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CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified | 12 Months Ended
--- | ---
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011
OPERATING ACTIVITIES |  |  |
Net income including noncontrolling interests | $ 20,996 | $ 26,217 | $ 29,783
Adjustments to reconcile net income including noncontrolling interests to net cash provided by operating activities: |  |  |
Depreciation and amortization | 5,562 | 5,287 | 5,449
Provision for doubtful accounts | 4,384 | 4,824 | 3,778
Gain on purchase price settlement |  |  | (5,435)
Equity-based awards compensation expense | 2,743 | 2,102 | 2,032
Loss (gain) on sale of business and fixed assets | 7,335 | 175 | 182
Excess tax benefit from exercise of stock options | (695) | (1,351) | (217)
Deferred income tax | 2,369 | 3,738 | 3,833
Other |  |  | 437
Changes in operating assets and liabilities: |  |  |
Increase in patient accounts receivable | (5,389) | (1,663) | (5,147)
Increase in accounts receivable - other | (5) | (561) | (990)
(Increase) decrease in other assets | 1,803 | (585) | (1,972)
(Decrease) increase in accounts payable and accrued expenses | 4,833 | (340) | 1,190
(Decrease) increase in other liabilities | 859 | 1,381 | (275)
Net cash provided by operating activities | 44,795 | 39,249 | 32,655
INVESTING ACTIVITIES |  |  |
Purchase of fixed assets | (4,637) | (4,234) | (3,222)
Purchase of businesses, net of cash acquired | (46,628) | (7,929) | (9,451)
Acquisitions of noncontrolling interests | (1,876) | (2,244) | (20,439)
Sale of noncontrolling interests | 233 | 239 |
Settlement of purchase price |  |  | (3,835)
Proceeds on sale of business and fixed assets, net | 459 | 64 | 6
Net cash used in investing activities | (52,449) | (14,104) | (31,606)
FINANCING ACTIVITIES |  |  |
Distributions to noncontrolling interests | (9,164) | (9,332) | (9,767)
Cash dividends to shareholders | (4,838) | (9,017) | (3,789)
Purchase and retire of common stock |  |  | (4,656)
Proceeds from revolving line of credit | 150,800 | 79,900 | 118,900
Payments on revolving line of credit | (128,200) | (86,000) | (100,900)
Payment of notes payable | (459) | (434) | (250)
Tax benefit from stock options exercised | 695 | 1,351 | 217
Other | 47 | 75 |
Net cash provided by (used in) financing activities | 8,881 | (23,457) | (245)
Net increase in cash and cash equivalents | 1,227 | 1,688 | 804
Cash and cash equivalents - beginning of period | 11,671 | 9,983 | 9,179
Cash and cash equivalents - end of period | 12,898 | 11,671 | 9,983
Cash paid during the period for: |  |  |
Income taxes | 4,111 | 6,361 | 9,037
Interest | 352 | 639 | 325
Non-cash investing and financing transactions during the period: |  |  |
Purchase of business - seller financing portion | 1,300 | 350 | 200
Acquisition of noncontrolling interest - seller financing portion |  |  | $ 367

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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 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=31042434&loc=d3e3602-108585 Reference 2: 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=26872669&loc=d3e20235-122688 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 03 -Paragraph 5 -Article 5 + Details
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- Definition Amount of cash outflow for payment of an obligation from a lender, including but not limited to, letter of credit, standby letter of credit and revolving credit arrangements. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.4-08.(f)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 08 -Paragraph f -Article 4 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=31042434&loc=d3e3291-108585 Reference 4: 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 a borrowing supported by a written promise to pay an obligation. + 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=31042434&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 aggregate amount of noncash, equity-based employee remuneration. This may include the value of stock or unit options, amortization of restricted stock or units, and adjustment for officers' compensation. As noncash, this element is an add back when calculating net cash generated by operating activities using the indirect method. + References Reference 1: 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=31042434&loc=d3e3602-108585 + Details
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- Definition Acquisition of noncontrolling interest -- seller financing portion + References No definition available. + Details
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- Definition Acquisitions of noncontrolling interests. + References No definition available. + Details
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- Definition Gain Loss On Sale Or Abandonment Of Assets Net + References No definition available. + Details
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- Definition Gain On Purchase Price Settlement + References No definition available. + Details
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- Definition Increase in patient accounts receivable. + References No definition available. + Details
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- Definition Proceeds From Sale Of Non Controlling Interest Fixed Assets And Business + References No definition available. + Details
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- Definition Settlement of purchase price. + References No definition available. + Details
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- Definition Purchase of business - seller financing portion. + References No definition available. + Details
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