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General (Details 3) (USD $)
In Thousands, unless otherwise specified
3 Months Ended
Mar. 31, 2013
Mar. 31, 2012
Concentration of Business    
Net revenue $ 821,761 $ 773,213
Minimum
   
Concentration of Business    
Term of Contract 1 year  
Term of renewed contract 1 year  
Notice period for termination of contract 60 days  
Maximum
   
Concentration of Business    
Term of Contract 3 years  
Term of renewed contract 2 years  
Notice period for termination of contract 180 days  
Pennsylvania Counties
   
Concentration of Business    
Net revenue 86,700 92,300
Florida Areas
   
Concentration of Business    
Net revenue $ 33,300 $ 34,100