Revenue Deductions and Uncompensated Care	3 Months Ended
Sep. 30, 2011
Revenue Deductions and Uncompensated Care [Abstract]
Revenue Deductions and Uncompensated Care	2. REVENUE DEDUCTIONS AND UNCOMPENSATED CARE Allowance for Doubtful Accounts Vanguard estimates the allowance for doubtful accounts using a standard policy that reserves all accounts aged greater than 365 days subsequent to discharge date plus percentages of uninsured accounts and self-pay after insurance accounts less than 365 days old. Vanguard analyzes the allowance for doubtful accounts quarterly using a hindsight calculation that utilizes write-off data for all payer classes during the previous twelve-month period to estimate the allowance for doubtful accounts at a point in time. Vanguard also supplements the analysis by comparing cash collections to net patient revenues and monitoring self-pay utilization. The standard percentages in the allowance for doubtful accounts reserve are adjusted as necessary given changes in trends from these analyses or policy changes. Significant changes in payer mix, business office operations, general economic conditions and healthcare coverage provided by federal or state governments or private insurers may have a significant impact on our estimates and significantly affect our liquidity, results of operations and cash flows. Vanguard's estimate of the allowance for doubtful accounts and recoveries of accounts previously written off determine its provision for doubtful accounts recorded during the period. Vanguard records the provision for doubtful accounts at the time the services are provided for uninsured patients, since historical experience shows that the significant majority of uninsured balances will not be collected. Vanguard records the provision for doubtful accounts related to self-pay after insurance accounts at the time the insurance payment has been received. The allowance for doubtful accounts was approximately $205.0 million and $251.2 million as of June 30, 2011 and September 30, 2011, respectively. These balances as a percent of accounts receivable net of contractual adjustments were approximately 29.7% and 30.8% as of June 30, 2011 and September 30, 2011, respectively. On a same hospital basis, Vanguard's combined allowance for doubtful accounts, uninsured discounts and charity care covered approximately 92.5% and 93.5% of combined uninsured and self-pay after insurance accounts receivable as of June 30, 2011 and September 30, 2011, respectively. The increase in allowance for doubtful accounts during the three months ended September 30, 2011 was primarily the result of an increase in uninsured and self-pay after insurance accounts receivable from 20.4% Vanguard's total accounts receivable as of June 30, 2011 to 24.5% as of September 30, 2011. Charity Care In the ordinary course of business, Vanguard provides services to patients who are financially unable to pay for hospital care. Vanguard includes charity care as a revenue deduction measured by the value of its services, based on standard charges, to patients who qualify under Vanguard's charity care policy (typically those who meet certain minimum income guidelines and do not otherwise qualify for reimbursement under a governmental program). The estimated cost incurred by Vanguard to provide these services to patients who qualify for charity care was approximately $5.4 million and $13.2 million for the three months ended September 30, 2010 and 2011, respectively. These estimates were determined using a ratio of cost to gross charges calculated from Vanguard's most recently filed Medicare cost reports and applying that ratio to the gross charges associated with providing charity care for the period.

Revenue Deductions and Uncompensated Care

3 Months Ended

Sep. 30, 2011

Revenue Deductions and Uncompensated Care [Abstract]

Revenue Deductions and Uncompensated Care

2. REVENUE DEDUCTIONS AND UNCOMPENSATED CARE

Allowance for Doubtful Accounts

Vanguard estimates the allowance for doubtful accounts using a standard policy that reserves all accounts aged greater than 365 days subsequent to discharge date plus percentages of uninsured accounts and self-pay after insurance accounts less than 365 days old. Vanguard analyzes the allowance for doubtful accounts quarterly using a hindsight calculation that utilizes write-off data for all payer classes during the previous twelve-month period to estimate the allowance for doubtful accounts at a point in time. Vanguard also supplements the analysis by comparing cash collections to net patient revenues and monitoring self-pay utilization. The standard percentages in the allowance for doubtful accounts reserve are adjusted as necessary given changes in trends from these analyses or policy changes. Significant changes in payer mix, business office operations, general economic conditions and healthcare coverage provided by federal or state governments or private insurers may have a significant impact on our estimates and significantly affect our liquidity, results of operations and cash flows. Vanguard's estimate of the allowance for doubtful accounts and recoveries of accounts previously written off determine its provision for doubtful accounts recorded during the period. Vanguard records the provision for doubtful accounts at the time the services are provided for uninsured patients, since historical experience shows that the significant majority of uninsured balances will not be collected. Vanguard records the provision for doubtful accounts related to self-pay after insurance accounts at the time the insurance payment has been received.

The allowance for doubtful accounts was approximately $205.0 million and $251.2 million as of June 30, 2011 and September 30, 2011, respectively. These balances as a percent of accounts receivable net of contractual adjustments were approximately 29.7% and 30.8% as of June 30, 2011 and September 30, 2011, respectively. On a same hospital basis, Vanguard's combined allowance for doubtful accounts, uninsured discounts and charity care covered approximately 92.5% and 93.5% of combined uninsured and self-pay after insurance accounts receivable as of June 30, 2011 and September 30, 2011, respectively. The increase in allowance for doubtful accounts during the three months ended September 30, 2011 was primarily the result of an increase in uninsured and self-pay after insurance accounts receivable from 20.4% Vanguard's total accounts receivable as of June 30, 2011 to 24.5% as of September 30, 2011.

Charity Care

In the ordinary course of business, Vanguard provides services to patients who are financially unable to pay for hospital care. Vanguard includes charity care as a revenue deduction measured by the value of its services, based on standard charges, to patients who qualify under Vanguard's charity care policy (typically those who meet certain minimum income guidelines and do not otherwise qualify for reimbursement under a governmental program). The estimated cost incurred by Vanguard to provide these services to patients who qualify for charity care was approximately $5.4 million and $13.2 million for the three months ended September 30, 2010 and 2011, respectively. These estimates were determined using a ratio of cost to gross charges calculated from Vanguard's most recently filed Medicare cost reports and applying that ratio to the gross charges associated with providing charity care for the period.