Acquisitions and Investments in Unconsolidated Affiliates (Narrative) (Details) (USD $)	12 Months Ended								0 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2013 Minimum [Member]	Dec. 31, 2013 Maximum [Member]	Dec. 31, 2013 Noncontrolling Interest Number Of Centers [Member] Centers	Dec. 31, 2013 Controlling Interest [Member] Centers	Dec. 31, 2012 Controlling Interest [Member] Centers	Sep. 01, 2011 Acquired Nsc Centers [Member] Centers	Dec. 31, 2013 Acquired Nsc Centers [Member]	Dec. 31, 2012 Acquired Nsc Centers [Member]	Dec. 31, 2013 Current Year Acquisitions [Member]
Business Acquisition [Line Items]
Equity Method Investments	$ 16,392,000	$ 11,274,000										$ 5,201,000
Gain (loss) on deconsolidation	2,237,000	0	0
Estimated Probability Of Fair Value Variables Range				5.00%	30.00%
Number of Businesses Acquired						1	5	17	17
Payments to Acquire Businesses, Net of Cash Acquired	73,594,000	277,388,000	239,223,000
Purchase Price Payable Commitment											2,744,000
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High									7,500,000
Contingent Purchase Price Obligation, Settlement Amount	2,744,000									2,744,000
Goodwill deductible for tax purposes	70,147,000	260,547,000
Other operating expenses in acquisition related costs, primarily attorney fees	$ 300,000	$ 700,000