v2.4.0.8
Long-term Debt - Additional Information (Detail) (USD $)
In Thousands, unless otherwise specified
 1 Months Ended 12 Months Ended 1 Months Ended 1 Months Ended 1 Months Ended 12 Months Ended 12 Months Ended 12 Months Ended 12 Months Ended 12 Months Ended 1 Months Ended
Aug. 28, 2012
Dec. 31, 2013
Dec. 31, 2012
Dec. 31, 2011
Nov. 01, 2012
Dec. 31, 2013
Maximum
Nov. 01, 2012
Five Year Term Loan A-3
Dec. 31, 2013
Five Year Term Loan A-3
Nov. 01, 2012
Five Year Term Loan A-3
Minimum
Nov. 01, 2012
Five Year Term Loan A-3
Maximum
Nov. 01, 2012
Seven Year Term Loan B-2
Dec. 31, 2013
Seven Year Term Loan B-2
Aug. 28, 2012
Semi Annual Payment, First Payment
Aug. 28, 2012
Semi Annual Payment, Second Payment
Aug. 26, 2011
Senior Secured Credit Facility
Dec. 31, 2013
HealthCare Partners (HCP)
Dec. 31, 2013
Interest rate cap agreements
Dec. 31, 2013
Interest rate swap agreements
Dec. 31, 2013
Term Loan A
Dec. 31, 2012
Term Loan A
Dec. 31, 2013
Term Loan A
Interest rate swap agreements
Contract
Dec. 31, 2013
Term Loan A-3
Dec. 31, 2013
Term Loan A-3
Interest rate swap agreements
Dec. 31, 2013
Term Loan B
Dec. 31, 2012
Term Loan B
Dec. 31, 2013
Term Loan B
Minimum
Dec. 31, 2013
Term Loan B
Maximum
Dec. 31, 2013
Term Loan B
Interest rate cap agreements
Contract
Dec. 31, 2013
Term Loan B
Interest rate cap agreements
Maximum
Dec. 31, 2013
Term Loan B-2
Dec. 31, 2013
Term Loan B-2
Interest rate cap agreements
Dec. 31, 2013
Term Loan A , Term Loan A-3, Term Loan B and Term Loan B-2
Dec. 31, 2013
Term Loan A , Term Loan A-3, Term Loan B and Term Loan B-2
Minimum
Dec. 31, 2013
Term Loan A , Term Loan A-3, Term Loan B and Term Loan B-2
Maximum
Dec. 31, 2013
Term Loan A-3
Dec. 31, 2012
Term Loan A-2
Aug. 26, 2011
Term Loan A-2
Dec. 31, 2013
Letter of Credit
Dec. 31, 2013
Senior Notes 6.375 Percent Due 2018
Dec. 31, 2012
Senior Notes 6.375 Percent Due 2018
Dec. 31, 2013
Senior Notes 6.625 Percent Due 2020
Dec. 31, 2012
Senior Notes 6.625 Percent Due 2020
Aug. 28, 2012
Senior Notes 5.75 Percent Due 2022
Dec. 31, 2013
Senior Notes 5.75 Percent Due 2022
Dec. 31, 2012
Senior Notes 5.75 Percent Due 2022
Debt Instrument [Line Items]                                                                                          
Term Loan A, Term Loan A-2 and Term Loan B maturity date range                                                                 1 month 12 months                      
Debt Instrument Interest Additional Interest Above LIBOR Rate                                     2.75%             2.75% 3.00%     3.00%                              
Interest rate margin, minimum                                     2.25%     2.00%                         2.00%                    
Interest rate margin, maximum                                     2.75%     2.50%                         2.50%                    
Interest Rate Description                                                               At December 31, 2013, the overall weighted average interest rate for the Term Loan A and the Term Loan A-3 was determined based upon the LIBOR interest rates in effect for all of the individual tranches plus the interest rate margin.                          
