Condensed Consolidated Statements Of Cash Flows (USD $) In Thousands	9 Months Ended
	Sep. 30, 2011	Sep. 30, 2010
Cash Flows from Operating Activities:
Net (loss) income	$ (386,662)	$ 91,004
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	28,907	25,297
Provision for doubtful accounts	9,918	14,069
Non-cash compensation	8,265	8,317
401(k) employer match	5,845	17,536
Loss on disposal of property and equipment	1,796	2,314
Deferred income taxes	(133,623)	300
Equity in earnings of unconsolidated joint ventures	(1,114)	(2,310)
Amortization of deferred debt issuance costs	1,182	1,182
Return on equity investment	1,088	1,390
Goodwill and other intangibles impairment charge	574,114
Changes in operating assets and liabilities, net of impact of acquisitions:
Patient accounts receivable	(5,883)	(250)
Other current assets	8,960	16,251
Other assets	(4,304)	(2,181)
Accounts payable	814	3,195
Accrued expenses	(1,475)	(4,057)
Other long-term obligations	(3,535)	551
Net cash provided by operating activities	104,293	172,608
Cash Flows from Investing Activities:
Proceeds from sale of deferred compensation plan assets	859	2,425
Purchases of deferred compensation plan assets	(472)	(1,053)
Purchases of property and equipment	(38,573)	(37,535)
Purchase of investment	(4,500)
Acquisitions of businesses, net of cash acquired	(125,977)	(3,121)
Acquisitions of reacquired franchise rights		(2,376)
Net cash used in investing activities	(168,663)	(41,660)
Cash Flows from Financing Activities:
Proceeds from issuance of stock upon exercise of stock options and warrants	245	1,494
Proceeds from issuance of stock to employee stock purchase plan	3,961	4,690
Tax benefit from stock option exercises	(427)	2,427
Non-controlling interest distribution	(568)	(185)
Purchase of company stock		(11,796)
Principal payments of long-term obligations	(29,674)	(34,026)
Net cash used in financing activities	(26,463)	(37,396)
Net (decrease) increase in cash and cash equivalents	(90,833)	93,552
Cash and cash equivalents at beginning of period	120,295	34,485
Cash and cash equivalents at end of period	29,462	128,037
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest	7,094	7,949
Cash paid for income taxes, net of refunds received	11,273	49,870
Supplemental Disclosures of Non-Cash Financing and Investing Activities:
Notes payable issued for/assumed in acquisitions	1,058	750
Notes payable issued for software licenses		$ 10,801