Commitments and Contingencies (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended			9 Months Ended
	Sep. 30, 2012		Sep. 30, 2011	Sep. 30, 2012		Sep. 30, 2011	Jun. 30, 2012	Dec. 31, 2011		Jun. 30, 2011	Dec. 31, 2010
Loss Contingencies [Line Items]
Restricted cash, current	$ 14,252			$ 14,252				$ 15,706
Restricted cash, non-current	354			354				353
Total assets	749,844			749,844				755,666
Self insurance liabilites, noncurrent	158,224			158,224				157,267
Total liabilities	519,439			519,439				530,210
Employee health insurance liability	7,213			7,213				6,978
Self Insurance [Member]
Loss Contingencies [Line Items]
Gross balance, beginning of period	206,448		205,501	208,097		210,556
Less: anticipated insurance	(24,656)		(28,423)	(24,656)		(28,423)	(24,656)	(24,320)		(28,423)	(30,200)
Net balance, beginning of period	181,792		177,078	183,777		180,356
Current year provision, continuing operations	15,237		14,545	43,744		43,643
Current year provision, discontinued operations	793		870	2,678		2,611
Claims paid, continuing operations	(8,594)		(10,091)	(30,611)		(36,599)
Claims paid, discontinued operations	(2,277)		(1,119)	(7,445)		(3,708)
Amounts paid for administrative services and other	(2,323)		(2,506)	(7,515)		(7,526)
Gross balance, end of period	209,284		207,200	209,284		207,200
Plus: anticipated insurance	(24,656)		(28,423)	(24,656)		(28,423)	(24,656)	(24,320)		(28,423)	(30,200)
Net balance, end of period	184,628		178,777	184,628		178,777
Self Insurance Restricted Cash, Current	14,055			14,055				15,586
Self Insurance Restricted Cash, Non-Current	0			0				0
Self Insurance Restricted Cash	14,055	[1]		14,055	[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	38,711			38,711				39,906
Self insurance liabilities, current	51,060			51,060				50,832
Self insurance liabilites, noncurrent	158,224			158,224				157,267
Self Insurance Reserve	209,284	[3]		209,284	[3]			208,099	[3]
Collateral Deposits and Other [Member]
Loss Contingencies [Line Items]
Restricted cash	551	[1]		551	[1]			473	[1]
Revolving Credit Facility [Member]
Loss Contingencies [Line Items]
Letters of credit	57,438			57,438				55,335
Professional Liability [Member] | Self Insurance [Member]
Loss Contingencies [Line Items]
Gross balance, beginning of period	118,506		109,315	120,856		113,971
Less: anticipated insurance	(2,388)		(2,273)	(2,388)		(2,273)	(2,388)	(2,390)		(2,273)	(2,100)
Net balance, beginning of period	116,118		107,042	118,466		111,871
Current year provision, continuing operations	8,135		7,664	23,770		23,012
Current year provision, discontinued operations	467		482	1,501		1,431
Claims paid, continuing operations	(4,819)		(6,382)	(17,933)		(24,174)
Claims paid, discontinued operations	(1,664)		(604)	(5,847)		(2,330)
Amounts paid for administrative services and other	(649)		(788)	(2,369)		(2,396)
Gross balance, end of period	119,976		109,687	119,976		109,687
Plus: anticipated insurance	(2,388)		(2,273)	(2,388)		(2,273)	(2,388)	(2,390)		(2,273)	(2,100)
Net balance, end of period	117,588		107,414	117,588		107,414
Self Insurance Restricted Cash, Current	5,725			5,725				6,254
Self Insurance Restricted Cash, Non-Current	0			0				0
Self Insurance Restricted Cash	5,725	[1]		5,725	[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	8,113			8,113				8,644
Self insurance liabilities, current	29,442			29,442				28,758
Self insurance liabilites, noncurrent	90,534			90,534				92,099
Self Insurance Reserve	119,976	[3]		119,976	[3]			120,857	[3]
Workers' Compensation [Member] | Self Insurance [Member]
Loss Contingencies [Line Items]
Gross balance, beginning of period	87,942		96,186	87,241		96,585
Less: anticipated insurance	(22,268)		(26,150)	(22,268)		(26,150)	(22,268)	(21,930)		(26,150)	(28,100)
Net balance, beginning of period	65,674		70,036	65,311		68,485
Current year provision, continuing operations	7,102		6,881	19,974		20,631
Current year provision, discontinued operations	326		388	1,177		1,180
Claims paid, continuing operations	(3,775)		(3,709)	(12,678)		(12,425)
Claims paid, discontinued operations	(613)		(515)	(1,598)		(1,378)
Amounts paid for administrative services and other	(1,674)		(1,718)	(5,146)		(5,130)
Gross balance, end of period	89,308		97,513	89,308		97,513
Plus: anticipated insurance	(22,268)		(26,150)	(22,268)		(26,150)	(22,268)	(21,930)		(26,150)	(28,100)
Net balance, end of period	67,040		71,363	67,040		71,363
Self Insurance Restricted Cash, Current	8,330			8,330				9,332
Self Insurance Restricted Cash, Non-Current	0			0				0
Self Insurance Restricted Cash	8,330	[1]		8,330	[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	30,598			30,598				31,262
Self insurance liabilities, current	21,618	[4]		21,618	[4]			22,074	[4]
Self insurance liabilites, noncurrent	67,690	[4]		67,690	[4]			65,168	[4]
Self Insurance Reserve	$ 89,308	[3],[4]		$ 89,308	[3],[4]			$ 87,242	[3],[4]

[1] Total restricted cash includes cash collateral deposits posted and other cash deposits held by third parties. Total restricted cash above excludes $551 and $473 at September 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 September 30, 2012 and December 31, 2011 consolidated balance sheets.

[3] Total self-insurance liabilities above exclude $7,213 and $6,978 at September 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 $57,438 as of September 30, 2012 and $55,335 as of December 31, 2011.