Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Operating activities
Net loss	$ (40,151)	$ (36,199)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	36,063	37,614
Non-cash interest	14,360	3,597
Stock-based compensation	2,552	1,900
Provision for losses on accounts receivable	3,059	1,846
Deferred income taxes (refunds)	418	(221)
Change in fair value of contingent consideration	80
Changes in operating assets and liabilities:
Accounts receivable	8,365	(13,780)
Prepaid expenses and other assets	(3,338)	(3,386)
Accounts payable and accrued expenses	4,734	(2,511)
Deferred revenue	(835)	(820)
Net cash provided by (used in) operating activities	25,307	(11,960)
Investing activities
Acquisitions, net of cash acquired	(3,124)	(650)
Purchases of property and equipment	(8,377)	(9,288)
Net cash used in investing activities	(11,501)	(9,938)
Financing activities
Revolving credit facility - draws	29,000	41,500
Revolving credit facility - repayments	(29,000)	(24,500)
Payments for capital lease obligations	(688)	(453)
Issuance of common stock		414
Payments on long-term debt	(12,750)	(12,750)
Net cash (used in) provided by financing activities	(13,438)	4,211
Effect of foreign exchange rates	63	(142)
Net increase (decrease) in cash	431	(17,829)
Cash at beginning of period	43,407	23,439
Cash at end of period	43,838	5,610
Supplemental disclosure:
Cash paid for interest	24,857	29,770
Income taxes (refunds) paid, net of refunds	(311)	325
Significant non-cash investing and financing activities
Purchases of property and equipment in accounts payable and accrued expenses on the consolidated balance sheets	$ 21	$ 222