Income Taxes (Tables)

12 Months Ended

Dec. 31, 2012

Income Taxes

Schedule of significant components of the Company's tax provision

	For the Year Ended December 31,
	2010		2011		2012
	(In thousands)
Current:
Federal	$	34,854	$	40,007	$	74,076
State and local		7,076		5,672		11,589
Total current		41,930		45,679		85,665
Deferred		9,450		35,305		7,909
Total income tax provision	$	51,380	$	80,984	$	93,574

Schedule of differences between the expected income tax provision and income taxes computed at the federal statutory rate

	For the Year Ended December 31,
	2010			2011			2012
Expected federal tax rate		35.0	%		35.0	%		35.0	%
State and local taxes, net of federal benefit		3.7			3.9			4.0
Other permanent differences		0.8			0.9			0.6
Valuation allowance		(4.0	)		(0.4	)		(0.6	)
Uncertain tax positions		(0.7	)		(3.1	)		(0.5	)
IRS audit settlements		—			—			(0.5	)
Non-controlling interest		(1.1	)		(0.9	)		(0.9	)
Sale of entities		—			2.7			—
Other		0.1			—			(0.4	)
Total		33.8	%		38.1	%		36.7	%

Summary of deferred tax assets and liabilities

	December 31, 2011									December 31, 2012
	Total			Current			Non- Current			Total			Current			Non- Current
	(In thousands)
Deferred tax assets
Allowance for doubtful accounts	$	2,183		$	2,183		$	—		$	1,496		$	1,496		$	—
Compensation and benefit related accruals		42,302			35,831			6,471			45,784			38,254			7,530
Malpractice insurance		14,409			3,762			10,647			17,005			5,003			12,002
Restructuring reserve		1,988			1,988			—			679			679			—
Net operating loss carryforwards		26,941			853			26,088			24,543			777			23,766
Other		2,475			2,117			358			1,025			996			29
Stock options		1,927			—			1,927			4,089			—			4,089
Excess capital loss		270			—			270			—			—			—
Uncertain tax positions		3,096			—			3,096			2,661			—			2,661
Total deferred tax assets		95,591			46,734			48,857			97,282			47,205			50,077
Deferred tax liabilities
Deferred income		(31,660	)		(24,698	)		(6,962	)		(33,188	)		(26,253	)		(6,935	)
Other		(2,048	)		(356	)		(1,692	)		(1,311	)		(118	)		(1,193	)
Depreciation and amortization		(109,873	)		—			(109,873	)		(121,075	)		—			(121,075	)
Total deferred tax liabilities		(143,581	)		(25,054	)		(118,527	)		(155,574	)		(26,371	)		(129,203	)
Net deferred taxes before valuation allowance		(47,990	)		21,680			(69,670	)		(58,292	)		20,834			(79,126	)
Valuation allowance		(15,733	)		(3,375	)		(12,358	)		(13,341	)		(2,957	)		(10,384	)
Net deferred taxes	$	(63,723	)	$	18,305		$	(82,028	)	$	(71,633	)	$	17,877		$	(89,510	)

Schedule of state net operating loss carry forwards

The total state net operating losses are approximately $545.1 million. State net operating loss carry forwards expire and are subject to gross valuation allowances as follows (in thousands):

	State Net Operating Losses		Gross Valuation Allowance
2013	$	40,220	$	40,054
2014		7,780		6,247
2015		9,513		8,334
2016		8,525		8,302
Thereafter through 2032		479,046		339,030

Schedule of reconciliation of the Company's unrecognized tax benefits

The reconciliation of the Company's unrecognized tax benefits is as follows (in thousands):

Gross tax contingencies—January 1, 2010	$	22,735
Acquired contingencies—Regency Management Company		915
Reductions for tax positions taken in prior periods due primarily to statute expiration		(2,972	)
Additions for existing tax positions taken		1,632
Gross tax contingencies—December 31, 2010		22,310
Reductions for tax positions taken in prior periods due primarily to statute expiration		(2,706	)
Reductions for tax positions taken in prior periods due to change in estimate		(7,012	)
Additions for existing tax positions taken		3,064
Gross tax contingencies—December 31, 2011		15,656
Reductions for tax positions taken in prior periods due primarily to statute expiration		(2,516	)
Additions for existing tax positions taken		750
Gross tax contingencies—December 31, 2012	$	13,890