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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands, unless otherwise specified
 6 Months Ended
Jun. 30, 2014
Jun. 30, 2013
CASH FLOWS FROM OPERATING ACTIVITIES    
Net (loss) income $ (7,119) $ 1,395
Depreciation and amortization 30,770 29,288
Provision for bad debts 14,413 13,777
Equity in earnings of joint ventures (2,713) (2,864)
Distributions from joint ventures 5,041 3,971
Deferred rent amortization 420 1,844
Amortization of deferred financing costs 1,148 1,066
Write off of deferred loan costs due to refinance 665 0
Amortization of bond and term loan discounts 1,343 1,025
Loss on sale and disposal of equipment 292 362
Loss on early extinguishment of Senior Notes 15,927 0
Gain on Sale of Imaging Centers 0 (2,108)
Stock-based compensation 1,636 1,582
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:    
Accounts receivable (27,361) (23,171)
Other current assets (2,877) (423)
Other assets 55 190
Deferred taxes (4,117) 692
Deferred revenue 132 75
Accounts payable and accrued expenses (7,977) 2,076
Net cash provided by operating activities 19,678 28,777
CASH FLOWS FROM INVESTING ACTIVITIES    
Purchase of imaging facilities (1,811) (3,625)
Purchase of property and equipment (26,798) (28,349)
Proceeds from sale of equipment 4 505
Proceeds from sale of imaging facilities 0 3,920
Proceeds from sale of joint venture interests 0 2,640
Equity contributions in existing joint ventures (900) (1,803)
Net cash used in investing activities (29,505) (26,712)
CASH FLOWS FROM FINANCING ACTIVITIES    
Principal payments on notes and leases payable (9,368) (5,211)
Proceeds from borrowings 210,000 35,122
Payments on Senior Notes (211,344) 0
Deferred financing costs (6,650) (432)
Net proceeds (payments) on line of credit 18,980 (32,000)
Distributions to noncontrolling interests (139) (7)
Proceeds from issuance of common stock upon exercise of options/warrants 786 469
Net cash provided by (used in) financing activities 2,265 (2,059)
EFFECT OF EXCHANGE RATE CHANGES ON CASH (19) (117)
NET DECREASE IN CASH AND CASH EQUIVALENTS (7,581) (111)
CASH AND CASH EQUIVALENTS, beginning of period 8,412 362
CASH AND CASH EQUIVALENTS, end of period 831 251
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION    
Cash paid during the period for interest 23,464 21,792
SUPPLEMENTAL SCHEDULE OF NON-CASH INVESTING AND FINANCING ACTIVITIES    
Purchase of equipment and leasehold improvements not yet paid for 13,800 13,300
Capital lease debt relating to radiology equipment $ 12,600