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Supplemental Condensed Consolidating Financial Information (Schedule Of Condensed Consolidating Statements Of Cash Flows) (Details) (USD $) In Thousands, unless otherwise specified | 12 Months Ended
--- | ---
Dec. 31, 2011 | Dec. 31, 2010 | Dec. 31, 2009
Net cash provided by operating activities | $ 718,251 | $ 501,344 | $ 541,262
Property and equipment additions, net of disposals | (285,682) | (239,274) | (379,748)
Proceeds received from sale of assets and businesses | 67,592 | 21,460 | 9,770
Acquisition of property and businesses | (29,466) | (1,958,298) | (12,499)
Costs incurred for purchase and development of electronic health records application | (38,249) | (17,971) | (7,957)
Net cash used in investing activities | (285,805) | (2,194,083) | (390,434)
Reduction of long-term debt | (381,517) | (1,392,086) | (66,499)
Additional borrowings | 98,100 | 3,266,146 | 26,069
Financing costs | (23,608) | (101,815) |
Repurchase of common shares | (60,482) | (11,528) | (63,288)
Dividends paid | (19,466) | (19,422) | (16,706)
Issuance of common stock | 4,779 | 3,594 | 3,290
Profit distributions to noncontrolling interests | (38,497) | (32,456) | (29,866)
Proceeds from sale of noncontrolling interests in majority owned business |  | 600 |
Capital contributions from noncontrolling interests |  |  | 121
Purchase of noncontrolling interests in majority owned businesses |  | (600) | (229)
Changes in intercompany balances with affiliates, net | 0 | 0 | 0
Net cash (used in) provided by financing activities | (420,691) | 1,713,033 | (147,108)
Increase (decrease) in cash and cash equivalents | 11,755 | 20,294 | 3,720
Cash and cash equivalents, beginning of period | 29,474 | 9,180 | 5,460
Cash and cash equivalents, end of period | 41,229 | 29,474 | 9,180
Parent [Member] |  |  |
Net cash provided by operating activities | (4,990) | (139,226) | (130,200)
Property and equipment additions, net of disposals | 0 | 0 | 0
Proceeds received from sale of assets and businesses | 0 | 0 | 0
Acquisition of property and businesses | 0 | 0 | 0
Costs incurred for purchase and development of electronic health records application | 0 | 0 | 0
Net cash used in investing activities | 0 | 0 | 0
Reduction of long-term debt | (382,060) | (1,388,679) | (58,779)
Additional borrowings | 98,100 | 3,266,146 | 25,408
Financing costs | (23,608) | (101,815) |
Repurchase of common shares | (60,482) | (11,528) | (63,288)
Dividends paid | (19,466) | (19,422) | (16,706)
Issuance of common stock | 4,779 | 3,594 | 3,290
Profit distributions to noncontrolling interests | 0 | 0 | 0
Proceeds from sale of noncontrolling interests in majority owned business |  | 0 |
Capital contributions from noncontrolling interests |  |  | 0
Purchase of noncontrolling interests in majority owned businesses |  |  | 0
Changes in intercompany balances with affiliates, net | 387,727 | (1,609,070) | 240,275
Net cash (used in) provided by financing activities | 4,990 | 139,226 | 130,200
Increase (decrease) in cash and cash equivalents | 0 | 0 | 0
Cash and cash equivalents, beginning of period | 0 | 0 | 0
Cash and cash equivalents, end of period | 0 | 0 | 0
Guarantors [Member] |  |  |
Net cash provided by operating activities | 518,462 | 342,633 | 331,518
Property and equipment additions, net of disposals | (226,848) | (186,967) | (282,868)
Proceeds received from sale of assets and businesses | 0 | 21,460 | 8,952
Acquisition of property and businesses | 0 | (1,958,904) | (12,499)
Costs incurred for purchase and development of electronic health records application | (38,249) | (17,971) | (7,957)
Net cash used in investing activities | (265,097) | (2,142,382) | (294,372)
Reduction of long-term debt | (1,442) | (753) | (4,297)
Additional borrowings | 0 | 0 | 661
Financing costs | 0 | 0 |
Repurchase of common shares | 0 | 0 | 0
Dividends paid | 0 | 0 | 0
Issuance of common stock | 0 | 0 | 0
Profit distributions to noncontrolling interests | 0 | 0 | 0
Proceeds from sale of noncontrolling interests in majority owned business |  | 0 |
Capital contributions from noncontrolling interests |  |  | 0
Purchase of noncontrolling interests in majority owned businesses |  |  | (229)
Changes in intercompany balances with affiliates, net | (240,087) | 1,816,520 | (30,129)
Net cash (used in) provided by financing activities | (241,529) | 1,815,767 | (33,994)
Increase (decrease) in cash and cash equivalents | 11,836 | 16,018 | 3,152
Cash and cash equivalents, beginning of period | 21,385 | 5,367 | 2,215
Cash and cash equivalents, end of period | 33,221 | 21,385 | 5,367
Non Guarantors [Member] |  |  |
Net cash provided by operating activities | 204,779 | 297,937 | 339,944
Property and equipment additions, net of disposals | (58,834) | (52,307) | (96,880)
Proceeds received from sale of assets and businesses | 67,592 | 0 | 818
