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Property and Equipment - Additional Information (Detail) (USD $)
 12 Months Ended
Dec. 31, 2013
Dec. 31, 2012
Dec. 31, 2011
Property, Plant and Equipment [Line Items]      
Medical and other equipment held under capital leases $ 146,910,000 $ 133,789,000  
Accumulated depreciation of property and equipment held under capital leases 86,999,000 74,051,000  
Recorded depreciation expense 15,500,000 15,800,000 15,000,000
Medical and Other Equipment [Member]
      
Property, Plant and Equipment [Line Items]      
Medical and other equipment held under capital leases 1,400,000 1,400,000  
Accumulated depreciation of property and equipment held under capital leases $ 1,200,000 $ 1,100,000