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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