CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	9 Months Ended
	Sep. 30, 2012	Sep. 30, 2011
Cash Flows from Operating Activities:
Net income (loss)	$ 23,424	$ (386,662)
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	30,046	28,907
Provision for doubtful accounts	16,286	9,918
Non-cash compensation	6,065	8,265
401(k) employer match	7,575	5,845
Loss on disposal of property and equipment	1,066	1,796
Deferred income taxes	11,637	(133,623)
Equity in earnings of equity investments	(1,091)	(1,114)
Amortization of deferred debt issuance costs	1,182	1,182
Return on equity investment	1,050	1,088
Goodwill and other intangibles impairment charge		574,114
Changes in operating assets and liabilities, net of impact of acquisitions:
Patient accounts receivable	(31,686)	(5,883)
Other current assets	2,875	8,960
Other assets	(483)	(4,304)
Accounts payable	194	814
Accrued expenses	(10,815)	(1,475)
Other long-term obligations	(421)	(3,535)
Net cash provided by operating activities	56,904	104,293
Cash Flows from Investing Activities:
Proceeds from sale of deferred compensation plan assets	239	859
Proceeds from the sale of property and equipment	609
Purchases of deferred compensation plan assets	(155)	(472)
Purchases of property and equipment	(32,198)	(38,573)
Purchase of investment		(4,500)
Acquisitions of businesses, net of cash acquired	(8,744)	(125,977)
Net cash used in investing activities	(40,249)	(168,663)
Cash Flows from Financing Activities:
Proceeds from issuance of stock upon exercise of stock options and warrants	145	245
Proceeds from issuance of stock to employee stock purchase plan	2,934	3,961
Tax benefit from stock option exercises	(3,038)	(427)
Non-controlling interest distribution	(105)	(568)
Principal payments of long-term obligations	(25,489)	(29,674)
Net cash used in financing activities	(25,553)	(26,463)
Net decrease in cash and cash equivalents	(8,898)	(90,833)
Cash and cash equivalents at beginning of period	48,004	120,295
Cash and cash equivalents at end of period	39,106	29,462
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest	6,896	7,094
Cash paid for income taxes, net of refunds received	1,620	11,273
Supplemental Disclosures of Non-Cash Financing and Investing Activities:
Notes payable issued for/assumed in acquisitions		1,058
Notes payable issued for software licenses	$ 2,214