CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Operating activities:
Net income	$ 60,248	$ 143,616	$ 137,933
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	23,143	20,917	21,249
Amortization and impairment of operating lease right of use asset	41,042	37,506	34,546
Stock-based compensation expense	20,017	15,868	14,347
Deferred income taxes	16,304	22,789	(13,261)
Loss (gain) on disposal of assets	742	(1,134)	412
Impairment of intangibles and other	10,854	937	1,849
Changes in operating assets and liabilities, net of acquisitions:
Receivables	34,389	(35,361)	(16,561)
Prepaid expenses	1,865	(5,902)	(754)
Other assets	1,404	(11,015)	(3,169)
Prepaid income taxes	(9,589)	(7,531)	9,652
Accounts payable and accrued expenses	21,846	12,345	(22,506)
Salaries, wages, and benefits payable and self-insurance reserves	504	3,004	6,482
Other liabilities	(26,790)	(26,758)	51,856
Contract liabilities - deferred revenue	(106,489)	(211,473)	317,962
Operating lease payable	(40,846)	(37,360)	(34,226)
Income tax payable	(101)	(20,347)	23,800
Net amounts due to/from governmental entities	1,431	(433)	(364)
Net cash provided by (used in) operating activities	49,974	(100,332)	529,247
Investing activities:
Cash paid for acquisitions, net of cash acquired	(23,552)	(569,583)	(24,545)
Minority interest investments	(15,250)	(10,100)	0
Proceeds from sale of assets	52	3,350	7,920
Proceeds from sale of an entity	0	1,531	0
Purchases of property, building and equipment	(19,510)	(32,976)	(65,875)
Purchase of intangible assets	(100)	0	0
Net cash used in investing activities	(58,360)	(607,778)	(82,500)
Financing activities:
Proceeds from line of credit	1,043,276	1,025,559	296,229
Payments on line of credit	(971,473)	(384,362)	(529,229)
Government stimulus advance	0	(93,257)	93,257
Proceeds from employee stock purchase plan	2,380	2,472	2,177
Payments on deferred financing fees	0	(3,556)	0
Payments on repurchasing common stock	(34,565)	(74,643)	0
Noncontrolling interest distributions	(21,531)	(28,857)	(24,837)
Purchase of additional controlling interest	(1,858)	(2,113)	(24,295)
Sale of noncontrolling interest	5,203	1,934	4,856
Withholding taxes paid on stock-based compensation	(4,944)	(11,827)	(10,008)
Net cash provided by (used in) financing activities	16,488	431,350	(191,850)
Change in cash	8,102	(276,760)	254,897
Cash at beginning of period	9,809	286,569	31,672
Cash at end of period	17,911	9,809	286,569
Supplemental disclosures of cash flow information
Interest paid	29,275	4,168	5,011
Income taxes paid	10,457	43,728	16,830
Non-Cash Operating activity:
Operating right of use assets in exchange for lease obligations	35,620	41,364	43,047
Non-Cash Investing activity:
Accrued capital expenditures	176	417	2,922
Net working capital adjustment	1,440	890	0
Non-Cash Financing activity:
Contribution of noncontrolling interest	$ 0	$ 0	$ 230