Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2020	Mar. 31, 2019
Cash flows from operating activities
Net (loss) income		$ (14,419)	$ 11
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization		24,369	21,533
Accretion of contract rights under development agreements and placement fees	[1]	1,859	1,271
Amortization of deferred loan costs and discount		492	468
Stock-based compensation expense		1,551	1,196
(Benefit) provision for bad debts		(299)	52
Loss on disposition of assets		49	266
Impairment of assets		6	350
Fair value adjustment of contingent consideration			400
Benefit for deferred income tax		(101)	(298)
Changes in assets and liabilities that relate to operations:
Accounts receivable		20,284	(4,155)
Inventories		(5,324)	522
Prepaid expenses		(2,068)	(1,554)
Deposits and other		408	318
Other assets, non-current		3,681	5,268
Accounts payable and accrued liabilities		(11,679)	(13,993)
Net cash provided by operating activities		18,809	11,655
Cash flows from investing activities
Customer notes receivable		(2,301)
Business acquisitions, net of cash acquired			(50,779)
Purchase of intangible assets		(699)	(1,231)
Software development and other expenditures		(3,756)	(2,669)
Proceeds from disposition of assets		27	109
Purchases of property and equipment		(6,150)	(15,105)
Net cash used in investing activities		(12,879)	(69,675)
Cash flows from financing activities
Repayment of first lien credit facilities		(1,347)	(1,347)
Payment of financed placement fee obligations		(3,444)	(971)
Borrowing on revolver		30,000
Payments of previous acquisition obligation		(201)	(157)
Payments on finance leases and other obligations		(333)	(417)
Repurchase of stock		(348)
Proceeds from stock option exercise		158	556
Distributions to non-controlling interest owners			(57)
Net cash provided by (used in) financing activities		24,485	(2,393)
Effect of exchange rates on cash and cash equivalents		(13)	(2)
Net increase (decrease) in cash and cash equivalents		30,402	(60,415)
Cash, cash equivalents and restricted cash, beginning of period		13,182	70,804
Cash, cash equivalents and restricted cash, end of period		43,584	10,389
Non-cash investing and financing activities:
Intangible assets obtained under financed placement fee arrangements			33,129
Leased assets obtained in exchange for new finance lease liabilities		254	494
Leased assets obtained in exchange for new operating lease liabilities			$ 10,102

[1] Non-cash item related to the accretion of contract rights under development agreements and placement fees.