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Supplemental Condensed Consolidating Statements of Cash flows (Detail) (USD $) In Thousands, unless otherwise specified | 3 Months Ended
--- | ---
Mar. 31, 2013 | Mar. 31, 2012
Condensed Financial Statements, Captions [Line Items] |  |
Net cash provided by operating activities | $ 187,763 | $ 127,223
Cash Flows from Investing Activities: |  |
Property and equipment additions, net of disposals | (95,919) | (92,563)
Proceeds received from sale of assets and businesses | 6,657 | 53,461
Acquisition of property and businesses | 0 |
Costs incurred for purchase and implementation of electronic health records application | (16,412) | (14,501)
Return of deposit on terminated purchase agreement | 0 | 6,500
Net cash used in investing activities | (105,674) | (47,103)
Cash Flows from Financing Activities: |  |
Reduction of long-term debt | (69,926) | (70,942)
Additional borrowings | 9,500 | 0
Repurchase of common shares | (14,027) | (2,017)
Dividends paid | (4,870) | (4,832)
Issuance of common stock | 1,232 | 1,016
Profit distributions to noncontrolling interests | (10,074) | (2,575)
Changes in intercompany balances with affiliates, net | 0 | 0
Net cash (used in) provided by financing activities | (88,165) | (79,350)
Decrease in cash and cash equivalents | (6,076) | 770
Cash and cash equivalents, beginning of period | 23,471 | 41,229
Cash and cash equivalents, end of period | 17,395 | 41,999
Parent |  |
Condensed Financial Statements, Captions [Line Items] |  |
Net cash provided by operating activities | 74,013 | 93,390
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 implementation of electronic health records application | 0 | 0
Return of deposit on terminated purchase agreement | 0 | 0
Net cash used in investing activities | 0 | 0
Cash Flows from Financing Activities: |  |
Reduction of long-term debt | (63,612) | (69,052)
Additional borrowings | 9,500 |
Repurchase of common shares | (14,027) | (2,017)
Dividends paid | (4,870) | (4,832)
Issuance of common stock | 1,232 | 1,016
Profit distributions to noncontrolling interests | 0 | 0
Changes in intercompany balances with affiliates, net | (2,236) | (18,505)
Net cash (used in) provided by financing activities | (74,013) | (93,390)
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 | 35,367 | 10,893
Cash Flows from Investing Activities: |  |
Property and equipment additions, net of disposals | (54,822) | (79,339)
Proceeds received from sale of assets and businesses | 4,178 | 49,984
Acquisition of property and businesses | 0 |
Costs incurred for purchase and implementation of electronic health records application | (16,412) | (14,501)
Return of deposit on terminated purchase agreement | 0 | 6,500
Net cash used in investing activities | (67,056) | (37,356)
Cash Flows from Financing Activities: |  |
Reduction of long-term debt | (265) | (305)
Additional borrowings | 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 | 28,322 | 26,964
Net cash (used in) provided by financing activities | 28,057 | 26,659
Decrease in cash and cash equivalents | (3,632) | 196
Cash and cash equivalents, beginning of period | 11,949 | 33,221
Cash and cash equivalents, end of period | 8,317 | 33,417
Non Guarantors |  |
Condensed Financial Statements, Captions [Line Items] |  |
Net cash provided by operating activities | 78,383 | 22,940
Cash Flows from Investing Activities: |  |
Property and equipment additions, net of disposals | (41,097) | (13,224)
Proceeds received from sale of assets and businesses | 2,479 | 3,477
Acquisition of property and businesses | 0 |
Costs incurred for purchase and implementation of electronic health records application | 0 | 0
Return of deposit on terminated purchase agreement | 0 | 0
Net cash used in investing activities | (38,618) | (9,747)
Cash Flows from Financing Activities: |  |
Reduction of long-term debt | (6,049) | (1,585)
Additional borrowings | 0 |
Repurchase of common shares | 0 | 0
Dividends paid | 0 | 0
Issuance of common stock | 0 | 0
Profit distributions to noncontrolling interests | (10,074) | (2,575)
Changes in intercompany balances with affiliates, net | (26,086) | (8,459)
Net cash (used in) provided by financing activities | (42,209) | (12,619)
Decrease in cash and cash equivalents | (2,444) | 574
Cash and cash equivalents, beginning of period | 11,522 | 8,008
Cash and cash equivalents, end of period | 9,078 | 8,582
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 implementation of electronic health records application | 0 | 0
Return of deposit on terminated purchase agreement | 0 | 0
Net cash used in investing activities | 0 | 0
Cash Flows from Financing Activities: |  |
Reduction of long-term debt | 0 | 0
Additional borrowings | 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 | 0
Net cash (used in) provided by financing activities | 0 | 0
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

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- Definition The cash outflow to reacquire common stock during the period. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 20 -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 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 Reference 3: 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 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3291-108585 + Details
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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 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 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 3: 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 4: 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. + 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 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 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 3: 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 4: 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 + 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 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 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 Reference 3: 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 4: 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. + Details
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