Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities
Net loss	$ (20,846)	$ (45,106)	$ (81,374)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	77,535	71,649	80,181
Accretion of contract rights under development agreements and placement fees	4,552	4,680	4,702
Amortization of deferred loan costs and discount	1,826	2,976	3,542
Payment-in-kind interest capitalized	0	15,935	15,396
Payments-in-kind interest payments	(37,624)	(2,698)	0
Write off of deferred loan cost and discount	3,876	3,294	0
Share-based Compensation	10,933	0	0
Provision (benefit) for bad debts	(441)	651	2,290
Provision (benefit) for bad debts	(441)	651	2,290
Loss on disposition of assets	1,963	3,901	1,149
Impairment of assets	6,089	584	4,749
Fair value adjustments to contingent consideration and other items	701	0	0
(Benefit) provision of deferred income tax	(970)	(7,062)	(7,998)
Changes in assets and liabilities related to operations:
Accounts receivable	(11,488)	(8,348)	(3,191)
Inventories	4,907	(1,636)	307
Prepaid expenses	(895)	(599)	2,021
Deposits and other	(748)	(374)	(315)
Other assets, non-current	12,204	(2,290)	467
Accounts payable and accrued liabilities	(6,063)	8,451	12,567
Net cash provided by operating activities	45,511	44,008	34,493
Cash flows from investing activities
Business acquisitions, net of cash acquired	(4,452)	(63,850)	0
Purchase of intangible assets	(1,119)	(1,226)	(1,311)
Software development and other expenditures	(10,460)	(7,664)	(6,526)
Proceeds from disposition of assets	519	514	87
Purchases of property and equipment	(54,602)	(48,585)	(32,879)
Net cash used in investing activities	(70,114)	(120,811)	(40,629)
Cash flows from financing activities
Proceeds from issuance of first lien credit facilities	0	448,725	0
Proceeds from incremental term loans	29,874	65,000	0
Repayment of senior secured facilities	(115,000)	(410,655)	0
Proceeds from employees in advance of common stock issuance	(5,211)	(2,413)	(6,987)
Deferred offering costs paid	(4,160)	(653)	0
Repurchase of shares issued to management	0	(128)	(1,125)
Payment of financed placement fee obligations	(3,628)	(3,807)	(3,516)
Repayment of seller notes	0	(12,401)	0
Proceeds from Stock Options Exercised	774	0	0
Payments on equipment long term note payable and capital lease	(2,883)	(2,372)	0
Repurchase of shares issued to management	0	0	(50)
Proceeds from issuance of common stock	176,341	0	0
Proceeds from employees in advance of common stock issuance	0	25	75
Payment of deferred loan costs	(41)	(3,267)	0
Net cash provided by (used in) financing activities	76,066	78,054	(11,603)
Effect of exchange rates on cash, cash equivalents and restricted cash	(1)	14	(6)
Increase (decrease) in cash cash, cash equivalents and restricted cash	51,462	1,265	(17,745)
Cash, cash equivalents and restricted cash, beginning of period	19,342	18,077	35,822
Cash, cash equivalents and restricted cash, end of period	70,804	19,342	18,077
Supplemental cash flow information:
Cash paid during the period for interest	35,392	35,890	40,060
Cash paid during the period for taxes	1,742	1,157	1,247
Non-cash investing and financing activities:
Non-cash consideration given in business acquisitions	500	2,600	0
Financed purchase property and equipment	1,454	368	2,662
Financed purchase of intangible asset	$ 2,000	$ 4,866	$ 0