Debt Instrument interest LIBOR rate                                 2.50%             1.50%       2.50% 4.00% 1.00%                              
Interest rate agreements, notional amount                                   $ 600,000     $ 800,000   $ 1,282,500         $ 1,250,000     $ 1,485,000                            
Remaining outstanding debt                                                       447,500     148,500                            
Annual principal payment                                     100,000 50,000   67,500   17,500 17,500         16,500           1,500                  
Undrawn revolving credit facilities   350,000                                                                                      
Outstanding letters of credit                               1,000                                           70,000              
Senior notes   2,800,000 2,800,000                                                                       775,000 775,000 775,000 775,000   1,250,000 1,250,000
Senior notes, stated interest percentage                                                                             6.375% 6.375% 6.625% 6.625%   5.75% 5.75%
Senior notes, due period                                                                             2018 2018 2020 2020   2022 2022
Fixed interest rate, lower limit                                   0.72%     1.59%   0.49%                                            
Fixed interest rate, upper limit                                   0.75%     1.64%   0.52%                                            
Weighted average effective interest rate                                         4.36%   3.01%                                            
Interest rate margin in effect                                         2.75%   2.50%                                            
Cap agreements, expiration date                                 Sep. 30, 2016 Sep. 30, 2016     Sep. 30, 2014   Sep. 30, 2016         Sep. 30, 2014                                  
Debt expense recognized   405,010 272,134 227,667                         1,829       12,423   3,255         3,589                                  
Fair value of assets                                 7,566 1,537         4,386         1                                  
Unrealized pre-tax losses in other comprehensive income                                   666     7,988   3,415                                            
Swap rate agreement effective date                                   2014-09-30                                                      
Unrealized loss in other comprehensive income   169 (6,204) (29,049)                         971                                                        
Number of interest rate agreements                                         9             5                                  
Total liability fair value                                         7,988                                                
LIBOR interest rate for interest cap                                                           2.50%                              
Overall weighted average effective interest rate on Senior Secured Credit Facilities   4.18%                                                                                      
Current margin in effect                                     2.75%     2.50%   3.00%           3.00%         2.50%                    
Maximum additional borrowing capacity         3,000,000   1,350,000       1,650,000                                                                    
LIBOR plus interest rate margin             2.50%   2.00% 2.50%                                                                      
Long term borrowing annual principal payment, 2013               67,500       16,500                                                                  
Long term borrowing annual principal payment, 2014   274,697           67,500       16,500                                                                  
Long term borrowing annual principal payment, 2015   845,831           135,000       16,500                                                                  
Long term borrowing annual principal payment, 2016   1,897,554           202,500       16,500                                                                  
Long term borrowing annual principal payment, 2017   910,263           877,500       16,500                                                                  
Floor rate                     1.00%                                                                    
Long term borrowings, interest rate                     3.00%                                                                    
Long term borrowing annual principal payment, 2018   806,339                   16,500                                                                  
Long term borrowing annual principal payment, 2019                       1,551,000                                                                  
Covenants factor leverage ratio           3.501                                                                              
Senior notes issued                                                                                     1,250,000    
Senior notes interest payment period The 5 3/4% Senior Notes pay interest on February 15 and August 15 of each year, and the first interest payment date was on February 15, 2013.                                                                                        
Senior unsecured notes, interest payable date                         --02-15 --08-15                                                              
Debt redemption date                                                                                     Aug. 15, 2017    
Debt redemption optional date                                                                                     Aug. 15, 2015    
Percentage of redemption                                                                                     35.00%    
Proceeds from issuance of debts     4,250,000                                                                                    
Proceeds from borrowings on Term Loan A-3 and Term Loan B-2     3,000,000                                                                                    
Proceeds from the issuance of the senior notes     1,250,000                                                                                    
Fees and expense paid     71,840                                                                                    
Debt refinancing cost     10,963                                                                                    
Increase for additional borrowings on revolving credit facility                             100,000                                                            
Maximum borrowing capacity                             350,000                                           200,000                
Weighted average effective interest rate   4.84%                                                                                      
Overall weighted average effective interest rate   4.86%                                                                                      
Amortization of deferred financing costs   $ 24,933 $ 16,420 $ 13,423