Supplemental Condensed Consolidating Statements of Cash flows (Detail) (USD $) In Thousands, unless otherwise specified	6 Months Ended
	Jun. 30, 2013	Jun. 30, 2012
Condensed Financial Statements, Captions [Line Items]
Net cash provided by operating activities	$ 406,002	$ 372,862
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	(175,944)	(182,351)
Proceeds received from sale of assets and businesses	34,008	53,461
Acquisition of property and businesses	(1,320)	(11,476)
Costs incurred for purchase and implementation of electronic health records application	(33,396)	(28,008)
Return of deposit on terminated purchase agreement	0	6,500
Net cash used in investing activities	(176,652)	(161,874)
Cash Flows from Financing Activities:
Reduction of long-term debt	(196,096)	(195,686)
Additional borrowings	11,000	0
Repurchase of common shares	(21,373)	(2,927)
Dividends paid	(9,795)	(9,673)
Issuance of common stock	2,735	2,575
Profit distributions to noncontrolling interests	(26,734)	(13,565)
Changes in intercompany balances with affiliates, net	0	0
Net cash used in financing activities	(240,263)	(219,276)
(Decrease) increase in cash and cash equivalents	(10,913)	(8,288)
Cash and cash equivalents, beginning of period	23,471	41,229
Cash and cash equivalents, end of period	12,558	32,941
Parent
Condensed Financial Statements, Captions [Line Items]
Net cash provided by operating activities	16,014	2,144
Cash Flows from Investing Activities:
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	0
Costs incurred for purchase and implementation of electronic health records application	0	0
Return of deposit on terminated purchase agreement		6,500
Net cash used in investing activities	0	6,500
Cash Flows from Financing Activities:
Reduction of long-term debt	(189,188)	(191,898)
Additional borrowings	11,000
Repurchase of common shares	(21,373)	(2,927)
Dividends paid	(9,795)	(9,673)
Issuance of common stock	2,735	2,575
Profit distributions to noncontrolling interests	0	0
Changes in intercompany balances with affiliates, net	190,607	193,279
Net cash used in financing activities	(16,014)	(8,644)
(Decrease) 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
Condensed Financial Statements, Captions [Line Items]
Net cash provided by operating activities	242,016	279,941
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	(133,607)	(153,894)
Proceeds received from sale of assets and businesses	7,552	49,984
Acquisition of property and businesses	(1,320)	(11,476)
Costs incurred for purchase and implementation of electronic health records application	(33,396)	(28,008)
Return of deposit on terminated purchase agreement		0
Net cash used in investing activities	(160,771)	(143,394)
Cash Flows from Financing Activities:
Reduction of long-term debt	(526)	(2,289)
Additional borrowings	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	(89,098)	(144,331)
Net cash used in financing activities	(89,624)	(146,620)
(Decrease) increase in cash and cash equivalents	(8,379)	(10,073)
Cash and cash equivalents, beginning of period	11,949	33,221
Cash and cash equivalents, end of period	3,570	23,148
Non Guarantors
Condensed Financial Statements, Captions [Line Items]
Net cash provided by operating activities	147,972	90,777
Cash Flows from Investing Activities:
Property and equipment additions, net of disposals	(42,337)	(28,457)
Proceeds received from sale of assets and businesses	26,456	3,477
Acquisition of property and businesses	0	0
Costs incurred for purchase and implementation of electronic health records application	0	0
Return of deposit on terminated purchase agreement		0
Net cash used in investing activities	(15,881)	(24,980)
Cash Flows from Financing Activities:
Reduction of long-term debt	(6,382)	(1,499)
Additional borrowings	0
Repurchase of common shares	0	0
Dividends paid	0	0
Issuance of common stock	0	0
Profit distributions to noncontrolling interests	(26,734)	(13,565)
Changes in intercompany balances with affiliates, net	(101,509)	(48,948)
Net cash used in financing activities	(134,625)	(64,012)
(Decrease) increase in cash and cash equivalents	(2,534)	1,785
Cash and cash equivalents, beginning of period	11,522	8,008
Cash and cash equivalents, end of period	8,988	9,793
Consolidating Adjustments
Condensed Financial Statements, Captions [Line Items]
Net cash provided by operating activities	0	0
Cash Flows from Investing Activities:
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	0
Costs incurred for purchase and implementation of electronic health records application	0	0
Return of deposit on terminated purchase agreement		0
Net cash used in investing activities	0	0
Cash Flows from Financing Activities:
Reduction of long-term debt	0	0
Additional borrowings	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
Net cash used in financing activities	0	0
(Decrease) 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