United Surgical Partners International (USPI) 10-Q 6 Nov 14 2014 Q3 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	9 Months Ended
	Sep. 30, 2014	Nov. 06, 2014
Document And Entity Information [Abstract]	'	'
Document Type	'10-Q	'
Amendment Flag	'false	'
Document Period End Date	30-Sep-14	'
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q3	'
Entity Registrant Name	'UNITED SURGICAL PARTNERS INTERNATIONAL INC	'
Entity Central Index Key	'0001101723	'
Current Fiscal Year End Date	'--12-31	'
Entity Filer Category	'Non-accelerated Filer	'
Entity Common Stock, Shares Outstanding	'	100

Consolidated_Balance_Sheets

Consolidated Balance Sheets (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
ASSETS	'	'
Cash and cash equivalents	$57,259	$78,741
Available for sale securities (Note 5)	9,230	10,802
Accounts receivable, net of allowance for doubtful accounts of $10,902 and $10,236, respectively	49,667	51,608
Other receivables	24,146	24,191
Inventories of supplies	8,326	9,049
Deferred tax asset, net	22,382	22,333
Prepaids and other current assets	16,483	16,076
Total current assets	187,493	212,800
Property and equipment, net	128,496	132,474
Investments in unconsolidated affiliates	609,481	521,833
Goodwill	1,231,974	1,229,282
Intangible assets, net	367,151	356,119
Other assets	32,459	28,176
Total assets	2,557,054	2,480,684
LIABILITIES AND EQUITY	'	'
Accounts payable	18,588	17,407
Accrued salaries and benefits	29,696	28,932
Due to affiliates	166,279	184,961
Accrued interest	19,966	10,034
Current portion of long-term debt	18,940	18,916
Other current liabilities	57,314	54,949
Total current liabilities	310,783	315,199
Long-term debt, less current portion	1,481,701	1,454,692
Other long-term liabilities	36,304	36,030
Deferred tax liability, net	193,999	181,543
Total liabilities	2,022,787	1,987,464
Noncontrolling interests - redeemable (Note 3)	179,439	166,578
Commitments and contingencies (Note 8)	'	'
United Surgical Partners International, Inc. (USPI) stockholder's equity:	'	'
Common stock, $0.01 par value; 100 shares authorized; issued and outstanding	'	'
Additional paid-in capital	218,507	228,794
Accumulated other comprehensive income	7	10
Retained earnings	87,873	50,818
Total USPI stockholder's equity	306,387	279,622
Noncontrolling interests - non-redeemable (Note 3)	48,441	47,020
Total equity	354,828	326,642
Total liabilities and equity	$2,557,054	$2,480,684

Consolidated_Balance_Sheets_Pa

Consolidated Balance Sheets (Parenthetical) (USD $)	Sep. 30, 2014	Dec. 31, 2013
In Thousands, except Share data, unless otherwise specified
Statement of Financial Position [Abstract]	'	'
Allowance for doubtful accounts receivable	$10,902	$10,236
Common stock, par value	$0.01	$0.01
Common stock, shares authorized	100	100
Common stock, shares issued	100	100
Common stock, shares outstanding	100	100

Consolidated_Statements_of_Inc

Consolidated Statements of Income (Unaudited) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Revenues:	'	'	'	'
Net patient service revenues	$132,040	$126,683	$388,443	$378,203
Management and contract service revenues	24,617	21,864	70,039	64,741
Other revenues	2,533	2,462	7,625	8,408
Total revenues	159,190	151,009	466,107	451,352
Equity in earnings of unconsolidated affiliates	27,527	20,923	73,599	63,759
Operating expenses:	'	'	'	'
Salaries, benefits, and other employee costs	44,383	40,991	129,878	120,425
Medical services and supplies	27,051	24,945	78,248	72,831
Other operating expenses	28,251	24,722	83,487	75,691
General and administrative expenses	11,718	10,396	34,958	30,793
Provision for doubtful accounts	2,918	1,599	7,526	7,781
Net loss (gain) on deconsolidations, disposals and impairments	1,419	-506	2,336	4,893
Depreciation and amortization	6,608	6,683	19,616	20,758
Total operating expenses	122,348	108,830	356,049	333,172
Operating income	64,369	63,102	183,657	181,939
Interest income	385	322	1,235	1,062
Interest expense	-24,082	-24,032	-71,325	-77,288
Loss on early retirement of debt	'	'	'	-5,536
Other, net	-55	1	-80	-3
Total other expense, net	-23,752	-23,709	-70,170	-81,765
Income before income taxes	40,617	39,393	113,487	100,174
Income tax expense	-8,623	-7,462	-21,997	-17,903
Income from continuing operations	'	'	91,490	82,271
Discontinued operations, net of tax:	'	'	'	'
Loss on disposal of discontinued operations	'	'	-332	'
Net income	31,994	31,931	91,158	82,271
Less: Net income attributable to noncontrolling interests	-18,518	-20,009	-53,951	-55,338
Net income attributable to USPI's common stockholder	13,476	11,922	37,207	26,933
Amounts attributable to USPI's common stockholder:	'	'	'	'
Income from continuing operations, net of tax	'	'	37,539	26,933
Loss from discontinued operations, net of tax	'	'	-332	'
Net income attributable to USPI's common stockholder	$13,476	$11,922	$37,207	$26,933

Consolidated_Statements_of_Com

Consolidated Statements of Comprehensive Income (Unaudited) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Statement of Comprehensive Income [Abstract]	'	'	'	'
Net income	$31,994	$31,931	$91,158	$82,271
Other comprehensive income:	'	'	'	'
Unrealized gain (loss) on available-for-sale securities, net of tax	-14	20	-3	-44
Comprehensive income	31,980	31,951	91,155	82,227
Less: Comprehensive income attributable to noncontrolling interests	-18,518	-20,009	-53,951	-55,338
Comprehensive income attributable to USPI's common stockholder	$13,462	$11,942	$37,204	$26,889

Consolidated_Statement_of_Chan

Consolidated Statement of Changes in Equity (Unaudited) (USD $)	Total	Outstanding Shares [Member]	Par Value [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive Income [Member]	Retained Earnings [Member]	Noncontrolling Interests Non-Redeemable [Member]
In Thousands, except Share data	USD ($)		USD ($)	USD ($)	USD ($)	USD ($)	USD ($)
Beginning Balance at Dec. 31, 2012	$271,987	'	$0	$231,056	$64	$2,595	$38,272
Beginning Balance, Shares at Dec. 31, 2012	'	100	'	'	'	'	'
Distributions to noncontrolling interests	-2,541	'	0	0	0	0	-2,541
Purchases of noncontrolling interests	-215	'	0	-192	0	0	-23
Sales of noncontrolling interests	1,552	'	0	-3,284	0	0	4,836
Contribution related to equity award grants by parent and other	447	'	0	447	0	0	0
Net income	9,360	'	0	0	0	7,586	1,774
Other comprehensive income (loss)	2	'	0	0	2	0	0
Ending Balance at Mar. 31, 2013	280,592	'	0	228,027	66	10,181	42,318
Ending Balance, Shares at Mar. 31, 2013	'	100	'	'	'	'	'
Distributions to noncontrolling interests	-1,925	'	0	0	0	0	-1,925
Purchases of noncontrolling interests	612	'	0	831	0	0	-219
Sales of noncontrolling interests	-2,364	'	0	-2,647	0	0	283
Acquisition of new business	2,179	'	0	0	0	0	2,179
Contribution related to equity award grants by parent and other	296	'	0	296	0	0	0
Payment of common stock dividend	-55	'	0	0	0	-55	0
Net income	9,582	'	0	0	0	7,425	2,157
Other comprehensive income (loss)	-66	'	0	0	-66	0	0
Ending Balance at Jun. 30, 2013	288,851	'	0	226,507	0	17,551	44,793
Ending Balance, Shares at Jun. 30, 2013	'	100	'	'	'	'	'
Distributions to noncontrolling interests	-2,560	'	0	0	0	0	-2,560
Purchases of noncontrolling interests	-405	'	0	752	0	0	-1,157
Sales of noncontrolling interests	-754	'	0	-1,247	0	0	493
Contribution related to equity award grants by parent and other	454	'	0	454	0	0	0
Net income	15,441	'	0	0	0	11,922	3,519
Other comprehensive income (loss)	20	'	0	0	20	0	0
Ending Balance at Sep. 30, 2013	301,047	'	0	226,466	20	29,473	45,088
Ending Balance, Shares at Sep. 30, 2013	'	100	'	'	'	'	'
Beginning Balance at Dec. 31, 2013	326,642	'	0	228,794	10	50,818	47,020
Beginning Balance, Shares at Dec. 31, 2013	'	100	'	'	'	'	'
Distributions to noncontrolling interests	-2,815	'	0	0	0	0	-2,815
Purchases of noncontrolling interests	1,749	'	0	1,769	0	0	-20
Sales of noncontrolling interests	-8,274	'	0	-8,755	0	0	481
Contribution related to equity award grants by parent and other	508	'	0	508	0	0	0
Net income	7,186	'	0	0	0	5,230	1,956
Other comprehensive income (loss)	3	'	0	0	3	0	0
Ending Balance at Mar. 31, 2014	324,999	'	0	222,316	13	56,048	46,622
Ending Balance, Shares at Mar. 31, 2014	'	100	'	'	'	'	'
Distributions to noncontrolling interests	-2,720	'	0	0	0	0	-2,720
Purchases of noncontrolling interests	-5	'	0	41	0	0	-46
Sales of noncontrolling interests	-400	'	0	-870	0	0	470
Contribution related to equity award grants by parent and other	577	'	0	577	0	0	0
Payment of common stock dividend	-152	'	0	0	0	-152	0
Net income	21,498	'	0	0	0	18,501	2,997
Other comprehensive income (loss)	8	'	0	0	8	0	0
Ending Balance at Jun. 30, 2014	343,805	'	0	222,064	21	74,397	47,323
Ending Balance, Shares at Jun. 30, 2014	'	100	'	'	'	'	'
Distributions to noncontrolling interests	-2,592	'	0	0	0	0	-2,592
Purchases of noncontrolling interests	-2	'	0	-2	0	0	0
Sales of noncontrolling interests	-3,264	'	0	-3,916	0	0	652
Contribution related to equity award grants by parent and other	361	'	0	361	0	0	0
Net income	16,534	'	0	0	0	13,476	3,058
Other comprehensive income (loss)	-14	'	0	0	-14	0	0
Ending Balance at Sep. 30, 2014	$354,828	'	$0	$218,507	$7	$87,873	$48,441
Ending Balance, Shares at Sep. 30, 2014	'	100	'	'	'	'	'

