Alliance Healthcare Services (AIQ) Annual Cash Flow Statement

Cash Flow Summary

Alliance Healthcare Services (AIQ) annual cash flow statement covering fiscal 2011 through 2016, as reported to the SEC.

Equipment purchases were $56.4M in fiscal 2016, up 1.6% from $55.51M.
Net income was $17.48M, down 35.5% from $27.11M.
Net change in cash was -$15.83M, after a profit of $5.04M in fiscal 2015.

A cash flow statement shows the cash that actually came in and went out, split between running the business, investing and financing.

Figures in USD thousands

						Dec'16	Dec'15	Dec'14	Dec'13	Dec'12	Dec'11
Operating activities:
Net income
17,478	27,115	25,501	-8,442	-1,163	-155,104	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net income						17,478	27,115	25,501	-8,442	-1,163	-155,104	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustments to reconcile net income to net cash provided by operating activities:
Provision for doubtful accounts
2,255	2,911	2,634	3,415	2,871	6,046	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Provision for doubtful accounts						2,255	2,911	2,634	3,415	2,871	6,046	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Share-based payment
2,713	1,701	1,515	1,487	730	4,695	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Share-based payment						2,713	1,701	1,515	1,487	730	4,695	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Depreciation and amortization
65,533	57,920	62,851	77,292	95,194	106,418	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Depreciation and amortization						65,533	57,920	62,851	77,292	95,194	106,418	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Amortization of deferred financing costs
8,126	2,554	1,926	3,052	4,006	3,947	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Amortization of deferred financing costs						8,126	2,554	1,926	3,052	4,006	3,947	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accretion of discount on long-term debt
513	481	447	1,013	1,690	1,611	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accretion of discount on long-term debt						513	481	447	1,013	1,690	1,611	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustment of derivatives to fair value
-727	-29	-342	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustment of derivatives to fair value						-727	-29	-342	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Distributions from unconsolidated investees
1,335	3,880	5,245	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Distributions from unconsolidated investees						1,335	3,880	5,245	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Earnings from unconsolidated investees
1,290	3,391	4,654	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Earnings from unconsolidated investees						1,290	3,391	4,654	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Deferred income taxes
1,780	6,350	6,582	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Deferred income taxes						1,780	6,350	6,582	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustment of derivatives to fair value
-	-	-	21	-46	113	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustment of derivatives to fair value						-	-	-	21	-46	113	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Distributions more than undistributed earnings from investees
-	-	-	-337	-41	450	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Distributions more than undistributed earnings from investees						-	-	-	-337	-41	450	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Deferred income taxes
-	-	-	-12,486	-7,030	-38,189	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Deferred income taxes						-	-	-	-12,486	-7,030	-38,189	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Gain on sale of assets, net
1,133	1,883	565	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Gain on sale of assets, net						1,133	1,883	565	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Gain on sale of assets
-	-	-	-	-2,087	-2,167	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Gain on sale of assets						-	-	-	-	-2,087	-2,167	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash gain on step acquisition
-	10,672	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Non-cash gain on step acquisition						-	10,672	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Loss on extinguishment of debt
-	-	-	-26,018	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Loss on extinguishment of debt						-	-	-	-26,018	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other non-cash gain
423	209	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other non-cash gain						423	209	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Impairment charges
632	6,817	308	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Impairment charges						632	6,817	308	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Changes in fair value of contingent consideration related to acquisitions
4,790	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Changes in fair value of contingent consideration related to acquisitions						4,790	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Gain on sale of assets
-	-	-	1,391	-2,087	-2,167	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Gain on sale of assets						-	-	-	1,391	-2,087	-2,167	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Impairment charges
-	-	-	13,031	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Impairment charges						-	-	-	13,031	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess tax benefit from share-based payment arrangements
100	-5	623	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess tax benefit from share-based payment arrangements						100	-5	623	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Impairment charges
-	-	-	-	-	167,792	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Impairment charges						-	-	-	-	-	167,792	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess tax benefit from share-based payment arrangements
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess tax benefit from share-based payment arrangements						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Changes in operating assets and liabilities, net of the effects of acquisitions:
Accounts receivable
6,270	7,112	1,424	4,808	-5,510	8,489	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accounts receivable						6,270	7,112	1,424	4,808	-5,510	8,489	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Prepaid expenses
-3,567	877	5,064	2,475	-1,384	-3,698	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Prepaid expenses						-3,567	877	5,064	2,475	-1,384	-3,698	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other current assets
-1,267	-1,494	114	-1,672	-403	703	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other current assets						-1,267	-1,494	114	-1,672	-403	703	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other assets
881	-2,607	1,852	-2,990	-896	-988	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other assets						881	-2,607	1,852	-2,990	-896	-988	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accounts payable
8,040	3,442	953	-4,281	-3,729	2,800	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accounts payable						8,040	3,442	953	-4,281	-3,729	2,800	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued compensation and related expenses
4,962	-1,363	-1,358	-1,315	4,277	645	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued compensation and related expenses						4,962	-1,363	-1,358	-1,315	4,277	645	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued interest payable
-15	168	1,509	-3,436	-1,501	696	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Accrued interest payable						-15	168	1,509	-3,436	-1,501	696	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Income taxes payable
868	40	31	-	-252	-294	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Income taxes payable						868	40	31	-	-252	-294	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other accrued liabilities
