including , but not limited to : the cares act allowed for qualified healthcare providers to receive advanced payments under the existing medicare accelerated and advance payments program ( “ maapp funds ” ) during the covid-19 pandemic . under this program , healthcare providers could choose to receive advanced payments for future medicare services provided . we applied for and received approval to receive maap funds from centers for medicare & medicaid services ( “ cms ” ) in april 2020. we will record these payments as a liability until all performance obligations have been met as the payments were made on behalf of patients before services were provided . currently , maapp funds received are required to be applied to future medicare billings commencing in august 2021 , with all such remaining amounts required to be repaid by january 2024. beginning january 2024 , any unpaid balance will begin accruing interest . we currently intend to repay funds prior to august 2021. included in cash and cash equivalents and accrued liabilities at december 31 , 2020 is $ 14.1 million of maapp funds . we elected to defer depositing the employer 's share of social security taxes for payments due from march 27 , 2020 through december 31 , 2020 , interest-free and penalty-free . as of december 31 , 2020 , $ 4.2 million related to these deferred payments is included in accrued liabilities and $ 4.1 million is included in long term liabilities . the cares act provided additional waivers , reimbursement , grants and other funds to assist health care providers during the covid-19 pandemic , including $ 100.0 billion in appropriations for the public health and social services emergency fund , also referred to as the provider relief fund , to be used for preventing , preparing , and responding to the coronavirus , and for reimbursing eligible health care providers for lost revenues and health care related expenses that are attributable to covid-19 . through december 31 , 2020 , our consolidated subsidiaries received approximately $ 13.5 million of payments under the cares act ( “ relief funds ” ) . in accordance with gaap , these payments have been recorded as other income – relief funds . for the year ended december 31 , 2020 , we have recognized approximately $ 13.5 million , as other income – relief funds on the accompanying consolidated statements of income . these funds are not required to be repaid upon attestation and provided that we comply with certain terms and conditions regarding the use of such funds , which could change materially based on evolving grant compliance provisions and guidance provided by the u.s. department of health and human services . currently , we can attest to and comply with the terms and conditions . we will continue to monitor the evolving guidelines and may record adjustments as additional information is released . critical accounting policies critical accounting policies are those that have a significant impact on our results of operations and financial position involving significant estimates requiring our judgment . our critical accounting policies are : 26 revenue recognition . revenues are recognized in the period in which services are rendered . net patient revenues consists of revenues for physical therapy and occupational therapy clinics that provide pre-and post-operative care and treatment for orthopedic related disorders , sports-related injuries , preventative care , rehabilitation of injured workers and neurological-related injuries . net patient revenues ( patient revenues less estimated contractual adjustments ) are recognized at the estimated net realizable amounts from third-party payors , patients and others in exchange for services rendered when obligations under the terms of the contract are satisfied . there is an implied contract between us and the patient upon each patient visit . generally , this occurs as we provide physical and occupational therapy services , as each service provided is distinct and future services rendered are not dependent on previously rendered services . we have agreements with third-party payors that provide for payments to us at amounts different from our established rates . the allowance for estimated contractual adjustments is based on terms of payor contracts and historical collection and write-off experience . management contract revenues , which are included in other revenues in the consolidated statements of net income , are derived from contractual arrangements whereby we manage a clinic owned by a third party . we do not have any ownership interest in these clinics . typically , revenues are determined based on the number of visits conducted at the clinic and recognized at the point in time when services are performed . costs , typically salaries for our employees , are recorded when incurred . story_separator_special_tag : replace_table_token_9_th for 2020 , our net income attributable to shareholders , in accordance with gaap , was $ 35.2 million as compared to $ 40.0 million for the comparable period of 2019. inclusive of the charge for revaluation of non-controlling interest , net of tax , used to compute diluted earnings per share in accordance with gaap , earnings per share was $ 2.48 per share for 2020 and $ 2.45 per share for 2019. for both 2020 and 2019 , in accordance with current accounting guidance , the revaluation of redeemable non-controlling