CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	12 Months Ended
Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Cash Flows from Operating Activities:
Net income (loss)	$ 13,089us-gaap_ProfitLoss	$ (97,775)us-gaap_ProfitLoss	$ (98,583)us-gaap_ProfitLoss
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:
Depreciation and amortization	28,347	37,383	40,059
Provision for doubtful accounts	16,369us-gaap_ProvisionForDoubtfulAccounts	16,461us-gaap_ProvisionForDoubtfulAccounts	21,728us-gaap_ProvisionForDoubtfulAccounts
Non-cash compensation	5,597us-gaap_ShareBasedCompensation	6,519us-gaap_ShareBasedCompensation	7,217us-gaap_ShareBasedCompensation
401(k) employer match	6,216us-gaap_PensionExpense	7,998us-gaap_PensionExpense	10,013us-gaap_PensionExpense
Loss on disposal of property and equipment	4,592	2,742	1,471
Gain (loss) on sale of care centers	(2,967)us-gaap_GainsLossesOnSalesOfAssets	(1,752)us-gaap_GainsLossesOnSalesOfAssets	0us-gaap_GainsLossesOnSalesOfAssets
Deferred income taxes	22,561us-gaap_DeferredIncomeTaxExpenseBenefit	(57,095)us-gaap_DeferredIncomeTaxExpenseBenefit	(31,161)us-gaap_DeferredIncomeTaxExpenseBenefit
Write off deferred debt issuance costs	488	121	573
Equity in earnings of equity investments	(2,991)	(1,520)	(1,695)
Amortization of deferred debt issuance costs	797	699	1,442
Return on equity investment	2,025	1,650	1,575
Goodwill and other intangibles impairment charge	3,107	9,492	162,103
Changes in operating assets and liabilities, net of impact of acquisitions:
Patient accounts receivable	(5,290)	41,578	(42,840)
Other current assets	(6,269)	(501)	10,622
Other assets	1,694	(1,596)	(927)
Accounts payable	(3,168)	(9,876)	8,072
U.S. Department of Justice settlement	(150,000)	150,000
Accrued expenses	3,495	(6,104)	(19,994)
Other long-term obligations	(3,226)	3,839	(181)
Net cash (used in) provided by operating activities	(65,534)	102,263	69,494
Cash Flows from Investing Activities:
Proceeds from sale of deferred compensation plan assets	11	128	312
Proceeds from the sale of property and equipment	3	1,809	631
Purchases of deferred compensation plan assets	(132)	(111)	(175)
Purchases of property and equipment	(12,008)	(41,736)	(48,262)
Purchase of Investment	(6,407)	(10,067)	0
Acquisitions of businesses, net of cash acquired	0	(1,627)	(12,499)
Proceeds from dispositions of care centers	4,233	5,146	0
Net cash (used in) investing activities	(14,300)	(46,458)	(59,993)
Cash Flows from Financing Activities:
Proceeds from issuance of stock upon exercise of stock options and warrants	564	261	156
Proceeds from issuance of stock to employee stock purchase plan	2,433us-gaap_ProceedsFromStockPlans	3,181us-gaap_ProceedsFromStockPlans	3,913us-gaap_ProceedsFromStockPlans
Tax benefit from stock option exercises	0	57	0
Non-controlling interest distribution	0	(163)	(323)
Proceeds from revolving line of credit	241,800us-gaap_ProceedsFromShortTermDebt	25,500us-gaap_ProceedsFromShortTermDebt	0us-gaap_ProceedsFromShortTermDebt
Repayments of revolving line of credit	(226,800)us-gaap_RepaymentsOfShortTermDebt	(25,500)us-gaap_RepaymentsOfShortTermDebt	0us-gaap_RepaymentsOfShortTermDebt
Proceeds from issuance of long-term obligations	68,250	0	60,000
Debt issuance costs	(1,780)us-gaap_PaymentsOfFinancingCosts	(576)us-gaap_PaymentsOfFinancingCosts	(2,265)us-gaap_PaymentsOfFinancingCosts
Principal payments of long-term obligations	(13,904)us-gaap_RepaymentsOfLongTermDebt	(55,807)us-gaap_RepaymentsOfLongTermDebt	(104,441)us-gaap_RepaymentsOfLongTermDebt
Net cash provided by (used in) financing activities	70,563	(53,047)	(42,960)
Net increase (decrease) in cash and cash equivalents	(9,271)	2,758	(33,459)
Cash and cash equivalents at beginning of period	17,303	14,545	48,004
Cash and cash equivalents at end of period	8,032	17,303	14,545
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest	7,602us-gaap_InterestPaid	3,990us-gaap_InterestPaid	7,779us-gaap_InterestPaid
Cash paid for income taxes, net of refunds received	(1,766)us-gaap_IncomeTaxesPaidNet	3,385us-gaap_IncomeTaxesPaidNet	2,945us-gaap_IncomeTaxesPaidNet
Supplemental Disclosures of Non-Cash Financing and Investing Activities
Notes payable issued for software licenses	0us-gaap_NotesIssued1	0us-gaap_NotesIssued1	2,214us-gaap_NotesIssued1
(Sale) acquistion of noncontrolling interests	$ (1,549)	$ 145	$ 15,931

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The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets.

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The cash outflow to acquire investments (not to include restricted cash) that are pledged or subject to withdrawal restrictions.

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The amount of pension benefit costs recognized during the period for (1) defined benefit plans and (2) defined contribution plans. For defined benefit plans, pension expense includes the following components: service cost, interest cost, expected return on plan assets, gain (loss) on plan assets, prior service cost or credit, transition asset or obligation, and gain (loss) due to settlements or curtailments. For defined contribution plans, the pension expense generally equals the firm's contribution to employees' accounts (if the firm contributes) during the period.

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The cash inflow associated with the amount received from the sale of a portion of the company's business, for example a segment, division, branch or other business, during the period.

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The cash inflow from a debt initially having maturity due after one year or beyond the operating cycle, if longer.

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The cash inflow from the sale of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale.

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The cash inflow associated with the sale of investments that are pledged or subject to withdrawal restrictions during the period.

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The cash inflow from a borrowing having initial term of repayment within one year or the normal operating cycle, if longer.

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The cash inflow associated with the amount received from holders exercising their stock options. This item inherently excludes any excess tax benefit, which the entity may have realized and reported separately.

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The cash inflow associated with the amount received from the stock plan during the period.

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The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

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Amount of expense related to write-down of receivables to the amount expected to be collected. Includes, but is not limited to, accounts receivable and notes receivable.

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The cash outflow for debt initially having maturity due after one year or beyond the normal operating cycle, if longer.

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The cash outflow for a borrowing having initial term of repayment within one year or the normal operating cycle, if longer.

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The aggregate amount of noncash, equity-based employee remuneration. This may include the value of stock or unit options, amortization of restricted stock or units, and adjustment for officers' compensation. As noncash, this element is an add back when calculating net cash generated by operating activities using the indirect method.

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