XML 20 R55.htm IDEA: XBRL DOCUMENT v2.4.0.8
Accrued Professional Liability - Additional Information (Detail) (USD $)
Dec. 31, 2013
Dec. 31, 2012
Dec. 31, 2011
Dec. 31, 2010
Payables And Accruals [Abstract]        
Total accrued professional liability $ 158,691,000 $ 137,036,000 $ 122,847,000 $ 111,662,000
Accrued professional liability incurred but loss reserves not reported for claims 110,300,000 90,600,000    
Accrued professional liability incurred and loss reserves reported for claims $ 48,400,000 $ 46,400,000