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Accrued Professional Liability (Tables)
 12 Months Ended
Dec. 31, 2011
Accrued Professional Liability [Abstract]  
Schedule Of Accrued Professional Liability
     Years Ended December 31,  
     2011     2010     2009  

Balance at beginning of year

    $ 40,672      $ 41,355      $ 36,366   

Provision (adjustment) for losses related to:

       

Current year

      18,645        17,256        16,497   

Prior years

      (4,283 )      (4,029 )      (3,519 ) 
  

 

 

    

 

 

    

 

 

  

Total provision for losses

      14,362        13,227        12,978   

Claim payments related to:

       

Current year

      (221 )      (553 )      (568 ) 

Prior years

      (11,526 )      (13,357 )      (7,421 ) 
  

 

 

    

 

 

    

 

 

  

Total payments

      (11,747 )      (13,910 )      (7,989 ) 
  

 

 

    

 

 

    

 

 

  

Balance at end of year

    $ 43,287      $ 40,672      $ 41,355