Condensed Consolidated Statements of Cash Flows (Unaudited) (USD $) In Thousands, unless otherwise specified	9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012
Net income (loss)	$ 108	$ (2,893)
Adjustments to reconcile net income (loss) to net cash used in operating activities:
Depreciation	1,555	3,743
Provision for loss on doubtful accounts	388	704
Loss on sale of investments		8
Impairment charges		37
Gain on sale of assets	(180)	(221)
Stock-based compensation	957	1,531
Insurance reserve	(102)	(318)
Changes in operating assets and liabilities:
Patient accounts receivable	(773)	(1,719)
Other accounts receivable	(207)	(60)
Prepaid expenses and other	(108)	870
Accounts payable	(1,585)	(2,660)
Deferred revenue, net of professional fees	(680)	(1,838)
Accrued liabilities and other	(3,744)	(2,144)
Net cash used in operations	(4,371)	(4,960)
Cash flow from investing activities:
Purchases of property and equipment	(505)	(973)
Proceeds from sale of assets	217	283
Purchases of investment securities	(1,984)	(39,659)
Proceeds from sale of investment securities	2,804	62,064
Net cash provided by investing activities	532	21,715
Cash flow from financing activities:
Principal payments on loans	(304)	(4,004)
Shares repurchased for treasury stock	(231)	(357)
Proceeds from exercise of stock options		57
Net cash used in financing activities	(535)	(4,304)
Net effect of exchange rate changes on cash and cash equivalents	(150)	167
(Decrease) increase in cash and cash equivalents	(4,524)	12,618
Cash and cash equivalents at beginning of period	31,653	18,568
Cash and cash equivalents at end of period	$ 27,129	$ 31,186