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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