Acquisition of property and businesses | (29,466) | 606 | 0
Costs incurred for purchase and development of electronic health records application | 0 | 0 | 0
Net cash used in investing activities | (20,708) | (51,701) | (96,062)
Reduction of long-term debt | 1,985 | (2,654) | (3,423)
Additional borrowings | 0 | 0 | 0
Financing costs | 0 | 0 |
Repurchase of common shares | 0 | 0 | 0
Dividends paid | 0 | 0 | 0
Issuance of common stock | 0 | 0 | 0
Profit distributions to noncontrolling interests | (38,497) | (32,456) | (29,866)
Proceeds from sale of noncontrolling interests in majority owned business |  | 600 |
Capital contributions from noncontrolling interests |  |  | 121
Purchase of noncontrolling interests in majority owned businesses |  |  | 0
Changes in intercompany balances with affiliates, net | (147,640) | (207,450) | (210,146)
Net cash (used in) provided by financing activities | (184,152) | (241,960) | (243,314)
Increase (decrease) in cash and cash equivalents | (81) | 4,276 | 568
Cash and cash equivalents, beginning of period | 8,089 | 3,813 | 3,245
Cash and cash equivalents, end of period | 8,008 | 8,089 | 3,813
Consolidating Adjustments [Member] |  |  |
Net cash provided by operating activities | 0 | 0 | 0
Property and equipment additions, net of disposals | 0 | 0 | 0
Proceeds received from sale of assets and businesses | 0 | 0 | 0
Acquisition of property and businesses | 0 | 0 | 0
Costs incurred for purchase and development of electronic health records application | 0 | 0 | 0
Net cash used in investing activities | 0 | 0 | 0
Reduction of long-term debt | 0 | 0 | 0
Additional borrowings | 0 | 0 | 0
Financing costs | 0 | 0 |
Repurchase of common shares | 0 | 0 | 0
Dividends paid | 0 | 0 | 0
Issuance of common stock | 0 | 0 | 0
Profit distributions to noncontrolling interests | 0 | 0 | 0
Proceeds from sale of noncontrolling interests in majority owned business |  | 0 |
Capital contributions from noncontrolling interests |  |  | 0
Purchase of noncontrolling interests in majority owned businesses |  |  | 0
Changes in intercompany balances with affiliates, net | 0 | 0 | 0
Net cash (used in) provided by financing activities | 0 | 0 | 0
Increase (decrease) in cash and cash equivalents | 0 | 0 | 0
Cash and cash equivalents, beginning of period | 0 | 0 | 0
Cash and cash equivalents, end of period | $ 0 | $ 0 | $ 0

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- Definition 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. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3213-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 15 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 17 -Subparagraph c -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 + Details
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- Definition The cash inflow from the additional capital contribution to the entity. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3255-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 18 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 19 -Subparagraph a -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 + Details
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- Definition The net cash inflow or outflow from noncontrolled interest to increase or decrease the number of shares they have in the entity. This does not include dividends paid to the noncontrolling interest. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 18 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. + Details
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- Definition The cash inflow resulting from the sale of an interest in a corporate unit during the period. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3255-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 18 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 19 -Subparagraph a -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 + Details
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- Definition The cash inflow from the sale of other tangible or intangible assets used to produce goods or deliver services not otherwise defined in the taxonomy. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3179-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 15 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 16 -Subparagraph c -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 + Details
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- Definition The cash outflow for debt initially having maturity due after one year or beyond the normal operating cycle, if longer. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3291-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 18 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 20 -Subparagraph b -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 + Details
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