General (Details 3) (USD $) In Thousands, unless otherwise specified	3 Months Ended		6 Months Ended
	Jun. 30, 2012	Jun. 30, 2011	Jun. 30, 2012	Jun. 30, 2011
Concentration of Business
Net revenue	$ 805,473	$ 698,338	$ 1,578,686	$ 1,391,093
Minimum
Concentration of Business
Term of Contract (in years)			1
Term of renewed contract (in years)			1
Notice period for termination of contract (in days)			60
Maximum
Concentration of Business
Term of Contract (in years)			3
Term of renewed contract (in years)			2
Notice period for termination of contract (in days)			180
Pennsylvania Counties
Concentration of Business
Net revenue			182,400	178,200
Florida Areas
Concentration of Business
Net revenue			$ 67,700	$ 67,200