CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	6 Months Ended
	Jun. 30, 2013	Jun. 30, 2012
Cash flows from operating activities
Net loss	$ (38,862)	$ (27,364)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation	26,222	25,637
Amortization	4,269	5,806
Deferred rent expense	422	549
Deferred income taxes	(1,138)	(702)
Stock-based compensation	345	3,012
Provision for doubtful accounts	5,090	9,861
Loss on the sale / disposal of property and equipment	76	22
Gain on the sale of an interest in a joint venture	(1,460)
Amortization of termination of interest rate swap		958
Write-off of loan costs		525
Early extinguishment of debt		4,473
Termination of derivative interest rate swap agreements		(972)
Loss on foreign currency transactions	34	18
Loss on foreign currency derivative contracts	242	220
Amortization of debt discount	391	417
Amortization of loan costs	2,731	2,609
Equity interest in net loss of joint ventures	332	539
Distribution received from unconsolidated joint ventures		9
Changes in operating assets and liabilities:
Accounts receivable and other current assets	(9,677)	(18,102)
Income taxes payable	(261)	(441)
Inventories	(461)	(713)
Prepaid expenses	46	1,111
Accounts payable and other current liabilities	8,822	(2,701)
Accrued deferred compensation	656	602
Accrued expenses / other current liabilities	5,795	6,314
Net cash provided by operating activities	3,614	11,687
Cash flows from investing activities
Purchases of property and equipment	(17,769)	(16,298)
Acquisition of medical practices	(22,848)	(23,742)
Restricted cash associated with initial deposit in the potential acquisition of medical practices	(5,001)
Proceeds from the sale of property and equipment	4	27
Loans to employees	(153)	(115)
Contribution of capital to joint venture entities	(542)	(225)
Proceeds from the sale of equity interest in a joint venture	1,460
Payment of foreign currency derivative contracts	(171)	(432)
Premiums on life insurance policies	(626)	(518)
Change in other assets and other liabilities	5	7
Net cash used in investing activities	(45,641)	(41,296)
Cash flows from financing activities
Proceeds from issuance of debt (net of original issue discount of $-0- and $1.7 million, respectively)	83,880	434,061
Principal repayments of debt	(45,501)	(369,903)
Repayments of finance obligation	(99)	(53)
Proceeds from noncontrolling interest holders - redeemable and non-redeemable	765
Cash distributions to noncontrolling interest holders - redeemable and non-redeemable	(650)	(2,018)
Payments of loan costs		(14,225)
Net cash provided by financing activities	38,395	47,862
Effect of exchange rate changes on cash and cash equivalents	(19)	(5)
Net (decrease) increase in cash and cash equivalents	(3,651)	18,248
Cash and cash equivalents, beginning of period	15,410	10,177
Cash and cash equivalents, end of period	11,759	28,425
Supplemental disclosure of non-cash transactions
Recorded finance obligation related to real estate projects	5,029	1,457
Recorded capital lease obligations related to the purchase of equipment	78	696
Recorded property and equipment related to the North Broward Hospital District license agreement		4,260
Recorded capital lease obligations related to the acquisition of medical practices	8,748	5,726
Recorded seller financing promissory note related to the acquisition of medical practices	2,097
Recorded noncash contribution of capital by noncontrolling interest holders	$ 4,235