Supplemental Condensed Consolidating Financial Information (Schedule Of Condensed Consolidating Statements Of Cash Flows) (Details) (USD $) In Thousands	9 Months Ended
	Sep. 30, 2011	Sep. 30, 2010
Net cash provided by operating activities	$ 562,502	$ 412,815
Property and equipment additions, net of disposals	(195,404)	(177,750)
Proceeds received from sale of assets and businesses	23,682	21,460
Acquisition of property and businesses	(8,599)	0
Restricted cash related to bond issuance held in escrow pending completion of PSI acquisition	0	(256,972)
Costs incurred for purchase and development of electronic health records application	(27,874)	(13,216)
Net cash used in investing activities	(208,195)	(426,478)
Reduction of long-term debt	(267,539)	(194,600)
Additional borrowings	36,000	250,000
Financing costs	(23,559)	(5,016)
Repurchase of common shares	(44,532)	(3,963)
Dividends paid	(14,638)	(14,555)
Issuance of common stock	3,596	5,204
Profit distributions to noncontrolling interests	(33,962)	(23,558)
Changes in intercompany balances with affiliates, net	0	0
Proceeds from sale of noncontrolling interest in majority owned business	0	600
Net cash (used in) provided by financing activities	(344,634)	14,112
Increase in cash and cash equivalents	9,673	449
Cash and cash equivalents, beginning of period	29,474	9,180
Cash and cash equivalents, end of period	39,147	9,629
Parent [Member]
Net cash provided by operating activities	60,800	515
Property and equipment additions, net of disposals	0	0
Proceeds received from sale of assets and businesses	0	0
Acquisition of property and businesses	0
Restricted cash related to bond issuance held in escrow pending completion of PSI acquisition		0
Costs incurred for purchase and development of electronic health records application	0	0
Net cash used in investing activities	0	0
Reduction of long-term debt	(252,289)	(191,174)
Additional borrowings	36,000	250,000
Financing costs	(23,559)	(5,016)
Repurchase of common shares	(44,532)	(3,963)
Dividends paid	(14,638)	(14,555)
Issuance of common stock	3,596	5,204
Profit distributions to noncontrolling interests	0	0
Changes in intercompany balances with affiliates, net	234,622	(41,011)
Proceeds from sale of noncontrolling interest in majority owned business		0
Net cash (used in) provided by financing activities	(60,800)	(515)
Increase in cash and cash equivalents	0	0
Cash and cash equivalents, beginning of period	0	0
Cash and cash equivalents, end of period	0	0
Guarantors [Member]
Net cash provided by operating activities	388,838	294,698
Property and equipment additions, net of disposals	(143,953)	(132,382)
Proceeds received from sale of assets and businesses	0	21,460
Acquisition of property and businesses	0
Restricted cash related to bond issuance held in escrow pending completion of PSI acquisition		(256,972)
Costs incurred for purchase and development of electronic health records application	(27,874)	(13,216)
Net cash used in investing activities	(171,827)	(381,110)
Reduction of long-term debt	(1,156)	(1,659)
Additional borrowings	0	0
Financing costs	0	0
Repurchase of common shares	0	0
Dividends paid	0	0
Issuance of common stock	0	0
Profit distributions to noncontrolling interests	0	0
Changes in intercompany balances with affiliates, net	(205,164)	86,734
Proceeds from sale of noncontrolling interest in majority owned business		0
Net cash (used in) provided by financing activities	(206,320)	85,075
Increase in cash and cash equivalents	10,691	(1,337)
Cash and cash equivalents, beginning of period	21,385	5,367
Cash and cash equivalents, end of period	32,076	4,030
Non Guarantors [Member]
Net cash provided by operating activities	112,864	117,602
Property and equipment additions, net of disposals	(51,451)	(45,368)
Proceeds received from sale of assets and businesses	23,682	0
Acquisition of property and businesses	(8,599)
Restricted cash related to bond issuance held in escrow pending completion of PSI acquisition		0
Costs incurred for purchase and development of electronic health records application	0	0
Net cash used in investing activities	(36,368)	(45,368)
Reduction of long-term debt	(14,094)	(1,767)
Additional borrowings	0	0
Financing costs	0	0
Repurchase of common shares	0	0
Dividends paid	0	0
Issuance of common stock	0	0
Profit distributions to noncontrolling interests	(33,962)	(23,558)
Changes in intercompany balances with affiliates, net	(29,458)	(45,723)
Proceeds from sale of noncontrolling interest in majority owned business		600
Net cash (used in) provided by financing activities	(77,514)	(70,448)
Increase in cash and cash equivalents	(1,018)	1,786
Cash and cash equivalents, beginning of period	8,089	3,813
Cash and cash equivalents, end of period	7,071	5,599
Consolidating Adjustments [Member]
Net cash provided by operating activities	0	0
Property and equipment additions, net of disposals	0	0
Proceeds received from sale of assets and businesses	0	0
Acquisition of property and businesses	0
Restricted cash related to bond issuance held in escrow pending completion of PSI acquisition		0
Costs incurred for purchase and development of electronic health records application	0	0
Net cash used in investing activities	0	0
Reduction of long-term debt	0	0
Additional borrowings	0	0
Financing costs	0	0
Repurchase of common shares	0	0
Dividends paid	0	0
Issuance of common stock	0	0
Profit distributions to noncontrolling interests	0	0
Changes in intercompany balances with affiliates, net	0	0
Proceeds from sale of noncontrolling interest in majority owned business		0
Net cash (used in) provided by financing activities	0	0
Increase in cash and cash equivalents	0	0
Cash and cash equivalents, beginning of period	0	0
Cash and cash equivalents, end of period	$ 0	$ 0