3,888	454	6,439	-5,130	-2,317	-4,634	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other accrued liabilities						3,888	454	6,439	-5,130	-2,317	-4,634	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash provided by operating activities
108,782	92,461	100,629	86,522	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash provided by operating activities						108,782	92,461	100,629	86,522	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other liabilities
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Other liabilities						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash provided by operating activities
-	-	-	-	103,143	93,527	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash provided by operating activities						-	-	-	-	103,143	93,527	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investing activities:
Equipment purchases
56,401	55,511	32,236	27,048	37,564	49,609	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Equipment purchases						56,401	55,511	32,236	27,048	37,564	49,609	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Increase in deposits on equipment
11,768	15,751	9,228	193	2,968	-5,878	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Increase in deposits on equipment						11,768	15,751	9,228	193	2,968	-5,878	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Acquisitions, net of cash received
25,912	49,140	16,043	-	-	47,725	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Acquisitions, net of cash received						25,912	49,140	16,043	-	-	47,725	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Increase in cash from escrow
-	-	-	475	-2,496	-1,063	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Increase in cash from escrow						-	-	-	475	-2,496	-1,063	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Increase in notes receivable
-	-	2,776	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Increase in notes receivable						-	-	2,776	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investment in unconsolidated joint ventures
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investment in unconsolidated joint ventures						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from sale of assets
1,830	1,941	1,557	3,156	37,450	573	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from sale of assets						1,830	1,941	1,557	3,156	37,450	573	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in investing activities
-92,251	-118,461	-58,726	-24,560	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in investing activities						-92,251	-118,461	-58,726	-24,560	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Financing activities:
Principal payments on equipment debt and capital lease obligations
16,925	12,697	10,368	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on equipment debt and capital lease obligations						16,925	12,697	10,368	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from equipment debt
7,101	27,049	4,527	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from equipment debt						7,101	27,049	4,527	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on term loan facility
5,200	9,951	4,900	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on term loan facility						5,200	9,951	4,900	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from term loan facility
-	29,850	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from term loan facility						-	29,850	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on equipment debt and capital lease obligations
-	-	-	14,233	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on equipment debt and capital lease obligations						-	-	-	14,233	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investment in unconsolidated joint ventures
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Investment in unconsolidated joint ventures						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in investing activities
-	-	-	-	-586	-89,820	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in investing activities						-	-	-	-	-586	-89,820	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from equipment debt
-	-	-	4,846	6,526	1,885	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from equipment debt						-	-	-	4,846	6,526	1,885	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on term loan facility
-	-	-	342,710	83,515	31,450	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on term loan facility						-	-	-	342,710	83,515	31,450	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on equipment debt
-	-	-	-	13,566	12,207	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on equipment debt						-	-	-	-	13,566	12,207	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from term loan facility
-	-	-	487,200	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from term loan facility						-	-	-	487,200	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on revolving loan facility
61,000	33,000	45,000	-	-	25,000	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on revolving loan facility						61,000	33,000	45,000	-	-	25,000	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from revolving loan facility
63,000	50,500	28,000	19,000	-	25,000	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from revolving loan facility						63,000	50,500	28,000	19,000	-	25,000	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of debt issuance costs and deferred financing costs
25,741	808	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of debt issuance costs and deferred financing costs						25,741	808	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Distributions to noncontrolling interest in subsidiaries
23,526	21,659	16,970	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Distributions to noncontrolling interest in subsidiaries						23,526	21,659	16,970	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Contributions from noncontrolling interest in subsidiaries
1,411	1,732	881	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Contributions from noncontrolling interest in subsidiaries						1,411	1,732	881	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Equity purchase of noncontrolling interest
-	-	691	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Equity purchase of noncontrolling interest						-	-	691	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of debt retirement costs
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of debt retirement costs						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of contingent consideration
-	-	-	-	1,797	1,626	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of contingent consideration						-	-	-	-	1,797	1,626	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from senior subordinated notes
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from senior subordinated notes						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of debt issuance and amendment costs
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of debt issuance and amendment costs						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Noncontrolling interest in subsidiaries
-	-	-	14,409	11,035	6,826	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Noncontrolling interest in subsidiaries						-	-	-	14,409	11,035	6,826	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess tax benefit from share-based payment arrangements
100	-5	623	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess tax benefit from share-based payment arrangements						100	-5	623	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on senior notes
-	-	-	190,000	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Principal payments on senior notes						-	-	-	190,000	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of debt issuance costs
-	-	-	16,522	3,235	6,332	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Payments of debt issuance costs						-	-	-	16,522	3,235	6,332	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchase of derivative instruments
-	-	-	815	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchase of derivative instruments						-	-	-	815	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Issuance of common stock
