CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash flows (used in) provided by operating activities:
Net loss	$ (7,977)	$ (3,330)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	7,955	7,998
Benefit from doubtful accounts	(170)	(211)
Share-based compensation expense	2,903	3,179
Deferred income taxes	(2,466)	(1,795)
Amortization of debt discounts and issuance costs	518	472
Gain on sale and disposal of fixed assets	(228)	(524)
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable, net	12,845	11,093
Inventories	4,259	(1,437)
Other current assets and other assets	(2,540)	(3,492)
Income taxes	33	25
Accounts payable	(6,038)	(14,055)
Accrued expenses and other current liabilities	1,328	(1,299)
Accrued compensation related costs	(17,245)	(36,936)
Other liabilities	(1,598)	(1,576)
Operating lease liabilities, net of amortization of right-of-use assets	123	(478)
Changes in operating assets and liabilities:	(8,833)	(48,155)
Net cash used in operating activities	(8,298)	(42,366)
Cash flows used in investing activities:
Purchase of property, plant, and equipment	(4,003)	(6,541)
Acquisitions, net of cash acquired	(4,001)	(19,377)
Purchase of therapeutic program equipment leased to third parties under operating leases	(450)	(395)
Proceeds from sale of property, plant, and equipment	551	796
Net cash used in investing activities	(7,903)	(25,517)
Cash flows used in financing activities:
Payment of employee taxes on share-based compensation	(3,452)	(4,520)
Payment on Seller Notes	(3,087)	(446)
Repayment of term loan	(1,263)	(1,263)
Payments of financing lease obligations	(266)	(265)
Payments under vendor financing arrangements	0	(275)
Proceeds from the exercise of options	0	366
Net cash used in financing activities	(8,068)	(6,403)
Decrease in cash and cash equivalents	(24,269)	(74,286)
Cash and cash equivalents at beginning of period	61,692	144,602
Cash and cash equivalents at end of period	37,423	70,316
Non-cash financing and investing activities:
Purchase of property, plant, and equipment in accounts payable at period end	3,393	3,458
Seller Notes and other non-cash consideration related to acquisitions	978	4,865
Right-of-use assets obtained in exchange for finance lease obligations	$ 0	$ 82