Consolidated_Statements_of_Cas

Consolidated Statements of Cash Flows (Unaudited) (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013
Cash flows from operating activities:	'	'
Net income	$91,158	$82,271
Adjustments to reconcile net income to net cash provided by operating activities:	'	'
Loss from discontinued operations	332	0
Loss on early retirement of debt	'	5,536
Provision for doubtful accounts	7,526	7,781
Depreciation and amortization	19,616	20,758
Net loss on deconsolidations, disposals and impairments	2,336	4,893
Amortization of debt issue costs and discount	3,345	3,263
Deferred income tax expense	9,496	1,391
Distributions received from unconsolidated affiliates, net of earnings	16,024	130
Equity-based compensation	1,715	1,353
Increases (decreases) in cash from changes in operating assets and liabilities, net of effects from purchases of new businesses:	'	'
Accounts receivable	-6,226	-1,289
Other receivables	5,756	-6,378
Inventories of supplies, prepaids and other current assets	-1,581	-2,070
Accounts payable and other current liabilities	12,224	9,072
Long-term liabilities	-1,858	1,374
Net cash provided by operating activities	159,863	128,085
Cash flows from investing activities:	'	'
Purchases of new businesses and equity interests, net of cash received	-142,745	-15,279
Proceeds from sale of businesses and equity interests	1,225	9,983
Purchases of property and equipment	-7,876	-17,357
Sales (purchases) of marketable securities, net	1,572	-183
Returns of capital from unconsolidated affiliates	22,000	0
Increase in deposits and notes receivable	-2,005	-700
Net cash used in investing activities	-127,829	-23,536
Cash flows from financing activities:	'	'
Proceeds from long-term debt, net of debt issuance costs	73,596	145,341
Payments on long-term debt	-51,783	-159,162
Decrease in cash held on behalf of unconsolidated affiliates and other	-19,265	-4,194
Purchases of noncontrolling interests, net	-316	-717
Payment of common stock dividend	-152	-55
Distributions to noncontrolling interests	-55,596	-57,421
Net cash used in financing activities	-53,516	-67,820
Net (decrease) increase in cash and cash equivalents	-21,482	36,729
Cash and cash equivalents at beginning of period	78,741	51,203
Cash and cash equivalents at end of period	57,259	87,932
Supplemental information:	'	'
Interest paid	58,408	64,170
Income taxes paid	11,938	17,527
Non-cash transactions:	'	'
Assets acquired under capital lease obligations	$4,863	$854

Basis_of_Presentation

Basis of Presentation	9 Months Ended
	Sep. 30, 2014
Accounting Policies [Abstract]	'
Basis of Presentation	'
	-1	Basis of Presentation
	(a) Description of Business
	United Surgical Partners International, Inc., a Delaware corporation, and subsidiaries (USPI or the Company) was formed in February 1998 for the primary purpose of ownership and management of ambulatory surgery centers, surgical hospitals and related businesses. At September 30, 2014, the Company, headquartered in Dallas, Texas, operated 219 short-stay surgical facilities in the United States. Of these 219 facilities, the Company consolidates the results of 64 and accounts for 155 under the equity method. The majority of the Company’s facilities are jointly owned with local physicians and a health system partner that has other healthcare businesses in the region. At September 30, 2014, the Company had agreements with health system partners providing for joint ownership of 152 of the Company’s 219 facilities and also providing a framework for the planning, construction and acquisition of additional facilities in the future. All but two of the Company’s facilities include physician owners.
	The Company is subject to changes in government legislation that could impact Medicare, Medicaid, and other government reimbursement levels and is also subject to changes in payment systems that may impact the level and timing of payments for services rendered.
	The Company maintains its books and records on the accrual basis of accounting, and the accompanying consolidated financial statements are prepared in accordance with accounting principles generally accepted in the United States of America (GAAP). The accompanying consolidated financial statements and notes should be read in conjunction with the Company’s December 31, 2013 Form 10-K. It is management’s opinion that the accompanying consolidated financial statements reflect all adjustments necessary for a fair presentation of the results for the periods presented. The results of operations for any interim period are not necessarily indicative of results for the full year.
	The preparation of financial statements in conformity with GAAP requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
	The Company operates in one reportable business segment, the ownership and operation of surgery related businesses in the United States.

Investments_in_Unconsolidated_

Investments in Unconsolidated Affiliates and Business Combinations	9 Months Ended
	Sep. 30, 2014
Equity Method Investments and Joint Ventures [Abstract]	'
Investments in Unconsolidated Affiliates and Business Combinations	'
	-2	Investments in Unconsolidated Affiliates and Business Combinations
	The Company acquires interests in existing surgery centers and invests in new facilities that it develops in partnership with health system partners and local physicians. Some of these transactions result in the Company controlling the acquired entity and meet the GAAP definition of a business combination. The financial results of the acquired entities are included in the Company’s consolidated financial statements beginning on the acquisitions’ effective closing date. The adjustments to arrive at pro forma operating results for these acquisitions are not material. During the nine months ended September 30, 2014, these transactions resulted in a cash outflow of approximately $3.0 million, which is summarized as follows:
	Effective Date		Facility Location			Amount
	Investments
	Feb-14			Georgia	(1)	$	2.0 million
	Sep-14			Missouri	(1)		1.0 million
	Total					$	3.0 million
	-1	Acquisition of a controlling interest in and the right to manage a surgical facility in which the Company previously had no involvement. The facility is jointly owned with local physicians.
	The Company controls 64 of its entities and therefore consolidates their results. However, the Company accounts for a majority (155 of its 219 facilities at September 30, 2014) as investments in unconsolidated affiliates, i.e., under the equity method, as the Company’s level of influence is significant but does not reach the threshold of controlling the entity. The majority of these investments are partnerships or limited liability companies, which require the associated tax benefit or expense to be recorded by the partners or members. Summarized financial information for the Company’s equity method investees on a combined basis is as follows (amounts are in thousands, except number of facilities, reflect 100% of the investees’ results on an aggregated basis and are unaudited):
			Three Months						Nine Months
			Ended						Ended
			September 30,						September 30,
			2014			2013			2014			2013
	Unconsolidated facilities operated at period-end			155			149			155			149
	Income statement information:
	Revenues		$	492,673		$	435,665		$	1,379,621		$	1,298,122
	Operating expenses:
	Salaries, benefits, and other employee costs			116,625			107,056			332,684			319,498
	Medical services and supplies			119,420			105,272			336,037			317,661
	Other operating expenses			114,009			103,629			325,000			307,342
	Net gain on asset disposals, net			(362	)		(1,339	)		(6,166	)		(1,800	)
	Depreciation and amortization			18,903			18,315			55,655			54,485
	Total operating expenses			368,595			332,933			1,043,210			997,186
	Operating income			124,078			102,732			336,411			300,936
	Interest expense, net			(7,174	)		(7,776	)		(21,607	)		(23,490	)
	Other, net			(140	)		(283	)		365			(262	)
	Income before income taxes		$	116,764		$	94,673		$	315,169		$	277,184
	Balance sheet information:
	Current assets		$	381,853		$	328,996		$	381,853		$	328,996
	Noncurrent assets			573,388			563,415			573,388			563,415
	Current liabilities			209,010			204,287			209,010			204,287
	Noncurrent liabilities			375,548			377,265			375,548			377,265
	The Company also regularly engages in the purchase and sale of equity interests with respect to its investments in unconsolidated affiliates that do not result in a change of control. These transactions are primarily the acquisitions and sales of equity interests in unconsolidated surgical facilities and the investment of additional cash in unconsolidated affiliates that need capital for acquisitions, new construction or other business growth opportunities. The cash flow impact of these transactions is classified within investing activities. During the nine months ended September 30, 2014, these transactions resulted in a cash outflow of approximately $138.4 million, which is summarized as follows:
	Effective Date		Facility Location			Amount
	Investments
	Mar-14			Indiana	(1)	$	32.3 million
	Apr-14			New Jersey	(1)		16.9 million
	Jun-14			Dallas-Fort Worth	(2)		4.2 million
	Jul-14			South Dakota	(3)		51.4 million
	Jul-14			New Jersey	(1)		26.8 million
	Various			Various	(4)		6.8 million
	Total					$	138.4 million
	-1	Acquisition of a noncontrolling interest in and the right to manage a surgical facility in which the Company previously had no involvement. The facility is jointly owned with local physicians.
	-2	Acquisition of a noncontrolling interest in and the right to manage two surgical facilities in which the Company previously had no involvement. These facilities are jointly owned with a health system partner and local physicians.
	-3	Acquisition of a noncontrolling interest in and the right to manage a surgical facility in which the Company previously had no involvement. The facility is jointly owned with a health system partner and local physicians.
	-4	Represents the net payment related to various other purchases and sales of equity interests and contributions of cash to equity method investees.
	During the nine months ended September 30, 2014, the Company received a return of capital in the amount of $22.0 million from one of its unconsolidated affiliates.

Noncontrolling_Interests

Noncontrolling Interests	9 Months Ended
	Sep. 30, 2014
Noncontrolling Interest [Abstract]	'
Noncontrolling Interests	'
	-3	Noncontrolling Interests
	The Company controls and therefore consolidates the results of 64 of its 219 facilities. Similar to its investments in unconsolidated affiliates, the Company regularly engages in the purchase and sale of equity interests with respect to its consolidated subsidiaries that do not result in a change of control. These transactions are accounted for as equity transactions, as they are undertaken among the Company, its consolidated subsidiaries, and noncontrolling interests. Their cash flow effect is classified within financing activities.
	During the nine months ended September 30, 2014, the Company purchased and sold redeemable equity interests in various consolidated subsidiaries in amounts totaling $4.4 million and $4.1 million, respectively. The basis difference between the Company’s carrying amount and the proceeds received or paid in each transaction is recorded as an adjustment to additional paid-in capital. The impact of these transactions is summarized as follows (in thousands):
			Three Months			Nine Months			Three Months			Nine Months
			Ended			Ended			Ended			Ended
			September 30,			September 30,			September 30,			September 30,
			2014			2014			2013			2013
	Net income attributable to USPI’s common stockholder		$	13,476		$	37,207		$	11,922		$	26,933
	Transfers to the noncontrolling interests:
	Decrease in USPI’s additional paid-in capital for sales of subsidiaries’ equity interests			(3,916	)		(13,541	)		(1,247	)		(7,178	)
	Increase in USPI’s additional paid-in capital for purchases of subsidiaries’ equity interests			(2	)		1,808			752			1,391
	Net transfers to noncontrolling interests			(3,918	)		(11,733	)		(495	)		(5,787	)
	Change in equity from net income attributable to USPI and transfers to noncontrolling interests		$	9,558		$	25,474		$	11,427		$	21,146
	Were certain fundamental regulatory changes to occur, the Company could be obligated, under the terms of its investees’ partnership and operating agreements, to purchase some or all of the noncontrolling interests related to the Company’s consolidated subsidiaries. These repurchase requirements are limited to the portions of its facilities that are owned by physicians who perform surgery at the Company’s facilities and would be triggered by regulatory changes making the existing ownership structure illegal. While the Company is not aware of events that would make the occurrence of such a change probable, regulatory changes are outside the control of the Company. Accordingly, the noncontrolling interests subject to these repurchase provisions have been classified outside of equity and are carried as “noncontrolling interests — redeemable” on the Company’s consolidated balance sheets. The activity for the three and nine months ended September 30, 2014 and 2013 is summarized below (in thousands):
			2014
			Noncontrolling
			Interests —
			Redeemable
	Balance, December 31, 2013		$	166,578
	Net income attributable to noncontrolling interests			13,457
	Distributions to noncontrolling interests			(15,821	)
	Purchases of noncontrolling interests			(3,776	)
	Sales of noncontrolling interests			9,791
	Acquisition of new business			1,542
	Balance, March 31, 2014			171,771
	Net income attributable to noncontrolling interests			17,023
	Distributions to noncontrolling interests			(15,476	)
	Purchases of noncontrolling interests			(1,150	)
	Sales of noncontrolling interests			1,508
	Deconsolidation of subsidiary			(172	)
	Balance, June 30, 2014			173,504
	Net income attributable to noncontrolling interests			15,460
	Distributions to noncontrolling interests			(16,172	)
	Purchases of noncontrolling interests			(1,226	)
	Sales of noncontrolling interests			6,102
	Acquisition of new business			1,771
	Balance, September 30, 2014		$	179,439
			2013
			Noncontrolling
			Interests —
			Redeemable
	Balance, December 31, 2012		$	153,399
	Net income attributable to noncontrolling interests			15,466
	Distributions to noncontrolling interests			(16,993	)
	Purchases of noncontrolling interests			(270	)
	Sales of noncontrolling interests			4,246
	Balance, March 31, 2013			155,848
	Net income attributable to noncontrolling interests			15,933
	Distributions to noncontrolling interests			(16,648	)
	Purchases of noncontrolling interests			(3,686	)
	Sales of noncontrolling interests			4,777
	Acquisition of new business			6,111
	Balance, June 30, 2013			162,335
	Net income attributable to noncontrolling interests			16,489
	Distributions to noncontrolling interests			(16,754	)
	Purchases of noncontrolling interests			(1,429	)
	Sales of noncontrolling interests			1,631
	Balance, September 30, 2013		$	162,272

