CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Cash flows provided by (used in) operating activities:
Net income	$ 2,140	$ 6,829
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Depreciation and amortization	16,079	16,005
Benefit from doubtful accounts	(68)	(292)
Share-based compensation expense	6,504	6,418
Deferred income taxes	(734)	232
Amortization of debt discounts and issuance costs	1,044	948
Gain on sale and disposal of fixed assets	(863)	(718)
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable, net	1,262	5,363
Inventories	309	(5,899)
Other current assets and other assets	(2,197)	(6,202)
Income taxes	584	57
Accounts payable	4,597	(6,577)
Accrued expenses and other current liabilities	1,606	(2,765)
Accrued compensation related costs	2,284	(21,412)
Other liabilities	(1,186)	(522)
Operating lease liabilities, net of amortization of right-of-use assets	(416)	(780)
Changes in operating assets and liabilities:	6,843	(38,737)
Net cash provided by (used in) operating activities	30,945	(9,315)
Cash flows used in investing activities:
Purchase of property, plant, and equipment	(10,596)	(13,339)
Acquisitions, net of cash acquired	(12,490)	(35,349)
Purchase of therapeutic program equipment leased to third parties under operating leases	(1,358)	(870)
Proceeds from sale of property, plant, and equipment	1,392	1,332
Net cash used in investing activities	(23,052)	(48,226)
Cash flows used in financing activities:
Payment of employee taxes on share-based compensation	(3,478)	(4,560)
Payment on Seller Notes	(5,000)	(2,265)
Repayment of term loan	(36,263)	(2,525)
Payments of financing lease obligations	(515)	(529)
Payments under vendor financing arrangements	0	(1,375)
Proceeds from the exercise of options	51	371
Net cash used in financing activities	(45,205)	(10,883)
Decrease in cash and cash equivalents	(37,312)	(68,424)
Cash and cash equivalents at beginning of period	61,692	144,602
Cash and cash equivalents at end of period	24,380	76,178
Non-cash financing and investing activities:
Purchase of property, plant, and equipment in accounts payable at period end	2,732	3,349
Seller Notes and other non-cash consideration related to acquisitions	4,002	10,057
Right-of-use assets obtained in exchange for finance lease obligations	$ 223	$ 95