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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2018
Mar. 31, 2017
CASH FLOWS FROM OPERATING ACTIVITIES    
Net loss $ (5,454) $ (860)
Adjustments to reconcile net loss to net cash provided by operating activities:    
Depreciation and amortization 17,856 16,654
Provision for bad debts 0 11,646
Equity in earnings of joint ventures (2,977) (1,928)
Distributions from joint ventures 2,821 2,323
Amortization of deferred financing costs and loan discount 974 814
Gain on sale of equipment (1,936) (45)
Stock-based compensation 3,745 3,276
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:    
Accounts receivable (6,132) (16,974)
Other current assets 1,003 4,043
Other assets (2,715) 8
Deferred taxes (2,759) (1,090)
Deferred rent 1,302 1,976
Deferred revenue 105 58
Accounts payable, accrued expenses and other 18,480 10,995
Net cash provided by operating activities 24,313 30,896
CASH FLOWS FROM INVESTING ACTIVITIES    
Purchase of imaging facilities (5,819) (3,154)
Investments at cost (2,200) (500)
Purchase of property and equipment (23,946) (30,371)
Proceeds from sale of equipment 2,116 59
Net cash used in investing activities (29,849) (33,966)
CASH FLOWS FROM FINANCING ACTIVITIES    
Principal payments on notes and leases payable (1,736) (2,158)
Payments on Term Loan Debt/Senior Notes (8,270) (6,063)
Deferred financing costs and debt discount 0 (570)
Proceeds on revolving credit facility 0 105,100
Payments on revolving credit facility 0 (105,100)
Dividends paid to noncontrolling interests (759) (485)
Net cash used in financing activities (10,765) (9,276)
EFFECT OF EXCHANGE RATE CHANGES ON CASH 22 2
NET DECREASE IN CASH AND CASH EQUIVALENTS (16,279) (12,344)
CASH AND CASH EQUIVALENTS, beginning of period 51,322 20,638
CASH AND CASH EQUIVALENTS, end of period 35,043 8,294
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION    
Cash paid during the period for interest 9,050 11,035
Supplemental Schedule of Non-Cash Investing and Financing Activities    
Equipment and certain leasehold improvements not yet paid 36,100 19,000
Capital lease debt from acquisition 4,000 0
Investment in joint venture, capital contribution 1,600 0
Fixed assets received $ 16,800 $ 0