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Consolidated Statements Of Cash Flows (USD $)
In Thousands, unless otherwise specified
3 Months Ended
Mar. 31, 2012
Mar. 31, 2011
Cash flows from operating activities:    
Net (loss) earnings $ 54,939 $ 44,628
Adjustments to reconcile net earnings to net cash flows provided by operating activities:    
Depreciation and amortization 7,375 5,913
Net (gain) loss on sale of long-lived assets 599 102
Share-based compensation 1,792 1,593
Excess tax benefit from share-based compensation (79) (542)
Deferred income taxes 8,722 5,646
Equity in earnings of unconsolidated affiliates, net (395) 0
Increase (decrease) in cash and cash equivalents, net of effects of acquisitions and dispositions, due to changes in:    
Accounts receivable, net (1,119) (1,244)
Supplies inventory 177 (74)
Prepaid and other current assets (633) 1,362
Accounts payable (1,693) (2,147)
Accrued expenses and other liabilities (985) (4,392)
Other, net 445 435
Net cash flows provided by operating activities 69,145 51,280
Cash flows from investing activities:    
Acquisition of interests in surgery centers and related transactions (9,857) (3,695)
Acquisition of property and equipment (6,046) (4,344)
Proceeds from sale of interests in surgery centers 0 3,366
Net cash flows used in investing activities (15,903) (4,673)
Cash flows from financing activities:    
Proceeds from long-term borrowings 19,600 15,620
Repayment on long-term borrowings (30,877) (24,776)
Distributions to noncontrolling interests (39,009) (31,863)
Proceeds from issuance of common stock upon exercise of stock options 2,521 3,597
Repurchase of common stock (2,823) (6,185)
Capital contributions and ownership transactions by noncontrolling interests 869 23
Excess tax benefit from share-based compensation 79 542
Financing cost incurred 0 (4)
Net cash flows provided by (used in) financing activities (49,640) (43,046)
Net increase (decrease) in cash and cash equivalents 3,602 3,561
Cash and cash equivalents, beginning of period 40,718 34,147
Cash and cash equivalents, end of period $ 44,320 $ 37,708