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CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands
9 Months Ended
Sep. 30, 2011
Sep. 30, 2010
CASH FLOWS FROM OPERATING ACTIVITIES  
Net income (loss)$ 2,846$ (16,077)
Depreciation and amortization42,52640,153
Provision for bad debts25,26124,603
Equity in earnings of joint ventures(6,129)(6,114)
Distributions from joint ventures6,4088,339
Deferred rent amortization1,9191,875
Amortization of deferred financing costs2,1862,074
Amortization of bond discount180107
Loss (gain) on sale and disposal of equipment(1,928)606
Loss on extinguishment of debt 9,871
Amortization of cash flow hedge918611
Stock-based compensation2,4992,820
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:  
Accounts receivable(49,865)(27,678)
Other current assets(2,312)(5,675)
Other assets(464)(48)
Deferred revenue(377) 
Accounts payable and accrued expenses10,38414,687
Net cash provided by operating activities34,05250,154
CASH FLOWS FROM INVESTING ACTIVITIES  
Purchase of imaging facilities(13,686)(34,580)
Purchase of property and equipment(34,283)(33,135)
Proceeds from insurance claims on damaged equipment2,740 
Proceeds from sale of equipment31094
Purchase of equity interest in joint ventures(1,500) 
Net cash used in investing activities(46,419)(67,621)
CASH FLOWS FROM FINANCING ACTIVITIES  
Principal payments on notes and leases payable(14,397)(16,295)
Repayment of debt (412,000)
Proceeds from borrowings 482,360
Deferred financing costs(217)(17,407)
Proceeds from, net of payments on, line of credit31,300 
Payments to counterparties of interest rate swaps, net of amounts received(4,874)(4,783)
Distributions to noncontrolling interests(111)(84)
Proceeds from issuance of common stock upon exercise of options/warrants24249
Net cash provided by financing activities11,94331,840
EFFECT OF EXCHANGE RATE CHANGES ON CASH51(5)
NET (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS(373)14,368
CASH AND CASH EQUIVALENTS, beginning of period62710,094
CASH AND CASH EQUIVALENTS, end of period25424,462
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION  
Cash paid during the period for interest$ 30,847$ 23,579