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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014
Cash Flows from Operating Activities: |  |  |
Net income | $ 97,201 | $ 97,650 | $ 77,184
Discontinued Operation, Gain (Loss) on Disposal of Discontinued Operation, Net of Tax | 0 | (25,703) | 0
Depreciation and amortization | 62,249 | 51,569 | 38,296
Provision for Doubtful Accounts | 10,788 | 10,486 | 7,047
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Provision for deferred income taxes | 12,834 | 11,549 | 15,948
Allocated Share-based Compensation Expense | 27,024 | 22,018 | 16,199
Write off of Deferred Debt Issuance Cost | 0 | 3,751 | 0
Gross excess tax benefits from stock-based compensation | (3,081) | (6,551) | (4,943)
Workers’ compensation and medical malpractice provision | 2,693 | 2,117 | 3,321
Other Noncash Income (Expense) | (5,642) | (7,136) | (1,408)
Changes in operating assets and liabilities: |  |  |
Accounts receivable | (43,289) | (53,775) | (45,361)
Prepaid expenses and income taxes | 6,433 | 100 | (8,304)
Increase (Decrease) in Income Taxes Payable | 3,346 | (7,679) | (8,023)
Accounts payable | (2,236) | 1,684 | (1,693)
Accrued payroll and contract professional pay | 23,556 | 242 | 11,275
Increase (Decrease) in Workers' Compensation Liabilities | (2,691) | (901) | (2,192)
Other | 561 | 3,800 | (4,140)
Net cash provided by operating activities | 196,250 | 117,493 | 96,022
Cash Flows from Investing Activities: |  |  |
Cash paid for property and equipment | (27,138) | (24,689) | (19,729)
Cash paid for acquisitions, net of cash acquired | 0 | (552,777) | 0
Proceeds from Divestiture of Businesses, Net of Cash Divested | 6,000 | 115,440 | 0
Other | (846) | 496 | 169
Net cash used in investing activities | (21,984) | (461,530) | (19,560)
Cash Flows from Financing Activities: |  |  |
Principal payments of long-term debt | (129,000) | (516,125) | (148,688)
Proceeds from long-term debt | 11,000 | 875,000 | 164,000
Proceeds from option exercises and employee stock purchase plan | 9,758 | 6,591 | 6,358
Payment of employment taxes related to release of restricted stock awards | (7,024) | (8,823) | (6,498)
Gross excess tax benefits from stock-based compensation | 3,081 | 6,551 | 4,943
Repurchase of common stock | (41,096) | (1,645) | (100,049)
Debt issuance or amendment costs | (889) | (23,890) | (467)
Payments of Merger Related Costs, Financing Activities | 16,814 | 0 | 691
Payments of accrued earn-outs | (4,780) | 0 | 0
Net cash provided by (used in) financing activities | (170,984) | 337,659 | (81,092)
Effect of exchange rate changes on cash and cash equivalents | (107) | (1,467) | (1,006)
Net Increase (Decrease) in Cash and Cash Equivalents | 3,175 | (7,845) | (5,636)
Cash and Cash Equivalents at Beginning of Year | 23,869 | 31,714 | 37,350
Cash and Cash Equivalents at End of Year | 27,044 | 23,869 | 31,714
Supplemental Disclosure of Cash Flow Information |  |  |
Income taxes | 38,190 | 45,478 | 56,320
Interest | 26,829 | 22,282 | 11,559
Non-Cash Investing and Financing Activities: |  |  |
Equity consideration for acquisition | 0 | 30,183 | 0
Proceeds from Stock Options Exercised | 0 | 2,174 | 0
Acquisition of property and equipment through accounts payable | 438 | 989 | 2,932
Unsettled repurchases of common stock | $ 1,995 | $ 0 | $ 0

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- Definition The cash outflow associated with other payments to acquire businesses including deposit on pending acquisitions and preacquisition costs. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3213-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 + Details
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- Definition Amount of cash outflow for taxes classified as other. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 25 -Subparagraph (g) -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3536-108585 + Details
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- Definition Amount of cash (inflow) outflow from investing activities classified as other. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 2: 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=66902209&loc=d3e3098-108585 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=66902209&loc=d3e3095-108585 + Details
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- Definition The cash outflow to reacquire common stock during the period. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3291-108585 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 + Details
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- Definition The cash outflow for loan and debt issuance costs. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3291-108585 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 + Details
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- Definition The cash outflow for financing costs associated with business combinations. + References Reference 1: 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 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3291-108585 + Details
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- Definition The cash outflow associated with the acquisition of a business, net of the cash acquired from the purchase. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3213-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 + Details
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- Definition The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3213-108585 + Details
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- Definition This element represents the cash inflow during the period from the sale of a component of the entity. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3179-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 + Details
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- Definition The cash inflow from a debt initially having maturity due after one year or beyond the operating cycle, if longer. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3255-108585 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 + Details
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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 Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 Reference 2: 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=66902209&loc=d3e3255-108585 + Details
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- Definition The cash inflow associated with the amount received from holders exercising their stock options. This item inherently excludes any excess tax benefit, which the entity may have realized and reported separately. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (j) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 Reference 2: 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=66902209&loc=d3e3255-108585 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 + Details
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- Definition Amount of expense related to write-down of receivables to the amount expected to be collected. Includes, but is not limited to, accounts receivable and notes receivable. + References Reference 1: 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=63488584&loc=d3e20235-122688 Reference 2: 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=66902209&loc=d3e3602-108585 + 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 Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3291-108585 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 + Details
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- Definition The fair value of stock issued in noncash financing activities. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 50 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=6367179&loc=d3e4332-108586 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 50 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=6367179&loc=d3e4304-108586 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 50 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=6367179&loc=d3e4313-108586 + Details
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- Definition Write-off of amounts previously capitalized as debt issuance cost in an extinguishment of debt. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 225 -SubTopic 10 -Section S99 -Paragraph 2 -Subparagraph (SX 210.5-03.8) -URI http://asc.fasb.org/extlink&oid=63488584&loc=d3e20235-122688 + Details
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