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CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($)
$ in Thousands
 3 Months Ended 6 Months Ended 12 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Jun. 30, 2020
Jun. 30, 2019
Dec. 31, 2019
OPERATING ACTIVITIES          
Net income including non-controlling interests $ 14,763 $ 19,800 $ 18,101 $ 32,175  
Adjustments to reconcile net income including non-controlling interests to net cash provided by operating activities:          
Depreciation and amortization     5,333 4,958  
Provision for doubtful accounts 739 1,240 2,100 2,446  
Equity-based awards compensation expense     3,389 3,558  
Deferred income taxes     (1,737) 5,421  
Loss on sale of fixed assets     429 0  
Gain on sale of partnership interest, net of tax     (1,073) (5,514)  
Write-off of goodwill - closed clinics 0 0 1,859 0 $ 0
Other     0 21  
Changes in operating assets and liabilities:          
Decrease (increase) in patient accounts receivable     8,880 (4,956)  
Decrease (increase) in accounts receivable - other     283 (2,468)  
Decrease (increase) in other assets     5,969 (2,759)  
Increase (decrease) in accounts payable and accrued expenses     4,478 (3,560)  
Increase (decrease) in other liabilities     345 (701)  
Net cash provided by operating activities     48,356 28,621  
INVESTING ACTIVITIES          
Purchase of fixed assets     (4,628) (4,876)  
Purchase of majority interest in businesses, net of cash acquired     (11,633) (18,239)  
Purchase of redeemable non-controlling interest, temporary equity     (2,388) (2,053)  
Purchase of non-controlling interest, permanent equity     (144) (138)  
Proceeds on sale of redeemable non-controlling interest, temporary equity     19 0  
Proceeds on sales of partnership interest and clinics     674 0  
Proceeds on sale of fixed assets     21 65  
Net cash used in investing activities     (18,079) (25,241)  
FINANCING ACTIVITIES          
Distributions to non-controlling interests, permanent and temporary equity     (5,707) (7,934)  
Cash dividends paid to shareholders     (4,110) (6,891)  
Proceeds from revolving line of credit     99,000 80,000  
Payments on revolving line of credit     (112,000) (56,000)  
Principal payments on notes payable     (314) (1,057)  
Medicare Accelerated and Advance Payment Funds     12,861 0  
Other     0 (7)  
Net cash provided by (used in) financing activities     (10,270) 8,111  
Net increase in cash and cash equivalents     20,007 11,491  
Cash and cash equivalents - beginning of period     23,548 23,368 23,368
Cash and cash equivalents - end of period 43,555 34,859 43,555 34,859 $ 23,548
Cash paid during the period for:          
Income taxes     57 4,339  
Interest     944 902  
Non-cash investing and financing transactions during the period:          
Purchase of businesses - seller financing portion     300 4,000  
Purchase of business - payable to common shareholders of acquired business     0 502  
Purchase of redeemable non-controlling interest - notes payable 137 0 137 0  
Payable due to purchase of redeemable non-controlling interest $ 699 $ 0 699 0  
Receivables related to sale of partnership interest     0 11,601  
Notes receivables related to sale of partnership interest     386 2,780  
Payable related to purchase of partnership interest - settlement of redeemable non-controlling interest     $ 0 $ 2,200