Condensed Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014
Cash flows from operating activities
Net loss	$ (75,397)	$ (233,844)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Depreciation	38,331	35,275
Amortization	6,480	7,609
Deferred rent expense	338	230
Deferred income taxes	(781)	378
Stock-based compensation	5	71
Provision for doubtful accounts	8,221	7,724
(Gain) loss on the sale/disposal of property and equipment	(243)	59
Loss on sale leaseback transaction		135
Impairment loss		182,000
Early extinguishment of debt	37,390
Equity initial public offering expenses		4,163
Loss on foreign currency transactions	38
Gain on foreign currency derivative contracts		(4)
Fair value adjustment of noncontrolling interest and earn-out liability	3,205	403
Fair value adjustment of embedded derivative	6,559
Amortization of debt discount	746	1,301
Amortization of loan costs	2,630	3,039
Equity interest in net (earnings) loss of joint ventures	(212)	135
Distribution received from unconsolidated joint ventures	106	106
Changes in operating assets and liabilities:
Accounts receivable and other current assets	(37,921)	(26,977)
Income taxes payable	1,649	(649)
Inventories	124	(439)
Prepaid expenses	(1,003)	3,096
Accounts payable and other current liabilities	2,395	13,857
Accrued deferred compensation	686	591
Accrued expenses / other current liabilities	19,690	11,610
Net cash provided by operating activities	13,036	9,869
Cash flows from investing activities
Purchase of property and equipment	(25,753)	(33,147)
Acquisition of medical practices	(25,611)	(40,843)
Restricted cash associated with medical practice acquisitions	4,001	(10,992)
Proceeds from the sale of property and equipment	1,122	73
Loans to employees	160	(410)
Contribution of capital to joint venture entities		(620)
Purchase of noncontrolling interest - non-redeemable	(1,233)
Proceeds from foreign currency derivative contracts		26
Premiums on life insurance policies	(670)	(450)
Change in other assets and other liabilities	(156)	(401)
Net cash used in investing activities	(48,140)	(86,764)
Cash flows from financing activities
Proceeds from issuance of debt (net of original issue discount of $6.1 million and $2.9 million, respectively)	970,618	130,016
Principal repayments of debt	(911,717)	(41,759)
Repayments of finance obligation	(136)	(113)
Proceeds from issuance of noncontrolling interest	743	1,250
Proceeds from noncontrolling interest holders - redeemable and non-redeemable	3,230	229
Cash distributions to noncontrolling interest holders - redeemable and non-redeemable	(2,022)	(956)
Payments for contingent considerations	(12,184)
Payments of costs for equity securities offering		(2,550)
Payment of call premium on long term debt	(24,877)
Payments of loan costs	(25,626)	(967)
Net cash (used in) provided by financing activities	(1,971)	85,150
Effect of exchange rate changes on cash and cash equivalents	(10)	(35)
Net decrease in cash and cash equivalents	(37,085)	8,220
Cash and cash equivalents, beginning of period	99,167	17,462
Cash and cash equivalents, end of period	62,082	25,682
Supplemental disclosure of non-cash investing and financing activities
Finance obligation related to real estate projects	782	1,106
Derecognition of finance obligation related to real estate projects	12,215	4,119
Capital lease obligations related to the purchase of equipment	582	7,069
Medical equipment and service contract component related to the acquisition of medical equipment through accounts payable	1,265	5,175
Issuance of notes payable relating to the acquisition of medical practices		2,000
Liability relating to the escrow debt and purchase price of medical practices		11,687
Capital lease obligations related to the acquisition of medical practices		47,796
Earn-out accrual related to the acquisition of medical practices	1,258	1,003
Assumed debt obligations related to the acquisition of medical practices	290
Amounts payable to sellers in the purchase of a medical practice		390
Costs incurred for professional fees relating to issuance of equity securities		1,613
Amounts payable for related deferred financing costs	855
Noncash dividend declared to noncontrolling interest	10	$ 282
Noncash dividend declared from unconsolidated joint venture	496
Accrued dividends on Series A convertible preferred stock	45,534
Accretion of redemption value on Series A convertible preferred stock	4,011
Change in additional paid-in capital from sale/purchase of interest in subsidiaries	$ 378