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Consolidated Statements of Cash Flows (Unaudited) (USD $)
In Thousands, unless otherwise specified
 6 Months Ended
Jun. 30, 2012
Jun. 30, 2011
OPERATING ACTIVITIES    
Net income including noncontrolling interests $ 14,126 $ 13,788
Adjustments to reconcile net income including noncontrolling interests to net cash provided by operating activities:    
Depreciation and amortization 2,646 2,752
Provision for doubtful accounts 2,397 1,128
Equity-based awards compensation expense 1,043 963
Loss on sale or abandonment of assets, net 83 75
Deferred income tax 1,046 950
Other   (591)
Changes in operating assets and liabilities:    
Increase in patient accounts receivable (1,613) (3,728)
Increase in accounts receivable - other (400) (1,112)
Decrease (increase) in other assets 301 (1,251)
Decrease in accounts payable and accrued expenses (693) (548)
Increase in other liabilities 31 415
Net cash provided by operating activities 18,967 12,841
INVESTING ACTIVITIES    
Purchase of fixed assets (1,943) (1,484)
Purchase of businesses, net of cash acquired (7,180)  
Acquisitions of noncontrolling interests (965) (15,885)
Sale of noncontrolling interests 239  
Net proceeds on sale of fixed assets and business 28 4
Net cash used in investing activities (9,821) (17,365)
FINANCING ACTIVITIES    
Distributions to noncontrolling interests (4,751) (4,597)
Cash dividends to shareholders (2,117) (1,890)
Proceeds from revolving line of credit 32,400 42,300
Payments on revolving line of credit (35,900) (32,000)
Payment of notes payable (184) (100)
Excess tax benefit from stock options exercised 184 622
Other 50 2
Net cash (used in) provided by financing activities (10,318) 4,337
Net decrease in cash (1,172) (187)
Cash - beginning of period 9,983 9,179
Cash - end of period 8,811 8,992
Cash paid during the period for:    
Income taxes 3,886 3,367
Interest 422 188
Non-cash investing and financing transactions during the period:    
Purchase of business - seller financing portion 350  
Acquisition of noncontrolling interest - seller financing portion   $ 367