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Commitments and Contingencies - Additional Information (Detail) £ in Millions | 3 Months Ended | 12 Months Ended | 60 Months Ended |  |  |
--- | --- | --- | --- | --- | --- | ---
Mar. 31, 2019 USD ($) | Mar. 31, 2019 GBP (£) | Mar. 31, 2018 USD ($) | Dec. 31, 2018 USD ($) | Dec. 31, 2017 USD ($) | Dec. 31, 2014 USD ($) | Dec. 31, 2013 USD ($) | Dec. 31, 2012 USD ($) | Dec. 31, 2011 USD ($) Hospital | Mar. 31, 2019 USD ($) | Jan. 31, 2017 USD ($) | Jan. 31, 2017 GBP (£) | Dec. 31, 2016 USD ($) | Dec. 31, 2015 USD ($)
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Self-insured for professional and general liability, current | $ 42,000,000 |  |  | $ 42,000,000 |  |  |  |  |  | $ 42,000,000 |  |  |  |
Compensation liability claims | 71,000,000 |  |  | 72,000,000 |  |  |  |  |  | 71,000,000 |  |  |  |
Compensation and related benefits | 40,000,000 |  |  | 40,000,000 |  |  |  |  |  | 40,000,000 |  |  |  |
Accounts receivable, net | 1,602,405,000 |  |  | 1,509,909,000 |  |  |  |  |  | 1,602,405,000 |  |  |  |
Department of Human Services |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Repayment of legal settlement amount on demand |  |  |  |  |  | $ 4,000,000 | $ 4,000,000 | $ 4,000,000 | $ 4,000,000 |  |  |  |  |
Amount claimed from over payments of legal settlements |  |  |  |  |  | 7,000,000 | 7,000,000 | $ 4,000,000 |  |  |  |  |  |
Amount claimed from over payments of legal settlements due to change in calculations |  |  |  |  |  |  | 2,000,000 |  |  |  |  |  |  |
DOJ |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Increase in aggregate pre-tax reserve | 123,000,000 |  |  | 123,000,000 | $ 22,000,000 |  |  |  |  |  |  |  |  |
Pre-tax increase to reserve for civil aspects |  |  | $ 13,000,000 | 102,000,000 |  |  |  |  |  |  |  |  |  |
River Point Behavioral Health |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Amount withheld in contingent medicare payment suspension |  |  |  |  |  |  |  |  |  | 9,000,000 |  |  |  |
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 |  |  |  |
Illinois |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Accounts receivable, net | 34,000,000 |  |  | 32,000,000 |  |  |  |  |  | 34,000,000 |  |  |  |
Accounts receivable net greater than sixty days Past due | 19,000,000 |  |  | 18,000,000 |  |  |  |  |  | 19,000,000 |  |  |  |
Pennsylvania | Department of Human Services |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Number of behavioral health care hospitals | Hospital |  |  |  |  |  |  |  |  | 7 |  |  |  |  |
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 | LAS VEGAS, NEVADA | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | $ 500,000,000 |  |  |  |  |  |  |  |  | $ 500,000,000 |  |  |  |
Maximum | CALIFORNIA | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 130,000,000 |  |  |  |  |  |  |  |  | 130,000,000 |  |  |  |
Maximum | Faulty Zones of UNITED STATES | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 100,000,000 |  |  |  |  |  |  |  |  | 100,000,000 |  |  |  |
Maximum | PUERTO RICO | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | 40,000,000 |  |  |  |  |  |  |  |  | 40,000,000 |  |  |  |
Maximum | OTHER STATES | Earthquake |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial property insurance policies covering catastrophic losses | $ 250,000,000 |  |  |  |  |  |  |  |  | $ 250,000,000 |  |  |  |
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 | $ 246,000,000 |  |  | $ 243,000,000 |  |  |  |  |  | $ 246,000,000 |  |  |  |
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 |  |  |  |  |  | $ 250,000,000 | $ 200,000,000 |  |  |  |  |  | $ 250,000,000 | $ 250,000,000
Liability for claims paid under commercially insured coverage | $ 5,000,000 |  |  |  |  |  |  |  |  | $ 5,000,000 |  |  |  |
Subsidiaries | General And Professional Liability Insurance Policies | Maximum | Located in U.K. |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commitments and Contingencies Disclosure [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |
Liability for claims paid under commercially insured coverage | $ 8,500,000 |  |  |  |  |  |  |  |  | $ 8,500,000 |  |  |  |

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