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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified | 12 Months Ended
--- | ---
Dec. 31, 2012 | Dec. 31, 2011 | Dec. 31, 2010
Cash Flows from Operating Activities: |  |  |
Net income | $ 42,653 | $ 24,297 | $ (9,897)
Adjustments to reconcile net income (loss) to net cash provided by operating activities: |  |  |
Depreciation | 6,686 | 6,505 | 5,881
Amortization of intangible assets | 18,016 | 2,346 | 2,115
Provision for doubtful accounts and billing adjustments | (166) | 1,127 | 644
Deferred income tax (benefit) provision | 4,970 | 3,748 | 2,274
Stock-based compensation | 9,706 | 6,927 | 7,749
Amortization of deferred loan costs | 1,960 | 460 | 961
Gross excess tax benefits from stock-based compensation | (4,638) | (1,113) | (205)
Impairment of goodwill | 0 | 0 | 15,399
Workers’ compensation and medical malpractice provision | 3,594 | 3,196 | 4,310
Other | (362) | (1,765) | 1,993
Changes in operating assets and liabilities, net of effects of acquisitions: |  |  |
Accounts receivable | (18,604) | (25,079) | (10,532)
Prepaid expenses | (1,881) | (1,633) | (501)
Prepaid income taxes | 4,047 | (1,292) | 4,223
Accounts payable | 1,987 | (1,812) | 1,032
Accrued payroll and contract professional pay | (28,053) | 6,400 | 3,880
Workers’ compensation and medical malpractice loss reserves | (2,049) | (1,467) | (3,948)
Other | 2,831 | 2,574 | 1,483
Net cash provided by operating activities | 40,697 | 23,419 | 26,861
Cash Flows from Investing Activities: |  |  |
Cash paid for property and equipment | (14,354) | (8,411) | (6,302)
Cash paid for acquisitions, net of cash acquired | (347,743) | (32,818) | (10,458)
Other | (869) | 109 | 179
Net cash used in investing activities | (362,966) | (41,120) | (16,581)
Cash Flows from Financing Activities: |  |  |
Principal payments of long-term debt | (173,163) | (20,500) | (79,163)
Proceeds from term debt | 513,000 | 40,500 | 68,000
Proceeds from stock transactions | 8,384 | 2,701 | 333
Payment of employment taxes related to release of restricted stock awards | (2,627) | (2,214) | (1,955)
Gross excess tax benefits from stock-based compensation | 4,638 | 1,113 | 205
Repurchase of common stock | 0 | (2,230) | (2,000)
Debt issuance or amendment costs | (17,113) | (87) | (1,938)
Payments of other long-term liabilities | (1,198) | (1,731) | (52)
Other | (43) | (43) | (44)
Net cash provided by (used in) financing activities | 331,878 | 17,509 | (16,614)
Effect of exchange rate changes on cash and cash equivalents | 131 | (478) | (1,231)
Net Increase (Decrease) in Cash and Cash Equivalents | 9,740 | (670) | (7,565)
Cash and Cash Equivalents at Beginning of Year | 17,739 | 18,409 | 25,974
Cash and Cash Equivalents at End of Year | 27,479 | 17,739 | 18,409
Supplemental Disclosure of Cash Flow Information |  |  |
Income taxes | 33,915 | 16,163 | (2,578)
Interest | 14,722 | 2,659 | 5,478
Goodwill | 266,788 | 30,504 | 10,458
Identifiable intangible assets acquired | 251,555 | 7,726 | 1,761
Net tangible assets acquired | 54,958 | 4,934 | 0
Fair value of assets acquired, net of cash received | 573,301 | 43,164 | 12,219
Non-Cash Investing and Financing Activities: |  |  |
Equity consideration for acquisition | 225,558 | 0 | 0
Payable for employment taxes withheld related to release of restricted stock awards | 2,907 | 0 | 96
Accrued earn-out payments | 0 | 10,346 | 3,700
Acquisition of property and equipment through accounts payable | $ 369 | $ 324 | $ 383

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- Definition The cash inflow from the issuance of common stock, preferred stock, treasury stock, stock options, and other types of equity. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 19 -Subparagraph a -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 18 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3255-108585 + Details
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- Definition The net cash inflow or outflow from other financing activities. This element is used when there is not a more specific and appropriate element in the taxonomy. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 18, 19, 20 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3095-108585 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 9 -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3098-108585 + Details
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- Definition Amount of the current period expense charged against operations, the offset which is generally to the allowance for doubtful accounts for the purpose of reducing receivables, including notes receivable, to an amount that approximates their net realizable value (the amount expected to be collected). + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 03 -Paragraph 5 -Article 5 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 28 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3602-108585 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 225 -SubTopic 10 -Section S99 -Paragraph 2 -Subparagraph (SX 210.5-03.5) -URI http://asc.fasb.org/extlink&oid=6880815&loc=d3e20235-122688 + Details
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- Definition The cash outflow for debt initially having maturity due after one year or beyond the normal operating cycle, if longer. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 18 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3291-108585 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 20 -Subparagraph b -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. + Details
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