interest , net of tax , is not included in net income but rather charged directly to retained earnings ; however , the charge for this change is included in the earnings per basic and diluted share calculation . see table below ( in thousands , except per share data ) . replace_table_token_10_th for 2020 , our operating results ( as defined below ) , including relief funds ( defined below ) , was $ 38.4 million , or $ 2.99 per diluted share , as compared to $ 36.0 million , or $ 2.82 per diluted share in 2019. for 2020 , our operating results , excluding relief funds , was $ 30.6 million , or $ 2.39 per diluted share , as compared to $ 36.0 million , or $ 2.82 per diluted share in 2019. operating results , a non-generally accepted accounting principle ( “ gaap ” ) measure , equals net income attributable to our shareholders per the consolidated statements of net income plus charges incurred for closure costs , less gain on the sale of partnership interests and clinics , less allocated non-controlling interests , excludes expenses incurred for the transition to our new chief financial officer , all net of tax . the earnings per share from operating results also excludes the impact of the revaluation of redeemable non-controlling interest . see table below for a detailed computation ( in thousands , except per share data ) : 31 replace_table_token_11_th for 2020 , the company 's adjusted ebitda was $ 70.0 million compared to $ 72.8 million in 2019. for 2020 , the company 's adjusted ebitda , excluding relief funds , was $ 56.5 million . adjusted ebitda is defined as earnings before interest income , interest expense – debt and other , taxes , depreciation , amortization , derecognition of goodwill and equity-based awards compensation expense . see reconciliation of adjusted ebitda to net income attributable to our shareholders in the following table ( in thousands ) : 32 replace_table_token_12_th the above tables reconcile net income attributable to our shareholders calculated in accordance with gaap to adjusted ebitda and operating results , non-gaap measures defined above . we believe that operating results , which eliminates certain items described above that can be subject to volatility and unusual costs , is one of the principal measures to evaluate and monitor financial performance period over period . we also believe that operating results is useful information for investors to use in comparing the company 's period-to-period results as well as for comparing with other similar businesses . we believe adjusted ebitda is useful information for investors in comparing the company 's period-to-period results as well as comparing with similar businesses which report adjusted ebitda as defined by their company . operating results and adjusted ebitda are not measures of financial performance under gaap . operating results and adjusted ebitda should not be considered in isolation or as an alternative to , or substitute for , net income attributable to our shareholders presented in the consolidated financial statements . net patient revenues net patient revenues from physical therapy operations decreased approximately 13.8 % or $ 60.0 million to $ 373.3 million in 2020 from $ 433.3 million in 2019. included in net patient revenues above are revenues related to clinics sold or closed in 2020 and 2019 of $ 4.4 million in 2020 and $ 28.6 million in 2019. during 2020 , the company sold its interest in 14 clinics and closed 34 clinics . during 2019 , the company sold its interest in a partnership which include 30 clinics and closed 11 clinics . for comparison purposes , adjusted for revenue from the clinics sold or closed , net patient revenues from physical therapy operations was approximately $ 369.0 million in 2020 , inclusive of $ 9.7 million related to new clinics and $ 404.8 million in 2019. net patient revenues related to mature clinics decreased by $ 45.5 million in 2020 compared to 2019. the reduction is largely attributable to the adverse effects of the covid-19 pandemic . see table below for a detail of net patient revenues from physical therapy operations ( in thousands ) : replace_table_token_13_th including all clinics operational during 2020 and 2019 , the average net patient revenue per visit was $ 105.66 and $ 105.90 respectively . total patient visits were 3,533,371 in 2020 and 4,091,967 in 2019. the reduction is largely attributable to the adverse effects of the covid-19 pandemic . 33 net patient revenues are based on established billing rates less allowances and discounts for patients covered by contractual programs and workers ' compensation . net patient revenues reflect contractual and other adjustments , which we evaluate monthly , relating to patient discounts from certain payors . payments received under these contractual programs and workers ' compensation are based on predetermined rates and are generally less than the established billing rates of the clinics . other revenues other revenues , consisting primarily of revenues from our industrial injury prevention business and management fees revenue , increased by $ 1.0 million , from $ 48.6 million in 2019 to $ 49.6 million in 2020. revenues from management contracts were $ 8.4 million for 2020 as compared to $ 8.7 million for 2019. revenue from our industrial injury prevention business increased 4.6 % to $ 39.2 million in 2020 compared to $ 37.5 million

