Accounting for Stock-Based Compensation (Details) (USD $) In Thousands, except Share data, unless otherwise specified	3 Months Ended	9 Months Ended
Sep. 30, 2011 Year Hospital	Jun. 30, 2011	Mar. 31, 2011	Sep. 30, 2010 Year	Sep. 30, 2011 Month Year Hospital	Sep. 30, 2010 Year
Impact of Total Compensation Expense
Effect on income from continuing operations before income taxes	$ (10,855)			$ (9,481)	$ (31,588)	$ (29,899)
Effect on net income	(6,893)			(5,964)	(20,059)	(18,806)
Fair value of stock options
Expected volatility	57.80%			38.00%	32.80%	33.70%
Expected dividends	0			0	0	0
Expected term	4			3	4	3.1
Risk-free interest rate	0.60%			0.80%	1.70%	1.40%
Options outstanding and exercisable
Beginning Balance, shares	8,474,472	8,503,393	7,834,332		7,834,332
Granted, Shares	73,000	45,000	1,329,000
Exercised, Shares	(2,665)	(23,579)	(595,431)
Forfeited and cancelled, Shares	(118,087)	(50,342)	(64,508)
Ending Balance, shares	8,426,720	8,474,472	8,503,393		8,426,720
Beginning of Period, Weighted Average Exercise Price	$ 33.08	$ 33.10	$ 32.08		$ 32.08
Granted, Weighted Average Exercise Price	$ 17.95	$ 28.12	$ 37.96		$ 17.95
Exercised, Weighted Average Exercise Price	$ 18.18	$ 29.98	$ 30.44		$ 18.18
Forfeited and cancelled, Weighted Average Exercise Price	$ 32.21	$ 32.70	$ 34.84
End of Period, Weighted Average Exercise Price	$ 32.95	$ 33.08	$ 33.10		$ 32.95
Weighted Average Remaining Contractual Term	5.6				5.6
Aggregate Intrinsic Value	49				49
Exercisable, Shares	5,851,497				5,851,497
Exercisable, Weighted Average Exercise Price	$ 32.78				$ 32.78
Exercisable, Weighted Average Remaining Contractual Term	4.1
Exercisable, Intrinsic Value	24				24
Restricted stock outstanding
Beginning Balance, Shares	2,243,578	2,247,578	2,125,291		2,125,291
Granted, Shares	4,000	8,000	1,084,949
Vested, Shares	(9,331)	(12,000)	(962,662)
Forfeited, Shares	(2,001)	0	0
Ending Balance, Shares	2,236,246	2,243,578	2,247,578		2,236,246
Beginning of Period, Weighted Average Grant Date Fair Value	$ 33.02	$ 33.04	$ 27.92		$ 27.92
Granted, Weighted Average Grant Date Fair Value	$ 17.95	$ 28.12	$ 37.96
Vested, Weighted Average Grant Date Fair Value	$ 30.26	$ 33.49	$ 27.27
Forfeited, Weighted Average Grant Date Fair Value	$ 33.31	$ 0	$ 0		$ 33.31
End of Period, Weighted Average Grant Date Fair Value	$ 33.00	$ 33.02	$ 33.04		$ 33.00
Deferred Director's Fee
Directors' fees earned and deferred into plan	$ 55			$ 45	$ 165	$ 135
Share equivalent units	3,305			1,453	6,822	4,003

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The estimated amount of dividends to be paid to holders of the underlying shares (expected dividends) over the option's term. Dividends are taken into account because payment of dividends to shareholders reduces the fair value of the underlying shares, and option holders generally do not receive dividends.

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The estimated measure of the percentage by which a share price is expected to fluctuate during a period. Volatility also may be defined as a probability-weighted measure of the dispersion of returns about the mean. The volatility of a share price is the standard deviation of the continuously compounded rates of return on the share over a specified period. That is the same as the standard deviation of the differences in the natural logarithms of the stock prices plus dividends, if any, over the period.

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The risk-free interest rate assumption that is used in valuing an option on its own shares.

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