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General (Details 4) (USD $)
In Thousands, unless otherwise specified
3 Months Ended 6 Months Ended
Jun. 30, 2011
Jun. 30, 2010
Jun. 30, 2011
Jun. 30, 2010
Concentration of Business        
Net revenue $ 698,338 $ 741,658 $ 1,391,093 $ 1,469,711
Term of contract, low end of the range (in years)     1  
Term of contract, high end of the range (in years)     3  
Term of renewed contract, low end of the range (in years)     1  
Term of renewed contract, high end of the range (in years)     2  
Notice period for termination of contract, low end of the range (in days)     60  
Notice period for termination of contract, high end of the range (in days)     180  
Pennsylvania Counties
       
Concentration of Business        
Net revenue     178,200 169,900
Florida Areas
       
Concentration of Business        
Net revenue     $ 67,200 $ 71,200