Other_Investments

Other Investments	9 Months Ended
	Sep. 30, 2014
Accounting Policies [Abstract]	'
Other Investments	'
	-4	Other Investments
	The consolidated financial statements include the financial statements of USPI and subsidiaries the Company controls, usually indicated by majority ownership. The Company also determines if it is the primary beneficiary of (and therefore should consolidate) any entity whose operations it does not control with voting rights.
	The Company is the primary beneficiary of an entity that operates and manages ten surgical facilities in the Houston, Texas area. Despite not holding a majority voting interest, the Company is the primary beneficiary because the Company is able to make the decisions that are most significant to the operations of the entity and has provided all of the funding for the entity, which the entity has used to acquire surgical facilities. The Company is entitled to a majority of the entity’s earnings until the Company has received a specified return on the investment. The Company has no exposure for the entity’s losses beyond this investment. Accordingly, the Company did not provide any financial or other support to the entity that it was not previously contractually required to provide during the nine months ended September 30, 2014 or 2013. At September 30, 2014 and 2013, the total assets of this entity were $125.9 million and $101.5 million, and the total liabilities owed to third parties were $23.7 million and $23.6 million, respectively. Such amounts are included in the accompanying consolidated balance sheet.

Fair_Value_of_Financial_Instru

Fair Value of Financial Instruments	9 Months Ended
	Sep. 30, 2014
Fair Value Disclosures [Abstract]	'
Fair Value of Financial Instruments	'
	-5	Fair Value of Financial Instruments
	The fair value of a financial instrument is the amount at which the instrument could be exchanged in an orderly transaction between market participants to sell the asset or transfer the liability. The Company uses fair value measurements based on quoted prices in active markets for identical assets or liabilities (Level 1), significant other observable inputs (Level 2) or unobservable inputs for assets or liabilities (Level 3), depending on the nature of the item being valued. The estimated fair values may not be representative of actual values that will be realized or settled in the future.
	The carrying amounts of cash and cash equivalents, accounts receivable, and accounts payable approximate fair value because of the short maturity of these instruments.
	The fair value of the Company’s long-term debt is determined by either (i) estimation of the discounted future cash flows of the debt at rates currently quoted or offered to the Company for similar debt instruments of comparable maturities by its lenders, or (ii) quoted market prices at the reporting date for the traded debt securities. At both September 30, 2014 and 2013, both the aggregate carrying amount and the estimated fair value of long-term debt was approximately $1.5 billion. The fair value of debt is classified within Level 2 of the valuation hierarchy.
	At September 30, 2014 and 2013, the Company had approximately $9.2 million and $10.7 million, respectively, of marketable securities, which are held by the Company’s wholly-owned insurance subsidiary. These investments are used in connection with its retained professional and general liability risks and are not available for general corporate purposes. The marketable securities consist of U.S. Treasury and corporate debt, are classified as available-for-sale and are recorded at fair value on the consolidated balance sheet. The fair value of these securities are classified within Level 2 of the valuation hierarchy, and are based on closing market prices of the investments when applicable, or alternatively, valuations utilizing market data and other observable inputs. Realized gains and losses on the sale of these securities are reclassified out of other comprehensive income and into “Other, net” on the accompanying consolidated statements of income.

Equitybased_Compensation

Equity-based Compensation	9 Months Ended
	Sep. 30, 2014
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]	'
Equity-based Compensation	'
	-6	Equity-based Compensation
	The Company accounts for equity-based compensation, such as stock options and other stock-based awards to employees and directors, at fair value. The fair value of the compensation is measured at the date of grant and recognized as expense over the recipient’s requisite service period.
	The Company’s equity-based compensation consists primarily of stock options and restricted stock granted by the Company’s parent, USPI Group Holdings, Inc., to certain employees and members of the board of directors. The fair value of stock options was estimated at the date of grant using the Black-Scholes formula based on assumptions derived from historical experience.
	Total equity-based compensation, included in the accompanying consolidated statements of income, classified by line item, is as follows (in thousands):
			Three Months			Nine Months			Three Months			Nine Months
			Ended			Ended			Ended			Ended
			September 30,			September 30,			September 30,			September 30,
			2014			2014			2013			2013
	Salaries, benefits and other employee costs		$	219		$	504		$	148		$	373
	General and administrative expenses			413			1,211			306			980
	Expense before income tax benefit			632			1,715			454			1,353
	Income tax benefit			(210	)		(570	)		(25	)		(109	)
	Total equity-based compensation expense, net of tax		$	422		$	1,145		$	429		$	1,244
	Total equity-based compensation, included in the accompanying consolidated statements of income, classified by type of award, is as follows (in thousands):
			Three Months			Nine Months			Three Months			Nine Months
			Ended			Ended			Ended			Ended
			September 30,			September 30,			September 30,			September 30,
			2014			2014			2013			2013
	Share awards		$	129		$	455		$	98		$	390
	Stock options			503			1,260			356			963
	Expense before income tax benefit			632			1,715			454			1,353
	Income tax benefit			(210	)		(570	)		(25	)		(109	)
	Total equity-based compensation expense, net of tax		$	422		$	1,145		$	429		$	1,244

Related_Party_Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2014
Related Party Transactions [Abstract]	'
Related Party Transactions	'
	-7	Related Party Transactions
	Included in general and administrative expenses are management fees payable to an affiliate of Welsh Carson, which holds a controlling interest in the Company, in the amount of $0.5 million and $1.5 million in both the three months and nine months ended September 30, 2014 and 2013, respectively. Such amounts accrue at an annual rate of $2.0 million. The Company pays $1.0 million in cash per year with the unpaid balance due and payable upon a change in control. At September 30, 2014, the Company had approximately $8.0 million accrued related to such management fee, of which $0.5 million is included in other current liabilities and $7.5 million is included in other long-term liabilities in the accompanying consolidated balance sheet.

Commitments_and_Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2014
Commitments and Contingencies Disclosure [Abstract]	'
Commitments and Contingencies	'
	-8	Commitments and Contingencies
	As of September 30, 2014, the Company had issued guarantees of the indebtedness and other obligations of its investees to third parties, which could potentially require the Company to make maximum aggregate payments totaling approximately $65.2 million. Of the total, $10.2 million relates to the obligations of consolidated subsidiaries, whose obligations are included in the Company’s consolidated balance sheet and related disclosures, and $52.1 million of the remaining $55.0 million relates to the obligations of unconsolidated affiliated companies, whose obligations are not included in the Company’s consolidated balance sheet and related disclosures. The remaining $2.9 million represents guarantees of the obligations of two facilities which have been sold. The Company has full recourse to the buyers with respect to these amounts.
	The Company has recorded long-term liabilities of approximately $0.6 million related to the guarantees the Company has issued to unconsolidated affiliates on or after January 1, 2003, and has not recorded any liabilities related to guarantees issued prior to that date. Generally, these arrangements (a) consist of guarantees of real estate and equipment financing, (b) are secured by the related property and equipment, (c) require payments by the Company, when the collateral is insufficient, in the event of a default by the investee primarily obligated under the financing, (d) expire as the underlying debt matures at various dates through 2030, and (e) provide no recourse for the Company to recover any amounts from third parties. The Company also has $1.6 million of letters of credit outstanding.

Subsequent_Events

Subsequent Events	9 Months Ended
	Sep. 30, 2014
Subsequent Events [Abstract]	'
Subsequent Events	'
	-9	Subsequent Events
	In October 2014, the Company paid $10.3 million for a noncontrolling interest in and the right to manage a surgical facility in which the Company previously had no involvement. The facility is located in California and is jointly owned with a health system partner and local physicians.
	The Company also has entered into letters of intent with various entities regarding possible acquisition, joint venture, development or other transactions. These possible acquisitions, joint ventures, developments of new facilities or other transactions are in various stages of negotiation.

