CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Cash flows from operating activities:
Net income from continuing operations	$ 52,607	$ 43,967
Net income (loss) from discontinued operations	2,625	(179,482)
Adjustments to reconcile net income (loss) to net cash provided by operating activities, net of business acquisitions:
Depreciation and amortization	2,446	30,319
Amortization of deferred loan costs	2,318	1,645
Amortization of debt discount	5,941	5,618
Share-based employee compensation expense	5,019	15,367
(Gain) loss on sale of TPHS business	(4,782)	195,772
Loss on release of cumulative translation adjustment	3,044	0
Equity in income from joint ventures	0	(271)
Deferred income taxes	27,545	(89,013)
(Increase) decrease in accounts receivable, net	(2,986)	1,837
Decrease in other current assets	2,035	5,548
Decrease in accounts payable	(1,247)	(3,698)
Decrease in accrued salaries and benefits	(10,925)	(5,457)
(Decrease) increase in other current liabilities	(7,487)	1,568
Other	(2,525)	(5,642)
Net cash flows provided by operating activities	73,628	18,078
Cash flows from investing activities:
Acquisition of property and equipment	(3,974)	(12,860)
Investment in joint ventures	0	(1,298)
Proceeds from sale of MeYou Health	0	5,156
Payments related to sale of TPHS business	0	(27,469)
Other	0	(787)
Net cash flows used in investing activities	(3,974)	(37,258)
Cash flows from financing activities:
Proceeds from issuance of long-term debt	330,700	396,491
Payments of long-term debt	(400,945)	(385,188)
Payments related to tax withholding for share-based compensation	(1,798)	(4,962)
Exercise of stock options	4,314	8,747
Deferred loan costs	(2,452)	(424)
Change in cash overdraft and other	2,083	2,556
Net cash flows (used in) provided by financing activities	(68,098)	17,220
Effect of exchange rate changes on cash	1,750	817
Less: net increase in discontinued operations cash and cash equivalents	0	(1,637)
Net increase in cash and cash equivalents	3,306	494
Cash and cash equivalents, beginning of period	1,602	233
Cash and cash equivalents, end of period	$ 4,908	$ 727