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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 3 Months Ended 6 Months Ended 12 Months Ended
Jun. 30, 2021
Jun. 30, 2020
Jun. 30, 2021
Jun. 30, 2020
Dec. 31, 2020
OPERATING ACTIVITIES          
Net income including non-controlling interests $ 17,472 $ 14,763 $ 29,358 $ 18,101  
Adjustments to reconcile net income including non-controlling interests to net cash provided by operating activities:          
Depreciation and amortization     5,484 5,333  
Provision for credit losses 1,364 739 2,564 2,100  
Equity-based awards compensation expense     3,405 3,389  
Deferred income taxes     3,160 (1,737)  
Loss on sale of fixed assets     106 429  
Gain on sale of partnership interest     0 (1,073)  
Derecognition (write-off) of goodwill - closed clinics 0 0 0 1,859 $ 1,859
Changes in operating assets and liabilities:          
(Increase) decrease in patient accounts receivable     (5,325) 8,880  
Decrease in accounts receivable - other     129 283  
(Increase) decrease in other assets     (255) 5,969  
(Decrease) increase in accounts payable and accrued expenses     (3,672) 4,478  
Increase in other long-term liabilities     602 345  
Net cash provided by operating activities     35,556 48,356  
INVESTING ACTIVITIES          
Purchase of fixed assets     (3,301) (4,628)  
Purchase of majority interest in businesses, net of cash acquired     (20,402) (11,633)  
Purchase of redeemable non-controlling interest - temporary equity     (9,536) (2,388)  
Purchase of non-controlling interest, permanent equity     0 (144)  
Proceeds on sale of redeemable non-controlling interest, temporary equity     32 19  
Proceeds on sales of partnership interest, clinics and fixed assets     (168) 695  
Net cash used in investing activities     (33,375) (18,079)  
FINANCING ACTIVITIES          
Distributions to non-controlling interests, permanent and temporary equity     (9,398) (5,707)  
Cash dividends paid to shareholders     (9,028) (4,110)  
Proceeds from revolving line of credit     128,000 99,000  
Payments on revolving line of credit     (106,000) (112,000)  
Principal payments on notes payable     (4,207) (314)  
(Payment) receipt of Medicare Accelerated and Advance Funds     (14,054) 12,861  
Other     7 0  
Net cash used in financing activities     (14,680) (10,270)  
Net (decrease) increase in cash and cash equivalents     (12,499) 20,007  
Cash and cash equivalents - beginning of period     32,918 23,548 23,548
Cash and cash equivalents - end of period 20,419 43,555 20,419 43,555 $ 32,918
Cash paid during the period for:          
Income taxes     6,967 57  
Interest     741 944  
Non-cash investing and financing transactions during the period:          
Purchase of businesses - seller financing portion     550 300  
Purchase of businesses - payable     1,000 0  
Purchase of redeemable non-controlling interest - notes payable 0 137 0 137  
Notes payable due to purchase of non-controlling interest, permanent equity $ 0 $ 699 0 699  
Note receivables related to sale of partnership interest     $ 287 $ 386