Schedule II - Valuation of Qualifying Accounts (Details) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013		Dec. 31, 2012		Dec. 31, 2011
Allowance for doubtful accounts
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	$ 3,143		$ 2,233		$ 2,277
Charged to Costs and Expenses	4,191		3,064		1,780
Charged to Other Accounts	0		0		0
Other	0		0		0
(Write-offs) net of Recoveries	(3,335)		(2,154)		(1,824)
Balance at End of Period	3,999		3,143		2,233
Professional Liability Reserve
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	22,740		19,357		17,251
Charged to Costs and Expenses	6,530		5,617		3,069
Charged to Other Accounts	3,163	[1]	448	[1]	2,848	[1]
Other	0		0		0
Payments	(5,366)	[2]	(2,682)	[2]	(3,811)	[2]
Balance at End of Period	27,067		22,740		19,357
Workers Compensation Reserve
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	287		309		346
Charged to Costs and Expenses	473		142		1,323
Charged to Other Accounts	0	[1]	0	[1]	0	[1]
Other	(87)		311		(257)
Payments	(497)	[2]	(475)	[2]	(1,103)	[2]
Balance at End of Period	176		287		309
Health Insurance Reserve
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	679		853		1,003
Charged to Costs and Expenses	9,095		7,207		7,247
Charged to Other Accounts	105	[1]	0	[1]	0	[1]
Other	0		0		0
Payments	(9,036)	[2]	(7,381)	[2]	(7,397)	[2]
Balance at End of Period	$ 843		$ 679		$ 853

[1] As discussed in Note 4 of the Consolidated Financial Statements, the Company has presented the results of certain divestiture and lease termination transactions as discontinued operations. The amounts charged to Other Accounts represent the amounts charged to discontinued operations.

[2] Payments for the Professional Liability Reserve include amounts paid for claims settled during the period as well as payments made under structured arrangements for claims settled in earlier periods.