Goodwill and Other Intangible Assets (Details) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2012	Sep. 30, 2011	Sep. 30, 2012	Sep. 30, 2011	Dec. 31, 2011
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible amortization expense	$ 11,000,000	$ 10,000,000	$ 33,000,000	$ 30,000,000
Statement [Line Items]
Goodwill acquired during period			20,610,000
Disposition of businesses			(14,258,000)
Other			(546,000)
Ending balance, Goodwill	4,256,385,000		4,256,385,000		4,250,579,000
Long Term Care Group [Member]
Statement [Line Items]
Goodwill acquired during period			20,610,000
Disposition of businesses			(14,258,000)
Other			(546,000)
Ending balance, Goodwill	3,577,757,000		3,577,757,000		3,571,951,000
specialty care group [Member]
Statement [Line Items]
Goodwill acquired during period			0
Disposition of businesses			0
Other			0
Ending balance, Goodwill	$ 678,628,000		$ 678,628,000		$ 678,628,000