Acquisitions and Dispositions (Details) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Oct. 18, 2013 Harden Healthcare Holdings Inc. [Member]
Business Acquisition [Line Items]
Cash				$ 10,203
Accounts receivable				46,195
Deferred Tax Assets Current				13,589
Prepaid expense and other current assets				1,890
Fixed assets, net				9,476
Identifiable intangible assets				70,706
Goodwill	390,081	656,364	641,669	331,482
Other assets				2,889
Total assets acquired				486,430
Accounts payable and accrued liabilities				58,563
Other current liabilities				8,720
Deferred tax liabilities noncurrent				396
Total liabilities assumed				67,679
Net assets acquired				$ 418,751