Consolidated Statements of Cash Flows (USD $) In Thousands, unless otherwise specified	9 Months Ended
	Sep. 30, 2012	Sep. 30, 2011
Cash flows from operating activities:
Consolidated net loss	$ (22,022)	$ (14,044)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation	60,435	58,351
Amortization of intangibles, deferred financing costs and bond premium	13,800	13,339
Non-cash write off of deferred financing cost and bond premium of repurchased notes	2,541
Tender premium for purchase of notes	9,798
Provision for doubtful accounts	584	593
Provision for inventory obsolescence	236	99
Non-cash stock-based compensation expense	3,225	3,294
Non-cash gain on trade-in of recalled equipment	(15,872)	(8,360)
Gain on sales and disposals of equipment	(1,237)	(1,297)
Deferred income taxes	(3,557)	(6,717)
Changes in operating assets and liabilities:
Accounts receivable	(3,630)	(4,328)
Inventories	(1,910)	(267)
Other operating assets	(250)	(759)
Accounts payable	3,178	813
Other operating liabilities	6,294	15,350
Net cash provided by operating activities	51,613	56,067
Cash flows from investing activities:
Medical equipment purchases	(41,901)	(60,563)
Property and office equipment purchases	(4,783)	(5,861)
Proceeds from disposition of property and equipment	5,675	2,599
Acquisitions, net of cash acquired	(14,418)	(65,039)
Net cash used in investing activities	(55,427)	(128,864)
Cash flows from financing activities:
Proceeds under senior secured credit facility	113,000	132,250
Payments under senior secured credit facility	(96,200)	(185,150)
Payments of principal under capital lease obligations	(4,909)	(4,286)
Purchase of refinanced bonds	(405,000)	(4,340)
Payments on acquired debt	(4,163)
Proceeds from issuance of bonds	425,000	178,938
Accrued interest received from bondholders		661
Distributions to non controlling interests	(571)	(291)
Contributions from new members to limited liability companies		7
Proceeds from exercise of parent company stock options	150	41
Dividend and equity distribution payments	(763)	(32,729)
Tender premium for purchase of notes	(9,798)
Payment of deferred financing costs	(9,983)	(4,340)
Change in book overdrafts	(1,648)	755
Net cash provided by financing activities	5,115	85,856
Net change in cash and cash equivalents	1,301	13,059
Cash and cash equivalents at the beginning of period	1,161
Cash and cash equivalents at the end of period	2,462	13,059
Supplemental cash flow information:
Interest paid	37,856	22,711
Income taxes paid	976	361
Non-cash activities:
Medical equipment purchases included in accounts payable (at end of period)	6,061	13,113
Dividend declared to Parent		1,771
Capital lease additions	$ 3,551	$ 3,191