Commitments and Contingencies (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended			6 Months Ended
	Jun. 30, 2012		Jun. 30, 2011	Jun. 30, 2012		Jun. 30, 2011	Mar. 31, 2012	Dec. 31, 2011		Dec. 31, 2010	Mar. 31, 2010
Loss Contingencies [Line Items]
Restricted cash, current	$ 14,330			$ 14,330				$ 15,706
Restricted cash, non-current	354			354				353
Total assets	747,914			747,914				755,666
Self insurance liabilites, noncurrent	155,048			155,048				157,267
Total liabilities	519,991			519,991				530,210
Employee health insurance liability	6,228			6,228				6,978
Self Insurance [Member]
Loss Contingencies [Line Items]
Gross balance, beginning of period	206,168			208,097		210,556					208,517
Less: anticipated insurance	(24,656)		(28,423)	(24,656)		(28,423)	(24,320)	(24,320)		(30,200)	(30,200)
Net balance, beginning of period	181,848			183,777		180,356					178,317
Current year provision, continuing operations	13,190		14,541	28,507		29,098
Current year provision, discontinued operations	1,093		890	1,885		1,741
Claims paid, continuing operations	(10,772)		(12,326)	(22,017)		(26,508)
Claims paid, discontinued operations	(1,529)		(1,877)	(5,168)		(2,589)
Amounts paid for administrative services and other	(2,038)		(2,467)	(5,192)		(5,020)
Gross balance, end of period	206,448		205,501	206,448		205,501					208,517
Plus: anticipated insurance	(24,656)		(28,423)	(24,656)		(28,423)	(24,320)	(24,320)		(30,200)	(30,200)
Net balance, end of period	181,792		177,078	181,792		177,078					178,317
Self Insurance Restricted Cash, Current	13,981			13,981				15,586
Self Insurance Restricted Cash, Non-Current	0			0				0
Self Insurance Restricted Cash	13,981	[1]		13,981	[1]			15,586	[1]
Anticipated insurance recoveries, current	3,303	[2]		3,303	[2]			3,254	[2]
Anticipated insurance recoveries, noncurrent	21,353	[2]		21,353	[2]			21,066	[2]
Anticipated insurance recoveries	24,656	[2]		24,656	[2]			24,320	[2]
Self Insurance Assets	38,637			38,637				39,906
Self insurance liabilities, current	51,400			51,400				50,832
Self insurance liabilites, noncurrent	155,048			155,048				157,267
Self Insurance Reserve	206,448	[3]		206,448	[3]			208,099	[3]
Collateral Deposits and Other [Member]
Loss Contingencies [Line Items]
Restricted cash	703	[1]		703	[1]			473	[1]
Revolving Credit Facility [Member]
Loss Contingencies [Line Items]
Letters of credit	57,538			57,538				55,335
Professional Liability [Member] | Self Insurance [Member]
Loss Contingencies [Line Items]
Gross balance, beginning of period	118,626			120,856		113,971					110,742
Less: anticipated insurance	(2,388)		(2,273)	(2,388)		(2,273)	(2,390)	(2,390)		(2,100)	(2,100)
Net balance, beginning of period	116,236			118,466		111,871					108,642
Current year provision, continuing operations	7,500		8,375	15,635		15,348
Current year provision, discontinued operations	567		482	1,034		949
Claims paid, continuing operations	(6,695)		(8,277)	(13,114)		(17,792)
Claims paid, discontinued operations	(914)		(1,380)	(4,183)		(1,726)
Amounts paid for administrative services and other	(576)		(800)	(1,720)		(1,608)
Gross balance, end of period	118,506		109,315	118,506		109,315					110,742
Plus: anticipated insurance	(2,388)		(2,273)	(2,388)		(2,273)	(2,390)	(2,390)		(2,100)	(2,100)
Net balance, end of period	116,118		107,042	116,118		107,042					108,642
Self Insurance Restricted Cash, Current	5,458			5,458				6,254
Self Insurance Restricted Cash, Non-Current	0			0				0
Self Insurance Restricted Cash	5,458	[1]		5,458	[1]			6,254	[1]
Anticipated insurance recoveries, current	483	[2]		483	[2]			524	[2]
Anticipated insurance recoveries, noncurrent	1,905	[2]		1,905	[2]			1,866	[2]
Anticipated insurance recoveries	2,388	[2]		2,388	[2]			2,390	[2]
Self Insurance Assets	7,846			7,846				8,644
Self insurance liabilities, current	29,946			29,946				28,758
Self insurance liabilites, noncurrent	88,560			88,560				92,099
Self Insurance Reserve	118,506	[3]		118,506	[3]			120,857	[3]
Workers' Compensation [Member] | Self Insurance [Member]
Loss Contingencies [Line Items]
Gross balance, beginning of period	87,542			87,241		96,585					97,775
Less: anticipated insurance	(22,268)		(26,150)	(22,268)		(26,150)	(21,930)	(21,930)		(28,100)	(28,100)
Net balance, beginning of period	65,612			65,311		68,485					69,675
Current year provision, continuing operations	5,690		6,166	12,872		13,750
Current year provision, discontinued operations	526		408	851		792
Claims paid, continuing operations	(4,077)		(4,049)	(8,903)		(8,716)
Claims paid, discontinued operations	(615)		(497)	(985)		(863)
Amounts paid for administrative services and other	(1,462)		(1,667)	(3,472)		(3,412)
Gross balance, end of period	87,942		96,186	87,942		96,186					97,775
Plus: anticipated insurance	(22,268)		(26,150)	(22,268)		(26,150)	(21,930)	(21,930)		(28,100)	(28,100)
Net balance, end of period	65,674		70,036	65,674		70,036					69,675
Self Insurance Restricted Cash, Current	8,523			8,523				9,332
Self Insurance Restricted Cash, Non-Current	0			0				0
Self Insurance Restricted Cash	8,523	[1]		8,523	[1]			9,332	[1]
Anticipated insurance recoveries, current	2,820	[2]		2,820	[2]			2,730	[2]
Anticipated insurance recoveries, noncurrent	19,448	[2]		19,448	[2]			19,200	[2]
Anticipated insurance recoveries	22,268	[2]		22,268	[2]			21,930	[2]
Self Insurance Assets	30,791			30,791				31,262
Self insurance liabilities, current	21,454	[4]		21,454	[4]			22,074	[4]
Self insurance liabilites, noncurrent	66,488	[4]		66,488	[4]			65,168	[4]
Self Insurance Reserve	$ 87,942	[3],[4]		$ 87,942	[3],[4]			$ 87,242	[3],[4]

[1] Total restricted cash includes cash collateral deposits and other cash held by third parties. Total restricted cash above excludes $703 and $473 at June 30, 2012 and December 31, 2011, respectively, held for bank collateral, various mortgages, bond payments and capital expenditures on HUD-insured buildings.

[2] Anticipated insurance recovery assets are presented as Other Assets (both current and long-term) in our June 30, 2012 and December 31, 2011 consolidated balance sheets.

[3] Total self-insurance liabilities above exclude $6,228 and $6,978 at June 30, 2012 and December 31, 2011, respectively, related to our employee health insurance liabilities.

[4] Total self-insurance liabilities for workers’ compensation claims are collateralized, in addition to the restricted cash, by letters of credit of $57,538 as of June 30, 2012 and $55,335 as of December 31, 2011.