Income Taxes (Tables)

12 Months Ended

Dec. 31, 2020

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


	Year Ended December 31,
	2020		2019		2018
	(amounts in thousands)
United States	$	(12,998)	$	(24,783)	$	(18,619)
Foreign	668		572		424
Loss before income taxes	$	(12,330)	$	(24,211)	$	(18,195)

Components of Income Tax Expense (Benefit)

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


	Year Ended December 31,
	2020		2019		2018
	(amounts in thousands)
Current:
Federal	$	25	$	(35)	$	43
State	600		499		620
Foreign	119		109		269
Total	744		573		932
Deferred:
Federal	(138)		17,406		(2,137)
State	(818)		13,799		(1,277)
Foreign	24		(46)		4
Total	(932)		31,159		(3,410)
Income tax (benefit) expense	$	(188)	$	31,732	$	(2,478)

Significant Components of Deferred Tax Assets and Liabilities

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


	December 31,
	2020		2019
	(amounts in thousands)




























Deferred Tax Assets:
Accrued other and prepaid expenses	$	1,600	$	1,557
Allowance for doubtful accounts	909		624
Intangible assets	27,036		28,889
Net operating loss carryforwards	20,536		19,796

Accrued professional liability claims	1,525		1,794
Accrued workers’ compensation claims	3,015		2,839
Share-based compensation	721		381
Operating lease liabilities	4,871		6,108

Credit carryforwards	188		188
Other	—		128
Gross deferred tax assets	60,401		62,304
Valuation allowance	(37,472)		(37,345)
	22,929		24,959
Deferred Tax Liabilities:
Depreciation	(1,077)		(224)

Indefinite-lived intangibles	(25,546)		(27,609)
Operating lease right-of-use assets	(2,499)		(4,312)
Tax on unrepatriated earnings	(361)		(337)
Other	(38)		—
	(29,521)		(32,482)
Net deferred taxes	$	(6,592)	$	(7,523)

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) expense is as follows:


	Year Ended December 31,
	2020		2019 (b)		2018 (b)
	(amounts in thousands)
Tax at U.S. statutory rate	$	(2,589)	$	(5,084)	$	(3,821)
State taxes, net of federal benefit	135		(554)		(543)
Noncontrolling interest	(172)		(372)		(252)
Non-deductible items(a)	544		562		564
Foreign tax expense (benefit)	1		(58)		180
Valuation allowances	117		36,224		—
Uncertain tax positions	1,110		400		1,629


Officers' compensation	621		418		148


Return to provision	87		2		(458)
Other	(42)		194		75
Income tax (benefit) expense	$	(188)	$	31,732	$	(2,478)

________________

(a) Includes non-deductible meals and incidentals and other miscellaneous non-deductible items.

(b) Certain amounts in prior periods were reclassified to accommodate additional line items reflecting material activity in the year ended December 31, 2020.

Reconciliation of Beginning and Ending Amounts of Unrecognized Tax Benefits

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


	Year Ended December 31,
	2020		2019		2018
	(amounts in thousands)
Balance at January 1	$	5,792	$	5,412	$	3,807
Additions based on tax positions related to the current year	974		1,283		1,401
Additions (reductions) based on tax positions related to prior years	125		(498)		204

Reductions as a result of a lapse of applicable statute of limitations	—		(405)		—


Balance at December 31	$	6,891	$	5,792	$	5,412