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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands, unless otherwise specified
 12 Months Ended
Dec. 31, 2013
Dec. 31, 2012
Dec. 31, 2011
Cash Flows from Operating Activities:      
Net income $ 84,512 $ 42,653 $ 24,297
Discontinued Operation, Gain (Loss) on Disposal of Discontinued Operation, Net of Tax (30,840) 0 0
Depreciation and amortization 29,882 24,702 8,851
Adjustments to reconcile net income (loss) to net cash provided by operating activities:      
Provision for deferred income taxes 4,111 4,970 3,748
Stock-based compensation 14,411 9,706 6,927
Write off of Deferred Debt Issuance Cost 14,958 813 0
Gross excess tax benefits from stock-based compensation (5,308) (4,638) (1,113)
Workers’ compensation and medical malpractice provision 5,956 3,594 3,196
Other Noncash Income (Expense) 66 (619) 178
Changes in operating assets and liabilities, net of effects of acquisitions:      
Accounts receivable (20,155) (18,604) (25,079)
Prepaid expenses and income taxes 6,628 2,166 (2,925)
Accounts payable (1,580) 1,987 (1,812)
Accrued payroll and contract professional pay 17,554 (28,053) 6,400
Deferred compensation (9,980) 312 (303)
Other 441 470 1,410
Net cash provided by operating activities 110,524 40,697 23,419
Cash Flows from Investing Activities:      
Cash paid for property and equipment (16,531) (14,354) (8,411)
Cash paid for acquisitions, net of cash acquired (110,700) (347,743) (32,818)
Cash received from sale of discontinued operations, net 59,899    
Other (1,023) (869) 109
Net cash used in investing activities (68,355) (362,966) (41,120)
Cash Flows from Financing Activities:      
Principal payments of long-term debt (456,275) (173,163) (20,500)
Proceeds from term debt 429,500 513,000 40,500
Proceeds from stock transactions 7,054 8,384 2,701
Payment of employment taxes related to release of restricted stock awards (7,600) (2,627) (2,214)
Gross excess tax benefits from stock-based compensation 5,308 4,638 1,113
Repurchase of common stock     (2,230)
Debt issuance or amendment costs (6,938) (17,113) (87)
Payments of other long-term liabilities (3,425) (1,198) (1,731)
Other (14) (43) (43)
Net cash provided by (used in) financing activities (32,390) 331,878 17,509
Effect of exchange rate changes on cash and cash equivalents 92 131 (478)
Net Increase (Decrease) in Cash and Cash Equivalents 9,871 9,740 (670)
Cash and Cash Equivalents at Beginning of Year 27,479 17,739 18,409
Cash and Cash Equivalents at End of Year 37,350 27,479 17,739
Supplemental Disclosure of Cash Flow Information      
Income taxes 32,350 33,915 16,163
Interest 15,158 14,722 2,659
Non-Cash Investing and Financing Activities:      
Equity consideration for acquisition 0 225,558 0
Payable for employment taxes withheld related to release of restricted stock awards 0 2,907 0
Accrued earn-out 7,860 0 10,346
Acquisition of property and equipment through accounts payable 594 369 324
Acquisition accounting $ 0 $ (1,805) $ 0