Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Cash flows from operating activities:
Consolidated net loss	$ (5,249)	$ (8,745)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation	36,614	38,315
Asset impairment charges		1,703
Amortization of intangibles, deferred financing costs and bond premium	6,011	6,532
Provision for doubtful accounts	130	54
Provision for inventory obsolescence	86	225
Non-cash share-based compensation expense	1,514	1,140
Gain on sales and disposals of equipment	(1,863)	(2,522)
Deferred income taxes	120	108
Interest on note receivable	(3)
Changes in operating assets and liabilities:
Accounts receivable	(5,301)	(3,980)
Inventories	(80)	(393)
Other operating assets	(1,100)	669
Accounts payable	(1,338)	2,000
Other operating liabilities	(6,537)	5,119
Net cash provided by operating activities	23,004	40,225
Cash flows from investing activities:
Medical equipment purchases	(27,412)	(27,437)
Property and office equipment purchases	(2,083)	(2,433)
Proceeds from disposition of property and equipment	6,944	9,426
Issuance of note receivable from officer	(983)
Acquisition		(2,600)
Net cash used in investing activities	(23,534)	(23,044)
Cash flows from financing activities:
Proceeds under senior secured credit facility	75,700	63,900
Payments under senior secured credit facility	(74,500)	(75,900)
Payments of principal under capital lease obligations	(2,944)	(4,154)
Payment of deferred financing costs	(97)
Holdback payment related to acquisition	(500)
Distributions to noncontrolling interests	(196)	(240)
Contributions from new members to limited liability companies		70
Dividend and equity distribution payments	(24)	(39)
Proceeds from exercise of parent company stock options	66
Change in book overdrafts	3,025	(818)
Net cash provided by (used in) financing activities	530	(17,181)
Supplemental cash flow information:
Interest paid	25,926	26,151
Income taxes paid	533	697
Non-cash activities:
Medical equipment purchases included in accounts payable (at end of period)	7,546	9,039
Capital lease additions	$ 3,484	$ 6,766