Condensed_Consolidating_Financ

Condensed Consolidating Financial Statements	9 Months Ended
	Sep. 30, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]	'
Condensed Consolidating Financial Statements	'
	-10	Condensed Consolidating Financial Statements
	The following information is presented as required by regulations of the U.S. Securities and Exchange Commission (SEC). None of this information is routinely prepared for use by management. The operating and investing activities of the separate legal entities included in the consolidated financial statements are fully interdependent and integrated. Accordingly, the operating results of the separate legal entities are not representative of what the operating results would be on a stand-alone basis. Revenues and operating expenses of the separate legal entities include intercompany charges for management and other services.
	The Company’s $440.0 million of 9.0% senior unsecured notes due in April 2020 (Notes) were issued in a private offering on April 3, 2012 and were subsequently registered as publicly traded securities through a Form S-4 declared effective by the SEC on September 5, 2012. The exchange offer was completed in October 2012. The Notes are unsecured obligations of the Company; however, the Notes are guaranteed by most of the Company’s direct and indirect 100%-owned domestic subsidiaries. USPI, which issued the Notes, does not have independent assets or operations. USPI’s investees in which USPI owns less than 100% are not guarantors of the obligation. The financial positions and results of operations (below, in thousands) of the respective guarantors are based upon the guarantor relationship at the end of the period presented. Consolidation adjustments include purchase accounting entries for investments in which the Company’s ownership percentage in non-participating investees is not high enough to permit the application of pushdown accounting.
	Condensed Consolidating Balance Sheets:
	As of September 30, 2014		Guarantors			Non-Participating			Consolidation			Consolidated
						Investees			Adjustments			Total
	ASSETS
	Current assets:
	Cash and cash equivalents		$	47,191		$	10,068		$	—		$	57,259
	Available for sale securities			9,230			—			—			9,230
	Accounts receivable, net			—			49,667			—			49,667
	Other receivables			126,256			29,036			(131,146	)		24,146
	Inventories of supplies			18			8,308			—			8,326
	Prepaids and other current assets			36,734			2,131			—			38,865
	Total current assets			219,429			99,210			(131,146	)		187,493
	Property and equipment, net			37,608			90,688			200			128,496
	Investments in unconsolidated affiliates			1,011,425			79,543			(481,487	)		609,481
	Goodwill and intangible assets, net			961,899			226,833			410,393			1,599,125
	Other assets			33,716			1,628			(2,885	)		32,459
	Total assets		$	2,264,077		$	497,902		$	(204,925	)	$	2,557,054
	LIABILITIES AND EQUITY
	Liabilities and Equity
	Current liabilities:
	Accounts payable		$	3,867		$	14,721		$	—		$	18,588
	Accrued expenses and other			285,051			119,424			(131,220	)		273,255
	Current portion of long-term debt			10,135			9,041			(236	)		18,940
	Total current liabilities			299,053			143,186			(131,456	)		310,783
	Long-term debt, less current portion			1,433,089			51,521			(2,909	)		1,481,701
	Other long-term liabilities			225,548			4,991			(236	)		230,303
	Parent’s equity			306,387			243,557			(243,557	)		306,387
	Noncontrolling interests			—			54,647			173,233			227,880
	Total liabilities and equity		$	2,264,077		$	497,902		$	(204,925	)	$	2,557,054
	As of December 31, 2013		Guarantors			Non-Participating			Consolidation			Consolidated
						Investees			Adjustments			Total
	ASSETS
	Current assets:
	Cash and cash equivalents		$	73,765		$	4,976		$	—		$	78,741
	Available for sale securities			10,802			—			—			10,802
	Accounts receivable, net			—			51,608			—			51,608
	Other receivables			79,664			29,938			(85,411	)		24,191
	Inventories of supplies			1,133			7,916			—			9,049
	Prepaids and other current assets			36,200			2,209			—			38,409
	Total current assets			201,564			96,647			(85,411	)		212,800
	Property and equipment, net			37,935			94,245			294			132,474
	Investments in unconsolidated affiliates			978,305			33,804			(490,276	)		521,833
	Goodwill and intangible assets, net			952,765			217,448			415,188			1,585,401
	Other assets			27,535			1,451			(810	)		28,176
	Total assets		$	2,198,104		$	443,595		$	(161,015	)	$	2,480,684
	LIABILITIES AND EQUITY
	Liabilities and Equity
	Current liabilities:
	Accounts payable		$	3,249		$	14,158		$	—		$	17,407
	Accrued expenses and other			288,914			75,286			(85,324	)		278,876
	Current portion of long-term debt			10,182			9,452			(718	)		18,916
	Total current liabilities			302,345			98,896			(86,042	)		315,199
	Long-term debt, less current portion			1,403,500			51,685			(493	)		1,454,692
	Other long-term liabilities			212,637			5,270			(334	)		217,573
	Parent’s equity			279,622			235,809			(235,809	)		279,622
	Noncontrolling interests			—			51,935			161,663			213,598
	Total liabilities and equity		$	2,198,104		$	443,595		$	(161,015	)	$	2,480,684
	Condensed Consolidating Statements of Income:
	For the Nine Months Ended September 30, 2014		Guarantors			Non-Participating			Consolidation			Consolidated
						Investees			Adjustments			Total
Revenues		$	90,523		$	396,436		$	(20,852	)	$	466,107
Equity in earnings of unconsolidated affiliates			112,303			6,317			(45,021	)		73,599
Operating expenses, excluding depreciation and amortization			73,122			284,065			(20,754	)		336,433
Depreciation and amortization			6,051			13,471			94			19,616
Operating income			123,653			105,217			(45,213	)		183,657
Interest expense, net			(67,437	)		(2,653	)		—			(70,090	)
Other income (expense), net			(29	)		(51	)		—			(80	)
Income from continuing operations before income taxes			56,187			102,513			(45,213	)		113,487
Income tax expense			(18,648	)		(3,349	)		—			(21,997	)
Income from continuing operations			37,539			99,164			(45,213	)		91,490
Loss from discontinued operations, net of tax			(332	)		—			—			(332	)
Net income			37,207			99,164			(45,213	)		91,158
Less: Net income attributable to noncontrolling interests			—			(17,983	)		(35,968	)		(53,951	)
Net income attributable to Parent		$	37,207		$	81,181		$	(81,181	)	$	37,207
For the Nine Months Ended September 30, 2013		Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
Revenues		$	87,455		$	384,075		$	(20,178	)	$	451,352
Equity in earnings of unconsolidated affiliates			108,138			4,881			(49,260	)		63,759
Operating expenses, excluding depreciation and amortization			68,759			263,702			(20,047	)		312,414
Depreciation and amortization			6,941			13,720			97			20,758
Operating income			119,893			111,534			(49,488	)		181,939
Interest expense, net			(72,926	)		(3,300	)		—			(76,226	)
Loss on early retirement of debt			(5,536	)		—			—			(5,536	)
Other income (expense), net			(904	)		901			—			(3	)
Income before income taxes			40,527			109,135			(49,488	)		100,174
Income tax expense			(13,594	)		(4,309	)		—			(17,903	)
Net income			26,933			104,826			(49,488	)		82,271
Less: Net income attributable to noncontrolling interests			—			(14,763	)		(40,575	)		(55,338	)
Net income attributable to Parent		$	26,933		$	90,063		$	(90,063	)	$	26,933
Condensed Consolidating Statements of Comprehensive Income:
For the Nine Months Ended September 30, 2014		Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
Net income		$	37,207		$	99,164		$	(45,213	)	$	91,158
Other comprehensive income:
Unrealized gain on available for sale securities, net of tax			(3	)		—			—			(3	)
Comprehensive income			37,204			99,164			(45,213	)		91,155
Comprehensive income attributable to noncontrolling interests			—			(17,983	)		(35,968	)		(53,951	)
Comprehensive income attributable to Parent		$	37,204		$	81,181		$	(81,181	)	$	37,204
For the Nine Months Ended September 30, 2013		Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
Net income		$	26,933		$	104,826		$	(49,488	)	$	82,271
Other comprehensive income (loss):
Unrealized loss on available for sale securities, net of tax			(44	)		—			—			(44	)
Comprehensive income			26,889			104,826			(49,488	)		82,227
Comprehensive income attributable to noncontrolling interests			—			(14,763	)		(40,575	)		(55,338	)
Comprehensive income attributable to Parent		$	26,889		$	90,063		$	(90,063	)	$	26,889
Condensed Consolidating Statements of Cash Flows:
For the Nine Months Ended September 30, 2014		Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
Cash flows from operating activities:
Net income		$	37,207		$	99,164		$	(45,213	)	$	91,158
Loss on discontinued operations			332			—			—			332
Changes in operating and intercompany assets and liabilities and noncash items included in net income			52,260			12,910			3,203			68,373
Net cash provided by operating activities			89,799			112,074			(42,010	)		159,863
Cash flows from investing activities:
Purchases of property and equipment, net			(2,602	)		(5,274	)		—			(7,876	)
Purchases and sales of new businesses and equity interests, net			(89,836	)		(51,684	)		—			(141,520	)
Other items, net			(31,941	)		1,530			51,978			21,567
Net cash used in investing activities			(124,379	)		(55,428	)		51,978			(127,829	)
Cash flows from financing activities:
Long-term borrowings, net			29,271			(6,235	)		(1,223	)		21,813
Purchases and sales of noncontrolling interests, net			(316	)		—			—			(316	)
Distributions to noncontrolling interests			—			(97,606	)		42,010			(55,596	)
Increase in cash held on behalf of noncontrolling interest holders and other			(20,949	)		52,287			(50,755	)		(19,417	)
Net cash provided by (used in) financing activities			8,006			(51,554	)		(9,968	)		(53,516	)
Net increase (decrease) in cash			(26,574	)		5,092			—			(21,482	)
Cash at the beginning of the period			73,765			4,976			—			78,741
Cash at the end of the period		$	47,191		$	10,068		$	—		$	57,259
For the Nine Months Ended September 30, 2013		Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
Cash flows from operating activities:
Net income		$	26,933		$	104,826		$	(49,488	)	$	82,271
Loss on early retirement of debt			5,536			—			—			5,536
Changes in operating and intercompany assets and liabilities and noncash items included in net income			24,391			14,448			1,439			40,278
Net cash provided by operating activities			56,860			119,274			(48,049	)		128,085
Cash flows from investing activities:
Purchases of property and equipment, net			(11,928	)		(5,429	)		—			(17,357	)
Purchases and sales of new businesses and equity interests, net			1,099			(6,395	)		—			(5,296	)
Other items, net			(6,670	)		1,167			4,620			(883	)
Net cash used in investing activities			(17,499	)		(10,657	)		4,620			(23,536	)
Cash flows from financing activities:
Long-term borrowings, net			(6,256	)		(7,985	)		420			(13,821	)
Purchases and sales of noncontrolling interests, net			(717	)		—			—			(717	)
Distributions to noncontrolling interests			—			(105,470	)		48,049			(57,421	)
Increase in cash held on behalf of noncontrolling interest holders and other			2,973			6,206			(5,040	)		4,139
Net cash used in financing activities			(4,000	)		(107,249	)		43,429			(67,820	)
Net increase in cash			35,361			1,368			—			36,729
Cash at the beginning of the period			42,291			8,912			—			51,203
Cash at the end of the period		$	77,652		$	10,280		$	—		$	87,932

New_Accounting_Pronouncement

New Accounting Pronouncement	9 Months Ended
	Sep. 30, 2014
Accounting Changes and Error Corrections [Abstract]	'
New Accounting Pronouncement	'
	-11	New Accounting Pronouncement
	On May 28, 2014, the Financial Accounting Standards Board issued ASU No. 2014-09, Revenue from Contracts with Customers (ASU), which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. The ASU will replace most existing revenue recognition guidance in U.S. GAAP when it becomes effective. The new standard is effective for the Company on January 1, 2017. Early application is not permitted. The ASU permits the use of either the retrospective or cumulative effect transition method. The Company is evaluating the effect that the ASU will have on its consolidated financial statements and related disclosures. The Company has not yet selected a transition method nor has it determined the effect of the standard on its ongoing financial reporting.

Basis_of_Presentation_Policies

Basis of Presentation (Policies)	9 Months Ended
	Sep. 30, 2014
Accounting Policies [Abstract]	'
Description of Business	'
	(a) Description of Business
	United Surgical Partners International, Inc., a Delaware corporation, and subsidiaries (USPI or the Company) was formed in February 1998 for the primary purpose of ownership and management of ambulatory surgery centers, surgical hospitals and related businesses. At September 30, 2014, the Company, headquartered in Dallas, Texas, operated 219 short-stay surgical facilities in the United States. Of these 219 facilities, the Company consolidates the results of 64 and accounts for 155 under the equity method. The majority of the Company’s facilities are jointly owned with local physicians and a health system partner that has other healthcare businesses in the region. At September 30, 2014, the Company had agreements with health system partners providing for joint ownership of 152 of the Company’s 219 facilities and also providing a framework for the planning, construction and acquisition of additional facilities in the future. All but two of the Company’s facilities include physician owners.
	The Company is subject to changes in government legislation that could impact Medicare, Medicaid, and other government reimbursement levels and is also subject to changes in payment systems that may impact the level and timing of payments for services rendered.
	The Company maintains its books and records on the accrual basis of accounting, and the accompanying consolidated financial statements are prepared in accordance with accounting principles generally accepted in the United States of America (GAAP). The accompanying consolidated financial statements and notes should be read in conjunction with the Company’s December 31, 2013 Form 10-K. It is management’s opinion that the accompanying consolidated financial statements reflect all adjustments necessary for a fair presentation of the results for the periods presented. The results of operations for any interim period are not necessarily indicative of results for the full year.
	The preparation of financial statements in conformity with GAAP requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
	The Company operates in one reportable business segment, the ownership and operation of surgery related businesses in the United States.

