CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash flows from operating activities:
Income (loss) from continuing operations	$ 107,376	$ 56,869	$ 45,217
Loss from discontinued operations	(2,462)	(280,500)	(332,038)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Loss on extinguishment of debt	18,237
Depreciation and amortization	11,298	45,887	50,775
Amortization and write-off of deferred loan costs	2,973	9,190	4,487
Amortization and write-off of debt discount	1,861	8,604	3,711
Share-based employee compensation expense	10,060	14,077	18,832
(Gain) loss on derivatives	(2,627)	14,562
Unrealized gain on investments in equity securities	(39,232)
Realized gain on investments in equity securities	(2,469)
Impairment of goodwill and intangible assets of discontinued operation		199,500	377,100
Loss on sale of Nutrition business		90,163
Deferred income taxes	3,649	(38,438)	(52,076)
(Increase) decrease in accounts receivable, net	(36,749)	63,239	(8,283)
Changes in income taxes receivable and payable	7,901	(11,401)	1,125
(Increase) decrease in other current assets	(1,549)	12,125	941
Decrease in accounts payable	(951)	(3,182)	(10,052)
Increase in accrued salaries and benefits	2,876	128	3,608
Increase (decrease) in other current liabilities	5,342	(18,765)	(21,900)
(Decrease) increase in deferred revenue	(1,089)	686	(1,198)
Other	2,678	6,703	2,056
Net cash flows provided by operating activities	87,123	169,447	82,305
Cash flows from investing activities:
Acquisition of property and equipment	(14,750)	(15,525)	(24,713)
Proceeds from sale of Nutrition business, net of cash transferred	2,747	558,067
Proceeds from sale of equity securities	2,728
Settlement on derivatives not designated as hedges	(6,697)	(1,499)
Business acquisitions, net of cash acquired			(1,062,818)
Net cash flows provided by (used in) investing activities	(15,972)	541,043	(1,087,531)
Cash flows from financing activities:
Proceeds from issuance of long-term debt	398,000	196,525	1,611,970
Payments of long-term debt	(502,275)	(795,100)	(574,329)
Deferred loan costs	(3,953)		(30,189)
Payments related to tax withholding for share-based compensation	(8,796)	(6,257)	(4,733)
Proceeds from exercise of stock options	686	1,025	989
Repurchases of common stock	(751)
Change in cash overdraft and other	5,685	(8,784)	2,083
Net cash flows provided by (used in) financing activities	(111,404)	(612,591)	1,005,791
Effect of exchange rate changes on cash			(12)
Net increase (decrease) in cash and cash equivalents	(40,253)	97,899	553
Cash and cash equivalents, beginning of period	100,385	2,486	1,933
Cash and cash equivalents, end of period	60,132	100,385	2,486
Supplemental disclosure of cash flow information:
Cash paid for interest	29,465	71,439	67,717
Cash paid for income taxes, net of refunds	$ 13,951	$ 20,433	$ 8,370