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Consolidated Statements of Cash Flows (USD $)
In Thousands, unless otherwise specified
 12 Months Ended
Dec. 31, 2012
Dec. 31, 2011
Dec. 31, 2010
OPERATING ACTIVITIES      
Net income including noncontrolling interests $ 26,218 $ 29,783 $ 24,700
Adjustments to reconcile net income including noncontrolling interests to net cash provided by operating activities:      
Depreciation and amortization 5,287 5,449 5,667
Provision for doubtful accounts 4,848 3,785 3,241
Gain on purchase price settlement   (5,435)  
Equity-based awards compensation expense 2,102 2,032 1,292
Loss (gain) on sale of business and fixed assets 175 182 (333)
Excess tax benefit from exercise of stock options 1,351 (217) (336)
Deferred income tax 3,738 3,833 452
Other   437 (414)
Changes in operating assets and liabilities:      
Increase in patient accounts receivable (1,663) (5,147) (4,169)
Increase in accounts receivable - other (561) (990) (297)
(Increase) decrease in other assets (585) (1,972) 206
(Decrease) increase in accounts payable and accrued expenses (340) 1,190 (292)
(Decrease) increase in other liabilities (1,321) (275) 804
Net cash provided by operating activities 39,249 32,655 30,521
INVESTING ACTIVITIES      
Purchase of fixed assets (4,234) (3,222) (3,673)
Purchase of businesses, net of cash acquired (7,929) (9,451) (18,197)
Acquisitions of noncontrolling interests (2,244) (20,439) (682)
Sale of noncontrolling interests 239    
Settlement of purchase price   (3,835)  
Proceeds on sale of business and fixed assets, net 64 6 919
Net cash used in investing activities (14,104) (31,606) (21,633)
FINANCING ACTIVITIES      
Distributions to noncontrolling interests (9,332) (9,767) (9,580)
Cash dividends to shareholders (9,017) (3,789)  
Purchase and retire of common stock   (4,656) (1,401)
Proceeds from revolving line of credit 79,900 118,900 46,300
Payments on revolving line of credit (86,000) (100,900) (41,200)
Payment of notes payable (434) (250) (1,013)
Tax benefit from stock options exercised 1,351 217 336
Other 75   420
Net cash used in financing activities (23,457) (245) (6,138)
Net increase in cash and cash equivalents 1,688 804 2,750
Cash and cash equivalents - beginning of period 9,983 9,179 6,429
Cash and cash equivalents - end of period 11,671 9,983 9,179
Cash paid during the period for:      
Income taxes 6,361 9,037 7,804
Interest 639 325 179
Non-cash investing and financing transactions during the period:      
Purchase of business - seller financing portion 350 200 525
Acquisition of noncontrolling interest - seller financing portion   $ 367