Investments_in_Unconsolidated_1

Investments in Unconsolidated Affiliates and Business Combinations (Tables)	9 Months Ended
	Sep. 30, 2014
Equity Method Investments and Joint Ventures [Abstract]	'
Summary of Cash Outflow in Purchase and Sale of Equity Interests	'
	During the nine months ended September 30, 2014, these transactions resulted in a cash outflow of approximately $3.0 million, which is summarized as follows:
	Effective Date		Facility Location			Amount
	Investments
	Feb-14			Georgia	(1)	$	2.0 million
	Sep-14			Missouri	(1)		1.0 million
	Total					$	3.0 million
	-1	Acquisition of a controlling interest in and the right to manage a surgical facility in which the Company previously had no involvement. The facility is jointly owned with local physicians.
Summarized Financial Information for Equity Method Investees	'
	Summarized financial information for the Company’s equity method investees on a combined basis is as follows (amounts are in thousands, except number of facilities, reflect 100% of the investees’ results on an aggregated basis and are unaudited):
			Three Months Ended						Nine Months Ended
			September 30,						September 30,
			2014			2013			2014			2013
	Unconsolidated facilities operated at period-end			155			149			155			149
	Income statement information:
	Revenues		$	492,673		$	435,665		$	1,379,621		$	1,298,122
	Operating expenses:
	Salaries, benefits, and other employee costs			116,625			107,056			332,684			319,498
	Medical services and supplies			119,420			105,272			336,037			317,661
	Other operating expenses			114,009			103,629			325,000			307,342
	Net gain on asset disposals, net			(362	)		(1,339	)		(6,166	)		(1,800	)
	Depreciation and amortization			18,903			18,315			55,655			54,485
	Total operating expenses			368,595			332,933			1,043,210			997,186
	Operating income			124,078			102,732			336,411			300,936
	Interest expense, net			(7,174	)		(7,776	)		(21,607	)		(23,490	)
	Other, net			(140	)		(283	)		365			(262	)
	Income before income taxes		$	116,764		$	94,673		$	315,169		$	277,184
	Balance sheet information:
	Current assets		$	381,853		$	328,996		$	381,853		$	328,996
	Noncurrent assets			573,388			563,415			573,388			563,415
	Current liabilities			209,010			204,287			209,010			204,287
	Noncurrent liabilities			375,548			377,265			375,548			377,265
Summary of Cash Outflow by Acquisitions and Sale of Equity Interests	'
	During the nine months ended September 30, 2014, these transactions resulted in a cash outflow of approximately $138.4 million, which is summarized as follows:
	Effective Date		Facility Location			Amount
	Investments
	Mar-14			Indiana	(1)	$	32.3 million
	Apr-14			New Jersey	(1)		16.9 million
	Jun-14			Dallas-Fort Worth	(2)		4.2 million
	Jul-14			South Dakota	(3)		51.4 million
	Jul-14			New Jersey	(1)		26.8 million
	Various			Various	(4)		6.8 million
	Total					$	138.4 million
	-1	Acquisition of a noncontrolling interest in and the right to manage a surgical facility in which the Company previously had no involvement. The facility is jointly owned with local physicians.
	-2	Acquisition of a noncontrolling interest in and the right to manage two surgical facilities in which the Company previously had no involvement. These facilities are jointly owned with a health system partner and local physicians.
	-3	Acquisition of a noncontrolling interest in and the right to manage a surgical facility in which the Company previously had no involvement. The facility is jointly owned with a health system partner and local physicians.
	-4	Represents the net payment related to various other purchases and sales of equity interests and contributions of cash to equity method investees.

Noncontrolling_Interests_Table

Noncontrolling Interests (Tables)	9 Months Ended
	Sep. 30, 2014
Noncontrolling Interest [Abstract]	'
Schedule of Change in Equity from Net Income (Loss) Attributable to USPI and Transfers to Noncontrolling Interests	'
	The basis difference between the Company’s carrying amount and the proceeds received or paid in each transaction is recorded as an adjustment to additional paid-in capital. The impact of these transactions is summarized as follows (in thousands):
		Three Months			Nine Months			Three Months			Nine Months
		Ended			Ended			Ended			Ended
		September 30,			September 30,			September 30,			September 30,
		2014			2014			2013			2013
	Net income attributable to USPI’s common stockholder	$	13,476		$	37,207		$	11,922		$	26,933
	Transfers to the noncontrolling interests:
	Decrease in USPI’s additional paid-in capital for sales of subsidiaries’ equity interests		(3,916	)		(13,541	)		(1,247	)		(7,178	)
	Increase in USPI’s additional paid-in capital for purchases of subsidiaries’ equity interests		(2	)		1,808			752			1,391
	Net transfers to noncontrolling interests		(3,918	)		(11,733	)		(495	)		(5,787	)
	Change in equity from net income attributable to USPI and transfers to noncontrolling interests	$	9,558		$	25,474		$	11,427		$	21,146
Schedule of Redeemable Noncontrolling Interests	'
	The activity for the three and nine months ended September 30, 2014 and 2013 is summarized below (in thousands):
		2014
		Noncontrolling
		Interests —
		Redeemable
	Balance, December 31, 2013	$	166,578
	Net income attributable to noncontrolling interests		13,457
	Distributions to noncontrolling interests		(15,821	)
	Purchases of noncontrolling interests		(3,776	)
	Sales of noncontrolling interests		9,791
	Acquisition of new business		1,542
	Balance, March 31, 2014		171,771
	Net income attributable to noncontrolling interests		17,023
	Distributions to noncontrolling interests		(15,476	)
	Purchases of noncontrolling interests		(1,150	)
	Sales of noncontrolling interests		1,508
	Deconsolidation of subsidiary		(172	)
	Balance, June 30, 2014		173,504
	Net income attributable to noncontrolling interests		15,460
	Distributions to noncontrolling interests		(16,172	)
	Purchases of noncontrolling interests		(1,226	)
	Sales of noncontrolling interests		6,102
	Acquisition of new business		1,771
	Balance, September 30, 2014	$	179,439
		2013
		Noncontrolling
		Interests —
		Redeemable
	Balance, December 31, 2012	$	153,399
	Net income attributable to noncontrolling interests		15,466
	Distributions to noncontrolling interests		(16,993	)
	Purchases of noncontrolling interests		(270	)
	Sales of noncontrolling interests		4,246
	Balance, March 31, 2013		155,848
	Net income attributable to noncontrolling interests		15,933
	Distributions to noncontrolling interests		(16,648	)
	Purchases of noncontrolling interests		(3,686	)
	Sales of noncontrolling interests		4,777
	Acquisition of new business		6,111
	Balance, June 30, 2013		162,335
	Net income attributable to noncontrolling interests		16,489
	Distributions to noncontrolling interests		(16,754	)
	Purchases of noncontrolling interests		(1,429	)
	Sales of noncontrolling interests		1,631
	Balance, September 30, 2013	$	162,272

Equitybased_Compensation_Table

Equity-based Compensation (Tables)	9 Months Ended
	Sep. 30, 2014
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]	'
Equity-Based Compensation Included in Consolidated Statements of Income, Classified by Income Statement Line Item	'
	Total equity-based compensation, included in the accompanying consolidated statements of income, classified by line item, is as follows (in thousands):
		Three Months			Nine Months			Three Months			Nine Months
		Ended			Ended			Ended			Ended
		September 30,			September 30,			September 30,			September 30,
		2014			2014			2013			2013
	Salaries, benefits and other employee costs	$	219		$	504		$	148		$	373
	General and administrative expenses		413			1,211			306			980
	Expense before income tax benefit		632			1,715			454			1,353
	Income tax benefit		(210	)		(570	)		(25	)		(109	)
	Total equity-based compensation expense, net of tax	$	422		$	1,145		$	429		$	1,244
Equity-Based Compensation Included in Consolidated Statements of Income, Classified by Type of Award	'
	Total equity-based compensation, included in the accompanying consolidated statements of income, classified by type of award, is as follows (in thousands):
		Three Months			Nine Months			Three Months			Nine Months
		Ended			Ended			Ended			Ended
		September 30,			September 30,			September 30,			September 30,
		2014			2014			2013			2013
	Share awards	$	129		$	455		$	98		$	390
	Stock options		503			1,260			356			963
	Expense before income tax benefit		632			1,715			454			1,353
	Income tax benefit		(210	)		(570	)		(25	)		(109	)
	Total equity-based compensation expense, net of tax	$	422		$	1,145		$	429		$	1,244

