Condensed Consolidated Statements of Cash Flows (Unaudited) (USD $) In Thousands, unless otherwise specified	9 Months Ended
	Sep. 30, 2012	Sep. 30, 2011
Cash flows from operating activities
Net income	$ 260,177	$ 224,503
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	536,362	485,917
Stock-based compensation expense	30,708	31,588
Loss on sale, net		3,300
Impairment of hospitals sold		47,930
Loss from early extinguishment of debt	115,453
Excess tax benefit relating to stock-based compensation	(1,545)	(4,616)
Other non-cash expenses, net	22,482	14,279
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures:
Patient accounts receivable	(227,814)	(90,805)
Supplies, prepaid expenses and other current assets	(68,247)	(31,455)
Accounts payable, accrued liabilities and income taxes	103,156	146,166
Other	7,133	(6,572)
Net cash provided by operating activities	777,865	820,235
Cash flows from investing activities
Acquisitions of facilities and other related equipment	(312,927)	(209,451)
Purchases of property and equipment	(557,469)	(532,845)
Proceeds from disposition of hospitals and other ancillary operations		172,578
Proceeds from sale of property and equipment	4,808	9,251
Increase in other investments	(222,164)	(130,980)
Net cash used in investing activities	(1,087,752)	(691,447)
Cash flows from financing activities
Proceeds from exercise of stock options	5,750	18,880
Repurchase of restricted stock shares for payroll tax withholding requirements	(9,165)
Deferred financing costs	(135,647)	(100)
Excess tax benefit relating to stock-based compensation	1,545	4,616
Stock buy-back		(85,790)
Proceeds from noncontrolling investors in joint ventures	535	1,229
Redemption of noncontrolling investments in joint ventures	(39,709)	(4,784)
Distributions to noncontrolling investors in joint ventures	(60,676)	(49,928)
Borrowings under credit agreements	5,924,377	83,000
Issuance of long-term debt	3,825,000
Proceeds from receivables facility	300,000
Repayments of long-term indebtedness	(9,391,338)	(128,768)
Net cash provided by (used in) financing activities	420,672	(161,645)
Net change in cash and cash equivalents	110,785	(32,857)
Cash and cash equivalents at beginning of period	129,865	299,169
Cash and cash equivalents at end of period	240,650	266,312
Supplemental disclosure of cash flow information:
Interest payments	461,604	548,359
Income tax paid (refunds received), net	$ 55,404	$ (2,708)