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CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2015
Sep. 30, 2014
OPERATING ACTIVITIES    
Net income including non-controlling interests $ 23,332 $ 23,161
Adjustments to reconcile net income including non-controlling interests to net cash provided by operating activities:    
Depreciation and amortization 5,656 4,682
Provision for doubtful accounts 3,119 3,094
Equity-based awards compensation expense 3,368 2,456
Loss on sale or abandonment of assets, net 3 20
Excess tax benefit from shared-based compensation (816) (526)
Deferred income tax 3,181 3,888
Write-off of goodwill - closed clinic 180  
Changes in operating assets and liabilities:    
Increase in patient accounts receivable (4,148) (4,952)
Increase in accounts receivable - other (145) (62)
Increase in other assets (1,485) (1,803)
(Decrease) in accounts payable and accrued expenses (3,766) (1,739)
Increase in other Long term liabilities 380 607
Net cash provided by operating activities 28,859 28,826
INVESTING ACTIVITIES    
Purchase of fixed assets (4,690) (3,912)
Purchase of businesses, net of cash acquired (14,434) (12,240)
Acquisitions of non-controlling interests (including redeemable non-controlling interests) (2,802) (4,998)
Proceeds on sale of fixed assets, net 71 43
Net cash used in investing activities (21,855) (21,107)
FINANCING ACTIVITIES    
Distributions to non-controlling interests (including redeemable non-controlling interests) (6,836) (7,067)
Cash dividends to shareholders (5,586) (4,399)
Proceeds from revolving line of credit 75,000 112,300
Payments on revolving line of credit (63,500) (105,800)
Payment of notes payable (616) (575)
Tax benefit from share-based compensation 816 526
Other 5 222
Net cash provided by financing activities (717) (4,793)
Net increase in cash and cash equivalents 6,287 2,926
Cash and cash equivalents - beginning of period 14,271 12,898
Cash - end of period 20,558 15,824
Cash paid during the period for:    
Income taxes 5,659 7,920
Interest 616 857
Non-cash investing and financing transactions during the period:    
Purchase of non-controlling interest 1,240 0
Purchase of business - seller financing portion 1,350 400
Revaluation of redeemable non-controlling interests $ 627 $ 1,841