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Condensed Consolidating Statements of Cash Flows (Detail) (USD $)
In Thousands, unless otherwise specified
 6 Months Ended
Jun. 30, 2012
Jun. 30, 2011
Condensed Financial Statements, Captions [Line Items]    
Net cash provided by operating activities $ 372,862 $ 355,776
Cash Flows from Investing Activities:    
Property and equipment additions, net of disposals (182,351) (116,240)
Proceeds received from sale of assets and businesses 53,461 2,041
Acquisition of property and businesses (11,476) 0
Costs incurred for purchase and development of electronic health records application (28,008) (11,416)
Return of deposit on terminated purchase agreement 6,500 0
Net cash used in investing activities (161,874) (125,615)
Cash Flows from Financing Activities:    
Reduction of long-term debt (195,686) (200,566)
Additional borrowings 0 36,000
Financing costs 0 (23,534)
Repurchase of common shares (2,927) (6,163)
Dividends paid (9,673) (9,763)
Issuance of common stock 2,575 2,408
Profit distributions to noncontrolling interests (13,565) (23,201)
Changes in intercompany balances with affiliates, net 0 0
Net cash (used in) provided by financing activities (219,276) (224,819)
Increase (decrease) in cash and cash equivalents (8,288) 5,342
Cash and cash equivalents, beginning of period 41,229 29,474
Cash and cash equivalents, end of period 32,941 34,816
Parent
    
Condensed Financial Statements, Captions [Line Items]    
Net cash provided by operating activities 2,144 13,222
Cash Flows from Investing Activities:    
Property and equipment additions, net of disposals 0 0
Proceeds received from sale of assets and businesses 0 0
Acquisition of property and businesses 0  
Costs incurred for purchase and development of electronic health records application 0 0
Return of deposit on terminated purchase agreement 6,500  
Net cash used in investing activities 6,500 0
Cash Flows from Financing Activities:    
Reduction of long-term debt (191,898) (188,161)
Additional borrowings   36,000
Financing costs   (23,534)
Repurchase of common shares (2,927) (6,163)
Dividends paid (9,673) (9,763)
Issuance of common stock 2,575 2,408
Profit distributions to noncontrolling interests 0 0
Changes in intercompany balances with affiliates, net 193,279 175,991
Net cash (used in) provided by financing activities (8,644) (13,222)
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
    
Condensed Financial Statements, Captions [Line Items]    
Net cash provided by operating activities 279,941 298,741
Cash Flows from Investing Activities:    
Property and equipment additions, net of disposals (153,894) (88,240)
Proceeds received from sale of assets and businesses 49,984 2,041
Acquisition of property and businesses (11,476)  
Costs incurred for purchase and development of electronic health records application (28,008) (11,416)
Return of deposit on terminated purchase agreement 0  
Net cash used in investing activities (143,394) (97,615)
Cash Flows from Financing Activities:    
Reduction of long-term debt (2,289) (850)
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 (144,331) (194,187)
Net cash (used in) provided by financing activities (146,620) (195,037)
Increase (decrease) in cash and cash equivalents (10,073) 6,089
Cash and cash equivalents, beginning of period 33,221 21,385
Cash and cash equivalents, end of period 23,148 27,474
Non Guarantors
    
Condensed Financial Statements, Captions [Line Items]    
Net cash provided by operating activities 90,777 43,813
Cash Flows from Investing Activities:    
Property and equipment additions, net of disposals (28,457) (28,000)
Proceeds received from sale of assets and businesses 3,477 0
Acquisition of property and businesses 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 (24,980) (28,000)
Cash Flows from Financing Activities:    
Reduction of long-term debt (1,499) (11,555)
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 (13,565) (23,201)
Changes in intercompany balances with affiliates, net (48,948) 18,196
Net cash (used in) provided by financing activities (64,012) (16,560)
Increase (decrease) in cash and cash equivalents 1,785 (747)
Cash and cash equivalents, beginning of period 8,008 8,089
Cash and cash equivalents, end of period 9,793 7,342
Consolidating Adjustments
    
Condensed Financial Statements, Captions [Line Items]    
Net cash provided by operating activities 0 0
Cash Flows from Investing Activities:    
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
Cash Flows from Financing Activities:    
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