| Income Tax Disclosure [Abstract] | Period [Axis] |
|---|
2015-01-01 - 2015-12-31 |
|---|
Income Tax Disclosure [Abstract] | |
Schedule Of Total Income Tax Expense | Total income taxes expense (benefit) for the years ended December 31, 2015, 2014 and 2013 was included within the following sections of the consolidated financial statements as follows (in thousands):
| | | | | | | | | | | | | | 2015 | | 2014 | | 2013 | Earnings from continuing operations | $ | 113,790 |
| | $ | 48,103 |
| | $ | 48,654 |
| Discontinued operations | (694 | ) | | (643 | ) | | 9 |
| Shareholders’ equity | (2,227 | ) | | (3,177 | ) | | (7,381 | ) | Total | $ | 110,869 |
| | $ | 44,283 |
| | $ | 41,282 |
|
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Schedule of Components of Income Tax Expense (Benefit) | Income tax expense from continuing operations for the years ended December 31, 2015, 2014 and 2013 was comprised of the following (in thousands): | | | | | | | | | | | | | | 2015 | | 2014 | | 2013 | Current: | | | | | | Federal | $ | 83,228 |
| | $ | 8,640 |
| | $ | 7,895 |
| State | 14,268 |
| | 4,396 |
| | 3,598 |
| Deferred: | |
| | |
| | |
| Federal | 11,715 |
| | 27,505 |
| | 31,509 |
| State | 4,579 |
| | 7,562 |
| | 5,652 |
| Income tax expense | $ | 113,790 |
| | $ | 48,103 |
| | $ | 48,654 |
|
|
Schedule of Effective Income Tax Rate Reconciliation | Income tax expense from continuing operations for the years ended December 31, 2015, 2014 and 2013 differed from the amount computed by applying the U.S. federal income tax rate of 35% to earnings before income taxes as a result of the following (in thousands): | | | | | | | | | | | | | | 2015 | | 2014 | | 2013 | Statutory federal income tax | $ | 173,572 |
| | $ | 102,967 |
| | $ | 106,101 |
| Less federal income tax assumed directly by noncontrolling interests | (76,364 | ) | | (66,783 | ) | | (64,219 | ) | State income taxes, net of federal income tax benefit | 11,604 |
| | 6,616 |
| | 5,539 |
| Increase in valuation allowances | 317 |
| | 4,662 |
| | 924 |
| Interest related to unrecognized tax benefits | (548 | ) | | (161 | ) | | (155 | ) | Other | 5,209 |
| | 802 |
| | 464 |
| Income tax expense | $ | 113,790 |
| | $ | 48,103 |
| | $ | 48,654 |
|
|
Summary of Income Tax Contingencies | A reconciliation of the beginning and ending amount of the liability associated with unrecognized tax benefits for the years ended December 31, 2015, 2014 and 2013 is as follows (in thousands): | | | | | | | | | | | | | | 2015 | | 2014 | | 2013 | Balance at beginning of year | $ | 7,336 |
| | $ | 6,330 |
| | $ | 9,235 |
| Additions for tax positions of current year | — |
| | 204 |
| | 46 |
| Increases (decreases) for tax positions taken during a prior period | (1,006 | ) | | 1,069 |
| | — |
| Lapse of statute of limitations | (3,178 | ) | | (267 | ) | | (2,951 | ) | Balance at end of year | $ | 3,152 |
| | $ | 7,336 |
| | $ | 6,330 |
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Schedule of Deferred Tax Assets and Liabilities | The tax effects of temporary differences that give rise to significant portions of the deferred tax assets and deferred tax liabilities at December 31, 2015 and 2014 were as follows (in thousands): | | | | | | | | | | 2015 | | 2014 | Deferred tax assets: | | | |
| Allowance for uncollectible accounts | $ | 3,276 |
| | $ | 1,096 |
| Accrued assets and other | 36,600 |
| | 27,537 |
| Share-based compensation | 10,710 |
| | 7,719 |
| Interest on unrecognized tax benefits | 113 |
| | 245 |
| Accrued liabilities and other | 4,080 |
| | 3,931 |
| Medical malpractice | 19,035 |
| | 16,240 |
| Operating and capital loss carryforwards | 29,718 |
| | 22,709 |
| Valuation allowances | (21,814 | ) | | (17,457 | ) | Total deferred tax assets | 81,718 |
|
| 62,020 |
| Deferred tax liabilities: | | | | Prepaid expenses | 1,789 |
| | 2,435 |
| Property and equipment, principally due to differences in depreciation | 16,787 |
| | 15,235 |
| Goodwill, intangible assets and other, principally due to differences in amortization | 762,640 |
| | 655,358 |
| Total deferred tax liabilities | 781,216 |
| | 673,028 |
| Net deferred tax liabilities | $ | 699,498 |
| | $ | 611,008 |
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