Condensed Consolidated Statements of Cash Flows (Unaudited) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2012	Mar. 31, 2011
Cash flows from operating activities
Net income	$ 99,252	$ 78,325
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	174,354	161,318
Stock-based compensation expense	10,495	9,918
Loss on sale, net		3,234
Impairment of hospitals sold		8,368
Loss from early extinguishment of debt	63,429
Excess tax benefit relating to stock-based compensation	(1,004)	(4,675)
Other non-cash expenses, net	2,569	(11,173)
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:
Patient accounts receivable	(163,484)	(56,454)
Supplies, prepaid expenses and other current assets	(125,111)	14,336
Accounts payable, accrued liabilities and income taxes	96,109	(14,938)
Other	30,701	(748)
Net cash provided by operating activities	187,310	187,511
Cash flows from investing activities
Acquisitions of facilities and other related equipment	(248,436)	(45,422)
Purchases of property and equipment	(184,903)	(153,875)
Proceeds from disposition of ancillary operations		14,583
Proceeds from sale of property and equipment	748	7,587
Increase in other investments	(67,708)	(32,277)
Net cash used in investing activities	(500,299)	(209,404)
Cash flows from financing activities
Proceeds from exercise of stock options	308	18,125
Repurchase of restricted stock shares for payroll tax withholding requirements	(9,032)
Deferred financing costs	(24,787)
Excess tax benefit relating to stock-based compensation	1,004	4,675
Proceeds from noncontrolling investors in joint ventures	0	863
Redemption of noncontrolling investments in joint ventures	(31,096)	(225)
Distributions to noncontrolling investors in joint ventures	(27,038)	(15,333)
Borrowings under credit agreements	4,315,011
Issuance of long-term debt	1,025,000
Proceeds from receivables facility	300,000
Repayments of long-term indebtedness	(5,236,948)	(14,665)
Net cash provided by (used in) financing activities	312,422	(6,560)
Net change in cash and cash equivalents	(567)	(28,453)
Cash and cash equivalents at beginning of period	129,865	299,169
Cash and cash equivalents at end of period	129,298	270,716
Supplemental disclosure of cash flow information:
Interest payments	161,140	226,124
Income tax refunds received, net	$ (61)	$ (677)