CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	6 Months Ended
	Jun. 30, 2013	Jun. 30, 2012
Cash Flows from Operating Activities:
Net income	$ 297,738	$ 260,014
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation & amortization	161,677	148,703
Stock-based compensation expense	13,579	10,996
Gains on sales of assets and businesses, net of losses	(2,277)	0
Changes in assets & liabilities, net of effects from acquisitions and dispositions:
Accounts receivable	(82,224)	(63,937)
Accrued interest	13,199	15,873
Accrued and deferred income taxes	18,365	3,955
Other working capital accounts	32,421	(13,085)
Other assets and deferred charges	9,069	13,866
Other	4,083	2,050
Accrued insurance expense, net of commercial premiums paid	(22,590)	42,241
Payments made in settlement of self-insurance claims	(37,038)	(47,814)
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)
Net cash used in financing activities	(240,263)	(219,276)
Decrease 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
Supplemental Disclosures of Cash Flow Information:
Interest paid	54,067	62,158
Income taxes paid, net of refunds	$ 152,553	$ 141,571