CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Cash Flows from Operating Activities:
Net (loss) income	$ (98,583)	$ (382,342)	$ 113,273
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	40,059	39,559	34,589
Provision for doubtful accounts	21,728	13,708	19,214
Non-cash compensation	7,217	8,292	10,634
401(k) employer match	10,013	7,550	22,762
Loss on disposal of property and equipment	1,471	2,440	3,236
Deferred income taxes	(31,161)	(122,402)	25,927
Write off of deferred debt issuance costs	573
Equity in earnings of equity investments	(1,695)	(1,494)	(3,016)
Amortization of deferred debt issuance costs	1,442	1,576	1,576
Return on equity investment	1,575	1,638	1,765
Goodwill and other intangibles impairment charge	162,103	579,955
Changes in operating assets and liabilities, net of impact of acquisitions:
Patient accounts receivable	(42,840)	(6,526)	(10,494)
Other current assets	10,622	(2,033)	1,981
Other assets	(927)	(258)	(2,387)
Accounts payable	8,072	(1,521)	4,606
Accrued expenses	(19,994)	5,049	(17,813)
Other long-term obligations	(181)	(1,981)	420
Net cash provided by operating activities	69,494	141,210	206,273
Cash Flows from Investing Activities:
Proceeds from sale of deferred compensation plan assets	312	985	2,592
Proceeds from the sale of property and equipment	631		49
Purchases of deferred compensation plan assets	(175)	(545)	(1,089)
Purchases of property and equipment	(48,262)	(44,415)	(63,971)
Purchase of investment		(4,500)	(5,000)
Acquisitions of businesses, net of cash acquired	(12,499)	(132,235)	(3,821)
Acquisitions of reacquired franchise rights			(2,376)
Net cash used in investing activities	(59,993)	(180,710)	(73,616)
Cash Flows from Financing Activities:
Proceeds from issuance of stock upon exercise of stock options and warrants	156	245	1,501
Proceeds from issuance of stock to employee stock purchase plan	3,913	5,149	6,204
Tax benefit from stock option exercises			2,386
Non-controlling interest distribution	(323)	(700)	(304)
Proceeds from issuance of long-term obligations	60,000
Payment of deferred financing fees	(2,265)
Purchase of company stock			(11,796)
Principal payments of long-term obligations	(104,441)	(37,485)	(44,838)
Net cash used in financing activities	(42,960)	(32,791)	(46,847)
Net (decrease) increase in cash and cash equivalents	(33,459)	(72,291)	85,810
Cash and cash equivalents at beginning of period	48,004	120,295	34,485
Cash and cash equivalents at end of period	14,545	48,004	120,295
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest	7,779	7,340	8,339
Cash paid for income taxes, net of refunds received	2,945	11,655	50,765
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	2,214		10,801
Acquired non-controlling interests	$ 15,931		$ 300