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Supplemental Condensed Consolidating Financial Information (Schedule Of Condensed Consolidating Statements Of Cash Flows) (Details) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended
Mar. 31, 2012
Mar. 31, 2011
Net cash provided by operating activities $ 127,223 $ 183,177
Property and equipment additions, net of disposals (92,563) (56,558)
Proceeds received from sale of assets and businesses 53,461 991
Costs incurred for purchase and development of electronic health records application (14,501) (8,145)
Return of deposit on terminated purchase agreement 6,500 0
Net cash used in investing activities (47,103) (63,712)
Reduction of long-term debt (70,942) (136,403)
Additional borrowings 0 73,500
Financing costs 0 (23,140)
Repurchase of common shares (2,017) (3,170)
Dividends paid (4,832) (4,876)
Issuance of common stock 1,016 1,251
Profit distributions to noncontrolling interests (2,575) (4,025)
Changes in intercompany balances with affiliates, net 0 0
Net cash (used in) provided by financing activities (79,350) (96,863)
Increase (decrease) in cash and cash equivalents 770 22,602
Cash and cash equivalents, beginning of period 41,229 29,474
Cash and cash equivalents, end of period 41,999 52,076
Parent [Member]
    
Net cash provided by operating activities 93,390 59,016
Property and equipment additions, net of disposals 0 0
Proceeds received from sale of assets and businesses 0 0
Costs incurred for purchase and development of electronic health records application 0 0
Return of deposit on terminated purchase agreement 0  
Net cash used in investing activities 0 0
Reduction of long-term debt (69,052) (135,334)
Additional borrowings   73,500
Financing costs   (23,140)
Repurchase of common shares (2,017) (3,170)
Dividends paid (4,832) (4,876)
Issuance of common stock 1,016 1,251
Profit distributions to noncontrolling interests 0 0
Changes in intercompany balances with affiliates, net (18,505) 32,753
Net cash (used in) provided by financing activities (93,390) (59,016)
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 10,893 109,876
Property and equipment additions, net of disposals (79,339) (41,016)
Proceeds received from sale of assets and businesses 49,984 991
Costs incurred for purchase and development of electronic health records application (14,501) (8,145)
Return of deposit on terminated purchase agreement 6,500  
Net cash used in investing activities (37,356) (48,170)
Reduction of long-term debt (305) (396)
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
Changes in intercompany balances with affiliates, net 26,964 (37,292)
Net cash (used in) provided by financing activities 26,659 (37,688)
Increase (decrease) in cash and cash equivalents 196 24,018
Cash and cash equivalents, beginning of period 33,221 21,385
Cash and cash equivalents, end of period 33,417 45,403
Non Guarantors [Member]
    
Net cash provided by operating activities 22,940 14,285
Property and equipment additions, net of disposals (13,224) (15,542)
Proceeds received from sale of assets and businesses 3,477 0
Costs incurred for purchase and development of electronic health records application 0 0
Return of deposit on terminated purchase agreement 0  
Net cash used in investing activities (9,747) (15,542)
Reduction of long-term debt (1,585) (673)
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 (2,575) (4,025)
Changes in intercompany balances with affiliates, net (8,459) 4,539
Net cash (used in) provided by financing activities (12,619) (159)
Increase (decrease) in cash and cash equivalents 574 (1,416)
Cash and cash equivalents, beginning of period 8,008 8,089
Cash and cash equivalents, end of period 8,582 6,673
Consolidating Adjustments [Member]
    
Net cash provided by operating activities 0 0
Property and equipment additions, net of disposals 0 0
Proceeds received from sale of assets and businesses 0 0
Costs incurred for purchase and development of electronic health records application 0 0
Return of deposit on terminated purchase agreement 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
Changes in intercompany balances with affiliates, net 0  
Net cash (used in) provided by financing activities 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