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Commitments and Contingencies - Additional Information (Detail) £ in Millions | 12 Months Ended | 45 Months Ended |  |  |  |
--- | --- | --- | --- | --- | --- | ---
Dec. 31, 2017 USD ($) | Dec. 31, 2017 GBP (£) | Dec. 31, 2013 USD ($) | Dec. 31, 2012 USD ($) | Dec. 31, 2011 USD ($) Hospital | Dec. 31, 2017 USD ($) | Jan. 31, 2017 USD ($) | Jan. 31, 2017 GBP (£) | Dec. 31, 2016 USD ($) | Dec. 31, 2015 USD ($) | Dec. 31, 2014 USD ($)
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability | $ 298,222,000 |  |  |  |  | $ 298,222,000 |  |  | $ 274,815,000 | $ 271,476,000 | $ 259,718,000
Self-insured for professional and general liability, current | 54,000,000 |  |  |  |  | 54,000,000 |  |  | 48,000,000 |  |
Compensation liability claims | 70,000,000 |  |  |  |  | 70,000,000 |  |  | 67,000,000 |  |
Compensation and related benefits | 35,000,000 |  |  |  |  | 35,000,000 |  |  | 33,000,000 |  |
Combined estimated future purchase obligations | 315,000,000 |  |  |  |  | 315,000,000 |  |  |  |  |
Defined benefit pension plan estimated payments through 2089 | 188,000,000 |  |  |  |  | 188,000,000 |  |  |  |  |
Other retirement plan liabilities | 18,000,000 |  |  |  |  | 18,000,000 |  |  |  |  |
Department of Human Services |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Repayment of legal settlement amount on demand |  |  | $ 11,000,000 | $ 11,000,000 | $ 4,000,000 |  |  |  |  |  |
McAllen Medical Center |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Amount awarded to plaintiff | 3,850,000 |  |  |  |  |  |  |  |  |  |
Total amount of order, including prejudgment interest | 9,000,000 |  |  |  |  |  |  |  |  |  |
DOJ |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Reserve for civil aspects | 22,000,000 |  |  |  |  | 22,000,000 |  |  |  |  |
River Point Behavioral Health |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Amount withheld in contingent medicare payment suspension |  |  |  |  |  | 10,000,000 |  |  |  |  |
Construction Commitment |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Combined estimated future purchase obligations | 30,000,000 |  |  |  |  | 30,000,000 |  |  |  |  |
Revenue Cycle Data Processing Services |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Combined estimated future purchase obligations | 73,000,000 |  |  |  |  | 73,000,000 |  |  |  |  |
Electronic Health Records And Revenue Cycle Application |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Combined estimated future purchase obligations | 240,000,000 |  |  |  |  | 240,000,000 |  |  |  |  |
Estimated Minimum Liabilities For Physician Commitments |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Combined estimated future purchase obligations | 2,000,000 |  |  |  |  | 2,000,000 |  |  |  |  |
Related to Certain Equipment |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Combined estimated future purchase obligations | 206,000,000 |  |  |  |  | 206,000,000 |  |  |  |  |
Commercial Health Insurer and Self-insured Employee Benefit Plans |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Combined estimated future purchase obligations | 86,000,000 |  |  |  |  | 86,000,000 |  |  |  |  |
Pennsylvania | Department of Human Services |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Number of behavioral health care hospitals | Hospital |  |  |  |  | 7 |  |  |  |  |  |
Wind Storms |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Minimum Insurance Deductible | 50,000 |  |  |  |  | 50,000 |  |  |  |  |
Maximum insurance deductible | 250,000 |  |  |  |  | 250,000 |  |  |  |  |
Flood |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Maximum insurance deductible | 500,000 |  |  |  |  | 500,000 |  |  |  |  |
Professional And General Liability |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Increase in professional and general liability self-insurance reserves relating to prior years | 15,000,000 |  |  |  |  |  |  |  |  |  |
Cygnet Health Care Limited |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Property insurance | £ |  | £ 1,290 |  |  |  |  |  |  |  |  |
Maximum | Wind Storms |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | $ 1,000,000,000 |  |  |  |  | $ 1,000,000,000 |  |  |  |  |
Percentage of insurance deductible | 5.00% |  |  |  |  | 5.00% |  |  |  |  |
Maximum | Earthquake | LAS VEGAS, NEVADA |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | $ 500,000,000 |  |  |  |  | $ 500,000,000 |  |  |  |  |
Maximum | Earthquake | CALIFORNIA |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 130,000,000 |  |  |  |  | 130,000,000 |  |  |  |  |
Maximum | Earthquake | PUERTO RICO |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 40,000,000 |  |  |  |  | 40,000,000 |  |  |  |  |
Maximum | Earthquake | OTHER STATES |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 250,000,000 |  |  |  |  | 250,000,000 |  |  |  |  |
Maximum | Earthquake | Faulty Zones of UNITED STATES |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | $ 100,000,000 |  |  |  |  | $ 100,000,000 |  |  |  |  |
Minimum | Wind Storms |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Percentage of insurance deductible | 3.00% |  |  |  |  | 3.00% |  |  |  |  |
General and Professional Liability |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability | $ 228,691,000 |  |  |  |  | $ 228,691,000 |  |  | 207,459,000 | 203,973,000 | 192,904,000
Subsidiaries | Professional Liability | Cygnet Health Care Limited |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability | £ |  |  |  |  |  |  |  | £ 10 |  |  |
Subsidiaries | Professional Liability | Maximum |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability |  |  |  |  |  |  | $ 5,000,000 |  | 10,000,000 |  |
Subsidiaries | General Liability | Cygnet Health Care Limited |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability | £ |  |  |  |  |  |  |  | £ 25 |  |  |
Subsidiaries | General Liability | Maximum |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability |  |  |  |  |  |  | $ 3,000,000 |  | 3,000,000 |  |
Subsidiaries | General And Professional Liability Insurance Policies |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Percentage of liability for claims paid under commercially insured coverage | 10.00% |  |  |  |  | 10.00% |  |  |  |  |
Subsidiaries | General And Professional Liability Insurance Policies | Maximum |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |
Purchased several excess policies through commercial insurance carriers per occurrence |  |  | $ 200,000,000 |  |  |  |  |  | $ 250,000,000 | $ 250,000,000 | $ 250,000,000
Liability for claims paid under commercially insured coverage | $ 5,000,000 |  |  |  |  | $ 5,000,000 |  |  |  |  |

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