CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Cash flows from operating activities:
Net (loss) income	$ (298,086)	$ 8,043
Adjustments to reconcile net (loss) income to net cash provided by operating activities
Depreciation and amortization of property and equipment	17,978	8,125
Amortization of intangible assets	9,441	2,811
Accretion of closure and post-closure obligations	1,266	1,125
Property and equipment impairment charges		25
Goodwill impairment charges	300,300
Unrealized foreign currency loss (gain)	2,703	(371)
Deferred income taxes	(3,320)	2,905
Share-based compensation expense	1,564	1,222
Share-based payments of business development and integration expenses	181
Unrecognized tax benefits	52	131
Net loss (gain) on disposition of assets	184	(272)
Gain on insurance proceeds from damaged property and equipment		(4,653)
Amortization and write-off of debt issuance costs	298	204
Amortization and write-off of debt discount	245
Change in fair value of contingent consideration	(1,127)
Changes in assets and liabilities (net of effects of business acquisitions):
Receivables	13,467	16,577
Income taxes receivable	893	(1,487)
Other assets	(2,957)	525
Accounts payable and accrued liabilities	(13,618)	(11,935)
Deferred revenue	7,083	(47)
Accrued salaries and benefits	(7,446)	(3,417)
Income taxes payable	662	(517)
Closure and post-closure obligations	(417)	(470)
Net cash provided by operating activities	29,346	18,524
Cash flows from investing activities:
Business acquisitions (net of cash acquired)	(3,309)
Purchases of property and equipment	(19,131)	(7,223)
Insurance proceeds from damaged property and equipment		5,000
Proceeds from sale of property and equipment	781	459
Purchases of restricted investments	(56)	(23)
Net cash used in investing activities	(21,715)	(1,787)
Cash flows from financing activities:
Proceeds from long-term debt	90,000
Payments on long-term debt	(1,125)	(30,000)
Payments on short-term borrowings	(49,871)	(4,331)
Proceeds from short-term borrowings	50,267	6,449
Repurchase of common stock	(18,332)	(915)
Dividends paid	(5,667)	(3,970)
Payment of equipment financing obligations	(1,525)	(199)
Net cash provided by (used in) financing activities	63,747	(32,966)
Effect of foreign exchange rate changes on cash	(2,825)	393
Increase (decrease) in Cash and cash equivalents and restricted cash	68,553	(15,836)
Cash and cash equivalents and restricted cash at beginning of period	42,140	32,753
Cash and cash equivalents and restricted cash at end of period	110,693	16,917
Supplemental Disclosures:
Income taxes paid, net of receipts	1,241	2,085
Interest paid	7,642	3,462
Non-cash investing and financing activities:
Capital expenditures in accounts payable	$ 3,531	$ 912