CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	12 Months Ended
Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Operating activities
Income from continuing operations	$ 28,752us-gaap_ProfitLoss	$ 29,146us-gaap_ProfitLoss	$ 35,428us-gaap_ProfitLoss
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and Amortization Expense	9,571us-gaap_DepreciationAndAmortization	8,325us-gaap_DepreciationAndAmortization	7,806us-gaap_DepreciationAndAmortization
Provision for bad debts	15,780us-gaap_ProvisionForDoubtfulAccounts	13,929us-gaap_ProvisionForDoubtfulAccounts	11,875us-gaap_ProvisionForDoubtfulAccounts
Stock-based compensation expense	4,094us-gaap_ShareBasedCompensation	3,886us-gaap_ShareBasedCompensation	4,390us-gaap_ShareBasedCompensation
Deferred income taxes	2,402us-gaap_DeferredIncomeTaxExpenseBenefit	2,351us-gaap_DeferredIncomeTaxExpenseBenefit	2,204us-gaap_DeferredIncomeTaxExpenseBenefit
Impairment of intangibles and other	3,650	520	755
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(16,372)	(18,961)	(4,497)
Prepaid expenses and other assets	191	(749)	1,780
Prepaid income taxes	911us-gaap_IncreaseDecreaseInPrepaidTaxes	3,299us-gaap_IncreaseDecreaseInPrepaidTaxes	18,855us-gaap_IncreaseDecreaseInPrepaidTaxes
Accounts payable and accrued expenses	(10,460)	4,395	(4,288)
Net amounts due to/from governmental entities	138	(226)	464
Net cash provided by (used in) operating activities	38,657	45,915	74,772
Investing activities
Cash paid for acquisitions, primarily goodwill and intangible assets	(73,933)	(26,920)	(6,758)
Proceeds from sale of assets	0	0	33
Purchases of property, building and equipment	(8,105)	(8,343)	(8,415)
Net cash (used in) investing activities	(82,038)	(35,263)	(15,140)
Financing activities
Proceeds from line of credit	75,000us-gaap_ProceedsFromLinesOfCredit	73,000us-gaap_ProceedsFromLinesOfCredit	188,561us-gaap_ProceedsFromLinesOfCredit
Payments on line of credit	(37,000)us-gaap_RepaymentsOfLinesOfCredit	(70,500)us-gaap_RepaymentsOfLinesOfCredit	(203,881)us-gaap_RepaymentsOfLinesOfCredit
Excess tax benefits from vesting of restricted stock	124	18	0
Proceeds from issuance of common stock under ESPP	782us-gaap_ProceedsFromStockPlans	786us-gaap_ProceedsFromStockPlans	783us-gaap_ProceedsFromStockPlans
Proceeds from debt issuance	0	1,212	0
Payments on debt	(202)
Noncontrolling interest distributions	(6,843)	(8,126)	(8,444)
Payments of deferred financing fees	(852)us-gaap_PaymentsOfFinancingCosts	0us-gaap_PaymentsOfFinancingCosts	0us-gaap_PaymentsOfFinancingCosts
Purchase of Additional Controlling Interest	(359)us-gaap_PaymentsToMinorityShareholders	(1,879)us-gaap_PaymentsToMinorityShareholders	(309)us-gaap_PaymentsToMinorityShareholders
Sale of noncontrolling interest	193	0	80
Redemption of treasury stock to pay income tax	(945)	(869)	0
Repurchase of common stock	0	0	(26,958)
Net cash provided by (used in) financing activities	29,898	(6,358)	(50,168)
Change in cash	(13,483)	4,294	9,464
Cash at beginning of period	14,014us-gaap_Cash	9,720us-gaap_Cash	256us-gaap_Cash
Cash at end of period	531us-gaap_Cash	14,014us-gaap_Cash	9,720us-gaap_Cash
Supplemental disclosures of cash flow information
Interest paid	2,461us-gaap_InterestPaidNet	1,961us-gaap_InterestPaidNet	1,550us-gaap_InterestPaidNet
Income taxes paid	$ 11,781us-gaap_IncomeTaxesPaidNet	$ 21,606us-gaap_IncomeTaxesPaidNet	$ 8,645us-gaap_IncomeTaxesPaidNet

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The cash inflow from the sale of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale.

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The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

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