1	1	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Issuance of common stock						1	1	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from exercise of stock options
614	25	466	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from exercise of stock options						614	25	466	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchase of treasury stock
-	-	140	121	148	179	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Purchase of treasury stock						-	-	140	121	148	179	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Settlement of contingent consideration related to acquisitions
825	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Settlement of contingent consideration related to acquisitions						825	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess tax benefit from share-based payment arrangements
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Excess tax benefit from share-based payment arrangements						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from shared-based payment arrangements
-	-	-	527	-	56	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from shared-based payment arrangements						-	-	-	527	-	56	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from shareholder transaction
28,630	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Proceeds from shareholder transaction						28,630	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in financing activities
-32,360	31,037	-43,572	-67,237	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash used in financing activities						-32,360	31,037	-43,572	-67,237	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash (used in) provided by financing activities
-	-	-	-	-106,770	-56,679	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net cash (used in) provided by financing activities						-	-	-	-	-106,770	-56,679	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net increase (decrease) in cash and cash equivalents
-15,829	5,037	-1,669	-5,275	-4,213	-52,972	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net increase (decrease) in cash and cash equivalents						-15,829	5,037	-1,669	-5,275	-4,213	-52,972	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Supplemental disclosure of cash flow information:
Interest paid
25,368	23,373	21,037	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Interest paid						25,368	23,373	21,037	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Interest paid
-	-	-	35,495	50,355	44,396	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Interest paid						-	-	-	35,495	50,355	44,396	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Income taxes paid (refunded), net
-3,852	-664	6,504	2,463	760	-2,708	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Income taxes paid (refunded), net						-3,852	-664	6,504	2,463	760	-2,708	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Supplemental disclosure of non-cash investing and financing activities:
Net book value of assets exchanged
170	199	-	5	5,434	315	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Net book value of assets exchanged						170	199	-	5	5,434	315	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Capital lease obligations related to the purchase of equipment
6,558	11,273	1,725	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Capital lease obligations related to the purchase of equipment						6,558	11,273	1,725	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Changes in equipment purchases in accounts payable and accrued equipment
-4,591	3,700	834	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Changes in equipment purchases in accounts payable and accrued equipment						-4,591	3,700	834	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Extinguishment of note receivable (Note 3)
-	3,071	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Extinguishment of note receivable (Note 3)						-	3,071	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Transfer of equity investment as consideration in step acquisition (Note 3)
-	721	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Transfer of equity investment as consideration in step acquisition (Note 3)						-	721	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Transfer of assets as consideration in acquisitions (Note 3)
9,900	477	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Transfer of assets as consideration in acquisitions (Note 3)						9,900	477	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Transfer of fair value of equity investment in step acquisition (Note 3)
-	13,645	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Transfer of fair value of equity investment in step acquisition (Note 3)						-	13,645	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Capital lease obligations related to the purchase of equipment
-	-	-	-	4,017	6,587	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Capital lease obligations related to the purchase of equipment						-	-	-	-	4,017	6,587	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Capital lease obligations transferred
-	-	-	-	-	-2,631	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Capital lease obligations transferred						-	-	-	-	-	-2,631	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Unrealized gain (loss) on hedging transactions, net of taxes
-	-	-	-	-234	-281	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Unrealized gain (loss) on hedging transactions, net of taxes						-	-	-	-	-234	-281	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Equipment debt assumed in connection with acquisitions
-	-	-	-	-	25,973	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Equipment debt assumed in connection with acquisitions						-	-	-	-	-	25,973	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Comprehensive gain from hedging transactions, net of taxes
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Comprehensive gain from hedging transactions, net of taxes						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Equipment purchases in accounts payable and accrued equipment
-	-	-	560	282	2,977	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Equipment purchases in accounts payable and accrued equipment						-	-	-	560	282	2,977	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Contingent consideration for acquisitions
-	-	-	-	308	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Contingent consideration for acquisitions						-	-	-	-	308	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Noncontrolling interest assumed in connection with acquisitions
39,141	36,231	13,014	-	1,254	39,610	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Noncontrolling interest assumed in connection with acquisitions						39,141	36,231	13,014	-	1,254	39,610	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Mandatorily redeemable noncontrolling interest in connection with acquisition (Note 3)
-	2,386	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Mandatorily redeemable noncontrolling interest in connection with acquisition (Note 3)						-	2,386	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Fair value of contingent consideration related to acquisitions
420	5,750	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Fair value of contingent consideration related to acquisitions						420	5,750	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustment to equity of noncontrolling interest
-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustment to equity of noncontrolling interest						-	-	-	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Debt related to purchase of equipment
-	-	3,183	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Debt related to purchase of equipment						-	-	3,183	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustment to equity of noncontrolling interest
-	-	1,700	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx
Adjustment to equity of noncontrolling interest						-	-	1,700	-	-	-	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx	xxxxx