CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
OPERATING ACTIVITIES
Net income including non-controlling interest	$ 37,220	$ 43,407	$ 57,924
Adjustments to reconcile net income including non-controlling interest to net cash provided by operating activities:
Depreciation and amortization	15,695	14,743	11,591
Provision for credit losses	6,172	5,548	5,305
Equity-based awards compensation expense	7,236	7,264	7,867
Amortization of debt issue costs	420	305	56
Change in deferred income taxes	4,490	4,309	5,688
Change in revaluation of put-right liability	(2,582)	5	0
Change in fair value of contingent earn-out consideration	1,550	(2,520)	0
Equity of earnings in unconsolidated affiliate	(955)	(1,175)	(112)
Loss (gain) on sale of clinics and fixed assets	166	(643)	0
Impairment of goodwill and other intangible assets	17,495	9,112	0
Other	0	(83)	(134)
Changes in operating assets and liabilities:
Increase in patient accounts receivable	(5,645)	(10,279)	(9,417)
Increase in accounts receivable - other	(356)	(307)	(1,538)
Increase (decrease) in other current and long term assets	(197)	(5,940)	(633)
Decrease (increase) in accounts payable and accrued expenses	15	(7,755)	4,657
Decrease (increase) in other long-term liabilities	1,254	2,546	(4,848)
Net cash provided by operating activities	81,978	58,537	76,406
INVESTING ACTIVITIES
Purchase of fixed assets	(9,294)	(8,248)	(8,201)
Purchase of majority interest in businesses, net of cash acquired	(26,582)	(59,788)	(86,823)
Purchase of redeemable non-controlling interest, temporary equity	(10,986)	(14,987)	(28,465)
Purchase of non controlling interest, permanent equity	(281)	(280)	(1,274)
Proceeds on sale of non-controlling interest, permanent equity	102	0	131
Proceeds on sale of partnership interest - redeemable non-controlling interest, temporary equity	875	402	69
Distributions from unconsolidated affiliate	830	1,259	152
Proceeds on sale of partnership interest, clinics and fixed assets	0	373	275
Other	321	0	0
Net cash used in investing activities	(45,015)	(81,269)	(124,136)
FINANCING ACTIVITIES
Proceeds from issuance of common stock pursuant to the secondary public offering, net of issuance costs	163,646	0	0
Proceeds from revolving facility	24,000	101,000	316,000
Distributions to non-controlling interest, permanent and temporary equity	(16,100)	(15,348)	(16,931)
Cash dividends paid to shareholders	(24,128)	(21,321)	(18,765)
Payments on revolving facility	(55,000)	(184,000)	(218,000)
Principal payments on notes payable	(4,400)	(930)	(4,899)
Payments on term loan	(3,750)	(1,875)	0
Proceeds from term loan	0	150,000	0
Payment of deferred financing costs	0	(1,779)	0
Payment of Medicare Accelerated and Advance Funds	0	0	(14,054)
Other	0	12	28
Net cash provided by financing activities	84,268	25,759	43,379
Net increase in cash and cash equivalents	121,231	3,027	(4,351)
Cash and cash equivalents - beginning of period	31,594	28,567	32,918
Cash and cash equivalents - end of period	152,825	31,594	28,567
Cash paid during the period for:
Income taxes	4,926	7,615	12,214
Interest paid	8,655	5,687	1,352
Non-cash investing and financing transactions during the period:
Purchase of businesses - seller financing portion	1,815	1,574	3,050
Liabilities assumed associated with a purchase of a business	524	0	0
Notes payable related to purchase of redeemable non-controlling interest, temporary equity	1,087	1,074	1,759
Notes payable related to the purchase of non-controlling interest, permanent equity	200	296	0
Notes receivable related to sale of redeemable non-controlling interest, temporary equity	4,136	1,580	914
Notes receivable related to the sale of non-controlling interest, permanent equity	$ 458	$ 0	$ 0