Condensed_Consolidating_Financ1

Condensed Consolidating Financial Statements (Tables)	9 Months Ended
	Sep. 30, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]	'
Condensed Consolidating Balance Sheets	'
	Condensed Consolidating Balance Sheets:
	As of September 30, 2014	Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
	ASSETS
	Current assets:
	Cash and cash equivalents	$	47,191		$	10,068		$	—		$	57,259
	Available for sale securities		9,230			—			—			9,230
	Accounts receivable, net		—			49,667			—			49,667
	Other receivables		126,256			29,036			(131,146	)		24,146
	Inventories of supplies		18			8,308			—			8,326
	Prepaids and other current assets		36,734			2,131			—			38,865
	Total current assets		219,429			99,210			(131,146	)		187,493
	Property and equipment, net		37,608			90,688			200			128,496
	Investments in unconsolidated affiliates		1,011,425			79,543			(481,487	)		609,481
	Goodwill and intangible assets, net		961,899			226,833			410,393			1,599,125
	Other assets		33,716			1,628			(2,885	)		32,459
	Total assets	$	2,264,077		$	497,902		$	(204,925	)	$	2,557,054
	LIABILITIES AND EQUITY
	Liabilities and Equity
	Current liabilities:
	Accounts payable	$	3,867		$	14,721		$	—		$	18,588
	Accrued expenses and other		285,051			119,424			(131,220	)		273,255
	Current portion of long-term debt		10,135			9,041			(236	)		18,940
	Total current liabilities		299,053			143,186			(131,456	)		310,783
	Long-term debt, less current portion		1,433,089			51,521			(2,909	)		1,481,701
	Other long-term liabilities		225,548			4,991			(236	)		230,303
	Parent’s equity		306,387			243,557			(243,557	)		306,387
	Noncontrolling interests		—			54,647			173,233			227,880
	Total liabilities and equity	$	2,264,077		$	497,902		$	(204,925	)	$	2,557,054
	As of December 31, 2013	Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
	ASSETS
	Current assets:
	Cash and cash equivalents	$	73,765		$	4,976		$	—		$	78,741
	Available for sale securities		10,802			—			—			10,802
	Accounts receivable, net		—			51,608			—			51,608
	Other receivables		79,664			29,938			(85,411	)		24,191
	Inventories of supplies		1,133			7,916			—			9,049
	Prepaids and other current assets		36,200			2,209			—			38,409
	Total current assets		201,564			96,647			(85,411	)		212,800
	Property and equipment, net		37,935			94,245			294			132,474
	Investments in unconsolidated affiliates		978,305			33,804			(490,276	)		521,833
	Goodwill and intangible assets, net		952,765			217,448			415,188			1,585,401
	Other assets		27,535			1,451			(810	)		28,176
	Total assets	$	2,198,104		$	443,595		$	(161,015	)	$	2,480,684
	LIABILITIES AND EQUITY
	Liabilities and Equity
	Current liabilities:
	Accounts payable	$	3,249		$	14,158		$	—		$	17,407
	Accrued expenses and other		288,914			75,286			(85,324	)		278,876
	Current portion of long-term debt		10,182			9,452			(718	)		18,916
	Total current liabilities		302,345			98,896			(86,042	)		315,199
	Long-term debt, less current portion		1,403,500			51,685			(493	)		1,454,692
	Other long-term liabilities		212,637			5,270			(334	)		217,573
	Parent’s equity		279,622			235,809			(235,809	)		279,622
	Noncontrolling interests		—			51,935			161,663			213,598
	Total liabilities and equity	$	2,198,104		$	443,595		$	(161,015	)	$	2,480,684
Condensed Consolidating Statements of Income	'
	Condensed Consolidating Statements of Income:
	For the Nine Months Ended September 30, 2014	Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
	Revenues	$	90,523		$	396,436		$	(20,852	)	$	466,107
	Equity in earnings of unconsolidated affiliates		112,303			6,317			(45,021	)		73,599
	Operating expenses, excluding depreciation and amortization		73,122			284,065			(20,754	)		336,433
	Depreciation and amortization		6,051			13,471			94			19,616
	Operating income		123,653			105,217			(45,213	)		183,657
	Interest expense, net		(67,437	)		(2,653	)		—			(70,090	)
	Other income (expense), net		(29	)		(51	)		—			(80	)
	Income from continuing operations before income taxes		56,187			102,513			(45,213	)		113,487
	Income tax expense		(18,648	)		(3,349	)		—			(21,997	)
	Income from continuing operations		37,539			99,164			(45,213	)		91,490
	Loss from discontinued operations, net of tax		(332	)		—			—			(332	)
	Net income		37,207			99,164			(45,213	)		91,158
	Less: Net income attributable to noncontrolling interests		—			(17,983	)		(35,968	)		(53,951	)
	Net income attributable to Parent	$	37,207		$	81,181		$	(81,181	)	$	37,207
	For the Nine Months Ended September 30, 2013	Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
	Revenues	$	87,455		$	384,075		$	(20,178	)	$	451,352
	Equity in earnings of unconsolidated affiliates		108,138			4,881			(49,260	)		63,759
	Operating expenses, excluding depreciation and amortization		68,759			263,702			(20,047	)		312,414
	Depreciation and amortization		6,941			13,720			97			20,758
	Operating income		119,893			111,534			(49,488	)		181,939
	Interest expense, net		(72,926	)		(3,300	)		—			(76,226	)
	Loss on early retirement of debt		(5,536	)		—			—			(5,536	)
	Other income (expense), net		(904	)		901			—			(3	)
	Income before income taxes		40,527			109,135			(49,488	)		100,174
	Income tax expense		(13,594	)		(4,309	)		—			(17,903	)
	Net income		26,933			104,826			(49,488	)		82,271
	Less: Net income attributable to noncontrolling interests		—			(14,763	)		(40,575	)		(55,338	)
	Net income attributable to Parent	$	26,933		$	90,063		$	(90,063	)	$	26,933
Condensed Consolidating Statements of Comprehensive Income	'
	Condensed Consolidating Statements of Comprehensive Income:
	For the Nine Months Ended September 30, 2014	Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
	Net income	$	37,207		$	99,164		$	(45,213	)	$	91,158
	Other comprehensive income:
	Unrealized gain on available for sale securities, net of tax		(3	)		—			—			(3	)
	Comprehensive income		37,204			99,164			(45,213	)		91,155
	Comprehensive income attributable to noncontrolling interests		—			(17,983	)		(35,968	)		(53,951	)
	Comprehensive income attributable to Parent	$	37,204		$	81,181		$	(81,181	)	$	37,204
	For the Nine Months Ended September 30, 2013	Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
	Net income	$	26,933		$	104,826		$	(49,488	)	$	82,271
	Other comprehensive income (loss):
	Unrealized loss on available for sale securities, net of tax		(44	)		—			—			(44	)
	Comprehensive income		26,889			104,826			(49,488	)		82,227
	Comprehensive income attributable to noncontrolling interests		—			(14,763	)		(40,575	)		(55,338	)
	Comprehensive income attributable to Parent	$	26,889		$	90,063		$	(90,063	)	$	26,889
Condensed Consolidating Statements of Cash Flows	'
	Condensed Consolidating Statements of Cash Flows:
	For the Nine Months Ended September 30, 2014	Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
	Cash flows from operating activities:
	Net income	$	37,207		$	99,164		$	(45,213	)	$	91,158
	Loss on discontinued operations		332			—			—			332
	Changes in operating and intercompany assets and liabilities and noncash items included in net income		52,260			12,910			3,203			68,373
	Net cash provided by operating activities		89,799			112,074			(42,010	)		159,863
	Cash flows from investing activities:
	Purchases of property and equipment, net		(2,602	)		(5,274	)		—			(7,876	)
	Purchases and sales of new businesses and equity interests, net		(89,836	)		(51,684	)		—			(141,520	)
	Other items, net		(31,941	)		1,530			51,978			21,567
	Net cash used in investing activities		(124,379	)		(55,428	)		51,978			(127,829	)
	Cash flows from financing activities:
	Long-term borrowings, net		29,271			(6,235	)		(1,223	)		21,813
	Purchases and sales of noncontrolling interests, net		(316	)		—			—			(316	)
	Distributions to noncontrolling interests		—			(97,606	)		42,010			(55,596	)
	Increase in cash held on behalf of noncontrolling interest holders and other		(20,949	)		52,287			(50,755	)		(19,417	)
	Net cash provided by (used in) financing activities		8,006			(51,554	)		(9,968	)		(53,516	)
	Net increase (decrease) in cash		(26,574	)		5,092			—			(21,482	)
	Cash at the beginning of the period		73,765			4,976			—			78,741
	Cash at the end of the period	$	47,191		$	10,068		$	—		$	57,259
	For the Nine Months Ended September 30, 2013	Guarantors			Non-Participating			Consolidation			Consolidated
					Investees			Adjustments			Total
	Cash flows from operating activities:
	Net income	$	26,933		$	104,826		$	(49,488	)	$	82,271
	Loss on early retirement of debt		5,536			—			—			5,536
	Changes in operating and intercompany assets and liabilities and noncash items included in net income		24,391			14,448			1,439			40,278
	Net cash provided by operating activities		56,860			119,274			(48,049	)		128,085
	Cash flows from investing activities:
	Purchases of property and equipment, net		(11,928	)		(5,429	)		—			(17,357	)
	Purchases and sales of new businesses and equity interests, net		1,099			(6,395	)		—			(5,296	)
	Other items, net		(6,670	)		1,167			4,620			(883	)
	Net cash used in investing activities		(17,499	)		(10,657	)		4,620			(23,536	)
	Cash flows from financing activities:
	Long-term borrowings, net		(6,256	)		(7,985	)		420			(13,821	)
	Purchases and sales of noncontrolling interests, net		(717	)		—			—			(717	)
	Distributions to noncontrolling interests		—			(105,470	)		48,049			(57,421	)
	Increase in cash held on behalf of noncontrolling interest holders and other		2,973			6,206			(5,040	)		4,139
	Net cash used in financing activities		(4,000	)		(107,249	)		43,429			(67,820	)
	Net increase in cash		35,361			1,368			—			36,729
	Cash at the beginning of the period		42,291			8,912			—			51,203
	Cash at the end of the period	$	77,652		$	10,280		$	—		$	87,932

Basis_of_Presentation_Addition

Basis of Presentation - Additional Information (Detail)	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
	Facility	Facility	Segment	Facility
			Facility
Significant Accounting Policies [Line Items]	'	'	'	'
Number of facilities	'	'	219	'
Number of facilities of which results are consolidated	'	'	64	'
Number of facilities accounted under equity method	155	149	155	149
Number of facilities accounted under joint ownership	'	'	152	'
Number of facilities include physician owners	'	'	2	'
Reportable business segment	'	'	1	'
Short-stay surgical facilities [Member]	'	'	'	'
Significant Accounting Policies [Line Items]	'	'	'	'
Number of facilities	'	'	219	'

Investments_in_Unconsolidated_2

Investments in Unconsolidated Affiliates and Business Combinations - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
	Facility	Facility	Facility	Facility
Equity Method Investments and Joint Ventures [Abstract]	'	'	'	'
Effective Investment amount	'	'	$3	'
Consolidated facilities by the company	'	'	64	'
Unconsolidated facilities operated at year-end	155	149	155	149
Number of facilities	'	'	219	'
Cash outflow by acquisitions and sale of equity interests	'	'	138.4	'
Proceeds from unconsolidated affiliates	'	'	$22	'

Investments_in_Unconsolidated_3

Investments in Unconsolidated Affiliates and Business Combinations - Summary of Cash Outflow in Purchase and Sale of Equity Interests (Detail) (USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Effective Investment amount	$3
February 2014 [Member] | Georgia [Member]	'
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Effective Investment amount	2
September 2014 [Member] | Missouri [Member]	'
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Effective Investment amount	$1

Investments_in_Unconsolidated_4

Investments in Unconsolidated Affiliates and Business Combinations - Summarized Financial Information for Equity Method Investees (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
	Facility	Facility	Facility	Facility
Investments in and Advances to Affiliates, Schedule of Investments [Abstract]	'	'	'	'
Unconsolidated facilities operated at period-end	155	149	155	149
Income statement information:	'	'	'	'
Revenues	$492,673	$435,665	$1,379,621	$1,298,122
Operating expenses:	'	'	'	'
Salaries, benefits, and other employee costs	116,625	107,056	332,684	319,498
Medical services and supplies	119,420	105,272	336,037	317,661
Other operating expenses	114,009	103,629	325,000	307,342
Net gain on asset disposals, net	-362	-1,339	-6,166	-1,800
Depreciation and amortization	18,903	18,315	55,655	54,485
Total operating expenses	368,595	332,933	1,043,210	997,186
Operating income	124,078	102,732	336,411	300,936
Interest expense, net	-7,174	-7,776	-21,607	-23,490
Other, net	-140	-283	365	-262
Income before income taxes	116,764	94,673	315,169	277,184
Balance sheet information:	'	'	'	'
Current assets	381,853	328,996	381,853	328,996
Noncurrent assets	573,388	563,415	573,388	563,415
Current liabilities	209,010	204,287	209,010	204,287
Noncurrent liabilities	$375,548	$377,265	$375,548	$377,265

Investments_in_Unconsolidated_5

Investments in Unconsolidated Affiliates and Business Combinations - Summary of Cash Outflow by Acquisitions and Sale of Equity Interests (Detail) (USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Payments to acquire interest	$138.40
Various [Member]	'
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Payments to acquire interest	6.8
March 2014 [Member] | Indiana [Member]	'
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Payments to acquire interest	32.3
April 2014 [Member] | New Jersey [Member]	'
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Payments to acquire interest	16.9
June 2014 [Member] | Dallas-Fort Worth [Member]	'
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Payments to acquire interest	4.2
July 2014 [Member] | New Jersey [Member]	'
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Payments to acquire interest	26.8
July 2014 [Member] | South Dakota [Member]	'
Payments to Acquire Interest in Subsidiaries and Affiliates [Abstract]	'
Payments to acquire interest	$51.40

