Condensed Consolidated Statements Of Cash Flows (USD $) In Thousands	9 Months Ended
	Sep. 30, 2011	Sep. 30, 2010
Cash flow from operating activities:
Net loss	$ (4,546)	$ (13,292)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation	4,346	7,375
Provision for loss on doubtful accounts	554	1,333
Loss (gain) on sale of investments	9	(1,008)
Impairment charges		1,694
Gain on sale of property and equipment	(498)	(1,577)
Deferred income taxes		377
Stock-based compensation	1,259	957
Insurance reserve	(223)	(796)
Changes in operating assets and liabilities:
Patient accounts receivable	(754)	1,311
Other accounts receivable	138	237
Prepaid income taxes	397	11,651
Prepaid expenses and other	499	1,385
Accounts payable	(1,311)	543
Deferred revenue, net of professional fees	(3,094)	(4,293)
Accrued liabilities and other	777	(1,284)
Net cash (used in) provided by operations	(2,447)	4,613
Cash flow from investing activities:
Purchases of property and equipment	(869)	(176)
Proceeds from sale of assets	1,252	1,721
Purchases of investment securities	(137,480)	(328,120)
Proceeds from sale of investment securities	142,716	325,133
Other	(6)	(34)
Net cash provided by (used in) investing activities	5,613	(1,476)
Cash flow from financing activities:
Principal payments of capital lease obligations and loan	(2,563)	(4,089)
Shares repurchased for treasury stock	(288)	(192)
Proceeds from exercise of stock options	23	14
Net cash used in financing activities	(2,828)	(4,267)
Net effect of exchange rate changes on cash and cash equivalents	(143)	82
Increase (decrease) in cash and cash equivalents	195	(1,048)
Cash and cash equivalents at beginning of period	19,350	24,529
Cash and cash equivalents at end of period	$ 19,545	$ 23,481