Consolidated Statements of Cash Flows (USD $) In Thousands, unless otherwise specified	6 Months Ended
	Jun. 30, 2014	Jun. 30, 2013
Cash flows from operating activities:
Consolidated net loss	$ (42,262)	$ (22,886)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation	42,853	41,675
Assets impairment charges	2,025	0
Intangible asset impairment charge	34,900	0
Amortization of intangibles, deferred financing costs and bond premium	7,039	8,227
Non-cash write off of deferred financing cost		1,853
Provision for doubtful accounts	85	1,033
Provision for inventory obsolescence	38	95
Non-cash share-based compensation expense - net	538	195
Gain on sales and disposals of equipment	(1,234)	(801)
Deferred income taxes	(13,629)	676
Changes in operating assets and liabilities:
Accounts receivable	810	(321)
Inventories	(476)	(921)
Other operating assets	(1,394)	(792)
Accounts payable	674	(1,465)
Other operating liabilities	2,234	3,639
Net cash provided by operating activities	32,201	30,207
Cash flows from investing activities:
Medical equipment purchases	(34,766)	(28,478)
Property and office equipment purchases	(2,560)	(4,178)
Proceeds from disposition of property and equipment	5,970	1,929
Purchases of noncontrolling interests	(34)
Holdback payment related to acquisition		(1,655)
Net cash used in investing activities	(31,390)	(32,382)
Cash flows from financing activities:
Proceeds under senior secured credit facility	76,129	43,300
Payments under senior secured credit facility	(69,129)	(36,800)
Payments of principal under capital lease obligations	(3,429)	(4,150)
Payments of floating rate notes		(230,000)
Proceeds from issuance of bonds		234,025
Accrued interest received from bondholders		8,620
Accrued interest paid to bondholders		(8,620)
Distributions to noncontrolling interests	(295)	(379)
Dividend and equity distribution payments	(73)
Payment of deferred financing costs		(4,102)
Change in book overdrafts	(4,014)	281
Net cash (used in) provided by financing activities	(811)	2,175
Supplemental cash flow information:
Interest paid	26,228	21,620
Income taxes paid	309	332
Non-cash activities:
Medical equipment purchases included in accounts payable (at end of period)	4,598	8,008
Capital lease additions	$ 768	$ 4,438