Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Cash flows from operating activities:
Net income	$ 29,611	$ 31,837
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	32,712	28,981
Amortization of deferred financing fees	767	571
Amortization of deferred gain on sale-leaseback	(256)	0
Long-lived asset impairment	111	137
Write-off of deferred financing fees	0	321
Deferred income taxes	575	(657)
Provision for doubtful accounts	21,934	20,070
Share-based compensation	6,755	6,907
Excess tax benefit from share-based compensation (Note 2)	0	(2,250)
Gain on disposition of property and equipment	(71)	(21)
Gain on sale of urgent care centers	0	(2,505)
Change in operating assets and liabilities
Accounts receivable	(33,098)	(43,207)
Prepaid income taxes	(13,820)	6,817
Prepaid expenses and other assets	(2,797)	47
Insurance subsidiary deposits and investments	(169)	(448)
Charge related to class action lawsuit (Note 18)	11,000	0
Liabilities related to operational closures (Note 7 and 17)	2,620	7,381
Accounts payable	2,499	2,155
Accrued wages and related liabilities	(8,717)	(6,849)
Income taxes payable	(1,182)	51
Other accrued liabilities	8,668	11,734
Accrued self-insurance liabilities	5,456	9,907
Deferred rent liability	651	205
Net cash provided by operating activities	63,249	71,184
Cash flows from investing activities:
Purchase of property and equipment	(39,775)	(52,273)
Cash payment for business acquisitions	(83,945)	(63,810)
Cash payment for asset acquisitions	(310)	(777)
Escrow deposits	(849)	(1,298)
Escrow deposits used to fund business acquisitions	1,582	400
Cash received from sale of urgent care centers and franchising businesses, net of note receivable	0	5,952
Cash proceeds from sale-leaseback	38,000	0
Cash proceeds from the sale of property and equipment and insurance proceeds	2,546	391
Restricted and other assets	(315)	(1,009)
Net cash used in investing activities	(83,066)	(112,424)
Cash flows from financing activities:
Proceeds from revolving credit facility (Note 15)	680,000	519,000
Payments on revolving credit facility and other debt (Note 15)	(668,089)	(447,481)
Issuance of treasury stock upon exercise of options	0	106
Issuance of common stock upon exercise of options	4,212	5,537
Repurchase of shares of common stock (Note 3)	(7,288)	(30,000)
Dividends paid	(6,528)	(6,131)
Excess tax benefit from share-based compensation (Note 2)	0	2,332
Purchase of non-controlling interest	(83)	0
Payments of deferred financing costs	(58)	(3,278)
Net cash provided by financing activities	2,166	40,085
Net decrease in cash and cash equivalents	(17,651)	(1,155)
Cash and cash equivalents beginning of period	57,706	41,569
Cash and cash equivalents end of period	40,055	40,414
Cash paid during the period for:
Interest	10,014	5,054
Income taxes	30,780	11,552
Non-cash financing and investing activity:
Accrued capital expenditures	4,780	4,168
Note receivable from sale of urgent care centers and franchising business	$ 0	$ 700