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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands, unless otherwise specified
9 Months Ended
Sep. 30, 2012
Sep. 30, 2011
CASH FLOWS FROM OPERATING ACTIVITIES    
Net Income $ 7,728 $ 2,846
Depreciation and amortization 43,154 42,526
Provision for bad debt 19,453 16,260
Equity in earnings of joint ventures (4,157) (3,789)
Distributions from joint ventures 5,526 4,068
Deferred rent amortization 2,990 1,919
Amortization of deferred financing cost 2,309 2,186
Amortization of bond discount 200 180
Loss (gain) on sale and disposal of equipment 255 (1,928)
Gain on deconsolidation of joint venture (2,777)   
Amortization of cash flow hedge 827 918
Stock-based compensation 2,139 2,499
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:    
Accounts receivable (18,362) (40,864)
Other current assets (433) (2,312)
Other assets (51) (464)
Deferred revenue 72 (377)
Accounts payable, accrued expenses and other (3,255) 10,384
Net cash provided by operating activities 55,618 34,052
CASH FLOWS FROM INVESTING ACTIVITIES    
Purchase of imaging facilities (10,617) (13,686)
Purchase of property and equipment (35,279) (34,283)
Proceeds from insurance claims on damaged equipment    2,740
Proceeds from sale of equipment 841 310
Proceeds from sale of imaging facilities 2,300   
Proceeds from sale of joint venture interests 1,800   
Purchase of equity interest in joint ventures (2,756) (1,500)
Net cash used in investing activities (43,711) (46,419)
CASH FLOWS FROM FINANCING ACTIVITIES    
Principal payments on notes and leases payable (11,180) (14,397)
Deferred financing costs    (217)
Proceeds from, net of payments on, line of credit 1,800 31,300
Payments to counterparties of interest rate swaps, net of amounts received (4,587) (4,874)
Distributions to noncontrolling interests (67) (111)
Proceeds from issuance of common stock upon exercise of options/warrants    242
Net cash (used in) provided by financing activities (14,034) 11,943
EFFECT OF EXCHANGE RATE CHANGES ON CASH 60 51
NET DECREASE IN CASH AND CASH EQUIVALENTS (2,067) (373)
CASH AND CASH EQUIVALENTS, beginning of period 2,455 627
CASH AND CASH EQUIVALENTS, end of period 388 254
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION    
Cash paid during the period for interest $ 32,074 $ 30,847