CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands |
12 Months Ended |
Dec. 31, 2015 |
Dec. 31, 2014 |
Dec. 31, 2013 |
| Cash Flows from Operating Activities: |
|
|
|
| Net (loss) income |
$ (2,312)
|
$ 13,089
|
$ (97,775)
|
| Adjustments to reconcile net (loss) income to net cash provided by (used in) operating activities: |
|
|
|
| Depreciation and amortization |
20,036
|
28,347
|
37,383
|
| Provision for doubtful accounts |
14,053
|
16,369
|
16,461
|
| Non-cash compensation |
11,824
|
5,597
|
6,519
|
| 401(k) employer match |
6,089
|
6,216
|
7,998
|
| Loss on disposal of property and equipment |
775
|
4,592
|
2,742
|
| Gain on sale of care centers |
(184)
|
(2,967)
|
(1,752)
|
| Deferred income taxes |
(677)
|
22,561
|
(57,095)
|
| Write off of deferred debt issuance costs/debt discount |
2,512
|
488
|
121
|
| Equity in earnings from equity method investments |
(9,823)
|
(2,991)
|
(1,520)
|
| Amortization of deferred debt issuance costs/debt discount |
959
|
797
|
699
|
| Return on equity investment |
5,610
|
2,025
|
1,650
|
| Asset impairment charge |
77,268
|
3,107
|
9,492
|
| Changes in operating assets and liabilities, net of impact of acquisitions: |
|
|
|
| Patient accounts receivable |
(36,493)
|
(5,290)
|
41,578
|
| Other current assets |
6,455
|
(6,269)
|
(501)
|
| Other assets |
(3,523)
|
1,694
|
(1,596)
|
| Accounts payable |
7,639
|
(3,168)
|
(9,876)
|
| U.S. Department of Justice settlement |
0
|
(150,000)
|
150,000
|
| Accrued expenses |
8,406
|
3,495
|
(6,104)
|
| Other long-term obligations |
(829)
|
(3,226)
|
3,839
|
| Net cash provided by (used in) operating activities |
107,785
|
(65,534)
|
102,263
|
| Cash Flows from Investing Activities: |
|
|
|
| Proceeds from sale of deferred compensation plan assets |
1,229
|
11
|
128
|
| Proceeds from the sale of property and equipment |
20,000
|
3
|
1,809
|
| Purchases of deferred compensation plan assets |
(19)
|
(132)
|
(111)
|
| Purchases of property and equipment |
(21,429)
|
(12,008)
|
(41,736)
|
| Purchase of investments |
(3,485)
|
(6,407)
|
(10,067)
|
| Proceeds from sale of investment |
5,000
|
0
|
0
|
| Acquisitions of businesses, net of cash acquired |
(69,130)
|
0
|
(1,627)
|
| Proceeds from disposition of care centers |
413
|
4,233
|
5,146
|
| Net cash used in investing activities |
(67,421)
|
(14,300)
|
(46,458)
|
| Cash Flows from Financing Activities: |
|
|
|
| Proceeds from issuance of stock upon exercise of stock options and warrants |
399
|
564
|
261
|
| Proceeds from issuance of stock to employee stock purchase plan |
2,204
|
2,433
|
3,181
|
| Tax benefit from stock options exercised and restricted stock vesting |
2,073
|
0
|
57
|
| Non-controlling interest distribution |
(436)
|
0
|
(163)
|
| Proceeds from revolving line of credit |
63,400
|
241,800
|
25,500
|
| Repayments of revolving line of credit |
(78,400)
|
(226,800)
|
(25,500)
|
| Proceeds from issuance of long-term obligations |
100,000
|
68,250
|
0
|
| Debt issuance costs |
(2,553)
|
(1,780)
|
(576)
|
| Principal payments of long-term obligations |
(103,000)
|
(13,904)
|
(55,807)
|
| Purchase of company stock |
(4,581)
|
0
|
0
|
| Net cash (used in) provided by financing activities |
(20,894)
|
70,563
|
(53,047)
|
| Net increase (decrease) in cash and cash equivalents |
19,470
|
(9,271)
|
2,758
|
| Cash and cash equivalents at beginning of period |
8,032
|
17,303
|
14,545
|
| Cash and cash equivalents at end of period |
27,502
|
8,032
|
17,303
|
| Supplemental Disclosures of Cash Flow Information: |
|
|
|
| Cash paid for interest |
6,175
|
7,602
|
3,990
|
| Cash paid for income taxes, net of refunds received |
(12,185)
|
(1,766)
|
3,385
|
| Supplemental Disclosures of Non-Cash Financing and Investing Activities |
|
|
|
| (Sale) acquistion of noncontrolling interests |
$ 0
|
$ (1,549)
|
$ 145
|