XML 61 R45.htm IDEA: XBRL DOCUMENT v3.8.0.1
Revenue Recognition Revenue Recognition (Detail) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2018
Mar. 31, 2017
Dec. 31, 2017
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]      
Allowance for Doubtful Accounts Receivable $ 162,516   $ 218,399
Contract with Customer, Performance Obligation Satisfied in Previous Period 67,410    
Provision for uncollectible accounts (25,545) $ 107,058  
Difference between Revenue Guidance in Effect before and after Topic 606 [Member]      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]      
Contract with Customer, Performance Obligation Satisfied in Previous Period $ 24,000    
Medicare      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]      
Percent of revenue paid by a payor 80.00%