CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	6 Months Ended
	Jun. 30, 2012	Jun. 30, 2011
Cash Flows from Operating Activities:
Net income	$ 260,014	$ 246,021
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation & amortization	148,703	144,949
Stock-based compensation expense	10,996	8,665
Changes in assets & liabilities, net of effects from acquisitions and dispositions:
Accounts receivable	(63,937)	(77,661)
Accrued interest	15,873	(2,309)
Accrued and deferred income taxes	3,955	55,420
Other working capital accounts	(13,085)	(48,417)
Other assets and deferred charges	13,866	11,525
Other	2,050	3,468
Accrued insurance expense, net of commercial premiums paid	42,241	47,480
Payments made in settlement of self-insurance claims	(47,814)	(33,365)
Net cash provided by operating activities	372,862	355,776
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	(182,351)	(116,240)
Proceeds received from sale of assets and businesses	53,461	2,041
Acquisition of property and businesses	(11,476)	0
Costs incurred for purchase and implementation of electronic health records application	(28,008)	(11,416)
Return of deposit on terminated purchase agreement	6,500	0
Net cash used in investing activities	(161,874)	(125,615)
Cash Flows from Financing Activities:
Reduction of long-term debt	(195,686)	(200,566)
Additional borrowings	0	36,000
Financing costs	0	(23,534)
Repurchase of common shares	(2,927)	(6,163)
Dividends paid	(9,673)	(9,763)
Issuance of common stock	2,575	2,408
Profit distributions to noncontrolling interests	(13,565)	(23,201)
Net cash (used in) provided by financing activities	(219,276)	(224,819)
(Decrease) increase in cash and cash equivalents	(8,288)	5,342
Cash and cash equivalents, beginning of period	41,229	29,474
Cash and cash equivalents, end of period	32,941	34,816
Supplemental Disclosures of Cash Flow Information:
Interest paid	62,158	102,213
Income taxes paid, net of refunds	$ 141,571	$ 83,532