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Commitments and Contingencies - Schedule of Changes in General and Professional Liability and Workers Compensation Reserves (Detail) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2015 | Dec. 31, 2014 | Dec. 31, 2013
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |
Beginning balance | $ 259,718 | $ 270,088 |  | $ 344,553 |
Plus: Accrued insurance expense, net of commercial premiums paid | 90,895 | 59,276 | [1] | (3,821) | [1]
Less: Payments made in settlement of self-insured claims | (79,137) | (69,646) |  | (70,644) |
Ending balance | 271,476 | 259,718 |  | 270,088 |
General and Professional Liability |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |
Beginning balance | 192,904 | 206,290 |  | 278,599 |
Plus: Accrued insurance expense, net of commercial premiums paid | 58,460 | 22,601 | [1] | (35,182) | [1]
Less: Payments made in settlement of self-insured claims | (47,391) | (35,987) |  | (37,127) |
Ending balance | 203,973 | 192,904 |  | 206,290 |
Workers’ Compensation |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |
Beginning balance | 66,814 | 63,798 |  | 65,954 |
Plus: Accrued insurance expense, net of commercial premiums paid | 32,435 | 36,675 | [1] | 31,361 | [1]
Less: Payments made in settlement of self-insured claims | (31,746) | (33,659) |  | (33,517) |
Ending balance | $ 67,503 | $ 66,814 |  | $ 63,798 |
[1] | General and professional liability amounts are net of adjustments recorded during 2014 and 2013, as discussed below.

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- Definition The increase (decrease) during the period in the carrying amount of accrued known and estimated losses incurred for which no insurance coverage exists, and for which a claim has been made or is probable of being asserted, typically arising from workmen's' compensation-type of incidents and personal injury to nonemployees from accidents on the entity's property. + References No definition available. + Details
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- Definition Carrying amount (including both current and noncurrent portions) of accrued known and estimated losses incurred as of the balance sheet date for which no insurance coverage exists, and for which a claim has been made or is probable of being asserted, typically arising from workmen's compensation-type of incidents and personal injury to nonemployees from accidents on the entity's property. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02.24) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 + Details
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