Noncontrolling_Interests_Addit

Noncontrolling Interests - Additional Information (Detail) (USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014
	Facility
Noncontrolling Interest [Abstract]	'
Consolidated facilities by the company	64
Number of facilities	219
Purchase of equity interests in various consolidated subsidiaries	$4.40
Sale of equity interests in various consolidated subsidiaries	$4.10

Noncontrolling_Interests_Sched

Noncontrolling Interests - Schedule of Change in Equity from Net Income (Loss) Attributable to USPI and Transfers to Noncontrolling Interests (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Noncontrolling Interest [Abstract]	'	'	'	'
Net income attributable to USPI's common stockholder	$13,476	$11,922	$37,207	$26,933
Transfers to the noncontrolling interests:	'	'	'	'
Decrease in USPI's additional paid-in capital for sales of subsidiaries' equity interests	-3,916	-1,247	-13,541	-7,178
Increase in USPI's additional paid-in capital for purchases of subsidiaries' equity interests	-2	752	1,808	1,391
Net transfers to noncontrolling interests	-3,918	-495	-11,733	-5,787
Change in equity from net income attributable to USPI and transfers to noncontrolling interests	$9,558	$11,427	$25,474	$21,146

Noncontrolling_Interests_Sched1

Noncontrolling Interests - Schedule of Redeemable Noncontrolling Interests (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013
Redeemable Noncontrolling Interest [Line Items]	'	'	'	'	'	'
Balance, Beginning	'	'	$166,578	'	'	'
Distributions to noncontrolling interests	-2,592	-2,720	-2,815	-2,560	-1,925	-2,541
Purchases of noncontrolling interests	-2	-5	1,749	-405	612	-215
Balance, Ending	179,439	'	'	'	'	'
Noncontrolling Interests - Redeemable [Member]	'	'	'	'	'	'
Redeemable Noncontrolling Interest [Line Items]	'	'	'	'	'	'
Balance, Beginning	173,504	171,771	166,578	162,335	155,848	153,399
Net income attributable to noncontrolling interests	15,460	17,023	13,457	16,489	15,933	15,466
Distributions to noncontrolling interests	-16,172	-15,476	-15,821	-16,754	-16,648	-16,993
Purchases of noncontrolling interests	-1,226	-1,150	-3,776	-1,429	-3,686	-270
Sales of noncontrolling interests	6,102	1,508	9,791	1,631	4,777	4,246
Acquisition of new business	1,771	'	1,542	'	6,111	'
Deconsolidation of subsidiary	'	-172	'	'	'	'
Balance, Ending	$179,439	$173,504	$171,771	$162,272	$162,335	$155,848

Other_Investments_Additional_I

Other Investments - Additional Information (Detail) (Entity operations not control with voting rights [Member], USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013
	Facility
Entity operations not control with voting rights [Member]	'	'
Variable Interest Entity [Line Items]	'	'
Number of surgical facilities operates by variable interest entity	10	'
Total assets	$125.90	$101.50
Total liabilities owed to third parties	$23.70	$23.60

Fair_Value_of_Financial_Instru1

Fair Value of Financial Instruments - Additional Information (Detail) (USD $)	Sep. 30, 2014	Sep. 30, 2013
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Aggregate carrying amount of long-term debt	$1,500,000,000	$1,500,000,000
Estimated fair value of long-term debt	1,500,000,000	1,500,000,000
Other current assets [Member] | Level 2 [Member]	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Marketable securities held by wholly-owned subsidiary	$9,200,000	$10,700,000

EquityBased_Compensation_Equit

Equity-Based Compensation - Equity-Based Compensation Included in Consolidated Statements of Income, Classified by Income Statement Line Item (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Expense before income tax benefit	$632	$454	$1,715	$1,353
Income tax benefit	-210	-25	-570	-109
Total equity-based compensation expense, net of tax	422	429	1,145	1,244
Salaries, benefits and other employee costs [Member]	'	'	'	'
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Expense before income tax benefit	219	148	504	373
General and administrative expenses [Member]	'	'	'	'
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Expense before income tax benefit	$413	$306	$1,211	$980

EquityBased_Compensation_Equit1

Equity-Based Compensation - Equity-Based Compensation Included in Consolidated Statements of Income, Classified by Type of Award (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Expense before income tax benefit	$632	$454	$1,715	$1,353
Income tax benefit	-210	-25	-570	-109
Total equity-based compensation expense, net of tax	422	429	1,145	1,244
Share awards [Member]	'	'	'	'
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Expense before income tax benefit	129	98	455	390
Employee Stock Options [Member]	'	'	'	'
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Expense before income tax benefit	$503	$356	$1,260	$963

Related_Party_Transactions_Add

Related Party Transactions - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Schedule of Other Related Party Transactions [Line Items]	'	'	'	'
General and administrative expenses	$0.50	$0.50	$1.50	$1.50
Management fees accrual at annual rate	'	'	2	'
Cash paid to related party	'	'	1	'
Accrued management fee	8	'	8	'
Other long-term liabilities [Member]	'	'	'	'
Schedule of Other Related Party Transactions [Line Items]	'	'	'	'
Accrued management fee	7.5	'	7.5	'
Other current liabilities [Member]	'	'	'	'
Schedule of Other Related Party Transactions [Line Items]	'	'	'	'
Accrued management fee	$0.50	'	$0.50	'

Commitments_and_Contingencies_

Commitments and Contingencies - Additional Information (Detail) (USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014
	Facility
Guarantor Obligations [Line Items]	'
Maximum aggregate payments for guarantees of indebtedness and other obligations	$65.20
Number of facilities sold with continuing guarantees	2
Debt instrument year	'2030
Letters of credit outstanding	1.6
Non Affiliated Entity [Member]	'
Guarantor Obligations [Line Items]	'
Maximum aggregate payments for guarantees of indebtedness and other obligations	2.9
Unconsolidated affiliated companies [Member]	'
Guarantor Obligations [Line Items]	'
Maximum aggregate payments for guarantees of indebtedness and other obligations	52.1
Long-term liabilities related to guarantees	0.6
Consolidated subsidiaries [Member]	'
Guarantor Obligations [Line Items]	'
Maximum aggregate payments for guarantees of indebtedness and other obligations	10.2
Obligation of sale of facilities [Member]	'
Guarantor Obligations [Line Items]	'
Maximum aggregate payments for guarantees of indebtedness and other obligations	$55

Subsequent_Events_Additional_I

Subsequent Events - Additional Information (Detail) (Subsequent Event [Member], USD $)	1 Months Ended
In Millions, unless otherwise specified	Oct. 31, 2014
Subsequent Event [Member]	'
Subsequent Events [Line Items]	'
Payments to acquire noncontrolling interest	$10.30

Condensed_Consolidating_Financ2

Condensed Consolidating Financial Statements - Additional Information (Detail) (USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014
Stockholders Equity Excluding Portion Attributable To Subsidiaries Noncontrolling Interest [Abstract]	'
9.0% Senior unsecured notes	$440
9.0% Senior unsecured notes due date	'2020
Interest rate of senior unsecured notes	9.00%

Condensed_Consolidating_Financ3

Condensed Consolidating Financial Statements - Condensed Consolidating Balance Sheets (Detail) (USD $)	Sep. 30, 2014	Dec. 31, 2013	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Current assets:	'	'	'	'
Cash and cash equivalents	$57,259	$78,741	$87,932	$51,203
Available for sale securities	9,230	10,802	'	'
Accounts receivable, net	49,667	51,608	'	'
Other receivables	24,146	24,191	'	'
Inventories of supplies	8,326	9,049	'	'
Prepaids and other current assets	38,865	38,409	'	'
Total current assets	187,493	212,800	'	'
Property and equipment, net	128,496	132,474	'	'
Investments in unconsolidated affiliates	609,481	521,833	'	'
Goodwill and intangible assets, net	1,599,125	1,585,401	'	'
Other assets	32,459	28,176	'	'
Total assets	2,557,054	2,480,684	'	'
Current liabilities:	'	'	'	'
Accounts payable	18,588	17,407	'	'
Accrued expenses and other	273,255	278,876	'	'
Current portion of long-term debt	18,940	18,916	'	'
Total current liabilities	310,783	315,199	'	'
Long-term debt, less current portion	1,481,701	1,454,692	'	'
Other long-term liabilities	230,303	217,573	'	'
Parent's equity	306,387	279,622	'	'
Noncontrolling interests	227,880	213,598	'	'
Total liabilities and equity	2,557,054	2,480,684	'	'
Consolidation Adjustments [Member]	'	'	'	'
Current assets:	'	'	'	'
Cash and cash equivalents	'	'	'	'
Available for sale securities	'	'	'	'
Accounts receivable, net	'	'	'	'
Other receivables	-131,146	-85,411	'	'
Inventories of supplies	'	'	'	'
Prepaids and other current assets	'	'	'	'
Total current assets	-131,146	-85,411	'	'
Property and equipment, net	200	294	'	'
Investments in unconsolidated affiliates	-481,487	-490,276	'	'
Goodwill and intangible assets, net	410,393	415,188	'	'
Other assets	-2,885	-810	'	'
Total assets	-204,925	-161,015	'	'
Current liabilities:	'	'	'	'
Accounts payable	'	'	'	'
Accrued expenses and other	-131,220	-85,324	'	'
Current portion of long-term debt	-236	-718	'	'
Total current liabilities	-131,456	-86,042	'	'
Long-term debt, less current portion	-2,909	-493	'	'
Other long-term liabilities	-236	-334	'	'
Parent's equity	-243,557	-235,809	'	'
Noncontrolling interests	173,233	161,663	'	'
Total liabilities and equity	-204,925	-161,015	'	'
Guarantors [Member]	'	'	'	'
Current assets:	'	'	'	'
Cash and cash equivalents	47,191	73,765	77,652	42,291
Available for sale securities	9,230	10,802	'	'
Accounts receivable, net	'	'	'	'
Other receivables	126,256	79,664	'	'
Inventories of supplies	18	1,133	'	'
Prepaids and other current assets	36,734	36,200	'	'
Total current assets	219,429	201,564	'	'
Property and equipment, net	37,608	37,935	'	'
Investments in unconsolidated affiliates	1,011,425	978,305	'	'
Goodwill and intangible assets, net	961,899	952,765	'	'
Other assets	33,716	27,535	'	'
Total assets	2,264,077	2,198,104	'	'
Current liabilities:	'	'	'	'
Accounts payable	3,867	3,249	'	'
Accrued expenses and other	285,051	288,914	'	'
Current portion of long-term debt	10,135	10,182	'	'
Total current liabilities	299,053	302,345	'	'
Long-term debt, less current portion	1,433,089	1,403,500	'	'
Other long-term liabilities	225,548	212,637	'	'
Parent's equity	306,387	279,622	'	'
Noncontrolling interests	'	'	'	'
Total liabilities and equity	2,264,077	2,198,104	'	'
Non-Participating Investees [Member]	'	'	'	'
Current assets:	'	'	'	'
Cash and cash equivalents	10,068	4,976	10,280	8,912
Available for sale securities	'	'	'	'
Accounts receivable, net	49,667	51,608	'	'
Other receivables	29,036	29,938	'	'
Inventories of supplies	8,308	7,916	'	'
Prepaids and other current assets	2,131	2,209	'	'
Total current assets	99,210	96,647	'	'
Property and equipment, net	90,688	94,245	'	'
Investments in unconsolidated affiliates	79,543	33,804	'	'
Goodwill and intangible assets, net	226,833	217,448	'	'
Other assets	1,628	1,451	'	'
Total assets	497,902	443,595	'	'
Current liabilities:	'	'	'	'
Accounts payable	14,721	14,158	'	'
Accrued expenses and other	119,424	75,286	'	'
Current portion of long-term debt	9,041	9,452	'	'
Total current liabilities	143,186	98,896	'	'
Long-term debt, less current portion	51,521	51,685	'	'
Other long-term liabilities	4,991	5,270	'	'
Parent's equity	243,557	235,809	'	'
Noncontrolling interests	54,647	51,935	'	'
Total liabilities and equity	$497,902	$443,595	'	'

