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Supplemental Condensed Consolidating Statements of Cash flows (Detail) - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2015
Jun. 30, 2014
Condensed Financial Statements, Captions [Line Items]    
Net cash (used in) provided by operating activities $ 531,603 $ 458,416
Cash Flows from Investing Activities:    
Property and equipment additions, net of disposals (170,580) (186,786)
Proceeds received from sale of assets and businesses 0 11,450
Acquisition of property and businesses (34,500) (71,000)
Costs incurred for purchase and implementation of electronic health records application 0 (8,399)
Net cash used in investing activities (205,080) (254,735)
Cash Flows from Financing Activities:    
Reduction of long-term debt (255,658) (179,126)
Additional borrowings 5,200 0
Repurchase of common shares (68,157) (35,773)
Dividends paid (19,804) (9,884)
Issuance of common stock 4,039 3,287
Excess income tax benefits related to stock-based compensation 28,489 28,493
Profit distributions to noncontrolling interests (23,295) (13,184)
Proceeds received from sale/leaseback of real property 12,765 0
Changes in intercompany balances with affiliates, net 0 0
Net cash (used in) provided by financing activities (316,421) (206,187)
Effect of exchange rate changes on cash and cash equivalents 293 0
(Decrease) increase in cash and cash equivalents 10,395 (2,506)
Cash and cash equivalents, beginning of period 32,069 17,238
Cash and cash equivalents, end of period 42,464 14,732
Consolidating Adjustments    
Condensed Financial Statements, Captions [Line Items]    
Net cash (used in) provided by operating activities   0
Cash Flows from Investing Activities:    
Property and equipment additions, net of disposals 0 0
Proceeds received from sale of assets and businesses   0
Acquisition of property and businesses 0 0
Costs incurred for purchase and implementation of electronic health records application   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
Excess income tax benefits related to stock-based compensation 0 0
Profit distributions to noncontrolling interests 0 0
Proceeds received from sale/leaseback of real property 0  
Changes in intercompany balances with affiliates, net 0 0
Net cash (used in) provided by financing activities 0 0
Effect of exchange rate changes on cash and cash equivalents 0  
(Decrease) increase 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
Parent    
Condensed Financial Statements, Captions [Line Items]    
Net cash (used in) provided by operating activities (9,690) 6,497
Cash Flows from Investing Activities:    
Property and equipment additions, net of disposals 0 0
Proceeds received from sale of assets and businesses   0
Acquisition of property and businesses 0 0
Costs incurred for purchase and implementation of electronic health records application   0
Net cash used in investing activities 0 0
Cash Flows from Financing Activities:    
Reduction of long-term debt (252,189) (167,755)
Additional borrowings 5,200  
Repurchase of common shares (68,157) (35,773)
Dividends paid (19,804) (9,884)
Issuance of common stock 4,039 3,287
Excess income tax benefits related to stock-based compensation 28,489 28,493
Profit distributions to noncontrolling interests 0 0
Proceeds received from sale/leaseback of real property 0  
Changes in intercompany balances with affiliates, net 312,112 175,135
Net cash (used in) provided by financing activities 9,690 (6,497)
Effect of exchange rate changes on cash and cash equivalents 0  
(Decrease) increase 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 (used in) provided by operating activities 333,512 256,770
Cash Flows from Investing Activities:    
Property and equipment additions, net of disposals (97,857) (116,688)
Proceeds received from sale of assets and businesses   11,450
Acquisition of property and businesses (22,513) (67,699)
Costs incurred for purchase and implementation of electronic health records application   (8,399)
Net cash used in investing activities (120,370) (181,336)
Cash Flows from Financing Activities:    
Reduction of long-term debt (2,865) (317)
Additional borrowings 0  
Repurchase of common shares 0 0
Dividends paid 0 0
Issuance of common stock 0 0
Excess income tax benefits related to stock-based compensation 0 0
Profit distributions to noncontrolling interests 0 0
Proceeds received from sale/leaseback of real property 0  
Changes in intercompany balances with affiliates, net (202,798) (78,577)
Net cash (used in) provided by financing activities (205,663) (78,894)
Effect of exchange rate changes on cash and cash equivalents 293  
(Decrease) increase in cash and cash equivalents 7,772 (3,460)
Cash and cash equivalents, beginning of period 21,784 7,990
Cash and cash equivalents, end of period 29,556 4,530
Non Guarantors    
Condensed Financial Statements, Captions [Line Items]    
Net cash (used in) provided by operating activities 207,781 195,149
Cash Flows from Investing Activities:    
Property and equipment additions, net of disposals (72,723) (70,098)
Proceeds received from sale of assets and businesses   0
Acquisition of property and businesses (11,987) (3,301)
Costs incurred for purchase and implementation of electronic health records application   0
Net cash used in investing activities (84,710) (73,399)
Cash Flows from Financing Activities:    
Reduction of long-term debt (604) (11,054)
Additional borrowings 0  
Repurchase of common shares 0 0
Dividends paid 0 0
Issuance of common stock 0 0
Excess income tax benefits related to stock-based compensation 0 0
Profit distributions to noncontrolling interests (23,295) (13,184)
Proceeds received from sale/leaseback of real property 12,765  
Changes in intercompany balances with affiliates, net (109,314) (96,558)
Net cash (used in) provided by financing activities (120,448) (120,796)
Effect of exchange rate changes on cash and cash equivalents 0  
(Decrease) increase in cash and cash equivalents 2,623 954
Cash and cash equivalents, beginning of period 10,285 9,248
Cash and cash equivalents, end of period $ 12,908 $ 10,202