Income Taxes (Tables)

12 Months Ended

Dec. 31, 2017

Income Tax Disclosure [Abstract]

Components of Income (Loss) Before Income Taxes

The components of the Company's income before income taxes are as follows:

	Year Ended December 31,
	2017		2016		2015
	(amounts in thousands)
United States	$	3,826	$	3,309	$	3,565
Foreign	475		1,236		595
Income before income taxes	$	4,301	$	4,545	$	4,160

Components of Income Tax Expense (Benefit)

The components of the Company’s income tax benefit are as follows:

	Year Ended December 31,
	2017			2016			2015
	(amounts in thousands)
Current:
Federal	$	(555	)	$	227		$	551
State	(273		)	587			(21		)
Foreign	139			322			220
Total	(689		)	1,136			750
Deferred:
Federal	(23,245		)	(4,114		)	(1,819		)
State	(10,684		)	(866		)	8
Foreign	117			(342		)	267
Total	(33,812		)	(5,322		)	(1,544		)
Total income tax benefit	$	(34,501	)	$	(4,186	)	$	(794	)

Significant Components of Deferred Tax Assets and Liabilities

Significant components of the Company’s deferred tax assets and liabilities are as follows:

	December 31,
	2017			2016
	(amounts in thousands)
Deferred Tax Assets:
Accrued other and prepaid expenses	$	2,955		$	3,494
Allowance for doubtful accounts	624			704
Intangible Assets	7,776			10,725
Net operating loss carryforwards	14,718			17,228
Derivative interest	—			7,940
Accrued professional liability claims	1,709			2,632
Accrued workers’ compensation claims	2,512			3,439
Share-based compensation	734			—
Credit carryforwards	189			1,055
Other	444			584
Gross deferred tax assets	31,661			47,801
Valuation allowance	(1,076		)	(46,454		)
	30,585			1,347
Deferred Tax Liabilities:
Depreciation	(41		)	(70		)
Indefinite intangibles	(9,964		)	(13,971		)
Tax on unrepatriated earnings	(466		)	(263		)
Share-based compensation	—			(197		)
	(10,471		)	(14,501		)
Net deferred taxes	$	20,114		$	(13,154	)

Reconciliation of Income Tax Computed At U. S. Federal Statutory Rate to Income Tax (Benefit) Expense

The reconciliation of income tax computed at the U. S. federal statutory rate to income tax benefit is as follows:

	Year Ended December 31,
	2017			2016			2015
	(amounts in thousands)
Tax at U.S. statutory rate	$	1,506		$	1,591		$	1,456
State taxes, net of federal benefit	(1,374		)	344			(13		)
Noncontrolling interest	(455		)	(260		)	—
Non-deductible meals and entertainment	2,676			1,546			1,510
Foreign tax expense	175			(5		)	(6		)
Valuation allowances	(45,354		)	(8,379		)	(5,078		)
Uncertain tax positions	1,145			1,090			917
Federal rate change	8,011			—			—
Other	(831		)	(113		)	420
Total income tax benefit	$	(34,501	)	$	(4,186	)	$	(794	)

Reconciliation of Beginning and Ending Amounts of Unrecognized Tax Benefits

A reconciliation of the beginning and ending amounts of unrecognized tax benefits is approximately as follows: 

	2017			2016		2015
	(amounts in thousands)
Balance at January 1	$	5,180		$	4,071	$	3,777
Additions based on tax positions related to the current year	1,145			1,054		861
Additions based on tax positions related to prior years	—			55		62
Reductions based on settlements of tax positions related to prior years	(439		)	—		(624		)
2017 Tax Act federal tax rate change	(1,859		)	—		—
Other	(220		)	—		(5		)
Balance at December 31	$	3,807		$	5,180	$	4,071