Accrued Professional Liability - Schedule of Accrued Professional Liability (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended
Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Payables and Accruals [Abstract]
Balance at beginning of year	$ 158,691	$ 137,036	$ 122,847
Provision (adjustment) for losses related to Current year	39,386	41,235	35,441
Provision (adjustment) for losses related to Prior years	(16,125)	(8,100)	(8,119)
Total provision for losses	23,261	33,135	27,322
Claim payments related to Current year	(293)	(741)	(569)
Claim payments related to Prior years	(13,290)	(10,739)	(12,564)
Total payments	(13,583)	(11,480)	(13,133)
Balance at end of year	$ 168,369	$ 158,691	$ 137,036

Malpractice loss contingency provision for losses.

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- Definition

Provision (adjustment) for losses related to current year.

+ References

No definition available.

+ Details

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- Definition

Provision (adjustment) for losses related to prior year.

+ References

No definition available.

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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

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- Definition

Amount of loss recognized for asserted and unasserted malpractice claims.

+ References

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- Definition

Amount of increase in asserted and unasserted malpractice claims that were originally recognized in a prior period.

+ References

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- Definition

Amount of costs associated with malpractice claims and insurance premiums incurred during an accounting period, less insurance recoveries and returns of previously paid premiums.

+ 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

Reference 3: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 954

-SubTopic 720

-Section 25

-Paragraph 1

-URI http://asc.fasb.org/extlink&oid=25501930&loc=d3e8578-115644

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