Consolidated Statements Of Cash Flows (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Cash flow from operating activities:
Net loss	$ (6,198)	$ (20,577)	$ (33,244)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation	5,703	9,408	14,198
Provision for loss on doubtful accounts	746	1,061	3,320
Gain on investments	(42)	(943)	(48)
Impairment charges	104	1,694	5,414
Gain on sale of property and equipment	(618)	(1,962)	(385)
Deferred income taxes		393	10,943
Stock-based compensation	1,676	1,272	790
Insurance reserves	(191)	(1,748)	(335)
Changes in operating assets and liabilities:
Patient accounts receivable	(1,128)	1,975	3,587
Other accounts receivable	(397)	(106)	(103)
Prepaid income taxes	432	11,563	(3,313)
Prepaid expenses and other	352	1,548	773
Accounts payable	(7)	1,643	(1,562)
Deferred revenue, net of professional fees	(3,938)	(5,536)	(8,196)
Accrued liabilities and other	5	1,673	9,049
Net cash (used in) provided by operations	(3,501)	1,358	888
Cash flows from investing activities:
Purchases of property and equipment	(1,509)	(878)	(240)
Proceeds from sale of assets	1,400	2,829	466
Purchases of investment securities	(166,968)	(404,339)	(327,367)
Proceeds from sale of investment securities	173,430	401,714	333,438
Other, net		(35)	99
Net cash provided by (used in) investing activities	6,353	(709)	6,396
Cash flows from financing activities:
Principal payments of capital lease obligations and loan	(3,280)	(5,859)	(7,962)
Shares repurchased for treasury stock	(288)	(193)	(36)
Proceeds from exercise of stock options	24	13	18
Net cash used in financing activities	(3,544)	(6,039)	(7,980)
Net effect of exchange rate changes on cash and cash equivalents	(90)	211	584
Decrease in cash and cash equivalents	(782)	(5,179)	(112)
Cash and cash equivalents at beginning of year	19,350	24,529	24,641
Cash and cash equivalents at end of year	18,568	19,350	24,529
Cash paid or received during the year for:
Interest	529	620	873
Income taxes refunded	499	12,086	8,612
Income taxes paid	$ 64	$ 125	$ 299