CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating activities:
Net income	$ 27,676	$ 23,401
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	5,133	4,202
Amortization of operating lease right of use asset	8,512	7,399
Stock-based compensation expense	3,680	1,804
Deferred income taxes	4,367	1,578
Amortization of operating leases	(13)	0
Loss on disposal of assets	47	56
Impairment of intangibles and other	0	6,319
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(67,470)	(16,284)
Prepaid expenses	(11,728)	(1,069)
Other assets	2,268	1,539
Prepaid income taxes	(4,537)	1,883
Accounts payable and accrued expenses	(11,159)	(10,413)
Salaries, wages, and benefits payable	24,826	16,169
Operating lease liabilities	(8,415)	(5,285)
Income taxes payable	2,298	184
Net amounts due to/from governmental entities	51	(55)
Net cash (used in) provided by operating activities	(24,464)	31,428
Investing activities:
Purchases of property, building and equipment	(13,502)	(2,801)
Proceeds from sale of property, building and equipment	1,149	0
Cash received (paid) for acquisitions	3,125	(1,413)
Net cash used in investing activities	(9,228)	(4,214)
Financing activities:
Proceeds from line of credit	188,728	17,000
Payments on line of credit	(143,657)	(13,000)
Proceeds from employee stock purchase plan	610	478
Payments on debt	0	(7,650)
Noncontrolling interest distributions	(4,874)	(9,194)
Withholding taxes paid on stock-based compensation	(7,064)	(7,577)
Purchase of additional controlling interest	(23,575)	(18,000)
Exercise of vested awards and stock options	160
Exercise of vested awards and stock options		(114)
Net cash provided by (used in) financing activities	10,328	(38,057)
Change in cash	(23,364)	(10,843)
Cash at beginning of period	31,672	49,363
Cash at end of period	8,308	38,520
Supplemental disclosures of cash flow information:
Interest paid	2,830	2,855
Income taxes paid	1,269	318
Non-Cash Operating Activity:
Operating right of use assets in exchange for lease obligations	9,041	91,174
Non-Cash Investing Activity:
Accrued capital expenditures	$ 2,226	$ 4,600