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CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands, unless otherwise specified
 12 Months Ended
Dec. 31, 2013
Dec. 31, 2012
Dec. 31, 2011
CASH FLOWS FROM OPERATING ACTIVITIES      
Net income $ 2,376 $ 59,604 $ 7,342
Depreciation and amortization 58,890 57,740 57,481
Provision for bad debt 27,911 25,904 22,339
Equity in earnings of joint ventures (6,194) (6,476) (5,224)
Distributions from joint ventures 7,204 6,477 4,993
Deferred rent amortization 3,871 3,608 2,282
Amortization of deferred financing cost 2,286 2,474 2,940
Amortization of bond and term loan discounts 2,279 1,163 244
Loss (gain) on sale and disposal of equipment 1,032 456 (2,240)
Gain on bargain purchase 0 (810) 0
Gain on sale of imaging centers (2,108) 0 0
Gain on de-consolidation of joint venture 0 (2,777) 0
Amortization of cash flow hedge 0 918 1,225
Stock-based compensation 2,574 2,736 3,110
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:      
Accounts receivable (31,531) (17,350) (45,014)
Other current assets (2,243) 3,565 (3,935)
Other assets 260 (578) 43
Deferred taxes 2,907 (56,142) 0
Deferred revenue 71 197 (492)
Accounts payable and accrued expenses (3,163) (5,440) 12,542
Net cash provided by operating activities 66,422 75,269 57,636
CASH FLOWS FROM INVESTING ACTIVITIES      
Purchase of imaging facilities (7,223) (45,493) (42,990)
Purchase of property and equipment (48,623) (44,448) (42,720)
Proceeds from sale of equipment 635 1,549 325
Proceeds from insurance claims on damaged equipment 0 0 2,740
Proceeds from sale of imaging facilities 3,920 2,300 0
Proceeds from sale of joint venture interests 2,640 1,800 0
Purchase of equity interest in joint ventures (2,009) (2,756) (5,094)
Net cash used in investing activities (50,660) (87,048) (87,739)
CASH FLOWS FROM FINANCING ACTIVITIES      
Principal payments on notes and leases payable (9,764) (22,223) (18,756)
Proceeds from borrowings upon refinancing 35,122 344,485 0
Repayment of debt 0 (277,875) 0
Deferred financing costs (432) (3,753) (944)
Proceeds from, net of payments on, line of credit (33,000) (25,000) 58,000
Payments to counterparties of interest rate swaps, net of amounts received 0 (5,823) (6,455)
Distributions to noncontrolling interests (18) (71) (154)
Equity attributable to non-controlling interests 0 (117) 0
Proceeds from issuance of common stock upon exercise of options/warrants 469 0 242
Net cash (used in) provided by financing activities (7,623) 9,623 31,933
EFFECT OF EXCHANGE RATE CHANGES ON CASH (89) 63 (2)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS 8,050 (2,093) 1,828
CASH AND CASH EQUIVALENTS, beginning of period 362 2,455 627
CASH AND CASH EQUIVALENTS, end of period 8,412 362 2,455
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION      
Cash paid during the period for interest 41,841 47,806 47,310
Cash paid during the period for income taxes 1,142 918 514
SUPPLEMENTAL SCHEDULE OF NON-CASH INVESTING AND FINANCING ACTIVITIES      
Purchase of equipment and leasehold improvements not yet paid for $ 16,700 $ 14,400 $ 9,300