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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands, unless otherwise specified
 9 Months Ended
Sep. 30, 2014
Sep. 30, 2013
CASH FLOWS FROM OPERATING ACTIVITIES    
Net (loss) income $ (2,610) $ 1,028
Adjustments to reconcile net (loss) income to net cash provided by operating activities:    
Depreciation and amortization 45,193 44,050
Provision for bad debts 21,945 20,810
Equity in earnings of joint ventures (4,722) (4,481)
Distributions from joint ventures 7,358 5,624
Deferred rent amortization 653 2,893
Amortization of deferred financing costs 1,708 1,676
Write off of deferred loan costs due to refinance 665 0
Amortization of bond and term loan discounts 2,071 1,651
Loss on sale and disposal of equipment 1,581 357
Loss on early extinguishment of Senior Notes 15,927 0
Gain on Sale of Imaging Centers 0 (2,108)
Stock-based compensation 2,069 2,045
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:    
Accounts receivable (42,887) (25,096)
Other current assets (4,754) (1,504)
Other assets (72) 172
Deferred taxes (2,461) 575
Deferred revenue 604 175
Accounts payable, accrued expenses and other (8,225) (5,357)
Net cash provided by operating activities 34,043 42,510
CASH FLOWS FROM INVESTING ACTIVITIES    
Purchase of imaging facilities (9,428) (5,918)
Purchase of noncontrolling interests (196) 0
Purchase of property and equipment (33,895) (39,291)
Proceeds from sale of equipment 766 510
Proceeds from sale of imaging facilities 0 3,290
Proceeds from sale of joint venture interests 0 2,640
Equity contributions in existing joint ventures (1,161) (1,803)
Net cash used in investing activities (43,914) (40,572)
CASH FLOWS FROM FINANCING ACTIVITIES    
Principal payments on notes and leases payable (16,733) (7,476)
Proceeds from borrowings 210,000 35,122
Payments on Senior Notes (211,344) 0
Deferred financing costs (6,650) (432)
Net proceeds (payments) on revolving credit facility 25,100 (29,600)
Distributions to noncontrolling interests (148) (11)
Proceeds from issuance of common stock upon exercise of options/warrants 1,546 469
Net cash provided by (used in) financing activities 1,771 (1,928)
EFFECT OF EXCHANGE RATE CHANGES ON CASH (38) (104)
NET DECREASE IN CASH AND CASH EQUIVALENTS (8,138) (94)
CASH AND CASH EQUIVALENTS, beginning of period 8,412 362
CASH AND CASH EQUIVALENTS, end of period 274 268
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION    
Cash paid during the period for interest 32,389 26,614
SUPPLEMENTAL SCHEDULE OF NON-CASH INVESTING AND FINANCING ACTIVITIES    
Purchase of equipment and leasehold improvements not yet paid for 16,600 11,300
Capital lease debt relating to radiology equipment $ 12,600