Condensed_Consolidating_Financ4

Condensed Consolidating Financial Statements - Condensed Consolidating Statements of Income (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Condensed Income Statements, Captions [Line Items]	'	'	'	'
Revenues	$159,190	$151,009	$466,107	$451,352
Equity in earnings of unconsolidated affiliates	27,527	20,923	73,599	63,759
Operating expenses, excluding depreciation and amortization	'	'	336,433	312,414
Depreciation and amortization	6,608	6,683	19,616	20,758
Operating income	64,369	63,102	183,657	181,939
Interest expense, net	'	'	-70,090	-76,226
Loss on early retirement of debt	'	'	'	-5,536
Other income (expense), net	-55	1	-80	-3
Income before income taxes	40,617	39,393	113,487	100,174
Income tax expense	-8,623	-7,462	-21,997	-17,903
Income from continuing operations	'	'	91,490	82,271
Loss from discontinued operations, net of tax	'	'	-332	0
Net income	31,994	31,931	91,158	82,271
Less: Net income attributable to noncontrolling interests	-18,518	-20,009	-53,951	-55,338
Net income attributable to Parent	13,476	11,922	37,207	26,933
Consolidation Adjustments [Member]	'	'	'	'
Condensed Income Statements, Captions [Line Items]	'	'	'	'
Revenues	'	'	-20,852	-20,178
Equity in earnings of unconsolidated affiliates	'	'	-45,021	-49,260
Operating expenses, excluding depreciation and amortization	'	'	-20,754	-20,047
Depreciation and amortization	'	'	94	97
Operating income	'	'	-45,213	-49,488
Interest expense, net	'	'	'	'
Loss on early retirement of debt	'	'	'	'
Other income (expense), net	'	'	'	'
Income before income taxes	'	'	-45,213	-49,488
Income tax expense	'	'	'	'
Income from continuing operations	'	'	-45,213	'
Loss from discontinued operations, net of tax	'	'	'	'
Net income	'	'	-45,213	-49,488
Less: Net income attributable to noncontrolling interests	'	'	-35,968	-40,575
Net income attributable to Parent	'	'	-81,181	-90,063
Guarantors [Member]	'	'	'	'
Condensed Income Statements, Captions [Line Items]	'	'	'	'
Revenues	'	'	90,523	87,455
Equity in earnings of unconsolidated affiliates	'	'	112,303	108,138
Operating expenses, excluding depreciation and amortization	'	'	73,122	68,759
Depreciation and amortization	'	'	6,051	6,941
Operating income	'	'	123,653	119,893
Interest expense, net	'	'	-67,437	-72,926
Loss on early retirement of debt	'	'	'	-5,536
Other income (expense), net	'	'	-29	-904
Income before income taxes	'	'	56,187	40,527
Income tax expense	'	'	-18,648	-13,594
Income from continuing operations	'	'	37,539	'
Loss from discontinued operations, net of tax	'	'	-332	'
Net income	'	'	37,207	26,933
Less: Net income attributable to noncontrolling interests	'	'	'	'
Net income attributable to Parent	'	'	37,207	26,933
Non-Participating Investees [Member]	'	'	'	'
Condensed Income Statements, Captions [Line Items]	'	'	'	'
Revenues	'	'	396,436	384,075
Equity in earnings of unconsolidated affiliates	'	'	6,317	4,881
Operating expenses, excluding depreciation and amortization	'	'	284,065	263,702
Depreciation and amortization	'	'	13,471	13,720
Operating income	'	'	105,217	111,534
Interest expense, net	'	'	-2,653	-3,300
Loss on early retirement of debt	'	'	'	'
Other income (expense), net	'	'	-51	901
Income before income taxes	'	'	102,513	109,135
Income tax expense	'	'	-3,349	-4,309
Income from continuing operations	'	'	99,164	'
Loss from discontinued operations, net of tax	'	'	'	'
Net income	'	'	99,164	104,826
Less: Net income attributable to noncontrolling interests	'	'	-17,983	-14,763
Net income attributable to Parent	'	'	$81,181	$90,063

Condensed_Consolidating_Financ5

Condensed Consolidating Financial Statements - Condensed Consolidating Statements of Comprehensive Income (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Condensed Financial Statements, Captions [Line Items]	'	'	'	'
Net income	$31,994	$31,931	$91,158	$82,271
Other comprehensive income (loss):	'	'	'	'
Unrealized gain on available for sale securities, net of tax	-14	20	-3	-44
Comprehensive income	31,980	31,951	91,155	82,227
Comprehensive income attributable to noncontrolling interests	-18,518	-20,009	-53,951	-55,338
Comprehensive income attributable to Parent	13,462	11,942	37,204	26,889
Consolidation Adjustments [Member]	'	'	'	'
Condensed Financial Statements, Captions [Line Items]	'	'	'	'
Net income	'	'	-45,213	-49,488
Other comprehensive income (loss):	'	'	'	'
Unrealized gain on available for sale securities, net of tax	'	'	'	'
Comprehensive income	'	'	-45,213	-49,488
Comprehensive income attributable to noncontrolling interests	'	'	-35,968	-40,575
Comprehensive income attributable to Parent	'	'	-81,181	-90,063
Guarantors [Member]	'	'	'	'
Condensed Financial Statements, Captions [Line Items]	'	'	'	'
Net income	'	'	37,207	26,933
Other comprehensive income (loss):	'	'	'	'
Unrealized gain on available for sale securities, net of tax	'	'	-3	-44
Comprehensive income	'	'	37,204	26,889
Comprehensive income attributable to noncontrolling interests	'	'	'	'
Comprehensive income attributable to Parent	'	'	37,204	26,889
Non-Participating Investees [Member]	'	'	'	'
Condensed Financial Statements, Captions [Line Items]	'	'	'	'
Net income	'	'	99,164	104,826
Other comprehensive income (loss):	'	'	'	'
Unrealized gain on available for sale securities, net of tax	'	'	'	'
Comprehensive income	'	'	99,164	104,826
Comprehensive income attributable to noncontrolling interests	'	'	-17,983	-14,763
Comprehensive income attributable to Parent	'	'	$81,181	$90,063

Condensed_Consolidating_Financ6

Condensed Consolidating Financial Statements - Condensed Consolidating Statements of Cash Flows (Detail) (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2014	Sep. 30, 2013
Cash flows from operating activities:	'	'
Net income	$91,158	$82,271
Loss on discontinued operations	332	0
Loss on early retirement of debt	'	5,536
Changes in operating and intercompany assets and liabilities and noncash items included in net income	68,373	40,278
Net cash provided by operating activities	159,863	128,085
Cash flows from investing activities:	'	'
Purchases of property and equipment, net	-7,876	-17,357
Purchases and sales of new businesses and equity interests, net	-141,520	-5,296
Other items, net	21,567	-883
Net cash used in investing activities	-127,829	-23,536
Cash flows from financing activities:	'	'
Long-term borrowings, net	21,813	-13,821
Purchases and sales of noncontrolling interests, net	-316	-717
Distributions to noncontrolling interests	-55,596	-57,421
Increase in cash held on behalf of noncontrolling interest holders and other	-19,265	-4,194
Net cash provided by (used in) financing activities	-53,516	-67,820
Net (decrease) increase in cash and cash equivalents	-21,482	36,729
Cash and cash equivalents at beginning of period	78,741	51,203
Cash and cash equivalents at end of period	57,259	87,932
Consolidation Adjustments [Member]	'	'
Cash flows from operating activities:	'	'
Net income	-45,213	-49,488
Loss on discontinued operations	'	'
Loss on early retirement of debt	'	'
Changes in operating and intercompany assets and liabilities and noncash items included in net income	3,203	1,439
Net cash provided by operating activities	-42,010	-48,049
Cash flows from investing activities:	'	'
Purchases of property and equipment, net	'	'
Purchases and sales of new businesses and equity interests, net	'	'
Other items, net	51,978	4,620
Net cash used in investing activities	51,978	4,620
Cash flows from financing activities:	'	'
Long-term borrowings, net	-1,223	420
Purchases and sales of noncontrolling interests, net	'	'
Distributions to noncontrolling interests	42,010	48,049
Increase in cash held on behalf of noncontrolling interest holders and other	-50,755	-5,040
Net cash provided by (used in) financing activities	9,968	43,429
Net (decrease) increase in cash and cash equivalents	'	'
Cash and cash equivalents at beginning of period	'	'
Cash and cash equivalents at end of period	'	'
Guarantors [Member]	'	'
Cash flows from operating activities:	'	'
Net income	37,207	26,933
Loss on discontinued operations	332	'
Loss on early retirement of debt	'	5,536
Changes in operating and intercompany assets and liabilities and noncash items included in net income	52,260	24,391
Net cash provided by operating activities	89,799	56,860
Cash flows from investing activities:	'	'
Purchases of property and equipment, net	-2,602	-11,928
Purchases and sales of new businesses and equity interests, net	-89,836	1,099
Other items, net	-31,941	-6,670
Net cash used in investing activities	-124,379	-17,499
Cash flows from financing activities:	'	'
Long-term borrowings, net	29,271	-6,256
Purchases and sales of noncontrolling interests, net	-316	-717
Distributions to noncontrolling interests	'	'
Increase in cash held on behalf of noncontrolling interest holders and other	-20,949	2,973
Net cash provided by (used in) financing activities	8,006	-4,000
Net (decrease) increase in cash and cash equivalents	-26,574	35,361
Cash and cash equivalents at beginning of period	73,765	42,291
Cash and cash equivalents at end of period	47,191	77,652
Non-Participating Investees [Member]	'	'
Cash flows from operating activities:	'	'
Net income	99,164	104,826
Loss on discontinued operations	'	'
Loss on early retirement of debt	'	'
Changes in operating and intercompany assets and liabilities and noncash items included in net income	12,910	14,448
Net cash provided by operating activities	112,074	119,274
Cash flows from investing activities:	'	'
Purchases of property and equipment, net	-5,274	-5,429
Purchases and sales of new businesses and equity interests, net	-51,684	-6,395
Other items, net	1,530	1,167
Net cash used in investing activities	-55,428	-10,657
Cash flows from financing activities:	'	'
Long-term borrowings, net	-6,235	-7,985
Purchases and sales of noncontrolling interests, net	'	'
Distributions to noncontrolling interests	-97,606	-105,470
Increase in cash held on behalf of noncontrolling interest holders and other	52,287	6,206
Net cash provided by (used in) financing activities	-51,554	-107,249
Net (decrease) increase in cash and cash equivalents	5,092	1,368
Cash and cash equivalents at beginning of period	4,976	8,912
Cash and cash equivalents at end of period	$10,068	$10,280