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CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands, unless otherwise specified
 12 Months Ended
Dec. 31, 2011
Dec. 31, 2010
Dec. 31, 2009
CASH FLOWS FROM OPERATING ACTIVITIES      
Net income (loss) $ 7,342 $ (12,685) $ (2,175)
Depreciation and amortization 57,481 53,997 53,800
Provision for bad debts 34,679 33,158 32,704
Equity in earnings of joint ventures (5,224) (4,952) (5,209)
Distributions from joint ventures 4,993 7,639 4,420
Deferred rent amortization 2,282 1,848 1,094
Amortization of deferred financing cost 2,940 2,797 2,678
Amortization of bond discount 244 164  
Loss (gain) on sale and disposal of equipment (2,240) 1,136 523
Loss on extinguishment of debt   9,871  
Gain on bargain purchase     (1,387)
Amortization of cash flow hedge 1,225 917 6,119
Stock-based compensation 3,110 3,718 3,607
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:      
Accounts receivable (57,354) (35,985) (24,432)
Other current assets (3,935) (3,226) 4,206
Other assets 43 24 51
Deferred revenue (492) 207  
Accounts payable and accrued expenses 12,542 8,256 619
Net cash provided by operating activities 57,636 66,884 76,618
CASH FLOWS FROM INVESTING ACTIVITIES      
Purchase of imaging facilities (42,990) (61,774) (6,085)
Proceeds from sale of imaging facilities     650
Purchase of property and equipment (42,720) (40,293) (30,752)
Proceeds from sale of equipment 325 685 219
Proceeds from insurance claims on damaged equipment 2,740    
Purchase of equity interest in joint ventures (5,094)   (315)
Net cash used in investing activities (87,739) (101,382) (36,283)
CASH FLOWS FROM FINANCING ACTIVITIES      
Principal payments on notes and leases payable (18,756) (21,463) (23,660)
Proceeds from borrowings upon refinancing   482,360  
Repayment of debt   (412,000)  
Deferred financing costs (944) (17,613)  
Proceeds from, net of payments on, line of credit 58,000   (1,742)
Payments to counterparties of interest rate swaps, net of amounts received (6,455) (6,382) (4,739)
Distributions to noncontrolling interests (154) (131) (116)
Proceeds from issuance of common stock upon exercise of options/warrants 242 271 16
Net cash provided by (used in) financing activities 31,933 25,042 (30,241)
EFFECT OF EXCHANGE RATE CHANGES ON CASH (2) (11)  
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS 1,828 (9,467) 10,094
CASH AND CASH EQUIVALENTS, beginning of period 627 10,094  
CASH AND CASH EQUIVALENTS, end of period 2,455 627 10,094
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION      
Cash paid during the period for interest 47,310 40,352 40,092
Cash paid during the period for income taxes $ 514 $ 659 $ 348