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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2016
Sep. 30, 2015
CASH FLOWS FROM OPERATING ACTIVITIES    
Net income $ 3,940 $ 7,378
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 49,541 43,836
Provision for bad debts 33,883 25,295
Gain from return of common stock (5,032) 0
Equity in earnings of joint ventures (8,129) (6,301)
Distributions from joint ventures 2,929 6,255
Amortization and write off of deferred financing costs and loan discount 4,244 4,000
Loss on sale and disposal of equipment 375 774
Gain on sale of imaging centers 0 (4,823)
Stock-based compensation 4,918 6,477
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:    
Accounts receivable (53,277) (32,485)
Other current assets 10,420 (15,628)
Other assets 751 (1,254)
Deferred taxes 1,746 2,750
Deferred rent (678) 6,034
Deferred revenue 60 (641)
Accounts payable, accrued expenses and other 9,039 (1,602)
Net cash provided by operating activities 54,730 40,065
CASH FLOWS FROM INVESTING ACTIVITIES    
Purchase of imaging facilities (6,603) (41,237)
Purchase of property and equipment (52,110) (38,736)
Proceeds from sale of equipment 63 648
Proceeds from sale of imaging facilities 0 35,500
Cash distribution from existing JV partner 994 443
Equity contributions in existing and purchase of interest in joint ventures (1,374) (265)
Net cash used in investing activities (59,030) (43,647)
CASH FLOWS FROM FINANCING ACTIVITIES    
Principal payments on notes and leases payable (9,219) (6,645)
Proceeds from borrowings 476,503 74,401
Payments on Term Loan Debt (463,022) (17,548)
Deferred financing costs (945) (531)
Net proceeds (payments) on revolving credit facility 1,600 (15,300)
Distributions paid to non-controlling interests (492) (613)
Proceeds from sale of non-controlling interests 0 5,005
Purchase of non-controlling interests (350) 0
Proceeds from issuance of common stock upon exercise of options/warrants 150 594
Net cash provided by financing activities 4,225 39,363
EFFECT OF EXCHANGE RATE CHANGES ON CASH (13) (34)
NET (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS (88) 35,747
CASH AND CASH EQUIVALENTS, beginning of period 446 307
CASH AND CASH EQUIVALENTS, end of period 358 36,054
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION    
Cash paid during the period for income taxes 26,819 26,543
SUPPLEMENTAL SCHEDULE OF NON-CASH INVESTING AND FINANCING ACTIVITIES    
Purchase of equipment and leasehold improvements not yet paid for 14,700 15,700
Capital lease debt 1,300 0
Noncash gain from return of common stock 5,000 0
Assets transferred to joint venture 2,700 0
Gain from earn out provision from sale of controlling interest $ 992 $ 0