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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
CASH FLOWS FROM OPERATING ACTIVITIES      
Net income $ 2,075 $ 8,004 $ 8,638
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 66,796 66,610 60,611
Provision for bad debts 46,555 45,387 36,033
Gain on return from common stock 0 (5,032) 0
Equity in earnings of joint ventures (13,554) (9,767) (8,927)
Distributions from joint ventures 8,690 2,926 7,731
Amortization and write off of deferred financing costs and loan discount 3,483 5,045 5,369
Loss on sale and disposal of equipment 1,142 767 866
Gain on sale of imaging centers (3,146) 0 (5,434)
Stock-based compensation 6,787 5,826 7,647
Non cash severance 1,047 0 0
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:      
Accounts receivable (37,164) (47,055) (34,514)
Other current assets 1,461 11,038 (14,198)
Other assets (801) 1,267 (3,813)
Deferred taxes 19,504 3,446 4,036
Deferred rent 2,135 (1,668) 7,011
Deferred revenue 1,034 (82) (366)
Accounts payable, accrued expenses and other 36,181 4,929 (3,653)
Net cash provided by operating activities 142,225 91,641 67,037
CASH FLOWS FROM INVESTING ACTIVITIES      
Purchase of imaging facilities (27,612) (6,641) (90,792)
Investment at cost (500)    
Purchase of property and equipment (61,336) (59,251) (42,964)
Proceeds from sale of equipment 852 481 1,282
Proceeds from sale of imaging and medical practice assets 8,429 0 35,500
Proceeds from sale of internal use software 492 301 443
Cash contribution from partner in JV formation 1,473 994 0
Equity contributions in existing and purchase of interest in joint ventures (1,118) (1,374) (265)
Net cash used in investing activities (79,320) (65,490) (96,796)
CASH FLOWS FROM FINANCING ACTIVITIES      
Principal payments on notes and leases payable (6,836) (11,880) (9,773)
Proceeds from borrowings 170,000 476,504 73,869
Payments on senior notes (196,666) (469,086) (23,727)
Payments on deferred financing costs and debt discount (5,062) (945) 0
Distributions paid to noncontrolling interests (1,528) (492) (729)
Proceeds from sale of noncontrolling interest, net of taxes 7,720 992 5,005
Contributions from noncontrolling partners 125 0 0
Proceeds from revolving credit facility 200,800 435,900 248,400
Payments on revolving credit facility (200,800) (435,900) (263,700)
Purchase of non-controlling interests 0 (1,153) 0
Proceeds from issuance of common stock upon exercise of options 0 150 594
Net cash (used in) provided by financing activities (32,247) (5,910) 29,939
EFFECT OF EXCHANGE RATE CHANGES ON CASH 26 (49) (41)
NET INCREASE IN CASH AND CASH EQUIVALENTS 30,684 20,192 139
CASH AND CASH EQUIVALENTS, beginning of period 20,638 446 307
CASH AND CASH EQUIVALENTS, end of period 51,322 20,638 446
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION      
Cash paid during the period for interest 34,197 37,487 36,028
Cash paid during the period for income taxes 4,939 2,798 1,781
Equipment acquired and leasehold improvements 18,500 28,800 32,400
Capital lease debt 5,500 1,300 $ 7,800
Investment in joint venture, ScriptSender, LLC 2,000    
Assets transferred to Santa Monica Imaging Group LLC 2,500    
Assets transferred to Advanced Imaging at Timonium Crossing, LLC 4,600    
Acquisition of Diagnostic Imaging Associates, cash 13,000    
Acquisition of Diagnostic Imaging Associates, for RadNet common stock 1,500    
Acquisition of RadSite, LLC, for common stock 1,000    
Acquisition of RadSite, LLC, cash $ 856    
Non-cash gain on return of common stock   5,000  
Fixed Assets transferred to Glendale Advanced Imaging, LLC   $ 2,700