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Accrued Professional Liability - Schedule of Accrued Professional Liability (Detail) (USD $) In Thousands, unless otherwise specified | 12 Months Ended
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Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011
Payables And Accruals [Abstract] |  |  |
Balance at beginning of year | $ 137,036 | $ 122,847 | $ 111,662
Provision (adjustment) for losses related to Current year | 41,235 | 35,441 | 33,031
Provision (adjustment) for losses related to Prior years | (8,100) | (8,119) | (10,099)
Total provision for losses | 33,135 | 27,322 | 22,932
Claim payments related to Current year | (741) | (569) | (221)
Claim payments related to Prior years | (10,739) | (12,564) | (11,526)
Total payments | (11,480) | (13,133) | (11,747)
Balance at end of year | $ 158,691 | $ 137,036 | $ 122,847

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- Definition Amount of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability) at the end of the accounting period. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=25496072&loc=d3e14326-108349 + Details
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- Definition Amount of loss recognized for asserted and unasserted malpractice claims. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=25496072&loc=d3e14326-108349 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 954 -SubTopic 450 -Section 30 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=6491336&loc=d3e5870-115623 + Details
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- Definition Amount of increase in asserted and unasserted malpractice claims that were originally recognized in a prior period. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=25496072&loc=d3e14326-108349 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 954 -SubTopic 450 -Section 30 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=6491336&loc=d3e5870-115623 + Details
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