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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