Income Taxes

The provision for income taxes consists of the following (in thousands):



	Year Ended December 31,
	2015			2014			2013
Current:
Federal	$	31,295		$	28,581		$	26,284
State	5,837			5,060			4,910
Foreign	2,048			2,181			1,204
	39,180			35,822			32,398
Deferred:
Federal & State	11,520			15,991			4,244
Foreign	(209		)	(256		)	(84		)
	11,311			15,735			4,160
	$	50,491		$	51,557		$	36,558

Income from continuing operations before income taxes consists of the following (in thousands):



	Year Ended December 31,
	2015		2014		2013
United States	$	116,011	$	122,496	$	82,970
Foreign	5,902		2,556		4,728
	$	121,913	$	125,052	$	87,698

The components of deferred tax assets (liabilities) are as follows (in thousands):



	December 31,
	2015			2014
Intangibles	$	(70,588	)	$	(59,226	)
Depreciation expense	(14,369		)	(13,405		)
Allowance for doubtful accounts	2,607			2,027
Employee related accruals	7,573			7,240
Workers’ compensation and medical malpractice loss reserves	720			4,068
Stock-based compensation	7,354			3,022
Other	5,061			7,286
Net operating loss carryforwards	1,147			1,260
Valuation allowance	(1,044		)	(1,114		)
	$	(61,539	)	$	(48,842	)

The table above includes non-current deferred income tax liabilities of $0.8 million for the Physician Segment as of December 31, 2014 (see "Note 5. Discontinued Operations").

The reconciliation between the amount computed by applying the U.S. federal statutory tax rate of 35.0 percent to income before income taxes and the income tax provision is as follows (in thousands):



	Year Ended December 31,
	2015		2014		2013
Income tax provision at the statutory rate	$	42,669	$	43,768	$	30,694
State income taxes, net of federal benefit	4,559		4,674		3,807
Disallowed meals and entertainment expenses	1,718		1,608		1,592
Other	1,545		1,507		465
	$	50,491	$	51,557	$	36,558

As of December 31, 2015, the Company had no federal net operating losses, $8.8 million of state net operating losses, and $4.9 million of foreign net operating losses. The state net operating losses can be carried forward up to 20 years and begin expiring in 2016. The foreign net operating losses in the United Kingdom and Spain can be carried forward indefinitely. The Company has a valuation allowance of approximately $1.0 million related to net operating loss carryforwards at December 31, 2015 and 2014.

The Company has not provided deferred income taxes on $11.0 million of undistributed earnings of its foreign subsidiaries as of December 31, 2015 since the Company intends to reinvest these earnings indefinitely. Those earnings are considered to be indefinitely reinvested; accordingly, no provision for U.S. federal and state income taxes has been provided thereon. Upon repatriation of those earnings, in the form of dividends or otherwise, the Company would be subject to both U.S. income taxes (subject to an adjustment for foreign tax credits) and withholding taxes payable to the various foreign countries. Determination of the amount of unrecognized deferred U.S. income tax liability is not practicable due to the complexities associated with its hypothetical calculation; however, unrecognized foreign tax credit carryforwards would be available to reduce some portion of the U.S. liability.

The Company had gross deferred tax assets of $29.2 million and $24.1 million, and gross deferred tax liabilities of $89.7 million and $71.4 million, at December 31, 2015 and 2014, respectively. Management has determined the gross deferred tax assets are realizable, with the exception of foreign net operating losses discussed above.

At December 31, 2015, 2014 and 2013, there were $0.8 million to $0.9 million of unrecognized tax benefits that if recognized would affect the annual effective tax rate. The gross unrecognized tax benefit is carried in other long-term liabilities. The Company recognizes interest and penalties related to uncertain tax positions in income tax expense. The amount of interest and penalties recognized in the financial statements is not significant. The Company believes that there will be no significant increases or decreases to unrecognized tax benefits within the next 12 months. The following is a reconciliation of the total amounts of unrecognized tax benefits (in thousands):



	Year Ended December 31,
	2015			2014			2013
Unrecognized tax benefit beginning of year	$	848		$	979		$	376
Gross increases - tax positions in prior year	—			126			1,240
Gross decreases - tax positions in prior year	(34		)	—			(177		)
Lapse of the statute of limitations	—			(131		)	—
Discontinued operations	—			(126		)	(460		)
Unrecognized tax benefit end of year	$	814		$	848		$	979

The Company is subject to taxation in the United States and various states and foreign jurisdictions. The Company remains subject to U.S. Federal income tax examinations for 2012 and subsequent years. For major U.S. states, with few exceptions, the Company remains subject to examination for 2011 and subsequent years. Generally, for the foreign tax jurisdictions, the Company remains subject to examination for 2011 and subsequent years.