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Supplemental Condensed Consolidating Financial Information (Schedule of Condensed Consolidating Statements of Cash Flows) (Details) (USD $)
In Thousands
 6 Months Ended
Jun. 30, 2011
Jun. 30, 2010
Net cash provided by operating activities $ 355,776 $ 227,724
Property and equipment additions, net of disposals (116,240) (121,640)
Proceeds received from sales of assets and businesses 2,041 5,000
Costs incurred for purchase and implementation of electronic health records application (11,416) (8,354)
Net cash used in investing activities (125,615) (124,994)
Reduction of long-term debt (200,566) (77,974)
Additional borrowings 36,000 0
Financing costs (23,534) 0
Repurchase of common shares (6,163) (3,703)
Dividends paid (9,763) (9,693)
Issuance of common stock 2,408 3,833
Profit distributions to noncontrolling interests (23,201) (12,336)
Proceeds from sale of noncontrolling interest in majority owned business 0 300
Net cash used in financing activities (224,819) (99,573)
Changes in intercompany balances with affiliates, net 0 0
Increase (decrease) in cash and cash equivalents 5,342 3,157
Cash and cash equivalents, beginning of period 29,474 9,180
Cash and cash equivalents, end of period 34,816 12,337
Parent [Member]
    
Net cash provided by operating activities 13,222 2,654
Property and equipment additions, net of disposals 0 0
Proceeds received from sales of assets and businesses 0 0
Costs incurred for purchase and implementation of electronic health records application 0 0
Net cash used in investing activities 0 0
Reduction of long-term debt (188,161) (75,403)
Additional borrowings 36,000  
Financing costs (23,534)  
Repurchase of common shares (6,163) (3,703)
Dividends paid (9,763) (9,693)
Issuance of common stock 2,408 3,833
Profit distributions to noncontrolling interests 0 0
Proceeds from sale of noncontrolling interest in majority owned business   0
Net cash used in financing activities (13,222) (2,654)
Changes in intercompany balances with affiliates, net 175,991 82,312
Increase (decrease) in cash and cash equivalents 0 0
Cash and cash equivalents, beginning of period 0 0
Cash and cash equivalents, end of period 0 0
Guarantors [Member]
    
Net cash provided by operating activities 298,741 191,348
Property and equipment additions, net of disposals (88,240) (91,991)
Proceeds received from sales of assets and businesses 2,041 5,000
Costs incurred for purchase and implementation of electronic health records application (11,416) (8,354)
Net cash used in investing activities (97,615) (95,345)
Reduction of long-term debt (850) (1,338)
Additional borrowings 0  
Financing costs 0  
Repurchase of common shares 0 0
Dividends paid 0 0
Issuance of common stock 0 0
Profit distributions to noncontrolling interests 0 0
Proceeds from sale of noncontrolling interest in majority owned business   0
Net cash used in financing activities (195,037) (93,773)
Changes in intercompany balances with affiliates, net (194,187) (92,435)
Increase (decrease) in cash and cash equivalents 6,089 2,230
Cash and cash equivalents, beginning of period 21,385 5,367
Cash and cash equivalents, end of period 27,474 7,597
Non Guarantors [Member]
    
Net cash provided by operating activities 43,813 33,722
Property and equipment additions, net of disposals (28,000) (29,649)
Proceeds received from sales of assets and businesses 0 0
Costs incurred for purchase and implementation of electronic health records application 0 0
Net cash used in investing activities (28,000) (29,649)
Reduction of long-term debt (11,555) (1,233)
Additional borrowings 0  
Financing costs 0  
Repurchase of common shares 0 0
Dividends paid 0 0
Issuance of common stock 0 0
Profit distributions to noncontrolling interests (23,201) (12,336)
Proceeds from sale of noncontrolling interest in majority owned business   300
Net cash used in financing activities (16,560) (3,146)
Changes in intercompany balances with affiliates, net 18,196 10,123
Increase (decrease) in cash and cash equivalents (747) 927
Cash and cash equivalents, beginning of period 8,089 3,813
Cash and cash equivalents, end of period 7,342 4,740
Consolidating Adjustments [Member]
    
Net cash provided by operating activities 0 0
Property and equipment additions, net of disposals 0 0
Proceeds received from sales of assets and businesses 0 0
Costs incurred for purchase and implementation of electronic health records application 0 0
Net cash used in investing activities 0 0
Reduction of long-term debt 0 0
Additional borrowings 0  
Financing costs 0  
Repurchase of common shares 0 0
Dividends paid 0 0
Issuance of common stock 0 0
Profit distributions to noncontrolling interests 0 0
Proceeds from sale of noncontrolling interest in majority owned business   0
Net cash used in financing activities 0 0
Changes in intercompany balances with affiliates, net 0 0
Increase (decrease) in cash and cash equivalents 0 0
Cash and cash equivalents, beginning of period 0 0
Cash and cash equivalents, end of period $ 0 $ 0