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5. REVOLVING CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASES (Tables)
 3 Months Ended
Mar. 31, 2018
Debt Disclosure [Abstract]  
Schedule of notes payable, line of credit and capital lease obligations

As of the three months ended March 31, 2018 our debt obligations consist of the following (in thousands):

 

    March 31,     December 31,  
    2018     2017  
             
First Lien Term Loans     612,001       620,272  
                 
Discounts on term loans     (17,630 )     (18,470 )
                 
Promissory note payable to the former owner of a practice acquired at an interest rate of 1.5% due through 2019     496       592  
                 
Equipment notes payable at interest rates ranging from 3.3% to 5.6%, due through 2020, collateralized by medical equipment     164       195  
                 
Obligations under capital leases at interest rates ranging from 4.3% to 11.2%, due through 2022, collateralized by medical and office equipment     8,950       6,538  
Total debt obligations     603,981       609,127  
Less: current portion     (34,340 )     (34,090 )
Long term portion debt obligations   $ 569,641     $ 575,037  
Schedule of First Lien Credit Agreement

Thereafter, the rates of the applicable margin for borrowing under the First Lien Credit Agreement will adjust depending on our leverage ratio, according to the following schedule:

 

First Lien Leverage Ratio Eurodollar Rate Spread Base Rate Spread
> 5.50x 4.50% 3.50%
> 4.00x but ≤ 5.50x 3.75% 2.75%
>3.50x but ≤ 4.00x 3.50% 2.50%
≤ 3.50x 3.25% 2.25%
Schedule of leverage ratio

Pursuant to the Fifth Amendment, the applicable margin was amended to vary based on our leverage ratio in accordance with the following schedule:

 

First Lien Leverage Ratio Eurodollar Rate Spread Base Rate Spread
> 5.50x 4.50% 3.50%
> 4.00x but ≤ 5.50x 3.75% 2.75%
>3.50x but ≤ 4.00x 3.50% 2.50%
≤ 3.50x 3.25% 2.25%